@article {pmid42202985,
year = {2026},
author = {Sultana, S and Asai, Y and Ishioka, H and Ikeda, S and Ohtera, A and Matsunaga, N and Tsuzuki, S and Ohmagari, N},
title = {Self-Reported Long COVID Symptoms among Japanese Adults: Findings of CARE Japan Online Questionnaire-Based Prospective Cohort Study.},
journal = {Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy},
volume = {},
number = {},
pages = {103003},
doi = {10.1016/j.jiac.2026.103003},
pmid = {42202985},
issn = {1437-7780},
abstract = {INTRODUCTION: We conducted a comprehensive assessment of long COVID and associated risk factors, among an online cohort of Japanese adults in omicron dominant COVID-19 period in Japan.

METHODS: We used data from the online questionnaire-based CARE Japan Study, that collected data on patient demographics and information on post-COVID-19 symptoms. Long COVID, was defined as the presence of ≥1 symptom for ≥3 months after the initial COVID-19 infection. We performed Kaplan-Meier survival analysis to estimate the restricted mean resolution time (RMST) of long COVID and sex-stratified multivariable Cox proportional hazards model for hazard ratios (HRs) with 95% confidence interval (CIs).

RESULTS: The final analysis included 1071 patients with COVID-19. The cumulative prevalence of long COVID in the studied cohort was 66.7%. 32% of the respondents with long COVID reported fatigue and runny nose, and 20%-24% reported headache, cough, nasal congestion, and sore throat. The RMST of long COVID was 311.1 days for men and 323.9 days for women. Younger individuals were more likely to experience long COVID than older patients. Overweight, obese or underweight patients reported long COVID more frequently than patients with normal weight. Patients with pre-existing psychological disorders or seasonal allergies showed higher risks of long COVID than participants with no pre-existing psychological disorders or seasonal allergies.

CONCLUSIONS: The prolonged duration of symptoms may affect work ability and recovery, highlighting the need for continued follow-up and supportive care, including return-to-work support and access to outpatient services. These implications should be interpreted within the context of the cohort.},
}

@article {pmid42203277,
year = {2026},
author = {Antolini, L and Valsecchi, MG and Bussi, A and La Piana, G and Pagani, E and Pascarella, MG and Patroni, A and Pellegrino, I and Pozzi, A and Sorlini, M and Ticozzelli, M and Villa, M and Zappa, M and Russo, AG and Lucifora, C},
title = {Unveiling the burden of long covid in hospital and community settings: findings from the Post-Acute Sequelae of SARS-CoV-2 Network (PASCNET) cohort study in Italy's pandemic epicentre.},
journal = {BMJ open},
volume = {16},
number = {5},
pages = {e114399},
doi = {10.1136/bmjopen-2025-114399},
pmid = {42203277},
issn = {2044-6055},
mesh = {Humans ; *COVID-19/epidemiology/therapy/complications ; Italy/epidemiology ; Middle Aged ; Male ; Adult ; Retrospective Studies ; Aged ; Post-Acute COVID-19 Syndrome ; *Hospitalization/statistics & numerical data ; Female ; SARS-CoV-2 ; Incidence ; Pandemics ; Young Adult ; Adolescent ; Prospective Studies ; },
abstract = {OBJECTIVES: Post-COVID-19 condition (PCC) has emerged as a major public health concern. We aimed to estimate the 1-year incidence of PCC in adults with confirmed SARS-CoV-2 infection in Lombardy, Italy, comparing community-managed and hospitalised patients and to assess the prognostic value of the National Institutes of Health (NIH) Researching COVID to Enhance Recovery (RECOVER) score to support estimation of long-term PCC prevalence.

DESIGN: Retrospective-prospective observational cohort study enrolling patients infected between 1 March 2020 and 31 December 2022. The study visit was conducted between 16 January and 23 December 2024.

SETTING: Multicentre study involving seven public hospitals and general practitioners across Lombardy.

PARTICIPANTS: Randomly sampled adults aged 18-70 years with confirmed SARS-CoV-2 infection. Hospitalised patients (HP) were admitted for COVID-19; general practitioner patients (GPP) were managed in the community. The total sample comprised: 1162 (546 HP, 616 GPP).

INTERVENTION: This is an observational study with no active intervention.

Primary outcome: 1-year incidence of PCC retrospectively assessed at the study visit.

SECONDARY OUTCOMES: symptom profiles, long-term PCC prevalence at the study visit and predictive value of the NIH RECOVER score.

RESULTS: Median age was 57.1 years in HP and 42.9 years in GPP; 66.1% of HP and 47.7% of GPP were male. PCC developed in 280 patients (223 HP, 57 GPP). The 1-year cumulative incidence was 39.9% in HP (95% CI 35.9% to 44.1%) and 9.1% in GPP (95% CI 7.1% to 11.7%). The NIH RECOVER score was associated with PCC at 1 year (OR 1.18, 95% CI 1.14 to 1.21). Model-based long-term PCC prevalence was 31.8% in HP and 6.3% in GPP.

CONCLUSIONS: PCC remained frequent and heterogeneous, particularly among previously HP. In this cohort, the NIH RECOVER score showed prognostic value for estimating longer-term PCC burden. These findings underscore the need for structured long-term follow-up across both hospital and primary care settings.},
}

Humans
*COVID-19/epidemiology/therapy/complications
Italy/epidemiology
Middle Aged
Male
Adult
Retrospective Studies
Aged
Post-Acute COVID-19 Syndrome
*Hospitalization/statistics & numerical data
Female
SARS-CoV-2
Incidence
Pandemics
Young Adult
Adolescent
Prospective Studies

@article {pmid42184698,
year = {2026},
author = {Gozalo-Margüello, M and González-Rico, C and Fariñas-Álvarez, C and Fernández-Sampedro, M and Arnaiz de Las Revillas, F and Parra-Fariñas, R and Runza-Buznego, P and Baldeón-Conde, C and Ferrer-Pargada, D and Portilla Chocarro, R and Abascal Carrera, I and Calvo-Montes, J and Ocampo-Sosa, A and Fariñas, MC and , },
title = {Persistent symptoms and healthcare utilisation during five-year follow-up after SARS-CoV-2 infection: A multicentre cohort study in Spain.},
journal = {Journal of infection and public health},
volume = {19},
number = {7},
pages = {103270},
doi = {10.1016/j.jiph.2026.103270},
pmid = {42184698},
issn = {1876-035X},
abstract = {OBJECTIVES: To describe long-term symptom persistence and healthcare utilisation related to SARS-CoV-2 infection over a five-year follow-up period in a multicentre cohort of patients with confirmed COVID-19 in Spain.

METHODS: We conducted a multicentre cohort study including individuals aged ≥ 16 years with RT-PCR-confirmed SARS-CoV-2 infection in Cantabria, Spain, between March 2020 and March 2022. Early follow-up (1-2 years post-infection) involved in-person interviews using a standardised questionnaire. Late follow-up (5 years post-infection) was based on electronic health record review. Outcomes included persistent symptoms, long COVID diagnoses, and healthcare utilisation related to post-COVID symptoms.

RESULTS: The cohort included 266 participants (198 hospitalised and 68 non-hospitalised). Among 200 participants with available early follow-up, 112/200 (56.0%) reported at least one persistent symptom during the medium-term post-infection period (1-2 years after SARS-CoV-2 infection). Persistent symptoms occurred in 76/132 (57.6%) hospitalised participants and in 36/68 (53.0%) non-hospitalised participants. Fatigue was the most frequent symptom in both groups. Only 9 participants (3.4%) had a formal diagnosis of long COVID recorded in their medical records. Female sex, chest pain during acute infection, and smoking were associated with symptom persistence. At five-year follow-up, 38 participants (14.3% of the total cohort; 19.0% of those with early follow-up) sought healthcare for symptoms compatible with post-COVID conditions. However, these encounters were not formally attributed to prior SARS-CoV-2 infection in the medical records.

CONCLUSIONS: Persistent symptoms were common during the medium-term post-infection period, while formal long COVID diagnoses and healthcare encounters explicitly attributed to COVID-19 were relatively uncommon in routine clinical records at five years. These findings highlight the challenges of recognising and attributing long-term post-COVID manifestations in clinical practice and suggest that the burden of long-term post-COVID symptoms may be under-recognised in healthcare systems.},
}

@article {pmid42190841,
year = {2026},
author = {Fukunaga, N and Asakura, T and Terai, H and Tanaka, H and Azekawa, S and Iizuka, S and Ozawa, T and Nagao, G and Nakagawara, K and Morita, A and Atsumi, A and Yagi, K and Kaji, M and Ogata, A and Konishi, S and Matsuyama, E and Ito, F and Takaoka, H and Shigematsu, L and Shimada, T and Otake, S and Sunata, K and Okada, M and Fukushima, T and Ohgino, K and Masaki, K and Miyata, J and , },
title = {Association between corticosteroid therapy during acute COVID-19 and Long COVID symptoms: a propensity score overlap-weighted analysis.},
journal = {Respiratory medicine},
volume = {},
number = {},
pages = {108914},
doi = {10.1016/j.rmed.2026.108914},
pmid = {42190841},
issn = {1532-3064},
abstract = {BACKGROUND: The association between acute-phase corticosteroid therapy and subsequent Long COVID symptoms remains uncertain. Therefore, we aimed to evaluate the association between systemic corticosteroid therapy during hospitalization and patient-reported Long COVID symptoms during follow-up.

METHODS: In this prospective multicenter observational study, we enrolled adults hospitalized with laboratory-confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection at 26 hospitals in Japan between January 2020 and February 2021. To account for evolving corticosteroid prescription practices, we used propensity score overlap weighting with calendar time adjustment relative to the RECOVERY trial announcement and fit overlap-weighted mixed-effects logistic regression models to estimate longitudinal associations across follow-up (3, 6, and 12 months). Additionally, symptom-specific outcomes were evaluated at 3 months.

RESULTS: Among the 1044 participants, 373 received systemic corticosteroids and 671 did not. Corticosteroid therapy was associated with higher odds of any Long COVID symptom during follow-up (OR: 1.71; 95% CI: 1.12-2.63). In exploratory subgroup analyses stratified by oxygen requirement, no clear association was observed among patients who required oxygen therapy during hospitalization, whereas the association was more apparent among those who did not require oxygen therapy. At 3 months, corticosteroid therapy was associated with muscle weakness (OR: 2.43; 95% CI: 1.27-4.65).

CONCLUSIONS: In this observational overlap-weighted analysis, acute-phase systemic corticosteroid therapy during COVID-19 hospitalization was associated with higher odds of patient-reported Long COVID symptoms during follow-up. However, these findings should not be interpreted as evidence against appropriately indicated corticosteroid therapy in patients with hypoxemic COVID-19 or respiratory failure.},
}

@article {pmid42194393,
year = {2026},
author = {Baloğlu, M},
title = {Neuropathic Symptoms and Persistent Pain After Hospitalization for COVID-19: An 8-Month Longitudinal Follow-Up Study.},
journal = {Healthcare (Basel, Switzerland)},
volume = {14},
number = {10},
pages = {},
doi = {10.3390/healthcare14101300},
pmid = {42194393},
issn = {2227-9032},
abstract = {Background: Persistent pain, neuropathic symptoms, dyspnea, and impaired quality of life are common components of post-COVID syndrome. However, the long-term trajectory of these symptoms and the factors associated with persistent pain remain incompletely understood. Methods: This longitudinal cohort study included 80 patients previously hospitalized with COVID-19. Participants were evaluated at approximately 1, 4, and 8 months after discharge. Pain severity was assessed using the Visual Analog Scale (VAS), neuropathic symptoms using the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) scale, dyspnea using the modified Medical Research Council (mMRC) scale, functional limitation using the Post-CO9VID Functional Status (PCFS) scale, and health-related quality of life using the EQ-5D-5L and EQ-VAS scales. Functional performance was additionally assessed using the 30 s chair stand test and the Modified Borg Scale. Multivariable linear regression and logistic regression analyses were performed to identify predictors of reduced quality of life and persistent pain at 8 months. Results: A total of 80 patients were included in the study. Median VAS score decreased from 3.0 (0-6) at 1 month to 0 (0-0) at 4 months and 1 (0-1) at 8 months (p < 0.001). Median LANSS score decreased from 0 (0-2) at 1 month to 0 (0-0) at 4 and 8 months (p < 0.001), while the proportion of patients with LANSS ≥ 12 declined from 11.3% to 2.5%. EQ-5D index scores improved from 0.81 (0.72-0.91) to 0.93 (0.88-0.96) during follow-up (p < 0.001). Dyspnea severity, exertional symptoms, and functional limitation also improved significantly over time. Most of the clinical recovery occurred between the 1-month and 4-month evaluations, although smaller but significant improvements continued until 8 months for pain severity, functional performance, and quality-of-life measures. Older age, baseline dyspnea, anxiety, and higher baseline LANSS scores were independently associated with lower EQ-VAS scores at 8 months, whereas only higher baseline LANSS scores remained independently associated with persistent pain. Conclusions: Patients hospitalized with COVID-19 experience persistent pain, dyspnea, neuropathic symptoms, and reduced quality of life during follow-up, although most symptoms improve substantially over time. Early neuropathic symptom burden and baseline dyspnea may help identify patients at risk of poorer long-term recovery, although the associations should be interpreted cautiously.},
}

@article {pmid42194643,
year = {2026},
author = {Król-Kulikowska, M and Kepinska, M and Siwy, J and Keller, F and Mischak, H and Wendt, R and Sarenmalm, E and Nilsson, Å and Peters, B and Dudoignon, E and Zunara, F and Michel, M and Salgueira, M and Spasovski, G and Scholz, C and Wawrzonkowski, P and Banasik, M and UriCoV Working Group, },
title = {Post-Acute Sequelae of COVID-19 (PASC) in Hospitalized and Ambulatory Patients: A Comparative Study.},
journal = {Journal of clinical medicine},
volume = {15},
number = {10},
pages = {},
doi = {10.3390/jcm15103681},
pmid = {42194643},
issn = {2077-0383},
support = {PerMed/V/80/UriCov/2023//National Centre for Research and Development/ ; 2523FSB114//Federal Ministry of Health/ ; 01KU2309//German Ministry for Education and Science/ ; 2022-00542//Sweden's innovation agency (Vinnova)/ ; ANR-22-PERM-0014//Agence Nationale de la Recherche/ ; I 6471//FWF Austrian Science Fund/ ; Grant-DOI 10.55776/I6471//ERA PerMed/ ; },
abstract = {Background/Objectives: COVID-19 may result in persistent symptoms, some of which can be disabling, referred to as post-acute sequelae of SARS-CoV-2 (PASC, or long COVID). The growing recognition of PASC as a public health challenge underscores the need for comprehensive studies of its course, risk factors, and clinical outcomes. This multicentric study aimed to compare the prevalence, symptom spectrum, and functional impact of PASC in two patient groups: those hospitalized with COVID-19 and those managed exclusively in ambulatory care. Methods: Molecular, clinical, and demographic data were obtained from 319 patients diagnosed with COVID-19 in seven European countries. Patients were classified as PASC in accordance with the WHO definition. Results: PASC is more frequent and severe among hospitalized patients, while ambulatory patients present with milder but prolonged symptoms. Categorical age analysis suggests that older age was associated with a higher incidence of PASC, highlighting the need for multidisciplinary management and targeted support. Conclusions: Our findings highlight distinct differences in the presentation and impact of PASC across patient groups, with important implications for individualized care, multidisciplinary management, and effective healthcare planning in the post-pandemic era.},
}

@article {pmid42194664,
year = {2026},
author = {Suyama, A and Otsuka, Y and Nakano, Y and Tokumasu, K and Sakurada, Y and Matsuda, Y and Honda, H and Soejima, Y and Hasegawa, T and Takase, R and Omura, D and Oguni, K and Ueda, K and Otsuka, F},
title = {Exploratory Analysis of Serum IGF-I Levels and Symptom Trajectories in Long COVID During the Omicron Period.},
journal = {Journal of clinical medicine},
volume = {15},
number = {10},
pages = {},
doi = {10.3390/jcm15103702},
pmid = {42194664},
issn = {2077-0383},
support = {2025//Ofuji Endocrine Medical Award/ ; 2025//Kobayashi Magobe Memorial Medical Foundation/ ; 2025//Growth Science Foundation (2025)/ ; Grant Number JP26K20545//Kobayashi Magobe Memorial Medical Foundation/ ; },
abstract = {Background: Although several risk factors have been reported for long COVID (LC), reliable biomarkers for this illness remain lacking. Insulin-like growth factor (IGF)-I, a major mediator of growth hormones, plays an important role in metabolism, neuroprotection, and systemic homeostasis, and therefore may be useful in predicting the severity and prognosis of LC. Methods: This study included patients who visited a specialized clinic for long COVID between 2022 and 2025 during the Omicron period and had serum IGF-I measurements taken. IGF-I levels were expressed as age- and sex-adjusted standard deviation scores (IGF-I SD), and patients were classified into low (SD < -1.0), normal (-1.0 ≤ SD < 1.0), and high (SD ≥ 1.0) groups. Clinical characteristics, patient-reported outcomes, laboratory data, and follow-up duration were analyzed. Results: A total of 811 patients were included (median 42 years; 52.5% female). Compared with the normal group, the low-IGF-I group exhibited higher fatigue (FAS: 37.0 vs. 34.0; p < 0.05) and depressive (SDS: 50.0 vs. 49.0; p < 0.05) status. Multivariable linear regression analyses identified lower IGF-I SD as independently associated with higher scores of both FAS and SDS. IGF-I SD values showed negative correlations with ferritin (ρ = -0.125, p < 0.05) and TSH (ρ = -0.202, p < 0.01) and positive correlations with albumin (ρ = 0.227, p < 0.01) and FT4 (ρ = 0.165, p < 0.01). Among the 237 patients who completed follow-up, the median duration from the initial visit to recovery tended to be longer in the low-IGF-I group (221 days) compared with the normal (191 days) and high (109 days) groups, although these differences were not statistically significant overall. In patients aged < 50 years, the low-IGF-I group showed a relatively longer follow-up duration (p < 0.05). Furthermore, the low-IGF-I group had a longer time to recovery compared to the high-IGF-I group (p < 0.05), and this difference was more pronounced in patients under 50 years of age, with significant differences observed among the three IGF-I groups. Conclusions: Lower IGF-I levels in LC may be associated with greater fatigue and depressive symptoms and longer recovery time, particularly in younger patients. Further studies are needed to clarify the clinical significance of these findings.},
}

@article {pmid42194670,
year = {2026},
author = {Sołomacha, S and Alimowski, M and Moniuszko-Malinowska, A and Kiszkiel, Ł and Laskowski, P and Dubatówka, M and Sowa, P and Kamiński, K},
title = {Symptom Trajectories and Long-Term Sequelae of COVID-19: A Matched Case-Control Study with Population-Based Controls.},
journal = {Journal of clinical medicine},
volume = {15},
number = {10},
pages = {},
doi = {10.3390/jcm15103707},
pmid = {42194670},
issn = {2077-0383},
support = {2020/37/B/NZ7/03380//National Science Centre/ ; },
abstract = {Background/Objectives: Post-COVID-19 condition involves heterogeneous, multisystem symptoms with uncertain recovery. We characterized symptom trajectories from hospitalization to approximately 4 weeks and to 6-8 months and compared the 6-8-month symptom burden with season-matched controls, accounting for serology-identified, previously unrecognized infections. Methods: An individually pair-matched case-control study of adults with RT-PCR-confirmed SARS-CoV-2 and population controls from the Bialystok PLUS cohort, matched on age, sex and a two-month visit window, was performed. All participants underwent anti-nucleocapsid serology. Hospitalized cases were reassessed at approximately 4 weeks and 6-8 months. Cross-sectional outcomes used non-parametric tests and multivariable regression; longitudinal change used paired tests and generalized estimating equations. Results: We included 402 adults (201 post-COVID-19; 201 controls). In hospitalized cases, respiratory symptoms declined rapidly by approximately 4 weeks and remained low at 6-8 months; smell/taste recovered more slowly; fatigue improved modestly; anxiety changed minimally. At 6-8 months, total symptom counts were higher in post-COVID-19 than in controls (median 4 vs. 2), with serology-positive controls intermediate (median 3). Excess burden was concentrated in non-respiratory domains (fatigue, neurocognitive, cardiovascular, and dermatologic), whereas respiratory differences were not significant. In the multivariable model, female sex remained an independent predictor of higher multisystem burden, whereas age, body mass index, hospitalization, and acute biomarker severity were not associated. Conclusions: Six to eight months after symptomatic COVID-19, multisystem symptom burden remains substantial relative to season-matched controls, despite substantial resolution of respiratory complaints. Serology-based identification of previously unrecognized infections indicates an intermediate burden and can guide targeted follow-up.},
}

@article {pmid42194942,
year = {2026},
author = {Brindisi, G and Gori, A and Pignataro, E and Colletti, G and Iavarone, S and Spalice, A and Anania, C and Zicari, AM},
title = {Allergic Status, Long COVID, and Post-Restriction Respiratory Outcomes in Children: A Single-Center Questionnaire-Based Study.},
journal = {Journal of clinical medicine},
volume = {15},
number = {10},
pages = {},
doi = {10.3390/jcm15103982},
pmid = {42194942},
issn = {2077-0383},
abstract = {Background: The relationship between allergic status, SARS-CoV-2 infection, Long COVID, and post-restriction respiratory outcomes in children remains incompletely understood. This study aimed to explore the associations between allergic status and Long COVID, as well as between SARS-CoV-2 vaccination and post-restriction changes in allergic rhinitis (AR), asthma, and upper respiratory infections, in a pediatric tertiary-care cohort. Methods: We conducted a single-center, questionnaire-based observational study involving children aged 0-16 years, who were followed at the Pediatric Allergy Clinic of Umberto I Hospital in Rome. Parents completed an email-based questionnaire addressing SARS-CoV-2 infection, vaccination, persistent post-infectious symptoms, allergic diseases, and respiratory infections following restrictions. Analyses of Long COVID were limited to children with confirmed SARS-CoV-2 infection. Results: A total of 214 questionnaires were analyzed. Allergic status was not significantly associated with SARS-CoV-2 infection in the overall cohort. Among infected children, allergic status was independently associated with higher odds of Long COVID (adjusted OR 3.12, 95% CI 1.20-8.09; p = 0.019). Severe acute infection was also strongly associated with Long COVID (adjusted OR 6.84, 95% CI 2.72-17.21; p < 0.001). Complete vaccination was associated with lower odds of SARS-CoV-2 infection in the overall sample (adjusted OR 0.20, 95% CI 0.09-0.46; p < 0.001) but was not independently associated with Long COVID among infected children. After the removal of COVID-19 restrictions, 90.1% of allergic children reported worsening AR and 52.0% reported worsening asthma, with no significant association with SARS-CoV-2 infection or Long COVID. Group A Streptocossus (GAS) pharyngitis was reported in 50.0% and viral pharyngitis in 10.7% of the cohort, with no significant differences between allergic and non-allergic children. Conclusions: In this single-center, questionnaire-based pediatric cohort, allergic status was correlated with increased likelihood of Long COVID among children with confirmed SARS-CoV-2 infection; however, it was not associated with a higher risk of infection itself. Complete vaccination was linked to a reduced risk of infection, whereas no independent correlation with Long COVID was identified. Post-restriction exacerbation of allergic respiratory symptoms was prevalent, while the incidence of bacterial and viral pharyngitis did not vary significantly according to allergic status.},
}

@article {pmid42196466,
year = {2026},
author = {Petrov, S and Bozhkova, M and Ivanovska, M and Kalfova, T and Dudova, D and Todorova, Y and Dimitrova, R and Murdjeva, M and Taskov, H and Nikolova, M and Maes, M},
title = {Comprehensive Immunophenotyping of Monocytes and Dendritic Cells Suggests Distinct Pathophysiology in Chronic Fatigue Syndrome and Long COVID.},
journal = {International journal of molecular sciences},
volume = {27},
number = {10},
pages = {},
doi = {10.3390/ijms27104488},
pmid = {42196466},
issn = {1422-0067},
support = {Contract No BG-RRP-2.004-0007-C01//Strategic Research and Innovation Programme for the Development of the Medical University-Plovdiv (SRIPD-MUP)/ ; },
mesh = {Humans ; *Dendritic Cells/immunology/metabolism ; *Monocytes/immunology/metabolism ; *COVID-19/immunology/physiopathology/pathology ; Immunophenotyping/methods ; Female ; *Fatigue Syndrome, Chronic/immunology/physiopathology/pathology ; Male ; Post-Acute COVID-19 Syndrome ; Receptors, CCR7/metabolism ; Middle Aged ; Adult ; SARS-CoV-2/immunology ; Flow Cytometry ; B7-1 Antigen/metabolism ; T-Cell Exhaustion ; T-Lymphocyte Subsets/immunology ; },
abstract = {Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and long Coronavirus Disease 2019 (long COVID) are complex chronic conditions that often follow infectious triggers with overlapping clinical features but poorly defined pathophysiological relationships. This study aimed to identify disease-specific immune signatures through multiparameter immunophenotyping of monocytes, dendritic cells, and T cell subsets. A total of 207 participants were included (ME/CFS: n = 103; long COVID: n = 63; healthy controls: n = 41). Peripheral blood mononuclear cells were analyzed using multiparameter flow cytometry. Statistical analyses included non-parametric testing, age-adjusted Analysis of covariance (ANCOVA), correlation network analysis, and principal component analysis (PCA). Long COVID was characterized by increased M2-like monocyte polarization, elevated CD80 expression across monocyte subsets, expansion of dendritic cells, and reduced expression of activation markers, indicating persistent immune activation with features of immune exhaustion. In contrast, ME/CFS exhibited reduced costimulatory molecule expression, impaired C-C chemokine receptor type 7 (CCR7)-mediated immune cell trafficking, and less coordinated activation patterns, consistent with a state of immune suppression. Correlation network analysis revealed more extensive and integrated immune interactions in long COVID, while PCA identified distinct immunophenotypic components and enabled moderate discrimination between the two conditions. These findings demonstrate that ME/CFS and long COVID are characterized by distinct immune profiles, supporting the concept of divergent immunopathological mechanisms. The identified signatures may contribute to biomarker development and guide targeted therapeutic approaches.},
}

Humans
*Dendritic Cells/immunology/metabolism
*Monocytes/immunology/metabolism
*COVID-19/immunology/physiopathology/pathology
Immunophenotyping/methods
Female
*Fatigue Syndrome, Chronic/immunology/physiopathology/pathology
Male
Post-Acute COVID-19 Syndrome
Receptors, CCR7/metabolism
Middle Aged
Adult
SARS-CoV-2/immunology
Flow Cytometry
B7-1 Antigen/metabolism
T-Cell Exhaustion
T-Lymphocyte Subsets/immunology

@article {pmid42196834,
year = {2026},
author = {Guindani, N and Gaffuri, M and Bonaffini, PA and Valle, C and Caruso, A and Carioli, G and Fenili, F and Zangari, R and Sironi, S and Chiodini, F and Castelli, CC},
title = {Prevalence of Osteonecrosis of the Femoral Head in High-Risk Male Patients with Severe COVID-19 Treated with High-Dose Corticosteroids: A Prospective Cohort Study Using Screening MRI-How Many Have Been Left Behind?.},
journal = {Diagnostics (Basel, Switzerland)},
volume = {16},
number = {10},
pages = {},
doi = {10.3390/diagnostics16101466},
pmid = {42196834},
issn = {2075-4418},
abstract = {Objectives: The association between osteonecrosis (ON) and Coronavirus Disease of 2019 (COVID-19) was reported early during the pandemic. ON of the femoral head (ONFH) is particularly problematic, as it may destroy the joint and lead to arthroplasty, although early diagnosis and treatment might mitigate its progression. The aim of the present study was to quantify the prevalence of symptomatic and asymptomatic ONFH in patients with severe COVID-19 treated with high doses of corticosteroids during the first pandemic wave. Methods: For this prospective, observational, monocentric cohort study, patients were selected according to the risk factors described for severe acute respiratory syndrome coronavirus in 2002-2004 (SARS-1): young males (<61 years old), high cumulative cortisone doses (≥2 g), severe disease, and followed up clinically and with magnetic resonance imaging. ONFH was classified with the ARCO classification. Results: Out of 1944 patients admitted for COVID-19 from 23 February to 21 May 2020, 856 of 1944 were treated in ICU; 30/1944 were selected according to the inclusion criteria and 27 of 30 were enrolled. The mean age at admission was 54 years (range, 42-60). The mean dose of cumulative cortisone was 6.25 g (range, 2-16). A total of 4/27 (15%) patients had ONFH; only 2 of 4 (50%) were symptomatic, including 1 with multiple ON of major joints. Conclusions: A high-risk cohort of patients with COVID-19 and high doses of corticosteroids had a 15% rate of ONFH, and 2 years after the event, 50% of them were asymptomatic. For those patients, relying solely on clinical evaluation would risk underestimating ONFH, potentially influencing treatment and outcomes. Moreover, other joints might develop ON. The data collected in the present study can be considered for the management of long-COVID. The association between severe COVID-19, high doses of corticosteroids and ONFH suggests the need for focused clinical and magnetic resonance imaging, considering the high rate of asymptomatic patients.},
}

@article {pmid42197510,
year = {2026},
author = {Manta, BA and Mateescu, DM and Iurciuc, S and Precup, CV and Pescaru, CC and Tischer, AA},
title = {Clinical Outcomes, Inflammatory Profile, Bacterial Co-Infections and Post-Acute Symptom Burden in Hospitalised COVID-19 Patients During the Omicron BA.5 Wave: A Single-Centre Cohort Study from Western Romania.},
journal = {Microorganisms},
volume = {14},
number = {5},
pages = {},
doi = {10.3390/microorganisms14051124},
pmid = {42197510},
issn = {2076-2607},
support = {Victor Babeș University of Medicine and Pharmacy Timișoara//Victor Babeș University of Medicine and Pharmacy Timișoara/ ; },
abstract = {Evidence on hospitalised COVID-19 patients during the Omicron BA.5 wave from Eastern European, vaccine-heterogeneous cohorts remains limited. We conducted a retrospective single-centre cohort study of 395 consecutive adults admitted with laboratory-confirmed COVID-19 to a tertiary infectious-diseases unit in western Romania between 1 July and 31 October 2022. Median age was 72 years (IQR 65-81); 33.2% were unvaccinated, 42.8% had documented prior SARS-CoV-2 infection, and 41.3% were obese. Multivariable logistic regression identified independent predictors of in-hospital mortality and post-acute symptom burden. In-hospital mortality was 15.7% (62/395). Vaccination was independently associated with lower mortality (adjusted odds ratio [aOR] 0.55, 95% CI 0.30-0.99; p = 0.048), as was each 1% increase in admission SpO2 (aOR 0.83, 95% CI 0.76-0.92; p < 0.001), whereas COPD independently increased mortality risk (aOR 2.42, 95% CI 1.15-5.10; p = 0.020). Interleukin-6 was the most discriminating admission biomarker for in-hospital mortality (AUROC 0.70). Bloodstream bacterial co-infection, detected in 22.5% of patients tested on clinical suspicion, was dominated by gut-derived organisms with case-fatality ≥30%. At discharge, 90.1% reported persistent symptoms, most commonly cognitive (24.6%). Prior SARS-CoV-2 infection independently predicted post-acute symptom burden (aOR 2.96, 95% CI 1.75-5.01; p < 0.001), with a specific cardiopulmonary signature. In this BA.5 cohort, vaccination remained protective; IL-6 was the most informative admission biomarker; bloodstream infections suggested gut translocation; and prior infection was an independent determinant of early post-acute symptom burden.},
}

@article {pmid42199154,
year = {2026},
author = {Li, Y and Chen, L and Zhang, Y and Lin, CY and Jiang, X and Sun, S and Jiang, H and Ge, X and Zhang, Z and Fu, H and Zhang, Y and Wu, D},
title = {Site-Specific Olfactory Cleft Opacification Predicts Olfactory Function and Olfactory Training Outcome in Persistent Postinfection Olfactory Dysfunction.},
journal = {International forum of allergy & rhinology},
volume = {},
number = {},
pages = {},
doi = {10.1002/alr.70190},
pmid = {42199154},
issn = {2042-6984},
support = {BYSYZD2023029//the Key clinical projects of Peking University Third Hospital/ ; BYSYDL2025021//Peking University Third Hospital Clinical Cohort Construction Project/ ; 82000954//Natural Science Foundation of China/ ; },
abstract = {BACKGROUND: Persistent postinfectious olfactory dysfunction (PIOD) is a prevalent and often refractory condition, with low recovery rates following olfactory training (OT), primarily due to sustained localized inflammation and opacification within the olfactory cleft (OC). However, conventional radiological assessments of OC opacification overlook the vertical distribution of olfactory neuroepithelium, limiting prognostic accuracy. This study introduces a modified subregion computed tomography (CT) scoring system integrated with computational fluid dynamics (CFD) to evaluate OC opacification's role in baseline olfaction and OT efficacy.

METHODS: In this prospective study, 58 adults with persistent PIOD of more than 3 months' duration were enrolled and completed CT imaging, psychophysical olfactory testing (Sniffin' Sticks TDI score), and questionnaire assessments. Using a modified scoring system, the OC was segmented on coronal sections into upper (superior one-third) and lower (inferior two-thirds) portions, with three coronal sections assessed in both the anterior and posterior OC. Each section was scored dichotomously (0 for no opacification, 1 for opacification), and bilateral scores were recorded. Unsupervised K-means clustering identified phenotypes, random forest modeling predicted functional anosmia, and CFD analyzed airflow dynamics. Thirty-one patients completed 3-month OT with follow-up assessments.

RESULTS: OC opacification was present in 69.0% of persistent PIOD patients, with opacification in the upper posterior OC notably serving as the primary determinant of baseline olfactory function. Random forest analysis further confirmed that upper OC opacification ranked as the top predictor for functional anosmia, with the combined model achieving an area under the curve of 0.920. Cluster analysis revealed three distinct phenotypes, among which the diffuse severe opacification cluster involving upper OC regions was associated with the poorest olfactory function. Although posterior OC opacification was positively correlated with increased airflow velocity ratios (r = 0.570, p < 0.01) and these ratios were negatively correlated with olfactory scores, OC airflow itself did not significantly mediate the relationship between structure and olfactory function. Only 25.8% of patients achieved clinically meaningful olfactory improvement. Significant improvements were observed in TDI (p = 0.001), olfactory threshold (p = 0.010), olfactory discrimination (p = 0.028), and olfactory VAS scores (p < 0.001) after OT. Baseline opacification in posterior-middle section of OC significantly predicted non-response.

CONCLUSIONS: The modified subregion OC opacification scoring system provides a more refined assessment of site‑specific OC obstruction for patients with persistent PIOD, underscoring the critical role of OC opacification in mediating olfactory impairment and resistance to OT.

CLINICAL IMPLICATION: For patients with persistent PIOD, this modified olfactory cleft opacification scoring system allows for olfactory assessment and prognosis by identifying specific opacification patterns associated with olfactory training outcomes.},
}

@article {pmid42200125,
year = {2026},
author = {Martín-Sanz, MB and Moro-López-Menchero, P and Fernández-De-Las-Peñas, C and Gómez-Sánchez, SM and Gil-Crujera, A and Ceballos-García, L and Escribano-Mediavilla, NI and Fuentes-Fuentes, MV and Florencio, LL and Palacios-Ceña, D},
title = {Challenges to continuity of care among patients with long COVID-related taste and smell disorders: a qualitative study.},
journal = {Frontiers in public health},
volume = {14},
number = {},
pages = {1784507},
pmid = {42200125},
issn = {2296-2565},
mesh = {Humans ; Female ; *COVID-19/complications/therapy ; Male ; Middle Aged ; Qualitative Research ; *Continuity of Patient Care ; *Taste Disorders/etiology/therapy ; *Olfaction Disorders/therapy/etiology ; Adult ; Post-Acute COVID-19 Syndrome ; Aged ; Spain ; SARS-CoV-2 ; Interviews as Topic ; },
abstract = {Taste and smell disorders are predominant symptoms of acute SARS-CoV-2 infection and can persist in individuals with post-acute sequelae of SARS-CoV-2 infection (PASC), commonly referred to as Long COVID. These sensory impairments continue to significantly affect daily life and wellbeing, yet clinical understanding and care strategies remain insufficient. There is an ongoing need to address the specific healthcare requirements of this population. The aim of this study was to describe the experiences and perceptions of individuals with Long COVID related taste and smell disorders regarding symptom management and the challenges affecting continuity of care. A qualitative descriptive study was conducted in 2024 in the Community of Madrid (Spain) using purposive sampling. Data were collected through in-depth interviews and analyzed using thematic analysis, an approach appropriate for examining patient experiences in healthcare. Twelve participants with previously confirmed SARS-CoV-2 infection and persistent loss and/or impairment of taste and smell were interviewed. Four themes were identified: (a) Implications of Long COVID taste and smell disorders, (b) Expectations regarding prognosis and symptom cure, (c) Professional approach and symptom management, (d) Barriers and facilitators to continuity of care. Findings highlight the clinical and social relevance of taste and smell disorders in Long COVID and illustrate how qualitative methods can capture patient perspectives that may inform future mixed-methods research.},
}

Humans
Female
*COVID-19/complications/therapy
Male
Middle Aged
Qualitative Research
*Continuity of Patient Care
*Taste Disorders/etiology/therapy
*Olfaction Disorders/therapy/etiology
Adult
Post-Acute COVID-19 Syndrome
Aged
Spain
SARS-CoV-2
Interviews as Topic

@article {pmid42200220,
year = {2026},
author = {O'Donnell, A and Simon, ID and Iademarco, MF},
title = {More Attention on Infection-Associate Chronic Conditions Requires Restoring Support for Long COVID.},
journal = {Clinical infectious diseases : an official publication of the Infectious Diseases Society of America},
volume = {},
number = {},
pages = {},
doi = {10.1093/cid/ciag332},
pmid = {42200220},
issn = {1537-6591},
}

@article {pmid42201014,
year = {2026},
author = {Pinto, EF and Albuquerque Filho, NJB and Leite, JC and Gusmão, TME and de Souza, LN and Silva Júnior, RRD and Knackfuss, MI and Piuvezam, G},
title = {Exercise-Based Rehabilitation in Severe COVID-19 Survivors with Long COVID: A Randomized Controlled Pilot Study.},
journal = {Medical sciences (Basel, Switzerland)},
volume = {14},
number = {2},
pages = {},
doi = {10.3390/medsci14020222},
pmid = {42201014},
issn = {2076-3271},
mesh = {Humans ; *COVID-19/rehabilitation/physiopathology ; Female ; Pilot Projects ; Quality of Life ; Male ; Middle Aged ; SARS-CoV-2 ; *Exercise Therapy/methods ; Survivors ; Aged ; Post-Acute COVID-19 Syndrome ; Pandemics ; Muscle Strength ; },
abstract = {INTRODUCTION: Post-hospital rehabilitation is essential for survivors of severe COVID-19, as prolonged immobility and clinical severity often lead to muscle weakness, reduced cardiovascular capacity, and impaired respiratory function. Physical exercise during and after hospitalization may mitigate these effects and support functional recovery. This study aimed to evaluate the effectiveness of a physical exercise-based rehabilitation program in survivors of severe COVID-19.

METHODOLOGY: A randomized clinical trial was conducted with 30 survivors allocated to two groups: multicomponent exercise (GEm) and multicomponent exercise combined with inspiratory muscle training (GEmTMI). The interventions were performed three times per week for 40-60 min. Quality of life, physical activity level, functional status, and physical capacity were assessed before and after six weeks.

RESULTS: Comparisons between GEm and GEmTMI showed significant differences in the 6 min walk test (6MWT) at baseline (p = 0.043) and in the Physical Activity Index (IPAQ) after the intervention (p = 0.002). When the total sample was analyzed, significant improvements were observed across all outcomes after rehabilitation, including quality of life (SF-36), functional capacity (PCFS), physical activity level (IPAQ), respiratory muscle strength, and additional functional tests. Notable improvements included SF-36 Physical Functioning (p = 0.006) and Social Functioning (p = 0.009), PCFS (p = 0.011), IPAQ (p = 0.012), and performance in the 6MWT, STS, STS-1min, TUG, handgrip strength, PEmax, and PImax (all p < 0.001).

DISCUSSION: Multicomponent physical rehabilitation, with or without inspiratory muscle training, produced significant gains in physical activity level, functional capacity, dynamic balance, neuromuscular fitness, respiratory muscle strength, and quality of life. These findings underscore the importance of structured post-ICU rehabilitation to support comprehensive physical and psychosocial recovery in survivors of severe COVID-19.},
}

Humans
*COVID-19/rehabilitation/physiopathology
Female
Pilot Projects
Quality of Life
Male
Middle Aged
SARS-CoV-2
*Exercise Therapy/methods
Survivors
Aged
Post-Acute COVID-19 Syndrome
Pandemics
Muscle Strength

@article {pmid42201061,
year = {2026},
author = {Smit, A and Fleischmann, P and Knauer, TS and Mardin, CY and Michelson, G and Zott, J and Güttes, M and Sarmiento, H and Ilgner, M and Jakobi, M and Rech, J and Hohberger, B},
title = {Task-Evoked Pupillary Dynamics Are Altered in Post-COVID Syndrome.},
journal = {Medical sciences (Basel, Switzerland)},
volume = {14},
number = {2},
pages = {},
doi = {10.3390/medsci14020269},
pmid = {42201061},
issn = {2076-3271},
support = {2490-PC-2021-V14//Bavarian Health and Food Safety Authority/ ; Gesamt-2490- 252 PCS-2023-V6//Bavarian Health and Food Safety Authority/ ; GRK 2504/1//Deutsche Forschungsgemeinschaf/ ; 01EO2105//Federal Ministry 254 of Education and Research/ ; },
mesh = {Humans ; Female ; Male ; Post-Acute COVID-19 Syndrome ; Middle Aged ; Cross-Sectional Studies ; *COVID-19/physiopathology/complications ; *Pupil/physiology ; Adult ; Aged ; SARS-CoV-2 ; },
abstract = {Background/Objectives: Post-COVID syndrome (PCS) is frequently associated with persistent cognitive complaints such as fatigue and impaired concentration, yet objective markers related to cognitive dysfunction are lacking. Pupillary oscillation metrics have emerged as non-invasive indicators of task-related cognitive load and autonomic regulation. This study investigated the Index of Pupillary Activity (IPA) and the Low/High Index of Pupillary Activity (LHIPA) in a large cohort of patients with PCS compared with healthy controls. Methods: In this cross-sectional study, 526 participants (397 PCS patients, 129 controls) performed a standardized virtual reality-based stereoscopic task at three disparity levels: 275 arcsec (high difficulty), 550 arcsec (medium difficulty), and 1100 arcsec (low difficulty), using a head-mounted display with integrated eye tracking. Continuous pupillometry data were recorded, and IPA and LHIPA were calculated. Linear mixed-effects models with random intercepts for participants were applied, adjusting for age, sex, and task difficulty. Results: Both IPA and LHIPA were significantly lower in PCS patients than in controls at all three task difficulty levels in post hoc model-based contrasts. In adjusted mixed-effects models, PCS was also associated with lower overall IPA (β=-0.111, 95% CI -0.160 to -0.062, p<0.001) and lower overall LHIPA (β=-0.164, 95% CI -0.253 to -0.074, p<0.001). Lower task difficulty was associated with higher values of both metrics: for IPA, β=0.164 at 550 arcsec and β=0.287 at 1100 arcsec (both p<0.001); for LHIPA, β=0.161 at 550 arcsec and β=0.254 at 1100 arcsec (both p<0.001), relative to 275 arcsec. Thus, both indices showed an inverse association with task difficulty. Age was negatively associated with both metrics, whereas male sex was positively associated with both. No significant interaction between cohort and task difficulty was observed. Conclusions: PCS was associated with reduced IPA and LHIPA during a standardized stereoscopic task. These findings indicate altered task-related pupillary dynamics in PCS and may reflect altered cognitive-load processing and autonomic regulation. LHIPA, and with caution also IPA, may contribute to the objective assessment of task-related pupillary alterations in PCS.},
}

Humans
Female
Male
Post-Acute COVID-19 Syndrome
Middle Aged
Cross-Sectional Studies
*COVID-19/physiopathology/complications
*Pupil/physiology
Adult
Aged
SARS-CoV-2

@article {pmid42201733,
year = {2026},
author = {Tian, J and Azhir, A and Decaro, M and Chau, N and Hügel, J and Morris, M and Cheng, J and Fard, P and Bassett, IV and Bell, DS and Bernstam, EV and Visweswaran, S and Klann, JG and Murphy, SN and Estiri, H},
title = {Long COVID Persistence and Surveillance Gaps Across 58 US Hospitals.},
journal = {JAMA network open},
volume = {9},
number = {5},
pages = {e2614909},
doi = {10.1001/jamanetworkopen.2026.14909},
pmid = {42201733},
issn = {2574-3805},
mesh = {Humans ; *COVID-19/epidemiology/complications/diagnosis ; Female ; Retrospective Studies ; United States/epidemiology ; Male ; Post-Acute COVID-19 Syndrome ; Middle Aged ; Adult ; Hospitals/statistics & numerical data ; SARS-CoV-2 ; Aged ; Prevalence ; Chronic Disease/epidemiology ; Population Surveillance ; },
abstract = {IMPORTANCE: Surveillance of postacute sequelae of SARS-CoV-2 infection (PASC) depends on diagnostic coding systems that capture fewer than one-half of affected individuals, rendering millions invisible to health systems and policymakers.

OBJECTIVE: To quantify the gap between true PASC burden and diagnostic code-based estimates, determine the proportion representing chronic disease, and characterize organ system heterogeneity and temporal trends across diverse populations.

This retrospective cohort study used electronic health record data from 58 hospitals and affiliated clinics in 4 US regions, from 2017 to 2025. Adults (aged ≥18 years) with laboratory-confirmed SARS-CoV-2 infection or a COVID-19 diagnosis code were included. A custom artificial intelligence algorithm, the Precision Phenotyping for Research Cohorts (P2RC), was implemented using federated infrastructure.

EXPOSURE: Laboratory-confirmed SARS-CoV-2 infection or COVID-19 diagnosis code.

MAIN OUTCOMES AND MEASURES: The primary outcomes were PASC prevalence, the proportion classified as chronic conditions, organ system distribution, and temporal trends from 2020 to 2024. χ2 Tests were used to assess organ system heterogeneity across regions, and negative binomial regression was used to model quarterly temporal trends, yielding incidence rate ratios (IRRs) with 95% CIs.

RESULTS: In this cohort study of 457 950 COVID-19 cases (mean age, 52.05 years; 275 107 [60.07%] female), the P2RC algorithm identified 74 560 PASC cases (16.28% overall; 28 585 [18.58%] in New England, 978 [19.55%] in Southeast Texas, 10 534 [22.69%] in Southern California, and 34 463 [13.64%] in Western Pennsylvania), more than 2-fold higher than the proportion identified by code-based surveillance (<7%). Of 883 International Statistical Classification of Diseases, Tenth Revision, Clinical Modification codes associated with PASC, 594 (67.27%) represented chronic or potentially chronic conditions. Of 74 560 patients with PASC, 66 587 (89.31%) developed chronic conditions requiring ongoing clinical management; this represents 14.54% of the total number of 457 950 patients with COVID-19. Substantial organ system heterogeneity was observed (χ2 = 2504.73; P < .001): New England demonstrated thyroid-predominant endocrine patterns, while Southeast Texas, Southern California, and Western Pennsylvania showed metabolic-predominant profiles. Negative binomial regression revealed increasing PASC prevalence through mid-2024 (IRR per quarter, 1.01 [95% CI, 1.00-1.01; P < .001] in New England; 1.00 [95% CI, 1.00-1.01; P < .001] in Southern California; and 1.02 [95% CI, 1.01-1.02; P < .001] in Western Pennsylvania), indicating an accumulating rather than resolving burden.

CONCLUSIONS AND RELEVANCE: In this cohort study, approximately 1 in 6 patients with COVID-19 developed PASC, and 89.31% of these patients had at least 1 chronic condition. Current diagnostic coding captured fewer than one-half of the cases, obscuring a substantial chronic disease burden. The persistently increasing prevalence through 2024 indicated an accumulating health care burden requiring investment in surveillance infrastructure and integrated care pathways.},
}

Humans
*COVID-19/epidemiology/complications/diagnosis
Female
Retrospective Studies
United States/epidemiology
Male
Post-Acute COVID-19 Syndrome
Middle Aged
Adult
Hospitals/statistics & numerical data
SARS-CoV-2
Aged
Prevalence
Chronic Disease/epidemiology
Population Surveillance

@article {pmid42201907,
year = {2026},
author = {Sirotiak, Z and Oberhauser, AM and Sirotiak, AM and Nettleton, KA and Lee, DC and Thomas, EBK and Brellenthin, AG},
title = {Exploring the perceived impact of physical activity on physical and mental health among individuals with long COVID: A qualitative interview inquiry.},
journal = {PloS one},
volume = {21},
number = {5},
pages = {e0350121},
doi = {10.1371/journal.pone.0350121},
pmid = {42201907},
issn = {1932-6203},
mesh = {Humans ; Female ; Middle Aged ; *COVID-19/psychology ; *Mental Health ; Male ; *Exercise/psychology ; Post-Acute COVID-19 Syndrome ; Adult ; Aged ; SARS-CoV-2/isolation & purification ; Qualitative Research ; Symptom Burden ; Health Status ; },
abstract = {OBJECTIVES: Long COVID presents a significant health burden with limited treatment options. Physical activity (PA) has been suggested for self-management, yet symptom worsening has been reported in similar patient populations. This study aims to identify PA's perceived impact on physical and mental health in adults with long COVID.

METHODS: Semi-structured interviews were conducted with 34 adults (mean age 52 years, 62% women) based in the United States (U.S.) self-reporting long COVID. PA-related content was analyzed using deductive thematic analysis, assessing worsened and improved health experiences attributed to PA.

RESULTS: Participants' perceived health scores were one standard deviation worse than the general U.S. population. Most participants (64.7%) reported worsening long COVID symptoms with PA, while 14.7% noted improvement. Themes for worsened physical health included post-exertional malaise, specific symptom worsening (e.g., fatigue), limited PA abilities, external control perceptions, forced inactivity, and loss of previous PA abilities. Improved health themes involved beliefs in health benefits, symptom improvement, increased energy, accomplishment, enhanced PA abilities, and hope.

DISCUSSION: PA's impact on health varied among individuals with long COVID, highlighting the need to tailor PA recommendations to individual needs and limits.},
}

Humans
Female
Middle Aged
*COVID-19/psychology
*Mental Health
Male
*Exercise/psychology
Post-Acute COVID-19 Syndrome
Adult
Aged
SARS-CoV-2/isolation & purification
Qualitative Research
Symptom Burden
Health Status

@article {pmid42183165,
year = {2026},
author = {Uddin, AS and Bulusu, S and Oderinde, OM and Zheng, QH},
title = {Positron emission tomography imaging of T-cell activity in cardiovascular disease and its emerging role in imaging adaptive immunity.},
journal = {American journal of nuclear medicine and molecular imaging},
volume = {16},
number = {2},
pages = {77-89},
pmid = {42183165},
issn = {2160-8407},
abstract = {T lymphocytes are central mediators of cardiovascular disease, driving myocardial injury in myocarditis, transplant rejection, post-infarct remodeling, atherosclerosis, and post-viral syndromes. Yet current imaging tools ([[18]F]FDG PET, somatostatin receptor tracers, CXCR4 PET, and cardiac MRI) offer only indirect or nonspecific measures of immune activity. The ability to noninvasively visualize and quantify T-cell infiltration and activation could transform diagnosis and management in cardio-immunology. Advances in immuno-PET have produced a growing arsenal of T-cell specific tracers. CD8-targeted agents ([89]Zr-Df-IAB22M2C) and small-molecule probes such as [[18]F]F-AraG have entered early clinical trials, demonstrating feasibility and safety in humans. Other tracers, including CD4- and CD3-directed antibodies, IL-2R and OX40 probes, checkpoint tracers (PD-1, CTLA-4), and granzyme B ligands, remain largely preclinical but show strong potential for cardiovascular translation. Applications span acute myocarditis, noninvasive transplant rejection surveillance, assessment of post-MI immune remodeling, plaque vulnerability in atherosclerosis, and systemic immune activation in long COVID. Compared with existing imaging modalities, T-cell PET offers cell-type specificity, quantitative longitudinal monitoring, and the capacity for whole-body immune mapping, particularly when integrated with total-body PET or hybrid PET/MR. Challenges include low T-cell density in the myocardium, tracer specificity, radiation burden, and the need for histopathologic validation. Future directions involve repurposing oncology tracers for cardiology, engineering antibody fragments with improved kinetics, and establishing T-cell PET as a mechanistic biomarker in cardiovascular clinical trials. With further innovation and validation, T-cell PET has the potential to evolve from an experimental tool into a clinically actionable modality, reshaping the management of immune-mediated heart disease.},
}

@article {pmid42175344,
year = {2026},
author = {Kaufmann, B and Hess, G and Cvijic, L and Denecke, K},
title = {Long Covid and Digital Health in Switzerland: Potentials and Limitations.},
journal = {Studies in health technology and informatics},
volume = {336},
number = {},
pages = {2284-2288},
doi = {10.3233/SHTI260677},
pmid = {42175344},
issn = {1879-8365},
mesh = {Switzerland/epidemiology ; *COVID-19/therapy/epidemiology ; Humans ; *Telemedicine/statistics & numerical data/organization & administration ; *Mobile Applications ; SARS-CoV-2 ; Digital Health ; },
abstract = {Post-COVID-19 (or Long Covid) presents a complex and persistent health challenge affecting a growing number of individuals worldwide. Digital health interventions (DHIs) offer potential support for symptom monitoring, self-management, and information access. However, their availability, quality, and sustainability remain uncertain, particularly in smaller healthcare markets such as Switzerland. This study provides a descriptive assessment of ten representative DHIs for Long Covid available from Switzerland. Each tool was evaluated using a 19-item framework derived from validated instruments. Three independent reviewers tested all interventions on iOS and Android devices, with consensus ratings across five quality categories. Results showed strong usability (average 6.3/8) and practical usefulness (5/8), but consistent weaknesses in accessibility (3.7/8) and data protection (4.6/8). Total scores ranged from 14.7 to 26.3 out of 38. Several Swiss-based apps were discontinued during the study period, highlighting market fragility. Findings underscore the need for inclusive design, transparent data practices, and institutional support if DHIs are to complement Long Covid care sustainably.},
}

Switzerland/epidemiology
*COVID-19/therapy/epidemiology
Humans
*Telemedicine/statistics & numerical data/organization & administration
*Mobile Applications
SARS-CoV-2
Digital Health

@article {pmid42178526,
year = {2026},
author = {Tsai, YT and Wang, BY and Ho, SW and Yang, SF and Wang, YH and Yeh, CB and Chen, YC},
title = {Association of long-COVID with major adverse cardiovascular events and mortality: a real-world data cohort study.},
journal = {BMC cardiovascular disorders},
volume = {},
number = {},
pages = {},
doi = {10.1186/s12872-026-06026-x},
pmid = {42178526},
issn = {1471-2261},
support = {CSH-2023-A-007//Chung Shan Medical University Hospital/ ; },
abstract = {BACKGROUND: There is a limited body of research examining the association between long COVID and major adverse cardiovascular events (MACE) as well as all-cause mortality. This study aimed to investigate the association between long COVID and both MACE and mortality.

METHODS: This retrospective cohort study utilized multicenter real-world data from the TriNetX research network platform, which contains electronic health records from multiple healthcare organizations. Patients aged 18 years and older who were diagnosed with COVID-19 between 2020 and 2023 were included. The exposure group comprised individuals diagnosed with long-COVID within 3 to 6 months after their initial COVID-19 diagnosis, while the comparison group included COVID-19 patients without a diagnosis of long-COVID. The primary outcomes were the risk of major adverse cardiovascular events (MACE) and all-cause mortality. Follow-up commenced 90 days after the index date and continued until the occurrence of the study outcome or the date of the last available medical record.

RESULTS: The risk of MACE was markedly higher in the long-COVID cohort compared to the non-long-COVID cohort. The overall hazard ratio (HR) for MACE was 4.48 (95% CI: 3.95-5.07). Specific conditions such as coronary artery disease and stroke exhibited particularly high HRs, at 6.48 (5.29-7.95) and 3.46 (2.96-4.04) respectively. Mortality was significantly higher in the long-COVID group, with an HR of 1.53 (1.38-1.69).

CONCLUSIONS: Compared to patients without long COVID, patients with long COVID had a higher risk of developing MACE.},
}

@article {pmid42181509,
year = {2026},
author = {Dummer, SDC and Gonçalves, JIB and Varella, FJ and Zamin, MR and Kripka, G and Friedrich, F and Jones, MH and Centofante, GO and Colcete, FNDR and Da Costa, JC and Marinowic, DR},
title = {Impact of physical activity on cognitive function in long COVID patients: a cross-sectional observational study.},
journal = {Frontiers in sports and active living},
volume = {8},
number = {},
pages = {1738512},
pmid = {42181509},
issn = {2624-9367},
abstract = {INTRODUCTION: The COVID-19 pandemic has resulted in long-term sequelae known as long COVID, which is often characterized by cognitive dysfunctions that impair quality of life. Evidence suggests that physical activity may mitigate these impairments through neurobiological mechanisms that enhance neuroplasticity and cerebral perfusion.

OBJECTIVE: This study examined the association between physical fitness and cognitive function in individuals who had recovered from COVID-19.

METHODS: A cross-sectional observational study was conducted involving 34 adults who had been previously hospitalized for COVID-19. Cognitive performance was assessed using the Addenbrooke's Cognitive Examination-Revised (ACE-R), while cardiorespiratory fitness was evaluated through VO₂ max testing. Correlation analyses and generalized linear models adjusted for age, sex, and body mass index were applied to examine associations between physical fitness and cognitive domains.

RESULTS: Participants had a mean age of 52 ± 12 years, a BMI of 28.7 ± 4.4 kg/m[2], and a mean VO₂ max of 36 ± 9 mL/kg·min⁻[1]. A strong positive correlation was observed between VO₂ max and the total ACE-R score (r = 0.653; p < 0.001), with the memory domain showing the strongest association (r = 0.739; p < 0.001). Higher physical activity levels, as assessed by the IPAQ, were also associated with better cognitive outcomes.

DISCUSSION: Physical fitness was significantly associated with better cognitive performance in post-COVID-19 patients. These findings support the inclusion of structured exercise programs in rehabilitation strategies to mitigate the cognitive sequelae of long COVID and underscore the importance of promoting physical activity as a public health intervention.},
}

@article {pmid42181627,
year = {2026},
author = {Maurya, N and Le, A and Melbourne, G and Chow, JSF},
title = {Long-term cardiovascular impact of COVID-19 among hospitalised and non-hospitalised populations: a narrative synthesis review.},
journal = {Frontiers in cardiovascular medicine},
volume = {13},
number = {},
pages = {1741293},
pmid = {42181627},
issn = {2297-055X},
abstract = {INTRODUCTION: COVID-19, initially recognised as a respiratory illness, affects multiple organ systems, including the cardiovascular system. Both hospitalised and non-hospitalised patients may experience persistent cardiac complications; however, the long-term impact across different levels of disease severity remains unclear. This review aims to summarise the existing evidence on the long-term cardiovascular impact of COVID-19, with a particular focus on differences between hospitalised and non-hospitalised patients.

METHOD: PubMed, MEDLINE, CINAHL, and Embase databases were searched for studies published between December 2019 and January 2024 that investigated cardiovascular outcomes in long COVID. Studies were screened for eligibility, and data were extracted using a standardised form. Due to heterogeneity across the included studies, a narrative synthesis was performed.

RESULTS: Seventy-one studies were included, most of which were observational and conducted in Europe and Asia, with follow-up periods ranging from <1 to >24 months. Hospitalised patients reported more frequent cardiovascular symptoms; however, echocardiographic abnormalities were observed across all groups. Reporting of symptom severity was inconsistent. Common cardiovascular manifestations included palpitations, chest pain, fatigue, and arrhythmias. Persistent cardiac dysfunction and dysautonomia were observed regardless of hospitalisation status.

CONCLUSION: Hospitalised patients are at higher risk of long-term cardiovascular complications, including myocardial injury, arrhythmias, and heart failure, while non-hospitalised individuals may experience subclinical cardiac changes. Vaccination appears to have a protective effect. Standardised, prospective studies are needed to clarify long-term cardiovascular risks and to guide follow-up care.},
}

@article {pmid42175169,
year = {2026},
author = {Weber, M and Knak, AK and Wulff, A},
title = {A Mobile Research App for Post-COVID Fatigue Monitoring.},
journal = {Studies in health technology and informatics},
volume = {336},
number = {},
pages = {1614-1618},
doi = {10.3233/SHTI260498},
pmid = {42175169},
issn = {1879-8365},
mesh = {Humans ; *Mobile Applications ; *COVID-19/complications ; *Fatigue/diagnosis/etiology ; SARS-CoV-2 ; },
abstract = {Post-COVID fatigue is a common and burdensome symptom that fluctuates throughout the day, making it difficult to assess within clinical visits. To capture post-COVID symptom fatigue in daily settings, we developed a mobile research app based on a previous survey-based tool, designed as a progressive web application (PWA) using React. The app combines offline functionality, flexible testing times, visual instructions and local storage of participant data. The development was guided by a requirements analysis conducted through interviews with patients, identifying core needs for usability, flexibility and personalized tracking. Compared to a survey-based tool, key improvements include reduced cognitive load, a modern, minimalist design and optimization for mobile devices. Technical tests across Android and iOS devices confirmed stable and compatible performance. Future work includes a systematic usability and feasibility evaluation with both healthy participants and post-COVID patients. The application provides a flexible, user-friendly platform for symptom tracking for post-COVID studies and has potential for further development into self-management for patients.},
}

Humans
*Mobile Applications
*COVID-19/complications
*Fatigue/diagnosis/etiology
SARS-CoV-2

@article {pmid42170694,
year = {2026},
author = {Yenokyan, K and Wentz, E and Ni, Z and Kammerling, T and Sagona, M and DeVito, A and Mehta, SH and Lau, B and Duggal, P},
title = {Association of Comorbid and Incident Depression and Other Mental Health Conditions With Long-COVID: Results From the Johns Hopkins COVID Long Study.},
journal = {Journal of medical virology},
volume = {98},
number = {5},
pages = {e70970},
doi = {10.1002/jmv.70970},
pmid = {42170694},
issn = {1096-9071},
mesh = {Humans ; Male ; Female ; *COVID-19/epidemiology/complications/psychology ; Middle Aged ; Comorbidity ; *Depression/epidemiology ; Adult ; *Anxiety/epidemiology ; Aged ; Incidence ; Mental Health ; SARS-CoV-2 ; Mental Disorders/epidemiology ; Baltimore/epidemiology ; Post-Acute COVID-19 Syndrome ; },
abstract = {Long-term complications following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, known as long-COVID, present significant global health challenges. The factors associated with developing long-COVID remain poorly understood, especially in individuals with pre-existing comorbidities, including mental health conditions. Additionally, the relationship between persistent symptoms and incident depression and anxiety symptoms remains unclear. We analysed baseline data from 9637 participants in the Johns Hopkins COVID Long Study. Logistic regression was utilised to estimate the odds of developing long-COVID in participants with/without pre-existing mental health comorbidities (n = 3351) and incident depression and/or anxiety in participants with persistent symptoms who had only pre-existing non-mental health comorbidities (n = 3036) and those without comorbidities (n = 1781). Participants with pre-existing non-mental health comorbidities had higher odds of developing long-COVID (adjusted odds ratio (aOR) 1.47, 95% confidence interval (CI) 1.20, 1.80) compared to those without comorbidities. Participants with only mental health comorbidities showed similar elevated odds (aOR 1.49, 95% CI 1.14, 1.95). An increasing number of persistent symptoms demonstrated a strong dose-response relationship with developing incident depression and/or anxiety symptoms in both participants with only non-mental health comorbidities and those without comorbidities. Long-COVID affects individuals with and without pre-existing comorbidities; those with pre-existing comorbidities demonstrated increased odds of developing long-COVID. However, the odds among those with mental health comorbidities were not elevated beyond other comorbidities. Monitoring both physical and mental health outcomes is crucial for post-acute COVID-19 patients. Enhanced understanding of the factors associated with long-COVID is essential for improving patient care and developing effective interventions.},
}

Humans
Male
Female
*COVID-19/epidemiology/complications/psychology
Middle Aged
Comorbidity
*Depression/epidemiology
Adult
*Anxiety/epidemiology
Aged
Incidence
Mental Health
SARS-CoV-2
Mental Disorders/epidemiology
Baltimore/epidemiology
Post-Acute COVID-19 Syndrome

@article {pmid42172525,
year = {2026},
author = {Bayramov, T},
title = {Stellate ganglion block for the treatment of olfactory and gustatory dysfunction in patients with long COVID-19.},
journal = {Agri : Agri (Algoloji) Dernegi'nin Yayin organidir = The journal of the Turkish Society of Algology},
volume = {38},
number = {2},
pages = {141-143},
doi = {10.5606/agri.2026.37},
pmid = {42172525},
issn = {2458-9446},
}

@article {pmid42173633,
year = {2026},
author = {Agrawal, P},
title = {AI in multi-omics analysis of COVID-19 patient data.},
journal = {Progress in molecular biology and translational science},
volume = {222},
number = {},
pages = {261-293},
doi = {10.1016/bs.pmbts.2026.01.017},
pmid = {42173633},
issn = {1878-0814},
mesh = {*COVID-19/genetics/metabolism/virology ; Humans ; *Artificial Intelligence ; *Genomics/methods ; *SARS-CoV-2 ; Metabolomics ; Proteomics ; Machine Learning ; Epigenomics ; Neural Networks, Computer ; Multiomics ; },
abstract = {The COVID-19 pandemic has led to an unprecedented increase in the volume of biological data generation, demonstrating the importance of developing an integrative and intelligent analytical framework. In the last few years, advancements in the artificial intelligence (AI) approaches have completely transformed the biological research landscape. Researchers have integrated the AI approaches with the multi-omics data generated from the COVID-19 patients to have a systems-level understanding of underlying disease mechanisms, predicting new variants and their spread rate, disease severity, immune response, and therapeutic opportunities. In this chapter, we have explored the utility of AI on multi-omics data. We started with an introduction to different kinds of omics data, such as genomics, epigenomics, transcriptomics, proteomics, and metabolomics. Next, we elaborated on what AI is and discussed its types, which include conventional machine learning methods (supervised and unsupervised), deep learning methods (autoencoders and convolutional neural networks), and network-based methods (graph neural networks, network propagation, and knowledge graphs). Next, we discussed different types of integration methods (early, intermediate, and late) used for integrating AI and multi-omics data. Moving ahead, we mentioned several applications of AI, such as biomarker discovery, host-pathogen interaction, drug repurposing, and predicting long COVID. Lastly, we mentioned several important projects and consortia and discussed several important case studies highlighting the usefulness of integrating AI with multi-omics data for personalized medicine.},
}

*COVID-19/genetics/metabolism/virology
Humans
*Artificial Intelligence
*Genomics/methods
*SARS-CoV-2
Metabolomics
Proteomics
Machine Learning
Epigenomics
Neural Networks, Computer
Multiomics

@article {pmid42173973,
year = {2026},
author = {Schwarz, J and Eicke, M and Schwedler, N and von Komorowski, G and Goldfuss, V and Fladerer, W and Barbolan, B and Mogk, M and Sommer, N},
title = {A randomized controlled trial of adjunctive speleotherapy in asthma, COPD and long COVID.},
journal = {Scientific reports},
volume = {16},
number = {1},
pages = {},
pmid = {42173973},
issn = {2045-2322},
mesh = {Humans ; *Asthma/therapy/physiopathology ; Female ; Male ; *Pulmonary Disease, Chronic Obstructive/therapy/physiopathology ; *COVID-19/therapy/physiopathology ; Middle Aged ; Aged ; Quality of Life ; Respiratory Function Tests ; Treatment Outcome ; SARS-CoV-2 ; Adult ; Carbon Dioxide/blood ; },
abstract = {Speleotherapy (underground climate therapy) is a non-pharmacological intervention for chronic respiratory diseases. This randomized controlled trial investigated whether a 3-week speleotherapy course (6 sessions, 2 h/week) improves respiratory outcomes in patients on standard background therapy with asthma, COPD, or Long COVID, and whether it affects blood CO2 levels. The control group did not receive speleotherapy but continued their standard therapy. A total of 208 patients (asthma: n = 107; COPD: n = 59; Long COVID: n = 42) were enrolled across nine centers in Germany, Austria, and Italy. Assessments were conducted pre-intervention (T1), post-intervention (T2), and at 3-month follow-up (T3). Outcome measures included airway inflammation (FeNO), pulmonary function parameters (FVC% predicted values, FEV1% predicted values, FEV1/FVC, PEF% predicted values), and respiratory muscle strength (MIP and MEP in absolute values). In addition the following validated questionnaires were administered: Asthma Control Test (ACT), Asthma Quality of Life Questionnaire (AQLQ), COPD Assessment Test (CAT), St. George's Respiratory Questionnaire (SGRQ), Nijmegen Questionnaire (NQ), and Fatigue Assessment Scale (FAS), along with the Long COVID questionnaire from the Median Clinic Group. CO2 levels were assessed via capillary blood (SpCO2) and end-tidal CO2 (PetCO2). Between-group comparisons used the Mann-Whitney U test; within-group changes were assessed with the Wilcoxon signed-rank test (Bonferroni-Holm corrected). In patients with asthma, the predefined primary endpoint (FeNO) showed no significant improvement. In contrast, patient-reported outcomes improved significantly, with clinically relevant gains in asthma control (ACT: p < 0.001) and asthma-related quality of life (total AQLQ: p = 0.005). Lung function parameters showed statistically significant but modest improvements at T2 (FVC: p = 0.011; PEF: p = 0.010; FEV1 in participants < 70 years: p = 0.035). In patients with COPD, symptom burden improved according to CAT scores (p = 0.036), while no improvements in lung function were observed. Patients with Long COVID reported significant improvements in dysfunctional breathing (NQ: T2: p = 0.014), dyspnea (T2: p = 0.026; T3: p = 0.001), and "problems with stair climbing/muscle exertion" (T2: p = 0.042), as well as improvements in anxiety and sleep-related symptoms (T2: p = 0.021). No improvements in lung function were observed in this group. In the total cohort, the intervention group showed statistically significant improvements compared to controls in respiratory muscle strength (MIP: p = 0.002; MEP: p = 0.018) and dysfunctional breathing (NQ scores at T2: p = 0.007; T3: p = 0.017). In CO2-rich speleotherapy centers, both SpCO2 (p = 0.026) and PetCO2 (p < 0.001) increased at T2. While speleotherapy did not improve FeNO, it was associated with clinically relevant improvements in patient-reported outcomes across disease groups. Changes in lung function and respiratory muscle strength were statistically significant but modest and should be interpreted with caution. Overall, speleotherapy may have direct effects on the airways and breathing regulation, with more consistent evidence for improvements in breathing patterns than for direct effects on the airways.Trial registration: DRKS00033365 (retrospectively registered).},
}

Humans
*Asthma/therapy/physiopathology
Female
Male
*Pulmonary Disease, Chronic Obstructive/therapy/physiopathology
*COVID-19/therapy/physiopathology
Middle Aged
Aged
Quality of Life
Respiratory Function Tests
Treatment Outcome
SARS-CoV-2
Adult
Carbon Dioxide/blood

@article {pmid42174604,
year = {2026},
author = {Watton, P and Prusty, BK},
title = {Reframing ME/CFS: toward a unified mechanistic model of chronic post-infectious diseases.},
journal = {Journal of translational medicine},
volume = {},
number = {},
pages = {},
doi = {10.1186/s12967-026-08319-3},
pmid = {42174604},
issn = {1479-5876},
abstract = {BACKGROUND: Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a severe multisystem illness marked by post-exertional malaise (PEM), cognitive dysfunction, autonomic disturbance, and impaired physiological resilience. Historically, the absence of validated biomarkers, heterogeneous definitions, and limited investigative capacity have complicated mechanistic interpretation and contributed to the use of psychosocial and rehabilitative frameworks in clinical practice and in parts of the literature.

MAIN BODY: Advances in systems biology, accelerated by Long-COVID research, have transformed our understanding of post-infectious syndromes, implicating persistent immune dysregulation, mitochondrial and metabolic reprogramming, endothelial and microvascular dysfunction, abnormal coagulation, lipid-mediated signalling, extracellular vesicle communication, and viral protein-associated immune activation. This review charts the shift from early post-infectious observations through psychosocial dominance to contemporary biological frameworks, emphasising that pathology is state-dependent and revealed under physiological stress.

CONCLUSION: ME/CFS is thus reframed here as a disorder of impaired adaptive capacity within post-infectious disease biology.},
}

@article {pmid42174645,
year = {2026},
author = {Plaut, S},
title = {A systematic scoping review and conceptual analysis of new-onset fibromyalgia manifestations after non-hospitalized COVID-19: empirics, definitions, methodologies, pathophysiology, mapping of literature, and knowledge gaps.},
journal = {Journal of translational medicine},
volume = {},
number = {},
pages = {},
doi = {10.1186/s12967-026-08145-7},
pmid = {42174645},
issn = {1479-5876},
abstract = {BACKGROUND: The global coronavirus pandemic has led to a quiet wave of a chronic illness referred to as 'Long/Post Covid-19 syndrome' (LC) which bears a notable resemblance to functional-somatic or 'fibromyalgia-type' syndromes, and whose pathophysiology is undetermined. The lack of effective therapies for LC is straining healthcare systems worldwide and causing widespread public health and socioeconomic concerns. "Fibromyalgia" is a controversial chronic pain condition of unknown etiology largely attributed to generalized sensory hypersensitivity due to dysregulated central pain processing pathways (i.e. neuroplasting central sensitization). Despite intense research and growing attention in the scientific community, the clinical overlap of fibromyalgia, somatic symptom disorder, and post-viral chronic fatigue, is a medical puzzle yet to be solved, especially when occurring in non-severe infections and previously healthy individuals.

METHODS: This systematic scoping review covers the empirical findings on new-onset fibromyalgia manifestations after non-hospitalized covid-19. MEDLINE, Web of Science, and APA PsycINFO were searched in a systematic scoping approach for empirical studies on new-onset fibromyalgia after non-severe non-hospitalized covid-19, charting study characteristics and outcome data. A total of 228 records were included.

FINDINGS: Various types of methods, tools, and study designs are being used for LC research, with inconsistency in key concepts and definitions. This leads to a fragmented understanding of the relationship between SARS-CoV-2 infection and LC. Prevalence studies of post-Covid fibromyalgia are ongoing and susceptible to bias. The empirical evidence supports an overlap between LC, chronic fatigue syndrome, and fibromyalgia but the molecular mechanisms still remain unclear. There are conflicting findings regarding presence of viral particles, central sensitization, autoantibodies, and more.

DISCUSSION: This review highlights the need for standardized definitions and rigorous methodologies in research on LC. Future research should focus on epidemiological population-based studies with representative sampling and improving methodology, refining evolving definitions, harmonization of research, elucidating neurological mechanisms in hypothesis driven studies, and developing effective therapeutic strategies. The discussion synthesizes findings and offers an integrative mechanism for the pathophysiology of fibromyalgia and multisystem medically unexplained manifestations of LC as a non-autoimmune connective tissue disease. It helps explain neuropsychiatric and psychosomatic manifestations and is used to make testable theory-based predictions for future hypothesis-driven investigations.},
}

@article {pmid42167698,
year = {2026},
author = {Patel, A and Ryu, S and Whittington, B and Chyu, C and Chrzanowski, E and Ahmed, S and Slocum, E and Fleischer, NL},
title = {Prospective association between long COVID and COVID-related post-traumatic stress disorder among a population-based cohort of adults diagnosed with COVID-19 in Michigan.},
journal = {Journal of affective disorders},
volume = {},
number = {},
pages = {122009},
doi = {10.1016/j.jad.2026.122009},
pmid = {42167698},
issn = {1573-2517},
abstract = {OBJECTIVE: To better understand the mental health impacts of Long COVID, we examine the prospective association between Long COVID and risk of COVID-related post-traumatic stress disorder (PTSD) symptoms.

METHODS: We used baseline and follow-up data from the Michigan COVID-19 Recovery Surveillance Study, a population-based study of adults diagnosed with polymerase chain reaction-confirmed COVID-19 between March 2020 and May 2022 in Michigan (n = 3492). Baseline data were collected a median of 4.4 months (interquartile range (IQR): 3.4-5.7 months) and follow-up data were collected a median of 18.4 months (IQR: 15.0-21.3 months) after initial COVID-19 onset. We defined Long COVID at baseline as having not recovered to usual state of health 90 days or more after initial COVID-19 onset and having COVID-related PTSD symptoms at follow-up based on a six-item version of the PTSD Checklist for Civilians anchored to each individual's COVID-19 diagnosis. We ran modified Poisson regression models adjusting for sociodemographic characteristics, pre-existing comorbidities, COVID-19 illness severity, survey mode, and phase of the pandemic when diagnosed with COVID-19.

RESULTS: At baseline, 17.0% of adults diagnosed with COVID-19 had Long COVID, and 10.1% of adults reported COVID-related PTSD symptoms at follow-up. In the fully adjusted model, the risk of COVID-related PTSD symptoms was 2.08 times higher (95% confidence interval: 1.65-2.63) among adults with Long COVID than among adults without Long COVID.

CONCLUSION: Long COVID is prospectively associated with a higher risk of COVID-related PTSD symptoms suggesting a need to strengthen mental health screening, monitoring, and interventions among adults with this condition.},
}

@article {pmid42168400,
year = {2026},
author = {Si, Y and Zhu, X and Zhang, Y and Zhou, Z and Liu, Y and Ma, H},
title = {PANoptosis as a Therapeutic Target for COVID-19.},
journal = {Current microbiology},
volume = {83},
number = {7},
pages = {},
pmid = {42168400},
issn = {1432-0991},
support = {No.2023-CX-TD-66//the Innovation Capability Support Program of Shaanxi/ ; 82202367//the National Natural Science Foundation of China/ ; },
mesh = {Humans ; *SARS-CoV-2/drug effects ; *COVID-19/immunology/virology/pathology ; *COVID-19 Drug Treatment ; Apoptosis/drug effects ; *Necroptosis/drug effects ; Pyroptosis/drug effects ; Antiviral Agents/therapeutic use/pharmacology ; Cytokine Release Syndrome ; Animals ; },
abstract = {Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has sparked a global pandemic with extensive spread, posing a severe threat to public health due to its high mortality rate in severe cases. The continuous emergence of variants with enhanced immune evasion capabilities, coupled with the prolonged and debilitating symptoms of Long Coronavirus Disease (Long COVID) such as intermittent dyspnea, persistent fatigue, and cognitive impairment (brain fog), has become a major global concern. The pathogenesis of COVID-19 is a complex interplay of direct viral cytotoxicity and an overwhelming secondary inflammatory response in the host, with the latter being a key driver of immune homeostasis disruption. Accumulating evidence indicates that PANoptosis, an integrated programmed cell death process involving the crosstalk and coordinated activation of apoptosis, pyroptosis, and necroptosis, is closely linked to the cytokine storm syndrome triggered by SARS-CoV-2 infection. As a critical mediator of various infectious diseases, PANoptosis plays a pivotal role in regulating the balance between viral clearance and pathological inflammation. This review specifically targets SARS-CoV-2, adopting a "basic mechanism-molecular regulation-therapeutic target-clinical translation" framework. We elaborate on SARS-CoV-2-induced PANoptosis mechanisms, including its constituent cell death pathways and contributions to cytokine storms. By dissecting the intricate regulatory networks between PANoptosis and interferon (IFN) signaling during viral infection, this work aims to identify potential therapeutic targets and provide novel insights for the development of effective strategies to mitigate severe COVID-19 and its long-term sequelae.},
}

Humans
*SARS-CoV-2/drug effects
*COVID-19/immunology/virology/pathology
*COVID-19 Drug Treatment
Apoptosis/drug effects
*Necroptosis/drug effects
Pyroptosis/drug effects
Antiviral Agents/therapeutic use/pharmacology
Cytokine Release Syndrome
Animals

@article {pmid42168930,
year = {2026},
author = {Shen, Y and Shahn, Z and Robertson, MM and Gebo, K and Nash, D},
title = {Long COVID longitudinal symptoms burden clusters within a national community-based cohort.},
journal = {BMC infectious diseases},
volume = {},
number = {},
pages = {},
doi = {10.1186/s12879-026-13590-2},
pmid = {42168930},
issn = {1471-2334},
abstract = {BACKGROUND: Long COVID is clinically heterogeneous, with evolving symptom trajectories that complicate classification. Prior clustering studies often rely on Electronic Health Records data, risking underreporting. We examined longitudinal, community-based symptom clusters and associated factors.

METHODS: We analyzed CHASING COVID Cohort participants with confirmed SARS-CoV-2 infection between December 2020 and December 2022, ≥ 12 months of follow-up, and long COVID (≥ 1 new symptom and concurrent activity limitation 3-12 months post-infection, both absent pre-infection). The infection in this window was the index infection; those with pre-index long COVID were excluded. Symptoms were self-reported pre-infection and at ~ 3, 6, 9, and 12 months. Missing data were handled via multiple imputation by chained equations (30 datasets). Longitudinal K-means clustering was performed within each imputed dataset, with hierarchical aggregation to derive final assignments. Logistic regression (age- and sex-adjusted) assessed associations of demographic, clinical, and social factors with cluster membership. Within the highest-burden cluster, hierarchical clustering identified symptom phenotypes.

RESULTS: Of 1,787 infected participants, 511 met criteria (22% ≥50 years; 55% female; 60% White non-Hispanic; 54% mental health disorder; 7.2% immunodeficiency; 21% ≥2 comorbidities). Three longitudinal clusters emerged: highest, moderate, and lowest burden. The highest-burden cluster showed persistent multisystem symptoms (median 6 symptoms at 6-9 months) with frequent fatigue, concentration difficulty, post-exertional malaise, myalgia, sleep disturbance, gastrointestinal symptoms, headache, irritability, and mobility limitations. The moderate cluster peaked at 3 symptoms, while the lowest remained at 1 symptom. Older age (aOR 2.68, 95% CI 1.59-4.53), female sex (2.36, 1.48-3.76), mental health disorder (2.65, 1.65-4.25), and immunodeficiency (4.23, 1.71-10.51) were associated with highest vs. lowest burden. Within the highest-burden cluster, three phenotypes emerged: multisystemic dysfunction, psychiatric/neurological dysfunction, and physical/respiratory dysfunction.

CONCLUSIONS: Distinct long COVID clusters and phenotypes underscore heterogeneity and support tailored management and risk stratification.},
}

@article {pmid42170596,
year = {2026},
author = {Philippot, Q and Debray, MP and Guyard, A and Achkar, A and Le Voyer, T and Le Hingrat, Q and Crestani, B and Borie, R},
title = {Good? A very long COVID-19.},
journal = {Journal of human immunity},
volume = {2},
number = {1},
pages = {e20250178},
pmid = {42170596},
issn = {3065-8993},
abstract = {We report a case of chronic SARS-CoV-2 infection resulting from impaired B cell-mediated immunity to SARS-CoV-2 in a patient with Good syndrome. Immunoglobulin replacement therapy alone was sufficient to achieve clinical and radiological resolution.},
}

@article {pmid42158877,
year = {2026},
author = {Sanhueza, S and Cabrera, C and Quiroga, R and Antilef, B and Muñoz, C and Vera, A and Cartes, R and Lamperti, L and Guzmán-Gutiérrez, E and Aguayo, C and Ormazábal, V and Hernández, MA and Lastra, J and Riffo, B and Cerda, G and Ferrada, L and De Gonzalo-Calvo, D and García-Hidalgo, MC and Henríquez, M and Barría, MI and Verdugo, RA and Colombo, A and Labarca, G and Nova-Lamperti, E},
title = {De novo COVID-19-associated insulin resistance drives dysregulated neutrophil extracellular trap formation (NETosis) four months after infection.},
journal = {Frontiers in immunology},
volume = {17},
number = {},
pages = {1787799},
pmid = {42158877},
issn = {1664-3224},
mesh = {Humans ; *Extracellular Traps/immunology/metabolism ; *COVID-19/immunology/complications ; Male ; Female ; Middle Aged ; *Insulin Resistance/immunology ; *SARS-CoV-2/immunology ; *Neutrophils/immunology/metabolism ; Aged ; Adult ; },
abstract = {BACKGROUND: Glucose metabolism disorders (GMDs) are established risk factors for severe COVID-19, but increasing evidence indicates that they may also develop de novo after SARS-CoV-2 infection. Neutrophil extracellular trap formation (NETosis) plays a central role in immunothrombosis, and because neutrophils rely predominantly on glycolysis, they are particularly sensitive to systemic metabolic disturbances. However, the impact of post-COVID-19 GMDs on NETosis remains poorly understood. This study aimed to characterize the emergence of GMDs after COVID-19 and to determine their effect on neutrophil NETosis.

METHODS: Sixty COVID-19 patients were stratified according to the presence or absence of GMDs before infection and at four months post-infection. Demographic, clinical, metabolic, and inflammatory parameters were assessed. Vital NETosis was quantified by flow cytometry. In addition, the capacity of patient plasma to induce NETosis was evaluated using live-cell imaging of healthy neutrophils as biosensors.

RESULTS: Among patients without pre-existing GMDs, 24 of 36 developed insulin resistance (IR) four months after COVID-19. Neutrophils from these patients exhibited increased basal NETosis but showed impaired NETosis in response to TLR7/8 agonists, key sensors of viral single-stranded RNA, compared with control groups. In contrast, NETosis responses to IL-6 and TNF-α were preserved, excluding an intrinsic neutrophil defect. Plasma from IR patients significantly enhanced NETosis, and in vitro experiments demonstrated that insulin enhances NETosis independently of glucose concentrations.

DISCUSSION: De novo IR following COVID-19 dysregulates NETosis primarily through an insulin-enhancing effect. Post-viral control of glucose metabolism disorders may be critical to limit pathological NETosis and its thrombo-inflammatory consequences.},
}

Humans
*Extracellular Traps/immunology/metabolism
*COVID-19/immunology/complications
Male
Female
Middle Aged
*Insulin Resistance/immunology
*SARS-CoV-2/immunology
*Neutrophils/immunology/metabolism
Aged
Adult

@article {pmid42159650,
year = {2026},
author = {Ortega-Martin, E and Alvarez-Galvez, J},
title = {Development of the long COVID - 6 dimensions quality of life (LC-6D-QoL) scale: a Delphi study.},
journal = {Journal of patient-reported outcomes},
volume = {},
number = {},
pages = {},
doi = {10.1186/s41687-026-01084-3},
pmid = {42159650},
issn = {2509-8020},
abstract = {BACKGROUND: Long COVID significantly impairs quality of life through multi-systemic complexity, including fatigue, cognitive dysfunction, and dysautonomia. Existing generic tools fail to capture these manifestations, limiting patient-centered assessment. To address this gap, this study proposed a patient-focused, 16-item scale developed and content-refined through expert consensus, to evaluate quality of life in people with Long COVID.

METHODS: A two-round Delphi study involved two rounds of questionnaires and feedback. 37 experts with clinical or research experience in Long COVID participated in the first round, and 26 completed the second. In the first round, experts rated the relevance of proposed indicators. The second questionnaire incorporated modifications based on the experts' comments. Quantitative data were analyzed using descriptive statistics and agreement measures, while qualitative comments were thematically coded.

RESULTS: Experts reached substantial agreement, above 83%, on the dimensions covering the main aspects of quality of life. Based on participants' comments, the initial scale was modified, and a consensus between 80 and 92% was reached in all dimensions. The Delphi process resulted in a scale composed of 6 dimensions and 16 items, which include dysautonomia assessment and affective-sexual life impact, omitted in generic tools. The dimensions of the LC-6D-QoL Scale were: (1) general health; (2) physical health; (3) mental health; (4) daily functioning; (5) social relationships and support; and (6) economic and work-related aspects.

CONCLUSIONS: This study establishes an expert-informed foundation for future validation of the LC-6D-QoL Scale, integrating clinical and experiential knowledge to refine its preliminary structure. The LC-6D-QoL Scale is a patient-centered instrument capturing six key dimensions often missed in generic tools-such as dysautonomia, mental fatigue, and work-related impact-to better assess quality of life in Long COVID.},
}

@article {pmid42160940,
year = {2026},
author = {Spedding, M and Aerts, J and Alexander, S and Bellozzi Woestelandt, AG and Chiricozzi, E and Henriques, A and Lledo, PM and Loeffler, JP and Perera, R and Platt, FM and Pradat, PF and Rene, F and Schapira, A and St Clair, L and Talbot, K and Taquet, M and Toborek, M and Turner, B and Zandi, M and Gressens, P},
title = {Erratum to "Links between COVID-19, long COVID, and neurodegeneration: The role of glycosphingolipids" [Pharmacological Reviews 78 (2026) 100113].},
journal = {Pharmacological reviews},
volume = {78},
number = {4},
pages = {100142},
doi = {10.1016/j.pharmr.2026.100142},
pmid = {42160940},
issn = {1521-0081},
}

@article {pmid42162520,
year = {2026},
author = {Rivelli, A and Ording, J and Sheehan, J and Hirschtick, JL},
title = {Demographic Differences in Long COVID Diagnosis Across Levels of Care: Implications for Clinical Practice.},
journal = {Journal of general internal medicine},
volume = {},
number = {},
pages = {},
pmid = {42162520},
issn = {1525-1497},
abstract = {BACKGROUND: Long COVID is a novel condition primarily studied in outpatient settings, failing to capture the full spectrum of affected patients, particularly those from disadvantaged populations. Demographic differences in the medical encounter setting of initial long COVID diagnosis suggest disparities in symptom severity, care access, and utilization.

OBJECTIVE: To identify demographic factors associated with the encounter setting at initial long COVID diagnosis.

DESIGN: Retrospective study utilizing data from the electronic medical record within the largest Midwestern non-profit healthcare system.

PATIENTS: In total, 8008 patients aged 18+ with initial long COVID diagnosis (ICD-10 U09.9) between March 1, 2020, and October 31, 2023.

MAIN MEASURES: Demographic factors (age, sex, race/ethnicity, insurance, median household income) and encounter setting at first long COVID diagnosis were extracted. We used multinomial logistic regression to estimate adjusted odds of encounter setting at first diagnosis by demographic subgroup.

KEY RESULTS: Patients were most frequently diagnosed with long COVID in an outpatient non-diagnostic encounter (92%), followed by emergency (3%), outpatient diagnostic (e.g., following laboratory or imaging; 3%), and inpatient (2%). After mutually adjusting for all demographic factors, relative to first long COVID diagnosis in the outpatient non-diagnostic setting, older age was associated with higher odds of first diagnosis in outpatient diagnostic and inpatient settings but lower odds in the emergency setting. Greater median household income was associated with higher odds of first diagnosis in the outpatient diagnostic setting but lower odds in the emergency setting. Patients with Medicaid had lower odds of first diagnosis in the outpatient diagnostic setting but 3.0 times higher odds in emergency settings.

CONCLUSIONS: Patients with lower socioeconomic status indicators had increased odds of first long COVID diagnosis in higher acuity settings, suggesting potential differences in symptom severity, access, and care-seeking behaviors. Long COVID research and education should target patients and providers in these settings.},
}

@article {pmid42163148,
year = {2026},
author = {Ghosal, R and Gronowski, B and Fish, D and Rinaldi, JB and Vartanian, K},
title = {A mixed-methods study comparing clinical and patient-reported perspectives on long COVID: insights from electronic health records and narrative journal entries.},
journal = {BMC infectious diseases},
volume = {},
number = {},
pages = {},
doi = {10.1186/s12879-026-13593-z},
pmid = {42163148},
issn = {1471-2334},
abstract = {BACKGROUND: Many studies of Long COVID have used a variety of clinical and self-reported data to characterize this condition. Previous research has shown the many ways in which these two types of data sources can differ. Our study aims to expand on previous research by exploring descriptions of Long COVID using electronic health records (EHRs) and narrative journal entries collected from the same patients to understand how they align and differ.

METHODS: This convergent mixed methods observational study design analyzed narrative patient-reported data (journal entries) and EHRs from adults with a clinical Long COVID diagnosis. From August 2020 to July 2023, adults across seven states who tested positive for COVID-19 were invited to participate in My COVID Diary (MCD) for up to a year; in 2023 they re-consented for EHR access. Of 18,941 MCD participants, 3,323 consented to EHR access (17.54% participation rate). Inclusion required at least one medical encounter and one journal entry between 4 and 52 weeks post-infection, plus an EHR-recorded Long COVID diagnosis. Ninety-two individuals met all criteria. EHR was used to descriptively analyze patient demographics, medical encounters, and diagnoses. MCD journal entries were coded and analyzed using a framework analysis to identify themes. Ten individuals with journal entries within 1 week of a clinical visit were randomly selected and the records were manually reviewed for semantic overlap to qualitatively illustrate alignment.

RESULTS: The most frequent types of medical encounters for participants in the study window were outpatient primary care or specialist visits. The most common diagnoses found in the EHR were respiratory conditions, joint pain, cardiovascular issues, malaise and fatigue, and ear, nose, and throat issues. Journal entries highlighted similar symptoms like tiredness/fatigue, pain, respiratory challenges, mental health concerns, and cardiovascular issues. Key differences were that journal entries had a greater emphasis on more subjective or functional symptoms and experiences such as fatigue, brain fog, and mental health and included the impact of long COVID on daily, work, and social activities. Comparison of co-occurring EHR and journal entries for individual encounters illustrated limited to no overlap in symptom description for the 10 selected cases.

CONCLUSIONS: While our study is limited by a small sample size that impacts generalizability, our in-depth review of these data sources indicates that neither EHR nor patient-reported data alone conveys the complete experience of Long COVID. Integration of patient-reported and EHR data is likely needed to fully understand and treat patients struggling with Long COVID.},
}

@article {pmid42163696,
year = {2026},
author = {Seneff, S and Nigh, G and Kyriakopoulos, AM},
title = {Melatonin in Health and Disease and its Metabolism by the Gut Microbes: Implications for Deuterium Homeostasis?.},
journal = {Current medicinal chemistry},
volume = {},
number = {},
pages = {},
doi = {10.2174/0109298673468554260508041733},
pmid = {42163696},
issn = {1875-533X},
abstract = {Deuterium (2H), a heavy isotope of protium (1H), is a naturally occurring element with a significant impact on human metabolism. Despite its natural presence, deuterium can impair mitochondrial function by damaging ATPase pumps; consequently, biological organisms have evolved sophisticated strategies to mitigate the risks of deuterium overload and protect mitochondrial integrity. Multiple enzymes have evolved to prefer hydrogen over deuterium in their reactions to protect these pumps. One class of enzymes is the cytochrome P450 (CYP) enzymes, which oxidize many substrates, mainly in the Endoplasmic Reticulum (ER), often producing water as a by-product. Furthermore, hydrogen peroxide (H2O2), produced in the ER by ERO1, can travel via the cytoplasm to the mitochondria, where it is reduced to two molecules of water via glutathione peroxidase. Melatonin is an ancient antioxidant molecule that first appeared in photosynthetic bacteria billions of years ago to protect against oxygen produced by respiration. In this paper, we present a hypothesis that melatonin metabolism in the gut provides deuterium- depleted protons to the enterocyte mitochondria. Few are aware that melatonin, known mainly as the hormone produced by the pineal gland to regulate circadian rhythms, is produced in the gut at 400 times the amount produced by the pineal gland. In the gut lining, melatonin is synthesized from N-acetylserotonin through the addition of a methyl group from S-adenosylmethionine. This methyl group, which we argue is severely deuterium-depleted due to its gut microbial source, is then fully metabolized by CYP2C19 in the ER of enterocytes in the small intestine, producing four molecules of water, which we argue would also be depleted in deuterium. Melatonin is recycled from the gut to the liver multiple times via the bile acids, and it is repeatedly converted back to N-acetylserotonin and regenerated, each time producing four water molecules derived from its methyl group. Butyrate, another nutrient supplied by gut microbes, stimulates the synthesis of serotonin and melatonin from tryptophan in the gut. Melatonin is a powerful antioxidant in mitochondria and promotes a healthy microbiome. Melatonin deficiency is associated with the severity of long COVID, and melatonin supplementation can help minimize side effects.},
}

@article {pmid42163969,
year = {2026},
author = {Hendriks, S and Grady, C and Fitzgerald, ML and Gross, RS and Maughan, C and Peluso, MJ and Varma, S and Nath, A and Rid, A},
title = {The next phase in Long COVID research: addressing the ethical challenges in trials of disease-modifying treatments.},
journal = {EClinicalMedicine},
volume = {95},
number = {},
pages = {103918},
pmid = {42163969},
issn = {2589-5370},
abstract = {Almost five years after COVID-19 emerged, multiple scientific uncertainties remain about why some people experience ongoing symptoms long after being infected with SARS-CoV-2 (Long COVID). The pathophysiology underlying Long COVID and its potential to represent several endotypes are still under investigation. These scientific uncertainties around Long COVID have been cited as a reason to delay treatment trials until the disease is better understood. In this paper, a group of bioethicists, clinician-scientists and people with lived experience with Long COVID argue that it is ethically imperative to conduct trials of disease-modifying treatments for Long COVID now. Furthermore, we argue that although conducting such trials can pose ethical challenges, these challenges can be overcome through careful research priority-setting, rigorous trial design, fair participant selection, and ensuring that the risk-benefit profile is favorable.},
}

@article {pmid42153547,
year = {2026},
author = {Freitas, RDS and Garcia, ALH and Martins, BAA and Dalberto, D and Da Silva, FR and Borges, MS and Peralta, GEP and Bobermin, LD and Quincozes-Santos, A and Da Silva, J},
title = {Ultra-Processed Foods and Diet Quality in Long COVID: Associations with Symptom Burden, DNA Damage, and Inflammation.},
journal = {Mutagenesis},
volume = {},
number = {},
pages = {},
doi = {10.1093/mutage/geag020},
pmid = {42153547},
issn = {1464-3804},
abstract = {Diet quality can be a potential modifier of post-acute COVID-19 syndrome (PACS), yet the relationship between dietary patterns, symptom burden, and biological markers remains poorly understood. We hypothesized that a low-quality diet would positively associate with PACS symptom burden, DNA damage, inflammatory and neurotrophic markers, and with overall health quality. 186 individuals were classified into three groups: control (n = 64), acute PACS (n = 66), and chronic PACS (n = 55). Dietary intake was assessed by a food frequency questionnaire (FFQ), and diet quality was quantified via the Protective and Risk Eating Score (PRES). Blood samples were analyzed for inflammatory (TNF-α, TGF-β, IL-6, IL-1β) and neurotrophic (BDNF, GDNF, S100B) markers. DNA damage was assessed by micronuclei frequency, telomere length, and comet assay parameters. Health index (HI) was assessed by daily habits (alcohol consumption, sleeping patterns, hydration, exercise frequency, smoking habits, anthropometric parameters, and PRES). No significant differences were found among groups in ultra-processed foods (UPF) or sugary products intake, PRES scores, inflammatory or neurotrophic biomarkers, DNA damage indicators, and HI. Of note, poorer diet quality was associated with higher symptom burden in PACS women, mainly in fatigue, memory, mental health, circulatory, and skin symptom domains. Few associations among diet quality, HI, and biomarkers emerged. Of note, principal component analysis shows that PACS relies on the convergence of genomic instability, systemic inflammation, and low diet quality. These findings suggest that diet may represent a modifiable factor in PACS management, warranting longitudinal and interventional studies to determine causality and therapeutic potential.},
}

@article {pmid42156850,
year = {2026},
author = {Peter, RS and Nieters, A and Sedelmaier, L and Kräusslich, HG and Brockmann, SO and Göpel, S and Merle, U and Steinacker, JM and Rothenbacher, D and Kern, WV and , },
title = {Population-based comparison of post-acute sequelae of COVID-19 and health-related quality of life across pandemic periods: Omicron era versus early pandemic.},
journal = {Scientific reports},
volume = {16},
number = {1},
pages = {},
pmid = {42156850},
issn = {2045-2322},
mesh = {Humans ; *Quality of Life ; *COVID-19/epidemiology/complications ; Adult ; Male ; Middle Aged ; Female ; Aged ; Adolescent ; SARS-CoV-2/isolation & purification ; Young Adult ; Post-Acute COVID-19 Syndrome ; Pandemics ; Prevalence ; Surveys and Questionnaires ; Germany/epidemiology ; },
abstract = {Post-COVID-19 syndrome (PCS) may vary across pandemic phases. We compared the prevalence of post-acute COVID-19 symptom clusters following SARS-CoV-2 infection in the early pandemic and during the Omicron era using a population-based approach. The EPILOC study enrolled individuals aged 18-65 years who tested PCR-positive for SARS-CoV-2 during the early pandemic, between October 2020 and April 2021, in defined geographic regions within Baden-Württemberg. EPILOC-Omicron used an identical design for individuals infected between June and July 2022. Participants completed a standardised questionnaire assessing sociodemographics, lifestyle, symptoms, and health-related quality of life (SF-12). PCS was defined as ≤ 80% recovery of general health or work capacity plus at least one new moderate-to-strong symptom, both compared to before index infection. Generalised linear models adjusted for age, sex, and education were used to estimate relative risks (RRs). We analysed data from 11,710 EPILOC (24% response) and 12,560 EPILOC-Omicron participants (17% response). Participants were similar in age and sex distribution. Vaccination before infection differed markedly (< 3 vs. > 92%). PCS prevalence was 29.6% in EPILOC and 14.5% in EPILOC-Omicron. Predictors of PCS were similar for both. Symptom clusters were consistently less frequent after infection during the Omicron era (e.g., fatigue RR = 0.54; neurocognitive impairment RR = 0.53; chest symptoms RR = 0.47; smell/taste disorder RR = 0.17). Health-related quality of life was similar in PCS cases of both cohorts (mean SF-12Physical 40.3 vs. 41.0, mean SF-12Mental 38.9 vs. 40.7). PCS was less common following SARS-CoV-2 infection in the Omicron era compared to the early pandemic period. However, affected individuals continue to experience substantial, comparable impairment in hrQoL across both pandemic periods.},
}

Humans
*Quality of Life
*COVID-19/epidemiology/complications
Adult
Male
Middle Aged
Female
Aged
Adolescent
SARS-CoV-2/isolation & purification
Young Adult
Post-Acute COVID-19 Syndrome
Pandemics
Prevalence
Surveys and Questionnaires
Germany/epidemiology

@article {pmid42157207,
year = {2026},
author = {Dhir-Hewitt, E and Newlands, F and Shafran, R and Stephenson, T and Richards-Belle, A and Dalrymple, E and Chalder, T and Ford, T and Fox-Smith, L and Heyman, I and N Ladhani, S and G Semple, M and Segal, TY and Swann, O and Whittaker, E and , and Pinto Pereira, SM},
title = {Exploring post-Covid-19 condition in children and young people 3.5 years after infection: a mixed-methods analysis from the CLoCk study.},
journal = {BMC public health},
volume = {},
number = {},
pages = {},
doi = {10.1186/s12889-026-27520-z},
pmid = {42157207},
issn = {1471-2458},
support = {ES/T00200X/1//ESRC-BBSRC Soc-B Centre for Doctoral Training/ ; MR/Y009398/1//UK Medical Research Council Senior Non-clinical fellowship/ ; },
abstract = {BACKGROUND: Comprehensive data on the persistence of Post-COVID-19 Condition (PCC; also known as Long COVID) and its impact on children and young people (CYP), incorporating their own perspective, is crucial to enhance our understanding of the condition, improve service provision and inform clinical management.

METHODS: We examine long-term symptoms, health, and well-being among CYP persistently meeting PCC criteria up to 3.5-years after SARS-CoV-2 infection (when they were aged between 11-to-17-years), using a mixed-methods approach. 68 CYP from the CLoCk study who persistently met PCC criteria at 3- (April-June 2021), 6- (July-September 2021), 12- (January-March 2022), and 24-months (January-March 2023) post-infection were invited to complete an additional follow-up (October-November 2024). The survey assessed current symptoms and health status using validated measures, and symptom experiences through open-text responses. Quantitative data were analysed descriptively; qualitative data were analysed using thematic framework analysis. Findings were integrated using a convergent parallel design.

RESULTS: 50 CYP completed the survey; of these 42 (84%) responders continued to meet the PCC definition 3.5-years post-infection. All 42 (100%) reported tiredness and 34 (81%) reported 5 + symptoms 3.5-years post-infection. Qualitative analysis reinforced tiredness as a central symptom, alongside co-occurring symptoms that impact daily life. While quantitative and qualitative findings largely converged, context as to why CYP reported high levels of impact were only available from qualitative data.

CONCLUSIONS: CYP with PCC persisting for 3.5-years post-infection experience multiple symptoms of wide-ranging severity and disruption to daily life, education and social participation.},
}

@article {pmid42158498,
year = {2026},
author = {Kaleem, S and Sawano, M and Krumholz, HM},
title = {Ocular Symptoms in Long COVID: A Cross-Sectional Study [Response to Letter].},
journal = {Clinical ophthalmology (Auckland, N.Z.)},
volume = {20},
number = {},
pages = {620572},
pmid = {42158498},
issn = {1177-5467},
}

@article {pmid42119916,
year = {2026},
author = {Swanson, JM},
title = {Editorial: Fetal Exposure to Maternal Infection by SARS-CoV-2 and Effects on Child Neurodevelopment.},
journal = {Journal of the American Academy of Child and Adolescent Psychiatry},
volume = {},
number = {},
pages = {},
doi = {10.1016/j.jaac.2026.04.016},
pmid = {42119916},
issn = {1527-5418},
abstract = {The systematic review and meta-analysis by Rizzo et al.[1] should be of interest to child psychiatrists and pediatricians based on its historical and contemporary relevance (Table 1[2-9]). Historically, it addresses the 2019 COVID-19 pandemic-so far the most devastating health-related event of the 21[st] century-which may haunt us for decades because of post-acute sequelae of SARS-CoV-2 (PASC) or Long-COVID, which is now affecting millions of individuals. Contemporarily, it addresses an unresolved issue regarding neurodevelopment in children with a history of fetal exposure to SARS-CoV-2 during pregnancy (presumably uninfected, because vertical transmission is rare), as well as a contentious public debate regarding outcomes of children with fetal and childhood exposure to COVID-19 vaccinations. For this review, the authors applied both a narrow approach (by restricting the review to studies of neurodevelopment in children) and a broad approach (by including studies with "neurodevelopmental outcomes of the child at any age" and "any available measure of child development"). They did the following: (1) identified studies that met the exposure criteria (ie, maternal infection or vaccination) for the review ("70 studies" with 88 neurodevelopmental outcomes); (2) described basic characteristics and findings of all studies in an informative table ("which summarizes methodologies, key findings, and covariates adjustments"); (3) presented structured narrative syntheses for the studies classified into 7 outcome subdomains (with "… consistency [defined] as >70% of studies within a domain reporting effects in the same direction"): and (4) conducted meta-analyses for multiple studies with dichotomous outcomes (based on "…the number of individuals screening positive versus negative for specific auditory or developmental concerns"). As outlined in Table 1, the narrative syntheses suggested reassurances that fetal exposure did not disrupt neurodevelopment (because adverse effects of were not consistent across studies for any outcome domain), but the authors did not accept the null hypothesis (even though it was consistent with their own research). Instead, they conducted meta-analyses that suggested that there may be cause for concern (given that adverse effects were statistically significant for an initial neonatal auditory test and for some ratings of neurodevelopment).},
}

@article {pmid42149980,
year = {2026},
author = {Shoshina, II and Fernandes, TP and Santos, NA and Dahlgren, LN},
title = {Divergent Long-Term Recovery After Long COVID in Tobacco Use Disorder and Healthy Controls: A Longitudinal Study.},
journal = {Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco},
volume = {},
number = {},
pages = {},
doi = {10.1093/ntr/ntag112},
pmid = {42149980},
issn = {1469-994X},
abstract = {INTRODUCTION: Although tobacco use disorder (TUD) and long COVID (LC) have been associated to neuropsychiatric disturbances, it remains unclear how tobacco dependence affects the recovery of clinical, cognitive, and biological processes over time.

METHODS: This study compared individuals with tobacco use disorder and healthy controls using longitudinal assessments from pre-infection baseline through two post-COVID follow-ups over 12 months. Comprehensive assessments covered clinical, neuropsychiatric, and cognitive functioning, tobacco dependence and exposure, and peripheral biomarkers reflecting neuroendocrine regulation, inflammation, neuroplasticity-related processes, and nicotine metabolism relevant to post-COVID recovery.

RESULTS: Both groups exhibited marked clinical, cognitive, and biological alterations following LC; however, recovery trajectories diverged over time. Healthy controls showed clear improvement by 12 months, whereas individuals with TUD showed persistent impairment across clinical and cognitive functioning. Cognitive performance recovered in controls but remained reduced in the TUD group. Biological trajectories paralleled clinical recovery patterns. Dimensional analyses identified two latent components reflecting neuropsychiatric and inflammatory-neurobiological processes. Within the TUD group, two recovery-related phenotypes emerged: a persistently impaired subgroup and an adaptive subgroup showing partial recovery.

CONCLUSIONS: Tobacco use disorder is associated with impaired and incomplete clinical and biological recovery following long COVID, beyond smoking exposure alone. These findings emphasize the need for post-COVID care models that integrate tobacco dependence with recovery-related clinical and biological processes, supporting sustained recovery and cessation outcomes.},
}

@article {pmid42151044,
year = {2026},
author = {Pan, LC and Lin, YH and Liu, YH and Chiang, CY and Chen, JY and Lee, HS and Fang, YY},
title = {[Developing and Validating the Long COVID-19 Symptom Severity Index (LCSSI) for Patients With Chronic Obstructive Pulmonary Disease].},
journal = {Hu li za zhi The journal of nursing},
volume = {73},
number = {3},
pages = {},
doi = {10.6224/JN.26306},
pmid = {42151044},
issn = {0047-262X},
mesh = {Humans ; *Pulmonary Disease, Chronic Obstructive/physiopathology ; *COVID-19/complications ; Male ; *Severity of Illness Index ; Female ; Cross-Sectional Studies ; Middle Aged ; Aged ; },
abstract = {BACKGROUND: Existing tools for assessing Long COVID are primarily designed for the general population. Few instruments adequately capture the needs and vulnerabilities of high-risk groups such as patients with chronic obstructive pulmonary disease (COPD), who have structurally vulnerable lungs.

PURPOSE: This study was designed to develop and validate the Long COVID Symptom Severity Index (LCSSI), a concise and clinically sensitive instrument designed specifically for use on patients with respiratory diseases.

METHODS: The study was conducted in two phases. In Phase I, item generation was based on a literature review and expert panel discussion involving six pulmonologists. In Phase II, a cross-sectional validation study was conducted in the chest medicine wards and outpatient clinics of a medical center in southern Taiwan. The psychometric properties of the LCSSI were examined.

RESULTS: One hundred and twenty-eight patients with COPD (93% male) were enrolled, of whom 63.3% were classified under GOLD (global initiative for chronic obstructive lung disease) Group E. The most prevalent symptoms found were cough/sputum (100%), fatigue/weakness (90.6%), and dyspnea (88.3%). The LCSSI demonstrated excellent internal consistency (Cronbach's α = .88), and correlated positively with the COPD Assessment Test (p < .01) and negatively with the 15D Health-Related Quality of Life scale (p < .01). Mean LCSSI scores differed significantly across GOLD groups, with Group E showing higher mean total and core symptom scores (all p < .01), supporting construct validity.

Based on this sample, the results indicate the LCSSI has acceptable internal consistency and validity, supporting its use as a reference tool for symptom assessment in patients with COPD during the late recovery phase for Long COVID.},
}

Humans
*Pulmonary Disease, Chronic Obstructive/physiopathology
*COVID-19/complications
Male
*Severity of Illness Index
Female
Cross-Sectional Studies
Middle Aged
Aged

@article {pmid42152441,
year = {2026},
author = {Luo, S and Zheng, Z and Karimi, L and Plebanski, M and Anderson, KLM and Jovanovski, N and Lankatillake, C and Cockshaw, W and Wollersheim, D and Sheahan, J and Seal, EL and Butler-Henderson, K and Campbell, D and Clarke, A and Cleary, S and Danaher, J and El-Ansary, D and Figueiredo, B and Flanagan, KL and Hines, C and Jessup, RL and Mehmet, H and Miller, SM and Seeley, MC and Sivan, M and Smarrelli, F and Smith, AB and Vesty, G and Vindigni, D and Xenos, S and Stocco, L and Hartman, S and Ivory, I and Itsiopoulos, C},
title = {Impact of long COVID on diverse Australian populations: a multi-site, longitudinal prospective cohort study protocol.},
journal = {BMJ open},
volume = {16},
number = {5},
pages = {e114928},
doi = {10.1136/bmjopen-2025-114928},
pmid = {42152441},
issn = {2044-6055},
mesh = {Humans ; Australia/epidemiology ; *COVID-19/psychology/epidemiology/complications ; Longitudinal Studies ; Prospective Studies ; SARS-CoV-2 ; Adult ; Psychometrics ; Surveys and Questionnaires ; Research Design ; Post-Acute COVID-19 Syndrome ; Chronic Disease ; Female ; Multicenter Studies as Topic ; Male ; },
abstract = {BACKGROUND: Long COVID is a complex, multisystem chronic condition that may persist or fluctuate for months to years after SARS-CoV-2 infection. Despite emerging international research, significant gaps remain in understanding the full breadth of long COVID's impacts in Australia. No study has yet prospectively examined these multidimensional impacts using a culturally appropriate, user-validated toolkit. Our study aims to characterise symptom profiles, functional outcomes and psychological, social, financial and behavioural impacts of long COVID in Australian adults; identify factors associated with recovery trajectories; and validate a set of measures to support research and clinical care.

METHODS: This national, multi-site, longitudinal prospective cohort study comprises three phases: (1) survey selection and user-testing; (2) psychometric validation; and (3) a longitudinal cohort study. Survey selection was informed by literature review, Australian parliament inquiry reports and international recommendations, and refined through iterative user-testing and expert review. A total of 1000 participants aged ≥18 years from diverse cultural backgrounds with ongoing symptoms following COVID-19 infection will be divided into three cohorts based on time since infection. Surveys will be administered at seven time points over 24 months, with optional follow-up to 36 months. Data linkage to state and national health datasets will enable an objective assessment of healthcare utilisation and associated costs. Psychometric properties of the tools will be evaluated using baseline responses from the initial 300 participants, including assessments of structural/construct validity, convergent validity, known-groups validity, cross-validity, internal reliability, responsiveness and test-retest reliability. Other data analyses will include descriptive statistics, repeated-measures analysis of variance, linear mixed-effects modelling and multivariable regression models.

ETHICS AND DISSEMINATION: Ethics approval was obtained from The St Vincent's Hospital Melbourne Human Research Ethics Committee (HREC) (112108/2024/PID00364) and RMIT University HREC (28124). Research findings will be disseminated at conferences and in peer-reviewed publications.

TRIAL REGISTRATION NUMBER: Australian New Zealand Clinical Trials Registry (ACTRN12625001415493).},
}

Humans
Australia/epidemiology
*COVID-19/psychology/epidemiology/complications
Longitudinal Studies
Prospective Studies
SARS-CoV-2
Adult
Psychometrics
Surveys and Questionnaires
Research Design
Post-Acute COVID-19 Syndrome
Chronic Disease
Female
Multicenter Studies as Topic
Male

@article {pmid42152450,
year = {2026},
author = {Boutry, C and Phillips, J and Knight, C and Holmes, J and Patel, P and Morriss, R and das Nair, R and Douglas, E and Bolton, CE and Guo, B and Radford, K},
title = {Developing a job retention vocational rehabilitation intervention for people with long covid: a person-based approach.},
journal = {BMJ open},
volume = {16},
number = {5},
pages = {e109740},
doi = {10.1136/bmjopen-2025-109740},
pmid = {42152450},
issn = {2044-6055},
mesh = {Humans ; *COVID-19/rehabilitation/complications/psychology ; *Return to Work ; *Rehabilitation, Vocational/methods ; SARS-CoV-2 ; Male ; Female ; Middle Aged ; Adult ; Fatigue/rehabilitation ; Job Security ; },
abstract = {BACKGROUND: Long covid affects a significant proportion of people following SARS-CoV-2 infection and is associated with persistent symptoms such as fatigue, cognitive dysfunction and breathlessness which can negatively impact a person's ability to return to and remain in work. Although tiered vocational rehabilitation (VR) models have been proposed, these are often generic, lack empirical validation and may not address the complex, fluctuating needs of this population.

OBJECTIVES: To co-design a VR intervention (the COVID-19-VR intervention) to support return to work (RTW) for people with long covid (pwLC).

SETTING: Primary and secondary care.

DESIGN: Mixed-methods target population-centred, person-based approach in three stages: Stage 1: interviews (n=21) with pwLC to identify issues and challenges faced in working with long covid. Stage 2: three co-design workshops with pwLC and service providers to (a) generate guiding principles, (b) identify key intervention features to address work needs, (c) create a logic model to illustrate how the intervention could work and (d) develop a treatment plan and resources. Stage 3: feasibility and acceptability testing in six cases (three critical care admissions, three primary care referrals).

RESULTS: PwLC described work-related problems relating to: fluctuating symptoms (cognition, fatigue and breathlessness), employer, coworker and family's understanding of long covid and workplace adjustments. We developed a 6-session, 12-week individually tailored, remotely delivered intervention that included vocational goal setting, RTW planning, fatigue/symptom management, financial advice, and where permitted, education for family/employers, employer engagement and negotiation of a phased RTW. Following feasibility testing, changes included accommodating the long-term nature of long covid, addressing unmet psychological needs, and adding content on adjustment, processing traumatic experience and performance/symptom anxiety, with extended delivery including monitoring, review and case coordination.

CONCLUSIONS: PwLC may need specialist help to RTW. Our COVID-19-VR appears feasible and acceptable and warrants further evaluation using a staged approach, prior to any definitive effectiveness trial.},
}

Humans
*COVID-19/rehabilitation/complications/psychology
*Return to Work
*Rehabilitation, Vocational/methods
SARS-CoV-2
Male
Female
Middle Aged
Adult
Fatigue/rehabilitation
Job Security

@article {pmid42152584,
year = {2026},
author = {Hori, M and Hayama-Terada, M and Kitamura, A and Hosozawa, M and Muto, Y and Iba, A and Takayama, Y and Kimura, T and Iso, H},
title = {Prevalence and Risk Factors for Persistent Post-COVID-19 Condition at 3, 6, 12, and 18 Months After Initial Infection Among Adults Living in a Community of Japan: Yao COVID-19 Study.},
journal = {Journal of medical virology},
volume = {98},
number = {5},
pages = {e70973},
doi = {10.1002/jmv.70973},
pmid = {42152584},
issn = {1096-9071},
support = {JPMH21HA2011//MHLW Research on Emerging and Re-Emerging Infectious Diseases and Immunization/ ; JPMH23HA2011//MHLW Research on Emerging and Re-Emerging Infectious Diseases and Immunization/ ; JPMH24HA2015//MHLW Research on Emerging and Re-Emerging Infectious Diseases and Immunization/ ; JPMH25HA2005//MHLW Research on Emerging and Re-Emerging Infectious Diseases and Immunization/ ; },
mesh = {Humans ; Female ; Adult ; Middle Aged ; Male ; Japan/epidemiology ; *COVID-19/epidemiology/complications ; Risk Factors ; Prevalence ; Aged ; Prospective Studies ; Young Adult ; Adolescent ; SARS-CoV-2 ; Comorbidity ; },
abstract = {The risk factors for long-term persistent post-coronavirus disease (COVID-19) condition (PCC) years after infection remain unclear. In this study, we investigated the prevalence of PCC and the associated risk factors after severe acute respiratory syndrome coronavirus 2 infection in the general population. This prospective cohort study included individuals aged 18-79 years diagnosed with COVID-19 between March 2021 and April 2022 and matched non-infected individuals living in Yao City, Japan. Baseline and follow-up surveys were conducted in 2022 and 2024, respectively. PCC was defined as symptoms persisting for ≥2 months at 3 months post-infection. Among 7404 eligible individuals, 3628 (2314 infected, mean age: 44.2 years, 62.7% females; 1314 non-infected, mean age: 45.0 years, 63.2% females) participated in the follow-up survey. PCC prevalence at 3, 6, 12, and 18 months was 14.3%, 12.0%, 6.3%, and 5.4%, respectively. Older age, being overweight, comorbidities, severe disease in the acute phase, and low household income were associated with persistent PCC at ≥ 18 months. Compared with no vaccination, ≥ 2 doses of the COVID-19 vaccine prior to infection were associated with a lower PCC risk. These findings highlight PCC as an important public health concern in the post-COVID-19 era. Trial Registration: UMIN000049807.},
}

Humans
Female
Adult
Middle Aged
Male
Japan/epidemiology
*COVID-19/epidemiology/complications
Risk Factors
Prevalence
Aged
Prospective Studies
Young Adult
Adolescent
SARS-CoV-2
Comorbidity

@article {pmid42152966,
year = {2026},
author = {Farooqui, I and Kumar, M},
title = {Prevalence and Severity of Depression, Anxiety, and Stress Among COVID-19 Survivors in Urban Hazaribagh, Jharkhand: A Community-Based Cross-Sectional Study.},
journal = {Cureus},
volume = {18},
number = {5},
pages = {e109015},
pmid = {42152966},
issn = {2168-8184},
abstract = {BACKGROUND: Mental health sequelae following COVID-19 recovery are well-documented in large urban centers, yet community-based data from semi-urban India, particularly Jharkhand, remain scarce.

OBJECTIVE: To assess the prevalence and severity of depression, anxiety, and stress among COVID-19 survivors in urban Hazaribagh using the Depression Anxiety Stress Scale-21 (DASS-21) and to identify associated sociodemographic and clinical factors.

MATERIALS AND METHODS: A community-based cross-sectional study was conducted from March 2022 to June 2022, following approval from the Institutional Ethics Committee (IEC), RIMS, Ranchi, obtained prior to data collection. Using systematic random sampling from Integrated Disease Surveillance Programme (IDSP) COVID-19 registers, every seventh from 1,065 first-wave cases and every 17th from 7,686 second-wave cases, 601 consenting recovered adults were enrolled from 640 contacted (response rate: 93.9%). The DASS-21 was administered in its validated Hindi version alongside a semi-structured questionnaire. Data were analyzed in JASP using chi-square and Fisher's exact tests; a value of p<0.05 was considered significant.

RESULTS: Depression was the most prevalent domain: 337 (56.07%) scored above normal, with 154 (25.62%) moderate, 80 (13.31%) severe, and 44 (7.32%) extremely severe. Anxiety was present at any grade in 260 (43.26%), predominantly mild (211 [35.11%]); stress was elevated in 200 (33.28%). The wave of infection was significantly associated with all three domains (all p≤0.030). Hospitalization was strongly associated with anxiety and stress (both p<0.001). Age was significantly associated with anxiety (p<0.001) and stress (p=0.015); occupation with depression (p=0.045); and smoking with stress (p=0.014). Gender was not significantly associated with any domain.

CONCLUSION: COVID-19 survivors in urban Hazaribagh carry a substantial post-recovery psychological burden. Depression at moderate-to-extremely-severe intensity is the most predominant manifestation. Integrating routine DASS-21 screening into community-level post-COVID follow-up care, with priority for high-risk groups, is recommended.},
}

@article {pmid42141891,
year = {2026},
author = {Schmetz, A and Knaul, J and Müller, S and Wilke, T and Yang, J and Spinner, C and Lehmann, C},
title = {Clinical and economic benefits of seasonal COVID-19 vaccination in Germany: results from the ROUTINE-COV19 Study, September 2022 to March 2024.},
journal = {Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin},
volume = {31},
number = {15},
pages = {},
pmid = {42141891},
issn = {1560-7917},
mesh = {Humans ; Germany/epidemiology ; *COVID-19/prevention & control/epidemiology/economics ; Male ; Female ; Middle Aged ; SARS-CoV-2/immunology ; Retrospective Studies ; Adult ; *COVID-19 Vaccines/economics/administration & dosage ; *Health Care Costs/statistics & numerical data ; Seasons ; *Vaccination/economics/statistics & numerical data ; Hospitalization/statistics & numerical data/economics ; Aged ; Sick Leave/economics/statistics & numerical data ; Young Adult ; Adolescent ; },
abstract = {BACKGROUNDVaccinations against COVID-19 were integrated into routine care in Germany in April 2023. However, evidence of the impact of seasonal vaccination remains limited.AIMTo assess the clinical and economic impact of COVID-19 vaccination in routine care during the early SARS-CoV-2-endemic phase in Germany.METHODSA retrospective cohort study using statutory health insurance data from two German federal states (Saxony and Thuringia), covering over 3 million individuals, was conducted. Adults aged ≥ 18 years vaccinated against COVID-19 between 1 September and 30 November 2023 were matched 1:1 with unvaccinated individuals using propensity scores. Outcomes during the 4-month follow-up included occurrence of SARS-CoV-2 infection, long COVID, other respiratory infections, hospitalisations, mortality, healthcare costs and indirect costs caused by sick leave. Rate and hazard ratios (RR, HR) with 95% confidence intervals (CI) were calculated. Sensitivity analyses tested robustness.RESULTSA total of 146,132 individuals (73,066 per group) were matched. COVID-19 vaccination was associated with reduced rates of long COVID (RR: 0.43; 95% CI: 0.26-0.70), respiratory infections (RR: 0.91; 95% CI: 0.87-0.95) and COVID-19-related hospitalisations (RR: 0.41; 95% CI: 0.31-0.54). All-cause mortality was 25% lower among COVID-19-vaccinated individuals (HR: 0.76; 95% CI: 0.70-0.82). Healthcare costs were lower in the vaccinated cohort, particularly for inpatient care, e.g. EUR 1 million savings in COVID-19-related hospitalisations. Indirect costs caused by sick leave were also reduced by EUR 1.3 million.CONCLUSIONSeasonal COVID-19 vaccinations in routine care settings were associated with substantial clinical and economic benefits. These real-world findings support continued implementation of national immunisation recommendations during the endemic phase of SARS-CoV-2 circulation.},
}

Humans
Germany/epidemiology
*COVID-19/prevention & control/epidemiology/economics
Male
Female
Middle Aged
SARS-CoV-2/immunology
Retrospective Studies
Adult
*COVID-19 Vaccines/economics/administration & dosage
*Health Care Costs/statistics & numerical data
Seasons
*Vaccination/economics/statistics & numerical data
Hospitalization/statistics & numerical data/economics
Aged
Sick Leave/economics/statistics & numerical data
Young Adult
Adolescent

@article {pmid42142447,
year = {2026},
author = {Chen, W and Ye, K and Chen, Z},
title = {Comment on "Association of symptoms of neuropsychological long COVID with imaging and plasma biomarkers".},
journal = {Journal of the neurological sciences},
volume = {487},
number = {},
pages = {126002},
doi = {10.1016/j.jns.2026.126002},
pmid = {42142447},
issn = {1878-5883},
}

@article {pmid42144858,
year = {2026},
author = {St-Jean, D and Haynes, S and Ficara, V and Streib, A and Ouédraogo, F and Spiridigliozzi, AM and Minichiello, R and Ehrmann Feldman, D and Mazer, B},
title = {Experiences of People With Long COVID Accessing Rehabilitation Services: A Qualitative Study.},
journal = {Occupational therapy international},
volume = {2026},
number = {1},
pages = {e4676712},
pmid = {42144858},
issn = {1557-0703},
support = {//Foundation Cité de la Santé/ ; //Jewish Rehabilitation Hospital Foundation/ ; },
mesh = {Humans ; Male ; *COVID-19/rehabilitation/psychology ; Female ; Qualitative Research ; *Health Services Accessibility ; Middle Aged ; Adult ; Aged ; SARS-CoV-2 ; *Occupational Therapy ; Social Support ; Interviews as Topic ; },
abstract = {PURPOSE: Long COVID is associated with a range of physical, cognitive, and/or psychological symptoms that significantly affect daily functioning. These individuals require rehabilitation services to address their limitations. This study explored the experiences of people with long COVID regarding access to and receipt of rehabilitation services.

METHODS: This qualitative study recruited 12 individuals with long COVID from a population-based survey among the population of Laval (Quebec). Semistructured telephone interviews were conducted, recorded, transcribed verbatim, and analyzed using inductive thematic content analysis. Relevant elements were extracted, coded, and organized into themes/subthemes.

RESULTS: Twelve participants (seven females; five males) participated in the study. We identified three main themes, each with subthemes: (1) impact of long COVID on personal and professional life (e.g., professional life, leisure activities, and social life); (2) rehabilitation services (access barriers, perceptions of services received); and (3) psychosocial support (lack or presence of support). Access to rehabilitation services was hampered by several barriers: difficulties obtaining referrals, financial constraints, lack of awareness among health professionals, and service shortages. Participants who accessed rehabilitation services reported satisfaction with care they received and appreciated the multidisciplinary approach.

CONCLUSIONS: Improving access to rehabilitation services for people with long COVID is essential to support their recovery, as timely and coordinated rehabilitation can facilitate reintegration into daily activities and reduce functional limitations. Strategies to enhance access include increasing health professional awareness, reducing financial and logistical barriers, and expanding service availability.},
}

Humans
Male
*COVID-19/rehabilitation/psychology
Female
Qualitative Research
*Health Services Accessibility
Middle Aged
Adult
Aged
SARS-CoV-2
*Occupational Therapy
Social Support
Interviews as Topic

@article {pmid42148138,
year = {2026},
author = {Dai, R and Hua, Q and Liu, X and Ma, L and Bao, R and Lei, H and Yu, P and Liao, Y and Yang, J and Han, S and Jiang, J and Zhang, H},
title = {Safety, immunogenicity, and long COVID outcomes following inactivated COVID-19 vaccine boosters in elderly Chinese: a prospective cohort study.},
journal = {Frontiers in immunology},
volume = {17},
number = {},
pages = {1813716},
pmid = {42148138},
issn = {1664-3224},
mesh = {Humans ; Aged ; Male ; Female ; *COVID-19/prevention & control/immunology/epidemiology ; *COVID-19 Vaccines/immunology/adverse effects/administration & dosage ; Middle Aged ; Antibodies, Viral/blood/immunology ; *SARS-CoV-2/immunology ; Antibodies, Neutralizing/blood/immunology ; Aged, 80 and over ; Prospective Studies ; China/epidemiology ; Vaccines, Inactivated/immunology/adverse effects/administration & dosage ; *Immunogenicity, Vaccine ; *Immunization, Secondary ; Immunoglobulin G/blood/immunology ; East Asian People ; },
abstract = {BACKGROUND: Adults aged ≥60 years face elevated risks of severe COVID-19 and long COVID. Although inactivated SARS-CoV-2 vaccines are safe and effective, critical gaps remain regarding optimal booster timing, durability of immune responses, and protection against emerging variants in this vulnerable population.

METHODS: In this prospective cohort study in Zhejiang Province, China, 450 adults aged ≥60 years were randomized to receive an inactivated SARS-Cov-2 vaccine (CoronaVac or Covilo) under three dosing schedules. Neutralizing antibody titers, SARS-CoV-2-specific IgG, and variant-specific neutralization were evaluated using serum samples collected at multiple timepoints. Safety outcomes included local and systemic adverse reactions and long COVID symptoms.

RESULTS: Participants (age: 60-80 years; 50.9% male) with balanced baseline demographics were stratified into six subgroups by vaccine type and schedule (S1/S2/S3; n=75 each; all P>0.05). Adverse reaction incidence was low (0.0%-8.0%), with CoronaVac-S3 recipients experiencing significantly more local reactions than Covilo-S3 recipients (8.0% vs. 0.0%; P = 0.0124). Immunogenicity varied markedly at 1 month post vaccination, with the highest geometric mean titers (GMTs) of neutralizing antibodies in both S3 groups (Covilo: 57.2; CoronaVac: 59.4; P<0.001 vs. respective S1/S2 groups), and CoronaVac-S1 inducing higher GMTs than Covilo-S1 (21.8 vs. 15.4; P = 0.009). At 12 months post vaccination, GMTs remained highest in Covilo-S3 (9.9), while CoronaVac-S2 exceeded Covilo-S2 (8.0 vs. 5.1; P = 0.021). Covilo-S2 and -S3 were superior to their CoronaVac counterparts in inhibition against the wild-type strain and Delta variant at 1 month post vaccination (all P<0.05). Multivariate analysis identified male sex as a protective factor against COVID-19 symptoms, long COVID, and fatigue (odds ratios <0.5 and P<0.05 for all).

CONCLUSIONS: A third booster of inactivated SARS-CoV-2 vaccine administered within 2-6 months of the second dose is safe and significantly boosts humoral immunity in adults ≥60 years. The three-dose Covilo regimen and a 6-month dosing interval optimized immunogenicity and were associated with the lowest risks of COVID-19 symptoms and long COVID, highlighting the importance of vaccine-specific and interval-adjusted booster strategies for older populations.},
}

Humans
Aged
Male
Female
*COVID-19/prevention & control/immunology/epidemiology
*COVID-19 Vaccines/immunology/adverse effects/administration & dosage
Middle Aged
Antibodies, Viral/blood/immunology
*SARS-CoV-2/immunology
Antibodies, Neutralizing/blood/immunology
Aged, 80 and over
Prospective Studies
China/epidemiology
Vaccines, Inactivated/immunology/adverse effects/administration & dosage
*Immunogenicity, Vaccine
*Immunization, Secondary
Immunoglobulin G/blood/immunology
East Asian People

@article {pmid42148664,
year = {2026},
author = {Arnaboldi, PM and Becker, J and Nath, A and Coyle, PK and Handel, A and Sellati, TJ and Gomes-Solecki, M and Garcet, S and Henderson, MK and Mullins, P and Cowan, E and McCombie, WR and Wellins, AM and Allegretta, M and Bergquist, J and Schutzer, SE},
title = {Designing studies for post-treatment Lyme disease and other infection-associated chronic illnesses.},
journal = {Brain : a journal of neurology},
volume = {},
number = {},
pages = {},
doi = {10.1093/brain/awag016},
pmid = {42148664},
issn = {1460-2156},
support = {//Banbury Center of Cold Spring Harbor Laboratory/ ; },
abstract = {Infection-associated chronic illnesses (IACIs) encompass a spectrum of poorly understood syndromes often marked by significant neurologic and multisystem symptoms following an infectious event. This review focuses on several diseases representative of the IACI spectrum. These are post-treatment Lyme disease syndrome (PTLDS), long COVID, myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and multiple sclerosis (MS). Their clinical and biological complexity, combined with a lack of clear diagnostic criteria and objective available laboratory biomarkers, makes them difficult to distinguish from conditions with overlapping features. This presents challenges for research studies, as well as diagnosis and clinical management. This diagnostic ambiguity, coupled with heterogeneous patient presentations, has led to challenges in research, including misclassification of study participants and inconsistent or irreproducible findings. Some PTLDS research exemplifies these issues, which also extend to other IACIs. To advance the field, we highlight key methodological refinements and approaches for studying IACIs, including rigorous participant selection, standardized sample collection protocols, and the use of appropriate control groups, including those with microbiologic proof of the initial infection when known and technologically feasible. We also address broader influences on research quality, such as stigma, historical neglect, and the urgency to find treatments, which have contributed to the proliferation of poorly controlled studies and questionable practices. Drawing lessons from past challenges, we propose a path forward grounded in fit-for-purpose methodological rigour to improve scientific understanding and support evidence-based therapeutic development for IACIs.},
}

@article {pmid42149360,
year = {2026},
author = {Mertens, A and Smith, J and Bergs, I and Fischer, J and Jansen, S and Breitschwerdt, S and Pracht, E and Killer, A and Schipper, L and Kuklik, N and Frank, M and Schwichtenberg, J and Bührmann, S and Zeissler, L and Dreher, M and Rockstroh, J and Rohn, H and Lehmann, C and Tepasse, PR and Schmidt, B and Dragano, N and Bode, J and Luedde, T and Jensen, BE and , },
title = {Characterization of post-COVID syndrome by self-perceived symptom severity stratified by infection wave: beyond COVID, a prospective, multicenter cohort study in Germany.},
journal = {Infection},
volume = {},
number = {},
pages = {},
pmid = {42149360},
issn = {1439-0973},
abstract = {BACKGROUND: Post-COVID syndrome (PCS) refers to persistent or new-onset symptoms 3 months after SARS-CoV-2 infection lasting for at least 2 months. The characterization of PCS varies across studies, with a substantial heterogeneity regarding different study samples, survey instruments, and follow-up periods. This is particularly the case in hospitalized patients vs. outpatients, as well as regarding different variants of concern (VOCs) and their impact on the frequency and severity of specific symptoms.

METHODS: The study population of Beyond COVID was recruited in six German cities by inviting (1) individuals registered as SARS-CoV-2 PCR positive at the local Public Health Authorities and (2) previously hospitalized patients with infection date after 1st March 2021. Participants were allocated to the predominant VOC of their first infection. Questionnaires to assess pre-existing conditions, symptoms during infection, and persisting symptomswere performed. Follow-up at sixth-month intervals is planned for 3 years. The study is ongoing. This publication describes the parameters at the baseline visit (BV).

RESULTS: We included 1257 participants (13% hospitalized-based; 87% population-based). Most participants had BA.2 (n = 436; 35%), followed by Delta (n = 336; 27%), BA.1 (n = 238; 19%), and Alpha (n = 218; 17%). The mean age was 47.1 years, and 59% of the participants were female. 72% reported at least one persisting symptom. Fatigue was the most frequent ongoing symptom (33%), followed by concentration disorders (25%) and dyspnoea (22%). Female sex, lower education, and a shorter period between infection and BV were associated with higher rates of persisting symptoms and symptom severity. Among all VOCs, participants with BA.1 and BA.2 had the lowest rates of persisting symptoms and symptom severity.

CONCLUSION: Analysis of baseline data from the Beyond-COVID cohort confirms a high percentage of persistent symptoms. Omicron variants had lower rates of persistent symptoms and symptom severity. We are confident, that long-term follow-up and the additional results from our clinical examinations, blood samples, sociodemographic and psychosocial data will further contribute to the characterization of PCS.},
}

@article {pmid42141452,
year = {2026},
author = {Gao, Y and Zhu, Q and Xu, M},
title = {Chronic fatigue syndrome in nursing practice: a concept analysis.},
journal = {BMC nursing},
volume = {},
number = {},
pages = {},
doi = {10.1186/s12912-026-04749-y},
pmid = {42141452},
issn = {1472-6955},
abstract = {BACKGROUND: Nurses are essential in chronic fatigue syndrome (CFS) management, serving as care coordinators and patient advocates, but currently lack a unified guiding framework. CFS affects about 0.89% of the global population based on CDC-1994 criteria, with higher prevalence in women. Since its initial definition in 1988, over 25 diagnostic criteria have been introduced, leading to ongoing confusion about core symptoms and diagnosis. This inconsistency poses significant challenges for nurses, including difficulties in patient identification, inconsistent assessment approaches, and lack of standardized care pathways. A clear theoretical model is needed to improve nursing assessments, intervention planning, and care standardization.

METHODS: A concept analysis was conducted using the Walker and Avant's eight-step method. Eight databases were systematically searched for literature from January 1988 to December 2025. Studies on CFS definitions, diagnostic criteria, or conceptual frameworks were included if they addressed key attributes, antecedents, consequences, or measurement methods. Two graduate students and professors independently performed two-stage screening and data extraction. Multiple discussion rounds ensured analytical rigor.

RESULTS: Sixty-eight studies were included. CFS antecedents included infections, immune dysregulation, genetics, and stress. Five core attributes were identified as defining features of CFS in the reviewed literature: persistent severe fatigue, post-exertional malaise (PEM), non-restorative sleep, cognitive impairment and/or orthostatic intolerance, and multisystem involvement. Consequences involved disability, poor quality of life, psychological distress, social isolation, and economic burden. Empirical referents included diagnostic criteria, symptom scales, and functional measures.

CONCLUSIONS: This study proposed a nursing-oriented conceptual framework for CFS based on the reviewed literature, identifying five core features that may help distinguish it from general fatigue. The framework suggests plausible directions for nursing practice, including prioritizing PEM assessments, promoting energy management and pacing as potential interventions, and considering nurses as care coordinators in multidisciplinary teams. It may also contribute to CFS-focused nursing education and the development of assessment instruments. Given shared pathophysiological features reported in the literature, the framework may offer a conceptual basis for application to post-infectious fatigue conditions such as long COVID, though this transferability requires empirical validation in specific populations and clinical contexts.},
}

@article {pmid42141069,
year = {2026},
author = {Ali, YH and Abbas, U and Khalid, MU and Ahmed, I and Hussain, N and Baloch, I and Mahboob, H and Zafar, AA and Musawwir, UA},
title = {Integrated immune, apoptotic and mitochondrial gene dysregulation in Long COVID and their association with symptom burden at 10 months post-infection.},
journal = {Scientific reports},
volume = {},
number = {},
pages = {},
doi = {10.1038/s41598-026-53455-x},
pmid = {42141069},
issn = {2045-2322},
abstract = {Long COVID is characterized by persistent symptoms following acute SARS-CoV-2 infection, yet its biological mechanisms remain incompletely understood. Emerging evidence suggests that immune dysregulation, mitochondrial dysfunction, and altered cell survival pathways may contribute to prolonged symptomatology. In this cross-sectional study, peripheral blood mononuclear cells were collected from individuals with Long COVID approximately 10 months post-infection and from recovered individuals without Long COVID symptoms. Symptom burden was assessed using a composite domain-based score. mRNA expression of immune and antiviral genes (IL-6, IL-1β, IL-10, SOCS3, HIF-1α, OAS1, MAVS, IFN-α, IFN-γ), anti-apoptotic markers (MCL1, BCL-2, XIAP, LIVIN), cell cycle kinases (CDK4, CDK6), mitochondrial biogenesis and dynamics markers (NRF1, TFAM, PGC-1α, DRP1, MFN1/2, OPA1), and mitophagy regulators (PARKIN, PINK1) were quantified using quantitative real-time PCR. Data was analyzed by SPSS and GraphPad Prism. Individuals with Long COVID demonstrated significantly higher expressions of IL-6, IL-1β, IL-10, SOCS3, HIF-1α, OAS1, MAVS, NRF1, DRP1, PARKIN, MCL1, and LIVIN compared with recovered controls after using the Benjamini-Hochberg False Discovery Rate (FDR) method. Several transcriptional markers, particularly HIF-1α, IL-1β, IL-10, and NRF1, remained independently associated with symptom burden after adjustment for age and sex. Correlation analysis demonstrated coordinated transcriptional co-expression patterns across immune, antiviral, mitochondrial, and apoptosis-related genes. Long COVID at 10 months post-infection is associated with coordinated transcriptional alterations across multiple biological pathways. The association of these changes with symptom burden suggests a potential link between persistent immunometabolic activation and clinical manifestations. These findings are exploratory and highlight the need for longitudinal and functional studies to further elucidate underlying mechanisms.},
}

@article {pmid42134898,
year = {2026},
author = {eBioMedicine, },
title = {Towards biology-informed therapies for long COVID.},
journal = {EBioMedicine},
volume = {127},
number = {},
pages = {106302},
doi = {10.1016/j.ebiom.2026.106302},
pmid = {42134898},
issn = {2352-3964},
}

@article {pmid42135534,
year = {2026},
author = {Rosa, GD and Raffo, M and Tammaro, S and Morelli, M and Arcaniolo, D and Pandolfo, SD and Sciorio, C and Romano, L and Manfredi, C and Cindolo, L and De Sio, M and Spirito, L},
title = {The impact of COVID-19 on sexual behavior, male sexual function, and reproductive health: an interdisciplinary narrative review from a urological perspective.},
journal = {International urology and nephrology},
volume = {},
number = {},
pages = {},
pmid = {42135534},
issn = {1573-2584},
abstract = {The COVID-19 pandemic profoundly modified daily life and interpersonal relationships, with relevant consequences on sexual health, which integrates biological, psychological, and social components. This narrative review summarizes current evidence regarding the impact of the pandemic on sexual behavior, sexual function, and male reproductive health. A comprehensive literature search of recent studies and clinical reports was performed focusing on psychosexual wellbeing, erectile function, fertility, and healthcare access during and after infection or lockdown periods. Current evidence indicates that lockdown-related stress, anxiety, and depression were consistently associated with reduced sexual desire and frequency of sexual activity, as reported in predominantly cross-sectional, questionnaire-based studies conducted during lockdown periods, particularly among couples with children and non-cohabiting partners, whereas alternative sexual practices increased. Sexual activity generally recovered after restrictions were lifted. Emerging data suggest a possible association between COVID-19 and erectile dysfunction mediated by endothelial damage, hypogonadism, and psychological distress, while long-COVID symptoms may further worsen sexual function. Male fertility alterations related to inflammatory and oxidative stress pathways have also been reported. Overall, the pandemic primarily affected sexuality through psychosocial mechanisms, although potential organic effects of SARS-CoV-2 infection on erectile function and fertility cannot be excluded. This review provides an interdisciplinary synthesis of current evidence with a specific focus on clinically relevant urological implications, including erectile dysfunction and male reproductive health, which remain incompletely addressed in the existing literature.},
}

@article {pmid42136400,
year = {2026},
author = {Jin, X and Wei, F and Kandala, SS and Lopez, G and Laubichler, MD and Bils, T and Li, R and Gorantla, R},
title = {The impact of culturally tailored video interventions for Long COVID among Hispanic/Latino populations.},
journal = {Journal of global health},
volume = {16},
number = {},
pages = {04162},
doi = {10.7189/jogh.16.04162},
pmid = {42136400},
issn = {2047-2986},
mesh = {Humans ; Female ; *Hispanic or Latino ; Male ; *COVID-19/ethnology/prevention & control ; Adult ; Middle Aged ; *Health Education/methods ; Arizona/epidemiology ; *Health Knowledge, Attitudes, Practice/ethnology ; Young Adult ; SARS-CoV-2 ; *Video Recording ; Adolescent ; White ; },
abstract = {BACKGROUND: Long COVID has disproportionately affected Hispanic/Latino communities, particularly in Arizona. Structural inequities contribute to disparities, but limited culturally tailored health information remains an underexplored barrier to effective communication. This study evaluated the impact of culturally designed Long COVID educational videos for Hispanic/Latino audiences.

METHODS: We developed animated videos incorporating cultural symbols and diversity cues. Participants completed pre- and post-intervention surveys assessing Long COVID knowledge. Pre-post regression analyses examined knowledge gains, subgroup differences (education, gender, lived experience), and the influence of cultural design elements.

RESULTS: Baseline knowledge was higher among participants with greater educational attainment; however, post-intervention knowledge levels were similar across education groups. Female participants demonstrated lower scores than males, diverging from typical health information-seeking trends. Participants with lived experience of Long COVID reported higher baseline knowledge. Cultural design features, including symbolism and perceived diversity, showed modest effects, particularly among younger viewers. Overall, knowledge increased significantly following video exposure across all subgroups.

CONCLUSIONS: Culturally tailored Long COVID videos effectively enhanced knowledge among Hispanic/Latino audiences, mitigating educational disparities and engaging individuals with diverse experiences. While cultural design elements had limited influence, they may enhance relevance for specific subgroups. These findings support the potential of culturally responsive video interventions to improve health education access in underserved communities and highlight areas for refinement in future multimedia health communication strategies.},
}

Humans
Female
*Hispanic or Latino
Male
*COVID-19/ethnology/prevention & control
Adult
Middle Aged
*Health Education/methods
Arizona/epidemiology
*Health Knowledge, Attitudes, Practice/ethnology
Young Adult
SARS-CoV-2
*Video Recording
Adolescent
White

@article {pmid42136829,
year = {2026},
author = {Luo, T and Luo, Y and Liu, D and Jin, H and An, Y and Huang, J and Luo, K and Guo, Y and Wang, D and Huang, L and Wu, X},
title = {Acupuncture for cognitive functions in post-COVID-19 condition: study protocol of a three-armed, randomized controlled trial with multimodal MRI.},
journal = {Frontiers in medicine},
volume = {13},
number = {},
pages = {1796351},
pmid = {42136829},
issn = {2296-858X},
abstract = {BACKGROUND: Post-COVID-19 condition (PCC), commonly called long COVID, is a prevalent sequela of SARS-CoV-2 infection and can affect multiple organ systems. Cognitive dysfunction is one of the most common symptoms in PCC, with a prevalence of 22%. It can persist for years and significantly reduce patients' quality of life. The brain network is the neural basis underlying human cognitive processes. Diffusion tensor imaging (DTI) and functional magnetic resonance imaging (fMRI) studies have revealed that cognitive impairments across attention, memory, executive function, and language are associated with alterations in network characteristics for PCC. Currently, there is no accepted therapy for cognitive impairment in PCC. Acupuncture has the potential to improve cognitive deficits in PCC. This trial aims to investigate the effect of acupuncture on cognitive functions in patients with PCC, and to explore the underlying mechanism of its effects on cognition in this condition using DTI and fMRI.

METHODS: In this three-armed, randomized controlled trial, 117 PCC patients with cognitive symptoms will be randomly assigned in a 1:1:1 ratio to verum acupuncture (VA), sham acupuncture (SA), or a waitlist control group. Participants in the VA and SA groups will receive three sessions of treatment per week for 8 weeks. The primary outcome measures are the changes in Addenbrooke's Cognitive Examination-III (ACE-III) total score and phonemic fluency test score at week 8. The secondary outcome measures include the Digit Span Test (DST), Symbol Digit Modality Test (SDMT), Trail Making Test (TMT), Rey's Auditory Verbal Learning Test (RAVLT), Rey-Osterrieth Complex Figure Test (RCFT), Stroop Color Word Test (SCWT), category fluency test, action fluency test, and Boston Naming Test (BNT-30), as well as global and regional topological measures of structural and functional brain networks constructed from DTI and fMRI data. Additionally, the Fatigue Severity Scale (FSS), the Generalized Anxiety Disorder-7 (GAD-7), the 24-item Hamilton Depression Scale (HAMD-24), and the MOS 36-item Short Form Health Survey (SF-36) will also be measured.

DISCUSSION: The results of this study will reveal the effect of acupuncture treatment on cognitive functions for PCC and provide insights into the mechanisms by which acupuncture may improve cognition in PCC.

CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov (www.clinicaltrials.gov), identifier: NCT07355751.},
}

@article {pmid42137753,
year = {2026},
author = {Liu, A and Hodkiewicz, VA and Benson, M and Patel, M and Roach, P},
title = {Patient with Acute-On-Chronic Cholecystitis Complicated by Portal Vein Thrombosis Following "Long COVID-19": A Case Report.},
journal = {The International journal of angiology : official publication of the International College of Angiology, Inc},
volume = {35},
number = {2},
pages = {156-160},
pmid = {42137753},
issn = {1061-1711},
abstract = {Portal vein thrombosis (PVT) is a rare but serious complication of hypercoagulable states or conditions that increase portal pressure, such as liver cirrhosis, inherited or acquired coagulation cascade abnormalities, myeloproliferative disorders, malignancy, inflammation, or infection. COVID-19 has been associated with a prothrombotic state, leading to both arterial and venous thromboses. Here, we present a patient with minimal hypercoagulable risk factors who presented with PVT and acute-on-chronic cholecystitis with bacteremia, likely provoked by residual hypercoagulability from a "long COVID-19" syndrome. An 81-year-old male developed PVT as a complication of acute-on-chronic cholecystitis, with contributing factors potentially including hypercoagulability related to prior COVID-19 infection more than 4 months prior. PVT should remain a diagnostic consideration in patients with various hypercoagulable risk factors, including long COVID-19, who present with relevant clinical findings. There should be a low threshold for the pursuit of further diagnostic imaging, given the serious consequences of delayed diagnosis.},
}

@article {pmid42138268,
year = {2026},
author = {Camps-Massa, P and Pérez-Mormeneu, J and Guevara-Nuñez, D and Saiz-Escobedo, L and Calatayud, L and González-Díaz, A and Sanllorente, A and Vicens-Zygmunt, V and Santos, S and Morros, R and Salvador-González, B and Domínguez, MÁ and Martí, S and , },
title = {Gut microbiome shift in long COVID: impact of disease and montelukast treatment.},
journal = {Journal of global health},
volume = {16},
number = {},
pages = {04164},
doi = {10.7189/jogh.16.04164},
pmid = {42138268},
issn = {2047-2986},
mesh = {Humans ; *Cyclopropanes/therapeutic use ; *Sulfides/therapeutic use ; *Quinolines/therapeutic use ; *Gastrointestinal Microbiome/drug effects ; *Acetates/therapeutic use ; *COVID-19/microbiology/complications ; Male ; Female ; Cross-Sectional Studies ; Middle Aged ; SARS-CoV-2 ; Feces/microbiology ; Adult ; Aged ; Longitudinal Studies ; *COVID-19 Drug Treatment ; },
abstract = {BACKGROUND: Long COVID-19 is a post-infectious syndrome with persistent symptoms that can involve multiple organ systems. Evidence suggests that SARS-CoV-2 infection may disrupt gut microbiome composition, potentially contributing to long-term effects. As treatment remains symptom-based, interest has grown in repurposing drugs like montelukast. However, non-antibiotic medications may also alter gut microbial communities, raising questions about their impact. Here, we compare gut microbiota between long COVID patients and healthy controls and examine how montelukast treatment affects microbial composition.

METHODS: We analysed stool samples from long COVID patients and healthy controls using 16S rRNA gene sequencing (Illumina MiSeq). We evaluate alpha (Shannon) and beta (Bray-Curtis) diversity, followed by relative abundance and linear discriminant effect size analysis, to identify differentially abundant taxa. This proof-of-concept study included a cross-sectional comparison and a longitudinal analysis of montelukast-treated patients vs. placebo.

RESULTS: Cross-sectional analysis revealed a significant structural reorganisation of the gut microbial community in long COVID patients, although overall species richness was largely maintained. Linear discriminant effect size analysis revealed that this architectural shift was driven by an enrichment of Firmicutes (Agathobacter and Faecalibacterium genera) in the long COVID group, while healthy controls were characterised by higher abundances of the phyla Verrucomicrobiota and Actinobacteriota, as well as genera Alistipes and Akkermansia. Longitudinal analysis demonstrated that the broader community structure remained stable in both groups; however, montelukast treatment led to a specific enrichment of the genus Dialister, suggesting targeted and potentially transient effects without disrupting the overall microbial landscape.

CONCLUSIONS: Long COVID is characterised by a significant restructure of the gut ecosystem. This qualitative dysbiosis reflects a shift in homeostatic balance, where the core microbial community remains present, but its proportions are altered. Short-term montelukast treatment shows a minimal impact on the microbial landscape, suggesting treatment does not further destabilise the gut environment. These findings highlight the specific and targeted nature of gastrointestinal involvement in long COVID.},
}

Humans
*Cyclopropanes/therapeutic use
*Sulfides/therapeutic use
*Quinolines/therapeutic use
*Gastrointestinal Microbiome/drug effects
*Acetates/therapeutic use
*COVID-19/microbiology/complications
Male
Female
Cross-Sectional Studies
Middle Aged
SARS-CoV-2
Feces/microbiology
Adult
Aged
Longitudinal Studies
*COVID-19 Drug Treatment

@article {pmid42140088,
year = {2026},
author = {Kohli, M and Maschio, M and Lee, A and Kissler, S and Carroll, S and van de Velde, N and Beck, E and Balogh, O and Joshi, K},
title = {The cost-effectiveness of vaccination against COVID-19 in at-risk populations and older adults in the United Kingdom: Projections using a dynamic transmission model.},
journal = {Vaccine},
volume = {85},
number = {},
pages = {128687},
doi = {10.1016/j.vaccine.2026.128687},
pmid = {42140088},
issn = {1873-2518},
abstract = {OBJECTIVE: This study estimates the potential clinical impact and cost-effectiveness of an Autumn COVID-19 vaccination campaign in the United Kingdom (UK) using a variant-adapted mRNA-1273 vaccine in those aged ≥65 years and those aged 6 months-64 years at high risk (base case population) of severe outcomes, as well as the effect of implementing more restrictive vaccine eligibility requirements.

METHODS: A Susceptible-Exposed-Infected-Recovered (SEIR) model was used to predict COVID-19 cases and hospitalisations in the UK. A COVID-19 vaccination and infection consequences decision tree was used to predict health outcomes, costs and quality-adjusted life-year (QALY) losses associated with symptomatic SARS-CoV-2 infections as well as costs and QALY losses associated with COVID-19 vaccination and adverse events over a 1-year time horizon.

RESULTS: Compared to no vaccination, an Autumn mRNA-1273 vaccination campaign is predicted to decrease the number of symptomatic infections from 21.9 million to 20.0 million, and the number of hospitalisations from 150,000 to 116,000. COVID-related deaths and long COVID cases are decreased by 7200 and 18,000, respectively. Costs saved are £467.7 million with 52,000 QALYs gained, resulting in an incremental cost-effectiveness ratio (ICER) of £8963/QALY gained. The ICER was most sensitive to infection incidence, population immunity before the vaccination campaign, vaccine effectiveness against hospitalisation, and hospitalisation probabilities. Narrowing the vaccination eligibility criteria to those aged ≥75 years and those aged 6 months-74 years at high risk of severe outcomes results in fewer outcomes prevented, with 525,300 more symptomatic infections, 6000 more hospitalisations, 1100 additional deaths, and 5200 additional cases of long COVID, compared to the base case. Vaccination of the broader population compared to the narrower population is associated with an ICER of £11,753/QALY gained.

CONCLUSIONS: Vaccinating adults aged ≥65 years and high-risk individuals 6 months-64 years remains cost-effective compared both to no vaccination and vaccination of the narrower population.},
}

@article {pmid42140539,
year = {2026},
author = {Tamariz, L and Shehadeh, LA and Bast, E and Klimas, N and Palacio, A},
title = {The role of the endothelium in long COVID.},
journal = {Vascular pharmacology},
volume = {},
number = {},
pages = {107654},
doi = {10.1016/j.vph.2026.107654},
pmid = {42140539},
issn = {1879-3649},
abstract = {SARS-CoV2 infection significantly increases the risk of cardiovascular events through multiple interconnected mechanisms including systemic inflammation, dysautonomia, endothelial dysfunction, and prothrombotic states. The endothelium plays a critical role in this increase in risk together with dysautonomia and mast cell activation. SARS-CoV2 activates endothelial cells creating a pro-inflammatory, and pro-thrombotic phenotype. This phenotype could lead to microcirculatory changes that decrease oxygen delivery to tissues because of loss of laminar flow, lack of nitric oxide dependent vasodilation, increased viscosity and abnormal constriction of vascular smooth muscle cells due to neuropathy. There are several ways of identifying patients with endothelial dysfunction and the most used is flow mediated dilation. Many randomized trials have already found significant treatments for endothelial dysfunction and include antihypertensives, statins, beta-blockers, supplements and lifestyle interventions. Only two studies using vitamin C and L-arginine demonstrated improvements in flow mediated dilation in patients with long COVID.},
}

@article {pmid42129014,
year = {2026},
author = {Saurel, M and Fornasieri, I and Del Sordo, GC and Chatain, C and Fantini, ML and Gruet, M and Saidi, O},
title = {Sleep in myalgic encephalomyelitis/chronic fatigue syndrome shows marked night-to-night fluctuation under free-living conditions-results from a matched case-control study.},
journal = {Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine},
volume = {22},
number = {1},
pages = {},
pmid = {42129014},
issn = {1550-9397},
mesh = {Humans ; *Fatigue Syndrome, Chronic/complications/physiopathology ; Case-Control Studies ; Male ; Female ; Adult ; Sleep Quality ; Middle Aged ; *Sleep/physiology ; Accelerometry ; *Sleep Wake Disorders ; },
abstract = {PURPOSE: Unrefreshing and non-restorative sleep is a hallmark complaint in people with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). However, little is known about their habitual sleep and night-to-night fluctuations under real-life conditions. This study aimed to characterize sleep, and the intraindividual variability (IIV) of sleep in people living with ME/CFS compared with matched controls.

METHODS: In this case-control study, 38 ME/CFS and 38 controls wore a wrist accelerometer continuously for 7 days and completed concurrent sleep diaries, the Pittsburgh Sleep Quality Index (PSQI), and Epworth Sleepiness Scale (ESS). Within the ME/CFS group, participants were also stratified by symptom severity using the Bell Disability Scale. Sleep IIV was quantified using the coefficient of variation, the root mean square of successive differences, and the Bayesian variability model, respectively.

RESULTS: Compared with controls, individuals with ME/CFS spent significantly more time in bed and exhibited poorer sleep efficiency (SE) (all p < 0.05). Despite a longer time in bed, total sleep time did not differ between groups. ME/CFS participants also displayed significantly greater IIV in SE. By contrast, sleep timing (bedtime) was more regular among ME/CFS. Exploratory analyses did not detect clear differences across ME/CFS severity subgroups for mean sleep variables or variability indices.

CONCLUSION: Under real-life conditions, people with ME/CFS exhibit poor sleep quality and unstable SE. These findings highlight sleep IIV as a clinically relevant dimension of sleep health in ME/CFS.

Unrefreshing sleep is a core symptom of ME/CFS, yet most evidence relies on single- or two-night laboratory assessments that may not reflect habitual sleep under real-life conditions. Moreover, night-to-night sleep variability, a potentially critical dimension of sleep health, has not been systematically examined in ME/CFS.

STUDY IMPACT: Using week-long wrist accelerometry, this study shows that under free-living conditions sleep in ME/CFS is characterized not only by impaired sleep efficiency but also by pronounced night-to-night variability, despite relatively stable bedtime compared to controls. These findings highlight sleep efficiency variability as a clinically relevant feature of ME/CFS and underscore the need for multi-night assessment and targeted strategies addressing sleep variability.},
}

Humans
*Fatigue Syndrome, Chronic/complications/physiopathology
Case-Control Studies
Male
Female
Adult
Sleep Quality
Middle Aged
*Sleep/physiology
Accelerometry
*Sleep Wake Disorders

@article {pmid42129072,
year = {2026},
author = {Veenstra, TD},
title = {Viral Prognosis Using Proteomics.},
journal = {Advances in experimental medicine and biology},
volume = {1511},
number = {},
pages = {75-102},
pmid = {42129072},
issn = {0065-2598},
mesh = {Humans ; *COVID-19/virology/diagnosis/metabolism/epidemiology ; *Proteomics/methods ; *SARS-CoV-2/genetics/metabolism/pathogenicity ; Prognosis ; Pandemics ; },
abstract = {So much was learned during the COVID-19 pandemic of 2020-2023. Some of the things that were learned were obvious. Many people in the public learned about social distancing, personal hygiene, and how to conduct a COVID-19 diagnostic test. Pharmaceutical companies and government organizations learned to efficiently work together to produce and distribute vaccines in record time. Although it may have generated controversy, the value in getting vaccinated was revalidated. There were other things that the world learned, although it was not as obvious. The effect of vaccination rate on preventing virus mutation became evident during the pandemic. The original SARS-CoV-2 virus that started the pandemic mutated several times over the course of the pandemic. One thing that became clear during the pandemic was the lack of knowledge on how SARS-CoV-2 infection would affect individuals during the course of the disease. This inability to accurately prognose the disease made it difficult to personalize treatments for specific individuals and the distribution of resources to protect the most vulnerable populations challenging. What is required to increase the accuracy of prognosis is more knowledge about how dynamic changes occur within the host cell during viral infection. Since many proteins become dysregulated during infection, proteomics is a prime technology for gaining this knowledge to increase prognostic capabilities and enable personalized treatments that alleviate the suffering viruses cause on humanity.},
}

Humans
*COVID-19/virology/diagnosis/metabolism/epidemiology
*Proteomics/methods
*SARS-CoV-2/genetics/metabolism/pathogenicity
Prognosis
Pandemics

@article {pmid42130374,
year = {2026},
author = {Kell, DB and Pretorius, E},
title = {Assessing the Health and Functionality of the Microcirculation Using Thermal Imaging.},
journal = {Journal of biophotonics},
volume = {19},
number = {5},
pages = {e70270},
doi = {10.1002/jbio.70270},
pmid = {42130374},
issn = {1864-0648},
support = {18//Balvi/ ; //Polybio/ ; //Kanro/ ; },
mesh = {*Microcirculation ; Humans ; *Thermography/methods ; Animals ; },
abstract = {The microcirculation, composed of vessels below 100 μm in diameter, sustains tissue perfusion and metabolic exchange. Its dysfunction is increasingly implicated in chronic, inflammatory, and thrombotic disorders such as diabetes, sepsis, cardiovascular disease, and Long COVID. Accurate, noninvasive assessment of microvascular health is therefore clinically significant. Infrared thermal imaging provides a rapid, contact-free, and physiologically coherent means of visualizing temperature distributions that reflect underlying blood flow. Because thermal gradients directly correspond to perfusion heterogeneity, this approach offers an interpretable surrogate for assessing microvascular function. Here, we review the physical principles of thermal imaging, summarize its application to the peripheral circulation, and compare it with established modalities including nailfold capillaroscopy and laser-based techniques. We also outline its utility across diverse pathologies associated with fibrinaloid microclot complexes and endothelial injury. Thermal imaging thus emerges as an inexpensive/scalable tool for evaluating microcirculatory dysfunction in both research and (where approved) in clinical settings.},
}

*Microcirculation
Humans
*Thermography/methods
Animals

@article {pmid42130887,
year = {2026},
author = {Taylor, I and Boyd, JK and McIndoo, E and Ammons, MCB},
title = {A retrospective cohort study of viral and sociodemographic determinants of long COVID among Idaho veterans.},
journal = {Frontiers in public health},
volume = {14},
number = {},
pages = {1625363},
pmid = {42130887},
issn = {2296-2565},
mesh = {Humans ; Male ; Female ; *COVID-19/epidemiology/virology ; *Veterans/statistics & numerical data ; Middle Aged ; Retrospective Studies ; SARS-CoV-2/isolation & purification ; Aged ; Idaho/epidemiology ; Adult ; Rural Population/statistics & numerical data ; },
abstract = {PURPOSE: To investigate associations between cardiopulmonary, neuropsychiatric, and multisystem long COVID phenotypes, and sequence-defined SARS-CoV-2 viral variant and sociodemographic predictors in a population from a rural state.

METHODS: SARS-CoV-2 clinical samples were collected from 1,120 veterans treated at the Veterans Affairs (VA) Medical Center in Boise, Idaho from April 2, 2020 to December 20, 2022. Viral variants were identified through sequencing and annotated with clinical data from the VA Corporate Data Warehouse, as well as CDC rurality and social vulnerability. Cardiopulmonary, neuropsychiatric, and multisystem long COVID phenotypes were determined by the addition of one or more ICD-10 codes 90-270 days post-infection. Multinomial logistic regression was used to estimate phenotype prevalence in a base model with predictors viral variant, age, sex, rurality, and social vulnerability, as well as in models that adjusted for patient health (comorbidity, healthcare utilization, and smoking status), and treatments (vaccination and Paxlovid).

FINDINGS: Female patients experienced more neuropsychiatric long COVID and less recovery, whereas the neuropsychiatric phenotype was less prevalent among older patients. Omicron variants had less recovery and more multisystem long COVID relative to pre-Delta-a finding that may indicate an association between infection with Omicron and post-acute gastrointestinal symptoms.

CONCLUSION: This study is perhaps the largest to investigate viral variant effects on long COVID using sequence rather than date-based variant definitions, and is also unique in its focus on a population living in one of the most rural states in the United States. Our results are consistent with other studies finding contributions from both biological and social predictors to long COVID outcomes.},
}

Humans
Male
Female
*COVID-19/epidemiology/virology
*Veterans/statistics & numerical data
Middle Aged
Retrospective Studies
SARS-CoV-2/isolation & purification
Aged
Idaho/epidemiology
Adult
Rural Population/statistics & numerical data

@article {pmid42131622,
year = {2026},
author = {Ikeda, G and Koike-Ieki, M and Inoue, H and Dadhania, AV and El Kamari, V and Jagannathan, P and Geng, LN and Miglis, MG and Shafer, RW and Yang, PC and Bonilla, HF},
title = {Plasma Extracellular Vesicle Surface Marker Profiling Reveals Immune Cell-Associated Mitochondrial Membrane Potential Alterations in Long COVID and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.},
journal = {Open forum infectious diseases},
volume = {13},
number = {5},
pages = {ofag209},
pmid = {42131622},
issn = {2328-8957},
abstract = {BACKGROUND: Long COVID (LC) is characterized by symptoms persisting at least 3 months after SARS-CoV-2 infection and affecting multiple organ systems. Diagnosis relies on subjective criteria without established biomarkers. Immune dysregulation and mitochondrial dysfunction are implicated in LC pathophysiology. Given clinical overlap with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), we investigated whether plasma extracellular vesicles (EVs) capture shared molecular signatures.

METHODS: Plasma EVs from 125 individuals across pandemic-era and prepandemic cohorts were analyzed. The pandemic-era cohort included COVID-Recovered, LC with ME/CFS phenotype (LC-ME/CFS), and ME/CFS without infection (pan-ME/CFS). The prepandemic cohort included ME/CFS and matched controls. Extracellular vesicles were isolated using size-exclusion chromatography. Concentration and size were assessed by nanoparticle tracking analysis, and surface markers and mitochondrial membrane potential were evaluated by flow cytometry.

RESULTS: Both pan-ME/CFS and LC-ME/CFS exhibited elevated EV concentrations compared with COVID-recovered controls after false discovery rate (FDR) correction (q = 0.0042 and 0.0024). Leukocyte-, monocyte/macrophage-, and platelet-derived EVs were increased, whereas B cell-derived EVs were reduced in both groups. Compared with controls, pan-ME/CFS demonstrated increased mitochondrial membrane potential in B cell-, monocyte/macrophage-, and NK cell-derived subsets after FDR correction, whereas no significant differences were observed in LC-ME/CFS. Prepandemic ME/CFS showed a nominal increase in leukocyte-derived EVs that did not persist after correction, whereas elevated mitochondrial membrane potential in B cell-derived EV subsets remained significant.

CONCLUSIONS: ME/CFS and LC-ME/CFS demonstrate partially overlapping immune cell-associated EV alterations. Mitochondrial membrane potential alterations within selected immune-derived EV subsets, particularly B cell-associated EVs, suggest immune-metabolic involvement. Plasma EV profiling may inform future biomarker development.},
}

@article {pmid42133310,
year = {2026},
author = {Thiel, F and Soares, RN and Peter, RS and Göpel, S and Nieters, A and Rothenbacher, D and Kern, WV and Nieß, AM and Mattioni Maturana, F},
title = {Impaired microvascular reactivity in post-COVID-19 syndrome is independent of cardiorespiratory fitness.},
journal = {American journal of physiology. Regulatory, integrative and comparative physiology},
volume = {},
number = {},
pages = {},
doi = {10.1152/ajpregu.00050.2026},
pmid = {42133310},
issn = {1522-1490},
support = {MR/S028188/1//Ministerium für Wissenschaft, Forschung und Kunst Baden-Württemberg (MWK)/ ; },
abstract = {Current evidence demonstrates that patients that suffer from long-term SARS-CoV-2 symptoms (i.e., post-COVID-19 syndrome, PCS) often present muscle fatigue and dyspnea. This is discussed to be a result of vascular dysfunction and oxidative stress triggered by the infection. However, its effects on the microvasculature remains unknown. 62 participants (61.3% women) were recruited (50.0±11.8 yr, body mass index (BMI) 27.6±5.3 kg·m[-2], maximal oxygen uptake (V̇O2max) 26.2±9.4 mL·kg[-1]·min[-1]) from the EPILOC (Epidemiology and clinical characteristics of PCS) phase 2 study. Participants were divided into either a case group (patients with new or prolonged symptoms and impaired general health or work ability compatible with persistent PCS) or control group (symptom-free age-sex matched patients with uneventful recovery after COVID-19). The brachial-ankle pulse wave velocity (baPWV) was assessed via BOSO-ABI system100. To evaluate the microvascular function, a tissue oxygen saturation (StO2) reperfusion rate assessment using near-infrared spectroscopy was performed on the flexor digitorum superficialis muscle. No significant statistical differences were observed between the case and control groups in age, BMI, and baPWV (p>0.05). The control group achieved a greater V̇O2max than the case group (p=0.02). After adjusting for V̇O2max, a significant effect of group (F (1,52) =5.28, p=0.026) in microvascular function was observed, with the case group presenting lower values than the control group ((?)=-0.53, p=0.02). No a priori power calculation was performed - post-hoc sensitivity analysis indicated a minimum detectable effect of Cohen's d=0.72, and secondary outcomes should be interpreted cautiously. Our results indicate a reduced microvascular function in patients with PCS, as compared with the control group. Such impairment may be linked to the prolonged symptoms experienced by patients, causing capillary flow disturbance and, subsequently, limiting muscle oxygen uptake.},
}

@article {pmid42119693,
year = {2026},
author = {Schomerus, G and Nicolas, ML and Fritz, F and Schneider, D and Büchner, R},
title = {[What is the Role of "the Psyche"? Long COVID and ME/CFS as Test Cases for Evidence-Based and Patient-Centered Psychiatry and Psychotherapy].},
journal = {Psychiatrische Praxis},
volume = {},
number = {},
pages = {},
doi = {10.1055/a-2866-9127},
pmid = {42119693},
issn = {1439-0876},
abstract = {The role of psychological factors in the development and course of Long Covid (LC) and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) remains a subject of controversial debate. We argue that psychologizing LC and ME/CFS carries significant risks: it leads to potentially harmful therapies, invalidates the patients' experience of illness, hinders effective interventions such as pacing, diverts focus from necessary physical diagnostics and treatment, disadvantages patients in medical assessments, and places a considerable additional burden on the families of affected children or other relatives. We show that many of the arguments presented for a psychological contribution are nonspecific or insufficiently supported by empirical evidence. Our essay therefore advocates for extreme caution in attributing psychological factors to these conditions, in the interest of a specific, evidence-based, and patient-centered psychiatry and psychotherapy.},
}

@article {pmid42120715,
year = {2026},
author = {Tatai, O and Nagy, S and Nguyen, THT and Tóth, BL and Antal-Szalmás, P and Siket, IM and Pintér, TB and Fagyas, M and Papp, Z and Csécsei, P and Lehoczki, A and Szappanos, Á and Ungvari, Z and Molnár, T and Tóth, A},
title = {Tissue-specific autoantibody signatures reveal immune alterations undetected by routine serology in long COVID.},
journal = {GeroScience},
volume = {},
number = {},
pages = {},
pmid = {42120715},
issn = {2509-2723},
support = {Advanced 152363//National Research, Development and Innovation Fund of Hungary/ ; TKP2021-NKTA-47//National Research, Development and Innovation Fund of Hungary/ ; National Cardiovascular Laboratory Program (RRF-2.3.1-21-2022-00003)//National Research, Development and Innovation Fund of Hungary/ ; Project no. 135784//National Research, Development and Innovation Fund of Hungary/ ; K20 funding scheme//National Research, Development and Innovation Fund of Hungary/ ; the European University for Well-Being (EUniWell) program (grant agreement number: 101004093/ EUniWell/EAC-A02-2019 / EAC-A02-2019-1)//National Research, Development and Innovation Fund of Hungary/ ; EKÖP-24-2 University Research Scholarship Program of the Ministry for Culture//National Research, Development and Innovation Fund of Hungary/ ; Innovation//National Research, Development and Innovation Fund of Hungary/ ; 2015-1.2.1.-HU-RIZONT-2-25-00016 (INNOBRAIN)//National Research, Development and Innovation Office of Hungary/ ; Mission-driven National Cardiovascular Laboratory Program (2026)//National Research, Development and Innovation Office of Hungary/ ; },
abstract = {Long COVID affects a substantial proportion of individuals recovering from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, yet its underlying pathophysiology remains poorly understood. Although autoimmunity is increasingly implicated in disease pathogenesis, routine diagnostics frequently fail to detect relevant immune dysregulation. To address this gap, we analyzed sera from Long COVID patients (n = 114) and pre-pandemic controls (n = 36) using tissue-based Western blotting targeting cardiac, pulmonary, and vascular antigens, alongside standard ANA HEp-2 testing. Longitudinal samples were additionally evaluated to assess autoantibody dynamics. Autoantibodies were detected in the majority of patients (83% vs. 53% in controls; p < 0.05), showing a dominant cardiovascular pattern. While cardiac (54% vs. 33% in controls; p = 0.16) and pulmonary (34% vs. 30% in controls; p = 0.50) prevalences did not reach significance, vascular autoreactivity was markedly elevated in Long COVID (34% vs. 8% in controls; p < 0.05). Responses exhibited broad polyreactivity and IgM dominance, with longitudinal follow-up showing persistent IgM and the emergence of additional isotypes. Clinically, cardiac autoreactivity was associated with hypertension and headache, while the overall autoreactivity correlated with anosmia and ageusia. In contrast, ANA HEp-2 testing showed no discriminatory value or clinical associations. Distinct autoreactivity patterns further aligned with female sex and clinical parameters (C-reactive protein, creatinine, troponin, body mass index). Together, these findings reveal a high burden of tissue-specific autoantibodies invisible to standard ANA screening. This persistent, IgM-skewed profile suggests ongoing immune dysregulation and may reflect a previously underrecognized component of the immunological response in long COVID, highlighting the need for targeted immunodiagnostic approaches beyond routine serology.},
}

@article {pmid42121112,
year = {2026},
author = {Jovicic, F and McCracken, LM and Rozental, A and Buhrman, M},
title = {Impacts of Post-Covid Condition (PCC) in Sweden: a cross-sectional observational survey study.},
journal = {BMC public health},
volume = {26},
number = {1},
pages = {},
pmid = {42121112},
issn = {1471-2458},
mesh = {Humans ; Sweden/epidemiology ; Female ; *COVID-19/psychology/complications/epidemiology ; Male ; Cross-Sectional Studies ; Middle Aged ; Adult ; Aged ; Surveys and Questionnaires ; Fatigue/epidemiology ; Quality of Life ; Young Adult ; },
abstract = {BACKGROUND: The COVID-19 pandemic left many people with persistent health problems following a COVID-19 infection. Research on the condition better known as Post-Covid Condition (PCC) is still inconclusive, and few evidence-based treatments are currently available, although several studies report promising results. There are however people in need of treatment and support.

METHODS: To better understand what such help might entail, we conducted an online-based survey (n = 629, 82.6% women) to examine the impact of PCC in Sweden and explore relationships among various variables using correlation analysis. Swedish-speaking adults with at least one persisting health problem after COVID-19 were included in the study. The survey included demographic and psychosocial variables, historic COVID-19 data, other clinical measures of psychological distress, satisfaction with life, and daily functioning impairment.

RESULTS: Results indicate a substantial and heterogeneous impact of PCC in this sample. Participants reported an average of 10.70 (SD = 5.62) symptoms with the most frequently reported being fatigue (90.9%, n = 507) and cognitive deficits (73.3%, n = 409). The highest average symptom burden scores were reported for post-exertional malaise (PEM; M = 8.37, SD = 1.70) and fatigue (M = 8.22, SD = 1.77). Medication, self-help advice, and physiotherapy were the most frequently reported treatment modalities. Most participants reported their problems being unchanged or improved after treatment, but there were reports of worsening as well. Regarding psychological distress, participants reported mild anxiety, moderate depression, and subclinical but notable levels of sleeping problems. On average, daily functioning was substantially impaired by PCC and participants reported being "somewhat dissatisfied with life". The correlational analyses revealed several significant correlations (|r| = 0.11-0.93, p < .01), with strongest relationships between the clinical variables.

CONCLUSIONS: While this study aimed to measure impacts of PCC in many different areas of life, it holds some limitations, and there are many questions remaining. We present several recommendations for methodology and future research topics. Identifying modifiable variables that can be used in developing a treatment is naturally a next step. Based on empiric evidence from similar conditions, psychological flexibility (PF) may be a promising one.},
}

Humans
Sweden/epidemiology
Female
*COVID-19/psychology/complications/epidemiology
Male
Cross-Sectional Studies
Middle Aged
Adult
Aged
Surveys and Questionnaires
Fatigue/epidemiology
Quality of Life
Young Adult

@article {pmid42121889,
year = {2026},
author = {Kopańska, M and Trojniak, J and Góral-Półrola, J and Pąchalska, M},
title = {Alterations in Cortical Oscillatory Dynamics Following SARS-CoV-2 Infection: QEEG Biomarkers of Vulnerability to Attention and Seizure-Related Symptoms.},
journal = {Cells},
volume = {15},
number = {9},
pages = {},
doi = {10.3390/cells15090790},
pmid = {42121889},
issn = {2073-4409},
mesh = {Humans ; *COVID-19/complications/physiopathology ; *Electroencephalography/methods ; *Seizures/physiopathology/etiology ; Biomarkers/metabolism ; SARS-CoV-2 ; *Attention/physiology ; *Cerebral Cortex/physiopathology ; },
abstract = {SARS-CoV-2 infection is associated with not only acute respiratory symptoms but is also characterized by strong neurotropism which may contribute to the development of the multisystem post-COVID syndrome (PASC). Patients frequently report chronic neurocognitive disorders such as brain fog, significant attention deficits and increased susceptibility to epileptiform discharges. The aim of this review is to systematize the knowledge regarding deviations in quantitative electroencephalography (QEEG) recordings in convalescents and to evaluate the utility of this method as an objective biomarker. This work constitutes a comprehensive literature review integrating the latest data on neuroinflammation, blood-brain barrier damage and changes in cortical oscillatory dynamics induced by the infection. The literature analysis indicates that the virus may induce a pathological excitation and inhibition imbalance (E/I imbalance) in neuronal networks. In QEEG studies this manifests as excessive activity of slow bands (Theta, Delta), a deficit of rhythms responsible for attention and sensorimotor integration (SMR) and a pathologically elevated Theta to Beta ratio (TBR). In conclusion, QEEG can serve as an objective and highly sensitive tool supporting the diagnosis and stratification of patients with neurocognitive complications of Long COVID. The integration of precise electrophysiological phenotyping with targeted behavioral neuromodulation (e.g., EEG-Biofeedback) fits into the paradigm of personalized medicine and offers a prospective strategy for mitigating long-term neurological burdens.},
}

Humans
*COVID-19/complications/physiopathology
*Electroencephalography/methods
*Seizures/physiopathology/etiology
Biomarkers/metabolism
SARS-CoV-2
*Attention/physiology
*Cerebral Cortex/physiopathology

@article {pmid42123618,
year = {2026},
author = {Wirth, KJ and Scheibenbogen, C},
title = {Imbalance of Excitatory and Inhibitory Neurotransmitter Systems in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.},
journal = {International journal of molecular sciences},
volume = {27},
number = {9},
pages = {},
doi = {10.3390/ijms27094041},
pmid = {42123618},
issn = {1422-0067},
mesh = {Humans ; *Fatigue Syndrome, Chronic/metabolism/physiopathology ; *Neurotransmitter Agents/metabolism ; *COVID-19/metabolism/complications ; SARS-CoV-2 ; Synaptic Transmission ; Animals ; },
abstract = {Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) and post-COVID-19 syndrome share a symptom profile, including severe fatigue, cognitive dysfunction, exertional intolerance, sleep disturbances, hypervigilance, and the paradoxical state of being "wired but tired." A well-established finding is sympathetic hyperactivity with reduced vagal tone, typically interpreted as autonomic nervous system dysfunction. Emerging evidence, however, suggests a broader disturbance across multiple neurotransmitter systems. This paper reviews current knowledge on neurotransmitter systems implicated in ME/CFS and Long COVID, focusing on potential mechanisms of dysregulation and their roles in disease pathology and symptom generation, as well as implications for treatment. In addition to abnormalities of the noradrenergic system, disturbances in serotonergic, GABAergic, and glutamatergic signaling have been reported. Contributing factors may include autoimmunity, neuroinflammation, gut dysbiosis, epigenetic influences, and stressors such as orthostatic intolerance, metabolic strain, and pain. A shift favoring excitatory over inhibitory neurotransmission can lead to excessive neural activation, autonomic dysfunction, sensory hypersensitivities, sleep disturbances, and cognitive impairment. Reduced GABAergic tone combined with increased glutamatergic and noradrenergic activity may elevate skeletal muscle tone, contributing to calcium overload, mitochondrial dysfunction, exertional intolerance, and post-exertional malaise. Various pharmacological treatments may partially rebalance these neurotransmitter systems, but limited efficacy highlights the need for systematic investigation and individualized strategies.},
}

Humans
*Fatigue Syndrome, Chronic/metabolism/physiopathology
*Neurotransmitter Agents/metabolism
*COVID-19/metabolism/complications
SARS-CoV-2
Synaptic Transmission
Animals

@article {pmid42127260,
year = {2026},
author = {Antar, AAR},
title = {CROI 2026: Acute and Postacute COVID-19.},
journal = {Topics in antiviral medicine},
volume = {34},
number = {2},
pages = {494-500},
pmid = {42127260},
issn = {2161-5853},
mesh = {Humans ; *COVID-19/complications/immunology/therapy ; SARS-CoV-2/immunology ; COVID-19 Drug Treatment ; Post-Acute COVID-19 Syndrome ; Antibodies, Monoclonal/therapeutic use ; },
abstract = {The 2026 Conference on Retroviruses and Opportunistic Infections (CROI) furthered our understanding of acute COVID-19, long COVID, postacute sequelae of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), viral immunity, and SARS-CoV-2 therapeutics. Results of a first-in-human validation study of DNA-encoded monoclonal antibody (DMAb) technology demonstrated safety and robust and durable monoclonal antibody (mAb) production, giving the green light to further develop the DMAb platform. Pemivibart administration to people with advanced HIV was well tolerated and associated with good levels of neutralizing antibodies. A new pan-coronavirus 3C-like protease inhibitor was shown to have similar pharmacokinetics and a similar safety profile in people with renal impairment and people with hepatic impairment. A study of SARS-CoV-2 infections in 2023 demonstrated continued risk for new incident diagnoses and worsening of prior comorbidities in the year after infection. SARS-CoV-2 infection in people with HIV is associated with discernible decline in estimated glomerular filtration rate in the 2 years after infection. A blinded study of circulating SARS-CoV-2 antigen found no association between the presence of antigen and the likelihood of having long COVID. Most people with long COVID in a cohort study have experienced stigma or feeling dismissed in interactions with their clinicians.},
}

Humans
*COVID-19/complications/immunology/therapy
SARS-CoV-2/immunology
COVID-19 Drug Treatment
Post-Acute COVID-19 Syndrome
Antibodies, Monoclonal/therapeutic use

@article {pmid42112321,
year = {2026},
author = {Bentebbal, S and Zaqout, A and Meqbel, B and Bensmail, I and Aldushain, A and de la Fuente, A and Thomas, R and Naik, A and Shaath, H and Al-Akl, NS and Adam, A and Moussa, HYA and Shin, KC and Taha, RZ and Abukhattab, M and Al-Maslamani, MA and Alajez, NM and Arredouani, A and Park, Y and Abdulla, SA and El-Agnaf, OMA and Abdesselem, HB and Omrani, AS and Decock, J},
title = {Post-booster longitudinal plasma proteomic changes following BNT162b2 COVID-19 vaccination in Qatar.},
journal = {Frontiers in immunology},
volume = {17},
number = {},
pages = {1762522},
pmid = {42112321},
issn = {1664-3224},
mesh = {Humans ; *COVID-19/prevention & control/immunology/blood ; Male ; *BNT162 Vaccine/immunology ; Adult ; Longitudinal Studies ; Female ; *SARS-CoV-2/immunology ; Proteomics ; *Proteome ; Middle Aged ; Qatar ; *Immunization, Secondary ; Young Adult ; Vaccination ; },
abstract = {BACKGROUND: The COVID-19 pandemic imposed a major global health and economic burden. Although the pandemic was no longer declared a public health emergency of international concern in May 2023, SARS-CoV-2 variants continue to emerge, and millions remain affected by long COVID. This raises the question whether continued vaccination provides lasting benefits in preventing viral transmission and severe illness.

AIM: This longitudinal study assessed the effects of the third BNT162b2 mRNA vaccine dose on the circulating proteome for 6 months.

METHODS: Plasma levels of 354 unique proteins were quantified before, and at 3- and 6-months post-booster using Olink technology in 70 healthy individuals; 35 infection-naïve and 35 previously infected individuals (18 infected before, 17 after completing the two-dose regimen).

RESULTS: Infection-naïve individuals showed altered levels of eleven and eight proteins at 3- and 6-months post-booster, respectively, including a significant sustained increase in PARP-1 (FC = 1.53, p=8.59x10[-5], pFDR=0.01) and significant decrease in MMP-7 (FC = 0.68, p=4.58x10[-5], pFDR=0.01), in addition to elevated levels of MMP-1 (FC = 1.46, p=0.04, pFDR>0.05) and decrease in 4E-BP1 (FC = 0.58, p=0.01, pFDR>0.05) at 6 months post-booster. Similarly, previously infected individuals, in particular those with earlier infections before receiving the second dose exhibited a significant sustained upregulation of PARP-1 (FC = 2.10, p=1.19x10[-5], pFDR=0.003) and downregulation of MMP-7 (FC = 0.58, p=2.19x10[-5], pFDR=0.003) at 6-months post-booster. Notably, PARP-1 and MMP-7 were consistently affected across all individuals. Longitudinal proteome profiling revealed dysregulation of key inflammatory proteins for up to 6 months post-booster, including PARP-1 and MMP-7 (pFDR=1.58x10[-8] and pFDR=1.59x10[-5], respectively).

CONCLUSIONS: These findings provide insights into the temporal dynamics of circulating proteomic responses following booster vaccination, highlighting molecular features that may be relevant to immune readiness and post-vaccination inflammatory processes.},
}

Humans
*COVID-19/prevention & control/immunology/blood
Male
*BNT162 Vaccine/immunology
Adult
Longitudinal Studies
Female
*SARS-CoV-2/immunology
Proteomics
*Proteome
Middle Aged
Qatar
*Immunization, Secondary
Young Adult
Vaccination

@article {pmid42114957,
year = {2026},
author = {Järvholm, K and Bygdell, M and Dreifaldt, J and Åkesson, E and Lundberg, T},
title = {"It's sad, and I want to go back to how things were before": a qualitative study of young people's experiences of living with long COVID.},
journal = {BMJ paediatrics open},
volume = {10},
number = {1},
pages = {},
doi = {10.1136/bmjpo-2025-004167},
pmid = {42114957},
issn = {2399-9772},
mesh = {Humans ; Female ; Male ; *COVID-19/psychology/complications ; Qualitative Research ; Adolescent ; Sweden/epidemiology ; Child ; Adaptation, Psychological ; SARS-CoV-2 ; Interviews as Topic ; Quality of Life ; Chronic Disease/psychology ; },
abstract = {BACKGROUND: Long COVID is a newly recognised condition that also affects children and young people (CYP). However, little is known about how it impacts their daily lives and well-being from their own perspective. This study aimed to explore the lived experiences of CYP living with long COVID.

METHODS: Swedish-speaking CYP who developed long COVID before the age of 18 years were invited to participate in semistructured interviews. Between February and September 2024, seven CYP (four girls and three boys) participated (mean interview duration=51 min). Data were analysed using reflexive thematic analysis to identify codes and then themes with related subthemes.

RESULTS: Two main themes were generated. The first main theme 'I am stumbling in the dark: Living with unpredictability and limitations' covers how CYP were affected by the consequences of long COVID. The subtheme 'How do I live and function now?' illustrates how the CYP tried to navigate the disabling and yet fluctuating symptoms, and the subtheme 'Who am I now?' represents the identity-related consequences. The second main theme 'Navigating responses from others to find support' illustrates how others have responded to their symptoms and how these responses were perceived by the CYP. The subthemes 'Stop being sceptical!', 'Just try to help me!' and 'Accept and validate me!' illustrate interactions perceived as invalidating or disrespectful, what has been experienced as helpful or unhelpful and the kinds of support adolescents have valued.

CONCLUSIONS: Long COVID negatively impacted the CYP's lives, affecting their relationships, education, leisure activities and sense of identity. Dismissive and sceptical attitudes from professionals and peers substantially increased the burden, whereas encountering acceptance and knowledgeable professionals facilitated coping with long COVID.},
}

Humans
Female
Male
*COVID-19/psychology/complications
Qualitative Research
Adolescent
Sweden/epidemiology
Child
Adaptation, Psychological
SARS-CoV-2
Interviews as Topic
Quality of Life
Chronic Disease/psychology

@article {pmid42115979,
year = {2026},
author = {Mazzali, C and Magnoni, P and Valsecchi, MG and Vigani, D and Lucifora, C and Russo, AG and , },
title = {Incident diabetes within the first two years after SARS-CoV-2 infection: a population-based retrospective cohort study of the Agency for Health Protection of Milan, Italy.},
journal = {BMC infectious diseases},
volume = {},
number = {},
pages = {},
doi = {10.1186/s12879-026-13467-4},
pmid = {42115979},
issn = {1471-2334},
support = {2021-4388//Fondazione Cariplo/ ; },
abstract = {BACKGROUND: Postacute sequelae of SARS-CoV-2 infection (PASC), including persistent symptoms and acute and chronic diagnoses, have become a major research focus. Diabetes mellitus, beyond its established link to COVID-19 severity, is increasingly recognized as a potential long-term outcome. This study investigated the association between SARS-CoV-2 infection and incident diabetes using population-level health administrative data (HAD) from the Agency for Health Protection of Milan, where the epicenter of the pandemic in Italy took place.

METHODS: This retrospective cohort study included adult residents without a history of diabetes who underwent SARS-CoV-2 testing between 1 March and 31 December 2020. Test-positive individuals were matched 1:1 to test-negative individuals based on sex, age, and testing week. The cohort was followed through 31 December 2021. The incidence of diabetes, identified using an HAD-based case-detection algorithm, was compared between the two groups, and in stratified analyses by sex and age, using weighted Cox models adjusted for chronic comorbidities, area-level deprivation, influenza and pneumococcal vaccinations. Weights were calculated via the inverse probability weighting approach. Effect estimates are presented as hazard ratios (HRs).

RESULTS: Our final cohort included 248,176 residents (124,026 test-negative, 124,150 test-positive). Over a median follow-up time of 415 days, 739 positive (0.60%) and 657 negative (0.53%) individuals were newly identified with diabetes. The incidence among positive individuals was 572.82 per 100,000 person-years (CI 531.52-614.12), and that among negative individuals was 509.50 per 100,000 person-years (CI 470.54-548.46). The overall HR was 1.13 (CI 1.02-1.25). In stratified analyses, this effect was prominent in women aged 41-60 years (HR 1.31; CI 1.02-1.68).

CONCLUSIONS: This study provides population-based evidence supporting an association between SARS-CoV-2 infection and newly detected diabetes. These findings contribute to understanding the long-term health impact of COVID-19 and may inform public health strategies for PASC prevention and management.},
}

@article {pmid42116095,
year = {2026},
author = {Thölking, T and Müller, F and Riester, T and Lampe, V and Theil, LM and Hummers, E and Sarpari, K and Dopfer-Jablonka, A and Happle, C and Steffens, S and Meier-Maiwald, M and Mikuteit, M and Schröder, D},
title = {Impact of post-exertional malaise frequency and fatigue in Long COVID patients on health-related quality of life.},
journal = {Health and quality of life outcomes},
volume = {24},
number = {1},
pages = {},
pmid = {42116095},
issn = {1477-7525},
mesh = {Humans ; *Quality of Life/psychology ; Male ; Female ; *Fatigue/etiology/psychology/epidemiology ; Cross-Sectional Studies ; Middle Aged ; *COVID-19/complications/psychology ; Germany/epidemiology ; Adult ; Aged ; SARS-CoV-2 ; Severity of Illness Index ; Surveys and Questionnaires ; },
abstract = {PURPOSE: The aim of this study was to investigate the impact of post-exertional malaise (PEM) frequency and PEM severity on health-related quality of life (HRQoL) among individuals with Long COVID.

METHODS: We conducted a cross-sectional online survey including adults in Germany with self-reported Long COVID and PEM. Fatigue severity was assessed with the Fatigue Assessment Scale (FAS), and HRQoL was measured using the EQ-5D-3L (descriptive index and visual analogue scale [EQ-VAS]). Associations between PEM frequency, fatigue, and HRQoL were examined using correlations and non-parametric group comparisons. Multiple linear regression models were fitted to predict HRQoL while controlling for age, sex, employment status, and subjective social status.

RESULTS: Higher PEM frequency was associated with significantly lower EQ-5D index scores (ρ = - 0.32, p<.001). PEM severity was also strongly correlated with reduced HRQoL (EQ-5D index: ρ = - 0.43, p<.001). In multivariable regression models, greater fatigue and higher PEM frequency independently predicted poorer HRQoL, even after adjustment for sociodemographic factors.

CONCLUSION: Both PEM frequency and PEM severity substantially impair HRQoL in individuals with Long COVID. These findings underscore the clinical relevance of PEM as a key symptom and highlight the need for targeted management strategies to mitigate its impact on daily life.

CLINICAL TRIAL NUMBER: German Clinical Trials Register DRKS00026007; registration date: 9 September 2021.},
}

Humans
*Quality of Life/psychology
Male
Female
*Fatigue/etiology/psychology/epidemiology
Cross-Sectional Studies
Middle Aged
*COVID-19/complications/psychology
Germany/epidemiology
Adult
Aged
SARS-CoV-2
Severity of Illness Index
Surveys and Questionnaires

@article {pmid42116147,
year = {2026},
author = {Fonka, CB},
title = {Perspectives of senior health managers on COVID-19 response and challenges, lessons learned and opportunities against future outbreaks in Gauteng province, South Africa.},
journal = {BMC health services research},
volume = {},
number = {},
pages = {},
doi = {10.1186/s12913-026-14635-7},
pmid = {42116147},
issn = {1472-6963},
abstract = {BACKGROUND: This study explores senior health managers' perspectives on COVID-19 response and challenges, lessons learned, and opportunities in Gauteng, one of the most affected provinces in South Africa, and further presents recommendations for health systems strengthening, preparedness, and effective response against future infectious outbreaks or pandemics.

METHOD: Using a qualitative exploratory study, online in-depth interviews were conducted with purposively selected senior managers from the Gauteng Department of Health (GDoH) who were at the forefront of managing the pandemic. Recordings were transcribed verbatim, and saturation was reached with thirteen interviewees (n = 13). Thematic and inductive analyses were performed in NVivo 10 and reported following the Consolidated Criteria for Reporting Qualitative Research (COREQ).

RESULTS: The findings are presented in four main themes, namely: GDoH's response to the COVID-19 pandemic, COVID-19-related challenges, lessons learned and opportunities from COVID-19, and participants' recommendations on dealing with future pandemics. The managers' perspectives suggest that GDoH's response to COVID-19 was comprehensive, multi-sectoral, and effective through public awareness, the War Room/nerve Centre that managed the response, resources mobilization like the recruitment of additional nurses and doctors, and vaccination. The challenges included the adverse effects of "long-COVID" and mental health, demised health workers, corruption and embezzlement of COVID-19 funds, high cost of living, and gender-based violence associated with COVID-19. The lessons learned included the importance of technology, surveillance, and data analytics during crises, improved hygiene-like hand washing, to mitigate infection transmission, and the urgency to build resilient health systems. The pandemic also highlighted the need for inclusive and collaborative public-private partnerships in the National Health Insurance (NHI) implementation. Participants' recommendations for dealing with future outbreaks included improvements in ICT, the need for social media regulation, working remotely, pandemic incentives for health workers, improved and accountable leadership, addressing corruption and the need for further COVID-19 research.

CONCLUSION: According to the health managers interviewed in this study, the GDoH response to COVID-19 appeared to be resilient, comprehensive, multi-sectoral and effective despite the challenges emanating from the pandemic. Although the pandemic harmed the health system, lessons were learned with opportunities for leveraging the impact of future outbreaks, particularly as South Africa is in the process of providing universal health coverage, pronounced through the NHI.

CLINICAL TRIAL REGISTRATION: Not applicable.},
}

@article {pmid42117068,
year = {2026},
author = {Rivas, JC and Restrepo, A and Barbosa, MM and Cordoba-Melo, BD and Arteaga-Tobar, AA and Naranjo-Ramirez, MC and Ochoa-Rojas, MC and Miranda-Bastidas, CA and Casanova Rojas, AF and Mina Sánchez, AF and Tovar Cuevas, JR and Gómez-Mesa, JE},
title = {Factorial structure of the patient health questionnaire-9 in long-term survivors of severe COVID-19.},
journal = {Frontiers in psychology},
volume = {17},
number = {},
pages = {1657877},
pmid = {42117068},
issn = {1664-1078},
abstract = {INTRODUCTION: Depression is prevalent among survivors of severe COVID-19, yet psychometric evidence for screening instruments in this population remains limited, particularly in Latin America. The factor structure of the Patient Health Questionnaire-9 (PHQ-9) remains unclear in long-term survivors of severe COVID-19. This study aimed to evaluate the psychometric properties and factor structure of the PHQ-9 in a Colombian cohort of long-term survivors of severe COVID-19.

MATERIALS AND METHODS: The PHQ-9 was administered to 177 individuals previously hospitalized with severe COVID-19, with follow-up extending up to 20 months post-discharge. Both exploratory (EFA) and confirmatory factor analyses (CFA) were conducted to evaluate competing structural models.

RESULTS: The unifactorial solution demonstrated superior internal consistency (α = 0.81, ω = 0.86) compared with the two-factor solution (Factor 1: α = 0.74; Factor 2: α = 0.61). The two-factor item distribution did not correspond to established depression frameworks. CFA showed both models had acceptable fit, but chi-square difference testing revealed no significant improvement for the two-factor model (Δχ[2] = 0.27, p = 0.602). The fatigue item exhibited the lowest factor loading.

CONCLUSION: The PHQ-9 demonstrated a predominantly unidimensional structure in this population. The weak performance of the fatigue item suggests potential overlap between long COVID-related fatigue and depressive symptomatology, warranting future criterion validation against structured psychiatric assessment.},
}

@article {pmid42040960,
year = {2026},
author = {Valverde, A and Capistrano, K and Naqvi, RA and Elshourbagy, S and Etminan, S and Sandoval, G and Bambrilla, M and Nares, S and Shukla, D and Schwartz, J and Naqvi, A},
title = {Periodontitis Primes the Oral Microenvironment for PS-Dependent Non-Canonical Entry Pathways Linked to SARS-CoV-2 Susceptibility.},
journal = {Research square},
volume = {},
number = {},
pages = {},
pmid = {42040960},
issn = {2693-5015},
abstract = {SARS-CoV-2 infection extends beyond the respiratory tract, with the oral cavity emerging as a critical site of viral activity shaped by epithelial receptor expression, microbial interactions, and inflammatory status. Periodontal disease (PD), a chronic dysbiotic condition, may heighten susceptibility to SARS-CoV-2 through inflammation-driven upregulation of non-canonical viral entry pathways. In this study, we investigated genes in the phosphatidylserine (PS)-dependent pathway, including ADAM17, ATP11c, TIM1, TIM3, and TIM4, in gingival tissue, saliva, and oral keratinocytes to define how PD and SARS-CoV-2 coordinately modulate oral viral entry mechanisms. Prepandemic gingival biopsies revealed significant upregulation of all non-canonical receptors in inflamed tissue, indicating that PD alone establishes a permissive molecular environment for PS-mediated microbial entry. In a post-vaccination cohort, salivary expression of these receptors was markedly elevated in COVID-19-positive individuals with PD, accompanied by significantly increased salivary PS levels, suggesting synergistic effects of viral exposure and periodontal inflammation. In vitro co-infection of primary human oral keratinocytes with SARS-CoV-2 and periodontal pathogens (P. gingivalis, A. actinomycetemcomitans) induced robust, synergistic activation of PS-dependent entry genes, particularly TIM family receptors. Together, these findings identify PS and its associated receptors as inflammation-responsive mediators that expand SARS-CoV-2 entry routes in the oral mucosa. This work highlights a mechanistic intersection between COVID-19 and periodontal disease, with implications for viral persistence, immune dysregulation, and long-term oral health outcomes.},
}

@article {pmid42107843,
year = {2026},
author = {Floridia, M and Weimer, LE and Lo Forte, A and Palange, P and Agostoni, P and Ciardi, MR and Tosato, M and Lacedonia, D and Gnerre, P and Barisione, E and Martino, GP and Vagheggini, G and Onder, G and , },
title = {Dyspnea and fatigue in Long-COVID: definition of risk factors and of DLCO-based phenotypes in a multicenter study of 765 patients from Italy.},
journal = {Respiratory medicine},
volume = {},
number = {},
pages = {108880},
doi = {10.1016/j.rmed.2026.108880},
pmid = {42107843},
issn = {1532-3064},
abstract = {BACKGROUND: Dyspnea and fatigue represent common Long-COVID symptoms, but their presence is not always accompanied by lung function abnormalities. Aim of the study was to evaluate dyspnea and fatigue in relation to pulmonary function and exercise capacity.

METHODS: Multicenter cohort study. Multivariable analyses were used to characterize, for both symptoms, functional phenotypes with and without pulmonary impairment according to the diffusing lung capacity for carbon monoxide (DLCO). Exercise capacity was assessed through the distance walked in 6 minutes (6MWD).

RESULTS: Among 765 patients evaluated at a mean interval of six months from COVID-19, rates of dyspnea and fatigue were 41.3% and 41.6%, respectively. Roughly half of the patients with these two symptoms (51.6% and 54.7%, respectively) had normal pulmonary function at DLCO testing (≥80% of predicted). Low-DLCO (<80%) dyspnea was significantly associated with female sex, anxiety, duration of hospitalisation, use of corticosteroids and of monoclonal neutralizing antibodies, and its risk decreased at the increasing in time from acute infection. Normal-DLCO dyspnea was associated with younger age and obesity. Low-DLCO fatigue was associated with female sex, heart failure, anxiety and use of corticosteroids. Normal-DLCO fatigue was not associated with demographics, comorbidities, or COVID-19 severity. For both symptoms, the low-DLCO phenotypes had a significantly lower 6MWD.

CONCLUSIONS: The clinical phenotypes of dyspnea and fatigue with normal pulmonary function should be further explored, possibly with additional tests that assess cardiorespiratory and cardiovascular function. DLCO testing should be included in the evaluation of patients who report dyspnea and/or fatigue as possible Long-COVID symptoms.},
}

@article {pmid42108247,
year = {2026},
author = {Yamamoto, S and Kurano, M and Okamoto, K and Kubota, M and Tsutsumi, T and Aoki, J and Moriya, K},
title = {Sphingolipid and glycerophospholipid profiling in post-acute sequelae of SARS-CoV-2 infection.},
journal = {Scientific reports},
volume = {},
number = {},
pages = {},
doi = {10.1038/s41598-026-50505-2},
pmid = {42108247},
issn = {2045-2322},
abstract = {Post-acute sequelae of severe acute respiratory syndrome coronavirus 2 infection (PASC) is a heterogeneous multisystemic condition with unclear pathogenesis. Emerging evidence suggests that the disruption in metabolism, including lipid metabolism, can be involved in the pathogenesis of coronavirus disease 2019 (COVID-19). We previously measured the bioactive lipids in acute COVID-19, and we hypothesized that bioactive lipid dysregulation play a role in PASC pathogenesis. We conducted targeted LC-MS/MS analysis of sphingolipids and glycerophospholipids in serum samples from individuals with acute-phase COVID-19, including those who developed PASC, alongside healthy controls. We systematically examined lipidomic changes in serum samples, including analyses using linear mixed model, and found that no sphingolipid or glycerophospholipid species differed between the COVID-19 and PASC groups. Although these results are exploratory, the group x time interaction in the linear mixed model suggested that phosphatidylglycerol (PG) may represent a bioactive lipid distinguishing the COVID-19 and PASC groups. Given the small PASC sample size and that the signal was detected only at specific time points, these findings are hypothesis generating and should be confirmed in larger, adequately powered, and independently validated cohorts.},
}

@article {pmid42108528,
year = {2026},
author = {Mosha Miller, SA and Hicar, MD and Berry, CS and Anderson, KB and Lindo, JF and Morse, GD and Christie, CDC},
title = {Long COVID-19 in Hospitalized and Ambulatory Children in Jamaica.},
journal = {The Pediatric infectious disease journal},
volume = {},
number = {},
pages = {},
doi = {10.1097/INF.0000000000005259},
pmid = {42108528},
issn = {1532-0987},
abstract = {This retrospective observational cohort study evaluated acute illness predictors of pediatric Long coronavirus disease 2019 in Jamaica. Poisson regression modeling associated acute univariate symptoms of vomiting, abdominal pain, ageusia, anosmia, fatigue, confusion, brain fog, and multisystem inflammatory syndrome in children and multivariable composite predictors of multisystem inflammatory syndrome in children, vomiting and ageusia. The 47.3% incidence supports the need for improvements in similar resource-constrained settings.},
}

@article {pmid42108714,
year = {2026},
author = {Jang, E and Nan, Y and Chang, H and Young, LE},
title = {Disentangling the Network Structure of Online Social Support: A Multilayer Network Analysis of a Twitter Long COVID Community.},
journal = {Health communication},
volume = {},
number = {},
pages = {1-12},
doi = {10.1080/10410236.2026.2672056},
pmid = {42108714},
issn = {1532-7027},
abstract = {Online social support has been shown to be an important resource for people experiencing chronic illnesses. Although numerous studies have examined online support communities, few have conducted in-depth analyses grounded in social network theory and methodologies. To address this gap, this study investigates the types of support and the overall patterning of such exchanges (i.e., the network structure) on Twitter (now X), focusing on a community of people who seek and provide support for Long COVID. Using an exhaustive keyword-based corpus of Long COVID tweets (N = 19,196) collected from August 1-31, 2021, we identified two types of social support shared in this community-informational and emotional-through human annotation combined with supervised machine learning. Conducting descriptive and stochastic social network analysis, we examined how exchanges of each type of support were structured. We focused on the density, reciprocity, and centralization of support ties-three structural features shown to be related to specific types of support. Our results showed that informational support was more prevalent than emotional support. Additionally, these informational and emotional support networks tended to be both reciprocal and concentrated around a small number of central users who received considerable support (i.e., were centralized). Our findings suggest that online health communities hosted on platforms such as Twitter may be better suited for informational support. We also observed that central actors play an important role in facilitating these exchanges. These findings provide practical insights for effective social network interventions.},
}

@article {pmid42109469,
year = {2026},
author = {Cardenas-Jara, AR and Ongaya, A and Shiluli, C and Ramos, LB and Senador, LC and Flores, JA and Kanoi, BN and Reijneveld, JF and Ruvalcaba, A and Perez, D and Waiganjo, P and Lindestam-Arlehamn, CS and Henrich, TJ and Peluso, MJ and Leon, SR and Gitaka, J and Suliman, S},
title = {Prevalence of Long COVID in Mycobacterium tuberculosis-exposed groups.},
journal = {Journal of clinical tuberculosis and other mycobacterial diseases},
volume = {44},
number = {},
pages = {100610},
pmid = {42109469},
issn = {2405-5794},
abstract = {OBJECTIVES: Long COVID (LC), i.e. the persistence of new or worsening symptoms for 3 months after Severe Acute Respiratory Syndrome of Coronavirus 2 (SARS-CoV-2) infection, is an emerging global health burden. The prevalence of LC remains poorly characterized in low- and middle-income countries (LMICs), where other respiratory diseases, like tuberculosis (TB), are prevalent. We aimed to address this gap in Mycobacterium tuberculosis (Mtb)-exposed populations in Peru.

METHODS: We recruited people with TB (n = 36) and their asymptomatic household contacts (n = 63) in Peru. We collected clinical data using a questionnaire adapted from a United States-based study of LC. Participants were recruited within 2 years of SARS-CoV-2 diagnosis.

RESULTS: In Peru, 41% participants reported LC symptoms. The most common LC symptoms were neurological (e.g., headache) and musculoskeletal (e.g., back pain). We did not detect an association between TB disease or Mtb infection and LC at this sample size. However, the quality-of-life dimensions worsened during the post-COVID period.

CONCLUSIONS: LC prevalence in Peru aligns with global trends, underscoring significant health burdens. Those with LC reported high levels of musculoskeletal and neurological symptoms, highlighting the need for long-term follow-up and larger studies in different geographic settings to dissect the impact of TB comorbidity on LC.},
}

@article {pmid42109976,
year = {2026},
author = {Ballard, DW and Warton, EM and Skarbinski, J and Siqueiros, MH and Cholleti, SM and Vinson, DR and Mark, DG and Durant, EJ and DiLena, DD and Reed, ME},
title = {The Long Tail of Long COVID-19: Broad and Extensive Increase in Utilization Within an Integrated Healthcare System.},
journal = {Cureus},
volume = {18},
number = {4},
pages = {e106676},
pmid = {42109976},
issn = {2168-8184},
abstract = {BACKGROUND: The impact of the emergence of Long COVID on healthcare utilization in a U.S. community setting remains underexplored.

OBJECTIVE: To examine the healthcare utilization of Long COVID patients compared with pre-COVID-19 era controls before and after SARS-CoV-2 infection within a large integrated delivery system.

METHODS: This was a retrospective cohort study of adult patients with documented SARS-CoV-2 infection (1/1/2021-6/30/2022) in a multi-site Northern California health system. Long COVID diagnosis was defined by at least one encounter with an associated International Classification of Diseases, Tenth Revision code and/or referral to Long COVID specialty care. Utilization outcomes included inpatient/outpatient encounters, laboratory/imaging/functional testing, specialty care referrals/encounters, and medication use. We used propensity-weighted difference-in-differences models adjusted for study month to compare outcomes between baseline and post-SARS-CoV-2 infection (Long COVID window).  Results: Among 600,295 patients with 635,230 SARS-CoV-2 episodes, 3,545 met criteria for Long COVID care-seeking. Long COVID patients had higher baseline utilization and greater increases in post-diagnosis utilization in adjusted analyses. After propensity weighting, these differences persisted and were consistent across the study period, particularly in cardiac and pulmonary care. Total encounters per year were 29.9 post and 14.1 pre (Long COVID) versus 17.7 post and 12.5 pre (NO Long COVID). Total annual ED visits per 100 patients were 65.1 post and 38.0 pre (Long COVID) versus 38.0 post and 32.0 pre (NO Long COVID). Annual hospitalizations per 100 patients were 10.5 post and 5.3 pre (Long COVID) versus 7.4 post and 5.5 pre (NO Long COVID).

CONCLUSION: Long COVID patients had higher healthcare utilization before and after diagnosis, with sharper increases across nearly all outcomes.},
}

@article {pmid42111378,
year = {2026},
author = {Mali, I and Harrison, M and Frizzell, B and Castro, M and McHorse, A and Que, LG and Mummy, D and Niedbalski, PJ},
title = {Using hyperpolarised xenon-129 magnetic resonance imaging to investigate longitudinal effects of long COVID on pulmonary function.},
journal = {ERJ open research},
volume = {12},
number = {2},
pages = {},
pmid = {42111378},
issn = {2312-0541},
abstract = {Hyperpolarised [129]Xe MRI shows significant improvements in VDP and select gas exchange metrics at ∼20 months compared to ∼14 months following initial COVID-19 infection https://bit.ly/3LoJry4.},
}

@article {pmid42103518,
year = {2027},
author = {Philip, KEJ and Owles, H and McVey, S and Pagnuco, T and Bruce, K and Warnock, B and Chomacki, A and Brunjes, H and Mollica, J and Lound, A and Zumpe, S and Abrahams, AM and Padmanaban, V and Hardy, TH and Lewis, A and Lalvani, A and Elkin, SL and Hopkinson, NS},
title = {An online singing-based breathing and wellbeing programme (ENO Breathe) in people with long COVID breathlessness in the UK: a cohort study.},
journal = {The Lancet. Digital health},
volume = {},
number = {},
pages = {100988},
doi = {10.1016/j.landig.2026.100988},
pmid = {42103518},
issn = {2589-7500},
abstract = {BACKGROUND: Post-COVID-19 condition (also known as long COVID) breathlessness is a common, complex, and frequently debilitating problem for which few evidence-based interventions exist. A previous randomised trial found that participation in an online 6-week breathing and wellbeing programme (ENO Breathe), using singing techniques, was associated with improvements in health-related quality of life (HRQOL) and breathlessness. We aimed to assess the impact of this intervention outside a trial setting.

METHODS: In this cohort study, participants were referred from 51 UK-based National Health Service (NHS) long COVID clinics, where they had been diagnosed with breathlessness due to long COVID. The eligibility criteria of ENO Breathe were age 18 years or older, having long COVID with associated breathlessness, diagnosis and referral from a specialist collaborating NHS long COVID clinic, and access and ability to engage with the online programme. We compared baseline and post-intervention data to assess the effect of the ENO Breathe programme on HRQOL assessed using the RAND-36 Mental and Physical Health Composite (MHC and PHC) primary outcome, with an estimated minimally clinically important difference of 3; breathlessness (assessed using Dyspnoea-12 scores and visual analogue scales [VAS] for breathlessness at rest, walking, using stairs, and running); anxiety (assessed using the Generalised Anxiety Disorder-7 questionnaire [GAD-7]); and respiratory symptoms (assessed using the COPD Assessment Test [CAT]).

FINDINGS: 1413 programme participants were included in this analysis (mean age 49 years [SD 11·9], BMI 28 kg/m[2] [7·2]). 1130 (80%) participants were female, 273 (19%) were male, and ten (1%) did not disclose their gender. 1165 (82%) participants were White, 87 (6%) were Asian, 47 (3%) were Black, 48 (3%) were of mixed or multiple ethnic backgrounds, 31 (2%) reported their ethnicity or race as other (ie, not one of the categories specified), and 35 (2%) did not disclose their ethnicity or race. Participants reported having long COVID symptoms for a median of 415 days (IQR 246-601) at the time of registration with the programme. 1188 (84%) of 1413 participants provided follow-up data on completion of the programme. Completing ENO Breathe was associated with improvements in HRQOL (median difference in RAND-36 MHC 2·98, IQR -1·53 to 8·42; and median difference in PHC 1·69, -1·32 to 5·01), breathlessness (mean difference in Dyspnoea-12 -4·29, 95% CI -4·64 to -3·94; VAS breathlessness scores walking median difference -5, IQR -18 to 6; stairs median difference -10, -25 to 3; and running median difference -3, -19 to 0), anxiety (median GAD-7 score difference -1, IQR -4 to 1), and respiratory symptom impact (mean CAT score difference -2·50, -2·81 to -2·19; all p<0·0001). The VAS breathlessness score at rest did not significantly change (median difference 0, IQR -10 to 13; p=0·24). The response to the ENO Breathe intervention did not differ by age, gender, ethnicity, or pre-existing asthma. There were no reported clinically significant adverse events.

INTERPRETATION: The ENO Breathe programme can improve HRQOL, breathlessness, anxiety, and respiratory symptoms in people with long COVID and breathlessness. ENO Breathe could be tested in other major causes of breathlessness and might help inform the development and delivery of other related interventions.

FUNDING: Imperial College London.},
}

@article {pmid42106490,
year = {2026},
author = {Azabou, E and Pillot, A and Bao, G and Mehlal, S and Arnould, A and Agar-Hug, N and Zagdoun, M and Genolini, A and Russo, A and Rangon, CM and Azouvi, P},
title = {Transcutaneous auricular vagus nerve stimulation improves dysautonomia, post-traumatic stress disorder and cognitive impairment in long covid patients: a pilot study.},
journal = {Scientific reports},
volume = {},
number = {},
pages = {},
doi = {10.1038/s41598-026-52582-9},
pmid = {42106490},
issn = {2045-2322},
abstract = {Long COVID is frequently associated with persistent autonomic dysfunction, cognitive impairment, and psychological distress, reflecting sustained neuroimmune and autonomic dysregulation. Effective disease-modifying therapies remain scarce. To evaluate the effects of transcutaneous auricular vagus nerve stimulation (taVNS) on autonomic symptoms, post-traumatic stress symptoms, and cognitive performance in patients with long COVID. In this open-label, single-arm prospective pilot study, seventeen patients with long COVID underwent weekly one-hour taVNS sessions for eight consecutive weeks. Autonomic symptoms were assessed using the Composite Autonomic Symptom Score-31 (COMPASS-31), psychological symptoms using the PTSD Checklist for DSM-5 (PCL-5), and cognitive function using a standardized attention and executive function battery (COGBAT). Outcomes were evaluated at baseline and post-intervention. Paired non-parametric analyses were performed. Following taVNS, autonomic symptoms improved significantly, with mean COMPASS-31 scores decreasing from 33.71 ± 16.81 to 13.78 ± 9.38 (p < 0.0001). Post-traumatic stress symptoms were significantly reduced (PCL-5: 25.76 ± 14.99 to 19.47 ± 14.63; p = 0.028). Cognitive performance improved, with COGBAT scores increasing from 37.71 ± 25.75 to 49.41 ± 26.79 (p = 0.011). No adverse events were reported. taVNS appears to be a safe and promising non-pharmacological intervention for improving autonomic dysfunction, cognitive impairment, and psychological symptoms in long COVID. These findings warrant confirmation in randomized, sham-controlled trials.},
}

@article {pmid42095154,
year = {2026},
author = {Rakab, MS and Mirza, I and Ali, MM and Khan, A and Darbar, D and Mahmoud, AM},
title = {Endothelial and cardiac dysfunction in long COVID With cardiovascular symptoms is associated with imbalance in the ADMA-DDAH-NOx pathway.},
journal = {Frontiers in cardiovascular medicine},
volume = {13},
number = {},
pages = {1802359},
pmid = {42095154},
issn = {2297-055X},
abstract = {BACKGROUND: Post-acute sequelae of COVID-19 (PASC) commonly feature lingering symptoms of persistent cardiovascular pathology, yet the mechanisms remain incompletely defined. The ADMA-DDAH-NOx axis is a central regulator of endothelial function: ADMA inhibits endothelial NOx synthase, while DDAH clears most circulating ADMA. Although ADMA is linked to acute COVID-19 severity, its regulation in PASC remains largely unknown.

METHODS: We performed integrated vascular and cardiac phenotyping in 49 RECOVER participants: never-infected controls (n = 10), recovered COVID-19 without persistent symptoms (PASC-, n = 20), and PASC with persistent cardiovascular-related symptoms lasting ≥12 weeks post-infection (PASC+, n = 19). We measured ADMA, DDAH, NO, inflammatory/coagulation markers, endothelial function [brachial and microvascular flow-mediated dilation (FMD)], and cardiac structure and function using comprehensive echocardiography with speckle-tracking strain.

RESULTS: PASC+ exhibited the highest inflammatory and thrombotic markers, with D-dimer being > 3-fold higher than controls, and hs-CRP nearly threefold higher. PASC+ demonstrated lower NOx and substantially higher ADMA than the other two groups, accompanied by only modest DDAH upregulation, suggesting insufficient counter-regulation. Endothelial function was significantly impaired in the PASC+ group compared to the control and PASC- groups, as evidenced by lower brachial and microvascular FMD. PASC+ individuals exhibited worse longitudinal mechanics and higher levels of hs-troponin and NT-proBNP. Ejection fraction was lower in PASC+ compared with Controls and PASC-.

CONCLUSIONS: These findings identify an imbalance in the ADMA-DDAH-NOx axis that is associated with endothelial dysfunction and cardiac involvement in cardiovascular-symptom PASC, supporting a potentially targetable pathway for risk stratification and therapeutic investigation.},
}

@article {pmid42099508,
year = {2026},
author = {Kawaguchi, M and Sakurada, Y and Tokumasu, K and Otsuka, Y and Nakano, Y and Matsuda, Y and Honda, H and Omura, D and Matsuki, N and Furukawa, M and Higashikage, A and Otsuka, F},
title = {Clinical Utility of SARS-CoV-2 Antibody Titers in the Management of Patients With Long COVID Infected With the Omicron Variant.},
journal = {British journal of biomedical science},
volume = {83},
number = {},
pages = {16255},
pmid = {42099508},
issn = {2474-0896},
mesh = {Humans ; Male ; Female ; *COVID-19/immunology/blood/virology/diagnosis ; Middle Aged ; *SARS-CoV-2/immunology ; Retrospective Studies ; *Antibodies, Viral/blood ; Adult ; Aged ; Spike Glycoprotein, Coronavirus/immunology ; COVID-19 Vaccines/administration & dosage/immunology ; Coronavirus Nucleocapsid Proteins/immunology ; },
abstract = {BACKGROUND: Long COVID (LC) presents persistent symptoms that pose a major clinical challenge. Identification of reliable biomarkers to evaluate LC pathophysiology is needed.

OBJECTIVES: To investigate whether serum S- and N-antibody titers against SARS-CoV-2 spike and nucleocapsid proteins reflect the clinical features of LC.

METHODS: This retrospective observational study included patients diagnosed with Omicron variant-related LC who attended a post-COVID-19 outpatient clinic between July 2023 and November 2024 and provided informed consent for antibody testing.

RESULTS: Among 275 patients (129 men and 146 women), 57 (21%) were unvaccinated. Median S- and N-antibody titers in vaccinated versus unvaccinated patients were 20,963 U/mL and 24.8 cut-off index (COI) versus 24 U/mL and 44.5 COI, respectively. S-antibody titers were associated with the number of vaccine doses received, whereas N-antibody titers correlated with disease severity during the acute phase of COVID-19 infection, with females having higher titers by multivariable analysis. N-antibody titers in unvaccinated patients with LC were negatively correlated with time interval from infection to clinic visit, with an estimated daily decline of 0.34% in measured N-antibody levels. Patients with LC having memory impairment had low S-antibody titers by multivariable logistic regression analysis, and low S-antibody levels were associated with reduced quality of life (QOL). Additionally, N-antibody titers positively correlated with lymphocyte counts and immunoglobulin levels.

CONCLUSION: Serum N-antibody titers reflect immune responses to COVID-19, although they are affected by gender differences and interval between infection and evaluation. Lower S-antibody titers were associated with brain fog symptoms and reduced QOL in patients with LC.},
}

Humans
Male
Female
*COVID-19/immunology/blood/virology/diagnosis
Middle Aged
*SARS-CoV-2/immunology
Retrospective Studies
*Antibodies, Viral/blood
Adult
Aged
Spike Glycoprotein, Coronavirus/immunology
COVID-19 Vaccines/administration & dosage/immunology
Coronavirus Nucleocapsid Proteins/immunology

@article {pmid42099668,
year = {2026},
author = {McAlpine, LS and Shorer, EF and Chiarella, J and Nelson, A and Veenhuis, R and Azola, A and Lee, A and Pierce, R and Farhadian, S and Rubin, LH and Spudich, SS and , and , },
title = {Vascular inflammation in neuropsychiatric long COVID.},
journal = {Brain, behavior, & immunity - health},
volume = {54},
number = {},
pages = {101247},
pmid = {42099668},
issn = {2666-3546},
abstract = {The role of vascular inflammation in neuropsychiatric Long COVID (LC) is suspected but not well understood. This study evaluated whether vascular inflammation is present in individuals with neuropsychiatric LC and how it relates to cognitive and mental health symptoms. This cross-sectional, case-control study included individuals with acute COVID-19 (AC), neuropsychiatric LC, and recovered controls. Participants were enrolled from the COVID Mind Study and the Yale IMPACT Study (hospitalized), and an independent cohort from the Johns Hopkins University (JHU) Long COVID Study. Fifty individuals with neuropsychiatric LC (new symptoms a median of 368 days post-COVID), 28 with AC, and 29 recovered controls (>3 months post-COVID) were evaluated. All underwent blood sampling and neuropsychiatric testing. The JHU cohort included 114 individuals with late LC (median 1065 days post-COVID illness associated with LC onset) and 31 recovered controls (median 852 days). Fourteen plasma biomarkers of vascular inflammation were measured. ANCOVA was used to compare groups, adjusting for comorbidities. Non-hospitalized participants completed the Global Neuropsychological Assessment, GAD-7, and PHQ-9. LC and recovered groups were demographically similar, while AC participants had higher obesity and hypertension rates. LC participants had elevated circulating biomarkers of endothelial, leukocyte, and platelet adhesion (sL-selectin, ADAMTS13, sP-selectin, sICAM-1) compared to recovered controls. Coagulation markers (D-dimer, fibrinogen) did not differ. Most biomarkers were highest in AC and lower in LC; however, fetuin, sL-selectin, and α-2 macroglobulin were higher in LC than AC. In LC, higher sP-selectin correlated with lower fluency and verbal learning. Lower α1-acid glycoprotein levels were strongly associated with poorer verbal memory, verbal learning, fluency, depression, and anxiety. In the JHU cohort, late LC and recovered controls showed no differences in biomarkers or demographics, suggesting normalization over time. Persistent dysregulation at the intersection of inflammation, platelet adhesion, and endothelial dysfunction is strongly linked to neuropsychiatric Long COVID. Elevated markers of endothelial adhesion in LC suggest distinct pathophysiology from AC. These biomarkers correlate with lower fluency and verbal learning, linking vascular dysfunction to brain function. This study underscores the critical need for longitudinal, within-person investigations to elucidate how vascular inflammation evolves over time.},
}