@article {pmid40650463,
year = {2025},
author = {Zhang, B and Grau, M and Puta, C and Arvidsson, D and Arz, M and Böcker, J and Chilibeck, P and Forbes, SC and Kaiser-Stolz, C and McLaurin, N and Miyamoto-Mikami, E and Pesta, D and Pustowalow, W and Tanaka, H and Rittweger, J and Bloch, W},
title = {Post-COVID-19 Condition in Track and Field Master Athletes: Severity, Symptoms, and Associations With Quality of Life and C-Reactive Protein Levels.},
journal = {Scandinavian journal of medicine & science in sports},
volume = {35},
number = {7},
pages = {e70106},
doi = {10.1111/sms.70106},
pmid = {40650463},
issn = {1600-0838},
support = {202306230030//China Scholarship Council/ ; //German Aerospace Center/ ; },
mesh = {Humans ; Male ; Female ; *Quality of Life ; *C-Reactive Protein/analysis/metabolism ; *COVID-19/complications/blood ; Middle Aged ; *Athletes ; Biomarkers/blood ; Adult ; Aged ; Severity of Illness Index ; Post-Acute COVID-19 Syndrome ; SARS-CoV-2 ; Surveys and Questionnaires ; Fatigue ; },
abstract = {Here, we assessed the prevalence of post-COVID-condition (PCC, also known as long-COVID) and investigated its associations with health-related quality of life and immune-related biomarkers in track and field masters athletes (MAs). A total of 216 MAs (114 males, 102 females; age: 58.3 ± 11.9 vs. 56.6 ± 11.7 years; BMI: 23.6 [22.2-24.8] vs. 21.3 [20.0-23.6] kg/m[2]) reported their post-COVID-conditions via the Post-COVID Syndrome Questionnaire (PCSQ). In a subgroup of 108 MAs, fasting blood samples were collected to assess C-reactive protein (CRP) levels as a biomarker of immune status (MAs-CRP). Based on their PCSQ sum score, MAs were divided into three groups: no/mild, moderate, and severe. Associations between PCC severity and sex, athletic specialty, and competition level were evaluated using Fisher's exact test. Forty-six (21%) MAs were identified with clinically relevant moderate-to-severe post-COVID-19 conditions (PCSQ score > 10.75). The most frequently reported symptoms included musculoskeletal pain (15%), sleep disturbance (13%), sensory or respiratory symptoms (11%), fatigue (11%), and flu-like symptoms (11%). PCC prevalence did not differ by sex, athletic specialties, training load, or prior competition level (all p > 0.05). MAs with moderate-to-severe PCC had significantly lower physical and mental component scores of quality of life compared with those with no or mild symptoms (p < 0.05). In the MAs-CRP subgroup, self-reported cardiac ailments and flu-like symptoms were significantly and positively associated with CRP levels (Spearman ρ = 0.27-0.30, all p < 0.01). Post-COVID-19 condition is associated with reduced quality of life in track and field masters athletes, independent of sex, prior competition levels, and training characteristics. Furthermore, low-grade inflammation based on CRP levels was associated with self-reported cardiac and flu-like symptoms.},
}

Humans
Male
Female
*Quality of Life
*C-Reactive Protein/analysis/metabolism
*COVID-19/complications/blood
Middle Aged
*Athletes
Biomarkers/blood
Adult
Aged
Severity of Illness Index
Post-Acute COVID-19 Syndrome
SARS-CoV-2
Surveys and Questionnaires
Fatigue

@article {pmid40649991,
year = {2025},
author = {Hein, ZM and Thazin, and Kumar, S and Che Ramli, MD and Che Mohd Nassir, CMN},
title = {Immunomodulatory Mechanisms Underlying Neurological Manifestations in Long COVID: Implications for Immune-Mediated Neurodegeneration.},
journal = {International journal of molecular sciences},
volume = {26},
number = {13},
pages = {},
doi = {10.3390/ijms26136214},
pmid = {40649991},
issn = {1422-0067},
mesh = {Humans ; *COVID-19/immunology/complications ; SARS-CoV-2/immunology ; *Neurodegenerative Diseases/immunology/etiology ; Blood-Brain Barrier/immunology ; Biomarkers ; Post-Acute COVID-19 Syndrome ; *Immunomodulation ; },
abstract = {The COVID-19 pandemic has revealed the profound and lasting impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on the nervous system. Beyond acute infection, SARS-CoV-2 acts as a potent immunomodulatory agent, disrupting immune homeostasis and contributing to persistent inflammation, autoimmunity, and neurodegeneration. Long COVID, or post-acute sequelae of SARS-CoV-2 infection (PASC), is characterized by a spectrum of neurological symptoms, including cognitive dysfunction, fatigue, neuropathy, and mood disturbances. These are linked to immune dysregulation involving cytokine imbalance, blood-brain barrier (BBB) disruption, glial activation, and T-cell exhaustion. Key biomarkers such as interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), glial fibrillary acidic protein (GFAP), and neurofilament light chain (NFL) correlate with disease severity and chronicity. This narrative review examines the immunopathological mechanisms underpinning the neurological sequelae of long COVID, focusing on neuroinflammation, endothelial dysfunction, and molecular mimicry. We also assess the role of viral variants in shaping neuroimmune outcomes and explore emerging diagnostic and therapeutic strategies, including biomarker-guided and immune-targeted interventions. By delineating how SARS-CoV-2 reshapes neuroimmune interactions, this review aims to support the development of precision-based diagnostics and targeted therapies for long COVID-related neurological dysfunction. Emerging approaches include immune-modulatory agents (e.g., anti-IL-6), neuroprotective drugs, and strategies for repurposing antiviral or anti-inflammatory compounds in neuro-COVID. Given the high prevalence of comorbidities, personalized therapies guided by biomarkers and patient-specific immune profiles may be essential. Advancements in vaccine technologies and targeted biologics may also hold promise for prevention and disease modification. Finally, continued interdisciplinary research is needed to clarify the complex virus-immune-brain axis in long COVID and inform effective clinical management.},
}

Humans
*COVID-19/immunology/complications
SARS-CoV-2/immunology
*Neurodegenerative Diseases/immunology/etiology
Blood-Brain Barrier/immunology
Biomarkers
Post-Acute COVID-19 Syndrome
*Immunomodulation

@article {pmid40649860,
year = {2025},
author = {Li, GH and Han, FF and Kalafatis, E and Kong, QP and Xiao, W},
title = {Systems Modeling Reveals Shared Metabolic Dysregulation and Potential Treatments in ME/CFS and Long COVID.},
journal = {International journal of molecular sciences},
volume = {26},
number = {13},
pages = {},
doi = {10.3390/ijms26136082},
pmid = {40649860},
issn = {1422-0067},
support = {Research Fund//Open Medicine Foundation/ ; },
mesh = {Humans ; *COVID-19/metabolism ; *Fatigue Syndrome, Chronic/metabolism/drug therapy ; Aspartic Acid/metabolism/therapeutic use ; SARS-CoV-2 ; Metabolomics ; Metabolic Networks and Pathways ; Asparagine/metabolism ; Male ; Metabolome ; Female ; Alanine/metabolism ; Adult ; Proline/metabolism ; },
abstract = {Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) and Long COVID are complex multisystem conditions that pose significant challenges in healthcare. Accumulated research evidence suggests that ME/CFS and Long COVID exhibit overlapping metabolic symptoms, indicating potential shared metabolic dysfunctions. This study aims to systematically explore shared metabolic disturbances in the muscle tissue of patients. Utilizing genome-wide metabolic modeling, we identified key metabolic irregularities in the muscle of patients with ME/CFS, notably the downregulation of the alanine and aspartate metabolism pathway and the arginine and proline metabolism pathway. Further, in silico knockout analyses suggested that supplementation with aspartate (ASP) or asparagine (ASN) could potentially ameliorate these metabolic deficiencies. In addition, assessments of metabolomic levels in Long COVID patients also showed the significant downregulation of ASP during post-exertional malaise (PEM) in both muscle and blood. Consequently, we propose that a combination of l-ornithine and l-aspartate (LOLA) is a potential candidate to alleviate metabolic symptoms in ME/CFS and Long COVID for future clinical trials.},
}

Humans
*COVID-19/metabolism
*Fatigue Syndrome, Chronic/metabolism/drug therapy
Aspartic Acid/metabolism/therapeutic use
SARS-CoV-2
Metabolomics
Metabolic Networks and Pathways
Asparagine/metabolism
Male
Metabolome
Female
Alanine/metabolism
Adult
Proline/metabolism

@article {pmid40649148,
year = {2025},
author = {de Brito, FAM and Laranjeira, C and Rossoni, SL and Ali, AM and Salci, MA and Carreira, L},
title = {Spatial Distribution and Post-COVID-19 Health Complications in Older People: A Brazilian Cohort Study.},
journal = {Journal of clinical medicine},
volume = {14},
number = {13},
pages = {},
doi = {10.3390/jcm14134775},
pmid = {40649148},
issn = {2077-0383},
support = {FCT-Fundação para a Ciência e a Tecnologia, I.P. (UIDB/05704/2020 and UIDP/05704/2020) and by the Scientific Employment Stimulus-Institutional Call - [https://doi.org/10.54499/CEECINST/00051/2018/CP1566/CT0012, accessed on 6 May 2025]//Fundação para a Ciência e Tecnologia/ ; grant number: 001/2023//Coordenação de Aperfeicoamento de Pessoal de Nível Superior/ ; },
abstract = {Background/Objectives: In the aftermath of the COVID-19 pandemic, individuals infected with SARS-CoV-2 have progressively displayed a range of symptoms linked to protracted COVID during the post-acute phase of illness. Concurrently, in several nations globally, the phenomenon of population aging has been intensifying. In this scenario, the aged population has become both vulnerable and high-risk during the acute phase of COVID-19, and faces significant dangers associated with long-COVID. This study seeks to analyze the incidence and spatial distribution of health complications in older people affected by COVID-19, in the first year of the pandemic (2020), in the State of Paraná, as well as to identify the factors associated with the development of cardiovascular, neurological, respiratory, and metabolic diseases. Method: An observational and retrospective study was carried out in the Brazilian state of Paraná. Participants were randomly selected from two databases. A total of 893 older people (≥60 years) participated in the study 12 months after acute COVID-19 infection. Telephone questionnaires were applied between March and December 2021. The Moran index test, logistic regression, and Poisson models were used to analyze the data. Results: In terms of age, most participants (66%) were between 60 and 69 years old, 25.8% were between 70 and 79 years old, and 8.2% were 80 years old or older. Most participants were female (51.2%), white (98.1%), had a partner (69.8%), and had been hospitalized due to COVID-19 (59.3%). Cardiovascular diseases were the most frequent in the population (39.5%), followed by metabolic diseases (27.3%). The long-term use of medication was associated with the development of metabolic diseases (aOR = 9.8), cardiovascular diseases (aOR = 6.6), and diseases in multiple organic systems (aOR = 3.2); living alone was associated with neurological diseases (aOR = 2.5), and the age group of 80 years or older (aOR = 2.4) was associated with cardiovascular events. The spatial distribution showed that complications in body groups are distributed randomly among the health regions of the state, with no influence from neighboring locations. Conclusions: Post-COVID-19 health complications are more frequent in older adults who have comorbidities and long-term medication use. Therefore, long-term monitoring of these individuals and investment in public policies for rehabilitation and prevention of complications are necessary.},
}

@article {pmid40648596,
year = {2025},
author = {Tarver, WL and Hu, X and MacEwan, SR and Gaughan, AA and McAlearney, AS},
title = {Long COVID Patients' Perceptions of Social Support in Their Work and Personal Lives: A Qualitative Study.},
journal = {Healthcare (Basel, Switzerland)},
volume = {13},
number = {13},
pages = {},
doi = {10.3390/healthcare13131568},
pmid = {40648596},
issn = {2227-9032},
support = {U54CA260582/CA/NCI NIH HHS/United States ; },
abstract = {Background: The onset and persistence of Long COVID can lead to cognitive and functional impairment, contributing to illness-induced employment and work disparities. Understanding how social support influences these issues can inform care strategies and support continued workforce participation. Objectives: This study explored perceptions of social support among patients with Long COVID. Methods: Semi-structured interviews were conducted with 21 patients receiving care at a post-COVID recovery clinic. Patient perspectives on social support in their work and personal lives were analyzed using both inductive and deductive thematic analysis. Findings were organized under the following five dimensions of social support theory: tangible support, emotional support, informational support, appraisal support, and belonging support. Results: Patients received positive tangible, emotional, and informational support from family, friends, and credible sources. However, patients also described receiving negative appraisal support from their personal lives and workplaces when others misunderstood the scope and duration of their limitations due to Long COVID. This negative appraisal support often labeled them as lazy or underperforming, leading to both personal and professional challenges to their self-esteem. Regarding companionship support, participants reported challenges keeping in touch with others and being less social. Conclusions: Social support impacts Long COVID patients' abilities to cope with the trauma of their experiences. Understanding the sources of and barriers to social support for Long COVID patients may inform strategies to enhance their care and well-being. Future interventions should offer opportunities for family, friends, and employers of Long COVID patients to learn about what it means to live with the illness.},
}

@article {pmid40645616,
year = {2025},
author = {Rohner, S and Schnepper, R and Meinlschmidt, G and Schaefert, R and Mayr, M and Bopp, K and Meienberg, A},
title = {Basel Long COVID Cohort Study (BALCoS): protocol of a prospective cohort study.},
journal = {BMJ open},
volume = {15},
number = {7},
pages = {e093981},
doi = {10.1136/bmjopen-2024-093981},
pmid = {40645616},
issn = {2044-6055},
mesh = {Humans ; *COVID-19/complications/psychology/epidemiology ; Prospective Studies ; SARS-CoV-2 ; Switzerland/epidemiology ; Female ; Male ; Post-Acute COVID-19 Syndrome ; Research Design ; Psychometrics ; },
abstract = {INTRODUCTION: The recent pandemic caused by SARS-CoV-2 had a profound global impact. While many individuals recovered from COVID-19, some developed long-lasting symptoms that significantly disrupted daily life. The WHO defines this condition as post-COVID-19 condition (PCC). Common symptoms include fatigue, dyspnoea, sleep disturbances and cognitive difficulties. Increasing evidence suggests that PCC is a multifactorial condition, shaped not only by biomedical but also psychological and social factors. This article presents the protocol of the Basel Long COVID Cohort Study (BALCoS), which aims to improve understanding of PCC by capturing clinical, functional and psychosocial aspects through repeated assessments over the course of 1 year.

METHODS AND ANALYSIS: BALCoS is a prospective, single-site cohort study. Inclusion criteria include either a probable or confirmed history of SARS-CoV-2 infection with persistent symptoms consistent with the WHO definition of PCC, sufficient German language skills and age ≥18 years. At baseline, we collected detailed information on previous SARS-CoV-2 infections, symptom history, reinfections, COVID-19 vaccination status and pre-existing medical conditions. The study includes standardised psychometric assessments, physical performance tests, ecological momentary assessments (EMAs), neurocognitive testing and blood sample collection. Assessments are scheduled at baseline and at 3-month, 6-month and 12-month follow-up. All participants complete psychometric assessments at each time point. Blood samples are only collected at baseline. Neurocognitive testing and physical performance measures are collected at baseline and 12-month follow-up for in-person participants only. Participants who are unable to attend in person complete a remote version of the study, excluding these in-clinic assessments. EMAs are initiated the day after each time point and consist of eight questions over 10 consecutive days. The study is exploratory in nature, with a target sample size of 120 participants. BALCoS is part of the Horizon Europe Long COVID project, a multinational interdisciplinary research consortium integrating mechanistic, clinical and interventional studies.

ETHICS AND DISSEMINATION: The study was approved by the Ethics Commission of Northwest and Central Switzerland (BASEC-ID: 2023-00359) and is registered at ClinicalTrials.gov (ID: NCT05781893). All participants provide written informed consent. Study findings will be disseminated through peer-reviewed publications.

TRIAL REGISTERATION NUMBER: NCT05781893.},
}

Humans
*COVID-19/complications/psychology/epidemiology
Prospective Studies
SARS-CoV-2
Switzerland/epidemiology
Female
Male
Post-Acute COVID-19 Syndrome
Research Design
Psychometrics

@article {pmid40645608,
year = {2025},
author = {Cabello Fernandez, C and Didone, V and Slama, H and Dupuis, G and Fery, P and Delrue, G and Lesoinne, A and Collette, F and Willems, S},
title = {Profiles of Individuals With Long COVID Reporting Persistent Cognitive Complaints.},
journal = {Archives of clinical neuropsychology : the official journal of the National Academy of Neuropsychologists},
volume = {},
number = {},
pages = {},
doi = {10.1093/arclin/acaf064},
pmid = {40645608},
issn = {1873-5843},
support = {LCOV21-1303//Belgian Health Care Knowledge Centre/ ; },
abstract = {OBJECTIVE: A subset of COVID-19 patients continues to experience cognitive difficulties 24 months post-infection. The factors driving these symptoms are complex, and the underlying pathophysiology is unclear. This study aimed to characterize individuals with Long COVID reporting cognitive issues.

METHOD: One hundred twenty-three patients underwent a comprehensive neuropsychological evaluation resulting from the baseline of an RCT study (COVCOG), along with questionnaires assessing cognitive complaints, fatigue, sleep difficulties, quality of life, psychological distress, and impact on daily activities. Latent Profile Analyses on cognitive scores were conducted to investigate the presence of different patient profiles. Robust analyses of variance and Pearson's chi-square examined the profiles' effects on demographic variables and questionnaire scores.

RESULTS: Patients had had predominantly mild to moderate infections (87.8%) and were assessed an average of 20.9 (±8.6) months post-infection. Neuropsychological assessment showed cognitive impairment in at least one domain in 72% of the patients, mainly in attention and executive functions. Over 80% reported sleep problems and fatigue, 97% concentration problems, and some 80% memory and word-finding problems. The self-report questionnaires also revealed significant complaints. Three profiles emerged (all ps < .001). Profiles 1 and 2 both experienced widespread cognitive issues; Profile 1 patients expressed more complaints about cognitive functioning and daily fatigue (all ps < .045). Patients in Profile 3 were more frequently men (all ps < .049) with a specific impairment of verbal long-term memory and fewer complaints.

CONCLUSIONS: The study identifies three different profiles of individuals with Long COVID, highlighting the need for comprehensive evaluations including neuropsychological, psychological, somatic, and functional aspects to implement effective, tailored interventions. Clinicaltrials.gov: NCT05167266.},
}

@article {pmid40645034,
year = {2025},
author = {Delpierre, C and Lemogne, C and Steichen, O and Tebeka, S and Makovski, TT and Coste, J},
title = {Influence of socioeconomic position on the relationship between long COVID and health-related quality of life: A nationwide random sampling survey in France in autumn 2022.},
journal = {Social science & medicine (1982)},
volume = {382},
number = {},
pages = {118368},
doi = {10.1016/j.socscimed.2025.118368},
pmid = {40645034},
issn = {1873-5347},
abstract = {Socioeconomic position (SEP) is associated with long COVID risk and health-related quality of life (HRQoL). SEP may influence the relationship between long COVID and HRQoL, but evidence is lacking. Our study therefore evaluated the influence of SEP on the relationship between long COVID or post-COVID-19 condition (PCC) and HRQoL in a representative sample of the general French population. After the Omicron waves in autumn 2022, a representative sample of 1448 adults infected with SARS-CoV-2 was assessed for post-COVID-19 symptoms, demographics, SEP, health factors and HRQoL using the PROMIS-29 questionnaire measuring HRQoL in eight domains (physical function, anxiety, depression, fatigue, sleep disturbance, ability to participate in social roles and activities, pain interference and pain intensity). PCC was defined according to the World Health Organisation. A conceptual model of the relationship between PCC and impaired HRQoL was proposed. Modifying effects of age, sex and SEP variables (geographic origin, education, household size, occupational category, employment status, household income) on the relationship between PCC and HRQoL were tested in the framework of this model. PCC, low education level and household income negatively impacted overall HRQoL and 5/8 PROMIS-29 domains (depression, fatigue, sleep disturbance, social participation and pain intensity). PCC-induced HRQoL impairment was significantly higher among people without a long tertiary education, unemployed individuals, business owners and entrepreneurs and people from mainland France. Healthcare providers and policymakers should better account for the differential impact of long COVID on HRQoL according to SEP. They should promote strategies to reduce health inequalities and lessen the burden of this condition in the general population.},
}

@article {pmid40644485,
year = {2025},
author = {Siddik, AB and Faisal, A and Khan, AH and Alam, MMM and Nayeem, J and Kulsum, U and Mukta, SA and Kawser, Z and Hasan, I and Azad, K and Hossain, M and Kar, S and Sultana, N and Alam, MR and Mustafa, A and Habib, MT and Ryan, ET and Qadri, F and Hassan, MR},
title = {Pulmonary function and comparative SARS-CoV-2 RBD-specific IgG antibody response among the COVID-19 recovered group.},
journal = {PloS one},
volume = {20},
number = {7},
pages = {e0318959},
pmid = {40644485},
issn = {1932-6203},
mesh = {Humans ; *COVID-19/immunology/physiopathology ; Male ; Female ; SARS-CoV-2/immunology ; *Immunoglobulin G/immunology/blood ; Middle Aged ; Case-Control Studies ; *Antibodies, Viral/immunology/blood ; Prospective Studies ; Adult ; Respiratory Function Tests ; Aged ; *Lung/physiopathology ; Pandemics ; *Betacoronavirus/immunology ; *Spike Glycoprotein, Coronavirus/immunology ; },
abstract = {BACKGROUND: Coronavirus disease 2019 (COVID-19) is a highly contagious infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) responsible for millions of deaths and substantial morbidity worldwide. Several studies report that up to 50% of individuals who recover from acute SARS-CoV-2 infection experience a plethora of long-COVID symptoms that may persist for weeks, months, or even up to a year. Abnormal pulmonary function is one of the most critical manifestations of long-COVID, even after recovering from COVID-19. Understanding the long-term pulmonary consequences and immune response among individuals recovering from COVID-19, who experienced disease severity ranging from mild to severe, is crucial for comprehensive post-recovery care and vaccination strategies.

METHODS: This prospective case-control study included 29 individuals who had recovered from COVID-19 with a history of mild to severe symptoms and 64 controls. Assessments of pulmonary functional measures, such as FVC, FEV1, FEV1/FVC ratio, FEF, MEF, and PEF were carried out following recovery from COVID-19. Additionally, IgG antibody responses were examined by ELISA for up to six months through multiple follow-ups following two doses of vaccination, with an additional follow-up 30 days after the booster dose (third dose).

RESULTS: Pulmonary functional abnormalities were prevalent in the recovered group, which had previously exhibited varying symptom severity (53% mild, 66% moderate, and 50% severe) compared to the control group (23%). Higher IgG antibody titers were observed among the recovered group, with significantly elevated titers in severe and moderate cases following vaccination. After vaccination, the recovered group showed significantly higher titers at day 14, particularly in the severe (1418 IU/mL) and moderate (1390 IU/mL) groups, compared to the control group (968 IU/mL) (p < 0.005). Notably, antibody titers were negatively correlated with pulmonary function test (PFT) parameters such as Forced Vital Capacity (FVC) and Forced Expiratory Volume in 1 second (FEV1). All groups experienced a significant (p < 0.005) decrease in antibody titers within 90-120 days after receiving two doses of vaccination. After five to six months, antibody titers returned to baseline levels, highlighting the importance of vaccination and additional booster doses regardless of previous infection history. Overall, our study underscores the significance of pulmonary function assessment post-COVID-19 recovery for long-term respiratory health and emphasizes the importance of vaccination regardless of infection history.

CONCLUSION: To assess the impact of long-COVID on respiratory health, this study underscores the importance of evaluating pulmonary function in individuals, whether they had symptomatic or asymptomatic COVID-19. Furthermore, the findings from the immune response analysis highlight the critical role of vaccination, regardless of infection history, as a key strategy of pandemic preparedness.},
}

Humans
*COVID-19/immunology/physiopathology
Male
Female
SARS-CoV-2/immunology
*Immunoglobulin G/immunology/blood
Middle Aged
Case-Control Studies
*Antibodies, Viral/immunology/blood
Prospective Studies
Adult
Respiratory Function Tests
Aged
*Lung/physiopathology
Pandemics
*Betacoronavirus/immunology
*Spike Glycoprotein, Coronavirus/immunology

@article {pmid40643736,
year = {2025},
author = {Venter, C and Pretorius, JH and Kell, DB and Pretorius, E},
title = {A novel metacyte metafer classifier for platelet morphology using long COVID as a model.},
journal = {Journal of thrombosis and thrombolysis},
volume = {},
number = {},
pages = {},
pmid = {40643736},
issn = {1573-742X},
support = {18//Balvi Foundation/ ; B31//Balvi Foundation/ ; NNF20CC0035580//Novo Nordisk Fonden/ ; },
}

@article {pmid40643301,
year = {2025},
author = {Beka, SG and Griffiths, RF and Myers, JA and Skirrow, PM},
title = {Appropriate Screening Tests to Assess Post-COVID-19 Cognitive Dysfunction in Aeromedical Settings.},
journal = {Aerospace medicine and human performance},
volume = {96},
number = {5},
pages = {414-424},
doi = {10.3357/AMHP.6500.2025},
pmid = {40643301},
issn = {2375-6322},
mesh = {Humans ; *COVID-19/complications/psychology ; *Cognitive Dysfunction/diagnosis/etiology ; *Pilots/psychology ; *Aerospace Medicine ; *Neuropsychological Tests ; SARS-CoV-2 ; Mass Screening ; },
abstract = {INTRODUCTION: Post-COVID-19, 10-20% of individuals may experience long-term symptoms (some having cognitive deficits), even after mild or nonsymptomatic infection. A sufficiently sensitive screening test of cognitive function, based on the typical cognitive effects of COVID-19 and skills considered most relevant to pilot performance, would be highly beneficial to be used alongside other performance checks. This study aimed to identify appropriate screening tests for post-COVID-19 cognitive dysfunction.

METHODS: Initially, a systematic search and narrative review identified 13 screening tools that are likely to be effective in screening pilots for post-COVID-19 neurocognitive impairment. Following a more in-depth evaluation of the identified tools, five tests including the Trail Making Test, Symbol Digit Modalities Test, Stroop Color Word Test, Psychomotor Vigilance Test, and Paced Auditory Serial Addition Test were chosen for a Delphi evaluation exercise. A two-round modified Delphi process was undertaken with international aviation medicine and psychology experts to obtain a consensus on which of the identified tests would be appropriate to screen for cognitive dysfunction in pilots.

RESULTS: Based on evaluation of literature review findings and Delphi consultation with subject matter experts, the Trail Making Test and Symbol Digit Modalities Test were identified as quick and suitable screening tests likely to detect post-COVID-19 cognitive dysfunction.

DISCUSSION: These tools are objective, have good utility, are available in multiple versions, and assess cognitive abilities relevant to pilot performance. Their use for screening in aeromedical examinations would be further supported by confirming their ability to reliably detect neurocognitive impacts associated with COVID-19. Beka SG, Griffiths RF, Myers JA, Skirrow PM. Appropriate screening tests to assess post-COVID-19 cognitive dysfunction in aeromedical settings. Aerosp Med Hum Perform. 2025; 96(5):414-424.},
}

Humans
*COVID-19/complications/psychology
*Cognitive Dysfunction/diagnosis/etiology
*Pilots/psychology
*Aerospace Medicine
*Neuropsychological Tests
SARS-CoV-2
Mass Screening

@article {pmid40642241,
year = {2025},
author = {Shaheen, A and Shaheen, N and , and Shoib, S and Saeed, F and Buhari, M and Bharmauria, V and Flouty, O},
title = {Deep learning analysis of long COVID and vaccine impact in low- and middle-income countries (LMICs): development of a risk calculator in a multicentric study.},
journal = {Frontiers in public health},
volume = {13},
number = {},
pages = {1416273},
pmid = {40642241},
issn = {2296-2565},
mesh = {Humans ; *COVID-19/prevention & control/epidemiology ; Female ; Male ; Adult ; Middle Aged ; *Developing Countries ; *Deep Learning ; *COVID-19 Vaccines/administration & dosage ; SARS-CoV-2 ; Risk Assessment/methods ; Surveys and Questionnaires ; Depression/epidemiology ; Young Adult ; Aged ; Vaccination/statistics & numerical data ; },
abstract = {BACKGROUND: Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a global pandemic affecting millions worldwide. This study aims to bridge the knowledge gap between acute and chronic symptoms, vaccination impact, and associated factors in patients across different low- and middle-income countries (LMICs).

MATERIALS AND METHODS: The study included 2,445 participants aged 18 years and older, testing positive for COVID-19. Data collection involved screening for medical histories, testing records, symptomatology, and persistent symptoms. Validated instruments, including the DePaul Symptom Questionnaire (DSQ-2) and the Patient Health Questionnaire-9 (PHQ-9), were used. We applied a self-supervised and unsupervised deep neural network to extract features from the questionnaire. Gradient boosted machines (GBM) model was used to build a risk calculator for chronic fatigue syndrome (CFS), depression, and prolonged COVID-19 symptoms.

RESULTS: Out of the study cohort, 68.1% of the patients had symptoms lasting longer than 2 weeks. The most frequent symptoms were loss of smell (46.8%), dry cough (40.1%), loss of taste (37.8%), headaches (37.2%), and sore throat (28.9%). The patients also reported high rates of depression (47.7%), chronic fatigue (6.5%), and infection after vaccination (23.7%). Factors associated with CFS included sex, age, and smoking. Vaccinated individuals demonstrated lower odds of experiencing prolonged COVID-19 symptoms, CFS, and depression. The predictive models achieved a high area under the curve (AUC) scores of 0.87, 0.82, and 0.74, respectively.

CONCLUSION: The findings underscore the significant burden of long-term symptoms such as chronic fatigue and depression, affecting a considerable proportion of individuals post-infection. Moreover, the study reveals promising insights into the potential benefits of vaccination in mitigating the risk of prolonged COVID-19 symptoms, CFS, and depression. Overall, this research contributes valuable knowledge towards comprehensive management and prevention efforts amidst the ongoing global pandemic.

CLINICAL TRIAL REGISTRATION: Clinical trials.gov, NCT05059184.},
}

Humans
*COVID-19/prevention & control/epidemiology
Female
Male
Adult
Middle Aged
*Developing Countries
*Deep Learning
*COVID-19 Vaccines/administration & dosage
SARS-CoV-2
Risk Assessment/methods
Surveys and Questionnaires
Depression/epidemiology
Young Adult
Aged
Vaccination/statistics & numerical data

@article {pmid40641353,
year = {2025},
author = {Silletti, F and Koire, A and Ma, C and Lin, HC and Mittal, L and Roffman, JL and Erdei, C and Musso, P and Liu, CH},
title = {COVID-19 experiences and persistent maternal mental health symptoms: Examining the role of long COVID, self-efficacy, and partner support.},
journal = {Development and psychopathology},
volume = {},
number = {},
pages = {1-10},
doi = {10.1017/S0954579425000379},
pmid = {40641353},
issn = {1469-2198},
abstract = {Perinatal women were particularly impacted during the pandemic, with documented consequences for both mothers' and infants' well-being. This study investigated the longitudinal relationships between COVID-19-related experiences during the peripartum and women's depression and anxiety symptoms at long-term follow-up. We explored the moderating role of long COVID for the first time, along with perceived partner support and maternal self-efficacy. A sample of 190 US perinatal women completed a survey from May 21, 2020, to September 15, 2021 (T1), and again between December 14, 2022, and February 14, 2024 (T2). The survey assessed COVID-19-related experiences, mental health, long COVID, maternal self-efficacy, partner support, and life events. Anxiety was associated with both long COVID and decreased partner support, and both depression and anxiety were linked to lower self-efficacy. A larger number of COVID-19-related experiences during the peripartum period was associated with higher levels of later depression and anxiety symptoms. Long COVID exacerbated these links, while partner support buffered them. Maternal self-efficacy dampened the association between COVID-19-related experiences and subsequent depression, but not anxiety. Findings suggest that COVID-19 has lasting effects on perinatal women's mental health, with partner support and maternal self-efficacy acting as resilience factors, highlighting the potential benefit of targeted interventions to enhance these modifiable factors.},
}

@article {pmid40640905,
year = {2025},
author = {Ewing, AG and Joffe, D and Blitshteyn, S and Brooks, AES and Wist, J and Bar-Yam, Y and Bilodeau, S and Curtin, J and Duncan, R and Faghy, M and Galland, L and Pretorius, E and Salamon, S and Buonsenso, D and Hastie, C and Kane, B and Khan, MA and Lal, A and Lau, D and MacIntyre, R and McFarland, S and Munblit, D and Nicholson, J and Ollila, HM and Putrino, D and Rosario, A and Tan, T and , },
title = {Correction: Long COVID clinical evaluation, research and impact on society: a global expert consensus.},
journal = {Annals of clinical microbiology and antimicrobials},
volume = {24},
number = {1},
pages = {41},
pmid = {40640905},
issn = {1476-0711},
}

@article {pmid40640033,
year = {2025},
author = {Giunta, S and Giuliani, A and Sabbatinelli, J and Olivieri, F},
title = {A multidimensional immunological perspective on long COVID.},
journal = {Cytokine & growth factor reviews},
volume = {},
number = {},
pages = {},
doi = {10.1016/j.cytogfr.2025.07.001},
pmid = {40640033},
issn = {1879-0305},
abstract = {Long COVID is a chronic condition that arises after SARS-CoV-2 infection and is characterized by persistent and often debilitating symptoms, such as fatigue, cognitive dysfunction ("brain fog"), dyspnea, and autonomic disturbances. Increasing evidence suggests that Long COVID shares key immunopathological mechanisms with autoimmune diseases, primarily sustained immune dysregulation. In individuals with genetic or immunological susceptibility, SARS-CoV-2 infection can trigger the production of autoantibodies targeting cytokines, membrane receptors, and components of the autonomic nervous system (ANS), thereby disrupting neuroimmune homeostasis. This immune imbalance may impair anti-inflammatory regulatory pathways, such as the cholinergic anti-inflammatory pathway (CAP), and may contribute to a chronic state of inflammation and autoimmunity. One proposed contributor to this process is inflammaging - a chronic, low-grade inflammation associated with aging - which may not only predispose individuals to Long COVID but may also be amplified by the persistent immune activation seen in this condition. In this perspective, we propose a conceptual framework in which inflammaging, immune-tolerance breakdown, and autonomic dysfunctions interact to sustain the pathophysiology of Long COVID. We discuss emerging biomarkers across these axes, including inflammatory cytokines, circulating autoantibodies, immune cell phenotypes, epigenetic modifications, and heart rate variability. Advances in inflammaging-related biomarkers and biological clocks may support early identification of individuals at higher risk for persistent immune and autonomic dysregulation, ultimately informing more precise diagnostic and therapeutic strategies for Long COVID.},
}

@article {pmid40636591,
year = {2025},
author = {James, L and Philip, AM and John, JO and Olafimihan, AG and Esparza, F},
title = {Clinical Characteristics and Long-Term Effects of COVID-19 in a Secondary Care Hospital in South India: A Study of Post-acute Sequelae and Pulmonary Outcomes.},
journal = {Cureus},
volume = {17},
number = {6},
pages = {e85576},
pmid = {40636591},
issn = {2168-8184},
abstract = {The coronavirus disease 2019 (COVID-19) pandemic has resulted in significant global morbidity, with long-term effects known as post-acute sequelae of SARS-CoV-2 (PASC) or long COVID syndrome. This study investigates the clinical characteristics and long-term effects of COVID-19 in a rural South Indian population. Conducted in a secondary healthcare setting in Kerala, India, the study involved 65 subjects who had tested positive for COVID-19 more than 90 days prior. Participants completed a detailed questionnaire on common COVID-19 and PASC symptoms and underwent pulmonary function testing. Data analysis included descriptive statistics, point-biserial correlation, and logistic regression. The prevalence of PASC symptoms was found to be 55.4%, with dyspnea being the most common symptom. Healthcare workers experienced a lower prevalence of PASC (41.9%) compared to non-healthcare workers (67.6%). Logistic regression indicated higher odds of PASC in men, non-healthcare workers, and those with comorbidities, though these findings were not statistically significant. Pulmonary function tests revealed reduced forced vital capacity in 23.1% of subjects. The study highlights the significant impact of long COVID on this unvaccinated population prior to the Delta wave, emphasizing the need for ongoing research to understand and manage the long-term effects of COVID-19.},
}

@article {pmid40636057,
year = {2025},
author = {Berentschot, JC and Bek, LM and Drost, M and van den Berg-Emons, RJG and Braunstahl, GJ and Ribbers, GM and Aerts, JGJV and Hellemons, ME and Heijenbrok-Kal, MH and , },
title = {Health outcomes up to 3 years and post-exertional malaise in patients after hospitalization for COVID-19: a multicentre prospective cohort study (CO-FLOW).},
journal = {The Lancet regional health. Europe},
volume = {53},
number = {},
pages = {101290},
pmid = {40636057},
issn = {2666-7762},
abstract = {BACKGROUND: Many patients experience long-lasting health problems after COVID-19. The study aimed to assess 3-year trajectories of a comprehensive set of patient-reported outcome measures (PROMs) in patients hospitalized for COVID-19, particularly focusing on the 2- to 3-year trajectory. Additionally, we evaluated prevalence of post-exertional malaise (PEM) at 3 years, its risk factors, co-occurring health problems, and the 3-year trajectories of patients with and without PEM.

METHODS: The CO-FLOW multicentre prospective cohort study followed up adults hospitalized for COVID-19 in 7 hospitals, located in the Netherlands. Study assessments were performed at 3, 6, 12, 24, and 36 months post-discharge, conducted between July 1, 2020, and May 22, 2024. PROMs on recovery, symptoms, fatigue, mental health, cognition, participation, sleep quality, work status, health-related quality of life (HRQoL), and PEM were collected. Generalized estimating equations were used to assess health trajectories and multivariable logistic regression to identify risk factors for PEM.

FINDINGS: In total, 299/344 (87%) patients completed the 3-year follow-up and were included in the analysis. Complete recovery rates increased (p < 0.001), from 12% at 3 months to 24% at 3 years. Symptoms of impaired fitness, fatigue, and muscle weakness (all p < 0.0019) and PROMs for fatigue score, participation, return to work, and HRQoL (all p < 0.005) improved significantly over time, while PROMs for cognitive failures worsened (p < 0.001). Between the 2- and 3-year visits, memory problems (OR 1.4 [1.1-1.7], p < 0.001), and scores of fatigue (MD +1.0 [0.4-1.6], p = 0.002), cognitive failures (MD +2.2 [0.9-3.4], p < 0.001), and SF-36 mental component summary (-2.2 [-3.1 to -1.3], p < 0.001) significantly worsened. At 3 years, 66% of patients experienced fatigue, 63% impaired fitness, 59% memory problems, and 53% concentration problems. PROMs showed that 62% reported poor sleep quality, 55% fatigue, and 28% cognitive failures. PEM was reported by 105/292 (36%) patients at 3 years; risk factors were female sex (OR 3.4 [95% CI 1.9-6.0], p < 0.001), pre-existing pulmonary disease (3.0 [1.7-5.6], p < 0.001), physical inactivity pre-COVID-19 (2.3 [1.2-4.1], p = 0.008), and ICU treatment for COVID-19 (1.8 [1.02-3.0], p = 0.04). Concurrent fatigue, cognitive failures, and dyspnea were more common in patients with (42%) than without (6%) PEM. Patients with PEM showed poor health outcomes throughout the entire follow-up period, including worsening fatigue and HRQoL during the third year.

INTERPRETATION: Many health problems persisted up to 3 years post-discharge, with self-reported fatigue and cognitive problems worsening in the third year. PEM was common, and linked to a more severe phenotype of long COVID. These findings highlight the urgent need to optimize treatment options and investigate underlying pathological mechanisms of COVID-19.

FUNDING: The Netherlands Organisation for Health Research and Development (ZonMw); Rijndam Rehabilitation; Laurens.},
}

@article {pmid40635708,
year = {2025},
author = {Huff, HV and Roberts, H and Bartrum, E and Norato, G and Grayson, N and Fleig, K and Wilkerson, MJ and Stussman, BJ and Nath, A and Walitt, B},
title = {Prevalence and severity of neurologic symptoms in Long-COVID and the role of pre-existing conditions, hospitalization, and mental health.},
journal = {Frontiers in neurology},
volume = {16},
number = {},
pages = {1562084},
pmid = {40635708},
issn = {1664-2295},
abstract = {BACKGROUND: Long-COVID refers to ongoing, relapsing, or new symptoms present 30 or more days after Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection. This study examined the prevalence and severity of neurologic symptoms at greater than 1 month following acute SARS-CoV-2 infection and the influence of pre-existing neurologic and psychiatric conditions, current depression and anxiety status, and hospitalization on the presence and severity of these symptoms.

METHODS: This prospective cohort study recruited primarily self-referred Long-COVID participants with confirmed SARS-CoV-2 infection. Online questionnaires inquiring about pre-existing conditions, neurologic symptoms and their severity pre, during and post COVID-19, and current anxiety and depression screening were completed by 213 participants at a median time of 8 months after infection. Descriptive analyses and prevalence modeling were performed.

RESULTS: The most frequent neurologic symptoms post COVID-19 were fatigue, concentration/memory difficulties, unrefreshed sleep, and dysarthria/word finding difficulties (73.2-86.4%). Neurologic symptoms were highly prevalent with significantly greater odds post COVID-19 compared to pre for all symptoms and higher prevalence at time periods farther from infection, including those implicit in fibromyalgia and myalgic encephalomyelitis/chronic fatigue syndrome. Several severe neurologic symptoms were significantly more prevalent post COVID-19. Moderate to severe anxiety (34%) and depression (27%) were observed post COVID-19. Preexisting neurologic or psychiatric conditions did not demonstrate any significant difference in neurologic symptom prevalence post COVID-19. Those who met criteria for moderate or severe anxiety post COVID-19 had a significant difference in prevalence of fatigue, sensitivity to touch and unrefreshed sleep. Similarly, fatigue, concentration/memory difficulty and unrefreshed sleep were more prevalent in moderate to severe depression. There were no significant differences in neurologic symptom prevalence in a hospitalized group when compared to non- hospitalized.

CONCLUSION: Long-COVID has a high burden of long lasting and severe neurological sequelae. These sequelae are independent of pre-existing self-reported neurologic and psychiatric conditions, as well as previous hospitalization. Current moderate to severe anxiety and depression status can impact fatigue, cognition, and sleep post COVID-19. Focus on the biological impact of SARS-CoV-2 on the nervous system will be essential in ameliorating the tremendous symptom burden left in the wake of the COVID-19 pandemic.

CLINICAL TRIAL REGISTRATION: http://clinicaltrials.gov, identifier: NCT04573062.},
}

@article {pmid40635480,
year = {2025},
author = {Cho, OH},
title = {Unraveling the immune responses in long COVID through cytokine profiling.},
journal = {The Korean journal of internal medicine},
volume = {40},
number = {4},
pages = {531-532},
doi = {10.3904/kjim.2025.179},
pmid = {40635480},
issn = {2005-6648},
}

@article {pmid40629217,
year = {2025},
author = {Kwon, J and Mensah, J and Milne, R and Rayner, C and Lawrence, RR and De Kock, J and Sivan, M and Petrou, S and , },
title = {Health economic outcomes and national economic impacts associated with Long COVID in England and Scotland.},
journal = {The European journal of health economics : HEPAC : health economics in prevention and care},
volume = {},
number = {},
pages = {},
pmid = {40629217},
issn = {1618-7601},
support = {COV-LT2-0016//National Institute for Health and Care Research/ ; },
abstract = {BACKGROUND: Two million people in the UK suffer from Long COVID (LC), imposing substantial health economic impacts. This study aimed to: 1) assess longitudinal changes in health utility scores and economic costs of LC, and number of services received at LC specialist clinics and clinic region to capture care intensity; 2) assess whether volume of services received responded to health needs; and 3) estimate the national economic impact of LC.

METHODS: LC patients from 10 specialist clinics participated in the LOCOMOTION study. Patient-reported outcomes measures (EQ-5D-5L, C19-YRS and Health Economics Questionnaire) were completed on a digital platform. Associations were assessed between changes in economic outcomes (EQ-5D-3L utility, health economic costs) and number/type of LC specialist services received and region. Per-person values of quality-adjusted life-year losses, public sector costs, productivity losses and informal care costs were multiplied by LC prevalence to estimate national economic impacts.

RESULTS: There was a statistically significant reduction in public sector costs over time. There was no significant association between the number of specialist services received and change in health utility scores. LC specialist clinic and outpatient service utilisation corresponded to health need and had significant regional variation after controlling for health need. LC is associated with a substantial economic impact nationally, estimated at £8.1 billion annually and £24.2 billion since its emergence, comparable to the annual cost of £9.4 billion for stroke.

CONCLUSION: The effectiveness of LC specialist clinic services warrants further research. The substantial national economic impact of LC warrants a nationwide LC care strategy.},
}

@article {pmid40628861,
year = {2025},
author = {Kumar, N and Lam, CN and Lee, R and Unger, JB and Sood, N},
title = {The association between baseline physical and mental health and the risk of postacute sequelae of COVID-19 infection.},
journal = {Scientific reports},
volume = {15},
number = {1},
pages = {24374},
pmid = {40628861},
issn = {2045-2322},
mesh = {Humans ; *COVID-19/complications/psychology/epidemiology ; Female ; Male ; Middle Aged ; *Mental Health ; Risk Factors ; Adult ; Aged ; Post-Acute COVID-19 Syndrome ; SARS-CoV-2/isolation & purification ; Depression/epidemiology ; Health Status ; },
abstract = {Post-acute sequelae of COVID-19 infection (PASC) is a widely reported phenomenon wherein symptoms of COVID-19 infection persist for four weeks or more beyond acute infection. Risk factors at baseline (prior to infection) for the development of PASC are not well understood. This study aimed to identify baseline demographic, physical and mental health characteristics associated with the development of PASC. We identified 351 participants who reported contracting COVID-19 and 145 that experienced PASC symptoms. Baseline physical health, mental health, and demographic data were collected for all participants. Risk factors for the development of PASC were identified using multivariable logistic regression. PASC was associated with lower income, Hispanic ethnicity, younger age, and respiratory conditions (asthma or COPD). Worse self-reported mental health status, a diagnosis of depression, and a higher patient health questionnaire-2 (PHQ-2) score were also associated with PASC. We then used latent class analysis and identified two subtypes of PASC, one with fewer PASC symptoms (n = 112) and another with many PASC symptoms (n = 33). Risk factors for membership in each class were different, but a past diagnosis of depression predicted membership in both classes compared to those without PASC. A diagnosis of depression was more strongly associated with the "many symptoms" class compared to the "few symptoms" class. We find that several mental health and demographic risk factors are linked to PASC. More research is necessary to understand both the two subtypes of PASC identified in our analysis, and the underlying relationship between COVID-19 infection and PASC.},
}

Humans
*COVID-19/complications/psychology/epidemiology
Female
Male
Middle Aged
*Mental Health
Risk Factors
Adult
Aged
Post-Acute COVID-19 Syndrome
SARS-CoV-2/isolation & purification
Depression/epidemiology
Health Status

@article {pmid40627396,
year = {2025},
author = {Shankar, V and Wilhelmy, J and Curtis, EJ and Michael, B and Cervantes, L and Mallajosyula, V and Davis, RW and Snyder, M and Younis, S and Robinson, WH and Shankar, S and Mischel, PS and Bonilla, H and Davis, MM},
title = {Oxidative stress is a shared characteristic of ME/CFS and Long COVID.},
journal = {Proceedings of the National Academy of Sciences of the United States of America},
volume = {122},
number = {28},
pages = {e2426564122},
doi = {10.1073/pnas.2426564122},
pmid = {40627396},
issn = {1091-6490},
support = {U19-AI057229//HHS | NIH | National Institute of Allergy and Infectious Diseases (NIAID)/ ; 5R01AI139550//HHS | NIH (NIH)/ ; NA//Khosla family gift fund/ ; NA//HHMI (HHMI)/ ; },
mesh = {Humans ; *Oxidative Stress ; Female ; Male ; *COVID-19/metabolism ; Reactive Oxygen Species/metabolism ; *Fatigue Syndrome, Chronic/metabolism ; Adult ; Middle Aged ; Mitochondria/metabolism ; SARS-CoV-2 ; Lymphocytes/metabolism ; },
abstract = {Over 65 million individuals worldwide are estimated to have Long COVID (LC), a complex multisystemic condition marked by fatigue, post-exertional malaise, and other symptoms resembling myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). With no clinically approved treatments or reliable diagnostic markers, there is an urgent need to define the molecular underpinnings of these conditions. By studying bioenergetic characteristics of peripheral blood lymphocytes in 25 healthy controls, 27 ME/CFS, and 20 LC donors, we find both ME/CFS and LC donors exhibit signs of elevated oxidative stress, especially in the memory subset. Using a combination of flow cytometry, RNA-seq, mass spectrometry, and systems chemistry analysis, we observed aberrations in reactive oxygen species (ROS) clearance pathways including elevated glutathione levels, decreases in mitochondrial superoxide dismutase protein levels, and glutathione peroxidase 4-mediated lipid oxidative damage. Strikingly, these redox pathways changes show sex-specific trends. While ME/CFS females exhibit higher total ROS and mitochondrial calcium levels, males have normal ROS levels, with pronounced mitochondrial lipid oxidative damage. In females, these higher ROS levels correlate with T cell hyperproliferation, consistent with the known role of elevated ROS in initiating proliferation. This hyperproliferation can be attenuated by metformin, suggesting this Food and Drug Administration (FDA)-approved drug as a possible treatment, as also suggested by a recent clinical study of LC patients. Moreover, these results suggest a shared mechanistic basis for the systemic phenotypes of ME/CFS and LC, which can be detected by quantitative blood cell measurements, and that effective, patient-tailored drugs might be discovered using standard lymphocyte stimulation assays.},
}

Humans
*Oxidative Stress
Female
Male
*COVID-19/metabolism
Reactive Oxygen Species/metabolism
*Fatigue Syndrome, Chronic/metabolism
Adult
Middle Aged
Mitochondria/metabolism
SARS-CoV-2
Lymphocytes/metabolism

@article {pmid40627388,
year = {2025},
author = {Eckey, M and Li, P and Morrison, B and Bergquist, J and Davis, RW and Xiao, W},
title = {Patient-reported treatment outcomes in ME/CFS and long COVID.},
journal = {Proceedings of the National Academy of Sciences of the United States of America},
volume = {122},
number = {28},
pages = {e2426874122},
doi = {10.1073/pnas.2426874122},
pmid = {40627388},
issn = {1091-6490},
support = {230275//Open Medicine Foundation (OMF)/ ; },
mesh = {Humans ; *COVID-19/therapy/complications/epidemiology ; *Patient Reported Outcome Measures ; *Fatigue Syndrome, Chronic/therapy/epidemiology ; Male ; Female ; Middle Aged ; Adult ; Treatment Outcome ; SARS-CoV-2 ; Aged ; Surveys and Questionnaires ; Post-Acute COVID-19 Syndrome ; },
abstract = {Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and long COVID are persistent multisystem illnesses affecting many patients. With no known effective FDA-approved treatments for either condition, patient-reported outcomes of treatments may prove helpful in identifying management strategies that can improve patient care and generate new avenues for research. Here, we present the results of an ME/CFS and long COVID treatment survey with responses from 3,925 patients. We assess the experiences of these patients with more than 150 treatments in conjunction with their demographics, symptoms, and comorbidities. Treatments with the greatest perceived benefits are identified. Patients with each condition who participated in the study shared similar symptom profiles, including all the core symptoms of ME/CFS, e.g., 89.7% of ME/CFS and 79.4% of long COVID reported postexertional malaise (PEM). Furthermore, treatment responses between these two patient groups were significantly correlated (R[2] = 0.68). Patient subgroups, characterized by distinct symptom profiles and comorbidities, exhibited increased responses to specific treatments, e.g., a POTS-dominant cluster benefiting from autonomic modulators and a cognitive-dysfunction cluster from CNS stimulants. This study underscores the symptomatic and therapeutic similarities between ME/CFS and long COVID and highlights the commonalities and nuanced complexities of infection-associated chronic diseases and related conditions. While this study does not provide recommendations for specific therapies, in the absence of approved treatments, insights from patient-reported experiences provide urgently needed real-world evidence for developing targeted patient care therapies and future clinical trials.},
}

Humans
*COVID-19/therapy/complications/epidemiology
*Patient Reported Outcome Measures
*Fatigue Syndrome, Chronic/therapy/epidemiology
Male
Female
Middle Aged
Adult
Treatment Outcome
SARS-CoV-2
Aged
Surveys and Questionnaires
Post-Acute COVID-19 Syndrome

@article {pmid40626567,
year = {2025},
author = {Lam, ICH and Chai, Y and Man, KKC and Lau, WCY and Luo, H and Lin, X and Yin, C and Chui, CSL and Li, X and Zhang, Q and Chan, EWY and Wan, EYF and Wong, ICK},
title = {The short-, medium- and long-term risk and the multi-organ involvement of clinical sequelae after COVID-19 infection: a multinational network cohort study.},
journal = {Journal of the Royal Society of Medicine},
volume = {},
number = {},
pages = {1410768251352666},
doi = {10.1177/01410768251352666},
pmid = {40626567},
issn = {1758-1095},
abstract = {ObjectivesTo generate comprehensive evidence on the risk of clinical sequelae involving different organ systems over time after coronavirus disease 2019 (COVID-19) infection.DesignMultinational retrospective cohort study.SettingElectronic medical records from the US, UK, France, Germany and Italy standardised to the Observational Medical Outcomes Partnership Common Data Model.ParticipantsA total of 303,251 individuals with a COVID-19 infection between 1 December 2019 and 1 December 2020 and propensity score matched non-COVID-19 comparators from 22,108,925 eligible candidates.Main outcome measuresIncidence of 73 clinical sequelae involving multiple organ systems including the respiratory, cardiovascular, dermatological and endocrine systems over the short- (0-6 months), medium- (6-12 months) and long-term (1-2 years) after COVID-19 infection. The hazard ratio (HR) and 95% confidence interval (95% CI) of individual disease outcomes were estimated using Cox proportional hazard regression.ResultsIndividuals with COVID-19 incurred a greater risk of clinical sequelae involving multiple organ systems including respiratory (France HR 2.23, 95%CI [2.10,2.37] to Italy 13.13 [11.80,14.63]), cardiovascular (Germany 1.39 [1.30,1.50] to US 1.79 [1.74,1.85]) and dermatological (UK 1.13 [1.01,1.25] to Italy 1.77 [1.42,2.21]) disorder over the short-term. While the risk of clinical sequelae has largely subsided during the medium-term, the risk of cardiovascular- (US 1.16 [1.11,1.21], France 1.10 [1.01,1.19]) and endocrine- (US 1.18 [1.12,1.24], Germany 1.15 [1.03,1.29]) related complications may continue to persist for up to two years.ConclusionsThrough a network of multinational healthcare databases, this study generated comprehensive and robust evidence supporting the extensive multi-organ involvement of post-COVID-19 condition over the short-term period and the subside in risk for most complications over the medium- and long-term.},
}

@article {pmid40624269,
year = {2025},
author = {Seibert, S and Eckert, I and Widmann, CN and Ebrahimi, T and Bösl, F and Franke, C and Prüss, H and Schultze, JL and Petzold, GC and Shirvani, O},
title = {Validity of the test for attentional performance in neurological post-COVID condition.},
journal = {Scientific reports},
volume = {15},
number = {1},
pages = {24208},
pmid = {40624269},
issn = {2045-2322},
mesh = {Humans ; Middle Aged ; Male ; Adult ; Female ; Aged ; *Attention/physiology ; *COVID-19/complications/psychology ; *Neuropsychological Tests ; Adolescent ; Young Adult ; *Cognitive Dysfunction/diagnosis ; SARS-CoV-2 ; ROC Curve ; },
abstract = {Neurological post-COVID condition (PCC) often involves attentional deficits that impact daily functioning. Traditional paper-based tests, like the Trail-Making Test (TMT), may inadequately capture these impairments due to their short duration and dependence on numerical and alphabetic sequencing. This study evaluates the validity of three subtests of the computerized Test for Attentional Performance (TAP) as alternatives for detecting attentional impairments in PCC. In the ongoing NEURO LC-19 DE study, 108 subjects aged 18 to 79 years, with PCC-related cognitive complaints (n = 67, 73% f) and healthy controls (n = 41, 56% f) underwent neuropsychological testing. The prevalence of impairment and classification ability of the TAP subtests were evaluated alongside standard paper-based tests, including the TMT and Montreal Cognitive Assessment, using receiver operating characteristic (ROC) analysis and regression. The TAP subtests identified significant impairments in sustained attention and processing speed in one-third of PCC patients, surpassing traditional tests in sensitivity, and classifying PCC with an AUC of 78%. Omissions in sustained attention significantly differentiated groups (OR = 1.14, p = 0.016, 95% CI [1.02-1.26]). Fatigue correlated with poorer performance on speed and accuracy (r > 0.30, p < 0.05). Cognitive slowing is prevalent in neurological PCC but is scarcely captured by conventional assessments. The TAP's computerized format with automated norming and independence from alphanumeric stimuli shows promise in improving the discriminatory ability for identifying attentional deficits in PCC patients.},
}

Humans
Middle Aged
Male
Adult
Female
Aged
*Attention/physiology
*COVID-19/complications/psychology
*Neuropsychological Tests
Adolescent
Young Adult
*Cognitive Dysfunction/diagnosis
SARS-CoV-2
ROC Curve

@article {pmid40623643,
year = {2025},
author = {Sisti, JS and Packard, SE and Yung, J and Metzler, J},
title = {Trajectories of post-traumatic stress disorder symptoms and subsequent risk of long COVID in the World Trade Center Health Registry.},
journal = {Journal of affective disorders},
volume = {},
number = {},
pages = {119814},
doi = {10.1016/j.jad.2025.119814},
pmid = {40623643},
issn = {1573-2517},
abstract = {OBJECTIVE: Though the etiology of long COVID is not well-understood, pre-existing mental health conditions have been identified as risk factors. We examined associations between post-traumatic stress disorder symptoms (PTSS) and long COVID among individuals exposed to the World Trade Center disaster.

METHODS: We used group-based trajectory modeling to identify five PTSS trajectories (resilient, low-stable, remitted, delayed onset, chronic-high) among enrollees in the World Trade Center Health Registry (2003-04 to 2020-2021). Among 5361 enrollees who reported a COVID-19 infection, we used modified Poisson regression to estimate risk ratios (RRs) and 95 % confidence intervals (95 % CI) for associations of PTSS trajectories with self-reported long COVID symptoms.

RESULTS: In 2022-23, 41 % of enrollees reported long COVID symptoms. In models adjusted for sociodemographic characteristics and self-reported diagnosed physical health conditions and depression, associations with long COVID were observed for all trajectories compared to the resilient trajectory, which was characterized by very low PTSS at all points. RRs were similar among trajectory groups characterized by a high lifetime prevalence of probable PTSD (RRremitted = 1.83, 95 % CI = 1.64, 2.04; RRdelayed = 1.86, 95 % CI = 1.67, 2.06; RRchronic = 1.80, 95 % CI = 1.59, 2.03). Risk of long COVID was also elevated among individuals in the low-stable trajectory group, who had a lower lifetime prevalence of probable PTSD (RR = 1.46, 95 % CI = 1.35, 1.58).

CONCLUSION: Risk of long COVID is elevated among individuals with a history of PTSS, including among those whose symptoms have improved. Populations at high risk of PTSD, including those exposed to traumatic events, may benefit from targeted screening to identify those with long COVID.},
}

@article {pmid40622937,
year = {2025},
author = {Bahillo Ruiz, E and Pérez-Pérez, L and Cárdaba-García, RM and Durantez-Fernández, C and Jiménez-Navascués, L and Velasco-Gonzalez, V and Muñoz-Del Caz, A and Madrigal, M and Olea, E},
title = {Relationships between fatigue severity scale (FSS)/ scale for mood assessment (EVEA) and clinical manifestations in spanish long-COVID patients.},
journal = {PloS one},
volume = {20},
number = {7},
pages = {e0324075},
doi = {10.1371/journal.pone.0324075},
pmid = {40622937},
issn = {1932-6203},
mesh = {Humans ; Female ; *Fatigue/epidemiology/psychology ; Male ; *COVID-19/psychology/complications/epidemiology ; Middle Aged ; Spain/epidemiology ; Adult ; Aged ; Severity of Illness Index ; Surveys and Questionnaires ; Depression/epidemiology ; SARS-CoV-2/isolation & purification ; *Mood Disorders/epidemiology ; Anxiety/epidemiology ; Affect ; },
abstract = {AIM: This study aims to investigate the influence of fatigue and mood disturbances in Spanish long-COVID patients and to establish relationships between these factors and other clinical manifestations.

METHOD: A descriptive correlational study was conducted using a self-administered online questionnaire. The sample was obtained through non-random convenience sampling, comprising 374 participants from various regions of Spain. Data collection occurred between July 2, 2022, and November 30, 2022. The questionnaire collected demographic information and inquired about symptomatology as well as self-perception of health status. Validated scales, namely the Fatigue Severity Scale (FSS) and the Scale for Mood Assessment (EVEA), were utilized.

RESULTS: The non-random sample consisted of 374 participants from diverse regions of Spain, of whom 79.9% were women. Over 70% of participants reported fatigue, while the EVEA revealed high scores in sadness-depression (4.94 ± 2.82) and anxiety (4.57 ± 2.88). Significant relationships were identified between fatigue and mood disturbances and neurological, psychological, locomotive, and pain symptoms.

CONCLUSIONS: Given the impact of the syndrome on psychological, social and economic spheres, regular monitoring of patients with long COVID is crucial. This study corroborates previous research findings and is notable for demonstrating the persistence of symptoms for over a year. Mood disorders, such as anxiety and depression, are closely related to physical symptoms, highlighting the need for holistic healthcare approaches.},
}

Humans
Female
*Fatigue/epidemiology/psychology
Male
*COVID-19/psychology/complications/epidemiology
Middle Aged
Spain/epidemiology
Adult
Aged
Severity of Illness Index
Surveys and Questionnaires
Depression/epidemiology
SARS-CoV-2/isolation & purification
*Mood Disorders/epidemiology
Anxiety/epidemiology
Affect

@article {pmid40622467,
year = {2025},
author = {Chatterjee, D and Maparu, K},
title = {Long COVID syndrome: exploring therapies for managing and overcoming persistent symptoms.},
journal = {Inflammopharmacology},
volume = {},
number = {},
pages = {},
pmid = {40622467},
issn = {1568-5608},
abstract = {Long COVID, or post-acute sequelae of SARS-CoV-2 infection (PASC), is a growing global health concern, affecting 10-35% of COVID-19 survivors. Characterized by persistent multisystem symptoms lasting beyond 12 weeks, common manifestations include fatigue, dyspnea, chest pain, cognitive impairment, depression, and anxiety. The underlying pathophysiology remains unclear but is likely to involve immune dysregulation, persistent inflammation, endothelial dysfunction, gut dysbiosis, and viral persistence. This review examines the epidemiology, risk factors, and clinical manifestations of long COVID, with a focus on its impact on cardiopulmonary, neurological, and mental health. Therapeutic approaches include pharmacological interventions such as anti-inflammatory agents, antioxidants, neuroprotective drugs, and repurposed medications. Non-pharmacological strategies, such as physical rehabilitation, cognitive therapy, dietary modification, and emerging therapies like stem cell therapy, as well as immunomodulatory approaches, offer promising avenues for recovery. We also highlight ongoing clinical trials evaluating targeted therapies for long-term COVID syndrome. Future research should focus on elucidating the pathophysiological mechanisms, identifying biomarkers, and optimizing personalized treatment strategies for long-term COVID-19 management.},
}

@article {pmid40622013,
year = {2025},
author = {Salmam, I and Desmeules, F and Perreault, K and Zahouani, I and Beaulieu-Bonneau, S and Campeau-Lecours, A and Paquette, JS and Deslauriers, S and Tittley, J and Drouin, G and Best, K and Roy, JS},
title = {Trajectories of Physical Disabilities Over Six Months in Patients With Long COVID.},
journal = {Physical therapy},
volume = {},
number = {},
pages = {},
doi = {10.1093/ptj/pzaf091},
pmid = {40622013},
issn = {1538-6724},
abstract = {IMPORTANCE: Understanding the long-term impact of long COVID on physical function and health-related quality of life (HRQoL) is essential to guide clinical care and rehabilitation strategies.

OBJECTIVE: The objective of this study was to compare physical capacity over time among adults without COVID-19 (control group), those who recovered from COVID without persistent symptoms (short COVID group), and those with long COVID (long COVID group [LCG]). A secondary objective was to identify baseline factors predicting HRQoL 6 months later in the LCG.

DESIGN: This study was a prospective longitudinal cohort study.

SETTING: Assessments were conducted at baseline, 3 months, and 6 months as part of in-laboratory evaluations performed either at the Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS) in Quebec City or at the Orthopedic Clinical Research Unit of the Maisonneuve-Rosemont Hospital Research Center in Montreal.

PARTICIPANTS: A total of 360 age- and sex-matched adults (n = 120 per group), including individuals without a history of COVID-19 (CG), those with short COVID (symptom resolution within 4 weeks, SCG), and those with long COVID (symptoms persisting ≥12 weeks, LCG) participated in the study.

INTERVENTION/EXPOSURE: Participants were categorized based on their COVID-19 history and symptom duration and no intervention or exposure was applied.

MAIN OUTCOMES AND MEASURES: Self-reported outcomes measuring HRQoL, comorbidities, sleep quality, pain, and fatigue, along with objective performance measures such as grip strength, Short Physical Performance Battery, 6-minute walk test (6MWT), and perceived exertion (Modified Borg Scale) during the 6MWT, were collected at each time point. Daily averages for resting heart rate, step count, and minutes of intensive activity were recorded over 7 days using a fitness tracker watch. Generalized estimating equations were used for longitudinal comparisons, and recursive partitioning analysis for predicting HRQoL factors.

RESULTS: Significant time × group interactions were observed for HRQoL, sleep quality, pain, fatigue, Short Physical Performance Battery, and 6MWT. Although the LCG showed significant improvements across these outcomes, only the reduction in fatigue reached a clinically meaningful level, whereas the other groups remained stable. A group effect was detected for all outcomes, except for heart rate and minutes of intensive activity, with the LCG consistently showing lower scores across all follow-ups. Recursive partitioning analysis identified 2 baseline predictors of HRQoL at 6 months in the LCG: self-reported fatigue and daily step count.

CONCLUSIONS AND RELEVANCE: These findings highlight the persistent impairments in adults with long COVID and emphasize early HRQoL predictor identification to anticipate long-term needs and adjust treatment plans accordingly.},
}

@article {pmid40621076,
year = {2025},
author = {Seo, IH and Park, B and Kim, H and Heo, SJ and Jung, DH},
title = {The effects of G1899 Korean red ginseng extract powder on long COVID for acute COVID19 infection: A randomized, double-blind, placebo-controlled trial.},
journal = {Journal of ginseng research},
volume = {49},
number = {4},
pages = {470-477},
pmid = {40621076},
issn = {1226-8453},
abstract = {BACKGROUND: In this study, we investigated the therapeutic potential effects of G1899 Korean Red Ginseng Extract Powder(G1899) on long COVID in a general population using flow cytometry and follow-up by questionnaire.

METHODS: We conducted a 12-week clinical pilot study on 220 COVID19 patients who were recently infected. The study was completed by 108 participants in the G1899 group and 108 participants in the placebo group. Participants were randomized 1:1 to the G1899 and placebo groups. We evaluated the long COVID by questionnaire including GAD-7, FSS and BFI-K at baseline and 12 weeks. To investigate the changes in the levels of CD4/CD8 T cell ratio and regulatory T cell population, multicolor flow cytometry was performed.

RESULTS: The G1899 group showed significantly chronic fatigue symptoms relieving compared with placebo group at 12 weeks in women. The CD4/CD8 ratio increased significantly in the G1899 group, rising from 1.71 (95 % CI: 1.35-2.07) at Visit 1 to 2.31 (95 % CI: 1.83-2.78) at Visit 4 (p = 0.0029). Unlike the G1899 group, there was a significant reduction in the Treg population, from 2.02 % at Visit 1-1.22 % at Visit 4 (p = 0.0005) in the placebo group.

CONCLUSION: These findings suggest that G1899 has beneficial effects on the amelioration of long COVID symptoms, with more prominent effects observed in women. Although the changes in Treg population were not statistically significant in the G1899 group, the significant reduction observed in the placebo group suggests a potential protective effect of G1899 against Treg depletion.},
}

@article {pmid40619575,
year = {2025},
author = {Turana, Y and Shen, R and Darmawan, O and Barus, JFA},
title = {Harlequin Syndrome in a Post-COVID-19 Infection Elderly: A Case Report.},
journal = {Acta neurologica Taiwanica},
volume = {},
number = {},
pages = {},
doi = {10.4103/ANT.ANT_113_0023},
pmid = {40619575},
issn = {1028-768X},
abstract = {Harlequin syndrome (HS) is a rare autonomic nervous system disorder caused by blockage of the unilateral upper-thoracic sympathetic pathway that provides vasomotor and sudomotor supply to the face. Infection and the subsequent immune response cascade are proposed as triggers for arterial occlusion due to microvascular ischemia, underlying the pathophysiology of HS in adult cases. We report this unusual case to inform readers about the possibility of causation and pathophysiological pathway of HS in post-COVID-19 infection. An 82-year-old male patient developing HS post-COVID-19 infection, presented with sudden left-hemifacial redness 4 days before admission, with similar recurrent complaints ten times since his resolved symptomatic COVID-19. Other physical and neurological examinations are regular. Laboratory results showed mild microcytic hypochromic anemia with D-dimer five-folds higher than normal limits. D-dimer fluctuated elevation during HS attacks is a sign of inflammatory process and increased thromboembolic risk in a long-COVID. The patient's history of chronic hypercholesterolemia with old lacunar infarction in the brain's frontal lobes suggested worsening microvascular disturbance. The patient was diagnosed as HS in post-COVID-19. To the author's knowledge, this is the first reported HS case in Indonesia and the second HS case post-COVID-19. Moreover, we also provide a schematic approach to the possible pathological process of HS in post-COVID-19. Post-COVID-19 infection is highly possible causing HS because of its persistent pathological inflammation leading to dysautonomic sympathetic fibers. However, its involvement in a specific pathophysiological pathway that disturbs the cervical sympathetic chain and causes HS, without presenting as systemic dysautonomia, should be further investigated.},
}

@article {pmid40618677,
year = {2025},
author = {Seco-Gonzalez, A and Antelo-Riveiro, P and Bravo, SB and Domínguez-Santalla, MJ and Rodríguez-Ruiz, E and Piñeiro, Á and Garcia-Fandino, R},
title = {Comprehensive molecular characterization of post-COVID condition: Immunoglobulin suppression and persistent SARS-CoV-2 antigens as key pathophysiological drivers.},
journal = {Journal of infection and public health},
volume = {18},
number = {10},
pages = {102870},
doi = {10.1016/j.jiph.2025.102870},
pmid = {40618677},
issn = {1876-035X},
abstract = {BACKGROUND: Post-COVID condition (PCC), or long COVID, affects a significant proportion of individuals following SARS-CoV-2 infection, yet its molecular framework remains poorly understood. This study aimed to define the molecular profile of PCC by integrating broad proteomic analysis using Sequential Window Acquisition of All Theoretical Mass Spectra (SWATH-MS) with targeted antigen quantification through targeted mass spectrometry (MRM/SRM).

METHODS: Plasma and pellet fractions from 65 PCC patients, classified as symptomatic or asymptomatic, were analyzed using SWATH-MS with updated SARS-CoV-2 protein libraries (v2022 and v2024), enabling a comprehensive profiling of immune- and viral-related proteins. The presence of viral antigens, specifically spike and nucleocapsid proteins, was quantified using MRM/SRM. A protein-concentration-based severity metric using clustering analysis and dimensionality reduction methods was proposed to assess correlations between proteomic alterations and clinical symptoms.

RESULTS: A key finding in PCC patients, particularly in symptomatic cases, was a pronounced downregulation of immunoglobulins, including kappa and lambda light chains. SWATH-MS analysis identified six proteins (corresponding to UniProt entries Q8N5F4, LV147, KV311, KVD20, A0A5C2G1U0, and KV315) that strongly correlated with disease severity (R² > 0.9), highlighting their potential as biomarkers. In pellet samples, the protein G1SG72 (ABCE1) emerged as a marker associated with severity, suggesting possible alterations in antiviral responses. The severity metric proposed showed a strong correlation with clinical symptoms, providing a quantifiable measure of PCC severity and enabling effective patient stratification. Additionally, MRM/SRM analysis detected the persistent presence of SARS-CoV-2 antigens, specifically the Spike and Nucleocapsid proteins, in symptomatic PCC patients.

CONCLUSIONS: This study defines a molecular profile of PCC, marked by immunoglobulin downregulation and the persistence of SARS-CoV-2 antigens, which may contribute to ongoing immune alterations in PCC. The severity metric derived from proteomic profiling provides a tool for categorizing PCC patients based on symptom severity and could support future studies aimed at targeted interventions.},
}

@article {pmid40618224,
year = {2025},
author = {Willis, MC and Hansen, DJ},
title = {Commentary: psychosocial features of pediatric long COVID and the challenges of considering temporal and environmental context during a pandemic.},
journal = {Journal of pediatric psychology},
volume = {},
number = {},
pages = {},
doi = {10.1093/jpepsy/jsaf052},
pmid = {40618224},
issn = {1465-735X},
}

@article {pmid40615692,
year = {2025},
author = {Hong, C and Wen, J and Zhang, HG and Ayakulangara Panickan, V and Yang, DY and Chen, AW and Xiong, X and Wang, X and Morris, M and Morini, S and Sangar, R and Dey, A and Samayamuthu, MJ and Liao, K and Bonzel, CL and Tanukonda, V and Maripuri, M and Honerlaw, J and Ho, YL and Visweswaran, S and Kohane, IS and Cho, K and Brat, G and Xia, Z and Cai, T},
title = {Label efficient phenotyping for Long COVID using electronic health records.},
journal = {NPJ digital medicine},
volume = {8},
number = {1},
pages = {405},
pmid = {40615692},
issn = {2398-6352},
abstract = {Long COVID poses a significant disease burden globally, but its heterogeneous presentation and unreliable coding practices render it difficult to study. Developing efficient phenotyping algorithms is crucial to enabling risk prediction and effective management of Long COVID. We introduce the LAbel-efficienT Long COVID pHenotyping (LATCH) algorithm, which synthesizes a small number of gold-standard labels and a large, unlabeled dataset with many electronic health record (EHR) features. Both internal validation and external validation demonstrated the superior performance of LATCH over methods using the U09.9 Long COVID EHR code alone. Our downstream analysis revealed a pattern of elevated healthcare utilization due to Long COVID, peaking at and continuing beyond the fourth month following COVID infection. LATCH enhances the classification of Long COVID by fully utilizing both labeled and unlabeled data, providing vital insights into healthcare utilization trends, informing clinical and public health responses to the enduring consequences of COVID-19.},
}

@article {pmid40614661,
year = {2025},
author = {Soares Pereira, LM and de Souza E Souza, I and Dos Santos Brito, WR and Dos Santos, EF and da Costa, FP and Lima de Sarges, KM and Damasceno Cantanhede, MH and de Brito, MTFM and da Silva, ALS and de Meira Leite, M and de Almeida Viana, MNDS and Barbosa Rodrigues, FB and da Silva, R and Rachid Viana, GM and do Socorro Souza Chaves, T and de Oliveira Lameira Veríssimo, A and da Silva Carvalho, M and Henriques, DF and da Silva, CP and Lima Nunes, JA and Costa, IB and Vieira Cayres-Vallinoto, IM and Brasil-Costa, I and Simões Quaresma, JA and Monteiro Rangel da Silva, AN and Freitas Queiroz, MA and Dos Santos, EJM and Magno Falcão, LF and Rosário Vallinoto, AC},
title = {Gene expression profile of immune response markers associated with long COVID and its clinical aspects in a cohort from northern Brazil.},
journal = {Human immunology},
volume = {86},
number = {4},
pages = {111341},
doi = {10.1016/j.humimm.2025.111341},
pmid = {40614661},
issn = {1879-1166},
abstract = {BACKGROUND: Long COVID is characterized by a multisystemic, and complex disease and current efforts are focused on the search for biomarkers associated with clinical outcomes.

OBJECTIVE: In this study, we evaluated the gene expression of 15 biomarkers and their relationship with the clinical aspects of the condition.

METHODS: c-DNA samples from 15 patients with long COVID, 15 patients recovered and without sequelae (RWS), and 15 patients with symptomatic acute COVID-19 were analyzed. The relative expression of genes was determined by the 2-ΔΔCT method from real-time PCR. Sociodemographic and clinical data of interest were extracted from medical records.

RESULTS: Of the 15 biomarkers, only the expression of TREX1, FOXP3, MYD88 and FASL was not associated with long COVID. The genes IRF7, IRF3, and IFI16 performed best as biomarkers of long COVID (AUC ≥ 0.90, p ≤ 0.05). Except for MDA5 and RIG-1 genes, the expression of the other eight genes was associated with the presence of comorbidities, medication use, and complaints of fever, abdominal pain, eye pain, and headache (H > 9.0; p ≤ 0.05). IRF3 expression was specifically associated with long COVID when compared to acute COVID (med.: 41.2; IQR: 116.20; p: 0.0036).

CONCLUSION: Our results suggest that classical immune response genes are upregulated in long COVID and that certain clinical aspects of the disease may influence the expression profile of the studied genes.},
}

@article {pmid40612098,
year = {2025},
author = {Martin, S and Janse Van Rensburg, M and Le, HT and Firth, C and Chandrasekar, A and Clark, SE and Vanderslott, S and Vindrola-Padros, C and Vera San Juan, N},
title = {LISTEN: lived experiences of Long COVID: a social media analysis of mental health and supplement use.},
journal = {Frontiers in big data},
volume = {8},
number = {},
pages = {1539724},
pmid = {40612098},
issn = {2624-909X},
abstract = {INTRODUCTION: Long COVID, or Post-Acute Sequelae of SARS-CoV-2 infection (PASC), is a complex condition characterized by a wide range of persistent symptoms that can significantly impact an individual's quality of life and mental health. This study explores public perspectives on the mental health impact of Long COVID and the use of dietary supplements for recovery, drawing on social media content. It uniquely addresses how individuals with Long COVID discuss supplement use in the absence of public health recommendations.

METHODS: The study employs the LISTEN method ("Collaborative and Digital Analysis of Big Qual Data in Time Sensitive Contexts"), an interdisciplinary approach that combines human insight and digital analysis software. Social media data related to Long COVID, mental health, and supplement use were collected using the Pulsar Platform. Data were analyzed using the free-text discourse analysis tool Infranodus and collaborative qualitative analysis methods.

RESULTS: The findings reveal key themes, including the impact of Long COVID on mental health, occupational health, and the use of food supplements. Analysis of attitudes toward supplement use highlights the prevalence of negative emotions and experiences among Long COVID patients. The study also identifies the need for evidence-based recommendations and patient education regarding supplement use.

DISCUSSION: The findings contribute to a better understanding of the complex nature of Long COVID and inform the development of comprehensive, patient-centered care strategies addressing both physical and mental health needs.},
}

@article {pmid40611083,
year = {2025},
author = {Esquenazi-Karonika, S and Mathews, PD and Wood, MJ and Mudumbi, PM and Linton, J and Briscoe, J and Seibert, E and Coombs, K and Laynor, G and Katz, SD and Chung, A},
title = {Quality improvement of a community-engaged authorship system: lessons learned from the RECOVER initiative.},
journal = {BMC health services research},
volume = {25},
number = {1},
pages = {919},
pmid = {40611083},
issn = {1472-6963},
support = {OT2HL161847/NH/NIH HHS/United States ; OT2HL161847/NH/NIH HHS/United States ; OT2HL161847/NH/NIH HHS/United States ; OT2HL161847/NH/NIH HHS/United States ; OT2HL161847/NH/NIH HHS/United States ; OT2HL161847/NH/NIH HHS/United States ; OT2HL161847/NH/NIH HHS/United States ; OT2HL161847/NH/NIH HHS/United States ; OT2HL161847/NH/NIH HHS/United States ; OT2HL161847/NH/NIH HHS/United States ; OT2HL161847/NH/NIH HHS/United States ; },
}

@article {pmid40610519,
year = {2025},
author = {Yukari Magawa, J and Jacintho, LC and Alves Ferreira, M and Ramos Oliveira, J and Rahal Guaragna Machado, R and Kuramoto Takara, A and Moreno Lima de Oliveira, R and Cesario Lima, A and Sasahara, GL and Lopes Adami, F and Xavier Medeiros, G and de Souza Apostolico, J and Ruz Fernandes, E and Bruna Leal de Oliveira, D and Durigon, EL and Giavina Bianchi, P and Boscardin, SB and Santoro Rosa, D and Cunha-Neto, E and Kalil, J and Coelho, V and Souza Santos, K},
title = {Protective role of anti-SARS-CoV-2 antibody responses against vital organ related long COVID symptoms.},
journal = {Scientific reports},
volume = {15},
number = {1},
pages = {23705},
pmid = {40610519},
issn = {2045-2322},
support = {001 (JO, JM, and AU)//Coordenação de Aperfeiçoamento de Pessoal de Nível Superior/ ; 001 (JO, JM, and AU)//Coordenação de Aperfeiçoamento de Pessoal de Nível Superior/ ; 001 (JO, JM, and AU)//Coordenação de Aperfeiçoamento de Pessoal de Nível Superior/ ; 001 (JO, JM, and AU)//Coordenação de Aperfeiçoamento de Pessoal de Nível Superior/ ; 001 (JO, JM, and AU)//Coordenação de Aperfeiçoamento de Pessoal de Nível Superior/ ; 001 (JO, JM, and AU)//Coordenação de Aperfeiçoamento de Pessoal de Nível Superior/ ; 408771/2022-4//Conselho Nacional de Desenvolvimento Científico e Tecnológico/ ; 408771/2022-4//Conselho Nacional de Desenvolvimento Científico e Tecnológico/ ; 408771/2022-4//Conselho Nacional de Desenvolvimento Científico e Tecnológico/ ; 408771/2022-4//Conselho Nacional de Desenvolvimento Científico e Tecnológico/ ; 2020/05256-7, 2017/24769-2, 2016/20045-7 and 2020/06409-1//Fundação de Amparo à Pesquisa do Estado de São Paulo/ ; 2020/05256-7, 2017/24769-2, 2016/20045-7 and 2020/06409-1//Fundação de Amparo à Pesquisa do Estado de São Paulo/ ; 2020/05256-7, 2017/24769-2, 2016/20045-7 and 2020/06409-1//Fundação de Amparo à Pesquisa do Estado de São Paulo/ ; 2020/05256-7, 2017/24769-2, 2016/20045-7 and 2020/06409-1//Fundação de Amparo à Pesquisa do Estado de São Paulo/ ; 2020/05256-7, 2017/24769-2, 2016/20045-7 and 2020/06409-1//Fundação de Amparo à Pesquisa do Estado de São Paulo/ ; 2020/05256-7, 2017/24769-2, 2016/20045-7 and 2020/06409-1//Fundação de Amparo à Pesquisa do Estado de São Paulo/ ; 01.20.0009.00//Financiadora de Estudos e Projetos/ ; 01.20.0009.00//Financiadora de Estudos e Projetos/ ; 01.20.0009.00//Financiadora de Estudos e Projetos/ ; 01.20.0009.00//Financiadora de Estudos e Projetos/ ; 01.20.0009.00//Financiadora de Estudos e Projetos/ ; 01.20.0009.00//Financiadora de Estudos e Projetos/ ; },
mesh = {Humans ; *COVID-19/immunology/epidemiology/complications/virology ; *SARS-CoV-2/immunology ; *Antibodies, Viral/immunology/blood ; Male ; Female ; Middle Aged ; Adult ; Post-Acute COVID-19 Syndrome ; Aged ; },
abstract = {COVID-19 pandemic continues to challenge the world with a major public health problem, long COVID (LC), which is estimated to affect over 400 million people worldwide. Many unknowns remain regarding the mechanisms involved in LC. We investigated the impact of anti-SARS-CoV-2 antibody and IFN-γ responses on the development of LC and its various phenotypes. We studied a cohort of 137 convalescents following predominantly mild COVID-19 during the first pandemic wave (2020) and up to one-year post-infection. We found 45% of LC cases that were associated with a greater number and duration of acute-phase symptoms. Cardiovascular and/or gastrointestinal symptoms in the acute phase were associated to protection against LC development, while pulmonary, otorhinolaryngological, musculoskeletal and other symptoms were associated with increased risk of LC development. Regarding LC phenotypes, we observed risk associations and potentially deleterious effects of anti-SARS-CoV-2 antibodies for LC symptoms classified as general or other. In contrast, for vital organ-related LC symptoms, we found only protective associations, particularly for cardiovascular symptoms, which indeed had a low prevalence in LC (16%). Collectively, our data suggest that anti-SARS-CoV-2 antibodies play a protective role against vital organ-related LC symptoms, especially cardiovascular symptoms, but are insufficient in preventing or limiting other highly prevalent LC symptoms, such as neurological, psychiatric and pulmonary.},
}

Humans
*COVID-19/immunology/epidemiology/complications/virology
*SARS-CoV-2/immunology
*Antibodies, Viral/immunology/blood
Male
Female
Middle Aged
Adult
Post-Acute COVID-19 Syndrome
Aged

@article {pmid40609301,
year = {2025},
author = {Lebrun, H and Zablith, I and Stone, J and Vasilache, A and Gouraud, C and Ancellin-Geay, A and Kachaner, A and Ranque, B and Lemogne, C and Pitron, V},
title = {Comparing labels for persistent physical symptoms: A cross-sectional study among lay participants and healthcare professionals.},
journal = {Journal of psychosomatic research},
volume = {195},
number = {},
pages = {112197},
doi = {10.1016/j.jpsychores.2025.112197},
pmid = {40609301},
issn = {1879-1360},
abstract = {CONTEXT: Numerous labels are used to describe physical symptoms that remain for at least several months and cause significant distress (i.e., persistent physical symptoms, PPS). This study aims to assess attitudes associated with various labels among lay participants and healthcare professionals.

METHODS: Participants recruited via mailing lists of volunteers completed an online questionnaire assessing their views on underlying physical and mental causations for ten diagnostic labels accounting for PPS. Lay participants rated their feelings of offence associated with each label, and healthcare professionals their willingness to take care of a patient diagnosed with each label. Mixed regression models investigated the factors associated with feelings of offence and willingness to care.

RESULTS: 266 lay participants (mean age: 43; 70 % women) and 126 healthcare professionals (mean age: 42; 69 % women) were included. Labels rated high on perceived mental causation tended to be rated low on physical causation and vice versa in both populations, although this effect was stronger in lay participants. "Long COVID", "persistent physical symptoms" and "functional symptoms" were rated with higher physical causation by lay participants compared to health professionals (p < 0.001), whereas "somatic symptom disorder" and "psychosomatic" were rated with higher mental causation. Regression models showed that perceived mental causation was associated with feelings of offence in lay participants, while perceived physical causation was associated with less offence. Perceived physical causation was associated with willingness to care among healthcare professionals.

DISCUSSION: Some diagnostic labels provoke negative attitudes, both among lay participants and healthcare professionals, probably hindering clinician/patient relationships and treatment.},
}

@article {pmid40609105,
year = {2025},
author = {Bustos-Viviescas, BJ and García-Yerena, CE and García-Galviz, JA},
title = {Myopathy, fatigue and long COVID-19: considerations of the new neuromuscular histopathology.},
journal = {Cirugia y cirujanos},
volume = {93},
number = {3},
pages = {337-338},
doi = {10.24875/CIRU.23000429},
pmid = {40609105},
issn = {2444-054X},
}

@article {pmid40608708,
year = {2025},
author = {Xu, Y and Yuan, Z and Li, J and Liu, W and Liu, L},
title = {A survey on the situation and risk factors of secondary infection after the second wave of the Omicron COVID-19 in China.},
journal = {Journal of infection in developing countries},
volume = {19},
number = {6},
pages = {812-820},
doi = {10.3855/jidc.20927},
pmid = {40608708},
issn = {1972-2680},
mesh = {Humans ; *COVID-19/epidemiology/prevention & control ; Male ; Female ; China/epidemiology ; Adult ; Risk Factors ; *Reinfection/epidemiology ; Middle Aged ; SARS-CoV-2 ; COVID-19 Vaccines/administration & dosage ; Surveys and Questionnaires ; Health Personnel/statistics & numerical data ; Vaccination/statistics & numerical data ; Young Adult ; },
abstract = {INTRODUCTION: Reinfection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been occurring more frequently. Healthcare workers are among the most at-risk groups due to their direct exposure to SARS-CoV-2 while providing medical care. We aimed to understand the potential factors that affect reinfection.

METHODOLOGY: 1399 healthy workers at the General Hospital of Central Theater Command were enrolled for an online questionnaire from 27 June to 10 July 2023. The selected individuals were divided into the primary infection group and the secondary infection group based on the number of SARS-CoV-2 infections.

RESULTS: About 95% of the total population had been vaccinated. A higher proportion of the primary group had received 3 doses of vaccines and inactivated vaccines, than the secondary group (p < 0.001). The symptoms, duration, and severity of the majority of participants significantly decreased during secondary infection, compared to primary infection. After adjusting for factors such as gender, age, vaccine dose, and vaccine type; multiple regression analysis indicated that the patients with disease duration > 7 days or long coronavirus disease 2019 (long COVID-19) history during primary infection had a higher risk of secondary infection with Omicron (odds ratio, OR = 2.2, p < 0.001; OR = 2.4, p < 0.001).

CONCLUSIONS: The patients with history of long COVID-19 or longer duration of disease after primary infection had a higher risk of Omicron reinfection. This study identified the clinical manifestations during Omicron primary and secondary infection; and the potential factors that may influence reinfection.},
}

Humans
*COVID-19/epidemiology/prevention & control
Male
Female
China/epidemiology
Adult
Risk Factors
*Reinfection/epidemiology
Middle Aged
SARS-CoV-2
COVID-19 Vaccines/administration & dosage
Surveys and Questionnaires
Health Personnel/statistics & numerical data
Vaccination/statistics & numerical data
Young Adult

@article {pmid40607414,
year = {2025},
author = {Abooali, M and Yasinska, IM and Thapa, G and Lei, X and da Costa, KAS and Schlichtner, S and Berger, SM and Fasler-Kan, E and Temperton, NJ and Vuono, R and Sumbayev, VV},
title = {Wuhan strain of SARS-CoV-2 triggers activation of immune evasion machinery similar to the one operated by cancer cells.},
journal = {Frontiers in immunology},
volume = {16},
number = {},
pages = {1599352},
pmid = {40607414},
issn = {1664-3224},
mesh = {Humans ; *SARS-CoV-2/immunology ; *COVID-19/immunology/virology ; *Immune Evasion/immunology ; Hypoxia-Inducible Factor 1, alpha Subunit/metabolism ; Spike Glycoprotein, Coronavirus/immunology/metabolism ; Indoleamine-Pyrrole 2,3,-Dioxygenase/metabolism ; Epithelial Cells/immunology/virology ; Cell Line ; B7-H1 Antigen/metabolism ; *Neoplasms/immunology ; Ketoglutaric Acids/metabolism ; },
abstract = {In the last 2 years, there has been an increasing concern that SARS-CoV-2 infection may represent a marker of undiagnosed cancers. A potential connection between COVID-19/long COVID and malignant transformation/cancer progression was reported in a number of studies. It is, however, unclear if the virus itself can cause malignant transformation or if it has a potential to support malignant processes in human body. We analyzed nasopharyngeal swabs collected from individuals infected with Wuhan strain of SARS-CoV-2 and conducted in vitro studies using BEAS-2B human bronchial epithelial cells. Here we report that Wuhan strain of SARS-CoV-2 and its spike protein induce activation of hypoxia-inducible factor 1 (HIF-1) transcription complex in infected cells. This effect is achieved through conversion of cellular 2-oxoglutarate into 2-hydroxy-glutarate, which most likely blocks the activity of HIF-1α prolyl hydroxylation. As such, it leads to activation of HIF-1, which triggers production of transforming growth factor-β type 1 (TGF-β). TGF-β induces expression of immune checkpoint proteins, such as galectin-9, programmed death-ligand 1, and indoleamine-2,3-dioxygenase, an enzyme, which is involved in production of immunosuppressive amino acid called L-kynurenine. These immune checkpoint pathways were capable of suppressing both helper and cytotoxic activities of T lymphocytes and, as such, could potentially support malignant processes in infected tissues.},
}

Humans
*SARS-CoV-2/immunology
*COVID-19/immunology/virology
*Immune Evasion/immunology
Hypoxia-Inducible Factor 1, alpha Subunit/metabolism
Spike Glycoprotein, Coronavirus/immunology/metabolism
Indoleamine-Pyrrole 2,3,-Dioxygenase/metabolism
Epithelial Cells/immunology/virology
Cell Line
B7-H1 Antigen/metabolism
*Neoplasms/immunology
Ketoglutaric Acids/metabolism

@article {pmid40607062,
year = {2025},
author = {García-López, DA and Monárrez-Espino, J and Borrego-Moreno, JC and Zheng, J and Mandal, R and Torres-Calzada, C and Oropeza-Valdez, JJ and Tenório Nunes, A and Sánchez Rodríguez, SH and López, JA and Calzada Rodríguez, BE and Wishart, DS and López-Hernández, Y},
title = {Comprehensive clinical and metabolomics profiling of COVID-19 Mexican patients across three epidemiological waves.},
journal = {Frontiers in molecular biosciences},
volume = {12},
number = {},
pages = {1607583},
pmid = {40607062},
issn = {2296-889X},
abstract = {INTRODUCTION: As of mid-2024, COVID-19 has affected over 676 million people worldwide, leading to more than 6.8 million deaths. Numerous studies have documented metabolic changes occurring during both the acute phase of the disease and the recovery phase, which, in some cases, contribute to the development of long COVID syndrome.

AIMS AND METHODS: In this study, we aimed to evaluate clinical, laboratory, and comprehensive metabolomic data from hospitalized COVID-19 patients during the second, third and fourth waves (Alpha, Delta, and Omicron). A targeted, fully quantitative metabolomics assay (TMIC MEGA Assay) was used to measure 529 metabolites and lipids in plasma samples. The metabolomic profiles of these patients were compared according to different and relevant factors impacting COVID-19 outcome, such as age, sex, comorbidities, and vaccination status.

RESULTS: Among the 21 classes of compounds evaluated in this study, amino acids and lipids were the most dysregulated when comparing age, sex, comorbidities, vaccination status, and the different epidemiological waves. This is the most comprehensive analysis in Mexico providing absolute quantitative data for 529 metabolites and lipids measured in hospitalized COVID-19 patients, which could be used to monitor their metabolic status and clinical outcomes associated with COVID-19 infection or with long COVID syndrome.},
}

@article {pmid40604227,
year = {2025},
author = {Noij, LCE and Lap, CR and Luijten, MAJ and Hashimoto, S and Teela, L and Oostrom, KJ and Alsem, MW and van Houten, MA and Biesbroek, G and Haverman, L and Maitland-van der Zee, AH and van Goudoever, JB and Terheggen-Lagro, SWJ},
title = {Quality of life and mental health in children with long COVID.},
journal = {Communications medicine},
volume = {5},
number = {1},
pages = {271},
pmid = {40604227},
issn = {2730-664X},
abstract = {BACKGROUND: Pediatric Long COVID (PLC) is a heterogeneous condition, which can have a substantial impact on daily life of children and adolescents. This study aimed to evaluate health related quality of life (HRQoL), and mental and social health of children with PLC, in relation to children with other chronic health conditions (CHC) and from the general population (GP) during the pandemic.

METHODS: Dutch children (8-18 years) with PLC (n = 106, 31% male) were included between May 2021 and March 2023. Reference data was available from a CHC-cohort (n = 90, 56% male) and GP-cohort (n = 844, 47% male) during the first wave of the pandemic (April-May, 2020). Participants completed the Pediatric Quality of Life Inventory (PedsQL) 4.0 and Patient-Reported Outcomes Measurement Information System (PROMIS) instruments (Anxiety, Anger, Depressive symptoms, Sleep-Related Impairment (SRI), and Peer Relationships). Mean scores were analyzed using adjusted ANCOVA. Relative risks (RR (95% CI)) were calculated for impaired HRQoL and severe PROMIS scores.

RESULTS: Children with PLC report high proportions of impaired HRQoL (84%, RR = 3.67 (2.35-5.74)), and have significantly lower PedsQL scores than children with CHC. Children with PLC also exhibit worse PROMIS T-scores of Anxiety, Depressive Symptoms, and SRI than children from the CHC- and GP-cohorts (mean difference range 2.2-9.8 (95%CI 0.6-11.7)), and significantly higher risks of severe anxiety (17%), depressive symptoms (18%), and SRI (17%).

CONCLUSIONS: PLC can severely impact HRQoL and mental and social health in children. Screening of these outcomes and individualized management of children with PLC should be a vital part of clinical care for these highly burdened patients.},
}

@article {pmid40608374,
year = {2024},
author = {Remick, S and Shim, WJ and Kim, C},
title = {Ketamine Infusion for Refractory Post-COVID-19 Fatigue: Case Report.},
journal = {Pain medicine case reports},
volume = {8},
number = {2},
pages = {45-47},
pmid = {40608374},
issn = {2768-5152},
mesh = {Humans ; *Ketamine/administration & dosage/therapeutic use ; *COVID-19/complications ; *Fatigue/drug therapy/etiology ; Male ; Infusions, Intravenous ; *Analgesics/administration & dosage/therapeutic use ; SARS-CoV-2 ; },
abstract = {BACKGROUND: Post-COVID-19 syndrome (PCS) symptoms are common after COVID-19 infections and despite recent efforts to study and treat, limited progress has been made. The most common of the symptoms, fatigue, can be debilitating and lack effective treatment options, and as a result, the need for potential management options is paramount.

CASE REPORT: We present a case report of a patient with refractory PCS fatigue. Following intravenous ketamine infusion, the patient noted significant improvement in his energy and fatigue symptoms.

CONCLUSIONS: We report the successful use of ketamine infusion for PCS fatigue symptoms.},
}

Humans
*Ketamine/administration & dosage/therapeutic use
*COVID-19/complications
*Fatigue/drug therapy/etiology
Male
Infusions, Intravenous
*Analgesics/administration & dosage/therapeutic use
SARS-CoV-2

@article {pmid40608373,
year = {2024},
author = {Shim, WJ and Remick, S and Kim, C},
title = {Stellate Ganglion Blocks for Post-COVID-19 Headaches: Case Report.},
journal = {Pain medicine case reports},
volume = {8},
number = {2},
pages = {41-43},
pmid = {40608373},
issn = {2768-5152},
mesh = {Humans ; *COVID-19/complications ; *Stellate Ganglion ; *Headache/etiology/therapy ; *Autonomic Nerve Block/methods ; Male ; Female ; Middle Aged ; SARS-CoV-2 ; Adult ; },
abstract = {BACKGROUND: Long COVID can impact patients with a wide range of new, returning, or ongoing health symptoms, lasting for months to years despite recovery from the acute infection. One of the symptoms is headaches. Post-COVID-19 headaches can affect the quality of life for many patients, and as a result, the management and treatment of the symptoms have become important issues.

CASE REPORT: We present a case series of patients with varying presentations of post-COVID-19 symptoms, including headaches, who responded positively to the use of stellate ganglion blocks (SGBs).

CONCLUSIONS: We report the successful use of a right-sided SGB for varying post-COVID-19 symptoms.},
}

Humans
*COVID-19/complications
*Stellate Ganglion
*Headache/etiology/therapy
*Autonomic Nerve Block/methods
Male
Female
Middle Aged
SARS-CoV-2
Adult

@article {pmid40602071,
year = {2025},
author = {Heald, A and Williams, R and Khan, Z and Mudaliar, R and Khan, A and Naseem, A and Stewart, S and Bakerly, ND and Ollier, W},
title = {The predisposing factors to having a coded diagnosis of Long COVID.},
journal = {Public health},
volume = {246},
number = {},
pages = {105826},
doi = {10.1016/j.puhe.2025.105826},
pmid = {40602071},
issn = {1476-5616},
abstract = {OBJECTIVES: Long COVID is characterized by a constellation of persistent symptoms following an initial infection with COVID-19 virus. The primary focus of this study was to investigate how the characteristics of people diagnosed with Long COVID differed from those of matched individuals who did not have a diagnosis of Long COVID, after at least one confirmed positive COVID-19 test.

STUDY DESIGN: A retrospective observational cohort study was performed using data collected for the time period, January 1, 2020 to January 31, 2024 from a population database of 2.85 million people.

METHODS: The primary outcome was a primary care coded diagnosis, or referral for treatment of Long COVID following an acute COVID-19 infection, to a Long COVID clinic. Twenty six thousand, six hundred and twenty six (26,626) individuals were identified with a diagnosis of Long COVID and at least one previous recorded COVID-19 positive test. These were matched by age and sex with 133,165 individuals (i.e. an approximate ratio of 5 controls to one case) with at least one previous recorded COVID-19 positive test but no recorded diagnosis of Long COVID. Mortality rate was also analysed in relation to having a previous confirmed acute COVID-19 infection.

RESULTS: There was a higher proportion of people with 2, 3, 4 and 5 or more comorbidities in the diagnosed Long COVID group compared to those with one or no comorbidity. Black/ Black British ethnicity (+28 %) and Mixed ethnicity (+37 %) were both associated with a higher likelihood of a Long COVID diagnosis when compared to White ethnicity. Those in the most disadvantaged quintile (as measured by Townsend index) were more than twice as likely to have Long COVID than the most advantaged quintile. The risk of Long COVID increased by 5.7 % per each comorbidity, with modulation by the number of COVID-19 vaccinations. The risk of Long COVID doubled for every additional confirmed positive COVID-19 test. BMI did not have an effect when account was taken of Townsend quintile. Lastly, we analysed mortality rates following a COVID-19 infection. Female sex was associated with a lower risk of death. More disadvantaged individuals as measured by Townsend quintile were more likely to have died. This risk was nearly doubled for the most deprived quintile compared to least deprived quintile.

CONCLUSIONS: In this city region wide study with individuals matched for age and sex, we have determined that being in a socially disadvantaged situation and being Black/Black British or of Mixed ethnicity increased the risk of developing Long COVID. BMI did not have an effect when account was taken of Townsend quintile. These findings can inform public health messages and public health interventions going forward, whether in relation to Long COVID or future pandemic preparedness.},
}

@article {pmid40600494,
year = {2025},
author = {Mir, G and Mullard, J and Parkin, A and Lee, C and Clarke, J and De Kock, JH and Prociuk, D and Darbyshire, JL and Evans, S and Sivan, M and , },
title = {Addressing Inequalities in Long Covid Healthcare: A Mixed-Methods Study on Building Inclusive Services.},
journal = {Health expectations : an international journal of public participation in health care and health policy},
volume = {28},
number = {4},
pages = {e70336},
doi = {10.1111/hex.70336},
pmid = {40600494},
issn = {1369-7625},
support = {//This study is independent research funded by the National Institute for Health and Care Research (NIHR) (long Covid grant, Ref: COV-LT2-0016)./ ; },
mesh = {Humans ; *Healthcare Disparities ; *COVID-19/therapy/epidemiology ; Female ; Male ; Qualitative Research ; Adult ; Middle Aged ; Primary Health Care ; Health Services Accessibility ; Interviews as Topic ; London ; Vulnerable Populations ; England ; SARS-CoV-2 ; Aged ; },
abstract = {BACKGROUND: Long Covid (LC) significantly impacts health, economic and social activities. Women, deprived, learning disability, homeless and some minority ethnic populations have high prevalence rates but low access to support, indicating health inequities in LC care.

AIM: To identify health inequities in LC care and inclusion strategies that align with the priorities of people with LC.

DESIGN AND SETTING: Mixed-methods study employing qualitative data from people with LC, professional experts, LC clinic staff and primary care data from North West (NW) London GPs.

METHOD: Qualitative interviews with 23 people with LC and 18 professional experts explored the experience of diagnosis and support for people from disadvantaged groups. Framework analysis identified themes that informed the subsequent collection of clinic and primary care data. Staff from 10 LC clinics across England provided survey and qualitative data describing their initiatives to identify and reduce inequalities. Descriptive quantitative analysis of NW London adult primary care records (n = 6078), linked to hospital use across England, explored LC diagnosis and care pathways for diverse groups of people with LC.

RESULTS: Study participants from disadvantaged groups reported delays in formal diagnosis and specialist referrals being initated and had low trust in healthcare services. They described difficulties in obtaining information, advice and support as barriers to access specialist referrals. LC clinics confirmed the under-referral of those from the most disadvantaged groups compared to the general population. Primary care data confirmed under-referral of people with LC to specialist clinics; however, incomplete data across the LC clinical pathway prevented an analysis of equity in referral patterns between population groups. Clinics used various strategies to improve access and increase the flow of disadvantaged groups from primary care to LC services. Interventions included data collection to identify underserved groups, targeting outreach to primary care and community providers, adapting clinic provision and developing care pathways involving multidisciplinary teams (MDTs), primary and secondary care practitioners and third sector organisations. These activities were not widespread, however, and were particular to a few clinics.

CONCLUSION: Strategies to improve access to LC healthcare provide a starting point to explore inclusive care pathways for people with LC from disadvantaged social groups. Future research should focus on the effectiveness of initiatives to increase access to specialist LC provision among disadvantaged groups and establish greater trust in healthcare providers.

This study highlights the need for health system practitioners to identify under-represented groups and target inclusion initiatives at these populations in sensitive and appropriate ways. Improved diagnosis and support for such populations would be helped by training health and social care practitioners to recognise and accept the accounts of people with LC about their symptoms. Protocols that support consistent practice in referrals for specialist care are also needed. People with LC from disadvantaged groups often lack access to evidence-based sources of advice and information. Practitioners should provide information on LC while individuals are waiting to receive specialist care and should advocate for support from employers, including work modifications.

People with lived experience of LC were involved in the study as members of the research team and LOCOMOTION Patient Advisory Group (PAG). The PAG was involved in the wider study design, including the initial grant application, attending proposal planning meetings and helping to develop the research aim, objectives and questions. During the course of the study, the PAG met quarterly with each other and at least monthly with other research team members to review progress and feed into data collection and analysis processes. PAG members also attended a Quality Improvement Collaborative meeting involving academics and LC practitioners, which discussed initial findings from data analysis of qualitative interviews on LC inequalities. Through these meetings, the group supported and oversaw the study as a whole in terms of how data was collected, recruitment of participants, involvement in data analysis and interpretation, as well as providing more specific advice to all the individual workstreams within the study. A PPI facilitator within the study team provided training and support to PAG members in these areas and was available to respond to other needs expressed by the group. PAG members have also been involved in organising and contributing to a wide range of study dissemination events. PAG involvement throughout the study has ensured that the research is aligned with the key research priorities of people diagnosed with LC as well as those with LC symptoms but no formal diagnosis. PAG members were recruited through and linked to the LC clinics involved in the study and have helped disseminate study findings to local clinical practice, the lay public and other LC centres with which they are involved. S.E. is a PAG member from a minority ethnic background and a co-author on the paper. She has been involved in overseeing and supporting data collection and interpretation relating to inequalities affecting people with LC and has contributed to the preparation of this manuscript from an early draft to production of the final version.},
}

Humans
*Healthcare Disparities
*COVID-19/therapy/epidemiology
Female
Male
Qualitative Research
Adult
Middle Aged
Primary Health Care
Health Services Accessibility
Interviews as Topic
London
Vulnerable Populations
England
SARS-CoV-2
Aged

@article {pmid40599534,
year = {2025},
author = {Sorets, TR and Finley, JA and LaFrance, WC and Patten, RV and Mordecai, K and Jimenez, M and Suchy, S and Cahan, J and Koralnik, IJ and Cherney, LR and Cotton, E},
title = {Beyond mood screening: a pilot study of emotional, cognitive, and somatic concerns in patients with Long COVID.},
journal = {Frontiers in psychology},
volume = {16},
number = {},
pages = {1517299},
pmid = {40599534},
issn = {1664-1078},
abstract = {OBJECTIVE: This descriptive pilot study reported the emotional, cognitive, and somatic concerns of a clinically referred sample of patients with Long COVID using a comprehensive psychological measure. These subjective concerns were considered in the context of other psychological characteristics and historical mental health factors.

METHODS: The study sample comprised 26 adults with Long COVID who were referred from a neurology COVID-19 clinic for neuropsychological screening based on the patient's cognitive concerns. Empirically established cutoffs from the Personality Assessment Inventory were used to assess clinically elevated emotional, cognitive, and somatic concerns. Preexisting mental health data were obtained via medical records and clinical interview.

RESULTS: Approximately 62 and 50% of the sample had elevated somatic and cognitive concerns, respectively. Additionally, 42% of the sample exhibited elevated emotional concerns associated with depression, but this was primarily driven by the physiological aspects of depression. Between 15-27% of patients had elevated anxiety-related concerns. Over 80% of the sample had previously received psychotherapy and had been diagnosed with a mental health disorder prior to their SARS-CoV-2 infection. Furthermore, over half of the sample reported a history of abuse, and 12-15% had previously attempted suicide or had been hospitalized for psychiatric reasons.

CONCLUSIONS: Findings suggest that patients with Long COVID may present with extensive psychiatric histories and various somatic, cognitive, and emotional concerns. These psychological characteristics may be important for the treatment of Long COVID but may be overlooked using screening measures.},
}

@article {pmid40599143,
year = {2025},
author = {Lespezeanu, DA and Ungureanu, FD and Circiumariu, B and Constantin, C and Serafinceanu, C and Radu, FI and Kraft, A and Bacalbasa, N},
title = {Control of type 2 diabetes in patients with cancer and chronic pro-inflammatory cytokines during the COVID-19 pandemic.},
journal = {Journal of medicine and life},
volume = {18},
number = {5},
pages = {428-439},
pmid = {40599143},
issn = {1844-3117},
mesh = {Humans ; *COVID-19/complications/epidemiology ; *Diabetes Mellitus, Type 2/drug therapy/complications ; *Neoplasms/complications ; Male ; Female ; Middle Aged ; Interleukin 1 Receptor Antagonist Protein/therapeutic use/administration & dosage ; Aged ; SARS-CoV-2 ; Retrospective Studies ; *Cytokines/blood ; Sulfonylurea Compounds/therapeutic use/administration & dosage ; Hypoglycemic Agents/therapeutic use/administration & dosage ; Azithromycin/therapeutic use/administration & dosage ; COVID-19 Drug Treatment ; Adult ; },
abstract = {Patients with cancer and severe COVID-19 pneumonia treated with injectable azithromycin and anakinra frequently develop dysglycemia, necessitating initiation of sulfonylurea therapy (gliquidone or glimepiride). We retrospectively reviewed adults (≥30 years) with diabetes and cancer who were hospitalised for COVID-19 at the Central Military Hospital Bucharest and the Matei Bals National Institute between March 2020 and August 2022. All patients completed a 14-day course of azithromycin + anakinra and survived to discharge. Glycaemic control was achieved with fixed-dose gliquidone 30 mg or glimepiride 2, 3, or 6 mg, chosen according to each patient's inflammatory-cardiac profile. Central insulin resistance may lead to the risk of cardiometabolic syndrome through the increase of inflammatory markers (TNF-alpha and PAI-1), treated with gliquidone, in 50 patients with cancer infected with COVID-19, who were dependent on developing immunothrombosis. Peripheral insulin resistance leads to the risk of cardiovascular events through the increase of inflammatory markers, IL-6 and Il-1, treated with glimepiride, in 50 patients with cancer infected with COVID-19.},
}

Humans
*COVID-19/complications/epidemiology
*Diabetes Mellitus, Type 2/drug therapy/complications
*Neoplasms/complications
Male
Female
Middle Aged
Interleukin 1 Receptor Antagonist Protein/therapeutic use/administration & dosage
Aged
SARS-CoV-2
Retrospective Studies
*Cytokines/blood
Sulfonylurea Compounds/therapeutic use/administration & dosage
Hypoglycemic Agents/therapeutic use/administration & dosage
Azithromycin/therapeutic use/administration & dosage
COVID-19 Drug Treatment
Adult

@article {pmid40598822,
year = {2025},
author = {Kvernebo, K and Liv Kristin Wikslund, L and Drezek, K and Jaramillo, A and Capone, L and Helmy, M and Zhao, Y and Aguirre, A and D'Alessandro, D},
title = {COVID-19 Patients Have Peripheral Microvascular Dysfunction and Tissue Hypoxia in Spite of Successful Treatment of Lung Failure: A Proof of Concept Study.},
journal = {Microcirculation (New York, N.Y. : 1994)},
volume = {32},
number = {5},
pages = {e70014},
doi = {10.1111/micc.70014},
pmid = {40598822},
issn = {1549-8719},
mesh = {Humans ; *COVID-19/physiopathology/complications/therapy/blood ; Male ; Female ; Middle Aged ; *SARS-CoV-2 ; Aged ; *Microcirculation ; *Hypoxia/physiopathology/etiology ; Oxygen Saturation ; Oxygen/metabolism/blood ; Proof of Concept Study ; Adult ; Microvessels/physiopathology ; *Respiratory Insufficiency/therapy/etiology ; },
abstract = {BACKGROUND: Availability of oxygen (O2) is essential for life and function of all cells of the human body (n ≈ 10[13]-10[14] cells). COVID-19 patients often have impaired lung function with compromised oxygen uptake, but little is known about microvascular oxygen delivery and tissue oxygenation.

OBJECTIVES: Use the Oxygen Delivery Index (ODIN) concept to assess peripheral microvascular regulation and oxygen extraction in COVID-19 patients.

METHODS: The ODIN concept includes two technologies (diffuse reflectance spectroscopy-DRS and computer assisted microscopy-CAM) for data acquisition from subepidermal nutritive capillaries. Output parameters are microvascular oxygen saturation (SmvO2) and functional capillary density (FCD).

RESULTS: Forty patients hospitalized for COVID-19 grouped into early discharge (< 7 days, n = 11), severe (beyond 7 days, n = 24) and non-survivors (n = 5), and healthy controls (n = 23) were examined. Microvascular oxygen saturation (SmvO2) and the corresponding O2 extraction (SaO2-SmvO2) was 56% ± 4%/42% ± 9% (mean ± SD) in healthy controls (n = 11), 61 ± 10/37 ± 10 for historic controls (n = 12), significantly different (p < 0.01) as compared with all COVID-19 groups (early discharge: 40% ± 13%/54% ± 13%, severe: 34% ± 15%/60% ± 15%, non-survivors 22% ± 15%/73% ± 16%). FCD expressed as the relative number of red pixels (belonging to a capillary erythrocyte) in a CAM frame were reduced in alle patient groups as compared to historic controls (p < 0⋅05).

CONCLUSION: Results show skin microvascular dysregulation and tissue hypoxia in patients, indicative of hypoxia also in other tissues. We hypothesize that tissue hypoxia is a cause of reversible and non-reversible long COVID-19 symptoms and of mortality.},
}

Humans
*COVID-19/physiopathology/complications/therapy/blood
Male
Female
Middle Aged
*SARS-CoV-2
Aged
*Microcirculation
*Hypoxia/physiopathology/etiology
Oxygen Saturation
Oxygen/metabolism/blood
Proof of Concept Study
Adult
Microvessels/physiopathology
*Respiratory Insufficiency/therapy/etiology

@article {pmid40597822,
year = {2025},
author = {Münte, C and Glattacker, M and Müller, S and Zülke, AE and Heinze, M and Riedel-Heller, SG and Pieper, D and Jacke, C and Deckert, S and Neumann, A},
title = {Long COVID in people with mental health disorders: a scoping review.},
journal = {BMC psychiatry},
volume = {25},
number = {1},
pages = {669},
pmid = {40597822},
issn = {1471-244X},
mesh = {Humans ; *COVID-19/complications/psychology ; *Mental Disorders/psychology/epidemiology/complications/therapy ; SARS-CoV-2 ; Post-Acute COVID-19 Syndrome ; },
abstract = {BACKGROUND: Long COVID, Post COVID Syndrome or PASC (post-acute sequelae of COVID-19), according to the World Health Organization (WHO), is defined as the continuation or development of new symptoms 3 months after the initial SARS-CoV-2 infection, with these symptoms lasting for at least 2 months with no other explanation. The term Long COVID will be used throughout this review. Little is known about individuals with pre-existing mental health conditions experiencing Long COVID. This scoping review aims to provide an overview of these individuals, focusing on: 1) the course of mental disorders, 2) care needs, 3) utilization of healthcare services, and 4) psychosocial aspects, as outlined by the International Classification of Functioning (ICF).

METHODS: This review followed the JBI (Joanna Briggs Institute) methodology for scoping reviews and the PRISMA extension for scoping reviews. We included reports focusing on individuals with at least one pre-existing mental health diagnosis and Long COVID. Full-text reports in English or German were included, with no geographical limitations. Literature searches were conducted in PubMed, Embase, and PsycINFO on November 1, 2023, for records published between January 2020 and October 2023. Six reviewers participated in the screening process in pairs, independently conducting study selection and data extraction. Conflicts were resolved by consensus. Citation tracking was performed, and data were summarized narratively in tables.

RESULTS: From 4256 initial hits and citation tracking, 8 reports were included. The studies were heterogeneous, including chart reviews, case reports, cross-sectional, and longitudinal studies. Evidence on the impact of Long COVID on pre-existing mental health conditions was inconsistent. Most findings focused on the course of mental health disorders, ranging from symptom worsening to new symptoms of anxiety, depression, or insomnia. Evidence on mental health care needs, service utilization, and psychosocial aspects was limited.

CONCLUSION: Limited evidence suggests that individuals with pre-existing mental health disorders who experience Long COVID may be at an increased risk of worsening mental health. However, critical aspects such as care needs, service utilization, and psychosocial factors remain under-researched, highlighting the need for further studies on mental health care for Long COVID.

REVIEW REGISTRATION: Open Science Framework https://osf.io/tqexa .

CLINICAL TRIAL NUMBER: Not applicable.},
}

Humans
*COVID-19/complications/psychology
*Mental Disorders/psychology/epidemiology/complications/therapy
SARS-CoV-2
Post-Acute COVID-19 Syndrome

@article {pmid40595626,
year = {2025},
author = {Carreras-Vidal, L and Pacheco-Jaime, L and Ariza, M and Cano, N and Garolera, M and Garcia-Vicente, C and Roura, I and Capdevila-Lacasa, C and Oltra, J and Pardo, J and Martín-Barceló, C and Campabadal, A and Sala-Llonch, R and Bargallo, N and Barrué, C and Bejar, J and Cortés, CU and Junqué, C and , and Segura, B},
title = {Functional brain abnormalities in post COVID-19 condition and their relationship with cognition.},
journal = {Scientific reports},
volume = {15},
number = {1},
pages = {22259},
pmid = {40595626},
issn = {2045-2322},
support = {LCF/BQ/DR22/11950012//'la Caixa' Foundation/ ; PRE2018-086675//Ministerio de Ciencia e Innovación/ ; PRE2021-099674//Ministerio de Economía y Competitividad/ ; },
mesh = {Humans ; Male ; *COVID-19/complications/physiopathology/diagnostic imaging ; Female ; Magnetic Resonance Imaging ; Middle Aged ; *Brain/physiopathology/diagnostic imaging ; *Cognition/physiology ; Adult ; SARS-CoV-2 ; *Cognitive Dysfunction/physiopathology/etiology/diagnostic imaging ; Neuropsychological Tests ; Aged ; Post-Acute COVID-19 Syndrome ; },
abstract = {After COVID-19 infection, some patients develop a post-COVID condition (PCC) that is popularly referred to as long COVID. Among its symptoms is persistent cognitive dysfunction that is potentially linked to altered brain functional connectivity (FC). While research has explored functional reorganization in patients with PCC, the intra- and inter- network connectivity and its relationship with cognitive status and clinical outcomes remain unclear. In this study, we recruited 121 individuals with PCC (67 with, and 54 without, cognitive impairment), 20 months after infection, along with 37 non-infected healthy controls from the NAUTILUS Project (ClinicalTrials.gov IDs: NCT05307549 and NCT05307575). Participants underwent resting-state functional magnetic resonance imaging and comprehensive neuropsychological assessment. Resting-state networks were characterized using independent component analyses, dual regression and network modelling for individual FC characterization. Group differences in intra- and inter-network FC, and their associations with clinical and neuropsychological data, were studied. Significance was set at a corrected p-value of < 0.05. Patients with PCC showed increased intra-network FC in 10 cognitively relevant networks, including the default mode, salience, executive control, auditory and basal ganglia networks, correlating positively with general cognition (Montreal Cognitive Assessment scores), time since infection, fatigue and subjective memory failures. Increased inter-network FC between default mode and sensorimotor networks was also observed. Increases in FC may reflect an inefficient compensatory mechanism in patients with PCC, associated with fatigue, subjective memory complaints and persistence of PCC.},
}

Humans
Male
*COVID-19/complications/physiopathology/diagnostic imaging
Female
Magnetic Resonance Imaging
Middle Aged
*Brain/physiopathology/diagnostic imaging
*Cognition/physiology
Adult
SARS-CoV-2
*Cognitive Dysfunction/physiopathology/etiology/diagnostic imaging
Neuropsychological Tests
Aged
Post-Acute COVID-19 Syndrome

@article {pmid40593486,
year = {2025},
author = {Fraser, HL and Haag, L and Brosnahan, N and McConnachie, A and Richardson, J and Haig, CE and Ibbotson, T and Ormerod, J and O'Donnell, CA and Lean, MEJ and Sattar, N and Blane, DN and Combet, E and McIntosh, E},
title = {Cost-effectiveness of the ReDIRECT/counterweight-plus weight management programme to alleviate symptoms of long COVID.},
journal = {Nature communications},
volume = {16},
number = {1},
pages = {5592},
pmid = {40593486},
issn = {2041-1723},
support = {COV-LT2-0059//DH | National Institute for Health Research (NIHR)/ ; },
mesh = {Humans ; Cost-Benefit Analysis ; *COVID-19/economics/complications ; Female ; Male ; *Weight Reduction Programs/economics/methods ; Middle Aged ; United Kingdom ; Quality-Adjusted Life Years ; Adult ; *Obesity/therapy/economics/complications ; SARS-CoV-2 ; Quality of Life ; *Overweight/therapy/economics ; Aged ; },
abstract = {Long-term effects of COVID-19 infection, termed Long COVID (LC), are associated with reduced quality of life. Symptoms associated with overweight/obesity overlap with and may aggravate those of LC. This paper reports the economic evaluation alongside the ReDIRECT Trial, which evaluated the impact of an evidence-based, remotely-delivered weight management programme on self-reported symptoms of LC in those living with overweight/obesity in the United Kingdom. Recruited participants (n = 234) were randomly allocated to the intervention group (weight management) or control group (usual care). Incremental costs and Quality-Adjusted Life Years (QALYs) were calculated using intervention cost, healthcare resource use and EQ-5D-5L data collected at baseline, three and 6 months. In this work, we show that the ReDIRECT intervention is likely cost-effective in improving LC symptoms from an NHS/PSS perspective, compared to usual care (Incremental Cost-Effectiveness Ratio of £14,754/QALY). Adopting a broader societal perspective, the intervention becomes potentially cost saving compared to usual care.},
}

Humans
Cost-Benefit Analysis
*COVID-19/economics/complications
Female
Male
*Weight Reduction Programs/economics/methods
Middle Aged
United Kingdom
Quality-Adjusted Life Years
Adult
*Obesity/therapy/economics/complications
SARS-CoV-2
Quality of Life
*Overweight/therapy/economics
Aged

@article {pmid40591023,
year = {2025},
author = {Pennacchia, F and Zoccali, F and Petrella, C and Talarico, G and Rusi, E and Zingaropoli, MA and Ruqa, WA and Bruno, G and Capuano, R and Catini, A and Di Natale, C and Minni, A and Barbato, C},
title = {Insight into NeuroCOVID: neurofilament light chain (NfL) as a biomarker in post-COVID-19 patients with olfactory dysfunctions.},
journal = {Journal of neurology},
volume = {272},
number = {7},
pages = {484},
pmid = {40591023},
issn = {1432-1459},
support = {CUP B53D23018450006//Ministero dell'Istruzione, dell'Università e della Ricerca/ ; },
mesh = {Humans ; *COVID-19/complications/blood ; Male ; Female ; *Neurofilament Proteins/blood ; *Olfaction Disorders/blood/etiology/diagnosis/virology ; Biomarkers/blood ; Middle Aged ; Pilot Projects ; Aged ; Adult ; Anosmia/blood/etiology ; },
abstract = {The term NeuroCOVID was coined to describe the neurological consequences observed in COVID-19 patients. Numerous patients infected with SARS-CoV-2 reported olfactory dysfunction as the first symptom preceding clinical manifestations, such as cough and fever, or even the only symptom, suggesting the sudden loss of smell or hyposmia as an important predictive factor for COVID-19 infection. Several patients developed long-term olfactory impairment, but to date there is not available a biochemical diagnosis of anosmia. The aim of this pilot study is to investigate the association between neurofilament light-chain (NfL) serum levels and the olfactory dysfunctions in post-COVID-19 patients. This study recruited patients who developed COVID-19 between January 2020 and August 2021. They were evaluated between October 2022 and March 2023 by Sniffin' Sticks tests to investigate deficits of odor identification, discrimination, and threshold and serum NfL biomarker measurement to assess a neuronal damage. Out of 27 patients, 11 were affected by post-viral permanent olfactory dysfunction (named Od-post-COVID-19) and 16 healed from the infection without residual Od problem, as a control group. We observed an increased levels of NfL 16.02 ± 1.91 pg/mL in Od-post-COVID-19, suggesting that NfL to be recognized as a biomarker of post-viral olfactory dysfunction, supporting the diagnostic process of NeuroCOVID, joined with other well-known neurological biomarkers and/or innovative investigative approaches.},
}

Humans
*COVID-19/complications/blood
Male
Female
*Neurofilament Proteins/blood
*Olfaction Disorders/blood/etiology/diagnosis/virology
Biomarkers/blood
Middle Aged
Pilot Projects
Aged
Adult
Anosmia/blood/etiology

@article {pmid40590752,
year = {2025},
author = {Buonsenso, D},
title = {Not Having a Diagnostic Code for Long COVID Could Crash Healthcare Systems Like a Computer Bug.},
journal = {Acta paediatrica (Oslo, Norway : 1992)},
volume = {},
number = {},
pages = {},
doi = {10.1111/apa.70192},
pmid = {40590752},
issn = {1651-2227},
}

@article {pmid40590624,
year = {2025},
author = {Ketata, N and Jdidi, J and Maamri, H and Baklouti, M and Issaoui, F and Olfa, C and Damak, J and Yaich, S and Mejdoub, Y and Hammemi, R},
title = {Post-COVID Syndrome in Southern Tunisia: Prevalence, Clinical Spectrum, and Associated Factors Among Non-Severe Patients.},
journal = {Hospital topics},
volume = {},
number = {},
pages = {1-11},
doi = {10.1080/00185868.2025.2524796},
pmid = {40590624},
issn = {1939-9278},
abstract = {INTRODUCTION: Post-COVID syndrome, a long-term consequence of the COVID-19 pandemic, remains insufficiently understood. This study aimed to estimate the prevalence of post-COVID syndrome, describe its clinical spectrum, and identify associated factors among patients with non-severe forms of the disease.

METHODS: We conducted a cross-sectional study using telephone interviews in Sfax, southern Tunisia, during January 2021. The study population included individuals who tested positive for SARS-CoV-2 in October 2020. Minors and deceased individuals were excluded. Post-COVID syndrome was defined as the persistence of symptoms for more than eight weeks following the initial COVID-19 diagnosis.

RESULTS: A total of 2,070 patients were enrolled. The sample included 1,230 women (59.4%), with a male-to-female ratio of 0.68. The median age was 40 years [semi-interquartile range (SIR): 12.5 years]. The prevalence of post-COVID syndrome was 41.6% (n = 861). Among these, 229 patients (26.5%) consulted a physician for persistent symptoms, and 122 (14.13%) underwent further paraclinical evaluation. The most commonly reported symptoms were ageusia (68.9%), cognitive difficulties including concentration and memory impairment (24.9%), and fatigue (17.4%). Independent factors significantly associated with post-COVID syndrome included: age under 60 years (AOR = 1.8; 95% CI: 1.50-2.66), female gender (AOR = 1.6; 95% CI: 1.35-1.96), history of chronic respiratory disease (AOR = 1.8; 95% CI: 1.2-2.8), history of cancer (AOR = 3.5; 95% CI: 1.03-12.2), anticoagulant therapy (AOR = 1.45; 95% CI: 1.1-1.8), salicylic acid use (AOR = 1.4; 95% CI: 1.1-1.9), and initial clinical severity categorized as mild (AOR = 5.5; 95% CI: 3.5-8.5) or moderate (AOR = 7.1; 95% CI: 4.2-11.9).

CONCLUSION: A better understanding of the long-term manifestations of COVID-19, such as post-COVID syndrome, is essential. In the context of widespread vaccination and evolving variants, multidisciplinary approaches must be reconsidered to improve patient follow-up and healthcare strategies.},
}

@article {pmid40590080,
year = {2025},
author = {Yi, GD and Ching, LW and Zhong, LLD},
title = {Effect of interventions for the management of sleep disturbances in patients with long COVID: a systematic review and meta-analysis of randomized controlled trials.},
journal = {Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine},
volume = {},
number = {},
pages = {},
doi = {10.5664/jcsm.11782},
pmid = {40590080},
issn = {1550-9397},
abstract = {STUDY OBJECTIVES: Long COVID presents with symptoms that persist for weeks or months post-infection, with sleep disturbances significantly affecting quality of life. The diverse approaches to managing sleep disturbances highlight the need for comparing treatment effectiveness to improve patient outcomes. This study systematically reviews and conducts a meta-analysis of randomized controlled trials to assess the effectiveness of current interventions for sleep disturbances in long COVID patients, and explores the underlying mechanisms and promising treatments.

METHODS: Relevant studies were identified through a comprehensive literature search across Embase, Web of Science, PubMed, Cochrane Library, China National Knowledge Infrastructure, and Wanfang Data databases. The included studies focused on interventions aimed at managing long COVID patients with sleep disturbances. Data extraction and analysis were performed, followed by a meta-analysis of comparable studies. The quality of evidence was assessed using the Cochrane risk-of-bias tool (RoB 2.0) and the GRADE system.

RESULTS: Out of 3,352 retrieved studies, 14 were included in the systematic review, and two in the meta-analysis. Interventions were categorized as pharmacological and non-pharmacological. While most studies indicated improved sleep quality measured by standardized scales, some did not demonstrate significant benefits. The quality of evidence varied from low to moderate.

CONCLUSIONS: The results suggest that sleep disturbances in long COVID result from a complex interplay of physiological, psychological, and neurological factors. Both pharmacological and non-pharmacological interventions show potential in managing these disturbances, with non-pharmacological approaches showing particular promise. To establish more robust evidence, more high-quality, large-scale randomized controlled trials are necessary in future research.},
}

@article {pmid40589858,
year = {2025},
author = {Saikarthik, J and Saraswathi, I and Padhi, BK and Shamim, MA and Alzerwi, N and Alarifi, A and Gandhi, AP},
title = {Structural and functional neuroimaging of hippocampus to study adult neurogenesis in long COVID-19 patients with neuropsychiatric symptoms: a scoping review.},
journal = {PeerJ},
volume = {13},
number = {},
pages = {e19575},
pmid = {40589858},
issn = {2167-8359},
mesh = {Humans ; *COVID-19/complications/diagnostic imaging/physiopathology ; *Hippocampus/diagnostic imaging/physiopathology/pathology ; *Neurogenesis/physiology ; SARS-CoV-2 ; Adult ; *Functional Neuroimaging ; *Mental Disorders/diagnostic imaging/physiopathology ; Neuroimaging ; Magnetic Resonance Imaging ; },
abstract = {BACKGROUND: Worsening of neuropsychiatric and neurodegenerative disorders occurs in COVID-19. Impaired adult neurogenesis is linked to most of the neuropsychiatric symptoms and disorders.

AIM: The current scoping review identified and mapped the available evidence on adult neurogenesis in long COVID-19, at a global level following the JBI methodology for scoping reviews and followed the framework by Arksey and O'Malley.

METHOD: Original studies focusing on structural and functional neuroimaging of the hippocampus to study adult neurogenesis in long COVID-19 were included in the review. Studies published in English language with no restriction on the time of publication were searched using the specified search strategy in PubMed, Web of Science, Embase, and SCOPUS. Articles obtained from the database search were collated and uploaded into the Nested Knowledge AutoLit semi-automated systematic review platform for data extraction.

RESULTS: The current review provides evidence of the potential alterations in adult neurogenesis in long COVID-19 and its potential link to neuropsychiatric sequelae of long COVID-19, with further research required to validate this assertion.

CONCLUSION: This review proposes conceptual and methodological approaches for future investigations to address existing limitations and elucidate the precise role of adult neurogenesis in the pathophysiology and treatment of long COVID-19.},
}

Humans
*COVID-19/complications/diagnostic imaging/physiopathology
*Hippocampus/diagnostic imaging/physiopathology/pathology
*Neurogenesis/physiology
SARS-CoV-2
Adult
*Functional Neuroimaging
*Mental Disorders/diagnostic imaging/physiopathology
Neuroimaging
Magnetic Resonance Imaging

@article {pmid40589563,
year = {2025},
author = {Ohira, M and Osada, T and Kimura, H and Sano, T and Takao, M},
title = {Contemporary positive signs of functional limb weakness in post-acute sequelae of SARS-CoV-2: an exploratory analysis of their utility in diagnosis and follow-up.},
journal = {BMJ neurology open},
volume = {7},
number = {1},
pages = {e000995},
pmid = {40589563},
issn = {2632-6140},
abstract = {BACKGROUND: Sequelae of the acute phase of coronavirus disease-19, termed long COVID, are characterised by numerous indicators, including neurological symptoms. Functional neurological disorder (FND) can occur with or without various structural diseases. No previous study has examined the relationship between long COVID and FND, with positive signs for FND. This study confirmed positive signs of functional limb weakness (hereafter positive signs) in patients with long COVID.

METHODS: This was an observational, retrospective, single-centre study at an outpatient clinic conducted from 1 June 2021 to 31 May 2024. We collected patients' clinical data, including positive signs. The primary outcome was the prevalence of positive signs. Patients with positive signs were followed up over 2 months, and subjective patient perceptions of symptomatic improvements and changes in positive signs were analysed.

RESULTS: Overall, 502 were diagnosed with long COVID, and 100 assessed patients had positive signs. Female sex, time of infection after 2022, comorbidity of psychiatric diseases, fatigue, headache and muscle weakness were statistically significant in patients with positive signs compared with those in patients without positive signs. 89 patients (41 with positive signs and 48 without positive signs) were followed up, and 28 (68.3%) with positive signs and 33 (68.8%) without positive signs reported improvements. Positive signs disappeared in patients with symptomatic improvements but not in patients without symptomatic improvements (p=0.0001).

CONCLUSIONS: Positive signs were found in over one-third of patients (33.9%) who were investigated in this study. Some positive signs disappeared concurrently with their symptomatic improvement.},
}

@article {pmid40589358,
year = {2025},
author = {Choi, S and Hong, Y and Kang, MK and Song, TJ and Cho, SJ},
title = {Calcitonin Gene-Related Peptide Monoclonal Antibody Treatment in Nine Cases of Persistent Headache Following COVID-19-Infection.},
journal = {Journal of Korean medical science},
volume = {40},
number = {25},
pages = {e127},
doi = {10.3346/jkms.2025.40.e127},
pmid = {40589358},
issn = {1598-6357},
support = {RS-2022-II220621//Institute of Information & Communications Technology Planning & Evaluation/Korea ; /KEIT/Korea Evaluation Institute of Industrial Technology/Korea ; RS-2023-00262087/MOHW/Ministry of Health and Welfare/Korea ; },
mesh = {Humans ; Female ; Middle Aged ; *COVID-19/complications ; *Calcitonin Gene-Related Peptide/immunology/antagonists & inhibitors ; Retrospective Studies ; Adult ; *Headache/drug therapy/etiology ; *Antibodies, Monoclonal/therapeutic use ; Quality of Life ; SARS-CoV-2 ; *COVID-19 Drug Treatment ; Male ; Aged ; },
abstract = {BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has underscored the need for effective treatment for post-infectious complications, including headaches. Owing to the variable nature of post-COVID headaches, identifying effective therapies through clinical trials is challenging and the burden on patients is often severe. This study aimed to summarize the presentation of post-COVID headache in clinical practice and evaluate its response to treatment with calcitonin gene-related peptide (CGRP) monoclonal antibodies (mAbs).

METHODS: In this retrospective cohort study, medical records obtained between March 2022 and May 2024 from two centers were analyzed. The study included nine patients with new-onset or significantly worsening or altered patterns of previous headaches lasting more than one month after COVID-19 infection who subsequently received CGRP mAbs. Demographics, headache frequency and severity, medication use, and quality of life were assessed before and after CGRP mAb treatment.

RESULTS: All patients were female (median age, 48 years), and 88.9% had headaches for more than three months despite conventional preventive therapies. Headache Impact Test-6 (HIT-6) scores were greater than 60 in all patients, and the headaches were unilateral (66.7%) and pulsating (22.2%). After CGRP mAb treatment, the monthly headache days, headache severity scores, and monthly medication days decreased significantly (median with interquartile range: 25 [15-28] to 5 [4-10], P = 0.012; 8 [7-9] to 3 [2-4], P = 0.011; 16 [15-20] to 5 [4-10], P = 0.017). The HIT-6 (65 [60-68] to 48 [48-60], P = 0.017) and Patient Health Questionnaire-9 scores (14 [5-15] to 10 [4-12], P = 0.028) also decreased significantly after treatment.

CONCLUSION: CGRP mAbs may be considered a potential treatment option for persistent headaches following COVID-19, especially the long-COVID headaches. Their use may contribute to an improved burden of headache and quality of life and may help alleviate the psychological symptoms associated with persistent headaches.},
}

Humans
Female
Middle Aged
*COVID-19/complications
*Calcitonin Gene-Related Peptide/immunology/antagonists & inhibitors
Retrospective Studies
Adult
*Headache/drug therapy/etiology
*Antibodies, Monoclonal/therapeutic use
Quality of Life
SARS-CoV-2
*COVID-19 Drug Treatment
Male
Aged

@article {pmid40586228,
year = {2025},
author = {Madrigal, M and Velasco-Gonzalez, V and Jiménez-Navascués, L and Cárdaba-García, RM and Durantez-Fernández, C and Bahillo Ruiz, E and Pérez-Pérez, L and Olea, E and Muñoz-Del Caz, A},
title = {Relationship Between Fatigue, Perceived Social Support and Symptomatology of Long-COVID Patients in Spain.},
journal = {Scandinavian journal of caring sciences},
volume = {39},
number = {3},
pages = {e70078},
doi = {10.1111/scs.70078},
pmid = {40586228},
issn = {1471-6712},
mesh = {Humans ; Spain/epidemiology ; Female ; *Fatigue/epidemiology/etiology ; Male ; *Social Support ; Middle Aged ; *COVID-19/complications/psychology/epidemiology/physiopathology ; Cross-Sectional Studies ; Adult ; Aged ; Surveys and Questionnaires ; SARS-CoV-2 ; },
abstract = {AIMS AND OBJECTIVES: Long-COVID, identified in approximately 15% of symptomatic cases of COVID-19 in Spain, is a chronic multiorgan disease characterised by persistent symptoms, such as fatigue, dyspnoea, and cognitive difficulties. This study aims to evaluate the relationship between fatigue, perceived social support, and symptomatology in Spanish patients with Long-COVID, with the objective of identifying variables that contribute to holistic care.

An observational, descriptive, cross-sectional study was conducted with a non-randomised sample of 374 patients belonging to Spanish associations of Long-COVID patients. It was conducted using self-administered questionnaires distributed between July and November 2022 through associations of patients with Long-COVID.

ETHICAL ISSUES AND APPROVAL: Ethical evaluation was requested by the research ethics committee of the Eastern Area of Valladolid, which granted approval with registration number PI-22-2747.

RESEARCH METHODS: A total of 374 individuals who met specific criteria, including proficiency in Spanish and persistent symptoms, participated. Sociodemographic variables, persistent symptomatology, levels of fatigue (FSS scale), and perceived social support (DUKE-UNC-11 scale) were assessed. Descriptive statistical analysis, linear regression, and logistic analysis were employed to determine associations between variables.

RESULTS: The sample predominantly consisted of women (79.9%) with a mean age of 47 years. Neurological symptoms (79.4%) and pain (75.9%) were the most prevalent. Notably, 54.5% of participants experienced severe fatigue, which was negatively correlated with perceived social support. Conversely, perceived social support exhibited a significant association with neurological, psychic, and pain symptoms. Additionally, variables such as age and fatigue level predicted affective and confidential social support.

CONCLUSION: Fatigue and pain are associated with low perceptions of social support, underscoring the necessity of integrating psychosocial assessments into care protocols for patients with Long-COVID. An approach focused on perceived social support could enhance the adaptation of these patients, contributing to a more comprehensive and personalised model of care.},
}

Humans
Spain/epidemiology
Female
*Fatigue/epidemiology/etiology
Male
*Social Support
Middle Aged
*COVID-19/complications/psychology/epidemiology/physiopathology
Cross-Sectional Studies
Adult
Aged
Surveys and Questionnaires
SARS-CoV-2

@article {pmid40585077,
year = {2025},
author = {Wells, AM and Rolin, S and Robles-Ramamurthy, B and Gibson-Lopez, G and Goros, M and Gelfond, JA and Gelfond, S and Balfanz, P and Deuter, M and McGeary, D and Verduzco-Gutierrez, M},
title = {Assessing Neuropsychiatric Symptoms in Long COVID: A Retrospective Cohort Study from a South Texas Long COVID Clinic.},
journal = {medRxiv : the preprint server for health sciences},
volume = {},
number = {},
pages = {},
doi = {10.1101/2024.11.03.24316669},
pmid = {40585077},
abstract = {UNLABELLED: Long COVID, previously known as Post-Acute Sequelae of SARS-CoV-2 (PASC), refers to prolonged symptoms or diagnosable conditions following COVID-19 infection. The neuropsychiatric profile of Long COVID patients remains ambiguous. This study aimed to assess neuropsychiatric symptoms in a retrospective cohort of Long COVID patients (N = 162) at a Rehabilitation Medicine clinic in South Texas. Clinical data from patient records were used to calculate a Symptom Score, and screening tools for stress/PTSD (PCL-5), depression (PHQ-9), anxiety (GAD-7), and quality of life (SWL) were employed to evaluate if Long COVID duration and severity could predict neuropsychiatric outcomes. The majority were female (71%) and Hispanics (53%) who presented for treatment of Long COVID symptoms during the study period, including fatigue (93%), coughing/shortness of breath (81%), fever (67%), anosmia (58%), ageusia (54%), and weight loss (56%). A minority of participants were hospitalized (N = 49) or required ventilator support (N = 5) during acute infection. There was a high burden of neuropsychiatric symptoms, including subjective cognitive impairment (79%), headache (74%), and insomnia (58%). Symptom Score (median = 9, IQR [8,11]) was significantly correlated with increased depression (PHQ-9; p < 0.05), anxiety (GAD-7; p < 0.05) and elevated stress/PTSD (PCL-5; p < 0.05) symptoms. Long COVID patients taking stimulants or mood stabilizers had higher GAD-7 (p < 0.031, p < 0.035) and PHQ-9 (p < 0.034, p < 0.009) scores but not PCL-5 scores. Importantly, duration of Long COVID symptomatology also did not predict PCL-5 scores. No patient factors (e.g., sex, age, BMI, ethnicity) mediated Symptom Score. Nonetheless, historically marginalized groups, such as women and Hispanics, have been disproportionately affected by COVID-19. This study is the first to utilize validated screening tools to determine the presence and severity of neuropsychiatric symptoms in Long COVID patients. These findings may guide clinical management and future research on Long COVID, especially in historically excluded populations.

SCOPE STATEMENT: We enthusiastically submit our Original Research article, entitled " Assessing Neuropsychiatric Symptoms in Long COVID: A Retrospective Cohort Study from a South Texas Long COVID Clinic " for consideration for publication in the journal Frontiers in Neurology. We believe the scope of our article aligns well with the scope and aim of the journal's Neurorehabilitation Section. Long COVID is a debilitating neurological disorder with prominent and enduring cognitive and psychological impact. This study sought to characterize Long COVID symptoms from a cohort of patients at a Rehabilitation Medicine/Long COVID clinic in Southwest Texas. We stratified symptoms using validated psychiatric evaluation tools (e.g., PCL-5, GAD-7, PHQ-9, SWL) to determine if and to what extent psychiatric comorbidity exacerbated Long COVID symptoms. Our findings suggest that a Long COVID patient's depression, anxiety, and stress/post traumatic stress scores are highly correlated with other neurological symptoms. We advance the implementation of a Long COVID "Symptom Score", as well as the use of validated screening instruments to identify psychiatric features of Long COVID with the goal of maximizing life satisfaction and function over the course of treatment.},
}

@article {pmid40584711,
year = {2025},
author = {Garbsch, R and Kotewitsch, M and Schäfer, H and Teschler, M and Mooren, FC and Schmitz, B},
title = {Use of speleotherapy in patients with post-COVID-19 syndrome.},
journal = {Frontiers in medicine},
volume = {12},
number = {},
pages = {1566235},
doi = {10.3389/fmed.2025.1566235},
pmid = {40584711},
issn = {2296-858X},
abstract = {BACKGROUND: The post-COVID-19 syndrome (PCS) is characterized by persistent or newly developed symptoms and performance deficits lasting at least 3 months following SARS-CoV-2 infection, with dyspnea as a common symptom. Speleotherapy, a form of climatotherapy utilizing the microclimatic conditions of natural or artificial caves, has been proposed as a supportive treatment for chronic airway diseases, potentially improving lung function and exercise tolerance.

METHODS: This study investigated the short-term effects of speleotherapy on lung diffusion capacity (DLCO) in PCS patients through a prospective interrupted time-series analysis. Forty-six patients (51.9 ± 9.3 years; 43% female) referred for rehabilitation were included, with a history of COVID-19 infection and persistent deficits lasting over 3 months. Patients underwent spirometric assessments of DLCO repeatedly on days without speleotherapy intervention and on days with intervention, alongside subjective symptom evaluations using the Nijmegen questionnaire.

RESULTS: PCS patients performed a median of four out of seven speleotherapy sessions during rehabilitation, resulting in a total of 388 measurements. Analysis revealed no significant changes in DLCO or related parameters (transfer coefficient (KCO), inspiratory volume (IV), total lung capacity (TLC), Residual volume (RV)) during rehabilitation and between speleotherapy and control days (p ≥ 0.544). Subgroup analysis of patients with DLCO below 80% of predicted reference and symptom severity assessments also revealed no therapeutic benefits. Speleotherapy frequency showed no dose-dependent effects on pulmonary outcomes (p = 0.171). Findings from a small control group confirmed these results (p ≥ 0.997).

CONCLUSION: Speleotherapy did not improve DLCO or alleviate symptoms in PCS patients within this study cohort. Further research is needed to investigate whether speleotherapy can alleviate pulmonary dysfunction in different PCS populations.},
}

@article {pmid40583757,
year = {2025},
author = {Cornwell, WK and Levine, BD and Baptiste, D and Bhave, N and Desai, S and Dineen, E and Durstenfeld, M and Edward, J and Huang, M and Jacobsen, R and Kim, JH and Spatz, E and , },
title = {Exercise Intolerance and Response to Training in Patients With Postacute Sequelae of SARS-CoV2 (Long COVID): A Scientific Statement From the American Heart Association.},
journal = {Circulation},
volume = {},
number = {},
pages = {},
doi = {10.1161/CIR.0000000000001348},
pmid = {40583757},
issn = {1524-4539},
abstract = {The postacute sequelae of SARS-CoV-2, also known as Long COVID, may affect 10% to 25% of individuals diagnosed with SARS-CoV-2. More than 100 symptoms have been reported among patients with Long COVID, but almost all patients report severe fatigue, orthostatic intolerance, shortness of breath, and reductions in exercise tolerance. Emerging data suggest that cardiovascular deconditioning plays a major role in the development of this syndrome and that reductions in functional capacity among patients with Long COVID are comparable to reductions seen among individuals with cardiovascular deconditioning resulting from bed rest. Concern has been raised about the use of exercise training as part of the management strategy for patients with Long COVID. However, exercise training appropriately tailored to the patient with cardiovascular deconditioning may be an effective strategy to facilitate improvement in symptoms. This American Heart Association scientific statement provides a concise yet comprehensive overview of mechanisms contributing to development of Long COVID and methods by which exercise training may be applied to this unique patient population to alleviate symptoms and improve quality of life. In addition, methods of reintroducing exercise and return to play among athletes affected by COVID-19 are discussed.},
}

@article {pmid40583236,
year = {2025},
author = {Tracy, MF and Hagstrom, S and Mathiason, MA and Wente, S and Lindquist, R},
title = {Longitudinal Multidimensional Symptom Experience Following COVID-19 Hospitalization: Implications from a Holistic Perspective.},
journal = {Western journal of nursing research},
volume = {},
number = {},
pages = {1939459251349753},
doi = {10.1177/01939459251349753},
pmid = {40583236},
issn = {1552-8456},
abstract = {BACKGROUND: While COVID-19 has lessened in urgency for the general United States population's day-to-day functioning, it continues to have significant impact for those who live with a wide range of ongoing sequelae. Wide variation of Long COVID symptoms must be considered as nurses facilitate holistic patient-centered care.

OBJECTIVES: We aimed to describe patients' symptom experiences from 3 to 12 months following COVID-19 hospitalization.

METHODS: A longitudinal descriptive design was used to explore adults' symptom experiences of Long COVID at 4 time points up to 12 months following hospital admission for COVID-19 between October 2020 and May 2022.

RESULTS: Most of the 37 participants (87%) continued to experience at least 1 physical symptom at 12 months, which was not significantly different than at 3 months (90%). Fatigue was the most common symptom reported at all the time points. Group mean scores on all PROMIS measures and the Impact of Events Scale-Revised did not indicate dysfunction; however, 37% reported having somewhat or a lot of symptom impact on their normal routines. In addition, at least 50% reported currently experiencing quality of life worse than prior to COVID at each time point.

CONCLUSIONS: Long COVID symptoms continue to affect significant numbers of people with ongoing impact to daily routines and quality of life. Nurses are in a unique position to generate new evidence on identifying the subset of patients recovering from COVID-19 who are at higher risk for developing Long COVID and provide holistic assessments, monitoring, and interventions to mitigate patients' physical, emotional, and mental health symptoms.},
}

@article {pmid40582622,
year = {2025},
author = {Xu, K and He, W and Yu, B and Wang, JJ and Wu, J and Wang, DW},
title = {Unveiling the silent threat: COVID-19 and myocardial injury.},
journal = {Pharmacology & therapeutics},
volume = {},
number = {},
pages = {108904},
doi = {10.1016/j.pharmthera.2025.108904},
pmid = {40582622},
issn = {1879-016X},
abstract = {Since COVID-19 firstly appeared in 2019 December, it has been defined as an infectious disease mainly performing lung symptoms, which contracted more attention. However, more and more findings indicate myocardial injury appears in considerable proportion of COVID-19 patients (30 % - 50 %) not only but also major cause leading to the death in patients, many of whom may be even without severe respiratory symptoms. Meanwhile myocarditis after injecting vaccines has been paid more attention to globally which always performs uncontrollable inflammation and lead to death. Now myocardial injury has been a main complication in patients with long COVID-19, which is worthy of attention. Furthermore, myocardial injury or myocarditis is detectable and treatable. In order to abstract attention to myocardial injury associated with COVID-19 and provide more evidence and experience for patients who still suffer myocardial injury from COVID-19 vaccines or long COVID-19, the review comprehensively summarized previous researches from pathogenesis, clinical symptoms, diagnosis and treatment and emphasized the crucial role of RASS inhibitors especially ARBs.},
}

@article {pmid40587610,
year = {2024},
author = {Butler, CS},
title = {Use of Neuromodulation to Treat Post-COVID Neuropathic Pain: A Case Report.},
journal = {Pain medicine case reports},
volume = {8},
number = {7},
pages = {253-256},
pmid = {40587610},
issn = {2768-5152},
mesh = {Humans ; Male ; *Neuralgia/therapy/etiology ; Adult ; *COVID-19/complications ; *Electric Stimulation Therapy/methods ; SARS-CoV-2 ; },
abstract = {BACKGROUND: Post-COVID-19 neuropathic pain is a difficult-to-treat condition seen in approximately one-third of patients with long COVID. It has been shown to be resistant to many first-line therapies as well as over-the-counter and prescription medications.

CASE REPORT: We present the case of a 27-year-old man who developed bilateral upper extremity neuropathic pain in conjunction with a severe COVID-19 infection. He failed occupational therapy, multiple medications, and a stellate ganglion block. A dorsal column stimulator was placed and provided the patient with both pain relief and improved functionality.

CONCLUSIONS: Given the results of this case and the history of neuromodulation in effectively treating neuropathic pain, we submit that neuromodulation is a viable option for patients with refractory post-COVID-19 neuropathic pain.},
}

Humans
Male
*Neuralgia/therapy/etiology
Adult
*COVID-19/complications
*Electric Stimulation Therapy/methods
SARS-CoV-2

@article {pmid40587609,
year = {2024},
author = {Escano Volquez, LM and Kanuri, SH and Haddad, R},
title = {Tibial Nerve Mononeuropathy Post-COVID-19 and Successful Management with Peripheral Nerve Stimulation: A Case Report.},
journal = {Pain medicine case reports},
volume = {8},
number = {7},
pages = {249-252},
pmid = {40587609},
issn = {2768-5152},
mesh = {Humans ; Female ; *COVID-19/complications ; Adult ; *Tibial Nerve ; *Mononeuropathies/therapy/etiology ; *Neuralgia/therapy/etiology ; *Transcutaneous Electric Nerve Stimulation/methods ; *Tibial Neuropathy/therapy/etiology ; SARS-CoV-2 ; },
abstract = {BACKGROUND: Infection with COVID-19 has evolved from a novel health crisis into an entity with a myriad of increasingly recognized sequelae. Among these, peripheral neuropathy is often an underrecognized and underdiagnosed complication. Neuropathic pain can be challenging to treat with many cases being refractory to conservative management, often requiring advanced techniques. Neuromodulation has become an important tool for the treatment of the refractory cases.

CASE REPORT: We present a case of a 43-year-old woman with refractory right tibial mononeuropathy secondary to COVID-19 infection who was treated successfully using peripheral nerve stimulation.

CONCLUSIONS: The use of peripheral neuromodulation represents a pivotal strategy for the management of difficult cases. Our case highlights the first use of neuromodulation to treat neuropathic pain secondary to COVID-19 infection. We hope that this case sparks further research on the topic, which could lead to better clarification of this condition and potential expansion of treatment strategies.},
}

Humans
Female
*COVID-19/complications
Adult
*Tibial Nerve
*Mononeuropathies/therapy/etiology
*Neuralgia/therapy/etiology
*Transcutaneous Electric Nerve Stimulation/methods
*Tibial Neuropathy/therapy/etiology
SARS-CoV-2

@article {pmid40580194,
year = {2026},
author = {Gorenshtein, A},
title = {Neuroprotection of medical gases: a potential effect on treating cognitive impairments in neurological symptoms of long-COVID.},
journal = {Medical gas research},
volume = {16},
number = {1},
pages = {84-85},
doi = {10.4103/mgr.MEDGASRES-D-25-00029},
pmid = {40580194},
issn = {2045-9912},
}

@article {pmid40579261,
year = {2025},
author = {Chen, YC and Chiu, CH and Chen, CJ},
title = {Neurological and psychiatric aspects of long COVID among vaccinated healthcare workers: An assessment of prevalence and reporting biases.},
journal = {Journal of microbiology, immunology, and infection = Wei mian yu gan ran za zhi},
volume = {},
number = {},
pages = {},
doi = {10.1016/j.jmii.2025.06.002},
pmid = {40579261},
issn = {1995-9133},
abstract = {BACKGROUND: This study assessed the prevalence and severity of neurological and psychiatric long COVID symptoms among healthcare workers (HCWs) based on their COVID-19 status, aiming to unravel the complexities associated with post-acute sequelae of SARS-CoV-2 infection.

METHODS: A cohort of 467 HCWs from a teaching hospital in northern Taiwan, who received at least three doses of COVID-19 vaccines, were surveyed for long COVID symptoms. Participants were categorized into symptomatic (n = 224), asymptomatic (n = 21), and absence of COVID-19 (n = 222) groups based on diagnostic criteria involving questionnaire responses, medical records, and anti-nucleoprotein antibody data. Through a comprehensive set of questionnaires, symptoms, memory dysfunction, anxiety, and depression were rigorously evaluated and statistically analyzed for group comparisons.

RESULTS: Despite meticulous data collection, the study revealed no statistically significant differences in the severity of neurological and psychiatric long COVID symptoms across the COVID-19 status groups. Noteworthy trends were observed, including higher instances of memory problems worsening over time, elevated anxiety levels in symptomatic cases, and subtle indicators of increased depression severity in this subgroup. The findings underscored the multifactorial nature of long COVID manifestations and the impact of COVID-19 history on reported symptoms.

CONCLUSION: The study highlighted potential biases in symptom reporting that may inflate long COVID prevalence estimates. While the robust methodology shed light on diverse health profiles among HCWs, future research should focus on longitudinal designs and objective diagnostic measures to provide more accurate assessments of long COVID's burden.},
}

@article {pmid40578337,
year = {2025},
author = {Menson, KE and Gaalema, DE},
title = {When the Treatment Needs a Home: The Application of Exercise Interventions in Long COVID.},
journal = {Journal of cardiopulmonary rehabilitation and prevention},
volume = {45},
number = {4},
pages = {233-235},
pmid = {40578337},
issn = {1932-751X},
}

@article {pmid40578132,
year = {2025},
author = {Shady, EFA and Ghallab, AF and Shaker, DA and Elsayed, RAE},
title = {Epstein-Barr virus (EBV) reactivation in post COVID-19.},
journal = {Auris, nasus, larynx},
volume = {52},
number = {4},
pages = {442-446},
doi = {10.1016/j.anl.2025.06.009},
pmid = {40578132},
issn = {1879-1476},
abstract = {OBJECTIVE: To determine if there is a link between prolonged COVID symptoms and the reactivation of EBV.

METHODS: This study was an observational (case-control) analysis involving 140 patients who tested positive for COVID-19 and are experiencing persistent symptoms such as fatigue and post-exertional malaise. Additionally, a control group of 80 individuals, matched for age and gender, who have fully recovered from SARS-CoV-2 infection without these symptoms, was included. The research took place between December 2023 and March 2024 at Benha University Hospitals in Benha, Egypt. The reactivation of the Epstein-Barr virus (EBV) was identified by detecting EBV genetic material using TaqMan probes, along with at least one set of primers (BamHI and LMP2).

RESULTS: Initial hospitalization during acute COVID-19 infection is significantly associated with post-COVID fatigue (p-value 0.007*). No significant associations were found for risk factors like diabetes and hypertension. EBV replication observed was due to EBV reactivation rather than primary infection. EBV-specific antibody titers EBNA-1 IgG (p-value 0.004*) and EA-D IgG (p-value 0.008*). 40/140 (28.6 %) patients with COVID-19 with persistent fatigue showed EBV reactivation in contrast to 9/80 (11.3 %) of controls (P-value 0.003*) using the same detection methods.

CONCLUSION: EBV reactivation plays a role in Long-COVID syndrome following COVID-19 infection supporting the usage of EBV inhibitors for long-term COVID-19 treatment.},
}

@article {pmid40576557,
year = {2025},
author = {Openshaw, JJ and Chen, J and Rodriguez, R and Gottlieb, M and McCullough, K and Santangelo, M and Hill, MJ and Gatling, K and Idris, AH and McDonald, S and Wisk, LE and Dyal, J and Wang, RC and Rising, KL and Kean, E and O'Laughlin, KN and Stephens, KA and Malicki, C and Lin, Z and Spatz, ES and Yu, H and Weinstein, RA and Elmore, J},
title = {The Effect of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Reinfection on Long-Term Symptoms in the Innovative Support for Patients With SARS-CoV-2 Infections Registry (INSPIRE).},
journal = {Clinical infectious diseases : an official publication of the Infectious Diseases Society of America},
volume = {},
number = {},
pages = {},
doi = {10.1093/cid/ciaf225},
pmid = {40576557},
issn = {1537-6591},
support = {/CC/CDC HHS/United States ; 75D30120C08008/IP/NCIRD CDC HHS/United States ; },
abstract = {BACKGROUND: The clinical consequences of repeated severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are not clear, especially as they relate to long-term symptoms after infection. We analyzed data collected for the Innovative Support for Patients with SARS-CoV-2 Infections Registry (INSPIRE) to determine whether reinfection changes the likelihood of symptoms 3-6 months after reinfection compared with the likelihood in individuals experiencing a single infection.

METHODS: Individuals reporting a single SARS-CoV-2 infection or a single reinfection were included in this analysis. A positive SARS-CoV-2 test occurring ≥90 days after a first infection was considered a reinfection. Outcomes included severe fatigue (fatigue severity score ≥25) and the presence of organ system symptoms 3-6 months after the last infection.

RESULTS: The analysis included 886 individuals, 415 (46.8%) of whom experienced reinfection. For individuals who experienced their first infections in either the pre-Delta or Delta periods, the odds of having ≥3 symptoms 3-6 months after their most recent infection was lower in those reinfected than those with a single infection (weighted adjusted odds ratio, 0.45 [95% confidence interval, .21-.95] and 0.51 [.32-.79], respectively). However, in individuals reporting their first infection during the Omicron wave, the odds of reporting ≥3 symptoms after the most recent infection was higher in those reinfected than in those with a single infection (weighted adjusted odds ratio, 1.54 [95% confidence interval, 1.02-2.34]).

CONCLUSIONS: The timing of initial infection, reinfection, and the variants involved may play important roles in longer-term clinical outcomes. Repeated infection with Omicron variants may increase the risk of long-term symptoms.},
}

@article {pmid40575972,
year = {2025},
author = {Zhu, T and Li, X and Gao, S and Cui, R and Wang, J and Deng, Q},
title = {Successful salvage therapy of ruxolitinib on interstitial pneumonia after long COVID or post-COVID-19 syndrome with follicular lymphoma: two case reports and literature review.},
journal = {Chinese clinical oncology},
volume = {14},
number = {3},
pages = {35},
doi = {10.21037/cco-24-106},
pmid = {40575972},
issn = {2304-3873},
mesh = {Humans ; Nitriles ; *Pyrazoles/therapeutic use ; *COVID-19/complications ; Pyrimidines ; *Lymphoma, Follicular/complications/drug therapy ; *Salvage Therapy/methods ; Male ; SARS-CoV-2 ; Middle Aged ; Female ; *Lung Diseases, Interstitial/drug therapy/etiology ; COVID-19 Drug Treatment ; Aged ; Methylprednisolone/therapeutic use ; },
abstract = {BACKGROUND: Immunocompromised patients with B lymphocyte deficiency and hypogammaglobulinemia after anti-CD19 chimeric antigen receptor (CAR) T cell therapy for relapsed/refractory follicular lymphoma (FL) are at high risk of severe coronavirus disease 2019 (COVID-19) infection.

CASE DESCRIPTION: In our study, two patients with refractory FL had persistent COVID-19 infection after their anti-CD19 CAR T cell therapy. The patients were diagnosed with post-COVID-19 syndrome or COVID-19 with interstitial inflammation and persistent hypoxemia. The patients received molnupiravir and Paxlovid, along with methylprednisolone therapy when their interleukin (IL)-6 levels were high. No response was observed in interstitial inflammation, persistent hypoxemia, or persistent positive expression of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2); however, the level of IL-6 decreased after these therapies. These two patients subsequently received low-dose ruxolitinib (5 mg, twice daily) as salvage therapy in combination with a gradually reduced dosage of methylprednisolone. After 1-2 months of ruxolitinib therapy, persistent hypoxemia was relieved, and interstitial inflammation was significantly absorbed. At the same time, the SARS-CoV-2 detection was found to be negative.

CONCLUSIONS: Ruxolitinib might be a safe and effective alternative salvage therapy for patients with COVID-19 having interstitial inflammation and persistent hypoxemia without high cytokine levels and no response to corticosteroids.},
}

Humans
Nitriles
*Pyrazoles/therapeutic use
*COVID-19/complications
Pyrimidines
*Lymphoma, Follicular/complications/drug therapy
*Salvage Therapy/methods
Male
SARS-CoV-2
Middle Aged
Female
*Lung Diseases, Interstitial/drug therapy/etiology
COVID-19 Drug Treatment
Aged
Methylprednisolone/therapeutic use

@article {pmid40574623,
year = {2025},
author = {Yang, J and Tamberou, C and Arnee, E and Squara, PA and Boukhlal, A and Nguyen, JL and Volkman, HR and Fievez, S and Lepoutre-Bourguet, M and Ben Romdhane, H and Renaudat, C and Crépey, P and Robineau, O},
title = {Quantifying all-cause healthcare resource utilization and costs of children with mild-to-moderate long COVID in France.},
journal = {Journal of medical economics},
volume = {},
number = {},
pages = {1-17},
doi = {10.1080/13696998.2025.2525002},
pmid = {40574623},
issn = {1941-837X},
abstract = {BACKGROUND: Although children are known to be at risk of developing long COVID, its economic burden is poorly described in these patients. We aimed to assess the all-cause healthcare resource utilization (HCRU) and associated direct medical costs of children with mild-to-moderate long COVID in France.

METHODS: This retrospective cohort study utilized The Health Improvement Network (THIN) primary care electronic health records (EHRs) to identify children aged <18 years with a confirmed/probable coronavirus disease 2019 (COVID-19) diagnosis during 03/2020-12/2022 who developed long COVID, which was identified per the World Health Organization as suggestive symptoms present ≥3 months following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Patient characteristics and all-cause HCRU were summarized, as were direct healthcare costs from a national health insurance perspective. HCRU and costs were stratified into seven areas of care: healthcare encounters, medical procedures, retail pharmacy usage, testing, sick leave, medical transport, and medical device usage.

RESULTS: Of 27,537 children diagnosed with acute COVID-19, 3,888 (14.1%) developed long COVID; mean age was 8.9 years, 49.2% were female and, among those with comorbidity, 24.5% had a Charlson Comorbidity Index (CCI) score ≥1. During a mean follow-up of 12.6 months after their acute COVID-19 diagnosis, 93.6% of children had general practitioner (GP) consultations, 93.5% had pharmacy usage, and 61.0% had medical procedures. Costs were highest during the first year, with per patient per year costs of €823; 4.3% of children required caregiver-related work absenteeism. When compared to children with COVID-19 who did not develop long COVID, a diagnosis of long COVID was associated with an incremental cost increase of €98 per patient per year.

LIMITATIONS: Our findings only represent a national health payer perspective. The true societal burden of long COVID in children is likely underestimated since the indirect costs associated with long COVID are not well captured and access to care varies.

CONCLUSION: Children living with long COVID managed in the community pose a non-neglectable burden on French national health insurance. These findings reinforce the importance of managing long COVID with a multidisciplinary approach and optimizing resource allocation for children.},
}

@article {pmid40572685,
year = {2025},
author = {Kallaste, A and Kisand, K and Aart, A and Salumets, A and Kisand, K and Peterson, P and Lember, M},
title = {Long COVID and Biomarker Dysregulation-A Shift Toward Immune Exhaustion?.},
journal = {Medicina (Kaunas, Lithuania)},
volume = {61},
number = {6},
pages = {},
pmid = {40572685},
issn = {1648-9144},
mesh = {Humans ; *COVID-19/immunology/blood/complications ; Biomarkers/blood ; Male ; Female ; Middle Aged ; Longitudinal Studies ; *Cytokines/blood ; Aged ; SARS-CoV-2 ; Adult ; Inflammation ; Post-Acute COVID-19 Syndrome ; Severity of Illness Index ; Immune System Exhaustion ; },
abstract = {Background: SARS-CoV-2 infection can lead to persistent or newly emerging symptoms lasting for months, a condition known as long COVID (LC). The pathophysiology of LC remains poorly understood, with cytokine dysregulation proposed as a key mechanism, although findings across the studies have been inconsistent. Patients and methods: We conducted a longitudinal study using the Olink[®] Target 96 Inflammation Panel to assess cytokines in COVID-19 (COV) patients at three months and six months post-infection. These profiles were compared with those of individuals recovering from other upper respiratory tract infections (non-COV). Additionally, we analyzed differences between individuals with LC and those who recovered from COVID-19. Predictive models for LC at three months and sixth months post-infection were developed using inflammatory markers and relevant clinical cofactors, including gender, age, BMI, hemogram, Β2-microglobulin, D-dimers, LDH, AST, ALT, Ferritin, vitamin D, CRP, and the severity of acute COVID-19 infection as classified by WHO criteria. Results: We observed a general decline in inflammatory biomarkers in post-COVID-19 patients over time, with only a few cytokines elevated (CCL4 at month 3 and CST5 at month 6) compared to non-COV controls. In LC patients, an early phase of low-grade inflammation transitioned into significant reduction in proinflammatory biomarkers compared to recovered individuals. Rather than indicating immune normalization, this pattern suggests a possible suppression or exhaustion of the immune response in the months following acute infection. Importantly, our predictive modeling demonstrated that this specific cytokine signature, in combination with acute disease severity and clinical cofactors, described well the presence of LC. Conclusions: Our findings suggest that inflammation-related biomarker dysregulation following acute SARS-CoV-2 infection evolves dynamically over a six-month period. By the sixth month, compared to the third month, the presence of LC is more accurately predicted by a combination of persistent biomarker alteration and the severity of the initial infection, as defined by WHO criteria. This represents a novel insight, as previous studies have primarily associated LC with elevated proinflammatory markers, whereas our results suggest that immune suppression or exhaustion may play a more prominent role in the later stages.},
}

Humans
*COVID-19/immunology/blood/complications
Biomarkers/blood
Male
Female
Middle Aged
Longitudinal Studies
*Cytokines/blood
Aged
SARS-CoV-2
Adult
Inflammation
Post-Acute COVID-19 Syndrome
Severity of Illness Index
Immune System Exhaustion

@article {pmid40570227,
year = {2025},
author = {Beloglazov, VA and Yatskov, IA and Kumelsky, ED and Teslenko, MA},
title = {[Experience of using grape polyphenol concentrate in elderly patients with bronchial asthma in the post-COVID period.].},
journal = {Advances in gerontology = Uspekhi gerontologii},
volume = {38},
number = {1},
pages = {145-149},
pmid = {40570227},
issn = {1561-9125},
mesh = {Humans ; *Vitis/chemistry ; Female ; Male ; *Asthma/drug therapy/blood ; *Polyphenols/administration & dosage/therapeutic use/pharmacology ; Aged ; *COVID-19/complications ; SARS-CoV-2 ; *COVID-19 Drug Treatment ; Lipopolysaccharides/blood ; Treatment Outcome ; Middle Aged ; },
abstract = {The state of long-COVID and post-COVID syndrome is associated with the presence of low-grade inflammation (LGI) in patients, associated, among other things, with impaired permeability of natural barriers for lipopolysaccharide (LPS) of gram-negative flora. Objective - to study the effect of adding polyphenolic grape concentrate to the course of spa treatment in patients with bronchial asthma and post-covid syndrome on the state of LGI, intestinal permeability and edotoxemia. The study included 70 patients with a verified diagnosis of Bronchial asthma who had suffered from infection caused by SARS-CoV-2. Patients were divided into two groups. The intervention group (n=40) received grape polyphenol concentrate in addition to standard spa treatment. Subsequent enzyme-linked immunosorbent assay (ELISA) performed for determination of the levels of C-RP, zonulin, LPS, lipopolysaccharide-binding protein (LBP), and bactericidal/permeability-increasing protein (BPI). In patients of the 1st group a reliable decrease in the level of C-RP (p<0,039) and the concentration of circulating LPS (p=0,008) was revealed. In both groups, a statistically significant increase in the concentration of BPI and zonulin was registered (p<0,05). The use of polyphenolic grape concentrate in elderly patients in the post-covid period reduces the level of C-RP and circulating blood endotoxin, which in the future should reduce the likelihood of long-term consequences associated with NCI, including cardiovascular, in patients who have undergone NCI.},
}

Humans
*Vitis/chemistry
Female
Male
*Asthma/drug therapy/blood
*Polyphenols/administration & dosage/therapeutic use/pharmacology
Aged
*COVID-19/complications
SARS-CoV-2
*COVID-19 Drug Treatment
Lipopolysaccharides/blood
Treatment Outcome
Middle Aged

@article {pmid40566632,
year = {2025},
author = {Chen, BK and Chan, CH and Wang, CK},
title = {Improvement on Ferrous Ion Accumulation and Mitochondrial Dysfunction in the COVID-19 Pseudovirus-Infected Cell Model Simulating the Long COVID Status by Nutritional Strategy.},
journal = {Life (Basel, Switzerland)},
volume = {15},
number = {6},
pages = {},
doi = {10.3390/life15060980},
pmid = {40566632},
issn = {2075-1729},
abstract = {The pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has plunged the world into a major crisis of overwhelming morbidity and mortality and emerged various mutant strains. Patients recovering from SARS-CoV-2 develop post-acute COVID syndrome, commonly known as long COVID (LC), lasting up to 12 weeks or even longer. The mechanism has yet to be clarified. COVID-19 pseudovirus is a suitable model to understand the infection of the COVID-19 virus to cells, which is suitable to see the acute change in cells owing to its one-time infection and inactivation. The ACE2-293T cell infected by COVID-19 pseudovirus was used in this study. After the infection and removal of the pseudovirus, high amounts of ferrous ions were accumulated in mitochondria and then released into the cytosol. Reactive oxygen species (ROS) accumulation was formed and caused mitochondrial dysfunction. To evaluate the effect of nutritional strategy on ferrous ion accumulation and mitochondrial dysfunction, lactoferrin, Q10 and Echinacea purpurea extract (EPE) were used in this study. Results showed that lactoferrin, Q10 and EPE could improve mitochondrial dysfunction by reducing the accumulation of ferrous ions and ROS in the mitochondria. HPLC analysis showed that EPE contained rich caffeic acid, and it also showed perfect improvement in mitochondrial dysfunction. In conclusion, cells infected with pseudovirus could increase the accumulation of ferrous ions and ROS in mitochondria and be released into the cytosol after removing pseudovirus, thereby causing mitochondrial dysfunction. Lactoferrin, Q10 and EPE were an effective nutritional strategy to suppress ferrous ion accumulation, ROS formation and advanced mitochondrial dysfunction.},
}

@article {pmid40566540,
year = {2025},
author = {Koutsiaris, AG and Karakousis, K},
title = {Long COVID Mechanisms, Microvascular Effects, and Evaluation Based on Incidence.},
journal = {Life (Basel, Switzerland)},
volume = {15},
number = {6},
pages = {},
doi = {10.3390/life15060887},
pmid = {40566540},
issn = {2075-1729},
abstract = {Since the initial reports of Long COVID symptoms, numerous pathophysiological mechanisms have been proposed to explain them; nevertheless, no consensus has been reached. Some of these mechanisms are directly linked to microcirculation, while others are related indirectly. Those with a direct connection involve the respiratory system (such as pulmonary embolism), the cardiovascular system (including cardiac arrest, heart failure, myocardial inflammation, stroke, endothelial dysfunction, and microangiopathy), hematological conditions (like coagulopathy, deep vein thrombosis, microclots, and endothelial irregularities), and brain function. However, few of these mechanisms are grounded in quantitative data and fundamental physiological principles. Furthermore, diagnostic and therapeutic methods remain inadequate. This report provides a brief overview of these processes, focusing primarily on quantitative data, recently proposed mechanisms, and advances in microcirculation, with a special emphasis on the tissue blood supply reduction (TBSR or SR in short) mechanism. Then, the SR pathophysiological mechanism is assessed based on the total incidence rate of the Long COVID symptoms that can be directly attributed to this mechanism. The proposed SR mechanism can account for seven principal Long COVID symptoms with a total normalized incidence of 76%.},
}

@article {pmid40566294,
year = {2025},
author = {Rocha, DM and Pedroso, AO and Menegueti, MG and Silveira, RCCP and Sousa, LRM and Gir, E and Reis, RK},
title = {Predictors of Anxiety, Depression, and Stress in Long COVID: Systematic Review of Prevalence.},
journal = {International journal of environmental research and public health},
volume = {22},
number = {6},
pages = {},
doi = {10.3390/ijerph22060867},
pmid = {40566294},
issn = {1660-4601},
support = {88881.657963/2021-01//Coordenação de Aperfeicoamento de Pessoal de Nível Superior/ ; },
mesh = {Humans ; *COVID-19/psychology/epidemiology/complications ; *Anxiety/epidemiology/etiology ; *Depression/epidemiology/etiology ; Prevalence ; *Stress, Psychological/epidemiology/etiology ; Aged ; SARS-CoV-2 ; Adult ; },
abstract = {Anxiety, depression, and stress are prevalent psychosocial manifestations in Long COVID, and understanding their global impact can guide safe, effective, and evidence-based interventions. This study reviewed the literature to analyze the prevalence indicators and predictors of anxiety, depression, or stress experienced by adults and older adults with Long COVID. This systematic prevalence review was conducted using the databases MEDLINE via PubMed[®], CINAHL-EBSCO, Web of Science, Scopus, EMBASE, LILACS, and BDENF. Observational studies that assessed anxiety, depression, or perceived stress in adults and older adults with Long COVID were included, with no restrictions on time or language. Two reviewers independently conducted the selection process. Full texts were analyzed for their eligibility potential. Methodological quality was assessed using the JBI Critical Appraisal Checklist for Studies. Ten observational studies with moderate methodological quality were included. Anxiety and depression were the most prevalent psychosocial symptoms in Long COVID, reported in mild, moderate, and severe cases of COVID-19 infection. Prevalence rates reached up to 47.8% for anxiety, 37.3% for depression, and 23% for stress. The combined analysis revealed a pooled prevalence of 15.3% (95% CI: 10.8% to 20.2%). Being female, having pre-existing mental disorders or associated clinical comorbidities, experiencing severe infection in the acute phase, and receiving intensive care were predictors of greater mental burden. The experience of anxiety, depression, and stress in prolonged COVID-19 was reported in countries with different income levels and was disproportionately experienced, especially by women and individuals with associated clinical conditions or psychopathological comorbidities.},
}

Humans
*COVID-19/psychology/epidemiology/complications
*Anxiety/epidemiology/etiology
*Depression/epidemiology/etiology
Prevalence
*Stress, Psychological/epidemiology/etiology
Aged
SARS-CoV-2
Adult

@article {pmid40565969,
year = {2025},
author = {Chynkiamis, N and Vontetsianos, A and Anagnostopoulou, C and Lekka, C and Gounaridi, MI and Oikonomou, E and Vavuranakis, M and Rovina, N and Bakakos, P and Koulouris, N and Kaltsakas, G and Vogiatzis, I},
title = {Hybrid Pulmonary Rehabilitation Improves Cardiorespiratory Exercise Fitness in Formerly Hospitalised Long COVID Patients.},
journal = {Journal of clinical medicine},
volume = {14},
number = {12},
pages = {},
doi = {10.3390/jcm14124225},
pmid = {40565969},
issn = {2077-0383},
abstract = {Background/Objectives: Supervised pulmonary rehabilitation (PR) is effective in improving cardiorespiratory fitness in non-hospitalised individuals with long COVID. However, there is limited evidence regarding PR-induced improvements in cardiorespiratory parameters in previously hospitalised COVID-19 survivors. This study aimed to investigate the effect of a hybrid PR programme (outpatient followed by a digital intervention) on exercise tolerance, cardiorespiratory adaptations, functional capacity and quality of life outcomes in previously hospitalised COVID-19 survivors. Methods: Forty-two patients (age (mean ± SD): 57 ± 12 yrs) with excessive fatigue due to long COVID (FACIT score (26 ± 10) were allocated to PR (n = 27) or usual care (UC) (n = 15) 140 ± 75 days from hospital discharge. PR consisted of 8 outpatient sessions (twice weekly for 4 weeks) followed by 24 home-based sessions (3 times/week for 8 weeks). Patients in the UC group were instructed to be physically active. Exercise tolerance was assessed by cardiopulmonary cycling testing to the limit of tolerance. Results: Following the completion of the hybrid PR programme, peak work rate (WRpeak) and peak oxygen uptake (VO2peak) were, respectively, improved in the PR group by 19 ± 10 Watt (p = 0.001) and by 2.4 ± 3.0 mL/kg/min (p = 0.001). Furthermore, in the PR group, the 6 min walk distance was increased by 72 ± 69 metres (p = 0.001). FACIT and mMRC scores were also improved in the PR group by 15 ± 10 (p = 0.001) and by 1.4 ± 1.0 (p = 0.001), respectively. In the UC group, only the mMRC score was improved by 0.7 ± 1.0 (p = 0.008). Conclusions: The application of a hybrid PR programme was beneficial in improving cardiorespiratory exercise fitness, functional capacity and quality of life in previously hospitalised COVID-19 survivors.},
}

@article {pmid40565006,
year = {2025},
author = {Coelho, SVA and Souza, GLE and Bezerra, BB and Lima, LR and Correa, IA and de Almeida, DV and Silva-Aguiar, RPD and Pinheiro, AAS and Sirois, P and Caruso-Neves, C and Costa, LJD and Scharfstein, J and Arruda, LB},
title = {SARS-Cov-2 Replication in a Blood-Brain Barrier Model Established with Human Brain Microvascular Endothelial Cells Induces Permeability and Disables ACE2-Dependent Regulation of Bradykinin B1 Receptor.},
journal = {International journal of molecular sciences},
volume = {26},
number = {12},
pages = {},
doi = {10.3390/ijms26125540},
pmid = {40565006},
issn = {1422-0067},
support = {(01.20.0029.000462/20 404096/2020-4; 01.22.0074.00 (1227/21))//Rede Corona-ômica BR MCTI/FINEP affiliated to RedeVírus/MCTI/ ; CAPES//Coordination for the Improvement of Higher Education Personnel/ ; CNPq//Brazilian National Council for Scientific and Technological Development/ ; FAPERJ; 740 LBA E-26/201.206/2021, E-26/204.307/2024; JS E-26/ 210.059/ 2020, and E-26/210.251/-2020 and E-741 26/201.062/2021; SVAC E-26/20.746/2022; BBB E-26/202.346/2024; LRL E-26/201.918/2024//Carlos Chagas Filho Research Support Foundation/ ; },
mesh = {Humans ; *Angiotensin-Converting Enzyme 2/metabolism/genetics ; *Blood-Brain Barrier/virology/metabolism/pathology ; *SARS-CoV-2/physiology ; *Receptor, Bradykinin B1/metabolism ; *Endothelial Cells/metabolism/virology ; *COVID-19/metabolism/virology/pathology ; *Virus Replication ; Bradykinin/metabolism/analogs & derivatives ; Brain/blood supply/metabolism ; Capillary Permeability ; Microvessels ; },
abstract = {Endothelial dysfunction plays a central role in COVID-19 pathogenesis, by affecting vascular homeostasis and worsening thromboinflammation. This imbalance may contribute to blood-brain barrier (BBB) disruption, which has been reported in long COVID-19 patients with neurological sequelae. The kallikrein-kinin system (KKS) generates bradykinin (BK), a proinflammatory peptide that induces microvascular leakage via B2R. Under inflammatory conditions, BK is converted to Des-Arg-BK (DABK), which activates B1R, a receptor upregulated in inflamed tissues. DABK is degraded by ACE2, the main SARS-CoV-2 receptor; thus, viral binding and ACE2 downregulation may lead to DABK/B1R imbalance. Here, we investigated these interactions using human brain microvascular endothelial cells (HBMECs), as a model of the BBB. Since endothelial cell lines express low levels of ACE2, HBMECs were modified with an ACE2-carrying pseudovirus. SARS-CoV-2 replication was confirmed by RNA, protein expression, and infectious particles release. Infection upregulated cytokines and endothelial permeability, enhancing viral and leukocyte transmigration. Additionally, viral replication impaired ACE2 function in HBMECs, amplifying the response to DABK, increasing nitric oxide (NO) production, and further disrupting endothelial integrity. Our findings reveal a mechanism by which SARS-CoV-2 impacts the BBB and highlights the ACE2/KKS/B1R axis as a potential contributor to long COVID-19 neurological symptoms.},
}

Humans
*Angiotensin-Converting Enzyme 2/metabolism/genetics
*Blood-Brain Barrier/virology/metabolism/pathology
*SARS-CoV-2/physiology
*Receptor, Bradykinin B1/metabolism
*Endothelial Cells/metabolism/virology
*COVID-19/metabolism/virology/pathology
*Virus Replication
Bradykinin/metabolism/analogs & derivatives
Brain/blood supply/metabolism
Capillary Permeability
Microvessels

@article {pmid40564201,
year = {2025},
author = {Hemat Jouy, S and Tonchev, H and Mostafa, SM and Mahmoud, AM},
title = {Post-COVID Metabolic Fallout: A Growing Threat of New-Onset and Exacerbated Diabetes.},
journal = {Biomedicines},
volume = {13},
number = {6},
pages = {},
doi = {10.3390/biomedicines13061482},
pmid = {40564201},
issn = {2227-9059},
support = {1R01HL161386-04/NH/NIH HHS/United States ; 1R00HL140049-03/NH/NIH HHS/United States ; },
abstract = {Emerging evidence highlights the profound and lasting impact of severe illnesses such as COVID-19, particularly among individuals with underlying comorbidities. Patients with pre-existing conditions like diabetes mellitus (DM) are disproportionately affected, facing heightened risks of both disease exacerbation and the onset of new complications. Notably, the convergence of advanced age and DM has been consistently associated with poor COVID-19 outcomes. However, the long-term metabolic consequences of SARS-CoV-2 infection, especially its role in disrupting glucose homeostasis and potentially triggering or worsening DM, remain incompletely understood. This review synthesizes current clinical and experimental findings to clarify the bidirectional relationship between COVID-19 and diabetes. We critically examine literature reporting deterioration of glycemic control, onset of hyperglycemia in previously non-diabetic individuals, and worsening of metabolic parameters in diabetic patients after infection. Furthermore, we explore proposed mechanistic pathways, including pancreatic β-cell dysfunction, systemic inflammation, and immune-mediated damage, that may underpin the development or progression of DM in the post-COVID setting. Collectively, this work underscores the urgent need for continued research and clinical vigilance in managing metabolic health in COVID-19 survivors.},
}

@article {pmid40564133,
year = {2025},
author = {Pisaturo, M and Russo, A and Grimaldi, P and Monari, C and Imbriani, S and Gjeloshi, K and Ricozzi, C and Astorri, R and Curatolo, C and Palladino, R and Caruso, F and Ambrisi, F and Onorato, L and Coppola, N},
title = {Prevalence, Evolution and Prognostic Factors of PASC in a Cohort of Patients Discharged from a COVID Unit.},
journal = {Biomedicines},
volume = {13},
number = {6},
pages = {},
doi = {10.3390/biomedicines13061414},
pmid = {40564133},
issn = {2227-9059},
support = {CUP: I83C22001810007//Regione Campania/ ; },
abstract = {Background and Aim: PASC is a potentially debilitating clinical condition consisting of different general symptoms experienced by about 10% of patients with previous SARS-CoV-2 infection. Our study analyses a cohort of patients with a history of hospitalization for COVID-19 and aims to evaluate prognostic factors for experiencing PASC and to investigate the characteristics of patients experiencing PASC symptoms. Methods: This is an observational, monocentric retrospective study including all adult patients admitted to our COVID unit from 28 February 2020 to 30 April 2022, discharged alive, and having performed at least one follow-up visit at our post-COVID outpatient clinic after a minimum of three months from discharge. Patients who experienced persistent clinical manifestations or the development of new symptoms three months after the initial SARS-CoV-2 infection, with these symptoms lasting for at least two months with no other explanation, were defined as having PASC. Results: A total of 429 patients were discharged alive from our COVID Unit and 244 patients performed at least one follow-up visit in our outpatient clinic. Of these, 134 patients did not experience PASC, while 110 patients experienced PASC. Long-COVID patients were more frequently female (43.6% vs. 31.3%, p = 0.048), more frequently presented throat pain and headache at hospital admission (respectively 8.9% vs. 2.5%, p = 0.041 and 15.8% vs. 5%, p = 0.007), and were more likely to have a history of type 2 diabetes mellitus (25.5% vs. 13%, p =0.013). At the multivariable analysis, female gender, type 2 diabetes, and headache at admission were factors associated with PASC. All 46 patients who performed at least two different admissions in our outpatient clinic were divided in two groups: the first including the 16 patients who experienced a reduction or a resolution of symptoms related to COVID-19, the second comprising the 30 patients who experienced clinical worsening or persisting symptoms. Smoking habit was more represented among patients with stable or worsening symptoms (42.3% vs. 7.7%, p = 0.042); myalgias at admission were more frequent in the clinical worsening group (27.6% vs. 0%, p= 0.039); and a larger amount of patients who reported neuropsychiatric symptoms and respiratory symptoms were in the stable or worsening PASC symptoms group. Discussion: In conclusion, this study underscores the complexity of PASC, identifying female sex, Type 2 diabetes, and certain acute COVID-19 symptoms as potential predisposing factors for its development. PASC still represents a substantial public health challenge, and ongoing efforts are essential to better understand its underlying mechanisms and improve patient outcomes.},
}

@article {pmid40563736,
year = {2025},
author = {Doskas, T and Vavougios, GD and Kormas, C and Kokkotis, C and Tsiptsios, D and Spiliopoulos, KC and Tsiakiri, A and Christidi, F and Aravidou, T and Dekavallas, L and Kazis, D and Dardiotis, E and Vadikolias, K},
title = {Neurocognitive Impairment After COVID-19: Mechanisms, Phenotypes, and Links to Alzheimer's Disease.},
journal = {Brain sciences},
volume = {15},
number = {6},
pages = {},
doi = {10.3390/brainsci15060564},
pmid = {40563736},
issn = {2076-3425},
abstract = {BACKGROUND/OBJECTIVES: SARS-CoV-2 can affect the central nervous system directly or indirectly. AD shares several similarities with long COVID cognitive impairment on a molecular and imaging level, as well as common risk factors. The objective of this review is to evaluate the incidence of post-acute COVID-19 cognitive impairment. Secondarily, we aim to determine if neuroinflammation in COVID-19 survivors may be associated with the onset of neurological disease, with a focus on Alzheimer's disease (AD).

METHODS: literature search up to March 2025 on the prevalence of cognitive deficits in COVID-19 survivors, underlying pathophysiology and associations with neurological disorders.

RESULTS: a wide array of neuropsychiatric manifestations is associated with COVID-19; executive function, memory, and attention are the most frequently reported neurocognitive deficits, regardless of COVID-19 severity. There are associations between the risks for cognitive deficits post-infection with the age of the patients and the severity of the disease. Increasing evidence suggests that neurocognitive deficits are associated with the onset of neurological and neuropsychiatric disease in COVID-19 survivors.

CONCLUSIONS: clinicians caring for COVID-19 survivors should actively investigate neurocognitive sequelae, particularly for patients with increased risk for cognitive deficits.},
}

@article {pmid40561297,
year = {2025},
author = {Alves, NS and Silva, END and Melo, GBT and Paulino, MAS and Angulo-Tuesta, A},
title = {Agenda for COVID-19 and long COVID research priorities in Brazil: results of wide consultation and Delphi consensus, 2022-2023.},
journal = {Epidemiologia e servicos de saude : revista do Sistema Unico de Saude do Brasil},
volume = {34},
number = {},
pages = {e20240623},
doi = {10.1590/S2237-96222025v34e20240623.en},
pmid = {40561297},
issn = {2237-9622},
mesh = {Brazil/epidemiology ; Humans ; *COVID-19/epidemiology ; Delphi Technique ; Consensus ; *Research/organization & administration ; Qualitative Research ; *Biomedical Research ; },
abstract = {OBJECTIVE: To propose an agenda of COVID-19 and long COVID research priorities, in order to guide government and research funding agencies to optimize health science, technology and innovation resources in Brazil.

METHODS: This is a qualitative study, carried out in two stages, between April 2022 and March 2023. In the first stage, a broad consultation was carried out to identify research priorities according to the axes of the COVID-19 Evidence Network to support Decision-making initiative, with 71 participants including researchers, health service managers, health science and technology managers, health professionals and health service users. In the second stage, a consensus was reached on the priorities proposed in the previous stage, using the Delphi method, with a panel of 20 experts on COVID-19 in the first round and 18 in the second round.

RESULTS: In the broad consultation, 186 priority lines of research on COVID-19 were received and consolidated into 161 research lines. Of these, 139 achieved consensus in the first round of the Delphi method, and a further 40 lines were received and included in the second round for consensus. The proposed agenda has 179 research lines on COVID-19. The predominant themes were evaluation, COVID-19 impact and sequelae, long COVID-19, mental illnesses and immunosuppression. The child population was of greatest interest.

CONCLUSIONS: This study demonstrated high levels of agreement among participants on COVID-19 and long COVID research priorities in Brazil.},
}

Brazil/epidemiology
Humans
*COVID-19/epidemiology
Delphi Technique
Consensus
*Research/organization & administration
Qualitative Research
*Biomedical Research

@article {pmid40560299,
year = {2025},
author = {Hung, CT and Hung, YC and Suk, CW and Wu, CH},
title = {Evaluating the associations among asthma, asthma control and long COVID in U.S. adults.},
journal = {Infection},
volume = {},
number = {},
pages = {},
pmid = {40560299},
issn = {1439-0973},
abstract = {OBJECTIVE: This study aimed to evaluate (1) the association between asthma and long COVID among U.S. adults and (2) the association between asthma control and long COVID among U.S. adults with asthma.

METHODS: Data from the 2023 National Health Interview Survey were used. Adults aged ≥ 18 years were included. Asthma control was measured by the history of asthma attacks and emergency room (ER) visits for asthma. Multivariable logistic regression models were used to evaluate the associations. A sensitivity analysis was performed by stratifying long COVID severity.

RESULTS: A total of 258,237,552 adults were included in this study. The prevalence of long COVID among U.S. adults in 2023 was 8.2%. When stratified by the presence of asthma, the prevalence was 15.2% for those with asthma and 7.6% for those without asthma (P < 0.01). After adjusting for covariates, adults with asthma had higher odds of long COVID than those without asthma (OR, 1.58; 95% CI, 1.37-1.83). This association was consistent across long COVID severity levels. Poor asthma control was associated with increased odds of long COVID (asthma attacks: OR, 1.47; 95% CI, 1.09-1.97; ER visits for asthma: OR, 1.52; 95% CI, 1.02-2.27).

CONCLUSION: Asthma was associated with increased odds of long COVID. Patients with poorly controlled asthma were associated with increased odds of long COVID. From a clinical perspective, it is crucial to proactively identify patients with asthma at increased risk of long COVID, especially those with certain comorbidities. Future research on specific symptoms and the duration of long COVID among patients with asthma will benefit clinical practice.},
}

@article {pmid40559200,
year = {2025},
author = {Cianciulli, A and Santoro, E and Manente, R and Pacifico, A and Comunale, G and Finizio, M and Capunzo, M and De Caro, F and Franci, G and Moccia, G and Boccia, G},
title = {Validation of a Questionnaire on the Post-COVID-19 Condition (Long COVID): A Cross-Sectional Study in Italy.},
journal = {Infectious disease reports},
volume = {17},
number = {3},
pages = {},
doi = {10.3390/idr17030069},
pmid = {40559200},
issn = {2036-7430},
abstract = {BACKGROUND/OBJECTIVES: Long COVID is a condition that was initially recognized by social support groups, and later by the scientific and medical communities. It affects COVID-19 survivors at various levels of severity, including young people, children and non-hospitalized people. Although the exact definition is unclear, the most common symptoms are fatigue and shortness of breath, which persist for months. Other symptoms include cognitive impairment, pain, palpitations, and gastrointestinal and heart problems. This study evaluated the reliability and validity of a questionnaire designed to examine the development and effects of long COVID.

METHODS: A questionnaire, composed of three sections, with a total of 24 items, was administered to subjects who had recovered from the COVID-19 disease in Italy. Data were collected from February to April 2025, and a statistical analysis was performed using R[®] statistical software for Windows, version 4.3.3. Cronbach's alpha was tested to check internal consistency. The questionnaire was completed voluntarily and anonymously by 250 individuals who had recovered from the SARS-CoV-2 infection. The questionnaire was self-administered and had open and structured questions.

RESULTS: The highest value of Cronbach's alpha was found on 18 items (alpha = 0.97), which means that the questionnaire has satisfactory internal validity.

CONCLUSIONS: This study highlights and confirms the continuity of symptoms manifested during the acute phase of the SARS-CoV-2 infection in the post-COVID-19 phase and the significant impact of these symptoms on daily life activities. Given its excellent reliability properties and high internal consistency, the instrument is recommended for future longitudinal studies and with large cohorts in order to carry out valid and replicable measurements of COVID-19 symptomatology.},
}

@article {pmid40559080,
year = {2025},
author = {Miana, M and Moreta-Fuentes, R and Jiménez-Antona, C and Moreta-Fuentes, C and Laguarta-Val, S},
title = {Improvement of Fatigue and Body Composition in Women with Long COVID After Non-Aerobic Therapeutic Exercise Program.},
journal = {Journal of personalized medicine},
volume = {15},
number = {6},
pages = {},
doi = {10.3390/jpm15060217},
pmid = {40559080},
issn = {2075-4426},
support = {II PI 2021/05//illustrious professional association of physiotherapists of the community of Madrid/ ; },
abstract = {Background/Objective: Fatigue is one of the most recurrent and most disabling symptoms of long COVID (LC) and is associated with a worse quality of life. Reducing body fat in these patients could be important to mitigate fatigue and post-exertional worsening. Aerobic exercise may not be indicated in LC patients who have orthostatic tachycardia and post-exertional worsening. The aim of this study was to evaluate the effects of a personalized supine therapeutic motor control exercise program on fatigue and fat tissue in women with LC. Methods: A single-arm exploratory case study, with a pre-post format, was conducted on 17 women with LC to test the effects of a plank-based strengthening exercise program on fatigue, which was evaluated by the Modified Fatigue Impact Scale and fat tissue assessed by bioimpedance. The twelve-week program included two weekly sessions. The exercise program was personalized, considering the symptoms and characteristics of the patients. Results: Participants with overweight or obesity (n = 12) comprised 70% of the entire sample. After completing the exercise program this value decreased by 5.9 percentage points. Significant differences were found in the total [(MD = -1.72, 95% CI -2.57 to -0.86), r = 0.73], trunk, upper and inner limbs body fat percentages (p < 0.05). The overall fatigue decreased at 12 weeks [(MD = -14.00, 95% CI -21.69 to -6.31), r = 0.69] as well as the physical and psychosocial fatigue sub-scale (p < 0.001); no differences were observed in the cognitive sub-scale. Conclusions: The plank-based personalized strengthening exercise program showed rapid improvements in fatigue and fat percentages. It could be an effective strategy to achieve improvements for LC patients.},
}

@article {pmid40557167,
year = {2025},
author = {Ćwilichowska-Puślecka, N and Makowiecka, A and Kalinka, M and Groborz, K and Puślecki, T and Drąg, M and Simon, K and Dąbrowska, K and Pazgan-Simon, M and Poręba, M},
title = {Understanding the long-term interplay of SARS-CoV-2 immune and inflammatory responses with proteases in COVID-19 recovery: a longitudinal study.},
journal = {Frontiers in immunology},
volume = {16},
number = {},
pages = {1517933},
pmid = {40557167},
issn = {1664-3224},
mesh = {Humans ; *COVID-19/immunology ; Longitudinal Studies ; *SARS-CoV-2/immunology ; Male ; Middle Aged ; Female ; *Peptide Hydrolases/immunology/blood/metabolism ; Adult ; Inflammation/immunology ; Aged ; Cytokines/blood/immunology ; Convalescence ; },
abstract = {INTRODUCTION: The immune and inflammatory responses following SARS-CoV-2 infection, particularly in the context of long COVID, remain critical areas of study. Understanding these responses is essential for addressing the long-term health impacts of COVID-19. Recent research also highlights the pivotal role of proteases in modulating immune responses and contributing to disease severity, making them a key focus of our analysis.

METHODS: We conducted a longitudinal analysis of 72 convalescent COVID-19 patients, assessing recovery at three key time points: immediately post-discharge, one month later, and three months post-infection. Additionally, a subset of 15 patients was followed up two years post-COVID-19. Clinical parameters, including demographics, comorbidities, treatment modalities, and COVID-19 severity, were evaluated. Using CyTOF technology, we characterized over 30 immune cell subsets, including granulocytes, T cells, B cells, NK cells, and monocytes. We also performed multiplexed analyses of blood samples to profile cytokines, chemokines, growth factors, proteases, and COVID-19-related proteins.

RESULTS: Our comprehensive approach revealed significant changes in the immune system over time, highlighting the role of specific immune cells and proteases in the recovery process. Key findings include a decreasing deregulatory effect on immune responses exerted by subsequent SARS-CoV-2 variants Alpha, Delta, and Omicron.

CONCLUSION: This study provides an in-depth understanding of the molecular dynamics of immune recovery following COVID-19. By integrating clinical profiling, plasma multiplex analysis, antibody profiling, mass cytometry immunophenotyping, in vitro PBMC stimulation, and the role of proteases, we offer valuable insights into the complex interplay of immune, inflammatory, and protease-mediated responses in individuals recovering from COVID-19.},
}

Humans
*COVID-19/immunology
Longitudinal Studies
*SARS-CoV-2/immunology
Male
Middle Aged
Female
*Peptide Hydrolases/immunology/blood/metabolism
Adult
Inflammation/immunology
Aged
Cytokines/blood/immunology
Convalescence

@article {pmid40556843,
year = {2025},
author = {Ojha, A and Bhasin, M and Agni, MB and Gowda, KD},
title = {Serum ferritin as a predictive marker of pulmonary fibrosis in post-COVID-19.},
journal = {Qatar medical journal},
volume = {2025},
number = {2},
pages = {44},
pmid = {40556843},
issn = {0253-8253},
abstract = {BACKGROUND: Pulmonary fibrosis is characterized by excessive matrix formation, which destroys typical lung architecture and increases the chances of comorbidity. It is essential to look into potential serum indicators for the early identification of individuals who may develop such severe fibrotic consequences since there is currently no specific marker for the early diagnosis of post-COVID-19 pulmonary fibrosis. The study is aimed at examining potential serum markers that could be used for early detection of pulmonary fibrosis in patients with COVID-19.

METHODS: It is a cross-sectional retrospective observational study that included male (n = 26) and female (n = 10) patients who were confirmed positive for COVID-19 using the Reverse transcription polymerase chain reaction (RTPCR) test. Various hematological parameters, such as platelet count, white blood cell count (WBC count), platelet-to-lymphocyte ratio (PLR), white blood cell count to mean platelet volume ratio (WMR), red cell distribution width (RDW), plateletcrit (PCT), mean platelet volume (MPV), platelet distribution width (PDW), serum ferritin level, and CT severity scores (CT-SSs) were recorded. The association between hematological parameters, serum ferritin level, and CT-SS was assessed by the Pearson correlation test using the GraphPad Prism software (version 10). p < 0.05 was considered statistically significant.

RESULTS: The descriptive analysis revealed no significant correlation between platelet count (r = 0.1610, p = 0.3483), WBC count (r = -0.1381, p = 0.4217), PLR (r = 0.2262, p = 0.1847), WMR (r = -0.1093, p = 0.5258), RDW (r = 0.05982, p = 0.7289), PCT (r = -0.059, p = 0.752), MPV (r = 0.046, p = 0.788), and PDW (r = -0.06, p = 0.699) with CT-SS. However, a significant positive correlation was observed between CT-SS and serum ferritin levels in COVID-19 patients (r = 0.5452, p = 0.0006).

CONCLUSIONS: As there was a significant positive correlation between serum ferritin level and CT-SS, the serum ferritin level could be considered as a simple and cost-effective biomarker for predicting the development of lung fibrosis in long COVID-19 conditions after controlling the confounders.},
}

@article {pmid40554922,
year = {2025},
author = {Weinerova, J and Yeung, S and Guo, P and Yau, A and Horne, C and Ghinn, M and Curtis, L and Adlard, F and Bhagat, V and Zhang, S and Kaser, M and Bozic, M and Schluppeck, D and Reid, A and Tibon, R and Cheke, L},
title = {Changes in memory function in adults following SARS-CoV-2 infection: Findings from the Covid and Cognition online study.},
journal = {Cortex; a journal devoted to the study of the nervous system and behavior},
volume = {189},
number = {},
pages = {205-225},
doi = {10.1016/j.cortex.2025.05.019},
pmid = {40554922},
issn = {1973-8102},
abstract = {SARS-CoV-2, the virus responsible for the Covid-19 pandemic, has been shown to have an impact on cognitive function, but the specific aspects of cognition that are affected remain unclear. In this Registered Report, we analysed cognitive data collected online from 296 participants (209 who had experienced Covid-19 infection and 87 who did not). We have found previously reported effect of Covid status on accuracy in 2 long-term memory tasks (verbal item memory task and nonverbal associative memory task), but did not replicate previously reported effect on reaction times. Further, across 4 long-term memory tasks, we found consistent effect of Covid status on memory accuracy but not reaction times. Contrary to our predictions, we did not find an interaction with memory type (associative versus item) or stimulus type (verbal versus nonverbal). Moreover, we compared cognitive functioning amongst vaccinated and unvaccinated individuals to explore the role of vaccination status in cognitive symptoms associated with Covid-19. Using Bayesian analysis, we did not find conclusive evidence for either the null or alternative hypothesis. Overall, the study replicates and extends previously reported findings, thereby providing valuable insights into the effects of SARS-CoV-2 infection on cognitive functions.},
}

@article {pmid40554575,
year = {2025},
author = {Vallée, G and Xi, D and Avramovic, G and O'Kelly, B and Lambert, JS},
title = {Evaluating the longitudinal physical and psychological health effects of persistent long Covid 3.5 years after infection.},
journal = {PloS one},
volume = {20},
number = {6},
pages = {e0326790},
doi = {10.1371/journal.pone.0326790},
pmid = {40554575},
issn = {1932-6203},
mesh = {Humans ; *COVID-19/psychology/epidemiology/complications ; Male ; Female ; Middle Aged ; Longitudinal Studies ; Adult ; *Mental Health ; SARS-CoV-2/isolation & purification ; Aged ; Anxiety ; Surveys and Questionnaires ; Fatigue ; },
abstract = {This is a 3.5-year single-center observational cohort study investigating the longitudinal impact of Long Covid on the physical and mental health of patients. Patients were assessed at 3 months, 1 year, and 3.5-years post-infection using the 12-item Short Form Survey, Patient Health Questionnaire-9, Generalized Anxiety Disorder-7 scale and the Impact of Events Scale-Revised questionnaire. Additionally, a clinical symptom review was conducted for patients with persistent Long Covid at the 3.5-year follow-up. We had 149 respondents at 3 months, 94 at 1 year and 85 at 3.5-year. Of those who participated, 72% had Long Covid at the 3-month follow-up, with 26% and 25% having persistence of Long Covid symptoms at 1-year and 3.5 years, respectively. The most reported symptoms at the 3.5-year timepoint included fatigue, difficulty sleeping and easy crashing following activities. Overall, patients' Physical Composite Scores significantly improved between the 3-month and 3.5-year timepoints. However, the Physical Composite Scores of patients with persistent Long Covid were significantly lower than those of non-Long Covid patients at both the 3-month and 1-year follow-ups. The Mental Composite Score of persistent Long Covid patients remained significantly lower than individuals without Long Covid at all timepoints. At 3 months, Long Covid disproportionately met the criteria for depression, anxiety and PTSD symptoms. At 1 and 3.5 years, patients with persistent Long Covid were more likely to meet the criteria for depressive symptoms than those without Long Covid. Between the 3-months and 3.5-year timepoints, there was a significant reduction in the number of patients with persistent Long Covid who met the criteria for PTSD and anxiety symptoms. Although patients with Long Covid for 3.5 years had shown improvements in both their physical and mental health over time, they continue to lag behind those without Long Covid.},
}

Humans
*COVID-19/psychology/epidemiology/complications
Male
Female
Middle Aged
Longitudinal Studies
Adult
*Mental Health
SARS-CoV-2/isolation & purification
Aged
Anxiety
Surveys and Questionnaires
Fatigue

@article {pmid40554463,
year = {2025},
author = {Gross, RS and Thaweethai, T and Salisbury, AL and Kleinman, LC and Mohandas, S and Rhee, KE and Snowden, JN and Tantisira, KG and Warburton, D and Wood, JC and Kinser, PA and Milner, JD and Rosenzweig, EB and Irby, K and Flaherman, VJ and Karlson, EW and Chibnik, LB and Pant, DB and Krishnamoorthy, A and Gallagher, R and Lamendola-Essel, MF and Hasson, DC and Katz, SD and Yin, S and Dreyer, BP and Blancero, F and Carmilani, M and Coombs, K and Fitzgerald, ML and Letts, RJ and Peddie, AK and Foulkes, AS and Stockwell, MS and , and , and Aschner, JL and Atz, AM and Banerjee, D and Bogie, A and Bukulmez, H and Clouser, K and Cottrell, LA and Cowan, K and D'Sa, VA and Dozor, A and Elliott, AJ and Faustino, EVS and Fiks, AG and Gaur, S and Gennaro, ML and Gordon, S and Hasan, UN and Hester, CM and Hogan, A and Hsia, DS and Kaelber, DC and Kosut, JS and Krishnan, S and McCulloh, RJ and Michelow, IC and Nolan, SM and Oliveira, CR and Olson, LM and Pace, WD and Palumbo, P and Raissy, H and Reyes, A and Ross, JL and Salazar, JC and Selvarangan, R and Stein, CR and Stevenson, MD and Teufel, RJ and Werzberger, A and Westfall, JM and Zani, K and Zempsky, WT and Zimmerman, E and Bind, MC and Chan, J and Guan, Z and Morse, RE and Reeder, HT and Metz, TD and Newburger, JW and Truong, DT},
title = {Characterizing Long COVID Symptoms During Early Childhood.},
journal = {JAMA pediatrics},
volume = {},
number = {},
pages = {},
doi = {10.1001/jamapediatrics.2025.1066},
pmid = {40554463},
issn = {2168-6211},
abstract = {IMPORTANCE: Recent studies have identified characteristic symptom patterns of long COVID (LC) in adults and children older than 5 years. However, LC remains poorly characterized in early childhood. This knowledge gap limits efforts to identify, care for, and prevent LC in this vulnerable population.

OBJECTIVES: To identify symptoms that had the greatest difference in frequency comparing children with a history of SARS-CoV-2 infection to those without, to identify differences in the types of symptoms by age group (infants/toddlers [0-2 years] vs preschool-aged children [3-5 years]), and to derive an index that can be used in research studies to identify young children with LC.

This was a multisite longitudinal cohort study with enrollment from over 30 US health care and community settings, including infants, toddlers, and preschool-aged children with and without SARS-CoV-2 infection history. Study data were analyzed from May to December 2024.

EXPOSURE: SARS-CoV-2 infection.

MAIN OUTCOMES AND MEASURES: LC and 41 symptoms among infants/toddlers and 75 symptoms among preschool-aged children.

RESULTS: The study included 472 infants/toddlers (mean [SD] age, 12 [9] months; 278 infected with SARS-CoV-2; 194 uninfected; 234 male [50%]; 73 Black or African American [16%]; 198 Hispanic, Latino, or Spanish [43%]; 242 White [52%]) and 539 preschool-aged children (mean [SD] age, 48 [10] months; 399 infected with SARS-CoV-2; 140 uninfected; 277 female [51%]; 70 Black or African American [13%]; 210 Hispanic, Latino, or Spanish [39%]; 287 White [54%]). The median (IQR) time between first infections and completion of symptom surveys was 318 (198-494) days for infants/toddlers and 520 (330-844) days for preschool-aged children. A research index was derived for each age group based on symptoms most associated with infection history. The index is calculated by summing scores assigned to each prolonged symptom that was present, where higher scores indicate greater magnitude of association with history of SARS-CoV-2 infection: poor appetite (5 points), trouble sleeping (3.5 points), wet cough (3.5 points), dry cough (3 points), and stuffy nose (0.5 points) for infants/toddlers, and daytime tiredness/sleepiness/low energy (6.5 points) and dry cough (3 points) for preschool-aged children. Among infants/toddlers with infection, 40 of 278 (14%) were classified as having probable LC by having an index of at least 4 points. Among preschool-aged children, 61 of 399 (15%) were classified as having probable LC by having an index of at least 3 points. Participants with higher indices often had poorer overall health, lower quality of life, and perceived delays in developmental milestones.

CONCLUSIONS AND RELEVANCE: This cohort study identified symptom patterns and derived research indices that were distinct between the 2 age groups and differed from those previously identified in older ages, demonstrating the need to characterize LC separately across age ranges.},
}

@article {pmid40553043,
year = {2025},
author = {Sanches, CA and Librantz, AFH and Sampaio, LMM and Belan, PA},
title = {Classification of COVID-19, Long COVID, and Healthy Controls Using Heart Rate Variability: Machine Learning Study With a Near-Real-Time Monitoring Component.},
journal = {Journal of medical Internet research},
volume = {},
number = {},
pages = {},
doi = {10.2196/76613},
pmid = {40553043},
issn = {1438-8871},
abstract = {BACKGROUND: Heart rate variability (HRV) is a validated biomarker of autonomic and inflammatory regulation, and has been associated with both acute COVID-19 and long COVID. Although RT-PCR remains the diagnostic gold standard for acute infection, there is a lack of accessible, noninvasive physiological tools to support ongoing monitoring and stage differentiation of COVID-19 and its sequelae. The growing availability of wearable devices capable of real-time HRV data collection opens opportunities for early detection and health status classification using machine learning.

OBJECTIVE: This study aimed to identify HRV patterns capable of distinguishing individuals with active COVID-19, long COVID, and healthy controls, using data collected from wearable devices and processed with machine learning models. A secondary objective was to assess the feasibility of a near-real-time health monitoring system based on these patterns using wearable-derived HRV data.

METHODS: HRV indices (SDNN, RMSSD, LF%, HF%) were collected from 61 participants (21 with active COVID-19, 20 with long COVID, and 20 healthy controls) using two standardized datasets. Classification models were developed using supervised machine learning algorithms (Decision Tree, SVM, k-NN, Neural Networks) and evaluated through cross-validation. A contextual clinical variable indicating recent SARS-CoV-2 infection was incorporated into one model configuration to assess its impact on classification performance. In addition, a prototype system for near-real-time monitoring was implemented and tested in a separate group of 4 participants.

RESULTS: Participants with active COVID-19 showed significantly lower HRV indices (SDNN, RMSSD, LF%, HF%) compared to both long COVID and healthy controls (P ≤ .0007), while differences between the long COVID and healthy groups were not statistically significant. Decision tree models trained solely on HRV features achieved 76.4% accuracy, with high discriminative performance for active COVID-19 (F1 = 88%, AUC = 0.85), but limited detection of long COVID (F1 = 56%). When a contextual clinical variable indicating recent SARS-CoV-2 infection was included, overall accuracy increased to 87%, and the F1-score for long COVID rose to 92%, with improved AUC metrics across classes. A prototype system tested on four independent participants correctly classified their status, demonstrating feasibility for near-real-time application.

CONCLUSIONS: HRV patterns collected from wearable devices and analyzed via machine learning successfully distinguished active COVID-19 from healthy individuals with high accuracy using physiological data alone. When a clinical contextual variable indicating recent infection was added, the model also achieved strong performance in identifying long COVID cases. A prototype system demonstrated feasibility for near-real-time application, reinforcing the potential of HRV for individualized health monitoring in line with emerging trends in digital and predictive healthcare.},
}

@article {pmid40552782,
year = {2025},
author = {Xu, Y and Xu, JW and Wu, Y and Rong, LJ and Ye, L and Franco, OH and Chien, CW and Feng, XR and Chen, JY and Tung, TH},
title = {Prevalence and prognosis of sarcopenia in acute COVID-19 and long COVID: a systematic review and meta-analysis.},
journal = {Annals of medicine},
volume = {57},
number = {1},
pages = {2519678},
doi = {10.1080/07853890.2025.2519678},
pmid = {40552782},
issn = {1365-2060},
mesh = {Humans ; *Sarcopenia/epidemiology ; *COVID-19/complications/epidemiology/mortality ; Prevalence ; Prognosis ; SARS-CoV-2 ; Length of Stay/statistics & numerical data ; Hospitalization/statistics & numerical data ; },
abstract = {BACKGROUND: A comprehensive investigation delineating the prevalence of sarcopenia across different infection phases, from acute COVID-19 to long COVID, is lacking. Meanwhile, the relationship between sarcopenia and adverse outcomes among COVID-19 patients remains inconsistent.

MATERIALS AND METHODS: A systematic search of MEDLINE/PubMed, Embase, Cochrane Library, Web of Science, and Scopus, before 22nd February 2025, was conducted to identify studies assessing sarcopenia prevalence in acute COVID-19 and long COVID. Random effects meta-analyses were performed to estimate the pooled prevalence of sarcopenia for acute COVID-19 and long COVID patients. Subgroup analyses stratified by assessment tool, region, income, hospitalization status, and age were performed. The associations between sarcopenia and COVID-19-related clinical outcomes were further quantified.

RESULTS: A total of 39 studies with 6,982 individuals were included. The pooled prevalence of sarcopenia was 48.7% (95% confidence interval (CI): 39.6-57.9%) in acute COVID-19 and 23.5% (95% CI: 12.7-39.4%) in long COVID. In acute COVID-19 patients, sarcopenia was not significantly associated with length of stay (mean difference = 2.215, 95% CI: -0.004 to 4.433), mechanical ventilation (Odds ratio (OR) = 1.80, 95% CI: 0.84-3.85), admission to the intensive care unit (OR = 1.05, 95% CI: 0.63-1.77), or mortality (OR = 1.41, 95% CI: 0.86-2.32), but was significantly associated with tracheostomy (OR = 2.48, 95% CI: 1.28-4.82).

CONCLUSION: In conclusion, our findings indicate that sarcopenia is highly prevalent in acute COVID-19 and persists in a substantial proportion of long COVID patients, suggesting prolonged muscle loss beyond the acute phase. Future well-designed studies are needed to further investigate the association between sarcopenia and short-term and long-term prognostic outcomes in both acute and long COVID patients.},
}

Humans
*Sarcopenia/epidemiology
*COVID-19/complications/epidemiology/mortality
Prevalence
Prognosis
SARS-CoV-2
Length of Stay/statistics & numerical data
Hospitalization/statistics & numerical data

@article {pmid40549427,
year = {2025},
author = {Luo, X and Li, Y and Xu, J and Zheng, Z and Ying, F and Huang, G},
title = {AI in Medical Questionnaires: Innovations, Diagnosis, and Implications.},
journal = {Journal of medical Internet research},
volume = {27},
number = {},
pages = {e72398},
doi = {10.2196/72398},
pmid = {40549427},
issn = {1438-8871},
mesh = {Humans ; *Artificial Intelligence ; Surveys and Questionnaires ; COVID-19/epidemiology ; *Mental Disorders/diagnosis ; SARS-CoV-2 ; },
abstract = {This systematic review aimed to explore the current applications, potential benefits, and issues of artificial intelligence (AI) in medical questionnaires, focusing on its role in 3 main functions: assessment, development, and prediction. The global mental health burden remains severe. The World Health Organization reports that >1 billion people worldwide experience mental disorders, with the prevalence of depression and anxiety among children and adolescents at 2.6% and 6.5%, respectively. However, commonly used clinical questionnaires such as the Hamilton Depression Rating Scale and the Beck Depression Inventory suffer from several problems, including the high degree of overlap of symptoms of depression with those of other psychiatric disorders and a lack of professional supervision during administration of the questionnaires, which often lead to inaccurate diagnoses. In the wake of the COVID-19 pandemic, the health care system is facing the dual challenges of a surge in patient numbers and the complexity of mental health issues. AI technology has now been shown to have great promise in improving diagnostic accuracy, assisting clinical decision-making, and simplifying questionnaire development and data analysis. To systematically assess the value of AI in medical questionnaires, this study searched 5 databases (PubMed, Embase, Cochrane Library, Web of Science, and China National Knowledge Infrastructure) for the period from database inception to September 2024. Of 49,091 publications, a total of 14 (0.03%) studies met the inclusion criteria. AI technologies showed significant advantages in assessment, such as distinguishing myalgic encephalomyelitis or chronic fatigue syndrome from long COVID-19 with 92.18% accuracy. In questionnaire development, natural language processing using generative models such as ChatGPT was used to construct culturally competent scales. In terms of disease prediction, one study had an area under the curve of 0.790 for cataract surgery risk prediction. Overall, 24 AI technologies were identified, covering traditional algorithms such as random forest, support vector machine, and k-nearest neighbor, as well as deep learning models such as convolutional neural networks, Bidirectional Encoder Representations From Transformers, and ChatGPT. Despite the positive findings, only 21% (3/14) of the studies had entered the clinical validation phase, whereas the remaining 79% (11/14) were still in the exploratory phase of research. Most of the studies (10/14, 71%) were rated as being of moderate methodological quality, with major limitations including lack of a control group, incomplete follow-up data, and inadequate validation systems. In summary, the integrated application of AI in medical questionnaires has significant potential to improve diagnostic efficiency, accelerate scale development, and promote early intervention. Future research should pay more attention to model interpretability, system compatibility, validation standardization, and ethical governance to effectively address key challenges such as data privacy, clinical integration, and transparency.},
}

Humans
*Artificial Intelligence
Surveys and Questionnaires
COVID-19/epidemiology
*Mental Disorders/diagnosis
SARS-CoV-2

@article {pmid40548547,
year = {2025},
author = {Boutet, M and Salmam, I and Roy, JS and Best, K and Perreault, K and Desmeules, F and Campeau-Lecours, A and Beaulieu-Bonneau, S},
title = {Cognitive and psychological functioning in individuals with long COVID: a comparative cross-sectional study.},
journal = {Disability and rehabilitation},
volume = {},
number = {},
pages = {1-8},
doi = {10.1080/09638288.2025.2521000},
pmid = {40548547},
issn = {1464-5165},
abstract = {PURPOSE: Although several studies have examined cognitive and psychological functioning in long COVID, few have included appropriate comparison groups and utilized both subjective and objective measures. First, this study compared objective cognitive performance and self-reported cognitive and psychological symptoms across individuals with long COVID, those recovered without persistent symptoms, and a Control Group with no history of COVID-19 infection. Second, the relationship between sociodemographic and disease characteristics and cognitive and psychological outcomes was explored in the Long COVID Group (LCG). Third, the association between cognitive and psychological outcomes and quality of life was examined in the LCG.

METHODS: Participants included 120 adults per group. The main outcome measures were three neuropsychological tests and self-report questionnaires on cognitive functioning, anxiety, depression, and quality of life.

RESULTS: Individuals with long COVID exhibited poorer attention and working memory performance, and reported higher cognitive, anxiety, and depression symptoms compared to the other groups. Within the LCG, better cognitive performance on a screening test and higher depressive symptoms were associated with poorer quality of life.

CONCLUSIONS: These findings highlight poorer cognitive performance and higher cognitive and psychological symptoms in long COVID, suggesting the importance of comprehensive assessments and integrated rehabilitation strategies.},
}

@article {pmid40548319,
year = {2025},
author = {Guillen-Burgos, HF and Gálvez-Flórez, JF and Moreno-López, S and Wong, S and Kwan, ATH and Ramirez-Posada, M and Anaya, JM and McIntyre, RS},
title = {Major Depressive Disorder in Long COVID and Exposure to Pro-Inflammatory Cytokines During Infection by SARS-CoV-2.},
journal = {Psychiatric research and clinical practice},
volume = {7},
number = {2},
pages = {139-149},
pmid = {40548319},
issn = {2575-5609},
abstract = {OBJECTIVE: Major Depressive Disorder (MDD) is common in long COVID syndrome; however, the neurobiological mechanisms are unclear. An immune activation response has been associated with COVID-19 severity as well as in MDD. We hypothesize that high levels of pro-inflammatory cytokines during SARS-CoV-2 infection may be associated with new-onset MDD and severe outcomes such as treatment-resistant depression (TRD) and risk of suicide ideation and behavior (SI/SB).

METHODS: A case-control nested to a cohort study was carried out on a total of 678 COVID-19 survivors (MDD = 184 vs. non-MDD = 494). A pro-inflammatory panel of serum levels of cytokines (IL-1β, IL-4, IL-6, IL-8, IL-13, IL-17α, TNF-α) was evaluated during COVID-19 hospitalization and severe outcomes such as TRD and SI/SB were assessed in individuals with new onset of MDD after hospital discharge compared to non-MDD COVID-19 survivors.

RESULTS: High levels of pro-inflammatory cytokines during SARS-CoV-2 infection were identified in MDD participants compared to non-MDD subgroups during long COVID. These differences were sustained also for TRD and SI/SB severity outcomes. There is a mild association of high levels of pro-inflammatory cytokines and MDD, TRD, and SI/SB.

CONCLUSION: High levels of pro-inflammatory cytokines during severe or critical COVID-19 exposure may explain long COVID associated MDD and thus severe outcomes such as TRD and SI/SB.

Identifying elevated pro-inflammatory cytokines during COVID-19 as a risk factor for MDD and severe outcomes underscores the need for early screening and targeted treatments in long COVID. Monitoring cytokine levels may help clinicians predict and manage TRD and SI/SB in this population, improving long-term psychiatric outcomes.},
}