@article {pmid40267966,
year = {2025},
author = {Brinkman, N and Teunis, T and Choi, S and Ring, D and Brode, WM},
title = {Factors associated with the presence and intensity of ongoing symptoms in Long COVID.},
journal = {PloS one},
volume = {20},
number = {4},
pages = {e0319874},
doi = {10.1371/journal.pone.0319874},
pmid = {40267966},
issn = {1932-6203},
mesh = {Humans ; *COVID-19/complications/epidemiology/psychology/pathology ; Male ; Female ; Middle Aged ; Cross-Sectional Studies ; Adult ; Aged ; SARS-CoV-2/isolation & purification ; Anxiety ; Post-Acute COVID-19 Syndrome ; Severity of Illness Index ; Risk Factors ; },
abstract = {OBJECTIVE: Identification of modifiable factors associated with symptom intensity among people seeking care for Post-Acute Sequelae of SARS-CoV-2 infection (PASC) could help guide the development of comprehensive, whole-person care pathways to alleviate symptoms irrespective of potential underlying pathophysiologies. We aimed to better define the key contributors to PASC, and sought the factors associated with PASC symptom presence and intensity.

METHODS: In this cross-sectional study, 249 patients presenting for PASC care at a dedicated Post-COVID-19 clinic completed a standardized screening assessment prior to initial visit and evaluation by a general internist or nurse practitioner. We measured 46 symptoms based on the WHO's Global COVID-19 Clinical Platform Case Report Form for Post COVID Condition and performed a factor analysis and item response theory based 2-parameter logistic model to develop a population-based t-score to measure PASC symptom presence and intensity (PASC-SPI). A multivariable linear regression analysis was used to assess factors associated with PASC-SPI, accounting for demographics, comorbidities, COVID-19 infection duration and severity, and mental health.

RESULTS: Greater PASC-SPI was associated with greater symptoms of anxiety, a longer duration of COVID-19 infection, and hypercholesterolemia. Lower PASC-SPI was associated with older age, self-reported 1-3 units of alcohol per week, and self-reported clinician confirmation of COVID-19 diagnosis. Symptoms of anxiety accounted for a considerably higher proportion of variation in PASC-SPI than other variables.

CONCLUSION: Symptoms of anxiety were the strongest correlate of PASC-SPI, highlighting it as both a potential neuroinflammatory marker of PASC and a modifiable component of the illness. This emphasizes the need for comprehensive, whole person treatment strategies that integrate evidence-based interventions to address the multifaceted nature of PASC.},
}

Humans
*COVID-19/complications/epidemiology/psychology/pathology
Male
Female
Middle Aged
Cross-Sectional Studies
Adult
Aged
SARS-CoV-2/isolation & purification
Anxiety
Post-Acute COVID-19 Syndrome
Severity of Illness Index
Risk Factors

@article {pmid40265979,
year = {2025},
author = {Belton, S and Sheridan, K},
title = {'The Second Arrow': A Collaborative Autoethnographic Exploration of What Can Be Learned From One Long COVID Journey.},
journal = {Health expectations : an international journal of public participation in health care and health policy},
volume = {28},
number = {3},
pages = {e70227},
doi = {10.1111/hex.70227},
pmid = {40265979},
issn = {1369-7625},
support = {//The authors received no specific funding for this work./ ; },
mesh = {Humans ; *COVID-19/psychology/rehabilitation ; Female ; Anthropology, Cultural ; SARS-CoV-2 ; Chronic Disease/psychology ; },
abstract = {INTRODUCTION: Long COVID is a complex multisystem illness with multiple relapsing-remitting symptoms, which can vary in severity and impact people's daily lives. This study utilises the first author's experience of falling ill with and recovering from long COVID to investigate the lived experience of the illness. Learnings that could positively influence how people with long COVID, and health professionals, approach rehabilitation and recovery from the illness going forward are identified.

METHODS: Employing collaborative autoethnography, the first author investigated her personal experience of falling ill with, and rehabilitating from, long COVID, while soliciting input of the second author (an athletic therapist and physiotherapist, and researcher with expertise in chronic pain) for the purpose of analysis and interpretation. Reflexive thematic analysis was employed across a number of data sources available to the first author, including journal entries, text messages, emails, and pharmacy receipts.

RESULTS: Four themes were generated from the data, supported by a number of subthemes: (i) Psychosocial impact of long COVID, (ii) Invalidated, (iii) Validated, and (iv) Power and Ownership. The negative impact of a siloed and reductionist approach to care for long COVID is evident in the findings of this study. In addition, the need for healthcare environments that enhance autonomy and empowerment, and that implement patient-centred care, where the person living with chronic illness is supported to engage in management strategies that meet their needs, is underlined.

CONCLUSION: This study highlights the detrimental cost, both personally and financially, of the ongoing use of the biomedical model of care in the treatment of long COVID. Findings support the need for an interdisciplinary approach to care that considers the whole person and adopts a biopsychosocial approach to care. Furthermore, the need for healthcare professionals to actively listen to, respect, validate and support the person living with long COVID on their individualised recovery journey is evident.

The first author was a long COVID patient, the context and extent of this is explained within the paper. As such, this paper is developed and written primarily from the perspective of a patient, as a first-hand narrative of the recovery journey from the illness, with the insights of a clinician (second author) providing context and the potential for a broader understanding of the journey. The goal of this work is, through the dissemination of the paper's findings, to improve pathways and outcomes for others living with long COVID.},
}

Humans
*COVID-19/psychology/rehabilitation
Female
Anthropology, Cultural
SARS-CoV-2
Chronic Disease/psychology

@article {pmid40265173,
year = {2025},
author = {Cheng, AL and DeFranco, AR and Furman, M and Hackert, SM and Hunt, DM and Marschall, J and McQueen, A},
title = {Shared Medical Appointments to Improve Equitable Access to Rehabilitative Care for Long COVID.},
journal = {Cardiopulmonary physical therapy journal},
volume = {36},
number = {1},
pages = {50-57},
pmid = {40265173},
issn = {1541-7891},
support = {U18 HS029911/HS/AHRQ HHS/United States ; },
abstract = {Long COVID is an infection-associated chronic condition that can cause a wide variety of symptoms and long-term functional impairments. While investigation into curative treatment is ongoing, current standard management of Long COVID relies heavily on rehabilitative care by physical, occupational, and speech therapists. Unfortunately, many persons with Long COVID encounter financial barriers to receiving rehabilitative care, especially because some state Medicaid programs and safety net health insurance plans do not cover one-on-one rehabilitation visits. Shared Medical Appointments (SMAs) are group visits which can deliver multidisciplinary care, and they are widely reimbursed by health insurance plans. SMAs also offer the added benefit of peer support and camaraderie, and they are an efficient method for clinicians to deliver care to many patients at once. SMAs can serve as an innovative method of delivering rehabilitative care for persons with Long COVID who cannot access individual appointments with a physical, occupational, and/or speech therapist. The purpose of this clinical perspective is to present the rationale, development, and organization and content of a six-session curriculum of SMAs that was created to deliver rehabilitation principles for Long COVID management. The curriculum covers physical activity, daily living activities, and thinking and speaking. It includes identification of functional concerns and goals, instruction in rehabilitative strategies and tools, and troubleshooting challenges that are encountered as patients implement strategies. The content in this clinical perspective is intended to be easily adapted and delivered by other clinicians in order to facilitate more equitable access to Long COVID rehabilitative care.},
}

@article {pmid40263530,
year = {2025},
author = {Zhang, L and Wen, J and Yuan, L and Yan, Y and Zhang, Z and Li, K and Tang, Z},
title = {Anxiety and depression in healthcare workers 2 years after COVID-19 infection and scale validation.},
journal = {Scientific reports},
volume = {15},
number = {1},
pages = {13893},
pmid = {40263530},
issn = {2045-2322},
support = {SY202215//Suqian Sci&Tech Program/ ; SY202215//Suqian Sci&Tech Program/ ; SY202215//Suqian Sci&Tech Program/ ; SY202215//Suqian Sci&Tech Program/ ; SY202215//Suqian Sci&Tech Program/ ; },
mesh = {Humans ; *COVID-19/psychology/epidemiology ; *Health Personnel/psychology ; Female ; Male ; Adult ; *Anxiety/epidemiology/etiology/diagnosis/psychology ; *Depression/epidemiology/diagnosis/etiology/psychology ; Cross-Sectional Studies ; Middle Aged ; SARS-CoV-2 ; Reproducibility of Results ; Surveys and Questionnaires ; Young Adult ; },
abstract = {This study aims to assess the levels of anxiety and depression among healthcare workers two years post COVID-19 infection and to validate the reliability and validity of the PHQ-9 and GAD-7 scales in this population. This cross-sectional study was conducted in June 2024 using a simple random sampling approach to survey healthcare institution workers. A total of 1038 valid samples were collected, and anxiety and depression levels were assessed using the PHQ-9 and GAD-7 scales. Participants included healthcare workers such as doctors, nurses, administrative staff, and students. Data analysis included descriptive statistics, correlation analysis, univariate, and multivariate analyses to explore the effects of variables such as occupation and gender on anxiety and depression. Long COVID was reported in 50.8% of participants. Occupational categories significantly influenced anxiety and depression levels: compared to students (reference group), doctors, nurses, and administrative staff exhibited significantly lower scores. Non-long COVID participants showed significantly lower anxiety and depression scores than those with long COVID. Additionally, the PHQ-9 and GAD-7 scales demonstrated high reliability and validity among COVID-19 population. Two years after COVID-19 infection, anxiety and depression levels among healthcare institution workers remain significantly influenced by occupational category and long COVID status. For healthcare workers, particularly those with long COVID and student groups, policymakers and healthcare administrators should consider optimizing mental health support systems. This includes implementing regular mental health screenings, providing personalized psychological interventions, offering counseling services, reducing work-related stress, and promoting the use of mental health assessment tools to improve the psychological well-being of this population.},
}

Humans
*COVID-19/psychology/epidemiology
*Health Personnel/psychology
Female
Male
Adult
*Anxiety/epidemiology/etiology/diagnosis/psychology
*Depression/epidemiology/diagnosis/etiology/psychology
Cross-Sectional Studies
Middle Aged
SARS-CoV-2
Reproducibility of Results
Surveys and Questionnaires
Young Adult

@article {pmid40261198,
year = {2025},
author = {Cheng, AL and Herman, E and Abramoff, B and Anderson, JR and Azola, A and Baratta, JM and Bartels, MN and Bhavaraju-Sanka, R and Blitshteyn, S and Fine, JS and Fleming, TK and Verduzco-Gutierrez, M and Herrera, JE and Karnik, R and Kurylo, M and Longo, MT and McCauley, MD and Melamed, E and Miglis, MG and Neal, JD and Oleson, CV and Putrino, D and Rydberg, L and Silver, JK and Terzic, CM and Whiteson, JH and Niehaus, WN},
title = {Multidisciplinary collaborative guidance on the assessment and treatment of patients with Long COVID: A compendium statement.},
journal = {PM & R : the journal of injury, function, and rehabilitation},
volume = {},
number = {},
pages = {},
doi = {10.1002/pmrj.13397},
pmid = {40261198},
issn = {1934-1563},
abstract = {BACKGROUND: In 2021, the American Academy of Physical Medicine and Rehabilitation established the Multi-Disciplinary Post-Acute Sequelae of SARS-CoV-2 Infection Collaborative to provide guidance from established Long COVID clinics for the evaluation and management of Long COVID. The collaborative previously published eight Long COVID consensus guidance statements using a primarily symptom-based approach. However, Long COVID symptoms most often do not occur in isolation.

AIMS: This compendium aims to equip clinicians with an efficient, up-to-date clinical resource for evaluating and managing adults experiencing Long COVID symptoms. The primary intended audience includes physiatrists, primary care physicians, and other clinicians who provide first-line assessment and management of Long COVID symptoms, especially in settings where subspecialty care is not readily available. This compendium provides a holistic framework for assessment and management, symptom-specific considerations, and updates on prevalence, health equity, disability considerations, pathophysiology, and emerging evidence regarding treatments under investigation. Because Long COVID closely resembles other infection-associated chronic conditions (IACCs) such as myalgic encephalomyelitis/chronic fatigue syndrome, the guidance in this compendium may also be helpful for clinicians managing these related conditions.

METHODS: Guidance in this compendium was developed by the collaborative's established modified Delphi approach. The collaborative is a multidisciplinary group whose members include physiatrists, primary care physicians, pulmonologists, cardiologists, psychiatrists, neuropsychologists, neurologists, occupational therapists, physical therapists, speech and language pathologists, patients, and government representatives. Over 40 Long COVID centers are represented in the collaborative.

RESULTS: Long COVID is defined by the National Academies of Sciences, Engineering, and Medicine as "an IACC that occurs after SARS-CoV-2 infection and is present for at least 3 months as a continuous, relapsing and remitting, or progressive disease state that affects one or more organ systems." The current global prevalence of Long COVID is estimated to be 6%. Higher prevalence has been identified among female gender, certain racial and ethnic groups, and individuals who live in nonurban areas. However, anyone can develop Long COVID after being infected with the SARS-CoV-2 virus. Long COVID can present as a wide variety of symptom clusters. The most common symptoms include exaggerated fatigue and diminished energy windows, postexertional malaise (PEM)/postexertional symptom exacerbation (PESE), cognitive impairment (brain fog), dysautonomia, pain/myalgias, and smell and taste alterations. Holistic assessment should include a traditional history, physical examination, and additional diagnostic testing, as indicated. A positive COVID-19 test during acute SARS-CoV-2 infection is not required to diagnose Long COVID, and currently, there is no single laboratory finding that is definitively diagnostic for confirming or ruling out the diagnosis of Long COVID. A basic laboratory assessment is recommended for all patients with possible Long COVID, and consideration for additional labs and diagnostic procedures is guided by the patient's specific symptoms. Current management strategies focus on symptom-based supportive care. Critical considerations include energy conservation strategies and addressing comorbidities and modifiable risk factors. Additionally, (1) it is essential to validate the patient's experience and provide reassurance that their symptoms are being taken seriously because many patients have had their symptoms dismissed by loved ones and clinicians; (2) physical activity recommendations must be carefully tailored to the patient's current activity tolerance because overly intense activity can trigger PEM/PESE and worsened muscle damage; and (3) treatment recommendations should be delivered with humility because there are many persistent unknowns related to Long COVID. To date, there are limited data to guide medication management specifically in the context of Long COVID. As such, medication use generally follows standard practice regarding indications and dosing, with extra attention to prioritize (1) patient preference via shared decision-making and (2) cautious use of medications that may improve some symptoms (eg, cognitive/attention impairment) but may worsen other symptoms (eg, PEM/PESE). Numerous clinical trials are investigating additional treatments. The return-to-work process for individuals with Long COVID can be challenging because symptoms can fluctuate, vary in nature, affect multiple functional areas (eg, physical and cognitive), and often manifest as an "invisible disability" that may not be readily acknowledged by employers or coworkers. Clinicians can help patients return to work by identifying suitable workplace accommodations and resources, providing necessary documentation, and recommending occupational or vocational therapy when needed. If these efforts are unsuccessful and work significantly worsens Long COVID symptoms or impedes recovery, applying for disability may be warranted. Long COVID is recognized as a potential disability under the Americans with Disabilities Act.

CONCLUSION: To contribute to the overall health and well-being for all patients, Long COVID care should be delivered in a holistic manner that acknowledges challenges faced by the patient and uncertainties in the field. For more detailed information on assessment and management of specific Long COVID symptoms, readers can reference the collaborative's symptom-specific consensus guidance statements.},
}

@article {pmid40260126,
year = {2025},
author = {Al-Oraibi, A and Woolf, K and Naidu, J and Nellums, LB and Pan, D and Sze, S and Tarrant, C and Martin, CA and Gogoi, M and Nazareth, J and Divall, P and Dempsey, B and Lamb, D and Pareek, M},
title = {Global prevalence of long COVID and its most common symptoms among healthcare workers: a systematic review and meta-analysis.},
journal = {BMJ public health},
volume = {3},
number = {1},
pages = {e000269},
pmid = {40260126},
issn = {2753-4294},
abstract = {OBJECTIVES: Long COVID, a condition where symptoms persist after the acute phase of COVID-19, is a significant concern for healthcare workers (HCWs) due to their higher risk of infection. However, there is limited knowledge regarding the prevalence, symptoms and clustering of long COVID in HCWs. We aimed to estimate the pooled prevalence and identify the most common symptoms of long COVID among HCWs who were infected with SARS-CoV-2 virus globally, and investigate any differences by geographical region and other factors.

DESIGN: Systematic review and meta-analysis (PROSPERO CRD42022312781).

DATA SOURCES: We searched MEDLINE, CINAHL, EMBASE, PsycINFO and the grey literature from 31 December 2019 until 18 February 2022.

ELIGIBILITY CRITERIA: We included studies reporting primary data on long COVID prevalence and symptoms in adult HCWs who had SARS-CoV-2 infection.

DATA EXTRACTION AND SYNTHESIS: Methodological quality was assessed using the Joanna Briggs Institute checklist. Meta-analysis was performed for prevalence data of long COVID following SARS-CoV-2 infection.

RESULTS: Out of 5737 articles, 28 met the inclusion criteria, with a combined sample size of 6 481 HCWs. 15 articles scored equal to or above the median score for methodological quality. The pooled prevalence of long COVID among HCWs who had SARS-CoV-2 infection was 40% (95% CI: 29% to 51%, I[2]: 97.2%; 12 studies), with a mean follow-up period of 22 weeks. The most prevalent symptoms reported were fatigue (35%), neurologic symptoms (25%), loss/decrease of smell and/or taste (25%), myalgia (22%) and shortness of breath (19%).

CONCLUSION: This review highlights the substantial burden of long COVID among HCWs worldwide. However, limitations in data quality and inconsistent definitions of long COVID impact the generalisability of these findings. To improve future interventions, we recommend enhanced cohort study designs for better characterisation of long COVID prevalence and symptoms in HCWs.},
}

@article {pmid40259893,
year = {2025},
author = {von Falkenhausen, AS and Gail, A and Geipel, S and Scherer, C and Stockhausen, S and Sams, LE and Becker, F and Massberg, S and Kääb, S and Sinner, MF},
title = {Symptoms of Depression and Anxiety After COVID-19 Despite Systematic Telemedical Care: Results From the Prospective COVID-SMART Study.},
journal = {Depression and anxiety},
volume = {2025},
number = {},
pages = {9989990},
pmid = {40259893},
issn = {1520-6394},
mesh = {Humans ; *COVID-19/psychology/complications/therapy/epidemiology ; Male ; Female ; *Telemedicine ; Middle Aged ; *Anxiety/epidemiology/etiology ; *Depression/epidemiology/etiology ; Adult ; Prospective Studies ; Aged ; Prevalence ; },
abstract = {Background: Long-COVID has attracted increased attention with rising numbers of affected patients and high individual symptom burden. Prior studies have described its prevalence, course of disease, and severity. Yet, the influence of intensive care, including telemedical support for patients at risk for a severe course of the initial COVID-19 disease, on the occurrence of Long-COVID and its associated symptoms is studied to a lesser extent. Methods: Here, we report the long-term results of the COVID-SMART study, which randomized at-risk COVID-19 patients to either smartwatch-based monitoring with telemedical support or standard care. We investigate Long-COVID symptoms, including symptoms of depression and anxiety after 12 months. Findings: Between October 2020 and May 2022, we enrolled 607 patients in the COVID-SMART study. Complete 12-month follow-up was available for 573 patients, with 288 patients randomized to the intervention group and 285 to the control group. Overall, 234 participants (40.8%) reported COVID-related symptoms, with a high prevalence of symptoms of depression (209 participants, 36.5%) and anxiety (232 participants, 40.5%). However, telemedical support did not reduce these symptoms at follow-up. Multivariable regression analysis identified sex, active smoking, and pre-existing asthma as significant predictors of both outcomes. Interpretation: COVID-SMART is the first prospective, randomized clinical trial to systematically assess the impact of telemedical care on the development of Long-COVID associated risk of depression and anxiety. We identify in part modifiable risk factors for these outcomes. However, telemedical support does not appear to be beneficial in reducing symptoms of anxiety and depression and should hence be focused to the acute infection phase. Trial Registration: ClinicalTrials.gov identifier: NCT04471636.},
}

Humans
*COVID-19/psychology/complications/therapy/epidemiology
Male
Female
*Telemedicine
Middle Aged
*Anxiety/epidemiology/etiology
*Depression/epidemiology/etiology
Adult
Prospective Studies
Aged
Prevalence

@article {pmid40196285,
year = {2025},
author = {Zhang, B and Wu, Q and Jhaveri, R and Zhou, T and Becich, MJ and Bisyuk, Y and Blanceró, F and Chrischilles, EA and Chuang, CH and Cowell, LG and Fort, D and Horowitz, CR and Kim, S and Ladino, N and Liebovitz, DM and Liu, M and Mosa, ASM and Schwenk, HT and Suresh, S and Taylor, BW and Williams, DA and Morris, JS and Forrest, CB and Chen, Y},
title = {Reinfection with SARS-CoV-2 in the Omicron Era is Associated with Increased Risk of Post-Acute Sequelae of SARS-CoV-2 Infection: A RECOVER-EHR Cohort Study.},
journal = {medRxiv : the preprint server for health sciences},
volume = {},
number = {},
pages = {},
pmid = {40196285},
support = {OT2 HL161847/HL/NHLBI NIH HHS/United States ; },
abstract = {IMPORTANCE: Post-acute sequelae of SARS-CoV-2 infection (PASC) remains a major public health challenge. While previous studies have focused on characterizing PASC and identifying its subphenotypes in children and adolescents following an initial SARS-CoV-2 infection, the risks of PASC with Omicron-variant reinfections remain unclear. Using a real-world data approach, this study investigates the risks of PASC following reinfections during the Omicron phase in the pediatric population.

OBJECTIVE: To investigate the risks of PASC diagnosis and 24 PASC symptoms and conditions after reinfection of SARS-CoV-2 during Omicron period in the pediatric population.

This retrospective cohort study used data from the RECOVER consortium comprising 40 children's hospitals and health institutions in U.S. between January 2022 and October 2023.

EXPOSURES: A second SARS-CoV-2 infection, confirmed by a positive polymerase-chain-reaction (PCR) or antigen tests, or a diagnose of COVID-19, occurring at least 60 days after the initial infection, compared to the initial infection.

MAIN OUTCOMES AND MEASURES: PASC was identified using two approaches: (1) the ICD-10-CM diagnosis code U09.9 and (2) a symptom-based definition including 24 physician-identified symptoms and conditions. Absolute risks of incident PASC were reported, and relative risks (RRs) were calculated by comparing the second infection episode with the first infection episode groups using a modified Poisson regression model, adjusting for demographic, clinical, and healthcare utilization factors through exact matching and propensity scoring matching.

RESULTS: A total of 465,717 individuals under 21 years old (mean [SD] age 8.17 [6.58] years; 52% male) were included. Compared to the first infection, a second infection was associated with significantly increased risk of an overall PASC diagnosis (RR, 2.08; 95% confidence interval [CI], 1.68-2.59), and with many specific conditions including: myocarditis (RR, 3.60; 95% CI, 1.46-8.86); changes in taste and smell (RR, 2.83; 95% CI, 1.41-5.67); thrombophlebitis and thromboembolism (RR, 2.28; 95% CI, 1.71-3.04); heart disease (RR, 1.96; 95% CI, 1.69 to 2.28); acute kidney injury (RR, 1.90; 95% CI, 1.38 to 2.61); fluid and electrolyte (RR, 1.89; 95% CI, 1.62 to 2.20); generalized pain (RR, 1.70; 95% CI, 1.48 to ; arrhythmias (RR, 1.59; 95% CI, 1.45-1.74); abnormal liver enzyme (RR, 1.56; 95% CI, 1.24 to ; fatigue and malaise (RR, 1.50; 95% CI, 1.38 to 1.64); musculoskeletal pain (RR, 1.45; 95% CI, 1.37 to 1.54); abdominal pain (RR, 1.42; 95% CI, 1.34 to 1.50); postural orthostatic tachycardia syndromes (POTS)/dysautonomia (RR, 1.35; 95% CI, 1.20 to 1.51); cognitive functions (RR, 1.32; 95% CI, 1.15 to 1.50); and respiratory signs and symptoms (RR, 1.29; 95% CI, 1.25 to 1.33). The risks were consistent across various organ systems, including cardiovascular, respiratory, gastrointestinal, neurological, and musculoskeletal systems.

CONCLUSIONS AND RELEVANCE: Children and adolescents face significantly higher risk of various PASC outcomes after reinfection with SARS-CoV-2. These findings suggest a cumulative risk of PASC and highlight the urgent need for targeted prevention strategies to reduce reinfections, which includes an increased emphasis on initial or re-vaccination of children.},
}

@article {pmid40259865,
year = {2025},
author = {Bjorvatn, B and Merikanto, I and Chung, F and Holzinger, B and Morin, CM and Penzel, T and De Gennaro, L and Dauvilliers, Y and Wing, YK and Benedict, C and Xue, P and Reis, C and Korman, M and Landtblom, AM and Matsui, K and Hrubos-Strøm, H and Mota-Rolim, S and Nadorff, MR and Berezin, L and Sarkanen, T and Liu, Y and Scarpelli, S and Brandao, LEM and Cedernaes, J and Fränkl, EC and Partinen, E and Bolstad, CJ and Plazzi, G and Partinen, M and Espie, CA},
title = {Sleep During Pandemic Times: Summary of Findings and Future Outlook Through the Lens of the International COVID Sleep Study (ICOSS).},
journal = {Journal of sleep research},
volume = {},
number = {},
pages = {e70076},
doi = {10.1111/jsr.70076},
pmid = {40259865},
issn = {1365-2869},
abstract = {To study the impact of the COVID-19 pandemic on sleep and circadian rhythms-two fundamental pillars for health-the collaboration International COVID-19 Sleep Study (ICOSS) was established. The present overview comprehensively discusses the findings from this collaboration. Involving sleep researchers across the globe, ICOSS used a harmonised questionnaire to cover changes in sleep and sleep disorders, as well as physical and mental health. Two survey waves were conducted, one in 2020 and another one in 2021. In ICOSS-1, a total of 26,539 people from 14 countries across four continents (Europe, Asia, North and South America) participated. In ICOSS-2, two more countries joined ICOSS, and 15,813 people participated. The focus in ICOSS-2 was on Long COVID. Participants accessed the widely disseminated online surveys in their native language. In the 20 papers published so far, the surveys have uncovered several novel findings, including how the pandemic impacted sleep patterns, the prevalence of sleep disorders, chronotype-based differences and sleep-immune system interactions. To the best of our knowledge, there is no other large-scale multinational study targeting the general population investigating the role of sleep and sleep disorders alongside a variety of psychological, biological, social and economic factors during the recent COVID-19 pandemic.},
}

@article {pmid40259563,
year = {2025},
author = {Cornish, F and Sabaine, B and Soares, L and Caldas, B and Portela, MC and Bousquat, A and Aveling, EL},
title = {The erasure of infection-associated chronic conditions: Critical interpretive synthesis of literature on healthcare for long COVID and related conditions in Brazil.},
journal = {Global public health},
volume = {20},
number = {1},
pages = {2490720},
doi = {10.1080/17441692.2025.2490720},
pmid = {40259563},
issn = {1744-1706},
mesh = {Humans ; Brazil/epidemiology ; *COVID-19/epidemiology/therapy/complications ; Chronic Disease/epidemiology/therapy ; SARS-CoV-2 ; *Delivery of Health Care ; Post-Acute COVID-19 Syndrome ; },
abstract = {Evidence is emerging that long COVID is at least as prevalent in the Global South as the Global North, but literature on long COVID healthcare in the Global South is in its infancy. Brazil is seeing significant levels of debility due to long COVID but a limited national evidence-base. long COVID shares symptomatology and appropriate care with a wider category of infection-associated chronic conditions (IACCs). This article reviews literature published between 2000 and 2023 addressing healthcare for long COVID and IACCs in Brazil, in the interest of exploring challenges and opportunities for the SUS (Brazil's universal health system) to offer appropriate long COVID healthcare. We find that long COVID and IACCs collectively are subject to erasure from Brazilian healthcare knowledge, through lack of expertise, a resource-limited health system prioritising urgent care, and the concentration of poor health in marginalised populations with limited decision-making power. A nascent intellectual will to address long COVID, and a tradition of social participation in healthcare governance present potential opportunities. We call for ignition of a global step-change in tackling healthcare for long COVID and IACCs. Global equity in long COVID healthcare requires the development and sharing of expertise regarding its universal and context-specific features.},
}

Humans
Brazil/epidemiology
*COVID-19/epidemiology/therapy/complications
Chronic Disease/epidemiology/therapy
SARS-CoV-2
*Delivery of Health Care
Post-Acute COVID-19 Syndrome

@article {pmid40258532,
year = {2025},
author = {Berends, MS and Homburg, M and Kupers, T and Meijer, EN and Bos, I and Verheij, R and Kuiper, J and Berger, MY and Peters, LL},
title = {Impact of Pre-Existing Comorbidities and Multimorbidities, Demography and Viral Variants on Post-Acute Sequelae of COVID-19 ('Long COVID') in Dutch Primary Care: A Retrospective Cohort Study.},
journal = {International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases},
volume = {},
number = {},
pages = {107912},
doi = {10.1016/j.ijid.2025.107912},
pmid = {40258532},
issn = {1878-3511},
abstract = {INTRODUCTION: Post-acute sequelae of COVID-19 (PASC), or Long COVID, involves persistent symptoms following acute infection, posing a global health challenge. While a growing number of studies have investigated potential predictors and risk factors, uncertainties remain regarding their consistency and clinical applicability. This study investigates PASC prevalence, comorbidities, demographics, and viral variants using Dutch primary care electronic healthcare records (EHR).

METHODS: A retrospective cohort study used EHR data from 59 general practices in northern Netherlands, including 19,638 SARS-CoV-2 PCR-positive patients from January 1, 2020, to December 31, 2021. PASC was identified via WHO and CDC guidelines, a Dutch Word2Vec model, and clinical assessments. Relative risk (RR) calculations analyzed comorbidities, demographics, and viral variants.

RESULTS: PASC prevalence was 5.8% (CI95%: 5.4-6.1%). Comorbidities significantly increasing PASC risk included lung disease (RR: 1.95), cardiovascular disease (RR: 1.73), diabetes (RR: 1.82), kidney disease (RR: 1.98), and mental illness (RR: 1.29). Females and individuals aged ≥45 had increased risk. Multivariate regression revealed higher odds of prolonged PASC for ages 45-59 (AOR: 3.02), 60-74 (AOR: 3.25), and 75+ (AOR: 2.44). Combined mental illness and lung disease further increased risk (AOR: 2.55).

CONCLUSION: Chronic conditions, multimorbidity, and demographics significantly influence PASC onset and duration. Targeted interventions may mitigate its long-term impact.},
}

@article {pmid40257144,
year = {2025},
author = {Caamaño, E and Rodrigo, LV and Garcia-Ramos, S and Garcia, AC and Cerro, SR and Power, M and Asencio, JM and Piñeiro, P and Hortal, J and Garutti, I},
title = {Risk factors for readmission of COVID-19 ICU survivors: A three-year follow up.},
journal = {The Indian journal of medical research},
volume = {161},
number = {2},
pages = {190-198},
doi = {10.25259/IJMR_726_2024},
pmid = {40257144},
issn = {0971-5916},
mesh = {Humans ; *COVID-19/mortality/therapy/epidemiology ; Male ; *Patient Readmission/statistics & numerical data ; Female ; *Intensive Care Units/statistics & numerical data ; Risk Factors ; Middle Aged ; *Survivors/statistics & numerical data ; Follow-Up Studies ; Aged ; Prospective Studies ; SARS-CoV-2 ; Length of Stay/statistics & numerical data ; Adult ; },
abstract = {Background & objectives Evidence suggests that individuals who have been hospitalised due to COVID-19 are more susceptible to future mortality and readmission, thereby imposing a substantial strain on their quality of life. The available data on intensive care unit (ICU) survivors, particularly in terms of long-term outcomes, is notably insufficient. This study focused on the long-term outcomes for ICU survivors of COVID-19, specifically readmission and mortality, as well as possible risk factors that could lead to their need for readmission. Methods We conducted a prospective observational study of 505 individuals admitted to the ICU of a tertiary care hospital between March 2020 and March 2021. Follow up concluded in January 2024. We evaluated the need for hospital and ICU readmissions, examining potential risk factors, including patient comorbidities, clinical situation at the time of the previous hospital and ICU admission, and evolution and treatment in the ICU. As a secondary objective, we determined the prevalence of long-term mortality. Results Among 341 ICU survivors, 75 (22%) required hospital readmission, with a median time to readmission of 415 days (IQR: 166-797). The most frequent cause of readmission was respiratory conditions (29.3%). The median hospital stay during readmission was six days. Independent risk factors for hospital readmission included age, elevated creatinine levels at ICU admission, and length of stay in the ICU. Of the 75 readmitted to the hospital, 19 required ICU readmission. Ten individuals died following hospital discharge. Interpretation & conclusions Patients requiring ICU admission due to COVID-19 have a significant risk of hospital readmission, particularly those with advanced age, elevated creatinine levels at ICU admission, and longer ICU stays.},
}

Humans
*COVID-19/mortality/therapy/epidemiology
Male
*Patient Readmission/statistics & numerical data
Female
*Intensive Care Units/statistics & numerical data
Risk Factors
Middle Aged
*Survivors/statistics & numerical data
Follow-Up Studies
Aged
Prospective Studies
SARS-CoV-2
Length of Stay/statistics & numerical data
Adult

@article {pmid40256946,
year = {2025},
author = {},
title = {Comment on "Intermittent Hypoxic-Hyperoxic Training During Inpatient Rehabilitation Improves Exercise Capacity and Functional Outcome in Patients With Long Covid: Results of a Controlled Clinical Pilot Trial" by Doehner et al.},
journal = {Journal of cachexia, sarcopenia and muscle},
volume = {16},
number = {2},
pages = {e13802},
doi = {10.1002/jcsm.13802},
pmid = {40256946},
issn = {2190-6009},
}

@article {pmid40256447,
year = {2025},
author = {Cheetham, NJ and Bowyer, V and García, MP and Bowyer, RCE and Carpentieri, JD and Guise, A and Thompson, EJ and Sudre, CH and Molteni, E and Antonelli, M and Penfold, RS and Harvey, NR and Canas, LS and Rjoob, K and Murray, B and Kerfoot, E and Hammers, A and Ourselin, S and Duncan, EL and Steves, CJ and , },
title = {Social determinants of recovery from ongoing symptoms following COVID-19 in two UK longitudinal studies: a prospective cohort study.},
journal = {BMJ public health},
volume = {3},
number = {1},
pages = {e001166},
pmid = {40256447},
issn = {2753-4294},
abstract = {INTRODUCTION: Social gradients in COVID-19 exposure and severity have been observed internationally. Whether combinations of pre-existing social factors, particularly those that confer cumulative advantage and disadvantage, affect recovery from ongoing symptoms following COVID-19 and long COVID is less well understood.

METHODS: We analysed data on self-perceived recovery following self-reported COVID-19 illness in two UK community-based cohorts, COVID Symptom Study Biobank (CSSB) (N=2548) and TwinsUK (N=1334). Causal effects of sociodemographic variables reflecting status prior to the COVID-19 pandemic on recovery were estimated with multivariable Poisson regression models, weighted for inverse probability of questionnaire participation and COVID-19 infection and adjusted for potential confounders. Associations between recovery and social strata comprising combinations of sex, education level and local area deprivation were estimated using the intersectional multilevel analysis of individual heterogeneity and discriminatory accuracy (MAIHDA) approach. Further analyses estimated associations with variables reflecting experiences during the pandemic.

RESULTS: Gradients in recovery from COVID-19 along the lines of social advantage were observed in intersectional MAIHDA models, with predicted probability of recovery lowest in female strata with lowest education and highest deprivation levels (CSSB: 55.1% (95% CI 44.0% to 65.1%); TwinsUK: 73.9% (95% CI 61.1% to 83.0%)) and highest in male strata with highest education and lowest deprivation levels (CSSB: 79.1% (95% CI 71.8% to 85.1%); TwinsUK: 89.7% (95% CI 82.5% to 94.1%)). Associations were not explained by differences in prepandemic health. Adverse employment, financial, healthcare access and personal experiences during the pandemic were also negatively associated with recovery.

CONCLUSIONS: Inequalities in likelihood of recovery from COVID-19 were observed, with ongoing symptoms several months after coronavirus infection more likely for individuals with greater social disadvantage prior to the pandemic.},
}

@article {pmid40256200,
year = {2025},
author = {Naik, H and Pongratz, K and Malbeuf, M and Kung, S and Last, L and Sugiyama, A and Khor, E and McGuire, M and Levin, A and Tran, KC},
title = {MyGuide long COVID: An online self-management tool for people with long COVID.},
journal = {Internet interventions},
volume = {40},
number = {},
pages = {100825},
pmid = {40256200},
issn = {2214-7829},
abstract = {BACKGROUND: Long COVID is a relatively new condition for which patients are asked to employ self-management strategies to manage their symptoms. However, it can be challenging for individuals with long COVID to find reliable and actionable self-management resources. The objective of this project was to develop an online tool for individuals with long COVID that is patient-centered, accessible, and customizable to meet individual needs.

METHODS: MyGuide Long COVID (www.longCOVIDguide.ca) was developed in British Columbia (BC), Canada, by a team that included long COVID clinicians and patient partners. Site visitors answer questions about their symptoms, and MyGuide generates a curated set of self-management resources tailored to their needs. Since its launch in August 2023, Google Analytics has been used to monitor website activity.

RESULTS: Within the first year, MyGuide had 52,578 total page views and 8570 new users. The most popular method to access MyGuide was by computer (56.3 % of users), and the most represented city was Vancouver, BC (23.5 % of users). The most popular topics were "Post Exertional Malaise" (1339 sessions) and "What is long COVID?" (1257 sessions).

CONCLUSIONS: An online tool to support chronic disease self-management can be successfully co-developed with patient partners and engagement tracked using web analytics.},
}

@article {pmid40256045,
year = {2025},
author = {Birnie, E and Vergouwe, M and Appelman, B and Biemond, JJ and Heijmans, J and Nichols, BE and Wiersinga, WJ and Popping, S and , },
title = {Cost-effectiveness Analysis of Nirmatrelvir/Ritonavir for COVID-19 Among Individuals at High Risk: A Modeling Study.},
journal = {Open forum infectious diseases},
volume = {12},
number = {4},
pages = {ofaf187},
pmid = {40256045},
issn = {2328-8957},
abstract = {BACKGROUND: To prevent severe disease, nirmatrelvir/ritonavir (nirmatrelvir/r) is administered to individuals infected with SARS-CoV-2 who are at high risk, and it is currently priced at approximately $1375 in the Netherlands. We aim to evaluate the health outcomes and cost-effectiveness of nirmatrelvir/r among patients with high risk of severe disease.

METHODS: We used a decision-analytic model parameterized with clinical and health care utilization data from individuals at high risk who were infected with SARS-CoV-2 between September 2021 and November 2023. We assumed baseline event rates of 1% for hospitalization and 0.05% for intensive care unit admission. Nirmatrelvir/r-related factors were varied. Costs were collected from a third-party payer's perspective, and the cost-effectiveness threshold was <$88 000 per quality-adjusted life-year gained. Sensitivity analyses were performed to account for uncertainties.

RESULTS: This study included 949 individuals at high risk who were infected with SARS-CoV-2. The sample had a median age of 65 years (IQR, 53-75), and 416 (44%) participants were female. Comorbidities included obesity (25%), hematologic malignancy (21%), solid organ/stem cell transplantation (17%), and immunosuppressive medication use (47%). With an assumed low effectiveness, nirmatrelvir/r could reduce hospitalizations and deaths (relative risk reduction, 21% and 44%, respectively). With high effectiveness, relative risk reductions of 89% and 90% were calculated for hospitalizations and deaths. Higher baseline rates for intensive care unit and hospital admission positively influenced cost-effectiveness thresholds. Nirmatrelvir/r is cost-effectively priced at <$512 with low effectiveness and <$1071 with high effectiveness.

CONCLUSIONS: With current low baseline event rates for hospitalization, nirmatrelvir/r has the potential, not only to reduce hospitalizations and deaths in individuals with COVID-19 who are at high risk, but to do so cost-effectively with a drug price reduction of 22% to 63%. These findings are relevant for policy makers and physicians and emphasize the importance of reevaluating current drug pricing.

CLINICAL TRIALS REGISTRATION: NCT05195060 (ClinicalTrials.gov).},
}

@article {pmid40254623,
year = {2025},
author = {Mksoud, M and Ittermann, T and Holtfreter, B and Söhnel, A and Söhnel, C and Welk, A and Paris, S and Melzow, FS and Wiegand, A and Kanzow, P and Rau, A and Kindler, S and Kocher, T},
title = {Vaccination rate and symptoms of long COVID among dental teams in Germany.},
journal = {Scientific reports},
volume = {15},
number = {1},
pages = {13654},
pmid = {40254623},
issn = {2045-2322},
mesh = {Humans ; *COVID-19/epidemiology/prevention & control/diagnosis ; Germany/epidemiology ; Male ; Female ; Adult ; *Vaccination/statistics & numerical data ; SARS-CoV-2/isolation & purification ; Middle Aged ; Dentists/statistics & numerical data ; Surveys and Questionnaires ; *COVID-19 Vaccines/administration & dosage ; Dental Hygienists/statistics & numerical data ; },
abstract = {Although COVID-19 is no longer a global public health threat, its consequences persist, with long COVID affecting at least 10% of patients and manifesting in various organ systems. National and international health agencies promoted vaccination to enhance population immunity, prioritizing healthcare personnel due to their high occupational risk. In a previous study, we found that the risk of SARS-CoV-2 transmission among dental teams in Germany was not higher than in the general population. This follow-up investigation aims to assess the vaccination status and the prevalence and severity of long COVID symptoms among dental teams in Germany. As part of a follow-up investigation involving the original cohort, 267 team members from 186 German dental practices previously included in the initial study completed an online questionnaire. The questionnaire covered three topics: (1) vaccination status, (2) confirmed COVID-19 diagnosis, and (3) self-reported long COVID symptoms. One hundred and seventy-two dentists (64.4%), 74 dental assistants (27.7%) and 21 dental hygienists (7.9%) completed the questionnaire. In total, 245 participants (91.8%) were at least once vaccinated. A COVID-19 infection after January 1st 2021 was reported by 146 (54.7%) participants, of which 33 participants (22.6%) suffered from long COVID symptoms. Our results showed lower vaccination rates among dental auxiliary personnel compared to dentists (95.9% vs. 84.2%). Individuals with long COVID symptoms were more often dental assistants (48.5% vs. 29.2%) or dental hygienists (15.2% vs. 8.0%) than dentists (36.4% vs. 62.8%) compared to the group not reporting long COVID symptoms (p = 0.025). In addition, it is unlikely that dental healthcare personnel are more prone to experiencing more severe symptoms compared to the general population. Vaccination against SARS-CoV-2 is likely to help against symptoms of long COVID.},
}

Humans
*COVID-19/epidemiology/prevention & control/diagnosis
Germany/epidemiology
Male
Female
Adult
*Vaccination/statistics & numerical data
SARS-CoV-2/isolation & purification
Middle Aged
Dentists/statistics & numerical data
Surveys and Questionnaires
*COVID-19 Vaccines/administration & dosage
Dental Hygienists/statistics & numerical data

@article {pmid40254579,
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 = {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 = {27},
pmid = {40254579},
issn = {1476-0711},
mesh = {Humans ; *COVID-19/diagnosis/therapy/complications/epidemiology ; Consensus ; SARS-CoV-2 ; Delphi Technique ; Post-Acute COVID-19 Syndrome ; Global Health ; Child ; },
abstract = {BACKGROUND: Long COVID is a complex, heterogeneous syndrome affecting over four hundred million people globally. There are few recommendations, and no formal training exists for medical professionals to assist with clinical evaluation and management of patients with Long COVID. More research into the pathology, cellular, and molecular mechanisms of Long COVID, and treatments is needed. The goal of this work is to disseminate essential information about Long COVID and recommendations about definition, diagnosis, treatment, research and social issues to physicians, researchers, and policy makers to address this escalating global health crisis.

METHODS: A 3-round modified Delphi consensus methodology was distributed internationally to 179 healthcare professionals, researchers, and persons with lived experience of Long COVID in 28 countries. Statements were combined into specific areas: definition, diagnosis, treatment, research, and society.

RESULTS: The survey resulted in 187 comprehensive statements reaching consensus with the strongest areas being diagnosis and clinical assessment, and general research. We establish conditions for diagnosis of different subgroups within the Long COVID umbrella. Clear consensus was reached that the impacts of COVID-19 infection on children should be a research priority, and additionally on the need to determine the effects of Long COVID on societies and economies. The consensus on COVID and Long COVID is that it affects the nervous system and other organs and is not likely to be observed with initial symptoms. We note, biomarkers are critically needed to address these issues.

CONCLUSIONS: This work forms initial guidance to address the spectrum of Long COVID as a disease and reinforces the need for translational research and large-scale treatment trials for treatment protocols.},
}

Humans
*COVID-19/diagnosis/therapy/complications/epidemiology
Consensus
SARS-CoV-2
Delphi Technique
Post-Acute COVID-19 Syndrome
Global Health
Child

@article {pmid40253365,
year = {2025},
author = {Vieira, YP and da Silva, LN and Nunes, BP and Gonzalez, TN and Duro, SMS and de Oliveira Saes, M},
title = {Relationship between long covid and functional disability in adults and the seniors in the south of Brazil.},
journal = {BMC public health},
volume = {25},
number = {1},
pages = {1458},
pmid = {40253365},
issn = {1471-2458},
mesh = {Humans ; *COVID-19/epidemiology/complications ; Male ; Cross-Sectional Studies ; Brazil/epidemiology ; Female ; *Activities of Daily Living ; Middle Aged ; Aged ; Adult ; *Persons with Disabilities/statistics & numerical data ; Disability Evaluation ; SARS-CoV-2 ; Aged, 80 and over ; },
abstract = {BACKGROUND: Individuals living with long COVID experience a range of symptoms that affect their ability to carry out daily activities or participate in social and community life. This study aimed to analyze association between functional disability and the occurrence of long COVID symptoms, as well as to analyze the effect of symptom persistence time on functional disability.

METHODS: This is a cross-sectional study using data from the SulCovid-19 study, which interviewed individuals who had COVID-19 between December 2020 and March 2021. The functional disability outcome was assessed using the Basic Activities of Daily Living (BADL) and Instrumental Activities of Daily Living (IADL) scales, while the exposures were the symptoms of long COVID. Adjusted analyses between outcomes and exposures, stratified by time after the acute phase of infection, were performed using Poisson regression with robust variance adjustment.

RESULTS: The prevalence of BADL disability was 4.8% (95%CI 4.0;5.6), and for IADL disability, it was 8.4% (95%CI 7.4;9.4). The main symptoms associated with BADL disability were dyspnea, dry cough and sore throat, while for IADL, they were joint pain, muscle pain, loss of sensation, nasal congestion, sore throat and runny nose. When stratified by tertiles of time after the acute phase of infection, a relationship was found between BADL disability and dyspnea, ageusia and, nasal congestion in the 3rd tertile, while only ageusia was found to be related to IADL disability in the 3rd tertile.

CONCLUSIONS: Long COVID symptoms were associated wiht limitations in the functional capacity of adults and the seniors. The findings can be used to guide the care and rehabilitation of individuals with disabilities who have had COVID-19, particularly for referral to appropriate health professionals.},
}

Humans
*COVID-19/epidemiology/complications
Male
Cross-Sectional Studies
Brazil/epidemiology
Female
*Activities of Daily Living
Middle Aged
Aged
Adult
*Persons with Disabilities/statistics & numerical data
Disability Evaluation
SARS-CoV-2
Aged, 80 and over

@article {pmid40251531,
year = {2025},
author = {Bonfim, LPF and Oliveira, CRA and Correa, TR and Kopittke, L and Teixeira, AL and Marcolino, MS},
title = {Persistent cognitive symptoms in mild COVID-19 infection: a retrospective cohort study.},
journal = {BMC infectious diseases},
volume = {25},
number = {1},
pages = {555},
pmid = {40251531},
issn = {1471-2334},
mesh = {Humans ; *COVID-19/complications/psychology/epidemiology ; Female ; Male ; Retrospective Studies ; Middle Aged ; Brazil/epidemiology ; Adult ; Aged ; SARS-CoV-2 ; Telemedicine ; *Cognitive Dysfunction/epidemiology ; },
abstract = {BACKGROUND: The COVID-19 pandemic represented a healthcare challenge of unparalleled magnitude worldwide. As patients recovered from the acute infection, a new challenge emerged, i.e., the development of post-acute symptoms. The main goal of this study was to evaluate the trajectory of cognitive symptoms since the acute phase of COVID-19 among patients followed through a telehealth program in Brazil.

METHODS: A retrospective cohort study was conducted with confirmed COVID-19 patients followed by a Brazilian telehealth program who presented cognitive symptoms in the acute phase of infection. The objective of the current analysis was to assess the persistence or remission of cognitive symptoms at 24 weeks after the onset of acute COVID-19 symptoms, as well as the factors associated with such manifestations. The study used chi-square tests and multivariate logistic regression models to assess the association between patients' parameters and the presence of cognitive symptoms. A backward stepwise method was applied to define significant characteristics, which were then evaluated using odds ratios and 95% confidence intervals.

RESULTS: Among 319 patients who had cognitive symptoms during acute COVID-19, 89 (27.9%) reported persistence of cognitive symptoms for more than 24 weeks from the acute onset of the infection. Female sex (OR 2.33 [95% CI 1.23-4.43]) and having been infected during the second wave of COVID-19 (OR 2.30 [95% CI 1.34-3.96]) were associated with the persistence of symptoms beyond 24 weeks.

CONCLUSIONS: Approximately one-third of patients with COVID-19, mainly women and people infected during the second wave of infection, experienced persistent cognitive symptoms.},
}

Humans
*COVID-19/complications/psychology/epidemiology
Female
Male
Retrospective Studies
Middle Aged
Brazil/epidemiology
Adult
Aged
SARS-CoV-2
Telemedicine
*Cognitive Dysfunction/epidemiology

@article {pmid40251050,
year = {2025},
author = {Vieth, K and Hummers, E and Roder, S and Müller, F and Wegener, GS and Müllenmeister, C and El-Sayed, I and Königs, G and Schröder, D and Schmachtenberg, T},
title = {[How do people with long COVID cope with their symptoms and everyday limitations? A qualitative study with four focus groups].},
journal = {Zeitschrift fur Evidenz, Fortbildung und Qualitat im Gesundheitswesen},
volume = {},
number = {},
pages = {},
doi = {10.1016/j.zefq.2025.03.005},
pmid = {40251050},
issn = {2212-0289},
abstract = {BACKGROUND: The heterogenous and fluctuating intensity of long COVID symptoms poses a challenge to both patients and healthcare providers due to a lack of causal treatment options. The aim of supportive therapies is to help individuals cope with symptoms in daily life and maintain functionality. This study aims to identify coping strategies employed by those affected by long COVID and their perceived benefits.

METHODS: A qualitative study was conducted with four focus groups comprising 23 adult patients suffering from long COVID. The recorded and transcribed group discussions were analyzed using content-structuring content analysis according to Kuckartz. The results were then systematically analyzed, interpreted, and put in a theoretical context.

RESULTS: Participants utilized healthcare resources but developed their own strategies for dealing with long COVID because of their dissatisfaction with medical care. These strategies included energy and resource management, physical activity, enhancing health literacy, changing mindset and lifestyle, infection prevention, using medical aids, and dietary changes.

CONCLUSIONS: This study demonstrates that people with long COVID employ a variety of strategies to cope with impairments in everyday life. According to the interviewees, integrating these approaches into the treatment of long COVID can help to reduce the burden of symptoms on those affected, restore their everyday functionality, and improve their self-efficacy and quality of life. Established concepts like "pacing" or "shared-decision making" can serve as a starting point for developing individualized coping strategies and treatment concepts together with patients.},
}

@article {pmid40250803,
year = {2025},
author = {Hatakeyama, J and Nakamura, K and Kanda, N and Kawauchi, A and Fujitani, S and Oshima, T and Kato, H and Ota, K and Kamijo, H and Asahi, T and Muto, Y and Hori, M and Iba, A and Hosozawa, M and Iso, H},
title = {Long-term functional prognosis with tocilizumab in severe COVID-19 infection: A multicenter prospective observational study on mechanically ventilated ICU patients in the COVID-19 Recovery Study II.},
journal = {Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy},
volume = {},
number = {},
pages = {102708},
doi = {10.1016/j.jiac.2025.102708},
pmid = {40250803},
issn = {1437-7780},
abstract = {BACKGROUND: Tocilizumab, an IL-6 receptor antagonist, may prevent functional impairments in critically ill patients by attenuating the cytokine storm. This study investigated a potential effect of tocilizumab on preventing functional impairments in patients with severe coronavirus infection 2019 (COVID-19).

METHODS: In a multicenter prospective observational study, patients with COVID-19 ≥20 years requiring mechanical ventilation admitted to the intensive care unit between April 2021 and September 2021 and discharged alive were followed for one year. A self-administered questionnaire on sequelae and functional impairments was mailed in August 2022, and data were collected. A multivariate logistic regression was used to assess the impact of tocilizumab on physical function, mental health, and Long COVID.

RESULTS: Of 157 analyzed patients, 41 received tocilizumab. The tocilizumab group had more severe illness, but a lower prevalence of physical impairment (17.1% vs. 23.3%, p = 0.41) and mental disorders (19.5% vs. 39.7%, p = 0.009) than the non-tocilizumab group. The prevalence of Long COVID was higher in the tocilizumab group (92.7% vs. 80.2%, p = 0.06), whereas fatigue/malaise was significantly lower (19.5% vs. 37.1%, p = 0.039). Adjusted odds ratios (95% confidence interval) for physical impairment, mental disorders, and Long COVID with tocilizumab were 0.70 (0.2 to 2.1), 0.40 (0.16 to 1.01), and 2.94 (0.7 to 12.3), respectively, with no significant difference.

CONCLUSIONS: Tocilizumab was associated with a lower prevalence of physical impairment and mental disorders at 1 year in patients with severe COVID-19. Furthermore, Long COVID had a weaker impact on physical and cognitive functions.},
}

@article {pmid40250063,
year = {2025},
author = {Hibino, K and Ariie, T},
title = {Letter to the editor regarding: "Effectiveness of a 12-week telerehabilitation training in people with long COVID: A randomized controlled trial".},
journal = {Annals of physical and rehabilitation medicine},
volume = {68},
number = {4},
pages = {101957},
doi = {10.1016/j.rehab.2025.101957},
pmid = {40250063},
issn = {1877-0665},
}

@article {pmid40250060,
year = {2025},
author = {Lai, CY and Lin, CH and Chiang, SL},
title = {Response to comment on "Effectiveness of a 12-week telerehabilitation training in people with long COVID: A randomized controlled trial".},
journal = {Annals of physical and rehabilitation medicine},
volume = {68},
number = {4},
pages = {101975},
doi = {10.1016/j.rehab.2025.101975},
pmid = {40250060},
issn = {1877-0665},
}

@article {pmid40249096,
year = {2025},
author = {Uhlig-Reche, H and Rolin, S and Karnik, R and Lyons, M and Verduzco-Gutierrez, M},
title = {Compassion fatigue, work engagement, and psychological distress in health care workers treating patients with long COVID.},
journal = {PM & R : the journal of injury, function, and rehabilitation},
volume = {},
number = {},
pages = {},
doi = {10.1002/pmrj.13383},
pmid = {40249096},
issn = {1934-1563},
abstract = {BACKGROUND: Health care workers (HCWs) caring for patients with chronic disease are more likely to experience compassion fatigue. The impacts on HCWs caring for patients with a new complex chronic disease, long COVID, are unknown.

OBJECTIVE: To measure compassion fatigue, work engagement, and psychological distress in HCWs caring for patients with long COVID and investigate associations with personal history of long COVID and demographic and occupational characteristics.

DESIGN: Cross-sectional survey study assessing demographic and occupational characteristics, Compassion Fatigue-Short Scale (CF-SS), Utrecht Work Engagement Scale-3 (UWES-3), and Screening Tool for Psychological Distress (STOP-D) in HCWs caring for patients with long COVID.

SETTING: Online survey from March-June 2023.

PARTICIPANTS: 116 HCWs caring for patients with long COVID.

INTERVENTIONS: Not applicable.

MAIN OUTCOME MEASURES: CF-SS, UWES-3, and STOP-D scores and associations with personal history of long COVID, demographic and occupational factors.

RESULTS: HCWs with a personal history of long COVID had worse scores in all outcome measures compared to those without long COVID. Effects were moderate (UWES-3: η[2] = -0.09, p = .01; STOP-D: η[2] = 0.06, p = .02; CF-SS: η[2] = 0.07, p = .02). Outcome measures were comparable between physical medicine and rehabilitation physicians and other HCWs (p > .05). CF-SS showed a small positive correlation (rs = 0.19, n = 112, p = .04) with the percentage of the provider's patient population with long COVID. Mean outcome measures differed between career-level groups with medium to large effects (UWES-3: η[2] = 0.13, STOP-D: η[2] = 0.06, CF-SS: η[2] = 0.06). Work engagement was worse in early career compared to late career (p  <.01). Psychological distress was worse in middle career compared to late career (p = .02). Compassion fatigue was worse in early career compared to late career (p = .02).

CONCLUSIONS: Among HCWs caring for patients with long COVID, mean scores for all primary outcomes were worse in HCWs with a personal history of long COVID compared to those without. Early career HCWs caring for this population are less engaged and experience greater compassion fatigue whereas those in middle career experience greater psychological distress.},
}

@article {pmid40248705,
year = {2025},
author = {Scott, JM and Qiu, Z and Rahman, J and Moskowitz, CS and Michalski, MG and Lehman, S and Lee, CP and Harrison, J and Yu, AF and Marouf, A and Vardhana, S and Boutros, PC and Jones, LW},
title = {Case Report: Decentralized trial of tolerability-adapted exercise therapy after severe Covid-19.},
journal = {Frontiers in immunology},
volume = {16},
number = {},
pages = {1529385},
pmid = {40248705},
issn = {1664-3224},
mesh = {Humans ; *COVID-19/therapy/immunology ; *Exercise Therapy/methods/adverse effects ; *SARS-CoV-2 ; Male ; Middle Aged ; Female ; Aged ; Quality of Life ; Prospective Studies ; Treatment Outcome ; },
abstract = {We assessed the safety, tolerability, and effects of exercise therapy in three patients with cancer and hospitalization for SARS-CoV-2 infection in an early-phase prospective trial. All study assessments and exercise sessions were conducted remotely (decentralized) in patient's homes. Patients received five escalated doses of aerobic exercise therapy (range, 90 to 375 minutes per week) following a tolerability-based adapted schedule over 30 consecutive weeks. Exercise therapy was safe (i.e., no serious adverse events), tolerable (i.e., all exercise therapy doses were completed, with an overall average relative exercise dose intensity of 89%), and associated with improvements in patient physiology (e.g., exercise capacity) and patient-reported outcomes (e.g., quality of life). Correlative proteomic and single-cell immune sequencing of peripheral blood samples revealed marked alterations in protein and immune phenotypes implicated in post COVID-19 condition. (ClinicalTrials.gov number, NCT04824443).},
}

Humans
*COVID-19/therapy/immunology
*Exercise Therapy/methods/adverse effects
*SARS-CoV-2
Male
Middle Aged
Female
Aged
Quality of Life
Prospective Studies
Treatment Outcome

@article {pmid40248479,
year = {2025},
author = {Gong, KD and Afshar, AS and Brown, F and Alavi, R and Ganesh, R and Kharrazi, H},
title = {Assessing the Impact of Post-COVID Clinics on 6-Month Health Care Utilization for Patients With Long COVID: A Single-Center Experience.},
journal = {Mayo Clinic proceedings. Innovations, quality & outcomes},
volume = {9},
number = {3},
pages = {100603},
pmid = {40248479},
issn = {2542-4548},
abstract = {OBJECTIVE: To assess the impact of post-COVID clinics by examining the association between their early usage and downstream health care utilization.

PATIENTS AND METHODS: In a case-control study spanning data from March 11, 2020 to June 1, 2023, patients with Long COVID were identified from a major health system using diagnosis codes. The Fast, Large-Scale Almost Matching Exactly algorithm was used to match patients who presented early to post-COVID clinics with patients with Long COVID who did not attend such clinics. Matching was performed on demographic characteristics, acute COVID severity, comorbidities, diagnosis date, and vaccination, to reduce confounders for the comparison of the health care utilization and mortality between cohorts.

RESULTS: When exactly matching on all 46 features, the algorithm yielded 2814 matched patients, of whom 692 (24.6%; 66.6% females; mean [SD] age, 48.8 [14.5] years) were seen in post-COVID clinics within the first 6 months and 2122 (75.4%; 64.1% females; mean [SD] age, 49.7 [15.2] years) who were not. The average treatment effect (95% CI) of early post-COVID clinic usage was -0.60 (-0.83 to -0.39) on inpatient visits, -0.19 (-0.26 to -0.11) on emergency department visits, 7.62 (6.96-8.56) on outpatient visits, -$3467 (-$6267 to -$754) on estimated costs, and -0.006 (-0.010 to -0.003) on mortality.

CONCLUSION: Early usage of post-COVID clinics by patients with Long COVID is associated with not only fewer downstream inpatient stays, emergency department visits, estimated costs, and reduced mortality within the first 6 months but also greater outpatient utilization. Results suggest early post-COVID clinic involvement shifts care to outpatient settings, potentially reducing costs and mortality.},
}

@article {pmid40247373,
year = {2025},
author = {Cruz, T and Albacar, N and Ruiz, E and Lledo, GM and Perea, L and Puebla, A and Torvisco, A and Mendoza, N and Marrades, P and Sellares, J and Agustí, A and Viñas, O and Sibila, O and Faner, R},
title = {Persistence of dysfunctional immune response 12 months after SARS-CoV-2 infection and their relationship with pulmonary sequelae and long COVID.},
journal = {Respiratory research},
volume = {26},
number = {1},
pages = {152},
pmid = {40247373},
issn = {1465-993X},
support = {ID 100010434, LCF/BQ/PI22/11910042//'la Caixa' Foundation/ ; },
mesh = {Humans ; *COVID-19/immunology/complications/blood/diagnosis ; Male ; Female ; Middle Aged ; Aged ; Autoantibodies/blood ; SARS-CoV-2/immunology ; Time Factors ; Adult ; *Lung/immunology/physiopathology ; Post-Acute COVID-19 Syndrome ; },
abstract = {INTRODUCTION: Most patients recover fully after an acute infection by SARS-CoV-2. Some, however, may develop pulmonary sequelae (PS) and/or long COVID (LC). However, whether these two clinical conditions have similar or different pathogenic mechanisms is unknown.

METHODS: The levels of autoantibodies and 184 inflammatory and organ damage associated proteins in plasma were determined (by immunofluorescence and Olink panels, respectively) 1 year after an acute infection by SARS-CoV-2 in 51 patients with PS (DLCO < 80% ref), 31 patients with LC and 31 patients fully recovered (Rec). PS was defined by the presence of reduced carbon monoxide diffusing capacity (DLCO) lower than 80% ref. LC was defined by the presence of chronic symptoms in the absence of an alternative diagnosis.

RESULTS: We found that patients with PS or LC both showed increased levels than Rec of anti-microbial, immune cell activation and recruitment related proteins. Patients with PS showed higher levels of anti-nuclear autoantibodies, whereas LC patients had increased levels of organ-damage associated proteins. In patients with PS most of the elevated proteins correlate with the impairment of lung function (DLCO). Finally, in PS we additionally performed the determinations at an earlier time point (6 months) and showed that the expression of CCL20 and IFN-ɣ was already higher at 6 months, while CCL3 and CCL19 increase from 6 to 12 months, suggesting a pathogenic role in PS persistence.

CONCLUSIONS: Patients with PS or LC have abnormal but different persistent circulatory immune and organ damage biomarkers, suggesting different underlying biology of both post-COVID conditions.},
}

Humans
*COVID-19/immunology/complications/blood/diagnosis
Male
Female
Middle Aged
Aged
Autoantibodies/blood
SARS-CoV-2/immunology
Time Factors
Adult
*Lung/immunology/physiopathology
Post-Acute COVID-19 Syndrome

@article {pmid40246685,
year = {2025},
author = {},
title = {Correction to: Impact of intravenous laser irradiation of blood on cognitive function and molecular pathways in long COVID patients: a pilot study.},
journal = {QJM : monthly journal of the Association of Physicians},
volume = {},
number = {},
pages = {},
doi = {10.1093/qjmed/hcaf083},
pmid = {40246685},
issn = {1460-2393},
}

@article {pmid40246350,
year = {2025},
author = {Rubio-Casillas, A and Rodríguez-Quintero, CM and Hromić-Jahjefendić, A and Uversky, VN and Redwan, EM and Brogna, C},
title = {The essential role of prebiotics in restoring gut health in long COVID.},
journal = {Progress in molecular biology and translational science},
volume = {213},
number = {},
pages = {385-411},
doi = {10.1016/bs.pmbts.2025.01.004},
pmid = {40246350},
issn = {1878-0814},
mesh = {Humans ; *Prebiotics/administration & dosage ; *COVID-19/microbiology/immunology ; *Gastrointestinal Microbiome/drug effects ; SARS-CoV-2 ; Dysbiosis/microbiology ; Probiotics ; Pandemics ; },
abstract = {The gut microbiota (GM) plays an essential role in human health, influencing not only digestive processes but also the immune system´s functionality. The COVID-19 pandemic has highlighted the complex interaction between viral infections and the GM. Emerging evidence has demonstrated that SARS-CoV-2 can disrupt microbial homeostasis, leading to dysbiosis and compromised immune responses. The severity of COVID-19 has been associated with a reduction in the abundance of several beneficial bacteria in the gut. It has been proposed that consuming probiotics may help to re-colonize the GM. Although probiotics are important, prebiotics are essential for their metabolism, growth, and re-colonization capabilities. This chapter delves into the critical role of prebiotics in restoring GM after COVID-19 disease. The mechanisms by which prebiotics enhance the metabolism of beneficial bacteria will be described, and how prebiotics mediate the re-colonization of the gut with beneficial bacteria, thereby restoring microbial diversity and promoting the resilience of the gut-associated immune system. The benefits of consuming prebiotics from natural sources are superior to those from chemically purified commercial products.},
}

Humans
*Prebiotics/administration & dosage
*COVID-19/microbiology/immunology
*Gastrointestinal Microbiome/drug effects
SARS-CoV-2
Dysbiosis/microbiology
Probiotics
Pandemics

@article {pmid40246346,
year = {2025},
author = {Adilović, M},
title = {COVID-19 related complications.},
journal = {Progress in molecular biology and translational science},
volume = {213},
number = {},
pages = {259-314},
doi = {10.1016/bs.pmbts.2025.02.002},
pmid = {40246346},
issn = {1878-0814},
mesh = {Humans ; *COVID-19/complications ; *SARS-CoV-2 ; Pregnancy ; Pandemics ; Female ; },
abstract = {The COVID-19 pandemic has significantly impacted global healthcare systems, revealed vulnerabilities and prompted a re-evaluation of medical practices. Acute complications from the virus, including cardiovascular and neurological issues, have underscored the necessity for timely medical interventions. Advances in diagnostic methods and personalized therapies have been pivotal in mitigating severe outcomes. Additionally, Long COVID has emerged as a complex challenge, affecting various body systems and leading to respiratory, cardiovascular, neurological, psychological, and musculoskeletal problems. This broad spectrum of complications highlights the importance of multidisciplinary management approaches that prioritize therapy, rehabilitation, and patient-centered care. Vulnerable populations such as paediatric patients, pregnant women, and immunocompromised individuals face unique risks and complications, necessitating continuous monitoring and tailored management strategies to reduce morbidity and mortality associated with COVID-19.},
}

Humans
*COVID-19/complications
*SARS-CoV-2
Pregnancy
Pandemics
Female

@article {pmid40244965,
year = {2024},
author = {Boucher, C and Glatt, S and Silver, C and Chennapragada, L and Sullivan, S and Dichiara, A and Sokol, Y and Patel, S and Goodman, M},
title = {A qualitative analysis of lived experiences, mental health treatment needs, and psychotherapeutic applications among veterans with long COVID.},
journal = {Psychological services},
volume = {},
number = {},
pages = {},
doi = {10.1037/ser0000925},
pmid = {40244965},
issn = {1939-148X},
support = {//US Department of Veterans Affairs; Veteran Affairs Research Department/ ; },
abstract = {Long COVID remains a pressing health concern among Americans, with current data suggesting that 45% of those infected by COVID-19 experience at least one symptom of Long COVID. Veterans are a particularly at-risk population due to their unique demographic characteristics and lived experiences. Despite this, there has been a lack of treatment development for Long COVID that targets mental health symptoms and is veteran specific. There is a need for effective treatments to help veterans cope with a Long COVID diagnosis and recovery. This quality improvement project aims to gain insight into the lived experiences and mental health needs of veterans with Long COVID to help inform future treatment development. A sample of 21 veterans (57% male, 67% Black, 43% Hispanic) participated in qualitative interviews where they were asked 23 questions about their experiences living with Long COVID and seeking medical treatment, as well as their ongoing mental health needs. Qualitative data were extracted from these interviews and analyzed. Four main themes were identified: interpersonal concerns and challenges with social interaction; difficulties with day-to-day living; barriers and facilitators to accessing medical treatment; and mental health effects and attitudes toward psychotherapy. Veterans described significant impairments in functioning, as well as feelings of isolation and loneliness. These findings demonstrate the need for a psychotherapeutic intervention that can facilitate interpersonal connection, improve functioning, and decrease psychiatric symptoms. (PsycInfo Database Record (c) 2025 APA, all rights reserved).},
}

@article {pmid40243865,
year = {2025},
author = {Dos Reis, GG and Silvestre, RT and Alves, G and Delmonico, L and Chantre-Justino, M and Moreira, ADS and Müller, BLA and do Nascimento, CR and da Silva, DLP and Dos Santos, LS and Mattos-Guaraldi, AL and Ornellas, MH},
title = {Leukocyte telomere length and telomerase activity in Long COVID patients from Rio de Janeiro, Brazil.},
journal = {Memorias do Instituto Oswaldo Cruz},
volume = {120},
number = {},
pages = {e240129},
pmid = {40243865},
issn = {1678-8060},
mesh = {Humans ; *Telomerase/blood/metabolism ; *COVID-19/enzymology ; Male ; Female ; *Leukocytes/enzymology ; *Telomere/genetics ; Middle Aged ; Brazil ; Real-Time Polymerase Chain Reaction ; Adult ; SARS-CoV-2 ; Case-Control Studies ; Aged ; },
abstract = {BACKGROUND: Coronavirus disease 2019 (COVID-19) is caused by the new coronavirus 2 (severe acute respiratory syndrome coronavirus 2 - SARS-CoV-2). Long COVID is a new condition associated with persistent COVID-19 symptoms and/or new emerging symptoms. Telomeres are specialised structures for genome protection at the end of chromosomes and telomerase is the enzyme that synthesises telomere DNA.

OBJECTIVES: Patients with Long COVID symptoms were recruited at the Pedro Ernesto University Hospital (HUPE) in Rio de Janeiro, Brazil, with the main purpose of investigating the association between telomere length and Long COVID.

METHODS: Leukocyte telomere length (LTL) was determined by quantitative real-time polymerase chain reaction (qPCR) in 34 Long COVID patients compared to a control group (n = 122). Telomerase activity was determined by qPCR assays using the commercial kit from ScienCell. A questionnaire on symptoms, vaccine doses and blood count was completed.

FINDINGS: The Long COVID patients were found to have an increase in LTL. Telomerase activity was also examined in a smaller number of patients and found to be reactivated in the blood.

MAIN CONCLUSIONS: It will be necessary to conduct further studies and monitor Long COVID patients to determine if future health issues could be linked to telomerase activity and elongated telomeres.},
}

Humans
*Telomerase/blood/metabolism
*COVID-19/enzymology
Male
Female
*Leukocytes/enzymology
*Telomere/genetics
Middle Aged
Brazil
Real-Time Polymerase Chain Reaction
Adult
SARS-CoV-2
Case-Control Studies
Aged

@article {pmid40242142,
year = {2024},
author = {Cherif, H and Mokaddem, S and Debiche, S and Kalboussi, S and Yangui, F and Charfi, MR},
title = {Incidence and predictive factors of hyperventilation syndrome in patients after COVID 19 pneumonia: a prospective cohort study.},
journal = {F1000Research},
volume = {13},
number = {},
pages = {1497},
pmid = {40242142},
issn = {2046-1402},
mesh = {Humans ; Male ; *COVID-19/complications/epidemiology ; Female ; Middle Aged ; Incidence ; Prospective Studies ; Aged ; *Hyperventilation/epidemiology/etiology ; Adult ; SARS-CoV-2 ; Stress Disorders, Post-Traumatic/epidemiology ; Risk Factors ; Comorbidity ; Syndrome ; },
abstract = {BACKGROUND: This study investigates the incidence and predictive factors of Hyperventilation Syndrome (HVS) in patients after COVID 19 pneumonia, addressing the clinical overlap between these conditions.

METHODS: A one-month prospective study was conducted, tracking survivors of COVID-19 pneumonia. Patients were evaluated for ongoing clinical status, including HVS and post-traumatic syndrome disorder (PTSD), using clinical questionnaires, mMRC, Post-COVID-19 Functional Status (PCFS) Score, Nijmegen score, and PTSD Checklist for DSM-5 questionnaire.

RESULTS: Our study included 222 patients (median age: 57 years, male predominance 62.6%). Somatic comorbidities, primarily metabolic disorders, were reported in 71.2% of cases. The majority had severe or critical infection forms (78.4%), and 91.9% experienced acute symptoms, with 86.5% having three or more symptom clusters. At one month follow-up, dyspnea (52.9%) and asthenia (21.7%) persisted. Functional limitations (PCFS Grade > 2) were observed in 19.6% of patients. The overall incidence of HVS was 158 per 1000 patients, and PTSD was 445 per 1000 patients. Multivariate logistic regression identified cognitive impairment (acute phase), persistent weight loss (post-COVID-19 phase), PCFS grade > 2, and PTSD as independent factors for developing HVS, with relative risks (RRs) of 3.47 (95%CI [1.48-8.31]; p = 0.004), 11.87 (95%CI [1.25-112.88]; p = 0.031), 3.24 (95%CI [1.34-7.86]; p = 0.009), and 5.98 (95%CI [2.27-15.77]; p < 0.001), respectively.

CONCLUSION: HVS is prevalent in the post-COVID-19 phase, affecting 15.6 % of survivors. Identified predictive factors suggest the convergence of psychosomatic pathophysiological mechanisms. Further research is crucial for a detailed understanding of these mechanisms in long COVID-19 patients.},
}

Humans
Male
*COVID-19/complications/epidemiology
Female
Middle Aged
Incidence
Prospective Studies
Aged
*Hyperventilation/epidemiology/etiology
Adult
SARS-CoV-2
Stress Disorders, Post-Traumatic/epidemiology
Risk Factors
Comorbidity
Syndrome

@article {pmid40241147,
year = {2025},
author = {Morello, R and De Rose, C and Martino, L and Raffaelli, F and Zampino, G and Valentini, P and Buonsenso, D},
title = {Role of nutrient supplements in children with post-COVID condition: a retrospective preliminary observation and narrative review.},
journal = {Italian journal of pediatrics},
volume = {51},
number = {1},
pages = {119},
pmid = {40241147},
issn = {1824-7288},
mesh = {Humans ; *Dietary Supplements ; Retrospective Studies ; *COVID-19/complications ; Child ; Male ; Female ; Child, Preschool ; Adolescent ; SARS-CoV-2 ; },
abstract = {BACKGROUND: Post-COVID Condition (PCC), emerging as a significant long-term consequence of SARS-CoV-2 infection, affects not only adults but also the pediatric population. Despite ongoing research, the precise pathophysiology of PCC remains elusive. However, several putative mechanisms have been identified, leading to the exploration of various therapeutic strategies. Notably, in the adult population, there has been substantial interest in the potential efficacy of nutritional supplements. Regrettably, information regarding the use of such supplements in the pediatric population is currently lacking.

METHODS: The present study was conducted to assess the impact of nutritional supplements on alleviating long COVID symptoms in children. To achieve this, we conducted a retrospective analysis of nutrient supplements administered by parents to children with Post-COVID Condition (PCC) between February 2020 and October 2022. Statistical analyses were employed to determine associations between categorical variables.

RESULTS: A total of 1243 children were enrolled following documented SARS-CoV-2 infection, with 940 (76.2%) diagnosed as recovered and 294 (23.8%) diagnosed with Long COVID. Among Long COVID patients experiencing disabling symptoms, treatment with oral lactoferrin and/or a Multi-Element Product (MEP) with antioxidant and anti-inflammatory properties was initiated. The correlation analysis between the use of supplements and persistence of long COVID at the next follow-up showed that the use of MEP alone (OR 5.7, 95% CI 3.8-8.5), or the combination of MEP and lactoferrin (OR 5.06, 95% CI 3.3-7.6) three months after the initial infection and for the following three months, were associated with a lower risk having long covid at six months following initial infection, when compared with the use of lactoferrin alone (OR 7.6 95% CI 5.1-11.4).

CONCLUSIONS: This proof-of-concept study revealed that MEP and lactoferrin, when administered three months after initial infection in patients with a new diagnosis of long covid, may have a positive impact on improving Long COVID symptoms in children during follow-up evaluations. This positive trend toward reducing Post-COVID Condition (PCC) exhibited by MEP and lactoferrin suggested a potential benefit worthy of exploration in future randomized controlled trials.},
}

Humans
*Dietary Supplements
Retrospective Studies
*COVID-19/complications
Child
Male
Female
Child, Preschool
Adolescent
SARS-CoV-2

@article {pmid40240378,
year = {2025},
author = {Vieira, YP and Rocha, JQS and Dos Santos Ferreira Viero, V and Nunes, BP and Facchini, LA and Duro, SMS and Neves, RG and Fernández-de-Las-Peñas, C and de Oliveira Saes, M},
title = {Dose-response effect between the number of long COVID symptoms and the use of different health services.},
journal = {Scientific reports},
volume = {15},
number = {1},
pages = {13104},
pmid = {40240378},
issn = {2045-2322},
mesh = {Humans ; *COVID-19/epidemiology/complications/therapy ; Male ; Female ; Brazil/epidemiology ; Middle Aged ; Adult ; Cross-Sectional Studies ; SARS-CoV-2/isolation & purification ; Primary Health Care/statistics & numerical data ; Post-Acute COVID-19 Syndrome ; Aged ; *Health Services/statistics & numerical data ; },
abstract = {This study aims to identify the use of health services by individuals with long COVID residing in South Brazil 6 months after the acute phase of a SARS-CoV-2 infection. A cross-sectional cohort study of individuals who survived coronavirus disease was conducted in Rio Grande, Brazil. The participants were asked about their use of health services during the 6-10 months following recovery from SARS-CoV-2 infection. Data on the overall use of primary healthcare services, general practitioner services, emergency services, specialist doctors' services, and specialized services were collected. Individuals with long COVID reported more frequent use of primary healthcare services, emergency services, specialist doctors' services, and specialized services than those without long COVID. The musculoskeletal, neurological, and respiratory symptoms of long COVID were associated with frequent use of primary healthcare services, whereas the neurological, digestive, and respiratory symptoms were associated with frequent use of emergency services. Finally, the use of specialist doctors' services and specialized services was more frequent in participants with neurological symptoms than in those without these symptoms. Individuals with long COVID used more healthcare services than those without long COVID in South Brazil. Participants with a greater number of symptoms used more health services than those with fewer symptoms. Healthcare services use depends on the type of the long COVID symptoms. Health services in Brazil need to be reorganized and adapted to provide adequate treatment and care to people with long COVID.},
}

Humans
*COVID-19/epidemiology/complications/therapy
Male
Female
Brazil/epidemiology
Middle Aged
Adult
Cross-Sectional Studies
SARS-CoV-2/isolation & purification
Primary Health Care/statistics & numerical data
Post-Acute COVID-19 Syndrome
Aged
*Health Services/statistics & numerical data

@article {pmid40239863,
year = {2025},
author = {Schamess, A and Velten, M and Friedberg, A},
title = {Long COVID in 2025: a clinical viewpoint.},
journal = {Life sciences},
volume = {},
number = {},
pages = {123633},
doi = {10.1016/j.lfs.2025.123633},
pmid = {40239863},
issn = {1879-0631},
}

@article {pmid40236471,
year = {2024},
author = {McAllister, K},
title = {Contextualising Long Covid: Viral Sequelae, 'Post-Encephalitis' Lethargica and the Modern British Healthcare System, c. 1918-1945.},
journal = {Social history of medicine : the journal of the Society for the Social History of Medicine},
volume = {37},
number = {4},
pages = {737-757},
doi = {10.1093/shm/hkae052},
pmid = {40236471},
issn = {0951-631X},
abstract = {In the months after March 2020, people across Britain began to seek medical attention for protracted illness following an infection with coronavirus disease 2019. Through the efforts of patients, these illnesses were eventually gathered into the diagnostic category of 'Long Covid' and therefore viewed as viral sequelae, in turn opening up the possibility for medical care and treatment in the British health system. This article adds to such patient-made knowledge of Long Covid through a comparative historical analysis with the problem of 'Post-Encephalitis' Lethargica (EL). In the early twentieth century, the viral sequelae of EL were parsed in line with and thus shaped by the binary divisions that were becoming used to structure healthcare in Britain. By telling this story of the past, this article provides a framework to understand if and how such administrative divisions within the National Health Service (NHS) might continue to inform perceptions of and responses to Long Covid in the present.},
}

@article {pmid40235692,
year = {2025},
author = {Radhakrishna, K and Holland, J and O'Keeffe, F and Gaynor, K and Kinsella, J and Bramham, J},
title = {Analysis of the A-B Neuropsychological Assessment Schedule as a Cognitive Screener for Long COVID.},
journal = {Cureus},
volume = {17},
number = {4},
pages = {e82311},
pmid = {40235692},
issn = {2168-8184},
abstract = {Aim To determine the sensitivity and specificity of the psychometric measures of the A-B Neuropsychological Assessment Schedule (ABNAS) to aid screening of long COVID (LC). Methods The participants (N=235) were recruited from an online study of cognitive and psychological consequences of LC, involving individuals attending an LC service in an acute tertiary university hospital and a comparison sample of community controls.The ABNAS for LC, a patient-perceived assessment scale in relation to the challenges they had encountered from LC, was used to identify the specific psychometric measures implicated in LC. Results The optimal cut-off value for total ABNAS scores and its psychometric subsets were obtained from receiver operating characteristic (ROC) curves. The sensitivity of the total ABNAS score of ≥21.5 was 81.6% for LC, taken as a post-COVID functional status (PCFS)grade of ≥ 2 as true positives, with a specificity = 72.3%. The specificity of the ABNAS fatigue subscale score of ≥ 8.5 for LC was 87.2%, while its sensitivity was 66.7%. The sensitivity of the ABNAS mental slowing subscale score of ≥ 4.5 was 82.8%, and the specificity was 70.3%. Conclusion Total ABNAS scores and their psychometric subsets (fatigue and mental slowing) are sensitive and specific for LC.},
}

@article {pmid40234933,
year = {2025},
author = {Makovski, TT and Steichen, O and Rushyizekera, M and van den Akker, M and Coste, J},
title = {Relationship between multimorbidity, SARS-COV-2 infection and long COVID: a cross-sectional population-based French survey.},
journal = {BMC medicine},
volume = {23},
number = {1},
pages = {222},
pmid = {40234933},
issn = {1741-7015},
mesh = {Humans ; Female ; France/epidemiology ; *COVID-19/epidemiology/complications ; Cross-Sectional Studies ; Male ; Middle Aged ; *Multimorbidity ; Adult ; Aged ; SARS-CoV-2 ; Post-Acute COVID-19 Syndrome ; Prevalence ; },
abstract = {BACKGROUND: Understanding the risks of COVID-19-related consequences for vulnerable groups such as people with multimorbidity is crucial to better tailor health care and public health measures. The main objective of this study was to explore the association between multimorbidity and WHO-defined post-COVID condition (PCC), while also considering the association with SARS-COV-2 infection given that the infection is a prerequisite of PCC.

METHODS: This population-representative cross-sectional study was conducted in the general adult population in mainland France between 29 August and 31 December 2022 (N = 1813). The analyses of the association between multimorbidity (defined as disease count and most prevalent dyads/triads) and PCC or SAR-COV-2 infection were adjusted for age, sex, socioeconomic variables and number of infections (for PCC only) using adjusted Poisson regression with robust variance.

RESULTS: The study population had a mean age (SD) of 53 (± 18.5) years, while 53.6% were women. The likelihood of SARS-COV-2 infection increased with disease count but was only significant for ≥ 4 diseases. Five dyads and one triad presented a higher risk; almost all included anxiety. The likelihood of PCC increased with disease count, prevalence ratios (PRs) (95% CI) for 1, 2-3 and ≥ 4 diseases versus 0 were 1.90 (1.16-3.13), 3.32 (2.07-5.35) and 5.65 (3.41-9.38), respectively, and for 19 of 26 most prevalent dyads and the triad. The association was strongest for cardiac rhythm disorder and either low back pain (PR (95%CI) 4.17 (2.03-8.53)) or anxiety (PR (95%CI) 3.73 (1.98-7.01)).

CONCLUSIONS: Multimorbidity, most frequently in combination with anxiety or low back pain, presented a significant association with PCC beyond that of SARS-CoV-2 infection underscoring the importance of implementing strategies to prevent and manage persistent symptoms in vulnerable groups.},
}

Humans
Female
France/epidemiology
*COVID-19/epidemiology/complications
Cross-Sectional Studies
Male
Middle Aged
*Multimorbidity
Adult
Aged
SARS-CoV-2
Post-Acute COVID-19 Syndrome
Prevalence

@article {pmid40234823,
year = {2025},
author = {Yan, D and Liu, Y and Chen, R and Zhou, L and Wang, C and Ma, AHY and Chen, X and Song, Q and Qian, G},
title = {Follow-up of long COVID based on the definition of WHO: a multi-centre cross-sectional questionnaire-based study.},
journal = {BMC public health},
volume = {25},
number = {1},
pages = {1412},
pmid = {40234823},
issn = {1471-2458},
support = {XGZ2301//Academy Level Project of the First Affiliated Hospital of Ningbo University/ ; Evaluation of the effect of traditional Chinese medicine on the elderly patients with severe coronavirus disease 2019//Zhejiang Province Traditional Chinese Medicine Science and Technology Project/ ; LTGG23H260002//Zhejiang Provincial Natural Science Foundation of China/ ; Y23H190011//Zhejiang Provincial Natural Science Foundation of China/ ; 2023QL055//Youth Science and Technology Innovation Leading Talent project of Ningbo/ ; },
mesh = {Humans ; Female ; Male ; *COVID-19/epidemiology/complications ; Middle Aged ; Cross-Sectional Studies ; Surveys and Questionnaires ; Adult ; China/epidemiology ; Follow-Up Studies ; Aged ; World Health Organization ; Risk Factors ; Post-Acute COVID-19 Syndrome ; Young Adult ; SARS-CoV-2 ; Severity of Illness Index ; },
abstract = {BACKGROUND: Since long COVID has hindered people from normal life, it is essential to understand its full spectrum of manifestation. However, it was heterogeneous in the existing studies and few large-scale studies have been conducted on Asian populations. Here, we conducted a multi-centre questionnaire-based study among Chinese people to explore the long COVID based on the definition of WHO.

METHODS: During March 20, 2023 and June 18, 2023, individuals with a history of confirmed or self-reported SARS-CoV-2 infection were recruited from three hospitals to fill out the questionnaire for long COVID. Each symptom was assigned with 0 to 3 points based on their severity. And the long COVID score was a sum of these points of each symptom. The reporting rate, time trend and risk factors of long COVID stratified by different systems were explored.

RESULTS: 3,693 individuals were recruited for the study. The reporting rate of at least one persistent long COVID symptoms and symptoms impacting daily life was 30.2% (1,117) and 10.7% (394). Systemic symptoms (20.7%, 765) were most easily reported. The most common symptoms were fatigue (16.3%, 602), cough (6.3%, 234) and expectoration (5.5%, 203). The reporting rate of long COVID and long COVID score decreased over time during a 180-day follow-up period (P < 0.05). For long COVID, older age (OR: 1.63, 1.38-1.93), female (OR: 1.19, 1.03-1.38) and SARS-CoV-2 reinfection (OR: 3.56, 2.63-4.80) were risk factors; while number of COVID-19 vaccine doses (OR: 0.87, 0.81-0.94) was a protective factor. The use of traditional Chinese medicine (OR: 0.51, 0.37-0.71) was a protective factor for symptoms impacting daily life.

CONCLUSIONS: Early interventions should be taken to minimize the impact of long COVID, especially for the elderly, females and those with SARS-CoV-2 reinfection. COVID-19 booster vaccination might play a potential role in minimizing the impact of long COVID.},
}

Humans
Female
Male
*COVID-19/epidemiology/complications
Middle Aged
Cross-Sectional Studies
Surveys and Questionnaires
Adult
China/epidemiology
Follow-Up Studies
Aged
World Health Organization
Risk Factors
Post-Acute COVID-19 Syndrome
Young Adult
SARS-CoV-2
Severity of Illness Index

@article {pmid40234084,
year = {2025},
author = {Taylor, OL and Treneman-Evans, G and Riley, M and Bond-Kendall, J and Pike, KC},
title = {How young people experienced long covid services: a qualitative analysis.},
journal = {BMJ paediatrics open},
volume = {9},
number = {1},
pages = {},
doi = {10.1136/bmjpo-2024-003206},
pmid = {40234084},
issn = {2399-9772},
mesh = {Humans ; *COVID-19/therapy/epidemiology/psychology ; Child ; Adolescent ; Female ; Qualitative Research ; Male ; England/epidemiology ; SARS-CoV-2 ; Health Services Accessibility ; Interviews as Topic ; },
abstract = {UNLABELLED: ΒACKGROUND: After the COVID-19 pandemic, children and young people (CYP) with long covid were managed in specialist clinics. However, there is limited research on how CYP who accessed long covid clinics experienced them.

METHODS: We aimed to evaluate how acceptable paediatric long covid services were to patients. Semi-structured qualitative interviews with 13 paediatric patients were used to understand the experiences of patients with long covid. Recruited participants were aged 11-17 years old, had a long covid diagnosis, and accessed specialist paediatric service in the Southwest of England from June 2022 to September 2023. Clinicians working in the long covid clinics identified CYP who were eligible and asked their consent to be contacted by a member of the study team. All participants who consented to be involved in the study were sampled. Thematic analysis was used to extract codes and themes from the data.

RESULTS: Four themes were reported. Accessing specialist clinics helped CYP to feel validated; they appreciated consulting with clinicians who were knowledgeable about long covid and empathetic. CYP found comfort in knowing other CYP were experiencing long covid. CYP wanted to be proactive in their long covid management, appreciating regular appointments and the opportunity to learn about their condition. CYP desired normality, and therefore sought flexible appointment times, online appointments and reasonable adjustments. CYP found the waiting times to access long covid services were too long.

CONCLUSIONS: Our results stress the importance to CYP of several features of the care received in the specialist clinics. These relate to the experiences of CYP with long covid but potentially extend to CYP with other conditions, particularly long-term and/or poorly understood conditions. The results support creating community-based support groups for CYP with long-term medical conditions, providing online flexible appointments, offering early reasonable adjustments for school and providing quicker access to specialist clinics.},
}

Humans
*COVID-19/therapy/epidemiology/psychology
Child
Adolescent
Female
Qualitative Research
Male
England/epidemiology
SARS-CoV-2
Health Services Accessibility
Interviews as Topic

@article {pmid40234052,
year = {2025},
author = {Hermans, LE and Wasserman, S and Xu, L and Eikelboom, J},
title = {Long COVID prevalence and risk factors in adults residing in middle- and high-income countries: secondary analysis of the multinational Anti-Coronavirus Therapies (ACT) trials.},
journal = {BMJ global health},
volume = {10},
number = {4},
pages = {},
doi = {10.1136/bmjgh-2024-017126},
pmid = {40234052},
issn = {2059-7908},
mesh = {Humans ; Male ; Female ; *COVID-19/epidemiology/complications ; Adult ; Middle Aged ; Prevalence ; Risk Factors ; SARS-CoV-2 ; *Developed Countries/statistics & numerical data ; Aged ; Post-Acute COVID-19 Syndrome ; },
abstract = {BACKGROUND: During the recent COVID-19 pandemic, reports of long-term persistence or recurrence of symptoms after SARS-CoV-2 infection emerged, which are now collectively referred to as 'long COVID'. Most descriptions of long COVID originate from patients residing in high-income countries. We set out to characterise long COVID in a large-scale clinical trial that was conducted in low-middle, high-middle and high-income countries.

METHODS: The Anti-Coronavirus Therapies trials enrolled 6528 adult patients with symptomatic COVID-19 in Argentina, Brazil, Canada, Colombia, Ecuador, Egypt, India, Nepal, Pakistan, Philippines, Russia, Saudi Arabia, South Africa and the United Arab Emirates. Long COVID was defined as the presence of patient-reported symptoms at 180 days after enrolment. Multivariable logistic regression was used to evaluate associations of baseline characteristics with long COVID.

RESULTS: Of 4697 included participants, 1181 (25.1%) reported long COVID symptoms. The most frequently reported symptoms were sleeping disorders (n=601; 12.8%), joint pain (n=461; 9.8%), fatigue (n=410; 8.7%) and headaches (n=382; 8.1%). Long COVID prevalence was higher in participants from lower middle-income compared with high-income countries (29.8% (850/2854) vs 14.4% (102/706); adjusted OR (aOR) 1.53 (1.10 to 2.14); p=0.012). Prevalence also varied between participants of different ethnic backgrounds and was highest (36.1% (775/2145)) for patients of Arab/North African ethnicity. Patients requiring inpatient admission were at increased risk of long COVID (aOR: 2.04 (1.63 to 2.54); p<0.001). Other independent predictors of long COVID were male sex, older age and hypertension. Vaccination, prior lung disease, smoking and diabetes mellitus conferred protective effects.

CONCLUSION: Symptoms of long COVID are reported in a quarter of cases of symptomatic COVID-19 in this study and were significantly more prevalent in participants from countries with lower income status and in patients of Arab/North African ethnicity. Research to further assess the health burden posed by long COVID in low- and middle-income countries is urgently needed.},
}

Humans
Male
Female
*COVID-19/epidemiology/complications
Adult
Middle Aged
Prevalence
Risk Factors
SARS-CoV-2
*Developed Countries/statistics & numerical data
Aged
Post-Acute COVID-19 Syndrome

@article {pmid40232883,
year = {2025},
author = {Rattanawijit, M and Samutpong, A and Apiwattanakul, N and Assawawiroonhakarn, S and Techasaensiri, C and Boonsathorn, S and Chaisavaneeyakorn, S},
title = {Rates, Risk Factors and Outcomes of Complications After COVID-19 in Children.},
journal = {The Pediatric infectious disease journal},
volume = {44},
number = {5},
pages = {449-454},
doi = {10.1097/INF.0000000000004649},
pmid = {40232883},
issn = {1532-0987},
support = {P-20-50966//the National Science and Technology Development Agency, Thailand, the Royal College of Pediatricians of Thailand and Pediatric Society of Thailand/ ; },
mesh = {Humans ; *COVID-19/complications/epidemiology ; Child ; Child, Preschool ; Male ; Adolescent ; Female ; Infant ; Risk Factors ; Retrospective Studies ; Prospective Studies ; SARS-CoV-2 ; *Systemic Inflammatory Response Syndrome/epidemiology/etiology ; Infant, Newborn ; },
abstract = {BACKGROUND: Coronavirus disease 2019 (COVID-19) can lead to various complications, including multisystem inflammatory syndrome in children (MIS-C) and post-COVID-19 conditions (long COVID). This study aimed to determine the rates, risk factors and outcomes of MIS-C and long COVID in children previously diagnosed with COVID-19.

METHODS: This study was a combined retrospective and prospective cohort study. Patients 0-18 years of age diagnosed with COVID-19 or another respiratory virus infection were enrolled between October 2021 and April 2022. Demographic and clinical data were reviewed. Information on persisting symptoms and their impacts were recorded at 1-3, 3-6 and 6-12 months after infection. Laboratory investigations and chest imaging examinations were performed during follow-up. MIS-C and long COVID were defined according to the Centers for Disease Control and Prevention (CDC) and World Health Organization (WHO) definitions.

RESULTS: A total of 618 patients were enrolled, comprising 437 (70.7%) with COVID-19 and 181 (29.3%) with another respiratory virus infection. At 1-3 months, the rate of persisting symptoms was 16.5% in patients with COVID-19, compared with 1.1% in patients with another respiratory virus infection. The rate of MIS-C was 0.7%. The rate of long COVID according to the CDC and WHO definitions were 20.4% and 13.0%, respectively. Respiratory systems were most affected in long COVID. Age 5-18 years, anosmia during COVID-19, history of pneumonia and infection during the delta and omicron waves were associated with long COVID in children.

CONCLUSIONS: Long COVID after COVID-19 in children is uncommon. Children with anosmia and a history of pneumonia during COVID-19 require follow-up for long COVID.},
}

Humans
*COVID-19/complications/epidemiology
Child
Child, Preschool
Male
Adolescent
Female
Infant
Risk Factors
Retrospective Studies
Prospective Studies
SARS-CoV-2
*Systemic Inflammatory Response Syndrome/epidemiology/etiology
Infant, Newborn

@article {pmid40231351,
year = {2025},
author = {Le, GH and Kwan, ATH and Guo, Z and Dev, DA and Wong, S and Badulescu, S and Ceban, F and Teopiz, KM and Johnson, DE and Gill, H and Di Vincenzo, JD and Meshkat, S and Rhee, TG and Ho, R and Phan, L and Rosenblat, JD and Mansur, RB and Subramaniapillai, M and McIntyre, RS},
title = {Impact of Fatigue on Subjective and Objective Cognitive Functions in Persons with Post-COVID-19 Condition.},
journal = {Clinical nursing research},
volume = {},
number = {},
pages = {10547738251329412},
doi = {10.1177/10547738251329412},
pmid = {40231351},
issn = {1552-3799},
abstract = {Post-COVID-19 condition (PCC) is a serious debilitating condition that develops after the resolution of an acute infection of severe acute respiratory syndrome-associated coronavirus 2. Some commonly reported symptoms include fatigue and cognitive deficits. Multiple lines of evidence have indicated fatigue to be associated with cognitive deficits in the general population. Herein, we perform a secondary analysis of the effects of fatigue on subjective and objective cognition in persons with PCC using a generalized linear model. In this study, fatigue was measured using the Fatigue Severity Scale (FSS) and cognition was measured using the Digit-Symbol Substitution Test (DSST) and the Trails Making Test parts A and B (TMT-A/B). FSS had a statistically significant negative correlation with DSST and TMT-A/B scores. Fatigue serves as a possible target for the development of PCC therapeutics. Fatigue and cognition correlates should be further investigated for underlying neurobiological substrates in persons with PCC.},
}

@article {pmid40231214,
year = {2025},
author = {Serafini, RA and Frere, JJ and Giosan, IM and Nwaneshiudu, CA},
title = {SARS-CoV-2-induced sensory perturbations: A narrative review of clinical phenotypes, molecular pathologies, and possible interventions.},
journal = {Brain, behavior, & immunity - health},
volume = {45},
number = {},
pages = {100983},
pmid = {40231214},
issn = {2666-3546},
abstract = {BACKGROUND: The acute and post-acute sequelae of SARS-CoV-2 infection have been of great clinical interest since the inception of the COVID-19 pandemic. Despite a high prevalence of individuals with persistent symptoms, a wholistic view of the effects of SARS-CoV-2 on special sensory systems is lacking. Considering the significant impact of normal sensory function on quality of life, the goal of this review is to highlight unresolved issues related to SARS-CoV-2-associated insults to the sensory nervous system.

MAJOR FINDINGS: In this narrative review, we discuss the epidemiology of SARS-CoV-2-induced sensory perturbations, underlying pathological mechanisms, and possible therapeutic strategies across the olfactory, gustatory, somatosensory, visual, and auditory systems. Examined literature included studies with human biospecimens, human-derived cell lines, and naturally susceptible animal models, which highlighted evidence of persistent functional disruption in all sensory systems. SARS-CoV-2 infection was associated with persistent inflammation in the olfactory epithelium/bulb, somatosensory ganglia, and gustatory systems, long-term transcriptional perturbations in the sensory central nervous system and peripheral nervous system, and detectable degeneration/apoptosis in the gustatory and visual systems. Few studies have proposed evidence-based therapeutic strategies for attenuating specific sensory abnormalities after SARS-CoV-2 infection.

CONCLUSION: While the olfactory system, and to some extent the visual and somatosensory systems, have been more thoroughly investigated from symptomatology, behavioral and molecular perspectives, there is still an unmet need for the development of therapeutics to treat COVID-induced impairment of these systems. Further, additional attention must be placed on COVID-associated impairment of the gustatory, visual, and auditory systems, which lack detailed mechanistic investigations into their pathogenesis.},
}

@article {pmid40230744,
year = {2025},
author = {Gupta, A and Rajan, V and Aravindakshan, R and Sirisha, P},
title = {Unmasking the Long-Term Effects of COVID-19 With a Focus on Chronic Fatigue Syndrome: A Community-Based Study From India.},
journal = {Cureus},
volume = {17},
number = {3},
pages = {e80597},
pmid = {40230744},
issn = {2168-8184},
abstract = {Background The COVID-19 pandemic has highlighted the enduring health burden of long COVID, scientifically termed the postacute sequelae of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection or PASC. Long COVID manifests as diverse symptoms affecting multiple organ systems, significantly impacting individuals globally, and especially underrepresented rural populations. Objective This study aimed to evaluate the prevalence of chronic fatigue syndrome (CFS) among laboratory-confirmed COVID-19 patients in rural India, focusing on identifying its predictors and the implications for healthcare systems in resource-limited settings. Methodology Retrospective data analysis was conducted on the follow-up visits of post-COVID-19 patients in the field practice area of AIIMS Mangalagiri, Nuthakki, Andhra Pradesh, India. The study involved 500 COVID-19 survivors diagnosed via reverse transcription polymerase chain reaction (RT-PCR) between 2023 and 2024. Data was collected via a semi-structured questionnaire to retrieve socio-demographic and clinical parameters, while CFS severity was assessed using a validated scoring system. Multivariable logistic regression and path analysis were used to examine the associations between the predictors of CFS. Results The prevalence of CFS was seen in 107 patients (21.4%; 95% CI: 18.01-25.22). Risk factors included older age (adjusted odds ratio or aOR: 15.90 for ≥60 years), female gender (aOR: 1.90), and comorbidities (aOR: 3.92). Common symptoms observed were fatigue in 180 (36%), joint pain in 185 (37%), and muscle pain in 182 (36.4%) patients. There was no significant association between vaccination and CFS. Conclusion The study underscores the substantial burden of post-COVID fatigue in rural populations, with female patients, older adults, and those with comorbidities being at greater risk. Tailored healthcare interventions and proactive post-COVID monitoring are critical to address this challenge. Future research should explore the underlying mechanisms and assess the role of vaccination in mitigating the post-COVID sequelae.},
}

@article {pmid40230626,
year = {2025},
author = {Musachia, J and Radosta, J and Ukwade, D and Rizvi, S and Wahba, R},
title = {Postacute Sequelae From SARS-CoV-2 at the University of Illinois Hospital and Clinics: An Examination of the Effects of Long COVID in an Underserved Population Utilizing Manual Extraction of Electronic Health Records.},
journal = {American journal of medicine open},
volume = {13},
number = {},
pages = {100095},
pmid = {40230626},
issn = {2667-0364},
abstract = {BACKGROUND: Although there has been a steady decrease in morbidity and mortality from the SARS-CoV-2 virus since the 2020-2021 period, thousands of Americans are still infected with the virus daily. Some proportion of these infected individuals will go on to develop postacute sequelae from SARS-CoV-2 (PASC, or Long COVID), manifesting symptoms 4 weeks or more after recovery from COVID-19. PASC and its underlying pathophysiology are still poorly described and understood. Although hundreds of peer-reviewed, published investigations on Long COVID exist, few have focused on underserved urban patient populations. Most of the published research has involved reviews of diagnostic codes from electronic health records, or responses to questionnaires.

METHODS: We sought to review Long COVID in an underserved population in Chicago, and to go beyond electronic health record reviews of diagnostic codes, utilizing in-depth chart reviews, gleaned via manual extraction, focusing on notations of care providers. We investigated which specific preexisting conditions, if any, might be associated with specific Long COVID symptomatology's, and if any preexisting conditions predicted Long COVID. Study participants included 204 Long COVID patients, 98 COVID-19-positive patients, and 104 healthy (no history of COVID-19 infection) patients from an inner-city health system caring for underserved communities, whose records were reviewed via manual data extraction from electronic health records, focusing on provider notes in patient charts.

RESULTS: Our Long COVID symptom frequencies were distinct compared to frequencies from other reviews that did not focus on underserved populations and done with medical records when only diagnostic codes are utilized. Preexisting medical conditions did not predict similar Long COVID symptomologies, save for the significant association between preexisting cough/dyspnea/pulmonary conditions and preexisting migraine/headache and their analogous Long COVID symptoms.

CONCLUSIONS: The odds of having Long COVID increased comparatively in subjects hospitalized with COVID-19, subjects with BMI >30, and female subjects.},
}

@article {pmid40230529,
year = {2025},
author = {Zhang, Y and Ye, G and Zeng, W and Zhu, R and Li, C and Zhu, Y and Li, D and Liu, J and Wang, W and Li, P and Fan, L and Wang, R and Niu, X},
title = {Segregation and integration of resting-state brain networks in a longitudinal long COVID cohort.},
journal = {iScience},
volume = {28},
number = {4},
pages = {112237},
pmid = {40230529},
issn = {2589-0042},
abstract = {Long COVID is characterized by debilitating fatigue, likely stemming from abnormal interactions among brain regions, but the neural mechanisms remain unclear. Here, we utilized a nested-spectral partition (NSP) approach to study the segregation and integration of resting-state brain functional networks in 34 patients with long COVID from acute to chronic phase post infection. Compared to healthy controls, patients with long COVID exhibited significantly higher fatigue scores and shifted the brain into a less segregated state at both 1 month and 3 months post infection. During the recovery of fatigue severity, there was no significant difference of segregation/integration. A positive correlation between network integration and fatigue was observed at 1 month, shifting to a negative correlation by 3 months. Gene Ontology analysis revealed that both acute and long-term effects of fatigue were associated with abnormal social behavior. Our findings reveal the brain network reconfiguration trajectories during post-viral fatigue progression that serve as functional biomarkers for tracking neurocognitive sequelae.},
}

@article {pmid40228860,
year = {2025},
author = {Delfino, C and Carcel, C and Lin, X and Muñoz-Venturelli, P and Naismith, SL and Woodward, M and Peters, R and Wijesuriya, N and Law, M and Harding, IH and Wang, X and Elliott, J and Leder, K and Hutchings, O and Stecher, X and Zoungas, S and Anderson, CS},
title = {STatin TReatment for COVID-19 to Optimise NeuroloGical recovERy (STRONGER): study protocol for a randomised, open label clinical trial in patients with persistent neurological symptoms after COVID-19 infection.},
journal = {BMJ open},
volume = {15},
number = {4},
pages = {e089382},
pmid = {40228860},
issn = {2044-6055},
mesh = {Humans ; *Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use ; *COVID-19/complications ; *Atorvastatin/therapeutic use ; *COVID-19 Drug Treatment ; SARS-CoV-2 ; Quality of Life ; Prospective Studies ; Randomized Controlled Trials as Topic ; Male ; Female ; *Nervous System Diseases/drug therapy ; Adult ; Middle Aged ; Multicenter Studies as Topic ; Cognition/drug effects ; },
abstract = {INTRODUCTION: Increasing awareness of the high frequency, wide spectrum and disabling nature of symptoms that can persist following COVID-19 infection has prompted the investigation of management strategies. Our study aims to determine the effectiveness of atorvastatin on cognitive function, physical activity, mood, health-related quality of life and features of neurovascular impairment and neuroinflammation in adults with ongoing neurological symptoms after COVID-19 infection.

METHODS AND ANALYSIS: The STatin TReatment for COVID-19 to Optimise NeuroloGical recovERy study is an ongoing international, investigator-initiated and conducted, multicentre, prospective, randomised, open label, blinded endpoint trial with fixed time points for outcome assessments. A total of 410 participants with long covid neurological symptoms were planned to be randomly assigned to either the intervention group to receive 40 mg atorvastatin for 12 months or to a control group of no treatment, on top of usual care.

ETHICS AND DISSEMINATION: This study protocol was designed, implemented and reported, in accordance with the International Conference on Harmonisation guidelines for Good Clinical Practice, the National Health and Medical Research Council of Australia, the National Statement on Ethical Conduct in Human Research and with the ethical principles laid down in the World Medical Association Declaration of Helsinki. Central ethics committee approval was obtained from Sydney Local Health District Royal Prince Alfred Hospital Ethics (No: X21-0113 and 2021/ETH00777 10) in Australia. Site-specific ethics committee approvals were obtained elsewhere before any local study activities. All participants provided written informed consent.

TRIAL REGISTRATION NUMBER: The study protocol is registered at Clinicaltrials.gov (NCT04904536).},
}

Humans
*Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use
*COVID-19/complications
*Atorvastatin/therapeutic use
*COVID-19 Drug Treatment
SARS-CoV-2
Quality of Life
Prospective Studies
Randomized Controlled Trials as Topic
Male
Female
*Nervous System Diseases/drug therapy
Adult
Middle Aged
Multicenter Studies as Topic
Cognition/drug effects

@article {pmid40228859,
year = {2025},
author = {Kjellberg, A and Hassler, A and Boström, E and El Gharbi, S and Al-Ezerjawi, S and Schening, A and Fischer, K and Kowalski, JH and Rodriguez-Wallberg, KA and Bruchfeld, J and Ståhlberg, M and Nygren-Bonnier, M and Runold, M and Lindholm, P},
title = {Ten sessions of hyperbaric oxygen versus sham treatment in patients with long covid (HOT-LoCO): a randomised, placebo-controlled, double-blind, phase II trial.},
journal = {BMJ open},
volume = {15},
number = {4},
pages = {e094386},
pmid = {40228859},
issn = {2044-6055},
mesh = {Humans ; Female ; Double-Blind Method ; Male ; Middle Aged ; Adult ; *COVID-19/therapy/complications ; *Hyperbaric Oxygenation/methods ; *Quality of Life ; Sweden ; SARS-CoV-2 ; Treatment Outcome ; Adolescent ; Young Adult ; },
abstract = {OBJECTIVES: To evaluate if 10 sessions of hyperbaric oxygen treatments (HBOTs) improve short- and long-term health related quality of life, symptoms and physical performance in long covid patients compared with placebo.

DESIGN: Parallel, randomised, placebo-controlled, double-blind trial.

SETTING: Single-centre, university hospital, Sweden.

PARTICIPANTS: Previously healthy subjects aged 18-60 years, diagnosed with long covid were included. We excluded pregnant women, patients with RAND-36 (role limitations due to physical health (RP) and physical functioning (PF)) above 70, diabetes, hypertension and contraindications for HBOT.

INTERVENTIONS: Subjects were randomly assigned to 10 sessions of HBOT or sham (placebo) treatments over 6 weeks. HBOT involved 100% oxygen, 2.4 bar, 90 min, placebo medical air, 1.34-1.2 bar. Randomisation (1:1) was done electronically, in blocks stratified by sex and disease severity. Subjects and investigators were blinded to allocation.

Primary endpoints were changes from baseline in RAND-36 PF and RP at 13 weeks. Efficacy was analysed on an intention-to-treat basis. Harms were evaluated according to the actual treatment given.

RESULTS: Between 15 September 2021 and 20 June 2023, 80 subjects (65 women, 15 men) were enrolled and randomised (40 in each group). The trial is completed. The primary endpoint analysis included 79 subjects (40 in HBOT and 39 in control). At 13 weeks, both groups showed improvement, with no significant difference between HBOT and placebo in PF (least square mean difference between groups (LSD), 0.63 (95% CI -7.04 to 8.29), p=0.87) and RP (LSD, 2.35 (95% CI -5.95 to 10.66), p=0.57).

HARMS: 43 adverse events (AEs), most commonly cough and chest pain/discomfort, occurred in 19 subjects (49%) of the HBOT group and 38 AEs in 18 subjects (44%) of the placebo group, one serious AE in HBOT and one death in the placebo group.

CONCLUSIONS: 10 HBOT sessions did not show more short-term benefits than placebo for long covid patients. Both groups improved, with a notable sex difference. HBOT has a favourable harm profile.

TRIAL REGISTRATION NUMBER: ClinicalTrials.gov (NCT04842448), EudraCT (2021-000764-30). The trial was funded by Vetenskapsrådet (2022-00834), Region Stockholm (2020-0731, 2022-0674), Hjärt-Lungfonden and OuraHealth Oy.},
}

Humans
Female
Double-Blind Method
Male
Middle Aged
Adult
*COVID-19/therapy/complications
*Hyperbaric Oxygenation/methods
*Quality of Life
Sweden
SARS-CoV-2
Treatment Outcome
Adolescent
Young Adult

@article {pmid40227084,
year = {2025},
author = {Ottaway, Z and Campbell, L and Fox, J and Burns, FM and Hamzah, L and Schoeman, S and Price, D and Clarke, A and Pett, SL and Onyango, D and Sabin, C and Miller, RF and Post, FA and , },
title = {Post-acute sequelae of COVID-19 in people of Black ethnicities living with HIV in the United Kingdom.},
journal = {International journal of STD & AIDS},
volume = {},
number = {},
pages = {9564624251334227},
doi = {10.1177/09564624251334227},
pmid = {40227084},
issn = {1758-1052},
abstract = {BackgroundThe COVID-19 pandemic disproportionately affected people of Black ethnicities, however, there are limited data on the post-acute sequelae of COVID-19 infection in these populations, and none in those with HIV.MethodsWe conducted a cross-sectional study in people of Black ethnicities with HIV in the UK. Participants were assessed for functional impairment, frailty, respiratory symptoms, anxiety and depression; they were also asked to rate aspects of their physical and mental health on a scale from 1 (poor) to 10 (excellent), both at enrolment and prior to the pandemic. We report associations with COVID-19 history and recovery status.ResultsWe enrolled 183 participants between June 2021 and October 2022, 131 (72%) of whom reported COVID-19. A history of COVID-19 was associated with a reduced ability to carry out usual activities (OR 2.54 [1.03-6.21], p = 0.04), an increase in pain, tiredness and breathlessness, and overall decline in physical health. Of those with a history of COVID-19, 111 (85%) reported to have fully recovered. Those who had not fully recovered reported poorer functional status (p < 0.001) and had higher generalised anxiety scores (p = 0.02). Objective measures of physical function were similar in those who reported no COVID-19, COVID-19 with full recovery, and COVID-19 with incomplete recovery.ConclusionsIn this cohort of Black people with HIV, participants with a history of COVID-19 reported a reduced ability to carry out activities of daily living and various other health issues. Although most people reported full recovery from COVID-19, self-reported limitations in functional status and anxiety were common sequelae.},
}

@article {pmid40226780,
year = {2025},
author = {Zhang, H and Yang, P and Gu, X and Sun, Y and Zhang, R and Zhang, D and Zhang, J and Wang, Y and Ma, C and Liu, M and Ma, J and Li, A and Wang, Y and Ma, X and Cui, X and Wang, Y and Liu, Z and Wang, W and Zheng, Z and Li, Y and Wu, J and Wang, Q and Cao, B},
title = {Health outcomes one year after Omicron infection among 12,789 adults: a community-based cross-sectional study.},
journal = {The Lancet regional health. Western Pacific},
volume = {56},
number = {},
pages = {101507},
pmid = {40226780},
issn = {2666-6065},
abstract = {BACKGROUND: Characterizing the paradigm and impact of long COVID is crucial for addressing this worldwide health challenge. This study aimed to investigate the prevalence of long COVID one year after primary Omicron infection and characterize differences in long-term health consequence between participants with persistent long COVID and those who fully recovered.

METHODS: This a community-based cross-sectional study conducted from December 2023 to March 2024 at the China-Japan Friendship Hospital and 16 administrative districts in Beijing. 12,789 participants infected with Omicron between December 2022 and January 2023 were recruited through stratified multistage random sampling and included in the final analysis. Of them, 376 participants with persistent long COVID and 229 without long COVID were matched for further physical examinations. The primary outcome was the prevalence of long COVID one year after infection. Secondary outcomes included muscle strength, exercise capacity, health-related quality of life (HRQoL), mental health, work status, laboratory tests, and examinations.

FINDINGS: Among 12,789 participants (media [IQR] age, 48.4 [37.3 to 61.4] years; 7817 females [61.1%]), 995 of them (7.8%) experienced long COVID within one year, with 651 (5.1%) having persistent symptoms. Fatigue (598/995 [60.1%]) and post-exertional malaise (367/995 [36.9%]) were the most common symptoms. Brain fog had the lowest resolution proportion as 4.2% within one year. The odds of long COVID increased with reinfections (odds ratios for one reinfection 2.592 [95% CI: 2.188 to 3.061]; two or more: 6.171 [3.227 to 11.557]; all p < 0.001). Participants with persistent long COVID had markedly lower muscle strength (upper-limb: 26.9 ± 12.4 vs. 29.1 ± 14.5 Kg; lower-limb: 40.0 [27.0 to 62.0] vs. 43.0 [28.0 to 59.0] s), worse exercise capacity and poorer HRQoL, and meaningful difference in laboratory tests results compared to those without long COVID. They also exhibited significantly higher proportions of abnormal lung function (FEV1 %pred<80%: 13.0% vs. 2.0%; DLco %pred<80%: 32.7% vs. 19.9%) and lung imaging abnormalities (23.5% vs. 13.6%).

INTERPRETATION: The considerable health burden of long COVID and the progression of neurological symptoms following Omicron infection warrant close monitoring. Utilizing professional questionnaires and developing reliable diagnostic tools are necessary for improving diagnosis and treatment of long COVID.

FUNDING: This work was supported by Beijing Research Center for Respiratory Infectious Diseases (BJRID2024-012), Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences (2022-I2M-CoV19-005/CIFMS 2021-I2M-1-048), the National Natural Science Foundation of China (82241056/82200114/82200009), the New Cornerstone Science Foundation.},
}

@article {pmid40226209,
year = {2025},
author = {de Assumpção, LECC and Romeo, BGP and Guerra, JCC and Camargo, LFA and Nagaoka, MA and Amgarten, DE and Dorlass, EG and Petroni, RC and Cardoso, ACA and Ruiz, RM and Bittante, CD and Teich, VD and Pinho, JRR and Doi, AM},
title = {Case report: Persistent COVID-19 in a patient with B cell lymphoma refractory to antiviral treatment due to resistance to Remdesivir.},
journal = {IDCases},
volume = {40},
number = {},
pages = {e02199},
pmid = {40226209},
issn = {2214-2509},
abstract = {BACKGROUND: There is a significant concern of the pandemic impact of SARS-CoV-2 infection in immunocompromised patients. These patients can develop long COVID-19 due to impairment of cellular and humoral immunity. On the other hand, prolonged infection can lead to mutations in the SARS CoV-2 genome that can impact on the resistance to antiviral therapy. Remdesivir cases have been reported in patients receiving antiviral drug treatment.

CASE PRESENTATION: A 46-year-old male with previous mantle cell lymphoma resolved by autologous bone marrow transplantation without other comorbidities had SARS-CoV-2 detected in February 2022 and received the recommended antiviral treatment with Remdesivir. COVID-19 evolved in four months with worsening of the symptoms, despite an initial rapid improvements and high RT-PCR Ct values. The patient was relieved from hospital care stable and well but still maintaining positive test results.

CONCLUSIONS: the patient presented prolonged COVID-19 with persistence of virus detected by RT-PCR for several months. The strain sequenced presented a mutation different from all reported previously. Although it was no possible to sequence the initial strain without these mutations, our data suggests that immunocompromised patient with prolonged COVID-19 may serve as reservoir for strains of SARS-CoV-2 with resistant components in his genome.},
}

@article {pmid40224556,
year = {2025},
author = {Carpio-Orantes, LD},
title = {From long COVID to neurodegeneration.},
journal = {Brain circulation},
volume = {11},
number = {1},
pages = {94-95},
pmid = {40224556},
issn = {2455-4626},
}

@article {pmid40223754,
year = {2025},
author = {Chuang, CH and Wang, YH and Yeh, LT and Yeh, CB},
title = {Long-Term Stroke and Mortality Risk Reduction Associated With Acute-Phase Paxlovid Use in Mild-to-Moderate COVID-19.},
journal = {Journal of medical virology},
volume = {97},
number = {4},
pages = {e70351},
doi = {10.1002/jmv.70351},
pmid = {40223754},
issn = {1096-9071},
support = {//This study was supported by Chung Shan Medical University Hospital./ ; },
mesh = {Humans ; Male ; Female ; Middle Aged ; Aged ; Retrospective Studies ; *COVID-19/mortality/complications ; *COVID-19 Drug Treatment ; Adult ; *Stroke/prevention & control/mortality ; Aged, 80 and over ; SARS-CoV-2 ; Risk Factors ; *Antiviral Agents/therapeutic use ; United States/epidemiology ; },
abstract = {This retrospective cohort study investigated whether Paxlovid (nirmatrelvir/ritonavir) use during the acute phase of mild-to-moderate COVID-19 reduces the risk of ischemic or hemorrhagic stroke occurring more than 3 months post-diagnosis, a condition classified as long COVID. Utilizing TriNetX electronic health records comprising 118 million patients in the United States, adults aged 18 years or older with confirmed COVID-19 diagnoses from 2022 to 2023 were categorized into Paxlovid (administered within 5 days of diagnosis) and non-Paxlovid groups. Exclusion criteria included prior cerebrovascular disease, mortality within 3 months, use of specific antivirals, and severe clinical conditions such as ICU admission, intubation, mechanical support, SpO2 < 90%, respiratory rate > 30/min, sepsis, systemic inflammatory response syndrome, and acute respiratory distress syndrome. The index date was the initial COVID-19 diagnosis. Propensity score matching in a 1:1 ratio controlled for confounding factors, and stroke (ischemic or hemorrhagic) and mortality were analyzed using Kaplan-Meier survival curves and Cox proportional hazards models. Among 181 992 matched pairs, Paxlovid use was associated with a significantly reduced risk of ischemic and hemorrhagic stroke (hazard ratio [HR] 0.85; 95% confidence interval [CI]: 0.80-0.89) and all-cause mortality (HR 0.68; 95% CI: 0.63-0.73) during the long COVID period, defined as more than 90 days post-diagnosis. Subgroup analyses demonstrated consistent protective effects across age, sex, BMI, comorbidities such as hypertension, diabetes, and hyperlipidemia, and vaccination status. Notably, older adults (HR 0.81; 95% CI: 0.76-0.86) and individuals with metabolic conditions, including obesity (HR 0.86; 95% CI: 0.78-0.96), exhibited pronounced benefits, and the protective effects were observed irrespective of vaccination status. These findings highlight that Paxlovid use during the acute phase of COVID-19 significantly reduces the risk of long-term cerebrovascular events and mortality, emphasizing its critical role in mitigating long-term complications associated with COVID-19.},
}

Humans
Male
Female
Middle Aged
Aged
Retrospective Studies
*COVID-19/mortality/complications
*COVID-19 Drug Treatment
Adult
*Stroke/prevention & control/mortality
Aged, 80 and over
SARS-CoV-2
Risk Factors
*Antiviral Agents/therapeutic use
United States/epidemiology

@article {pmid40223130,
year = {2025},
author = {Coste, J and Delpierre, C and Robineau, O and Rushyizekera, M and Richard, JB and Alleaume, C and Gallay, A and Tebeka, S and Steichen, O and Lemogne, C and Makovski, TT},
title = {A multidimensional network of factors associated with long COVID in the French population.},
journal = {Communications medicine},
volume = {5},
number = {1},
pages = {114},
pmid = {40223130},
issn = {2730-664X},
abstract = {BACKGROUND: Various factors associated with long COVID have been evidenced, but the heterogeneity of definitions and epidemiological investigations has often hidden risk pathways relevant for understanding and preventing this condition.

METHODS: This nationwide random sampling survey conducted in France after the Omicron waves in autumn 2022 assessed eight sets of factors potentially associated with long COVID in a structured epidemiological investigation based on a conceptual model accounting for the relationships between these sets of factors. A representative sample of 1813 adults of whom 55% were infected with SARS-CoV-2 was assessed for infection dates and context, post-COVID symptoms and these factors. Four definitions of long COVID, including the World Health Organisation's, were used.

RESULTS: Female sex, household size (≥2), low financial security, negative impact of COVID-19 pandemic on occupation and work conditions, number of comorbidities (≥2), presence of respiratory disease, mental and sensory disorders, number of SARS-CoV-2 infections (≥2) and initial symptoms (≥6), perceived high severity of COVID-19 are positively and consistently associated with long COVID. Age ≥ 75 years, retirement, SARS-CoV-2 vaccination (≥2 doses) and good perceived information regarding long Covid are negatively associated with the condition.

CONCLUSIONS: The broad spectrum of factors confirmed here strongly suggests that long COVID should be regarded not only as a direct complication of SARS-CoV-2 infection but also as driven by a broader network of contextual, medical, psychological and social factors. These factors should be better considered in strategies aimed at limiting the long COVID burden in the general population.},
}

@article {pmid40222950,
year = {2025},
author = {Angelhoff, C and Jedenfalk, M and Fernlund, E and Svensson, E and Duchen, K and Ertzgaard, P},
title = {Development and Validation of POCOKIDS-Q-A Questionnaire to Assess Post COVID-19 Symptoms in Children.},
journal = {Acta paediatrica (Oslo, Norway : 1992)},
volume = {},
number = {},
pages = {},
doi = {10.1111/apa.70094},
pmid = {40222950},
issn = {1651-2227},
support = {//The Joanna Cocozza Foundation for Children's Medical Research/ ; FORSS-994671//Forskningsrådet i Sydöstra Sverige/ ; //Majblommans Riksförbund/ ; //Henry and Ella Margareta Ståhls Stiftelse/ ; },
abstract = {AIM: To identify the symptom burden in children and adolescents with post COVID-19, a validated and reliable instrument is needed, particularly to assess symptoms and their impact on the child. The aim of this study was to describe the development, validation, and reliability of the Post COVID-19 in Kids Questionnaire (POCOKIDS-Q), which was designed to assess post COVID-19 symptoms in children and adolescents.

METHODS: The POCOKIDS-Q was developed based on literature, clinical experience, and questionnaires for adults with post COVID-19. The linguistic validation involved 9- to 17-year-old children. Children and adolescents with the onset of post COVID-19 symptoms were asked to complete the final version through a web link. Exploratory and confirmatory factor analyses were performed to identify a factor structure that explains the covariances between the variables.

RESULTS: The link to the POCOKIDS-Q was opened 324 times and fully completed by 213 (66%) children and young adults (median age 14 years) with post COVID-19 symptoms. Confirmatory factor analyses revealed four significant and correlated factors: brain fatigue, cognitive impact, physical impact, and emotional impact. The explanatory power of the factor model is high.

CONCLUSION: The POCOKIDS-Q is applicable for assessing post COVID-19 symptoms in children and young adults.},
}

@article {pmid40221847,
year = {2025},
author = {Sarma, N and Gage, S and Hough, CL and Hope, AA},
title = {'We Don't Have to Prove to People How We're Feeling': Understanding the Role of Peer Support Groups in Countering Epistemic Injustices in Long COVID at a US Centre.},
journal = {Health expectations : an international journal of public participation in health care and health policy},
volume = {28},
number = {2},
pages = {e70266},
pmid = {40221847},
issn = {1369-7625},
support = {//Dr. Hope is supported by grants from the NIH/NHLBI (K01 HL140279)./ ; },
mesh = {Humans ; *COVID-19/psychology ; Female ; Male ; *Peer Group ; Middle Aged ; Qualitative Research ; *Self-Help Groups ; Adult ; Interviews as Topic ; SARS-CoV-2 ; Aged ; Chronic Disease/psychology ; *Social Justice/psychology ; },
abstract = {BACKGROUND: Long COVID, an infection-associated chronic condition characterised by new or worsening signs or symptoms for more than 3 months after a SARS-CoV-2 infection, is a chronic debilitating illness which remains poorly understood. Epistemic injustice in healthcare describes the unique harms or wrongs done to a person in their capacity to share and acquire knowledge about their illness. Although the concept of epistemic injustice has been described in other chronic conditions, few studies have explored these concepts in Long COVID.

OBJECTIVES: (1) To understand the lived experience of epistemic injustice in adults with Long COVID who were participating in a peer support group intervention and (2) to describe the potential impact of the support group on these experiences in participants.

METHODS: Qualitative analysis utilising inductive analysis of semi-structured individual interviews of patients with Long COVID who participated in a peer support group intervention at an academic medical centre in Oregon, USA.

RESULTS: We identified three themes that captured the lived experiences of epistemic injustice in Long COVID support group participants: (1) dismissal and disregard; (2) episodic and unpredictable symptoms and impairment, and (3) knowledge and interpretation practices. We also found that the peer support potentially impacted these experiences of epistemic injustice through (1) recognition and validation; (2) solidarity and community, and (3) information exchange and expectation setting.

CONCLUSIONS: Long COVID patients are at risk of experiencing epistemic injustice in seeking healthcare for this complex condition. Peer support programmes may be one approach to help counter these experiences and should be further studied as a complex intervention for improving patient-centred care in Long COVID.},
}

Humans
*COVID-19/psychology
Female
Male
*Peer Group
Middle Aged
Qualitative Research
*Self-Help Groups
Adult
Interviews as Topic
SARS-CoV-2
Aged
Chronic Disease/psychology
*Social Justice/psychology

@article {pmid40221694,
year = {2025},
author = {Chepo, M and Martin, S and Déom, N and Khalid, AF and Vindrola-Padros, C},
title = {Mind the gap: examining policy and social media discourse on Long COVID in children and young people in the UK.},
journal = {BMC public health},
volume = {25},
number = {1},
pages = {1373},
pmid = {40221694},
issn = {1471-2458},
support = {MR/W029766/1//MRC-UKRI Better Methods, Better Research/ ; MR/W029766/1//MRC-UKRI Better Methods, Better Research/ ; MR/W029766/1//MRC-UKRI Better Methods, Better Research/ ; MR/W029766/1//MRC-UKRI Better Methods, Better Research/ ; MR/W029766/1//MRC-UKRI Better Methods, Better Research/ ; },
mesh = {Humans ; *Social Media ; *COVID-19/epidemiology ; United Kingdom/epidemiology ; Child ; *Health Policy ; Adolescent ; *Policy Making ; },
abstract = {BACKGROUND: Long COVID in children and young people (CYP) has posed significant challenges for health systems worldwide. Despite its impact on well-being and development, policies addressing the needs of CYP remain underdeveloped. This study examines UK Long COVID policies using ethical frameworks, integrating policy and social media analyses to explore public and professional concerns.

METHODS: A mixed-methods approach was applied. Policy documents were reviewed using Thompson et al.'s pandemic preparedness framework and Campbell and Carnevale's child-inclusive ethical model. Social media discourse (12,650 posts) was analysed using Brandwatch™ to identify key themes around CYP and Long COVID policies. Data was collected and triangulated through the LISTEN method, which integrates policy analysis with social media discourse to ensure a holistic understanding of systemic gaps and public perceptions.

RESULTS: Analysis highlighted gaps in accountability, inclusiveness, and transparency in policy development. Social media data reflected significant public dissatisfaction, primarily critiquing government accountability (90% of posts) and delayed policy responsiveness (29% of posts). Key ethical challenges included limited CYP representation and unequal access to services.

CONCLUSIONS: Recommendations include improving transparency, incorporating CYP perspectives in policymaking, and ensuring equitable access to care. These findings provide a foundation for ethically sound and inclusive policies addressing Long COVID in CYP.},
}

Humans
*Social Media
*COVID-19/epidemiology
United Kingdom/epidemiology
Child
*Health Policy
Adolescent
*Policy Making

@article {pmid40219044,
year = {2025},
author = {Marchesi, N and Allegri, M and Bruno, GM and Pascale, A and Govoni, S},
title = {Exploring the Potential of Dietary Supplements to Alleviate Pain Due to Long COVID.},
journal = {Nutrients},
volume = {17},
number = {7},
pages = {},
pmid = {40219044},
issn = {2072-6643},
mesh = {Humans ; *Dietary Supplements ; *COVID-19/complications ; SARS-CoV-2 ; *Chronic Pain/etiology ; Analgesics/therapeutic use ; *Pain Management/methods ; Post-Acute COVID-19 Syndrome ; *Pain/etiology/drug therapy ; },
abstract = {Long COVID, characterized by persistent symptoms following COVID-19 infection, significantly impacts individuals' health and daily functioning due to fatigue and pain. Focusing on pain, this review addresses nociplastic and chronic pain conditions. Interventions designed to reduce inflammation, oxidative stress, and enhance vagal activity may offer a promising approach to managing post-pandemic pain. This review presents individual components of food supplements with demonstrated efficacy in one or more pain conditions, focusing on their proposed mechanisms and clinical activity in pain, including their use in post-COVID-19 pain when available. Many of these substances have a long history of safe use and may offer an alternative to long-term analgesic drug treatment, which is often associated with potential side effects. This review also explores the potential for synergistic effects when combining these substances with each other or with conventional analgesics, considering the advantages for both patients and the healthcare system in using these substances as adjunctive or primary therapies for pain symptoms related to long COVID. While preclinical scientific literature provides a mechanistic basis for the action of several food supplements on pain control mechanisms and signaling pathways, clinical experience, particularly in the field of long COVID-associated pain, is still limited. However, the reviewed literature strongly suggests that the use of food supplements in long COVID-associated pain is an attainable goal, provided that rigorous clinical trials are conducted.},
}

Humans
*Dietary Supplements
*COVID-19/complications
SARS-CoV-2
*Chronic Pain/etiology
Analgesics/therapeutic use
*Pain Management/methods
Post-Acute COVID-19 Syndrome
*Pain/etiology/drug therapy

@article {pmid40218944,
year = {2025},
author = {Umsumarng, S and Semmarath, W and Arjsri, P and Srisawad, K and Intanil, I and Jamjod, S and Prom-U-Thai, C and Dejkriengkraikul, P},
title = {Anthocyanin-Rich Fraction from Kum Akha Black Rice Attenuates NLRP3 Inflammasome-Driven Lung Inflammation In Vitro and In Vivo.},
journal = {Nutrients},
volume = {17},
number = {7},
pages = {},
pmid = {40218944},
issn = {2072-6643},
support = {FF059/2567//Fundamental Fund 2024, Chiang Mai University, Thailand/ ; },
mesh = {*Anthocyanins/pharmacology ; *NLR Family, Pyrin Domain-Containing 3 Protein/metabolism ; Animals ; Humans ; *Inflammasomes/metabolism/drug effects ; Mice, Inbred C57BL ; *Oryza/chemistry ; A549 Cells ; *Plant Extracts/pharmacology ; Mice ; *Pneumonia/drug therapy/metabolism ; *Anti-Inflammatory Agents/pharmacology ; Disease Models, Animal ; Male ; Lipopolysaccharides ; Lung/drug effects/pathology ; },
abstract = {BACKGROUND/OBJECTIVES: Chronic lower respiratory tract inflammation can result from exposure to bacterial particles, leading to the activation of the NLRP3 inflammasome pathway. These effects may cause irreversible respiratory damage, contributing to persistent lung injury and chronic obstructive pulmonary disease (COPD), as observed in long COVID or bacterial pneumonia in older adults' patients. Given its profound impact, the NLRP3 inflammasome has emerged as a key therapeutic target for mitigating aberrant inflammatory responses.

METHODS: In this study, we investigated the anti-inflammatory effects of Kum Akha black rice, a functional food, on the attenuation of NLRP3 inflammasome pathway using lipopolysaccharide-induced A549 lung epithelial cells and a C57BL/6NJcl mouse model. The anthocyanin-rich fraction from Kum Akha black rice germ and bran extract (KA1-P1) was obtained using a solvent-partitioned extraction technique.

RESULTS: KA1-P1 exhibited a high anthocyanin content (74.63 ± 1.66 mg/g extract) as determined by the pH differential method. The HPLC analysis revealed cyanidin-3-O-glucoside (C3G: 45.58 ± 0.48 mg/g extract) and peonidin-3-O-glucoside (P3G: 6.92 ± 0.29 mg/g extract) as its anthocyanin's active compounds. Additionally, KA1-P1 demonstrated strong antioxidant activity, as assessed by DPPH and ABTS assays. KA1-P1 (12.5-100 μg/mL) possessed inhibitory effects on LPS + ATP-induced A549 lung cells inflammation through the significant suppressions of NLRP3, IL-6, IL-1β, and IL-18 mRNA levels and the inhibition of cytokine secretions in a dose-dependent manner (p < 0.05). Mechanistic analysis revealed that KA1-P1 downregulated key proteins in the NLRP3 inflammasome pathway (NLRP3, ASC, pro-caspase-1, and cleaved-caspase-1). Furthermore, in vivo studies demonstrated that KA1-P1 significantly diminished LPS-induced lower respiratory inflammation in C57BL/6NJcl mice, as evidenced by the reduced bronchoalveolar lavage fluid and blood levels of inflammatory cytokines (IL-6, IL-1β, and IL-18) and diminished histopathological inflammatory lung lesions.

CONCLUSIONS: Overall, our findings suggest that the anti-inflammatory properties of KA1-P1 may support its application as a functional supplement or promote the consumption of pigmented rice among the elderly to mitigate chronic lower respiratory tract inflammation mediated by the NLRP3 inflammasome pathway.},
}

*Anthocyanins/pharmacology
*NLR Family, Pyrin Domain-Containing 3 Protein/metabolism
Animals
Humans
*Inflammasomes/metabolism/drug effects
Mice, Inbred C57BL
*Oryza/chemistry
A549 Cells
*Plant Extracts/pharmacology
Mice
*Pneumonia/drug therapy/metabolism
*Anti-Inflammatory Agents/pharmacology
Disease Models, Animal
Male
Lipopolysaccharides
Lung/drug effects/pathology

@article {pmid40218919,
year = {2025},
author = {Ayats-Vidal, R and Albiciuc, IA and Bruch-Molist, C and Cuartero-Gorjón, A and Cordobilla, B and Pedrosa-Domínguez, M and Susanna-Calero, M and García-González, M and Valdesoiro-Navarrete, L and Larramona-Carrera, H and Asensio-de la Cruz, O and Castro-Marrero, J and Domingo, JC},
title = {Erythrocyte Fatty Acid Profile, Mediterranean Diet and Asthma Severity in Childhood Allergic Asthma: Preliminary Findings from a Cohort Study in Spain.},
journal = {Nutrients},
volume = {17},
number = {7},
pages = {},
pmid = {40218919},
issn = {2072-6643},
support = {2022 SEICAP//Spanish Society of Clinical Immunology, Allergology and Pediatric Asthma/ ; },
mesh = {Humans ; *Asthma/blood/epidemiology ; *Diet, Mediterranean ; Male ; Female ; Child ; Spain/epidemiology ; *Erythrocytes/chemistry/metabolism ; Cross-Sectional Studies ; Prospective Studies ; Severity of Illness Index ; Fatty Acids, Omega-3/blood ; *Fatty Acids/blood ; Adolescent ; Cohort Studies ; Child, Preschool ; },
abstract = {Background: Allergic asthma incidence is increasing, probably due to the influence of the Western diet. Adherence to the Mediterranean diet (MedDi) and omega-3 fatty acids composition (n-3 PUFAs) may be linked to a lower prevalence and lower severity of childhood asthma; however, the association is inconclusive. This study aims to examine the relationship between adherence to the MedDi, asthma severity, and erythrocyte fatty acid profile in Spanish children with atopic asthma. Methods: This study was based on an ongoing single-center, prospective, cross-sectional cohort study involving 95 consecutively enrolled children from an outpatient tertiary referral center. Of these, 55 had atopic asthma and 40 were age-matched healthy controls. Blood samples were collected to analyze the erythrocyte fatty acid content. Participants' demographic and clinical characteristics were recorded using validated self-reported outcome measures. Asthma severity and pulmonary function were assessed. Results: Asthmatics presented poorer adherence to the MedDi (p = 0.034) and lower n-3 PUFA levels (p = 0.019). Asthmatics with poor adherence to the MedDi were more likely to be overweight (p = 0.001) and to have moderate-severe asthma (p = 0.049); and lower n-3 PUFAs levels (p = 0.033). Children with mild asthma had higher n-3 PUFAs levels than those with moderate or severe asthma (p = 0.036). Conclusions: These findings highlight that adherence to the MedDi and a high erythrocyte fatty acid profile seem to have a protective effect in childhood asthma. Future well-controlled interventions should focus on the effects of MedDi patterns and n-3 PUFA intake on the primary prevention of childhood asthma.},
}

Humans
*Asthma/blood/epidemiology
*Diet, Mediterranean
Male
Female
Child
Spain/epidemiology
*Erythrocytes/chemistry/metabolism
Cross-Sectional Studies
Prospective Studies
Severity of Illness Index
Fatty Acids, Omega-3/blood
*Fatty Acids/blood
Adolescent
Cohort Studies
Child, Preschool

@article {pmid40218114,
year = {2025},
author = {Gölz, LA and Poß-Doering, R and Merle, U and Wensing, M and Stengel, S},
title = {Patient Perspectives on the Care in a Long COVID Outpatient Clinic-A Regional Qualitative Analysis from Germany.},
journal = {Healthcare (Basel, Switzerland)},
volume = {13},
number = {7},
pages = {},
doi = {10.3390/healthcare13070818},
pmid = {40218114},
issn = {2227-9032},
support = {no grant number//Ministry of Science, Research and Arts of the State of Baden-Wuerttemberg; Germany/ ; },
abstract = {Background/Objectives: Long COVID specialized outpatient clinics (sOCs), which are part of the recommended long COVID care, usually face high demand. Few studies focused on the experience of care in such facilities in Germany. This study investigated how patients experience care in a sOC at a German university hospital. Methods: Semi-structured interviews were conducted with patients attending this clinic between October 2022 and January 2023. Data analysis was based on thematic analysis. Results: The themes from interviews with 14 patients (F = 11, M = 3) could be broadly categorized into statements on the pathway to the sOC, and statements on care provided in the sOC. Findings show that patients' high expectations at the sOC appointment were shaped by previous experiences with care, which were mainly perceived as inadequate. Care in the sOC was predominantly perceived as competent, empathetic and relevant for further care and coping with the disease. A deterioration in health directly related to the consultation (classifiable as post-exertional malaise) was frequently described, as was a high need for ongoing consultation. Conclusions: Overall, the findings point to a need for adaptations in the sOC, such as identifying optimized models of care and tailoring them to the patients' limited resources. This includes measures to improve care outside the sOC.},
}

@article {pmid40217997,
year = {2025},
author = {Bassem, A and Hussein, A and Sharawe Taha, MA and El Sayed, SM and Sadek, EM and AlRasheed, HA and Bahaa, MM and Kamal, M},
title = {Persistent Symptoms and Associated Risk Factors of COVID-19: A Cross-Sectional Study in Minia, Upper Egypt.},
journal = {Healthcare (Basel, Switzerland)},
volume = {13},
number = {7},
pages = {},
doi = {10.3390/healthcare13070699},
pmid = {40217997},
issn = {2227-9032},
abstract = {Background: A significant number of COVID-19 survivors around the world have been reporting persistent symptoms following their recovery. Long COVID is recognized as a condition affecting not only the respiratory but also the gastrointestinal, cardiovascular, neurological, immune, and hematopoietic systems. Objective: This study aimed to describe persistent symptoms in COVID-19 survivors six months post-infection in Minia, Upper Egypt, and investigate associated risk factors. Methods: This observational cross-sectional study included 189 hospitalized and non-hospitalized patients previously diagnosed with COVID-19. Demographic data, symptom severity, comorbidities, and persistent symptoms were collected. A logistic regression analysis was used to identify risk factors associated with long COVID, with statistical significance set at p < 0.05. Results: In total, 68.8% of participants were women, and 83.5% of patients reported at least one ongoing symptom. The most self-reported symptoms were fatigue (73.5%) and myalgia (45.5%), followed by dyspnea (43.3%). Age was associated with an increased risk of developing long COVID (OR 1.028, 95% CI 1.003-1.054, p = 0.030). Patients who were hospitalized during the acute phase had more than twice the risks of having persistent symptoms (OR 2.384, 95% CI 1.055-5.387, p = 0.037). Conclusions: A substantial proportion of COVID-19 survivors in Minia, Upper Egypt, continues to experience persistent symptoms, primarily constitutional and neurological manifestations. Many patients reported self-medicating with unprescribed antibiotics, highlighting a need for public awareness regarding viral infections and the risks associated with improper antibiotic use.},
}

@article {pmid40217157,
year = {2025},
author = {Seixas, AFAM and Marcolino, MS and Guimarães, FS and Rocha, GM and Menezes, AC and Silva, HKC and Cardoso, CS},
title = {Exploring the landscape of long COVID: prevalence and associated factors in patients assisted by a telehealth service.},
journal = {BMC infectious diseases},
volume = {25},
number = {1},
pages = {509},
pmid = {40217157},
issn = {1471-2334},
mesh = {Humans ; Female ; Male ; *COVID-19/epidemiology/complications ; Middle Aged ; Adult ; Cross-Sectional Studies ; *Telemedicine ; Prevalence ; SARS-CoV-2 ; Aged ; Comorbidity ; Risk Factors ; Young Adult ; Post-Acute COVID-19 Syndrome ; },
abstract = {INTRODUCTION: Long COVID is a condition that occurs in patients with a previous history of COVID-19, and symptoms that cannot be explained by another diagnosis persist.

OBJECTIVE: To evaluate the prevalence of long COVID and associated factors in patients treated with a public telehealth service during acute COVID-19.

METHOD: This was a cross-sectional study involving users of a COVID-19 telehealth service offered during the critical phase of the pandemic, called TeleCOVID-MG. Individuals older than 18 years of age who tested positive for SARS-CoV-2 and were monitored during social isolation were eligible. Prevalence was calculated, and descriptive analysis and group comparisons (patients with and without long COVID symptoms) were performed in addition to logistic regression with odds ratios and 95% confidence intervals.

RESULTS: Among the 699 patients included in the study, 60.8% were women aged between 30 and 49 years (44.6%) and had a high school education (46.5%). The main comorbidities were hypertension (20.9%), diabetes (8.3%), and heart disease (3.9%). The incidence of long COVID was 26.8% (95% CI: 23.5; 30.1). Cognitive symptoms (49.7%), chronic diarrhea (49.2%), and cough (40.6%) were the most persistent symptoms. Female sex (OR: 2.51), secondary education (OR: 2.13), elementary education (OR: 2.81), monthly income between 600 and 1,000 USD (OR: 5.85), supplementary health assistance (OR: 1.98), anosmia during acute COVID-19 (OR: 4.52) and need for in-person care (OR: 2.44) were factors associated with a higher incidence of long COVID.

CONCLUSION: Long COVID affected almost one-third of the study population. Although the COVID-19 pandemic is under control, the virus continues to infect individuals, raising doubts about the long-term complications of the disease.},
}

Humans
Female
Male
*COVID-19/epidemiology/complications
Middle Aged
Adult
Cross-Sectional Studies
*Telemedicine
Prevalence
SARS-CoV-2
Aged
Comorbidity
Risk Factors
Young Adult
Post-Acute COVID-19 Syndrome

@article {pmid40215369,
year = {2025},
author = {Greaves, K and King, A and Bourne, Z and Welsh, J and Morgan, M and Tolosa, MX and Johnston, T and Bonner, C and Stanton, T and Korda, R},
title = {Consent to recontact for future research using linked primary healthcare data: Outcomes and general practice perceptions from the ATHENA COVID-19 study.},
journal = {Clinical trials (London, England)},
volume = {22},
number = {2},
pages = {188-199},
doi = {10.1177/17407745241304094},
pmid = {40215369},
issn = {1740-7753},
mesh = {Humans ; *COVID-19/epidemiology ; *Primary Health Care ; *Informed Consent ; Male ; Queensland/epidemiology ; Female ; Middle Aged ; *General Practice ; Adult ; Aged ; *Patient Selection ; SARS-CoV-2 ; Clinical Trials as Topic ; },
abstract = {BACKGROUND: The ATHENA COVID-19 study was set up to recruit a cohort of patients with linked health information willing to be recontacted in future to participate in clinical trials and also to investigate the outcomes of people with COVID-19 in Queensland, Australia, using consent. This report describes how patients were recruited, their primary care data extracted, proportions consenting, outcomes of using the recontact method to recruit to a study, and experiences interacting with general practices requested to release the primary care data.

METHODS: Patients diagnosed with COVID-19 from 1 January 2020 to 31 December 2020 were systematically approached to gain consent to have their primary healthcare data extracted from their general practice into a Queensland Health database and linked to other datasets for ethically approved research. Patients were also asked to consent to allow future recontact to discuss participation in clinical trials and other research studies. Patients who consented to recontact were later approached to recruit to a long-COVID study. Patients' general practices were contacted to export the patient files. All patient and general practice interactions were recorded. Outcome measures were proportions of patients consenting to data extraction and research, permission to recontact, proportions of general practices agreeing to participate. A thematic analysis was conducted to assess attitudes regarding export of healthcare data, and the proportions consenting to participate in the long-COVID study were also reported.

RESULTS: Of 1212 patients with COVID-19, contact details were available for 1155; 995 (86%) were successfully approached, and 842 (85%) reached a consent decision. Of those who reached a decision, 581 (69%), 615 (73%) and 629 (75%) patients consented to data extraction, recontact, and both, respectively. In all, 382 general practices were contacted, of whom 347 (91%) had an electronic medical record compatible for file export. Of these, 335 (88%) practices agreed to participate, and 12 (3%) declined. In total, 526 patient files were exported. The majority of general practices supported the study and accepted electronic patient consent as legitimate. For the long-COVID study, 376 (90%) of those patients recontacted agreed to have their contact details passed onto the long-COVID study team and 192 (53%) consented to take part in their study.

CONCLUSION: This report describes how primary care data were successfully extracted using consent, and that the majority of patients approached gave permission for their healthcare information to be used for research and be recontacted. The consent-to-recontact concept demonstrated its effectiveness to recruit to new research studies. The majority of general practices were willing to export identifiable patient healthcare data for linkage provided consent had been obtained.},
}

Humans
*COVID-19/epidemiology
*Primary Health Care
*Informed Consent
Male
Queensland/epidemiology
Female
Middle Aged
*General Practice
Adult
Aged
*Patient Selection
SARS-CoV-2
Clinical Trials as Topic

@article {pmid40215290,
year = {2025},
author = {Medeiros, RS and Neves, L and Sousa, I and Pereira, BD},
title = {Arginine-vasopressin deficiency due to long COVID-associated infundibulo-neurohypophysitis.},
journal = {Archives of endocrinology and metabolism},
volume = {68},
number = {},
pages = {e240168},
doi = {10.20945/2359-4292-2024-0168},
pmid = {40215290},
issn = {2359-4292},
mesh = {Humans ; *COVID-19/complications ; Male ; Middle Aged ; *Diabetes Insipidus, Neurogenic/etiology/diagnosis ; *Arginine Vasopressin/deficiency ; SARS-CoV-2 ; },
abstract = {Long COVID is defined by the occurrence of signs, symptoms, and conditions that develop after COVID-19 and may affect several organs and systems. Arginine-vasopressin deficiency (AVP-D; central diabetes insipidus) is a very rare complication of COVID-19 and SARS-CoV-2 immunization. Case reports, original studies, and reviews on AVP-D and long COVID published until February 2024 were retrieved from PubMed. A 47-year-old man presented with polydipsia, polyuria, memory loss, and mental fog 8 weeks after an episode of mild COVID-19. His past personal and family medical history were unremarkable. Biochemical evaluation was relevant for low urine osmolality and a 24-hour urine volume of 10,350 mL. Basal anterior pituitary evaluation was normal. A water deprivation test was started and interrupted after 2 hours due to the development of hypernatremia, high serum osmolality, and low urine osmolality. Urine osmolality significantly increased after intranasal desmopressin 20 μg. Contrast-enhanced pituitary MRI was suggestive of infundibulo-neurohypophysitis. Further biochemical, genetic, and imaging tests excluded secondary AVP-D causes.The patient was subsequently started on oral desmopressin, showing prompt response. After a follow-up of 20 months, he remained well-controlled with isolated AVP-D. Although molecular and histologic confirmation of SARS-CoV-2 infundibulo-neurohypophysitis could not be investigated, a strong temporal relationship and the absence of an alternative diagnosis rendered plausible the inclusion of AVP-D in the myriad of long COVID manifestations. Further studies with patients recovered from COVID-19 are necessary for a better understanding of the epidemiology, pathophysiology, and clinical course of this very rare endocrine condition.},
}

Humans
*COVID-19/complications
Male
Middle Aged
*Diabetes Insipidus, Neurogenic/etiology/diagnosis
*Arginine Vasopressin/deficiency
SARS-CoV-2

@article {pmid40215236,
year = {2025},
author = {J, VK and Koshy, JM and S, D and Narreddy, S and Gowri S, M and Rupali, P and Sathyendra, S},
title = {Prevalence and predictors of long COVID at 1 year in a cohort of hospitalized patients: A multicentric qualitative and quantitative study.},
journal = {PloS one},
volume = {20},
number = {4},
pages = {e0320643},
pmid = {40215236},
issn = {1932-6203},
mesh = {Humans ; Male ; *COVID-19/epidemiology/complications ; Female ; Middle Aged ; Prevalence ; Adult ; Quality of Life ; Hospitalization ; SARS-CoV-2/isolation & purification ; India/epidemiology ; Post-Acute COVID-19 Syndrome ; Risk Factors ; Aged ; },
abstract = {INTRODUCTION: According to WHO long COVID is defined as a 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. We followed up patients after an episode of acute COVID-19 for 1 year after hospital discharge from different parts of India.

METHODS: This was a multi-centric study among patients ≥18 years hospitalized with COVID-19, which recruited patients at 6 weeks after hospital discharge (baseline). Quantitative data on demographics, pre-existing co-morbidities, risk factors, signs and symptoms and hospital parameters during acute COVID-19 infection were noted at baseline. They were followed up and data collected telephonically thereafter at 3-6, 6-9 and 9-12 months regarding self-reported persistence of symptoms. A qualitative component included face to face in-depth interviews to elicit information on perceived health problems, quality of life and financial burden due to COVID-19.

RESULTS: A total of 315 patients were enrolled, with the majority being males (59.4%). The median age was 52 years (IQR 40, 63). The prevalence of long COVID was 16.5%. At 6 weeks and 12 months, 35.2% and 25.9% of patients, reported more than one new symptom that affected their quality of life. Shortness of breath was common at each time point, persistent muscle pain and weakness waxed and waned. Variables at 6 weeks post discharge (baseline) such as shortness of breath (OR 2.22 CI 1.06-4.65, p = <0.05), cough (OR 6.93, CI 2.36-20.30, p = <0.05), fatigue (OR 2.34, CI 1.05-5.23, p = <0.05), and weight loss (OR 2.90, CI 1.30-6.49, p = <0.05) were significantly associated with long COVID.

CONCLUSION: We found that long COVID was noted in 16.5% patients who self reported non - recovery at 1 year. Physical symptoms, mental health issues and mobility were persistent in a significant number of patients following an initial recovery from an acute COVID-19 infection. In 25.9% of patients more than 1 symptom was reported at 1 year after COVID-19. We urgently need therapeutic interventions which can improve the quality of life in these patients.},
}

Humans
Male
*COVID-19/epidemiology/complications
Female
Middle Aged
Prevalence
Adult
Quality of Life
Hospitalization
SARS-CoV-2/isolation & purification
India/epidemiology
Post-Acute COVID-19 Syndrome
Risk Factors
Aged

@article {pmid40212283,
year = {2025},
author = {Brodwall, EM and Selvakumar, J and Havdal, LB and Sommen, S and Berven, LL and Cvejic, E and Bratholm Wyller, VB and Pedersen, M},
title = {Predictors of fatigue progression in long COVID among young people.},
journal = {Brain, behavior, & immunity - health},
volume = {45},
number = {},
pages = {100982},
pmid = {40212283},
issn = {2666-3546},
abstract = {Long COVID, or post-COVID-19 condition (PCC), has emerged as a significant health concern, with fatigue being the most prevalent persistent symptom among young people. However, research on predictors of fatigue progression in young populations is limited. This study aimed to investigate factors during acute SARS-CoV-2 infection that could predict fatigue progression between six and 12 months post-infection in a cohort of young people with chronic fatigue following COVID-19. Data from the Long-Term Effects of COVID-19 in Adolescents (LoTECA) project were analyzed. A total of 93 participants (mean age 18.5 years, 84 % female) with chronic fatigue at six months, completed the 12-month follow-up. Multivariate analyses identified non-European ethnicity, higher interferon gamma (IFN-γ) levels, and lower RR-interval (higher resting heart rate) during acute infection as significant predictors of fatigue progression from six to 12 months. These three factors explained 21 % of the variance in the fatigue score, highlighting the importance of ethnicity, immune response, and autonomic function in the trajectory of long COVID fatigue. Early identification and targeted interventions, particularly for ethnic minorities and those with specific immune or autonomic markers during acute infection, may be helpful in reducing long-term fatigue. Further research is needed to explore treatment strategies for affected young populations.},
}

@article {pmid40217361,
year = {2024},
author = {Hao, X and Zhang, Q and Zhong, C and Li, E and Jiang, Y and Xu, J and Li, Y and Zhou, D and Yan, B},
title = {Frequency and risk factors of psychological distress among individuals with epilepsy before and during the outbreak of the SARS-CoV-2 Omicron variant in China: an online questionnaire survey.},
journal = {Acta epileptologica},
volume = {6},
number = {1},
pages = {2},
pmid = {40217361},
issn = {2524-4434},
support = {2022YFC2503801//the National Key R&D Program of China/ ; 2023-110//the Cadre Health Care Project of the Sichuan Provincial Department of Health/ ; HXHL21032//West China Nursing Discipline Development Special Fund Project, Sichuan University/ ; },
abstract = {BACKGROUND: The COVID-19 pandemic substantially increases the risk of severe psychological distress among people with epilepsy (PWE), especially those with monthly household income < 5000 RMB or with uncontrolled seizures. Patients with Kessler scores > 12 should consult a psychiatrist, especially during major disasters. This study was aimed to compare the frequency of psychological distress among Chinese PWE before and during the outbreak of the SARS-CoV-2 Omicron variant, and to identify risk factors for such distress.

METHODS: In this prospective study, we collected sociodemographic data of PWE aged > 14 years, who were treated at our center during December 1 to 15, 2022. All participants completed the 6-item Kessler Psychological Distress Scale before the outbreak and again during the outbreak. Health visitors who were unrelated to those patients during the outbreak were included as a control. Multivariate logistic regression analysis was performed to identify risk factors of severe psychological distress and its exacerbation.

RESULTS: Of the 223 PWE, 127 were tested positive for SARS-CoV-2, while 174 of 218 controls were positive for SARS-CoV-2. The neurological symptoms were similar between PWE and controls with SARS-CoV-2. The average Kessler score of PWE was significantly higher during the outbreak than before it (9.93 ± 3.98 vs. 8.52 ± 0.23, P < 0.001). The average score of controls during the outbreak (5.146 ± 0.35, P < 0.001) was significantly lower than that of the PWE. We identified three independent predictors for severe psychological distress in PWE during the outbreak, i.e., monthly household income < 5000 RMB (OR = 0.252, 95%CI 0.064-0.998, P = 0.048), severe psychological distress before the outbreak (OR = 0.067, 95%CI 0.026-0.174, P < 0.001), and seizure onset within 30 days before the assessment during the outbreak (OR = 0.356, 95%CI 0.157-0.805, P = 0.013). Of the three predictors, the last one was also an independent predictor for exacerbation of psychological distress during the outbreak (OR = 0.302, 95%CI 0.123-0.741, P = 0.009).

CONCLUSIONS: Our analysis suggests that the COVID-19 pandemic has substantially increased psychological distress of individuals with epilepsy, regardless of the viral infection or not. Various neurological symptoms similar to those of "long COVID" appeared for the first time among these individuals during the Omicron outbreak, highlighting the need for clinicians to screen carefully for this condition. Management of epilepsy during the pandemic or a similar major disaster should focus on the control of seizures and maintenance of mental health, especially among those with monthly household incomes below 5000 RMB, suffering uncontrolled seizures and having a history of severe psychological distress.},
}

@article {pmid40212158,
year = {2025},
author = {Abbas, AH and Haji, MR and Shimal, AA and Kurmasha, YH and Al-Janabi, AAH and Azeez, ZT and Al-Ali, ARS and Al-Najati, HMH and Al-Waeli, ARA and Abdulhadi, NASA and Al-Tuaama, AZH and Al-Ashtary, MM and Hussin, OA},
title = {A multidisciplinary review of long COVID to address the challenges in diagnosis and updated management guidelines.},
journal = {Annals of medicine and surgery (2012)},
volume = {87},
number = {4},
pages = {2105-2117},
pmid = {40212158},
issn = {2049-0801},
abstract = {Long COVID has emerged as a significant challenge since the COVID-19 pandemic, which was declared as an outbreak in March 2020, marked by diverse symptoms and prolonged duration of disease. Defined by the WHO as symptoms persisting or emerging for at least two months post-SARS-CoV-2 infection without an alternative cause, its prevalence varies globally, with estimates of 10-20% in Europe, 7.3% in the USA, and 3.0% in the UK. The condition's etiology remains unclear, involving factors, such as renin-angiotensin system overactivation, persistent viral reservoirs, immune dysregulation, and autoantibodies. Reactivated viruses, like EBV and HSV-6, alongside epigenetic alterations, exacerbate mitochondrial dysfunction and energy imbalance. Emerging evidence links SARS-CoV-2 to chromatin and gut microbiome changes, further influencing long-term health impacts. Diagnosis of long COVID requires detailed systemic evaluation through medical history and physical examination. Management is highly individualized, focusing mainly on the patient's symptoms and affected systems. A multidisciplinary approach is essential, integrating diverse perspectives to address systemic manifestations, underlying mechanisms, and therapeutic strategies. Enhanced understanding of long COVID's pathophysiology and clinical features is critical to improving patient outcomes and quality of life. With a growing number of cases expected globally, advancing research and disseminating knowledge on long COVID remain vital for developing effective diagnostic and management frameworks, ultimately supporting better care for affected individuals.},
}

@article {pmid40212085,
year = {2025},
author = {Marques, JG and de Carvalho, BM and Guedes, LA and Costa-Abreu, MD},
title = {Pattern recognition in SARS cases: insights from t-SNE and k-means clustering applied to COVID-19 symptomatology.},
journal = {Frontiers in artificial intelligence},
volume = {8},
number = {},
pages = {1536486},
pmid = {40212085},
issn = {2624-8212},
abstract = {INTRODUCTION: Despite the end of the SARS-CoV-2 pandemic, the medical field continues to address several lasting effects, the most notable being long COVID. However, COVID-19 presents another specific challenge that complicates diagnosis: the similarity of its symptoms with those of other viral diseases, particularly among various SARS strains. This overlap makes it difficult to identify distinct and meaningful symptom patterns as they develop. This study proposes a dimensionality reduction approach combined with a clustering technique to visually analyse structural similarities among SARS-infected individuals, aiming to determine whether aspects such as case progression and diagnosis impact these patterns.

METHODS: This analysis utilised the t-Distributed Stochastic Neighbour Embedding (t-SNE) algorithm for dimensionality reduction, combined with Gower's distance to handle categorical data, and k-means clustering. The study focused on symptoms, case progression, and diagnoses of SARS-CoV-2 and unspecified SARS cases using data from the Brazilian SARS dataset for São Paulo State during 2020 and 2021. The process began with a visual analysis aimed at identifying structural patterns in the symptom data, highlighting potential similarities between COVID-19 patients and those diagnosed with unspecified SARS. Following this, an intra-cluster analysis was performed to investigate the common features that defined each cluster, providing insights into shared characteristics among grouped individuals.

RESULTS: The analysis revealed that both diagnoses share substantial similarities, particularly in the presence or absence of COVID-19-related symptoms, even when the majority of individuals were diagnosed with unspecified SARS.

DISCUSSION: The analysis is crucial, as Brazil was one of the countries most severely affected by the pandemic, experiencing profound impacts across multiple dimensions.},
}

@article {pmid40211768,
year = {2025},
author = {Gao, J and Zhao, D and Nouri, HR and Chu, HW and Huang, H},
title = {Transcriptional Regulation of Mouse Mast Cell Differentiation and the Role of Human Lung Mast Cells in Airway Inflammation.},
journal = {Immunological reviews},
volume = {331},
number = {1},
pages = {e70026},
doi = {10.1111/imr.70026},
pmid = {40211768},
issn = {1600-065X},
support = {R01AI083986/NH/NIH HHS/United States ; R01AI107022/NH/NIH HHS/United States ; R01AI150082/NH/NIH HHS/United States ; R01AI152504/NH/NIH HHS/United States ; R01AI161296/NH/NIH HHS/United States ; U19AI125357/NH/NIH HHS/United States ; },
mesh = {Animals ; Humans ; *Mast Cells/immunology/metabolism ; Cell Differentiation/genetics ; Mice ; *Lung/immunology ; Gene Expression Regulation ; Inflammation/immunology ; *COVID-19/immunology ; Transcription Factors/metabolism ; *SARS-CoV-2/immunology ; },
abstract = {Mast cells (MCs) play a critical role in allergic inflammation, anaphylaxis, and chronic inflammatory diseases such as asthma, COPD, and osteoarthritis. Dysregulated MC activation can lead to MC activation syndrome (MACS), which is observed in patients with long COVID. MCs express the high-affinity receptor for IgE and, upon activation, release mediators and cytokines that trigger anaphylactic shock and promote allergic inflammation. They also interact with epithelial and nerve cells, which are crucial in forming a complex network of cell-cell and gene-gene interactions driving chronic inflammation that can confer resistance to treatment. In this review, in the context of the literature, we focus on experiments conducted in our laboratory investigating how transcription factors and enhancers regulate genes critical in mouse MC differentiation and function related to human lung inflammation.},
}

Animals
Humans
*Mast Cells/immunology/metabolism
Cell Differentiation/genetics
Mice
*Lung/immunology
Gene Expression Regulation
Inflammation/immunology
*COVID-19/immunology
Transcription Factors/metabolism
*SARS-CoV-2/immunology

@article {pmid40211686,
year = {2025},
author = {Wohlrab, F and Eltity, M and Ufer, F and Paul, F and Scheibenbogen, C and Bellmann-Strobl, J},
title = {Autoantibody targeting therapies in post COVID syndrome and myalgic encephalomyelitis/chronic fatigue syndrome.},
journal = {Expert opinion on biological therapy},
volume = {},
number = {},
pages = {},
doi = {10.1080/14712598.2025.2492774},
pmid = {40211686},
issn = {1744-7682},
}

@article {pmid40211079,
year = {2025},
author = {Graham, F},
title = {Daily briefing: Long-COVID activists fought Trump research cuts and won - for now.},
journal = {Nature},
volume = {},
number = {},
pages = {},
doi = {10.1038/d41586-025-01115-x},
pmid = {40211079},
issn = {1476-4687},
}

@article {pmid40210986,
year = {2025},
author = {Powers, JP and McIntee, TJ and Bhatia, A and Madlock-Brown, CR and Seltzer, J and Sekar, A and Jain, N and Hornig, M and Seibert, E and Leese, PJ and Haendel, M and Moffitt, R and Pfaff, ER and , },
title = {Identifying commonalities and differences between EHR representations of PASC and ME/CFS in the RECOVER EHR cohort.},
journal = {Communications medicine},
volume = {5},
number = {1},
pages = {109},
pmid = {40210986},
issn = {2730-664X},
abstract = {BACKGROUND: Shared symptoms and biological abnormalities between post-acute sequelae of SARS-CoV-2 infection (PASC) and myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) could suggest common pathophysiological bases and would support coordinated treatment efforts. Empirical studies comparing these syndromes are needed to better understand their commonalities and differences.

METHODS: We analyzed electronic health record data from 6.5 million adult patients from the National COVID Cohort Collaborative. PASC and ME/CFS diagnostic groups were defined based on recorded diagnoses, and other recorded conditions within the two groups were used to train separate machine learning-driven computable phenotypes (CPs). The most predictive conditions for each CP were examined and compared, and the overlap of patients labeled by each CP was examined. Condition records from the diagnostic groups were also used to statistically derive condition clusters. Rates of subphenotypes based on these clusters were compared between PASC and ME/CFS groups.

RESULTS: Approximately half of patients labeled by one CP are also labeled by the other. Dyspnea, fatigue, and cognitive impairment are the most-predictive conditions shared by both CPs, whereas other most-predictive conditions are specific to one CP. Recorded conditions separate into cardiopulmonary, neurological, and comorbidity clusters, with the cardiopulmonary cluster showing partial specificity for the PASC groups.

CONCLUSIONS: Data-driven approaches indicate substantial overlap in the condition records associated with PASC and ME/CFS diagnoses. Nevertheless, cardiopulmonary conditions are somewhat more commonly associated with PASC diagnosis, whereas other conditions, such as pain and sleep disturbances, are more associated with ME/CFS diagnosis. These findings suggest that symptom management approaches to these illnesses could overlap.},
}

@article {pmid40210368,
year = {2025},
author = {Verduzco-Gutierrez, M and Fleming, TK and Azola, AM},
title = {Considerations for Long COVID Rehabilitation in Women.},
journal = {Physical medicine and rehabilitation clinics of North America},
volume = {36},
number = {2},
pages = {371-387},
doi = {10.1016/j.pmr.2024.11.009},
pmid = {40210368},
issn = {1558-1381},
mesh = {Humans ; *COVID-19/rehabilitation/epidemiology ; Female ; SARS-CoV-2 ; Post-Acute COVID-19 Syndrome ; Sex Factors ; },
abstract = {The coronavirus disease 2019 (COVID-19) pandemic has given rise to long COVID, a prolonged manifestation of severe acute respiratory syndrome coronavirus 2 infection, which presents with varied symptoms and conditions lasting beyond expected acute illness. Despite efforts, diagnostic and treatment approaches remain insufficient, particularly for women who experience higher prevalence rates. Rehabilitation professionals have played a crucial role during the pandemic. Individualized rehabilitation plans, encompassing various therapies and interdisciplinary collaborations, are essential. Addressing disparities and biological sex differences is paramount, requiring increased research, understanding, and advocacy for effective rehabilitative care tailored to all individuals affected by long COVID.},
}

Humans
*COVID-19/rehabilitation/epidemiology
Female
SARS-CoV-2
Post-Acute COVID-19 Syndrome
Sex Factors

@article {pmid40209192,
year = {2025},
author = {Yee, B and McKenzie, F and Ellison-Loschmann, L and Russell, L and Jeffreys, M},
title = {Metabolic risk factors and long COVID: a cross-sectional study in Aotearoa New Zealand.},
journal = {The New Zealand medical journal},
volume = {138},
number = {1613},
pages = {12-23},
doi = {10.26635/6965.6699},
pmid = {40209192},
issn = {1175-8716},
support = {The Ngā Kawekawe o Mate Korona | Impacts of COVID-19 in Aotearoa study was funded by the New Zealand Ministry of Health (2021; Award number: not applicable).//New Zealand Ministry of Health/ ; },
mesh = {Humans ; New Zealand/epidemiology ; *COVID-19/epidemiology ; Cross-Sectional Studies ; Male ; Female ; Middle Aged ; Adult ; Aged ; Risk Factors ; Body Mass Index ; SARS-CoV-2 ; Adolescent ; Hypertension/epidemiology ; Young Adult ; Diabetes Mellitus/epidemiology ; Heart Diseases/epidemiology ; },
abstract = {AIM: To describe the association between metabolic risk factors and the risk of developing long COVID in Aotearoa New Zealand.

METHODS: Individuals aged 16 years and above who had confirmed or probable COVID-19 before December 2021 were eligible for inclusion. Metabolic risk factors were high body mass index (BMI, ≥25kg/m2), high blood pressure, diabetes, heart disease and stroke. Logistic regression was used to estimate the association between metabolic risk factors and long COVID.

RESULTS: Of the 990 survey respondents, 21.9% met the definition of long COVID. After adjusting for socio-demographic factors, COVID-19 vaccination and hospitalisation, high BMI was strongly associated with long COVID (adjusted odds ratio [aOR] 2.35; 95% confidence interval [CI] 1.33-4.17, p=0.003). There was a suggestion of an association between heart disease and long COVID (aOR 4.31; 95% CI 0.80-23.3, p=0.090). No other metabolic factors were associated with long COVID. Among Māori, no associations were found between high BMI and long COVID compared with underweight/normal BMI.

CONCLUSION: High BMI as a risk factor adds to accumulating evidence on the aetiology of long COVID.},
}

Humans
New Zealand/epidemiology
*COVID-19/epidemiology
Cross-Sectional Studies
Male
Female
Middle Aged
Adult
Aged
Risk Factors
Body Mass Index
SARS-CoV-2
Adolescent
Hypertension/epidemiology
Young Adult
Diabetes Mellitus/epidemiology
Heart Diseases/epidemiology

@article {pmid40208885,
year = {2025},
author = {Lorman, V and Bailey, LC and Song, X and Rao, S and Hornig, M and Utidjian, L and Razzaghi, H and Mejias, A and Leikauf, JE and Brill, SB and Allen, A and Bunnell, HT and Reedy, C and Mosa, ASM and Horne, BD and Geary, CR and Chuang, CH and Williams, DA and Christakis, DA and Chrischilles, EA and Mendonca, EA and Cowell, LG and McCorkell, L and Liu, M and Cummins, MR and Jhaveri, R and Blecker, S and Forrest, CB and , },
title = {Pediatric Long COVID Subphenotypes: An EHR-based study from the RECOVER program.},
journal = {PLOS digital health},
volume = {4},
number = {4},
pages = {e0000747},
pmid = {40208885},
issn = {2767-3170},
abstract = {Pediatric Long COVID has been associated with a wide variety of symptoms, conditions, and organ systems, but distinct clinical presentations, or subphenotypes, are still being elucidated. In this exploratory analysis, we identified a cohort of pediatric (age <21) patients with evidence of Long COVID and no pre-existing complex chronic conditions using electronic health record data from 38 institutions and used an unsupervised machine learning-based approach to identify subphenotypes. Our method, an extension of the Phe2Vec algorithm, uses tens of thousands of clinical concepts from multiple domains to represent patients' clinical histories to then identify groups of patients with similar presentations. The results indicate that cardiorespiratory presentations are most common (present in 54% of patients) followed by subphenotypes marked (in decreasing order of frequency) by musculoskeletal pain, neuropsychiatric conditions, gastrointestinal symptoms, headache, and fatigue.},
}

@article {pmid40209255,
year = {2024},
author = {Luis Del, CO and Daniela, TH and Sergio, GM and Jesús, SS and Andrés, AS and Ener, LR},
title = {Reply to the letter "Clinical and epidemiological characteristics of patients with long COVID-19 in Mexico".},
journal = {Gaceta medica de Mexico},
volume = {160},
number = {6},
pages = {653-654},
doi = {10.24875/GMM.M24000950},
pmid = {40209255},
issn = {0016-3813},
}

@article {pmid40208261,
year = {2025},
author = {Ioannou, GN and Berry, K and Rajeevan, N and Li, Y and Yan, L and Huang, Y and Bui, D and Hynes, DM and Rowneki, M and Hickok, A and Niederhausen, M and Shahoumian, TA and Bohnert, A and Boyko, EJ and Korpak, A and Fox, A and Baraff, A and Iwashyna, TJ and Maciejewski, ML and Smith, VA and Berkowitz, TSZ and Pura, JA and Hebert, P and Wong, ES and O'Hare, AM and Osborne, TF and Viglianti, EM and Aslan, M and Bajema, KL},
title = {Target Trial Emulation of Severe Acute Respiratory Syndrome Coronavirus 2 Infection Versus No Infection and Risk of Post-Coronavirus Disease 2019 Conditions in the Omicron Variant Versus Prior Eras.},
journal = {Clinical infectious diseases : an official publication of the Infectious Diseases Society of America},
volume = {},
number = {},
pages = {},
doi = {10.1093/cid/ciaf087},
pmid = {40208261},
issn = {1537-6591},
support = {/CU/CSP VA/United States ; C19 21-278/HX/HSRD VA/United States ; //US Department of Veterans Affairs./ ; },
abstract = {BACKGROUND: Coronavirus disease 2019 (COVID-19) has been linked to the development of post-COVID-19 conditions (PCCs). We investigated whether severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection increases the risk of selected PCCs or death up to 1 year after infection, separately in the wild-type (WT), Alpha-transition, Delta, and Omicron eras and by vaccination status.

METHODS: We used health records of the Veterans Health Administration to emulate a hypothetical target trial of SARS-CoV-2 infection versus no infection. Veterans who tested positive for SARS-CoV-2 between March 2020 and April 2022 (n = 430 160) were matched 1:1 to veterans who had not tested positive for SARS-CoV-2. All-cause mortality and cumulative incidence of 32 potential PCCs were ascertained at 31-180 and 181-365 days after infection or matched index date.

RESULTS: From 31 to 180 days, the cumulative incidence of death and all organ-level PCCs was greater in infected versus uninfected participants, with cumulative incidence differences lower in the Omicron than in the WT era and lower in vaccinated than in unvaccinated persons. In the Omicron era, the cumulative incidence of death and most PCCs from day 181-365 were higher in infected than in uninfected participants only among unvaccinated but not among vaccinated persons.

CONCLUSIONS: Excess burden of PCCs and mortality persisted 31-180 days after infection in the Omicron era, albeit at a lower level than in the WT and Delta eras. Excess burden of mortality and most PCCs was much lower 181-365 days after infection and was observed in the Omicron era only among unvaccinated persons, suggesting a protective effect of vaccination.},
}

@article {pmid40207927,
year = {2025},
author = {Liu, J and Guo, L and Zhong, J and Wu, Y and Wang, X and Tang, X and Min, K and Yang, Y and Peng, W and Wang, Q and Ding, T and Gu, X and Zhang, H and Liu, Y and Huang, C and Cao, B and Wang, J and Ren, L and Yang, J},
title = {Proteomic Analysis of 442 Clinical Plasma Samples From Individuals With Symptom Records Revealed Subtypes of Convalescent Patients Who Had COVID-19.},
journal = {Journal of medical virology},
volume = {97},
number = {4},
pages = {e70203},
doi = {10.1002/jmv.70203},
pmid = {40207927},
issn = {1096-9071},
support = {//This work was supported by grants from the National Key R&D Program of China (2023YFC2507102), the Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences, China (CIFMS2022-I2M-1-011, CIFMS2022-I2M-2-001, CIFMS2021-I2M-1-057, CIFMS2021-I2M-1-049, CIFMS2021-I2M-1-044, CIFMS2021-I2M-1-016, CIFMS2021-I2M-1-001, 2022-I2M-CoV19-003, and CIFMS2022-I2M-JB-003), the National Natural Science Foundation of China (82341064), the Haihe Laboratory of Cell Ecosystem Innovation Fund (22HHXBSS00008 and 22HHKYZX0034), and State Key Laboratory Special Fund 2060204./ ; },
mesh = {Humans ; *COVID-19/blood ; Male ; Female ; Proteomics ; Middle Aged ; Adult ; SARS-CoV-2 ; Convalescence ; *Proteome/analysis ; Aged ; *Blood Proteins/analysis ; Young Adult ; },
abstract = {After the coronavirus disease 2019 (COVID-19) pandemic, the postacute effects of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection have gradually attracted attention. To precisely evaluate the health status of convalescent patients with COVID-19, we analyzed symptom and proteome data of 442 plasma samples from healthy controls, hospitalized patients, and convalescent patients 6 or 12 months after SARS-CoV-2 infection. Symptoms analysis revealed distinct relationships in convalescent patients. Results of plasma protein expression levels showed that C1QA, C1QB, C2, CFH, CFHR1, and F10, which regulate the complement system and coagulation, remained highly expressed even at the 12-month follow-up compared with their levels in healthy individuals. By combining symptom and proteome data, 442 plasma samples were categorized into three subtypes: S1 (metabolism-healthy), S2 (COVID-19 retention), and S3 (long COVID). We speculated that convalescent patients reporting hair loss could have a better health status than those experiencing headaches and dyspnea. Compared to other convalescent patients, those reporting sleep disorders, appetite decrease, and muscle weakness may need more attention because they were classified into the S2 subtype, which had the most samples from hospitalized patients with COVID-19. Subtyping convalescent patients with COVID-19 may enable personalized treatments tailored to individual needs. This study provides valuable plasma proteomic datasets for further studies associated with long COVID.},
}

Humans
*COVID-19/blood
Male
Female
Proteomics
Middle Aged
Adult
SARS-CoV-2
Convalescence
*Proteome/analysis
Aged
*Blood Proteins/analysis
Young Adult

@article {pmid40206472,
year = {2025},
author = {Madenbayeva, AM and Kurmangaliyeva, SS and Urazayeva, ST and Kurmangaliyev, KB and Bazargaliyev, YS and Kudabayeva, KI},
title = {Impact of QazVac vaccination on clinical manifestations and immune responses in post-COVID syndrome: a cross-sectional study.},
journal = {Frontiers in medicine},
volume = {12},
number = {},
pages = {1556623},
pmid = {40206472},
issn = {2296-858X},
abstract = {INTRODUCTION: Post-COVID syndrome, also known as long COVID, has emerged as a major public health concern, affecting a substantial proportion of individuals recovering from SARS-CoV-2 infection. This condition is characterized by persistent symptoms lasting at least 2 months after acute infection, significantly impacting quality of life and increasing healthcare burdens. In Kazakhstan, the recognition of post- COVID syndrome in national clinical protocols highlights the need for effective prevention and management strategies. Vaccination has been suggested as a key intervention to reduce the severity and prevalence of long COVID symptoms, yet data on its effectiveness, particularly for the domestic QazVac vaccine, remain limited. The aim of this study is to investigate the impact of vaccination with the domestic QazVac vaccine on the features of humoral and cellular immunity in patients with post-COVID conditions and to identify the leading clinical variants of the course.

METHODS: We analyzed data from 90 vaccinated and 217 non-vaccinated patients, examining sex, age, smoking status, BMI, comorbidities, and clinical manifestations.

RESULTS: There were no significant differences between the groups with regard to sex, age, and smoking status. However, the characteristics of the subjects indicated that vaccination was correlated with a lower prevalence of diabetes mellitus (2.2% vs. 11.1%, p = 0.011) and cardiovascular diseases (0.0% vs. 10.1%, p = 0.047), and a higher prevalence of hypertension among non-vaccinated subjects. With regard to clinical symptoms, vaccinated individuals presented a significantly decreased frequency of neurological (51.1% vs. 74.2%, p = 0.001), gastrointestinal (4.4% vs. 15.2%, p = 0.008), respiratory (21.1% vs. 36.4%, p = 0.009), rheumatological symptoms (26.7% vs. 38.7%, p = 0.044), and kidney symptoms (2.2% vs. 9.7%, p = 0.024). In contrast, unvaccinated participants had more memory loss (49.8% vs. 22.2%, p < 0.001), depression (31.3% vs. 6.7%, p < 0.001), joint pain (33.2% vs. 14.4%, p = 0.001), and other psychopathological symptoms.

DISCUSSION: A sharp decrease in the frequency of neurological, gastrointestinal, respiratory, and rheumatological symptoms was recorded in vaccinated patients, advocating for the protective role of vaccination against long COVID-19 sequelae. These findings highlight the potential for vaccination to mitigate the burden of post-COVID complications across various organ systems.},
}

@article {pmid40206293,
year = {2025},
author = {Pommy, JM and Cohen, A and Mahil, A and Glass Umfleet, L and Swanson, SJ and Franczak, M and Obarski, S and Ristow, K and Wang, Y},
title = {Changes in cerebrovascular reactivity within functional networks in older adults with long-COVID.},
journal = {Frontiers in neurology},
volume = {16},
number = {},
pages = {1504573},
pmid = {40206293},
issn = {1664-2295},
abstract = {INTRODUCTION: Cognitive symptoms are reported in the vast majority of individuals with long-COVID and there is growing support to suggest neurovascular mechanisms may play a role. Older adults are at increased risk for developing complications associated with COVID-19, including heightened risk for cognitive decline. Cerebrovascular Reactivity (CVR), a marker of neurovascular health, has been linked to age related cognitive decline and may play a role in long-COVID, however, this has not yet been explored.

METHODS: The present study examined group differences in CVR in 31 older adults with long-COVID compared to 31 cognitively unimpaired older adults without long-COVID symptoms. Follow up analyses were conducted to examine how CVR was associated with both subjective cognitive symptoms and neuropsychological (NP) test performance. A subject-specific approach, Distribution-Corrected Z-scores (DisCo-Z), was used.

RESULTS: Analyses revealed the long-COVID group demonstrated significantly greater incidence of extreme CVR clusters within the brain (>100 voxels) and within functional networks thought to drive attention and executive function. Extreme positive CVR clusters were positively associated with greater number of subjective cognitive symptoms and negatively correlated with NP performance.

DISCUSSION: These findings are among the first to provide a link between cognitive functioning in long-COVID and neurovascular changes relevant for aging and mechanistic studies of long-COVID.},
}

@article {pmid40205590,
year = {2025},
author = {Babicki, M and Kapusta, J and Kołat, D and Kałuzińska-Kołat, Ż and Mastalerz-Migas, A and Jankowski, P and Chudzik, M},
title = {Cardiac symptoms in patients 3-6 months after contracting COVID-19- data from the polish STOP-COVID registry.},
journal = {BMC infectious diseases},
volume = {25},
number = {1},
pages = {489},
pmid = {40205590},
issn = {1471-2334},
mesh = {Humans ; *COVID-19/complications/epidemiology ; Male ; Female ; Middle Aged ; Retrospective Studies ; Registries ; Aged ; Adult ; Poland/epidemiology ; SARS-CoV-2 ; Fatigue ; Anxiety ; Depression/epidemiology ; Electrocardiography, Ambulatory ; Blood Pressure Monitoring, Ambulatory ; Echocardiography ; },
abstract = {BACKGROUND: Common complaints of long COVID patients are cardiac symptoms such as fatigue, weakness, and a feeling of palpitations. The study aimed to investigate the clinical features of patients with persistent cardiological symptoms occurring within 3 to 6 months after COVID-19. Differences in ambulatory blood pressure monitoring (ABPM), Holter ECG (electrocardiogram) and Echocardiography between people with and without persistent cardiological symptoms were evaluated. We also assessed whether the symptoms of anxiety and depression may be implicated in the clinical outcomes.

MATERIALS AND METHODS: This was a retrospective study of patients affiliated with the STOP-COVID registry who attended a follow-up visit 3-6 months after undergoing COVID-19. The visit assessed the clinical symptoms present and performed tests: ABPM, Holter ECG and Echocardiography. 504 patients additionally had GAD-2 (Generalized Anxiety Disorder 2-item) and PHQ-2 (Patient Health Questionnaire-2) tests performed.

RESULTS: The analysis included 1080 patients. At least 1 of the analyzed symptoms was present in 586 patients (54.3%). The most common symptom was fatigue (38.9%). Comparing patients with or without palpitations showed that the mean value of ventricular extrasystole was higher in the former group (p = 0.011). Comparing patients with and without cardiac symptoms, there were differences in the mean values of the PHQ-2 (p = 0.022) and GAD-2 (p < 0.001) scales, as well as in the percentage of responses related to the risk of anxiety or depression.

CONCLUSION: Cardiological symptoms are common among health issues that patients must face after contracting COVID-19. People with palpitations had more excessive ventricular extrasystoles than patients without these symptoms.

TRIAL REGISTRATION: Our retrospective study was based on analysis of medical data of patients with COVID-19 treated on out-patient basis in the STOP-COVID registry of the Polish Long-Covid Cardiovascular (PoLoCOV-CVD) study (ClinicalTrials.gov identifier- NCT05018052, the registration date 29.05.2020). Consent to conduct the study was obtained from the Bioethics Committee of the District Medical Chamber in Lodz (no. KB-0115/2021).},
}

Humans
*COVID-19/complications/epidemiology
Male
Female
Middle Aged
Retrospective Studies
Registries
Aged
Adult
Poland/epidemiology
SARS-CoV-2
Fatigue
Anxiety
Depression/epidemiology
Electrocardiography, Ambulatory
Blood Pressure Monitoring, Ambulatory
Echocardiography

@article {pmid40205414,
year = {2025},
author = {Al-Oraibi, A and Tarrant, C and Woolf, K and Nellums, LB and Pareek, M},
title = {The impact of long COVID on UK healthcare workers and their workplace: a qualitative study of healthcare workers with long COVID, their families, colleagues and managers.},
journal = {BMC health services research},
volume = {25},
number = {1},
pages = {519},
pmid = {40205414},
issn = {1472-6963},
support = {2122-59//NHS Race and health observatory/ ; },
mesh = {Humans ; *COVID-19/psychology/epidemiology ; Qualitative Research ; *Health Personnel/psychology ; Female ; Male ; United Kingdom/epidemiology ; Adult ; *Workplace/psychology ; Middle Aged ; SARS-CoV-2 ; Adaptation, Psychological ; Interviews as Topic ; Family/psychology ; },
abstract = {BACKGROUND: Healthcare workers (HCWs) have been particularly impacted by long COVID, with negative effects on their work patterns and wellbeing. The aim of this study was to explore the intersection between work and long COVID for HCWs, to understand the impact of long COVID on their professional identify, their orientation to work, their wellbeing as professionals, and support needs and strategies for them as well as their managers to continue to work.

METHODS: This qualitative study was conducted through semi-structured online interviews with three groups: HCWs with long COVID, their support network members, and healthcare managers between March 2023 and May 2024. To maintain confidentiality and address concerns about workplace stigma, healthcare managers were not matched with specific HCWs. Participants were recruited through purposive and snowball sampling, until data saturation was reached, defined as the point at which no new insights or themes were identified. Data were analysed using reflexive thematic analysis.

RESULTS: A total of 42 participants were interviewed from three groups, comprising 24 HCWs, five support network members, and 13 healthcare managers. Four key themes were identified describing experiences of long COVID for HCWs: (1) Living and coping with long COVID as a HCW, (2) Workplace impact and adjustments, (3) The uncertain nature of long COVID and challenges of the definition, and (4) Feelings of guilt, stigma and blame.

CONCLUSION: In conclusion, long COVID has created significant challenges not only for HCWs but also for their managers, who struggled with staffing shortages and lack of clear guidance, and support network members who experienced emotional strain while providing care. The combination of these challenges threatens NHS workforce stability and service delivery. Developing and embedding flexible, standardised workplace interventions-such as phased return-to-work policies and tailored occupational health support-could mitigate these impacts and inform scalable solutions across diverse healthcare systems. Enhanced training for healthcare managers and further research into culturally diverse coping mechanisms could improve support for affected HCWs, reduce stigma, and contribute to a more stable and resilient healthcare workforce. While based in the UK, these findings offer important insights for health systems globally that are grappling with the long-term workforce implications of long COVID.},
}

Humans
*COVID-19/psychology/epidemiology
Qualitative Research
*Health Personnel/psychology
Female
Male
United Kingdom/epidemiology
Adult
*Workplace/psychology
Middle Aged
SARS-CoV-2
Adaptation, Psychological
Interviews as Topic
Family/psychology

@article {pmid40202056,
year = {2025},
author = {Jawad, F and Jawad, AS},
title = {Low muscle mass and the risk of long COVID.},
journal = {Journal of the Royal Society of Medicine},
volume = {},
number = {},
pages = {1410768251326488},
doi = {10.1177/01410768251326488},
pmid = {40202056},
issn = {1758-1095},
}

@article {pmid40200747,
year = {2025},
author = {MacLean, A and Driessen, A and Hinton, L and Nettleton, S and Wild, C and Anderson, E and Brown, A and Hoddinott, P and O'Dwyer, C and Ziebland, S and Hunt, K},
title = {Rethinking 'Recovery': A Comparative Qualitative Analysis of Experiences of Intensive Care With COVID and Long Covid in the United Kingdom.},
journal = {Health expectations : an international journal of public participation in health care and health policy},
volume = {28},
number = {2},
pages = {e70253},
pmid = {40200747},
issn = {1369-7625},
support = {//This study was supported by Economic and Social Research Council (EP/V039083/1 COVID), National Institute for Health Research (COV-LT2-0005), Scotland's Chief Scientist Office (COV/LTE/20/04), and Health Foundation./ ; },
mesh = {Humans ; *COVID-19/psychology/therapy ; United Kingdom/epidemiology ; Qualitative Research ; Female ; Male ; Middle Aged ; Intensive Care Units ; Adult ; Aged ; *Critical Care/psychology ; Interviews as Topic ; SARS-CoV-2 ; Adaptation, Psychological ; },
abstract = {INTRODUCTION: Interpretations of 'recovery' from illness are complex and influenced by many factors, not least patient expectations and experiences. This paper examines meanings of 'recovery', and how it is strived towards, drawing on the example of COVID-19 infection.

METHODS: Drawing on qualitative interviews (n = 93) conducted in the UK between February 2021 and July 2022, we compare adults' accounts of being admitted to an Intensive Care Unit (ICU) with COVID-19 to accounts of being ill with Long COVID, defined as ongoing symptoms for at least 12 weeks postinfection. We conducted a multi-stage comparative analysis using Nvivo to organise and code the data.

RESULTS: We identified similarities and differences in participants' descriptions of their 'worlds of illness'. For both groups, perceptions of recovery were shaped by the novel, unknown nature of COVID-19. Participants questioned the achievability of full restoration of prior states of health, highlighted the heterogeneity of 'recovery trajectories' and described the hard physical and emotional work of adjusting to changed selves. Themes that revealed differences in 'worlds of illness' described included the different baselines, waymarkers, and pathways of illness experiences. Differences in other people's responses to their illness were also evident. For ICU participants, hospitalisation, and especially ICU admission, conferred legitimate patient status and authenticity to their symptoms. Family, friends and healthcare professionals acknowledged their illness, celebrated their survival, and granted them latitude to recover. For Long Covid participants, their patient status often lacked comparable authenticity in others' eyes. They reported encountering a lack of recognition and understanding of their ongoing need to recover.

CONCLUSIONS: This study highlights how the meanings of illness ascribed by others can influence how recovery is experienced. Our findings highlight the importance of ensuring people are made to feel their illness experiences are legitimate, regardless of hospitalisation status, formal diagnosis or lack of medical knowledge and pathways. They also indicate the value of emphasising the different permutations, and lack of linearity, that recovery can take. This may help to help to guard against a lack of understanding for experiences of recovery which do not meet idealised notions.

Both studies were guided by an advisory panel that included patient and public involvement representatives with lived experience of Intensive Care/COVID experience and Long COVID respectively. Through regular meetings with the research teams, the advisory panel had input into all aspects of the study conduct, including recruitment methods and content of the interview topic guide and feedback on preliminary analyses. The Long COVID study also included a lived experience coinvestigator who contributed to data interpretation and analysis.},
}

Humans
*COVID-19/psychology/therapy
United Kingdom/epidemiology
Qualitative Research
Female
Male
Middle Aged
Intensive Care Units
Adult
Aged
*Critical Care/psychology
Interviews as Topic
SARS-CoV-2
Adaptation, Psychological

@article {pmid40200524,
year = {2025},
author = {Bilionis, I and Quer Palomas, S and Vidal-Alaball, J},
title = {Digital Health for Tracking Long-Covid Symptoms with Data Insights from Mobile App Questionnaires and Wearable Devices.},
journal = {Studies in health technology and informatics},
volume = {323},
number = {},
pages = {434-438},
doi = {10.3233/SHTI250127},
pmid = {40200524},
issn = {1879-8365},
mesh = {Humans ; *Wearable Electronic Devices ; *COVID-19/diagnosis/complications/physiopathology ; *Mobile Applications ; Surveys and Questionnaires ; Male ; Female ; Middle Aged ; SARS-CoV-2 ; Adult ; Telemedicine ; Digital Health ; },
abstract = {With the ongoing mutations of COVID-19 leaving many survivors with debilitating symptoms known as Long-Covid, countless individuals are struggling with persistent fatigue, cognitive impairments, and respiratory issues that can last for months or even years, profoundly disrupting their daily lives and rendering them unable to return to work or engage in social activities. Thus, this paper develops a comprehensive methodology that integrates wearable biometric data and patient-reported outcomes to enhance the monitoring and management of Long-Covid symptoms, desgined to support patient care and quality of life. The methodology involved collecting biometric data from wearable devices and psychometric assessments through mobile app questionnaires, and modeling them using mixed linear regression. Results indicated that variations in heart rate and physical activity levels were significant predictors of fatigue, stress, and pain, with lower morning activity linked to increased anxiety and pain. Additionally, participant feedback highlighted the mobile app's user-friendliness and effectiveness in tracking symptoms. Integrating wearable technology with psychological assessments in clinical practice can facilitate accurate symptom tracking and personalized interventions for individuals suffering from Long-Covid, ultimately improving patient outcomes and overall health management.},
}

Humans
*Wearable Electronic Devices
*COVID-19/diagnosis/complications/physiopathology
*Mobile Applications
Surveys and Questionnaires
Male
Female
Middle Aged
SARS-CoV-2
Adult
Telemedicine
Digital Health

@article {pmid40200480,
year = {2025},
author = {Finkelstein, J and Gabriel, AS and Tsai, TY and Reategui-Rivera, CM and Rocco, P and Smiley, A and Powers, C and Brown, JP},
title = {A Wearable Solution for Managing POTS: Patient Perspectives on Real-Time Heart Rate Monitoring and Activity Pacing.},
journal = {Studies in health technology and informatics},
volume = {323},
number = {},
pages = {226-230},
doi = {10.3233/SHTI250083},
pmid = {40200480},
issn = {1879-8365},
mesh = {Humans ; *Wearable Electronic Devices ; *Postural Orthostatic Tachycardia Syndrome/diagnosis/therapy/physiopathology ; Female ; Male ; *Heart Rate ; *Mobile Applications ; Adult ; *Self Care/methods ; *Monitoring, Ambulatory/instrumentation ; },
abstract = {Managing postural tachycardia syndrome (POTS) requires continuous symptom monitoring, yet effective tools for patient self-management are limited. This study assessed patient perspectives on a wearable app designed for POTS management. Participants valued features like real-time heart rate monitoring and symptom tracking, which reduced cognitive strain and fostered confidence. Challenges such as navigation and alert management highlighted the need for improved interface design and customization. These findings demonstrate the app's potential to enhance self-management and foster patient autonomy. Future research should examine long-term outcomes and integrate suggested improvements to optimize patient-centered POTS care.},
}

Humans
*Wearable Electronic Devices
*Postural Orthostatic Tachycardia Syndrome/diagnosis/therapy/physiopathology
Female
Male
*Heart Rate
*Mobile Applications
Adult
*Self Care/methods
*Monitoring, Ambulatory/instrumentation

@article {pmid40200430,
year = {2025},
author = {Yamashita, LD and Desai, N and Manning, AR and Pileggi, C and Peskin, SM and Sandsmark, DK and Kolson, DL and Schindler, MK},
title = {Clinical Phenotyping of Long COVID Patients Evaluated in a Specialized Neuro-COVID Clinic.},
journal = {Annals of clinical and translational neurology},
volume = {},
number = {},
pages = {},
doi = {10.1002/acn3.70031},
pmid = {40200430},
issn = {2328-9503},
abstract = {OBJECTIVE: To report Long COVID characteristics and longitudinal courses of patients evaluated between 4/14/21-4/14/22 at the University of Pennsylvania Neurological COVID Clinic (PNCC), including clinical symptoms, neurological examination findings, and neurocognitive screening tests from a standardized PNCC neurological evaluation approach.

METHODS: This is a retrospective cross-sectional and longitudinal study in a single-center tertiary care academic center. Participants include 240 patients with documented evidence of a positive SARS-CoV-2 PCR or antibody test who underwent initial evaluation and 182 patients with longitudinal follow-up. Main outcomes evaluated are patient demographics, duration of illness prior to self-reported improvement, and cognitive testing results-including the Montreal Cognitive Assessment (version 8.2) (MoCA) and Oral Trail Making Test-B (OTMT-B).

RESULTS: The majority (73%) of patients did not require hospitalization for their acute COVID-19 symptoms. Frequent Long COVID complaints included headache (60%), dizziness/vertigo (40%), and disturbance of taste/smell (40%). Almost all (94%) patients reported cognitive symptoms, and over 30% of patients had abnormal scores on cognitive testing. Severe infection, fewer years of education level, and non-White race were found to be statistically associated with an increased likelihood of having abnormal scores on cognitive testing. Neuroimaging and clinical laboratory testing were largely not informative for patient care. Sixty-two percent of patients with follow-up visits self-reported improvement in their primary neurological complaint within 1 year of evaluation.

INTERPRETATION: Performance on standardized cognitive screening tests may not be consistent with frequently reported cognitive complaints in Long COVID patients. The most common clinical trajectory was self-reported improvement in the primary neurological symptom.},
}

@article {pmid40200197,
year = {2025},
author = {Wu, JI and Lee, SH and Chen, PJ},
title = {Case report: post COVID-19 encephalopathy and oral cenesthopathy.},
journal = {BMC psychiatry},
volume = {25},
number = {1},
pages = {351},
pmid = {40200197},
issn = {1471-244X},
mesh = {Humans ; Female ; Aged ; *COVID-19/complications/psychology ; *Cognitive Dysfunction/etiology ; *Brain Diseases/etiology/drug therapy ; *Delusions/etiology/drug therapy ; *Depressive Disorder, Major/etiology/drug therapy ; Aripiprazole/therapeutic use ; Carbamazepine/therapeutic use ; SARS-CoV-2 ; },
abstract = {Post-COVID-19 encephalopathy is a neurological complication characterized by cognitive impairment, memory loss, and other neuropsychiatric symptoms in COVID-19 survivors. Oral cenesthopathy, a rare somatic delusion characterized by unusual oral sensations without physical findings, is typically associated with affective disorders and schizophrenia. This case report describes a 73-year-old female who developed post-COVID-19 encephalopathy, presenting initially with cognitive decline, followed by major depression and oral cenesthopathy 16 months after the infection. Comprehensive investigations excluded autoimmune encephalitis, Creutzfeldt-Jakob disease, and other structural or vascular abnormalities. Treatment with Aripiprazole and Carbamazepine resulted in partial improvement, though symptom control was limited by medication side effects. This case represents a rare presentation of long COVID syndrome, highlighting the complex neuropsychiatric sequelae of COVID-19. Further research is needed to explore the pathophysiology, treatment strategies, and long-term impacts of such manifestations.},
}

Humans
Female
Aged
*COVID-19/complications/psychology
*Cognitive Dysfunction/etiology
*Brain Diseases/etiology/drug therapy
*Delusions/etiology/drug therapy
*Depressive Disorder, Major/etiology/drug therapy
Aripiprazole/therapeutic use
Carbamazepine/therapeutic use
SARS-CoV-2

@article {pmid40199960,
year = {2025},
author = {Kim, D},
title = {A nationwide study of risk factors for long COVID and its economic and mental health consequences in the United States.},
journal = {Communications medicine},
volume = {5},
number = {1},
pages = {104},
pmid = {40199960},
issn = {2730-664X},
abstract = {BACKGROUND: In the United States, concerns have been increasingly raised over the future public health and economic burden of long COVID including disability and declines in labor force participation. However, only a handful of U.S. studies have explored sociodemographic or socioeconomic characteristics that put people at risk of long COVID or have investigated its economic and mental health sequelae.

METHODS: Using repeated cross-sectional data on over 375,000 adults including nearly 50,000 adults with long COVID pooled from U.S. nationally-representative Household Pulse Survey data collected between September and November 2022 and between August and October 2023, I fit age- and gender-adjusted and multivariable modified Poisson regression models to examine multiple sociodemographic and socioeconomic factors as predictors of long COVID. I further estimate the risks of unemployment, financial hardship, and anxiety and depression among working-aged adults and adults with current long COVID symptoms, and estimate the economic burden of lost wages due to long COVID.

RESULTS: Nearly one in seven adults (~35 million) and working-aged adults (~30 million) reported having a history of long COVID by late 2022 and late 2023. In age- and gender-adjusted models and fully-adjusted multivariable models, I find several factors predict long COVID including lower household income, and being Hispanic, female, gay/lesbian or bisexual. I also find having long COVID is linked to higher risks of recent unemployment, financial hardship, and anxiety and depressive symptomatology, with evidence of dose-response relationships.

CONCLUSIONS: Overall, an estimated 24 million working-aged adults with long COVID had been or may still be at risk of adverse socioeconomic and mental health outcomes. The lost earnings due to long COVID among working-aged adults are estimated to total $211 billion in 2022 and $218 billion in 2023. These findings highlight the substantial public health and economic implications of long COVID among Americans.},
}

@article {pmid40199308,
year = {2024},
author = {Bona, JP},
title = {Knowledge Representation and Management in the Age of Long Covid and Large Language Models: a 2022-2023 Survey.},
journal = {Yearbook of medical informatics},
volume = {33},
number = {1},
pages = {216-222},
doi = {10.1055/s-0044-1800747},
pmid = {40199308},
issn = {2364-0502},
mesh = {*COVID-19 ; Humans ; *Artificial Intelligence ; *Language ; Surveys and Questionnaires ; Large Language Models ; },
abstract = {OBJECTIVES: To select, present, and summarize cutting edge work in the field of Knowledge Representation and Management (KRM) published in 2022 and 2023.

METHODS: A comprehensive set of KRM-relevant articles published in 2022 and 2023 was retrieved by querying PubMed. Topic modeling with Latent Dirichlet Allocation was used to further refine this query and suggest areas of focus. Selected articles were chosen based on a review of their title and abstract.

RESULTS: An initial set of 8,706 publications were retrieved from PubMed. From these, fifteen papers were ultimately selected matching one of two main themes: KRM for long COVID, and KRM approaches used in combination with generative large language models.

CONCLUSIONS: This survey shows the ongoing development and versatility of KRM approaches, both to improve our understanding of a global health crisis and to augment and evaluate cutting edge technologies from other areas of artificial intelligence.},
}

*COVID-19
Humans
*Artificial Intelligence
*Language
Surveys and Questionnaires
Large Language Models

@article {pmid40198595,
year = {2025},
author = {Erdik, B},
title = {Driving under viral impairment: Linking acute SARS-CoV-2 infections to elevated car crash risks.},
journal = {PLOS global public health},
volume = {5},
number = {4},
pages = {e0004420},
doi = {10.1371/journal.pgph.0004420},
pmid = {40198595},
issn = {2767-3375},
abstract = {This study explores the linkage between acute SARS-CoV-2 and car crashes across U.S. states, correlating with COVID-19 mitigation strategies, vaccination rates, and Long COVID prevalence. This investigation analyzed aggregate COVID-19 and car crash data spanning 2020-2023, with data collection occurring between March and May 2024. Analysis was done via a Poisson regression model, adjusted for population. Key variables included vaccination status, month-specific effects relating to initial pandemic shutdowns, and Long COVID rates. Results demonstrated a significant association between acute COVID-19 infections and an increase in car crashes, independent of Long COVID status to the tune of an OR of 1.25 [1.23-1.26]. This association was observed despite varying mitigation efforts and vaccination rates across states. The study found no protective effect of vaccination against car crashes, challenging prior assumptions about the benefits of vaccination. Notably, the risk associated with COVID-19 was found to be analogous to driving impairments seen with alcohol consumption at legal limits. Findings suggest significant implications for public health policies, especially in assessing the readiness of individuals recovering from COVID-19 to engage in high-risk activities such as pilots or nuclear plant employees. Further research is necessary to establish causation and explore the exact effects of COVID-19 within the CNS affecting cognition and behavior.},
}

@article {pmid40197282,
year = {2025},
author = {Nguyen, ATP and Ski, CF and Thompson, DR and Abbey, SE and Kloiber, S and Sheikhan, NY and Selby, P and Shields, R and Rossell, SL and Strudwick, G and Castle, D and Hawke, LD},
title = {Health and social service provider perspectives on challenges, approaches, and recommendations for treating long COVID: a qualitative study of Canadian provider experiences.},
journal = {BMC health services research},
volume = {25},
number = {1},
pages = {509},
pmid = {40197282},
issn = {1472-6963},
mesh = {Humans ; Canada ; *COVID-19/therapy/psychology ; Qualitative Research ; Female ; Middle Aged ; Male ; Adult ; *Social Work ; SARS-CoV-2 ; Interviews as Topic ; *Health Personnel/psychology ; *Attitude of Health Personnel ; Post-Acute COVID-19 Syndrome ; Quality of Life ; },
abstract = {BACKGROUND: Many people who contract the SAR-CoV-2 virus present with multiple persistent and debilitating physical, cognitive and mental health symptoms that endure beyond the acute infection period. This new syndrome - generally referred to as long COVID - negatively affects patients' emotional wellbeing and quality of life, and presents a major challenge for treatment providers. Considering the lack of evidence-based treatment and supports, this qualitative descriptive study explores the experiences of Canadian health and social service providers working with individuals with long COVID, as well as their suggestions for intervention development.

METHODS: Twenty health and social service providers between the ages of 29 and 57 across Canada completed virtual individual interviews to discuss their care experiences and service recommendations for long COVID. Participants were from a range of service sectors, including primary care, rehabilitation, mental health, and community support. Interviews were recorded, transcribed, and analyzed using codebook thematic analysis.

RESULTS: Four themes illustrated providers' the experiences of (1) selecting personalized treatments based on patient presentation and similar conditions amidst uncertainty; and their recommendations for long COVID services, including (2) building an integrated and evidence-based model of care; (3) providing holistic support for patients and families through psychoeducation and daily living resources; and (4) caring for mental health in long COVID.

CONCLUSIONS: Canadian health and social service providers are adopting personalized treatment approaches to address the symptom persistence of long COVID in the face of a considerable knowledge gap. A comprehensive, integrated care pathway is needed to support patients' physical and psychosocial wellbeing while increasing provider preparedness to treat this complex condition.},
}

Humans
Canada
*COVID-19/therapy/psychology
Qualitative Research
Female
Middle Aged
Male
Adult
*Social Work
SARS-CoV-2
Interviews as Topic
*Health Personnel/psychology
*Attitude of Health Personnel
Post-Acute COVID-19 Syndrome
Quality of Life

@article {pmid40195851,
year = {2025},
author = {Chung, J and Pierce, J and Franklin, C and Olson, RM and Morrison, AR and Amos-Landgraf, J},
title = {Translating animal models of SARS-CoV-2 infection to vascular, neurological and gastrointestinal manifestations of COVID-19.},
journal = {Disease models & mechanisms},
volume = {18},
number = {9},
pages = {},
doi = {10.1242/dmm.052086},
pmid = {40195851},
issn = {1754-8411},
support = {U42OD010918//Institutes of Health (NIH)/ ; T32OD011126//NIH Office of the Director/ ; IK2BX002527//U.S. Department of Veterans Affairs/ ; },
mesh = {*COVID-19/complications/pathology/virology ; Animals ; *Disease Models, Animal ; *SARS-CoV-2/physiology ; *Gastrointestinal Diseases/virology/etiology/pathology ; Humans ; *Nervous System Diseases/virology/etiology/pathology ; *Vascular Diseases/virology/etiology ; Gastrointestinal Tract/pathology/virology ; *Translational Research, Biomedical ; },
abstract = {Since the emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) initiated a global pandemic resulting in an estimated 775 million infections with over 7 million deaths, it has become evident that COVID-19 is not solely a pulmonary disease. Emerging evidence has shown that, in a subset of patients, certain symptoms - including chest pain, stroke, anosmia, dysgeusia, diarrhea and abdominal pain - all indicate a role of vascular, neurological and gastrointestinal (GI) pathology in the disease process. Many of these disease processes persist long after the acute disease has been resolved, resulting in 'long COVID' or post-acute sequelae of COVID-19 (PASC). The molecular mechanisms underlying the acute and systemic conditions associated with COVID-19 remain incompletely defined. Appropriate animal models provide a method of understanding underlying disease mechanisms at the system level through the study of disease progression, tissue pathology, immune system response to the pathogen and behavioral responses. However, very few studies have addressed PASC and whether existing models hold promise for studying this challenging problem. Here, we review the current literature on cardiovascular, neurological and GI pathobiology caused by COVID-19 in patients, along with established animal models of the acute disease manifestations and their prospects for use in PASC studies. Our aim is to provide guidance for the selection of appropriate models in order to recapitulate certain aspects of the disease to enhance the translatability of mechanistic studies.},
}

*COVID-19/complications/pathology/virology
Animals
*Disease Models, Animal
*SARS-CoV-2/physiology
*Gastrointestinal Diseases/virology/etiology/pathology
Humans
*Nervous System Diseases/virology/etiology/pathology
*Vascular Diseases/virology/etiology
Gastrointestinal Tract/pathology/virology
*Translational Research, Biomedical

@article {pmid40195483,
year = {2025},
author = {Ledford, H and Kozlov, M},
title = {Long COVID activists fought Trump team's research cuts and won - for now.},
journal = {Nature},
volume = {},
number = {},
pages = {},
doi = {10.1038/d41586-025-00995-3},
pmid = {40195483},
issn = {1476-4687},
}

@article {pmid40193038,
year = {2025},
author = {Sadowski, J and Ostrowska, SA and Klaudel, T and Zaborska, M and Chruszcz, M and Sztangreciak-Lehun, A and Bułdak, RJ},
title = {Neuropsychiatric disorders in the course to SARS-CoV-2 virus infection, including biological pathomechanisms, psychosocial factors and long COVID-19 associated with "brain fog".},
journal = {Journal of neurovirology},
volume = {},
number = {},
pages = {},
pmid = {40193038},
issn = {1538-2443},
abstract = {During the COVID-19 pandemic, neuropsychiatric disorders began to be observed in a significant proportion of patients, occurring at different times after infection and characterised by varying degrees of severity. This article discusses neurological and psychiatric disorders associated with SARS-CoV-2 virus infection, taking into account biological pathomechanisms and psychosocial factors. The long COVID-19 along with the "brain fog" phenomenon were considered in the study. The purpose of the study is to analyse and discuss the available information from the scientific literature on the possible association between SARS-CoV-2 virus infection and the occurrence of neuropsychiatric disorders with different degrees of severity and temporal correlation. To discuss the correlation of COVID-19 with the occurrence of neuropsychiatric disorders, a systematic literature review was conducted using the following databases: PubMed, Elsevier and Google Scholar. The following keywords were used when searching the materials used: "neuropsychiatric disorders", "COVID-19", "SARS-CoV-2", "NeuroCOVID", "cytokine storm" and "long COVID-19". Focusing on the characteristics of the materials and methods used, as well as the results obtained and conclusions reached in each article, 164 publications of research, meta-analysis, review and case reports were included in the study. Neuropsychiatric disorders resulting from SARS-CoV-2 virus infection are multifactorial in nature. The main elements responsible for the varied pattern of symptoms include direct and indirect central nervous system effects of the disease, individual patient conditions, psychosocial factors, severity of immune responses and severity of infection. The neuropsychiatric effects of SARS-CoV-2 infection can be divided into symptoms directly related to the neurological and psychiatric zones and mixed disorders.},
}