@article {pmid41101206,
year = {2025},
author = {January, J and Zwaenepoel, O and Sanga, N and Gettemans, J and Iwuoha, E},
title = {High sensitivity perovskite-tagged nanobody electrochemiluminescent immunosensor for spike (S1) protein biomarker-based persistent viral reservoir detection.},
journal = {Bioelectrochemistry (Amsterdam, Netherlands)},
volume = {168},
number = {},
pages = {109137},
doi = {10.1016/j.bioelechem.2025.109137},
pmid = {41101206},
issn = {1878-562X},
abstract = {Persistent viral reservoirs (PVR) of SARS-CoV-2 (or long COVID-19) and latent COVID-19 disease have been of great concern to clinicians. Several studies have identified spike protein (S1) as a definitive biomarker for the early detection of persistent viral reservoirs and latent COVID-19. A novel sandwich-format electrochemical immunosensor integrating a nanocomposite material was engineered for rapid and sensitive latent COVID-19 detection. The platform structure, AuSPE||strep|Nb1|BSA|biotin|S1|strep-LiSmZrO3-Nb2 + BSA (AuSPE = gold screen-printed electrode, strep = streptavidin-thiol, Nb1 = primary nanobody, Nb2 = secondary nanobody, BSA = bovine serum albumin, and spike (S1) protein = S1), featured a disposable AuSPE modified with strep to anchor a biotinylated camelid Nb1 specific to the spike protein. A Nb2 conjugated to streptavidin-labelled LiSmZrO3 perovskite completed the sandwich complex, enhancing both affinity and signal transduction. Electrochemical responses of the sensor were studied via electrochemiluminescent (ECL) signal transduction. The S1-sensitive sandwich immunosensor had a detection range of 0-1000 pg mL[-1] with a limit of detection of 0.04 pg mL[-1] via ECL. As feasibility studies, commercial spike protein in buffered solutions and human serum, highlighting the potential for the immunosensor to be used in SARS-CoV-2 patients and PVRs. The nanobody sandwich immunosensor showed excellent stability, selectivity, sensitivity, and reproducibility. The immunosensor serves as a broad PVR for a SARS-CoV-2 screening tool, detecting elevated S1 levels to enable early, targeted diagnostics.},
}

@article {pmid41101103,
year = {2025},
author = {Adebisi, YA and Ogunkola, IO and Jimoh, ND and Alshahrani, NZ and Shomuyiwa, DO and Alaran, AJ and Lucero-Prisno, DE},
title = {Tobacco smoking and the risk of Long COVID: a prospective cohort study with mediation analysis.},
journal = {Journal of epidemiology and population health},
volume = {73},
number = {5},
pages = {203142},
doi = {10.1016/j.jeph.2025.203142},
pmid = {41101103},
issn = {2950-4333},
abstract = {BACKGROUND: Tobacco smoking is a well-established risk factor for severe acute COVID-19 outcomes, but evidence regarding its role in Long COVID is limited and inconsistent. This study investigated whether pre-pandemic smoking independently predicted Long COVID and assessed mediation by long-standing illness or disability in a nationally representative cohort.

METHODS: We analysed data from Waves 10 (2018-19) and 14 (2022-23) of the UK Household Longitudinal Study. Smoking status (current vs non-smoker) and covariates (age, sex, education, income satisfaction, ethnicity, rural/urban residence) were measured at baseline (Wave 10). Long COVID, defined as symptoms lasting ≥12 weeks following initial COVID-19 infection, was assessed at follow-up (Wave 14). Logistic regression was used to estimate the total association between smoking and Long COVID. We then applied generalized structural equation modelling and parametric causal mediation analysis, specifying long-standing illness or disability at baseline as the mediator.

RESULTS: Among 11,944 participants, 1097 (9.2 %) reported Long COVID symptoms at follow-up. In the unadjusted model, smoking was associated with increased odds of Long COVID (odds ratio [OR] = 1.22, 95 % CI: 1.00-1.48, p = 0.05), although this was only borderline significant. After adjusting for demographic and socioeconomic factors, the association was no longer statistically significant (adjusted OR = 1.11, 95 % CI: 0.91-1.35, p = 0.32). The structural equation model indicated that smoking was associated with higher likelihood of long-standing illness or disability at baseline (β = 0.461, 95 % CI: 0.33-0.59, p <0.001, log-odds scale), which in turn predicted Long COVID (β = 0.435, 95 % CI: 0.30-0.57, p <0.001, log-odds scale). Mediation analysis revealed a small but statistically significant indirect effect of smoking on Long COVID operating through long-standing illness or disability (risk difference = 0.0057, 95 % CI: 0.0020-0.0095, p = 0.003), but no significant direct effect (risk difference = 0.0027, 95 % CI: -0.0144 to 0.0199, p = 0.76).

CONCLUSION: Smoking did not independently predict Long COVID, but may increase vulnerability indirectly through pre-existing long-standing illness or disability.},
}

@article {pmid41099164,
year = {2025},
author = {Chate, RC and Carvalho, CRR and Sawamura, MVY and Salge, JM and Fonseca, EKUN and Amaral, PTMA and de Almeida Lamas, C and de Luna, LAV and Kay, FU and Junior, ANA and Nomura, CH},
title = {Quantitative Chest Computed Tomography and Machine Learning for Subphenotyping Small Airways Disease in Long COVID.},
journal = {Journal of thoracic imaging},
volume = {},
number = {},
pages = {},
doi = {10.1097/RTI.0000000000000861},
pmid = {41099164},
issn = {1536-0237},
abstract = {PURPOSE: To investigate imaging phenotypes in posthospitalized COVID-19 patients by integrating quantitative CT (QCT) and machine learning (ML), with a focus on small airway disease (SAD) and its correlation with plethysmography.

MATERIALS AND METHODS: In this single-center cross-sectional retrospective study, a subanalysis of a larger prospective cohort, 257 adult survivors from the initial COVID-19 peak (mean age, 56±13 y; 49% male) were evaluated. Patients were admitted to a quaternary hospital between March 30 and August 31, 2020 (median length of stay: 16 [8-26] d) and underwent plethysmography along with volumetric inspiratory and expiratory chest CT 6 to 12 months after hospitalization. QCT parameters were derived using AI-Rad Companion Chest CT (Siemens Healthineers).

RESULTS: Hierarchical clustering of QCT parameters identified 4 phenotypes among survivors, named "SAD," "intermediate," "younger fibrotic," and "older fibrotic," based on clinical and imaging characteristics. The SAD cluster (n=37, 14%) showed higher residual volume (RV) and RV/total lung capacity (TLC) ratios as well as lower FEF25-75/forced vital capacity (FVC) on plethysmography. The older fibrotic cluster (n=42, 16%) had the lowest TLC and FVC values. The younger fibrotic cluster (n=79, 31%) demonstrated lower RV and RV/TLC ratios and higher FEF25-75 than the other phenotypes. The intermediate cluster (n=99, 39%) exhibited characteristics that were intermediate between those of SAD and fibrotic phenotypes.

CONCLUSION: The integration of inspiratory and expiratory chest CT with quantitative analysis and ML enables the identification of distinct imaging phenotypes in long COVID patients, including a unique SAD cluster strongly associated with specific pulmonary function abnormalities.},
}

@article {pmid41098726,
year = {2025},
author = {Afrin, F and Zhang, Q and Alturaiki, W and Mahallawi, W},
title = {Editorial: Advances in understanding mucosal immunity in coronaviruses: from mechanisms to vaccines.},
journal = {Frontiers in immunology},
volume = {16},
number = {},
pages = {1702286},
pmid = {41098726},
issn = {1664-3224},
}

@article {pmid41097103,
year = {2025},
author = {Lesgards, JF and Cerdan, D and Perronne, C},
title = {Correction: Lesgards et al. Do Long COVID and COVID Vaccine Side Effects Share Pathophysiological Picture and Biochemical Pathways? Int. J. Mol. Sci. 2025, 26, 7879.},
journal = {International journal of molecular sciences},
volume = {26},
number = {19},
pages = {},
doi = {10.3390/ijms26199513},
pmid = {41097103},
issn = {1422-0067},
abstract = {In the original publication [...].},
}

@article {pmid41096962,
year = {2025},
author = {László, N and Mărginean, C and Mátyás, BB and Man, CA and Nagy, EE and Jimborean, G},
title = {Macrophage Migration Inhibitory Factor and Post-Discharge Inflammatory Profiles in Severe COVID-19: A Prospective Observational Study from Romania.},
journal = {International journal of molecular sciences},
volume = {26},
number = {19},
pages = {},
doi = {10.3390/ijms26199697},
pmid = {41096962},
issn = {1422-0067},
mesh = {Humans ; *Macrophage Migration-Inhibitory Factors/blood ; *COVID-19/blood/immunology/pathology ; Female ; Romania/epidemiology ; Male ; Middle Aged ; Prospective Studies ; Aged ; Adult ; Cytokines/blood ; *Inflammation/blood ; SARS-CoV-2 ; Severity of Illness Index ; Patient Discharge ; Tumor Necrosis Factor-alpha/blood ; Intramolecular Oxidoreductases ; },
abstract = {Dysregulated cytokine responses are a hallmark of severe COVID-19; however, the persistence of these responses following hospital discharge remains inadequately understood. This study aimed to characterize the inflammatory profile of hospitalized COVID-19 patients in Mureș County, Romania, at the point of admission and one month post-discharge. We conducted a prospective observational study involving 68 patients with RT-PCR-confirmed SARS-CoV-2 infection, classified according to disease severity. Blood samples were collected at baseline and after one month. Macrophage migration inhibitory factor (MIF) levels were quantified using ELISA, while other cytokines, including MCP-1, IP-10, IFN-γ, IL-4, IL-10, IL-13, IL-17, and TNF-α, were measured via Luminex multiplex assays. Patients with severe disease exhibited significantly elevated levels of MIF, IFN-γ, IL-17, and TNF-α at admission (p < 0.0001). Although cytokine concentrations generally declined over time, patients with severe disease continued to display persistently elevated MIF (mean 31,035 pg/mL), IFN-γ, and TNF-α, indicative of ongoing inflammatory processes. Clinical parameters such as respiratory rate and oxygen saturation correlated with disease severity. These findings suggest that severe COVID-19 induces a prolonged inflammatory response, with MIF and IFN-γ remaining elevated beyond the acute phase. Cytokine profiling holds potential for improving prognostic assessments and identifying patients at risk of long-term immune dysregulation, with MIF emerging as a potential candidate marker for immune recovery and a possible target for therapy.},
}

Humans
*Macrophage Migration-Inhibitory Factors/blood
*COVID-19/blood/immunology/pathology
Female
Romania/epidemiology
Male
Middle Aged
Prospective Studies
Aged
Adult
Cytokines/blood
*Inflammation/blood
SARS-CoV-2
Severity of Illness Index
Patient Discharge
Tumor Necrosis Factor-alpha/blood
Intramolecular Oxidoreductases

@article {pmid41095969,
year = {2025},
author = {Zhou, LM and Duncan, EH and Boelig, RC and Costanzo, M and Currier, JR and Bergmann-Leitner, ES},
title = {Whole-Blood Cellular Responses: A Promising Indicator of SARS-CoV-2 Immunity Compared to Serology.},
journal = {Journal of clinical medicine},
volume = {14},
number = {19},
pages = {},
doi = {10.3390/jcm14196889},
pmid = {41095969},
issn = {2077-0383},
support = {PR211676//Congressionally Directed Medical Research Programs/ ; },
abstract = {Background: Currently available immunological tests for SARS-CoV-2 assess only antibody responses. Despite the growing evidence that T cells play a crucial role in protection, especially against emerging viral variants, no routine test is available to determine T cell immunity. The prognostic value of SARS-CoV-2-specific antibodies for determining whether individuals are immune and protected against disease remains uncertain. This is in part due to the following: (a) specificity and limitations such as the sensitivity of antibody tests, and (b) the lack of correlation between antibody titers (quantity) and the antiviral function of antibodies (quality). Approximately a quarter of SARS-CoV-2-infected patients with symptoms fail to show seroconversion in serological assays. Methods: The current report describes the development and application of a whole-blood-based assay to detect previous exposure to SARS-CoV-2. Whole blood is stimulated with SARS-CoV-2-derived peptides identified during assay development and stimulation-induced cytokines quantified using a multiplex testing platform. The resulting cytokine profiles are generated using computational tools to identify previous exposure to the virus. Results: The application of the assay revealed a lack of self-awareness of individuals' COVID-19 infection history and demonstrated the value of this new assay to assess the prevalence of SARS-CoV-2 exposure history and immunity in populations. Conclusions: Positive responses in this assay can facilitate the identification of underlying causes of unexplained symptoms and provide clinically actionable insights for healthcare applications, including in the continued conundrum of post-acute sequela of SARS-CoV-2 infection (PASC or "long COVID"), for which both diagnosis and management remain challenging.},
}

@article {pmid41094377,
year = {2025},
author = {Arab, Z and Shayanfar, N and Mojaver, MR and Khormali, M and Boskabady, MH and Niazmand, S},
title = {Cardiopulmonary crosstalk in Long COVID: a systematic review of emerging evidence.},
journal = {BMC cardiovascular disorders},
volume = {25},
number = {1},
pages = {742},
pmid = {41094377},
issn = {1471-2261},
mesh = {Humans ; *COVID-19/physiopathology/complications ; Renin-Angiotensin System ; Post-Acute COVID-19 Syndrome ; SARS-CoV-2 ; *Endothelium, Vascular/physiopathology ; *Pulmonary Fibrosis/physiopathology ; },
abstract = {BACKGROUND: Long COVID is a complex, multisystem syndrome with significant cardiopulmonary implications. Persistent inflammation, endothelial dysfunction, and microvascular injury contribute to prolonged symptoms such as dyspnea, chest pain, and exercise intolerance. Despite growing recognition of these complications, the underlying mechanisms of cardiopulmonary interactions remain poorly understood.

METHODS: A comprehensive literature search was conducted on PubMed, Scopus, Google Scholar, and Web of Science covering studies from 2019 to 2025. Keywords included "Long COVID", "cardiopulmonary interaction", "pulmonary fibrosis", "myocardial inflammation", and "endothelial dysfunction". A total of 102 articles were included, comprising 65 original research studies and 37 review articles.

RESULTS: Pulmonary sequelae, such as fibrotic remodeling, persistent hypoxia, and microthrombosis, impose significant strain on the cardiovascular system, exacerbating myocardial inflammation, arrhythmias, and endothelial dysfunction. Shared mechanisms, such as oxidative stress, immune dysregulation, and neurohumoral activation, create a vicious cycle of sustained cardiopulmonary impairment. The disruption of the renin-angiotensin-aldosterone system (RAAS) further contributes to systemic vascular dysregulation.

CONCLUSION: A deeper understanding of cardiopulmonary interactions in Long COVID is essential for developing effective management strategies. Targeting inflammatory pathways, restoring endothelial function, and addressing autonomic instability may provide therapeutic benefits. As the long-term impact of this syndrome continues to evolve, further research is needed to refine treatment approaches and mitigate its burden on global health.},
}

Humans
*COVID-19/physiopathology/complications
Renin-Angiotensin System
Post-Acute COVID-19 Syndrome
SARS-CoV-2
*Endothelium, Vascular/physiopathology
*Pulmonary Fibrosis/physiopathology

@article {pmid41092189,
year = {2025},
author = {Silva, AS and Dornelas, R and Silva, JRLE},
title = {Long COVID: persistent impacts and challenges for speech-language-hearing therapy.},
journal = {CoDAS},
volume = {37},
number = {5},
pages = {e20240291},
doi = {10.1590/2317-1782/e20240291pt},
pmid = {41092189},
issn = {2317-1782},
}

@article {pmid41091675,
year = {2025},
author = {Nagra, G and Ezeugwu, VE and Bostick, GP and Branton, E and Dennett, L and Drake, K and Durand-Moreau, Q and Guptill, C and Hall, M and Ho, C and Hung, P and Khan, A and Lam, GY and Nowrouzi-Kia, B and Gross, DP},
title = {Return-to-work for people living with long COVID: A scoping review of interventions and recommendations.},
journal = {PloS one},
volume = {20},
number = {10},
pages = {e0321891},
doi = {10.1371/journal.pone.0321891},
pmid = {41091675},
issn = {1932-6203},
mesh = {Humans ; *COVID-19/rehabilitation/epidemiology ; *Return to Work ; SARS-CoV-2/isolation & purification ; },
abstract = {INTRODUCTION: Long COVID is characterized by the presence of new onset or persistent symptoms 3 months after a suspected or confirmed history of SARS-CoV-2 infection. It is a complex and multi-faceted condition that affects people in different ways. Long COVID affects individuals' labour market participation. While some cannot work, others may return to work (RTW) in a limited capacity. Determining what rehabilitation or related strategies are safe and effective for facilitating RTW is necessary.

OBJECTIVES: To synthesize evidence on RTW interventions for people living with Long COVID and to identify 'promising' interventions for enhancing work ability and RTW.

METHODS: We followed Arksey & O'Malley's methodology and the PRISMA extension for scoping reviews. Five electronic bibliographic databases and grey literature were searched. The literature search included various study designs, such as randomized controlled trials (RCT), quasi-experimental designs, and observational studies as well as clinical practice guidelines (CPGs). Two reviewers conducted screening and data extraction, with disagreements resolved through consensus. Intervention studies were categorized as promising (statistically significant RTW outcomes or ≥ 50% RTW), somewhat promising (20% to < 50% RTW), not promising (non-statistically significant RTW outcomes or < 20% RTW), or uncertain (did not specify proportion of RTW).

RESULTS: Twelve CPGs and nineteen intervention studies were identified. Of the intervention studies, 5 were cohort studies, 3 quasi-experimental studies, 4 observational, 2 interventional, 3 RCTs, and 2 case reports. Promising interventions included multimodal and interdisciplinary work-focused rehabilitation, multidisciplinary inpatient and outpatient rehabilitation, psychoeducation, pacing, and breathing strategies, shifting focus from symptom monitoring to optimizing functional outcomes, enhanced external counterpulsation inflatable pressure to improve blood flow, and constraint-induced cognitive therapy.

CONCLUSION: Many uncertainties remain regarding which RTW interventions are effective or the optimal characteristics of these interventions.},
}

Humans
*COVID-19/rehabilitation/epidemiology
*Return to Work
SARS-CoV-2/isolation & purification

@article {pmid41089957,
year = {2025},
author = {Begum, S and Mirghani, HO and Alhowiti, A and Alrasheed, T and Sulaiman, AHA},
title = {Prevalence and risk factors for post-COVID-19 syndrome on medical students in Tabuk, Saudi Arabia-2023-2024.},
journal = {Journal of family medicine and primary care},
volume = {14},
number = {9},
pages = {3729-3734},
pmid = {41089957},
issn = {2249-4863},
abstract = {BACKGROUND: COVID-19 has infected 221 million individuals worldwide and new strains are discovered continuously. An important complication is the post-COVID-19 syndrome that affects various organs with substantial morbidities. Studies on post-COVID-19 symptoms and risk factors are scarce. We aimed to assess the same among medical students at the University of Tabuk, Saudi Arabia.

METHODOLOGY: This cross-sectional study was conducted among 424 medical students at the University of Tabuk, Saudi Arabia, during the period from July 2023 to October 2024. A web-based questionnaire detailing the demographic factors, post-COVID-19 symptoms, comorbidities, vitamin D deficiency, and the cumulative grade average (GPA) was used.

RESULTS: Out of the 424 students, 38.2% were overweight and 9.4% were obese, 26.9% had bronchial asthma, and diabetes was found in 11.8%. Smoking was observed in 25%, and 58.5% were vitamin D deficient, while 22.6% were hospitalized with COVID-19. The majority of students received > two doses (74.1%), 24.5% received two doses, and 1.4% received one dose. The majority (80.7%) of students reported at least one post-COVID-19 symptom, and headache was the commonest symptom (63.7%), followed by cough in 50.5%. The absence from classrooms was 54.2%, 32.1%, and 13.7% (3 days, 3-8 days, and >10 days/month, respectively), and 44.8% thought that long COVID-19 negatively affected their GPA.

CONCLUSION: Post-COVID-19 syndrome was associated with diabetes, bronchial asthma, and vitamin D deficiency, odd ratios, 95% CI, 0.011-0.910, 0.005-0.312, 0.203-0.821, respectively, P values > 0.05. No significant association was found regarding, age, gender, and smoking, P values >0.05.},
}

@article {pmid41089587,
year = {2025},
author = {Albazee, E and Alajmi, SA and Alkandari, AM and Aladwani, AN and Alenezi, YY and Alsaeed, MA and Uqlah, B and Abu-Zaid, A},
title = {Platelet-Rich Plasma for COVID-19-Related Olfactory Dysfunction: A Systematic Review and Meta-analysis of Randomized Controlled Trials.},
journal = {Cureus},
volume = {17},
number = {10},
pages = {e94386},
pmid = {41089587},
issn = {2168-8184},
abstract = {A notable rise in olfactory dysfunction (OD) prevalence has been observed since the COVID-19 pandemic. COVID-19-related OD is associated with several consequences, especially deteriorated quality of life. Hence, several treatment options have been investigated, with platelet-rich plasma (PRP) showing promising results. A systematic review and meta-analysis summarizing randomized controlled trial (RCT) evidence were retrieved from PubMed, Google Scholar, Scopus, and Web of Science up to June 2025. The risk of bias was assessed using the Cochrane Risk of Bias 2 assessment tool. Data were analyzed using Stata MP version 18 (StataCorp LLC, College Station, TX), pooling dichotomous outcomes as relative risks (RRs) and continuous outcomes as standardized mean differences (SMDs), each with 95% confidence intervals (CIs). Four RCTs, including 198 participants, were included in our meta-analysis. PRP significantly improved objective olfactory scores (SMD = 1.86, 95% CI (0.14, 3.57), p = 0.03) and subjective olfactory scores (SMD = 0.92, 95% CI (0.32, 1.51), p < 0.001). Additionally, PRP significantly increased the response rate (RR = 1.79, 95% CI (1.14, 2.81), p = 0.01). PRP was generally well-tolerated across the included trials, with no major adverse events reported. Two RCTs showed an overall low risk of bias, one trial showed some concerns, and another showed a high risk of bias. With uncertain evidence, PRP may improve both objective and subjective smell function and clinical outcomes in people with long COVID-related OD. PRP treatment was reported to be safe, with minor, temporary side effects primarily related to the procedure. Although initial results are promising, the small number of RCTs requires a cautious approach to interpretation.},
}

@article {pmid41089328,
year = {2025},
author = {Blitshteyn, S and Funez-dePagnier, G and Szombathy, A and Hutchinson, M},
title = {Immunotherapies for postural orthostatic tachycardia syndrome, other common autonomic disorders, and Long COVID: current state and future direction.},
journal = {Frontiers in cellular and infection microbiology},
volume = {15},
number = {},
pages = {1647203},
pmid = {41089328},
issn = {2235-2988},
mesh = {Humans ; *Postural Orthostatic Tachycardia Syndrome/therapy/immunology ; *COVID-19/therapy/immunology/complications ; *Immunotherapy/methods/trends ; *Autonomic Nervous System Diseases/therapy/immunology ; Immunoglobulins, Intravenous/therapeutic use ; SARS-CoV-2 ; Plasmapheresis ; Adrenal Cortex Hormones/therapeutic use ; Post-Acute COVID-19 Syndrome ; },
abstract = {Postural orthostatic tachycardia syndrome (POTS), neurocardiogenic syncope, and orthostatic hypotension are the most common autonomic disorders encountered in clinical practice. The autoimmune etiology and association of these conditions with systemic autoimmune and inflammatory disorders, autonomic neuropathy, and post-acute infectious syndromes, including Long COVID, suggest that immunotherapies should be considered as a therapeutic option, at least in a subset of patients. However, the treatment of common autonomic disorders has traditionally included pharmacologic and non-pharmacologic symptomatic therapies as the standard approach. Unfortunately, these symptomatic therapies have been of limited or insufficient efficacy to meaningfully improve functional status or result in recovery, especially in patients with severe symptoms. Case reports, case series, and clinical experience suggest that intravenous and subcutaneous immunoglobulin, as well as other immunologic therapies (such as plasmapheresis, corticosteroids, and rituximab), may be effective in some patients with severe POTS and other common autonomic disorders who are refractory to standard therapies. In this narrative review, we summarize the literature available on the topic of immunotherapies for POTS, other common autonomic disorders, and Long COVID. We also highlight the need for large, multicenter, placebo-controlled trials of immunoglobulin, plasmapheresis, intermittent corticosteroids, and other repurposed immunotherapies in patients with common autonomic disorders who have significant functional impairment.},
}

Humans
*Postural Orthostatic Tachycardia Syndrome/therapy/immunology
*COVID-19/therapy/immunology/complications
*Immunotherapy/methods/trends
*Autonomic Nervous System Diseases/therapy/immunology
Immunoglobulins, Intravenous/therapeutic use
SARS-CoV-2
Plasmapheresis
Adrenal Cortex Hormones/therapeutic use
Post-Acute COVID-19 Syndrome

@article {pmid41088275,
year = {2025},
author = {Portela, MC and Escosteguy, CC and Lima, SML and Bernardino, M and do Nascimento Caldas, B and Soares, L and de Vasconcellos, MTL and Martins, M and de Andrade, CLT and Baginski, NP and Góes, G and Sabaine, B and Cavalcanti, M and Furtado, D and Stelson, E and Cornish, F and Aveling, EL},
title = {Healthcare gaps and inequities following hospitalisation for COVID-19 in Brazil's universal healthcare system: a patient-engaged survey of Long COVID healthcare needs, use and barriers.},
journal = {International journal for equity in health},
volume = {24},
number = {1},
pages = {275},
pmid = {41088275},
issn = {1475-9276},
mesh = {Humans ; Brazil/epidemiology ; *COVID-19/therapy/epidemiology ; Female ; Male ; Middle Aged ; Adult ; *Health Services Accessibility/statistics & numerical data ; *Hospitalization/statistics & numerical data ; *Healthcare Disparities/statistics & numerical data ; SARS-CoV-2 ; *Health Services Needs and Demand/statistics & numerical data ; Surveys and Questionnaires ; Aged ; *Universal Health Care ; Young Adult ; Cohort Studies ; Adolescent ; },
abstract = {BACKGROUND: Long COVID (LC) is an infection-associated chronic condition (IACC) that tends to be neglected by healthcare systems. Studies of post-COVID healthcare utilisation find elevated levels of use but have mainly been conducted in high-income settings. In the context of Brazil's universal health system (SUS), our patient-engaged study aimed to map healthcare needs, use, and access barriers related to LC up to 24 months following COVID-19 hospitalisation, in the interest of informing health system planning for an equitable LC response.

METHODS: A cohort survey included a probabilistic sample of hospitalised COVID-19-confirmed individuals aged ≥ 18, who had been discharged from public hospitals in Rio de Janeiro between December 2020 and November 2022. Socio-demographic and clinical data were collected, including self-reported LC symptoms, self-reported LC, healthcare needs, use, and access barriers.

RESULTS: In a sample of 556 participants, corresponding to an estimated population of 11,328 individuals, 50.0% (95%CI 44.3-55.6%) reported healthcare needs in the six months prior, due to new-onset or worsened conditions after COVID-19. Almost 45.0% did not complete high school, while 26.5% lived below the poverty line (~ US$6.85 per day), indicating a high proportion of socially vulnerable individuals. High prevalence of LC symptoms, self-reported LC, and new diagnoses were observed. Healthcare needs were associated with acute disease severity, number of LC symptoms, and new post-COVID diagnoses, including cardiovascular and kidney diseases, and endocrine and musculoskeletal disorders. Significant gaps existed between need and access to services, and part of the access to services involved substantial out-of-pocket expenditure. These gaps were particularly pronounced for specialised medical services, scans/imaging, post-COVID rehabilitation services, and mental healthcare. Despite a universal health system, those with higher monthly incomes (above R$1,500 or ~ US$250) were more likely to have accessed specialised medical care.

CONCLUSIONS: The SUS is not meeting the high need for LC healthcare, raising concerns about deepening health inequities. In Brazil, as elsewhere, LC joins other IACCs in becoming an invisibilised epidemic, with LC patients, especially those unable to pay for care, neglected amid general healthcare backlogs. A comprehensive pandemic response must include dedicated efforts to surveil and treat the long-term impacts of infection.},
}

Humans
Brazil/epidemiology
*COVID-19/therapy/epidemiology
Female
Male
Middle Aged
Adult
*Health Services Accessibility/statistics & numerical data
*Hospitalization/statistics & numerical data
*Healthcare Disparities/statistics & numerical data
SARS-CoV-2
*Health Services Needs and Demand/statistics & numerical data
Surveys and Questionnaires
Aged
*Universal Health Care
Young Adult
Cohort Studies
Adolescent

@article {pmid41087378,
year = {2025},
author = {Yonker, LM and Dredge, D and Munro, A and Di Chiara, C and Cotugno, N and Buonsenso, D},
title = {The second-order effects that the COVID-19 pandemic has had on pediatric populations.},
journal = {Expert review of anti-infective therapy},
volume = {},
number = {},
pages = {},
doi = {10.1080/14787210.2025.2575044},
pmid = {41087378},
issn = {1744-8336},
abstract = {INTRODUCTION: There is growing recognition that SARS-CoV-2 can have long-term health consequences that persist beyond acute infection. While the long-term health impact of SARS-CoV-2 is evident in adults and the elderly, the impact on children and adolescents remains under recognized. In this paper, we navigate the second-order post-acute effects that the COVID-19 has had on the pediatric populations, with the exception of mental health implication of social restrictions, out of the scope of this review.

AREAS COVERED: We outline common scenarios related with SARS-CoV-2 infection encountered in pediatric clinical practice, such as in the Multisystem inflammatory syndrome (MIS-C), Long Covid, neurological and autoimmune complications of Covid-19, immunological impact of the viral infection, as well as epidemiological and public health consequences associated with the implementation of non-pharmacological interventions.

EXPERT OPINION: SARS-CoV-2 has had several second-order effects on child health, from a biological, epidemiological, and public health perspective, highlighting the complexity of dealing with new infections and the urgent need to implement multidisciplinary interventions that support the health of people at single person and societal level. Funding on modern surveillance system, preventing strategies and research to better understand and cure post-acute complications of viral infections should be a priority of every funding agency.},
}

@article {pmid41087247,
year = {2025},
author = {Tanaka, H and Kubota, E and Otori, N and Mori, E},
title = {Olfactory cleft adhesion in post-COVID-19 olfactory dysfunction.},
journal = {European annals of otorhinolaryngology, head and neck diseases},
volume = {},
number = {},
pages = {},
doi = {10.1016/j.anorl.2025.09.004},
pmid = {41087247},
issn = {1879-730X},
abstract = {Post-COVID-19 olfactory dysfunction (PCOD) typically resolves within weeks to months; however, persistent cases exist in approximately 10% of patients beyond a year. This study investigated the role of olfactory cleft adhesions in prolonged PCOD and evaluated surgical intervention as a treatment option. Four cases of PCOD unresponsive to medical therapy underwent endoscopic sinus surgery (ESS) to address bilateral olfactory cleft obstruction identified on computed tomography (CT) scan. Adhesions between the superior/middle turbinates and nasal septum were surgically divided, and silicone plates were inserted to prevent reattachment. All patients reported significant subjective improvements in olfaction within one week of silicone removal. Objective olfactory test scores continued to improve over subsequent months, and postoperative CT scan confirmed improved ventilation of the olfactory cleft. These findings suggest that adhesions formed during inflammatory healing contribute to conductive olfactory dysfunction in Long-COVID cases, distinct from sensorineural or central OD. Surgical intervention may be beneficial for carefully selected patients with PCOD persisting for at least one year, anosmia or severe olfactory loss confirmed by testing, and CT evidence of olfactory cleft obstruction. However, the risks such as mucosal damage and potential worsening or no improvement of OD should be discussed thoroughly. Individualized treatment strategies are recommended, and further studies are warranted to optimize management of persistent PCOD.},
}

@article {pmid41086513,
year = {2025},
author = {Grafström, T and Barros, GWF and Persson, IL and Sundh, J and Forsell, MNE and Ahlm, C and Månsson, E and Tevell, S and Lind, A and Normark, J and Cajander, S},
title = {Post COVID-19 condition phenotypes: A prospective cohort study identifying four symptom clusters and their impact on long-term outcomes.},
journal = {Journal of infection and public health},
volume = {18},
number = {12},
pages = {102994},
doi = {10.1016/j.jiph.2025.102994},
pmid = {41086513},
issn = {1876-035X},
abstract = {BACKGROUND: Current evidence indicates that Post COVID-19 Condition (PCC) is multifaceted with distinct phenotypes. While previous studies have identified symptom clusters-commonly featuring fatigue, respiratory symptoms, and cognitive impairment-findings have been inconsistent, and no clear consensus exists. Moreover, how these symptom clusters evolve over time, particularly beyond the first year post-infection, remains poorly understood.

METHODS: This multicentre prospective cohort study included 470 hospitalised and non-hospitalised adult individuals from the CoVUm study across four sites in Sweden between 2020 and 2021. Follow-ups were conducted up to 3 years after infection to assess persistent symptoms, health-related quality of life (HRQoL), and work capacity. Symptom clusters at 6 months were identified via hierarchical cluster analysis, and participants were tracked using a k-nearest neighbour algorithm.

RESULTS: The most common symptoms at 6 months were fatigue (33 %), dyspnoea (32 %), mental fatigue (30 %), and concentration difficulties (28 %), with a median EQ-5D-5L index of 0.98 (IQR 0.93-1). Four distinct symptom clusters were identified: (i) "Few Symptoms" (n = 265, 57 %), (ii) "Respiratory Symptoms" (n = 66, 14 %), (iii) "Neurocognitive Symptoms" (n = 75, 16 %), and (iv) "Multisystem Symptoms" (n = 52, 11 %). Participants in the latter three clusters were older, had more comorbidities, and were more often hospitalised during primary COVID-19 infection. These clusters also had significantly lower HRQoL compared to the "Few Symptoms" cluster. Over time, more than half of participants transitioned to a cluster with fewer or no symptoms, with significant perceived HRQoL improvement in the "Multisystem Symptoms" cluster.

CONCLUSION: While many patients with PCC improved over time, a subset had persistent symptoms at 3 years, especially if primary infection required hospitalisation. The identification of symptom clusters and their trajectories over time contributes to a better understanding of PCC heterogeneity, ultimately bringing the field closer to consensus on the classification and long-term impact of PCC.},
}

@article {pmid41085647,
year = {2025},
author = {Kippenbroek, N and Stölting, A and Schröder, D and Wetzke, M and Happle, C and Dopfer, C and Schmachtenberg, T and Witte, T and Steffens, S and Mikuteit, M and Müller, F and Behrens, GMN and Dopfer-Jablonka, A},
title = {[Inflammatory rheumatic diseases in patients with post-COVID syndrome].},
journal = {Zeitschrift fur Rheumatologie},
volume = {},
number = {},
pages = {},
pmid = {41085647},
issn = {1435-1250},
abstract = {BACKGROUND: The post-COVID syndrome (PCS) describes long-lasting symptoms after a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. PCS and rheumatic diseases, especially collagenoses, show strong overlap of symptoms and biomarkers. Thus far, no biomarkers that differentiate between PCS patients with and without rheumatic diseases exist, and data on the prevalence of rheumatic diseases in this collective in Germany is scarce.

METHOD: Based on the online platform DEFEAT-Corona, 80 people with PCS without a previously confirmed inflammatory rheumatic disease (IRD) and interest in a rheumatological evaluation were recruited. Typical complaints of PCS and rheumatic diseases were analyzed. In addition, comprehensive laboratory analyses were conducted.

RESULTS: In 6.25% (n = 5) of the PCS patients,IRD was suspected or confirmed. The remaining 75 PCS patients without IRD also showed a high degree of overlap with regard to complaints typical for rheumatic disease or PCS. The inflammation parameters C‑reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were significantly higher in PCS patients with suspected IRD compared to patients with PCS only and significantly more often exceeded normal range.

CONCLUSION: This study illustrates the high degree of overlap between PCS and rheumatic symptoms in PCS patients without previous suspicion of IRD. The risk for IRD could be elevated in PCS. However, in the view of the authors, PCS without additional risk factors, such as elevated CRP or arthritis, does not generally justify rheumatological evaluation in clinical routine. This recommendation should be further investigated in larger studies.},
}

@article {pmid41085475,
year = {2025},
author = {Stufano, A and Lucchese, G},
title = {Work Productivity Loss in People Living With Long COVID Symptoms: a good start and a missed opportunity.},
journal = {Journal of occupational and environmental medicine},
volume = {},
number = {},
pages = {},
doi = {10.1097/JOM.0000000000003584},
pmid = {41085475},
issn = {1536-5948},
}

@article {pmid41085471,
year = {2025},
author = {Naik, H and Zhang, W},
title = {Re: Work Productivity Loss in People Living With Long COVID Symptoms: a good start and a missed opportunity.},
journal = {Journal of occupational and environmental medicine},
volume = {},
number = {},
pages = {},
doi = {10.1097/JOM.0000000000003583},
pmid = {41085471},
issn = {1536-5948},
}

@article {pmid41085189,
year = {2025},
author = {Hadidchi, R and Ali, E and Piskun, H and Henry, S and Zhang, L and Duong, TQ},
title = {Elevated Risk of Long-Term Decline in Left Ventricular Ejection Fraction After COVID-19.},
journal = {Journal of the American Heart Association},
volume = {},
number = {},
pages = {e043976},
doi = {10.1161/JAHA.125.043976},
pmid = {41085189},
issn = {2047-9980},
abstract = {BACKGROUND: COVID-19 has been linked to cardiovascular complications, but its long-term impact on left ventricular (LV) function is unclear. We investigated whether SARS-CoV-2 infection is associated with increased risk of LV ejection fraction (LVEF) decline and whether vaccination mitigates this risk.

METHODS: In this retrospective study, we included patients with COVID-19, normal baseline LVEF (≥50%), and at least one follow-up echocardiogram from 2016 to 2024. Outcomes were LVEF dropping <50%, 40%, and 30%. Multivariable Cox models adjusted for demographics, comorbidities, vaccination status, and baseline LVEF. Associations with acute-phase blood biomarkers were examined.

RESULTS: Among 2853 patients who were COVID+ and 3963 patients who were COVID- (baseline LVEF ≥50%), patients with COVID-19 had lower mean follow-up LVEF (60.65% versus 61.53%, P<0.005) and higher rates of LVEF decline <50%, 40%, and 30%. Both hospitalized (adjusted hazard ratio [aHR], 1.57 [1.30-1.91]) and non-hospitalized (aHR, 1.48 [1.18-1.85]) patients with COVID-19 had greater risk of LVEF <50% versus controls; only hospitalized patients had significantly increased risk of LVEF<40% (aHR, 1.81 [1.35-2.43]) and <30% (aHR, 2.79 [1.72-4.54]). Vaccination was not significantly associated with LVEF decline. Baseline LVEF, older age, male sex, history of heart failure, myocardial infarction, and chronic kidney disease were associated with greater risk. Elevated troponin, B-type natriuretic peptide, D-dimer, and thrombocytopenia predicted greater risk in hospitalized patients with COVID-19.

CONCLUSIONS: SARS-CoV-2 infection is associated with long-term LVEF declines, especially in hospitalized patients. Vigilant cardiac surveillance may be needed in survivors of COVID-19 to mitigate progressive dysfunction.},
}

@article {pmid41083891,
year = {2025},
author = {Troxel, AB and Krishnan, JA and Verduzco-Gutierrez, M},
title = {The 2024 NASEM Long COVID Definition as a Starting Point for Research.},
journal = {Journal of general internal medicine},
volume = {},
number = {},
pages = {},
pmid = {41083891},
issn = {1525-1497},
}

@article {pmid41082082,
year = {2025},
author = {Wasim, R},
title = {From infection to intervention: post-acute sequelae of SARS-CoV-2 infection and cardiovascular risk.},
journal = {Inflammopharmacology},
volume = {},
number = {},
pages = {},
pmid = {41082082},
issn = {1568-5608},
abstract = {COVID is now a worldwide epidemic of non-communicable diseases. The symptoms, which impact several organs, might last for hours, weeks, or even months after the SARS-CoV-2 infection has ended. Electrocardiogram abnormalities (ECG), postural orthostatic tachycardia, and supraventricular or ventricular arrhythmias are among the common signs of long COVID-19. According to data, certain patient groups have persistent, post-infectious perimyocarditis, which may lead to left or right ventricular failure, arterial wall inflammation, or microthrombosis. This information has been made available by cardiac and vasculature imaging, and it may be used to develop efficient treatment plans for the cardiovascular symptoms of long COVID. Long COVID requires a greater understanding of the cellular and molecular processes. There are a variety of approaches that have been put forward, some of which include direct impacts on the heart and others that involve microthrombotic damage to the arteries or heart. When evaluated 3 months after SARS-CoV-2 infection, the currently employed circulating biomarkers, such as coagulation and inflammatory markers, do not serve as a highly predictive predictor for the existence or outcome of long COVID. However, further study is required to better understand the underlying processes and particular biomarkers for future COVID preventive methods.},
}

@article {pmid41081723,
year = {2025},
author = {Schlak, A and Seidel, I and Awan, O and Neal, J and Rao, M and Janssen, K and Warner, D and Lee, K and Park, A and Adly, M and Brill, E and Atkins, D and Jones, BE and Wander, PL},
title = {Reaching Consensus on Long COVID Symptoms and Patient-Reported Outcomes Across the Veterans Health Administration Using a Modified Hybrid Nominal Group-Delphi Approach.},
journal = {Medical care},
volume = {63},
number = {11},
pages = {842-850},
doi = {10.1097/MLR.0000000000002194},
pmid = {41081723},
issn = {1537-1948},
mesh = {Humans ; United States ; Delphi Technique ; *COVID-19/complications ; *United States Department of Veterans Affairs ; *Patient Reported Outcome Measures ; *Consensus ; SARS-CoV-2 ; Surveys and Questionnaires ; Post-Acute COVID-19 Syndrome ; },
abstract = {BACKGROUND: A consistent approach to track Long COVID symptoms at the Veterans Health Administration (VHA) was lacking.

OBJECTIVES: To reach consensus among clinical stakeholders on how long COVID symptoms should be assessed at VHA outpatient visits and recommend an assessment battery.

RESEARCH DESIGN: Hybrid Delphi-Nominal Group approach.

SUBJECTS: Members of the VHA Long COVID Field Advisory Board (FAB) and the VHA Long COVID Community of Practice (CoP) participated. Veteran stakeholders provided input.

MEASURES: A literature review and clinician questionnaires identified 68 instruments across 14 symptom domains. In the first consensus round, FAB members excluded instruments with limited clinical usability. The remaining 25 instruments were ranked by CoP members. Multiple rounds of asynchronous voting were conducted until one instrument remained per domain. The top instruments were grouped into 3 batteries. Final consensus on a preferred battery was reached through additional voting. Veterans from the Los Angeles Veteran Engagement Panel assessed clarity, burden, and feasibility.

RESULTS: The final battery included the Modified Yorkshire COVID-19 Rehabilitation Survey, VHA Whole Health Well-Being Signs, the Exercise Vital Signs Questionnaire, and the 2-Minute Step Test. Whole Health questions were also included to support the VHA's Whole Health System mission. Symptom-specific instruments already used in VHA routine care were not included in the final battery, as clinics already had access to them.

CONCLUSIONS: A structured, rapid consensus process was used to identify a battery of symptom instruments to standardize Long COVID symptom assessment across VHA clinics.},
}

Humans
United States
Delphi Technique
*COVID-19/complications
*United States Department of Veterans Affairs
*Patient Reported Outcome Measures
*Consensus
SARS-CoV-2
Surveys and Questionnaires
Post-Acute COVID-19 Syndrome

@article {pmid41080863,
year = {2025},
author = {Heath, GW and Levine, D and Oppong, G and Alghader, M},
title = {Prevalence of post COVID-19 condition and associations with risk factors among U.S. adults: 2023 Behavioral Risk Factor Surveillance System.},
journal = {Frontiers in public health},
volume = {13},
number = {},
pages = {1662273},
pmid = {41080863},
issn = {2296-2565},
mesh = {Humans ; *COVID-19/epidemiology/complications ; Adult ; Behavioral Risk Factor Surveillance System ; Male ; Female ; United States/epidemiology ; Middle Aged ; Risk Factors ; Exercise ; Prevalence ; SARS-CoV-2 ; Aged ; Young Adult ; Adolescent ; },
abstract = {INTRODUCTION: During the COVID-19 pandemic, between 12 and 20% of US adults were identified as having post-COVID-19 condition, commonly referred to as 'Long COVID'. These individuals maintained symptoms of COVID-19 for 3 months or longer following their illness but lacked an active infection. Using the Center for Disease Control's 2023 Behavioral Risk Factor Surveillance System, our hypotheses were that adults who did not meet the 2018 Physical Activity Guidelines for Americans for aerobic and strengthening activities, those not fully vaccinated against COVID-19, and those with certain non-communicable diseases would be at greater odds of reporting post COVID-19 conditions.

METHODS: The association of post COVID-19 conditions were examined among the 46.4% of adults 18 years and older who had tested positive for COVID-19 (n = 201,248), with a subset these adults reporting post COVID-19 conditions (n = 27,074, 13.6%). Univariate and logistic regression analyses were conducted using SPSS (v29) for complex samples. Univariate analyses were initially conducted on both behavioral risk factors and multiple non-communicable diseases. Subsequently, a series of logistic regression analyses controlling for age, sex, race/ethnicity, and educational attainment were carried out to compare the outcome variable of post-COVID-19 conditions with the exposure variables of (1) not meeting the Physical Activity Guidelines for Americans, (2) not being fully vaccinated, or (3) having the non-communicable diseases of overweight/obesity, coronary heart disease, asthma, or hypertension.

RESULTS: Adults (n = 13,449; 12.2%) who did not meet the Physical Activity Guidelines for Americans were at greater odds of reporting post COVID-19 conditions (aerobic activity - OR = 1.19, 95% CI 1.06, 1.33, p < 0.0001; strengthening activity - OR = 1.02, 95% CI 1.00, 1.03, p < 0.001) compared with those meeting the guidelines. Respondents who were not fully vaccinated (≤ 3 vaccinations) were at greater odds of reporting post COVID-19 conditions (OR = 1.42, 95% CI, 1.24, 1.49, p < 0.0001) compared with those reporting ≥4 vaccinations.

DISCUSSION: The present findings support the hypothesis that adults who were female, did not achieve the Physical Activity Guidelines, were not fully vaccinated, and had certain non-communicable diseases demonstrated a stronger association with reporting post COVID-19 conditions following COVID-19 infection.},
}

Humans
*COVID-19/epidemiology/complications
Adult
Behavioral Risk Factor Surveillance System
Male
Female
United States/epidemiology
Middle Aged
Risk Factors
Exercise
Prevalence
SARS-CoV-2
Aged
Young Adult
Adolescent

@article {pmid41080807,
year = {2025},
author = {Hammami, N and Karoui, S and Khezami, MA and Ceylan, Hİ and Dhahbi, W and Bahlouli, E and Ben Jeddou, I and Dergaa, I and Lebib, S and Ben Salah, FZ and Stefanica, V and Muntean, RI and Dziri, C},
title = {Adapted Physical Activity Protocol Improves Health-Related Quality of Life and Psychological Outcomes in Long COVID: A Prospective Longitudinal Study.},
journal = {Journal of multidisciplinary healthcare},
volume = {18},
number = {},
pages = {6445-6457},
pmid = {41080807},
issn = {1178-2390},
abstract = {BACKGROUND: Coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2, has resulted in persistent symptoms in some individuals-referred to as long COVID or post-acute sequelae of SARS-CoV-2 infection (PASC). Common symptoms such as fatigue, dyspnea, anxiety, and depression can markedly impair health-related quality of life (HRQOL). Conventional rehabilitation may be insufficient, raising interest in Adapted Physical Activity (APA) as a non-pharmacological strategy to improve physical and psychological outcome. Thus, this study aimed to evaluate the short- and medium-term effects of an APA protocol on HRQOL and psychological outcomes in patients with long COVID.

METHODS: Fifty non-hospitalized patients with long COVID (mean age 52.0 ± 15.3 years; 44% female) participated in in a prospective, longitudinal observational study. Each patient underwent a 6-week APA program consisting of two 30-minute individualized cardiorespiratory sessions per week. HRQOL (SF-12), anxiety, and depression (HADS) were evaluated at baseline (E1), immediately post-intervention (E2), and at 5-7 months follow-up (E3).

RESULTS: Significant improvements were found in both physical and mental SF-12 scores across time points (p < 0.001). The proportion of patients with normal physical HRQOL rose from 16% at baseline to 90% at E2 and remained higher than baseline at E3 (66%). Symptoms of anxiety and depression were significantly reduced (p < 0.001). Dyspnea prevalence decreased substantially from baseline to follow-ups. Strong negative correlations were observed between HRQOL and HADS scores (p < 0.001).

CONCLUSION: The APA protocol showed significant short- and medium-term improvements in HRQOL and psychological outcomes in long COVID patients. Benefits were more pronounced for physical symptoms and anxiety than for depression. These findings suggest that structured physical activity may offer a feasible, non-pharmacological strategy to enhance recovery and quality of life. Incorporating APA into routine care may help meet the diverse functional and psychological needs of this population.},
}

@article {pmid41080329,
year = {2025},
author = {Martinez Juarez, D and Gomez-Monterrosas, O and Zamora Rosales, F},
title = {Endothelial Dysfunction in a Patient With Post-COVID-19 Syndrome and Mutation of the MTHFR Gene and Prothrombin II.},
journal = {Cureus},
volume = {17},
number = {9},
pages = {e92056},
pmid = {41080329},
issn = {2168-8184},
abstract = {Post-COVID-19 syndrome (also known as long COVID) is defined as the persistence of cardiovascular symptoms (chest pain, fatigue, palpitations) 12 weeks after the acute phase of SARS-CoV-2 infection. SARS-CoV-2 has been shown to directly infect endothelial cells through ACE2 receptors, leading to endotheliitis and vascular inflammation. In susceptible individuals, this endothelial damage may persist after viral clearance, contributing to coronary microvascular dysfunction. Genetic predispositions (primary thrombophilias) may further aggravate endothelial injury. The prothrombin factor II G20210A mutation has been associated with an increased risk of venous and arterial thrombotic events. The MTHFR gene mutation, particularly the homozygous C677T polymorphism, is associated with reduced activity of methylenetetrahydrofolate reductase, impairing the conversion of homocysteine to methionine. This leads to hyperhomocysteinemia, which contributes to endothelial dysfunction (ED). We report the case of a 25-year-old Mexican woman with a four-month history of chest pain and dyspnea (following a previous COVID-19 infection associated with vaccination). She presented with acute chest pain and dyspnea requiring hospitalization. Echocardiography revealed abnormal regional longitudinal strain in the basal anteroseptal wall (-7%) and basal-mid anterolateral wall (-14% and -16%, respectively), with reduced myocardial work in basal and mid-segments (379-1715 mmHg%). Cardiac magnetic resonance imaging (CMRI) demonstrated myocardial involvement; however, coronary CT angiography (CCTA) excluded obstructive disease. Anti-SARS-CoV-2 IgG levels were markedly elevated (2893 AU/mL). Hematologic evaluation revealed abnormal platelet aggregation with platelet hyperreactivity and the identification of homozygous MTHFR C677T and heterozygous prothrombin factor II G20210A mutations. The patient initially received prophylactic anticoagulation with apixaban during hospitalization, which was discontinued after discharge. Long-term treatment included low-dose aspirin, folic acid, B-complex vitamins, bisoprolol, and trimetazidine for angina control. At a one-year follow-up, the patient showed clinical improvement, with a reduction in the frequency and intensity of angina. This case suggests that patients with platelet hyperreactivity, MTHFR (C677T), and prothrombin factor II (G20210A) mutations may be predisposed to developing ED and coronary microcirculatory impairment following SARS-CoV-2 infection in post-COVID-19 syndrome. We address the use of prophylactic anticoagulants in selected cases such as ours, which, although not specifically recommended by current guidelines (American Society of Hematology), may be considered after an individualized risk-benefit assessment.},
}

@article {pmid41079753,
year = {2025},
author = {Dadsena, R and Wetz, S and Hofmann, A and Costa, AS and Romanzetti, S and Lischewski, SA and Krockauer, C and Balloff, C and Binkofski, F and Schulz, JB and Reetz, K and Walders, J},
title = {Evidence of clinical and brain recovery in post-COVID-19 condition: a three-year follow-up study.},
journal = {Brain communications},
volume = {7},
number = {5},
pages = {fcaf366},
pmid = {41079753},
issn = {2632-1297},
abstract = {Fatigue and cognitive dysfunction linked to persistent brain changes have been reported for up to two years after COVID-19. In this study, we followed the clinical, neuroimaging and fluid biomarker trajectories over three years post SARS-CoV-2 infection to evaluate potential signs and underlying factors of brain recovery. We conducted a monocentric, longitudinal study using resting-state functional and structural T1-weighted magnetic resonance imaging data from 51 patients with post-COVID-19 condition (mean age 50 years, 33 female) collected at a mean time of 6, 23 and 38 months after COVID-19 infection. The trajectory of brain changes was compared to 23 age- and sex-matched healthy controls (mean age 37 years, 13 female) with similar time intervals between brain scans and analysed in relation to clinical, neuropsychological and fluid biomarkers including interleukins and neurodestruction markers at all timepoints. In addition, hand grip strength to evaluate muscular fatigue was assessed at the final follow-up visit. Self-reported fatigue improved over time but was still moderate on average three years after COVID-19 infection, while measures of hand grip strength and cognitive performance were largely unaffected. We found a significant increase of both lateral ventricles (∼8%) and the third (∼6%) ventricle accompanied by a structural volume reduction in adjacent areas including the thalamus, pallidum, caudate nucleus and putamen. An increased neuronal activation pattern was widespread and pronounced in these areas. The brainstem no longer exhibited volume loss as reported in our pervious study, but enhanced functional connectivity. Laboratory markers including interleukins and neuronal injury markers remained within the normal reference ranges across all study timepoints. Our study revealed an overall slow but evident clinical improvement, including improved fatigue, regular muscular strength and recovery as well as normal cognitive function without signs of systemic inflammation three years after COVID-19. Clinical improvement is reflected by a pattern of brain recovery along periventricular regions. This pattern is characterized by structural stabilization and increased connectivity starting in the brainstem as well as efficient neuronal recruitment and increased activation in the basal ganglia, with no evidence of neuronal injury. These results highlight the positive long-term recovery trajectory in post-COVID patients.},
}

@article {pmid41079027,
year = {2025},
author = {Damant, RW and Rourke, L and Lam, GY and Smith, MP and Weatherald, J and Laratta, CR and Fuhr, DP and Cui, Y and Stickland, MK and Ferrara, G},
title = {Exploring the temporal relationship between stigma, disease manifestations, and health outcomes in post COVID-19 condition: a longitudinal descriptive study.},
journal = {EClinicalMedicine},
volume = {89},
number = {},
pages = {103531},
pmid = {41079027},
issn = {2589-5370},
abstract = {BACKGROUND: Stigma is defined as a deeply discrediting attribute. Post COVID-19 Condition (PCC) is now recognized to be a source of health-related stigma and discrimination capable of negatively impacting the well-being of those affected. Our purpose was to explore the relationship between PCC-related stigma, disease manifestations, and health outcomes over time.

METHODS: Using previously validated instruments to measure PCC-related stigma, symptoms, depression, quality of life, function, and occupational status, we conducted a longitudinal descriptive study in a cohort of individuals with confirmed PCC between May 12 and August 13, 2023 in the Canadian city of Edmonton.

FINDINGS: Ninety-nine consenting participants completed study questionnaires 3-24 months following an initial diagnosis of PCC (enrollment) and again a mean (SD) of 1.6 (0.26) years later (follow-up). Individuals experienced marked variability in study scores over time. Measures of central tendency proved inadequate to detect changes within the cohort. There was minimal attenuation of stigma scores between enrollment and follow-up despite a "return to normal" from earlier pandemic responses: the change in mean stigma score from enrollment to follow-up was -0.2 (p = 0.97). Significant correlations were found between enrollment stigma and symptoms, depression, function, and quality of life measured at follow-up (r = 0.45-0.55). Similar correlations were noted between enrollment stigma and follow-up composite disease manifestation, health outcome, and global well-being scores (r = 0.39-0.54). Multivariate multiple regression demonstrated statistically significant associations between the change in stigma from enrollment to follow-up and symptoms, depression, functional status, and quality of life (B = -0.45 to -0.11). When participants were categorized as "improved stigma at enrollment" vs. "unchanged or worse stigma at enrollment", changes in stigma over time appeared to be predictive of disease manifestations and health outcomes at follow-up (Cohen's d = 0.43-0.77).

INTERPRETATION: This study provides insights into the temporal relationship between PCC-related stigma, disease manifestations, and health outcomes and could establish a foundation for screening, prognostication, treatment, and other efforts to mitigate the impact of stigma.

FUNDING: The Long COVID Web is funded by the Canadian Institute of Health Research (CIHR)-Grant #185352.},
}

@article {pmid41076807,
year = {2025},
author = {Domingo, JL},
title = {Differentiating COVID-19 vaccine-related adverse events from long COVID: A comprehensive review of clinical manifestations, pathophysiology, and diagnostic approaches.},
journal = {Vaccine},
volume = {66},
number = {},
pages = {127842},
doi = {10.1016/j.vaccine.2025.127842},
pmid = {41076807},
issn = {1873-2518},
abstract = {The global deployment of COVID-19 vaccines has introduced diagnostic challenges due to overlapping symptoms with long COVID, or post-acute sequelae of SARS-CoV-2 infection (PASC), prompting a comprehensive review of vaccine safety profiles, long COVID manifestations, and evidence-based differentiation strategies. Through a literature search (PubMed, Scopus, Web of Science) from December 2020 to June 2025, including peer-reviewed studies, clinical trials, and cohort studies, the present review reports that COVID-19 vaccines maintain robust safety, with rare adverse events like myocarditis and thrombosis with thrombocytopenia syndrome, while long COVID affects 10-40 % of SARS-CoV-2 survivors, presenting symptoms such as fatigue, cognitive dysfunction, and dyspnea. Differentiation between these conditions relies on careful analysis of the timing of symptom onset, detailed symptom characterization, and the use of advanced diagnostic tools. Systematic clinical assessment is essential for accurate diagnosis, which is critical for appropriate patient management, maintaining public confidence in vaccination, and guiding future research. Further studies are needed to validate diagnostic biomarkers, develop targeted therapies, and monitor long-term outcomes, with standardized global registries and interdisciplinary collaboration identified as key priorities for improving care and advancing the field.},
}

@article {pmid41075953,
year = {2025},
author = {Salmam, I and Tittley, J and Drouin, G and Perreault, K and Desmeules, F and Paquette, JS and Roy, JS and Best, KL},
title = {Metabolic and ventilatory constraints in long COVID individuals.},
journal = {Respiratory physiology & neurobiology},
volume = {},
number = {},
pages = {104504},
doi = {10.1016/j.resp.2025.104504},
pmid = {41075953},
issn = {1878-1519},
abstract = {Long COVID is characterized by persistent symptoms and physiological impairments beyond acute infection. Oxygen consumption (VO2) and ventilatory efficiency, key indicators of cardiorespiratory fitness, are commonly diminished in this population, contributing to exercise intolerance. This study compared cardiorespiratory patterns and exercise capacity among individuals with Long COVID (LCG), those with resolved symptoms (Short COVID; SCG), and healthy controls (CG). The secondary objective was to assess longitudinal changes over six months. Cross-sectional comparisons at baseline addressed the primary objective, while the longitudinal component explored on changes over time. Participants included 94 in the LCG, 100 in the SCG, and 70 in the CG. All performed a 6-minute walk test (6MWT) during which peak oxygen uptake (VO2peak), minute ventilation (VE), and VE/VCO2 (ratio of VE to carbon dioxide output, reflecting ventilatory efficiency) were continuously measured using the Metamax 3B system. Baseline differences were assessed by one-way ANOVA, and longitudinal changes by generalized estimating equations. At baseline, VO2peak was significantly reduced in the LCG (70.1% predicted) versus SCG (80.6%) and CG (84.6%) (p=0.001). VE/VCO2 was elevated in the LCG (30.2±4.2) compared to SCG (27.9±2.8) and CG (28.7±3.3) (p<.001). The 6MWT distance was also lower in the LCG (484±127m) than SCG (607±69.1m) and CG (571±89.6m) (p<.001). No statistically significant Group × Time interaction emerged between the groups. Individuals with Long COVID exhibited persistent ventilatory inefficiency and reduced exercise capacity, with impairments persisting over six months, underscoring the need for targeted rehabilitation. SHORT ABSTRACT: Individuals with Long COVID exhibit reduced exercise capacity and persistent ventilatory inefficiency compared to Short COVID and control groups. At baseline and over six months, VO2, VE/VCO2, and 6MWT distances were significantly impaired, highlighting the need for targeted rehabilitation strategies to address ongoing physiological limitations in this population.},
}

@article {pmid41074231,
year = {2025},
author = {Reagu, S and Alabdulla, M and Kader, NKA and Ajmal, NA and Abdelgafar, SKH and Wadoo, O},
title = {Long-term symptoms after SARS-CoV-2 infection in a cohort of healthcare workers in Qatar.},
journal = {BMC infectious diseases},
volume = {25},
number = {1},
pages = {1282},
pmid = {41074231},
issn = {1471-2334},
}

@article {pmid41074076,
year = {2025},
author = {Farré, X and Blay, N and Iraola-Guzmán, S and Fernández-Jiménez, F and Alzate-Piñol, S and Llucià-Carol, L and Espinosa, A and Castaño-Vinyals, G and Dobaño, C and Moncunill, G and Karachaliou, M and Garcia-Aymerich, J and Kogevinas, M and Barceló, C and Cadenas, I and de Cid, R},
title = {VEGFA sex-specific signature is associated to long COVID symptom persistence.},
journal = {BMC medicine},
volume = {23},
number = {1},
pages = {552},
pmid = {41074076},
issn = {1741-7015},
support = {TED2021-130626B-I00//Ministerio de Ciencia e Innovación/ ; CEX2018-000806-S//Ministerio de Ciencia e Innovación/ ; 167/C/2021//Fundació la Marató de TV3/ ; SR20-01024//'la Caixa' Foundation/ ; PI20/01267//Ministerio de Sanidad, Política Social e Igualdad/ ; PI18/01512//Ministerio de Sanidad, Política Social e Igualdad/ ; GA:101046314//HORIZON EUROPE Framework Programme/ ; },
mesh = {Humans ; Female ; *COVID-19/blood/metabolism ; Male ; *Vascular Endothelial Growth Factor A/blood/metabolism ; Middle Aged ; Sex Factors ; Aged ; SARS-CoV-2 ; Biomarkers/blood ; Adult ; Proteomics ; },
abstract = {BACKGROUND: Long COVID involves persistent symptoms after COVID-19 recovery, affecting multiple organ systems for months or years. Risk factors include female sex, prior chronic conditions, severe SARS-CoV-2 infection, reinfections, and lack of vaccination. As a major public health concern, ongoing research continues to investigate its causes, mechanisms, and long-term effects.

METHODS: Proteomic expression analysis of 171 individuals, in two time points, with confirmed SARS-CoV-2 infection, including 133 long COVID patients from the deeply characterized COVICAT cohort, assessed 1395 protein biomarkers using Olink® technology. Statistical analyses with linear mixed models examined protein expression changes, long COVID status, and sex-specific differences. Functional analysis included gene set enrichment analysis and protein-protein interaction networks.

RESULTS: Findings revealed VEGFA overexpression in long COVID patients (effect size 0.322, SE = 0.098, p = 0.0013), along with sex-specific expression patterns and the influence of sex-hormonal status in females, with significant overexpression of circulating VEGFA levels specifically in postmenopausal women (Mann-Whitney U test p value = 8.55 × 10[-3]). Network analysis identified 109 nodes and 274 edges, with VEGFA ranking highest in centrality. Dysregulated chemokine signaling, complement activation, and viral reactivation were also confirmed, consistent with prior studies.

CONCLUSIONS: Using high-throughput proteomic profiling in a population-based cohort, we observed that vascular dysfunction, particularly involving VEGFA, is a key feature of long COVID, especially in milder cases, with significant overexpression of VEGFA in postmenopausal women. Sex-specific proteomic patterns suggest distinct recovery mechanisms, highlighting the need to consider sex, vascular health, and disease severity in the pathogenesis and management of long COVID.},
}

Humans
Female
*COVID-19/blood/metabolism
Male
*Vascular Endothelial Growth Factor A/blood/metabolism
Middle Aged
Sex Factors
Aged
SARS-CoV-2
Biomarkers/blood
Adult
Proteomics

@article {pmid41073932,
year = {2025},
author = {Yan, X and Zhao, X and Wang, H and Du, Y and Liu, L and Liu, J and Wang, Q and Wei, S},
title = {Impact of vaccination on SARS-CoV-2 infections and long COVID symptoms: a cross-sectional study in China.},
journal = {BMC infectious diseases},
volume = {25},
number = {1},
pages = {1266},
pmid = {41073932},
issn = {1471-2334},
support = {72061137006//National Natural Science Foundation of China/ ; 2022YFC2305103//National Key Research and Development Program of China/ ; },
}

@article {pmid41073921,
year = {2025},
author = {Takamatsu, N and Kuga, H},
title = {Applicability and adaptation of cognitive behavior therapy for long COVID neuropsychiatric symptoms: a review with insights from ME/CFS.},
journal = {BMC infectious diseases},
volume = {25},
number = {1},
pages = {1275},
pmid = {41073921},
issn = {1471-2334},
support = {JP23K02953//Japan Society for the Promotion of Science/ ; },
}

@article {pmid41073392,
year = {2025},
author = {Baik, M and Yeom, J and Lee, SM and Jeong, H and Lee, AR and Seo, S and Choi, SM and Jo, Y and Park, HY and Kim, EY and Paik, JW},
title = {Discovery of molecular signature of long-term psychiatric sequelae in COVID-19 through proteome profiling of dried blood spots.},
journal = {Translational psychiatry},
volume = {15},
number = {1},
pages = {389},
pmid = {41073392},
issn = {2158-3188},
mesh = {Humans ; *COVID-19/complications/psychology/blood ; Male ; Female ; Middle Aged ; Adult ; Dried Blood Spot Testing ; Proteomics/methods ; *Proteome ; *Mental Disorders/blood/etiology ; Aged ; SARS-CoV-2 ; Biomarkers/blood ; },
abstract = {Neuropsychiatric sequelae represent a significant aspect of post-acute sequelae of SARS-CoV-2 (PASC, or long COVID), posing considerable public health challenges. This study identified molecular signatures associated with PASC in individuals with psychiatric morbidities via dried blood spot proteomic analysis. We evaluated 51 COVID-19 survivors ≥ 60 days post-infection, categorizing them into three groups: those with new-onset psychiatric disorders (n = 16, psychiatric PASC), those with persistent symptoms but no psychiatric disorders (n = 18, general PASC), and those symptomatically recovered (n = 17, recovered). Liquid chromatography-mass spectrometry analysis identified 1604 proteins. Differentially expressed proteins underwent Gene Ontology and Kyoto Encyclopedia of Genes and Genomes pathway enrichment analyses. Protein panels, including isoform 1 of fibronectin, sorbitol dehydrogenase, cytosolic acyl coenzyme A thioester hydrolase, and apolipoprotein A-II, differentiated psychiatric PASC from recovered individuals with an area under the curve (AUC) of 0.865 (95% CI: 0.658-1). Filamin A and vacuolar protein sorting-associated protein VTA1 homolog distinguished psychiatric PASC from general PASC at an AUC of 0.831 (95% CI: 0.6-1). Decision tree analysis revealed that alpha-synuclein, pyruvate kinase PKM, and sorbitol dehydrogenase effectively distinguished the three groups with 82% classification accuracy. These findings suggest that alterations in immune, glucose, and lipid metabolism pathways, along with neuroinflammation and neurodegeneration, contribute to the psychiatric PASC phenotype and highlight potential biomarkers for psychiatric disorders during the long-term COVID-19 clinical course.},
}

Humans
*COVID-19/complications/psychology/blood
Male
Female
Middle Aged
Adult
Dried Blood Spot Testing
Proteomics/methods
*Proteome
*Mental Disorders/blood/etiology
Aged
SARS-CoV-2
Biomarkers/blood

@article {pmid41073313,
year = {2025},
author = {Wang, MC and Liu, X and Hu, K},
title = {[Intermittent hypoxia exposure in the rehabilitation of long COVID patients].},
journal = {Zhonghua jie he he hu xi za zhi = Zhonghua jiehe he huxi zazhi = Chinese journal of tuberculosis and respiratory diseases},
volume = {48},
number = {10},
pages = {961-964},
doi = {10.3760/cma.j.cn112147-20250601-00295},
pmid = {41073313},
issn = {1001-0939},
support = {JCRCYG-2022-012//Interdisciplinary Innovative Talents Foundation from Renmin Hospital of Wuhan University/ ; },
mesh = {Humans ; *COVID-19/rehabilitation ; *Hypoxia/rehabilitation ; Quality of Life ; SARS-CoV-2 ; Post-Acute COVID-19 Syndrome ; Fatigue ; },
abstract = {Patients recovering from COVID-19 infection often experience "Long COVID", which is characterized by symptoms such as fatigue, reduced exercise capacity or dyspnea, and cognitive dysfunction. These symptoms negatively impact their quality of life. Currently, there is a lack of widely recognized therapeutic approaches or specific pharmacological interventions for managing these conditions. During intermittent hypoxic exposure (IHE), participants are alternated to hypoxic and normoxic exposure, which induced beneficial adaptive responses in the body. Emerging evidence suggests that IHE can alleviate symptoms of Long COVID through mechanisms such as improving ventilatory function, enhancing cardiopulmonary endurance, modulating immune responses, and reducing inflammation. These effects contribute to an improved quality of life and more holistic recovery, highlighting the promising potential of IHE in managing long COVID.},
}

Humans
*COVID-19/rehabilitation
*Hypoxia/rehabilitation
Quality of Life
SARS-CoV-2
Post-Acute COVID-19 Syndrome
Fatigue

@article {pmid41072669,
year = {2025},
author = {Baalbaki, N and van Egmond, D and Jaeger, P and Cornelissen, MEB and Verbeek, ST and Sokolowska, M and van Drunen, CM and Maitland-van der Zee, AH and Golebski, K and , },
title = {Barrier dysfunction in nasal epithelium contributes to persistent inflammation in long COVID.},
journal = {The Journal of allergy and clinical immunology},
volume = {},
number = {},
pages = {},
doi = {10.1016/j.jaci.2025.09.024},
pmid = {41072669},
issn = {1097-6825},
abstract = {RATIONALE AND OBJECTIVES: Long COVID (LC) is characterized by persistent symptoms associated with chronic inflammation and immune dysregulation, but the local tissue mechanisms driving these processes remain poorly understood. Given that the nasal epithelium is the primary entry and infection site for SARS-CoV-2, we aimed to investigate its role in LC and its potential contribution to systemic immune activation.

METHODS: We analyzed nasal epithelial samples and peripheral blood from participants in the Precision Medicine for more Oxygen (P4O2) COVID-19 cohort, post-COVID individuals and healthy controls. We assessed epithelial barrier integrity, evaluated wound healing and explored cytokine profiles. Transcriptomic analysis was performed via RNA-sequencing. Blood innate lymphoid cells (ILCs) were phenotyped by flow cytometry and stimulated in vitro for functional assays.

RESULTS: Among a subgroup of LC patients, nasal epithelial cells showed impaired barrier function, reduced expression of ZO-1 and occludin and exaggerated sensitivity to viral triggers. Despite faster wound closure, the epithelial repair was reduced. The LC nasal epithelium exhibited increased cytokine production, including IL-1β and transcriptomic signatures of inflammation, including upregulation of interferon pathways. Furthermore, we found that TFs ATF3 and EGR1 were downregulated in LC. Elevated IL-1β levels in nasal epithelium promoted ILC activation and plasticity towards IFN-γ-producing ILCs in blood.

CONCLUSION: While multiple organ systems are implicated in LC, our findings identified nasal epithelial dysfunction in a subgroup of LC patients and chronic activation as potential contributors to systemic immune dysregulation. The IL-1β-IFN-γ axis represents a novel targetable pathway that may support precision therapies for long COVID.},
}

@article {pmid41072215,
year = {2025},
author = {Wang, Q and Gao, F and Zhu, D and Ren, H and Xu, Y and Lou, M and Fei, C and Xu, X and Yu, Z and Ren, Z},
title = {Alterations in the oral microbiome detected during long-term follow-up of COVID-19 recovered patients.},
journal = {Journal of infection and public health},
volume = {18},
number = {12},
pages = {102983},
doi = {10.1016/j.jiph.2025.102983},
pmid = {41072215},
issn = {1876-035X},
abstract = {BACKGROUND: The oral biome was significantly altered in COVID-19 patients, but there is still a gap in long-term follow-up studies of the oral microbiota of recovering patients.

METHODS: We recruited 62 patients with a confirmed COVID-19 diagnosis and collected tongue moss samples at three time points: 1 month (RP1), 3 months (RP3) and 5 months (RP5) of rehabilitation. We then sequenced the tongue samples for 16S rRNA amplicons.

RESULTS: The results showed that there was no significant difference in the oral microbial composition of patients who had been rehabilitated for 3 months compared to those who had been rehabilitated for 1 month, whereas patients who had been rehabilitated for 5 months showed a significant increase in the diversity of the oral microbiome compared to those who had been rehabilitated for 1 month. In addition, we characterized the dynamics of the oral microbiome of COVID-19 patients during their rehabilitation.

CONCLUSION: As patients recover, the diversity of their oral microbiome gradually returns to normal, providing microbiological evidence for the clinical diagnosis and treatment strategies of COVID-19.},
}

@article {pmid41071398,
year = {2025},
author = {Palladini, M and Azzalin, AA and Bessi, M and De Lorenzo, R and Rovere-Querini, P and Benedetti, F and Mazza, MG},
title = {Cytokine Blockade Attenuates Inflammation and Improves Depressive Psychopathology After COVID-19: A Naturalistic Observational Study.},
journal = {Journal of neuroimmune pharmacology : the official journal of the Society on NeuroImmune Pharmacology},
volume = {20},
number = {1},
pages = {86},
pmid = {41071398},
issn = {1557-1904},
support = {GR-2021-12374872-1//Italian Ministry of Health/ ; },
mesh = {Humans ; Male ; Female ; Middle Aged ; *COVID-19/psychology/immunology/complications ; *Inflammation/drug therapy/immunology/psychology ; *Cytokines/antagonists & inhibitors ; Adult ; *Depression/drug therapy/etiology/immunology ; Aged ; *COVID-19 Drug Treatment ; *Antidepressive Agents/therapeutic use ; },
abstract = {Current insight on inflammation in psychiatry suggests that perturbation of inflammatory set points could foster psychopathology and recent evidence support immune-inflammatory mechanisms as targets for antidepressant pharmacology. In the present naturalistic observational study we evaluated the possible effect of the cytokine-blocking agents in preventing the development of post-COVID depression in a large sample of survivors also exploring the relationship between post-COVID depressive risk, treatment with cytokine-blocking agents, and innate immune response markers. 588 COVID-19 survivors were included, of them 374 received the best available treatment at the time and 131 received standard treatment combined with cytokine-blocking agents (anakinra, tocilizumab, sarilumab, reparixin and mavrilimumab). Post-COVID depressive psychopathology was evaluated at short (34.6 ± 17.39 days) and long term (126.76 ± 61.4 days) follow-ups. The systemic inflammation index as (neutrophils*platelets)/lymphocytes was computed in a subgroup of 274 patients. COVID-19 survivors who were treated with cytokine-blocking agents experienced less severe depressive symptomatology and, simultaneously, less susceptibility to develop clinically relevant depression. Moreover, the longitudinal investigations, revealed that patients treated with cytokine-blocking agents underwent a spontaneous symptoms relief over time. Systemic inflammation index decrease over hospitalization was found to affect the susceptibility to long-term depression. Finally, we observed that cytokine-blocking agents' impact on depression was mediated by lowering of systemic inflammation. Our findings indicate potential efficacy of cytokine-blocking agent treatment during the early stages of COVID-19, mitigating post-COVID depressive symptoms by attenuating systemic inflammation. Further investigation through preclinical and clinical studies is warranted to elucidate immune-inflammatory pathways as viable targets for antidepressant psychopharmacology.},
}

Humans
Male
Female
Middle Aged
*COVID-19/psychology/immunology/complications
*Inflammation/drug therapy/immunology/psychology
*Cytokines/antagonists & inhibitors
Adult
*Depression/drug therapy/etiology/immunology
Aged
*COVID-19 Drug Treatment
*Antidepressive Agents/therapeutic use

@article {pmid41070112,
year = {2025},
author = {Nuber-Champier, A and Breville, G and Voruz, P and Jacot de Alcântara, I and Lalive, PH and Allali, G and Benzakour, L and Lövblad, KO and Braillard, O and Nehme, M and Coen, M and Serratrice, J and Reny, JL and Pugin, J and Guessous, I and Landis, BN and Cionca, A and Assal, F and Péron, JA},
title = {Inflammatory predictors of Post-COVID fatigue.},
journal = {Brain, behavior, & immunity - health},
volume = {49},
number = {},
pages = {101109},
pmid = {41070112},
issn = {2666-3546},
abstract = {The biological mechanisms underlying objective and subjective fatigue in post-COVID syndrome remain unclear. This study investigates whether immune responses during the acute phase of SARS-CoV-2 infection predict fatigue dimensions 6-9 months post-infection. We analyzed serum immune markers from 54 hospitalized patients (mean age: 58.69 ± 10.90 yrs; female: 31 %) and assessed their association with chronic fatigue using general linear mixed models. Elevated levels of IL-1RA, IFNγ, TNFα, and monocyte percentage during acute infection predicted increased physical and total fatigue. Additionally, higher TNFα levels (r = -0.40, p = .019) correlated with reduced awareness of cognitive fatigue. These findings highlight the role of acute inflammation in the persistence of post-COVID fatigue.},
}

@article {pmid41070108,
year = {2025},
author = {Rwamwejo, F and Niyonkuru, VU and Rukundo, G and Remera, E and Rwagasore, E and Sztandera, L and Ruranga, C and Krebs, E},
title = {Prevalence and characterization of post-acute sequelae of SARS-CoV-2 infection (PASC) in Rwanda.},
journal = {IJID regions},
volume = {17},
number = {},
pages = {100738},
pmid = {41070108},
issn = {2772-7076},
abstract = {OBJECTIVES: Reliable, population-level estimates of post-acute sequelae of SARS-CoV-2 infection (PASC) remain scarce for sub-Saharan Africa. We aimed to quantify PASC prevalence and identify associated factors among adult COVID-19 survivors in Rwanda.

METHODS: A nationally representative cross-sectional telephone survey (August-October 2024) sampled 3143 adults from the national COVID-19 registry. PASC was defined as new or persisting symptoms ≥3 months after acute illness and lasting ≥2 months. The prevalence was calculated, and multivariable logistic regression identified factors independently associated with PASC.

RESULTS: Overall, PASC prevalence was 34%. Leading symptoms were back pain, headache, dizziness, fatigue, and reduced sexual desire. Higher odds of PASC occurred in women, adults ≥35 years, individuals with ≥2 COVID-19 infections, and those screening positive for anxiety. Current alcohol use was linked to lower odds. COVID-19 vaccination showed no association with PASC.

CONCLUSIONS: Approximately one-third of adult Rwandan COVID-19 survivors continue to experience persistent symptoms. This burden signals that post-COVID care must become an integral part of routine health services, especially as new variants periodically drive fresh waves of infection. Preventing repeat infections and integrating mental health support emerge as actionable priorities. Harmonized longitudinal studies are needed to clarify PASC causality.},
}

@article {pmid41069316,
year = {2025},
author = {Agergaard, J and Frostholm, L and Fink, P and Dantoft, TM and Schiøttz-Christensen, B and Petersen, MW},
title = {Symptom profiles in long COVID compared to functional somatic disorder and the general population.},
journal = {Danish medical journal},
volume = {72},
number = {10},
pages = {},
doi = {10.61409/A09240627},
pmid = {41069316},
issn = {2245-1919},
mesh = {Humans ; *COVID-19/complications/epidemiology/physiopathology ; Male ; Female ; Middle Aged ; Post-Acute COVID-19 Syndrome ; Adult ; *Somatoform Disorders/epidemiology/diagnosis/physiopathology ; Prevalence ; Aged ; SARS-CoV-2 ; Fatigue/epidemiology ; Surveys and Questionnaires ; Denmark/epidemiology ; },
abstract = {INTRODUCTION: Long COVID, characterised by persistent symptoms following COVID-19, affects about 10% of individuals recovering from SARS-CoV-2. The overlap of symptoms described in long COVID and functional somatic disorder (FSD) raises questions about shared pathophysiology. This report compares the prevalence and profiles of physical symptoms among patients with long COVID, patients with FSD and the general population.

METHODS: Data from a cohort of patients with long COVID referred for diagnostics, a cohort of patients seen in a regional clinic for FSD and individuals from the general population were used. Questionnaires, including the bodily distress syndrome checklist, were used to assess physical symptoms.

RESULTS: A total of 436 patients with long COVID, 264 patients with FSD and 9,656 individuals from the general population were included. A lower prevalence of symptoms was observed in patients with long COVID than in patients with FSD. However, the prevalence of symptoms in patients with long COVID remained higher than in the general population. In patients with long COVID, dominant symptoms were from the general symptoms (GS) cluster (concentration difficulties, fatigue, headache, memory problems) and muscle pain. Additionally, 11% met the criteria for multi-organ FSD, exhibiting a similar symptom profile to patients with FSD.

CONCLUSIONS: A total of 11% of long COVID patients had a symptom profile similar to that of patients with multi-organ FSD. GS, including fatigue and muscle pain, were common. These findings highlight the need for prospective studies to identify patients with similar symptoms, pathogenesis and treatment options.

FUNDING: None.

TRIAL REGISTRATION: Not relevant.},
}

Humans
*COVID-19/complications/epidemiology/physiopathology
Male
Female
Middle Aged
Post-Acute COVID-19 Syndrome
Adult
*Somatoform Disorders/epidemiology/diagnosis/physiopathology
Prevalence
Aged
SARS-CoV-2
Fatigue/epidemiology
Surveys and Questionnaires
Denmark/epidemiology

@article {pmid41068758,
year = {2025},
author = {Rochette, C and Pontevia, AFA and Francois, J},
title = {Individuals' perceptions of Long Covid: a phenomenological approach to an online health community narratives.},
journal = {BMC health services research},
volume = {25},
number = {1},
pages = {1336},
pmid = {41068758},
issn = {1472-6963},
}

@article {pmid41066748,
year = {2025},
author = {Tan, EC and Hsiao, FY and Yang, MC},
title = {The economic burden of COVID-19 in a region with stringent response measures: A case study of Taiwan.},
journal = {Journal of food and drug analysis},
volume = {33},
number = {3},
pages = {326-338},
doi = {10.38212/2224-6614.3558},
pmid = {41066748},
issn = {2224-6614},
mesh = {Humans ; *COVID-19/economics/epidemiology ; Taiwan/epidemiology ; *Cost of Illness ; Middle Aged ; Adult ; Aged ; Female ; Male ; SARS-CoV-2 ; Young Adult ; Health Care Costs ; Adolescent ; Pandemics/economics ; Child ; Hospitalization/economics ; Child, Preschool ; },
abstract = {The COVID-19 pandemic has imposed a significant economic burden globally, particularly in regions with stringent response measures. This study aims to assess the economic impact of COVID-19 in Taiwan, focusing on both direct and indirect costs. A cost-of-illness analysis was conducted, utilizing data from the Taiwan Centers for Disease Control (CDC), national databases, epidemiological studies, and economic surveys. The analysis included both direct costs (e.g., hospital admissions, outpatient care) and indirect costs (e.g., productivity losses due to long COVID, absenteeism, caregiving duties). The study encompassed Taiwan's population of 23.2 million, with particular attention to age-specific impacts on economic outcomes. The total economic burden of COVID-19 in Taiwan was estimated at USD 4431 million. Direct costs accounted for 24.40% (USD 1081 million), while indirect costs constituted 75.60% (USD 3350 million). The working age population bore the majority of this burden, with 88.68% (USD 3090 million) of total costs attributed to this group. Long COVID significantly contributed to the economic impact, causing a 35% reduction in productivity. Sensitivity analysis revealed that the frequency of outpatient visits among working age and elderly cohorts was a critical factor influencing overall costs. The study underscores the substantial economic burden of stringent COVID-19 policies in Taiwan, highlighting that indirect costs were nearly three times higher than direct costs. The findings emphasize the need for resilient healthcare systems and support for affected workers, particularly in regions with similar response strategies. The methodological approach offers insights that could be applied to other regions facing similar challenges.},
}

Humans
*COVID-19/economics/epidemiology
Taiwan/epidemiology
*Cost of Illness
Middle Aged
Adult
Aged
Female
Male
SARS-CoV-2
Young Adult
Health Care Costs
Adolescent
Pandemics/economics
Child
Hospitalization/economics
Child, Preschool

@article {pmid41066438,
year = {2025},
author = {Stauffer, SR},
title = {The Same and Not the Same: Discovery of S-892216, A Second-Generation Nonpeptidic Covalent 3CL Protease Inhibitor for Oral COVID-19 Therapeutics.},
journal = {Journal of medicinal chemistry},
volume = {},
number = {},
pages = {},
doi = {10.1021/acs.jmedchem.5c02784},
pmid = {41066438},
issn = {1520-4804},
abstract = {The COVID-19 pandemic underscored the critical need for effective antiviral therapeutics. While vaccines have been instrumental in mitigating disease severity, the emergence of variants and long-COVID symptoms highlight the ongoing importance of antiviral therapeutic interventions. Targeting the 3CL[pro] main protease has been successful in identifying clinical agents; however limited options exist, and improvements are still required to have broader clinical utility. Utilizing the established central scaffold to develop ensitrelvir, both noncovalent and covalent modes of action were leveraged using structural knowledge to identify S-892216 as a potential best-in-class reversible covalent nonpeptidic 3CL[pro] inhibitor with a superior preclinical profile for treatment of COVID-19 and future pandemic preparedness.},
}

@article {pmid41065846,
year = {2025},
author = {Chang, CC and Li, YH and Chen, HH and Sun, SF},
title = {Clinical applications and molecular mechanisms for intravenous laser blood irradiation: a systematic review.},
journal = {Lasers in medical science},
volume = {40},
number = {1},
pages = {416},
pmid = {41065846},
issn = {1435-604X},
support = {TSGH-D-110120//Tri-Service General Hospital/ ; VTA114-V3-1-2//Taipei, Taichung, Kaohsiung Veterans General Hospital, Tri-Service General Hospital, Academia Sinica Joint Research Program/ ; VTA114-V3-1-1//Taipei, Taichung, Kaohsiung Veterans General Hospital, Tri-Service General Hospital, Academia Sinica Joint Research Program/ ; KAFGH-ZY-A-113016//Zuoying Armed Forces General Hospital/ ; KSVGH-114-102//Kaohsiung Veterans General Hospital/ ; },
mesh = {Humans ; *Low-Level Light Therapy/methods ; Cardiovascular Diseases/radiotherapy ; *Blood/radiation effects ; Musculoskeletal Diseases/radiotherapy ; COVID-19 ; Nervous System Diseases/radiotherapy ; },
abstract = {Intravenous Laser Irradiation of Blood (ILIB) is a therapeutic approach that utilizes low-level laser energy to irradiate blood, showing potential clinical value in treating various diseases in recent years. This systematic review aims to comprehensively examine the basic principles, technological developments, biological effects, and clinical applications of ILIB, while analyzing the level of evidence and limitations of existing research. Through searching relevant literature in databases such as PubMed, this study collected research on ILIB applications in musculoskeletal diseases, respiratory diseases, cardiovascular diseases, and neurological disorders. Results indicate that ILIB exhibits multiple biological effects, including improved blood rheological properties, enhanced erythrocyte oxygen-carrying capacity, immune regulation, and reduction of inflammatory responses and oxidative stress. Clinical studies suggest that ILIB has positive therapeutic effects on musculoskeletal pain, sleep disorders, pulmonary diseases, and long COVID-related cognitive impairments. However, existing research still has limitations such as small sample sizes, lack of large-scale randomized controlled trials, and non-standardized dosage parameters. Future research should focus on developing standardized treatment protocols, exploring mechanisms of action in depth, and strategies for combining with conventional therapies to further establish ILIB's position in clinical practice.},
}

Humans
*Low-Level Light Therapy/methods
Cardiovascular Diseases/radiotherapy
*Blood/radiation effects
Musculoskeletal Diseases/radiotherapy
COVID-19
Nervous System Diseases/radiotherapy

@article {pmid41064382,
year = {2025},
author = {Boyarchuk, O and Perestiuk, V and Kosovska, T and Volianska, L},
title = {Anti-interferon α-antibodies in pediatric patients with COVID-19 and long COVID.},
journal = {Reumatologia},
volume = {63},
number = {4},
pages = {229-235},
pmid = {41064382},
issn = {0034-6233},
abstract = {INTRODUCTION: The involvement of neutralizing antibodies against type I interferon (IFN-I) in the development of severe coronavirus disease 2019 (COVID-19) in adult patients has been well documented. However, the role of anti-IFN-α autoantibodies, especially non-neutralizing types, remains underexplored, especially in children. Our study aimed to determine the frequency of antibodies against IFN-α in children with COVID-19 and long COVID, as well as their potential role in the development of long COVID.

MATERIAL AND METHODS: The study included 78 children aged 1 to 17 years with a documented history of COVID-19 from September 2022 to August 2023. All patients were divided into three groups: hospitalized with COVID-19, hospitalized with long COVID symptoms, and monitored in an outpatient care department for mild COVID-19 or symptoms of long COVID. Human anti-IFN-α antibodies were detected using enzyme-linked immunosorbent assay.

RESULTS: Binding anti-IFN-α antibodies were detected in 2/78 (2.6%) children with COVID-19 of varying severity. One patient with anti-IFN-α antibodies had comorbidities (obesity, allergic rhinitis) and critical COVID-19 pneumonia (SpO2 - 80%), significant inflammatory changes (neutrophil-to-lymphocyte ratio: 18.8, C-reactive protein: 95.5 mg/l), and a high D-dimer level, and later developed long COVID symptoms. In the second case, COVID-19 in a 13-year-old girl without significant comorbidities was not severe, but leukopenia and lymphopenia were observed. Subsequently, she developed pronounced long COVID symptoms (fatigue, reduced appetite, insomnia, headache, decreased attention, difficulty concentrating, weight loss, tachycardia, dizziness), which persisted for up to 6 months after the acute infection. The detection rate of binding anti-IFN-α antibodies among hospitalized COVID-19 patients was 4%, compared to 25% among patients with severe/critical disease. Among children who developed long COVID symptoms, anti-IFN-α was found in 3.4%.

CONCLUSIONS: Further studies in larger cohorts are needed to assess the role of anti-IFN-α antibodies (both neutralizing and non-neutralizing) in the development of long COVID symptoms, to understand their clinical significance, and to examine their dynamics over time.},
}

@article {pmid41062803,
year = {2025},
author = {Aboagye, NY and Hinchliffe, C and Del Din, S and Ng, WF and Baker, KF and Baker, MR},
title = {Systematic review: digital biomarkers of fatigue in chronic diseases.},
journal = {NPJ digital medicine},
volume = {8},
number = {1},
pages = {602},
pmid = {41062803},
issn = {2398-6352},
support = {853981//Innovative Medicines Initiative 2 Joint Undertaking (IMI2 JU) project IDEA-FAST/ ; 853981//Innovative Medicines Initiative 2 Joint Undertaking (IMI2 JU) project IDEA-FAST/ ; 853981//Innovative Medicines Initiative 2 Joint Undertaking (IMI2 JU) project IDEA-FAST/ ; CRFC-2021-005/HRBI_/Health Research Board/Ireland ; EP/X036146/1//Engineering and Physical Sciences Research Council/ ; NIHR303620//National Institute for Health and Care Research/ ; COV-LT2-022//National Institute for Health and Care Research/ ; },
abstract = {This systematic review explores the relationship between digital biomarkers, measured using wearable devices, and fatigue in patients with chronic diseases. Studies included in this review focused on individuals with diseases or conditions in 13 broad categories: multiple sclerosis (MS); rheumatoid arthritis (RA); chronic obstructive pulmonary disease (COPD); long COVID; cancer; chronic fatigue syndrome (CFS); pulmonary sarcoidosis; Parkinson's disease; chronic stroke; chronic inflammatory rheumatic disease (CIRD); Inflammatory Bowel Diseases (IBD), Primary Sjogren's Syndrome (PSS), and Systemic Lupus Erythematosus (SLE). The review synthesizes findings on the correlation between objective digital biomarkers and self-reported fatigue, highlighting the potential for disease-specific digital biomarkers to inform personalized fatigue management. The results suggest that reduced physical activity, increased sedentary behavior and autonomic dysfunction are associated with fatigue levels across multiple disease conditions included in this review, though the strength of this association and the specific biomarkers involved vary across diseases.},
}

@article {pmid41062170,
year = {2025},
author = {Houweling, L and Rots, I and Bloemsma, LD and van Vorstenbosch, R and Del Motto, S and Vermeulen, RCH and Maitland-Van der Zee, AH and Golebski, K and Downward, GS},
title = {Impact of air pollution on COVID-19 severity: a systematic review of underlying biological mechanisms.},
journal = {European respiratory review : an official journal of the European Respiratory Society},
volume = {34},
number = {178},
pages = {},
doi = {10.1183/16000617.0070-2025},
pmid = {41062170},
issn = {1600-0617},
mesh = {Humans ; *COVID-19/epidemiology/immunology/virology ; *Air Pollution/adverse effects ; Severity of Illness Index ; SARS-CoV-2 ; Particulate Matter/adverse effects ; *Air Pollutants/adverse effects ; },
abstract = {BACKGROUND: Our recent systematic review highlighted key associations between ambient air pollution (AAP) exposure and COVID-19 severity. This systematic review aims to summarise toxicological studies on the biological mechanisms underlying these associations.

METHODS: On 17 July 2025, PubMed, Embase, Scopus and Web of Science were searched for in vitro, in vivo and in silico studies that examined the biological mechanisms of AAP exposure on COVID-19 health outcomes. Two independent reviewers engaged in the selection and data extraction process. The methodological quality of the included studies was assessed with the Toxicological Data Reliability Assessment Tool. The Integrated Network and Dynamical Reasoning Assembler (INDRA) was used to provide visual biomechanistic summaries of the included studies by creating knowledge graphs of the described mechanisms.

RESULTS: A total of 18 studies were included in this review. Findings consistently indicated that AAP exposure can worsen COVID-19 severity through two key mechanisms 1) increased expression of viral entry factors (e.g. angiotensin-converting enzyme 2 and transmembrane serine protease 2), facilitating infection, and 2) immune dysregulation, resulting in increased inflammation and oxidative stress. These key mechanisms were also identified in the INDRA networks. While studies commonly focused on particulate matter (n=15), similar effects were seen with ultrafine particles and ozone.

CONCLUSION: These findings highlight the impact of AAP exposure on COVID-19 health outcomes on the molecular level. The findings of this review illustrate the urgent need for air quality improvements to help shape public health strategies to reduce and prevent future health impacts caused by AAP exposure.},
}

Humans
*COVID-19/epidemiology/immunology/virology
*Air Pollution/adverse effects
Severity of Illness Index
SARS-CoV-2
Particulate Matter/adverse effects
*Air Pollutants/adverse effects

@article {pmid41062137,
year = {2025},
author = {Daniels, S and Wei, H and McElvenny, DM and van Tongeren, M and Bramwell, D and Coleman, A and Forde, D and Wiggans, R},
title = {Return to work with long COVID: a rapid review of support and challenges.},
journal = {BMJ open},
volume = {15},
number = {10},
pages = {e101698},
doi = {10.1136/bmjopen-2025-101698},
pmid = {41062137},
issn = {2044-6055},
mesh = {Humans ; *Return to Work ; *COVID-19/rehabilitation ; SARS-CoV-2 ; Workplace ; },
abstract = {OBJECTIVES: To explore existing evidence for the provision of support for return to work (RTW) in long COVID (LC) patients and the barriers and facilitators to taking up this support.

DESIGN: A rapid review reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The study was preregistered in PROSPERO (ID: CRD42023478126).

DATA SOURCES: Searches were completed in June 2024 across major databases including MEDLINE, Embase, PsycINFO, evidence-based medicine reviews, Web of Science and Google Scholar.

ELIGIBILITY CRITERIA: Included studies focused on people with LC (PwLC) symptoms lasting over 12 weeks and addressed either: (1) non-workplace- or workplace-based support for RTW and/or (2) barriers and facilitators to RTW in this population.

DATA EXTRACTION AND SYNTHESIS: A quality assessment was conducted using the JBI Systematic Reviews critical appraisal tool. The data were summarised in tabular format and a narrative synthesis.

RESULTS: Twenty-five studies were included. While many studies demonstrated rigorous methodologies and low risk of bias levels, some had high and medium risk levels. Non-workplace-based support was mostly measured quantitatively and included interdisciplinary healthcare programmes, clinical interventions and rehabilitation programmes focusing on pacing and breathing strategies. Compensation and insurance schemes were important funders of these interventions.Workplace-based support was mostly measured qualitatively. Barriers to the provision of support at organisational level included lack of understanding of LC symptoms, insufficient workplace guidance and educational gaps among managers. Individual barriers included threat of income loss, remote working and disconnection from the workplace. Facilitators for support included recognition and validation of LC and its symptoms, and eligibility for disability benefits associated with work.

CONCLUSIONS: RTW is an important outcome of health-related absence and should be systematically recorded in studies of PwLC. The heterogeneity and unpredictability of LC symptoms create challenges for supporting working age populations. Further research is crucial to better understand the specific RTW needs for PwLC and address potential barriers and facilitators to workplace-based support, particularly through interventions, organisational practices and employ-led policies that enable sustained RTW. Consistent guidelines on LC's definition and disability status may facilitate the provision of support and the development of interventions.

PROSPERO REGISTRATION NUMBER: CRD42023478126.},
}

Humans
*Return to Work
*COVID-19/rehabilitation
SARS-CoV-2
Workplace

@article {pmid41059474,
year = {2025},
author = {Perestiuk, V and Kosovska, T and Volianska, L and Boyarchuk, O},
title = {Prevalence and duration of clinical symptoms of pediatric long COVID: findings from a one-year prospective study.},
journal = {Frontiers in pediatrics},
volume = {13},
number = {},
pages = {1645228},
pmid = {41059474},
issn = {2296-2360},
abstract = {BACKGROUND: Long COVID in children remains a poorly understood condition with wide variability in clinical presentation, duration, and risk factors. The aim of this study was to assess the prevalence, spectrum, and duration of long COVID symptoms in pediatric patients following acute SARS-CoV-2 infection using a standardized follow-up tool.

METHODS: We conducted a prospective cohort study involving 127 unvaccinated children aged 1 month to 18 years with long COVID according to the WHO definition and confirmed SARS-CoV-2 infection. Participants were followed up at 1-3, 3-6, 6-9, and 9-12 months post-infection using an adapted ISARIC Global Pediatric COVID-19 Follow-Up Questionnaire.

RESULTS: Persistent symptoms of long COVID were reported in 85.8% of patients at 3 months, decreasing to 56.1% at 9 months and 32.5% at 12 months. The most common long-term symptoms included fatigue (52.0%), reduced physical activity (44.1%), and headache (35.3%). Multivariable logistic regression showed that older age was significantly associated with a higher risk of decreased physical activity (OR = 1.51, p = 0.038), lack of energy (OR = 2.00, p = 0.003), neurological symptoms (OR = 1.86, p = 0.007), headache (OR = 4.51, p = 0.000), memory impairment (OR = 5.12, p = 0.000), difficulty communicating (OR = 4.28, p = 0.000), difficulty concentrating (OR = 2.74, p = 0.001), cardiological symptoms (OR = 2.34, p = 0.022), sensory symptoms (OR = 2.66, p = 0.011), and dizziness (OR = 10.02, p = 0.034). Younger age was associated with insomnia (OR = 0.49, p = 0.018). Female sex was significantly associated with a greater likelihood of lack of energy (OR = 2.55, p = 0.048). Hospitalization status was only significantly associated with muscle pain, with outpatients more frequently affected (OR = 0.28, p = 0.029).Overall, 32.5% of all participants continued to experience symptoms of long COVID more than one year acute infection, with fatigue persisting in 19.8%, reduced physical activity in 13.9%, headache in 12.3%.

CONCLUSIONS: Long COVID affects children across all age groups and may persist beyond one year in a significant subset. These findings highlight age- and sex-specific symptom profiles and underscore the need for structured pediatric follow-up.},
}

@article {pmid41057923,
year = {2025},
author = {Gidey, K and Niriayo, YL and Asgedom, SW and Lubetkin, E},
title = {Health-related quality of life in COVID-19 patients: a systematic review and meta-analysis of EQ-5D studies.},
journal = {Health and quality of life outcomes},
volume = {23},
number = {1},
pages = {97},
pmid = {41057923},
issn = {1477-7525},
support = {1627-RA//EuroQol Research Foundation/ ; 1627-RA//EuroQol Research Foundation/ ; 1627-RA//EuroQol Research Foundation/ ; 1627-RA//EuroQol Research Foundation/ ; },
abstract = {BACKGROUND: COVID-19 has affected millions globally, with a significant proportion experiencing long-COVID and impaired health-related quality of life (HRQoL). This systematic review and meta-analysis aimed to synthesize the existing literature on HRQoL in COVID-19 patients.

METHODS: We conducted a systematic search of PubMed, Embase, Web of Science, Scopus, and the Cochrane Library for studies published between December 2019 and March 2025. Eligible studies were peer-reviewed and assessed HRQoL in COVID-19 patients using the EQ-5D instrument. Study quality and risk of bias were evaluated using the Newcastle-Ottawa Scale. Pooled health utility values were estimated using a random-effects model, and heterogeneity was assessed via I[2] statistics. Predictors of poor HRQoL were qualitatively narrated.

RESULTS: Out of 3539 references, 187 studies with 116,525 participants were analyzed. The majority (80.2%) used the EQ-5D-5 L version. The pooled mean EQ-5D utility score was 0.76 (95% CI 0.74-0.79, I[2] = 99.9%) while the mean EQ-5D Visual Analogue Scale (VAS) score was 70.76 (95% CI 68.48-73.04; I[2] = 99.7%). Pain/discomfort and anxiety/depression were the most affected domains, reported by 51% and 46% of patients, respectively. Subgroup analysis showed significant differences in HRQoL based on national income status (p = 0.038) and geographic region (p < 0.001). Common predictors of lower HRQoL included older age, female gender, disease severity, comorbidities, and post-COVID-19 symptoms.

CONCLUSION: This systematic review demonstrates a substantial reduction in HRQoL among COVID-19 patients compared to the general population. The pooled utility values of COVID-19 contribute to understanding patients' HRQoL and can assist in calculating Quality-Adjusted Life Years. This provides essential data for future economic evaluations and informs health policy decisions.},
}

@article {pmid41057797,
year = {2025},
author = {Bessaguet, C and Bonilla, A and Polin, C and Lacroix, A and Cartz-Piver, L},
title = {A systematic review to find link between past psychiatric history and development of long covid.},
journal = {BMC psychiatry},
volume = {25},
number = {1},
pages = {942},
pmid = {41057797},
issn = {1471-244X},
abstract = {BACKGROUND: Covid-19 is a pandemic acute infectious disease that emerged in 2019. It is estimated that 10-20% will develop persistent symptoms, known as long Covid or post-Covid syndrome. The risk factors for the development of this syndrome are still being studied. Psychosocial factors are known to increase the duration and severity of respiratory infections.

AIMS: (i) to review current knowledge of the link between past psychiatric history and the development of long Covid; (ii) to obtain information on the psychological experience of the initial infection; (iii) to establish a link between the presence of psychiatric symptoms during the acute phase and the development of long Covid.

METHOD: We conducted a systematic review according to PRISMA standards using the Pubmed, Science Direct and Scopus databases. We included observational studies of adult subjects with long Covid whose psychiatric and/or addictive histories were searched.

RESULTS: A total of 36 articles were included in our review. Depression and anxiety appear to be risk factors for the development of long Covid. There is no consensus on the contribution of smoking to the onset of the syndrome. The negative psychological experience of the acute infection favours the persistence of symptoms. Psychological symptoms during the acute phase, studied in only one of our articles, seem to contribute to the persistence of concentration and attention problems.

CONCLUSION: Psychological comorbidities pre-existing COVID-19 infection, in particular depression and anxiety, as well as a poor psychological experience of the acute phase, may favour the development of long Covid.

TRIAL REGISTRATION NUMBER: PROSPERO registration number CRD42023391720.},
}

@article {pmid41056092,
year = {2025},
author = {Newby, MJ and Haracz, K and Lane, SJ and Tona, J},
title = {Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS) and Occupational Performance: A Scoping Review.},
journal = {The American journal of occupational therapy : official publication of the American Occupational Therapy Association},
volume = {79},
number = {6},
pages = {},
doi = {10.5014/ajot.2025.051238},
pmid = {41056092},
issn = {0272-9490},
mesh = {Humans ; *Occupational Therapy/methods ; Child ; *Obsessive-Compulsive Disorder/rehabilitation ; *Activities of Daily Living ; Social Participation ; Autoimmune Diseases ; },
abstract = {IMPORTANCE: Pediatric acute-onset neuropsychiatric syndrome (PANS) is a neuroimmune condition that significantly affects children's occupational performance across multiple domains. However, occupational performance is often overlooked in current PANS clinical frameworks, despite its critical role in daily functioning and well-being.

OBJECTIVE: To synthesize evidence on the occupational performance challenges experienced by children with PANS, the tools used to assess these challenges, and occupational therapy interventions used with these children.

DATA SOURCES: MEDLINE, CINAHL, Cochrane Library, PsycINFO, SCOPUS, ERIC, and EMBASE were searched from their inception through May 17, 2024.

Peer-reviewed studies addressing PANS and occupational performance were included, with data categorized using the Occupational Therapy Practice Framework, 4th Edition.

FINDINGS: Of 3,431 records, 40 studies met inclusion criteria. Occupational performance challenges centered on communication, nutrition, education, rest/sleep, social participation, and toileting, with limited data on bathing, dressing, personal hygiene, and play and leisure. Assessments emphasized client factors, rarely using occupation-based tools. Only 2 studies mentioned occupational therapy interventions.

CONCLUSIONS AND RELEVANCE: PANS has a pervasive impact on children's occupational performance, highlighting the urgent need to prioritize it within clinical frameworks. Future research should focus on occupation-based intervention studies and assessments to enhance outcomes for children with PANS. Plain-Language Summary: Pediatric acute-onset neuropsychiatric syndrome (PANS) causes sudden, severe symptoms, such as obsessive-compulsive behaviors, eating difficulties, sensory and motor changes, and developmental regression, which significantly disrupt children's ability to perform daily activities. This study included 40 research articles addressing what is known about the impact of PANS on children's daily functioning and the role of occupational therapy in managing challenges. Results showed that most studies focused on communication, nutrition, education, sleep, social, and toileting challenges, but few addressed other daily tasks like bathing, dressing, personal hygiene, and play or leisure. Despite identified challenges, only two studies mentioned occupational therapy interventions, highlighting a major gap in the evidence. Assessments focused mainly on a child's skills and challenges, rather than looking at how the child participates in everyday activities. The findings highlight the need to better understand the challenges children with PANS face in their everyday activities and to provide practical strategies to help them succeed. Positionality Statement: Newby is a pediatric occupational therapist and researcher with both professional and personal experience of PANS. Her clinical work with children diagnosed with PANS, along with personal experience supporting a family member with this condition, has deepened her interest in the episodic fluctuations in occupational performance that occur during periods of exacerbation and remission. Haracz is an occupational therapist, academic, and researcher with a focus on mental health and the intersection between physical and psychological well-being. Lane is an occupational therapist, academic, and researcher who specializes in the neuroscience of developmental conditions and how sensory processing differences affect children's engagement in daily occupations. Tona is an occupational therapist and educational psychologist whose interest in neuroinflammatory disorders emerged following a family member's diagnosis with PANS. Her research explores the characteristics of PANS, treatment access, caregiver burden, and the role of occupational therapy in improving participation in both PANS and long-COVID populations.},
}

Humans
*Occupational Therapy/methods
Child
*Obsessive-Compulsive Disorder/rehabilitation
*Activities of Daily Living
Social Participation
Autoimmune Diseases

@article {pmid41054864,
year = {2025},
author = {Bredström, A and Jämterud, SM},
title = {Post Covid-19 Condition as a Diagnosis: A Qualitative Study on Epistemological Tensions Among Experts in Sweden.},
journal = {Health expectations : an international journal of public participation in health care and health policy},
volume = {28},
number = {5},
pages = {e70463},
doi = {10.1111/hex.70463},
pmid = {41054864},
issn = {1369-7625},
support = {//The project is part of an interdisciplinary project, Biomedicine, Clinical Knowledge, and the Humanities in Collaboration: A Novel Epistemology for Radically Interdisciplinary Health Research and Policy-Work on Post COVID-19 Syndrome, funded by the Swedish Research Council (Vetenskapsrådet, grant number 2021-01245)./ ; },
mesh = {Humans ; Sweden ; *COVID-19/complications/diagnosis ; Qualitative Research ; Female ; Male ; Interviews as Topic ; SARS-CoV-2 ; Middle Aged ; Adult ; *Knowledge ; },
abstract = {BACKGROUND: At the onset of the Covid-19 pandemic, it became clear that some individuals experienced lingering symptoms after the infection. This condition, known as post Covid-19 condition (or long Covid), is defined by WHO as persistent or new symptoms 3 months after the initial infection, lasting for at least 2 months, and not attributable to another diagnosis. Hence, the definition is very broad.

AIM: This study aims to examine how post Covid-19 condition as a diagnosis is viewed and interpreted by Swedish stakeholders, showing how these understandings carry a range of epistemological tensions. The study also seeks to understand the implications of these epistemological tensions for treatment and care organisation.

METHODS: Qualitative interviews with 36 experts and key individuals in Sweden have been conducted.

RESULT: Experts agree that post Covid-19 condition is a complex syndrome and that persons who suffer are in need of care. However, several tensions in post Covid-19 condition as a diagnosis can be discerned. Most experts agreed on the gender and racial disparity where white women with Swedish background were a majority of post Covid-19 sufferers, while migrant patients and the elderly are largely absent. In relation to social categories, the question if children can have post Covid-19 condition is here a highly contested question. There is also disagreement on the aetiology of post Covid-19 condition, with some experts viewing it as a new, unique condition requiring specialised treatment, while others see it as similar to other post-viral conditions, treatable in primary care.

CONCLUSION: The article concludes that experts are divided in their understanding and that this affects Swedish policy on post Covid-19 care and treatment, showing that post Covid-19 condition is not only a medical issue but also a political battleground where science, expert opinion and patient experience shape policy.

The article focuses on studying stakeholders' perspectives as these are key for informing public opinion and policy. In this article, all main organisations and authorities involved in post Covid-19 care are represented. We also see patients as crucial stakeholders and representatives of patient organisations, as well as representatives of some migrant communities, who have been interviewed. The latter were included to gain insights from groups that were largely absent in post Covid-19 care.},
}

Humans
Sweden
*COVID-19/complications/diagnosis
Qualitative Research
Female
Male
Interviews as Topic
SARS-CoV-2
Middle Aged
Adult
*Knowledge

@article {pmid41054438,
year = {2025},
author = {Bailey, J and Schartau, P and Fazel, S and Nazareth, I and Petersen, I},
title = {Incidence of suicide within two years of a first diagnosis of depression, anxiety, or mixed anxiety and depression: an exploratory cohort study in primary care using the Clinical Practice Research Datalink.},
journal = {EClinicalMedicine},
volume = {87},
number = {},
pages = {103441},
pmid = {41054438},
issn = {2589-5370},
abstract = {BACKGROUND: The risk of suicide following first diagnosis of depression or anxiety in primary care is uncertain. We investigated suicide incidence within two years of a first diagnosis of depression, anxiety, or mixed anxiety and depression in primary care, analysing variation by diagnosis, age, sex, and social deprivation at lower layer Super Output Area level.

METHODS: We conducted a cohort study using the Clinical Practice Research Datalink, a large primary care electronic health records database, linked to mortality records. Adults with their first diagnosis of depression, anxiety, or mixed anxiety and depression between 1 January 1999 and 31 December 2018 were included. The outcome was suicides per 100,000 person-years at risk (PYAR) within two years of diagnosis. Adjusted incidence rate ratios (aIRR) were calculated using Poisson regression.

FINDINGS: Among 1,454,102 individuals diagnosed there were 1439 suicides within two years of diagnosis. Rates were higher in men across all cohorts. The highest rate for men was after depression diagnosis: 115·85 per 100,000 PYAR (95% confidence interval [CI] 107·60-124·58), five times higher than women: aIRR 4·99 (95% CI 4·29-5·79). For women the highest rate was after a mixed diagnosis: 27·73 per 100,000 PYAR (95% CI 21·70-34·92). The highest rate across all groups was seen in men aged 70+ after a mixed diagnosis: 156·43 per 100,000 PYAR (95% CI 89·41-254·03). There was no association between rate and deprivation.

INTERPRETATION: Suicide rates within two years of a diagnosis were higher than the UK general population rate as reported by the Office for National Statistics. Men consistently exhibited higher rates, with men aged 70 and over diagnosed with mixed anxiety and depression experiencing the highest rate. Women aged 50-59 with a first diagnosis of anxiety had over three times the rate of those aged 18-29 at diagnosis. These findings align with findings from other settings and add to the literature by quantifying the effects in primary care. Further analysis is required, particularly for older men and middle-aged women with anxiety-related conditions.

FUNDING: James Bailey is funded by a National Institute for Health and Care Research Doctoral Fellowship [NIHR302551].},
}

@article {pmid41054219,
year = {2025},
author = {Hudson, N and Hannah, S and Husted, M and Fryer, S and Ryan-Stewart, H and Rickenbach, M and Stone, K and Faulkner, J},
title = {The effect of uninterrupted and interrupted sitting on vascular function in adults with long COVID.},
journal = {Physiological reports},
volume = {13},
number = {19},
pages = {e70452},
doi = {10.14814/phy2.70452},
pmid = {41054219},
issn = {2051-817X},
support = {UoA23_22_Faulk//University of Winchester (UoW)/ ; },
mesh = {Humans ; Male ; Female ; *COVID-19/physiopathology/complications ; *Sitting Position ; Adult ; *Blood Pressure/physiology ; *Vascular Stiffness/physiology ; *Exercise/physiology ; Middle Aged ; Sedentary Behavior ; Pulse Wave Analysis ; Carotid-Femoral Pulse Wave Velocity ; SARS-CoV-2 ; },
abstract = {Acute prolonged sitting increases blood pressure (BP) and arterial stiffness (AS). Both of these may be mitigated via light physical activity (LPA). Whether long COVID (LC), which partly manifests as vascular sequelae, predisposes a heightened sensitivity to sitting or diminished benefits from its interruption is unknown. The aims of this study were to identify whether individuals with LC: (i) exhibit a worse BP/AS response to uninterrupted sitting and (ii) a diminished mitigation of BP/AS response to sitting interrupted with LPA, compared to healthy controls. Thirty participants with LC and 15 controls completed 2 h of uninterrupted sitting and sitting interrupted with LPA. Central and peripheral systolic and diastolic BP and carotid-femoral pulse wave velocity (cfPWV) were determined pre and post sitting. Linear mixed-effects models demonstrated no three-way or two-way interactions for any variable. There was a significant main effect of time, with increases in central systolic (MD = 3.37 mmHg, SE = 0.93 mmHg, p < 0.001) and central diastolic (MD = 3.00 mmHg, SE = 0.58 mmHg, p < 0.001) BP. cfPWV was not altered in sitting in either group (MD = 0.13 m/s, SE = 0.09 m/s, p = 0.170). Uninterrupted sitting increases BP similarly, but AS is unchanged. Interrupting sitting with LPA did not mitigate sitting-induced increase in BP regardless of LC diagnosis.},
}

Humans
Male
Female
*COVID-19/physiopathology/complications
*Sitting Position
Adult
*Blood Pressure/physiology
*Vascular Stiffness/physiology
*Exercise/physiology
Middle Aged
Sedentary Behavior
Pulse Wave Analysis
Carotid-Femoral Pulse Wave Velocity
SARS-CoV-2

@article {pmid41051570,
year = {2025},
author = {Zadeh, S and Robbins, N and Hernandez, R and Bryarly, M and Vernino, S},
title = {Letter to the editor regarding "Chronic autonomic symptom burden in long-COVID: a follow-up cohort study.".},
journal = {Clinical autonomic research : official journal of the Clinical Autonomic Research Society},
volume = {},
number = {},
pages = {},
pmid = {41051570},
issn = {1619-1560},
}

@article {pmid41050528,
year = {2025},
author = {Kranck, G and Ståhlberg, M and Andersson, U and Lundin, J and Fedorowski, A},
title = {Monitoring of cardiorespiratory vagal desynchrony using novel biomarkers derived from smartwatch electrocardiograms in a patient recovering from long COVID: case report.},
journal = {European heart journal. Case reports},
volume = {9},
number = {10},
pages = {ytaf425},
pmid = {41050528},
issn = {2514-2119},
abstract = {BACKGROUND: Long COVID and cardiovascular autonomic dysfunction, including postural orthostatic tachycardia syndrome (POTS), present significant healthcare challenges. Long-term monitoring is challenging due to the evolving nature of symptoms and the limited availability of objective diagnostic tools. With over 200 million electrocardiogram (ECG)-enabled smartwatches sold worldwide, these devices offer a promising solution for at-home diagnostics and disease tracking.

METHODS AND RESULTS: This study examines a 35-year-old male with long COVID, POTS, and chronic fatigue syndrome (CFS), who recorded 328 ECGs over using a Samsung smartwatch. The protocol required ECG recordings to be taken first in a sitting posture, followed by a standing position, with slow, controlled breathing. For testing, the patient used a Samsung smartwatch to perform a 30-s hand-to-hand single-lead ECG while engaging in 0.1 Hz diaphragmatic controlled breathing, consisting of 5 s of inhalation followed by 5 s of exhalation (Appendix 1). S-/R-peak amplitude ratios, heart rhythm changes, and other biomarkers were analysed to assess autonomic function. Fatigue levels were self-reported via the BREATHE FLOW app using a three-grade scale, and health status was tracked monthly with the EQ-5D-5L model. Initially, the patient experienced severe fatigue and heart rhythm changes consistent with POTS. Electrocardiogram analysis revealed an increased S-wave amplitude and higher S/R ratio in standing posture, along with worsening respiratory sinus arrhythmia (RSA), indicating cardiorespiratory desynchrony. Over time, as symptoms improved, heart rate responses between sitting and standing normalized, and S/R ratio and RSA index followed self-reported fatigue levels, including fluctuations due to post-exercise fatigue.

CONCLUSION: Smartwatch-derived S-/R-wave amplitude ratio may serve as an accessible biomarker for tracking disease progression in long COVID. Given the widespread availability of smartwatches, standardized at-home protocols could improve diagnostics and monitoring for autonomic dysfunction.},
}

@article {pmid41049923,
year = {2025},
author = {Pedraza, A and Bonnice, S and Won, MN and Kesselman, MM and Demory Beckler, M},
title = {Impact of COVID-19 on the Gut Microbiome: A Review.},
journal = {Cureus},
volume = {17},
number = {9},
pages = {e91470},
pmid = {41049923},
issn = {2168-8184},
abstract = {Coronavirus Disease 2019 (COVID-19) has resulted in over 6 million deaths worldwide in fewer than four years and is a result of infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The protein that mediates SARS-CoV-2 host cell entry is the angiotensin-converting enzyme 2 (ACE2), which is highly expressed on the membrane of gastrointestinal (GI) cells. Consequently, infection can lead to direct damage to the GI tract and gut dysbiosis, which is associated with an imbalance of microbiota, inflammation, and other systemic infections and diseases. In this review, we will focus on the impact of COVID-19 on the GI system. We will examine the pathophysiology of gut dysbiosis in COVID-19 patients, as well as emphasize the significance of probiotics in addressing this condition. Additionally, we will identify key areas of interest that warrant further investigation.},
}

@article {pmid41049897,
year = {2025},
author = {Castellano, B and Castellano, C and Sobczak, A and Khanna, D},
title = {Long-Term Manifestations of COVID-19: A Review.},
journal = {Cureus},
volume = {17},
number = {9},
pages = {e91492},
pmid = {41049897},
issn = {2168-8184},
abstract = {Although most coronavirus disease 2019 (COVID-19) cases resolve within a few weeks after the onset of infection, a considerable number of patients still suffer from prolonged or recurrent symptoms evident after weeks or months post-COVID-19 recovery. This paper analyzed the current literature related to long-term manifestations of COVID-19 and aimed to identify the common symptoms reported four weeks or more after the initial onset of the disease. COVID-19 has been shown to have lasting systemic effects on an array of organ systems, such as the lungs, heart, brain, and gastrointestinal systems. Common symptoms include, but are not limited to, fatigue, brain fog, respiratory difficulties, and loss of taste and smell. The impact of COVID-19 on multiple organ systems is thought to be associated with its ability to bind angiotensin-converting enzyme 2 (ACE2) receptors throughout the body and promote cytokine release. This study provides insight into common long-term manifestations of COVID-19. Future studies should look at how long COVID-19 syndrome affects various subpopulations differently.},
}

@article {pmid41048268,
year = {2025},
author = {Dale, Z and Wallington, SF and Penn-Marshall, M},
title = {Prevalence and characteristics of post-acute sequelae of COVID-19 in recovered patients.},
journal = {Frontiers in public health},
volume = {13},
number = {},
pages = {1648961},
pmid = {41048268},
issn = {2296-2565},
mesh = {Humans ; *COVID-19/epidemiology/complications ; Male ; Female ; Middle Aged ; Cross-Sectional Studies ; Risk Factors ; Adult ; Texas/epidemiology ; Post-Acute COVID-19 Syndrome ; Prevalence ; SARS-CoV-2 ; Aged ; Severity of Illness Index ; Comorbidity ; },
abstract = {INTRODUCTION: Long COVID, also known as post-acute sequelae of SARS-CoV-2 infection, has emerged as a major public health concern following the COVID-19 pandemic. Although initially perceived as a respiratory illness, growing biomedical evidence confirms that COVID-19 affects multiple organ systems. This study aimed to explore the clinical manifestations, risk factors, and long-term outcomes associated with long COVID and to identify patients at highest risk. The research also contributes to the ongoing discourse on establishing a unified definition of long COVID.

METHODS: A secondary analysis of a cross-sectional, community-based study was conducted using data from 168 households, representing a weighted total of 14,769 households in Third Ward, Houston, Texas. Data were collected via interviewer-administered surveys and included variables on demographics, pre-existing comorbidities, COVID-19 symptom severity, and post-acute symptom persistence. Symptom variables were recoded as binary indicators, and weighted logistic regression models were applied to identify associations between acute phase characteristics and the development of long COVID.

RESULTS: Risk factors significantly associated with long COVID included symptom severity during acute infection (OR = 29.58, 95% CI [1.38, 632.53]), heart disease (OR = 6.00, 95% CI [1.15, 31.28]), asthma (OR = 3.49, 95% CI [1.05, 11.59]), and poor physical health (OR = 4.20, 95% CI [1.12, 15.75]). Acute symptoms predictive of long COVID included anxiety (OR = 22.94, 95% CI [2.01, 262.31]), chest pain (OR = 7.15, 95% CI [1.13, 45.23]), constipation (OR = 16.81, 95% CI [1.33, 213.23]), heart palpitations (OR = 6.59, 95% CI [1.08, 40.18]), and shortness of breath (OR = 4.97, 95% CI [1.16, 21.36]). No statistically significant associations were found between long COVID and race, education, or income.

CONCLUSION: The findings underscore the multisystemic nature of long COVID, characterized by a diverse range of symptoms including fatigue, cognitive impairment, shortness of breath, and neuropsychiatric issues such as depression. While clinical factors are critical in understanding long COVID, the results also suggest that addressing associated health outcomes requires broader consideration of social determinants of health.},
}

Humans
*COVID-19/epidemiology/complications
Male
Female
Middle Aged
Cross-Sectional Studies
Risk Factors
Adult
Texas/epidemiology
Post-Acute COVID-19 Syndrome
Prevalence
SARS-CoV-2
Aged
Severity of Illness Index
Comorbidity

@article {pmid41048263,
year = {2025},
author = {Verma, A and Naidu, SV and Sulthana, H and Ullah, A and Shabil, M and Sah, R and Mehta, R and Jan, A and Ain, NU and Rahim, A and Abu Nahla, U},
title = {Musculoskeletal manifestations in post-acute sequelae of SARS-CoV-2 infection: a systematic review and meta-analysis.},
journal = {Frontiers in public health},
volume = {13},
number = {},
pages = {1662953},
pmid = {41048263},
issn = {2296-2565},
mesh = {Humans ; *COVID-19/complications/epidemiology ; *Musculoskeletal Diseases/epidemiology/etiology ; SARS-CoV-2 ; Post-Acute COVID-19 Syndrome ; Prevalence ; Incidence ; Myalgia/epidemiology ; },
abstract = {BACKGROUND: The COVID-19 pandemic has highlighted a spectrum of long-term sequelae, with musculoskeletal symptoms being a substantial component of Post-Acute Sequelae of SARS-CoV-2 infection (PASC). This systematic review and meta-analysis aimed to evaluate the incidence and nature of musculoskeletal manifestations in individuals recovering from COVID-19.

METHODS: A systematic search across PubMed, Embase, and Web of Science was performed up to February 15, 2024, to identify studies reporting on musculoskeletal symptoms post-COVID-19. Observational studies which reported any musculoskeletal symptoms of PASC were included. Data were pooled using a random-effects model to calculate the incidence of symptoms, with subgroup analyses based on time since infection. Statistical analysis were conducted in R software (V 4.3).

RESULTS: Sixty-four studies were included, demonstrating a pooled prevalence of muscle pain at 28% (95% CI: 22%-35%), which increased to 25.9% (95% CI: 20.7%-31.7%) at 12 months post-infection. Joint pain showed a pooled prevalence of 14.8% (95% CI: 10.6%-20.2%), with no significant temporal change. Muscle weakness was observed in 12.9% (95% CI: 4.2%-32.9%) of patients. Notable heterogeneity was observed across studies (I [2] > 89% for all symptoms).

CONCLUSION: Musculoskeletal symptoms are prevalent in individuals with PASC, with muscle pain being the most common. The findings highlight the need for comprehensive clinical management and continuous research to create targeted treatments and revise care protocols as the pandemic evolves.},
}

Humans
*COVID-19/complications/epidemiology
*Musculoskeletal Diseases/epidemiology/etiology
SARS-CoV-2
Post-Acute COVID-19 Syndrome
Prevalence
Incidence
Myalgia/epidemiology

@article {pmid41046766,
year = {2025},
author = {Reséndiz-Vazquez, J and Domínguez-Reyes, V and Terán-Paredes, E and Madero-Franco, N and Chávez-González, A and Majluf-Cruz, A and Alvarado-Moreno, JA},
title = {Deep Venous Thrombosis in Patients Recovered from COVID-19: A Long-Term Sequel.},
journal = {Archives of medical research},
volume = {57},
number = {3},
pages = {103305},
doi = {10.1016/j.arcmed.2025.103305},
pmid = {41046766},
issn = {1873-5487},
abstract = {BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), also known as COVID-19 disease has the ability to generate sequelae that extend for weeks or months, giving rise to long-term COVID-19 disease. This condition reduces patients' quality of life and predisposes them to several alterations, including failures in the blood coagulation system. Our laboratory has previously demonstrated abnormalities in endothelial colony-forming cells (ECFCs) of patients recovered from COVID-19.

OBJECTIVE: To analyze the functional state of ECFCs in patients who experienced venous thromboembolic disease (VTD) or arterial thrombosis (AT) during long COVID-19, or post-COVID condition (PCC).

METHODS: We compared 35 samples of peripheral blood (PB) mononuclear cells (MNCs) from patients with a thrombotic event (who had a healthy lifestyle before infection and were vaccinated) with 10 healthy volunteers and 10 samples from patients with a history of recurrent unprovoked VTD (rVTD) after a COVID-19 infection. The samples were cryopreserved in our laboratory and matched by age 25-50 years old and sex. The frequency, morphological characteristics, proliferation and angiogenic ability of ECFCs were evaluated in all samples.

RESULTS: There were no significant differences between male and female patients, and the laboratory data did not indicate risk factors for VTD or AT. The frequency of ECFCs was not different between controls and patients, but a reduced proliferative capacity, a high percentage of senescence and non-angiogenic activity were observed in VTD samples.

CONCLUSIONS: Our results demonstrate a strong association between VTD events in patients with PCC who had a healthy lifestyle prior to infection and ECFCs dysfunction.},
}

@article {pmid41044760,
year = {2025},
author = {Lillieberg, E and Ertzgaard, P and Fernlund, E and Duchen, K and Rytterström, P and Angelhoff, C},
title = {Experiences of living with long COVID during childhood and adolescence: a qualitative study from the child's perspective.},
journal = {BMC pediatrics},
volume = {25},
number = {1},
pages = {754},
pmid = {41044760},
issn = {1471-2431},
mesh = {Humans ; Child ; Adolescent ; Qualitative Research ; *COVID-19/psychology ; Male ; Female ; Adaptation, Psychological ; Interviews as Topic ; Chronic Disease ; Fatigue/psychology ; SARS-CoV-2 ; },
abstract = {BACKGROUND: In February 2023, the World Health Organization (WHO) defined long COVID in children, highlighting limited knowledge about its psychosocial impact. Studies show it as a complex, long-lasting condition affecting multiple systems. WHO and researchers emphasise the need for more understanding, particularly its effect on daily life. The aim of this study was to explore how life is experienced and how it changed whilst living with long COVID during childhood.

METHODS: We present a qualitative study with an inductive and exploratory approach. Between October 2022 and March 2024, 16 children between 9 and 18 years old diagnosed with long COVID were interviewed face-to-face using a semi-structured interview guide. The results were analysed using reflexive thematic analysis by Braun and Clarke.

RESULTS: The results present the subjective reality of children suffering from long COVID and their struggle in daily life. The findings are presented through three themes: Losing my foothold, Fatigue decides my path, and My way forward, illustrating a temporal and emotional journey, reflecting how children make sense of their experiences, adapt to the persistent impact of long COVID, and gradually move toward acceptance.

CONCLUSIONS: This study addresses the lack of knowledge of long COVID in the society, how it affects children in their struggle to find a new path in life. It also shows that, with knowledge and support, the symptoms and the burden of the condition can decrease or even pass. It is important that people around these children, including health care, school and family, use this knowledge to promote health and avoid educational, health and social problems at a vulnerable time in life.},
}

Humans
Child
Adolescent
Qualitative Research
*COVID-19/psychology
Male
Female
Adaptation, Psychological
Interviews as Topic
Chronic Disease
Fatigue/psychology
SARS-CoV-2

@article {pmid41044528,
year = {2025},
author = {Portela, MC and Lima, SML and Escosteguy, CC and Martins, M and de Vasconcellos, MTL and Caldas, BDN and Bernardino, M and Baginski, NP and Góes, G and Sabaine, B and Furtado, D and Cavalcanti, M and Soares, L and Stelson, E and Singer, S and Cornish, F and Aveling, EL},
title = {Long COVID in the population of COVID-19 hospitalized patients discharged from SUS' hospitals in Rio de Janeiro City, Brazil: a patient-engaged cohort survey study.},
journal = {BMC infectious diseases},
volume = {25},
number = {1},
pages = {1232},
pmid = {41044528},
issn = {1471-2334},
abstract = {BACKGROUND: Long COVID (LC) is a global health concern, affecting millions and placing significant strain on healthcare systems. However, there is a notable lack of LC research in low- and middle-income countries, particularly in the global south. This study aims to fill this gap by focusing on Brazil, a country with an emerging LC literature but limited population estimates due to sampling constraints. Our unique focus is to estimate the prevalence of persistent symptoms and LC self-reported diagnosis among COVID-19 patients hospitalized in Rio de Janeiro City public hospitals. We also aim to identify factors associated with the LC measures and most frequent symptoms, providing valuable insights for healthcare systems and policymakers.

METHODS: We designed a comprehensive, patient-engaged cohort survey study to assess LC symptoms and administered it to a probability sample of adults six to 24 months post-discharge from public hospitals in Rio de Janeiro City. LC was measured as (i) at least one persistent symptom or (ii) self-reported LC. Among the symptoms, we considered post-exertional malaise, which is frequently neglected in LC studies. Additionally, we applied an adaptation of the DePaul Symptom Questionnaire to account not only for the presence but also the frequency of symptom occurrence. We estimate the prevalence of symptoms and use logistic regression models to identify associations between LC and the most frequent LC symptoms and independent variables, assessing demographic, socioeconomic, lifestyle, and clinical characteristics, vaccination, and severity of acute disease.

RESULTS: Results indicate the predominant study's focus on low-income and highly vulnerable people, with an elevated prevalence of comorbidities before LC. In the study population of 11,328 persons, 71.3% (95%CI 66.3; 76.2) reported frequently experiencing at least one persistent symptom, and 39.3% (95%CI 34.2; 44.4) self-reported having LC. The most frequent symptoms were fatigue, post-exertional malaise, joint pain, sleep disturbance, and cognitive impairment, and symptoms were consistently more likely to occur among women. Age was non-linearly related to LC, and comorbidities before COVID-19 hospitalization were positively associated with LC symptoms.

CONCLUSIONS: Evidence is provided for the LC burden among COVID-19 hospitalized patients even 24 months post-discharge. LC accessible and appropriate healthcare is fundamental.},
}

@article {pmid41043444,
year = {2025},
author = {Buonsenso, D},
title = {Long COVID is here to stay-even in children.},
journal = {The Lancet. Infectious diseases},
volume = {},
number = {},
pages = {},
doi = {10.1016/S1473-3099(25)00496-7},
pmid = {41043444},
issn = {1474-4457},
}

@article {pmid41043442,
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 and , },
title = {Long COVID associated with SARS-CoV-2 reinfection among children and adolescents in the omicron era (RECOVER-EHR): a retrospective cohort study.},
journal = {The Lancet. Infectious diseases},
volume = {},
number = {},
pages = {},
doi = {10.1016/S1473-3099(25)00476-1},
pmid = {41043442},
issn = {1474-4457},
abstract = {BACKGROUND: Post-acute sequelae of SARS-CoV-2 infection (PASC) remain a major public health challenge. Although previous studies have focused on characterising PASC in children and adolescents after an initial infection, the risks of PASC after reinfection with the omicron variant remain unclear. We aimed to assess the risk of PASC diagnosis (U09.9) and symptoms and conditions potentially related to PASC in children and adolescents after a SARS-CoV-2 reinfection during the omicron period.

METHODS: This retrospective cohort study used data from 40 children's hospitals and health institutions in the USA participating in the Researching COVID to Enhance Recovery (RECOVER) Initiative. We included patients younger than 21 years at the time of cohort entry; with documented SARS-CoV-2 infection after Jan 1, 2022; and who had at least one health-care visit within 24 months to 7 days before the first infection. The second SARS-CoV-2 infection was confirmed by positive PCR, antigen tests, or a diagnosis of COVID-19 that occurred at least 60 days after the first infection. The primary endpoint was a clinician-documented diagnosis of PASC (U09.9). Secondary endpoints were 24 symptoms and conditions previously identified as being potentially related to PASC. We used the modified Poisson regression model to estimate the relative risk (RR) between the second and first infection episodes, adjusted for demographic, clinical, and health-care utilisation factors using exact and propensity-score matching.

FINDINGS: We identified 407 300 (87·5%) of 465 717 eligible children and adolescents with a first infection episode and 58 417 (12·5%) with a second infection episode from Jan 1, 2022, to Oct 13, 2023, in the RECOVER database. 233 842 (50·2%) patients were male and 231 875 (49·8%) were female. The mean age was 8·17 years (SD 6·58). The incident rate of PASC diagnosis (U09.9) per million people per 6 months was 903·7 (95% CI 780·9-1026·5) in the first infection group and 1883·7 (1565·1-2202·3) in the second infection group. Reinfection was associated with a significantly increased risk of an overall PASC diagnosis (U09.9) (RR 2·08 [1·68-2·59]) and a range of symptoms and conditions potentially related to PASC (RR range 1·15-3·60), including myocarditis, changes in taste and smell, thrombophlebitis and thromboembolism, heart disease, acute kidney injury, fluid and electrolyte disturbance, generalised pain, arrhythmias, abnormal liver enzymes, chest pain, fatigue and malaise, headache, musculoskeletal pain, abdominal pain, mental ill health, POTS or dysautonomia, cognitive impairment, skin conditions, fever and chills, respiratory signs and symptoms, and cardiovascular signs and symptoms.

INTERPRETATION: Children and adolescents face a significantly higher risk of various PASC outcomes after reinfection with SARS-CoV-2. These findings add to previous evidence linking paediatric long COVID to multisystem effects and highlight the need to promote vaccination in younger populations and support ongoing research to better understand PASC, identify high-risk subgroups, and improve prevention and care strategies.

FUNDING: National Institutes of Health.},
}

@article {pmid41043208,
year = {2025},
author = {Li, M and Wisniewski, T and Silva, F and Hammam, S and Alvarez, Z and Bilici, N and Caceres, LC and De La Cruz, N and Engelson, C and Greenberg, J and Gummadi, B and Hunter, J and Hernandez, DI and Karimi, S and Links, J and Rodriguez, M and Vedvyas, A and Vinitsky, H and Yakubov, A and Ge, Y and Thawani, S and Balcer, L and Galetta, S and Frontera, JA},
title = {Functional and cognitive outcomes three years after COVID-19.},
journal = {Clinical neurology and neurosurgery},
volume = {258},
number = {},
pages = {109180},
doi = {10.1016/j.clineuro.2025.109180},
pmid = {41043208},
issn = {1872-6968},
abstract = {BACKGROUND: There is paucity of data on long-term functional and cognitive outcomes after COVID-19 compared to COVID-negative controls.

METHODS: We conducted an observational cohort study of patients ≥ 1 year after COVID-19 compared to contemporaneous COVID-19 negative controls (SARS-CoV-2 nucleocapsid IgG negative with no history of COVID-19). Functional (modified Rankin Scale [mRS], Barthel Index), cognitive (telephone MoCA [t-MoCA]), and patient-reported neuropsychiatric symptoms were compared between groups using multivariable logistic regression analysis. In a subgroup of COVID-19 patients who were followed longitudinally, trajectories of recovery were assessed using the paired samples Sign test.

RESULTS: Of 145 participants, N = 115 COVID-19 patients (median age 62, 51 % female, 33 % hospitalized for COVID-19, median 2.9 years from index infection), and N = 30 non-COVID-19 controls (median age 75, 70 % female) were enrolled. Neuropsychiatric symptoms were reported in 76 % of COVID-19 patients versus 7 % of controls (aOR 15.0, 95 %CI 3.09-72.47, P < 0.001). Abnormal mRS> 0 occurred in 42 % of COVID-19 patients compared to 11 % of controls (P = 0.002). However, this difference was not significant after adjusting for age, sex, COVID-19 hospitalization and history of mood disorder (aOR 2.10, 95 %CI 0.52-8.51). Rates of abnormal t-MoCA≤ 18 (40 % of COVID-19 versus 41 % of controls, P = 1.00) and Barthel scores< 100 (19 % of COVID-19 versus 14 % in controls, P = 0.785) were similar. Among N = 26 COVID-19 patients with repeated measures, mRS significantly improved between 6-months to 3-years post-COVID (+1.3 points, p = 0.004), while no changes were observed in t-MoCA or Barthel.

CONCLUSIONS: Three years after COVID-19, neuropsychiatric symptoms were significantly more frequent compared to controls, however no differences in functional or cognitive status were detected.},
}

@article {pmid41042487,
year = {2025},
author = {Joost, FEA and Rose, N and Kimmig, A and Ruhnke, T and Dröge, P and Freytag, A and Günster, C and Pletz, MW and Roesler, M and Reuken, PA and Schlattmann, P and Schmidt, KFR and Stallmach, A and Storch, J and Reinhart, K and Wedekind, L and Fleischmann-Struzek, C},
title = {Long-term outcomes after intensive care unit-treated COVID-19, influenza and respiratory sepsis in 2020 - a comparative, population-based cohort study.},
journal = {Infection},
volume = {},
number = {},
pages = {},
pmid = {41042487},
issn = {1439-0973},
support = {01VSF21031//German Innovations Fund of the Federal Joint Committee/ ; },
abstract = {BACKGROUND: Sepsis survivors are affected by a broad spectrum of long-term impairments, which overlap with Long-Covid and sequelae after influenza in their clinical presentation. However, we lack comparative assessments on the burden of long-term outcomes, particularly with patients being recruited from the same, contemporary patient population. Therefore we compared long-term outcomes after respiratory sepsis (RS), SARS-CoV-2-associated sepsis (SS) and influenza-associated sepsis (IS).

METHODS: Retrospective, population-based cohort study. We included patients > 15 years hospitalized with RS, SS and IS between 01/2020 and 12/2020 in Germany, who received intensive care unit treatment. We compared mortality, readmissions, prevalence of diagnoses in the cognitive, psychological or medical domain, and the number of impaired domains in the 12 months post-discharge between the three survivor cohorts, adjusting for between-group differences in relevant covariates by inverse propensity score weighting based on generalized propensity scores.

RESULTS: Our study included 12,854 patients, of which 8,201 were RS, 3,964 SS and 689 IS survivors. RS survivors had a considerably higher risk for 12-month mortality compared to SS and IS survivors (relative risk, 1.77 [95% CI, 1.54-2.03]; P < 0.001 and relative risk, 1.37 [95% CI, 1.14-1.65]; P = 0.001, respectively). They were more often rehospitalized, affected by multiple domain impairments, cognitive decline and impairments related to the severity of acute disease, e.g. complications of the tracheostoma, compared to survivors after SS and IS. RS survivors had a lower risk for being affected by medical diagnoses compared to SS. Risks for psychological diagnoses did not differ between RS and the other survivor groups.

CONCLUSIONS: Although respiratory sepsis survivors seem to be affected by more severe long-term impairments, the overall burden of post-acute sequelae among all survivor groups is high. This warrants efforts to provide targeted aftercare for all survivor populations after life-threatening infections.},
}

@article {pmid41041184,
year = {2025},
author = {Anjum, A and Rauf, I and Mehvish, S and Parveen, S and Hussain, A},
title = {A cross-sectional study on long covid, cognition and neurasthenia-one year post covid.},
journal = {Journal of family medicine and primary care},
volume = {14},
number = {8},
pages = {3205-3210},
pmid = {41041184},
issn = {2249-4863},
abstract = {INTRODUCTION: The COVID-19 pandemic has led to long-term health effects in some patients, known as long COVID. This study aimed to delineate the symptoms of long COVID-19 and determine the presence of neurasthenia in patients one year after COVID-19 infection while excluding other potential causes of fatigue.

METHODS: A cross-sectional study was conducted on 512 RT-PCR-confirmed COVID-19 patients attending a follow-up clinic at least one year after infection. After excluding patients above 60 years, those with pre-existing psychiatric disorders, medical co-morbidities, and current psychiatric diagnoses, 87 patients were included in the final analysis. Patients were evaluated using the Schedule for Clinical Assessment in Neuropsychiatry (SCAN), Fatigue Severity Scale (FSS), and memory scale of PGI-BBD. A semi-structured questionnaire assessed changes in activities of daily living.

RESULTS: Of the 87 patients, 43 (49.4%) fulfilled the ICD-10 criteria for neurasthenia. Fatigue interfering with daily activities was reported by 41.3% of patients, with a mean FSS score of 6.1 in those with neurasthenia. Other symptoms included muscular aches (35.6%), tension headaches (27.5%), and weakness (31%). Cognitive difficulties, specifically problems with attention and concentration, were observed in 8% of patients. The severity of the initial COVID-19 infection did not correlate with the risk of developing neurasthenia.

CONCLUSION: Long COVID symptoms, particularly those resembling neurasthenia, persist in a significant proportion of patients one year after infection. The syndrome of long COVID shows similarities to the ICD-10 diagnosis of neurasthenia, suggesting a potential link between post-COVID symptoms and chronic low-grade inflammation. These findings highlight the need for recognition and management of long-term COVID-19 effects in public health policies.},
}

@article {pmid41038893,
year = {2025},
author = {da Silva Almeida, I and de Jesus Ferreira, LG and Cipriano, G and Costa, RR and Vaz, MA and Babault, N and de Cássia Marqueti, R and Durigan, JLQ},
title = {Persistent neuromuscular disorders associated with changes in tibialis anterior and gastrocnemius lateralis muscle architecture in long-covid: an observational longitudinal study.},
journal = {Scientific reports},
volume = {15},
number = {1},
pages = {34375},
pmid = {41038893},
issn = {2045-2322},
support = {001//Coordenação de Aperfeiçoamento de Pessoal de Nível Superior/ ; 001//Coordenação de Aperfeiçoamento de Pessoal de Nível Superior/ ; 00193.00000773/2021-72//Fundação de Apoio à Pesquisa do Distrito Federal/ ; 00193.00001222/2021-26//Fundação de Apoio à Pesquisa do Distrito Federal/ ; 00193-00001261/2021-23//Fundação de Apoio à Pesquisa do Distrito Federal/ ; 141130/2023-7//Conselho Nacional de Desenvolvimento Científico e Tecnológico/ ; 131422/2023-5//Conselho Nacional de Desenvolvimento Científico e Tecnológico/ ; 309435/2020-0//Conselho Nacional de Desenvolvimento Científico e Tecnológico/ ; 310269/2021-0//Conselho Nacional de Desenvolvimento Científico e Tecnológico/ ; 00193.00000859/2021-3//Fundação de Apoio à Pesquisa do Distrito Federal, Brazil/ ; },
mesh = {Humans ; Male ; *Muscle, Skeletal/diagnostic imaging/pathology/physiopathology ; Female ; *COVID-19/complications/physiopathology ; Longitudinal Studies ; Middle Aged ; Adult ; *Neuromuscular Diseases/etiology/physiopathology/pathology/diagnostic imaging ; SARS-CoV-2 ; Ultrasonography ; },
abstract = {Long COVID-19 causes complications, affecting quality of life and work capacity. However, its long-term impact on lower limb neuromuscular function remains unclear. To evaluate neuromuscular electrophysiological disorders (NEDs) and muscle architecture of the tibialis anterior (TA) and triceps surae (TS) in individuals with moderate or severe COVID-19 compared to control group over 12 months. Seventy participants were divided into moderate-COVID (n = 22), severe-COVID (n = 18), and control (n = 30) groups. COVID groups underwent four assessments over one year. NEDs in the TA and gastrocnemius lateralis (GL) were assessed via stimulus electrodiagnostic testing, while TA and TS muscle architecture was evaluated using ultrasound. Participants with severe-COVID exhibited significantly higher chronaxie (p < 0.001) in the TA at the first assessment, NEDs were observed in 55.55%, 33.33%, and 16.66% of participants across the first three assessments. GL showed 5.55% prevalence of NEDs. Echogenicity increased in TA and GL muscles in the severe-COVID group (p < 0.001). An association was found between TA chronaxie and echogenicity in the COVID groups during the short-term assessment (p < 0.001). Severe COVID-19 is associated with higher prevalence of NEDs in the TA muscle and persistent echogenicity increases, suggesting polyneuromyopathy in the TA and widespread echogenicity abnormalities in long COVID patients.},
}

Humans
Male
*Muscle, Skeletal/diagnostic imaging/pathology/physiopathology
Female
*COVID-19/complications/physiopathology
Longitudinal Studies
Middle Aged
Adult
*Neuromuscular Diseases/etiology/physiopathology/pathology/diagnostic imaging
SARS-CoV-2
Ultrasonography

@article {pmid41038267,
year = {2025},
author = {Thomas, D and Yang, PC and Wu, JC and Sayed, N},
title = {Decoding long COVID-associated cardiovascular dysfunction: Mechanisms, models, and new approach methodologies.},
journal = {Journal of molecular and cellular cardiology},
volume = {},
number = {},
pages = {},
doi = {10.1016/j.yjmcc.2025.09.008},
pmid = {41038267},
issn = {1095-8584},
abstract = {The COVID-19 pandemic has revealed that the impact of SARS-CoV-2 infection extends well beyond the acute phase, with long-term sequelae affecting multiple organ systems, most notably, the cardiovascular system. Long COVID, or post-acute sequelae of SARS-CoV-2 infection (PASC), is characterized by persistent symptoms such as fatigue, dyspnea, chest pain, and palpitations, which can last for months or even years after initial recovery. Increasing evidence implicates immune dysregulation, endothelial dysfunction, persistent viral antigens, and coagulopathy as central drivers of cardiovascular complications. Mechanistic studies demonstrate that direct viral infection of cardiac and vascular cells, along with autoantibody formation and cytokine-mediated injury, contribute to myocardial inflammation, fibrosis, and arrhythmias. Sex-based immunological differences and underlying comorbidities further influence individual susceptibility and disease trajectory. Large-scale epidemiological studies have confirmed significantly increased risks of pericarditis, cardiomyopathy, dysrhythmias, and heart failure among COVID-19 survivors. In parallel, the emergence of advanced preclinical platforms, including patient-derived induced pluripotent stem cell (iPSC)-based cardiac organoids, engineered heart tissues, and organ-on-a-chip systems has enabled mechanistic dissection of Long COVID pathophysiology. These human-relevant models, when integrated with clinical datasets and artificial intelligence (AI)-driven analytics, offer powerful tools for biomarker discovery, risk stratification, and precision therapeutic development. This review synthesizes the current understanding of cardiovascular involvement in Long COVID, highlights key mechanistic insights from both clinical and preclinical studies, and outlines future directions for diagnostic and therapeutic innovation.},
}

@article {pmid41037811,
year = {2025},
author = {Metz, TD and Reeder, HT and Clifton, RG and Flaherman, V and Aragon, LV and Baucom, LC and Beamon, CJ and Braverman, A and Brown, J and Carmilani, M and Cao, T and Chang, A and Costantine, MM and Dionne, JA and Gibson, KS and Gross, RS and Guerreros, E and Habli, M and Hess, R and Hillier, L and Hodder, S and Hoffman, MC and Hoffman, MK and Huang, W and Hughes, BL and Jia, X and Kale, M and Katz, SD and Laleau, V and Mendez-Figueroa, H and McComsey, GA and Ofotokun, I and Okumura, MJ and Pacheco, LD and Palatnik, A and Palomares, KTS and Parry, S and Pettker, CM and Plunkett, BA and Poppas, A and Ramsey, P and Reddy, UM and Rouse, DJ and Saade, GR and Sandoval, GJ and Sciurba, F and Simhan, HN and Skupski, DW and Sowles, A and Thorp, JM and Tita, ATN and Wiegand, S and Weiner, SJ and Yee, LM and Horwitz, LI and Foulkes, AS and Jacoby, VL and , },
title = {Long COVID After Acquisition of the Omicron Variant of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) During Pregnancy Compared With Outside of Pregnancy.},
journal = {Obstetrics and gynecology},
volume = {},
number = {},
pages = {},
pmid = {41037811},
issn = {1873-233X},
support = {OT2HL161847/HL/NHLBI NIH HHS/United States ; OT2HL161841/HL/NHLBI NIH HHS/United States ; },
abstract = {OBJECTIVE: To evaluate whether the risk of long COVID among individuals infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during pregnancy differs from that of individuals who were not pregnant at time of virus acquisition.

METHODS: We conducted a multicenter observational cohort study at 79 NIH RECOVER (Researching COVID to Enhance Recovery) sites. Individuals assigned female at birth aged 18-45 years with an index (first) SARS-CoV-2 infection on or after December 1, 2021, were included. The exposure was pregnancy (any gestational age) at the time of index SARS-CoV-2 infection. The primary outcome was long COVID 6 months after index infection, defined as RECOVER-Adult Long COVID Research Index score 11 or higher based on a detailed symptom survey. To account for confounding and differential selection between participants who were pregnant and not pregnant at infection, propensity score-matching methods were used to balance the groups on variables potentially associated with both pregnancy status and long COVID.

RESULTS: Overall 2,423 participants were included; 580 (23.9%) were pregnant at index SARS-CoV-2 infection. The median age at infection was 33 years (interquartile range 28-38 years), and 2,131 of participants (90.0%) with known vaccination status were vaccinated. After propensity score matching, the adjusted long COVID prevalence estimates 6 months after index infection were 10.2% (95% CI, 6.2-14.3%) among those pregnant at infection and 10.6% (95% CI, 8.8-12.4%) among those not pregnant at infection. Pregnancy was not associated with a difference in adjusted risk of long COVID (adjusted risk ratio 0.96, 95% CI, 0.63-1.48).

CONCLUSION: Acquisition of SARS-CoV-2 during pregnancy was not associated with a differential risk of long COVID at 6 months compared with similar-aged individuals who acquired SARS-CoV-2 outside of pregnancy.},
}

@article {pmid41036702,
year = {2025},
author = {Thierry, AR and Usher, T and Sanchez, C and Turner, S and Venter, C and Pastor, B and Waters, M and Thompson, A and Mirandola, A and Pisareva, E and Prevostel, C and Laubscher, GJ and Kell, DB and Pretorius, E},
title = {Circulating Microclots Are Structurally Associated With Neutrophil Extracellular Traps and Their Amounts Are Elevated in Long COVID Patients.},
journal = {Journal of medical virology},
volume = {97},
number = {10},
pages = {e70613},
doi = {10.1002/jmv.70613},
pmid = {41036702},
issn = {1096-9071},
support = {//The study was partially supported by SIRIC Montpellier Cancer Grant INCa_Inserm_DGOS_12553 (ART); South African National Research Foundation (142142); (EP); and the South African Medical Research Foundation (EP), the Novo Nordisk Foundation grant NNF20CC0035580 (DBK) and the Balvi Foundation grant 18 (DBK)./ ; },
mesh = {Humans ; *Extracellular Traps/metabolism ; *COVID-19/blood/complications/pathology ; Male ; Middle Aged ; Female ; Leukocyte Elastase/blood ; *Neutrophils/metabolism ; Biomarkers/blood ; Aged ; Fibrin/metabolism ; SARS-CoV-2 ; Adult ; },
abstract = {The persistence of vasculo-thrombotic complications has been put forward as a possible contributing factor in the Long COVID (LC) syndrome. Given the recently reported separate demonstration of the association of LC with elevated levels of heterogenous fibrin(ogen) amyloidogenic particles (microclots) and with those neutrophil extracellular traps (NETs), markers that are linked to thromboinflammation, this study considers the association of microclots with NETs. The results show that NETs markers (Myeloperoxydase, Neutrophil Elastase, and circulating DNA) are quantitatively and structurally associated with the size and number of microclots in patients with LC. These markers showed a strong diagnostic performance, both independently and when combined. Our study revealed that NETs may be a component of circulating microclots. We suggest that higher NETs formation might promote the stabilization of microclots in the circulation, potentially leading to deleterious effects which contribute causally to the LC syndrome.},
}

Humans
*Extracellular Traps/metabolism
*COVID-19/blood/complications/pathology
Male
Middle Aged
Female
Leukocyte Elastase/blood
*Neutrophils/metabolism
Biomarkers/blood
Aged
Fibrin/metabolism
SARS-CoV-2
Adult

@article {pmid41036177,
year = {2025},
author = {Fujimoto, Y and Abe, H and Eiro, T and Tsugawa, S and Tanaka, M and Hatano, M and Nakajima, W and Ichijo, S and Arisawa, T and Takada, Y and Kimura, K and Sano, A and Hirahata, K and Sasaki, N and Kimura, Y and Takahashi, T},
title = {Systemic increase of AMPA receptors associated with cognitive impairment of long COVID.},
journal = {Brain communications},
volume = {7},
number = {5},
pages = {fcaf337},
pmid = {41036177},
issn = {2632-1297},
abstract = {Long COVID primarily presents with persistent cognitive impairment (Cog-LC), imposing a substantial and lasting global burden. Even after the pandemic, there remains a critical global need for diagnostic and therapeutic strategies targeting Cog-LC. Nevertheless, the underlying neural mechanisms remain poorly understood. Given the central role of synapses in brain function, investigation of synaptic molecular changes may provide vital insights into Cog-LC pathophysiology. In this study, we used [[11]C]K-2 PET to characterize the density of AMPA receptors (AMPARs) on the post-synaptic cell surface, which are crucial synaptic components in brain signalling. Statistical parametrical mapping was used to spatially normalize and apply independent t-test for a voxel-based comparison. We selected patients with Cog-LC (n = 30) based on Repeatable Battery for the Assessment of Neuropsychological Status assessed persistent cognitive impairment and healthy controls (n = 80) with no diagnosed neuropsychiatric disorders. The primary objective was to compare [[11]C]K-2 standardized uptake value ratio with white matter (SUVRWM) as a reference region between patients with Cog-LC and healthy controls, and to define the regional extent of differences. The secondary objective was to examine associations between [[11]C]K-2 SUVRWM and plasma concentrations of cytokines or chemokines. As an exploratory objective, we tested whether [[11]C]K-2 PET data could distinguish Cog-LC from healthy controls using a partial least squares based classification algorithm. A voxel-based comparison (P < 0.05, T > 1.66, one-tailed, false discovery rate control) and a volume of interests analysis (P < 0.05, Bonferroni multiple comparison) demonstrated that increased index of AMPAR density in large parts of the brains of patients with Cog-LC compared with that in healthy controls. A voxel-based correlation analysis also showed the brain regions where [[11]C]K-2 SUVRWM correlated positively with plasma TNFSF12 and negatively with plasma CCL2 concentrations. A partial least squares model trained on the index of AMPAR density data demonstrated high diagnostic accuracy, achieving 100% sensitivity and 91.2% specificity. [[11]C]K-2 PET signal represents the index of AMPAR density on the post-synaptic neural cell surface, not on the glial cell surface. A systemic increase in synaptic AMPARs across the brain may drive abnormal information processing in Cog-LC and, through excessive excitatory signalling, pose a risk of excitotoxic neuronal damage. We derived the hypothesis that [[11]C]K-2 PET would be helpful in establishing a diagnostic framework for Cog-LC and that antagonists for cell surface AMPARs, such as perampanel, would be a potential therapeutic target. These hypotheses should be investigated in future large-scale clinical studies.},
}

@article {pmid41035536,
year = {2025},
author = {Daher, J and Koberssy, Z and Durieux, JC and Atieh, O and Baissary, J and Abboud, M and McComsey, GA},
title = {Cognitive Function 1 Year After COVID Infection.},
journal = {Open forum infectious diseases},
volume = {12},
number = {10},
pages = {ofaf583},
pmid = {41035536},
issn = {2328-8957},
abstract = {BACKGROUND: While emerging evidence suggests a potential link between COVID-19 and cognitive impairment, there is a lack of prospective longitudinal research that objectively assesses cognitive outcomes after SARS-CoV-2 infection. This study aims to evaluate changes in cognitive function following COVID-19 in a group of individuals with baseline pre-infectious cognitive assessments.

METHODS: In this cohort study, cognitive function was objectively measured using the computerized Cognivue Clarity® device. All participants who had available Cognivue® testing were followed with a second Cognivue® assessment ∼1 year later. Based on whether they contracted COVID-19 during this period, participants were categorized into 2 groups according to COVID status.

RESULTS: We enrolled 110 participants with a median age of 45 years, 35% females and 46% white; 55 (50%) participants experienced a documented COVID-19 infection during the follow-up period (COVID + group), and the rest remained free of COVID infection (COVID- group). COVID- and COVID + groups were balanced for demographics and duration of follow-up. In the COVID + group, only memory scores changed during follow-up (+3.9; P = .03). The COVID- group showed improvements in the overall Cognivue® score (+2; P = .03), as well as in visuospatial (+1.9; P = .04), executive function (+2.2; P = .02), and naming language (+2.2; P = .01) scores. No statistically significant differences were observed in the overall cognitive score or its subdomains between the 2 groups.

CONCLUSIONS: In a 45-year-old average population, no decrease in cognitive function was observed 1 year after COVID-19 infection.},
}

@article {pmid41034315,
year = {2025},
author = {Roy, S and Malik, A and Singh, A and Ray, S},
title = {Long term health related quality of life among individuals after COVID 19 recovery in a multicentric community based study.},
journal = {Scientific reports},
volume = {15},
number = {1},
pages = {34225},
pmid = {41034315},
issn = {2045-2322},
support = {OR/3/11/2021-ECD-II//Department of Health Research, Ministry of Health and Family Welfare, Government of India/ ; },
mesh = {Humans ; *Quality of Life ; *COVID-19/epidemiology/psychology ; Male ; Female ; Middle Aged ; Adult ; Cross-Sectional Studies ; Aged ; SARS-CoV-2/isolation & purification ; India/epidemiology ; Young Adult ; Surveys and Questionnaires ; Health Status ; },
abstract = {The COVID-19 pandemic has had a profound and far-reaching impact on global health, resulting in significant morbidity and mortality across populations. Long term post COVID-19 conditions can include neurological symptoms, chronic fatigue, and mental health disorders, which collectively contribute to a deterioration in health-related quality of life. This study aims assess long-term HRQoL using EuroQol (EQ 5D 5L) among COVID-19 patients in community settings. This study conducted a multicentric, community-based cross-sectional design to assess the long-term HRQoL among patients who have recovered from COVID-19. The study included participants aged above 18 years from two cities Delhi and Bhubaneswar. Descriptive statistics of categorical variables were presented in frequency and percentage, while continuous variables were presented in mean ± SD. The censored regression analysis has been performed by reporting beta coefficients and significance by (p < 0.05). The EQ-5D-5L index scores indicated a mean of 0.89 (95% CI 0.87, 0.91) for Delhi, compared to a lower mean score of 0.66 (95% CI 0.62, 0.71) for Bhubaneswar. Age was negatively correlated with health states, showing a crude coefficient of - 0.003 (95% CI - 0.005, 0.001) with a significant p value of 0.002, although the adjusted coefficient was - 0.002 (95% CI - 0.005, 0.001), indicating a loss of significance when controlling for other factors. The emphasizes the health-related quality of life of the COVID-19 recovered patients and challenges in their daily living. The study descriptively highlighting the quality-of-life and in association with age, educational status, marital status, health insurance availability, and treatment setting.},
}

Humans
*Quality of Life
*COVID-19/epidemiology/psychology
Male
Female
Middle Aged
Adult
Cross-Sectional Studies
Aged
SARS-CoV-2/isolation & purification
India/epidemiology
Young Adult
Surveys and Questionnaires
Health Status

@article {pmid41033506,
year = {2025},
author = {Greene, C},
title = {The broken barrier: neurovascular insights into long COVID.},
journal = {Brain, behavior, and immunity},
volume = {},
number = {},
pages = {106126},
doi = {10.1016/j.bbi.2025.106126},
pmid = {41033506},
issn = {1090-2139},
}

@article {pmid41033333,
year = {2025},
author = {Johnson, MJ and Williams, B and Keerie, C and Tuck, S and Hart, S and Bajwah, S and Chaudhuri, N and Pearson, M and Cohen, J and Evans, RA and Currow, DC and Higginson, IJ and Hall, P and Atter, M and Norrie, J and Fallon, MT and , },
title = {Morphine for chronic breathlessness (MABEL) in the UK: a multi-site, parallel-group, dose titration, double-blind, randomised, placebo-controlled trial.},
journal = {The Lancet. Respiratory medicine},
volume = {},
number = {},
pages = {},
doi = {10.1016/S2213-2600(25)00205-X},
pmid = {41033333},
issn = {2213-2619},
abstract = {BACKGROUND: The effectiveness of opioids for breathlessness seen in laboratory-based studies has not been replicated in clinical trials. We aimed to assess the effectiveness of oral morphine for breathlessness in long-term conditions.

METHODS: This phase 3, parallel-group, double-blind, placebo-controlled trial across 11 centres randomly assigned consenting adults (1:1, stratified by site and causal disease) with a modified Medical Research Council breathlessness score of 3 or more due to cardiorespiratory conditions to receive 5-10 mg twice daily oral long-acting morphine or placebo (as well as a blinded laxative) for 56 days. The primary outcome was worst breathlessness score in the past 24 h at day 28, measured using a numerical rating scale (NRS; 0=not breathless at all; 10=worst imaginable breathlessness). Secondary outcomes included physical activity levels, worst cough NRS, quality of life, and morphine-related toxicities. Patients who received at least one dose of study drug were eligible for inclusion in efficacy and safety analyses. The trial was registered with ISRCTN (ISRCTN87329095) and the EU Clinical Trials Register (EudraCT 2019-002479-33).

FINDINGS: Between March 18, 2021, and Oct 26, 2023, 143 participants were randomly assigned to receive either morphine (73 participants) or placebo (67 participants) and were included in the analyses; three participants did not receive the allocated treatment. Participants had a mean age of 70·5 (SD 9·4) years, were mostly male (93 [66%]), and were mostly White (132 [94%]). By day 28, 64 (88%) participants in the morphine group versus 66 (99%) in the placebo group had 90% adherence or greater. We found no evidence of difference in worst breathlessness at day 28 (morphine 6·19 [95% CI 5·57 to 6·81] vs placebo 6·10 [5·44 to 6·76]; adjusted mean difference 0·09 [95% CI -0·57 to 0·75], p=0·78) or any secondary measure, except for improved cough seen at day 56 (adjusted mean difference -1·41 [-2·18 to -0·64]). Increased moderate to vigorous physical activity was seen at day 28 (adjusted mean difference 9·51 min/day [0·54-18·48]) but this was not significant after multiple-measures correction. The morphine group had more adverse events (251 vs 162), serious adverse events (15 vs three, of which three in the morphine group and zero in the placebo group were deemed to be related to the study), and study drug withdrawals (13 vs two). There were no treatment-related deaths.

INTERPRETATION: We found no evidence that morphine improves worst breathlessness intensity. Further research is needed to understand whether there is any role for morphine in chronic breathlessness, but our findings do not support its use in this setting.

FUNDING: NIHR Health Technology Assessment programme (HTA Project 17/34/01).},
}

@article {pmid41033183,
year = {2025},
author = {Shimada, T and Tanabe, N and Chubachi, S and Asakura, T and Namkoong, H and Tanaka, H and Azekawa, S and Otake, S and Nakagawara, K and Fukushima, T and Watase, M and Maetani, T and Shiraishi, Y and Terai, H and Sasaki, M and Ueda, S and Kato, Y and Harada, N and Suzuki, S and Yoshida, S and Tateno, H and Yamada, Y and Jinzaki, M and Hirai, T and Okada, Y and Koike, R and Ishii, M and Kimura, A and Imoto, S and Miyano, S and Ogawa, S and Kanai, T and Fukunaga, K},
title = {Extent of pulmonary involvement on admission predicts long-term pulmonary and muscular sequelae of COVID-19: A longitudinal computed tomography study.},
journal = {Respiratory investigation},
volume = {63},
number = {6},
pages = {1215-1220},
doi = {10.1016/j.resinv.2025.09.014},
pmid = {41033183},
issn = {2212-5353},
abstract = {BACKGROUND: Studies on the association between chest computed tomography (CT) findings of extensive pulmonary involvement and long-term pulmonary and extrapulmonary coronavirus disease 2019 (COVID-19) sequelae are lacking. This study aimed to investigate the relationship between the severity of pneumonia on admission and residual pulmonary and extrapulmonary complications at three months post-hospitalization.

METHODS: Using data from the Japan COVID-19 Task Force database, we conducted quantitative analysis of CT scans of 164 patients obtained at admission and three months later. The parameters included pneumonia volume, total lung volume, and area and density of the pectoralis muscle (PM), subcutaneous and epicardial adipose tissue, and vertebral bone density.

RESULTS: Patients with extensive pneumonia on admission had high residual pneumonia volumes, reduced lung volumes, and decreased area and density of PM at three months. No significant differences were observed in the adipose tissue or bone parameters. The severity of pneumonia at admission was independently associated with PM atrophy.

CONCLUSIONS: CT-based quantification of pneumonia extent during the acute phase of COVID-19 may be useful in predicting long-term pulmonary sequelae and muscle wasting. This approach may allow the objective evaluation of Long COVID and facilitate the identification of potential therapeutic targets.},
}

@article {pmid41031103,
year = {2025},
author = {Dalton, AF and Baca, S and Raykin, J and Gregory, CO and Boehmer, T and Koumans, EH and Patel, PR and Patel, P and Saydah, S},
title = {Risk of Post-COVID-19 Conditions Among Adolescents and Adults Who Received Nirmatrelvir-Ritonavir for Acute COVID-19: A Retrospective Cohort Study.},
journal = {Open forum infectious diseases},
volume = {12},
number = {10},
pages = {ofaf567},
pmid = {41031103},
issn = {2328-8957},
abstract = {BACKGROUND: Post-COVID-19 Conditions (PCC) potentially affect millions of people, but it is unclear whether treating acute COVID-19 with nirmatrelvir-ritonavir may reduce the risk of PCC.

METHODS: This is a retrospective cohort study using real-world, closed claims data to assess the relationship between nirmatrelvir-ritonavir and PCC by age group (12-17, 18-49, 50-64, ≥65 years). Eligible patients had a COVID-19 index date (positive laboratory test, ICD-10 diagnosis code, or nirmatrelvir-ritonavir prescription) from 1 April to 31 August 2022, in the outpatient, telehealth, or emergency department setting, and had a higher risk of severe COVID-19 based on age (≥50 years) or underlying risk factors. Treated patients (ie, received a nirmatrelvir-ritonavir prescription within ±5 days of index date) were matched 1:2 on age, sex, month of index date, and HHS region with untreated patients. PCC was defined by the presence of ≥1 of 45 new-onset symptoms or conditions recorded ≥60 days after index date.

RESULTS: Of the treated patients, 291 433 were matched to 582 866 untreated patients. Treatment with nirmatrelvir-ritonavir reduced PCC risk in adults 50-64 years (adjusted hazard ratio [aHR] 0.93, 95% confidence interval [CI] 0.92-0.95) and ≥65 years (aHR 0.88, 95% CI 0.87-0.90). Treatment had minimal effect among high-risk adults 18-49 years (aHR 0.98, 95% CI 0.97-0.99) and no effect among high-risk adolescents 12-17 years (aHR 1.06, 95% CI 0.66-1.13).

CONCLUSIONS: Results using real-world data suggest a protective relationship between nirmatrelvir-ritonavir during acute illness and PCC risk among older adults, but not among adolescents. Consideration may be given to outpatient treatment of mild to moderate COVID-19 with nirmatrelvir-ritonavir to reduce the risk of severe disease and PCC.},
}

@article {pmid41030634,
year = {2025},
author = {Johnson, BL},
title = {"In-Flu-Enza and Out-Flew Hair:" Post-Epidemic Health and the Importance of the History of Epidemics.},
journal = {The Yale journal of biology and medicine},
volume = {98},
number = {3},
pages = {341-348},
pmid = {41030634},
issn = {1551-4056},
mesh = {Humans ; *COVID-19/epidemiology/history ; History, 20th Century ; *Influenza, Human/epidemiology/history ; SARS-CoV-2 ; *Epidemics/history ; Pandemics/history ; History, 21st Century ; Influenza Pandemic, 1918-1919/history ; },
abstract = {When COVID-19 survivors reported ongoing symptoms or new health concerns following their infections in 2020 and early 2021, many medical practitioners and health agencies questioned the connection between novel viruses and long-term health impacts. Medical historians studying epidemics understand the connection between viral infection and health complications emerging immediately or years or decades later. In this essay, I explore the similarities between the medical fallout of the 1918 influenza and COVID-19 pandemics. Despite the differences between the viruses, these novel strains produced similar medium- and long-term health difficulties, including cardiovascular dysfunction and crushing fatigue. As I demonstrate, a significant difference between these two pandemics is in the response by medical practitioners. Following influenza, practitioners expected new and worsening health issues and took their patients' complaints seriously, offering support through food delivery, convalescent care, specialist oversight, and in-home nursing. Early in the COVID-19 pandemic, many practitioners characterized ongoing or new symptoms as anxiety. Patients led efforts to recognize Long COVID as an authentic medical condition, and today, physicians around the country refer their patients to Long COVID clinics. The value of medical history is apparent in this comparison-if practitioners understand how historical epidemics impacted various populations, they expect that in the epidemic aftermath or the period following an acute epidemic crisis, not all patients get well. Including the history of epidemics in public health education, continuing education programming, and even medical school curricula can resist epidemic erasure and empower medical practitioners to expect the unexpected.},
}

Humans
*COVID-19/epidemiology/history
History, 20th Century
*Influenza, Human/epidemiology/history
SARS-CoV-2
*Epidemics/history
Pandemics/history
History, 21st Century
Influenza Pandemic, 1918-1919/history

@article {pmid41029812,
year = {2025},
author = {Su, S and Jiang, Z and Shi, L and Liu, X and Zhang, Z and Mei, H and Gao, N and Wu, S and Li, M and Zhang, X and Zhang, A and Tang, C and Zheng, Y and Zhao, Y and Zeng, N and Ni, S and Yan, W and Yuan, K and Sun, Y and Hong, Y and Lu, Y and Shi, J and Bao, Y and Li, X and Lu, L},
title = {Physical, cognitive, and mental health impacts of Omicron reinfection in patients with original SARS-CoV-2 infection: a community-based observational study.},
journal = {BMC medicine},
volume = {23},
number = {1},
pages = {526},
pmid = {41029812},
issn = {1741-7015},
support = {2021ZD0200700//the National Programs for Brain Science and Brain-like Intelligence Technology of China (STI2030-Major Projects)/ ; 82171514//the National Natural Science Foundation of China/ ; 81761128036//the National Natural Science Foundation of China/ ; 2024YFC2707801//National Key Research and Development Program of China Stem Cell and Translational Research/ ; BMU2022DJXK007//the Fundamental Research Funds for the Central Universities (Peking University Medicine Fund for world's leading discipline or discipline cluster development)/ ; 2021YFC0863700//National Key Research and Development Program of China/ ; 2021ZD0200800//the National Programs for Brain Science and Brain-like Intelligence Technology of China (STI2030-Major Project)/ ; },
mesh = {Humans ; *COVID-19/psychology/epidemiology/complications/physiopathology/virology ; Female ; Male ; Middle Aged ; *Reinfection/psychology/epidemiology ; *SARS-CoV-2 ; Adult ; China/epidemiology ; Aged ; *Mental Health ; },
abstract = {BACKGROUND: Epidemiological and clinical evidence suggests that severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) reinfection is a complication in a proportion of patients reporting ongoing health issues. However, most studies in the field of SARS-CoV-2 reinfection have focused only on self-reported symptoms and lacked long-term objective measurements. This study aimed to estimate the pattern of chronic symptoms of Omicron reinfection in patients with original SARS-CoV-2 infection by comprehensively assessments 3 years after recovery.

METHODS: This community-based observational study was conducted in Wuhan, China, between January and April in 2023. All participants were recruited from community and invited to participate the interview and examination in a hospital. The subjective multi-system symptoms were self-reported. The objective radiological features and laboratory data were assessed by measuring blood inflammation and performing chest computed tomography (CT) and pulse oxygen saturation.

RESULTS: Among 1438 individuals who participated in the study, 144 were infected with the original variant only in 2020, 980 were Omicron-infected in 2023, 215 were reinfected both in 2020 and 2023, and 99 were never infected. Compared with the non-infection group, the reinfection (odds ratio (OR), 5.15 [95% confidence intervals (CIs), 2.96-8.96]) group was associated with the highest risk of any of chronic physical symptoms, followed by the Omicron infection (3.45 [2.19-5.44]) and original variant infection (2.90 [1.63-5.15]) groups. Compared with the non-infection group, the reinfection (4.05 [2.30-7.14]), Omicron infection (3.72 [2.26-6.11]), and original variant infection (2.71 [1.48-4.95]) groups were associated with an increased risk of any of chronic mental symptoms. Moreover, of all groups, the reinfection group reported the highest seropositivity rate for C-reactive protein, and the highest prevalence rates of ground glass opacities on chest CT and hypoxaemia.

CONCLUSIONS: Our results suggest that reinfection may be a risk factor for long COVID conditions. These findings provide information for the clinical management and healthcare services of long COVID and SARS-CoV-2 reinfection and highlight the importance taking necessary action to prepare for a future pandemic. The long-term follow-up will be needed to verify the impact of different SARS-CoV-2 infection status on long COVID in the future.},
}

Humans
*COVID-19/psychology/epidemiology/complications/physiopathology/virology
Female
Male
Middle Aged
*Reinfection/psychology/epidemiology
*SARS-CoV-2
Adult
China/epidemiology
Aged
*Mental Health

@article {pmid41029414,
year = {2025},
author = {Dempsey, B and Blake, HA and Madan, I and Stevelink, SAM and Greenberg, N and Raine, R and Rafferty, AM and Bhundia, R and Wessely, S and Lamb, D},
title = {COVID-19-related sickness absence among 4,721 NHS staff in England and its relation with long COVID symptoms: findings from NHS CHECK.},
journal = {BMC health services research},
volume = {25},
number = {1},
pages = {1243},
pmid = {41029414},
issn = {1472-6963},
support = {CF/01/22//Colt Foundation/ ; M952//Rosetrees Trust/ ; MR/V034405/1/MRC_/Medical Research Council/United Kingdom ; ES/V009931/1//Economic and Social Research Council/ ; ISSF3/ H17RCO/C3//UCL/Wellcome/ ; },
}

@article {pmid41029357,
year = {2025},
author = {Dhariwal, R and Thakkar, K and Vaghela, K and Jain, M},
title = {Evaluating post-acute COVID-19 sequelae in younger population using symptom burden questionnaire (SQL).},
journal = {BMC public health},
volume = {25},
number = {1},
pages = {3195},
pmid = {41029357},
issn = {1471-2458},
mesh = {Humans ; Female ; *COVID-19/complications/epidemiology/psychology ; Cross-Sectional Studies ; Male ; Young Adult ; Adult ; Adolescent ; Surveys and Questionnaires ; Post-Acute COVID-19 Syndrome ; Anxiety/epidemiology ; Depression/epidemiology ; Prevalence ; Symptom Burden ; },
abstract = {The COVID-19 pandemic, declared by the World Health Organization on March 11, 2020, has led to over 650 million infections globally and a significant burden of long-term health issues, termed post-COVID-19 condition (PCC) or long COVID or post-acute sequelae of COVID-19 (PASC). This cross-sectional study assesses the prevalence and distribution of persistent symptoms among individuals aged 18-25 years using the Symptom Burden Questionnaire™ for Long COVID (SBQ™-LC), which evaluates 123 symptoms across 17 health domains. Our hypothesis interprets that the pandemic has laid mental health challenges among younger populations, evidenced by increased rates of depression and anxiety. Data from participants revealed high rates of mental health issues, sleep disturbances, and cognitive dysfunctions, even among those with mild or asymptomatic infections. Notably, female participants reported higher symptom severity across most domains. This research underscores the necessity for targeted assessments of post-acute sequelae in young adults to enhance understanding and management of long COVID-related health issues.},
}

Humans
Female
*COVID-19/complications/epidemiology/psychology
Cross-Sectional Studies
Male
Young Adult
Adult
Adolescent
Surveys and Questionnaires
Post-Acute COVID-19 Syndrome
Anxiety/epidemiology
Depression/epidemiology
Prevalence
Symptom Burden

@article {pmid41029289,
year = {2025},
author = {Lo, YP and Chiang, SL and Song, CY and Tzeng, WC and Chang, CC and Lin, CH},
title = {Associations between moderate-to-high physical activity levels and long COVID symptoms, heart rate recovery, cardiorespiratory fitness, sleep quality, and quality of life in patients with long COVID: a cross-sectional study.},
journal = {BMC public health},
volume = {25},
number = {1},
pages = {3204},
pmid = {41029289},
issn = {1471-2458},
support = {TSGH-D-112176//Tri-Service General Hospital/ ; TSGH-E-112249//Tri-Service General Hospital/ ; MND MAB-D-113085//Ministry of National Defense-Medical Affairs Bureau/ ; },
mesh = {Humans ; Cross-Sectional Studies ; *Quality of Life ; Male ; Female ; *COVID-19/physiopathology/complications ; Middle Aged ; *Heart Rate/physiology ; *Cardiorespiratory Fitness/physiology ; *Exercise/physiology ; *Sleep Quality ; Taiwan ; Adult ; Surveys and Questionnaires ; Aged ; },
abstract = {BACKGROUND: Moderate-to-high physical activity (PA) levels have been shown to mitigate health complications, improve cardiovascular health, and enhance patient-reported outcomes, such as sleep quality and quality of life (QoL), among patients with chronic diseases. However, little is known about the associations between moderate-to-high PA levels and long COVID symptoms, heart rate recovery, cardiorespiratory fitness, sleep quality, and QoL among patients with long COVID. This study aimed to examine whether moderate-to-high PA levels are associated with more favorable outcomes in terms of long COVID symptoms, heart rate recovery, cardiorespiratory fitness, and QoL, compared to those with low PA levels.

METHODS: A cross-sectional study was conducted to recruit patients with long COVID (n = 219) from an integrated outpatient clinic for post-COVID-19 at a medical center in northern Taiwan. Eligible participants were categorized into moderate-to-high and low PA groups. PA levels, sleep quality, and QoL were assessed using the International Physical Activity Questionnaire, Pittsburgh Sleep Quality Index, and World Health Organization Quality of Life Questionnaire-short form, respectively. Cardiorespiratory fitness and heart rate recovery were evaluated using cycle ergometer-based graded exercise tests. Multivariate linear and logistic regression models were used to evaluate the associations between PA levels, long COVID symptoms, heart rate recovery, sleep quality, and QoL.

RESULTS: Participants with a mean age of 48.7 years had a mean duration of post-COVID-19 of 12.3 weeks. Patients with moderate-to-high PA levels had a borderline lower risk of shortness of breath (OR = 0.44, p = 0.065), significantly greater VO₂ peak (B = 4.68, p < 0.001) and 2-minute heart rate recovery (B = 3.79, p = 0.049), better sleep quality (B = -1.68, p = 0.007), and higher scores in the physical (B = 0.99, p = 0.023) and psychological (B = 1.11, p = 0.030) domains of QoL, compared to those with lower PA levels.

CONCLUSIONS: Maintaining moderate-to-high PA levels among patients with long COVID may be associated with reduced symptom distress, greater cardiorespiratory fitness and heart rate recovery, and better sleep quality, which are in turn linked to better QoL.

CLINICAL TRIAL NUMBER: not applicable.},
}

Humans
Cross-Sectional Studies
*Quality of Life
Male
Female
*COVID-19/physiopathology/complications
Middle Aged
*Heart Rate/physiology
*Cardiorespiratory Fitness/physiology
*Exercise/physiology
*Sleep Quality
Taiwan
Adult
Surveys and Questionnaires
Aged

@article {pmid41028062,
year = {2025},
author = {Mezache, L and Soltisz, A and Tili, E and Nuovo, GJ and Veeraraghavan, R},
title = {SARS-CoV-2 spike protein-induced inflammation underlies proarrhythmia in COVID-19.},
journal = {Scientific reports},
volume = {15},
number = {1},
pages = {33991},
pmid = {41028062},
issn = {2045-2322},
support = {R01HL148736/HL/NHLBI NIH HHS/United States ; R01HL165751/HL/NHLBI NIH HHS/United States ; R01HL148736/HL/NHLBI NIH HHS/United States ; },
mesh = {*Spike Glycoprotein, Coronavirus/metabolism ; Animals ; *COVID-19/complications/virology/pathology ; *SARS-CoV-2/metabolism ; Connexin 43/metabolism ; Mice ; NAV1.5 Voltage-Gated Sodium Channel/metabolism ; Humans ; *Inflammation/virology ; *Arrhythmias, Cardiac/etiology/virology ; *Atrial Fibrillation/etiology/virology/pathology ; Male ; Mice, Inbred C57BL ; Angiotensin-Converting Enzyme 2/metabolism ; },
abstract = {Coronavirus disease 2019 (COVID-19) patients have a 1.7-fold higher arrhythmia risk with rates of cardiac complications ranging from 2% non-ICU patients to 59% in non-survivors. Atrial fibrillation (AF), the most common arrhythmia, is a frequent complication of acute and long COVID-19. The high expression of ACE2 in the heart suggested that infectious virus may underlie cardiac complications. However, we recently reported in human cardiac tissue from fatal COVID-19 cases perivascular spike protein, elevated pro-inflammatory cytokines, vascular damage, and cardiac remodeling without evidence for direct infection of cardiac cells by SARS-CoV2. Mislocalization of intercalated disc (ID) components, connexin-43 (Cx43) gap junctions and NaV1.5 sodium channels, was also evident in patients' hearts, recapitulating structural remodeling we previously identified as providing a substrate for atrial arrhythmias following an acute inflammatory insult. Therefore, we hypothesized that the inflammatory response elicited by SARS-CoV2 spike protein is sufficient to provoke atrial arrhythmias. Structural and functional assessments of WT murine hearts were performed five days following a single bolus intravenous injection of the viral spike protein. In vivo ECGs demonstrated increased atrial arrhythmia burden in spike-injected mice vs. control. Immunohistochemistry studies revealed elevated expression of inflammatory markers and evidence of vascular damage in these mice. Additionally, we observed disruption of ID ultrastructure and mislocalization of Cx43 and NaV1.5 in the atria of spike protein-injected mice. Our results suggest that vascular-leak inducing inflammatory insult from viral spike protein, and not direct infection by SARS-CoV2 results in the pathophysiology of cardiac dysfunction in fatal COVID-19.},
}

*Spike Glycoprotein, Coronavirus/metabolism
Animals
*COVID-19/complications/virology/pathology
*SARS-CoV-2/metabolism
Connexin 43/metabolism
Mice
NAV1.5 Voltage-Gated Sodium Channel/metabolism
Humans
*Inflammation/virology
*Arrhythmias, Cardiac/etiology/virology
*Atrial Fibrillation/etiology/virology/pathology
Male
Mice, Inbred C57BL
Angiotensin-Converting Enzyme 2/metabolism

@article {pmid41026737,
year = {2025},
author = {Yaker, N},
title = {Performing a Nonsurgical Hair Restoration Consultation.},
journal = {Plastic and aesthetic nursing},
volume = {45},
number = {4},
pages = {228-239},
pmid = {41026737},
issn = {2770-3517},
mesh = {Humans ; *Alopecia/therapy/nursing ; *Referral and Consultation ; COVID-19/complications ; *Hair/growth & development ; },
abstract = {The condition of an individual's skin and hair is an indication of the state of the physiological mechanisms inside their body. Practitioners performing hair restoration consultations should have a clear understanding of the anagen, catagen, and telogen phases of the hair growth cycle and a clear comprehension about the various types and causes of hair loss, including the use of glucagon-like peptide-1 medications and the effects of Long COVID. Nurses can use the Assessment, Diagnosis, Planning, Implementation, and Evaluation nursing process format when providing a professional hair consultation. The goal of this manuscript is to teach aesthetic practitioners how to conduct a thorough nonsurgical hair restoration consultation.},
}

Humans
*Alopecia/therapy/nursing
*Referral and Consultation
COVID-19/complications
*Hair/growth & development

@article {pmid41025260,
year = {2025},
author = {Björnson, M and Wijnbladh, K and Törnberg, A and Svensson-Raskh, A and Svensson, A and Ståhlberg, M and Runold, M and Fedorowski, A and Nygren Bonnier, M and Bruchfeld, J},
title = {Prevalence and Clinical Impact of Postural Orthostatic Tachycardia Syndrome in Highly Symptomatic Long COVID.},
journal = {Circulation. Arrhythmia and electrophysiology},
volume = {},
number = {},
pages = {e013629},
doi = {10.1161/CIRCEP.124.013629},
pmid = {41025260},
issn = {1941-3084},
abstract = {BACKGROUND: The incidence of postural orthostatic tachycardia syndrome (POTS) in long COVID has been a growing concern since the first cases were reported in 2021. The aim of this study was to assess the prevalence and clinical impact of POTS in a series of well-characterized patients with long COVID.

METHODS: We prospectively analyzed 467 nonhospitalized, highly symptomatic (sick leave ≥50%) patients with long COVID, and studied differences in demographics and clinical assessment outcomes between those diagnosed with POTS and the remaining long COVID patients. Examinations were performed at a median of 12 months after acute COVID-19, followed by a cardiologist evaluation with 48-hour ECG, head-up tilt test, and Active Stand Test for those with clinically suspected POTS.

RESULTS: Of all long COVID patients, 143 (31%) were diagnosed with POTS, 128 (27%) did not fulfill POTS criteria, while 196 (42%) had no clinical signs of POTS. Patients with POTS were younger (mean age, 40.0 versus 44.0 versus 47.0 years, respectively; P≤0.001) and predominantly female (91%). They had significantly lower physical activity compared with the other 2 groups, as measured with the Frändin-Grimby scale (P=0.001). Heart rates during the 6-minute walk test were significantly higher in the POTS group, both during walking and at rest afterward, with a significantly shorter walking distance (448 m versus 472 m versus 509 m, respectively; P≤0.001). However, the distribution of symptoms showed no significant differences between the groups.

CONCLUSIONS: In this cohort of predominantly younger women with highly symptomatic long COVID, POTS is common and presents with overlapping symptoms between POTS and non-POTS patients. Long COVID POTS confers lower physical activity and capacity compared with non-POTS long COVID and should be systematically assessed in this condition.},
}

@article {pmid41023887,
year = {2025},
author = {Guillen-Burgos, HF and Sarmiento, M and Gálvez-Flórez, JF and Rojas, C and Lora, YB and Lozada-Martinez, ID and Diazgranados-Garcia, MC and Gibacus, and Rojas, M and Salazar-Uribe, JC and Anaya, JM},
title = {Association between mental health symptoms and autoimmunity in patients with long COVID.},
journal = {BMC infectious diseases},
volume = {25},
number = {1},
pages = {1220},
pmid = {41023887},
issn = {1471-2334},
support = {PCS-MHO-001//Universidad Simon Bolivar/ ; INV-101//COOSALUD EPS/ ; INV-101//COOSALUD EPS/ ; INV-101//COOSALUD EPS/ ; INV-101//COOSALUD EPS/ ; },
mesh = {Humans ; Male ; *COVID-19/psychology/immunology/complications/epidemiology ; Female ; Middle Aged ; Cross-Sectional Studies ; Adult ; Autoantibodies/blood/immunology ; *Anxiety/immunology/epidemiology ; *Autoimmunity ; Sleep Initiation and Maintenance Disorders/immunology ; *Depression/immunology/epidemiology ; SARS-CoV-2 ; Aged ; Colombia/epidemiology ; Mental Health ; Antibodies, Antinuclear/blood ; },
abstract = {BACKGROUND: Neuropsychiatric symptoms are common features in long COVID. The pathogenesis of neuropsychiatric manifestations in both acute COVID-19 and long COVID remains unclear. This study aimed to examine mental health symptoms-depressive, anxiety, and insomnia symptoms-in COVID-19 survivors with long COVID, and to explore their potential association with autoimmune activity.

METHODS: We conducted an observational, cross-sectional study of 228 adults recruited from a long COVID program in Cartagena, Colombia. Participants underwent clinician-administered interviews and completed validated psychometric scales to assess depressive (PHQ-9), anxiety (GAD-7), and insomnia (ISI) symptoms. Sociodemographic, clinical, and biological data were collected. The autoantibody panel included antinuclear antibodies (ANA), anti-SSA/Ro, anti-SSB/La, anti-RNP, anti-Smith (Sm), rheumatoid factor (RF), anti-thyroglobulin (Tg), and anti-thyroid peroxidase (TPO), measured via ELISA and immunofluorescence. Robust logistic regression models were used to evaluate associations between long COVID, autoantibody positivity, and mental health symptoms, adjusting for age, sex, and relevant covariates.

RESULTS: 57% of participants with a history of COVID-19 acute infection reported long COVID. In participants with long COVID, we reported high proportions of depressive (21.2%), anxiety (31.2%), and insomnia (28.7%) symptoms. Moreover, an association of all three mental health symptoms with autoantibody positivity (particularly antinuclear antibodies [ANA] isolated or co-occurring with anti-TPO antibodies) was observed in individuals with long COVID. Our findings suggest a potential association between psychopathological symptoms, autoantibody positivity, and distinct clinical profiles of long COVID, warranting further longitudinal investigation.

CONCLUSIONS: Mental health symptoms (MHS) should be considered one of the main targets involved in translational research in long COVID. There is an urgent need for consultation-liaison physicians to work closely with immunologists, rheumatologists, and pain medicine physicians in clinical settings as well as in research. This will contribute to a better understanding of the impact of MHS during illness in long COVID variants.},
}

Humans
Male
*COVID-19/psychology/immunology/complications/epidemiology
Female
Middle Aged
Cross-Sectional Studies
Adult
Autoantibodies/blood/immunology
*Anxiety/immunology/epidemiology
*Autoimmunity
Sleep Initiation and Maintenance Disorders/immunology
*Depression/immunology/epidemiology
SARS-CoV-2
Aged
Colombia/epidemiology
Mental Health
Antibodies, Antinuclear/blood

@article {pmid41023255,
year = {2025},
author = {Lee, J and Rojas, NK and Pinto Pereria, SM and Stephenson, T and McGowan, J and Chalder, T and Dalrymple, E and Ford, T and Heyman, I and Ladhani, S and McOwat, K and Simmons, R and Swann, O and , and Shafran, R},
title = {Mental health of children and young people with pre-existing eating problems during the COVID-19 pandemic.},
journal = {Eating and weight disorders : EWD},
volume = {30},
number = {1},
pages = {77},
pmid = {41023255},
issn = {1590-1262},
support = {COVLT0022//National Institute for Health and Care Research/ ; COVLT0022//UK Research and Innovation/ ; MR/P020372/1//UK Medical Research Council Career Development Award/ ; MR/Y009398/1//Senior Non-clinical fellowship/ ; },
mesh = {Humans ; *COVID-19/psychology ; Female ; Child ; *Feeding and Eating Disorders/psychology/epidemiology ; Adolescent ; Male ; *Mental Health ; Retrospective Studies ; Surveys and Questionnaires ; SARS-CoV-2 ; Young Adult ; Pandemics ; },
abstract = {OBJECTIVE: The study sought to explore mental health trajectories of children and young people (CYP) who retrospectively reported eating problems prior to the pandemic, over a 2-year period (2021-23). Given the rapid increase in eating disorder presentations during the pandemic, these CYP may be particularly susceptible to pandemic-related challenges, including social and functional restrictions.

METHODS: Data on 2023 CYP from the Children and Young People with Long COVID (CLoCk) study recruited Jan-March 2021 who completed questionnaires at 3-, 6-, 12-, and 24-months post SARS-CoV-2 PCR-testing were analysed. Associations between baseline eating problems (N = 241) and emotional and behavioural symptoms (measured by the Strengths and Difficulties Questionnaire (SDQ) total difficulties and impact scores) at each time-point were examined by regression models. Multi-level models were used to determine whether SDQ total and impact trajectories of those with/without prior self-reported eating problems differed.

RESULTS: Compared to CYP who did not report pre-existing eating problems, those that did had more mental health difficulties at all time points: reflected in significantly higher SDQ total difficulties and impact scores. However, mental health scores of CYP reporting pre-pandemic eating problems were stable over time. Whereas, CYP without eating problems had a slight increase in mental health difficulties over time. Differences between groups diminished but remained significant when controlling for potential confounding variables including prior mental health difficulties.

DISCUSSION: Young people with eating problems had more emotional and behavioural symptoms during 2021-23, compared with those that did not have eating problems. However, mental health did not worsen over time amongst CYP with pre-existing eating problems, providing evidence of some relative resilience to the effects of the pandemic in this population.

PUBLIC SIGNIFICANCE: Eating disorders are a major public health concern and presentations have remained high since the Covid-19 pandemic. Understanding how eating difficulties relate to mental health symptomology over time has implications for service planning.

LEVEL OF EVIDENCE: Level III: Evidence obtained from well-designed cohort study.},
}

Humans
*COVID-19/psychology
Female
Child
*Feeding and Eating Disorders/psychology/epidemiology
Adolescent
Male
*Mental Health
Retrospective Studies
Surveys and Questionnaires
SARS-CoV-2
Young Adult
Pandemics

@article {pmid41021660,
year = {2025},
author = {Carazo, S and Phimmasone, J and Skowronski, DM and Giguère, K and Ouakki, M and Talbot, D and Guay, CA and Sauvageau, C and Brousseau, N and De Serres, G},
title = {Effectiveness of COVID-19 vaccination and prior infections to reduce long COVID risk during the pre-Omicron and Omicron periods.},
journal = {Clinical infectious diseases : an official publication of the Infectious Diseases Society of America},
volume = {},
number = {},
pages = {},
doi = {10.1093/cid/ciaf549},
pmid = {41021660},
issn = {1537-6591},
abstract = {BACKGROUND: We estimated vaccine effectiveness (VE) against COVID-19 and long COVID during pre-Omicron and Omicron periods, by number of doses and prior infection history.

METHODS: We combined survey information from a cohort of healthcare workers in Quebec, Canada, with immunization registry and laboratory administrative data. We defined COVID-19 cases as symptomatic laboratory-confirmed infections and long COVID as self-reported symptoms persisting ≥12 weeks. We assessed VE against COVID-19 and long COVID, stratified by infection history, using a test-negative design where vaccinated participants were compared to unvaccinated participants during the pre-Omicron period or to those twice vaccinated ≥6 months before laboratory testing during the Omicron period.

RESULTS: Analyses included 8230 COVID-19 participants and 43361 tested specimens. During the pre-Omicron period, one- and two-dose VE was 75% (95%CI:64-83) and 95% (95%CI:84-98) against COVID-19, respectively, and 91% (95%CI:79-96) and 87% (95%CI:22-98) against long COVID, respectively. During the Omicron period, booster dose VE was 41% (95%CI:34-47) against COVID-19 and 57% (95%CI:46-66) against long COVID, waning by 6 months. Hybrid VE in vaccinated and previously infected individuals ranged 81% (95%CI:38-94) to 92% (95%CI:87-95) regardless of number of doses, prior infecting variant or median time since last immunological event up to 9 months.

CONCLUSION: COVID-19 vaccination prevented long COVID during the pre-Omicron period and reduced the risk by more than half post-Omicron. With most of the population by now both vaccinated and infected, repeated booster doses may add little incremental value against long COVID, an observation with important public health, immunization program and cost implications.},
}

@article {pmid41019063,
year = {2025},
author = {Indolfi, C and Klain, A and Dinardo, G and Grella, C and Marrapodi, MM and Miraglia Del Giudice, M},
title = {Commentary: Long COVID in pediatric age: an observational, prospective, longitudinal, multicenter study in Italy.},
journal = {Frontiers in immunology},
volume = {16},
number = {},
pages = {1624011},
pmid = {41019063},
issn = {1664-3224},
}

@article {pmid41018705,
year = {2025},
author = {Hou, Y and Gu, T and Ni, Z and Shi, X and Ranney, ML and Mukherjee, B},
title = {Global Prevalence of Long COVID, Its Subtypes, and Risk Factors: An Updated Systematic Review and Meta-analysis.},
journal = {Open forum infectious diseases},
volume = {12},
number = {9},
pages = {ofaf533},
pmid = {41018705},
issn = {2328-8957},
abstract = {BACKGROUND: This mega-systematic review evaluated the global prevalence of long COVID and its subtypes and symptoms, and assessed the effects of risk factors for long COVID.

METHODS: Studies published from 5 July 2021 to 29 May 2024 were searched in PubMed, Embase, and Web of Science, with supplemental updates on 23 July 2024. Data were pooled using a random-effects framework with DerSimonian-Laird estimator. Risk of bias analysis was conducted.

RESULTS: A total of 429 studies were meta-analyzed. The global pooled long COVID prevalence was 36% (95% confidence interval [CI], 33%-40%) with 144 contributing studies. The highest prevalence rates were observed in South America (51% [95% CI, 35%-66%]). The prevalence of long COVID persisted over time, with 35% (95% CI, 31%-39%) at <1 year of follow-up and 46% (95% CI, 37%-57%) at 1-2 years. The most prevalent subtypes were respiratory (20% [95% CI, 14%-28%]) estimated from 31 studies, general fatigue (20% [95% CI, 18%-23%]) from 119 studies, psychological (18% [95% CI, 11%-28%]) from 10 studies, and neurological (16% [95% CI, 8%-30%]) from 23 studies. The 3 strongest risk factors were being unvaccinated for COVID-19 (pooled odds ratio [OR], 2.09 [95% CI, 1.55-2.81]) meta-analyzed from 7 studies, infections from pre-Omicron variants (OR, 1.74 [95% CI, 1.40-2.17]) from 6 studies, and female sex (OR, 1.56 [95% CI, 1.32-1.84]) from 33 studies.

CONCLUSIONS: Long COVID is globally prevalent after a severe acute respiratory syndrome coronavirus 2 infection, highlighting a continuing health challenge. The heterogeneity of estimates across populations argues the need for well-designed follow-up studies that use consistent measures and are globally representative.},
}

@article {pmid41018694,
year = {2025},
author = {de Lemos Muller, CH and Pohl, HH and Reckziegel, MB},
title = {Prevalence and clinical profile of COVID-19 among farmworkers from the interior of the state of Rio Grande do Sul, Brazil.},
journal = {Revista brasileira de medicina do trabalho : publicacao oficial da Associacao Nacional de Medicina do Trabalho-ANAMT},
volume = {23},
number = {3},
pages = {e20251444},
pmid = {41018694},
issn = {1679-4435},
abstract = {INTRODUCTION: Farmworkers in Brazil face poor living conditions, limited healthcare access, and high prevalence of chronic diseases. These vulnerabilities may increase COVID-19 risk, complications, and persistent symptoms, underscoring the importance of characterizing the disease's impact in this population.

OBJECTIVES: To identify the prevalence and clinical profile of COVID-19 among farmworkers of cities that participate of the Conselho Regional de Desenvolvimento do Vale do Rio Pardo.

METHODS: A retrospective cross-sectional study that utilized a database from a research performed with rural workers of cities from Conselho Regional de Desenvolvimento do Vale do Rio Pardo. Hundred seven volunteers were included (54.01 ± 13.02 years) who answered the questionnaries of life style and COVID-19, in addition to having performed body composition assessment. Prevalence ratio was measured to verify association between risk factors and COVID-19 diagnosis.

RESULTS: Twenty-five people (23.36%) were diagnosticated with COVID-19. The more described symptoms were fatigue (84%), fever (68%), cough (68%), loss of taste (68%), headache (68%), and sore throat (64%). None of the participants was hospitalized. Symptoms of long covid were observed in 52% participants, with fatigue (24%) and breathless (16%) being the most prevalent. The results showed positive association between COVID-19 diagnosis and hypertension (prevalence ratio 1.23), cancer (prevalence ratio 1.22) and obesity (prevalence ratio 1.76).

CONCLUSIONS: The results help to characterize the clinical profile of the disease in a population with less access to health services.},
}

@article {pmid41017688,
year = {2025},
author = {Mahoney, J and Shatri, G and Simmer, PE and Doherty, D and Matta, V and Valentino, DJ},
title = {Retrospective analysis of patients with cardiopulmonary symptoms in the setting of Long COVID syndrome: investigating risk factors.},
journal = {Journal of osteopathic medicine},
volume = {},
number = {},
pages = {},
pmid = {41017688},
issn = {2702-3648},
abstract = {CONTEXT: Long COVID, a debilitating condition characterized by persistent symptoms following acute Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection, continues to pose a significant public health burden. Currently, research is ongoing regarding risk factors for developing Long COVID. Identifying patients susceptible to symptoms of Long COVID can assist with identifying those at risk, and developing preventative strategies for these individuals.

OBJECTIVES: The objectives of this study are to evaluate a cohort of patients who followed up in the Long COVID clinic who were experiencing cardiopulmonary symptoms 8-12 weeks from initial inoculation, and to retrospectively identify any statistically significant risk factors or clinical features present.

METHODS: This retrospective cohort study examined patients identified between April 2021 and September 2022. Patients who were diagnosed with COVID-19 and developed persistent symptoms were subsequently referred to the post-COVID-19 pulmonary clinic. For the cohort of patients seen in post COVID-19 pulmonary clinic, pre-existing pulmonary and systemic disease, severity of COVID-19 illness, and treatments received were examined. Analysis was performed on these data utilizing Cox regression analysis.

RESULTS: Two hundred forty-six (246) adult patients who had Long COVID symptoms 8-12 weeks post-COVID-19 infection were identified and included in this analysis. Cox regression analysis indicated that in this population, patients who had required oxygen support (supplemental oxygen, noninvasive ventilation, or intubation) during their initial COVID-19 hospitalization and who also had prior history of either obstructive sleep apnea (OSA) or chronic obstructive pulmonary disease (COPD) and were more likely to develop Long COVID symptoms. Patients with pre-existing OSA had an odds ratio (OR) of 3.6 and a 95 % confidence interval (CI) of 1.70-7.65 (p=0.0012). Patients with pre-existing COPD had an OR of 12.19 and a 95 % CI of 2.38-62.33 (p=0.0015).

CONCLUSIONS: Patients who required oxygen support during their initial COVID-19 hospitalization who also had previous history of either OSA or COPD were more likely to develop cardiopulmonary Long COVID symptoms. This suggests that pre-existing respiratory conditions and the severity of the initial COVID-19 illness may influence the development of these symptoms of Long COVID.},
}

@article {pmid41013344,
year = {2025},
author = {Nji, MAM and Briones, EM and Issa, A and Tierney, M and Bertolli, J and Barshikar, S and Unger, ER and Wisnivesky, J and Vu, Q and Quimby, D and Abrams, J and Jagan, N and Manouchehripour, S and Laguerre, M and Cope, JR},
title = {Medical complexity and healthcare utilization among patients attending three U.S. post-COVID clinics.},
journal = {BMC infectious diseases},
volume = {25},
number = {1},
pages = {1145},
pmid = {41013344},
issn = {1471-2334},
mesh = {Humans ; Female ; Middle Aged ; Male ; *COVID-19/epidemiology/therapy ; Adult ; Aged ; Retrospective Studies ; Aged, 80 and over ; Adolescent ; Young Adult ; *Patient Acceptance of Health Care/statistics & numerical data ; SARS-CoV-2 ; United States/epidemiology ; Texas/epidemiology ; },
abstract = {BACKGROUND: Patients who do not fully recover or develop new symptoms following SARS-CoV-2 infection require follow-up and sometimes seek care at specialized multidisciplinary care clinics. We aimed to describe the clinical characteristics and care needs of patients at three such post-COVID clinics.

METHODS: We conducted a multisite retrospective electronic chart review of 984 patients, aged ≥ 18 years, who visited one of three post-COVID clinics at least 28 days after a clinical or polymerase chain reaction (PCR)-confirmed diagnosis of SARS-CoV-2 infection between January 20, 2020, and March 31, 2021. The clinics were located in Omaha, Nebraska, New York City, New York, and Dallas, Texas. Patient records were obtained through September 30, 2021. Data on clinical evaluations and healthcare provider visits were abstracted by trained clinical personnel using a standardized health record abstraction tool.

RESULTS: The median age was 52 years (range 18-89 years), 59.9% were female, and 69.0% were White. Of 984 patients, 79.9% had SARS-CoV-2 infection that was confirmed by PCR, 32.1% had three or more comorbid conditions, and 39.4% had been hospitalized. During post-COVID follow-up, the most common symptoms were shortness of breath (59.2%), post-exertional malaise (45.6%), fatigue (43.2%), and brain fog (42.8%). Nearly one in three patients had a diagnosis of post-viral fatigue syndrome (30.1%), and pulmonary system conditions (24.4%) were also common. Overall, the 984 participants attended 3914 visits (median 3; range 1-46) over a median follow-up period of 107 days (range 1-560) between first and last post-COVID follow-up visits. Of the 984 patients, 64.3% were referred for subspecialty care notably pulmonology, cardiology, and neurology. More than a third of patients were referred for rehabilitation therapy (37.9%) including physical, occupational, speech, and psychotherapy.

CONCLUSION: Adult patients at post-COVID clinics have a wide range of symptoms and conditions that highlight the medical complexity of these patients and their need for high levels of care, including multiple health care visits and referrals for therapy. This underscores the need for well-coordinated, multidisciplinary care, and planning of health resources for post-COVID-19 follow-up care.},
}

Humans
Female
Middle Aged
Male
*COVID-19/epidemiology/therapy
Adult
Aged
Retrospective Studies
Aged, 80 and over
Adolescent
Young Adult
*Patient Acceptance of Health Care/statistics & numerical data
SARS-CoV-2
United States/epidemiology
Texas/epidemiology

@article {pmid41012643,
year = {2025},
author = {Yang, YF and Ling, MP and Chen, SC and Lin, YJ and You, SH and Lu, TH and Chen, CY and Wang, WM and Chen, SY and Lai, IH and Hsiao, HA and Liao, CM},
title = {Biomarker-Based Risk Assessment Strategy for Long COVID: Leveraging Spike Protein and Proinflammatory Mediators to Inform Broader Postinfection Sequelae.},
journal = {Viruses},
volume = {17},
number = {9},
pages = {},
doi = {10.3390/v17091215},
pmid = {41012643},
issn = {1999-4915},
support = {NSTC 113-2313-B-002-032//National Science and Technology Council/ ; },
mesh = {Humans ; *Spike Glycoprotein, Coronavirus/metabolism/blood ; *COVID-19/diagnosis/virology/immunology ; *Biomarkers/blood ; Risk Assessment ; SARS-CoV-2 ; Male ; Middle Aged ; Female ; Models, Theoretical ; Interleukin-6/blood ; *Inflammation Mediators/blood ; Cytokines/blood ; Post-Acute COVID-19 Syndrome ; Interleukin-8/blood ; Tumor Necrosis Factor-alpha/blood ; Aged ; Adult ; },
abstract = {Long COVID, characterized by persistent symptoms following acute SARS-CoV-2 infection, has emerged as a significant public health challenge with wide-ranging clinical and socioeconomic implications. Developing an effective risk assessment strategy is essential for the early identification and management of individuals susceptible to prolonged symptoms. This study uses a quantitative approach to characterize the dose-response relationships between spike protein concentrations and effects, including Long COVID symptom numbers and the release of proinflammatory mediators. A mathematical model is also developed to describe the time-dependent change in spike protein concentrations post diagnosis in twelve Long COVID patients with a cluster analysis. Based on the spike protein concentration-Long COVID symptom numbers relationship, we estimated a maximum symptom number (~20) that can be used to reflect a persistent predictor. We found that among the crucial biomarkers associated with Long COVID proinflammatory mediator, CXCL8 has the lowest 50% effective dose (0.01 μg mL[-1]), followed by IL-6 (0.39), IL-1β (0.46), and TNF-α (0.56). This work provides a comprehensive risk assessment strategy with dose-response tools and mathematical modeling developed to estimate potential spike protein concentration. Our study suggests persistent Long COVID guidelines for personalized care strategies and could inform public health policies to support early interventions that reduce long-term disability and healthcare burdens with possible other post-infection syndromes.},
}

Humans
*Spike Glycoprotein, Coronavirus/metabolism/blood
*COVID-19/diagnosis/virology/immunology
*Biomarkers/blood
Risk Assessment
SARS-CoV-2
Male
Middle Aged
Female
Models, Theoretical
Interleukin-6/blood
*Inflammation Mediators/blood
Cytokines/blood
Post-Acute COVID-19 Syndrome
Interleukin-8/blood
Tumor Necrosis Factor-alpha/blood
Aged
Adult