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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

EXPOSURE: SARS-CoV-2 infection.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

@article {pmid40546581,
year = {2025},
author = {Koster, M and Moore, LD and Inabnit, LS},
title = {Pulmonary Symptoms After Mild COVID-19: A Retrospective Observational Study.},
journal = {Cureus},
volume = {17},
number = {5},
pages = {e84499},
doi = {10.7759/cureus.84499},
pmid = {40546581},
issn = {2168-8184},
abstract = {Background Patients have reported persisting or emerging symptoms weeks or months after the acute phase of a COVID-19 infection, even when the initial infection was mild or asymptomatic. Since data are limited on patients with a history of a mild acute phase, the pulmonary sequelae have been challenging to treat. The purpose of this study was to review diagnostic testing sessions from patients referred to the pulmonary function lab for a diagnosis or symptoms of long COVID following a mild acute phase. The collection and presentation of this data aim to provide insight into the possible cause of persistent pulmonary symptoms in this specific patient population. Methodology A retrospective review of patients at a single center who received pulmonary function test (PFT) and 6-minute walk test (6MWT) for long COVID symptoms following a mild acute phase of COVID-19 was conducted. Adult subjects were identified through electronic medical records if they received services between March 1, 2020, and September 2, 2023. The records of 19 patients were included in this review. Data analysis A Pearson correlation coefficient was used to analyze the relationship between dyspnea, pulmonary function impairment severity, and fatigue. The relationship between dyspnea and 6-minute walk test distance (6MWTD) was analyzed using the phi correlation coefficient. Results Weak correlations were identified between the reported symptoms of dyspnea and the severity of airway impairment, gas exchange, and 6MWTD. There was a strong positive correlation between dyspnea and fatigue. The sample size limits the analysis, but the data substantiate the need for additional research. Conclusion The severity of lung function impairments did not appear to correlate with the severity of dyspnea in patients following a mild acute phase of COVID-19. Therefore, pulmonary function impairments did not appear to be the primary cause of dyspnea. However, the symptoms of dyspnea and fatigue may contribute to each other.},
}

@article {pmid40545681,
year = {2025},
author = {Tsuchiya, H},
title = {Could Long COVID Oral Symptoms and COVID-19 Vaccination Oral Side Effects Be Induced by the Spike Protein?.},
journal = {Oral diseases},
volume = {},
number = {},
pages = {},
doi = {10.1111/odi.70005},
pmid = {40545681},
issn = {1601-0825},
support = {//Japan Society for the Promotion of Science/ ; },
}

@article {pmid40545236,
year = {2025},
author = {Wee, LE and Lim, JT and Tay, AT and Chiew, CJ and Young, BE and Vasoo, S and Lou, HX and Lye, DC and Tan, KB},
title = {Remdesivir and risk of multi-systemic long-term sequelae following COVID-19 hospitalisation.},
journal = {Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases},
volume = {},
number = {},
pages = {},
doi = {10.1016/j.cmi.2025.06.016},
pmid = {40545236},
issn = {1469-0691},
abstract = {OBJECTIVES: Significant heterogeneity has been reported in cohort studies evaluating the impact of antiviral treatment on long-term sequelae following COVID-19 hospitalisation. We evaluated the impact of intravenous (IV) remdesivir on risk of subsequent long-term cardiovascular/neurological/respiratory/autoimmune diagnoses and persistent symptoms.

METHODS: National COVID-19 registries and healthcare claims databases were utilised to construct a retrospective population-based cohort enrolling all adult Singaporeans hospitalised for COVID-19 (1[st] Sept 2021-31[st] Jul 2023), who fulfilled criteria for IV remdesivir. The cohort was divided into remdesivir-treated and untreated groups, with between-group differences in baseline sociodemographic and clinical characteristics adjusted using overlap-weighting. Risks of long-term new-incident (31-300 days) diagnoses/symptoms across cardiovascular/neurological/respiratory/autoimmune systems were compared across untreated/treated groups via competing-risks-regression.

RESULTS: 30,175 COVID-19 hospitalisations were included in the cohort for evaluating risk of long-term sequelae; 37.6% (11,353/30,175) received remdesivir. 88.9% of the cohort were fully-vaccinated, and 60.5% had received a booster dose; 77.4% were infected during Omicron. Risk of long-term new-onset diagnoses across cardiovascular, neurological, respiratory and autoimmune systems (any long-term diagnosis, adjusted-hazards-ratio, aHR=1.08[95%CI=0.97-1.20]) up to 300 days post-COVID-19-hospitalisation was not significantly different in the remdesivir-treated group, versus untreated individuals, across age and vaccination subgroups. Similarly, no significant difference in the incidence of long-term symptom persistence at 300 days post-COVID-19-hospitalisation was observed in the remdesivir-treated group, versus untreated individuals.

CONCLUSION: Receipt of remdesivir did not significantly reduce risk of long-term multi-systemic sequelae or long-term symptoms in a boosted cohort of adult Singaporeans hospitalised with COVID-19.},
}

@article {pmid40544471,
year = {2025},
author = {Akase, IE and Awodumila, SO and Nwanmah, CE and Ojo, OO and Agabi, OP and Ede, O and Nwaokorie, FO and Anyanwu, RA and Ghajiga, PS and Kalejaiye, O and Perez-Giraldo, GS and Orban, ZS and Jimenez, M and Koralnik, IJ and Okubadejo, NU},
title = {A Social Media Survey on the Prevalence of Post-COVID Neurologic Complications Among Nigerians.},
journal = {West African journal of medicine},
volume = {42},
number = {1},
pages = {29-35},
pmid = {40544471},
issn = {0189-160X},
abstract = {BACKGROUND AND OBJECTIVE: Cultural barriers and perceptual factors that are peculiar among Africans are known to limit the number of people seeking medical care for post-COVID conditions. The aim of this social media survey was to ascertain the burden of post-COVID neurologic complications in Nigeria in individuals with confirmed COVID-19.

METHODS: We performed a cross-sectional web-based survey of persons with PCR-confirmed or suspected SARS-CoV-2 infection in Nigeria with incident infection between March 2020 and April 2022. Our survey utilized Kobo Toolbox® and was disseminated via several online platforms (including WhatsApp ®, Facebook®, and Twitter (X)®). Participant demographics, COVID-19 symptom profile, SARS-CoV-2 test results, and the occurrence of persistent neurological symptoms were documented.

RESULTS: We analyzed the data of 963 participants with confirmed or suspected COVID-19 infection. The mean age was 36.9 ± 9.9 years, and 555/963 (57.6%) were female. Only 174/963 individuals (18.1%) had SARS-CoV-2 PCR confirmation at any point during the pandemic, of which 133 (76.4%) had accompanying symptoms consistent with the case definition. A total of 47/174 (27.0%) of the PCR-positive participants reported post-acute COVID symptoms, and 46/174 (26.4%) had post-COVID neurologic complaints. The most commonly reported symptoms were fatigue (25; 14.4%), generalized body weakness (22; 12.6%), and difficulty remembering things (15; 8.6%). Slightly over half of those with post-COVID symptoms (25/47; 53.2%) sought care, with 21/25 (84%) presenting to a medical facility. Others presented either to a community pharmacy (1/25) or a patent medicine store (3/25) for care.

CONCLUSION: Despite low testing rates in Nigeria, the prevalence of post-COVID neurologic complications is approximately 1 in 4 individuals. Further studies on the prognosis and management of post-COVID neurologic sequelae in Nigeria are warranted.},
}

@article {pmid40544138,
year = {2025},
author = {D'hoore, L and Germonpré, P and Rinia, B and Caeyers, L and Stevens, N and Balestra, C},
title = {Effect of normobaric and hyperbaric hyperoxia treatment on symptoms and cognitive capacities in Long COVID patients: a randomised placebo-controlled, prospective, double-blind trial.},
journal = {Diving and hyperbaric medicine},
volume = {55},
number = {2},
pages = {104-113},
doi = {10.28920/dhm55.2.104-113},
pmid = {40544138},
issn = {1833-3516},
abstract = {INTRODUCTION: Long COVID syndrome is a major health issue. Multiple treatments have been proposed but efficacy is inadequately investigated. Hyperbaric oxygen therapy (HBOT) has been promoted based on a small number of publications. As there is potential for a placebo effect and the financial cost of HBOT is high, we sought to investigate the effects of HBOT in Long COVID in a randomised trial.

METHODS: We randomised 101 patients into four treatment groups, receiving 10 sessions of oxygen 'treatment' inside a pressure chamber, according to one of four modalities: A - 100% oxygen at 253 kPa (2.5 atmospheres absolute); B - 40% oxygen at 253 kPa; C - 100% oxygen at 101.3 kPa (1 atmosphere absolute); D - 21% oxygen at 101.3 kPa. Groups B and C thus received a similar effective oxygen dose of 101.3 kPa. Quality of life symptom scores (Visual Analogue Scale; EQ-5D-5L, C19-YRSm), a 6-minute walking test and five neurocognitive tests were administered before and after the treatment series. At three months post-treatment, a telephone questionnaire probed for lasting effects.

RESULTS: All groups were comparable with regards to demographics, Long COVID symptoms and severity. After treatment, there were no significant differences in subjective symptoms, functional scores, and cognitive performance between any groups. The response to treatment was highly variable, with some patients in even the 'placebo' group D reporting a significant improvement in their well-being. This was not reflected in any objective outcome scores. No subgroups of patients responded better to any of the treatments.

CONCLUSIONS: There was no significant effect from different doses of oxygen in a hyperbaric chamber. It is possible that the very modest improvements reported in other studies were due to a placebo effect. Claims that HBOT has a significant effect on Long COVID need further investigation before indiscriminately prescribing or promoting HBOT.},
}

@article {pmid40544080,
year = {2025},
author = {Mateu-Campos, ML and Altaba-Tena, S and Boscá-Martínez, B and Camáñez-Fortanet, J and Viana-Marco, C and González-Núñez, AB and Villanova-Landete, AR and Sánchez-Morán, F and Navarro-Alcaraz, R},
title = {Clinical impact of COVID-19 respiratory infection 15 months after intensive care unit discharge.},
journal = {Medicina intensiva},
volume = {},
number = {},
pages = {502230},
doi = {10.1016/j.medine.2025.502230},
pmid = {40544080},
issn = {2173-5727},
abstract = {OBJECTIVES: To determine the prevalence of persistent COVID-19 symptoms in SARS-CoV-2 patients 15 months after ICU discharge,their impact on physical, psychological, and neurocognitive domains, and the burden on primary caregivers.

DESIGN: Descriptive, ambispective observational study.

SETTING: Intensive Care Unit from a tertiary-level hospital.

PATIENTS: SARS-CoV-2 patients discharged from ICU.

MAIN VARIABLES OF INTEREST: demographics and hospitalization data. Questionnaires assesing persistent COVID symptoms, functional tests (6-Minute Walk Test), anxiety (Beck Anxiety Inventory), PTSD and Zarit Caregiver Burden scales. Statistical analysis was performed using Stata for Mac, version 14.2.

RESULTS: 85 patients were evaluated, with a median age of 60.3 years (IQR 54.0-68.9), 70.6% males. A high percentage of patients reported musculoskeletal disorders such as arthralgia (44.7%) and myalgia (38.2%), cognitive impairments (52.9%), sleep disturbances (34.1%), asthenia (44.5%) and anxiety (34.5%). The overall BAI score was 2 (0-9), with paraesthesia being the most common symptom. Additionally, 29.4% of patients reported "fear of the worst", 35% had unpleasant or recurrent memories of their ICU stay, and 16.4% were unable to relax (moderate/severe degree). Interviews with primary caregivers revealed that 22.2% reported caregiving as a significant burden.

CONCLUSIONS: persistent COVID affects three primary functional domains: physical, cognitive and psychological, as well as on primary caregivers concerns and burdens.},
}

@article {pmid40543387,
year = {2025},
author = {Beuren, T and Ferrari, F and Franzoni, LT and Goulart, CDL and Val, F and Cipriano, G and Stein, R},
title = {Exploring the interplay between host genetics and acute and long COVID: A narrative review.},
journal = {Clinics (Sao Paulo, Brazil)},
volume = {80},
number = {},
pages = {100708},
doi = {10.1016/j.clinsp.2025.100708},
pmid = {40543387},
issn = {1980-5322},
abstract = {Over the past four years, pivotal discoveries have deepened the understanding of the relationship between genetic factors and SARS-CoV-2 infection. Numerous genes associated with severe COVID-19 suggest a potential genetic predisposition, which may help explain why some individuals develop more serious illnesses. Emerging evidence highlights the role of genes involved in pulmonary immunity, such as Forkhead box Protein P4 (FOXP4), whose increased expression in lung tissue has been linked to more severe disease. Other genes - Transmembrane Protease Serine-2 (TMPRSS2), Leucine Zipper Transcription Factor Like-1 (LZTFL1), Solute Carrier family 6 member 20 (SLC6A20), Tyrosine Kinase-2 (TYK2), Angiotensin-Converting Enzyme (ACE), and FYVE and Coiled-Coil Domain-Containing-1 (FYCO1) - have also been implicated in COVID-19 severity. In contrast, certain genetic variants - such as the T-allele of rs12329760 in the TMPRSS2 gene and rs35705950-T in the Mucin-5B (MUC5B) gene - may confer protection against severe disease. Overall, the evidence suggests that genetic factors can influence both susceptibility to and protection from severe COVID-19, although these associations are likely shaped by complex interactions with environmental, behavioral, and other biological factors. This review summarizes current knowledge on genetic determinants linked to COVID-19 outcomes.},
}

@article {pmid40542858,
year = {2025},
author = {van Leer, B and Londema, M and Kasalak, Ö and van Snick, JH and Duiverman, ML and Kuijvenhoven, JC and de Kruif, MD and Oprea-Lager, DE and Pabst, K and Hellemons, ME and Boersma, HH and Prokop, M and Nijsten, MW and Glaudemans, AWJM and Pillay, J and Slart, RHJA and , },
title = {[[68]Ga]FAPI PET/CT reveals increased pulmonary fibroblast activation protein expression in long COVID patients after ICU discharge.},
journal = {European journal of nuclear medicine and molecular imaging},
volume = {},
number = {},
pages = {},
pmid = {40542858},
issn = {1619-7089},
support = {50-56300-98-2104//ZonMW/ ; },
abstract = {PURPOSE: Post-acute sequelae of COVID-19 (PASC) has emerged as a major healthcare problem. A comprehensive mechanism of disease remains to be elucidated. In this study we aimed to explore pulmonary and muscle fibroblast activation protein (FAP) activity in former critical COVID-19 patients with persistent dyspnea, using [[68]Ga]FAPI-46 PET/CT.

METHODS: In this single center prospective observational study we included former critical COVID-19 patients reporting complaints of dyspnea > 3 months after hospital discharge. A [[68]Ga]FAPI PET/CT scan was performed including a high-resolution CT scan, lung function test, EQ-5D questionnaire, 6 min walking test and inflammatory markers. Age and sex-matched subjects, without pulmonary pathology, served as controls. The [[68]Ga]FAPI uptake was corrected for lean body mass and the target-to-background ratio (TBR) was calculated.

RESULTS: Eighteen PASC patients and 15 controls (median age 59 and 63 years and BMI of 34.6 and 25.2 kg/m[2]) were included. The interval between hospital discharge and study visit was 30 months. Increased pulmonary FAP expression was observed in PASC, (TBR 0.79 ± 0.23) compared to controls (TBR 0.40 ± 0.13, P < 0.001). Increased FAP expression was also observed in the paravertebral muscles (PASC: TBR 1.17 and controls TBR 1.00, P = 0.03). Forced expiratory volume and forced vital capacity showed moderate negative correlation with the pulmonary TBR, while the percentage of ground glass opacities showed a moderate positive correlation.

CONCLUSION: [[68]Ga]FAPI PET/CT demonstrated elevated FAP expression in PASC. These findings provide insight into possible pathophysiological mechanisms of PASC and a potential new diagnostic modality.},
}

@article {pmid40421566,
year = {2025},
author = {Grixti, JM and Chandran, A and Pretorius, JH and Walker, M and Sekhar, A and Pretorius, E and Kell, DB},
title = {Amyloid Presence in Acute Ischemic Stroke Thrombi: Observational Evidence for Fibrinolytic Resistance.},
journal = {Stroke},
volume = {56},
number = {7},
pages = {e165-7},
pmid = {40421566},
issn = {1524-4628},
}

@article {pmid40542141,
year = {2025},
author = {Harsányi, L and Kincses, Z and Veselinović, M and Zehetner, J and Altorjay, Á},
title = {Food passageway-related sequelae in the RefluxStop prospective multicenter trial: patient-centric outcomes of dysphagia, odynophagia, gas-bloating, and inability to belch and/or vomit at 5 years.},
journal = {Surgical endoscopy},
volume = {},
number = {},
pages = {},
pmid = {40542141},
issn = {1432-2218},
abstract = {INTRODUCTION: Standard surgical management of GERD may result in troublesome postoperative food passageway-related sequelae (i.e., dysphagia, odynophagia, gas-bloat syndrome, inability to belch/vomit), significantly impacting quality of life. Five-year results after the RefluxStop procedure are presented, involving reconstruction of the anti-reflux barrier without encircling the food passageway, reducing such related sequelae.

METHODS: RefluxStop surgery was evaluated in a prospective, single-arm, multicenter study with 50 GERD subjects. This report focuses on food passageway-related outcomes. Other basic outcomes (e.g., 24-h pH, PPI usage) are presented in a separate report with brief clinical correlation herein.

RESULTS: Forty-four subjects completed 5-year follow-up; three participants were missing due to COVID-19 (i.e., two deaths and one bedbound with long-COVID) and three terminated early. Data from 3- and 4-year follow-up were carried forward in COVID-affected cases. Food passageway-related adverse events (AEs) between 2 weeks of surgical recovery and 5-year follow-up included: one case (2.1%) of dysphagia (and another case, mild dysphagia for 2 weeks postoperatively, viewed as normal recovery); one case (2.1%) of odynophagia; zero (0%) cases of inability to belch/vomit; and gas-bloating none/improved in 42 cases with only two worsening. These outcomes were well-aligned with improvement in total GERD-HRQL score (i.e., median 29.5 at baseline to 3.0 at 5 years), PPI usage (2.1%), and 24-h pH monitoring (i.e., mean 1.57% acid exposure time at 5 years).

CONCLUSION: RefluxStop surgery resulted in a favorable profile of food passageway-related outcomes throughout the 5-year study: no AE dysphagia in 97.9% of subjects; no AE odynophagia in 97.9%; whereof at 5 years: gas-bloating none/improved in 95.7%, and no inability to belch/vomit in 100%. For clinical correlation, 97.9% of subjects did not take PPIs at 5 years. These outcomes add resolution to the overall treatment effect of RefluxStop and may show potential preference in GERD patients who prioritize minimization of postoperative sequelae.},
}

@article {pmid40542099,
year = {2025},
author = {Buonsenso, D},
title = {Danilo Buonsenso: ECI biocommentary.},
journal = {Pediatric research},
volume = {},
number = {},
pages = {},
doi = {10.1038/s41390-025-04236-1},
pmid = {40542099},
issn = {1530-0447},
}

@article {pmid40540816,
year = {2025},
author = {Filho, ADC and Fakoury, MK and Schmidt, GJ and Taboada Gjorup, AL and Marques, AC and Tolentino Junior, JC and Schmidt, JJ and Maia, A and van Duinkerken, E and Lewandrowski, KU and Blum, K and Schmidt, SL},
title = {Long-COVID-19 and Cognition: Persistent attention deficits after hospital discharge.},
journal = {Journal of psychiatric research},
volume = {189},
number = {},
pages = {277-279},
doi = {10.1016/j.jpsychires.2025.06.009},
pmid = {40540816},
issn = {1879-1379},
}

@article {pmid40540397,
year = {2025},
author = {Schneiderova, P and Mizera, J and Gharibian, A and Manukyan, G and Raska, M and Gajdos, P and Kosztyu, P and Genzor, S and Kudelka, M and Sova, M and Savara, J and Borikova, A and Shrestha, B and Mikulkova, Z and Stepanek, L and Kufa, J and Jakubec, P and Kriegova, E},
title = {The SARS-CoV-2 trigger highlights host interleukin 1 genetics in Epstein-Barr virus reactivation.},
journal = {Cell reports},
volume = {44},
number = {7},
pages = {115859},
doi = {10.1016/j.celrep.2025.115859},
pmid = {40540397},
issn = {2211-1247},
abstract = {Studies in large cohorts exposed to the same triggers associated with Epstein-Barr virus (EBV) reactivation and the follow-up of post-acute outcomes may uncover the pathomechanisms of autoimmune conditions and EBV-related cancer. We investigated a large cohort of individuals infected with SARS-CoV-2 infection reporting long COVID (LC) symptoms for positive serological markers of recent EBV reactivation (viral capsid antigen [VCA] immunoglobulin [Ig]M, VCA IgA, and early antigen D IgG), host interleukin (IL)1 and IL10 genetics, and immune response. Recent EBV reactivation occurs more frequently in individuals with a genetic risk of EBV reactivation in the IL1RN, IL1A, and IL1B genes associated with an elevated ratio of IL-1 receptor antagonist (IL-1Ra)/IL-1β and a higher latent EBV load in blood. High levels of anti-VCA IgA serve as a strong marker of recent EBV reactivation, which is associated with objective long-term pulmonary dysfunction in LC. Our data highlight the association between host IL1 genetics and EBV reactivation.},
}

@article {pmid40540167,
year = {2025},
author = {Lang, SM and Schiffl, H},
title = {Long-term renal consequences of COVID-19. Emerging evidence and unanswered questions.},
journal = {International urology and nephrology},
volume = {},
number = {},
pages = {},
pmid = {40540167},
issn = {1573-2584},
abstract = {PURPOSE: COVID-19 infection is associated with a high burden of acute or acute on chronic kidney injury (AKI), particularly in critically ill patients. Given the large numbers of COVID-19 survivors, characterization of long-term adverse kidney effects of COVID-19 have important implications for post-COVID-19 care.

METHODS: This narrative review provides a summary of epidemiologic evidence for post-COVID kidney disorders.

RESULTS: Precise post-COVID renal data are scarce. The true burden of long-COVID chronic kidney disease (CKD) remains unknown owing to under-recognition, under-diagnosis, clinical heterogeneity of patients, incomplete follow-up, and temporal trends in critical COVID-19 disease across waves of the pandemic. Collectively, the few well-designed studies assessing the impact of long-COVID on kidney health found that the overwhelming majority of patients with normal renal function at admission and without AKI during acute COVID-19 disease preserved kidney function. Post-infection kidney function trajectories of patients who experience a loss of renal function vary. Kidney function may decline gradually even in non-hospitalized patients, hospitalized patients may experience a rapid loss of kidney function 6-12 months after COVID-19 diagnosis or hospital discharge resulting from AKI during the acute phase of the disease. End-stage renal disease may occur after non-recovery from AKI and rapid progression of pre-existing CKD. Multiple mechanisms may trigger post-COVID CKD including maladaptive repair after AKI, or progression of renal lesions of systemic co-morbidities, persistence of the virus and dysregulation of inflammatory cytokines.

CONCLUSIONS: The COVID-19 pandemic has significantly impacted and may continue to have an impact on kidney health. Patients at risk have a higher propensity to develop critical COVID-19 disease. Post-COVID-19 care must pay close attention to renal function in patients discharged from hospital.},
}

@article {pmid40539617,
year = {2025},
author = {Souza, LMDN and Prigatano, GP and de Oliveira, SB and Braga, LW},
title = {Cognitive and Affective Performance of Brazilian Long COVID Patients: An In-Depth Analysis Before and After Psychoeducational Rehabilitation.},
journal = {NeuroRehabilitation},
volume = {56},
number = {4},
pages = {451-462},
doi = {10.1177/10538135251327122},
pmid = {40539617},
issn = {1878-6448},
abstract = {BackgroundLong COVID patients report various cognitive and affective symptoms that are poorly understood.ObjectiveThis study analyzed cognitive and affective performance in 208 Long COVID patients pre and post psychoeducational rehabilitation using a standardized screening test of higher cerebral functions. Identifying persistent difficulties may help guide future rehabilitation efforts.MethodsThe sample was comprised by a subset of 208 who completed psychoeducational rehabilitation from 614 Long COVID patients seeking rehabilitation. Performance on specific items was analyzed and compared to a reference sample of 114 educationally matched normal functioning adults.ResultsDetailed item analyses in 208 patients revealed persistent difficulties in the efficiency of learning and memory, affective expression, and the ability to accurately predict verbal memory performance compared to a reference sample. Long COVID patients showed variable performance deficits on attention, visual-spatial problem solving and memory measures. Language and related functions were consistently at a level commensurate with normally functioning individuals.ConclusionsPersistent cognitive and affective impairments were identified in Long COVID patients post-rehabilitation. Future programs should aim on to improve the efficiency of learning and memory, enhance the range of affective expression, and improve self-awareness of functional capacities. Rehabilitation should consider the multifactorial causes of these neuropsychological symptoms.},
}

@article {pmid40537277,
year = {2025},
author = {},
title = {Long COVID: equity in research.},
journal = {Archives of disease in childhood},
volume = {110},
number = {7},
pages = {527},
doi = {10.1136/archdischild-2025-329167},
pmid = {40537277},
issn = {1468-2044},
}

@article {pmid40537100,
year = {2025},
author = {Maas, MB and Reid, KJ and Jimenez, M and Lopez, M and Miller, J and Carnethon, MR and Zee, PC and Knutson, KL and Koralnik, IJ},
title = {Multidimensional Characterization of Long COVID Fatigue.},
journal = {Behavioral sleep medicine},
volume = {},
number = {},
pages = {1-10},
doi = {10.1080/15402002.2025.2522671},
pmid = {40537100},
issn = {1540-2010},
abstract = {OBJECTIVES: We performed a multidimensional analysis of mood, cognition, sleep and circadian rhythms in patients with post-acute sequelae of SARS-CoV-2 infection (PASC) with the objective of characterizing the phenotype of PASC fatigue.

METHODS: We recruited adult patients from a Neuro-COVID-19 Clinic with persistence of disabling symptoms beyond 6 weeks from acute infection. Self-reported symptoms were assessed with Patient-Reported Outcomes Measurement Information System instruments. We evaluated cognitive performance using NIH Toolbox measures and assessed sleep and rest-activity rhythms by 7 days of wrist actigraphy. We performed level 2 polysomnography in a subset of 20 participants.

RESULTS: We studied 58 participants: 83% White, 59% female and 91% not hospitalized for COVID-19. Fatigue severity was significantly correlated with worse self-reported cognitive abilities but not with objectively measured cognitive performance and with greater depression symptoms, several rest-activity rhythm and light exposure disruption measures, and greater actigraphy measured sleep time and time in bed. A multivariable model found significant, independent associations between fatigue severity and subjective cognitive abilities, depression symptoms, and rest-activity rhythm disruption.

CONCLUSIONS: Long total sleep times, disruption of light exposure and circadian rest-activity patterns, depression and subjective cognitive impairment are associated with PASC fatigue. Behaviorally influenced sleep and circadian abnormalities may exacerbate fatigue and be targets for therapeutic interventions.},
}

@article {pmid40536011,
year = {2025},
author = {Moen, JK and Baker, CA and Iwasaki, A},
title = {Neuroimmune pathophysiology of long COVID.},
journal = {Psychiatry and clinical neurosciences},
volume = {},
number = {},
pages = {},
doi = {10.1111/pcn.13855},
pmid = {40536011},
issn = {1440-1819},
support = {N/A/HHMI/Howard Hughes Medical Institute/United States ; R01AI157488//National Institute of Allergy and Infectious Diseases/ ; },
abstract = {Although COVID-19 was originally considered a respiratory illness, it is now well established that SARS-CoV-2 infection can have far-reaching impacts on the nervous system. Neurological symptoms such as chemosensory dysfunction are frequently observed during acute infection and approximately 10% of COVID-19 cases will go on to develop new or persistent long-term symptoms, a condition known in the literature as post-acute symptoms of COVID-19 (PASC) or by the patient-coined term Long COVID. Common neurological symptoms in Long COVID include new onset cognitive difficulties, dysautonomia, fatigue, and peripheral neuropathy. The emergence of Long COVID has prompted renewed interest in the study of post-acute infection syndromes (PAIS), particularly in the area of neuroimmune interactions. In this review we provide a comprehensive overview of the current body of literature on neurological manifestations of SARS-CoV-2 infection and Long COVID, with an emphasis on neuroimmune mechanisms drawn largely from autopsy studies and animal models. A more complete understanding of neuroimmune crosstalk in Long COVID will not only guide the development of therapies for this highly disabling condition but will also contribute to our general understanding of neuroimmune interactions in health and disease.},
}

@article {pmid40535019,
year = {2025},
author = {Palchevska, O and Dominguez, F},
title = {Syncytium: the viral escape room secret to persistent infection of SARS-CoV-2.},
journal = {Frontiers in microbiology},
volume = {16},
number = {},
pages = {1561274},
pmid = {40535019},
issn = {1664-302X},
}

@article {pmid40534826,
year = {2025},
author = {Souissi, A and Prieto-González, P and Ben Saad, H},
title = {Widespread pain syndrome in long COVID-19: melatonin as an adjuvant treatment.},
journal = {Frontiers in pain research (Lausanne, Switzerland)},
volume = {6},
number = {},
pages = {1609095},
pmid = {40534826},
issn = {2673-561X},
abstract = {Long coronavirus disease 2019 (LC19) represents a complex global health challenge. Survivors frequently report persistent problems like widespread pain syndrome (WPS), cognitive dysfunction, cardiovascular complications, and sleep disturbances. These health problems, which are worsened by oxidative stress and inflammaging, open the prospect of treatment strategies targeting these mechanisms. Melatonin is a potential option for treating LC19 problems because of its anti-inflammatory, antioxidant, and pain-modulating properties. Melatonin targets shared pathological pathways, offering a promising approach to reducing inflammation, oxidative stress, and neuroendocrine dysfunction. The present mini-review explores the therapeutic potential of melatonin in the treatment of LC19, focusing on its effects on WPS and inflammation.},
}

@article {pmid40534631,
year = {2025},
author = {Shah, SA and Phan, Q and Radel, JA},
title = {Role of enhanced external counterpulsation in long COVID.},
journal = {Open medicine (Warsaw, Poland)},
volume = {20},
number = {1},
pages = {20251216},
pmid = {40534631},
issn = {2391-5463},
}

@article {pmid40532111,
year = {2025},
author = {Risbano, MG},
title = {From fatigue to physiology: Submaximal 2-day cardiopulmonary exercise test and emerging standards in long COVID.},
journal = {Experimental physiology},
volume = {},
number = {},
pages = {},
doi = {10.1113/EP092958},
pmid = {40532111},
issn = {1469-445X},
support = {2025//Shadyside Hospital Foundation/ ; 1R01HL176493-01//HHS | NIH | NHLBI | Division of Intramural Research (DIR)/ ; },
}

@article {pmid40531392,
year = {2025},
author = {da Silva, MD and da Silva, TS and Mendes, CG and Valbão, MCM and Badu-Tawiah, AK and Laurindo, LF and Barbalho, SM and Direito, R and Miglino, MA},
title = {Advances in Understanding Long COVID: Pathophysiological Mechanisms and the Role of Omics Technologies in Biomarker Identification.},
journal = {Molecular diagnosis & therapy},
volume = {},
number = {},
pages = {},
pmid = {40531392},
issn = {1179-2000},
support = {200177/2022-2//Conselho Nacional de Desenvolvimento Científico e Tecnológico/ ; },
abstract = {Long coronavirus disease (COVID) is a multisystem condition that affects a significant proportion of individuals following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, with persistent symptoms ranging from fatigue and cognitive dysfunction to cardiovascular disorders. It is estimated that 30-60% of infected individuals experience symptoms lasting more than 12 weeks. Despite advances in understanding acute infection, the pathophysiological mechanisms underlying long COVID remain unclear. Current hypotheses suggest that viral persistence, immune dysfunction, and metabolic alterations play central roles. Omics approaches, including metabolomics, proteomics, and lipidomics, have played a crucial role in investigating molecular changes, identifying biomarkers, and refining therapeutic strategies. This review discusses recent advances in understanding long COVID, addressing its mechanisms, risk factors, the impact of viral variants, and the role of vaccination, with an emphasis on the importance of omics technologies in elucidating this condition.},
}

@article {pmid40529374,
year = {2025},
author = {Trautmann, A},
title = {Core features and inherent diversity of post-acute infection syndromes.},
journal = {Frontiers in immunology},
volume = {16},
number = {},
pages = {1509131},
pmid = {40529374},
issn = {1664-3224},
mesh = {Humans ; Post-Acute COVID-19 Syndrome ; Animals ; Fatigue/etiology ; *Infections/immunology/complications ; Critical Illness ; },
abstract = {Post-acute infection syndromes (PAIS), i.e., long-lasting pathologies subsequent to infections that do not properly resolve, have both a common core and a broad diversity of manifestations. PAIS include a group of core symptoms (pathological fatigue, cognitive problems, sleep disorders and pain) accompanied by a large set of diverse symptoms. Core and diverse additional symptoms, which can persist for years, exhibiting periods of relapses and remissions, usually start suddenly after an apparently common infection. PAIS display highly variable clinical features depending on the nature of the initial pathogen, and to an even larger extent, on the diversity of preexisting individual terrains in which PAIS are rooted. In a first part, I discuss biological issues related to the persistence of microbial antigens, dysregulated immune responses, reactivation of latent viruses, different potential self-sustained inflammatory loops, mitochondrial dysfunction, metabolic disorders in the tryptophan- kynurenin pathway (TKP) with impact on serotonin, and consequences of a dysfunctional bidirectional microbiota-gut-brain axis. The second part deals with the nervous system dependence of PAIS. I rely on the concept of interoception, the process by which the brain senses, integrates and interprets signals originating from within the body, and sends feebacks aimed at maintaining homeostasis. Interoception is central for understanding the origin of fatigue, dysautonomia, dysfunctioning of the hypothalamus-pituitary-adrenal (HPA) axis, and its relation with stress, inflammation or depression. I propose that all individual predispositions leading to self-sustained vicious circles constitute building blocks that can self-assemble in many possible ways, to give rise to both core and diverse features of PAIS. A useful discrimination between different PAIS subtypes should be obtained with a composite profiling including biomarkers, questionnaires and functional tests so as to take into account PAIS multidimensionality.},
}

Humans
Post-Acute COVID-19 Syndrome
Animals
Fatigue/etiology
*Infections/immunology/complications
Critical Illness

@article {pmid40529123,
year = {2025},
author = {Pasharawipas, T},
title = {Perspective: host factors variants and the underlying causes of long COVID.},
journal = {Frontiers in medicine},
volume = {12},
number = {},
pages = {1603317},
pmid = {40529123},
issn = {2296-858X},
abstract = {Long COVID, also known as post-COVID syndrome (PCS), is characterized by persistent and unexplained symptoms that can occur not only in individuals who experienced severe symptoms during the acute phase of SARS-CoV-2 infection but also in those who were asymptomatic or had only mild symptoms. These symptoms may persist for months, even in individuals who test negative via nasopharyngeal swab samples. This proposal aims to explain the cause of long COVID through the concept of host factor variants, including cellular variants and major histocompatibility complex (MHC) polymorphisms. A key aspect of this hypothesis is the role of antigen-presenting cells, such as macrophages and dendritic cells. It is proposed that blood or white blood cells could serve as suitable samples for diagnosing long COVID in affected individuals.},
}

@article {pmid40522927,
year = {2025},
author = {Özden, ME and Temizer, M},
title = {"Long COVID in patients with systemic lupus erythematosus: A case‒control study"-a methodological consideration.},
journal = {Lupus},
volume = {},
number = {},
pages = {9612033251352722},
doi = {10.1177/09612033251352722},
pmid = {40522927},
issn = {1477-0962},
}

@article {pmid40520224,
year = {2025},
author = {Lovaglio, PG and Borgonovo, F and Manzo Margiotta, A and Mowafy, M and Colaneri, M and Bandera, A and Gori, A and Capetti, AF},
title = {Estimating long COVID-19 prevalence across definitions and forms of sample selection.},
journal = {Frontiers in epidemiology},
volume = {5},
number = {},
pages = {1597799},
pmid = {40520224},
issn = {2674-1199},
abstract = {INTRODUCTION: Long COVID (LC) is a multisystem condition with prolonged symptoms persisting beyond acute SARS-CoV-2 infection. However, prevalence estimates vary widely due to differences in case definitions and sampling methodologies. This study aims to determine the prevalence of LC across different definitions and correct for selection bias using advanced statistical modeling.

METHODS: We conducted a retrospective, observational study at Luigi Sacco Hospital (Milan, Italy), analyzing 3,344 COVID-19 patients from two pandemic waves (2020-2021). Participants included 1,537 outpatients from the ARCOVID clinic and 1,807 hospitalized patients. LC was defined based on WHO and NICE criteria, as well as two alternative definitions: symptoms persisting at 3 and 6 months post-infection. We used a bivariate censored Probit model to account for selection bias and estimate adjusted LC prevalence.

RESULTS: LC prevalence varied across definitions: 67.4% (WHO), 76.3% (NICE), 80.2% (3 months), and 79.6% (6 months). Adjusted prevalence estimates remained consistent across definitions. The most common symptoms were fatigue (58.6%), dyspnea (41.1%), and joint/muscle pain (39.2%). Risk factors included female sex (OR 2.165-2.379), metabolic disease (OR 1.587-1.629), and older age (40-50 years, OR 1.847). Protective factors included antiplatelets (OR 0.640-0.689), statins (OR 0.616), and hypoglycemics (OR 0.593-0.706). Vaccination, hydroxychloroquine, and antibiotics were associated with an increased risk of LC. Selection bias significantly influenced prevalence estimates, underscoring the need for robust statistical adjustments.

DISCUSSION: Our findings highlight the high prevalence of LC, particularly among specific subgroups, with strong selection effects influencing outpatient participation. Differences in prevalence estimates emphasize the impact of case definitions and study designs on LC research. The identification of risk and protective factors supports targeted interventions and patient management strategies.

CONCLUSION: This study provides one of the most comprehensive analyses of LC prevalence while accounting for selection bias. Our findings call for standardized LC definitions, improved epidemiological methodologies, and targeted prevention strategies. Future research should explore prospective cohorts to refine LC prevalence estimates and investigate long-term health outcomes.},
}

@article {pmid40519702,
year = {2025},
author = {Al Masoodi, WT and Radhi, SW and Abdalsada, HK and Al-Hakeim, HK},
title = {Role of Galanin system and insulin resistance parameters as predictive tools for diagnosis of Long-COVID patients.},
journal = {Biochemistry and biophysics reports},
volume = {43},
number = {},
pages = {102068},
pmid = {40519702},
issn = {2405-5808},
abstract = {BACKGROUND: COVID-19 patients may have long-lasting symptoms known as long-COVID (LC) without any underlying medical issues or obvious organ damage. Much research suggested that these issues are attributed to cytokine storm, lung and nerve injury, and glucose homeostasis disruption. Galanin (Gal), a neuropeptide in the peripheral and central nervous systems, has several physiological activities connected to illnesses. The current case-control research hypothesized the role of insulin resistance (IR) and the Gal system in LC pathophysiology.

METHODS: This research included 30 healthy controls and 60 LC patients. Insulin, Gal, and GalR1 were determined using the enzyme-linked immunosorbent assay (ELISA). The HOMA2 calculator determined β-cell function (HOMA%B), insulin sensitivity (HOMA%S), and insulin resistance (HOMA2IR) by analyzing fasting serum insulin and glucose levels.

RESULTS: LC patients showed higher Gal, GalR1, and Gal/GalR1 concentrations than controls, suggesting Gal system activation. LC patients likely have an IR state. The correlation study showed a negative link between Gal, GalR1, and SpO2. Gal level was positively correlated with insulin, insulin/glucose, and HOMA2IR and negatively correlated with HOMA%S. With an AUC-ROC of 0.939, artificial neural networks (ANN) predicted a sensitivity of 71.4 % and a specificity of 87.5 %. In LC, IR parameters and Gal system biomarkers were strongly correlated, suggesting they may contribute to disease.

CONCLUSION: Galanin system and IR parameters are altered in LC patients and can predict LC in suspicious subjects with 91.7 % sensitivity and 100.0 % specificity using the neural network model. The top five predictors were CRP, insulin/glucose, Gal, glucose, and GalR1. CRP had the greatest importance (100.0 %), indicating the importance of inflammation, IR, and Gal system biomarkers in the pathophysiology of LC.},
}

@article {pmid40518292,
year = {2025},
author = {Vivaldi, G and Talaei, M and Blaikley, J and Jackson, C and Pfeffer, PE and Shaheen, SO and Martineau, AR},
title = {Bidirectional relationship between sleep problems and long COVID: a longitudinal analysis of data from the COVIDENCE UK study.},
journal = {BMJ open respiratory research},
volume = {12},
number = {1},
pages = {},
doi = {10.1136/bmjresp-2024-002506},
pmid = {40518292},
issn = {2052-4439},
mesh = {Humans ; *COVID-19/complications/epidemiology ; Female ; Male ; United Kingdom/epidemiology ; Middle Aged ; Longitudinal Studies ; *Sleep Wake Disorders/epidemiology ; Adult ; Prospective Studies ; SARS-CoV-2 ; Aged ; Sleep Quality ; Risk Factors ; Post-Acute COVID-19 Syndrome ; },
abstract = {BACKGROUND: Studies into the bidirectional relationship between sleep and long COVID have been limited by retrospective pre-infection sleep data and infrequent post-infection follow-up. We therefore used prospectively collected monthly data to evaluate how pre-infection sleep characteristics affect risk of long COVID and to track changes in sleep duration during the year after SARS-CoV-2 infection.

METHODS: COVIDENCE UK is a prospective, population-based UK study of COVID-19 in adults. We included non-hospitalised participants with evidence of SARS-CoV-2 infection and used logistic regression to estimate adjusted ORs for the association between preinfection sleep characteristics and long COVID. We assessed post-infection sleep duration using multilevel mixed models. We collected sleep data from participants using a subset of questions from the Pittsburgh Sleep Quality Index. We defined long COVID as unresolved symptoms at least 12 weeks after infection. COVIDENCE UK is registered with ClinicalTrials.gov, NCT04330599.

RESULTS: We included 3994 participants in our long COVID risk analysis, of whom 327 (8.2%) reported long COVID. We found an inverse relationship between pre-infection sleep quality and risk of long COVID (medium vs good quality: OR 1.37, 95% CI 1.04 to 1.81; medium-low vs good: 1.55, 1.12 to 2.16; low vs good: 1.94, 1.11 to 3.38). Greater variability in pre-infection sleep efficiency was also associated with long COVID when adjusted for infection severity (OR per percentage-point increase 1.07, 1.02 to 1.12). We assessed post-infection sleep duration in 6860 participants, observing a 0.11 hour (95% CI 0.09 to 0.14) increase in the first month after infection compared with pre-infection, with larger increases for more severe infections. After 1 month, sleep duration largely returned to pre-infection levels, although fluctuations in duration lasted up to 6 months after infection among people reporting long COVID.

CONCLUSIONS: While poor-quality sleep before SARS-CoV-2 infection associates with increased risk of long COVID thereafter, changes in sleep duration after infection in these non-hospitalised cases were modest and generally quick to resolve.

TRIAL REGISTRATION NUMBER: NCT04330599.},
}

Humans
*COVID-19/complications/epidemiology
Female
Male
United Kingdom/epidemiology
Middle Aged
Longitudinal Studies
*Sleep Wake Disorders/epidemiology
Adult
Prospective Studies
SARS-CoV-2
Aged
Sleep Quality
Risk Factors
Post-Acute COVID-19 Syndrome

@article {pmid40517846,
year = {2025},
author = {López-Güell, K and Català, M and Dedman, D and Duarte-Salles, T and Kolde, R and López-Blasco, R and Martínez, Á and Mercier, G and Abellan, A and Arinze, JT and Burkard, T and Burn, E and Cuccu, Z and Delmestri, A and Delseny, D and Khalid, S and Kim, C and Kim, JW and Kostka, K and Loste, C and Mayer, MA and Meléndez-Cardiel, J and Mercadé-Besora, N and Mosseveld, M and Nishimura, A and Nordeng, HM and Oyinlola, JO and Paredes, R and Pérez-Crespo, L and Pineda-Moncusí, M and Ramírez-Anguita, JM and Trinh, NT and Uusküla, A and Valdivieso, B and Prieto-Alhambra, D and Xie, J and Mateu, L and Jödicke, AM},
title = {Clusters of post-acute COVID-19 symptoms: a latent class analysis across 9 databases and 7 countries.},
journal = {Journal of clinical epidemiology},
volume = {},
number = {},
pages = {111867},
doi = {10.1016/j.jclinepi.2025.111867},
pmid = {40517846},
issn = {1878-5921},
abstract = {OBJECTIVE: Prior evidence has suggested the multisystem symptomatic manifestations of post-acute COVID-19 condition (PCC). Here we conducted a network cluster analysis of 24 WHO proposed symptoms to identify potential latent subclasses of PCC.

STUDY DESIGN AND SETTING: Individuals with a positive test of or diagnosed with SARS-CoV-2 after 09/2020 and with at least one symptom within ≥90 to 365 days following infection were included. Sub-analyses were conducted among people with ≥3 different symptoms. Summary characteristics were provided for each cluster. All analyses were conducted separately in 9 databases from 7 countries, including data from primary care, hospitals, national health claims and national health registries, allowing to compare clusters across the different healthcare settings.

RESULTS: 787,078 persons with PCC were included. Single-symptom clusters were common across all databases, particularly for joint pain, anxiety, depression and allergy. Complex clusters included anxiety-depression and abdominal-gastrointestinal symptoms.

CONCLUSION: Substantial heterogeneity within and between PCC clusters was seen across healthcare settings. Current definitions of PCC should be critically reviewed to reflect this variety in clinical presentation.},
}

@article {pmid40516783,
year = {2025},
author = {Bravi, B and Paolini, M and Colombo, F and Palladini, M and Bettonagli, V and Mazza, MG and Lorenzo, R and Rovere-Querini, P and Benedetti, F and Poletti, S},
title = {Long term effect of COVID-19 on brain metabolism and connectivity.},
journal = {Neuroscience},
volume = {},
number = {},
pages = {},
doi = {10.1016/j.neuroscience.2025.06.015},
pmid = {40516783},
issn = {1873-7544},
abstract = {AIMS: After 3 years from the beginning of SARS-CoV-2 pandemic, a substantial proportion of affected patients still present at least one symptom after infection. Given that: magnetic resonance imaging studies up to two years after COVID-19 reported changes in white matter (WM) microstructure and in functional connectivity; WM associates with glutamate and N-acetyl-aspartate levels in BD; the link between cognitive impairment and WM integrity, the aim of the study was to investigate metabolites associations with alterations in structural and functional brain connectivity and cognition in 64 COVID-19 survivors and 33 healthy controls (HC).

METHODS: We compared WM microstructure and metabolites levels between individuals recovering from COVID-19 and HCs. Then, we investigated the associations between WM and glutamate and N-acetyl-aspartate in the two groups.

RESULTS: Patients showed: higher levels of glutamate and NAA compared to HCs with a positive effect on cognitive complaints; higher fractional anisotropy (FA), and lower radial (RD) and mean diffusivity (MD); glutamate and N-acetyl-aspartate significant positive associations with FA, and a negative one with MD and RD. FA levels moderated the relation between the glutamate and cognitive deficits. Finally, N-acetyl-aspartate associated with higher rs-FC between VOI and the posterior cingulate gyrus in individuals recovering from COVID-19.

CONCLUSIONS: Our findings suggest that a process of brain repair and remyelination, as suggested by higher levels of glutamate and N-acetyl-aspartate and by higher measures of WM microstructure, may occur after SARS‑CoV‑2 infection which may help the recovery from long COVID-19 symptoms such as cognitive impairment.},
}

@article {pmid40515424,
year = {2025},
author = {Thomas, C and Kudiersky, N and Ansdell, P and Ashton, RE and Brown, C and Bewick, T and Carr, J and Hume, E and Spillane, P and Pastorio, E and Owen, R and Maden-Wilkinson, T and McNeil-Angopa, E and Parkington, T and Arena, R and Ozemek, C and Formenti, F and Veluswamy, SK and Gururaj, R and Faghy, MA},
title = {Submaximal 2-day cardiopulmonary exercise testing to assess exercise capacity and post-exertional symptom exacerbation in people with long COVID.},
journal = {Experimental physiology},
volume = {},
number = {},
pages = {},
doi = {10.1113/EP092576},
pmid = {40515424},
issn = {1469-445X},
support = {IN-UK-983-6080//Gilead Sciences/ ; },
abstract = {Long COVID has a complex pathology and a heterogeneous symptom profile that impacts quality of life and functional status. Post-exertional symptom exacerbation (PESE) affects one-third of people living with long COVID, but the physiological basis of impaired physical function remains poorly understood. Sixty-eight people (age (mean ± SD): 50 ± 11 years, 46 females (68%)) were screened for severity of PESE and completed two submaximal cardiopulmonary exercise tests separated by 24 h. Work rate was stratified relative to functional status and was set at 10, 20 or 30 W, increasing by 5 W/min for a maximum of 12 min. At the first ventilatory threshold (VT1), V ̇ O 2 ${\dot V_{{{\mathrm{O}}
_2}}
}$
was 0.73 ± 0.16 L/min on Day 1 and decreased on Day 2 (0.68 ± 0.16 L/min; P = 0.003). Work rate at VT1 was lower on Day 2 (Day 1 vs. Day 2; 28 ± 13 vs. 24 ± 12 W; P = 0.004). Oxygen pulse on Day 1 at VT1 was 8.2 ± 2.2 mL/beat and was reduced on Day 2 (7.5 ± 1.8 mL/beat; P = 0.002). The partial pressure of end tidal carbon dioxide was reduced on Day 2 (Day 1 vs. Day 2; 38 ± 3.8 vs. 37 ± 3.2 mmHg; P = 0.010). Impaired V ̇ O 2 ${\dot V_{{{\mathrm{O}}
_2}}
}$
is indicative of reduced transport and/or utilisation of oxygen. V ̇ O 2 ${\dot V_{{{\mathrm{O}}
_2}}
}$
at VT1 was impaired on Day 2, highlighting worsened function in the 24 h after submaximal exercise. The data suggest multiple contributing physiological mechanisms across different systems and further research is needed to investigate these areas.},
}

@article {pmid40514644,
year = {2025},
author = {Elboraay, T and Ebada, MA and Elsayed, M and Aboeldahab, HA and Salamah, HM and Rageh, O and Elmallahy, M and AboElfarh, HE and Mansour, LS and Nabil, Y and Eltawab, AKA and Atwan, H and Alkanj, S},
title = {Long-term neurological and cognitive impact of COVID-19: a systematic review and meta-analysis in over 4 million patients.},
journal = {BMC neurology},
volume = {25},
number = {1},
pages = {250},
pmid = {40514644},
issn = {1471-2377},
mesh = {Humans ; *COVID-19/complications/psychology/epidemiology ; *Nervous System Diseases/epidemiology/etiology ; *Cognitive Dysfunction/epidemiology/etiology ; Prevalence ; Fatigue/epidemiology ; },
abstract = {BACKGROUND: Neuropsychiatric symptoms emerged early in the COVID-19 pandemic as a key feature of the virus, with research confirming a range of neuropsychiatric manifestations linked to acute SARS-CoV-2 infection. However, the persistence of neurological symptoms in the post-acute and chronic phases remains unclear. This meta-analysis assesses the long-term neurological effects of COVID-19 in recovered patients, providing insights for mental health service planning.

METHODS: A comprehensive literature search was conducted across five electronic databases: PubMed, Scopus, Web of Science, EBSCO, and CENTRAL, up to March 22, 2024. Studies evaluating the prevalence of long-term neurological symptoms in COVID-19 survivors with at least six months of follow-up were included. Pooled prevalence estimates, subgroup analyses, and meta-regression were performed, and publication bias was assessed.

RESULTS: The prevalence rates for the different symptoms were as follows: fatigue 43.3% (95% CI [36.1-50.9%]), memory disorders 27.8% (95% CI [20.1-37.1%]), cognitive impairment 27.1% (95% CI [20.4-34.9%]), sleep disorders 24.4% (95% CI [18.1-32.1%]), concentration impairment 23.8% (95% CI [17.2-31.9%]), headache 20.3% (95% CI [15-26.9%]), dizziness 16% (95% CI [9.5-25.7%]), stress 15.9% (95% CI [10.2-24%]), depression 14.0% (95% CI [10.1-19.2%]), anxiety 13.2% (95% CI [9.6-17.9%]), and migraine 13% (95% CI [2.2-49.8%]). Significant heterogeneity was observed across all symptoms. Meta-regression analysis showed higher stress, fatigue, and headache in females, and increased stress and concentration impairment with higher BMI.

CONCLUSIONS: Neurological symptoms are common and persistent in COVID-19 survivors. This meta-analysis highlights the significant burden these symptoms place on individuals, emphasizing the need for well-resourced multidisciplinary healthcare services to support post-COVID recovery.

REGISTRATION AND PROTOCOL: This meta-analysis was registered in PROSPERO with registration number CRD42024576237.},
}

Humans
*COVID-19/complications/psychology/epidemiology
*Nervous System Diseases/epidemiology/etiology
*Cognitive Dysfunction/epidemiology/etiology
Prevalence
Fatigue/epidemiology

@article {pmid40514228,
year = {2025},
author = {Burrell, T and Simpson, A and Ramsenthaler, C and Crooks, MG and Johnson, MJ and Swan, F},
title = {Cool facial airflow hastens exertion recovery in chronic breathlessness: randomised crossover trial of different fan airflow speeds.},
journal = {BMJ supportive & palliative care},
volume = {},
number = {},
pages = {},
doi = {10.1136/spcare-2024-005103},
pmid = {40514228},
issn = {2045-4368},
abstract = {OBJECTIVES: Facial airflow from a hand-held fan (fan) hastens recovery from exertional breathlessness. We aimed to determine the effect of different airflow speeds on recovery from exertional breathlessness in patients with chronic breathlessness.

METHODS: A prospective, unblinded, randomised crossover trial. Participants with chronic breathlessness (modified Medical Research Council ≥3) completed five 1 min sit-to-stand (STS) tests to induce breathlessness. After each STS test, participants used a fan with one of four airflow speeds or control (no fan) during 10 min recovery. Numerical Rating Scale (NRS) breathlessness intensity, airflow pleasantness, heart rate, oxygen saturation and facial skin temperature were recorded.

RESULTS: 10 participants were recruited (n=1 withdrew due to health concerns) and 9 (mean±SD age 66±14 years; 5 men; 8 chronic obstructive pulmonary disease, 1 long covid) completed the trial. Per-protocol analysis identified no difference in NRS breathlessness recovery across fan speeds (p>0.05). Sensitivity analysis (n=1 excluded due to low exertional NRS breathlessness post STS test) identified a significant interaction effect for fan speed over time (p=0.010). Fan speed 2.85 m/s reduced NRS breathlessness compared with control at minutes 4-8 during recovery (p<0.05), whereas fan speeds 1.98 m/s, 3.70 m/s and 4.91 m/s only differed from control after 7 min recovery (p<0.05). The perceived most pleasant and preferred airflow rate was 2.85 m/s. NRS pleasantness decreased with faster airflow speeds, suggesting a ceiling limit to net benefit.

CONCLUSION: Our novel data suggest the optimal airflow speed to hasten recovery from exertional breathlessness in people with chronic breathlessness is 2.85 m/s. Net benefit reduces at higher flow rates.},
}

@article {pmid40512699,
year = {2025},
author = {Khammawan, P and Thongprachum, A and Intawong, K and Chariyalertsak, S},
title = {Severity, mortality, long COVID-19, and quality of life: Insights from a cohort study of hospitalized COVID-19 patients during the delta variant predominance period in Thailand.},
journal = {PloS one},
volume = {20},
number = {6},
pages = {e0324061},
doi = {10.1371/journal.pone.0324061},
pmid = {40512699},
issn = {1932-6203},
mesh = {Humans ; *COVID-19/mortality/epidemiology/virology/pathology ; Thailand/epidemiology ; *Quality of Life ; Male ; Female ; Middle Aged ; Adult ; Aged ; SARS-CoV-2/isolation & purification ; Hospitalization ; Severity of Illness Index ; Cohort Studies ; Anxiety ; Fatigue ; },
abstract = {BACKGROUND: The COVID-19 pandemic, declared in March 2020, has had significant global impacts, with Thailand reporting over 4.6 million cases and 32,000 fatalities by September 2022. Long COVID, or Post-COVID Conditions (PCC), affects 10-30% of COVID-19 patients globally, with symptoms lasting beyond three months. Common issues include fatigue, brain fog, respiratory problems, and psychological effects such as anxiety and depression. Symptoms can persist regardless of the initial infection severity, and ongoing research continues to refine understanding and management strategies. To address residual symptoms of COVID-19 during the Delta variant predominance period, a study was conducted from July to December 2021 at a tertiary care hospital in Chiang Mai, Thailand. The study aimed to describe the characteristics of COVID-19 patients, explore the Long COVID symptoms experienced by patients after discharge, and assess their quality of life.

METHODS: The study characterized 604 are moderate to severe COVID-19 patients at Tertiary Care Hospital during the Delta wave in Thailand (July-December 2021), using secondary data from medical records. Confirmed cases were cohort monitored using a Long COVID questionnaire for symptoms, chronic conditions, and social impact a year after discharge. Quality of life was evaluated using the SF-12 questionnaire (SF-12: 12-Item Short Form Survey). Long COVID, in this study, is defined as the persistence or emergence of one or more physical, psychological, or cognitive symptoms that last for more than 12 weeks after the initial onset of COVID-19 and cannot be explained by alternative diagnoses. This includes, but is not limited to, symptoms such as fatigue, dyspnea, chest pain, cough, cognitive dysfunction ("brain fog"), insomnia, anxiety, or depression.

FINDINGS: Most patients were Thai (85.9%) and female (57.3%), with obesity common among those aged 18-60 (48.3%). Severe cases and mortality were higher in patients over 60 (30.2%) and unvaccinated patients (60.4%). Severity was related with male gender, older age, lack of antiviral use, and being unvaccinated; overweight status, comorbidities, and abnormal chest x-rays were not significant. Deaths were influenced by gender, age, and antiviral use, but not hospital stay duration, overweight status, comorbidities, or vaccination status. At one-year follow-up, Long COVID symptoms were reported in a small proportion of patients (4.2% shortness of breath, 1.5% chronic cough), mostly in adults and older adults. Other symptoms were rare (<1%) and limited to the 18-60 age group. No severe neurological or systemic symptoms were reported. One-year post-hospitalization, 79.15% had no Long COVID symptoms. Quality of life scores were high (Physical Component Summary: PCS = 48.62, Mental Component Summary: MCS = 50.65).

INTERPRETATION: This study found a very low prevalence of Long COVID symptoms, which may be due to the severity of the Delta variant leading to higher mortality among patients with severe illness. Those who survived and recovered mostly had moderate symptoms and were predominantly under 60 years of age, which may explain the lower occurrence of Long COVID in this group. The majority of COVID-19 patients in Chiang Mai experienced moderate symptoms and had a high survival rate. Despite varied long COVID symptoms, most reported good physical and mental health one year after recovery. These findings highlight the resilience of patients and the importance of monitoring long-term health outcomes.},
}

Humans
*COVID-19/mortality/epidemiology/virology/pathology
Thailand/epidemiology
*Quality of Life
Male
Female
Middle Aged
Adult
Aged
SARS-CoV-2/isolation & purification
Hospitalization
Severity of Illness Index
Cohort Studies
Anxiety
Fatigue

@article {pmid40512228,
year = {2025},
author = {Goldenberg, DL},
title = {The pivotal role of central sensitization in long COVID, fibromyalgia and myalgic encephalomyelitis/chronic fatigue syndrome.},
journal = {Expert review of neurotherapeutics},
volume = {},
number = {},
pages = {1-17},
doi = {10.1080/14737175.2025.2516097},
pmid = {40512228},
issn = {1744-8360},
abstract = {INTRODUCTION: Long COVID is a condition characterized by persistent unexplained symptoms following COVID-19 infection. These symptoms are not related to another disease or organ damage and are similar to those in fibromyalgia and myslgic encephalomyelitis/chronic fatigue syndrome (ME/CFS).

AREAS COVERED: The similar clinical and pathophysiological features and management of long COVID, fibromyalgia and ME/CFS are explored from the unifying framework of central sensitivity syndromes. The article is based on a literature search utilizing PubMed for content published between 2021 and 1 May 2025, using search terms: long COVID, long COVID syndrome, post-COVID-19, post-acute SARS-CoV-2, fibromyalgia, ME/CFS, post-exertional malaise and central sensitization.

EXPERT OPINION: Once long COVID is redefined to exclude patients with well-defined organ disease, it fits best as a model of central sensitization. Long COVID is a single syndrome, rather than many distinct diseases. Optimal management of long COVID and similar central sensitivity syndromes should include personalized care with a primary care led-multidisciplinary team.},
}

@article {pmid40511514,
year = {2025},
author = {Doehner, W and Schueller, PO},
title = {Comment on "Intermittent Hypoxic-Hyperoxic Training During Inpatient Rehabilitation Improves Exercise Capacity and Functional Outcome in Patients With Long Covid: Results of a Controlled Clinical Pilot Trial" by Doehner et al.-The Authors' Reply.},
journal = {Journal of cachexia, sarcopenia and muscle},
volume = {16},
number = {3},
pages = {e13866},
doi = {10.1002/jcsm.13866},
pmid = {40511514},
issn = {2190-6009},
}

@article {pmid40511428,
year = {2025},
author = {Mistry, CP and Bhanderi, DJ},
title = {An Epidemiological Cross-sectional Study of Post-COVID-19 Syndrome in Patients of Anand District.},
journal = {Indian journal of community medicine : official publication of Indian Association of Preventive & Social Medicine},
volume = {50},
number = {3},
pages = {486-499},
pmid = {40511428},
issn = {0970-0218},
abstract = {BACKGROUND: Coronavirus has infected 44.7 million Indians until December 2022. After recovery, patients are developing long-term effects of COVID-19. Research is required to know the burden of post-COVID-19 syndrome (PCS) and factors leading it. To estimate the prevalence of PCS and its associated factors in Anand district of Gujarat state. This cross-sectional study was conducted in 8 talukas of Anand district.

METHODS AND MATERIAL: Sample size of 450 patients divided into the hospitalized group and home/facility isolated group with samples of 300 and 150, respectively. Information was collected using a pretested semistructured questionnaire after taking written informed consent. It included demographic details, personal history, COVID-19-related information, and questions regarding persistent/newly developed symptoms after 12 weeks of COVID-19. The data collected were entered in Microsoft Excel 2019 and analyzed by SPSS version 15. Descriptive analysis followed by univariate analysis and logistic regression was performed. Among 450, 56% of patients were male and 43.3% were female.

RESULTS: The study reported 25.11% prevalence of PCS. Majority (82%) of patients having PCS had Grade I symptoms. Common symptoms recorded were weakness (10%) and breathlessness (4%). PCS was found to be associated with the hospitalization status of a patient, administration of drugs like antacids, Ivermectin, and Insulin.

CONCLUSIONS: Looking at current prevalence of PCS, well-sensitized healthcare system is needed to be established. Further research is required to explore more risk factors leading to PCS and various treatment options for PCS.},
}

@article {pmid40507911,
year = {2025},
author = {Popa, E and Popa, AE and Poroch, M and Poroch, V and Ungureanu, MI and Slanina, AM and Bacusca, A and Coman, EA},
title = {The Molecular Mechanisms of Cognitive Dysfunction in Long COVID: A Narrative Review.},
journal = {International journal of molecular sciences},
volume = {26},
number = {11},
pages = {},
doi = {10.3390/ijms26115102},
pmid = {40507911},
issn = {1422-0067},
mesh = {Humans ; *COVID-19/complications/metabolism ; *Cognitive Dysfunction/etiology/metabolism/virology ; SARS-CoV-2 ; Biomarkers/metabolism ; Blood-Brain Barrier/metabolism ; },
abstract = {Cognitive dysfunction represents one of the most persistent and disabling features of Long COVID, yet its molecular underpinnings remain incompletely understood. This narrative review synthesizes current evidence on the pathophysiological mechanisms linking SARS-CoV-2 infection to long-term neurocognitive sequelae. Key processes include persistent neuroinflammation, blood-brain barrier (BBB) disruption, endothelial dysfunction, immune dysregulation, and neuroendocrine imbalance. Microglial activation and cytokine release (e.g., IL-6, TNF-α) promote synaptic dysfunction and neuronal injury, while activation of inflammasomes such as NLRP3 amplifies CNS inflammation. Vascular abnormalities, including microthrombosis and BBB leakage, facilitate the infiltration of peripheral immune cells and neurotoxic mediators. Hypothalamic-pituitary-adrenal axis dysfunction and reduced vagal tone further exacerbate systemic inflammation and autonomic imbalance. Biomarkers such as GFAP, NFL, IL-6, and S100B have been associated with both neuroinflammation and cognitive symptoms. Notably, transcriptomic signatures in Long COVID overlap with those observed in Alzheimer's disease, highlighting shared pathways involving tau dysregulation, oxidative stress, and glial reactivity. Understanding these mechanisms is critical for identifying at-risk individuals and developing targeted therapeutic strategies. This review underscores the need for longitudinal research and integrative biomarker analysis to elucidate the molecular trajectory of cognitive impairment in Long COVID.},
}

Humans
*COVID-19/complications/metabolism
*Cognitive Dysfunction/etiology/metabolism/virology
SARS-CoV-2
Biomarkers/metabolism
Blood-Brain Barrier/metabolism

@article {pmid40507564,
year = {2025},
author = {Oesch-Régeni, B and Germann, N and Hafer, G and Schmid, D and Arn, N},
title = {The Effect on Quality of Life of Therapeutic Plasmapheresis and Intravenous Immunoglobulins on a Population of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Patients with Elevated β-Adrenergic and M3-Muscarinic Receptor Antibodies-A Pilot Study.},
journal = {Journal of clinical medicine},
volume = {14},
number = {11},
pages = {},
doi = {10.3390/jcm14113802},
pmid = {40507564},
issn = {2077-0383},
abstract = {Background/Objectives: Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a debilitating condition with not fully understood causes, though evidence points to immune system involvement and possible autoimmunity. ME/CFS could be triggered by various infectious pathogens, like SARS-CoV-2; furthermore, a subset of the post-COVID-19 condition (PCC) patients fulfill the diagnostic criteria of ME/CFS. According to the Canadian Consensus Criteria (CCC), the presence of specific symptoms such as fatigue, post-exertional malaise, sleep dysfunction, pain, neurological/cognitive manifestations, and symptoms from at least two of the following categories lead to the diagnosis of ME/CFS: autonomic, neuroendocrine, and immune manifestation. In this study, the patient selection was based on the identification of ME/CFS patients with elevated autoantibodies, regardless of the triggering factor of their condition. Methods: The aim of this study was to identify ME/CFS patients among long COVID patients with elevated autoantibodies. In seven cases, plasmapheresis (PE) and intravenous immunoglobulins (IVIGs) with repetitive autoantibody measurements were applied: four PE sessions on days 1, 5, 30, and 60, and a low-dose IVIG therapy after each treatment. Antibodies were measured before the first PE and two weeks after the last PE session. To monitor clinical outcomes, the following somatic and psychometric follow-up assessments were conducted before the first PE, 2 weeks after the second, and 2 weeks after the last PE: the Schellong test, ISI (insomnia), FSS (fatigue), HADS (depression and anxiety), and EQ-5D-5L (quality of life) questionnaires. Results: There was a negative association between both the β2-adrenergic and M3-muscarinic receptor autoantibody concentration and the quality of life measurements assessed with the EQ-5D-5L questionnaire. Per 1 U/mL increase in the concentration levels of β2-adrenergic receptor antibodies or M3-muscarinic acetylcholine receptor antibodies, the EQ-5D-5L index score [-0.59 to 1] decreased by 0.01 (0.63%) or 0.02 (1.26%), respectively. There were no significant associations between the ISI, HADS, and FSS questionnaires and the β1-adrenergic and M4-muscarinic receptor antibodies titers. Conclusions: After a thorough selection of patients with present autoantibodies, this pilot study found negative associations concerning autoantibody concentration and somatic, as well as psychological wellbeing. To validate these promising feasibility study results-indicating the potential therapeutic potential of antibody-lowering methods-further investigation with larger sample sizes is needed.},
}

@article {pmid40507431,
year = {2025},
author = {Fresi, E and Pagani, E and Pezzetti, F and Montomoli, C and Monti, C and Betti, M and De Silvestri, A and Sagliocco, O and Zuccaro, V and Bruno, R and Klersy, C},
title = {Long COVID's Hidden Complexity: Machine Learning Reveals Why Personalized Care Remains Essential.},
journal = {Journal of clinical medicine},
volume = {14},
number = {11},
pages = {},
doi = {10.3390/jcm14113670},
pmid = {40507431},
issn = {2077-0383},
support = {code 2020-4238//CARIPLO Foundation/ ; },
abstract = {Background: Long COVID can develop in individuals who have had COVID-19, regardless of the severity of their initial infection or the treatment they received. Several studies have examined the prevalence and manifestation of symptom phenotypes to comprehend the pathophysiological mechanisms associated with these symptoms. Numerous articles outlined specific approaches for multidisciplinary management and treatment of these patients, focusing primarily on those with mild acute illness. The various management models implemented focused on a patient-centered approach, where the specialists were positioned around the patient. On the other hand, the created pathways do not consider the possibility of symptom clusters when determining how to define diagnostic algorithms. Methods: This retrospective longitudinal study took place at the "Fondazione IRCCS Policlinico San Matteo", Pavia, Italy (SMATTEO) and at the "Ospedale di Cremona", ASST Cremona, Italy (CREMONA). Information was retrieved from the administrative data warehouse and from two dedicated registries. We included patients discharged with a diagnosis of severe COVID-19, systematically invited for a 3-month follow-up visit. Unsupervised machine learning was used to identify potential patient phenotypes. Results: Three hundred and eighty-two patients were included in these analyses. About one-third of patients were older than 65 years; a quarter were female; more than 80% of patients had multi-morbidities. Diagnoses related to the circulatory system were the most frequent, comprising 46% of cases, followed by endocrinopathies at 20%. PCA (principal component analysis) had no clustering tendency, which was comparable to the PCA plot of a random dataset. The unsupervised machine learning approach confirms these findings. Indeed, while dendrograms for the hierarchical clustering approach may visually indicate some clusters, this is not the case for the PAM method. Notably, most patients were concentrated in one cluster. Conclusions: The extreme heterogeneity of patients affected by post-acute sequelae of SARS-CoV-2 infection (PASC) has not allowed for the identification of specific symptom clusters with the most recent statistical techniques, thus preventing the generation of common diagnostic-therapeutic pathways.},
}

@article {pmid40507399,
year = {2025},
author = {Diciolla, NS and Ampuero-López, A and Marques, A and Jiménez-Martín, A and García-De Villa, S and Torres-Lacomba, M and Yuste-Sánchez, MJ},
title = {Physical Activity and Sedentary Behaviour in People with Long COVID: A Follow-Up from 12 to 18 Months After Discharge.},
journal = {Journal of clinical medicine},
volume = {14},
number = {11},
pages = {},
doi = {10.3390/jcm14113641},
pmid = {40507399},
issn = {2077-0383},
support = {FPI-UAH-20//Universidad de Alcalá/ ; CPFM-2020/002_COVID19//Professional College of Physiotherapists of the Community of Madrid/ ; },
abstract = {Background/Objectives: Long-term effects of post-COVID-19 on several health outcomes remain unclear. We assessed PA and sedentary behaviour changes and explored behaviour-change factors twelve months post-COVID-19 in people with and without Long COVID. Methods: A prospective cohort study followed people treated for COVID-19 in different settings (home, hospital ward, intensive care unit) from twelve months to eighteen months post-COVID-19. Participants with and without Long COVID were identified. PA (Light PA-LPA, Moderate-to-Vigorous PA-MVPA, Steps·day[-1]), sedentary time, functional capacity (six-minute walk test-6MWT), muscle strength (quadriceps maximal voluntary contraction-QMVC), dyspnoea (modified Medical Research Council scale-mMRC), fatigue, symptoms of anxiety and depression, and health-related quality of life-HRQoL were assessed. Results: Among 148 participants (58 ± 15 years, 54% male), 101 had Long COVID. All remained physically inactive. People with Long COVID significantly increased LPA (LPALongCOVID +28 [1; 55] min·day[-1]; LPAControls +6 [-32; 45] min·day[-1]), and decreased MVPA (MVPALongCOVID -4 [-7; -2] min·day[-1]; MVPAControls -4 [-8; 1] min·day[-1]) and sedentarism (SedentarismLongCOVID -47 [-89; -4] min·day[-1]; SedentarismControls -30 [-88; 28] min·day[-1]). At eighteen months, higher proportions of individuals with Long COVID had impaired 6MWT (17% vs. 0%), reduced QMVC (25% vs. 6%), dyspnoea (24% vs. 0%), fatigue (67% vs. 13%), symptoms of anxiety (47% vs. 9%) and depression (26% vs. 0%) as well as poor HRQoL (50% vs. 6%). PA and sedentary behaviour changes at eighteen months were associated with dyspnoea and impaired QMVC at twelve months (LPA: mMRC ≥ 2: -41.56 [-129.30; 46.00] min·day[-1], Steps·day[-1]: mMRC: -416.13 [-1223.83; 391.57]; QMVC ≤ 70% predicted: -1251.39 [-2661.69; 158.91], Sedentarism: mMRC ≥ 2: +47.21 [-90.57; 184.99] min·day[-1]; 0.24 ≤ R[2] ≤ 0.32). Conclusions: PA and sedentary behaviour remain altered long after COVID-19, with people with Long COVID adjusting to fit lower PA levels, possibly driven by physical limitations and symptoms. Dyspnoea and muscle weakness may influence PA and sedentary behaviour.},
}

@article {pmid40507071,
year = {2025},
author = {Bigman, G and Rusu, ME and Shelawala, N and Sorkin, JD and Beamer, BA and Ryan, AS},
title = {A Comprehensive Scoping Review on Diet and Nutrition in Relation to Long COVID-19 Symptoms and Recovery.},
journal = {Nutrients},
volume = {17},
number = {11},
pages = {},
doi = {10.3390/nu17111802},
pmid = {40507071},
issn = {2072-6643},
mesh = {Humans ; *COVID-19/complications/physiopathology/diet therapy ; *Nutritional Status ; *Diet ; SARS-CoV-2 ; Post-Acute COVID-19 Syndrome ; Adult ; },
abstract = {Background/Objectives: Long COVID-19 is characterized by persistent symptoms lasting three months or more following SARS-CoV-2 infection. Nutrition has emerged as a modifiable factor influencing recovery trajectories and symptom burden; however, existing evidence remains fragmented across diverse study designs and populations. This scoping review synthesized global evidence on the role of diet and nutrition in managing long COVID-19 symptoms and supporting recovery. Methods: Following PRISMA-ScR and Joanna Briggs Institute guidelines for scoping reviews, we searched major biomedical databases for studies published between 2020 and 2025. Eligible studies examined dietary intake, nutritional status, or nutrition-related interventions in adults with long COVID-19. Results: After duplicates were removed, 1808 records were screened, resulting in 50 studies that met the inclusion criteria-27 intervention studies and 23 observational studies. Nutritional exposures included micronutrients (e.g., vitamins D, K2), amino acids (e.g., L-arginine), multinutrient formulations, microbiota-targeted therapies (e.g., probiotics, synbiotics), nutritional status, diet quality, and whole-diet patterns (e.g., the Mediterranean diet). Approximately 76% of studies reported improvements in long COVID-19-related symptoms such as fatigue, mood disturbances, physical function, and markers of inflammation. Conclusions: Diet and nutrition may support long COVID-19 recovery by targeting inflammation and the gut microbiome to alleviate symptoms and improve functional outcomes. Well-powered trials of whole-diet approaches, combined with targeted supplementation, are needed to confirm their potential as scalable, accessible tools for post-COVID-19 recovery and management.},
}

Humans
*COVID-19/complications/physiopathology/diet therapy
*Nutritional Status
*Diet
SARS-CoV-2
Post-Acute COVID-19 Syndrome
Adult

@article {pmid40503046,
year = {2025},
author = {Shirani, K and Khorvash, F and Karamshahi, A and Maghamimehr, A},
title = {Investigating outcomes and treatment of long coronavirus disease 2019 in patients with multiple sclerosis treated with rituximab: A case series study.},
journal = {Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences},
volume = {30},
number = {},
pages = {26},
pmid = {40503046},
issn = {1735-1995},
abstract = {Multiple sclerosis (MS) is a chronic autoimmune disease affecting the central nervous system, characterized by the destruction of the myelin sheath of nerves. MS patients treated with rituximab, an immunosuppressive drug, experience reduced immunoglobulin levels, which increases their risk of various infections, including coronavirus disease 2019 (COVID-19). During the COVID-19 pandemic, many of these patients developed long-term symptoms following infection. These chronic symptoms have led to significant complications and, in some cases, increased mortality. In this case series study, we investigated long COVID-19 symptoms in MS patients treated with rituximab and the effects of intravenous immunoglobulin (IVIG) therapy in alleviating chronic symptoms. The results demonstrated that the patients' long-term symptoms responded to IVIG treatment, with significant improvements in respiratory symptoms, fever, immune parameters, and a reduction in C-reactive protein levels. This study highlights the importance of targeted management of long COVID-19 in immunocompromised populations and suggests that COVID-19 patients with immune deficiencies require specific therapeutic approaches.},
}

@article {pmid40502605,
year = {2025},
author = {Butzin-Dozier, Z and Ji, Y and Wang, LC and Anzalone, AJ and Hurwitz, E and Patel, RC and van der Laan, MJ and Colford, JM and Hubbard, AE},
title = {Causal Inference via Electronic Health Records in the National Clinical Cohort Collaborative: Challenges and Solutions in Long COVID Research.},
journal = {medRxiv : the preprint server for health sciences},
volume = {},
number = {},
pages = {},
doi = {10.1101/2025.06.06.25329168},
pmid = {40502605},
abstract = {Observational analyses of electronic health record (EHR) data using databases such as the National Clinical Cohort Collaborative include unique challenges for researchers seeking causal inferences, particularly when evaluating subjectively-defined outcomes like Long COVID. We explore several challenges and describe potential solutions. 1. Lack of true negatives: Many diagnoses and conditions either have a positive indicator or a missing status, requiring investigators to carefully consider which patients are likely negative for this condition. 2. Differential monitoring: EHR data include nonrandom missingness driven by patients engaging with the healthcare system at different rates, which is often related to both the exposure and outcome of interest. 3. Bias: EHR data sources face many biases, but are particularly vulnerable to informative missingness, differential monitoring, and model misspecification. 4. Large sample size: High precision (i.e., narrow confidence intervals) paired with potential bias leads to a high risk of incorrectly rejecting the null hypothesis. 5. Defining index time: It is important that investigators deliberately define index time (i.e., t 0 , baseline) to ensure that they only adjust for baseline confounders and do not adjust for (or condition on) factors that are affected by the exposure of interest (i.e., colliders or mediators). 7. Parameter selection: Investigators should only select parameters that are supported by the data distribution. This manuscript provides an overview of these challenges and solutions, using both simulated data and real-world data, with the outcome of Long COVID as the running example.},
}

@article {pmid40501971,
year = {2025},
author = {DeLine-Caballero, S and Ratnasiri, K and Chen, H and Sahagun, SJ and Mangalanathan, UM and Barnard, TR and Turk, N and Yang, J and Saini, N and Ayhan, EM and Memetimin, H and Finlin, BS and Leicht, Z and Kern, PA and Emery, I and Leeman, BM and Edelstein, GE and Costa, S and Choi, A and Li, JZ and Rosen, C and McLaughlin, T and Blish, CA},
title = {COVID-19 induces persistent transcriptional changes in adipose tissue that are not associated with Long COVID.},
journal = {bioRxiv : the preprint server for biology},
volume = {},
number = {},
pages = {},
doi = {10.1101/2025.05.23.655815},
pmid = {40501971},
issn = {2692-8205},
abstract = {Long COVID is a heterogeneous condition characterized by a wide range of symptoms that persist for 90 days or more following SARS-CoV-2 infection. Now more than five years out from the onset of the SARS-CoV-2 pandemic, the mechanisms driving Long COVID are just beginning to be elucidated. Adipose tissue has been proposed as a potential reservoir for viral persistence and tissue dysfunction contributing to symptomology seen in Long COVID. To test this hypothesis, we analyzed subcutaneous adipose tissue (SAT) from two cohorts: participants with subacute COVID-19 (28-89 days post-infection) compared to pre-pandemic controls, and participants with Long COVID compared to those with those classified as "indeterminate" based on the RECOVER-Adult Long COVID Research Index (12-47 months post-infection). We found no evidence of persistent SARS-CoV-2 RNA in adipose tissue in any participant. SAT from participants with subacute COVID-19 displayed significant transcriptional remodeling, including depleted immune activation pathways and upregulated Hox genes and integrin interactions, suggesting resident immune cell exhaustion and perturbations in tissue function. However, no consistent changes in gene expression were observed between Long COVID samples and samples from indeterminant participants. Thus, SAT may contribute to inflammatory dysregulation following COVID-19, but does not appear to play a clear role in Long COVID pathophysiology. Further research is needed to clarify the role of adipose tissue in COVID-19 recovery.},
}

@article {pmid40500151,
year = {2025},
author = {Wei, Y and Horne, EM and Knight, R and Cezard, G and Walker, AJ and Fisher, L and Denholm, R and Taylor, K and Walker, V and Riley, S and Williams, DM and Willans, R and Davy, S and Bacon, S and Goldacre, B and Mehrkar, A and Denaxas, S and Greaves, F and Silverwood, RJ and Sheikh, A and Chaturvedi, N and Wood, AM and Macleod, J and Steves, C and Sterne, J and , },
title = {Patient characteristics associated with clinically coded long COVID: an OpenSAFELY study using electronic health records.},
journal = {BJGP open},
volume = {},
number = {},
pages = {},
doi = {10.3399/BJGPO.2024.0140},
pmid = {40500151},
issn = {2398-3795},
abstract = {BACKGROUND: Clinically coded long COVID cases in electronic health records are incomplete, despite reports of rising cases of long COVID.

AIM: To determine patient characteristics associated with clinically coded long COVID.

DESIGN & SETTING: With the approval of NHS England, we conducted a cohort study using electronic health records within the OpenSAFELY-TPP platform in England, to study patient characteristics associated with clinically coded long COVID from 29 January 2020 to 31 March 2022.

METHOD: We summarised the distribution of characteristics for people with clinically coded long COVID. We estimated age-sex adjusted hazard ratios and fully adjusted hazard ratios for coded long COVID. Patient characteristics included demographic factors, and health behavioural and clinical factors.

RESULTS: Among 17 986 419 adults, 36 886 (0.21%) were clinically coded with long COVID. Patient characteristics associated with coded long COVID included female sex, younger age (under 60 years), obesity, living in less deprived areas, ever smoking, greater consultation frequency, and history of diagnosed asthma, mental health conditions, pre-pandemic post-viral fatigue, or psoriasis. These associations were attenuated following two-doses of COVID-19 vaccines compared to before vaccination. Differences in the predictors of coded long COVID between the pre-vaccination and post-vaccination cohorts may reflect the different patient characteristics in these two cohorts rather than the vaccination status. Incidence of coded long COVID was higher in those with hospitalised COVID than with those non-hospitalised COVID-19.

CONCLUSIONS: We identified variation in coded long COVID by patient characteristic. Results should be interpreted with caution as long COVID was likely under-recorded in electronic health records.},
}

@article {pmid40496870,
year = {2025},
author = {Talamini, L and Fonseca, DLM and Kanduc, D and Chaloin, O and Verdot, C and Galmiche, C and Dotan, A and Filgueiras, IS and Borghi, MO and Meroni, PL and Gavrilova, NY and Ryabkova, VA and Churilov, LP and Halpert, G and Lensch, C and Thurner, L and Fong, SW and Ng, LFP and Rénia, L and Young, BE and Lye, DC and Lozano, JM and Cabral-Marques, O and Shoenfeld, Y and Muller, S},
title = {Long COVID-19 autoantibodies and their potential effect on fertility.},
journal = {Frontiers in immunology},
volume = {16},
number = {},
pages = {1540341},
pmid = {40496870},
issn = {1664-3224},
mesh = {Humans ; *COVID-19/immunology/complications ; *Autoantibodies/immunology/blood ; Male ; Female ; Animals ; *SARS-CoV-2/immunology ; Mice ; Spike Glycoprotein, Coronavirus/immunology ; *Fertility/immunology ; Adult ; Antibodies, Viral/immunology/blood ; Cross Reactions ; Middle Aged ; *Infertility, Male/immunology ; },
abstract = {Impaired spermatogenesis has been reported in coronavirus disease 2019 (COVID-19) patients. However, the impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on male fertility remains unclear. The purpose of this multicenter study was to investigate the possible impact of SARS-CoV-2 infection on male fertility and determine the potential reasons leading to impaired male reproductive functions. In silico approach identified ~60 amino acid sequences containing at least five continuous residues shared by SARS-CoV-2 Spike glycoprotein and spermatogenesis-linked proteins. Four synthetic peptides were tested with sera from independent cohorts of patients with acute and long COVID-19 syndrome (LCS), and naïve vaccinated subjects. Immunogenicity and pathogenicity studies were performed by immunizing mice with two selected peptides and testing the antigenicity of induced antibodies. While none of four peptides were recognized by antibodies from vaccinated people, infected patients exhibited high reactivity to peptide 4, and LCS patients, especially women, showed elevated antibody levels against peptide 2. Women with LCS and chronic fatigue syndrome had higher levels of peptide 2-reacting antibodies than those with idiopathic chronic fatigue syndrome. Noteworthy, peptide 2 antibodies showed, in in vitro experiment, a specific interaction with mouse testicular tissue antigens. These findings raise the possibility that cross-reactive epitopes between SARS-CoV-2 Spike protein and spermatogenesis-related antigens may affect infected patients' fertility, suggesting a potential for autoimmune responses with human consequences.},
}

Humans
*COVID-19/immunology/complications
*Autoantibodies/immunology/blood
Male
Female
Animals
*SARS-CoV-2/immunology
Mice
Spike Glycoprotein, Coronavirus/immunology
*Fertility/immunology
Adult
Antibodies, Viral/immunology/blood
Cross Reactions
Middle Aged
*Infertility, Male/immunology

@article {pmid40496528,
year = {2024},
author = {Akbari, B and Wang, JM and Baghaei-Yazdi, N and Lahooti, H and Sherman, JH},
title = {Systems Thinking, Causal Loop Diagram, and Systems Dynamic in Public Health Challenges: Navigating Long COVID Syndrome and Sense of Smell in LGBTQIA+ Communities.},
journal = {Public health challenges},
volume = {3},
number = {3},
pages = {e70004},
pmid = {40496528},
issn = {2769-2450},
abstract = {BACKGROUND: The coronavirus pandemic has profoundly affected global health, economic stability, and environmental sustainability. Despite these challenges, significant gaps in data remain, particularly in effectively assessing and engaging diverse communities such as color, LGBTQIA+ individuals, and low-income groups. This shortage of comprehensive research limits our capacity to undertake sensitive studies, specifically in dealing with the complexities of long COVID, which some individuals continue to suffer from after their initial recovery.

OBJECTIVE: This review delves into the ongoing repercussions of long-term COVID-19, a postinfectious syndrome marked by neurological symptoms such as cognitive deficits and sensory impairments, which may last well beyond the acute phase of the illness. These symptoms frequently overlap with mental health issues (e.g., anxiety and depression), which can aggravate the socioeconomic challenges faced by vulnerable populations, especially within the LGBTQA+ communities.

METHODS: To tackle these complex interactions, we have introduced a novel public health framework: model-based systems thinking (MBST), which incorporates System Dynamics and causal loop diagrams (CLD).

RESULTS AND DISCUSSION: The articles were selected on the basis of their discussion of COVID-19-associated anosmia, exploration of olfactory dysfunction alongside neurocognitive disorders, and the challenges experienced in LGBQA+ communities. This approach offers a robust framework for dissecting the intricate ties between socioeconomic factors, health outcomes, and the extended recovery trajectories associated with long-term COVID-19, with a particular focus on olfactory dysfunction. We also explore strategies to make our models more accessible to healthcare providers and the LGBTQA+ communities, encouraging its broader adoption.

CONCLUSION: Long COVID's impact on public health and marginalized communities highlights the urgent need for adopting systems thinking models. Additionally, this article calls for a concerted effort from all experts to foster multidisciplinary, team-based research and implement effective support measures for COVID-19 survivors across all communities, mainly focusing on the scientific, social, and behavioral challenges LGBTQIA+ and low-income individuals face.},
}

@article {pmid40495312,
year = {2025},
author = {Lai, CL and Wei, LC and Chiu, HJ},
title = {Expanding Perspectives on Long COVID: Multisystem Outcomes, Socioeconomic Factors, and Occupational Implications.},
journal = {American journal of industrial medicine},
volume = {},
number = {},
pages = {},
doi = {10.1002/ajim.23744},
pmid = {40495312},
issn = {1097-0274},
support = {//The authors received no specific funding for this work./ ; },
}

@article {pmid40324362,
year = {2025},
author = {Souza, JA and Pasqualoto, AS and Moraes, DAO and Cielo, CA},
title = {Lung Function, Voice, and Quality of Life in Post-COVID-19 Syndrome: A Follow-Up Study.},
journal = {Folia phoniatrica et logopaedica : official organ of the International Association of Logopedics and Phoniatrics (IALP)},
volume = {},
number = {},
pages = {1-17},
doi = {10.1159/000546258},
pmid = {40324362},
issn = {1421-9972},
abstract = {INTRODUCTION: COVID-19 sequelae may persist for years, particularly in individuals who experienced critical illness. This longitudinal study aimed to assess lung function, voice, and their correlation in post-COVID-19 syndrome (PCS) patients after intensive care discharge and evaluate the impact on general and voice-related quality of life (V-RQoL).

METHODS: Among the 284 patients who survived hospitalization at the University Hospital, 48 met the inclusion and exclusion criteria and participated in the study. Evaluations were conducted at an average of 4 and 8 months post-discharge and included assessments of dyspnea (modified Medical Research Council [mMRC] scale), spirometry, inspiratory (MIP), and expiratory (MEP) muscle strength, the 6-minute walk test (6MWT), maximum phonation time (MPT), sound pressure level (SPL), overall degree of dysphonia, general quality of life (Short Form Health Survey [SF-36]), and V-RQoL.

RESULTS: There was a reduction in mMRC, and an increase in MIP, MEP, 6MWT, MPT, and usual and minimum SPL. Women still exhibited reduced MPT, and both sexes had persistent dysphonia. A negative correlation was found between mMRC and MPT, and a positive correlation was found between 6MWT and MPT. Some SF-36 domains and the physical score of the V-RQoL for women remained reduced.

CONCLUSIONS: Eight months after COVID-19, there was an improvement in pulmonary function and MPT, but an increase in usual and minimum SPL and persistent dysphonia. These findings highlight the need for further research into persistent dysphonia as a significant aspect of PCS.},
}

@article {pmid40497072,
year = {2024},
author = {Mason, TB and Knight, TK and Lee, R and Herzig, SE and Meeker, D and Doctor, JN},
title = {Long covid and mental and physical health: A cross-sectional study of adults in California.},
journal = {Public health challenges},
volume = {3},
number = {1},
pages = {e152},
pmid = {40497072},
issn = {2769-2450},
abstract = {INTRODUCTION: Most people recover from COVID-19 infection over a short period of time, but a minority of individuals experience symptoms over a longer duration (≥28 days), termed "long covid." The purpose of the current study was to examine differences between individuals with a long covid diagnosis (i.e., diagnosed long covid), who believe they do or might have long covid (i.e., self-reported long covid), and people without long covid.

METHODS: Adults who had been diagnosed with COVID-19 completed survey questions about COVID-19 history, long covid, and mental and physical health. Analysis of covariance models showed an effect of long covid group (i.e., diagnosed, self-reported, and no long covid) with anxiety, depression, physical function, fatigue, social roles/activity limitations, and pain interference.

RESULTS: Analyses demonstrated that the self-reported long covid group had significantly greater anxiety and depression than the no long covid group. The diagnosed long covid group had significantly greater physical function problems than the no long covid group. Both diagnosed and self-reported long covid groups had significantly greater fatigue, social roles/activity limitations, and pain interference as compared to the no long covid group.

CONCLUSION: Overall, physical health challenges were reported by individuals with long covid, with fatigue being the most significant symptom. In addition, negative mental health was only experienced by individuals with self-reported long covid, suggesting the importance of long covid diagnosis and treatment.},
}

@article {pmid40496951,
year = {2023},
author = {Loreche, AM and Pepito, VCF and Dayrit, MM},
title = {Long Covid: A call for global action.},
journal = {Public health challenges},
volume = {2},
number = {1},
pages = {e69},
pmid = {40496951},
issn = {2769-2450},
abstract = {The COVID-19 pandemic has resulted in another global health crisis with millions of individuals with Long Covid experiencing disability, worse health-related quality of life, and productivity and income losses. Despite its impact on population health outcomes, health systems, and the economy, there remains a need for a global consensus on its standard definition, diagnostic approaches, and treatment plans to manage symptoms. In many low- and middle-income countries (LMICs), there are limited published estimates on Long Covid, limited studies on its diagnostics and therapeutics, and limited media and news coverage. We advocate for a global action plan and necessary investments on Long Covid research and treatment, meaningful involvement of patients and cooperation between high-income countries and LMICs, stronger and more effective public health communication surrounding the risks of Long Covid, and support toward financial risk protection as advocated by Universal Health Care.},
}

@article {pmid40492581,
year = {2025},
author = {Vlaming-van Eijk, LE and Tang, G and Bourgonje, AR and den Dunnen, WF and Hillebrands, JL and van Goor, H},
title = {Post-COVID-19 condition: clinical phenotypes, pathophysiological mechanisms, pathology, and management strategies.},
journal = {The Journal of pathology},
volume = {},
number = {},
pages = {},
doi = {10.1002/path.6443},
pmid = {40492581},
issn = {1096-9896},
abstract = {Post-COVID-19 condition (PCC), also known as long COVID, is a complex multiple organ system condition that can develop and persist for months after acute COVID-19. PCC encompasses a wide range of symptoms, resulting in heterogeneous clinical manifestations. These manifestations likely arise from diverse underlying pathophysiological mechanisms, which, in turn, are influenced by risk factors such as age, sex, and comorbidities. To this end, characterising clinical phenotypes of PCC is essential for deepening our understanding of its (potentially) distinct pathophysiological mechanisms and for advancing diagnostic and patient-tailored management strategies. PCC is thought to result from a complex interaction of various pathophysiological mechanisms, leading to functional and structural pathological alterations across multiple organ systems. Investigating these alterations is critical to improving our currently incomplete understanding of PCC's complex pathophysiology. This review provides an overview of the main clinical phenotypes of PCC, characterises these phenotypes by examining symptoms and signs, as well as the associated risk factors. The main hypothesised pathophysiological mechanisms are discussed by outlining the current knowledge on PCC pathology, focussing on the most commonly affected organ systems. Current PCC management includes supportive care such as physiotherapy and the repurposing of existing drugs primarily targeting persistence of SARS-CoV-2 (e.g. antivirals, monoclonal antibodies) and immune dysfunction (e.g. antiinflammatory drugs, immunomodulators). To date, prevention of SARS-CoV-2 infection remains critical, which can be achieved through effective public health measures and vaccination strategies. Finally, this review highlights current knowledge gaps and proposes future research directions to advance the understanding and treatment of PCC. © 2025 The Author(s). The Journal of Pathology published by John Wiley & Sons Ltd on behalf of The Pathological Society of Great Britain and Ireland.},
}

@article {pmid40492405,
year = {2025},
author = {Luker, S and Doveton, A and Manuel, K and Adey-Wakeling, Z and Jaggard, D and Crotty, M and Cameron, ID and Karnon, J and McNaughton, H and Ullah, S and Laver, K},
title = {Take charge after long COVID: a mixed methods randomised controlled pilot study protocol.},
journal = {Annals of medicine},
volume = {57},
number = {1},
pages = {2516694},
doi = {10.1080/07853890.2025.2516694},
pmid = {40492405},
issn = {1365-2060},
mesh = {Humans ; *COVID-19/rehabilitation/complications ; Pilot Projects ; Randomized Controlled Trials as Topic ; Prospective Studies ; SARS-CoV-2 ; *Self-Management/methods ; },
abstract = {INTRODUCTION: Post COVID-19 condition is a debilitating illness with over 200 symptoms across 10 organ systems and is presently impacting millions worldwide. The National Institute for Health and Care Excellence recommends a multidisciplinary treatment approach including person-centred self-management strategies, however evidence for specific programs is lacking. The Take Charge intervention is a person-centred, self-management rehabilitation approach that has been effective in recovery after stroke, but not yet tested in post COVID-19 condition.

METHODS & ANALYSIS: A prospective, single-centre, parallel, 2 group, mixed methods, randomized controlled trial with embedded process evaluation of the Take Charge intervention in individuals living with post COVID-19 condition. Participants will be at least 18 years of age, have a confirmed diagnosis of post COVID-19 condition with ongoing symptoms, and be known to a hospital clinic for assessment and treatment of patients with post-acute sequelae of COVID-19. The primary outcomes are the Modified COVID-19 Yorkshire Rehabilitation Scale and the COVID-19 Core Outcome Measure for Recovery. The secondary outcomes include physical and self-report measures, and feasibility measures. Qualitative interviews will also be conducted to understand the clinicians' and participants' experiences. Statistical analysis will be performed on an intention-to-treat basis using a multivariate mixed-effect linear regression model.

ETHICS & DISSEMINATION: This study adheres to the Declaration of Helsinki. This study was approved by the Southern Adelaide Clinical Human Research Ethics Committee (approval number: 2022/SSA00695/OFR: 219.22, protocol version 3.3 19 February 2024). The results will be disseminated in peer-reviewed journals, conference presentations, and media.},
}

Humans
*COVID-19/rehabilitation/complications
Pilot Projects
Randomized Controlled Trials as Topic
Prospective Studies
SARS-CoV-2
*Self-Management/methods

@article {pmid40491436,
year = {2025},
author = {Li, D and Zhang, DY and Chen, SJ and Lv, YT and Huang, SM and Chen, C and Zeng, F and Chen, RX and Zhang, XD and Xiong, JX and Chen, FD and Jiang, YH and Chen, Z and Mo, CY and Chen, JJ and Zhu, XL and Zhang, LJ and Bai, FH},
title = {Long-term alterations in gut microbiota following mild COVID-19 recovery: bacterial and fungal community shifts.},
journal = {Frontiers in cellular and infection microbiology},
volume = {15},
number = {},
pages = {1565887},
pmid = {40491436},
issn = {2235-2988},
mesh = {Humans ; *COVID-19/microbiology ; *Gastrointestinal Microbiome ; *Fungi/classification/genetics/isolation & purification ; Female ; *Bacteria/classification/genetics/isolation & purification ; Male ; Adult ; Middle Aged ; Feces/microbiology ; SARS-CoV-2 ; *Mycobiome ; Probiotics ; Metagenomics ; China ; },
abstract = {OBJECTIVE: COVID-19 has had a profound impact on public health globally. However, most studies have focused on patients with long COVID or those in the acute phase of infection, with limited research on the health of individuals who have recovered from mild COVID-19. This study investigates the long-term changes in bacterial and fungal communities in individuals recovering from mild COVID-19 and their clinical relevance.

METHODS: Healthy individuals from Hainan Province were enrolled before the COVID-19 outbreak, along with individuals recovering from COVID-19 at 3 months and 6 months post-recovery. Stool, blood samples, and metadata were collected. Metagenomic sequencing and Internal Transcribed Spacer (ITS) analysis characterized bacterial and fungal communities, while bacterial-fungal co-occurrence networks were constructed. A random forest model evaluated the predictive capacity of key taxa.

RESULTS: The gut microbiota of COVID-19 recoverees differed significantly from that of healthy individuals. At 3 months post-recovery, probiotics (e.g., Blautia massiliensis and Kluyveromyces spp.) were enriched, linked to improved metabolism, while at 6 months, partial recovery of probiotics (e.g., Acidaminococcus massiliensis and Asterotremella spp.) was observed alongside persistent pathogens (e.g., Streptococcus equinus and Gibberella spp.). Dynamic changes were observed, with Acidaminococcus massiliensis enriched at both baseline and 6 months but absent at 3 months. Co-occurrence network analysis revealed synergies between bacterial (Rothia spp.) and fungal (Coprinopsis spp.) taxa, suggesting their potential roles in gut restoration. The bacterial random forest model (10 taxa) outperformed the fungal model (8 taxa) in predicting recovery status (AUC = 0.99 vs. 0.80).

CONCLUSION: These findings highlight the significant long-term impacts of mild COVID-19 recovery on gut microbiota, with key taxa influencing metabolism and immune regulation, supporting microbiome-based strategies for recovery management.},
}

Humans
*COVID-19/microbiology
*Gastrointestinal Microbiome
*Fungi/classification/genetics/isolation & purification
Female
*Bacteria/classification/genetics/isolation & purification
Male
Adult
Middle Aged
Feces/microbiology
SARS-CoV-2
*Mycobiome
Probiotics
Metagenomics
China

@article {pmid40491049,
year = {2025},
author = {Nlandu, YM and Makulo, JR and Essig, M and Engole, YM and Mboliasa, MI and Nkodila, AN and Mokoli, VM and Nkondi, CN and Longo, AL and Kajingulu, FM and Ilunga, CK and Zinga, CV and Kadima, EM and Bukabau, JB and Ahuka, SM and Lumaka, A and Nseka, NM and Sumaili, EK},
title = {Longitudinal kidney outcomes in surviving COVID-19 patients in Africa: a prospective Congolese single-center cohort study.},
journal = {Renal failure},
volume = {47},
number = {1},
pages = {2514185},
doi = {10.1080/0886022X.2025.2514185},
pmid = {40491049},
issn = {1525-6049},
mesh = {Humans ; *COVID-19/complications/epidemiology ; Male ; Female ; Middle Aged ; Prospective Studies ; *Renal Insufficiency, Chronic/epidemiology/physiopathology/etiology ; *Acute Kidney Injury/epidemiology/physiopathology/etiology ; Glomerular Filtration Rate ; Incidence ; Aged ; Adult ; SARS-CoV-2 ; Intensive Care Units ; Longitudinal Studies ; Risk Factors ; Creatinine/blood ; },
abstract = {OBJECTIVES: The aim of this study was to determine kidney outcomes and associated factors in COVID-19 patients discharged from intensive care unit (ICU) in an African setting.

METHODS: In a prospective observational single-center cohort study, we compared the rate of decline in eGFRcr and the incidence of CKD between COVID-19 patients with and without AKI after discharge from ICU. Kidney function decline (KFD) and chronic kidney disease (CKD) during 2 years of follow-up were defined as eGFR decline ≥ 30% and eGFR less than 60 mL/min/1.73 m[2] and/or the presence of proteinuria, respectively. The association between COVID-19-associated AKI (COVID-AKI) and eGFR decline after hospital discharge was assessed using mixed-effects models. Logistic regression and Cox regression were used to define factors associated with KFD and CKD.

RESULTS: The incidence of KFD and CKD at two years of follow-up was 23% and 0.73 per 100 patient months (P-M), respectively. Patients with COVID-AKI had a greater decline in eGFR (-11.09 mL/min/1.73 m[2]/year [95% CI, -3.65 to-1.02]; p ˂0.001) and CKD incidence (3.11 per 100 P-M vs 0.18 per 100 P-M, p = 0.003) in the fully adjusted model controlling for comorbidities and peak creatinine level. AKI was associated with KFD (aOR: 3.46 [2.40-5.24], p = 0.001) and CKD (aHR: 3.37 [2.35-5.41], p = 0.003).

CONCLUSION: KFD and CKD are common in COVID-19 survivors. AKI was associated with both KFD and CKD after ICU discharge. Kidney care after COVID-19 needs to be organized in the context of AKI.},
}

Humans
*COVID-19/complications/epidemiology
Male
Female
Middle Aged
Prospective Studies
*Renal Insufficiency, Chronic/epidemiology/physiopathology/etiology
*Acute Kidney Injury/epidemiology/physiopathology/etiology
Glomerular Filtration Rate
Incidence
Aged
Adult
SARS-CoV-2
Intensive Care Units
Longitudinal Studies
Risk Factors
Creatinine/blood

@article {pmid40489988,
year = {2025},
author = {Venkatesan, P},
title = {US Government cuts funding for long COVID research.},
journal = {The Lancet. Microbe},
volume = {},
number = {},
pages = {101166},
doi = {10.1016/j.lanmic.2025.101166},
pmid = {40489988},
issn = {2666-5247},
}

@article {pmid40488309,
year = {2025},
author = {Bennett, J and Jeffreys, M and Waa, A and Zhang, J and Brooks, AES and Hockey, L and Kvalsvig, A and Baker, MG},
title = {Post-Covid-19 Symptoms in Children: A Cross-Sectional Survey.},
journal = {Journal of paediatrics and child health},
volume = {},
number = {},
pages = {},
doi = {10.1111/jpc.70104},
pmid = {40488309},
issn = {1440-1754},
support = {//Ministry of Health, New Zealand/ ; },
abstract = {AIM: To assess children's self or parental-rated health following Aotearoa New Zealand's (NZ) first widespread community transmission of SARS-CoV-2 in February 2022.

METHODS: This cross-sectional study recruited participants aged 3-20 years who had consented to be contacted after taking part in the NZ Health Survey. Participants over 15 years or guardians of younger children were surveyed by telephone between November 2022 and April 2023. Ordinal logistic regression was used to estimate the effect of Covid-19 infection on self-reported health.

RESULTS: The study included 4264 children and young adults, with 70.6% reporting having tested positive for Covid-19 at least once (via PCR or RAT test). Almost one-quarter (24.5%) reported more frequent coughs, colds and stomach bugs after Covid-19 infection. One-fifth reported headaches (21.7%), fatigue (20.6%) or stomach aches (14.6%) and 13.1% reported anxiety that was new since having Covid-19. At baseline, there were no significant differences between the self-rated health status of those children who later had Covid-19 and those who did not (p = 0.5274). Following widespread SARS-CoV-2 transmission, those who reported having had Covid-19 were significantly more likely to report a poorer health status than those who did not (p < 0.0001).

CONCLUSIONS: Greater than one-fifth of NZ children reported persisting symptoms after Covid-19 infection. Post-Covid-19 symptoms impacted the quality of children's day-to-day lives. Preventing infection is key to preventing post-Covid-19 symptoms.},
}

@article {pmid40488276,
year = {2025},
author = {Liu, JK and Zhou, ZS and Wang, SH and Zuo, SY and Lu, XF and He, Y and Tang, H and Xie, Y and Xie, MX and Zhang, XL},
title = {SARS-CoV-2 N protein interacts with Nav1.7 to promote pathological pain.},
journal = {Pain},
volume = {},
number = {},
pages = {},
doi = {10.1097/j.pain.0000000000003675},
pmid = {40488276},
issn = {1872-6623},
abstract = {Coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has led to a global health crisis, with many patients experiencing not only acute neurological and sensory symptoms but also persistent sensory abnormalities, commonly referred to as long COVID sequelae. The mechanisms underlying somatosensory abnormalities induced by SARS-CoV-2 remain largely unclear. In this study, we investigate the role of the SARS-CoV-2 nucleocapsid (N) protein in pain regulation. Our data show that SARS-CoV-2 N protein exacerbates pathological pain in mouse models of bone cancer, chemotherapy, neuropathic, and inflammatory, and promotes the chronification of acute inflammatory pain. We also identify a potential interaction between the N protein and Nav1.7 in dorsal root ganglion neurons from mice, monkeys, and humans. Furthermore, the N protein significantly increases Nav1.7 currents in dorsal root ganglion neurons from both mice and monkeys by delaying Nav1.7 inactivation without altering its expression or membrane trafficking. This modulation of Nav1.7 function by the N protein not only intensifies pain hypersensitivity but also prolongs the duration of pain, potentially facilitating the transition from acute to chronic pain. Our findings underscore the importance of vigilant management of SARS-CoV-2 infection in patients with pathological pain and suggest potential therapeutic targets for mitigating COVID-19-related pain.},
}

@article {pmid40485204,
year = {2025},
author = {Crea, F},
title = {Focus on trials: interventional cardiology, ischaemic heart disease, and long COVID.},
journal = {European heart journal},
volume = {46},
number = {22},
pages = {2037-2041},
doi = {10.1093/eurheartj/ehaf339},
pmid = {40485204},
issn = {1522-9645},
}

@article {pmid40485161,
year = {2025},
author = {O'Donnell, AN},
title = {Contextualizing Long COVID.},
journal = {American journal of health promotion : AJHP},
volume = {39},
number = {6},
pages = {951-953},
doi = {10.1177/08901171241308066},
pmid = {40485161},
issn = {2168-6602},
}

@article {pmid40485160,
year = {2025},
author = {Conard, S and Cunningham-Hill, M and Kusti, M and Mukherji, S and Rawlins, W and Schwartz, S and , },
title = {Employers' Long Game for Long Covid.},
journal = {American journal of health promotion : AJHP},
volume = {39},
number = {6},
pages = {965-968},
doi = {10.1177/08901171241308066c},
pmid = {40485160},
issn = {2168-6602},
}

@article {pmid40485158,
year = {2025},
author = {Unger, ER},
title = {Long COVID as an Infection-Associated Chronic Condition: Implications.},
journal = {American journal of health promotion : AJHP},
volume = {39},
number = {6},
pages = {960-965},
doi = {10.1177/08901171241308066b},
pmid = {40485158},
issn = {2168-6602},
}

@article {pmid40485157,
year = {2025},
author = {O'Donnell, AN and Berghaus, M and Simon, ID},
title = {Long COVID: Context, Considerations, and Calls for Change.},
journal = {American journal of health promotion : AJHP},
volume = {39},
number = {6},
pages = {953-960},
doi = {10.1177/08901171241308066a},
pmid = {40485157},
issn = {2168-6602},
}

@article {pmid40485127,
year = {2025},
author = {Felton, L and Kalfas, M and Brewin, D and Beckwith, C and Khan, T and Jolley, C and Hart, N and Duncan, EL and Nicholson, T and Witard, O and Moore, J and Metcalfe, A and Rafferty, GF and Chalder, T},
title = {Codeveloping a Novel Intervention for People With Post-COVID Condition: The Balance-ACT Study.},
journal = {Health expectations : an international journal of public participation in health care and health policy},
volume = {28},
number = {3},
pages = {e70320},
doi = {10.1111/hex.70320},
pmid = {40485127},
issn = {1369-7625},
support = {//This research was funded Guy's and St Thomas' Charity (COV210803). T.C. is part-funded by the National Institute for Health Research (NIHR) Biomedical Research Centre at a UK NHS Foundation Trust and received additional COVID-related grants from UKRI. E.L.D. has received funding for research into Long COVID from the Chronic Disease Research Foundation, specifically for the genetics of PCS/ongoing symptomatic COVID-19. Has also received funding from the BMA Foundation and Guy's and St Thomas' Charity for Long COVID-related research. C.J. has received funding from the BMA Foundation for research into Long COVID./ ; },
mesh = {Humans ; *COVID-19/complications/psychology ; Qualitative Research ; *Acceptance and Commitment Therapy/methods ; Female ; Male ; Fatigue/therapy/etiology ; Middle Aged ; SARS-CoV-2 ; Adult ; Post-Acute COVID-19 Syndrome ; },
abstract = {INTRODUCTION: Some people experience persistent symptoms, such as fatigue, brain fog and breathlessness, long after the onset of COVID-19 infection. This is known as the post-COVID syndrome (PCS). We developed a unique and holistic psycho-physiological intervention that integrates Acceptance and Commitment Therapy (ACT), a structured talking therapy, with principles of homeostasis. This aims to provide targeted support and treatment strategies for effectively managing the long-term repercussions of the condition and improve patient outcomes.

METHODS: This empirical study was informed by theory and other research strands. These strands included a qualitative study of people with lived experience, a scoping review of interventions for fatigue (including rehabilitation) and insights from a patient and public involvement (PPI) group. The PPI group were actively involved in the development of the intervention, manuals and overall study management, ensuring it was relevant, ethical and aligned with patient preferences and needs.

RESULTS: The qualitative study uncovered the tangible contexts in which the intervention would be implemented, and the attraction of Balance-ACT for those living with PCS. People living with PCS (n = 19) and health care professionals (HCPs; n = 12) provided overall endorsement for the intervention. Through an iterative process, their feedback, alongside input from the PPI group, informed the development of key materials, including a therapist manual, participant handbook, mindfulness recordings and an animation. Therapists were trained, and a novel fidelity measure was developed to ensure adherence to Balance-ACT principles.

CONCLUSION: We used an iterative approach to develop the Balance-ACT intervention, which was acceptable to patients and HCPs. Subsequent research will examine the efficacy of Balance-ACT.

This article represents work conducted as part of the Balance-ACT project. People with the post-COVID condition (PCC) were involved throughout all aspects of this study, in line with the National Institute for Health and Care Research framework, and contributed in several key ways. It ensured the research captured a diverse range of illness experiences. The study design was refined and addressed potential barriers to engagement. Patient-friendly language was used to improve accessibility, making the study more inclusive. Additionally, the outcome measures were informed by patient input to enhance their relevance. Finally, dissemination was guided to ensure that the findings were both useful and accessible, using clear language in reporting and incorporating feedback from patient representatives on drafts to ensure clarity. C.B. recorded the mindfulness exercises and was a core part of the management team throughout.},
}

Humans
*COVID-19/complications/psychology
Qualitative Research
*Acceptance and Commitment Therapy/methods
Female
Male
Fatigue/therapy/etiology
Middle Aged
SARS-CoV-2
Adult
Post-Acute COVID-19 Syndrome

@article {pmid40485056,
year = {2025},
author = {Ribeiro-Carvalho, A and Prado, MF and Marcelo, GG and Viveiros, L and de Andrade Fernandes, M and Nórte, CE},
title = {Cognitive and Emotional Health in Long COVID: a Cross-Sectional Study in Brazil.},
journal = {Archives of clinical neuropsychology : the official journal of the National Academy of Neuropsychologists},
volume = {},
number = {},
pages = {},
doi = {10.1093/arclin/acaf054},
pmid = {40485056},
issn = {1873-5843},
abstract = {OBJECTIVE: Long COVID is characterized by persistent symptoms following a COVID-19 infection, including cognitive and emotional impairment. Brazil has one of the highest rates of COVID-19 infections globally, but there are still few studies assessing the long-term impact of the disease on mental health in this population. In the present study, we evaluated cognition and emotional symptoms in patients with cognitive complaints after COVID infection in Rio de Janeiro, Brazil.

METHOD: Cognitive and emotional assessments were performed individually (n = 114) using the Cognitive Screening (TRIACOG) and the Depression, Anxiety, and Stress Scale-21 (DASS-21) in participants with long COVID. Of the total subjects, 78% were women, with a mean age of 50.4 ± 16 years. A total of 72.6% received treatment at home, whereas 28% were hospitalized during the acute phase of the infection.

RESULTS: Our data revealed a high prevalence of cognitive and emotional impairment. Approximately 66.7% exhibited symptoms suggestive of depression, 55.9% anxiety disorder, and 65.7% stress. Notably, executive functions and memory were the most affected cognitive domains. Intriguingly, the time from infection onset to assessment did not appear to influence cognitive performance, suggesting that cognitive impairment associated with COVID-19 may persist as a long-term comorbidity. Furthermore, hospitalization did not affect cognitive or DASS-21 scores.

CONCLUSIONS: These findings underscore the importance of investigating the long-term impacts of COVID-19 on mental health. Assessing emotional and cognitive functions after COVID-19 is crucial for developing therapeutic responses, both on an individual level and from a public health perspective.},
}

@article {pmid40483989,
year = {2025},
author = {Mendenhall, E and Banerjee, S and Wahlberg, A},
title = {Interembodiment among Long Haulers and their carers.},
journal = {Social science & medicine (1982)},
volume = {381},
number = {},
pages = {118282},
doi = {10.1016/j.socscimed.2025.118282},
pmid = {40483989},
issn = {1873-5347},
abstract = {Millions of people around the world experience the lingering disabling health effects of the pandemic, rendering new forms of chronic living. Chronic living is an interembodied experience, where people attend to, experience, and take care of themselves and their medical conditions with the indispensable help of loved ones, in differing life conditions, and with stratified access to (lifesaving) medical treatment and care. We suggest that this form of chronicity inherently involves caregivers who experience chronic disruption and dynamism. Nested within a study of Long Haulers involving more than 100 interviews, we draw from three case studies that illuminate an interdependence among patients and their carers where not only their social lives are mutually reinforced with others but their bodies are, too. We employ a theory of interembodiment to reveal how sick roles become essential elements of everyday life that are emotional, material, social and biological. Our first case study reveals an intergenerational connection between a Long Hauler and her children who are also living with the condition. The second case reveals how deeply illness is embodied among and between a Long Hauler and her caretaker who is battling cancer-both whose health futures remain uncertain. The third case how a Long Hauler who cares for her son with dementia receives support and legitimacy from a digital community. These examples demonstrate various forms of interembodiment that become realized in chronic living as people ill from Long Covid navigate the layers of support in the home, community, and clinic. As a consequence, people living with complex chronic conditions like Long Covid often - and ironically - must expend considerable amounts of energy in trying to have their condition acknowledged, treated, and cared for when engaging with family, friends, employers or healthcare professionals.},
}

@article {pmid40483738,
year = {2025},
author = {Aldujeli, A and Tsai, TY and Haq, A and Puipaite, K and Braukyliene, R and Tatarunas, V and Zaliaduonyte, D and Unikas, R and Renkens, M and Revaiah, PC and Miyashita, K and Tobe, A and Oshima, A and Sharif, F and Lesauskaite, V and Spertus, JA and Garg, S and Onuma, Y and Brilakis, ES and Serruys, PW},
title = {Impact of severe COVID-19 infection on coronary microvascular dysfunction in ANOCA patients: A cross-sectional study.},
journal = {Atherosclerosis},
volume = {407},
number = {},
pages = {120389},
doi = {10.1016/j.atherosclerosis.2025.120389},
pmid = {40483738},
issn = {1879-1484},
abstract = {BACKGROUND AND AIMS: Millions of survivors from severe COVID-19 infection suffer from residual symptoms including anginal chest pain. The pathophysiological mechanisms, particularly the role of coronary microvascular dysfunction (CMD), however, remain elusive. We compared the incidence and endotypes of CMD in patients with angina without obstructive coronary artery disease (ANOCA) between those who had a history of severe COVID-19 infection (COVID group, defined as COVID patients needing supplemental oxygen therapy with SpO2 < 90 % on room air), versus those who didn't (Control group).

METHODS: This multicentre, prospective cohort study enrolled 117 ANOCA patients (COVID group n = 59, Control group n = 58). All participants underwent exercise stress testing and invasive coronary physiology assessment to measure coronary flow reserve (CFR), and the index of microvascular resistance (IMR). CMD was defined as CFR<2.0 or IMR≥25. Patients also completed the modified Seattle Angina Questionnaire (SAQ-7) after invasive functional assessment.

RESULTS: CMD was diagnosed in 42 patients (35.9 %): 47.5 % in the COVID group and 24.1 % in the Control group (p = 0.015). The prevalence of structural CMD was significantly higher in the COVID group (28.8 % vs. 5.2 %, p < 0.001). The median IMR was significantly higher in the COVID versus the Control group (20.00 [15.00, 42.00] vs. 17.00 [12.00, 21.00], p = 0.002) while no significant differences were observed in CFR and FFR. The SAQ-7 summary scores (54.44 vs. 59.44, p = 0.003) and physical limitation and quality-of-life domain scores were all significantly lower in the COVID group.

CONCLUSIONS: The incidence of CMD, particularly structural CMD, was higher in ANOCA patients with a history of severe COVID-19 infection, suggesting a link between persistent angina and CMD in this population.},
}

@article {pmid40482860,
year = {2025},
author = {Baalbaki, N and Blankestijn, JM and Kazer, SW and Abdel-Aziz, MI and Bloemsma, LD and Bogaard, HJ and Cornelissen, MEB and van Drunen, CM and van Egmond, D and Nossent, EJ and Walsh, JML and Ordovas-Montanes, J and Golebski, K and Maitland-van der Zee, AH and , },
title = {Towards precision medicine: inflammatory nasal epithelial transcriptomic profiles in long COVID.},
journal = {The Journal of allergy and clinical immunology},
volume = {},
number = {},
pages = {},
doi = {10.1016/j.jaci.2025.05.023},
pmid = {40482860},
issn = {1097-6825},
abstract = {RATIONALE AND OBJECTIVES: Little is known about the role of the nasal epithelium in long COVID. This study aimed to assess nasal epithelial transcriptomes of long COVID(LC) patients to unravel pathophysiological mechanisms for disease management.

METHODS: Medical data and transcriptomes were obtained from participants in the 'Precision Medicine for more Oxygen'(P4O2) COVID-19 cohort, at 3-6(n=40) and 12-18(n=15) months post-COVID. Cell type frequencies were estimated by deconvolution from a single-cell dataset. Hierarchical clustering identified transcriptomic clusters and cellular clusters from which differences in gene expression, gene set enrichment and pulmonary phenotypes were assessed. Functional validation was performed using CRISPR-Cas9 gene editing and in vitro assays in primary mutant nasal epithelium and gene expression comparisons were made to healthy controls(n=51).

RESULTS: At 3-6 and 12-18 months, transcriptomes associated with inflammatory pathways(padj<0.05). Transcriptomic and cellular clusters were identified and were related to inflammation and ciliogenesis(padj<0.05). Comparison of transcriptomes of patients with and without pulmonary radiological abnormalities resulted in 613 significantly differentially expressed genes(padj<0.05). Upregulated inflammatory genes were observed in patients with abnormalities. SMURF1 expression was significantly increased in patients with compared to those without abnormalities and healthy controls. SMURF1[-/-] mutant nasal epithelial cells produced significantly lower levels(p<0.05) of pro-inflammatory cytokines upon virus exposure compared to controls.

CONCLUSION: Nasal epithelium in LC exhibits persistent inflammatory states. SMURF1 upregulation potentially contributes to an exacerbated inflammatory state in nasal epithelium of patients with radiological abnormalities. This study demonstrates the importance of understanding these inflammatory profiles within a clinical context and emphasizes the need for further assessment and validation of SMURF1's role in LC.},
}

@article {pmid40482598,
year = {2025},
author = {Pelà, G and Frizzelli, A and Pisi, R and Calzetta, L and Marchese, A and Chetta, A and Aiello, M},
title = {Post-COVID-19 exaggerated exertional tachycardia: Relationship with pulmonary and cardiac sequelae.},
journal = {Heart & lung : the journal of critical care},
volume = {73},
number = {},
pages = {228-235},
doi = {10.1016/j.hrtlng.2025.05.017},
pmid = {40482598},
issn = {1527-3288},
abstract = {BACKGROUND: Long-COVID patients frequently complain of an Exaggerated Exertional Tachycardia (EET) and may represent a specific phenotype of post-COVID tachycardia syndrome. So far, no studies have investigated the factors contributing to EET.

OBJECTIVES: To determine the predictor factors of EET, seventy-nine Long-COVID-19 patients underwent comprehensive cardiologic and respiratory evaluations at follow-up visit after a median of 23 weeks from the acute phase of the disease.

METHODS: The heart rate (HR) response to exercise was assessed by the 6-minute walk test (6MWT), stratifying patients into two groups: EET and NET (normal exertional tachycardia).

RESULTS: The EET group was older, had higher body mass index and systolic blood pressure, with more comorbidities and lower resting HR, when compared to the NET group. The EET group also showed higher High-Resolution computed tomography scores and D-dimer levels during the acute phase compared to NET. At follow-up visit EET patients exhibited higher left ventricular mass and reduced systolic and diastolic function in both ventricles, as assessed by Doppler tissue echocardiography (myocardial S and E' waves). We found a significant reduction in lung diffusion capacity and in mean oxygen saturation during the 6MWT in EET patients compared to NET ones. Stepwise logistic regression analysis identified the mean oxygen saturation during the 6MWT as the predictor of abnormal HR response to exercise.

CONCLUSIONS: We found that the exaggerated heart response to exercise in Long COVID-19 patients is associated to an impaired pulmonary function at rest and is predicted by the oxygen exercise-induced desaturation.},
}

@article {pmid40481718,
year = {2025},
author = {Pérez-Cózar, F and Cal-Sabater, P and Rybakowska, P and Arribas-Rodríguez, E and Fiz-López, A and García-Blesa, A and Hernández, J and Gutiérrez, S and Tellería, P and Novoa, C and Rello, SR and De Prado, Á and Pérez, C and Sedano, R and Domínguez-Gil, M and Peñarrubia, MJ and Pieren, DKJ and Garrote, JA and Arranz, E and Eiros, JM and Tamayo, E and Orduña, A and van Els, CACM and Dueñas, C and Marañón, C and Bernardo, D and Cuesta-Sancho, S},
title = {High-Dimensional Immunophenotyping of Post-COVID-19 and Post-Influenza Patients Reveals Persistent and Specific Immune Signatures After Acute Respiratory Infection.},
journal = {Journal of medical virology},
volume = {97},
number = {6},
pages = {e70435},
doi = {10.1002/jmv.70435},
pmid = {40481718},
issn = {1096-9071},
support = {//This study has been funded through Programa Estratégico Instituto de Biomedicina y Genética Molecular (IBGM Junta de Castilla y León. Ref. CCVC8485), Junta de Castilla y León (Proyectos COVID 07.04.467B04.74011.0) and the European Commission-NextGenerationEU (Regulation EU 2020/2094), through CSIC's Global Health Platform (PTI Salud Global: SGL21-03-026, SGL2021-03-038, COVID-19-117 and SGL2103015)./ ; },
mesh = {Humans ; *COVID-19/immunology ; Male ; Middle Aged ; Female ; Immunophenotyping/methods ; *Influenza, Human/immunology ; Adult ; Aged ; Leukocytes, Mononuclear/immunology ; SARS-CoV-2/immunology ; *Respiratory Tract Infections/immunology ; Post-Acute COVID-19 Syndrome ; },
abstract = {Long-term consequences of SARS-CoV-2 infection are unknown since recovered individuals can experience symptoms and latent viral reactivation for months. Indeed, acute post-infection sequelae have also been observed in other respiratory viral infections, including influenza. To characterize post-COVID-19 and post-influenza induced alterations to the cellular immunome, peripheral blood mononuclear cells (PBMCs) were obtained from patients 3 months after recovery from COVID-19 (n = 93) or influenza (n = 25), and from pre-pandemic healthy controls (n = 25). PBMCs were characterized using a 40-plex mass cytometry panel. Principal component analysis (PCA), classification models, and K-means clustering were subsequently applied. PCA identified distinct immune profiles between cohorts, with both post-COVID and post-flu patients displaying an altered chemokine receptor expression compared to pre-pandemic healthy controls. These alterations were more prominent in post-COVID patients since they exhibited highly increased expression of chemokine receptors CXCR3 and CCR6 by various lymphoid populations, while post-influenza patients mainly showed a decrease in CCR4 expression by naïve T cells, monocytes, and conventional dendritic cells. Classification models using immunophenotyping data confirm the three groups, while K-means clustering revealed two subgroups among post-COVID patients, with younger patients showing more pronounced immune alterations in the chemokine receptor profile, independently of long COVID symptoms. In conclusion, post-COVID and post-influenza patients exhibit distinct and unique persistent immune alterations. Understanding these altered immune profiles can guide targeted therapies for post-COVID syndrome and highlight differences in immune recovery from various respiratory infections.},
}

Humans
*COVID-19/immunology
Male
Middle Aged
Female
Immunophenotyping/methods
*Influenza, Human/immunology
Adult
Aged
Leukocytes, Mononuclear/immunology
SARS-CoV-2/immunology
*Respiratory Tract Infections/immunology
Post-Acute COVID-19 Syndrome

@article {pmid40481619,
year = {2025},
author = {Linton, J and Carmichael, J and Newlands, F and Puri, A and Fox-Smith, L and Pinto Pereira, SM and Coughtrey, A and Shafran, R and Stephenson, T},
title = {Pre-Pandemic Prevalence of Post COVID-19 Condition Symptoms in Adolescents.},
journal = {Acta paediatrica (Oslo, Norway : 1992)},
volume = {},
number = {},
pages = {},
doi = {10.1111/apa.70123},
pmid = {40481619},
issn = {1651-2227},
support = {COV-LT-0022//UK Research and Innovation/ ; 183885//Beryl Alexander Charity PhD Studentship/ ; MR/Y009398/1//UK Medical Research Council Senior Non-clinical Fellowship/ ; //NIHR Great Ormond Street Hospital Biomedical Research Centre/ ; },
abstract = {AIM: The emergence of post COVID-19 condition (PCC) within adolescents has been characterised by a wide range of symptoms, raising concerns for young people's health and quality of life. However, many symptoms are non-specific and there is considerable variation in symptom reporting. It is essential to understand how rates of these symptoms compare to the pre-pandemic health of adolescents.

METHODS: A systematic search of academic literature and websites, using traditional and automated search systems, was undertaken to identify symptoms described in adolescents aged 10-19 years in the 30 years up to and including 2019. Studies were reviewed and symptom prevalence data extracted.

RESULTS: Twenty-five sources (n = 483 097 participants) met the inclusion criteria, including longitudinal and cross-sectional study designs. The description and prevalence of symptoms varied widely, but there was a high pre-pandemic median prevalence of cough (13.6%), headache (30.0%), and fatigue (20.5%). These high prevalences highlight a gap in understanding of pre-pandemic adolescent health and the need for comprehensive, serial symptom profiling.

CONCLUSION: These findings provide a baseline of adolescent symptomatology prior to the emergence of PCC and provide important context for interpreting ongoing COVID symptoms. Data on PCC in adolescents should consider pre-pandemic symptom prevalence.},
}

@article {pmid40481056,
year = {2025},
author = {Duong, KE and Lu, JY and Wang, S and Duong, TQ},
title = {Incidence and risk factors of new clinical disorders in patients with COVID-19 hyperinflammatory syndrome.},
journal = {Scientific reports},
volume = {15},
number = {1},
pages = {19892},
pmid = {40481056},
issn = {2045-2322},
mesh = {Humans ; *COVID-19/epidemiology/complications ; Female ; Middle Aged ; Male ; Incidence ; Risk Factors ; Aged ; Adult ; SARS-CoV-2 ; Comorbidity ; *Inflammation/epidemiology ; Pulmonary Disease, Chronic Obstructive/epidemiology ; Cardiovascular Diseases/epidemiology ; Asthma/epidemiology ; },
abstract = {This study investigated new incident clinical disorders in patients with COVID-19-related hyperinflammatory syndrome (cHIS) 3.5 years post infection. We analyzed 14,335 patients hospitalized with COVID-19 from March-2020 to July-2023. cHIS was defined based on a point system that included elevated body temperature, macrophage activation, hematological dysfunction, coagulopathy, and hepatic enzyme. Outcomes were newly diagnosed disorders of hypertension, diabetes, cardiovascular diseases, chronic kidney disease (CKD), chronic obstructive pulmonary disease (COPD), and asthma post COVID-19. Cumulative incidences and hazard ratios were computed. Compared to non-cHIS patients, cHIS patients were older, fewer female, more Blacks, higher prevalence of pre-existing comorbidities. Patients with cHIS had higher risk of developing cardiovascular disease (HR = 1.24 [1.04,1.47] p < 0.05), CKD (1.24 [1.01, 1.53] p < 0.05), and obesity (1.61 [1.31,1.98], p < 0.001) but not hypertension, diabetes, COPD, and asthma. Cumulative incidence analysis showed that patients ≥ 50 years old showed markedly higher new incidences of individual new disorders compared to patients < 50 years old. COVID-19 related hyperinflammatory syndrome confers a significantly higher risk for developing new common clinical disorders. Identifying risks for developing new clinical disorders in patients with COVID-19 related hyperinflammatory syndrome may encourage diligent follow-up of high-risk individuals.},
}

Humans
*COVID-19/epidemiology/complications
Female
Middle Aged
Male
Incidence
Risk Factors
Aged
Adult
SARS-CoV-2
Comorbidity
*Inflammation/epidemiology
Pulmonary Disease, Chronic Obstructive/epidemiology
Cardiovascular Diseases/epidemiology
Asthma/epidemiology

@article {pmid40480667,
year = {2025},
author = {Nyaaba, GN and Torensma, M and Goldschmidt, MI and Nørredam, M and Moseholm, E and Appelman, B and Rostila, M and Tieleman, P and Biere-Rafi, S and Prins, M and Beune, E and Agyemang, C},
title = {Experiences of stigma and access to care among long COVID patients: a qualitative study in a multi-ethnic population in the Netherlands.},
journal = {BMJ open},
volume = {15},
number = {6},
pages = {e094487},
doi = {10.1136/bmjopen-2024-094487},
pmid = {40480667},
issn = {2044-6055},
mesh = {Humans ; Netherlands/epidemiology ; Female ; *COVID-19/ethnology/psychology/therapy ; Male ; *Health Services Accessibility ; *Social Stigma ; Qualitative Research ; Middle Aged ; Cross-Sectional Studies ; Adult ; Morocco/ethnology ; Turkey/ethnology ; *Ethnicity/psychology ; SARS-CoV-2 ; Aged ; },
abstract = {OBJECTIVE: This study explored the experience of stigma and access to healthcare by persons with long COVID from the majority Dutch and two ethnic minority populations (Turkish and Moroccan) living in the Netherlands.

DESIGN: This was a cross-sectional qualitative study that employed inductive and deductive thematic approaches to data analysis using MAXQDA.

SETTING AND PARTICIPANTS: Between October 2022 and January 2023, 23 semi-structured interviews were conducted with participants of Dutch, Moroccan and Turkish ethnic origins with long COVID living in the Netherlands. Participants were men and women aged 30 years and above.

RESULTS: Guided by the concepts of stigma and candidacy, the findings are structured according to the broader themes of stigma and access to care. The findings show that people with long COVID suffer self and public stigma resulting from the debilitating illness and symptoms. Especially among Turkish and Moroccan ethnic minority participants, strong filial obligations and gendered expectations of responsibility and support within their communities further worsen self-stigma. This experience of stigma persisted within healthcare where lack of information and appropriate care pathways led to feelings of frustration and abandonment, especially for participants with pre-existing health conditions which further complicate candidacy. Under the access to healthcare theme, the findings show multiple challenges in accessing healthcare for long COVID due to several multifaceted factors related to the various stages of candidacy which impacted access to care. Particularly for Turkish and Moroccan ethnic minority participants, additional challenges resulting from limited access to information, pre-existing structural challenges and experience of stereotyping based on ethnicity or assumed migrant identity by health professionals further complicate access to health information and long COVID care.

CONCLUSIONS: The findings call for urgent attention and research to identify and coordinate healthcare for long COVID. There is also a need for accessible, informative and tailored support systems to facilitate patients' access to information and care pathways for long COVID. Providing tailored information and support, addressing the various barriers that hinder optimal operating conditions in healthcare and leveraging on social networks is crucial for addressing stigma and facilitating candidacy for persons with long COVID towards improving access to care.},
}

Humans
Netherlands/epidemiology
Female
*COVID-19/ethnology/psychology/therapy
Male
*Health Services Accessibility
*Social Stigma
Qualitative Research
Middle Aged
Cross-Sectional Studies
Adult
Morocco/ethnology
Turkey/ethnology
*Ethnicity/psychology
SARS-CoV-2
Aged

@article {pmid40478845,
year = {2025},
author = {Kim, J and Lee, S and Weir, P},
title = {Long-COVID is associated with increased absenteeism from work.},
journal = {PloS one},
volume = {20},
number = {6},
pages = {e0325280},
doi = {10.1371/journal.pone.0325280},
pmid = {40478845},
issn = {1932-6203},
mesh = {Humans ; Female ; *COVID-19/epidemiology/economics ; Adult ; Male ; Middle Aged ; *Absenteeism ; SARS-CoV-2/isolation & purification ; Adolescent ; Young Adult ; Aged ; },
abstract = {Long-COVID, defined as COVID-19 symptoms persisting for more than 3 months, may lead to persistent health issues requiring extensive medical care. Despite its long-term health impact, the economic impact of long-COVID remains understudied. This study examined whether individuals with long-COVID had more missed workdays compared to those without long-COVID. Adults (≥18 years old) with full-time jobs were identified from the 2022 Full-Year Population Characteristics file of the Medical Expenditure Panel Survey (MEPS). A weighted two-part model was used to identify factors associated with missed workdays due to illness. The total population analyzed included 131,685,516 adults (unweighted n = 8,210), with an average (SD) age of 43 (14) years. Among them, 46% were female and 62% were non-Hispanic White. Approximately 7% of the population experienced long-COVID. Individuals with long-COVID reported an average of 8 days missed from work (SD: 12 days), while those without long-COVID reported an average of 4 days missed (SD: 9 days). The two-part model revealed that individuals with long-COVID had 2.54 more missed workdays compared to those without long-COVID (p < 0.01), after controlling for relevant variables. These results underscore significant productivity losses associated with long-COVID, highlighting the need for policymakers and employers to implement effective strategies to address this condition.},
}

Humans
Female
*COVID-19/epidemiology/economics
Adult
Male
Middle Aged
*Absenteeism
SARS-CoV-2/isolation & purification
Adolescent
Young Adult
Aged

@article {pmid40478517,
year = {2025},
author = {Schwartz, CE and Borowiec, K and Rapkin, BD},
title = {Long-COVID symptom burden and the experience of adversity: the importance of response-shift effects over 3 years of the pandemic.},
journal = {Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation},
volume = {},
number = {},
pages = {},
pmid = {40478517},
issn = {1573-2649},
abstract = {BACKGROUND/OBJECTIVES: Long COVID is a long-term legacy of the global pandemic. This study aimed to illuminate how Long COVID impacts individuals, and how response-shift effects influence Long COVID's impact. Methodologically, it expands the application of longitudinal statistical methods to test a more dynamic investigation of psychosocial factors in health over time.

METHODS: This quasi-experimental longitudinal cohort study collected data up to four times over 3 years of the COVID pandemic (May 2020 to April 2023). This study focused on 1151 participants divided into four Long-COVID Symptom Burden groups (Never Had COVID; Low, Medium, and High Long-COVID Symptom Burden). It examined COVID-specific outcomes: General Hardship, Healthcare Hardship, Worry, and Social Support. The Quality of Life Appraisal Profilev2-Short Form assessed cognitive-appraisal processes. Direct and moderated response-shift effects were tested using longitudinal mixed models that examined main effects and interactions of individuals' changes in cognitive-appraisal processes from their usual, over time, and by group over time, after adjusting for sociodemographic covariates and individual's usual appraisal processes, and considering the impact of multiple comparisons.

RESULTS: Notable response-shift effects were revealed on all four COVID-specific outcomes, reflecting both direct and moderated response-shift effects. The experience of COVID-specific adversity was related to various appraisal processes but the nature of the relationship often varied by Long-COVID symptom burden. The appraisal processes that were most salient included patterns of emphasis related to getting used to and handling demands or recent changes, problem-solving goals, and comparing oneself to similar others. Individuals in the high Long-COVID Symptom-Burden Group were particularly highlighted in response-shift effects. The broad conclusions of both raw and multiplicity-adjusted results were similar. That is, there were notable reprioritization and reconceptualization response-shift effects for all outcomes, and notable but fewer recalibration response-shift effects.

CONCLUSIONS: Response-shift effects, measured via the direct assessment of cognitive-appraisal processes, were prominent in dealing with the COVID pandemic. The present study documented that COVID-specific adversity can be attenuated or exacerbated depending on individuals' patterns of emphasis, goals, and standards of comparison. The study's utilization of data collected at four time points over 3 years of the global pandemic provided a more comprehensive and far-reaching evaluation of response shift than earlier work. The theory-driven analytic methodology developed in the present work facilitated a more nuanced description of direct and moderated response-shift effects.},
}