@article {pmid41204118,
year = {2025},
author = {Scolari, FL and Spinardi, J and Silva, MMDD and Trott, G and Rodrigues, CO and Rover, MM and Souza, EM and Manfio, JL and Camargo, NI and Souza, AP and Souza, D and Carli, RF and Roldão, ES and Mocellin, D and Miozzo, AP and Silva, GND and Souza, JMB and Santos, RDRMD and Itaqui, CR and Rech, GS and Irineu, VM and Francisco, SC and Silvestre, O and Neves, PDMM and Tramujas, L and Nobre, V and Carvalho, SM and Ferreira, CDDA and Oliveira, JC and Royer, CA and Luiz, RM and Baura, VA and Gradia, DF and Brandalize, APC and Pereira, HA and Poitevin, CG and Robinson, CC and Barreto, BB and Schvartzman, PR and Marcolino, M and Antonio, ACP and Polanczyk, CA and Maccari, JG and Nasi, LA and Valluri, SR and Julião, VW and d'Hellencourt, FL and Kyaw, MH and Castillo, GDCM and Falavigna, M and Rosa, RG},
title = {Impact of long COVID phenotypes on quality of life following symptomatic omicron infection in Brazil: a machine learning analysis.},
journal = {BMC infectious diseases},
volume = {25},
number = {1},
pages = {1523},
pmid = {41204118},
issn = {1471-2334},
abstract = {BACKGROUND: This study aimed to identify phenotypes of long COVID symptoms in adults following Omicron infection and assess their association with health-related quality of life (HRQoL).

METHODS: We analyzed three prospective observational studies in Brazil, enrolling adult patients who sought care for symptomatic Omicron infection between December 2021 and March 2023. The infection was confirmed by either an antigen test or reverse transcriptase polymerase chain reaction. Long COVID symptoms were assessed three months after enrollment through structured interviews. Phenotypes of Long COVID-19 were identified using a machine learning-based clustering approach. Exploratory analyses were conducted to examine predisposing factors and health-related quality of life utilities, measured by EQ-5D-3 L, associated with each phenotype.

RESULTS: A total of 2,989 patients were analyzed (39% women, median age 41 years, and 96% had completed the primary series of COVID-19 vaccination). Long COVID symptoms at three months were reported by 1,155 (38.6%) patients. Three phenotypes were identified: cluster 1 (n = 459 [39.7%]), characterized by a median of three symptoms (IQR, 2-5) with memory loss (80.4%), concentration problems (38.3%) and fatigue (35.7%) being most common; cluster 2 (n = 549 [47.5%]), characterized by a median of two symptoms (IQR, 1-4) with fatigue (43.7%), other symptoms (42.3%), and cough (20.6%) being most common; and cluster 3 (n = 147, 12.7%), characterized by a higher number of symptoms (median, 8; IQR, 7-10), with fatigue (89.9%), memory loss (88.4%), and anxiety (64.6%) as the most common. The mean EQ-5D-3 L utility at 3 months was 0.75 for cluster 1, 0.73 for cluster 2, and 0.59 for cluster 3 (p < 0.001). After adjusted regression analysis, cluster 3 was independently associated with the lowest EQ-5D-3 L utilities (mean difference, -0.21; 95%CI, -0.24 to -0.18; p < 0.001).

CONCLUSIONS: Distinct phenotypic presentations of Long COVID following Omicron infection in Brazil were identified, with significant differences in quality of life.

CLINICAL TRIAL NUMBER: Not applicable.},
}

@article {pmid41204001,
year = {2025},
author = {Kuodi, P and Shibli, H and Zayyad, H and Wertheim, O and Wiegler, KB and Jabal, KA and Dror, AA and Nazzal, S and Glikman, D and Charlett, A and Edelstein, M},
title = {Optimizing the schedule of BNT162b2 COVID-19 against long COVID and associated quality of life losses.},
journal = {Communications medicine},
volume = {5},
number = {1},
pages = {462},
pmid = {41204001},
issn = {2730-664X},
abstract = {BACKGROUND: The long-term impact of COVID-19 vaccination on post-acute COVID-19 symptoms and associated quality of life (QoL) changes remains incompletely described. This study aimed to explore the impact of the timing of COVID-19 priming and booster doses, on reporting long COVID symptoms and associated QoL changes.

METHODS: Individuals who had PCR testing for SARS-CoV-2 processed in government hospitals in Northern Israel between 15[th] March 2021 and 15[th] June 2022 were invited to answer serial online surveys collecting information on SARS-CoV-2 infection, vaccination status and post-acute symptoms every 3-4 months for two years. Participants were categorized into groups based on the number of doses received prior to infection. We compared these groups over time in terms of reporting post-COVID symptom clusters and QoL, using population-average and mixed-effects regression models, respectively.

RESULTS: A total of 4809 individuals are enrolled and respond to up to five follow-up surveys. Of these, 1377 (28.61%) report a positive SARS-CoV-2 test, while 3432 (71.39%) report a negative result. After adjustment for potential confounders, receiving at least three COVID-19 vaccine doses prior to infection is associated with a 34% reduction in the likelihood of reporting at least one long COVID symptom cluster compared to being unvaccinated (adjusted odds ratio [aOR] = 0.66, p = 0.022). Pre-infection vaccination is also associated with higher quality of life (QoL) scores (β = 0.07, p < 0.001). The estimated vaccine effectiveness of three pre-infection doses against long COVID over a two-year period is 26.5% (95% CI: 10.8-39.4). This protective effect remains stable over time. In contrast, vaccination received after infection shows no association with long COVID symptoms or QoL outcomes.

CONCLUSIONS: Receiving at least three COVID-19 vaccine doses prior to SARS-CoV-2 infection provides a sustained protective effect against long COVID and its negative impact on quality of life for at least two years. The longer-term durability of this protection, the role of reinfection, and the influence of emerging viral variants remains to be investigated.},
}

@article {pmid41202576,
year = {2025},
author = {Rottstädt, F and König, L and Seifert, C and Jesgarzewsky, T and Finke, K and Reuken, P and Stallmach, A and Vonderlind, S and Croy, I},
title = {Reduced interpersonal touch and elevated preferred interpersonal distance are signs of impaired social contact behavior in post-COVID syndrome.},
journal = {Journal of psychosomatic research},
volume = {199},
number = {},
pages = {112438},
doi = {10.1016/j.jpsychores.2025.112438},
pmid = {41202576},
issn = {1879-1360},
abstract = {BACKGROUND: Increased inflammation often evokes an adaptive sickness behavior with social withdrawal. We aimed to test whether reduced social contact also characterizes Post-COVID syndrome, a condition that is hypothesized to involve prolonged inflammation following SARS-CoV-2 infection.

METHODS: We queried 49 Post-COVID patients (mean age = 46.8 years, 38 (77.6 %) female, mean duration of disease = 16 months) and 49 age- and gender-matched healthy control paricipants for their satisfaction with socializing, frequency of interpersonal contact and touch, and preferred interpersonal distance. Additionally, severity of fatigue and depressive mood were assessed in all participants.

RESULTS: While Post-COVID patients did not differ significantly from healthy controls in the frequency of general interpersonal contact, they reported a markedly lowered satisfaction with socializing (p < .01, η[2] = 0.27). Specifically, touch frequency and desire for touch were reduced, with the largest difference observed for interactions with friends (p < .001, η[2] = 0.13). Furthermore, Post-COVID patients reported approximately a 50 % increase in preferred interpersonal distance towards others in order to feel comfortable (p < .001, η[2] = 0.17). Mediation analyses suggest that those deviations were primarily driven by fatigue rather than depressive symptoms in Post COVID patients.

CONCLUSIONS: Over the course of the disease, the observed impairments are concerning, as they deprive patients of social contact as a source of dyadic coping and mental health. Pacing strategies should be adapted to explicitly incorporate social contact as a key element. The findings also align with the sickness behavior theory.},
}

@article {pmid41202571,
year = {2025},
author = {Ahmed, S and Greenberg, J and Kenney, R and Marini, C and Hyman, S and Fung, S and Edeoga, N and Baltazar, M and Grossman, SN and Seixas, A and Jean-Louis, G and Osorio, RS and Condos, R and Frontera, J and Gonzalez-Duarte Briseno, MA and Galetta, SL and Balcer, LJ and Thawani, SP},
title = {Autonomic dysfunction and quality of life in a cohort of neurology outpatients with post-acute sequelae of COVID-19, a two-year follow-up study.},
journal = {Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia},
volume = {143},
number = {},
pages = {111719},
doi = {10.1016/j.jocn.2025.111719},
pmid = {41202571},
issn = {1532-2653},
abstract = {PURPOSE: Many studies estimate that more than 50% of non-hospitalized patients with long-COVID develop moderate to severe autonomic dysfunction. However, the specific impact of autonomic dysfunction as it relates to quality of life in long-COVID is not fully understood. The aim of the current study is to assess autonomic symptoms and quality-of-life in patients with Post-Acute Sequelae of COVID-19 (PASC) recruited from a neurology department outpatient setting.

METHODOLOGY: In a two-year follow-up study of a baseline cohort of 93 non-hospitalized SARS-CoV-2 laboratory-positive patients evaluated for PASC between November 2020-August 2021, 44 participants completed follow-up telephone questionnaires examining quality-of-life as well as neurologic and autonomic symptoms.

RESULTS: Among 93 participants, 44 (47 %) completed the two-year follow-up evaluation and 27 (61 %) were female with a median age of 55 years (IQR = 24-88). Most participants (95 %, 42/44) were vaccinated against COVID-19 and 43 % (19/44) had a pre-existing neurological disorder. Median time from index COVID-19 infection to follow-up was 26 months (IQR = 23-17), with a median of 15 months (IQR = 15-16) between visits. Fatigue, word finding difficulty, and changes in memory were the most commonly reported PASC symptoms. Sixty-six percent (29/44) of individuals met criteria for autonomic dysfunction as defined by the Composite Autonomic Symptom Score-31 (COMPASS-31) scale. Secretomotor and gastrointestinal subdomains demonstrated significant associations with Neuro-QoL metrics for Anxiety, Depression, and Fatigue. For every 1 additional PASC symptom reported at a follow-up study visit, there was an average increase of 1.5 points on the COMPASS-31 composite score. In addition, visual disturbances and sleep impairment were both associated with increased autonomic dysfunction.

CONCLUSION: The strong association between autonomic dysfunction and reduced QoL in PASC and the relation to insomnia, visual dysfunction, and functional impairment are valuable findings, reinforcing the clinical impact of these symptoms longitudinally after index COVID-19 infection.},
}

@article {pmid41201746,
year = {2025},
author = {Wander, PL and Awan, O and Neal, J and Seidel, I and Bell, KA and Cassell, A and Fattal, D and Ng, B and Pyne, ML and Rog, L and Helfand, M},
title = {Synopsis of 2024 VA Long COVID Clinical Guidance for U.S. Veterans: Part 1, Nervous System-Related Symptoms.},
journal = {Journal of general internal medicine},
volume = {},
number = {},
pages = {},
doi = {10.1007/s11606-025-09829-4},
pmid = {41201746},
issn = {1525-1497},
abstract = {DESCRIPTION: Long COVID is common and includes nervous system-related symptoms (e.g., autonomic dysfunction, cognitive impairment, fatigue, and pain). We sought to develop just-in-time evidence-informed guidance for nervous system-related Long COVID, a condition for which mature evidence is limited.

METHODS: The U.S. Veterans Affairs (VA) Veterans Health Administration (VHA) Long COVID Field Advisory Board commissioned an expert panel that worked with a GRADE methodologist to develop an evidence-to-decision framework for emergent conditions by applying core elements of the Standards for Developing Trustworthy Clinical Practice Guidelines and those of GRADE. We also convened a multidisciplinary writing group that identified a list of clinically relevant questions and commissioned an independent review and synthesis of existing evidence. The writing group conducted structured discussions and used this evidence base to make recommendations for evaluation and treatment ("Evidence-informed Recommendations"). For history-taking, physical exam, and commonly used, noninvasive diagnostic tests, statements were based on consensus determinations of useful and safe care ("Good Practice Statements"). We used a Whole Health Systems approach to support the development of guidance that was patient-centered, culturally appropriate, and available regardless of literacy or disability. Feedback was solicited from Veterans and other stakeholders. Where the published literature was insufficient, we used evidence from treatment of similar conditions.

RECOMMENDATIONS: We drafted 30 Evidence-informed Recommendations and 41 Good Practice Statements for nervous system-related Long COVID in Veterans and disseminated them VA-wide, targeting specialty care providers. More research on the effectiveness of diagnostic and therapeutic interventions is needed. In particular, evidence "borrowed" from other conditions and populations should be replaced or supplemented by evidence in Long COVID. Clinical guidance should be updated as this evidence becomes available.

KEY POINTS: QUESTION: How can clinicians provide evidence-informed care for nervous system-related Long COVID (e.g., autonomic dysfunction, cognitive impairment, fatigue, and pain)?

FINDINGS: We commissioned an independent rapid evidence review which found that evidence supporting the care of nervous system-related Long COVID symptoms was limited. Using available evidence and other considerations (e.g., costs, equity, and applicability to Veterans experiencing Long COVID), we drafted 30 Evidence-informed Recommendations and 41 Good Practice Statements for nervous system-related Long COVID.

MEANING: Although mature evidence was limited, this guidance can provide a framework for clinicians caring for patients with nervous system-related Long COVID. More research on the effectiveness of diagnostic and therapeutic interventions in Long COVID is needed.},
}

@article {pmid41200182,
year = {2025},
author = {Liu, H and Xu, Z and Karsidag, I and Wang, P and Weng, J},
title = {Immune cell communication networks and memory CD8[+] T cell signatures sustaining chronic inflammation in COVID-19 and Long COVID.},
journal = {Frontiers in immunology},
volume = {16},
number = {},
pages = {1689507},
pmid = {41200182},
issn = {1664-3224},
mesh = {Humans ; *COVID-19/immunology ; *CD8-Positive T-Lymphocytes/immunology ; *SARS-CoV-2/immunology ; *Inflammation/immunology ; *Cell Communication/immunology ; Female ; Male ; *Immunologic Memory ; Middle Aged ; Chronic Disease ; Single-Cell Analysis ; Post-Acute COVID-19 Syndrome ; },
abstract = {BACKGROUND: COVID-19, including its post-acute sequelae (Long COVID), is increasingly recognized as involving persistent immune dysregulation and chronic inflammation. Severe and prolonged disease states are often accompanied by sustained cytokine release, immune cell exhaustion, and ongoing cell-cell communication that shapes the inflammatory milieu. Among immune subsets, CD8[+] T cells play a central role in antiviral defense, yet the molecular mechanisms linking their dysfunction to prolonged inflammation remain incompletely understood.

METHODS: We analyzed 73,110 peripheral blood mononuclear cells (PBMCs) from individuals across four disease states (Healthy, Exposed, Infected, and Hospitalized) using single-cell RNA sequencing. Immune cell subsets were annotated, and T cell heterogeneity was profiled. Cytokine and inflammatory scores were calculated to assess immune activation. Differentially expressed genes (DEGs) underwent Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis. Cell-cell communication was evaluated to map ligand-receptor networks. Additionally, nine machine learning models were trained on a bulk RNA-seq cohort, and the SHapley Additive exPlanations (SHAP) framework was applied to interpret key predictive genes.

RESULTS: Progressive disease severity was associated with a decline in T cell proportions, enrichment of pro-inflammatory myeloid cells, and elevated cytokine expression, particularly IL-32. Memory CD8[+] T cells showed increased exhaustion and inflammatory scores while maintaining a central position in MHC-I-mediated communication networks. Persistent activation of immune and metabolic pathways, including antigen presentation and oxidative phosphorylation, was observed in prolonged disease states. Seven genes (RPS26, RPS29, RPL36, RPL39, RPS28, RPS21, and CD3E) were identified as strong predictors of chronic immune dysregulation, with the XGBoost model achieving the highest AUC. SHAP analysis confirmed their contributions to disease classification.

CONCLUSION: This study maps the immune landscape of COVID-19 and Long COVID at single-cell resolution, revealing that persistent immune cell communication, particularly involving memory CD8[+] T cells, may sustain chronic inflammation beyond the acute phase. The identified molecular signatures offer potential biomarkers and therapeutic targets for mitigating post-viral inflammatory syndromes.},
}

Humans
*COVID-19/immunology
*CD8-Positive T-Lymphocytes/immunology
*SARS-CoV-2/immunology
*Inflammation/immunology
*Cell Communication/immunology
Female
Male
*Immunologic Memory
Middle Aged
Chronic Disease
Single-Cell Analysis
Post-Acute COVID-19 Syndrome

@article {pmid41200018,
year = {2025},
author = {Feldman, C and Manentsa, N and Akpomiemie, G and Jabavu, A and Moller, K and Baskhar, E and Mtshazo, B and Edem, E and Sokhela, SM and Lalla-Edward, ST and Venter, WDF and Richards, GA},
title = {Pulmonary manifestations of long COVID in Johannesburg, South Africa.},
journal = {Southern African journal of infectious diseases},
volume = {40},
number = {1},
pages = {734},
pmid = {41200018},
issn = {2313-1810},
abstract = {BACKGROUND: There are few studies of long coronavirus disease (COVID) in low- and middle-income countries.

OBJECTIVES: This study investigated long-term pulmonary manifestations of long COVID among adults in Johannesburg, South Africa.

METHOD: This was a respiratory sub-study of a larger long COVID investigation. Cases with self-reported long COVID symptoms were recruited into four cohorts: prior asymptomatic infection, mild to moderate infection, hospitalised for severe infection and vaccinated prior to infection. Cases with respiratory comorbidity and/or well-characterised exposure to certain conditions (e.g. cigarette smoking) were excluded. Demographics, clinical features, spirometry, six-minute walk test (6MWT) and high-resolution computerised tomographic (HRCT) scan of the chest were recorded.

RESULTS: Of the 171 patients interviewed from the initial study, 36 with appropriate inclusion criteria were recruited a median of 2.1 years following their acute COVID-19 illness. Accordingly, the incidence of long COVID was 21.1% (36/171 patients) for the group as a whole and 5.9% (3/51), 25.0% (14/56), 37.8% (17/45) and 10.5% (2/19) for cohorts 1-4, respectively (p = 0.001). The major symptoms were tiredness and/or fatigue, shortness of breath and cough. Overall, 33 patients had abnormal 6MWT results, and 10 had abnormalities on spirometry; obstructive pattern in five, restrictive in three and mixed in two. Seven patients (six of whom were previously hospitalised) had probable/possible abnormalities compatible with long COVID on HRCT scan (p = 0.045).

CONCLUSION: This study documented respiratory abnormalities in patients as long as 2 years after prior SARS-CoV-2 infection, especially among those with severe prior infection.

CONTRIBUTION: This was among the first studies comprehensively documenting pulmonary abnormalities in patients with long COVID in South Africa.},
}

@article {pmid41199609,
year = {2025},
author = {Lee, C and Williams, P and Abrahams, A and Darbyshire, J and Davies, HE and De Kock, J and Esmer, U and Jones, SA and Newey, V and Scott, J and Smith, N and Winch, D and Master, H and Elkin, S and , },
title = {What Can We Learn Four Years On? A Multi-Centre Service Evaluation Exploring Symptoms, Functional Impact, Recovery and Care Pathways in Long Covid.},
journal = {Health expectations : an international journal of public participation in health care and health policy},
volume = {28},
number = {6},
pages = {e70435},
doi = {10.1111/hex.70435},
pmid = {41199609},
issn = {1369-7625},
support = {//This study is independent research funded by the National Institute for Health and Care Research (NIHR) (LOng COvid Multidisciplinary consortium: Optimising Treatments and servIces acrOss the NHS [LOCOMOTION], Ref: COV-LT2-0016)./ ; },
mesh = {Humans ; Female ; *COVID-19/complications/therapy/psychology ; Male ; Middle Aged ; England ; Adult ; Aged ; Surveys and Questionnaires ; SARS-CoV-2 ; Wales ; Activities of Daily Living ; Post-Acute COVID-19 Syndrome ; },
abstract = {BACKGROUND: Long Covid (LC) is associated with long-term health impacts that require ongoing support from healthcare services. We aimed to gain insights into patients' perceptions of their ongoing symptoms of LC, the effect on daily living and vocation, perceptions of what helps with LC recovery, as well as LC care pathways and ongoing care needs.

METHODS: An online survey was sent to 513 participants who had used one of three LC services across England and Wales between 2020 and 2024. Participants were invited to share their experiences. We employed a mixed-methods approach for data analysis, synthesising findings from quantitative and qualitative data. All data shared between sites was de-identified.

RESULTS: 269 (52.4%) participants completed the survey. The mean age was 52.7 (sd ± 12.0), 69.1% female and 55.0% were White-British. The mean duration since initial SARS-CoV-2 infection was over 3 years (1204.4 ± 275.7 days). The Post-Covid Functional Status (PCFS) scale indicated that most participants (94.1%, n = 253) had not fully recovered. When employing a global rate of change scale, 39.0% (n = 96) of 246 responders indicated they are still making improvements with respect to their recovery; 40.7% (n = 100) had plateaued, and 20.3% (n = 50) reported a worsening trajectory. Those with ongoing symptoms described fatigue 83.0% (n = 210), cognitive dysfunction 58.5% (n = 148) and breathlessness or wheezing 43.9% (n = 111) most frequently. Of those who responded, 20.8% (n = 48) were 'working as prior to their initial LC infection' and 25.5% (n = 59) were currently 'unable to work'. Almost half (44.3%; n = 86) were no longer receiving care whilst also reporting unmet care needs. In total, 62.7% (n = 126) of participants indicated unmet care needs, and qualitative analysis indicated five overarching domains as having an important impact on long-term LC recovery and ongoing healthcare needs. These were Living with LC, LC interventions and recovery, Approach to the delivery of care, Insufficient support and Suggestions and improvement.

CONCLUSION: This study indicates the extent to which individuals continue to experience ongoing symptoms of LC, including aspects related to recovery and vocational impact, highlighting the potential widening gap between the ongoing need to support those living with LC and the limited provision of care.

The survey was co-produced with Experts by Experience, who had previously attended an LC service and members of the Patient Advisory Group within the Locomotion Consortium. Collaboration and involvement continued throughout the study, including analysis, interpretation and writing processes.

CLINICAL TRIAL REGISTRATION: Study registration details are available at ClinicalTrials.gov: NCT05057260 and ISRCTN: 15022307.},
}

Humans
Female
*COVID-19/complications/therapy/psychology
Male
Middle Aged
England
Adult
Aged
Surveys and Questionnaires
SARS-CoV-2
Wales
Activities of Daily Living
Post-Acute COVID-19 Syndrome

@article {pmid41199272,
year = {2025},
author = {Blomberg, B and Myklebust, NN and Oppegaard, O and Tøndel, C and Cox, RJ and Iversen, A and Lehmann, ME and Sandvig, A and Dahl, TB and Valderhaug, VD and Szodoray, P and Wilhelmsen, M and Kirsebom, BE and Glambek, M and Kaarbøe, O and Aukrust, P and Lie, RT and Langeland, N},
title = {Randomized trial of nirmatrelvir/ritonavir versus placebo for adults with acute COVID-19 to prevent long COVID: PanoramicNOR Trial.},
journal = {Trials},
volume = {26},
number = {1},
pages = {477},
pmid = {41199272},
issn = {1745-6215},
mesh = {Humans ; *Ritonavir/administration & dosage/therapeutic use/adverse effects ; Adult ; Double-Blind Method ; *COVID-19 Drug Treatment ; *COVID-19/prevention & control/complications ; *Antiviral Agents/administration & dosage/therapeutic use/adverse effects ; Middle Aged ; Young Adult ; Adolescent ; Male ; Randomized Controlled Trials as Topic ; SARS-CoV-2 ; Female ; Drug Combinations ; Treatment Outcome ; Post-Acute COVID-19 Syndrome ; },
abstract = {BACKGROUND: The high prevalence of long-term persisting symptoms after COVID-19 (coronavirus disease 2019), termed long COVID or post-COVID-19 condition, even among those with mild initial disease, may have a large public health impact. Apart from avoiding infection, there is no proven prevention or treatment for long COVID. We will perform a randomized placebo-controlled clinical trial to assess whether treatment with the novel antiviral, nirmatrelvir and ritonavir (Paxlovid®) for acute COVID-19 can prevent the development of long COVID.

METHODS: This is a randomized double-blinded placebo-controlled trial that aims to recruit 2000 nonpregnant persons aged 18 to 64 years with acute COVID-19 with positive PCR and/or antigen test and symptom duration of not more than 5 days. Participants will be randomized 1:1 to a 5-day course of Paxlovid (two tablets 150-mg nirmatrelvir and one tablet 100-mg ritonavir twice daily) or a 5-day course of placebo (similar number of tablets of equal appearance). The primary endpoint will be persistent symptoms compatible with long COVID, assessed as the prevalence of a dichotomous variable corresponding to the presence (1) or absence (0) of one or more of the following symptoms: (i) fatigue, (ii) dyspnea, and (iii) cognitive symptoms (memory and/or concentration problems). The primary outcome will be evaluated at 3-month follow-up and then re-evaluated at 6, 12, and 24 months.

DISCUSSION: As more than 750 million people with confirmed COVID-19 have survived globally, the potential burden of long COVID on societies is formidable. If a simple 5-day oral treatment course with nirmatrelvir/ritonavir is shown to prevent long COVID, it would be a highly attractive intervention at an individual level and a mitigation of its public health consequences.

TRIAL REGISTRATION: ClinicalTrials.gov NCT05852873. Registered on May 2023.},
}

Humans
*Ritonavir/administration & dosage/therapeutic use/adverse effects
Adult
Double-Blind Method
*COVID-19 Drug Treatment
*COVID-19/prevention & control/complications
*Antiviral Agents/administration & dosage/therapeutic use/adverse effects
Middle Aged
Young Adult
Adolescent
Male
Randomized Controlled Trials as Topic
SARS-CoV-2
Female
Drug Combinations
Treatment Outcome
Post-Acute COVID-19 Syndrome

@article {pmid41197399,
year = {2025},
author = {Mohanty, MC and Jawade, KS and Rane, SS and Dravid, A and Gurav, YK and Bhardwaj, SD and Borse, R and Bargaje, MD and Sawardekar, V and Gupta, TM and Varose, SY and Patil, AP and Redewad, N and Bandare, G and More, S and Bhor, VM and Doke, P and Abraham, P},
title = {Persistence of post-acute COVID-19 sequelae up to four years in patients with long COVID from Western India: A cross-sectional descriptive study.},
journal = {Journal of infection and public health},
volume = {19},
number = {1},
pages = {103028},
doi = {10.1016/j.jiph.2025.103028},
pmid = {41197399},
issn = {1876-035X},
abstract = {BACKGROUND: Post-Acute Sequelae of COVID-19 or Long COVID (LC) affects millions globally, with persistent immune, neurological, and cardiovascular symptoms posing challenges to healthcare. This study analyses clinical, demographic, and lifestyle differences between LC and recovered (RC) individuals residing in Western India, extending observations up to four years post-infection.

METHODS: A cross-sectional study was conducted in four urban setting tertiary-care hospitals of Western India. Individuals aged 19-70 with documented SARS-CoV-2 infection and persistent or fluctuating symptoms beyond four weeks, unexplained by other diagnoses were recruited in LC group. Recovered individuals with confirmed past infection, negative SARS-CoV-2 RT-PCR at the time of enrolment, and no lingering symptoms were recruited in RC group. The demographic, socio-economic, and clinical data were collected.

RESULTS: Severe acute COVID-19 patients were more frequent in the LC group (n = 104) compared to the RC group (n = 83), though both LC and RC had similar proportions of mild/moderate acute COVID-19 patients. Fatigue was the most persistent symptom (79.80 %), followed by cough and anxiety. Respiratory, cardiovascular, neuro-psychiatric symptoms declined over time, while dermatological, ENT, gastrointestinal, and muscular symptoms fluctuated. LC patients predominantly had hypertension as comorbidity, lower SPO2, and higher pulse rates (p < 0.0001). Rates of hospitalization for COVID-19 treatment were similar, but mechanical ventilation use was exclusively observed in LC patients (10.6 %). Sedentary lifestyles were more frequent in LC (17.30 %) vs. RC (6.02 %, p = 0.0248).

CONCLUSION: Our study is one of the few in Indian population showing occurrence of multiple LC symptoms after 3-4 years of infection. We report severity of COVID-19, use of Remdesivir and mechanical ventilation to be associated with increased odds of LC. Fatigue, cough and anxiety were the most common symptoms reported by LC participants. Our findings establish a much-needed baseline for understanding symptom progression in LC patients, emphasizing the need for targeted interventions and long-term monitoring.},
}

@article {pmid41196899,
year = {2025},
author = {Malambo, W and Sampa-Kawana, M and Chanda, D and Fwoloshi, S and Kaonga, P},
title = {Parametric survival analysis of long COVID among hospitalized patients in Zambia: A retrospective cohort study on the time to symptoms resolving.},
journal = {PLOS global public health},
volume = {5},
number = {11},
pages = {e0004679},
doi = {10.1371/journal.pgph.0004679},
pmid = {41196899},
issn = {2767-3375},
abstract = {Long COVID refers to the continuation or emergence of new symptoms within three months after acute SARS-CoV-2 infection, lasting for at least two months. Although several studies have described COVID-19 sequelae, gaps remain in understanding the temporal dynamics of symptoms resolution - information crucial for patients management and recovery planning. This study evaluated the resolution of COVID-19-related symptoms over time and associated factors among hospitalized patients in Zambia. We conducted a retrospective cohort study among individuals discharged after COVID-19 hospitalization and attending follow-up care in 13 specialized clinics in Zambia from August-2020 to December-2022. Severe acute COVID-19 was defined as hospitalization requiring supplemental oxygen, ICU admission, and/or treatment with steroids/remdesivir. Time-to-symptoms resolution (i.e., survival time) and changes in underlying hazard rate were our primary and secondary outcomes, respectively. We estimated incidence rates, median survival time (onset-to-resolution), and factors associated with symptom resolution using survival analysis, including hazard ratios (HRs) and changes in the underlying hazard rate over time. Among 823 participants, 616 (84.3%) had severe acute COVID-19 illness; 50.6% were female, and median age was 54 years (IQR: 43-64). Overall, 597 (72.5%) had symptoms resolution at a median 51 person-days (IQR: 34-104). Most participants (59.4%) had baseline comorbidities, and 16.6% had received ≥1 COVID-19 vaccine dose. Symptoms resolved at a rate of 12.2 per 1,000 person-days. Severe acute COVID-19 was associated with slower symptom resolution (adjusted HR: 0.68, 95% CI: 0.50-0.92), while infection during the Omicron-predominant period compared to wild-type was associated with faster resolution (aHR: 2.71; 95% CI: 1.46-5.03). The hazard rate peaked around person-day 20 and declined thereafter, indicating a non-monotonic recovery pattern. COVID-19 symptoms resolved more rapidly during the first month of post-acute infection. Patients with persistent symptoms not resolved within this period may experience prolonged recovery, underscoring the need for targeted follow-up and supportive care.},
}

@article {pmid41196059,
year = {2025},
author = {Powers, JM and Leist, SR and Suryadevara, N and Zost, SJ and Binshtein, E and Abdelgadir, A and Mallory, ML and Edwards, CE and Gully, KL and Hubbard, ML and Zweigart, MR and Bailey, AB and Sheahan, TP and Crowe, JE and Montgomery, SA and Harkema, JR and Baric, RS},
title = {Mouse-adapted SARS-CoV-2 Omicron BA.5 infection induces post-acute lung fibrosis in BALB/c mice.},
journal = {Journal of virology},
volume = {},
number = {},
pages = {e0140625},
doi = {10.1128/jvi.01406-25},
pmid = {41196059},
issn = {1098-5514},
abstract = {UNLABELLED: Following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron BA.1, subsequent Omicron sub-lineages have continued to emerge, challenging the development of intervention and prevention strategies, including monoclonal antibodies and vaccines. To better understand the pathogenic effects caused by Omicron BA.5 infection, we developed a mouse-adapted virus with overt disease burden in BALB/c mice. Acute disease was characterized by significant weight loss and lung dysfunction following high-dose challenges. In survivor animals that were followed through 107 days post-infection, subpleural fibrosis with associated tertiary lymphoid structures was noted. Serum from these mice demonstrated potent neutralization against BA.5, with substantially reduced neutralization titers against early epidemic, zoonotic, and more recent contemporary XBB.1.5 variants. Intervention with pre-clinical monoclonal antibodies revealed that robust protection from BA.5-induced lung disease was possible after prophylactic administration. Together, this model enables the investigation of therapeutic approaches for both acute and post-acute sequelae of COVID-19.

IMPORTANCE: To best combat the evolving landscape of SARS-CoV-2 variants of interest and variants of concern, the development of effective small animal models is of critical importance. Herein, we describe the development of a model system in BALB/c mice to study the effects of SARS-CoV-2 BA.5 S gene in both acute and chronic disease manifestations. Intriguingly, we determined that fibrotic lung disease with tertiary lymphoid structures was a prominent feature in the lungs of mice that survived through the acute phase of infection. This is a prominent concern in human patients that survive the initial infection insult. As such, and most critically, the model system presented here provides researchers with an effective pathway in which long COVID manifestations and potential interventions can be studied.},
}

@article {pmid41194817,
year = {2025},
author = {Dimitrakopoulou, A and Sarantaki, A and Nanou, CI and Georgakopoulou, VE and Taskou, C and Chouli, M and Diamanti, A},
title = {Long COVID-Related Fatigue During Pregnancy: A Systematic Review.},
journal = {Cureus},
volume = {17},
number = {10},
pages = {e93877},
pmid = {41194817},
issn = {2168-8184},
abstract = {Long sequelae of COVID-19 (Long COVID), or post-acute sequelae of SARS-CoV-2 infection, encompasses a wide range of persistent symptoms, with fatigue emerging as one of the most prevalent and disabling. Pregnant individuals may be uniquely susceptible to post-viral fatigue due to immunological and physiological adaptations during gestation. This review consolidates existing data regarding the prevalence, risk factors, and clinical implications of Long COVID-associated fatigue in pregnant individuals. A narrative review was conducted of studies examining fatigue among pregnant individuals with confirmed SARS-CoV-2 infection. Key outcomes included fatigue prevalence, symptom persistence, associated risk or protective factors, and comparisons with non-pregnant populations. Across both the acute and post-acute stages of COVID-19, fatigue emerged as a consistently common symptom. Its prevalence and persistence varied significantly across studies, partly due to heterogeneity in assessment tools and follow-up durations. Severe acute illness, hospitalization, obesity, and smoking during pregnancy were linked to a higher risk of prolonged fatigue, whereas anosmia appeared to act as a potential protective factor. In contrast, comorbidities such as hypertension, diabetes, and lung disease were not significantly linked to fatigue risk. No consistent associations were found with maternal age or alcohol use. Long COVID-related fatigue presents a substantial burden in pregnancy, with implications for maternal health, quality of life, and postpartum recovery. Early recognition, individualized care strategies, and public health interventions targeting modifiable risk factors are essential to support this vulnerable population. Ongoing research is essential to uncover underlying mechanisms and guide evidence-based clinical management.},
}

@article {pmid41193216,
year = {2025},
author = {Atter, MJ and Hall, P and Evans, RA and Norrie, J and Cohen, J and Williams, B and Chaudhuri, N and Bajwah, S and Higginson, I and Pearson, M and Currow, D and Stewart, G and Fallon, M and Johnson, M},
title = {Morphine for chronic breathlessness (MABEL) in the UK: a health economic evaluation of a multisite, parallel-group, dose titration, double-blind, randomised, placebo-controlled trial.},
journal = {BMJ open},
volume = {15},
number = {11},
pages = {e102124},
pmid = {41193216},
issn = {2044-6055},
mesh = {Humans ; *Morphine/economics/administration & dosage/therapeutic use ; Cost-Benefit Analysis ; *Dyspnea/drug therapy/economics ; Double-Blind Method ; Male ; Female ; Aged ; Quality-Adjusted Life Years ; Chronic Disease ; United Kingdom ; *Analgesics, Opioid/economics/administration & dosage/therapeutic use ; Middle Aged ; Aged, 80 and over ; },
abstract = {OBJECTIVES: To compare costs and health consequences and to assess the cost-effectiveness of using low-dose oral long-acting morphine in people with chronic breathlessness.

DESIGN: Within-trial planned cost-consequences and cost-effectiveness analysis of data from a multisite, parallel-group, double-blind, randomised, placebo-controlled trial of low-dose, long-acting morphine.

SETTING: 11 hospital outpatients across the UK.

PARTICIPANTS: Consenting adults with chronic breathlessness due to long-term cardiorespiratory conditions.

INTERVENTION: 5-10 mg two times a day oral long-acting morphine with a blinded laxative for 56 days.

PRIMARY OUTCOME MEASURES: Mean and SD of healthcare resource use (HRU) by trial arm; mean differences and 95% CI of costs between trial arms.

SECONDARY OUTCOME MEASURES: Mean differences in 28- and 56-day quality-adjusted life years (QALYs based on EuroQol five-dimension five-level score), Short Form-six dimensional scores and ICEpop CAPability-Supportive Care Measure scores; cost-utility of long-acting morphine for chronic breathlessness.

RESULTS: 143 participants (75 morphine and 67 placebo) were randomised; 140 (90% power, males 66%, mean age 70.5 (SD 9.4)) formed the modified intention-to-treat population (participants receiving at least one dose of study medication). There were more inpatient and fewer outpatient services used by the morphine group versus the placebo. In the base-case analysis at 56 days, long-acting morphine was associated with similar mean per-patient costs and QALYs. There was an increase of £24 (95% CI -£395 to £552) and 0.002 (95% CI -0.004 to 0.008) QALYs. Hospitalisations were the main driver of cost differences. The corresponding incremental cost-effectiveness ratio was £12 000/QALY, with a probability of cost-effectiveness of 54% at a £20 000 willingness-to-pay threshold. In the scenario analysis that excluded costs of adverse events considered unrelated to long-acting morphine by site investigators and researchers, the probability of cost-effectiveness increased to 73%.

CONCLUSION: Oral morphine for chronic breathlessness is likely to be a cost-effective intervention provided adverse events are minimised, but the effect on outcome is small and cautious interpretation is warranted.

TRIAL REGISTRATION NUMBER: ISRCTN87329095.},
}

Humans
*Morphine/economics/administration & dosage/therapeutic use
Cost-Benefit Analysis
*Dyspnea/drug therapy/economics
Double-Blind Method
Male
Female
Aged
Quality-Adjusted Life Years
Chronic Disease
United Kingdom
*Analgesics, Opioid/economics/administration & dosage/therapeutic use
Middle Aged
Aged, 80 and over

@article {pmid41192910,
year = {2025},
author = {Kobayashi, D and Ishikawa, K and Shibutani, K and Jinta, T and Otani, N and Mori, N},
title = {Deterioration of the Swallowing Function Among Patients with COVID-19: A Propensity Score-Matched Cohort Study.},
journal = {Internal medicine (Tokyo, Japan)},
volume = {},
number = {},
pages = {},
doi = {10.2169/internalmedicine.6038-25},
pmid = {41192910},
issn = {1349-7235},
abstract = {Objective This study aimed to investigate whether the swallowing function deteriorates more significantly following coronavirus disease (COVID-19) infection in comparison to other viral respiratory infections in patients with mild to moderate (grade 2) COVID-19. Methods We conducted a propensity score-matched cohort study at St. Luke's International Hospital in Tokyo, Japan, from January 2010 to March 2024. Elderly patients (≥70 years) admitted for viral respiratory infections, including influenza and COVID-19, were included. Patients with suspected bacterial infections, patients who were incapable of oral intake at admission (including those with enteral nutrition and gastrostomy), and patients who died during hospitalization were excluded. The primary outcome was deterioration in the swallowing function, defined as downgrade in food texture category from admission to discharge. Results During the study period, 505 COVID-19 patients and 242 patients with other viral infections were admitted. The mean age was 81.7 years (±7.6) and 401 patients (53.7%) were male. Patients with COVID-19 showed a significantly higher rate of swallowing deterioration in comparison to patients with other viral infections (44.7% vs. 36.6%, p=0.04). Specifically, among patients who consumed a full diet at admission, those with COVID-19 had a higher rate of swallowing deterioration than those with other viral infections (41.9% vs. 31.7%, p<0.01). Conclusion COVID-19 was associated with a significant higher rate of downgrade in the food texture category in comparison to other viral respiratory infections, suggesting a potential impairment in the swallowing function. Given that this deterioration may contribute to prolonged hospitalization in COVID-19 patients, early intervention aimed at restoring and supporting swallowing function is warranted.},
}

@article {pmid41191586,
year = {2025},
author = {Rhodes, S and Douglas, C},
title = {Experiences of accessing primary care by those living with long Covid in New Zealand: A qualitative analysis.},
journal = {PloS one},
volume = {20},
number = {11},
pages = {e0324489},
doi = {10.1371/journal.pone.0324489},
pmid = {41191586},
issn = {1932-6203},
mesh = {Humans ; New Zealand/epidemiology ; *COVID-19/epidemiology/therapy ; *Primary Health Care ; Female ; Male ; Middle Aged ; Qualitative Research ; Adult ; *Health Services Accessibility ; Aged ; SARS-CoV-2/isolation & purification ; },
abstract = {BACKGROUND: Long Covid is the persistence of symptoms beyond 12 weeks following acute Covid-19 infection. It is estimated to affect one in ten people and can be extremely debilitating. With few publicly funded long Covid clinics, most people rely on primary care providers as a first point of contact. There is currently limited understanding of the experience of accessing primary health care by adults living with long Covid in New Zealand.

PURPOSE: To explore the experiences of accessing primary health care by adults living with long Covid.

METHODS: A narrative inquiry approach was used to capture participants lived experiences of accessing primary health care. Zoom interviews and discussions were conducted with study participants. The automatically generated transcripts were reviewed and corrected, and the collated data were analysed using Braun and Clarke's thematic analysis.

RESULTS: Eighteen people participated in the interviews. Codes were identified and, through an iterative process, themes were generated, reviewed, and named. The seven themes included lack of upskilling of primary care staff; let down by the Government; self-advocacy and its cost; and throwing money at it.

CONCLUSION(S): The picture painted by participants was bleak with a sense that the world had moved on from Covid-19 and left them behind, with some experiencing a lack of support in primary health care. Reducing the likely long-term health and economic burden of long Covid requires targeted investment and action by Government at every level, along with better utilisation of the allied health workforce in primary care.},
}

Humans
New Zealand/epidemiology
*COVID-19/epidemiology/therapy
*Primary Health Care
Female
Male
Middle Aged
Qualitative Research
Adult
*Health Services Accessibility
Aged
SARS-CoV-2/isolation & purification

@article {pmid41191177,
year = {2025},
author = {Hajek, A and Blome, C and Yon, DK and Soysal, P and Gyasi, RM and Peltzer, K and Pengpid, S and König, HH},
title = {Long COVID and psychosocial factors among middle-aged and older adults. Results of the nationally representative German Ageing Survey.},
journal = {Aging clinical and experimental research},
volume = {37},
number = {1},
pages = {313},
pmid = {41191177},
issn = {1720-8319},
mesh = {Humans ; Male ; Female ; Aged ; *COVID-19/psychology/epidemiology ; Germany/epidemiology ; Middle Aged ; *Social Isolation/psychology ; Loneliness/psychology ; Aged, 80 and over ; *Depression/epidemiology/psychology ; *Aging/psychology ; Adult ; SARS-CoV-2 ; Personal Satisfaction ; Surveys and Questionnaires ; Sex Factors ; },
abstract = {BACKGROUND: In addition to the physical symptoms, long COVID can cause considerable psychological burden.

AIMS: To investigate the association of long COVID with depressive symptoms, loneliness, perceived social isolation and life satisfaction (also stratified by sex).

METHODS: Data from the most recent eighth wave of the nationally representative German Ageing Survey was used, encompassing community-dwelling individuals 43 years to 90 years, n = 4,017 individuals in the analytic sample). Psychometrically sound tools were used to quantify the outcomes. Physician-diagnosed long COVID was used as independent variable. Adjusted (weighted) linear regressions with cluster-robust standard errors were used. Robustness checks were conducted.

RESULTS: Regressions adjusted for sociodemographic and lifestyle-related covariates showed that individuals with long COVID had consistently worse psychosocial outcomes compared to individuals without long COVID. However, after additionally adjusting for health-related covariates, only the association between long COVID and perceived social isolation remained significant (β = 0.29, p < 0.001). Stratified by sex, long COVID was significantly associated with higher social isolation scores among women (β = 0.37, p < 0.001), but not among men in the fully adjusted models.

DISCUSSION: Even after adjusting for a wide array of covariates, findings suggest that (female) individuals with long COVID have stronger feelings of not belonging to the society (compared to individuals without long COVID).

CONCLUSIONS: It may be beneficial to find ways to help such individuals feel included in society.},
}

Humans
Male
Female
Aged
*COVID-19/psychology/epidemiology
Germany/epidemiology
Middle Aged
*Social Isolation/psychology
Loneliness/psychology
Aged, 80 and over
*Depression/epidemiology/psychology
*Aging/psychology
Adult
SARS-CoV-2
Personal Satisfaction
Surveys and Questionnaires
Sex Factors

@article {pmid41190342,
year = {2024},
author = {Osati, EFO and Nagu, TJ and Sangeda, RZ and Shayo, GA},
title = {Residual cardiopulmonary manifestations following COVID-19: a Tanzanian ambispective study.},
journal = {BMJ public health},
volume = {2},
number = {Suppl 1},
pages = {e002082},
pmid = {41190342},
issn = {2753-4294},
abstract = {INTRODUCTION: Residual COVID-19 sequelae create a public health concern as they add to the already heavy burden of non-communicable diseases. We set out to investigate the magnitude of residual cardiopulmonary manifestations postacute COVID-19 and their associated factors in Tanzania.

METHODS: This was an ambispective study conducted between 26 March 2021 and 30 July 2021, among 712 hospitalised adults confirmed with SARS-CoV-2 in five tertiary-level hospitals in Tanzania. Retrospective data were analysed to determine baseline characteristics of the patients during acute COVID-19 admission. This was linked to prospective data that were collected 2 years postacute hospitalisation with COVID-19 to determine cardiopulmonary complications among these patients. Radiological pulmonary abnormalities were assessed by contrasted CT scan. Lung function tests were measured using a spirometer. Pulmonary hypertension and heart failure were confirmed by a transthoracic echocardiography. Generalised estimating equations were used to assess the associations between sociodemographic factors, clinical characteristics, treatment modalities and residual cardiopulmonary sequelae.

RESULTS: About half 317/712 (44.5%) were diagnosed with residual cardiopulmonary complications. Approximately 54% of participants were male. Median age (IQR) was 60 (48-69) years. Cardiopulmonary sequelae were significantly associated with body mass index (BMI) ≥25.0 kg/m[2] compared with those with BMI <25.0 kg/m[2] (adjusted OR (aOR) (95% CI)=3.4 (2.47 to 4.84), p<0.001), smokers compared with non-smokers (aOR (95% CI)=2.39 (1.09 to 5.23), p=0.030] and among participants who did not receive steroids during the acute COVID-19 (aOR (95% CI)= 1.62(1.16 to 1.92), p=0.042].

CONCLUSION: The independent predictors of residual cardiopulmonary manifestations due to COVID-19 were overweight, cigarette smoking, hypoxia and non-use of steroids during the acute phase of COVID-19 disease. Public health interventions addressing weight reduction and smoking cessation in conjunction with steroid use in acute COVID-19 may largely reduce the incidence of cardiopulmonary long COVID-19.},
}

@article {pmid41189723,
year = {2025},
author = {Fineberg, D and Moreau, A and Schneider-Futschik, EK and Armstrong, CW},
title = {A Perspective on the Role of Metformin in Treating Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) and Long COVID.},
journal = {ACS pharmacology & translational science},
volume = {8},
number = {10},
pages = {3411-3431},
pmid = {41189723},
issn = {2575-9108},
abstract = {Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and Long COVID (LC) are increasingly recognized as debilitating postinfectious conditions that impact both individuals and society. Recent research highlights the potential of metformin, an antidiabetic agent, as a treatment for these syndromes by targeting their underlying mechanisms. This review assesses the effectiveness of metformin in ME/CFS and LC, which involve complex dysfunctions related to cytokines, glycolysis, ATP generation, oxidative stress, gastrointestinal microbiomes, and vascular endothelial function. Metformin, traditionally known for its antihyperglycemic properties may offer broader therapeutic benefits by influencing these pathological pathways. It works by inhibiting complexes I and IV of the electron transport chain, which reduces the strain on malfunctioning complex V and decreases the production of harmful free radicals. Additionally, metformin's impact on mTOR signaling could improve energy metabolism in ME/CFS and LC by downregulating an overactive but underperforming protein, thereby alleviating symptoms. Beyond the impact on cellular metabolism, metformin has shown to have anti-inflammatory, vascular, gastrointestinal, neuroprotective and epigenetic effects. We explore this impact of metformin and the potential role it could play to help people with ME/CFS. While metformin shows promise, it is unlikely to be a stand-alone solution. Instead, it may be part of a broader treatment strategy that includes other therapies targeting neurocognitive and autonomic impairments.},
}

@article {pmid41187495,
year = {2025},
author = {Demir Unal, E},
title = {A Neuroimmunological Axis between systemic autoimmunity and Parkinson's disease following long-COVID: A case series.},
journal = {Journal of neuroimmunology},
volume = {410},
number = {},
pages = {578795},
doi = {10.1016/j.jneuroim.2025.578795},
pmid = {41187495},
issn = {1872-8421},
abstract = {BACKGROUND: Long COVID, a multisystemic syndrome following SARS-CoV-2 infection characterized by persistent immune dysregulation, systemic inflammation, and neuroimmune dysfunction, is a significant area of investigation in the neurological sciences. The hypothesis that this pathophysiological state can trigger de novo autoimmune diseases and potentially accelerate underlying neurodegenerative processes is gaining traction. This case series aims to illuminate the potential neuroimmunological link between these conditions by presenting the patients who developed de novo Crohn's disease (CD) and ankylosing spondylitis (AS) following Long COVID and were subsequently diagnosed with post-COVID Parkinson's Disease (PD).

CASE PRESENTATIONS: The first case is a 50-year-old female who developed de novo CD six months after COVID-19 pneumonia, managed with the TNF-α inhibitor. Eighteen months later, she presented with parkinsonian motor deficits. The post-COVID PD diagnosis was supported by susceptibility-weighted MRI showing loss of nigrosome-1 and DAT-SPECT revealing a presynaptic dopaminergic deficit. The second case is a 48-year-old female who was diagnosed with de novo AS eight months post-COVID, treated with adalimumab. Twenty-six months later, she developed progressive bradykinesia and rigidity. Neuroimaging confirmed post-COVID PD with corresponding loss of nigrosome-1 and a presynaptic dopaminergic deficit on DAT-SPECT. In both genetically negative cases, dopaminergic therapy led to substantial motor improvement, with Unified Parkinson's Disease Rating Scale (UPDRS) Part IIIscores decreasing from 8 to 3 and 14 to 4, respectively.

CONCLUSION: This case series proposes a pathogenic cascade wherein SARS-CoV-2 infection acts as an environmental trigger, initiating a Long COVID-associated immune dysregulation that first precipitates a systemic autoimmune disorder. We hypothesize that this sustained inflammatory milieu subsequently accelerates the dysfunction of the dopaminergic system in predisposed individuals, thereby unmasking the clinical phenotype of post-COVID PD. This novel association highlights a potential nexus between virally-induced autoimmunity and subsequent neurodegeneration, offering a new perspective in the field of neuroimmunology.},
}

@article {pmid41186895,
year = {2025},
author = {Dihan, QA and Alshammari, N and Elhusseiny, AM and Rickels, KL and Shakarchi, AF and Chauhan, MZ and Sallam, AB},
title = {Long COVID and the development of new-onset uveitis: a large database study.},
journal = {Journal of ophthalmic inflammation and infection},
volume = {15},
number = {1},
pages = {79},
pmid = {41186895},
issn = {1869-5760},
abstract = {PURPOSE: To determine the impact of long COVID diagnosis on the risk of developing uveitis among individuals vaccinated and not vaccinated against COVID.

METHODS: We conducted a population-based retrospective cohort study using an aggregate healthcare database, TriNetX, which includes data from over 127 million patients across 95 international healthcare organizations. Four cohorts were compared: (1) Unvaccinated, Long COVID; (2) Unvaccinated, No Long COVID; (3) Vaccinated, Long COVID; and (4) Vaccinated, No Long COVID. Patients with any history of uveitis prior to initial COVID diagnosis were excluded. The primary outcome was the risk of new-onset uveitis at 1 and 2 years following the diagnosis of long COVID.

RESULTS: Unvaccinated, long COVID patients demonstrated an increased risk of developing new-onset uveitis compared to unvaccinated, no long COVID controls at 1 year (aHR: 2.01, 95% CI: 1.19-3.38) and 2 years (aHR: 1.60, 95% CI: 1.08-2.37). The highest risk was seen for anterior uveitis at 1 year (aHR: 1.96, 95% CI: 1.13-3.41) and 2 years (aHR: 1.59, 95% CI: 1.06-2.40). Other uveitis subtypes did not show an increased risk in this cohort. Among vaccinated individuals, there was not increased risk in those with long COVID compared to those without at 1 year (aHR: 0.95, 95% CI: 0.58-1.55) and 2 years (aHR: 0.97, 95% CI: 0.65-1.46).

CONCLUSION: Unvaccinated individuals with long COVID have an increased risk of developing new uveitis, particularly anterior uveitis. Vaccinated individuals with long COVID did not have an increased risk of developing uveitis compared to vaccinated non-long COVID individuals.},
}

@article {pmid41184874,
year = {2025},
author = {Laursen, CH and Nielsen, TB and Leth, S and Schiøttz-Christensen, B and Nielsen, CV and Langagergaard, V and Sørensen, L and Sørensen, D and Oestergaard, LG},
title = {Characterising disability in patients with long COVID-does gender matter? an analytic cross-sectional study.},
journal = {BMC public health},
volume = {25},
number = {1},
pages = {3744},
pmid = {41184874},
issn = {1471-2458},
mesh = {Humans ; Male ; Female ; Cross-Sectional Studies ; *COVID-19/epidemiology ; Middle Aged ; *Activities of Daily Living ; Sick Leave/statistics & numerical data ; Adult ; Sex Factors ; *Persons with Disabilities/statistics & numerical data ; Denmark/epidemiology ; Employment/statistics & numerical data ; Aged ; },
abstract = {BACKGROUND: Long COVID affects patients' daily functioning and activity participation. However, gender-specific differences remain insufficiently explored despite well-documented effects of gender on health outcomes. This study examines gender differences in sociodemographic characteristics, employment status, sick leave, and mental fatigue among individuals with long COVID. Furthermore, this study explores self-reported and prioritised problems with activities of daily living (ADL) across genders and compares patterns between women and men. We hypothesised that traditional gender roles would manifest in distinct challenges for women and men.

METHODS: We included 780 individuals (567 women and 213 men) diagnosed with long COVID who were referred to occupational therapy at a Danish outpatient clinic for long COVID. Sociodemographic characteristics, employment status, and sick leave were self-reported. Mental fatigue was assessed using the Mental Fatigue Scale, and ADL problems using the Canadian Occupational Performance Measure. A qualitative deductive content analysis was conducted to further categorise prioritised ADL problems.

RESULTS: A higher proportion of women than men had higher education (55% vs. 37%). No statistically significant gender difference was seen in the prevalence of sick leave (57% vs. 50%). Moderate to severe mental fatigue was reported by 78% of women and 68% of men, with women reporting significantly higher fatigue (p < 0.001). Minor gender differences in ADL problems were observed, with more women reporting difficulties in household management, quiet recreation, and social interaction. Both women and men prioritised similar ADL problems, such as paid work, physical activity, social interaction, and fulfilling caregiving roles.

CONCLUSION: ADL challenges reported by women and men were largely similar and had a significant impact on their daily lives. Identifying key activity limitations is essential to inform effective rehabilitation strategies.},
}

Humans
Male
Female
Cross-Sectional Studies
*COVID-19/epidemiology
Middle Aged
*Activities of Daily Living
Sick Leave/statistics & numerical data
Adult
Sex Factors
*Persons with Disabilities/statistics & numerical data
Denmark/epidemiology
Employment/statistics & numerical data
Aged

@article {pmid41183079,
year = {2025},
author = {Konishi, K and Yamamoto, S and Sada, RM and Asano, K and Onozuka, D and Tanaka, S and Miyazawa, S and Kinoshita, M and Kutsuna, S},
title = {Research to evaluate safety and impact of long COVID intervention with Ensitrelvir for National Cohort (RESILIENCE Study): A protocol for a randomized, double-blind, placebo-controlled trial.},
journal = {PloS one},
volume = {20},
number = {11},
pages = {e0335609},
pmid = {41183079},
issn = {1932-6203},
mesh = {Humans ; Japan/epidemiology ; Double-Blind Method ; *COVID-19/virology ; SARS-CoV-2 ; *COVID-19 Drug Treatment ; Randomized Controlled Trials as Topic ; Registries ; Cohort Studies ; Indazoles ; Triazines ; Triazoles ; },
abstract = {This study was registered with the Japan Registry of Clinical Trials on February 16, 2024 (jRCTs051230184, https://jrct.mhlw.go.jp/en-latest-detail/jRCTs051230184).},
}

Humans
Japan/epidemiology
Double-Blind Method
*COVID-19/virology
SARS-CoV-2
*COVID-19 Drug Treatment
Randomized Controlled Trials as Topic
Registries
Cohort Studies
Indazoles
Triazines
Triazoles

@article {pmid41182495,
year = {2025},
author = {Pini, L and Guerini, M and Giordani, J and Levi, G and Latronico, N and Piva, S and Peli, E and Benoni, R and Pini, A and Zucchi, G and Piras, S and El Masri, Y and Visca, D and Caminati, M and Senna, G and De Ciuceis, C and Rosei, CA and Muiesan, ML and Tantucci, C},
title = {24-Month assessment of respiratory function in patients hospitalized for severe SARS-CoV-2 pneumonia: a follow-up study.},
journal = {Internal and emergency medicine},
volume = {},
number = {},
pages = {},
pmid = {41182495},
issn = {1970-9366},
abstract = {Long COVID affects multiple body systems, with the respiratory system being particularly vulnerable. This study aimed to analyze the lung ventilatory function and diffusion capacity of patients with severe SARS-CoV-2 pneumonia during a 24-month follow-up course. Ventilatory function and lung diffusion capacity were assessed 6, 12, 18, and 24 months after hospital discharge. Ventilatory parameters, Diffusion Lung Carbon Monoxide (DLCO), and KCO (Carbon Monoxide transfer coefficient) normalization were defined as achieving values > 80% predicted. A total of 222 patients admitted to the Intensive Care Unit (ICU) at ASST Spedali Civili di Brescia, Brescia, Italy, were enrolled. Among the 172 patients who completed the study, 140 (63%) achieved normalization of ventilatory parameters, DLCO, and KCO. The median time to recovery was 4.5 months, and the hazard ratio (HR) decreased by 2% for each year of age increase. The median time to normalize ventilatory parameters (VC, FVC, FEV1, FEV1/FVC, TLC, and KCO) was 1.5 months, while the median time to alveolar volume (VA) normalization was 4.5 months. Male gender reduces the odds of normalization for FEV1/FVC and VA. The median time to DLCO normalization was 9 months, with HR reduced by 3.1% as each year of age increased and augmented by 226% in obese subjects. 24 months after severe COVID pneumonia, 14% of patients had persistent ventilatory and/or diffusive defects. Our study documented that male sex, age, and obesity impact the odds of normalization of ventilatory function and diffusive capacity. These findings underline the chronic nature of lung damage following severe COVID-19 pneumonia and the need for long-term follow-ups.},
}

@article {pmid41181095,
year = {2025},
author = {Simón-Rueda, A and Sánchez-Menéndez, C and Casado, G and Fuertes, D and Murciano-Antón, MA and Mateos, E and Domínguez-Mateos, S and Pozo, F and García-Pérez, J and Pérez-Olmeda, M and Cervero, M and Massanella, M and Moncunill, G and Torres, M and Coiras, M},
title = {Immune dysregulation and endothelial dysfunction associate with a pro-thrombotic profile in Long COVID.},
journal = {Frontiers in immunology},
volume = {16},
number = {},
pages = {1613195},
pmid = {41181095},
issn = {1664-3224},
mesh = {Humans ; *COVID-19/immunology/complications/blood/virology ; Male ; Female ; Middle Aged ; *SARS-CoV-2/immunology ; Biomarkers/blood ; Aged ; Adult ; *Thrombosis/immunology ; Cohort Studies ; *Endothelium, Vascular/immunology ; Antibodies, Viral/blood ; Blood Coagulation ; },
abstract = {INTRODUCTION: Long COVID (LC) affects approximately 10% of individuals post-SARS-CoV-2 infection, with symptoms persisting beyond 12 weeks. The underlying mechanisms remain unclear, and current models often focus on pre-existing comorbidities.

METHODS: This cohort study aimed to identify robust biomarkers and clarify LC pathogenesis through a comprehensive analysis performed in 32 LC individuals 26 months post-infection compared with 35 fully recovered individuals recruited between March and July 2022. Blood and fecal samples were collected, and multiple parameters associated with immune dysfunction, endothelial damage, bacterial translocation, and coagulation alterations, alongside signs of viral persistence and sociodemographic and clinical features, were analyzed.

RESULTS: Although viral RNA was undetected on blood or stool, elevated plasma IgG against the nucleocapsid may indicate frequent reinfections, greater infection severity, or delayed immune normalization. Increased levels of prothrombin, thrombin, fibrinogen, sEPCR, and CRP pointed to persistent endothelial dysfunction and coagulation imbalance. Lower levels of the bactericidal protein REG3A suggest potential disruptions in mucosal immune response. We found no major differences in traditional comorbidities, highlighting that LC may stem from distinct pathogenic mechanisms beyond pre-existing conditions. Importantly, our study revealed impaired humoral immunity and identified an association between vaccine heterogeneity and increased LC risk, emphasizing the relevance of consistent vaccination strategies. A Random Forest model using the measured biomarkers achieved 100% accuracy in classifying LC individuals, reinforcing their diagnostic potential.

DISCUSSION: These findings support a multifactorial model of LC involving immune dysregulation and persistent endothelial damage that led to coagulation abnormalities and a pro-thrombotic profile, supporting that LC is more closely related to a sustained, uncontrolled inflammatory response rather than immunodeficiency, and underscoring the value of multidimensional biomarker profiling for guiding clinical management and prevention strategies.},
}

Humans
*COVID-19/immunology/complications/blood/virology
Male
Female
Middle Aged
*SARS-CoV-2/immunology
Biomarkers/blood
Aged
Adult
*Thrombosis/immunology
Cohort Studies
*Endothelium, Vascular/immunology
Antibodies, Viral/blood
Blood Coagulation

@article {pmid41179091,
year = {2025},
author = {Tadisina, S and Mohammed, S and Asad, R and Tselovalnikova, T and Nguyen, B and Akella, PV and Abu Kishk, M},
title = {Prevalence and Evolution of Thyroid Dysfunction in COVID-19: A Retrospective Study.},
journal = {Cureus},
volume = {17},
number = {9},
pages = {e93542},
pmid = {41179091},
issn = {2168-8184},
abstract = {Objective Coronavirus-19 (COVID-19) is known to mainly affect the respiratory system, but it has also been found to impact multiple endocrine systems. Various studies have shown a relationship between thyroid dysfunction and COVID-19 infection. However, there is controversy around thyroid-inflammatory autoimmune conditions contributing to a worse prognosis of COVID-19 infection. The main objective of our single-center retrospective study is to evaluate the prevalence and evolution of thyroid dysfunction in patients with COVID-19 infection. Methods A total of 615 adults with confirmed COVID-19 infection, between March 2020 and December 2023, who had thyroid function tests (TFTs), were included in the study. Patients with pre-existing thyroid disease or on medications affecting thyroid function were excluded. Thyroid dysfunction was defined as any abnormality in TFTs. Statistical analyses were performed using IBM SPSS Statistics for Windows, Version 26 (Released 2018; IBM Corp., Armonk, NY, USA). Differences in continuous variables were assessed using independent sample t-tests, and Pearson's Chi-square tests were used to compare categorical variables. Results The study showed that 84 patients (13.6%) had thyroid dysfunction. The most common abnormalities were non-thyroidal illness syndrome (NTIS, n = 39; 46.4%) and subclinical hypothyroidism (n = 37; 44%), followed by overt hyperthyroidism (n = 6; 7.1%) and overt hypothyroidism (n = 2; 2.3%). The evolution of thyroid dysfunction was followed for about one year by chart review and showed no progression to overt thyroid dysfunction. Conclusion We noted that thyroid dysfunction is not uncommon in patients with COVID-19, with subclinical hypothyroidism and NTIS being the most prevalent findings. These abnormalities are often transient and resolve without progression in most cases. The pathogenesis appears to involve both direct viral effects and systemic inflammatory responses. Given the potential overlap between thyroid dysfunction and long COVID symptoms, selective monitoring of thyroid function is warranted in symptomatic individuals.},
}

@article {pmid41178423,
year = {2025},
author = {Limami, Y and Wahnou, H and Ndayambaje, M and Hba, S and Chgari, O and Ammara, M and El Kebbaj, R and Naya, A and Oudghiri, M and Duval, RE},
title = {SARS-CoV-2: A Liver Brief.},
journal = {WIREs mechanisms of disease},
volume = {17},
number = {6},
pages = {e70005},
doi = {10.1002/wsbm.70005},
pmid = {41178423},
issn = {2692-9368},
mesh = {Humans ; *COVID-19/complications/virology/pathology/immunology ; *SARS-CoV-2/pathogenicity ; *Liver Diseases/virology/pathology ; *Liver/virology/pathology/immunology/metabolism ; Angiotensin-Converting Enzyme 2/metabolism ; Virus Internalization ; },
abstract = {The Coronavirus Disease 2019 (COVID-19) pandemic, caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), has revealed the virus's ability to induce multi-organ damage, including significant liver injury. The molecular mechanisms of liver dysfunction in COVID-19 patients are explored, focusing on direct viral infection, immune-mediated damage, and the gut-liver axis. SARS-CoV-2 enters liver cells through the Angiotensin-Converting Enzyme 2 (ACE2) and Transmembrane Serine Protease 2 (TMPRSS2) receptors, but alternative pathways, such as CD209/Dendritic Cell-Specific Intercellular adhesion molecule-3-Grabbing Non-integrin (DC-SIGN) and AXL receptors, can also contribute to viral entry. Additionally, immune responses, particularly the cytokine storm, exacerbate liver inflammation, leading to hepatocyte damage. Pre-existing liver conditions, such as metabolic-associated fatty liver disease (MAFLD), alcohol-related liver disease (ALD), and liver fibrosis, heighten the risk of severe outcomes in COVID-19 patients. Post-COVID-19 liver complications, including fibrosis progression and persistent liver damage, have been reported, with emerging evidence suggesting chronic inflammation, viral persistence, and autoimmune reactions as potential contributors. Furthermore, Drug-Induced Liver Injury (DILI) from COVID-19 treatments remains a concern, highlighting the need for careful management. Consequently, understanding the interplay between SARS-CoV-2 and the liver is critical for improving patient outcomes and developing targeted therapies to mitigate liver-related complications in both acute and Long COVID-19 phases. This article is categorized under: Infectious Diseases > Molecular and Cellular Physiology.},
}

Humans
*COVID-19/complications/virology/pathology/immunology
*SARS-CoV-2/pathogenicity
*Liver Diseases/virology/pathology
*Liver/virology/pathology/immunology/metabolism
Angiotensin-Converting Enzyme 2/metabolism
Virus Internalization

@article {pmid41177912,
year = {2025},
author = {Rhidenour, KB and Thompson, CM and Babu, S and Kelpinski, LF},
title = {"Everything Looks Normal": Patient Narratives of Contested Legitimacy in Long COVID Medical Encounters.},
journal = {Health communication},
volume = {},
number = {},
pages = {1-9},
doi = {10.1080/10410236.2025.2580322},
pmid = {41177912},
issn = {1532-7027},
abstract = {This study examines how individuals with long COVID navigate illness experiences when faced with normal test results. Through qualitative analysis of 1,043 posts from r/covidlonghaulers between July 2020 and January 2021, we identified four key themes: overlapping diagnostic possibilities increase confusion, discordance in treatment plans, sustained uncertainty, and challenges to credibility. Our findings reveal how polysemic meanings of normal become sites of tension between biomedical evidence and lived experiences, creating a communicative burden for patients who must advocate for legitimacy and care. The analysis demonstrates how overlapping symptomology with other conditions complicates diagnosis, while patients develop strategies to navigate dismissive healthcare encounters and establish credibility when symptoms persist despite normal results. Reddit served as a vital platform for patients to exchange communication strategies for healthcare encounters and find validation when test results invalidated their experiences. A strength of this study is its ability to capture the experience of people with long COVID at the community's inception through a platform that connected them despite geographical barriers. Our findings provide valuable insights into how patients navigate contested illness experiences and offer concrete pathways for enhancing patient-provider communication around medically unexplained symptoms across various diagnoses.},
}

@article {pmid41176968,
year = {2025},
author = {Thaweethai, T and Gross, RS and Pant, DB and Rhee, KE and Jernigan, TL and Kleinman, LC and Snowden, JN and Salisbury, AL and Kinser, PA and Milner, JD and Tantisira, K and Warburton, D and Mohandas, S and Wood, JC and Fitzgerald, ML and Carmilani, M and Krishnamoorthy, A and Reeder, HT and Foulkes, AS and Stockwell, MS and , },
title = {Preventive effect of vaccination on long COVID in adolescents with SARS-CoV-2 infection.},
journal = {Vaccine},
volume = {68},
number = {},
pages = {127907},
doi = {10.1016/j.vaccine.2025.127907},
pmid = {41176968},
issn = {1873-2518},
abstract = {PURPOSE: In adolescents (12-17 years), it is unknown whether COVID-19 vaccination reduces progression from COVID-19 to Long COVID (LC) beyond preventing SARS-CoV-2 infection. We assessed the effect of vaccination among SARS-CoV-2 infected adolescents.

METHODS AND RESULTS: Participants were recruited from over 60 US healthcare and community settings. The exposure was any COVID-19 vaccination 6 months prior to infection. The outcome was LC defined using the LC research index. Vaccinated (n = 724) and unvaccinated (n = 507) adolescents were matched on sex, infection date, and enrollment date. The risk of LC was 36 % lower (95 % CI, 17 %, 50 %) in vaccinated compared to unvaccinated participants.

CONCLUSIONS: Vaccination reduces the risk of LC. Given the profound impact LC can have on the health and well-being of adolescents and the limited availability of treatments during this developmental stage, this supports vaccination as a strategy for preventing LC by demonstrating an important secondary prevention effect.},
}

@article {pmid41176305,
year = {2025},
author = {Palacio, A and Bast, E and Phillip, P and Milanes, I and Klimas, N and Tamariz, L},
title = {Virtual Group Clinics Improve Self-Reported Long COVID Symptoms Among Veterans: Results From a Holistic Care Approach.},
journal = {Journal of the American Medical Directors Association},
volume = {},
number = {},
pages = {105963},
doi = {10.1016/j.jamda.2025.105963},
pmid = {41176305},
issn = {1538-9375},
}

@article {pmid41174646,
year = {2025},
author = {He, Z and Yi, S and Zhou, H and Hu, F and Nie, Q and Song, D and Liu, X and Wang, J and Zhou, J and Liu, J and Li, Y and Xu, L and Ou, Y and Mei, Y and Zeng, D and Cheng, G and Liu, D},
title = {Exploring the association between the post-pandemic period and psychological problems among university students in Wuhan: a cross-sectional analysis.},
journal = {BMC public health},
volume = {25},
number = {1},
pages = {3715},
pmid = {41174646},
issn = {1471-2458},
support = {No. 81870901//National Natural Science Foundation of China/ ; No. 81870901//National Natural Science Foundation of China/ ; No. 2020355//Hubei Teaching Program/ ; },
mesh = {Humans ; *COVID-19/psychology/epidemiology ; *Students/psychology/statistics & numerical data ; China/epidemiology ; Cross-Sectional Studies ; Male ; Female ; Universities ; Young Adult ; Adult ; *Anxiety/epidemiology ; Surveys and Questionnaires ; *Depression/epidemiology ; Sleep Initiation and Maintenance Disorders/epidemiology ; Pandemics ; Prevalence ; Adolescent ; SARS-CoV-2 ; },
abstract = {OBJECTIVE: Evidence demonstrates that Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection influences mental health through biological, psychological, and social mechanisms. In the post-pandemic period, defined as the time following the easing of major public health restrictions and the return to normalcy in daily life, university students represent a vulnerable population, experiencing a high prevalence of psychological problems due to the lingering influence of the pandemic on daily life and the emergence of long-term health consequences. There is an urgent need to understand these mental health symptoms and quantify their associated factors.

METHODS: A questionnaire was designed to investigate the mental health symptoms of anxiety, depression, and insomnia among university students in Wuhan, focusing on four key domains: individual, family, school, and pandemic. Logistic regression was employed to analyze the related factors and conduct attribution analysis.

RESULTS: Of the 2,668 eligible participants, 2,112 (79.2%) self-reported Omicron infection, and 352 (16.7%) experienced Long-COVID. The prevalence of moderate-to-severe depression was 18.2% (95% CI: 16.8%-19.7%), anxiety was 8.9% (95% CI: 7.8% - 10.0%) and insomnia was 31.4% (95% CI: 29.6%-33.1%). Moderate-to-severe psychological symptoms among university students were associated with ten factors across the four key domains, with total weighted Population Attributable Fractions (PAFs) accounting for 60.1% of depression, 40.8% of anxiety, and 61.6% of insomnia. Individual factors had the highest PAFs, contributing 31.2% to depression, 23.8% to anxiety, and 25.1% to insomnia, followed by pandemic-related PAFs of 17.7% ,10.3%, and 21.9% for depression, anxiety, and insomnia, respectively.

CONCLUSION: The psychological challenges confronting university students in Wuhan are alarmingly severe, with individual factors superimposed on the pandemic caused by SARS-CoV2 being the primary contributors. We propose targeted intervention measures: strengthening psychological counseling services, increasing communication and exchange to enhance students' psychological resilience, raising awareness about mental health and lifestyle, alleviating students' fear of sequelae, assisting university students with academic planning and career guidance, cultivating adaptability, and promoting overall physical and mental health.},
}

Humans
*COVID-19/psychology/epidemiology
*Students/psychology/statistics & numerical data
China/epidemiology
Cross-Sectional Studies
Male
Female
Universities
Young Adult
Adult
*Anxiety/epidemiology
Surveys and Questionnaires
*Depression/epidemiology
Sleep Initiation and Maintenance Disorders/epidemiology
Pandemics
Prevalence
Adolescent
SARS-CoV-2

@article {pmid41174473,
year = {2025},
author = {Abiri, E and Hemmatian, N},
title = {Investigating apoptosis in peripheral blood mononuclear cells among the elderly in the post-COVID-19 era.},
journal = {BMC immunology},
volume = {26},
number = {1},
pages = {86},
pmid = {41174473},
issn = {1471-2172},
mesh = {Humans ; *COVID-19/immunology/pathology ; Aged ; *Apoptosis/immunology ; *Leukocytes, Mononuclear/immunology ; Male ; Female ; *SARS-CoV-2/immunology ; Cross-Sectional Studies ; Aged, 80 and over ; Membrane Potential, Mitochondrial ; Caspase 3/metabolism ; Immunosenescence ; },
abstract = {BACKGROUND AND AIM: The COVID-19 pandemic has left a lasting imprint on immune function, particularly in the elderly-a population already vulnerable to immunosenescence. While acute and long-COVID immune responses have been widely studied, the long-term apoptotic behavior of peripheral blood mononuclear cells (PBMCs) remains underexplored. This study aims to investigate the legacy of SARS-CoV-2 on PBMC apoptosis in elderly individuals during the post-COVID era, shedding light on potential persistent immune dysregulation.

MATERIALS AND METHODS: In this cross-sectional study, PBMCs were isolated from peripheral blood samples of elderly individuals (> 65 years old) with a documented history of COVID-19 infection at least six months prior. Using multiparametric flow cytometry, we quantified early and late apoptosis markers (Annexin V/PI), mitochondrial membrane potential disruption (ΔΨm), and expression of pro-apoptotic (Bax, Caspase-3) and anti-apoptotic (Bcl-2) proteins. Statistical analyses were performed to assess intergroup differences and correlations with clinical history. This study was conducted in 2025.

RESULTS: Elderly post-COVID individuals exhibited a significantly elevated proportion of apoptotic PBMCs compared to controls (p < 0.01), particularly within the CD4 + and CD8 + T-cell subsets. Mitochondrial depolarization and increased Bax/Bcl-2 ratios indicated a shift toward intrinsic apoptotic pathways. Caspase-3 activation was also heightened in the post-COVID group. Notably, apoptotic burden correlated with time since infection and severity of initial illness.

DISCUSSION: Our findings suggest a prolonged apoptotic signature in the immune cells of elderly individuals following recovery from COVID-19. These alterations may reflect a sustained immune exhaustion or maladaptive remodeling of lymphocyte populations, potentially contributing to impaired immunosurveillance and increased vulnerability to secondary infections or chronic inflammatory conditions.

CONCLUSION: COVID-19 may cast a long immunological shadow in the elderly, with persistent PBMC apoptosis representing a novel facet of post-viral immune dysregulation. Flow cytometry reveals a unique apoptotic phenotype that could serve as a biomarker for long-term immune health and guide post-pandemic clinical management strategies for aging populations.},
}

Humans
*COVID-19/immunology/pathology
Aged
*Apoptosis/immunology
*Leukocytes, Mononuclear/immunology
Male
Female
*SARS-CoV-2/immunology
Cross-Sectional Studies
Aged, 80 and over
Membrane Potential, Mitochondrial
Caspase 3/metabolism
Immunosenescence

@article {pmid41173504,
year = {2025},
author = {Briggs, AH and Ibbetson, A and Walters, A and Houchen-Wolloff, L and Armstrong, N and Emerson, T and Gill, R and Hastie, C and Little, P and Overton, C and Pimm, J and Poinasamy, K and Singh, S and Walker, S and Leavy, OC and Richardson, M and Elneima, O and McAuley, H and Shikotra, A and Singapuri, A and Sereno, M and Saunders, RM and Harris, VC and Greening, NJ and Harrison, E and Docherty, A and Lone, NI and Quint, JK and Chalmers, J and Ho, LP and Horsley, AR and Raman, B and Wain, LV and Brightling, CE and Marks, M and Evans, RA and , },
title = {Clinical and cost-effectiveness of diverse posthospitalisation pathways for COVID-19: a UK evaluation using the PHOSP-COVID cohort.},
journal = {BMJ open respiratory research},
volume = {12},
number = {1},
pages = {},
doi = {10.1136/bmjresp-2025-003224},
pmid = {41173504},
issn = {2052-4439},
mesh = {Humans ; *COVID-19/economics/therapy/epidemiology ; Cost-Benefit Analysis ; United Kingdom/epidemiology ; Male ; Female ; Middle Aged ; Aged ; Quality of Life ; Quality-Adjusted Life Years ; SARS-CoV-2 ; Adult ; Prospective Studies ; Patient Discharge/economics ; Health Care Costs/statistics & numerical data ; },
abstract = {BACKGROUND: Long covid has emerged as a complex health condition for millions of people worldwide following the COVID-19 pandemic. Previously, we have categorised healthcare pathways for patients after discharge from hospital with COVID-19 across 45 UK sites. The aim of this work was to estimate the clinical and cost-effectiveness of these pathways.

METHODS: We examined prospectively collected data from 1013 patients at 12 months postdischarge on whether they felt fully recovered (self-report), number of newly diagnosed conditions (NDC), quality of life (EuroQoL-five dimension-five level (EQ-5D-5L) utility score compared with pre-COVID estimate) and healthcare resource costs (healthcare records). An analysis of the cost-effectiveness was performed by combining the healthcare resource cost and 1-year EQ-5D (giving a quality-adjusted life-year (QALY)) using statistical models that accounted for observed confounding.

RESULTS: At 1 year, 29% of participants felt fully recovered, and 41% of patients had an NDC. The most comprehensive services, where all patients could potentially access assessment, rehabilitation and mental health services, were more clinically effective when compared with either no service or light touch services (mean (SE) QALY 0.789 (0.012) vs 0.725 (0.026)), with an estimated cost per QALY of £1700 (95% uncertainty interval: dominated to £24 800).

CONCLUSION: Our analysis supports the need for proactive, stratified, comprehensive follow-up, particularly assessment and rehabilitation for adults after hospitalisation with COVID-19, showing these services are likely to be both clinically and cost-effective according to commonly accepted thresholds.},
}

Humans
*COVID-19/economics/therapy/epidemiology
Cost-Benefit Analysis
United Kingdom/epidemiology
Male
Female
Middle Aged
Aged
Quality of Life
Quality-Adjusted Life Years
SARS-CoV-2
Adult
Prospective Studies
Patient Discharge/economics
Health Care Costs/statistics & numerical data

@article {pmid41171518,
year = {2025},
author = {Mallouli, SZ and Munblit, D and Iakovleva, E and Winkler, AS and Fornari, A and Helbok, R and Struhal, W and Beretta, S and De Groote, W and Curatoli, C and Lanza, M and Ericka, F and Crivelli, L and Giussani, G and Wasay, M and Chakroun Walha, O and Safi, F and Leonardi, M and Allegri, R and Guekht, A and Triki, CC},
title = {Persistent neurological sequelae in children and adolescents after SARS-CoV-2: a scoping review.},
journal = {Infection},
volume = {},
number = {},
pages = {},
pmid = {41171518},
issn = {1439-0973},
abstract = {OBJECTIVES: For the past five years, COVID-19 has not only been a priority for health planning but also a hotspot for clinical research. Yet, the weight of the worldwide COVID-19 pandemic arises from the critical phase consequences due to the onset of acute disease, associated containment measures, and documented ongoing disabling symptoms. Investigating the global longitudinal effects on children and adolescents will inform future health directives tailored to this population's needs. This review aimed to report the spectrum of persistent neurological sequelae in children and adolescents following SARS-CoV-2 infection.

METHODS: Hence, we conducted a scoping review following the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). We included the peer-reviewed articles from PubMed, Google Scholar, Web of Science, Cochrane Library, and WHO COVID database to identify relevant literature on long-COVID-19 neurological signs/symptoms among children and adolescents. The search covered the period between September 2020 and September 2024.

RESULTS: The results of our analysis of 33 studies found long-COVID-19-related neurological signs/symptoms were predominantly: pain and sensory problems (N = 74,612/91,543; 81.5%), followed by sleep disturbances (N = 14,630/91,543; 15.9%), and cognitive difficulties (N = 2274/91,543; 2.4%). The global prevalence of long COVID-19 neurological signs/symptoms was estimated between 0.4% (20/5032; 95% CI = 2.1-3%) and 34% (27/79) based on data obtained through online questionnaire; while it varied between 1.8% (4/215) and 83.14% (74/89; 95%CI =   -  0.12; 0.30) based on patient assessment. Long-COVID-19-related neurological signs/symptoms were more common in the 11-16 age group. Children with immunocompetent profiles were at higher risk of developing long-COVID-19-related neurological signs/symptoms.

CONCLUSION: Our results demonstrate a considerable burden of COVID-19-related persistent neurological signs/symptoms in children and adolescents, which should be taken into consideration in healthcare decision-making.},
}

@article {pmid41171293,
year = {2025},
author = {Anderer, S},
title = {Long COVID Trial Explores Anti-Inflammatory Treatment.},
journal = {JAMA},
volume = {},
number = {},
pages = {},
doi = {10.1001/jama.2025.17537},
pmid = {41171293},
issn = {1538-3598},
}

@article {pmid41170051,
year = {2025},
author = {Jain, P and Paliwal, P and C Hundekari, J and Paliwal, M and Bajpai, T and Rajput, J and Mishra, K},
title = {Oxidative stress markers among post-Covid-19 survivors in Central India.},
journal = {Bioinformation},
volume = {21},
number = {7},
pages = {1922-1924},
pmid = {41170051},
issn = {0973-2063},
abstract = {Oxidative stress is an important element in the pathophysiology of COVID-19 leading to the development of post-COVID syndrome. Therefore, it is interest to evaluate the relationship between changes in oxidative status and the persistence of long-COVID symptoms. Our, data shows that the Superoxide dismutases and Serum Malondialdehyde (MDA) levels were low in cases than controls among post-Covid-19 srvivors.},
}

@article {pmid41169891,
year = {2025},
author = {Kamel, D and Vu, MH and Bender, J and Warburton, D and Wood, JC and Mohandas, S},
title = {Exploring long COVID in pediatric patients: clinical insights from a long COVID clinic.},
journal = {Frontiers in pediatrics},
volume = {13},
number = {},
pages = {1640747},
pmid = {41169891},
issn = {2296-2360},
abstract = {BACKGROUND: Long COVID describes the persistence or recurrence of symptoms beyond the acute phase of SARS-CoV-2 infection and is increasingly recognized in children and adolescents. Despite its prevalence, understanding of symptom patterns and the influence of vaccination on disease trajectory in pediatric populations remains limited.

METHODS: We conducted a retrospective study of patients aged 0-21 years evaluated at the Long COVID Clinic at Children's Hospital Los Angeles between August 2021 and November 2023. Patients were included if they reported persistent or new symptoms ≥4 weeks after SARS-CoV-2 infection.

RESULTS: A total of 123 patients were enrolled. The mean age was 13.1 years, and 51% were male. Symptom onset occurred a mean of 5 weeks after infection. At presentation, 56% of patients reported symptoms lasting 0-24 weeks, 28% for 25-52 weeks, and 16% for >52 weeks. Fatigue (93%) and headache (70%) were the most prevalent symptoms in both younger (<12 years) and older (>12 years) cohorts. Female patients more frequently reported brain fog, dizziness, palpitations, and postural orthostatic tachycardia syndrome. Overall symptom burden decreased significantly over time (p < 0.001). Vaccination status at baseline was not associated with difference in symptom duration on initial presentation (p = 0.4). However, among those vaccinated after developing long COVID, 41% reported subjective improvement in the following weeks.

CONCLUSION: Pediatric long COVID is marked by prolonged, multisystem symptoms. Vaccination may offer symptomatic benefit for some patients, though larger prospective studies are necessary to better define its role.},
}

@article {pmid41168795,
year = {2025},
author = {Gartmann, J and Sturm, C and Bökel, A},
title = {Physiotherapy interventions in post- and long-COVID-19: a scoping review of the literature up to February 2023.},
journal = {BMC health services research},
volume = {25},
number = {1},
pages = {1425},
pmid = {41168795},
issn = {1472-6963},
}

@article {pmid41167719,
year = {2025},
author = {Twycross, A and le May, A and McMahon, A and Maxwell, E},
title = {Resources page: foundations of Nursing Care for People with Long Covid.},
journal = {Evidence-based nursing},
volume = {},
number = {},
pages = {},
doi = {10.1136/ebnurs-2025-104419},
pmid = {41167719},
issn = {1468-9618},
}

@article {pmid41165819,
year = {2025},
author = {Helt, TW and Thomsen, RS and Christensen, J and Lund, TK and Kalhauge, A and Rönsholt, F and Podlekavera, D and Arndal, E and Lebech, AM and Berg, RMG and Katzenstein, TL and Mortensen, J},
title = {Relation of pulmonary diffusing capacity changes to HRCT chest and V/Q SPECT findings at short-term and intermediate follow-up after COVID-19: a prospective cohort study (The secure study).},
journal = {European journal of nuclear medicine and molecular imaging},
volume = {},
number = {},
pages = {},
pmid = {41165819},
issn = {1619-7089},
abstract = {BACKGROUND: Several patients exhibit a severity-dependent reduced pulmonary diffusing capacity (DLCOc) following coronavirus disease 2019 (COVID-19) infection. This has been attributed to fibrosis-like restrictive lung disease, as shown by chest high-resolution computed tomography (HRCT), and concurrent ventilatory disturbances observed by ventilation-perfusion single-photon emission computed tomography (V/Q SPECT) imaging. The aim of this study was to investigate whether reductions in DL,COc at short- and intermediate-term follow-up were associated with initial severity of COVID-19, and to which extend this was linked to the presence of fibrosis-like abnormalities on HRCT and ventilatory disturbances on V/Q SPECT.

METHODS: A total of 153 patients diagnosed with COVID-19 between March 2020 and March 2021 were included in the study. The patients underwent lung function testing, chest HRCT, and V/Q SPECT at short-term (5.6 months) follow-up. Individuals exhibiting any evidence of post-COVID-19 sequelae (n = 121) were also referred to intermediate follow-up (12.5 months).

RESULTS: At short-term follow-up, a severity dependent reduction in DL,COc was observed, which was not evident at intermediate follow-up. At both short-term and intermediate follow-up, HRCT showed ground-glass opacity (GGO) and fibrosis-like abnormalities related to disease severity. Most patients had V/Q defects mainly with ventilatory abnormalities, including both matched and inversely matched defects at both follow-up times.

CONCLUSION: The severity-dependent reduction in DL,COc at short-term follow-up, associated with restrictive lung function pattern, GGO and fibrosis on HRCT, and ventilatory disturbances on V/Q SPECT, showed spontaneous recovery by intermediate follow-up. However, the restrictive ventilatory disturbances and associated morphological changes persisted.},
}

@article {pmid41164784,
year = {2025},
author = {Jagannathan, P and Hedlin, H and Liang, JW and Shaw, B and Maestri, E and Lin, M and Utz, PJ and Singh, U and Geng, LN and Bonilla, H},
title = {Longitudinal Patient-Reported Outcome Trajectories in Long COVID: Findings From the STOP-PASC Clinical Trial.},
journal = {Open forum infectious diseases},
volume = {12},
number = {10},
pages = {ofaf634},
pmid = {41164784},
issn = {2328-8957},
abstract = {BACKGROUND: Long COVID is a heterogeneous post-infectious condition. Although patient-reported outcome (PRO) measures for diagnosis or therapeutic monitoring have been adapted from related complex chronic illnesses, no PRO has been validated specifically in Long COVID. The STOP-PASC randomized, placebo-controlled trial of nirmatrelvir/ritonavir (NMV/r) in adults with Long COVID showed no overall treatment effect. This exploratory analysis aimed to identify distinct symptom trajectories and clinical characteristics associated with improvement or worsening over time.

METHODS: We performed latent class trajectory modeling (LCTM) on PRO measures-including the Patient Global Impression of Severity (PGIS), Patient Global Impression of Change (PGIC), PROMIS domains, and core symptoms-among 155 randomized participants. Participants were followed for 15 weeks with serial symptom assessments. Trajectory groups were identified using Bayesian Information Criteria and characterized using descriptive statistics and absolute standardized differences.

RESULTS: LCTM revealed heterogeneity in symptom trajectories. Two groups emerged for PGIS (improving n = 17, persistent/severe n = 136) and PGIC (improving n = 130; worsening n = 22). PROMIS-Physical Function modeling identified four groups (improving, normal/mild, moderate, and severe), fatigue core symptom modeling identified three (improving; moderate; severe). Worsening groups had higher proportions of NMV/r-treated participants and greater prevalence of cardiovascular symptoms and low-dose naltrexone use. Improving groups had shorter time since infection and higher baseline physical function. No subgroup showed a clear benefit from NMV/r.

CONCLUSIONS: Distinct PRO trajectories reflect the clinical heterogeneity of Long COVID. NMV/r showed no clear benefit across subgroups. These findings emphasize the need for validated, Long COVID-specific PRO instruments and targeted therapeutic trials tailored to Long COVID subtypes.},
}

@article {pmid41164629,
year = {2025},
author = {Sekar, P and Dominic, M and Balakrishnan, S and Sreelakshmi, VK and Haneendhar, R and Gopan, SJ and Rathnasami, P and Moturi, SV},
title = {Post-COVID-19 Complications: A Study on Long COVID Symptoms and Their Pathophysiology.},
journal = {Journal of pharmacy & bioallied sciences},
volume = {17},
number = {Suppl 3},
pages = {S2557-S2559},
pmid = {41164629},
issn = {0976-4879},
abstract = {BACKGROUND: Long COVID refers to persistent symptoms lasting weeks or months after recovery from acute COVID-19. These symptoms can affect multiple systems and impair quality of life.

OBJECTIVE: To assess the prevalence, pattern, and probable pathophysiological mechanisms of long COVID symptoms in recovered patients.

MATERIALS AND METHODS: A cross-sectional study was conducted over 12 months among 210 adults recovered from COVID-19 (≥12 weeks postinfection). Clinical evaluation, lab investigations, and imaging were used to identify post-COVID symptoms and explore underlying mechanisms.

RESULTS: Common symptoms included fatigue (67.6%), breathlessness (42.8%), cognitive issues (39.5%), and myalgia (34.7%). Neuropsychiatric complaints were noted in 41%, while 29% had cardiopulmonary sequelae. Elevated inflammatory markers correlated with symptom persistence (P < 0.05).

CONCLUSION: Long COVID involves diverse symptoms, primarily fatigue and neurorespiratory complaints. Immune dysregulation and systemic inflammation appear central to its pathophysiology.},
}

@article {pmid41164396,
year = {2025},
author = {Pierson, BC and Craig-Kuhn, MC and Stewart, L and Sercy, E and Stern, CA and Graham, B and Michel, A and Parmelee, E and Koehlmoos, TP and Saunders, D and Mancuso, JD and Pollett, S and Burgess, T and Tribble, DR},
title = {Evaluating the risk and risk factors of dysautonomia as a post-acute sequelae of COVID-19: a secondary analysis of a matched case-control dataset.},
journal = {Frontiers in neurology},
volume = {16},
number = {},
pages = {1653175},
pmid = {41164396},
issn = {1664-2295},
abstract = {BACKGROUND: A significant proportion of patients presenting with post-acute sequelae of COVID-19 (PASC) have been found to meet diagnostic criteria for certain disorders of the autonomic nervous system. Substantial gaps remain in our understanding of these conditions. Our objective is to evaluate demographic and medical factors associated with PASC dysautonomia in active duty US Service members (ADSM). Additionally we assessed for risk factors in those diagnosed with COVID-19 for PASC dysautonomia, and differences in those with PASC dysautonomia and non-PASC dysautonomia.

METHODS: A matched case control dataset (n = 1,367,961) of ADSM diagnosed with COVID-19 matched with ADSM with no evidence of COVID-19 was utilized to assess associations of demographic and clinical factors with PASC dysautonomia. Logistic regression modeling was used to assess differences among those diagnosed with COVID-19. Conditional logistic regression modeling using propensity score weighting was used for comparisons between those with PASC dysautonomia and non-PASC dysautonomia.

RESULTS: We identified 619,983 COVID-19 cases (158 PASC dysautonomia) and 747,978 controls (219 non-PASC dysautonomia). Among COVID-19 cases, factors positively associated with PASC dysautonomia were white, non-Hispanic race/ethnicity, female sex, younger age, northeast region, more severe COVID-19 infection, and comorbid depression or anxiety. Among those with dysautonomia, those with PASC dysautonomia were more likely to be of female sex, younger, in the northeast region, and less likely to have comorbid anxiety.

CONCLUSION: PASC dysautonomia is rare in ADSM but associated with increased care utility and often prolonged diagnostic pathways. Important demographic and COVID-19 specific risk factors are associated with the development of PASC dysautonomia. PASC dysautonomia has significant differences in risk factors as compared to non-PASC dysautonomia, warranting further examination. These findings may support clinician awareness and prognostication and prompt further research on the pathophysiology and management of these conditions.},
}

@article {pmid41164170,
year = {2025},
author = {Raveendran, VV and AlQattan, S and AlMutairy, E},
title = {A review on clinical implications of S100 proteins in lung diseases.},
journal = {Frontiers in medicine},
volume = {12},
number = {},
pages = {1618772},
pmid = {41164170},
issn = {2296-858X},
abstract = {The S100 family of proteins plays a pivotal role in the pathogenesis of lung diseases, including asthma, chronic obstructive pulmonary disease (COPD), cystic fibrosis, pulmonary arterial hypertension (PAH), pulmonary fibrosis, lung cancers, acute lung injury, acute respiratory distress syndrome, COVID-19, and lung transplantation. This review comprehensively examines the contributions of S100 proteins to the progression of these disorders, focusing on their potential as diagnostic and prognostic biomarkers, as well as therapeutic targets. S100A protein-mediated key molecular mechanisms that influence inflammation, airway remodeling, fibrosis, and tumorigenesis in the lungs are discussed. The importance of their normal function is evident from the observation that simultaneous mutations in S100A3 and S100A13 predispose individuals to early-onset pulmonary fibrosis, underscoring their critical role in lung health. Furthermore, sustained S100 protein elevation is explored in the context of long COVID, shedding light on its role in chronic inflammation. These proteins act as damage-associated molecular patterns (DAMPs), activating immune pathways via receptors like TLR4 and RAGE, thereby driving inflammation and immune cell recruitment. Notably, in lung transplantation, elevated levels of S100A8, S100A9, and S100A12 serve as early biomarkers of graft rejection and complications such as graft-vs.-host disease, which indicates their role in mediating immune responses and transplant outcomes. While promising, the clinical application of S100 proteins faces challenges, including disease-specific variability and the need for robust validation across diverse populations. This narrative review underscores the dual potential of S100 proteins as biomarkers and therapeutic targets in respiratory medicine while emphasizing the importance of overcoming current limitations through targeted research and clinical trials.},
}

@article {pmid41161981,
year = {2025},
author = {Vishnu, P and Aboulafia, DM},
title = {Hemostatic Disorders Following Severe Acute Respiratory Syndrome Coronavirus 2 Infection, COVID-19 Vaccination, and Long-COVID Syndrome: Current Evidence and Controversies in Clinical Practice.},
journal = {Clinics in laboratory medicine},
volume = {45},
number = {4},
pages = {643-655},
doi = {10.1016/j.cll.2025.07.008},
pmid = {41161981},
issn = {1557-9832},
mesh = {Humans ; *COVID-19/complications/prevention & control ; *COVID-19 Vaccines/adverse effects ; *Hemostatic Disorders/etiology ; SARS-CoV-2 ; *Vaccination/adverse effects ; },
abstract = {The COVID-19 pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has presented profound global health challenges. Beyond acute illness, a substantial proportion of individuals experience persistent symptoms including fatigue, brain fog, and post-exertional malaise, collectively known as Long-COVID. Among the complications associated with SARS-CoV-2 infection and vaccination, hemostatic disorders ranging from mild platelet dysfunction to severe thromboembolic events, and rare but serious coagulation-related adverse effects, such as vaccine-induced immune thrombotic thrombocytopenia, have emerged as a significant concern. Herein we provide an overview of current information and controversies surrounding hemostatic complications in SARS-CoV-2 infection and COVID-19 vaccination.},
}

Humans
*COVID-19/complications/prevention & control
*COVID-19 Vaccines/adverse effects
*Hemostatic Disorders/etiology
SARS-CoV-2
*Vaccination/adverse effects

@article {pmid41161755,
year = {2025},
author = {Ozawa, T and Terai, H and Tanaka, H and Iba, A and Hosozawa, M and Hori, M and Muto, Y and Yoshida-Kohno, E and Namkoong, H and Chubachi, S and Takemura, R and Nagashima, K and Sato, Y and Ishii, M and Iso, H and Fukunaga, K and , },
title = {Japanese nationwide survey to track the impact of long COVID over 3 years.},
journal = {Environmental health and preventive medicine},
volume = {30},
number = {},
pages = {84},
doi = {10.1265/ehpm.25-00293},
pmid = {41161755},
issn = {1347-4715},
mesh = {Humans ; *COVID-19/epidemiology/economics/psychology/complications ; Japan/epidemiology ; Male ; Female ; Middle Aged ; Retrospective Studies ; Aged ; *Quality of Life ; Adult ; Aged, 80 and over ; SARS-CoV-2 ; Surveys and Questionnaires ; Post-Acute COVID-19 Syndrome ; East Asian People ; },
abstract = {BACKGROUND: The long-term impact of symptom classification on quality of life (QOL) and economic outcomes among individuals with long coronavirus disease (COVID) remains poorly understood. This study aimed to clarify the situation of long COVID in Japan by analyzing patients using cluster classification.

METHODS: This multicenter, retrospective cohort study enrolled 515 patients with COVID-19 and followed up for 36 months via standardized questionnaires. Patients were classified based on: 1) symptom trajectory over time and 2) symptom cluster profiles at 3 months.

RESULTS: While the number of symptoms decreased, fatigue and dyspnea frequently persisted, whereas anosmia and dysgeusia declined. Cough and sputum decreased gradually. The proportion of patients with 5-9 symptoms increased. The mean (interquartile range) presenteeism scores were lower in the continuous (60 [50-80]) and relapse groups (65 [48-80]) than in the recovered group (70 [50-80]). The multiple symptoms cluster had the worst SF-36, presenteeism, and absenteeism scores (47.2 [44.7-49.8], 48.8 [27.5-72.5], and 10.9 [0.0-11.0], respectively).

CONCLUSIONS: Patients with continuous and multiple symptoms experienced persistently lower QOL and greater economic burden up to 36 months after COVID-19 diagnosis. The long-term effects of long COVID are not only physical but also mental and economical. Thus, further research is needed to clarify the economical and physiological impact of long COVID.},
}

Humans
*COVID-19/epidemiology/economics/psychology/complications
Japan/epidemiology
Male
Female
Middle Aged
Retrospective Studies
Aged
*Quality of Life
Adult
Aged, 80 and over
SARS-CoV-2
Surveys and Questionnaires
Post-Acute COVID-19 Syndrome
East Asian People

@article {pmid41160239,
year = {2025},
author = {Krassnig, K and Bauer, R and Glasl, S and Haubenberger, P and Evanzin, HJ and Schneider, K and Margotti, D},
title = {[Herbal treatment options for post-viral symptoms and long COVID].},
journal = {Wiener medizinische Wochenschrift (1946)},
volume = {},
number = {},
pages = {},
pmid = {41160239},
issn = {1563-258X},
abstract = {BACKGROUND: Long COVID and post-viral symptom complexes have become a significant focus in medical practice. There is an urgent need to provide evidence-based treatment options to those patients. The aim of the literature review was to summarize herbal medicinal products as a treatment option for post-viral conditions, particularly long COVID.

METHODS: A working group of the Austrian Society for Phytotherapy conducted a narrative review between 2022 and 2024, based on external literature from the PubMed, PubPharm and Scopus databases and clinical experience from practice. The review identified the most relevant medicinal plants and their preparations for the most common symptom complexes of long COVID.

RESULTS: A total of 98 publications and 24 monographs were included in the literature review. The symptom complexes (+ relevant phytopharmaceuticals) include neurological complaints, such as myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) (Ginseng radix, Panax quinquefolii radix, Eleutherocci radix, Rhodiolae rhizoma et radix, Schisandrae fructus), nootropics (Ginkgo folium, Lavandulae flos), irritations of the respiratory tract (Liquiritiae radix, Nigellae semen, Eucalypti folium), gastrointestinal complaints (Gentianae radix, Centauri herba, Artemisii herba, Galangae rhizoma, Zingiberis rhizoma, Boswellia serrata, Curcuma longae rhizoma), circulatory weakness (Crataegi folium cum flore, Rosmarini folium, Salviae officinalis folium) and loss of smell (Rosae flos, Citri pericarpium, Caryophylli flos, Eucalypti folium). External evidence and clinical experience in medical practice show that many important symptoms of post-viral conditions can be successfully treated with herbal preparations.

CONCLUSION: Phytopharmaceuticals can provide evidence-based support for the therapeutic portfolio for viral diseases and their consequences in current and future viral epidemics.},
}

@article {pmid41159753,
year = {2025},
author = {Dette, A and Moers, F and Mayr, T and Stillfried, Sv and Bernhardt, M and Förster, S and Werlein, C and Ackermann, M and Muders, MH and Kristiansen, G and Boor, P and Gütgemann, I},
title = {Differential expression of viral entry protein neuropilin 1 (NRP1) and neuropilin 2 (NRP2) in fatal COVID-19.},
journal = {Journal of virology},
volume = {},
number = {},
pages = {e0138425},
doi = {10.1128/jvi.01384-25},
pmid = {41159753},
issn = {1098-5514},
abstract = {Coronavirus disease 2019 (COVID-19) is associated with hyperinflammation, endothelialitis, hypoxemia, and hypercoagulation, contributing to thrombosis in acute severe and long COVID. While ACE2 is the primary severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) receptor, its low expression in certain infected cell types suggests alternative co-receptors. Neuropilins (NRP1 and NRP2), widely expressed, have been proposed as co-factors for viral entry. We analyzed NRP1 and NRP2 expression in autopsy tissues from heart, lung, and hematolymphoid organs using immunohistochemistry (n = 20) and compared findings with public single-cell RNA sequencing (scRNAseq) data. Selected cases were further examined by spatial multiplex immunofluorescence (CODEX). In vitro binding of NRP1/NRP2 to SARS-CoV-2 spike fragments S1 and S1' was assessed by immunofluorescence microscopy. NRP1 was abundantly expressed in myocardial capillary endothelial cells (ECs) and macrophages in the heart and lung; NRP2 was found in alveolar macrophages and mast cells. scRNAseq re-analysis confirmed these in situ patterns. In vitro, NRP1 exclusively bound S1, while NRP2 bound both S1 and S1'. SARS-CoV-2 RNA was detected in neuropilin-positive, ACE2/TMPRSS2-negative vascular EC and mast cells. The detection of SARS-CoV-2 RNA in neuropilin-positive but ACE2/TMPRSS2-negative cell clusters supports that neuropilins are involved in systemic viral dissemination. NRP1 on vascular EC may contribute to angiogenesis, vascular damage, and microangiopathy, while NRP2 represents a potential immunomodulatory target to regulate macrophage activity, resolve inflammation, and potentially prevent the progression of pulmonary fibrosis and limit excessive mast cell activation in long COVID.IMPORTANCEThe well-known severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) receptor, angiotensin-converting enzyme 2 (ACE2), exhibits low expression in key cell types implicated in coronavirus disease 2019 (COVID-19) pathology, such as endothelial cells and B cells, macrophages, and mast cells. In contrast, neuropilins, identified as co-receptors for SARS-CoV-2, are abundantly expressed in these cells under physiological conditions and may be involved in virus-host interactions. This study presents a detailed in situ analysis of Neuropilin 1 (NRP1) and Neuropilin 2 (NRP2) expression in fatal COVID-19 cases using immunohistochemistry and spatial multiplex immunofluorescence phenotyping, complemented by single cell RNA sequencing. Additionally, it demonstrates differential binding affinities of NRP1 and NRP2 to SARS-CoV-2 spike protein fragments S1 and S1' in vitro, suggesting distinct roles for these neuropilins in viral recognition. This study highlights the impact of the unique furin cleavage site in SARS-CoV-2, which may contribute to increased pathogenicity through its interaction with NRP1.},
}

@article {pmid41159539,
year = {2025},
author = {Guzmán, V and Di Gravio, C and Cooper, E and Lound, A and Smith, N and O'Hara, M and Atchison, CJ and Cooke, G and Chadeau, M and Elliott, P and Ward, H},
title = {"I Put a Lot of Emphasis on Work Because I Want to Keep My Job": A Population-Based Interview Study of Long Covid and Employment Changes in England.},
journal = {Health expectations : an international journal of public participation in health care and health policy},
volume = {28},
number = {6},
pages = {e70476},
doi = {10.1111/hex.70476},
pmid = {41159539},
issn = {1369-7625},
support = {//This study is an independent research funded by the National Institute for Health and Care Research (NIHR) and UK Research and Innovation (UKRI): REACT-GE (UKRI MC_PC_20049) and REACT-LC (COV-LT-0040). The REACT-1 and REACT-2 studies were funded by the Department of Health and Social Care in England (DHSC). We also acknowledge support from the NIHR Imperial Biomedical Research Centre./ ; },
mesh = {Humans ; *COVID-19/psychology/complications ; England/epidemiology ; Male ; Female ; *Employment/psychology ; Middle Aged ; Qualitative Research ; Adult ; Interviews as Topic ; Adaptation, Psychological ; SARS-CoV-2 ; Aged ; },
abstract = {BACKGROUND: Long Covid is a complex condition characterised by persistent multisystemic symptoms following a Covid-19 infection, which can influence an individual's capability to sustain employment. However, there is limited evidence of how diverse presentations of long Covid can shape employment and what support strategies might be useful for different groups.

AIM: To address this, we aimed to explore the experiences of employment changes among people living with long Covid in England and to identify the perceived barriers and enablers they face to cope with work.

DESIGN AND METHODS: We conducted a qualitative analysis of data from the Real-time Assessment of Community Transmission (REACT) Study. Using a framework analysis approach, we analysed 60 semi-structured interviews with people who experienced persistent Covid-19 symptoms for 12 weeks or more.

RESULTS: We identified three key themes: (1) Persistent Covid-19 symptoms at work; (2) Ripple effects of balancing work, identity and well-being with persistent Covid-19 symptoms; and (3) Employment changes to cope with and manage persistent Covid-19 symptoms. Participants identified multiple employment changes, including reduction of working hours, restructuring of roles and modification of responsibilities, and adapted ways of working. Drivers of employment changes included disruptive and fluctuating symptoms but also broader pandemic circumstances and the opportunities available for accessing organizational support and putting in place appropriate management strategies.

CONCLUSION: Our results provide a thorough understanding of the work changes experienced by people living with long Covid and highlight the need for intersectional, adaptable work accommodations to support their sustainable employment and overall well-being.

Members of the public who are part of a Public Advisory Group (PAG) have provided ongoing input into various aspects of the umbrella cohort study, the Real-time Assessment of Community Transmission (REACT) Study, including the study design, data collection instruments and dissemination of findings. For this qualitative study, which draws on interview data from REACT Long COVID (REACT-LC), preliminary findings were presented to the PAG for feedback and suggestions, which helped refine the discussion. Additionally, two Public Advisors with lived experience of long Covid contributed to the writing and editing of this manuscript. In accordance with these contributions, they are included as authors.},
}

Humans
*COVID-19/psychology/complications
England/epidemiology
Male
Female
*Employment/psychology
Middle Aged
Qualitative Research
Adult
Interviews as Topic
Adaptation, Psychological
SARS-CoV-2
Aged

@article {pmid41159191,
year = {2025},
author = {Huff, HV and Villanueva-Colina, C and Diaz, MM and Tovar, S and Davila Luna, A and Wu, T and Hamer, DH and Koralnik, IJ and Solomon, T and Caniza, MA and Garcia, PJ},
title = {Correction: Neurologic symptoms following COVID-19 in Lima, Peru: a prospective longitudinal observational study.},
journal = {Frontiers in neurology},
volume = {16},
number = {},
pages = {1676667},
doi = {10.3389/fneur.2025.1676667},
pmid = {41159191},
issn = {1664-2295},
abstract = {[This corrects the article DOI: 10.3389/fneur.2025.1524613.].},
}

@article {pmid41158347,
year = {2025},
author = {Xie, K and Zhang, P and Li, Y and Xia, L},
title = {The post-COVID-19 pulmonary sequelae: manifestations, mechanisms and treatment strategies.},
journal = {Journal of thoracic disease},
volume = {17},
number = {9},
pages = {7414-7429},
pmid = {41158347},
issn = {2072-1439},
abstract = {Recent studies have increasingly demonstrated that coronavirus disease 2019 (COVID-19) patients may develop long-term sequelae of varying severity, collectively referred to as long COVID or post-COVID-19 condition. Pulmonary sequelae are particularly common, which significantly impair patients' quality of life. The mechanisms underlying post-COVID-19 pulmonary sequelae are complex and multifactorial, and their management is still at an exploratory stage. This review explores the manifestations, underlying mechanisms, and potential treatment approaches for post-COVID-19 pulmonary sequelae. Fatigue, dyspnea, myalgia, and sleep disturbances are the most commonly reported symptoms following COVID-19 infection, while anxiety and depression are also prevalent. Respiratory symptoms include dyspnoea, persistent cough, hypoxia, and reduced exercise capacity. Impaired lung diffusion capacity is the most frequently observed pulmonary function abnormality, and residual abnormalities on chest computed tomography (CT) commonly include ground-glass opacities (GGO) and fibrotic-like changes. Air trapping is also an important CT finding and has been reported to associated with impaired lung diffusion function. The potential mechanisms may include pulmonary fibrosis, chronic inflammation, immune dysregulation, coagulation abnormalities and thrombosis, and persistent viral infection. Current treatment strategies encompass vaccination, pulmonary rehabilitation, and pharmacological interventions such as antifibrotic, anti-inflammatory, and anticoagulant therapies. A comprehensive understanding of the recovery trajectory and the mechanisms underlying post-COVID-19 pulmonary sequelae is crucial for improving patient outcomes.},
}

@article {pmid41157669,
year = {2025},
author = {Matyja-Bednarczyk, A and Dziedzic, R and Drynda, A and Gradzikiewicz, A and Bociąga-Jasik, M and Wójcik, K and Lichołai, S and Górka, K and Celejewska-Wójcik, N and Stachura, T and Polok, K and Zaręba, L and Iwaniec, T and Sładek, K and Bazan-Socha, S},
title = {Baseline Dysregulation in B, T, and NK Cells in COVID-19 Predicts Increased Late Mortality but Not Long-COVID Symptoms: Results from a Single-Center Observational Study.},
journal = {Viruses},
volume = {17},
number = {10},
pages = {},
doi = {10.3390/v17101400},
pmid = {41157669},
issn = {1999-4915},
support = {Jagiellonian University Medical College//N41/DBS/000687/ ; },
mesh = {Humans ; *COVID-19/mortality/immunology ; Male ; Female ; *Killer Cells, Natural/immunology ; Middle Aged ; Aged ; SARS-CoV-2/immunology ; *B-Lymphocytes/immunology ; *T-Lymphocytes/immunology ; Adult ; Poland/epidemiology ; Lymphocyte Count ; Severity of Illness Index ; Lymphopenia ; },
abstract = {The SARS-CoV-2 pandemic presents a broad clinical spectrum from asymptomatic cases to severe respiratory failure with high mortality. Severe COVID-19 is characterized by immune dysregulation, including lymphopenia and alterations in the counts of T, B, and NK cells in peripheral blood. Due to the limited data on long-term outcomes related to immune dysregulation, we aimed to analyze immunologic features at baseline in severe and mild COVID-19 cases and assess follow-up characteristics associated with later mortality and long-COVID signs. We included adult patients consecutively hospitalized with COVID-19 between June and November 2020 at the University Hospital in Kraków, corresponding to the first and second waves of COVID-19 in Poland. We enrolled only those who had been thoroughly assessed in terms of clinic and laboratory data, including immunological workups, and survived the acute phase of the disease. In 2025, between February and April (median time of follow-up: 54 months), we conducted a telephone questionnaire on long-COVID symptoms among survivors who had given their consent. Statistical analyses were performed to compare groups with severe and mild disease in terms of dysregulation in lymphocyte subpopulations and the follow-up outcomes. The study included 103 COVID-19 patients, comprising 53 severe (based on the need for at least high-flow nasal oxygen therapy) and 50 mild cases, with no differences in age, sex, and body mass index. Severe COVID-19 patients compared to mild cases had lower CD3+ T cells (count and percentage), CD4+ T cells (count and percentage), CD8+ T cells (count), and NK cells (count), but higher CD19+ B cells (percentage) at baseline (p < 0.05, all). At the time of follow-up, we evaluated 80 patients (77.7% of the baseline participants), with 23 (22.3%) patients lost to follow-up. Among patients analyzed in the follow-up, 23 (28.8%) had died, and 29 of the 57 survivors (50.9%) reported persistent long-COVID symptoms. Patients who died had significantly lower baseline counts of CD3+ T cells (377 vs. 655 cells/µL), CD4+ T cells (224 vs. 372 cells/µL), CD8+ T cells (113 vs. 188 cells/µL), and NK cells (118 vs. 157 cells/µL) compared to survivors (p < 0.05, all). Notably, the percentage of CD19+ B cells was higher in deceased individuals (19.2% vs. 13.5%; p = 0.049). In contrast, we did not document differences in baseline immunological data among survivors with and without long-COVID signs. Our study suggests that dysregulation in lymphocyte subpopulations during the COVID-19 acute phase may be associated with increased late mortality, but not with the persistence of long-COVID symptoms.},
}

Humans
*COVID-19/mortality/immunology
Male
Female
*Killer Cells, Natural/immunology
Middle Aged
Aged
SARS-CoV-2/immunology
*B-Lymphocytes/immunology
*T-Lymphocytes/immunology
Adult
Poland/epidemiology
Lymphocyte Count
Severity of Illness Index
Lymphopenia

@article {pmid41157587,
year = {2025},
author = {Heath, AM and Li, D},
title = {Symptomatology of Long COVID Associated with Inherited and Acquired Thrombophilic Conditions: A Systematic Review.},
journal = {Viruses},
volume = {17},
number = {10},
pages = {},
doi = {10.3390/v17101315},
pmid = {41157587},
issn = {1999-4915},
mesh = {Humans ; *COVID-19/complications ; *Thrombophilia/complications ; SARS-CoV-2 ; },
abstract = {Thrombophilic conditions, conditions where blood has a tendency to form thrombi due to abnormal coagulatory processes, can affect the trajectory of diseases such as Post-Acute Sequelae of SARS-CoV-2 Infection, better known as Long COVID (LC), by worsening symptoms and complicating outlooks. As a comorbidity in pro-coagulatory diseases such as COVID-19 and LC, patients with thrombophilic conditions may experience worse symptoms than their peers, due to this elevated level of hypercoagulation. A 15-week literature review through the public PubMed database was conducted to investigate the severity, mechanisms, and symptom profiles of thrombophilic patients with LC. Papers were only included if samples included participants with pre-existing tendencies for hypercoagulable states, and confirmation of SARS-CoV-2 infection via a Polymerase Chain Reaction test. Each paper included in this review was analyzed by topic and assessed for eligibility against the Joanna Briggs Institute's Critical Appraisal tool. Each paper was also assessed for biases. Results from the 6 papers included in this review showed that LC could be predicted following COVID-19 illness by a hypercoagulable blood profile, indicating that LC may be linked to chronic hypercoagulation and inflammation post-infection. Additionally, symptoms linked to microthrombi formation, such as hair loss, arrhythmia, and dizziness, were exhibited more frequently in patients with thrombophilia and/or thrombophilic conditions, indicating that those with thrombophilic conditions may exhibit unique LC symptom profiles compared to healthy controls. This paper's research is preliminary and thus is limited in the strength of its findings; However, further research into LC and its interactions with co-morbidities like thrombophilic conditions would aid in the development of better treatment plans for patients, such as the usage of anticoagulants or screening for hypercoagulable blood profiles post-COVID-19 to assess patient risk.},
}

Humans
*COVID-19/complications
*Thrombophilia/complications
SARS-CoV-2

@article {pmid41157582,
year = {2025},
author = {Prakash, S and Karan, S and Lekbach, Y and Tifrea, DF and Figueroa, CJ and Ulmer, JB and Young, JF and Glenn, G and Gil, D and Jones, TM and Redfield, RR and BenMohamed, L},
title = {Insights into Persistent SARS-CoV-2 Reservoirs in Chronic Long COVID.},
journal = {Viruses},
volume = {17},
number = {10},
pages = {},
doi = {10.3390/v17101310},
pmid = {41157582},
issn = {1999-4915},
support = {AI158060//National Institute of Allergy and Infectious Diseases/ ; },
mesh = {Humans ; *COVID-19/virology/immunology/complications ; *SARS-CoV-2/physiology/genetics ; Animals ; Chronic Disease ; Post-Acute COVID-19 Syndrome ; RNA, Viral ; Disease Reservoirs/virology ; *Persistent Infection/virology ; },
abstract = {Long COVID (LC), also known as post-acute sequelae of COVID-19 infection (PASC), is a heterogeneous and debilitating chronic disease that currently affects 10 to 20 million people in the U.S. and over 420 million people globally. With no approved treatments, the long-term global health and economic impact of chronic LC remains high and growing. LC affects children, adolescents, and healthy adults and is characterized by over 200 diverse symptoms that persist for months to years after the acute COVID-19 infection is resolved. These symptoms target twelve major organ systems, causing dyspnea, vascular damage, cognitive impairments ("brain fog"), physical and mental fatigue, anxiety, and depression. This heterogeneity of LC symptoms, along with the lack of specific biomarkers and diagnostic tests, presents a significant challenge to the development of LC treatments. While several biological abnormalities have emerged as potential drivers of LC, a causative factor in a large subset of patients with LC, involves reservoirs of virus and/or viral RNA (vRNA) that persist months to years in multiple organs driving chronic inflammation, respiratory, muscular, cognitive, and cardiovascular damages, and provide continuous viral antigenic stimuli that overstimulate and exhaust CD4[+] and CD8[+] T cells. In this review, we (i) shed light on persisting virus and vRNA reservoirs detected, either directly (from biopsy, blood, stool, and autopsy samples) or indirectly through virus-specific B and T cell responses, in patients with LC and their association with the chronic symptomatology of LC; (ii) explore potential mechanisms of inflammation, immune evasion, and immune overstimulation in LC; (iii) review animal models of virus reservoirs in LC; (iv) discuss potential T cell immunotherapeutic strategies to reduce or eliminate persistent virus reservoirs, which would mitigate chronic inflammation and alleviate symptom severity in patients with LC.},
}

Humans
*COVID-19/virology/immunology/complications
*SARS-CoV-2/physiology/genetics
Animals
Chronic Disease
Post-Acute COVID-19 Syndrome
RNA, Viral
Disease Reservoirs/virology
*Persistent Infection/virology

@article {pmid41157565,
year = {2025},
author = {Lepojević-Stefanović, D and Živković, S and Marković, D and Marić, G and Marković-Nikolić, N},
title = {COVID-19 and Cardiovascular Complications: A Follow-Up Study from Tertiary Center.},
journal = {Viruses},
volume = {17},
number = {10},
pages = {},
doi = {10.3390/v17101293},
pmid = {41157565},
issn = {1999-4915},
support = {451-03-137/2025-03/200110//Ministry of Science, Technological Development and Innovation of the Republic of Serbia/ ; },
mesh = {Humans ; *COVID-19/complications/mortality/epidemiology ; Male ; Female ; *Cardiovascular Diseases/mortality/epidemiology/complications/etiology ; Tertiary Care Centers ; Middle Aged ; Aged ; Prospective Studies ; Follow-Up Studies ; Hospitalization ; SARS-CoV-2 ; Aged, 80 and over ; Adult ; },
abstract = {(1) Background: In addition to its fatal outcomes, COVID-19 is associated with a spectrum of non-fatal complications that significantly influence clinical trajectories and quality of life. Cardiovascular complications, in particular, are of major clinical relevance and are recognized as key contributors to both short- and long-term morbidity and mortality. The aim of the present study was to evaluate the short-term and long-term effects of COVID-19 infection on patients with underlying cardiovascular diseases. (2) Methods: The prospective cohort study included a total of 99 consecutive subjects hospitalized due to moderate and severe forms of COVID-19 pneumonia in "Zvezdara"-University Medical Center in the period of 18 March-18 April 2021. (3) Results: During hospitalization, 47% of patients had some new cardiovascular events. A total of 10 patients died during hospital stay. The highest chance for the lethal outcome was seen in those with previously diagnosed coronary heart disease (B = 3.356, OR = 28.667 (95% CI 2.69-305.14), p = 0.005), heart failure (B = 3.056, OR = 21.250 (95% CI 3.36-134.56), p = 0.001) and increased potassium values (B = 2.639, OR = 14.000 (95% CI 2.65-73.88), p = 0.002). (4) Conclusions: Care strategies for patients who survived the acute episode of COVID-19 should include attention to cardiovascular disease. Our findings emphasize the need for continued optimization of strategies for primary prevention of SARS-CoV-2 infections as the best way to prevent long COVID and serious cardiovascular complications.},
}

Humans
*COVID-19/complications/mortality/epidemiology
Male
Female
*Cardiovascular Diseases/mortality/epidemiology/complications/etiology
Tertiary Care Centers
Middle Aged
Aged
Prospective Studies
Follow-Up Studies
Hospitalization
SARS-CoV-2
Aged, 80 and over
Adult

@article {pmid41157211,
year = {2025},
author = {Genova, S and Pencheva, M and Burnusuzov, H and Bozhkova, M and Kulinski, G and Kostyaneva, S and Tilkiyan, E and Abadjieva, T},
title = {High Free IgE and Mast Cell Activation in Long COVID: Mechanisms of Persistent Immune Dysregulation.},
journal = {Life (Basel, Switzerland)},
volume = {15},
number = {10},
pages = {},
doi = {10.3390/life15101538},
pmid = {41157211},
issn = {2075-1729},
abstract = {Background: Elevated serum IgE has been reported in severe COVID-19, suggesting that mast cell activation, allergic-like responses, and possible viral immune evasion occur. Objective: This study aimed to assess serum IgE, IgG, eosinophils, basophils, IL-10, and IL-33 in COVID-19 patients, and evaluate the infiltration of mast cells, basophils, and plasma cells in fatal cases. Methods: This retrospective study included 21 patients with severe COVID-19 or related respiratory conditions hospitalized in Plovdiv, Bulgaria (February 2020-May 2022). Serum immunoglobulins were quantified via immunoassays; IL-10 and IL-33 were also measured. Lung tissues from 30 autopsies were examined histologically and immunohistochemically using CD117 (mast cells) and CD138 (plasma cells). Results: Elevated IgE (>100 IU/mL) occurred in 10/21 patients, with two patients exhibiting levels exceeding 1000 IU/mL. High IgE correlated with reduced eosinophils and basophils, except in post-COVID lobar pneumonia. IL-10 was significantly increased, while IL-33 was reduced in acute and long COVID. Lung histology showed the accumulation of mast cells and plasma cells (5-20/field) during the diffuse alveolar damage and acute respiratory distress syndrome (ARDS) phases, but not in later fibrotic stages. Basophils are located near capillary basement membranes and the endothelium. Conclusions: SARS-CoV-2 may induce IgE-driven allergic-like mechanisms that contribute to severity. Monitoring IgE and mast cell activity may provide prognostic and therapeutic value, while elevated IgG4 could mitigate the effects of IgE.},
}

@article {pmid41157147,
year = {2025},
author = {Jach, ME and Sajnaga, E and Bumbul, M and Serefko, A and Borowicz, KK and Golczyk, H and Kieliszek, M and Wiater, A},
title = {The Role of Probiotics and Their Postbiotic Metabolites in Post-COVID-19 Syndrome.},
journal = {Molecules (Basel, Switzerland)},
volume = {30},
number = {20},
pages = {},
doi = {10.3390/molecules30204130},
pmid = {41157147},
issn = {1420-3049},
mesh = {*Probiotics/therapeutic use/pharmacology ; Humans ; *COVID-19/complications ; Gastrointestinal Microbiome/drug effects ; SARS-CoV-2 ; Dysbiosis ; Fatty Acids, Volatile/metabolism ; },
abstract = {Post-COVID-19 syndrome, also known as long-COVID, is characterized by a wide spectrum of persistent symptoms involving multiple body organs and systems, including fatigue, gastrointestinal disorders, and neurocognitive dysfunction. Emerging evidence suggests that gut microbiota dysbiosis and disruption of the gut-brain axis play a central role in the pathophysiology of this condition. Probiotics and their metabolites (postbiotics) have gained increasing attention as potential therapeutic agents given their immunomodulatory, anti-inflammatory, and antiviral properties. In this review, we discuss the current understanding of the antiviral mechanisms of probiotics, including reinforcement of intestinal epithelial barrier function, direct virus inhibition, receptor competition, and immune system modulation. Special emphasis is placed on short-chain fatty acids (SCFAs), lactic acid, hydrogen peroxide, and bacteriocins as key factors that contribute to these effects. SCFAs appear to be essential postbiotic compounds during post-COVID recovery. We also highlight recent clinical trials involving specific probiotic species, such as Lactiplantibacillus plantarum, Lacticaseibacillus rhamnosus, and Bifidobacterium longum, and their potential role in alleviating long-term COVID symptoms. Although the current results are promising, further research is needed to clarify the most effective strains, dosages, and mechanisms of action in post-COVID therapeutic strategies.},
}

*Probiotics/therapeutic use/pharmacology
Humans
*COVID-19/complications
Gastrointestinal Microbiome/drug effects
SARS-CoV-2
Dysbiosis
Fatty Acids, Volatile/metabolism

@article {pmid41156656,
year = {2025},
author = {Delpino, MV and Quarleri, J},
title = {Mitochondrial Dysfunction in Aging, HIV, and Long COVID: Mechanisms and Therapeutic Opportunities.},
journal = {Pathogens (Basel, Switzerland)},
volume = {14},
number = {10},
pages = {},
doi = {10.3390/pathogens14101045},
pmid = {41156656},
issn = {2076-0817},
mesh = {Humans ; *Aging/metabolism ; *HIV Infections/metabolism/therapy/pathology ; *Mitochondria/metabolism/pathology ; *COVID-19/metabolism/therapy/pathology ; DNA, Mitochondrial/genetics ; *Mitochondrial Diseases/therapy ; Oxidative Stress ; SARS-CoV-2 ; Mitophagy ; },
abstract = {We hypothesize that a unified mitochondrial perspective on aging, HIV, and long COVID reveals shared pathogenic mechanisms and specific therapeutic vulnerabilities that are overlooked when these conditions are treated independently. Mitochondrial dysfunction is increasingly recognized as a common factor driving aging, HIV, and long COVID. Shared mechanisms-including oxidative stress, impaired mitophagy and dynamics, mtDNA damage, and metabolic reprogramming-contribute to ongoing energy failure and chronic inflammation. Recent advancements highlight new therapeutic strategies such as mitochondrial transfer, transplantation, and genome-level correction of mtDNA variants, with early preclinical and clinical studies providing proof-of-concept. This review summarizes current evidence on mitochondrial changes across aging and post-viral syndromes, examines emerging organelle-based therapies, and discusses key challenges related to safety, durability, and translation.},
}

Humans
*Aging/metabolism
*HIV Infections/metabolism/therapy/pathology
*Mitochondria/metabolism/pathology
*COVID-19/metabolism/therapy/pathology
DNA, Mitochondrial/genetics
*Mitochondrial Diseases/therapy
Oxidative Stress
SARS-CoV-2
Mitophagy

@article {pmid41156605,
year = {2025},
author = {Robinson, KF and Ahiya, AI and Richner, JM and Lutz, SE},
title = {SARS-CoV-2 Infection Influences Wnt/β-Catenin Pathway Components in Astrocytes.},
journal = {Pathogens (Basel, Switzerland)},
volume = {14},
number = {10},
pages = {},
doi = {10.3390/pathogens14100994},
pmid = {41156605},
issn = {2076-0817},
support = {K12GM139186/GM/NIGMS NIH HHS/United States ; R01NS138437/NS/NINDS NIH HHS/United States ; 1R01NS135072-01A1/NS/NINDS NIH HHS/United States ; W81XWH-21-1-0893//Department of Defense/ ; },
mesh = {*Astrocytes/virology/metabolism ; *Wnt Signaling Pathway ; Humans ; *COVID-19/metabolism/virology/pathology ; *SARS-CoV-2/physiology ; *beta Catenin/metabolism ; Induced Pluripotent Stem Cells/metabolism ; Wnt Proteins/metabolism/genetics ; Animals ; Cells, Cultured ; Mice ; },
abstract = {The mechanisms by which SARS-CoV-2 infection lead to neuroinflammation and cognitive impairment in COVID-19 and Long COVID are unclear. Cerebrovascular Wnt/β-catenin pathway activity is suppressed in association with neuroinflammation and cognitive impairment in a mouse model of COVID-19. In this study, we asked whether SARS-CoV-2 (NY Iota strain) infection of astrocytes would result in cell-autonomous changes in Wnt/β-catenin pathway components. We report that induced pluripotent stem cell (hiPSC)-derived human astrocytes (iAs) are susceptible to sustained infection with SARS-CoV-2 in vitro. Real-time PCR revealed that SARS-CoV-2 infection of iAs decreased transcripts for Wnt3a, Wnt10b, and the downstream pathway effectors β-catenin and TCF3. Wnt7b was increased, as was the proinflammatory chemokine CXCL10. No changes were noted in Wnt3, Wnt7a, TCF1, TCF4, or LEF1. These data indicate that SARS-CoV-2 infection differentially influences Wnt/β-catenin pathway components in astrocytes. These data could have implications for the mechanistic basis of COVID-19 and Long COVID.},
}

*Astrocytes/virology/metabolism
*Wnt Signaling Pathway
Humans
*COVID-19/metabolism/virology/pathology
*SARS-CoV-2/physiology
*beta Catenin/metabolism
Induced Pluripotent Stem Cells/metabolism
Wnt Proteins/metabolism/genetics
Animals
Cells, Cultured
Mice

@article {pmid41156478,
year = {2025},
author = {Navarro-Cáceres, A and Gómez-Sánchez, L and Arroyo-Romero, S and Suárez-Moreno, N and Domínguez-Martín, A and Lugones-Sánchez, C and González-Sánchez, S and Rodríguez-Sánchez, E and García-Ortiz, L and Gómez-Sánchez, M and Navarro-Matias, E and Gómez-Marcos, MA},
title = {Relationship of Mediterranean Diet and Its Components with Parameters of Structure, Vascular Function, and Vascular Aging in Subjects Diagnosed with Long COVID: BioICOPER Study.},
journal = {Nutrients},
volume = {17},
number = {20},
pages = {},
doi = {10.3390/nu17203226},
pmid = {41156478},
issn = {2072-6643},
support = {PI21/00454//Instituto de Salud Carlos III (ISCIII/ ; RD21/0016/0010//Network for Research on Chronicity. Primary Care. and Health Promotion (RICAPPS)/ ; GRS 2501/B/22 and GRS2714/C/2023//The government of Castilla y León also collaborated with the funding of this study through the research projects/ ; PI21/00454//Instituto de Salud Carlos III/ ; },
mesh = {Humans ; Male ; Female ; *Diet, Mediterranean ; Cross-Sectional Studies ; Middle Aged ; *COVID-19/physiopathology/complications ; Aged ; Carotid Intima-Media Thickness ; *Aging/physiology ; Pulse Wave Analysis ; Ankle Brachial Index ; SARS-CoV-2 ; Vascular Stiffness ; Adult ; Carotid-Femoral Pulse Wave Velocity ; Sex Factors ; },
abstract = {INTRODUCTION: Long COVID (LC) is associated with an increase in cardiovascular risk and chronic inflammation, whereas the Mediterranean Diet (MD) seems to improve the aforementioned factors. The aim of this study is to analyse the relationship between MD and its components with vascular structure, function, and aging in patients diagnosed with LC globally and by sex.

METHODS: This study was a cross-sectional study with 304 subjects diagnosed with LC; 207 were women and 97 men. Adherence to MD was evaluated with a validated MEDAS questionnaire, composed of 14 items. The vascular structure was assessed using carotid intima-media thickness (cIMT). Three measurements were carried out to evaluate vascular function: cardio-ankle vascular index (CAVI), brachial-ankle pulse wave velocity (baPWV), and carotid-femoral pulse wave velocity (cfPWV). Vascular aging index (VAI) was estimated.

RESULTS: The MD score was 7.80 ± 2.33, with no difference between sexes. Vascular function and aging parameter values were higher in men than in women. Use of olive oil as the principal source of fat for cooking, and consuming <1 serving of butter/day and <1 sugar-sweetened beverage/day showed >90% adherence. Logistic regression analysis displayed associations between cIMT < 0.625 and use of olive oil in the global analysis (OR = 0.148) and among men (OR = 0.120), and <2 commercial pastries/week in global (OR = 0.536). cfPWV < 7.400 m/s was associated with DM score ≥ 8 in global (OR = 0.444) and in women, as well as with <2 pastries/week in women (OR = 0.405). baPWV < 12.315 m/s was associated with ≥3 servings of pulses/week in global (OR = 0.481) and among women, as was <2 pastries/week in global (OR = 0.471) and in women. CAVI < 7.450 was associated with ≥4 tablespoons of olive oil/day in men. VAI < 63.693 was associated with DM score ≥ 8 in global (OR = 0.458) and in women, as well as <2 pastries/week in global (OR = 0.392).

CONCLUSIONS: Adherence to MD was associated with lower cfPWV and VAI measures in the global analysis and among women. In particular, several of the components were associated with a better vascular profile in LC patients.},
}

Humans
Male
Female
*Diet, Mediterranean
Cross-Sectional Studies
Middle Aged
*COVID-19/physiopathology/complications
Aged
Carotid Intima-Media Thickness
*Aging/physiology
Pulse Wave Analysis
Ankle Brachial Index
SARS-CoV-2
Vascular Stiffness
Adult
Carotid-Femoral Pulse Wave Velocity
Sex Factors

@article {pmid41156093,
year = {2025},
author = {Mîțu, DA and Buleu, F and Popa, DI and Trebuian, C and Sutoi, D and Coman, A and Lighezan, DF and Buleu, T and Sliman, N and Radbea, OR and Mederle, OA},
title = {Outcomes, Sequelae, and Ventilatory Strategies in Long COVID Patients with Severe ARDS: A Retrospective Cohort Study.},
journal = {Journal of clinical medicine},
volume = {14},
number = {20},
pages = {},
doi = {10.3390/jcm14207223},
pmid = {41156093},
issn = {2077-0383},
support = {Victor babes Univeristy of Medicine and Pharmacy, Timisoara//Victor babes Univeristy of Medicine and Pharmacy, Timisoara/ ; },
abstract = {Background and Aims: Severe acute respiratory distress syndrome (ARDS) in patients with long COVID remains associated with extremely high mortality and significant long-term sequelae. Non-invasive ventilatory strategies such as continuous positive airway pressure (CPAP) and high-flow nasal cannula (HFNC) are widely used before endotracheal intubation (ETI). Still, their comparative effectiveness in this population is not well established. Understanding survival outcomes and sequelae can help refine treatment strategies for this high-risk group. This study aimed to evaluate outcomes, sequelae, and treatment strategies in long COVID patients with severe ARDS, focusing on non-invasive ventilatory support before ETI. Materials and Methods: A retrospective cohort analysis was performed using a study comparing severe ARDS patients with and without COVID-19. The inclusion criterion was a Horovitz quotient (PaO2/FiO2) < 50 mmHg. Results: The study included a total of 59 patients diagnosed with long COVID-19 ARDS, with a mortality rate of 85%. A significant proportion of the patient population was male, accounting for 75%. The highest survival rate was observed among patients who initially received CPAP support, with a survival rate of 23.08%, in contrast to those treated solely with HFNC or those who alternated between HFNC and CPAP. Among patients who required endotracheal intubation and subsequent mechanical ventilation, survival rates were 40% for those who had previously received CPAP, 10% for those treated with alternating HFNC and CPAP, and 0% for those managed exclusively with HFNC before ETI. Survivors often exhibited sequelae, such as impaired pulmonary function, persistent dyspnea, and diminished physical performance. Conclusions: Patients with long COVID who develop severe ARDS (PaO2/FiO2 < 50 mmHg) face exceptionally high ICU mortality, with outcomes determined mainly by age, comorbidities, and profound hypoxemia. Although CPAP showed a trend toward improved survival, the data do not establish superiority and should be regarded as hypothesis-generating. Rather, they highlight the complexity of managing this underrepresented subgroup and underscore the need for larger, multicenter studies with broader inclusion criteria to confirm or refute these preliminary observations.},
}

@article {pmid41155411,
year = {2025},
author = {Caliman-Sturdza, OA and Hamamah, S and Iatcu, OC and Lobiuc, A and Bosancu, A and Covasa, M},
title = {Microbiome and Long COVID-19: Current Evidence and Insights.},
journal = {International journal of molecular sciences},
volume = {26},
number = {20},
pages = {},
doi = {10.3390/ijms262010120},
pmid = {41155411},
issn = {1422-0067},
support = {760073/23.05.2023, code 285/30.11.2022, within Pillar III, Component C9, Investment 8.//Romania's National Recovery and Resilience Plan/ ; 760073/23.05.2023, code 285/30.11.2022, within Pillar III, Component C9, Investment 8.//Romania's National Recovery and Resilience Plan/ ; },
mesh = {Humans ; *COVID-19/microbiology/complications ; *Gastrointestinal Microbiome ; SARS-CoV-2 ; Dysbiosis/microbiology ; Post-Acute COVID-19 Syndrome ; Probiotics/therapeutic use ; *Microbiota ; },
abstract = {Long COVID, also referred to as post-acute sequelae of SARS-CoV-2 infection (PASC), is characterized by persistent multi-systemic symptoms such as fatigue, cognitive impairment, and respiratory dysfunction. Accumulating evidence indicates that gut and oral microbiota play an important role in its pathogenesis. Patients with long COVID consistently exhibit reduced microbial diversity, depletion of beneficial short-chain fatty acid (SCFA)-producing species such as Faecalibacterium prausnitzii and Bifidobacterium spp. and enrichment of proinflammatory taxa including Ruminococcus gnavus, Bacteroides vulgatus, and Veillonella. These alterations may disrupt intestinal barrier integrity, sustain low-grade systemic inflammation, and influence host immune and neuroendocrine pathways through the gut-brain and gut-lung axes. Distinct microbial signatures have also been associated with symptom clusters, including neuropsychiatric, respiratory, and gastrointestinal manifestations. Proposed mechanisms linking dysbiosis to long COVID include impaired SCFA metabolism, tryptophan depletion, microbial translocation, and interactions with host immune and inflammatory responses, including autoantibody formation and viral antigen persistence. Preliminary interventional studies using probiotics, synbiotics, and fecal microbiota transplantation suggest that microbiome-targeted therapies may alleviate symptoms, although evidence remains limited and heterogeneous. This review synthesizes current literature on the role of gut and oral microbiota in long COVID, highlights emerging microbial biomarkers, and discusses therapeutic implications. While causality remains to be firmly established, restoring microbial balance represents a promising avenue for diagnosis, prevention, and management of long COVID.},
}

Humans
*COVID-19/microbiology/complications
*Gastrointestinal Microbiome
SARS-CoV-2
Dysbiosis/microbiology
Post-Acute COVID-19 Syndrome
Probiotics/therapeutic use
*Microbiota

@article {pmid41155393,
year = {2025},
author = {Mikheeva, EV and Aulova, KS and Nevinsky, GA and Timofeeva, AM},
title = {In Silico Analysis of MiRNA Regulatory Networks to Identify Potential Biomarkers for the Clinical Course of Viral Infections.},
journal = {International journal of molecular sciences},
volume = {26},
number = {20},
pages = {},
doi = {10.3390/ijms262010100},
pmid = {41155393},
issn = {1422-0067},
support = {25-15-00010//Russian Science Foundation/ ; },
mesh = {*MicroRNAs/genetics ; Humans ; *Gene Regulatory Networks ; Biomarkers/metabolism ; *Virus Diseases/genetics ; Computer Simulation ; Computational Biology/methods ; Gene Expression Profiling ; Gene Expression Regulation ; },
abstract = {MiRNA expression profiles exhibit notable alterations in numerous diseases, particularly viral infections. Consequently, miRNAs may be regarded as both therapeutic targets and markers for the development of complications. MiRNAs can significantly influence the modulation of immune responses, offering an extra layer of regulation during viral infections. In this study, miRNAs associated with viral infections were analyzed using an in silico approach. Computer modeling predicted a number of miRNAs capable of influencing the functionality of specific components of the immune system. As a result, 242 miRNAs common to the three types of infections were identified. A network of miRNA-gene regulatory interactions, encompassing 502 nodes (224 miRNAs and 278 genes) and 2236 interactions, was developed. Within this network, subnetworks were identified that are involved in the operation of specific connections in the immune response to viruses. For each step of the immune response, the miRNAs involved in governing these processes were examined. These predicted miRNAs are of particular interest for further analysis aimed at establishing the relationship between their differential expression and disease symptom severity. The obtained data lay the foundation for identifying the most promising molecules as predictive biomarkers and the subsequent development of a diagnostic system.},
}

*MicroRNAs/genetics
Humans
*Gene Regulatory Networks
Biomarkers/metabolism
*Virus Diseases/genetics
Computer Simulation
Computational Biology/methods
Gene Expression Profiling
Gene Expression Regulation

@article {pmid41155179,
year = {2025},
author = {Refrigeri, M and Tola, A and Mogavero, R and Pietracupa, MM and Gionta, G and Scatena, R},
title = {Mechanisms of Mitochondrial Impairment by SARS-CoV-2 Proteins: A Nexus of Pathogenesis with Significant Biochemical and Clinical Implications.},
journal = {International journal of molecular sciences},
volume = {26},
number = {20},
pages = {},
doi = {10.3390/ijms26209885},
pmid = {41155179},
issn = {1422-0067},
mesh = {Humans ; *Mitochondria/metabolism/virology/pathology ; *COVID-19/metabolism/virology/pathology ; *SARS-CoV-2/metabolism/pathogenicity ; Reactive Oxygen Species/metabolism ; Host-Pathogen Interactions ; Immunity, Innate ; },
abstract = {Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) closely interacts with host cellular mechanisms, with mitochondria playing a crucial role in this process. As essential organelles that control cellular energy production, apoptosis, reactive oxygen species (ROS) metabolism, and innate immune responses, mitochondria are vital to the development of COVID-19. However, the exact molecular interactions between mitochondria and SARS-CoV-2 remain under active investigation. Gaining a comprehensive understanding of mitochondrial involvement in SARS-CoV-2 infection is therefore essential for uncovering complex disease mechanisms, identifying prognostic biomarkers, and developing effective treatments. Ultimately, exploring these virus-host interactions may provide new insights into the fundamental and complex aspects of mitochondrial physiology and pathophysiology.},
}

Humans
*Mitochondria/metabolism/virology/pathology
*COVID-19/metabolism/virology/pathology
*SARS-CoV-2/metabolism/pathogenicity
Reactive Oxygen Species/metabolism
Host-Pathogen Interactions
Immunity, Innate

@article {pmid41154289,
year = {2025},
author = {Wilson, A and Ricciardiello Mejia, GC and Lomba, S and Geng, LN and Malunjkar, S and Bonilla, H and Sum-Ping, O},
title = {A Multidimensional Assessment of Sleep Disorders in Long COVID Using the Alliance Sleep Questionnaire.},
journal = {Healthcare (Basel, Switzerland)},
volume = {13},
number = {20},
pages = {},
doi = {10.3390/healthcare13202611},
pmid = {41154289},
issn = {2227-9032},
abstract = {Background/Objectives: Sleep disturbances are recognized as a common feature of Long COVID but detailed investigation into the specific nature of these sleep symptoms remain limited. This study analyzes comprehensive sleep questionnaire data from a Long COVID clinic to better characterize the nature and prevalence of sleep complaints in this population. Methods: We conducted a cross-sectional analysis of 200 adults referred to the Stanford Long COVID Clinic. Patients completed an intake questionnaire including three sleep-related items (unrefreshing sleep, insomnia, daytime sleepiness) rated on a 0-5 Likert scale. Additionally, patients completed the Alliance Sleep Questionnaire (ASQ), incorporating the Insomnia Severity Index, Epworth Sleepiness Scale, reduced Morningness-Eveningness Questionnaire, and modules for parasomnia, restless legs, and breathing symptoms. We calculated the prevalence of six sleep symptom domains. Standardized symptom data were analyzed using principal component analysis (PCA) and K-means clustering (k = 2) to explore latent phenotypes and used logistic regression to assess associations between demographic and clinical variables and each sleep complaint. Results: Sleep-related breathing complaints affected 57.5% of participants, insomnia 42.5%, and excessive daytime sleepiness 28.5%. Parallel analysis supported a nine-factor structure explaining ~90% of variance, with varimax rotation yielding interpretable domains such as insomnia/unrefreshing sleep, fatigue/post-exertional malaise, parasomnias, and respiratory symptoms. Gaussian mixture modeling favored a two-cluster solution (n = 94 and n = 106); one cluster represented a higher-burden phenotype characterized by greater BMI, insomnia, daytime sleepiness, gastrointestinal symptoms, and parasomnias. Logistic models using factor scores predicted insomnia with high accuracy (AUC = 0.90), EDS moderately well (AUC = 0.81), but extreme chronotype poorly (AUC = 0.39). In adjusted models, hospitalization during acute COVID-19 was significantly associated with insomnia (OR 4.41; 95% CI 1.27-15.36). Participants identifying as multiracial had higher odds of insomnia (OR 3.22; 95% CI 1.00-10.34), though this narrowly missed statistical significance. No other predictors were significant. Conclusions: Sleep disturbances are frequent and diverse in Long COVID. Factor analysis showed overlapping domains, while clustering identified a higher-burden phenotype marked by more severe sleep and systemic complaints. Symptom-based screening may help target those at greatest risk.},
}

@article {pmid41151241,
year = {2025},
author = {Raijmakers, RPH and Lund Berven, L and Keijmel, SP and Rodrigo, C and Wyller, VBB and Katz, BZ and Buchwald, D and Evans, RA and Gérardin, P and Knoop, H and Prins, M and Stavem, K and Stiansen-Sonerud, T and Taylor, R and Valencia Arroyo, BM and Wensaas, KA and Selvakumar, JP and van den Wijngaard, C and Lloyd, AR and Sandler, CX},
title = {Immunological associations in post-infective fatigue syndromes including Long COVID-a systematic review and meta-analysis.},
journal = {EBioMedicine},
volume = {121},
number = {},
pages = {105970},
doi = {10.1016/j.ebiom.2025.105970},
pmid = {41151241},
issn = {2352-3964},
abstract = {BACKGROUND: The pathophysiology of post-infective fatigue syndromes (PIFS), including Long COVID, is unknown. This systematic review and meta-analysis aimed to investigate if PIFS is associated with persistent immune activation.

METHODS: PubMed, EMBASE, and Web of Science were searched for terms related to infection, fatigue, persistent symptoms, and immunological markers.

POPULATION: adults and adolescents; Exposure: documented acute infection; Comparator: those who developed PIFS vs. recovered controls from the same exposure; and Outcomes: immunological biomarkers. Studies which documented acute infection, applied diagnostic criteria for PIFS, and assayed circulating immunologic markers were eligible.

FINDINGS: From 14,985 studies screened, 30 articles were included (n = 5102 participants; 833 PIFS/PIFS-like cases, n = 4269 recovered control participants) with many studies excluded by inadequate quality in eligibility criteria. The meta-analysis (11 studies; n = 413 PIFS cases, analysed with random-effects models) showed PIFS cases had increased: white cell counts at 3-6 months (Cohen's d: 0.41, 95% CI 0.09-0.74); and circulating levels of RANTES and TNFα at 6-12 months (Cohen's d: 0.45 [95% CI 0.16-0.73] and 0.30 [95% CI 0.04-0.57], respectively) compared to controls recovered from the same exposure.

INTERPRETATION: These findings provide cautious support for persistent immune activation in PIFS, but warrant further replication. Future studies should include better documentation of acute infection and PIFS case characterisation.

FUNDING: ARL is supported by a National Health and Medical Research Council Practitioner Fellowship (Grant 1041897). CXS is supported by a Cancer Institute New South Wales Early Career Fellowship (2021/ECF1310). BZK is supported by the National Institute of Allergy and Infectious Diseases (AI 105781). RE is supported by the National Institute for Health and Care.},
}

@article {pmid41149071,
year = {2025},
author = {Mazzanti, S and Barchiesi, F and Pallotta, F and Luchetti, I and Giacometti, A and Brescini, L},
title = {Severe Acute SARS-CoV-2 Infection and Long COVID: What Do We Know So Far? New Challenges in Diagnosis and Management.},
journal = {Diseases (Basel, Switzerland)},
volume = {13},
number = {10},
pages = {},
doi = {10.3390/diseases13100337},
pmid = {41149071},
issn = {2079-9721},
abstract = {BACKGROUND/OBJECTIVES: The long-term impact of the COVID-19 pandemic is not just limited to socioeconomic aspects; there are also important health issues to consider. Among these, one of the most important and obvious is long COVID. Despite a significant amount of scientific work having been published, this condition is still semi-unknown. The objective of this study was to collect useful information for the clarification of some epidemiological, clinical, and laboratory characteristics of this disease.

METHODS: This was a single-center study carried out at the Infectious Diseases Clinic of the hospital "AUO delle Marche" on all patients hospitalized for COVID-19 between November 2021 and March 2022.

RESULTS: From the data, it emerged that, following the resolution of the acute phase of SARS-CoV-2 infection, the majority of people experienced health problems that persisted for at least 6 months. The manifestations and outcomes affect different systems; therefore, long COVID, like COVID-19, has systemic involvement and the clinical manifestations may be residues of the damage caused by the disease during the acute phase, or new manifestations whose pathogenesis is still a matter of discussion.

CONCLUSIONS: The persistence of inflammation and the dysregulation of the immune system represent some of the pathogenetic hypotheses. Inflammation could therefore represent one of the physiopathogenetic mechanisms of long COVID, and it is possible that it is responsible for the clinical symptoms that appear in the months following the resolution of the acute phase of the disease.},
}

@article {pmid41148083,
year = {2025},
author = {Floridia, M and Pagnanelli, G and Piccinni, G and Weimer, LE and Onder, G and , },
title = {Persisting or recurrent dermatological manifestations in Long-COVID: Data from a national cohort of 1741 patients from Italy.},
journal = {Journal of the American Academy of Dermatology},
volume = {},
number = {},
pages = {},
doi = {10.1016/j.jaad.2025.10.024},
pmid = {41148083},
issn = {1097-6787},
}

@article {pmid41146907,
year = {2025},
author = {Padhye, AS and Koralnik, IJ and Hanson, BA and Visvabharathy, L and DeLisle, RK and Tachas, G},
title = {Blood diagnostic biomarkers for neurologic manifestations of long COVID.},
journal = {Brain, behavior, & immunity - health},
volume = {49},
number = {},
pages = {101110},
pmid = {41146907},
issn = {2666-3546},
abstract = {BACKGROUND: SARS-CoV-2 responsible for COVID-19 caused a global pandemic, with billions of infections, millions of deaths and ongoing manifestations post COVID-19. "Long Covid", a Post-Acute Sequelae of COVID-19 (PASC), is an ongoing global healthcare problem, affecting all age groups, with many manifestations, and occurring despite vaccines and antivirals. Neurologic manifestations of PASC (Neuro-PASC) such as brain fog can last for years and are amongst the most debilitating and prevalent. There is a need for diagnostic tools and treatments.

METHODS: Plasma samples from 48 non-hospitalized PASC patients with diagnosed Neuro-PASC symptoms (NP), 20 convalescent control (CC) subjects, and 24 unvaccinated healthy control (HC) subjects, was used to generate data on over 7000 proteins using the SomaLogic® proteomics platform. ProViz® software was used to perform T-tests, U-Tests, ANOVA and Kruskalis-Wallis tests at a Bonferroni p < 0.05 and a Benjamini-Hochberg corrected False Discovery Rate <0.02, and box plots and knowhow used to identify diagnostic biomarkers and therapeutic targets.

RESULTS: C5a, TGFβ1, and Gliomedin, used together differentiated patients with Neuro-PASC from control subjects with 94 % sensitivity and 86 % specificity, a 90 % accuracy. Additional biomarkers, Gal3ST1, IFNλ1, and GHRH, improved accuracy to 94 %, and a combination of 5 more biomarkers, LFA-3, FASLG + Transgelin-1 and GPNMB + IGHG1, improved accuracy close to 100 %. These markers are suggestive of pathways involved in Neuro-PASC pathogenesis. A dozen partly overlying biomarkers were modulated to which there are FDA approved drugs.

CONCLUSION: C5a, TGFβ1, Gliomedin expressed highly in serum could be developed as a diagnostic tool, and with clinical assessment used to personalize treatments with repurposed novel drugs.},
}

@article {pmid41146789,
year = {2025},
author = {Dudek, A and Bursy, M and Szkudlarek, W and Linkiewicz, J and Fabiszewski, Z and Starosta, P},
title = {Chronic Cardiovascular Disorders Associated With COVID-19: A Literature Review.},
journal = {Cureus},
volume = {17},
number = {9},
pages = {e93271},
pmid = {41146789},
issn = {2168-8184},
abstract = {The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), responsible for the COVID-19 pandemic, is now widely recognized for causing several long-term effects known as post-COVID-19 syndrome (PCS) or long COVID (LC). This presents a growing challenge for healthcare systems worldwide. This narrative review summarizes original peer-reviewed studies indexed in PubMed and published between January 2020 and August 2025. It focuses on adult populations unless stated otherwise. We included studies that provided primary clinical or imaging data on chronic cardiovascular outcomes after confirmed SARS-CoV-2 infection. We excluded case reports, pediatric-only cohorts, and non-peer-reviewed sources. Among the various cardiovascular issues related to LC, we focused on heart fibrosis (HF), postural orthostatic tachycardia syndrome (POTS), new-onset hypertension (HT), and coagulopathy. These conditions consistently show up in the reports and are significant in terms of illness, potential long-term disability, and public health impact. Although these issues are distinct in their underlying causes, they share common mechanisms. These include ongoing inflammation of the endothelium, disruption of the renin-angiotensin-aldosterone system (RAAS), immune-related tissue damage, and an ongoing state that promotes blood clots. These processes can lead to measurable myocardial fibrosis that cardiac magnetic resonance imaging can detect, autonomic dysfunction often seen as POTS, a greater risk of developing hypertension shortly after infection, and a long-term rise in thromboembolic events due to increased clotting and resistant microclots. Current management is mostly focused on relief of symptoms and involves a team approach. It uses repurposed medications and tailored physical rehabilitation since no specific cure is available yet. Promising but still experimental methods, such as endothelial-protective agents like sulodexide and targeting inflammatory pathways, need thorough testing. There are significant gaps in our understanding of the long-term risk of hypertension, the natural progression of fibrosis, and the best treatment for POTS. This highlights urgent needs for future research. Beyond caring for individual patients, these ongoing cardiovascular problems raise important public health concerns. They include higher healthcare use, long-term disability, and economic costs. This situation requires increased clinical attention and proactive cardiovascular monitoring for those recovering from COVID-19.},
}

@article {pmid41146089,
year = {2025},
author = {Blay, N and Farré, X and Garcia-Aymerich, J and Castaño-Vinyals, G and Kogevinas, M and de Cid, R},
title = {Pre-pandemic disease trajectories and genetic insights into long COVID susceptibility.},
journal = {BMC medicine},
volume = {23},
number = {1},
pages = {590},
pmid = {41146089},
issn = {1741-7015},
support = {TED2021-130626B-I00//Ministerio de Ciencia e Innovación/ ; SR20-01024//'la Caixa' Foundation/ ; 167/C/2021//Fundació la Marató de TV3/ ; PI18/01512//Ministerio de Sanidad, Consumo y Bienestar/ ; GA:101046314//HORIZON EUROPE Health/ ; },
mesh = {Humans ; Female ; *COVID-19/genetics/epidemiology ; Middle Aged ; Male ; Adult ; *Genetic Predisposition to Disease ; Aged ; SARS-CoV-2 ; Comorbidity ; Chronic Disease/epidemiology ; Multifactorial Inheritance ; Risk Factors ; Cohort Studies ; },
abstract = {BACKGROUND: Long COVID refers to the persistence of symptoms after SARS-CoV-2 infection. While individual comorbidities have been studied, the role of coexisting chronic conditions remains underexplored. This study investigates whether pre-pandemic disease trajectories-sequential patterns of chronic conditions-modify long COVID risk and symptom profiles and explores shared genetic susceptibility.

METHODS: We analysed 8322 adult participants (58.6% women) from the COVICAT cohort (aged 40-65 at recruitment), followed between 2020 and 2023. Disease trajectories were reconstructed from electronic health records (2010-2019), focusing on sequences of two chronic conditions found in ≥ 1% of the cohort. We evaluated shared genetic architecture and polygenic risk scores (PRS) for predictive capacity.

RESULTS: Thirty-eight disease trajectories were associated with increased long COVID risk. These trajectories primarily involved mental and neurological disorders (e.g. depression, anxiety, migraine), respiratory diseases (e.g. asthma, allergic rhinitis) and cardiometabolic or digestive conditions (e.g. hypertension, lipidaemia, obesity, gastroesophageal reflux). No significant genetic correlations with long COVID were detected, but polygenic risk scores for two nervous system and musculoskeletal conditions showed modest associations with increased risk.

CONCLUSIONS: Disease trajectories were significantly associated with long COVID, with a sex effect, highlighting the importance of pre-pandemic disease trajectories. While no strong overall genetic correlations were found, modest polygenic associations suggest a role for shared susceptibility in nervous system and musculoskeletal disorders. From a public health perspective, identifying high-risk multimorbid individuals may inform targeted prevention and care strategies.},
}

Humans
Female
*COVID-19/genetics/epidemiology
Middle Aged
Male
Adult
*Genetic Predisposition to Disease
Aged
SARS-CoV-2
Comorbidity
Chronic Disease/epidemiology
Multifactorial Inheritance
Risk Factors
Cohort Studies

@article {pmid41145523,
year = {2025},
author = {Martins Conde, P and Bulaev, D and Rauschenberger, A and Ohnmacht, J and Fritz, JV and O'Sullivan, MP and Ancien, F and Ghosh, S and Tsurkalenko, O and Kolodkin, A and Satagopam, V and Vaillant, M and Klucken, J and Krüger, R and , },
title = {Co-occurrence of memory impairment and fatigue distinguishes post COVID from pandemic-related health effects in the 4-year CON-VINCE cohort study.},
journal = {Scientific reports},
volume = {15},
number = {1},
pages = {37381},
pmid = {41145523},
issn = {2045-2322},
support = {FNR 14716281/CON-VINCE/Kruger//Fonds National de la Recherche Luxembourg/ ; 101016167//European Commission/ ; },
mesh = {Humans ; *COVID-19/complications/epidemiology/psychology ; Female ; *Fatigue/epidemiology/etiology/diagnosis ; Male ; *Memory Disorders/epidemiology/etiology/diagnosis ; Middle Aged ; Adult ; SARS-CoV-2/isolation & purification ; Aged ; Risk Factors ; Longitudinal Studies ; Post-Acute COVID-19 Syndrome ; Luxembourg/epidemiology ; Pandemics ; Anxiety/epidemiology ; Depression/epidemiology ; Cohort Studies ; Comorbidity ; },
abstract = {A major challenge in diagnosing post COVID lies in differentiating symptoms following a confirmed SARS-CoV-2 infection from those that may also occur in uninfected individuals (post COVID mimics) and be associated with a broader impact of the pandemic. The WHO post COVID definition was applied to the Luxembourgish longitudinal CON-VINCE cohort, where SARS-CoV-2 infection was confirmed via either a positive RT-qPCR or a serology test. Risk factor analysis was conducted on 1,865 individuals. Female gender, lower resilience, greater loneliness, and a higher number of comorbidities were associated with symptoms persistence. The symptomatology and comorbidity profiles of 559 participants (including 50 post COVID and 66 post COVID mimics) were investigated. Two distinct clusters of persistent symptoms were identified: (1) depression with anxiety, present in both infected and non-infected groups, and (2) memory impairment with fatigue, unique to the post COVID group. Therefore, presence of both memory impairment and fatigue may help differentiate post COVID patients from post COVID mimics. Yet, verification that memory impairment was newly developed was not possible, as this symptom was not recorded at baseline. Our findings suggest that future studies should consider factors affecting development of persistent post COVID-like symptoms observed in individuals that were never infected.},
}

Humans
*COVID-19/complications/epidemiology/psychology
Female
*Fatigue/epidemiology/etiology/diagnosis
Male
*Memory Disorders/epidemiology/etiology/diagnosis
Middle Aged
Adult
SARS-CoV-2/isolation & purification
Aged
Risk Factors
Longitudinal Studies
Post-Acute COVID-19 Syndrome
Luxembourg/epidemiology
Pandemics
Anxiety/epidemiology
Depression/epidemiology
Cohort Studies
Comorbidity

@article {pmid41145456,
year = {2025},
author = {Sujith, S and Gatzke, N},
title = {An overview of clinical presentation and management of long COVID.},
journal = {The Nurse practitioner},
volume = {50},
number = {11},
pages = {38-42},
doi = {10.1097/01.NPR.0000000000000374},
pmid = {41145456},
issn = {1538-8662},
mesh = {Humans ; *COVID-19/nursing/complications/therapy ; Risk Factors ; Nurse Practitioners ; SARS-CoV-2 ; },
abstract = {The COVID-19 pandemic has been the 21st century's most significant public health emergency. In addition to the acute symptoms of COVID-19, many individuals are facing long-term health issues related to the infection. The terms "long COVID," "postacute sequelae of SARS-CoV-2 infection," "postacute COVID syndrome," and "long-haul COVID-19" refer to long-term consequences of SARS-CoV-2 infection. Symptoms may persist for weeks or months, reducing quality of life. Health practitioners must stay updated and take proactive measures to manage long COVID effectively. This manuscript provides an overview of risk factors, diagnostic tools, and management strategies, which serve as a resource for understanding and managing long COVID.},
}

Humans
*COVID-19/nursing/complications/therapy
Risk Factors
Nurse Practitioners
SARS-CoV-2

@article {pmid41144164,
year = {2025},
author = {Colaneri, M and Galbussera, AA and Tettamanti, M and Puoti, M and Marchetti, G and Piva, S and Plebani, P and Raviglione, M and Gori, A and Bandera, A and Nobili, A},
title = {Specialist Healthcare Intervention and Follow-up Trends in Post-Acute COVID-19 Hospitalization as Compared to Other Respiratory Infections.},
journal = {Infectious diseases and therapy},
volume = {},
number = {},
pages = {},
pmid = {41144164},
issn = {2193-8229},
support = {2021-4236//Fondazione Cariplo/ ; },
abstract = {INTRODUCTION: Post-acute sequelae of COVID-19, often referred to as "long COVID," have raised concerns about increased healthcare utilization following hospitalization. Whether these patterns differ significantly from those observed after other acute respiratory infections (ARIs) remains unclear. This study aimed to compare post-discharge healthcare use between patients hospitalized for COVID-19 and those with other ARIs in Lombardy, Italy.

METHODS: We conducted a population-based cohort study using 2021 administrative healthcare data from the Lombardy Region. Patients aged ≥ 40 years hospitalized for COVID-19 or other ARIs were followed for 12 months post-discharge. We evaluated specialist consultations, rehospitalizations, diagnostic testing, and new chronic drug treatment initiations. Logistic regression models adjusted for age, sex, and comorbidities (Drug-Derived Complexity Index) were used to assess differences.

RESULTS: Among 57,795 patients, 35,458 were hospitalized for COVID-19 and 21,375 for other ARIs. Patients with COVID-19 were younger and had lower comorbidity burden and post-discharge mortality (10.7% vs. 33.5%). A higher proportion received at least one specialist visit (75.8% vs. 70.3%), though with a longer median time to first visit (63 vs. 45 days, p < 0.0001). Patients with COVID-19 had more frequent imaging and spirometry but initiated fewer chronic drug treatments overall. However, a higher prescription rate for antidiabetics (OR 1.42), psychoanaleptic (OR 1.21), and genitourinary/hormonal drugs (OR 1.29) emerged after COVID-19 hospitalizations: this rate remained statistically higher for antidiabetics even after excluding subjects who died in the year following discharge. Hospitalizations for causes other than COVID-19 were more frequent in patients with ARI.

CONCLUSIONS: Compared to other ARIs, COVID-19 survivors exhibited distinct post-discharge healthcare patterns, with delayed but focused specialist care and selective increases in diagnostic and pharmacological interventions.},
}

@article {pmid41143594,
year = {2025},
author = {Wehrli, S and Hartner, AM and Boender, TS and Arnrich, B and Irrgang, C},
title = {Information Pathways and Voids in Critical German Online Communities During the COVID-19 Vaccination Discourse: Cross-Platform and Mixed Methods Analysis.},
journal = {Journal of medical Internet research},
volume = {27},
number = {},
pages = {e76309},
doi = {10.2196/76309},
pmid = {41143594},
issn = {1438-8871},
mesh = {Germany/epidemiology ; Humans ; *COVID-19/prevention & control/epidemiology ; SARS-CoV-2 ; *COVID-19 Vaccines ; *Social Media ; Pandemics ; Public Health ; *Vaccination ; },
abstract = {BACKGROUND: In Germany, the messaging app Telegram (Telegram FZ-LLC) served as a tool to organize protests against public health measures during the COVID-19 pandemic. A community of diverse groups formed around these protests, which used Telegram to discuss and share views outside of the general public discourse and mainstream information ecosystem. This increasingly included conspiracy theories and extremist content, propagated by sources that opposed the mainstream positions of the government and traditional media. While the use of such sources has been thoroughly investigated, the role of mainstream information in these communities remains largely unclear.

OBJECTIVE: We aimed to better understand the use of mainstream information, that is, from government actors and established media outlets, within critical Telegram communities in the context of the COVID-19 pandemic in Germany. We focused on the discourse about the COVID-19 vaccination, a key public health measure. As a central element of this study, we compared the Telegram discourse with the discourse on X (formerly Twitter, X Corp) and in online news-this cross-platform analysis aimed to put the results into a broader societal context.

METHODS: We analyzed Telegram, X, and news data between 2019 and 2023 for popular topics related to the COVID-19 vaccination discourse. We used a mixed methods approach, including text clustering for the exploration of popular topics, a 2-stage keyword filtering scheme for multitopic classification, link sharing analysis for assessing the prevalence of mainstream information, correlation-based time series analysis for measuring the similarity of discourse dynamics, and thematic analysis to examine the reasons for sharing information.

RESULTS: We identified 5 popular vaccination-related topics that were discussed on both Telegram and X, namely death, long COVID, measures in schools, mandatory vaccination, and virus variants. On average per topic, 58% (SD 5.2%) of Telegram posts and 21% (SD 4.9%) of X posts contained an external link. Of these posts containing external links, 11%-35% of Telegram posts and 44%-60% of X posts contained a mainstream link per topic. The correlations for week-to-week changes in discourse intensity between Telegram, X, and online mainstream news ranged from no positive association (coefficient <0.2) to strong positive relationships (coefficient >0.6) per topic. Finally, the thematic analysis resulted in 5 themes describing the usage patterns of mainstream information on Telegram and X. The identified themes are observing news, news comments, directed accusations, participation, and reference in discussion (only X).

CONCLUSIONS: Mainstream information sources were part of the information mix within the analyzed critical Telegram communities. However, the role and prevalence of these sources varied. We argue that differences between platforms may indicate the existence of information voids, which pose a particular challenge in managing infodemics. These insights emphasize the importance of contextualized cross-platform analyses for understanding complex information pathways and their potential for targeted crisis communication.},
}

Germany/epidemiology
Humans
*COVID-19/prevention & control/epidemiology
SARS-CoV-2
*COVID-19 Vaccines
*Social Media
Pandemics
Public Health
*Vaccination

@article {pmid41142667,
year = {2025},
author = {Hirschtick, JL and Slocum, E and Whittington, B and Elliott, MR and Ahmed, S and Fleischer, NL},
title = {Comparison of survey questions to define long COVID: Implications for prevalence and disparities.},
journal = {Preventive medicine reports},
volume = {59},
number = {},
pages = {103269},
pmid = {41142667},
issn = {2211-3355},
abstract = {OBJECTIVE: To understand whether variation in survey-based Long COVID estimates is partially due to how and when survey questions are asked.

METHODS: We compared Long COVID prevalence using distinct questions within a population-based, longitudinal survey of adults with confirmed SARS-CoV-2 before June 2022 in Michigan.

RESULTS: In our sample (n = 3826), 17.0 % reported symptoms for 90+ days at baseline, a median of 4.4 months after COVID-19 onset. A median of 18.4 months after COVID-19 onset, 24.5 % reported ever experiencing Long COVID, 16.9 % reported current Long COVID, and 10.8 % reported diagnosed Long COVID. Among adults without 90-day symptoms at baseline, 17.3 % reported ever Long COVID at follow-up. Relatedly, among adults with 90-day symptoms at baseline, 31.1 % reported they never had Long COVID at follow-up. After adjustment for reinfection, respondents who were Hispanic (vs. White) or lower income (<$75,000 vs. $75,000+) had greater odds of reporting baseline symptoms but never experiencing Long COVID at follow-up. Conversely, Black (vs. White) respondents had greater odds of reporting ever Long COVID at follow-up without baseline symptoms.

CONCLUSION: Surveys should employ several questions to define Long COVID and interpret findings within the context of factors likely contributing to discrepancies, including reinfection, stigma, awareness, and care-seeking behaviors.},
}

@article {pmid41142132,
year = {2025},
author = {Kitsios, GD and Li, K and Blacka, S and Fitch, A and Jacobs, J and Naqvi, A and Zhang, B and Gentry, H and Murray, C and Wang, X and Patel, A and Puzniak, L and Rudolph, A and Dai, F and Mellors, J and Sciurba, F and Methe, B and Nouraie, SM and Morris, A},
title = {Oral and gut microbiota relate to symptom subphenotypes in long COVID, independent of viral persistence.},
journal = {iScience},
volume = {28},
number = {11},
pages = {113628},
pmid = {41142132},
issn = {2589-0042},
abstract = {Long COVID presents a significant public health challenge, complicating diagnosis and treatment. In a prospective study of 349 individuals with long COVID (March 2021-December 2023), latent class analysis identified three symptom subphenotypes: high constitutional symptom burden (21%), predominant smell/taste disturbances (17%), and minimal persisting symptoms (62%). While viral persistence in saliva and stool was limited, 16S rRNA gene sequencing revealed microbiota associations with symptomatology. Alpha diversity was lower in individuals with high symptom burden, and specific taxa correlated with nausea and smell/taste disturbances. Distinct oral and gut microbiota patterns emerged across symptom clusters, with microbiota profiles also linked to patient-reported outcomes, including employment and overall health impact. These findings suggest that bacterial dysbiosis may contribute to long COVID symptom variability and highlight the microbiome's potential role in its pathophysiology. Understanding microbial influences on symptom persistence may inform microbiome-targeted therapeutic strategies and improve long COVID management.},
}

@article {pmid41141591,
year = {2025},
author = {An, H and Yu, T and Wang, A and Hu, H and Zhang, C and Wang, Y and Li, M},
title = {Persistent lymphocytopenia in convalescent patients with COVID-19: dysregulated B cell, CD4[+] T cell, and treg compartments in 7-12% of moderate-severe cases.},
journal = {Frontiers in cellular and infection microbiology},
volume = {15},
number = {},
pages = {1693743},
pmid = {41141591},
issn = {2235-2988},
mesh = {Humans ; *COVID-19/immunology/complications/pathology ; *Lymphopenia/immunology ; Male ; Female ; Middle Aged ; *B-Lymphocytes/immunology ; *CD4-Positive T-Lymphocytes/immunology ; *T-Lymphocytes, Regulatory/immunology ; Longitudinal Studies ; Convalescence ; SARS-CoV-2/immunology ; Adult ; Aged ; Lymphocyte Count ; Severity of Illness Index ; },
abstract = {BACKGROUND: Long COVID manifests with heterogeneous clinical outcomes, potentially linked to immune dysfunction. However, the recovery of immune-cell subsets during convalescence remains incompletely understood.

METHODS: In this longitudinal cohort, 279 unvaccinated patients with confirmed SARS-CoV-2 infection (13 mild, 218 moderate, 48 severe) were enrolled. Peripheral lymphocyte subsets were analyzed by flow cytometry at admission and at 50 days post-symptom onset (DPSO 50).

RESULTS: Total T-cell counts normalized in 90-98% of patients in the moderate and severe groups by DPSO 50. Nevertheless, a subgroup exhibited persistent B-cell lymphopenia (<90 cells/µL) in 7.3% of moderate cases (median 77.1 cells/µL, IQR 51.9-83.8) and 12.5% of seltvere cases (median 54.5 cells/µL, IQR 28.4-79.3). Patients with B-cell deficiency also showed concurrent reductions in total T cells, CD4[+] T cells, and CD4[+]CD25[+]CD127low/FOXP3[+] regulatory T cells (Tregs). In moderate cases, CD4[+] T cell and Treg counts correlated positively (r = 0.72, p < 0.001), independent of B-cell status, whereas this relationship was absent in severe cases, indicating severity-dependent immune dysregulation.

CONCLUSIONS: Approximately 7-12% of moderate-to-severe COVID-19 survivors displayed persistent lymphopenia affecting B cells, CD4[+] T cells, and Tregs at ~50 days post-symptom onset. These findings highlight distinct recovery trajectories and provide insights into Long COVID pathogenesis that may inform therapeutic strategies.},
}

Humans
*COVID-19/immunology/complications/pathology
*Lymphopenia/immunology
Male
Female
Middle Aged
*B-Lymphocytes/immunology
*CD4-Positive T-Lymphocytes/immunology
*T-Lymphocytes, Regulatory/immunology
Longitudinal Studies
Convalescence
SARS-CoV-2/immunology
Adult
Aged
Lymphocyte Count
Severity of Illness Index

@article {pmid41140967,
year = {2025},
author = {Haq, AM},
title = {Comment on "Pre-pandemic diabetes and risk of long COVID: Longitudinal evidence".},
journal = {Journal of diabetes and metabolic disorders},
volume = {24},
number = {2},
pages = {245},
pmid = {41140967},
issn = {2251-6581},
}

@article {pmid41140205,
year = {2025},
author = {McCready, JL and Campbell, M and McCay, K and Moore, J and Deary, V and Vines, J and Higgs-McCallum, C and Webster, D and Ellis, J and Newton, J and Nobbs, C and Rapley, T and Hackett, KL},
title = {Optimising and beta-testing a user-centred, accessible, self-management rehabilitation smartphone app (reCOVer) for long-COVID fatigue using qualitative interview methods.},
journal = {Disability and rehabilitation},
volume = {},
number = {},
pages = {1-19},
doi = {10.1080/09638288.2025.2577872},
pmid = {41140205},
issn = {1464-5165},
abstract = {PURPOSE: Fatigue is one of the most common and disabling symptoms of long-COVID, yet individuals often struggle to access appropriate services and must self-manage. This study aimed to adapt an existing smartphone app, originally developed for fatigue in autoimmune rheumatic disease, for individuals with long-COVID.

MATERIALS AND METHODS: A multidisciplinary steering group reviewed current clinical and scientific evidence to inform the adaptation of the app, reCOVer. The app includes an activity pacing diary, goal-setting tool, assertiveness and communication cards, and guidance on fatigue, sleep, relaxation, and setbacks. Beta-testing was conducted with 11 individuals with long-COVID (aged 21-57). Each participant took part in two serial qualitative interviews: the first explored their experience of fatigue and initial reactions to the app; the second, after 7-10 days of use, captured usability and acceptability feedback.

RESULTS: Participants found reCOVer helpful, particularly for increasing awareness of unhelpful patterns (e.g., boom-bust cycles) and supporting behaviour change through pacing. Communication tools were valuable when cognitive difficulties were prominent. Suggested improvements included text-to-speech functionality, clearer goal-setting instructions, and better articulation of app benefits.

CONCLUSIONS: reCOVer shows promise as a self-management tool for long-COVID fatigue. Further research, such as a pilot RCT, is needed to evaluate feasibility and effectiveness.},
}

@article {pmid41138821,
year = {2025},
author = {Sano, K and Kimura, Y and Hirahata, K and Kato, H and Hasegawa, H and Akutsu, H and Ryo, A and Goto, A and Miyakawa, K},
title = {SARS-CoV-2 spike-specific IgG4 class switching associates with clinical recovery in Long COVID.},
journal = {The Journal of infection},
volume = {},
number = {},
pages = {106641},
doi = {10.1016/j.jinf.2025.106641},
pmid = {41138821},
issn = {1532-2742},
}

@article {pmid41138585,
year = {2025},
author = {Feter, N and Caputo, EL and Silveira da Silva, L and Cunha, L and Delpino, FM and de Almeida Paz, I and Cozzensa da Silva, M and Schröeder, N and Feter, J and Reichert, FF and Rombaldi, AJ},
title = {Long-term consequences of mental health distress during the COVID-19 pandemic on subjective memory decline: findings of the PAMPA cohort.},
journal = {Public health},
volume = {249},
number = {},
pages = {105974},
doi = {10.1016/j.puhe.2025.105974},
pmid = {41138585},
issn = {1476-5616},
abstract = {OBJECTIVES: While the acute impact of COVID-19 on mental health has been documented, less is known about its long-term consequences on cognitive health. We investigated the association between worsening depressive and anxiety symptoms during the pandemic with the risk of subjective memory decline over a three-year follow-up.

STUDY DESIGN: Prospective cohort study.

METHODS: We analyzed data from 682 adults participating in the PAMPA cohort, a longitudinal study in southern Brazil. Changes in depressive and anxiety symptoms were assessed at baseline (2020) and during the pre-pandemic period retrospectively. Subjective memory decline was self-reported in the fourth follow-up (2023). Robust Poisson regression was used to estimate associations. Inverse probability weighting was used to estimate selection bias.

RESULTS: Over follow-up, 51 % (95 %CI: 47.1 %-54.6 %) of participants reported subjective memory decline. Worsened depressive (RR: 1.33; 95 %CI: 1.21-1.64) and anxiety (RR: 1.36; 95 %CI: 1.28-1.44) symptoms were associated with a higher risk of subjective memory decline. Each one-point increase in depression (RR = 1.04; 95 % CI: 1.03-1.05) and anxiety (RR = 1.02; 95 % CI: 1.01-1.03) symptoms was linked to a 4.3 % and 2.4 % increase in the risk of subjective memory decline. Associations remained robust after adjusting for COVID-19 status and other potential confounders, including depressive and anxiety symptoms at follow-up. Results were consistent in sensitivity analyses excluding participants with long COVID.

CONCLUSION: Worsening mental health during the COVID-19 pandemic predicted subjective memory decline three years later. Our findings underscore the importance of mental health support as a public health strategy to preserve long-term cognitive function, particularly after large-scale crises.},
}

@article {pmid41138391,
year = {2025},
author = {Badhwar, S and Pereira, TJ and Kerr, K and Bray, R and Tabassum, F and Sergio, L and Edgell, H},
title = {Autonomic phenotyping, brain blood flow control, and cognitive-motor-integration in Long COVID and myalgic encephalomyelitis/chronic fatigue syndrome: A pilot study.},
journal = {Autonomic neuroscience : basic & clinical},
volume = {262},
number = {},
pages = {103358},
doi = {10.1016/j.autneu.2025.103358},
pmid = {41138391},
issn = {1872-7484},
abstract = {Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and the prolonged sequelae after COVID-19 (>3 months; Long COVID) have similar symptomology, are both associated with autonomic dysfunction, and a growing proportion of Long COVID patients are developing ME/CFS. We aimed to determine an autonomic phenotype of patients with ME/CFS vs Long COVID. We hypothesized that the groups would differ from controls yet be similar to one another. We recruited sedentary controls (n = 10), mild/moderate ME/CFS patients (n = 12), and Long COVID patients (n = 9) to undergo 1) breathing 5 % CO2, 2) breathing 10 % O2, and 3) 5-minutes of 70° head-up tilt. Respiratory, hemodynamic, and cerebrovascular variables were measured throughout the 3 trials. Resting vascular function and cognitive-motor-integration were also assessed. ME/CFS and Long COVID were similar to the healthy controls and each other with regard to resting vascular function and the hemodynamic responses to hypoxia, hypercapnia, and head-up tilt (p > 0.05). However, in ME/CFS we observed a greater reduction of cerebrovascular resistance (p = 0.041) and impaired autoregulation (p = 0.042) during hypercapnia alongside impaired cognitive-motor integration (p < 0.02), and in Long COVID we observed reduced peripheral and end-tidal oxygen (p < 0.04) and less vagal withdrawal during tilt (p = 0.028). Our findings suggest unique phenotypes when comparing ME/CFS and Long COVID whereby we have shown that Long COVID patients experience hypoxia while upright contributing to less vagal withdrawal, and ME/CFS patients experience impaired cerebrovascular control during hypercapnia potentially leading to reduced cognitive-motor integration. These differences could stem from disease severity/duration or some unique aspect of the COVID-19 virus.},
}

@article {pmid41138036,
year = {2025},
author = {Yamamoto, K and Inoue, T and Ikeda, T and Sawai, T and Nagayoshi, Y and Hashiguchi, K and Futsuki, Y and Matsubara, Y and Harada, Y and Ashizawa, N and Fukahori, S and Iwanaga, N and Takazono, T and Kido, T and Ishimoto, H and Hosogaya, N and Sakamoto, N and Tashiro, M and Tanaka, T and Fukushima, C and Jounai, K and Tsuji, R and Fujiwara, D and Ota, K and Kosai, K and Furumoto, A and Yanagihara, K and Izumikawa, K and Mukae, H},
title = {Efficacy of Lactococcus lactis Strain Plasma in Patients with Mild COVID-19: A Multicenter, Double-Blinded, Randomized-Controlled Trial (PLATEAU Study).},
journal = {Infectious diseases and therapy},
volume = {},
number = {},
pages = {},
pmid = {41138036},
issn = {2193-8229},
support = {H21003539//Kirin Holdings Co., Ltd./ ; },
abstract = {INTRODUCTION: Coronavirus disease 2019 (COVID-19), caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), is still an ongoing public health threat. COVID-19 can be accompanied by prolonged symptoms, known as "long COVID", however, no pharmaceutical treatments are currently available for these symptoms. Lactococcus lactis strain Plasma (LC-Plasma; Lactococcus lactis subsp. lactis JCM 5805) directly activates human plasmacytoid dendritic cells (pDCs) and triggers antiviral immune responses. We hypothesized that LC-Plasma reduced SARS-CoV-2 viral load and eased symptoms in patients with mild COVID-19.

METHODS: This PLATEAU study enrolled 100 patients with mild COVID-19 during Omicron BA.1 endemic, who were randomized into the LC-Plasma or placebo group in a 1:1 ratio and were observed for 14 days. The primary endpoint was change in total score of eight subjective symptoms (fatigue, anorexia, headache, cough, shortness of breath, chest pain, smell, and taste disturbance). Secondary endpoints included each symptom, SARS-CoV-2 viral load, and pDCs.

RESULTS: The primary endpoint did not show between-group differences. However, the proportion of patients without smell and taste disturbances was significantly higher in the LC-Plasma group on day 13 (p = 0.030). The LC-Plasma group showed a significantly earlier decrease in SARS-CoV-2 viral load on day 4 (p < 0.001) and an increase in pDCs on day 8 (p = 0.0498). Mild adverse events, such as diarrhea, cough-variant asthma, and urticaria, occurred in three (5.9%) patients in the LC-Plasma group.

CONCLUSIONS: The intake of LC-Plasma in patients with mild COVID-19 activates pDC, decreases SARS-CoV-2 viral load earlier, and may improve smell and taste disorders more quickly. LC-Plasma could be a safe, inexpensive, and easily accessible tool for the treatment of mild COVID-19.

TRIAL REGISTRATION: jRCTs071210097.},
}

@article {pmid41136644,
year = {2025},
author = {Miller, AJ and Wei, G and Stoddard, GJ and Jeyapalina, S and Agarwal, JP},
title = {Pre-existing comorbidities and hospitalization for COVID-19 are associated with post-COVID conditions in the U.S. veteran population.},
journal = {Communications medicine},
volume = {5},
number = {1},
pages = {442},
pmid = {41136644},
issn = {2730-664X},
support = {CO-US-983-6072//Gilead Sciences (Gilead)/ ; UM1TR004409//U.S. Department of Health & Human Services | NIH | National Center for Advancing Translational Sciences (NCATS)/ ; },
abstract = {INTRODUCTION: Although most survivors of COVID-19 return to their baseline health within two weeks, a notable proportion of individuals continue experiencing symptoms, collectively referred to as Post-COVID Conditions (PCC). To better understand risks associated with contracting PCC, this study aimed to determine whether association exists between pre-existing comorbidities, hospitalization for COVID-19 and the subsequent diagnosis of PCC in US veterans.

METHODS: This retrospective cohort study collected data from the US Department of Veterans Affairs electronic medical records from September 1, 2021, to July 31, 2023. Participants were limited to those with electronic medical records of a SARS-CoV-2 infection, who received care from the Veterans Affairs hospital system and survived at least 28 days following the infection.

RESULTS: The multivariable logistic regression analysis reveals in hospitalized veterans, chronic obstructive pulmonary disease (COPD) associates with a 21% increase in odds of a PCC diagnosis (adjusted OR 1.21, 95%CI 1.14-1.29; p < 0.001), while in non-hospitalized veterans, chronic kidney disease (OR 1.09 95%CI 1.03-1.15; p = 0.001)) and COPD (OR 1.33, 95%CI 1.27-1.40; p < 0.001) demonstrate an increase in odds of a PCC diagnosis. Additionally, unvaccinated and partially vaccinated veterans exhibit significantly higher odds for PCC (p < 0.001) compared to fully vaccinated veterans in both the hospitalized and non-hospitalized cohorts. Increasing age, increasing BMI, female sex, Hispanic ethnicity, and veterans residing in the Southwestern United States show a significant (p < 0.05) increase in risk for a positive diagnosis of PCC in both groups.

CONCLUSIONS: Veterans with pre-existing COPD or those hospitalized at the time of COVID-19 (indicating disease severity) are at higher risk of receiving a PCC diagnosis.},
}

@article {pmid41136524,
year = {2025},
author = {Georgopoulos, AP and James, LM and Peterson, PK},
title = {HLA and pathogens in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and other post-infection conditions.},
journal = {Scientific reports},
volume = {15},
number = {1},
pages = {37303},
pmid = {41136524},
issn = {2045-2322},
mesh = {Humans ; *Fatigue Syndrome, Chronic/virology/immunology/genetics ; Alleles ; *HLA Antigens/genetics/immunology/metabolism ; Antigens, Viral/immunology/metabolism ; Genetic Predisposition to Disease ; *Herpesviridae/immunology ; COVID-19/virology/immunology ; SARS-CoV-2/immunology ; },
abstract = {Viral infections have been widely implicated in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) pathogenesis. Recent evidence has also identified certain Human Leukocyte Antigen (HLA) alleles that are significantly associated with ME/CFS risk/protection. Here we tested the hypothesis that ME/CFS risk or protection conferred from those HLA alleles is associated with binding affinity to antigens of HHV viruses, a critical step in initiating the adaptive immune system response to foreign antigens. Specifically, we determined in silico the predicted binding affinity of two susceptibility alleles (C*07:04, DQB1*03:03) and two protective alleles (B*08:01, DPB1*02:01) to > 10,000 antigens of the 9 Human Herpes Viruses (HHV1, HHV2, HHV3, HHV4, HHV5, HHV6A, HHV6B, HHV7, HHV8) which have been implicated in the etiology of ME/CFS. We found that the binding affinity of all HHV antigens to the susceptibility alleles was significantly weaker than the binding affinity to the protective alleles (P < 0.001). In fact, none of the HHV antigens showed strong binding to the susceptibility alleles, in contrast to the strong bindings showed by the protective alleles. These findings are in keeping with the hypothesis that the effect of a putative HHV insult in contributing to ME/CFS is modulated by the host's HLA immunogenetic makeup. We speculate that strong HLA-antigen binding likely protects against ME/CFS via elimination of virus antigens; conversely, weak HLA-antigen binding may permit persistence of foreign antigens, contributing to ME/CFS and other chronic conditions. Finally, with respect to the latter, we determined the binding affinities to the 4 HLA alleles above to pathogens causing two chronic diseases with very similar symptomatology to ME/CFS, namely Long COVID and post-treatment Lyme disease syndrome (PTLDS). We found that the 2 ME/CFS susceptibility HLA alleles above had very weak binding with SARS-CoV-2 virus glycoprotein (involved in Long COVID) and 5 proteins of Borrelia burgdorferi (involved in PTLDS), in contrast to the ME/CFS protective alleles that showed strong bindings. These findings support the hypothesis that ME/CFS, long COVID and PTLDS are caused by persistent pathogenic antigens that could not be eliminated due to inadequate protection by the patient's HLA makeup.},
}

Humans
*Fatigue Syndrome, Chronic/virology/immunology/genetics
Alleles
*HLA Antigens/genetics/immunology/metabolism
Antigens, Viral/immunology/metabolism
Genetic Predisposition to Disease
*Herpesviridae/immunology
COVID-19/virology/immunology
SARS-CoV-2/immunology

@article {pmid41135584,
year = {2025},
author = {Botdorf, M and Dickinson, K and Lorman, V and Razzaghi, H and Marchesani, N and Rao, S and Rogerson, C and Higginbotham, M and Mejias, A and Salyakina, D and Thacker, D and Dandachi, D and Christakis, DA and Taylor, E and Schwenk, HT and Morizono, H and Cogen, JD and Pajor, NM and Jhaveri, R and Forrest, CB and Bailey, LC and , },
title = {Identifying Pediatric Long COVID: Comparing an EHR Algorithm to Manual Review.},
journal = {Applied clinical informatics},
volume = {16},
number = {5},
pages = {1445-1456},
doi = {10.1055/a-2702-1574},
pmid = {41135584},
issn = {1869-0327},
support = {OT2HL161847-01//NIH Researching COVID to Enhance Recovery (RECOVER) Initiative/ ; },
mesh = {Humans ; *Electronic Health Records ; *COVID-19/diagnosis/epidemiology ; Child ; Female ; *Algorithms ; Male ; SARS-CoV-2 ; Child, Preschool ; Adolescent ; },
abstract = {Long COVID, characterized by persistent or recurring symptoms post-COVID-19 infection, poses challenges for pediatric care and research due to the lack of a standardized clinical definition. Adult-focused phenotypes do not translate well to children, given developmental and physiological differences, and pediatric-specific phenotypes have not been compared with chart review.This study introduces and evaluates a pediatric-specific rule-based computable phenotype (CP) to identify long COVID using electronic health record data. We compare its performance to manual chart review.We applied the CP, composed of diagnostic codes empirically associated with long COVID, to 339,467 pediatric patients with SARS-CoV-2 infection in the RECOVER PCORnet EHR database. The CP identified 31,781 patients with long COVID. Clinicians conducted chart reviews on a subset of patients across 16 hospital systems to assess performance. We qualitatively reviewed discordant cases to understand differences between CP and clinician identification.Among the 651 reviewed patients (339 females, M age = 10.10 years), the CP showed moderate agreement with clinician identification (accuracy = 0.62, positive predictive value [PPV] = 0.49, negative predictive value [NPV] = 0.75, sensitivity = 0.52, specificity = 0.84). Performance was largely consistent across age and dominant variant but varied by symptom cluster count. Most discrepancies between the CP and chart review occurred when the CP identified a case, but the clinician did not, often because clinicians attributed symptoms to preexisting conditions (73%). When clinicians identified cases missed by the CP, they often used broader symptom or timing criteria (69%). Model performance improved when the CP accounted for preexisting conditions (accuracy = 0.71, PPV = 0.65, NPV = 0.74, sensitivity = 0.59, specificity = 0.79).This study presents a CP for pediatric long COVID. While agreement with manual review was moderate, most discrepancies were explained by differences in interpreting symptoms when patients had preexisting conditions. Accounting for these conditions improved accuracy and highlights the need for a consensus definition. These findings support the development of reliable, scalable tools for pediatric long COVID research.},
}

Humans
*Electronic Health Records
*COVID-19/diagnosis/epidemiology
Child
Female
*Algorithms
Male
SARS-CoV-2
Child, Preschool
Adolescent

@article {pmid41135020,
year = {2025},
author = {Andrassy, B and Tallada, S and Harris, M and Mukhdomi, T},
title = {Stellate Ganglion Block for Headache Pain and Cognitive Impairment Associated With Long COVID Persisting Over 12 Months: A Case Report.},
journal = {Pain medicine case reports},
volume = {9},
number = {6},
pages = {305-309},
pmid = {41135020},
issn = {2768-5152},
mesh = {Humans ; Female ; *Stellate Ganglion ; *Autonomic Nerve Block/methods ; Middle Aged ; *Cognitive Dysfunction/etiology/therapy ; *COVID-19/complications ; *Headache/etiology/therapy ; Bupivacaine ; Anesthetics, Local ; },
abstract = {BACKGROUND: Postacute sequelae of COVID-19 (PASC) are debilitating health conditions affecting over 7% of the US population. Clinical PASC manifestations are variable, but consistently involve dysautonomia and elevated inflammatory biomarkers. Common symptoms include pain, fatigue, cognitive impairment, sensory loss, and orthostatic intolerance. As neuroimmune hyperactivation and reductions in cerebral blood flow are each implicated in PASC pathophysiology, stellate ganglion block (SGB) represents a promising treatment option due to its ability to reset autonomic activity and reperfuse the brain. We sought to retrospectively assess the potential of SGB to treat head and neck pain, cognitive impairment, and fatigue associated with PASC persisting over 12 months.

CASE REPORT: We reviewed and analyzed case data from 2 middle-aged female patients with painful, longstanding PASC managed with repeat unilateral SGB. Procedures were performed under ultrasound guidance, with 3 mL 0.5% bupivacaine + 12 mg betamethasone as the injectate. Each patient received 2 SGBs, with all procedures being tolerated well. No complications occurred. One patient had a recurrence of migraine pain following the blocks, while the other experienced durable relief. Both patients saw improvements in cognitive function and fatigue postoperatively, which were sustained.

CONCLUSIONS: Most literature on SGB for PASC management concerns its ability to reverse sensory loss, rather than relieve chronic pain. This case report provides preliminary evidence supporting the effectiveness of SGB for managing pain and cognitive impairment in PASC. As PASC symptoms with longer durations tend to be less effectively managed with SGB, we speculate that chronicity of the patients' symptoms hampered SGB-mediated pain relief.},
}

Humans
Female
*Stellate Ganglion
*Autonomic Nerve Block/methods
Middle Aged
*Cognitive Dysfunction/etiology/therapy
*COVID-19/complications
*Headache/etiology/therapy
Bupivacaine
Anesthetics, Local

@article {pmid41134786,
year = {2025},
author = {Durstenfeld, MS and Mataraarachchi, N and Peluso, MJ and Levkova-Clark, M and Schaffer, V and Fehrman, EA and Anderson, G and Flores, D and Henrich, TJ and Long, CS and Deeks, SG and Hsue, PY},
title = {Case-control study of autonomic symptoms in the setting of Long COVID with tilt table testing.},
journal = {PloS one},
volume = {20},
number = {10},
pages = {e0335218},
doi = {10.1371/journal.pone.0335218},
pmid = {41134786},
issn = {1932-6203},
mesh = {Humans ; Female ; *Tilt-Table Test ; Middle Aged ; Male ; *COVID-19/complications/physiopathology ; Heart Rate/physiology ; Aged ; Case-Control Studies ; Adult ; SARS-CoV-2 ; *Autonomic Nervous System/physiopathology ; Blood Pressure/physiology ; Post-Acute COVID-19 Syndrome ; *Autonomic Nervous System Diseases/physiopathology/diagnosis ; Hypotension, Orthostatic/physiopathology/diagnosis ; },
abstract = {BACKGROUND: Autonomic symptoms and orthostatic syndromes have been reported in Long COVID, but few studies have characterized findings using head up tilt table testing.

OBJECTIVE: To characterize autonomic responses to positional changes among individuals with Long COVID.

METHODS: We assessed autonomic symptoms using the Composite Autonomic Symptom Scale 31 (COMPASS 31) instrument and performed head up tilt table testing for 30 minutes at 70 degrees among individuals with Long COVID and recovered comparators.

RESULTS: We included 26 participants (median age 56 years, 50% female median 25 months after first COVID): 16 with Long COVID and 10 recovered comparators. COMPASS 31 scores (0-100, higher is worse) were higher among those with Long COVID (median 30.5 vs 8, p = 0.003). Heart rate was 8 beats per minutes higher throughout tilt among those with Long COVID (95% CI 1.1 to 14.4; p = 0.02); there were no differences in blood pressure. Ten (63%) with Long COVID had symptoms during tilt compared to none among recovered participants (p = 0.003). Three (19%) with Long COVID had clinically abnormal findings: one each with orthostatic hypotension, and delayed orthostatic hypotension, and cardioinhibitory/vasovagal presyncope.

CONCLUSIONS: Among those with chronic autonomic symptoms in the setting of Long COVID, symptoms were common during tilt testing, and heart rate was increased, but most did not meet diagnostic criteria for a clinically abnormal hemodynamic response. Further research into mechanisms of autonomic symptoms in Long COVID is urgently needed.},
}

Humans
Female
*Tilt-Table Test
Middle Aged
Male
*COVID-19/complications/physiopathology
Heart Rate/physiology
Aged
Case-Control Studies
Adult
SARS-CoV-2
*Autonomic Nervous System/physiopathology
Blood Pressure/physiology
Post-Acute COVID-19 Syndrome
*Autonomic Nervous System Diseases/physiopathology/diagnosis
Hypotension, Orthostatic/physiopathology/diagnosis

@article {pmid41134747,
year = {2025},
author = {Algera, E and Maukner, AC and van Dorth, J and Alblas, MC and Sobel, J and de Vries, DH},
title = {'I Do Take the Number Seriously, but I Don't Let My Moods Depend on It': Negotiating Self-Tracking Data With People Living With Long COVID in the Netherlands, Austria and Switzerland.},
journal = {Sociology of health & illness},
volume = {47},
number = {8},
pages = {e70102},
doi = {10.1111/1467-9566.70102},
pmid = {41134747},
issn = {1467-9566},
support = {ISIDORe / grant agreement 101046133//HORIZON EUROPE Research Infrastructures/ ; },
mesh = {Humans ; Netherlands ; Switzerland/epidemiology ; *COVID-19/psychology ; Austria ; Male ; Female ; Middle Aged ; Interviews as Topic ; Aged ; Qualitative Research ; SARS-CoV-2 ; Adult ; Negotiating ; },
abstract = {For many people living with long COVID (PWLC), self-tracking has emerged as a valuable practice to monitor their illness. An examination of self-tracking practices can, therefore, shed light on the ways in which individuals navigate their care, make sense of their experiences and advocate for their needs. This study investigates how PWLC engage in self-tracking practices and how they utilise and negotiate the data generated. Based on 33 semi-structured interviews with PWLC in the Netherlands, Austria and Switzerland, we found that PWLC use self-tracking to recognise patterns and identify limits, triggers and effective interventions. The insights drawn from this are used to make informed decisions about health management strategies. Yet, self-tracking may also reify symptoms and negatively influence the subjective illness experience, exacerbating stress and anxiety. Although PWLC themselves negotiate and question their tracking data, they find a variety of responses from healthcare providers in clinical interactions. Using the concept of 'trading zone' (Kjærulff and Langstrup), we argue that although self-tracking cannot replace treatment and good care, its integration into the healthcare experience as a valuable form of patient knowledge may improve the patient-provider relationship.},
}

Humans
Netherlands
Switzerland/epidemiology
*COVID-19/psychology
Austria
Male
Female
Middle Aged
Interviews as Topic
Aged
Qualitative Research
SARS-CoV-2
Adult
Negotiating

@article {pmid41134583,
year = {2025},
author = {Abbasi, J},
title = {New Guidance on Cardiovascular Disease and COVID-19-From Infection to Long COVID to Vaccination.},
journal = {JAMA},
volume = {},
number = {},
pages = {},
doi = {10.1001/jama.2025.18834},
pmid = {41134583},
issn = {1538-3598},
}

@article {pmid41132887,
year = {2025},
author = {Vernon, SD and Rond, C and Sun, Y and Roundy, S and Bell, J and Rond, B and Kaufman, DL and Cash, AB and Yellman, B and Bateman, L},
title = {Relationships between fatigue, cognitive function, and upright activity in a randomized trial of oxaloacetate for myalgic encephalomyelitis/chronic fatigue syndrome.},
journal = {Frontiers in neurology},
volume = {16},
number = {},
pages = {1691147},
pmid = {41132887},
issn = {1664-2295},
abstract = {BACKGROUND: Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a debilitating condition characterized by fatigue, cognitive impairment, and reduced physical function. Oxaloacetate (OAA), a metabolic compound with potential mitochondrial and neuroprotective effects, has shown promise in reducing fatigue symptoms in ME/CFS. However, the interrelationships between fatigue, cognitive performance, and physical activity and their responsiveness to treatment remain poorly understood in ME/CFS.

METHODS: This 90-day randomized, double-blind, controlled trial evaluated the effects of 2,000 mg/day OAA or a control of 2,000 mg rice flour in 82 adults with ME/CFS. Self-reported fatigue (Chalder Fatigue Questionnaire), cognitive function (DANA Brain Vital), and upright activity time (UP Time) were assessed at baseline and three follow-up visits. Linear mixed-effects models examined associations between fatigue severity and cognitive/physical function, with treatment group interactions. Responder status at the last visit (Visit 4) was classified based on ≥15% fatigue reduction and/or ≥10% cognitive improvement.

RESULTS: The OAA group showed greater cognitive improvement over time, with a significant between-group difference at Visit 3, 60 days into the trial, (p = 0.034) and trends at other visits. Higher fatigue was significantly associated with reduced cognitive gains in the OAA group (β = -0.34, p < 0.0001), but not in controls. UP Time increased modestly in the OAA group, reaching significance at Visit 2, day 30 (p = 0.044), though fatigue was not a strong predictor of UP Time in either group. At Visit 4, day 90, Global and Fatigue Only Responders were more frequent in the OAA group, while Cognitive Only Responders were more frequent in controls, though group differences did not reach statistical significance (p = 0.10).

CONCLUSION: OAA supplementation was associated with improved cognitive performance and small improvement in UP Time in ME/CFS participants receiving OAA. Fatigue-cognition coupling was particularly strong in OAA-treated participants, suggesting a potentially targetable phenotype. These findings underscore the importance of multidimensional outcome measures in ME/CFS clinical trials and support the need for more research and trials of metabolic interventions in ME/CFS.},
}

@article {pmid41132394,
year = {2025},
author = {Sawyer, A and Preston, R and Leeming, H and Martin-Fuller, L and Proal, A and Putrino, D},
title = {Wearable technology in the management of complex chronic illness: preliminary survey results on self-reported outcomes.},
journal = {Frontiers in digital health},
volume = {7},
number = {},
pages = {1662255},
pmid = {41132394},
issn = {2673-253X},
abstract = {INTRODUCTION: Complex chronic illnesses like Long Covid (LC) and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) are marked by fluctuating symptoms, often exacerbated by physical, cognitive, or emotional exertion in a phenomenon known as post-exertional malaise (PEM). Home monitoring technologies offer potential benefits by enabling individuals to track symptoms and biometrics, aiding in disease self-management. However, the general effectiveness of such tools is still unknown.

METHODS: A random sample of users of the Visible mobile application (Visible Plus; requires both the armband and paid subscription), aged 18 or older and with self-identified complex chronic illnesses such as LC or ME/CFS, were invited to complete an online survey regarding the impact of the app on their chronic disease self-management. Descriptive statistics related to the responses were analyzed and reported.

RESULTS: The survey was distributed to 2,636 people, with 1,301 participants responding (49.3% response rate). The average age was 46 years. 82% of respondents were female, 8% were male, 8% were non-binary, and 2% preferred not to say or preferred to self-describe. Participants self-identified as having ME/CFS only (n = 534, 42%), LC only (n = 396, 31%), ME/CFS and LC (n = 236, 18%), or another illness (n = 122, 10%). Of the n = 2,636 randomly selected subscribers, the mostly commonly listed "other illnesses" were Postural Orthostatic Tachycardia Syndrome (POTS, 6%), fibromyalgia (5.2%), Ehlers Danlos Syndrome (EDS; 1.7%) and Mast Cell Activation Syndrome (MCAS, 1.2%). Of those with at least 30 days of data, 77% reported seeing an improvements associated with app use, corresponding to 23% of all invited users, 85% (corresponding to 29% of all invited users) reported feeling somewhat (53%) or significantly (32%), and 94% (corresponding to 33% of all invited users) reported a better understanding of their energy budget.

DISCUSSION: Home-monitoring based mobile applications are feasible and acceptable for a motivated subgroup of people with energy-limiting complex chronic illnesses, and are associated with self-reported benefits in energy management and participation in daily activities. The findings of this study should be interpreted as descriptive and hypothesis-generating and do not represent clinically significant effects, underscoring the need for randomized controlled trials to formally evaluate efficacy. Future studies should incorporate a comparison group to better differentiate intervention effects from improvements gained through lived experience.},
}

@article {pmid41132192,
year = {2025},
author = {Lo, M and Eiriksson, L and Hunter, S and Twomey, R and Skolnik, K and Chen, J and Afshar, EE and Weatherald, J and Lim, RK},
title = {Individually Tailored Physiotherapy in Persons With Respiratory Symptoms Related to Post-Acute Sequelae of COVID-19: A Feasibility Study With Mixed Methods.},
journal = {Health science reports},
volume = {8},
number = {10},
pages = {e71367},
pmid = {41132192},
issn = {2398-8835},
abstract = {BACKGROUND AND AIMS: Post-acute sequelae of COVID-19 (PASC) commonly present with persistent respiratory symptoms, even in individuals with normal chest imaging and pulmonary function. Given the heterogeneity within this population, a personalized approach to respiratory physiotherapy could improve outcomes. The purpose of this study was to assess the feasibility and impact of a tailored respiratory physiotherapy program on health-related quality of life (QoL), functional impairment, and patient-reported outcome measures (PROMs) in individuals with persistent respiratory symptoms due to PASC.

METHODS: A single-arm, open-label trial was conducted with 13 adults diagnosed with PASC, recruited from Long COVID clinics in Calgary, Canada. Participants underwent an 8-session personalized physiotherapy program, including education, breathing exercises, and strengthening. Feasibility was measured through recruitment, retention, and session completion rates. PROMs were collected at baseline and post-intervention, and qualitative interviews explored participant perspectives.

RESULTS: The program was highly feasible, with 100% retention and a 99% completion rate. Significant improvements were observed in QoL, functional status (Post COVID-19 Function Status scale), and self-efficacy scores. The 6-min walk test showed clinically meaningful improvements in three out of seven participants. Qualitative interviews (n = 8) identified three main themes: struggles with PASC, positive aspects of the program, and benefits from completing it. Participants valued the personalized approach, heart rate monitors, flexible scheduling, and a hybrid of in-person and virtual sessions, reporting increased confidence, improved symptom management, and better mental health.

CONCLUSION: A personalized respiratory physiotherapy program is feasible and may benefit individuals with PASC. Larger trials are needed to assess long-term efficacy and scalability.

TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT05040893.},
}

@article {pmid41131605,
year = {2025},
author = {Shan, D and Holland, C and Crawford, TJ},
title = {Treatment experiences, preferences, and expectations for cognitive impairments in long COVID among Chinese young and older adults: a constructivist grounded theory study.},
journal = {BMC medicine},
volume = {23},
number = {1},
pages = {579},
pmid = {41131605},
issn = {1741-7015},
mesh = {Humans ; Male ; Female ; Adult ; *COVID-19/complications/psychology/therapy ; Middle Aged ; China/epidemiology ; *Cognitive Dysfunction/therapy/psychology/etiology ; Aged ; Young Adult ; Grounded Theory ; Adolescent ; *Patient Preference ; Qualitative Research ; SARS-CoV-2 ; },
abstract = {BACKGROUND: Cognitive impairments associated with long COVID disrupt daily functioning and psychological well-being. While increasing research has examined prevalence and mechanisms, little is known about patients' treatment experiences, preferences, and expectations. In the absence of validated effective treatments, integrating these perspectives is essential for guiding research priorities and clinical trial design. In China, where long COVID is an emerging public health concern, awareness of cognitive impairments remains limited and access to specialised care is inadequate. Considering potentially substantial differences in baseline health and treatment expectations between young and older adults, this study aimed to explore and compare their perspectives using a qualitative approach.

METHODS: We adopted constructivist grounded theory to capture participants' lived experiences and develop a theory grounded in their narratives. Semi-structured online interviews were conducted with 23 individuals recruited via Chinese social media long COVID mutual aid groups, including 10 young adults (18-39 years) and 13 older adults (≥ 60 years). Theoretical sampling guided recruitment and iterative analysis through initial, focused, and theoretical coding, leading to the development of a framework explaining treatment preferences and expectations.

RESULTS: All participants reported cognitive impairments based on self-perception, with no formal medical diagnoses. We constructed a theoretical framework of "Individualised and Dynamic Adaptation to Cognitive Challenges". Preferences and expectations could be shaped by age, symptom severity, prior management experiences, lifestyle, doctor-patient interactions, and health literacy. Young adults showed a strong preference for non-pharmacological strategies, including self-directed approaches and emotional support to address stigma. Older adults emphasised a balanced use of pharmacological and non-pharmacological interventions, supported by family and structured routines, while expressing holistic expectations that encompassed cognitive, physical, and emotional well-being. Across both groups, improved sleep and psychological health were consistently emphasised.

CONCLUSIONS: Age-specific differences highlighted the heterogeneity of long COVID experiences and underscored the need for dynamic, patient-centred approaches. Tailored interventions that integrate patient perspectives may enhance care quality and outcomes. Holistic care, particularly for older adults who may face additional comorbidities and functional challenges, is essential. In China, increasing awareness among the public and healthcare providers, reducing stigma, and addressing inequalities in care access should be prioritised.},
}

Humans
Male
Female
Adult
*COVID-19/complications/psychology/therapy
Middle Aged
China/epidemiology
*Cognitive Dysfunction/therapy/psychology/etiology
Aged
Young Adult
Grounded Theory
Adolescent
*Patient Preference
Qualitative Research
SARS-CoV-2

@article {pmid39994858,
year = {2025},
author = {Sujith, S and Gatzke, N},
title = {Caring for youth in foster care: A trauma-informed practice guide.},
journal = {The Nurse practitioner},
volume = {50},
number = {3},
pages = {38-39},
pmid = {39994858},
issn = {1538-8662},
abstract = {The COVID-19 pandemic has been the 21st century's most significant public health emergency. In addition to the acute symptoms of COVID-19, many individuals are facing long-term health issues related to the infection. The terms “long COVID,” “postacute sequelae of SARS-CoV-2 infection,” “postacute COVID syndrome,” and “long-haul COVID-19” refer to long-term consequences of SARS-CoV-2 infection. Symptoms may persist for weeks or months, reducing quality of life. Health practitioners must stay updated and take proactive measures to manage long COVID effectively. This manuscript provides an overview of risk factors, diagnostic tools, and management strategies, which serve as a resource for understanding and managing long COVID.},
}

@article {pmid41130564,
year = {2025},
author = {Masoodi, WTA and Radhi, SW and Al-Hakeim, HK and Abdalsada, HK},
title = {Trace Element Imbalance as a Possible Factor in Long-COVID Pathophysiology: Links to Disease Duration and Inflammation.},
journal = {The American journal of the medical sciences},
volume = {},
number = {},
pages = {},
doi = {10.1016/j.amjms.2025.10.013},
pmid = {41130564},
issn = {1538-2990},
abstract = {BACKGROUND: Long-COVID is defined by persistent symptoms following an initial COVID-19 infection. The normal immune function depends on a precise balance of trace elements, which can provide fresh insights into prospective therapeutic strategies while maintaining oxidative balance and limiting excessive inflammation. Zinc, copper, cobalt, and manganese deficits or excesses can alter the immune system's normal functions and oxidative stress. The study aims to study the trace element profile for predicting long-COVID.

METHODS: The levels of serum copper and zinc were measured spectrophotometrically. In contrast, cobalt and manganese were measured using flameless atomic absorption spectrophotometry in 60 long-COVID patients and compared with the 30 controls who had previous SARS-CoV-2 infection but were free from long-COVID symptoms.

RESULTS: Serum levels of copper, cobalt, manganese, and the copper/zinc ratio were considerably elevated in long-COVID patients compared to the control groups. Nonetheless, there was no significant change in zinc levels relative to the control group. The cobalt concentration increases with the duration of the disease and inflammation. Serum manganese level is significantly and negatively correlated with weight. The duration of disease is inversely linked to serum zinc concentrations. There is a substantial correlation between serum copper levels and the period of recovery from acute SARS-CoV-2 infection.

CONCLUSIONS: Long-COVID is associated with alterations in serum trace elements (copper, cobalt, and manganese). The imbalances in the trace elements are associated with inflammation, duration of disease, and age. These imbalances may contribute to prolonged symptoms and greater disease severity, suggesting that trace element monitoring could be beneficial in managing long-COVID.},
}

@article {pmid41129241,
year = {2025},
author = {Adesse, D and Torices, S and Alcaide, ML and Beurel, E and Pallikkuth, S and Raccamarich, P and Cruz, A and Nogueira, NF and Jones, DL and Toborek, M},
title = {Plasma biomarkers of neurogenesis are increased among people with HIV after COVID.},
journal = {Journal of acquired immune deficiency syndromes (1999)},
volume = {},
number = {},
pages = {},
doi = {10.1097/QAI.0000000000003785},
pmid = {41129241},
issn = {1944-7884},
abstract = {OBJECTIVES: While acute COVID does not appear to markedly differ by HIV status, the long-term impact of COVID in people with HIV (PWH) remains unclear.

METHODS: Samples from forty-four participants with or without HIV were obtained approximately 10 days after the initial COVID diagnosis (t=0) and then three (t=1) and six (t=2) months later. Biomarkers of blood brain barrier (BBB) and vascular dysfunction, neurogenesis, and inflammatory responses were assessed by multiplex profiling and ELISA.

RESULTS: The majority of inflammatory biomarkers either decreased or remained unchanged over the evaluated time frame. Notable exceptions were IL-9, TNF-α, and CCL-4, which increased at t=2 compared to earlier time points. The BBB disruption and vascular dysfunction biomarkers (S100β and soluble ICAM1, respectively) increased at t=1 and then returned to basal levels, suggesting transient loss of BBB integrity. No significant changes were observed between people without HIV (PWOH) and PWH across studied inflammatory and BBB markers. Among biomarkers of neurogenesis, eotaxin/CCL11 was not altered, FGF-2 was transiently decreased at t=1 in PHW, and G-CSF was elevated at t=2 in PWH when compared to the previous time-points.

CONCLUSIONS: BBB and vascular dysfunction occur after COVID and may be implicated in the development of post-COVID conditions. HIV-1 infection may potentiate post COVID-induced neuropathology by impairing neurogenesis.},
}

@article {pmid41127613,
year = {2025},
author = {Escobar Villegas, PA and Cordoba-Melo, BD and Arango-Ibanez, JP and Naranjo-Ramirez, MC and Barbosa, MM and Casanova Rojas, AF and Mina Sánchez, AF and Herrera, CJ and Quintana Da Silva, MÁ and Buitrago Sandoval, AF and Coronel Gilio, ML and Chon Long, FP and Cárdenas Aldaz, L and Gomez-Mesa, JE},
title = {Xerostomia in survivors of severe COVID-19: findings from a Latin American cohort.},
journal = {Frontiers in oral health},
volume = {6},
number = {},
pages = {1633542},
pmid = {41127613},
issn = {2673-4842},
abstract = {OBJECTIVES: SARS-CoV-2 primary affects the respiratory tract; however, evidence suggests the oral cavity can be involved in severe COVID-19 survivors. This study investigates factors associated with xerostomia in severe COVID-19 survivors from a Latin American cohort.

MATERIALS AND METHODS: A prospective multicenter study from the Latin American Registry of Cardiovascular Disease and COVID-19, analyzed data on 272 severe COVID-19 patients from 7 institutions in 5 countries (Colombia, Dominican Republic, Ecuador, Argentina, and Paraguay). Long-term follow-up assessed demographics characteristics, comorbidities, lifestyle, cardiovascular complications, and oral health. Logistic regression in R software identified factors associated with xerostomia.

RESULTS: Xerostomia was reported in 20.6% of patients. Among affected individuals, 53.6% were female, while women represented 35.6% of those without the condition. In the overall cohort, the most common comorbidities were overweight/obesity (57.0%), hypertension (55.9%), and dyslipidemia (32.0%). Patients with xerostomia had higher rates of dyslipidemia (48.2% vs. 27.8%) and asthma/COPD (16.1% vs. 4.2%) compared to the group without xerostomia. In multivariable logistic regression, asthma/COPD (aOR: 5.14; 95% CI: 1.76-15.7), palpitations (aOR: 2.47; 95% CI: 1.04-5.94), and chest pain (aOR: 3.74; 95% CI: 1.67-8.43) were independently associated with xerostomia. Conversely, male sex was associated with lower odds of reporting xerostomia (aOR: 0.47; 95% CI: 0.24-0.89).

CONCLUSION: These findings underscore the need for clinicians to actively assess oral health symptoms such as xerostomia in post-COVID care, particularly in patients with cardiopulmonary comorbidities and persistent systemic symptoms.},
}

@article {pmid41127554,
year = {2025},
author = {Engelberts, R and Douglass, CH and Orozco, A and Eddy, S and Wilkinson, AL and Altermatt, A and van den Toren, S and Lim, MSC},
title = {Understanding Long COVID Among Young People in Victoria, Australia: Prevalence, Impact, and Associated Factors.},
journal = {Public health challenges},
volume = {4},
number = {4},
pages = {e70144},
pmid = {41127554},
issn = {2769-2450},
abstract = {INTRODUCTION: Long COVID is a significant public health concern. This study aimed to identify the prevalence, impact, and factors associated with long COVID among young people in Victoria, Australia.

METHODS: From April to June 2023, we conducted a cross-sectional online survey of people aged 15-29 years. Participants reported if they had ever experienced long COVID (defined as COVID-19 symptoms for more than 4 weeks) and the impact on their daily functioning. We used multivariable logistic regression to compare participants who reported long COVID with participants who reported acute COVID-19.

RESULTS: Among 765 participants, 11.2% reported they had ever had long COVID; however, only 1 in 10 had been diagnosed by a medical practitioner. Compared to those without prolonged symptoms, participants reporting long COVID were younger (adjusted odds ratio [aOR]: 0.92; 95% confidence interval [CI]: 0.85-0.99), reported worsened general health (aOR: 8.22; 95% CI: 4.34-15.56), expressed greater concern about getting long COVID again (aOR: 1.20; 95% CI: 1.09-1.33), and had more family or friends who also experienced long COVID (aOR: 4.43; 95% CI: 1.92-10.19). In the past 4 weeks, 79.1% of participants with current long COVID reported difficulties with performing work, and 79.1% accomplished less than desired.

CONCLUSIONS: One in 10 participants aged 15-29 years experienced long COVID, and most reported negative impacts on their daily life. General practitioners should be aware of the high burden of suspected long COVID in young people and consider supports to mitigate its effects on the health and well-being of this population.},
}