@article {pmid41668172,
year = {2026},
author = {Kim, DY and Youn, J and Kang, N and Cho, SI and Ha, IH},
title = {Potential application of brain-gut axis-based treatments in Long COVID and ME/CFS: a case-based systematic review.},
journal = {Journal of translational medicine},
volume = {},
number = {},
pages = {},
doi = {10.1186/s12967-026-07807-w},
pmid = {41668172},
issn = {1479-5876},
abstract = {BACKGROUND: Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and Long COVID share clinical features including persistent fatigue, post-exertional malaise (PEM), and gastrointestinal (GI) dysfunction. Growing evidence implicates brain-gut axis dysregulation, characterized by dysbiosis, neuroinflammation within the central nervous system (CNS), increased intestinal permeability, and microbial translocation in their pathophysiology. However, therapeutic strategies targeting these pathways remain poorly defined.

METHODS: We report a case of post-COVID ME/CFS successfully treated with electroacupuncture (EA)-based deep peroneal nerve stimulation which was employed to potentiate the vagal reflex. Fatigue trajectories were assessed using the Multidimensional Fatigue Inventory over 12 weeks. Based on the case, a systematic review of randomized controlled trials (RCTs) evaluating brain-gut axis-modulating interventions in ME/CFS or Long COVID was conducted.

RESULTS: The patient exhibited a significant reduction in total fatigue, with early improvements in motivation and mental fatigue, and delayed improvement in physical fatigue following transient systemic symptom flares. Across included RCTs (n = 8, 790 participants), four investigated gut microbiome-modulating therapies and four employed nerve stimulation. Synbiotic and herbal interventions demonstrated benefits for fatigue or PEM, accompanied by alterations in specific bacterial populations or CNS metabolisms. Regarding nerve stimulation, transcranial direct current stimulation (tDCS) combined with exercise program improved fatigue, whereas standalone tDCS, auricular or peripheral TENS showed limited efficacy.

CONCLUSION: Brain-gut axis-based interventions may alleviate fatigue in ME/CFS and Long COVID by potentially modulating neuroinflammation, restoring microbiome balance, and improving epithelial barrier function. EA-based vagal stimulation represents a feasible option for patients with severe or treatment-resistant symptoms. Larger mechanistic studies and rigorously designed RCTs are needed to establish therapeutic targets and optimize intervention strategies.},
}

@article {pmid41667155,
year = {2026},
author = {Charlton, BT and Janssen, K and Systrom, DM and Putrino, D and Wüst, RC},
title = {Post-exertional malaise and the myth of cardiac deconditioning: rethinking the pathophysiology of long covid.},
journal = {British journal of sports medicine},
volume = {},
number = {},
pages = {},
doi = {10.1136/bjsports-2025-111387},
pmid = {41667155},
issn = {1473-0480},
}

@article {pmid41666312,
year = {2026},
author = {Kaushal, S and Bhandal, J and Birks, P and Greiner, J and Levin, A and Malbeuf, M and Schwartz, Z},
title = {Use of a Specialist Telephone Consultation Line for Long COVID in Primary Care in British Columbia: Retrospective Descriptive Quality Improvement Study.},
journal = {JMIRx med},
volume = {7},
number = {},
pages = {e57021},
doi = {10.2196/57021},
pmid = {41666312},
issn = {2563-6316},
abstract = {BACKGROUND: Long COVID (post-COVID-19 condition) continues to challenge primary care. To support family physicians in British Columbia, the general internal medicine (GIM) COVID-19 Rapid Access to Consultative Expertise (RACE) line was launched in August 2020 to provide real-time specialist advice.

OBJECTIVE: This quality improvement study aimed to evaluate the implementation and utilization of the GIM-COVID-19 Long-Term Sequelae RACE line in British Columbia. Specifically, it sought to characterize the demographics of patients involved in RACE consultations, identify the most common themes and clinical queries presented by primary care providers, and assess how usage patterns evolved over time during the COVID-19 pandemic.

METHODS: We conducted a retrospective descriptive analysis of 149 RACE line call summaries between August 2020 and June 2021. Six calls were excluded due to insufficient information, such as incomplete documentation or absence of a clear COVID-19-related question. Because the original extraction notes are no longer available, further details about these calls cannot be provided, leaving 143 eligible calls. Data extracted included patient age, sex, geographical location, symptom type, and timing of symptom onset post-COVID-19 infection. Calls were categorized by symptom duration (acute: <2 wk, subacute: 2-12 wk, chronic: >12 wk), thematic content (respiratory, fatigue, neurological, etc), and query type (symptom management, return-to-work, vaccination, etc). Data were coded independently by two reviewers using a standardized spreadsheet and predefined codebook. Discrepancies were resolved through discussion. Descriptive statistics summarized the findings.

RESULTS: Many calls involved female patients (91/143, 64%), with the most common age group being 40-49 years (32/113, 28%). Most calls came from Greater Vancouver (35/83, 42%) and the Fraser Valley (29/83, 35%). Subacute symptoms (52/149, 35%) and vaccination-related concerns (29/149, 19%) were the most common inquiry types. Symptom-related inquiries accounted for 92 of 143 calls (64%), with 253 symptoms documented overall. Respiratory symptoms were most common (100/253, 40%), especially shortness of breath (35 calls), cough (26), and fatigue (23). Call volumes peaked from January to June 2021, coinciding with the provincial vaccine rollout.

CONCLUSIONS: The GIM-COVID-19 Long-Term Sequelae RACE line served as a critical early support system for primary care providers as the long COVID landscape evolved. This quality improvement study emphasizes the value of rapid access and specialist-informed consultation tools during emerging public health challenges. The trends ascertained may inform future health system responses, particularly when designing more scalable, interdisciplinary models to support primary care in managing complex chronic conditions.},
}

@article {pmid41663609,
year = {2026},
author = {Barnden, L and Baraniuk, J and Inderyas, M and Eaton-Fitch, N and Marshall-Gradisnik, S and Thapaliya, K},
title = {Impaired brain intrinsic connectivity in long COVID during cognitive exertion revealed by independent component analysis.},
journal = {Scientific reports},
volume = {},
number = {},
pages = {},
doi = {10.1038/s41598-026-36986-1},
pmid = {41663609},
issn = {2045-2322},
abstract = {Cognitive dysfunction is a symptom of Long COVID. To characterize functional connectivity changes that may contribute to cognitive dysfunction in Long COVID (LCov), two consecutive 450 s functional magnetic resonance imaging (fMRI) scans (Runs 1 and 2) were acquired on a 7 Tesla MRI scanner. During both, the Stroop colour-word task engaged intrinsic brain networks for conflict detection, conflict resolution and response execution. In this exploratory study we acquired data from 19 LCov and 16 healthy control (HC) participants. The aggregate dataset was subjected to independent component analysis (ICA) for each run to isolate 15 components with distinct spatial and temporal signatures. For each component we tested (1) for differences between LCov and HC (inter-network) connectivity to the rest of the brain and (2) for correlation of LCov connectivity with illness duration. Stroop response times (RTs) were slower in LCov than in HC in both Runs (p = 0.001, 0.003). Each ICA component occupied the hubs of a known intrinsic network. LCov had different inter-network connectivity to HC for Salience, Language, Central Executive, Sensorimotor and Visual networks. LCov deficits in Salience inter-network connectivity in Run 2 were deeper and more widespread than in Run 1. In contrast, Run 2 connectivity was greater in LCov for the angular gyrus which integrates visual, motor and language inputs and responses. With longer illness duration, LCov connectivity weakened to critical networks but showed compensatory effects in Lingual gyri. Slower Stroop RTs in both Runs, and Salience, Language and Central Executive inter-network connectivity deficits, and illness duration dependence, support cognitive impairment in LCov with some compensatory connectivity increases.},
}

@article {pmid41663412,
year = {2026},
author = {Wu, SI and Lin, CJ and Lin, YJ and Lin, IC and Hwang, LC and Chen, WL},
title = {Efficacy of heat-treated Lacticaseibacillus paracasei PS23 for individuals with long coronavirus disease-19 syndrome: a double-blinded randomized control pilot study.},
journal = {Scientific reports},
volume = {16},
number = {1},
pages = {5368},
pmid = {41663412},
issn = {2045-2322},
support = {IAC-11302//University-Industry Cooperation Fund, Mackay Memorial Hospital, Taipei, Taiwan/ ; MMH-113-19, MMH-MM-11103, MMH-111-51, MMH-MM-11002, MMH-110-110, MMH-109112, MMH-10914//Department of Medical Research, Mackay Memorial Hospital/ ; },
}

@article {pmid41662153,
year = {2026},
author = {Sirotiak, Z and Amro, HJ and Thomas, EBK},
title = {The lived experience of long COVID: A thematic analysis of an in-depth interview study.},
journal = {PLOS mental health},
volume = {3},
number = {2},
pages = {e0000500},
doi = {10.1371/journal.pmen.0000500},
pmid = {41662153},
issn = {2837-8156},
abstract = {Long COVID is associated with significant physical and mental health burden, resulting in substantial quality of life limitations. The lived experience of individuals with long COVID is a vital consideration in evaluating the impact of the condition. Thirty-four adults with self-reported long COVID participated in a semi-structured in-depth interview study. An interview guide assessed physical and mental health symptoms, changes to plans, goals, and beliefs, and social impacts of long COVID. Participants were an average age of 51.6 years (SD = 17.0), and most identified as female (61.8%), white (97.1%), and not Hispanic or Latino/a/e (97.1%). Two coders read each interview while creating a codebook. The coders individually coded each interview transcript with themes emerging from the coded interviews. Each code reached an agreement level of at least 80%, with a Kappa (RK) score range of 0.90 to 0.98 in each interview, indicating adequate interrater reliability. Five themes emerged from the thematic analysis: decreased autonomy, decreased trust, changes in worldview, social impacts, and uncertainty. Individuals with long COVID reported heterogenous experiences, with often significant changes to daily functional abilities and outlook on life. Considering the unique lived experiences of individuals with long COVID will be important in developing a complete understanding of the condition and its implications.},
}

@article {pmid41657438,
year = {2026},
author = {Tervo, JP and Jacobson, PT and Vilarello, BJ and Saak, TM and Caruana, FF and Gallagher, LW and Gary, JB and Gudis, DA and Joseph, PV and Choo, TH and Devanand, DP and Goldberg, TE and Overdevest, JB},
title = {Interrelatedness of Neurocognitive Domain Functioning Between Unprompted and Prompted Identification Testing With Psychophysical Olfactory Evaluation in a Post-COVID-19 Cohort.},
journal = {World journal of otorhinolaryngology - head and neck surgery},
volume = {12},
number = {1},
pages = {56-65},
pmid = {41657438},
issn = {2589-1081},
abstract = {OBJECTIVE: Assessment of olfactory function with psychophysical testing requires cognitive demand to correctly pair test odors with remembered scents. Individuals suffering from long-Corona Virus Disease 2019 (long-COVID-19) may develop a decline in neurocognitive performance, which may be concurrent with persistent olfactory dysfunction (OD). Given the rigorous cognitive demand of the unprompted identification (UI) olfactory assessment, the goal of this study is to understand whether it could serve as a proxy for specific neurocognitive domains during clinical assessment of olfaction.

METHODS: Participants from our long-COVID cohorts with persistent OD underwent a panel of neurocognitive screening followed by olfactory assessment of threshold followed by unprompted (UI) and prompted identification (PI) tests using Sniffin' Sticks. Hierarchical linear mixed-effect models were used to understand the relative impact of each neurocognitive variable after controlling for demographics and olfactory threshold scores.

RESULTS: Neurocognitive variables demonstrated common correlation trends. Models containing Montreal Cognitive Assessment (MoCA) and digit-span backward scores had statistically significant fits for both UI (MoCA: χ [2] = 10.20, p = 0.001/digit-span backward: χ [2] = 4.27, p = 0.04) and PI (MoCA: χ [2] = 4.51, p = 0.03/digit-span backward: χ [2] = 5.04, p = 0.02) linear mixed-effect models, but UI was further explained by logical memory (χ [2] = 7.84, p = 0.005), verbal fluency (χ [2] = 8.79, p = 0.003), and digit-span forward (χ [2] = 12.30, p = 0.0004). These relationships were statistically significant after controlling for demographic and olfactory threshold covariates.

CONCLUSIONS: UI and PI have interrelated neurocognitive dependence on global cognition (MoCA) and executive function (digit-span backward) among long-COVID participants. As UI draws upon neurocognitive domains of episodic (logical memory), semantic (verbal fluency), and working memory (digit-span forward), the inclusion of a UI task may provide supplementary screening for cognitive impairments in those undergoing clinical olfactory assessment, particularly among those with lingering effects of COVID-19.},
}

@article {pmid41656367,
year = {2026},
author = {Batur, ZZ and Delaruelle, K and Mortelmans, D and Dykstra, P and Bracke, P and Vergauwen, J},
title = {The long-term effects of the COVID-19 pandemic on loneliness in European older women and men: a growth curve analysis.},
journal = {European journal of ageing},
volume = {},
number = {},
pages = {},
doi = {10.1007/s10433-025-00901-w},
pmid = {41656367},
issn = {1613-9372},
support = {TD/231/DistantButClose//Belgian Federal Science Policy Office/ ; },
abstract = {This study examines the long-term impact of the COVID-19 pandemic on loneliness among adults aged 65 and over across 27 European countries, focusing on gender differences and the role of government-imposed containment measures. Using longitudinal data from four waves of the Survey of Health, Ageing and Retirement in Europe (SHARE), pre-pandemic (Wave 8), two SHARE Corona surveys (2020-2021), and post-pandemic (Wave 9), the analyses include 49,351 observations from 15,497 individuals. Logistic growth curve models (wave-individual-country) were estimated to assess changes in loneliness across pandemic periods and to explore how gender and policy stringency shaped these patterns. The results show that loneliness increased significantly during the second COVID-19 phases and remained elevated in the post-pandemic period compared with pre-pandemic levels, indicating a sustained rise in emotional vulnerability among older adults, especially for women. Higher policy stringency was associated with greater loneliness, following a curvilinear pattern: Loneliness rose with increasing restriction levels but leveled off and declined at the highest stringency levels. Interaction analyses showed that women were more sensitive to increases in policy stringency. The findings underscore the persistent and gendered effects of the COVID-19 pandemic on loneliness among Europe's older population. Public health and social policy interventions should adopt gender-sensitive and context-aware approaches to reduce loneliness and enhance resilience during and after large-scale crises.},
}

@article {pmid41654702,
year = {2026},
author = {Vargas, C and Moges, R and Caltabellotta, G and David, L and Manalili, N and Tseng, M and Marlow, EC and Lent, AB},
title = {Exploring the Role of Race/Ethnicity, Metropolitan Status, and Health Insurance in Long COVID Among U.S. Adults.},
journal = {Journal of racial and ethnic health disparities},
volume = {},
number = {},
pages = {},
pmid = {41654702},
issn = {2196-8837},
support = {5T34GM149492/GM/NIGMS NIH HHS/United States ; },
abstract = {OBJECTIVES: Limited evidence suggests possible disparities in COVID-19 across race/ethnicity, metropolitan status, and healthcare access. This study investigated racial/ethnic, metropolitan, and healthcare access disparities in Long COVID among U.S. adults.

METHODS: 2022-2023 cross-sectional Behavioral Risk Factor Surveillance System data were analyzed. U.S. adults who had COVID-19 were included, resulting in a final weighted sample size of n = 80,093,998. Logistic regressions examined associations between race/ethnicity, metropolitan status, health insurance and ever or currently experiencing Long COVID and reductions in daily function. Interactions were examined for metropolitan status and health insurance.

RESULTS: Versus non-Hispanic White (NHW) respondents, a higher odds of Long COVID were observed for Non-Hispanic American Indian/Alaskan Native (ever adj. OR = 1.24, 95% CI: 1.01, 1.53; currently adj. OR = 1.72, 95% CI: 1.39, 2.12) and Other Race/Multiracial (ever adj. OR = 1.41, 95% CI: 1.18, 1.62; currently adj. OR = 1.35, 95% CI: 1.16, 1.58) respondents. Black (ever adj. OR = 0.84, 95% CI: 0.76, 0.93), Asian (ever adj. OR = 0.54, 95% CI: 0.42, 0.70), and Native Hawaiian/Pacific Islander (currently adj. OR = 0.61, 95% CI: 0.39, 0.95) respondents had a lower odds. Non-metropolitan residents had a higher odds (ever adj. OR = 1.16, 95% CI: 1.08, 1.25; currently adj. OR = 1.16, 95% CI: 1.08, 1.24) versus metropolitan residents. Uninsured respondents had a higher odds versus insured respondents (currently adj. OR = 1.24, 95%: 1.08, 1.44). Interactions were statistically significant for metropolitan status (ever p-value = 0.026) and health insurance (ever p-value = 0.006; currently p-value = 0.008).

CONCLUSIONS: Long COVID is experienced unequally across race/ethnicity and metropolitan/non-metropolitan residence. Further research is needed to understand this heterogeneity and the effects of Long COVID.},
}

@article {pmid41654652,
year = {2026},
author = {Matits, L and Schellenberg, J and Mack, M and Kolassa, IT and Schilling, C and Rothenbacher, D and Peter, RS and Kern, WV and Nieters, A and Steinacker, JM and Bizjak, DA and , },
title = {Circulating mitochondrial and cellular damage markers in long COVID: Links to cognitive function, psychological distress, and inflammation.},
journal = {Molecular psychiatry},
volume = {},
number = {},
pages = {},
pmid = {41654652},
issn = {1476-5578},
support = {MR/S028188/1//Ministerium für Wissenschaft, Forschung und Kunst Baden-Württemberg (Ministry of Science, Research and Art Baden-Württemberg)/ ; },
abstract = {Persistent mitochondrial inflexibility and mitochondrial damage may contribute to Post-Acute Sequelae of COVID-19 (PASC). However, data linking mitochondrial biomarkers, such as circulating cell-free mitochondrial DNA (ccf-mtDNA) to long-COVID symptoms remain limited. We analyzed ccf-mtDNA relative to glycerinaldehyd-3-phosphat-dehydrogenase and total cell-free DNA (ccf-DNA) in a nested case-control study of 228 adults (PASC: n = 128, recovered controls: n = 100). Possible associations between these markers and general cognition, verbal memory, psychological distress, and inflammation were also examined. ccf-DNA (measured via UV-Vis spectroscopy), relative ccf-mtDNA (measured via quantitative real-time PCR, -ΔCT), C-reactive protein [CRP], and systemic immune-inflammation index [SII] were assessed. Principal component analysis (PCA) was applied to (neuro)psychological tests to derive three components: general cognition, verbal memory, and psychological distress, which were used in further analyses. PASC patients exhibited significantly lower cognitive function and higher psychological distress than recovered controls. They also had elevated CRP levels and lower relative ccf-mtDNA, with 25% showing low-grade inflammation. Across all participants, general cognition correlated positively with the relative ccf-mtDNA, while CRP correlated negatively with the relative ccf-mtDNA. Mediation analysis suggested relative ccf-mtDNA as a potential mediator of CRP differences between PASC and recovered controls. However, CRP differences did not remain after controlling for potential confounders (age, sex, education, smoking, body mass index, psychiatric medication). Lower relative ccf-mtDNA in PASC might indicate altered mitochondrial quality control, potentially leading to mitochondrial dysfunction, accumulation of damaged mitochondria, and increased inflammation.},
}

@article {pmid41654387,
year = {2026},
author = {Pérez-Martínez, L and Romero, L and Palacios, E and Barbero, R and Moreno-Blanco, A and Del Campo, R and Blanco, JR},
title = {Oral microbiota in patients with long COVID: A pilot study.},
journal = {Enfermedades infecciosas y microbiologia clinica (English ed.)},
volume = {44},
number = {2},
pages = {503072},
doi = {10.1016/j.eimce.2026.503072},
pmid = {41654387},
issn = {2529-993X},
mesh = {Humans ; Pilot Projects ; Male ; Female ; *COVID-19/microbiology/complications ; Case-Control Studies ; Middle Aged ; Saliva/chemistry/microbiology ; *Microbiota ; *Mouth/microbiology ; Fatty Acids, Volatile/analysis ; Adult ; Interleukin-6/analysis ; Aged ; Tumor Necrosis Factor-alpha/analysis ; Cytokines/analysis ; },
abstract = {INTRODUCTION: The COVID-19 pandemic continues to pose a substantial threat to global public health. While most efforts have focused on the acute phase SARS-CoV-2 infection, a significant proportion of individuals experience persistent symptoms after infection, known as "persistent COVID disease" (PCD). The etiology of PCD remains poorly understood, although some evidence suggests that microbiota, particularly those located in the upper respiratory tract, may play a role. The aim of this study was to investigate differences in the composition of the oral microbiota, salivary cytokine, and short-chain fatty acids (SCFAs) concentration, between PCD and healthy controls.

METHODS: We conducted an age- and sex-matched case-control study. Oral bacterial communities were profiled by 16S rDNA gene (V3-V4) amplicon high-throughput sequencing. Salivary IL-6 and TNF-α concentrations were measured, and SCFA were quantified by liquid chromatography-tandem mass spectrometry. Cognitive and fatigue status were assessed with the Montreal Cognitive Assessment (MoCA) and the Modified Fatigue Impact Scale (MFIS).

RESULTS: Oral-microbiota α/β-diversity did not differ between groups; salivary cytokines were likewise similar. After Benjamini-Hochberg correction, no SCFA differences were significant (q>0.05); valeric acid showed the strongest uncorrected signal (p=0.02; r=0.52) but not after adjustment (q=0.23; power ≈0.73). CPD participants had lower MoCA and higher MFIS scores than controls (both p<0.005).

CONCLUSIONS: The increase of valeric acid levels in PCD patients warrants further investigation to clarify its potential biological role and implications in the pathophysiology of this syndrome.},
}

Humans
Pilot Projects
Male
Female
*COVID-19/microbiology/complications
Case-Control Studies
Middle Aged
Saliva/chemistry/microbiology
*Microbiota
*Mouth/microbiology
Fatty Acids, Volatile/analysis
Adult
Interleukin-6/analysis
Aged
Tumor Necrosis Factor-alpha/analysis
Cytokines/analysis

@article {pmid41651528,
year = {2026},
author = {Lee, HW and Choi, KY and Lee, JK and Yoon, WS and Kim, Y and Yoo, KH and Hwang, YI},
title = {Recurrent COVID-19 infection and the risk of exacerbation, mortality and long covid in patients with chronic obstructive pulmonary disease: a nationwide retrospective cohort study.},
journal = {BMJ open},
volume = {16},
number = {2},
pages = {e112376},
doi = {10.1136/bmjopen-2025-112376},
pmid = {41651528},
issn = {2044-6055},
mesh = {Humans ; *Pulmonary Disease, Chronic Obstructive/mortality/complications/epidemiology ; *COVID-19/mortality/epidemiology/complications ; Retrospective Studies ; Male ; Female ; Middle Aged ; Republic of Korea/epidemiology ; Aged ; Recurrence ; SARS-CoV-2 ; Disease Progression ; Risk Factors ; Symptom Flare Up ; Adult ; },
abstract = {OBJECTIVES: To evaluate how recurrent COVID-19 infections influence the clinical course of patients with chronic obstructive pulmonary disease (COPD), focusing on moderate-to-severe symptom flare-ups, all-cause mortality and long covid.

DESIGN: Nationwide retrospective cohort study.

SETTING: Korean Health Insurance Review and Assessment database covering the entire Korean population between January 2020 and December 2023.

PARTICIPANTS: A total of 313 760 patients aged ≥40 years who met an established operational definition of COPD based on diagnostic codes and inhaled therapy prescriptions. Patients were stratified by the number of COVID-19 events: none, one, two or three or more.

The primary outcomes were moderate-to-severe COPD exacerbations and all-cause mortality. The secondary outcome was long covid, defined by WHO criteria using International Classification of Diseases (ICD)-10 codes persisting ≥2 months within 3 months after infection.

RESULTS: Among 313 760 patients, 154 095 (49.1 %) experienced at least one COVID-19 event. COVID-19 infection was associated with increased risk of exacerbations (adjusted HR (aHR) 1.64, 95% CI 1.62 to 1.66) and mortality (aHR 2.25, 95 % CI 2.19 to 2.31). Risk rose progressively with repeated infections, reaching an aHR of 2.41 for exacerbations and 2.93 for mortality after three or more events. Long covid was more frequent in patients with multiple infections, but most cases occurred after the first event, with diminishing occurrence after subsequent infections.

CONCLUSION: Recurrent COVID-19 infections in patients with COPD were linked to progressively higher risk of exacerbations and mortality, whereas the burden of long covid was greatest after the first infection. Preventing the initial infection and reducing reinfection risk remain critical components of COPD care in the post-COVID-19 era.},
}

Humans
*Pulmonary Disease, Chronic Obstructive/mortality/complications/epidemiology
*COVID-19/mortality/epidemiology/complications
Retrospective Studies
Male
Female
Middle Aged
Republic of Korea/epidemiology
Aged
Recurrence
SARS-CoV-2
Disease Progression
Risk Factors
Symptom Flare Up
Adult

@article {pmid41650882,
year = {2026},
author = {Engert, LC and Dang, R and Daniel, S and Bertisch, SM and Maley, JH and Fong, TG and Serhan, CN and Mullington, JM and Haack, M},
title = {Sleep disturbance affects inflammatory resolution in Long COVID.},
journal = {Prostaglandins, leukotrienes, and essential fatty acids},
volume = {208},
number = {},
pages = {102728},
doi = {10.1016/j.plefa.2026.102728},
pmid = {41650882},
issn = {1532-2823},
abstract = {BACKGROUND: Sleep disturbance, which is a common symptom in Long COVID, promotes a pro-inflammatory state and dysregulates lipid-derived specialized pro-resolving mediators (SPMs), presumably contributing to chronic unresolved inflammation. This study aimed to investigate the role of sleep disturbance in inflammatory resolution in Long COVID.

METHODS: We studied 39 participants (30F/9M, age range 22-68 years), including 31 individuals with Long COVID and 8 SARS-CoV-2-infected controls, who did not develop Long COVID. The study consisted of a 14-day at-home phase followed by a 1-day (24-h) in-laboratory stay. Sleep disturbance was assessed using PROMIS Sleep Disturbance T-scores. During the in-laboratory stay, a fasting morning blood sample was taken for assessment of lipid mediators. Data were analyzed using generalized linear mixed models.

RESULTS: Participants with Long COVID reported higher sleep disturbance than controls (p<.001). Pro-inflammatory lipid pathways were upregulated in Long COVID compared to control, as indicated by higher prostaglandin E2 (PGE2) levels (p<.05). Long COVID participants with high sleep disturbance (PROMIS Sleep Disturbance T-score ≥60) had lower SPM levels, including the precursor of D-series resolvins 17-hydroxydocosahexaenoic acid (17-HDHA), 17R/S-resolvin D1 (17R/S-RvD1), 15R-lipoxin B4 (15R-LXB4), and protectin D1n-3 DPA (PD1n-3 DPA) than those with low sleep disturbance (T-score <60) (p<.05).

CONCLUSIONS: This study suggests that sleep disturbance may contribute to chronic inflammation in Long COVID by compromising certain inflammatory resolution pathways. Promoting inflammatory resolution physiology in particular in those individuals with Long COVID suffering from sleep disturbance may serve as a mechanistic target to mitigate inflammation and symptom burden in Long COVID.

TRIAL REGISTRATION: ClinicalTrials.gov NCT05606211.},
}

@article {pmid41650532,
year = {2026},
author = {Labied, S and Atifi, F and Wahnou, H and Mabrouk, M and Jeddoub, O and Allaoui, A and Jalali, F and Zaid, Y},
title = {Megakaryocytes and afucosylated IgG in post-acute COVID-19: Bridging immune dysregulation and vascular pathology - A narrative review.},
journal = {Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie},
volume = {196},
number = {},
pages = {119049},
doi = {10.1016/j.biopha.2026.119049},
pmid = {41650532},
issn = {1950-6007},
abstract = {Post-acute sequelae of SARS-CoV-2 infection (PASC), also referred to as long COVID, encompasses a constellation of persistent symptoms lasting for at least three months after acute SARS-CoV-2 infection and not explained by alternative diagnoses. The multifactorial pathophysiology underlying PASC remains incompletely understood, limiting the development of effective management strategies. Increasing evidence suggests that both immune dysregulation and hemostatic imbalance play central roles in post-COVID-19 complications. Megakaryocytes, key regulators of platelet production and coagulation, have emerged as potential contributors to sustained thrombo-inflammatory processes following SARS-CoV-2 infection. In parallel, afucosylated IgG antibodies have been strongly implicated in exaggerated immune activation and hyperinflammatory responses during acute COVID-19. The persistence of such antibody glycosylation patterns beyond the acute phase raises the possibility that they may also contribute to chronic immune and vascular alterations observed in PASC. This narrative review explores the potential interplay between megakaryocyte dysfunction and afucosylated IgG antibodies in the pathogenesis of PASC. By examining mechanisms identified during acute SARS-CoV-2 infection, we discuss how prolonged immune-hemostatic crosstalk may promote persistent inflammation, endothelial dysfunction, and microvascular abnormalities. Understanding these interconnected pathways may provide mechanistic insight into the heterogeneity of PASC manifestations and help identify novel therapeutic targets for long-term post-COVID-19 sequelae.},
}

@article {pmid41649660,
year = {2026},
author = {Hidayana, I and Rahvenia, Z and Pelupessy, DC and Ahmad, MU},
title = {Quality of life among individuals with long COVID symptoms in Indonesia at four points of recovery.},
journal = {Discover mental health},
volume = {},
number = {},
pages = {},
doi = {10.1007/s44192-026-00374-y},
pmid = {41649660},
issn = {2731-4383},
}

@article {pmid41649074,
year = {2026},
author = {Busnel, Y and Légaré, F and Moumjid, N and Panse, L and Testud, A and Tran, VT and Haesebaert, J},
title = {Shared Decision Making among Patients with Chronic Conditions in France: A Cross-Sectional Survey in the ComPaRe E-Cohort.},
journal = {Medical decision making : an international journal of the Society for Medical Decision Making},
volume = {},
number = {},
pages = {272989X251407617},
doi = {10.1177/0272989X251407617},
pmid = {41649074},
issn = {1552-681X},
abstract = {BackgroundShared decision making (SDM) is a cornerstone of patient-centered care; however, little information is available on how SDM is practiced in routine care. We aimed to assess the level of SDM perceived by patients with chronic conditions for the most important health decision in the past 12 mo.MethodsThis was a cross-sectional online survey among ComPaRe, a nationwide e-cohort of patients with chronic conditions in France. The survey asked participants about their perception of SDM using the 9-item Shared Decision-Making Questionnaire (SDM-Q-9) regarding their most important health decision in the past 12 mo. We weighted the sample to represent French patients with chronic conditions and conducted regression models to identify factors associated with higher SDM levels, adjusting for sociodemographic and clinical characteristics.ResultsIn total, 2,087 patients were analyzed (participation rate: 34.9%). In the weighted sample, 53.0% were women, the mean (SD) age was 51.0 (15) y, and the most frequent conditions were endometriosis (27.3%), inflammatory rheumatic diseases (20.7%), and high blood pressure (19.3%). The most important health decisions in the past 12 mo were mainly about drug treatments (36.5%) or surgery (20.5%). The mean (SD) SDM-Q-9 score was 63 (27)/100 (moderate level of SDM). The highest scores were observed for cancer (70 [26]) and depression (69 [26]), whereas the lowest scores were for long COVID (54 [28]) and endometriosis (58 [25]). Decisions about surgery (71 [25]) and with specialists (64 [27]) were associated with higher scores compared with medication decisions (60 [28]) or with general practitioners (62 [27]). Multivariate analysis confirmed that a higher SDM level was associated with being a man; having higher health literacy; making decisions relating to cancer, surgery, or medical devices; and specialist involvement.ConclusionsPatients with chronic conditions in France report moderate levels of SDM, with substantial variations by condition, decision type, and patient characteristics. Findings highlight the need for tailored strategies to foster SDM in chronic care.HighlightsShared decision making (SDM) is considered a key component of the chronic disease management model.This study provides the first nationwide assessment of perceived SDM levels among patients with chronic conditions in France.Patients have a moderate overall SDM score, but significant disparities exist. Patients with less recognized conditions such as long COVID or endometriosis, low health literacy, and high treatment burden reported significantly lower SDM scores as compared with others in their care decisions.These findings underscore the need for targeted interventions to improve SDM implementation.},
}

@article {pmid41646734,
year = {2026},
author = {Pradeep, A and Carvour, ML and Sivamurugan, SM and Singh, U and Comellas, AP and Dayal, S},
title = {Cardiovascular, renal and pulmonary risks of Long COVID: a retrospective cohort study stratified by age and sex.},
journal = {medRxiv : the preprint server for health sciences},
volume = {},
number = {},
pages = {},
doi = {10.64898/2026.01.14.26344156},
pmid = {41646734},
abstract = {BACKGROUND: A substantial proportion of patients with acute COVID-19 develop post-acute sequelae of SARS-CoV-2 infection (Long COVID). The risk of adverse cardiovascular and related outcomes in Long COVID remain elusive. We hypothesized that individuals with Long COVID are at elevated risk for adverse cardiovascular, renal and pulmonary (CRP) outcomes compared to those who recovered from COVID-19 without developing Long COVID.

METHODS: We performed a retrospective cohort study using the global TriNetX electronic health record network (> 150 million patients). Adults with documented COVID-19 were classified by the presence/absence of Long COVID. We analyzed absolute risks (AR) and relative risks (RR) for 15 CRP outcomes, stratified by age (18-50, 51-64, ≥65 years). After excluding those with the preexisting outcomes of interest, propensity score matching was applied to adjust for age, sex, and common confounders.

RESULTS: Among 2,613,432 adults with COVID-19, 315,612 matched individuals were included in the study. Long COVID was associated with increased AR for most CRP outcomes across adult ages regardless of sex. RR were disproportionately higher in younger adults, especially in females for cardiovascular and renal outcomes and in males for selected pulmonary outcomes. In a secondary analysis among individuals with Long COVID, prior COVID-19 vaccination was not associated with a significantly lower risk of CRP outcomes.

CONCLUSIONS: Long COVID is associated with increased risk of adverse CRP outcomes, with relatively higher risks observed in younger adults. These findings support the need for continuing surveillance and risk-reduction strategies for cardiovascular and related disorders in Long COVID.},
}

@article {pmid41646510,
year = {2026},
author = {Melo-Oliveira, MES and Lourenço, RA and Louzada, EB and Moutinho, M and Barbosa, AF and Moreira, VG and Porto, LC},
title = {Systematic Review of Dyspnea and Chronic Fatigue in Patients With Long COVID: Clinical Characteristics and Associated Laboratory Parameters.},
journal = {Pulmonary medicine},
volume = {2026},
number = {},
pages = {5426125},
pmid = {41646510},
issn = {2090-1844},
mesh = {Humans ; *Dyspnea/etiology/physiopathology/virology/epidemiology ; *COVID-19/complications/physiopathology ; Quality of Life ; *Fatigue/etiology/physiopathology ; Post-Acute COVID-19 Syndrome ; SARS-CoV-2 ; *Fatigue Syndrome, Chronic/etiology ; },
abstract = {ABSTRACT: Dyspnea and chronic fatigue stand out as prevalent manifestations in the postacute phase of COVID, resulting in substantial adverse effects on patients' quality of life and functional capacity. Although these symptoms have been widely documented, there is no clear consensus on the pathophysiological mechanisms that underlie them. The available literature reveals a dispersion of clinical and laboratory data, and the variability in the methods of assessment of fatigue and dyspnea, as well as in the laboratory variables examined, limits the standardized understanding of this complex condition.

OBJECTIVE: This study was aimed at identifying and synthesizing the evidence on the main clinical and laboratory characteristics related to dyspnea and fatigue in patients during long COVID from 2021 onwards.

METHODS: The main databases used to select the studies were PubMed and Medline, also using LitCovid and Embase.

RESULTS: A total of 42 articles that met the inclusion criteria were included, covering a total population of 30,682 patients diagnosed with COVID-19. The findings underscore the significant impact of long COVID on patients' quality of life, with persistent symptoms such as fatigue and dyspnea affecting a considerable proportion of individuals for durations ranging from 1 to 24 months.

CONCLUSION: The heterogeneity in research approaches highlights the urgent need for collaborative initiatives to elucidate the determinants of long COVID symptomatology and create more consistent evaluation protocols.},
}

Humans
*Dyspnea/etiology/physiopathology/virology/epidemiology
*COVID-19/complications/physiopathology
Quality of Life
*Fatigue/etiology/physiopathology
Post-Acute COVID-19 Syndrome
SARS-CoV-2
*Fatigue Syndrome, Chronic/etiology

@article {pmid41645987,
year = {2026},
author = {Vyas, P and Joshi, D and Kanabar, K and Parmar, M and Vadodariya, J and Patel, K and Patel, B and Dave, S and Patel, M and Modi, G},
title = {Incidence and predictors of long Covid-19 in hospitalized patients: A cohort study.},
journal = {The National medical journal of India},
volume = {39},
number = {1},
pages = {19-22},
doi = {10.25259/NMJI_222_2023},
pmid = {41645987},
issn = {2583-150X},
mesh = {Humans ; *COVID-19/epidemiology/complications/diagnosis ; Male ; Female ; Incidence ; Middle Aged ; *Hospitalization/statistics & numerical data ; Adult ; SARS-CoV-2 ; Aged ; Severity of Illness Index ; Body Mass Index ; Prospective Studies ; India/epidemiology ; Risk Factors ; Age Factors ; Fatigue/epidemiology ; },
abstract = {Background Long-term Covid-19 symptoms have the potential to negatively impact health and quality of life. We evaluated the incidence and predictors of long Covid-19 among hospitalized patients. Methods We prospectively collected clinical data of 393 patients diagnosed as Covid-19 positive and admitted to our hospital. At 1-year follow-up, all vital parameters and laboratory investigations were recorded. A multiple logistic regression model was used to determine predictors of long Covid-19. Results Long Covid-19 was found in 34.4% of patients at 1-year follow-up. Most commonly reported symptoms were joint pain (40%), fatigue (33%), and dyspnoea (22.9%). Severity of disease at the time of admission (1.5; 95% Confidence Interval [CI] 1.09-2.2; p=0.01), high body-mass index (BMI) (1.1; 95% CI 1.03-1.13; p=0.003) and increased age (1.02; 95% CI 1.00-1.04; p=0.02) were independent predictors of long Covid-19 on follow-up. Conclusion Almost one-third of patients were diagnosed with long Covid-19 at 1-year follow-up. Severity of disease at the time of admission, increased BMI, and increased age were independent predictors of long Covid-19.},
}

Humans
*COVID-19/epidemiology/complications/diagnosis
Male
Female
Incidence
Middle Aged
*Hospitalization/statistics & numerical data
Adult
SARS-CoV-2
Aged
Severity of Illness Index
Body Mass Index
Prospective Studies
India/epidemiology
Risk Factors
Age Factors
Fatigue/epidemiology

@article {pmid41645148,
year = {2026},
author = {Polovin, T and Bilenko, N and Frankenthal, D and Bromberg, M and Keinan-Boker, L and Davidovitch, N},
title = {The association between Post-COVID syndrome and self-stigma among the adult Israeli population during the COVID-19 pandemic.},
journal = {BMC public health},
volume = {},
number = {},
pages = {},
doi = {10.1186/s12889-026-26489-z},
pmid = {41645148},
issn = {1471-2458},
}

@article {pmid41642863,
year = {2026},
author = {McMillan, M and Beazley, R and Vasilunas, N and Sullivan, TR and Edmond, T and Battersby, A and Britton, PN and McMullan, B and Jureidini, J and Del Fante, S and Marshall, HS},
title = {Children and adolescents: Respiratory infection and long-term effects longitudinal study (CARE Study): Study protocol.},
journal = {PloS one},
volume = {21},
number = {2},
pages = {e0341566},
doi = {10.1371/journal.pone.0341566},
pmid = {41642863},
issn = {1932-6203},
mesh = {Humans ; Child ; Adolescent ; *COVID-19/complications/epidemiology/virology ; Longitudinal Studies ; Child, Preschool ; SARS-CoV-2/isolation & purification ; Infant ; *Influenza, Human/complications/epidemiology ; Female ; Male ; *Respiratory Tract Infections/epidemiology ; Australia/epidemiology ; Post-Acute COVID-19 Syndrome ; Infant, Newborn ; Incidence ; },
abstract = {BACKGROUND: The effects of SARS-Cov-2 infection can extend beyond the acute phase of the illness, often described as Long COVID, post-COVID condition (PCC) or Post-acute sequelae of COVID (PASC). Post-acute sequelae (PAS) are also likely to be a problem for a small proportion of children and adolescents following influenza infection. However, there is no comprehensive ongoing data collection in Australian children and adolescents, and global data on both PCC during the SARS-Cov-2 Omicron variant period and PAS following influenza is limited.

AIM: This study aims to determine the cumulative incidence of PCC in Australian children and adolescents five years after the start of the COVID-19 pandemic. Secondary aims include identifying the cumulative incidence of PAS in children and adolescents following influenza infection.

METHODS: This longitudinal cohort study will recruit children and adolescents aged 0-18 years in South Australia who tested positive for SARS-Cov-2 or influenza in the previous 2 months. Following consent, participants will complete an online baseline survey and then at 3, 6, and 12 months post-infection. The survey has been adapted from the International Severe Acute Respiratory and Emerging Infection Consortium (ISARIC) Paediatric COVID-19 follow-up survey. The survey includes validated assessment tools such as the Pediatric Quality of Life Inventory (PedsQL), Multidimensional Fatigue Scale, and the Malmö Postural Orthostatic Tachycardia Syndrome (POTS) Score questionnaire. PCC following COVID-19 and PAS following influenza infection will be identified according to an adapted World Health Organization definition of PCC in children and adolescents.

DISCUSSION: This study addresses gaps in understanding PCC and PAS following influenza in children and adolescents during Omicron circulation. Whilst it is no longer feasible to prospectively compare post-acute sequelae in children and adolescents who have never had COVID-19, this design allows a comparison with another common viral infection, influenza, informing clinical management of children post-infection.},
}

Humans
Child
Adolescent
*COVID-19/complications/epidemiology/virology
Longitudinal Studies
Child, Preschool
SARS-CoV-2/isolation & purification
Infant
*Influenza, Human/complications/epidemiology
Female
Male
*Respiratory Tract Infections/epidemiology
Australia/epidemiology
Post-Acute COVID-19 Syndrome
Infant, Newborn
Incidence

@article {pmid41642857,
year = {2026},
author = {Churiwal, M and Tompkins, K and Streeter, G and Litel, C and Mason, S and Lin, K and Muller, M and Chhetri, S and Belvin, T and Lin, FC and Basham, C and Whittelsey, M and Rapp, T and Premkumar, L and Cerami, C and Lin, JT},
title = {Symptom burden, viral load, and antibody response to ancestral SARS-CoV-2 strain [D614G] in an outpatient household cohort.},
journal = {PloS one},
volume = {21},
number = {2},
pages = {e0313467},
doi = {10.1371/journal.pone.0313467},
pmid = {41642857},
issn = {1932-6203},
mesh = {Humans ; *COVID-19/virology/immunology/epidemiology ; *Viral Load ; Male ; *SARS-CoV-2/immunology/genetics/isolation & purification ; Female ; Middle Aged ; Adult ; *Antibodies, Viral/blood/immunology ; Outpatients ; Aged ; Cohort Studies ; Antibody Formation ; Family Characteristics ; Young Adult ; Symptom Burden ; },
abstract = {BACKGROUND: Early in the SARS-CoV-2 pandemic, description of COVID-19 illness among non-hospitalized patients was limited. Data from household cohorts can help reveal the full spectrum of disease and the potential for long-term sequelae, even in non-severe disease.

METHODS: Daily symptom diaries were collected in a US household cohort of SARS-CoV-2 infection from April to November 2020, during the pre-COVID vaccine period. SARS-CoV-2 nasal viral loads were measured at study entry and weekly until day 21; serologic testing was performed at study entry and day 28. A subset of volunteers underwent an additional assessment 8-10 months later. Participants who met the criteria for early infection-testing antibody-negative at study entry but PCR-positive either at baseline or during follow-up-were included in this analysis (n = 143).

RESULTS: Daily symptoms were ascertained in 143 outpatients with acute COVID-19, including 60 index cases who sought testing and 83 of their household contacts. Asymptomatic cases comprised 16% (13/83) of SARS-CoV-2 infections detected among household contacts. Among 119 persons with mild or moderate illness, the number of symptoms peaked 3 or 4 days after symptom onset. Fever and anosmia occurred in nearly half of participants. Symptom severity was associated with increased age, viral load, and cardiovascular disease. Increased BMI was associated with a higher antibody level at day 28, independent of symptom severity. Those with a higher day 28 antibody level were more likely to develop symptoms consistent with post-acute sequelae of SARS-CoV-2 (PASC), also known as long COVID-19, 8-10 months later.

CONCLUSIONS: Fever, anosmia, as well as asymptomatic infection were common features of COVID-19 non-severe illness when the D614G variant circulated in the US, before the availability of vaccines or outpatient therapies. Antibody levels following acute infection were linked to the development of symptoms of PASC 8-10 months later.},
}

Humans
*COVID-19/virology/immunology/epidemiology
*Viral Load
Male
*SARS-CoV-2/immunology/genetics/isolation & purification
Female
Middle Aged
Adult
*Antibodies, Viral/blood/immunology
Outpatients
Aged
Cohort Studies
Antibody Formation
Family Characteristics
Young Adult
Symptom Burden

@article {pmid41641915,
year = {2026},
author = {Hilbert, T and MacEachern, SN and Zhang, Y},
title = {Robust Distribution-Free Tests for the Linear Model.},
journal = {Statistics in medicine},
volume = {45},
number = {3-5},
pages = {e70404},
doi = {10.1002/sim.70404},
pmid = {41641915},
issn = {1097-0258},
support = {SES-1921523//National Science Foundation/ ; DMS-2413823//National Science Foundation/ ; DMS-2311109//National Science Foundation/ ; },
mesh = {Humans ; Linear Models ; COVID-19/immunology ; Computer Simulation ; Data Interpretation, Statistical ; },
abstract = {Recently, there has been growing concern about heavy-tailed and skewed noise in biological data. We introduce RobustPALMRT, a flexible permutation framework for testing the association of a covariate of interest adjusted for control covariates. RobustPALMRT controls type I error rate for finite-samples, even in the presence of heavy-tailed or skewed noise. The new framework expands the scope of state-of-the-art tests in three directions. First, our method applies to robust and quantile regressions, even with the necessary hyper-parameter tuning. Second, by separating model-fitting and model-evaluation, we discover that performance improves when using a robust loss function in the model-evaluation step, regardless of how the model is fit. Third, we allow fitting multiple models to detect specialized features of interest in a distribution. To demonstrate this, we introduce DispersionPALMRT, which tests for differences in dispersion between treatment and control groups. We establish theoretical guarantees, identify settings where our method has greater power than existing methods, and analyze existing immunological data on Long-COVID patients. Using RobustPALMRT, we unveil novel differences between Long-COVID patients and others even in the presence of highly skewed noise.},
}

Humans
Linear Models
COVID-19/immunology
Computer Simulation
Data Interpretation, Statistical

@article {pmid41641052,
year = {2025},
author = {Li, G and Zhao, Y and Gu, W and Wang, Q and Lu, X and Miao, X},
title = {The problem of frailty caused by acute infection and future health management strategies to improve frailty.},
journal = {Frontiers in public health},
volume = {13},
number = {},
pages = {1735577},
pmid = {41641052},
issn = {2296-2565},
mesh = {Humans ; Female ; *Frailty/epidemiology/etiology ; Male ; Aged ; *COVID-19/epidemiology ; China/epidemiology ; Middle Aged ; Follow-Up Studies ; Adult ; SARS-CoV-2 ; Aged, 80 and over ; Frail Elderly/statistics & numerical data ; Proportional Hazards Models ; Interrupted Time Series Analysis ; },
abstract = {BACKGROUND: We aimed to analyze changes in frailty associated with long-COVID, while providing effective health management measures to improve frailty.

METHODS: We conducted a 4-month follow-up cohort study involving 2,471 participants to analyze changes in body frailty after the prevalence of COVID-19 in China. We performed interrupted time series analysis to estimate the impact of acute infection on the changes in frailty. The time-dependent COX model was considered to assess the association between frailty status and infection, and sensitivity analysis was performed to verify the stability of the results. In addition, we established a traditional Cox model to analyze the relationship between healthy behaviors and infections, aiming to improve health management and reduce frailty.

RESULTS: There were significantly elevated trend changes in the frailty index compared to the prepandemic period in the total population (+0.029[0.016, 0.041], p < 0.001), and the frailty index was found to be higher in female individuals and people aged over 65 years. Participants with moderate frailty (HR = 1.19, 95% CI: 1.04-1.35, p < 0.001) and severe frailty (HR = 1.34, 95%CI: 1.15-1.56, p < 0.001) had a significantly higher hazard of infection than those with mild frailty. Long-term health monitoring indicated that positive mood, appropriate physical activities, sufficient intake of grains and vegetables, and reduced intake of sugary drinks can improve frailty and ultimately reduce the risk of infection.

CONCLUSION: In this study, it was found that the population generally became more frail after the pandemic, and frailty increases the risk of acute reinfection. Therefore, it is necessary to carry out health management strategies to improve frailty.},
}

Humans
Female
*Frailty/epidemiology/etiology
Male
Aged
*COVID-19/epidemiology
China/epidemiology
Middle Aged
Follow-Up Studies
Adult
SARS-CoV-2
Aged, 80 and over
Frail Elderly/statistics & numerical data
Proportional Hazards Models
Interrupted Time Series Analysis

@article {pmid41641003,
year = {2025},
author = {Leclerc, L and Poudrier, J and Power, C and Lam, GY and Falcone, EL},
title = {Intestinal barrier compromise, viral persistence, and immune dysregulation converge on neurological sequelae in Long COVID.},
journal = {Frontiers in aging neuroscience},
volume = {17},
number = {},
pages = {1744415},
pmid = {41641003},
issn = {1663-4365},
abstract = {Long COVID (LC) is a multisystem, post-infectious conditions diagnosed ≥3 months after acute SARS-CoV-2 infection and marked by relapsing, persistent, or progressive symptoms, especially fatigue, post-exertional symptom exacerbation and neuropsychiatric syndromes. We synthesized evidence suggesting that LC arises from intersecting pathways including viral persistence, intestinal dysbiosis and barrier compromise with microbial translocation, innate immune activation with neutrophil extracellular traps (NET) and thromboinflammation, and immune dysregulation with features of exhaustion and autoimmunity. These processes adversely impact blood-brain barrier (BBB) function and lead to neuroinflammation. We propose a mechanistic model in which viral antigens and translocated microbial products amplify pro-inflammatory networks promoting immunothrombosis and tissue hypoperfusion. Hematogenous and gut-brain pathways may then deliver inflammatory mediators to the central nervous system (CNS), resulting in BBB disruption and glial activation that underpin nervous system disorders in LC. Treatment regimens aimed at lowering antigen load, restoring mucosal barrier integrity and modulating myeloid/coagulation pathways may warrant investigation as novel therapeutic strategies to treat LC.},
}

@article {pmid41639776,
year = {2026},
author = {Aboulwafa, A and Lebbe, A and Khalil, A and Bayraktar, N and Mushannen, B and Ayoub, S and Sarker, S and Abdalla, MN and Laws, S and Mohammed, I and Yagan, L and Mushannen, M and Zakaria, D},
title = {New onset of severe and long-term hepatobiliary diseases post-COVID-19 infection: a systematic review.},
journal = {BMC infectious diseases},
volume = {26},
number = {1},
pages = {253},
pmid = {41639776},
issn = {1471-2334},
}

@article {pmid41639746,
year = {2026},
author = {Guo, P and Lim, JT and Wee, LE and Tay, AT and Zhai, Y and Chiew, CJ and Ong, B and Lye, DCB and Tan, KB},
title = {Characterization of post-acute multi-organ sequelae following SARS-CoV-2 Infection in the Delta and Omicron Eras in a highly boosted population.},
journal = {BMC global and public health},
volume = {4},
number = {1},
pages = {15},
pmid = {41639746},
issn = {2731-913X},
abstract = {BACKGROUND: Multi-organ post-acute sequelae of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (PASC) is extensively documented. Recent studies in predominantly Caucasian populations suggest that the evolution of SARS-CoV-2 variants can influence risk (as measured by hazard ratios) and rates (as measured by incidence rate ratios) of PASC, and they also highlight the protective effects of COVID-19 vaccination. However, it is unclear whether risks or rates of PASC have changed over different Omicron subvariants in an Asian population with high uptake of COVID-19 vaccine booster doses.

METHODS: We constructed a national cohort of individuals infected with SARS-CoV-2 and estimated the 31-300-day risks and rates of pre-specified new-incident diagnoses across the cardiovascular, neuropsychiatric, auto-immune, renal, and gastrointestinal domains between 1,427,985 and 3,284,081 unique individuals who tested positive or negative for SARS-CoV-2 infection respectively, across Delta, Omicron BA.1/2, BA.4/5, and XBB predominance. We compared risks/rates of new-incident diagnoses between test positives and test negatives in each era.

RESULTS: Compared to test-negatives, asides from increased risk of renal outcomes in BA.1/2 (aHR, 1.17; 95% CI, 1.09-1.26), there were no increased risks of composite diagnoses in other organ systems across all 4 variants of concern. In terms of individual outcomes, there were increased risks or rates of diagnosis of individual neuropsychiatric outcomes, such as memory problems, Alzheimer's disease across all eras, and loss of smell or taste only in Delta. There were also increased risks of diagnosis of individual renal outcomes, such as end stage renal failure in BA.1/2 (aHR, 1.52; 95% CI, 1.27-1.81). In COVID-19 survivors who were hospitalised, risks and rates of cardiovascular, neuropsychiatric, and renal diagnoses in the post-acute period were increased in most eras. COVID-19 vaccinations reduced the risks of composite diagnoses.

CONCLUSIONS: The risks/rates of pre-specified new-incident multi-organ PASC were modest over all studied COVID-19 eras. The risk was further attenuated with booster vaccination during the Omicron BA.4/5 and XBB periods compared with the Omicron BA.1/2 period.},
}

@article {pmid41638903,
year = {2026},
author = {Sarkar, BK and Kumar, A},
title = {The role of artificial intelligence in managing COVID-19 and long COVID: a narrative review.},
journal = {Osong public health and research perspectives},
volume = {},
number = {},
pages = {},
doi = {10.24171/j.phrp.2025.0347},
pmid = {41638903},
issn = {2210-9099},
abstract = {The coronavirus disease 2019 (COVID-19) pandemic had an unprecedented global impact, resulting in both positive and negative consequences. The virus not only affected millions of lives worldwide but also caused long-term harm to multiple organ systems in many survivors, thereby substantially impairing quality of life. This persistent condition is now referred to as long COVID (LC). The aim of this study is to raise awareness of LC-related organ system impacts and to highlight the key role of artificial intelligence (AI) in mitigating these effects. The present research conducts a narrative review focusing on LC-related impacts. In this context, unstructured searches were conducted to identify a total of 69 relevant studies indexed in Embase, PubMed, Web of Science, or Scopus, each of which was reviewed by at least 2 experts with sufficient domain knowledge in health sciences. Based on the authors' perspectives and insights, the review narratively examines damage to human organ systems attributable to LC and explores the role of AI in addressing LC-related challenges. Significant ethical, practical, and societal concerns arising from the extensive use of AI, particularly major issues such as data privacy and algorithmic bias, are also discussed. LC has caused lasting impacts on human organ systems, while AI is offering substantial potential for LC-related care.},
}

@article {pmid41636553,
year = {2026},
author = {Shi, F and Xia, H and Li, X and Olatosi, B and Weissman, S and Yang, X},
title = {Long COVID Between People With and Without HIV: a Statewide Cohort Analysis.},
journal = {Journal of acquired immune deficiency syndromes (1999)},
volume = {},
number = {},
pages = {},
doi = {10.1097/QAI.0000000000003840},
pmid = {41636553},
issn = {1944-7884},
abstract = {BACKGROUND: This study aims to compare the risks of a panel of long COVID manifestations between people with HIV (PWH) and people without HIV (PWoH).

METHODS: Using integrated statewide electronic health record data from the HIV cohort and COVID-19 tester cohort, we identified COVID-19-positive individuals by HIV status between March 02, 2020, and January 15, 2022, in South Carolina. A total of 13 diagnosis groups encompassing 131 potential long COVID categories were identified. We used inverse probability weighting based on propensity scores to balance covariates between the PWH and PWoH, including age, sex, race, and vaccination status. Cox Proportional Hazard regression models were used to estimate the risk of each diagnosis group examined.

RESULTS: Among a total of 838,520 COVID-19 positive individuals, 2,662 were with HIV, and 835,858 were without HIV. The prevalence of any long COVID diagnosis was 16.3% and 10.6% for PWH and PWoH, respectively. Compared with PWoH, PWH were found to be at a higher risk of at least one of the long COVID diagnosis groups (HR = 1.29, 95%CI: 1.09-1.54) and the highest risk was for diseases of the nervous system (HR = 2.04, 95%CI: 1.42-2.92), followed by mental disorders (HR = 1.78, 95%CI: 1.12-2.82) and respiratory system (HR = 1.78, 95%CI: 1.18-2.69).

CONCLUSIONS: Our study highlights the consistent and elevated LC burden in PWH, emphasizing the importance of sustained follow-up for COVID-19 survivors to improve their clinical outcomes and prevent morbidity of LC.},
}

@article {pmid41635577,
year = {2026},
author = {Khoo, A and Manuel, K and Ng, T and Crotty, M},
title = {Non-invasive electrodiagnostic testing for small fibre neuropathy in long COVID-19.},
journal = {BMJ neurology open},
volume = {8},
number = {1},
pages = {e001399},
pmid = {41635577},
issn = {2632-6140},
abstract = {BACKGROUND: Long COVID-19 is associated with a diverse range of debilitating neuropathic and autonomic symptoms that may indicate small fibre neuropathy (SFN). We aimed to assess the utility of multimodal non-invasive electrodiagnostic techniques in evaluating symptomatic individuals.

METHODS: People with confirmed long COVID-19 who scored >10 points on the Small Fibre Neuropathy Screening List (SFNSL) questionnaire underwent routine neurophysiological testing and a non-invasive SFN protocol of (a) sympathetic skin responses, (b) cutaneous silent period, (c) quantitative thermal thresholds and (d) electrochemical skin conductance. Clinical and demographic information was collected on all individuals who underwent comprehensive physical and psychometric evaluation, including a 6-min walk test, National Aeronautics and Space Administration (NASA) Lean Test, Composite Autonomic Symptom Score-31 (COMPASS-31), European Quality of Life 5-Dimension 5-Level Questionnaire (ED-5D-5L), Modified Fatigue Impact Scale (MFIS) score and Patient Health (depression) Questionnaire (PHQ-9).

RESULTS: We assessed nine individuals, of whom three (33%) had neurophysiological evidence of SFN. Median age was 47.8 (range 26.3-67.6) years, duration from COVID-19 infection 23.0 (range 8.5-35.7) months and median SFNSL 34/84. All individuals scored highly in disability measures.

CONCLUSIONS: Long COVID-19 is associated with functional disability and reduced quality of life. SFN should be considered in all individuals with a suggestive clinical phenotype of neuropathic and autonomic symptoms.},
}

@article {pmid41633328,
year = {2026},
author = {Kwon, K and Jang, CY and Kim, W and Son, J and Chang, E and Kim, SH},
title = {Evaluation of Post-Acute Sequelae of SARS-CoV-2 (PASC) Index and a Recent Long COVID Criteria in Korean Long COVID-19 Cohort.},
journal = {Journal of Korean medical science},
volume = {41},
number = {5},
pages = {e54},
doi = {10.3346/jkms.2026.41.e54},
pmid = {41633328},
issn = {1598-6357},
support = {HD22C2045//Korea Health Industry Development Institute/Republic of Korea ; },
mesh = {Humans ; *COVID-19/complications/epidemiology/diagnosis ; Male ; Female ; Middle Aged ; Adult ; Prospective Studies ; Aged ; SARS-CoV-2 ; Republic of Korea/epidemiology ; Post-Acute COVID-19 Syndrome ; Severity of Illness Index ; },
abstract = {BACKGROUND: To compare the post-acute sequelae of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection (PASC) index and the National Academies of Sciences, Engineering, and Medicine (NASEM) criteria in identifying long coronavirus disease (COVID) among adults with confirmed coronavirus disease 2019.

METHODS: A prospective cohort study was conducted from November 2022 to February 2025 at a single tertiary care hospital in Seoul, Korea. Adults aged 18 years or older with confirmed SARS-CoV-2 infection were enrolled, yielding a total of 183 participants. Follow-up assessments took place at 1-, 3-, 6-, and 12-months post-infection. The primary outcome was the prevalence of long COVID at 12 months, measured using the PASC index (≥ 12 points across specified symptoms) and the NASEM criteria (≥ 1 symptom persisting for at least 3 months).

RESULTS: Of 183 participants, 26.2% (48/183) met the PASC index, whereas 47.5% (87/183) fulfilled the NASEM criteria. Of the 48 patients who met the PASC index, 44 (91.7%) also met the NASEM criteria.

CONCLUSION: The NASEM criteria classified nearly half of participants with long COVID and covered those with PASC index, while the PASC index identified about one quarter. Although the NASEM criteria capture a broader range of persistent symptoms, the PASC index may offer a more stringent threshold, potentially informing targeted research and clinical decision-making.},
}

Humans
*COVID-19/complications/epidemiology/diagnosis
Male
Female
Middle Aged
Adult
Prospective Studies
Aged
SARS-CoV-2
Republic of Korea/epidemiology
Post-Acute COVID-19 Syndrome
Severity of Illness Index

@article {pmid41632491,
year = {2026},
author = {Nóbrega Júnior, JC and Brandão, SS and Fink, JB and Xavier, D and Torres, R and Ari, A and Reinaux, C and Campos, S and Brandão, D and Dornelas de Andrade, A},
title = {Effect of Inspiratory Muscle Training on Aerosol Deposition and Pulmonary Perfusion in Post-COVID-19 Syndrome: A Gamma Scintigraphy Study.},
journal = {Journal of aerosol medicine and pulmonary drug delivery},
volume = {},
number = {},
pages = {19412711261418482},
doi = {10.1177/19412711261418482},
pmid = {41632491},
issn = {1941-2703},
abstract = {BACKGROUND: Pulmonary dysfunction in individuals with post-coronavirus disease-2019 (COVID-19) syndrome may impair aerosol deposition and pulmonary perfusion, compromising respiratory efficiency. Inspiratory muscle training (IMT) has been proposed as a strategy to improve respiratory mechanics and lung function.

OBJECTIVE: To compare aerosol deposition and pulmonary perfusion in individuals with post-COVID-19 syndrome before and after 8 weeks of IMT.

METHODS: This was a randomized controlled clinical trial involving 19 participants, divided into an IMT group (n = 10) and a control group (n = 9). The IMT group performed training with a load adjusted to 50% of maximal inspiratory pressure, while the control group used a device without resistance. Aerosol deposition and pulmonary perfusion were evaluated by gamma scintigraphy using the radioisotopes technetium-labeled diethylene-triamine-pentaacetic acid and technetium99-labeled macroaggregated human serum albumin, respectively. Total radiopharmaceutical activity in both lungs, as well as in the right and left lungs separately, was quantified pre- and post-intervention.

RESULTS: After 8 weeks, the IMT group showed a significant increase in total lung activity for both aerosol deposition (p = 0.028) and perfusion (p = 0.013). In the right lung, activity increased significantly for aerosol deposition (p = 0.005) and perfusion (p = 0.005). In the left lung, significant increases were also observed for perfusion (p = 0.007). No significant increases were observed in the control group. In the between-group analysis, the IMT group showed higher activity in both lungs combined and separately, compared with controls, for aerosol deposition (all p < 0.05) and in the right lung for perfusion (p = 0.010).

CONCLUSION: IMT improved total aerosol deposition and perfusion in individuals with post-COVID-19 syndrome. These findings support the use of IMT as a rehabilitation strategy to enhance pulmonary deposition of inhaled agents and increase pulmonary perfusion in this population.},
}

@article {pmid41630820,
year = {2026},
author = {Rivas Nieto, JC and Cordoba-Melo, BD and Arango-Ibanez, JP and Seni-Molina, S and Barbosa Rengifo, MM and Miranda-Bastidas, CA and Casanova Rojas, AF and Mina Sanchez, AF and Herrera, CJ and Quintana Da Silva, MA and Buitrago, AF and Coronel Gilio, ML and Pow-Chon-Long, F and Gomez-Mesa, JE and , },
title = {Long-Term Mental Health Evaluation After COVID-19: Insights From the CARDIO COVID 20-21 Registry.},
journal = {Journal of clinical medicine research},
volume = {18},
number = {1},
pages = {18-30},
pmid = {41630820},
issn = {1918-3003},
abstract = {BACKGROUND: Psychopathological manifestations are key features of long COVID, contributing to a considerable global mental health burden. Neuropsychiatric sequelae such as anxiety, depression, cognitive dysfunction, and perceived stress may persist for months or years after infection. Latin American populations remain underrepresented, despite a high prevalence of long COVID and unique socio-demographic characteristics. Understanding these impacts is essential for targeted screening and interventions.

METHODS: We conducted a prospective study of patients hospitalized for severe COVID-19. Psychiatric evaluation used the General Anxiety Disorder-7, Patient Health Questionnaire-9, Perceived Stress Scale-14, and Addenbrooke's Cognitive Examination-III (ACE-III), at an average of 24.5 months post-illness. Bivariate analyses evaluated differences by sex and intensive care unit (ICU) admission. Multivariable linear regression was used to examine associations between cognitive scores and age, sex, education, socioeconomic status, ICU admission, body mass index, smoking exposure, hypertension, and diabetes.

RESULTS: We included 152 patients; the mean age was 56 years, and 58.5% were male. Anxiety symptoms were present in 33%, depression in 49%, and both perceived stress and cognitive dysfunction were each observed in 11% of patients. Women exhibited significantly higher levels of depression (P = 0.02) and stress (P = 0.011), whereas patients admitted to the ICU demonstrated greater cognitive impairment (P < 0.001). In multivariable regression, male sex (P = 0.002), higher education (P < 0.001), and hypertension (P = 0.037) were significantly associated with higher ACE-III scores, while ICU admission was associated with lower scores (P = 0.017).

CONCLUSION: Our study reveals a high prevalence of mental health symptoms and cognitive dysfunction among patients 2 years after severe COVID-19. Anxiety showed no differences by sex or ICU requirement. Women exhibited higher rates of depression and perceived stress, while ICU admission was associated with poorer cognitive performance. Our findings should encourage systematic screening, diagnosis, and management of long-term neuropsychiatric sequelae in COVID-19 survivors. However, due to the limitations of the single-center design, further longitudinal and multicenter studies are warranted to better elucidate the long-term psychiatric impact of COVID-19.},
}

@article {pmid41629267,
year = {2026},
author = {Sanal-Hayes, NE and Hayes, LD and Mair, JL and Iacono, AD and Ingram, J and Mclaughlin, M and Ormerod, J and Carless, D and Hilliard, N and Meach, R and Sculthorpe, NF},
title = {A digital platform with activity tracking for energy management support in long COVID: a randomised controlled trial.},
journal = {Nature communications},
volume = {17},
number = {1},
pages = {945},
pmid = {41629267},
issn = {2041-1723},
support = {COV-LT2-0010//DH | National Institute for Health Research (NIHR)/ ; COV-LT2-0010//DH | National Institute for Health Research (NIHR)/ ; },
mesh = {Humans ; Male ; Female ; *COVID-19/therapy/physiopathology/complications ; Middle Aged ; Adult ; *Mobile Applications ; SARS-CoV-2 ; Aged ; Exercise ; *Fitness Trackers ; Surveys and Questionnaires ; Wearable Electronic Devices ; },
abstract = {In a 6-month pragmatic randomised controlled trial (RCT; ISRCTN16033549), we compared a just-in-time intervention to support energy management in adults with long COVID (LC) to standard care. Participants received either the 'Pace Me' app and a wearable activity tracker (intervention) or an app only with data entry screens (control). The intervention group received just-in-time messages on energy management when they reached 50%, 75%, and 100% of their daily 'activity allowance'. The primary outcome was post-exertional malaise (PEM) measured by the DePaul Symptom Questionnaire-PEM (DSQ-PEM). Of 369 participants assessed for eligibility, 250 participants were randomised 1:1, and 77 controls and 84 intervention participants were included in the final per-protocol analysis. There was no time by group interaction for the DSQ-PEM. The intervention group value was 48 (95% CI 44-53) at baseline and 46 (95% CI 41-51) post-intervention (arbitrary units). The control group value was 47 (95% CI 42-52) at baseline and 44 (95% CI 39-49) at follow-up (interaction effect p = 0.614, η[2]p = 0.002; trivial). No individual question exhibited an interaction effect (p > 0.05). Although the intervention had minimal effect compared to control, the substantial recovery rates previously reported in LC, coupled with our wide inclusion criteria may have masked intervention effects. Therefore, future studies should consider this energy management framework in conditions without such recovery rates, such as CFS.},
}

Humans
Male
Female
*COVID-19/therapy/physiopathology/complications
Middle Aged
Adult
*Mobile Applications
SARS-CoV-2
Aged
Exercise
*Fitness Trackers
Surveys and Questionnaires
Wearable Electronic Devices

@article {pmid41628929,
year = {2026},
author = {Bruschi, M and Del Riccio, M and Lorini, C and Profili, F and Zanobini, P and Biagi, C and Papini, E and Floridia, M and Onder, G and Francesconi, P and Bonaccorsi, G},
title = {Prevalence of long covid symptoms in Tuscany, Italy: a population-representative cross-sectional telephone survey.},
journal = {BMJ open},
volume = {16},
number = {2},
pages = {e101321},
doi = {10.1136/bmjopen-2025-101321},
pmid = {41628929},
issn = {2044-6055},
mesh = {Humans ; Italy/epidemiology ; Female ; Male ; Cross-Sectional Studies ; *COVID-19/epidemiology/complications ; Middle Aged ; Prevalence ; Adult ; Aged ; SARS-CoV-2 ; Fatigue/epidemiology ; Post-Acute COVID-19 Syndrome ; Surveys and Questionnaires ; Young Adult ; Telephone ; Adolescent ; },
abstract = {OBJECTIVES: Long covid affects over 36 million individuals in the European region, but its clinical profile is still poorly defined, particularly in the general population with less severe acute disease. This study aimed to assess the prevalence of a broad spectrum of symptoms potentially linked to long covid in the general population of Tuscany, Italy.

METHODS: A cross-sectional study was conducted in January-February 2024 using Computer-Assisted Telephone Interviews in a representative population sample of Tuscany. Based on the WHO questionnaire long covid symptom list, data on 33 symptoms experienced in the past 6 months were collected, along with demographic and clinical characteristics. After excluding patients with COVID-19 within the past 6 months and those failing a screening cognitive test, symptom prevalence and ORs adjusted for sex, time since infection, smoking and concurrent diseases (aOR) were calculated according to COVID-19 history.

RESULTS: After excluding 129 failing the cognitive test (6.4%) and 123 recent COVID cases (6.1%), among 1753 participants interviewed, 1013 (57.8%) had a history of COVID-19. The symptoms significantly more prevalent in individuals with previous COVID-19 were fatigue (12.8% vs 8.9%, aOR 1.6 (95% CI 1.2 to 2.2)), concentration impairment (5.5% vs 2.4%, aOR 2.2 (95% CI 1.3 to 3.8)) and skin rashes (4.5% vs 2.4%, aOR 1.9 (95% CI 1.1 to 3.3)). Prevalences and ORs were higher in more recent COVID-19 cases, particularly females and individuals with concurrent diseases.

CONCLUSIONS: We identified in a population-based study some symptoms significantly more common in individuals with previous COVID-19. This approach complements data collected in clinical settings and in patients selected by greater disease severity. The findings may help future surveillance efforts and targeted public health interventions directed at optimising care pathways and mitigating long-term consequences.},
}

Humans
Italy/epidemiology
Female
Male
Cross-Sectional Studies
*COVID-19/epidemiology/complications
Middle Aged
Prevalence
Adult
Aged
SARS-CoV-2
Fatigue/epidemiology
Post-Acute COVID-19 Syndrome
Surveys and Questionnaires
Young Adult
Telephone
Adolescent

@article {pmid41627925,
year = {2026},
author = {Tangjitgamol, S and Maude, RR and Ativanichayapong, N and Walsh, R and Beer, E and Kaprakhon, K and Chaowanklang, C},
title = {Prevalence and pattern of abnormal menstruation after COVID-19 infection.},
journal = {Health care for women international},
volume = {},
number = {},
pages = {1-15},
doi = {10.1080/07399332.2026.2617332},
pmid = {41627925},
issn = {1096-4665},
abstract = {OBJECTIVE: To evaluate the prevalence of abnormal menstruation after COVID infection as well as the type of abnormality and risk factors.

METHODS: Data of women who still had menstruation with a history of COVID infection from February 2021 to June 2022 were collected. Clinical features, the presence and pattern of abnormal menstruation post-infection, were obtained through the questionnaire.

RESULTS: Of 87 women, the mean age was 33.5 ± 7.2 years. Nine had preexisting menstrual abnormalities (10.3%). The abnormalities were found in 20 women (23.0%), or 2.2-fold higher post-infection. Among these, 17 women (68.0%) had newly developed symptoms. Irregular menstruation was most common in both settings, 33.3% pre-infection and 20.0% post-infection. By univariate analysis, features with higher risk were age ≤ 33 years (crude odds ratio [cOR] 1.61), obesity (cOR 1.74), COVID vaccination > 3 doses (cOR 3.28), > 1 episode of infection (cOR 3.94), contraception use before (OR 1.47) or after infection (cOR 1.92), abnormal menstruation before COVID infection (cOR 44.0), and presence of other long COVID symptoms (cOR 2.09). The differences were statistically significant for vaccination > 3 doses and had abnormal menstruation pre-infection, with the latter as an independent risk by multivariate analysis (adjusted OR 39.58).

CONCLUSION: The prevalence of abnormal menstruation post-COVID infection was 23%. Abnormal menstruation pre-infection was an independent risk factor.},
}

@article {pmid41625963,
year = {2026},
author = {Huang, YW and Chen, YC and Lun Lau, EY and Su, YC and Tai, LK and Rosenthal, J and Wang, J and Lee, TY},
title = {REGENECYTE cord blood cell therapy in post-COVID syndrome: a phase IIa randomized, placebo-controlled trial.},
journal = {EClinicalMedicine},
volume = {91},
number = {},
pages = {103737},
pmid = {41625963},
issn = {2589-5370},
abstract = {BACKGROUND: Post-COVID syndrome affects a substantial proportion of individuals worldwide and imposes significant healthcare and economic burdens. Fatigue is one of the most common and debilitating symptoms in those with severe symptoms related to post-COVID fatigue syndrome, yet there remains a lack of targeted therapies, effective or approved treatments to address it. This study aimed to evaluate the safety, tolerability, and efficacy of repeated doses of REGENECYTE, an allogeneic hematopoietic progenitor cell (HPC) therapy derived from cord blood, in patients with post-COVID syndrome.

METHODS: In this randomized, single-blind, placebo-controlled, phase IIa trial, we evaluated repeated intravenous infusions of REGENECYTE from different donors (without HLA matching) in patients with post-COVID syndrome in the USA. Eligible adults aged 18-65 years had persistent post-COVID symptoms between 6 and 18 months and tested negative for SARS-CoV-2 within 7 days before enrollment. Participants were randomized into a 2:1 ratio to receive either REGENECYTE or placebo. Three infusions were administered over 6 weeks, 3 weeks apart, followed by a 20-week follow-up. Each dose of REGENECYTE contains at least 1 × 10[7] total nucleated cells (TNC)/kg, with a cumulative dose of at least 3 × 10[7] TNC/kg per patient. The primary endpoint was safety, assessed using the Common Terminology Criteria for Adverse Events by National Cancer Institute (NCI CTCAE) v5.0. The key secondary endpoint focused on changes in fatigue using the Chalder Fatigue Questionnaire (CFQ-11), while exploratory endpoints evaluated frailty, quality of life, and cognition using validated instruments. This trial was registered with ClinicalTrials.gov, NCT05682560.

FINDINGS: Between May 4 and Dec 26, 2023, 30 eligible patients were enrolled and completed the study. The mean age was 41.9 years; 70% were female. The average duration of post-COVID symptoms was 306 days. Only 2 patients (10%) in the REGENECYTE group experienced mild treatment-emergent adverse events (TEAEs), indicating good tolerability. Notably, REGENECYTE significantly and sustainably improved fatigue symptoms, as measured by CFQ-11 Bimodal and Likert scores, compared to placebo (p < 0.01). Improvements were observed as early as week 6 and persisted through the 20-week follow-up. The most pronounced benefit was seen in the physical fatigue domain. REGENECYTE also improved quality of life in domains such as usual activities and mental wellbeing. There were no significant changes in frailty or cognitive scores.

INTERPRETATION: REGENECYTE was well tolerated and safe when administered as repeat infusions from unmatched cord blood donors. It produced a meaningful and durable reduction in fatigue symptoms, the most burdensome feature of post-COVID syndrome-highlighting its potential as a novel therapeutic strategy. These findings support further clinical development of cord blood-based therapies targeting fatigue in post-COVID and potentially other fatigue-related conditions.

FUNDING: StemCyte International, Ltd.},
}

@article {pmid41625797,
year = {2025},
author = {Puthenveedu, VK and Prabhakaran, ST and Basheer, A},
title = {Clinical Spectrum and Outcomes of Post-COVID Syndrome Among Adults in Rural Kerala: A Cohort Study.},
journal = {Cureus},
volume = {17},
number = {12},
pages = {e100434},
pmid = {41625797},
issn = {2168-8184},
abstract = {Background Post-COVID syndrome (PCS) is a condition that affects some individuals who have recovered from COVID-19, characterized by persistent symptoms that last for weeks or months after the acute illness has resolved. Despite ongoing research on PCS, key gaps remain, including short follow-up, absence of control groups, small sample sizes, and limited representation of mild-to-moderate cases. Objectives The objective of this study is to determine the incidence proportion and outcomes of PCS over 12 months in a rural district of Kerala. Methods A prospective cohort study was conducted among 596 participants, of which 298 had a previous COVID-19 infection confirmed by reverse transcriptase polymerase chain reaction (RT-PCR) or antigen test (exposure group), while the remaining had no evidence of COVID-19 (control group). Field workers collected data by direct interviews. Study variables, including blood pressure (BP), blood sugar, oxygen (O2) saturation, and six-minute walk distance (6MWD), were recorded at six, nine, and 12 months following recruitment. Results The incidence proportion of PCS was 91.9% (95% CI: 88.8-95.0%) in the exposure cohort (i.e., 274/298) compared to 83.2% (95% CI: 79.0-87.4%) in the controls (i.e., 248/298) at six months. The differences in the incidence proportion of PCS between the groups were statistically significant. The differences in mean 6MWD at six, nine, and 12 months were statistically significant (p = 0.037), with a nadir at nine months. Mean systolic and diastolic BP were significantly higher in the exposure group than the control group at six and nine months, which converged by 12 months. Conclusion The persistence of symptoms and functional impairments was common among both the exposure and control groups, though more frequent in the exposure (COVID-19) group. The findings suggest that post-COVID morbidity may overlap with the background community symptom burden. Further, multicenter studies with serology and adjusted analyses are required to refine pathways for screening and long-term care.},
}

@article {pmid41625057,
year = {2026},
author = {Hirobumi, I},
title = {Epipharyngeal Abrasive Therapy (EAT) Improved Premature Ventricular Contractions (PVCs) and Brain Fog Associated With Long COVID: A Case Report.},
journal = {Cureus},
volume = {18},
number = {1},
pages = {e102533},
pmid = {41625057},
issn = {2168-8184},
abstract = {A 50-year-old man with premature ventricular contractions (PVCs) detected before coronavirus disease 2019 (COVID-19) infection developed persistent fatigue and brain fog following COVID-19, which caused difficulty in continuing his work. Epipharyngeal abrasive therapy (EAT) was started without pharmacological treatment. Serial Holter electrocardiography demonstrated a marked reduction in PVC burden after continued EAT. In contrast, improvement in brain fog and recovery of work motivation occurred at a later stage, eventually allowing him to return to work. PVCs are considered an autonomic-sensitive peripheral manifestation, whereas brain fog likely represents dysfunction of central autonomic networks. The temporal dissociation observed between early improvement in PVCs and delayed cognitive recovery indicates that EAT may exert time-dependent effects on peripheral and central autonomic regulation. This case suggests that EAT could serve as a non-pharmacological and minimally invasive therapeutic option for both peripheral and central symptoms associated with autonomic dysfunction in Long COVID.},
}

@article {pmid41624858,
year = {2025},
author = {Charles James, J and Teegen, B and Pakeerathan, T and Hütter, G and Ladopoulos, T and Siems, N and Trampe, N and Ayzenberg, I and Gold, R and Faissner, S},
title = {Anti-VGLUT2 autoantibodies associated with post-COVID neurocognitive dysfunction: a case report.},
journal = {Frontiers in immunology},
volume = {16},
number = {},
pages = {1731744},
pmid = {41624858},
issn = {1664-3224},
mesh = {Humans ; Male ; *COVID-19/complications/immunology ; *Autoantibodies/blood/immunology ; Adult ; *SARS-CoV-2/immunology ; *Cognitive Dysfunction/immunology/etiology ; Neuropsychological Tests ; Immunoglobulins, Intravenous/therapeutic use ; },
abstract = {Post-COVID-19 syndrome (PCS) is frequently associated with fatigue and cognitive dysfunction, while underlying mechanisms remain unclear. We report a 44-year-old male with persistent symptoms following SARS-CoV-2 infection, including severe cognitive and motor fatigue, word-finding difficulties, and impaired concentration. Neuropsychological testing revealed marked deficits in alertness, attention, fluency, and processing speed. Serum analysis demonstrated anti-VGLUT2 autoantibodies. IVIG therapy yielded subjective but no objective improvement. This appears to be the first PCS case associated with VGLUT2 autoantibodies and raises the hypothesis of a potential pathophysiological link that requires confirmation in larger cohorts.},
}

Humans
Male
*COVID-19/complications/immunology
*Autoantibodies/blood/immunology
Adult
*SARS-CoV-2/immunology
*Cognitive Dysfunction/immunology/etiology
Neuropsychological Tests
Immunoglobulins, Intravenous/therapeutic use

@article {pmid41623576,
year = {2026},
author = {Birla, S and Angural, A and Madathumchalil, A and Shende, RV and Shastry, SV and Shekar, PK and Mahadevappa, M and Vishwanath, P and Prashant, A},
title = {"Bridging the clinical, molecular and genetic perspectives on myocarditis in post-COVID-19 era".},
journal = {International journal of cardiology. Cardiovascular risk and prevention},
volume = {28},
number = {},
pages = {200576},
pmid = {41623576},
issn = {2772-4875},
abstract = {Myocarditis is a non-familial inflammatory manifestation of the myocardium, primarily induced by viral infections, but it may also stem from bacterial pathogens, autoimmune disorders, or adverse drug reactions. Its diagnosis remains challenging due to heterogeneous and often non-specific clinical presentations. Recent epidemiological studies have indicated a markedly increased incidence of myocarditis following SARS-CoV-2 infection and mRNA COVID-19 vaccinations (to a lesser extent) compared to pre-pandemic statistics. While a significant number of cases follow a mild and self-limiting disease course, severe manifestations can lead to arrhythmias, heart failure, or even sudden cardiac death. Importantly, accumulating evidence indicates that even mild myocarditis confers an elevated long-term risk of adverse cardiovascular outcomes. Beyond clinical and imaging-based observations, recent advances highlight a critical role for host genetic susceptibility in modulating immune responses, myocardial injury, and disease severity. This review provides a comprehensive synthesis of the etiology, pathophysiological mechanisms, clinical spectrum, diagnostic approaches, and evidence-based management of COVID-19-associated myocarditis, while critically integrating emerging genetic and transcriptomic insights that may explain disease heterogeneity, variable inter-individual susceptibility, and long-term prognosis. By bridging clinical aspects with molecular and genetic frameworks, this review underscores the importance of personalized risk stratification, vigilant post-recovery surveillance, and targeted preventive strategies in the post-pandemic era.},
}

@article {pmid41621351,
year = {2026},
author = {Sarkanen, T and Merikanto, I and Bjorvatn, B and Chung, F and Holzinger, B and Morin, CM and Penzel, T and De Gennaro, L and Wing, YK and Benedict, C and Xue, P and Reis, C and Korman, M and Landtblom, AM and Matsui, K and Hrubos-Strøm, H and Mota-Rolim, S and Nadorff, MR and Berezin, L and Liu, Y and Scarpelli, S and Brandao, LE and Cedernaes, J and Partinen, E and Bolstad, CJ and Plazzi, G and Espie, CA and Partinen, M and Dauvilliers, Y},
title = {Corrigendum to "Long COVID as a risk factor for hypersomnolence and fatigue: insights from the 2nd International Covid Sleep Study Collaboration (ICOSS-2)" [Sleep Med. 136 (2025) 106764].},
journal = {Sleep medicine},
volume = {140},
number = {},
pages = {108798},
doi = {10.1016/j.sleep.2026.108798},
pmid = {41621351},
issn = {1878-5506},
}

@article {pmid41613157,
year = {2025},
author = {Falco, P and Galosi, E and Litewczuk, D and Evangelisti, E and Di Stefano, G and Arendt-Nielsen, L and Truini, A and Leone, CM},
title = {Autonomic small fiber involvement in painful long COVID: a histological and clinical study.},
journal = {Frontiers in human neuroscience},
volume = {19},
number = {},
pages = {1719705},
pmid = {41613157},
issn = {1662-5161},
abstract = {BACKGROUND: Despite growing recognition of painful long COVID syndrome as a chronic neurological condition marked by pain and autonomic symptoms, the precise contribution of autonomic small fiber involvement is still not well characterized and understood. In this retrospective study, we aimed to identify autonomic small fiber involvement in patients with painful long COVID syndrome by analyzing skin biopsy data. We used nerve fiber density in the piloerector muscles (PMNFD) and sweat glands (SGNFD) as the primary histological outcomes of autonomic innervation.

METHODS: We reviewed skin biopsy samples from 50 patients with painful long COVID syndrome and included 31 patients with available PMNFD and SGNFD data for analysis. PMNFD and SGNFD were compared with an age- and sex-matched healthy control group (n = 42). To evaluate whether autonomic involvement was independent of somatic nerve fiber reduction, a subgroup analysis was performed in patients with normal intraepidermal nerve fiber density (IENFD) (n = 23). Correlations between histological findings and autonomic symptoms, assessed with the COMPASS-31 questionnaire, were also analyzed.

RESULTS: Piloerector muscle nerve fiber density and SGNFD were significantly reduced in patients with long COVID compared with controls, both in the full sample (p = 0.0135; p < 0.0001) and in the subgroup with normal IENFD (p = 0.0003; p = 0.0005). Neither PMNFD nor SGNFD correlated with COMPASS-31 scores (p = 0.27; p = 0.46) and no association with disease onset, duration and COVID-19 severity was found.

CONCLUSION: These findings provide histological evidence that autonomic small fiber damage is a prominent and measurable feature of painful long COVID syndrome. Importantly, this pathology was also observed in patients with preserved IENFD, indicating that autonomic involvement may occur independently of somatic small fiber loss.},
}

@article {pmid41612939,
year = {2026},
author = {Pang, H and Frontera, J and Jiang, L and Li, C and Boutajangout, A and Sun, Z and Debure, L and Ghuman, M and Vedvyas, A and Masurkar, AV and Wisniewski, T and Ge, Y},
title = {Choroid plexus alterations in long COVID and their associations with Alzheimer's disease risks.},
journal = {Alzheimer's & dementia : the journal of the Alzheimer's Association},
volume = {22},
number = {2},
pages = {e71020},
doi = {10.1002/alz.71020},
pmid = {41612939},
issn = {1552-5279},
support = {R01AG077422//The National Institutes of Health/National Institute on Aging/ ; U24 NS135568/NS/NINDS NIH HHS/United States ; P30AG066512//The National Institutes of Health/National Institute on Aging/ ; R01AG077422/GF/NIH HHS/United States ; U24 NS135568/GF/NIH HHS/United States ; P30AG066512/GF/NIH HHS/United States ; },
mesh = {Humans ; *Choroid Plexus/diagnostic imaging/pathology ; *Alzheimer Disease/diagnostic imaging ; Female ; Male ; Aged ; *COVID-19/complications/diagnostic imaging/pathology ; Magnetic Resonance Imaging ; Cerebrovascular Circulation/physiology ; tau Proteins/blood ; Biomarkers/blood ; Middle Aged ; Aged, 80 and over ; Cognitive Dysfunction ; },
abstract = {INTRODUCTION: Choroid plexus (ChP) enlargement is a neuroimaging biomarker of neuroinflammation and neurodegeneration. However, evidence of ChP structural and perfusion alterations in long coronavirus disease (COVID) and their clinical relevance remains limited.

METHODS: This study included 86 long COVID, 67 recovered COVID, and 26 COVID-negative healthy controls (HCs). ChP volume and cerebral blood flow (CBF) were quantified, and their associations with Alzheimer's disease (AD) symptoms and plasma biomarkers were examined.

RESULTS: Both patient groups showed higher ChP volume and lower CBF than HC. Relative to recovered COVID, long COVID patients had a larger ChP volume, but no significant difference in CBF. ChP volume correlated positively with glial fibrillary acidic protein (r = 0.35) and phosphorylated tau217 (p-tau217; r = 0.54), while CBF correlated negatively with p-tau217 (r = -0.56). Both ChP volume and CBF were associated with cognitive decline measured with Mini-Mental State Examination and Clinical Dementia Rating.

DISCUSSION: These findings suggest that ChP differences in long COVID are associated with AD-related cognitive decline and increased plasma biomarkers.

HIGHLIGHTS: Long coronavirus disease (COVID) patients show choroid plexus (ChP) enlargement and reduced cerebral blood flow. ChP alterations are associated with Alzheimer's disease (AD)-related symptoms and plasma biomarker changes. ChP alterations on magnetic resonance imaging may serve as imaging markers for tracking neurological symptoms and AD-related pathology in post-COVID patients.},
}

Humans
*Choroid Plexus/diagnostic imaging/pathology
*Alzheimer Disease/diagnostic imaging
Female
Male
Aged
*COVID-19/complications/diagnostic imaging/pathology
Magnetic Resonance Imaging
Cerebrovascular Circulation/physiology
tau Proteins/blood
Biomarkers/blood
Middle Aged
Aged, 80 and over
Cognitive Dysfunction

@article {pmid41612118,
year = {2026},
author = {Goldschmidt, MI and Mkoma, GF and Petersen, JH and Agyemang, C and Rostila, M and Thaning, P and Hansen, EF and Benfield, T and Norredam, M},
title = {Ethnic Differences in Symptom Burden, Work and Daily Life: A Study of Long COVID Patients in Denmark.},
journal = {Journal of general internal medicine},
volume = {},
number = {},
pages = {},
pmid = {41612118},
issn = {1525-1497},
abstract = {BACKGROUND: Ethnic minorities appear to be at higher risk of long COVID. Our objective was to estimate ethnic differences in the burden of long COVID symptoms and their impact on daily life and occupational status.

METHODS: Retrospective cohort study of adults (≥ 18 years) admitted to a Long COVID Clinic, Copenhagen University Hospital - Amager and Hvidovre, Copenhagen, Denmark, from February 2021 through November 2022. Data from symptom questionnaires were linked to clinical data from patient records and national register data. Using regression models, we calculated the burden and number of long COVID symptoms as well as the risk of certain symptom categories, of being on sick leave, of loss of independence, and of having returned to usual leisure activities.

RESULTS: A total of 864 patients from the long COVID clinic were included; hereof 31.2% were ethnic minorities. Compared to patients of Danish origin, ethnic minorities had an 18.32% higher mean burden of long COVID symptoms (adjusted mean difference (MDadj) 3.23, 95% confidence interval (CI): 1.67;4.78) and experienced 18.56% more long COVID symptoms on average (MDadj 1.56, 95% CI: 0.86;2.26). Ethnic minorities were more likely to experience cardio-pulmonary, psychological, and gastrointestinal symptoms. However, compared to patients of Danish origin, ethnic minorities had lower odds of being on sick leave (adjusted odds ratio (ORadj) 0.61, 95% CI: 0.40;0.94) and of having returned to usual leisure activities (ORadj 0.68, 95% CI: 0.48;0.94).

CONCLUSIONS: Ethnic minorities experienced a higher number and symptom burden of long COVID symptoms along with a higher risk of certain symptom categories, notably psychological symptoms. However, ethnic minorities had lower odds of being on sick leave. Additional research is needed into the explanations of the disparities identified in this study.},
}

@article {pmid41611926,
year = {2026},
author = {Dos Santos Pinto, A and Mwangi, VI and Neves, JCF and Maciel, ABS and Neto, AV and da Silva Valente, J and de Melo, GC and Monteiro, WM and de Souza Sampaio, V and da Costa, AG and Almeida-Val, FF},
title = {Clinical features and inflammatory signatures of patients with persistent gastrointestinal long COVID two years after severe SARS-CoV-2 infection.},
journal = {Scientific reports},
volume = {},
number = {},
pages = {},
doi = {10.1038/s41598-026-37595-8},
pmid = {41611926},
issn = {2045-2322},
support = {Doctorate scholarship//Coordenação de Aperfeiçoamento de Pessoal de Nível Superior/ ; Doctorate scholarship//Coordenação de Aperfeiçoamento de Pessoal de Nível Superior/ ; Doctorate scholarship//Coordenação de Aperfeiçoamento de Pessoal de Nível Superior/ ; PDJ scholarship (175855/2023-4)//Conselho Nacional de Desenvolvimento Científico e Tecnológico/ ; CNPq/MCTI/ CT-Saude Call - Research, development and innovation in long COVID); notice n°53/2022 (RECLAIM Brazil Study)//Conselho Nacional de Desenvolvimento Científico e Tecnológico/ ; Call No. 038/2022 - PDPG/CAPES/FAPEAM//Fundação de Amparo à Pesquisa do Estado do Amazonas/ ; Call No. 006/2020 - PCTI-EMERGESAÚDE/AM - Priority Areas//Fundação de Amparo a Pesquisa do Estado do Amazonas (FAPEAM)/ ; Call No. 006/2020 - PCTI-EMERGESAÚDE/AM - Priority Areas//Fundação de Amparo a Pesquisa do Estado do Amazonas (FAPEAM)/ ; },
}

@article {pmid41610163,
year = {2026},
author = {Morad, H and Vanhala, T and Kisiel, MA and Andreason, A and Li, M and Andersson, G and Laurell, G and Finger, TE and Hellekant, G},
title = {Taste dysfunction in Long COVID.},
journal = {Chemical senses},
volume = {},
number = {},
pages = {},
doi = {10.1093/chemse/bjaf068},
pmid = {41610163},
issn = {1464-3553},
abstract = {Persistent taste dysfunction is frequently reported in individuals with post-acute sequelae of infection by SARS-CoV-2 (Long COVID). The mechanisms and pathological correlates underlying this taste dysfunction are unknown. This study investigates the underlying pathology in 28 non-hospitalized subjects diagnosed with COVID-19 and who experienced taste disturbances more than 12 months after testing positive for SARS-CoV-2. To objectively establish the nature of taste deficit, we used the WETT taste test, which quantifies the subject's ability to taste each of the five taste qualities: sweet, umami, bitter, sour, and salty. We then biopsied five to eight fungiform taste papillae (FP) in 20 of the 28 subjects. The FPs were analyzed histologically for overall taste bud structure and innervation, and by quantitative PCR (qPCR) for mRNA expression of markers for different taste receptor cells. Although all subjects had reported taste dysfunction, only three showed overall taste scores below the 10th percentile for a normal population adjusted for age and sex. However, 11 of the 28 subjects exhibited total loss of one or more taste qualities. Loss of PLCβ2-dependent taste qualities (sweet, umami, bitter) was significantly more common and was correlated with reduced expression of PLCβ2 and Tas1R3 mRNAs. Histological analysis revealed generally preserved taste bud structure and innervation, but with occasional disorganized taste buds and abnormal, isolated PLCβ2-positive cells in the epithelium. Our findings suggest long-term taste dysfunction after COVID-19 occurs rarely -- more frequently involving PLCβ2-dependent taste qualities -- but is not due to wholesale disruption of the taste periphery.},
}

@article {pmid41608911,
year = {2026},
author = {Bramante, CT and Boulware, DR},
title = {Preventing Long COVID With Metformin.},
journal = {Clinical infectious diseases : an official publication of the Infectious Diseases Society of America},
volume = {},
number = {},
pages = {},
doi = {10.1093/cid/ciaf700},
pmid = {41608911},
issn = {1537-6591},
support = {K23DK124654/NH/NIH HHS/United States ; K24AI184270/NH/NIH HHS/United States ; },
}

@article {pmid41608121,
year = {2026},
author = {Gilbert, KM and Aglan, M and Jogdand, A and Khairnar, NV and Ssemaganda, H and Ong, MS and Farmer, JR},
title = {Nirmatrelvir/ritonavir use reduces risk for long COVID in patients with immunodeficiency.},
journal = {Journal of human immunity},
volume = {2},
number = {1},
pages = {e20250107},
pmid = {41608121},
issn = {3065-8993},
abstract = {Our retrospective study highlights that acute use of nirmatrelvir/ritonavir significantly reduces the risk of post-acute sequelae of SARS-CoV-2 infection (long COVID) in immunodeficient patients, emphasizing the need for clinical trials that include this high-risk population.},
}

@article {pmid41605818,
year = {2026},
author = {Keels, JN and LaPlante, RD and Lee, CS and Dwyer, AA},
title = {Prevalence of new-onset diabetes following COVID-19 infection: A systematic review and meta-analysis.},
journal = {Diabetes, obesity & metabolism},
volume = {},
number = {},
pages = {},
doi = {10.1111/dom.70508},
pmid = {41605818},
issn = {1463-1326},
support = {1F31NR021624-01/NR/NINR NIH HHS/United States ; },
abstract = {AIM: To estimate the prevalence of new-onset diabetes in adults (≥ 18 years) following SARS-CoV-2 infection.

MATERIALS AND METHODS: This meta-analysis includes studies written in English that measured the number of adults (≥ 18 years) diagnosed with diabetes following SARS-CoV-2 infection. Studies underwent dual independent review; quality was assessed by using the New Castle Ottawa Scale. A random-effects meta-analysis was conducted to obtain the pooled estimate of new-onset diabetes. To understand the relationship between patient characteristics (age, sex) and study variable (duration of follow-up), a random effects meta-regression was used.

RESULTS: A total of 33 articles were retained for analysis. The overall estimated prevalence of new-onset diabetes (combined T1DM and T2DM or undefined) was 8.33% (95% CI 7.47, 9.18%, z = 19.04, p < 0.001; Q = 6791.24, I[2], 99.68%). The overall estimated prevalence of new-onset T2DM in COVID-19 was 8.92% (95% CI 7.88%, 9.96%, z = 16.77, p < 0.001; Q = 27659.74; p < 0.001, I[2] = 99.96%). The overall estimated prevalence of new-onset T1DM was 0.86% (95% CI 0.0072%, 0.0099%, z = 12.59, p < 0.001; Q = 9456.28; p < 0.001, I[2] = 99.94%). At the study level, there was no significant relationship identified with age, sex, or follow-up duration.

CONCLUSIONS: This systematic review and meta-analysis revealed a notable increase in T2DM or combined (T1DM, T2DM, or undefined) conditions. As such, it may be important to understand the underlying factors contributing to increased prevalence.},
}

@article {pmid41605350,
year = {2026},
author = {Gerhards, SK and Luppa, M and Zülke, A and Sander, C and Schomerus, G and Buechner, R and Wirkner, K and Reusche, M and Zeynalova, S and Lehmann, J and Baber, R and Obrig, H and Herzig, S and Thöne-Otto, A and Witte, AV and Villringer, A and Fricke, C and Bergh, FT and Saur, D and Schroeter, ML and Löffler, M and Engel, C and Riedel-Heller, SG},
title = {Depressive and anxiety symptoms in individuals with Long-COVID: Does social network matter? - Results of a German Long-COVID study.},
journal = {Journal of affective disorders},
volume = {},
number = {},
pages = {121272},
doi = {10.1016/j.jad.2026.121272},
pmid = {41605350},
issn = {1573-2517},
abstract = {BACKGROUND: Some patients previously infected with SARS-CoV-2 develop symptoms that are summarized under the term Long COVID (LC). There is limited evidence on how social characteristics influence depressive and anxiety symptoms in adults with LC.

METHODS: Depressive symptoms were assessed using the Center for Epidemiological Studies Depression Scale (CES-D). Anxiety symptoms were measured using the Generalized Anxiety Disorder Scale (GAD-7). The living situation (alone vs. with someone) was assessed by a single question. The social network was assessed using the Lubben Social Network Scale (LSNS). Multivariate regression analysis was performed.

RESULTS: In n = 410 participants with LC from Leipzig, Germany (mean age = 47.12, SD = 12.24), we found that living with others was associated with fewer depressive symptoms compared to living alone (B = -2.18, p = .011). A larger social network was associated with fewer anxiety symptoms in adults with LC symptoms (IRR = 0.99, p = .008).

CONCLUSION: Social factors, such as social network and living situation, are associated with mental health factors like depressive and anxiety symptoms in adults with LC. Further research is required in order to elucidate the complex interplay between social factors and mental health in people with LC in the context of longitudinal studies. Future research directions are discussed.},
}

@article {pmid41603315,
year = {2026},
author = {Petry Moecke, DM and Kwong, EH and Cressman, S and Yao, J and Singh, C and Taylor, C and Camp, PG},
title = {Rehabilitation needs of long COVID patients in British Columbia.},
journal = {PM & R : the journal of injury, function, and rehabilitation},
volume = {},
number = {},
pages = {},
doi = {10.1002/pmrj.70092},
pmid = {41603315},
issn = {1934-1563},
support = {//Ministry of Health, British Columbia/ ; //British Columbia Lung Foundation/ ; //UBC Post-COVID Interdisciplinary Clinical Care Network with St. Paul's Foundation/ ; },
abstract = {INTRODUCTION: COVID-19 can result in persistent symptoms and functional impairment that significantly impact daily functioning, highlighting the need for targeted rehabilitation. However, there is a lack of data on what proportion of long COVID patients need rehabilitation and which types are required.

OBJECTIVE: To estimate the rehabilitation needs of patients with long COVID.

DESIGN: Retrospective, cross-sectional analysis of clinical data.

SETTING: Post-COVID recovery clinic in British Columbia, Canada.

PARTICIPANTS: Individuals with long COVID, defined as having symptoms persisting beyond 3 months post infection, with the first clinic visit occurring within 6 months post infection.

INTERVENTION: Not applicable.

MAIN OUTCOME MEASURES: We created thresholds based on objective tests and patient-reported outcomes to determine rehabilitation needs.

RESULTS: Data from 3709 patients who visited the clinic between March 2020 and May 2023 were available for analysis; 33% met the study eligibility criteria (n = 1237). Patients were primarily women (65%) and white (57%), with a mean age of 49 ± 14 years. Two thirds had required hospitalization. The average time from infection to clinic visit was 136 ± 34 days. At 3-6 months post infection, the most common COVID-19 symptoms were fatigue, dyspnea, muscle weakness, and muscle/joint aches. Most patients exceeded the rehabilitation threshold for dyspnea (83%), fatigue (78%), frailty (74%), and posttraumatic stress disorder (58%). Quality of life was impaired for 80%. Neuropsychological symptoms like anxiety (42%) and depression (36%) were also prevalent. Reductions in 6-minute walk distance (≥25%) and sit-to-stand performance (≥50%) occurred in 26% and 55% of patients, respectively. The majority of participants (98%) exceeded at least one test threshold for rehabilitation, and most (85%) were eligible for more than one type. The most required types of rehabilitation were pulmonary rehabilitation (83%), mental health support (78%), and neurorehabilitation (70%).

CONCLUSION: The need for rehabilitation services among individuals experiencing long COVID in British Columbia is substantial. Use of predefined thresholds that incorporate measures of both symptom burden and functional impairment can effectively support the identification of high-need patients and their overall rehabilitation needs. Combined with clinicians' expertise, this approach can facilitate timely, evidence-based referrals to specialized care for those who need it.},
}

@article {pmid41602330,
year = {2025},
author = {Arroyo-Romero, S and Gómez-Sánchez, L and Suárez-Moreno, N and Navarro-Cáceres, A and Domínguez-Martín, A and Lugones-Sánchez, C and González-Sánchez, S and Sánchez-Moreno, A and Rodríguez-Sánchez, E and García-Ortiz, L and Navarro-Matias, E and Gómez-Marcos, MA},
title = {Association between cardiovascular, psychotropic and anti-inflammatory/analgesic drug use and vascular dysfunction in individuals with long COVID. BioICOPER study.},
journal = {Frontiers in cardiovascular medicine},
volume = {12},
number = {},
pages = {1691153},
pmid = {41602330},
issn = {2297-055X},
abstract = {INTRODUCTION: While the deterioration in the general health of patients with long COVID (LC) is well documented, no studies have assessed changes in medication use and their relationships with vascular health. This study aimed to evaluate the increase in the use of various drug classes in LC and its relationship with vascular structure and function.

METHODS: Each participant in the sample of 305 subjects diagnosed with LC completed a questionnaire on medication use, verified in medical records. Pre-pandemic and current drug use were recorded. Arterial stiffness was measured with the VaSera device, which estimates the cardio-ankle vascular index and brachial-ankle pulse wave velocity (ba-PWV); carotid-femoral pulse wave velocity was determined using the Sphygmocor device. Vascular structure was assessed by carotid intima-media thickness (c-IMT), measured with a Sonosite Micromax ultrasound. This analysis focuses exclusively on macrovascular parameters. Statistical analyses were performed with SPSS software.

RESULTS: Use of all classes of medication increased. Patients with a greater rise in drug use after an LC diagnosis showed higher vascular parameters. Greater cardiovascular drug use was positively associated with ba-PWV, an indicator of arterial stiffness (β = 0.301, 95%CI: 0.024-0.577). Increased anti-inflammatory/analgesic drug use was positively associated with c-IMT, a marker of vascular wall thickness (β = 0.012, 95%CI: 0.001-0.023).

CONCLUSIONS: Medication use rose from 2019 to the time of inclusion in the study. The increase in cardiovascular and anti-inflammatory/analgesic drug use was positively associated with ba-PWV and c-IMT, respectively, suggesting a link between greater drug use and impaired vascular health in LC.},
}

@article {pmid41601165,
year = {2026},
author = {Amato, C and Iovino, P and Spinicci, M and Longobucco, Y and Livi, L and Giovannoni, L and Guidotti, C and Pietrini, L and Braschi, F and De Filippis, C and Ermini, L and Gori, L and Zocchi, C and Argirò, A and Bartoloni, A and Olivotto, I and Lavorini, F and Marchionni, N and Fattirolli, F and Rasero, L},
title = {Factors associated with persistent symptoms after COVID-19 infection: a longitudinal study on an Italian cohort of patients discharged from hospital.},
journal = {Infectious diseases (London, England)},
volume = {},
number = {},
pages = {1-12},
doi = {10.1080/23744235.2026.2620811},
pmid = {41601165},
issn = {2374-4243},
abstract = {BACKGROUND: Although the acute phase of the COVID-19 pandemic has subsided, long COVID remains a significant and ongoing public health concern. Persistent symptoms continue to affect a substantial proportion of COVID-19 survivors, increasing healthcare burden.

OBJECTIVE: This study aims to identify the determinants of long-term symptom trajectories following COVID-19 infection.

METHODS: We conducted a prospective cohort study of 1666 adults discharged after hospitalisation for COVID-19 in Tuscany, Italy. The presence of mental confusion, exertional dyspnoea, fatigue, and insomnia was assessed at 1, 3, 6, 9, and 12 months post-discharge. The mean hospital stay was 13.6 (±12) days and 131 patients required intensive care unit admissions. Latent growth curve models were used to examine the baseline prevalence and longitudinal trajectories of each symptom, and to identify demographic and clinical factors associated with symptom persistence.

RESULTS: Fatigue was the most common persistent symptom at baseline, followed by exertional dyspnoea, insomnia, and mental confusion. Female sex was consistently associated with both baseline presence and persistence of all symptoms. Older age was linked to baseline mental confusion and to persistent dyspnoea and fatigue. Markers of greater acute severity (ICU admission, longer hospital stay, higher WHO score) were associated with symptom improvement over time. Pre-existing coronary heart disease and cancer independently predicted persistent dyspnoea and fatigue, whereas hypertension appeared protective.

CONCLUSIONS: Persistent symptoms are common after COVID-19 and vary by sex, age, comorbidities, and acute disease features. Symptoms may persist up to 12 months post-hospitalisation, underscoring the need for long-term follow-up and targeted interventions.},
}

@article {pmid41600912,
year = {2025},
author = {de Melo, BP and da Silva, JAM and Rodrigues, MA and Palmeira, JDF and Saldanha-Araujo, F and Argañaraz, GA and Argañaraz, ER},
title = {Correction: de Melo et al. SARS-CoV-2 Spike Protein and Long COVID-Part 1: Impact of Spike Protein in Pathophysiological Mechanisms of Long COVID Syndrome. Viruses 2025, 17, 617.},
journal = {Viruses},
volume = {18},
number = {1},
pages = {},
doi = {10.3390/v18010002},
pmid = {41600912},
issn = {1999-4915},
abstract = {Error in Funding [...].},
}

@article {pmid41600911,
year = {2025},
author = {de Melo, BP and da Silva, JAM and Rodrigues, MA and Palmeira, JDF and Amato, AA and Argañaraz, GA and Argañaraz, ER},
title = {Correction: de Melo et al. SARS-CoV-2 Spike Protein and Long COVID-Part 2: Understanding the Impact of Spike Protein and Cellular Receptor Interactions on the Pathophysiology of Long COVID Syndrome. Viruses 2025, 17, 619.},
journal = {Viruses},
volume = {18},
number = {1},
pages = {},
doi = {10.3390/v18010003},
pmid = {41600911},
issn = {1999-4915},
abstract = {In the original publication [...].},
}

@article {pmid41599072,
year = {2026},
author = {Dave, RS and Fox, HS},
title = {Synergy of SARS-CoV-2 and HIV-1 Infections in the Human Brain.},
journal = {Pathogens (Basel, Switzerland)},
volume = {15},
number = {1},
pages = {},
doi = {10.3390/pathogens15010089},
pmid = {41599072},
issn = {2076-0817},
mesh = {Humans ; *COVID-19/virology/pathology/complications/epidemiology ; *HIV Infections/virology/pathology/complications ; *SARS-CoV-2 ; *HIV-1 ; *Brain/virology/pathology ; Microglia/virology/pathology ; Coinfection/virology ; Cytokines/metabolism ; },
abstract = {This review explores the interplay between SARS-CoV-2 and HIV-1 infections within the human brain, highlighting the significant neurological implications of these viral infections. SARS-CoV-2 can infect the central nervous system (CNS), with evidence of the virus detected in various brain regions, including the hypothalamus, cerebellum, and olfactory bulb. This infection is linked to microglial activation and neuroinflammation, which can lead to severe neurological outcomes in affected individuals. Autopsy studies revealed microglial changes, including downregulation of the P2RY12 receptor, indicating a shift from homeostatic to inflammatory phenotype. Similar changes in microglia are found in the brains of people with HIV-1 (PWH). In SARS-CoV-2, the correlation between inflammatory cytokines, such as IL-1, IL-6, and MCP-1, found in cerebrospinal fluid and brain tissues, indicates significant neurovascular inflammation. Astrogliosis and microglial nodules were observed, further emphasizing the inflammatory response triggered by the viral infections, again in parallel to those found in the brains of PWH. Epidemiologic data indicate that although SARS-CoV-2 infection rates in PWH mirror those in People without HIV (PWoH) populations, Long-COVID prevalence is markedly higher among PWH. Evidence of overlapping cognitive impairment, mental health burden, and persistent neuroinflammation highlights diagnostic complexity and therapeutic gaps. Despite plausible mechanistic synergy, direct neuropathological confirmation remains scarce, warranting longitudinal, biomarker-driven studies. Understanding these interactions is critical for developing targeted interventions to mitigate CNS injury and improve outcomes.},
}

Humans
*COVID-19/virology/pathology/complications/epidemiology
*HIV Infections/virology/pathology/complications
*SARS-CoV-2
*HIV-1
*Brain/virology/pathology
Microglia/virology/pathology
Coinfection/virology
Cytokines/metabolism

@article {pmid41598609,
year = {2026},
author = {Balan, OV and Malysheva, IE and Tikhonovich, EL and Lysenko, LA},
title = {Dysregulation of MMP-2 and MMP-9 in Post-COVID-19 and IPF: Correlations with Systemic Inflammation and Endothelial Dysfunction.},
journal = {Journal of clinical medicine},
volume = {15},
number = {2},
pages = {},
doi = {10.3390/jcm15020671},
pmid = {41598609},
issn = {2077-0383},
abstract = {Background/Objectives: Post-COVID-19 pulmonary fibrosis (PCPF) and idiopathic pulmonary fibrosis (IPF) exhibit significant clinical and pathophysiological overlap, suggesting convergent molecular pathways driving fibrosis. This prospective longitudinal study investigates the sustained dysregulation of matrix metalloproteinases (MMP)-2 and MMP-9 and its relationship with evolving systemic inflammation and endothelial dysfunction in convalescent COVID-19 patients, with comparative analysis to IPF. Methods: We conducted a prospective observational study of 86 patients at 6 and 12 months post-SARS-CoV-2 infection, stratified by high-resolution CT evidence of PCPF (FB+ group, n = 32) or absence of fibrosis (FB- group, n = 54). Gene expression of MMP-2 and MMP-9 in peripheral blood leukocytes and circulating levels of MMP-2, MMP-9, pro-inflammatory cytokines (TNF-α, IL-6), and endothelial dysfunction markers (Endothelin-1 [ET-1], adhesion molecules) were quantified via qRT-PCR and ELISA. A pre-pandemic healthy control group (HD, n = 20) and an IPF patient group (n = 10) served as comparators. Results: A significant, sustained elevation of MMP-2 and MMP-9 was observed in all post-COVID-19 patients versus HDs, most pronounced in the FB+ group and qualitatively similar to IPF. A critical divergence emerged: FB- patients showed resolution of systemic inflammation (reduced TNF-α, IL-6), whereas FB+ patients exhibited persistent cytokine elevation. Critically, a delayed, severe endothelial dysfunction, characterized by a profound surge in ET-1 and elevated adhesion molecules, manifested exclusively in the FB+ cohort at 12 months. Positive correlations linked plasma MMP-2/9 levels with ET-1 (rs = 0.65, p = 0.004; rs = 0.49, p = 0.009) and ET-1 with sICAM-1 (rs = 0.68, p = 0.01). Conclusions: The development of PCPF is associated with a distinct pathogenic triad: sustained MMP dysregulation, failure to resolve inflammation, and severe late-phase endothelial dysfunction. The correlative links between these components suggest a self-reinforcing loop. This systemic signature mirrors patterns in IPF, underscoring shared final pathways in fibrotic lung disease and identifying the MMP-inflammation-endothelial axis as a promising target for biomarker development and therapeutic intervention.},
}

@article {pmid41598473,
year = {2026},
author = {Goicoechea-Calvo, A and Navarro Expósito, N and Coll-Fernández, R and Colomer Giralt, M and Martín Saavedra, A and González-Aumatell, A and Méndez-Hernández, M and Carreras-Abad, C and Moreira, M and Giralt-López, M and Pallarès, N and Tebe Cordomi, C and Rodríguez-Palmero, A and Rodrigo, C and Mata, MJD},
title = {Impact of Pulmonary Rehabilitation on Physical, Mental Health and Quality of Life in Children with Post-COVID-19 Condition: A 12-Month Quasi-Experimental Study.},
journal = {Journal of clinical medicine},
volume = {15},
number = {2},
pages = {},
doi = {10.3390/jcm15020535},
pmid = {41598473},
issn = {2077-0383},
abstract = {Background/Objectives: Evidence on pulmonary rehabilitation (PR) in paediatric post-COVID-19 condition (PPCC) is scarce. This study aimed to evaluate the association of a PR programme with changes in physical and mental health and quality of life in PPCC over a 12-month follow-up. Methods: A quasi-experimental pre-post single-arm study was conducted, with no control group, in PPCC patients attending an outpatient PR unit. The primary outcome was change in exercise capacity (6 min walk test, 6MWT). Secondary outcomes included inspiratory and peripheral muscle strength, quadriceps muscle morphology by ultrasound, fatigue, physical activity, quality of life, and psychiatric symptoms, assessed using validated paediatric instruments. Results: A total of 115 PPCC patients (mean age 13.3 years; 66.1% female) completed the PR. 6MWD distance increased from 509 ± 87 to 546 ± 86 (+37 m; p < 0.001; D: 0.50). Handgrip strength increased by 2.4 kg, maximal inspiratory pressure increased by 15 cmH2O, physical activity increased by 2.4 points, fatigue score improved by 9.3 points, and quality of life improved by 11 points (all p < 0.001). Rectus femoris thickness increased by 0.56 mm (p = 0.005), psychiatric symptom scores decreased by 4.5 points (p < 0.001), and rectus femoris echo-intensity decreased (p = 0.003). Conclusions: Multidisciplinary PR appears feasible and potentially effective in improving physical function, psychological well-being, and quality of life in PPCC, supporting the need for evidence-based paediatric rehabilitation.},
}

@article {pmid41597495,
year = {2026},
author = {Jiménez-Antona, C and Moreta-Fuentes, R and Varillas-Delgado, D and Moreta-Fuentes, C and Laguarta-Val, S},
title = {From Exhaustion to Empowerment: A Pilot Study on Motor Control-Based Exercise for Fatigue and Quality of Life in Long COVID-19 Patients.},
journal = {Medicina (Kaunas, Lithuania)},
volume = {62},
number = {1},
pages = {},
doi = {10.3390/medicina62010210},
pmid = {41597495},
issn = {1648-9144},
mesh = {Humans ; Female ; Pilot Projects ; *Quality of Life/psychology ; *COVID-19/complications/psychology/rehabilitation ; *Fatigue/therapy/etiology/rehabilitation ; Middle Aged ; *Exercise Therapy/methods ; Adult ; SARS-CoV-2 ; Aged ; },
abstract = {Background and Objectives: Long COVID-19 (LC) is a multifaceted condition characterized by persistent fatigue and impaired health-related quality of life (HRQoL). Exercise intolerance and post-exertional symptom exacerbation (PESE) pose challenges for rehabilitation. This study aimed to evaluate the effects of a 12-week core-focused plank exercise program on fatigue and HRQoL in women with LC, using validated patient-reported measures. Materials and Methods: A pilot quasi-experimental design was implemented, with non-randomized group allocation. Thirty-nine women with LC were recruited from the Madrid Long COVID Association. Participants were assigned to either an intervention group (n = 20), which completed a supervised plank-based motor control program, or a control group (n = 19), which maintained usual activity. Fatigue was assessed using the Modified Fatigue Impact Scale (MFIS), and HRQoL was measured using the EQ-5D-5L and EQ Visual Analog Scale (EQ-VAS). Body composition was evaluated via bioelectrical impedance analysis. Results: The intervention group showed significant reductions after intervention in the MFIS total scores compared to the control group, particularly in the physical (21.26 ± 6.76 vs. 25.21 ± 6.06; p < 0.001) and psychosocial domains (4.51 ± 0.41 vs. 5.21 ± 0.38; p < 0.001), without triggering PESE. EQ-VAS scores improved significantly (63.94 ± 15.33 vs. 46.31 ± 14.74; p = 0.034). No significant changes were found in body composition parameters, suggesting that benefits were driven by neuromuscular adaptations rather than morphological changes. Conclusions: A core-focused, non-aerobic exercise program effectively reduced fatigue and improved perceived health status in women with LC. These findings support the use of motor control-based interventions as a safe and feasible strategy for LC rehabilitation, particularly in populations vulnerable to PESE, suggesting clinical applicability for the rehabilitation of women with LC. Further randomized trials are warranted to confirm these results and explore long-term outcomes.},
}

Humans
Female
Pilot Projects
*Quality of Life/psychology
*COVID-19/complications/psychology/rehabilitation
*Fatigue/therapy/etiology/rehabilitation
Middle Aged
*Exercise Therapy/methods
Adult
SARS-CoV-2
Aged

@article {pmid41597249,
year = {2026},
author = {Stigliano, E and Tocci, A and Florio, R and Arena, V and Amadoro, G},
title = {Olfactory Dysfunction and Cognitive Deterioration in Long COVID: Pathomechanisms and Clinical Implications in Development of Alzheimer's Disease.},
journal = {Cells},
volume = {15},
number = {2},
pages = {},
doi = {10.3390/cells15020176},
pmid = {41597249},
issn = {2073-4409},
support = {RF-2021-12374//Italian Ministry of Health/ ; 971925//Alzheimer's Association Research Grant/ ; FOE D.M865/2019//Fondo Ordinario Enti/ ; },
mesh = {Humans ; *COVID-19/complications/pathology ; *Alzheimer Disease/etiology/pathology ; *Olfaction Disorders/etiology ; SARS-CoV-2 ; *Cognitive Dysfunction/etiology ; Anosmia ; },
abstract = {Complete or partial loss of smell (anosmia), sometimes in association with distorted olfactory perceptions (parosmia), is a common neurological symptom affecting nearly 60% of patients suffering from post-acute neurological sequelae of COronaVIrus Disease of 2019 (COVID-19) syndrome, called long COVID. Severe Acute Respiratory Syndrome CoronaVirus 2 (SARS-CoV-2) may gain access from the nasal cavity to the brain (neurotropism), and the olfactory route has been proposed as a peripheral site of virus entry. COVID-19 is a risk factor for developing Alzheimer's Disease (AD), an age-dependent and progressive neurodegenerative disorder characterized in affected patients by early olfaction dysfunction that precedes signs of cognitive decline associated with neurodegeneration in vulnerable brain regions of their limbic system. Here, we summarize the recent literature data supporting the causal correlation between the persistent olfactory deterioration following SARS-CoV-2 infection and the long-delayed manifestation of AD-like memory impairment. SARS-CoV-2 infection of the olfactory neuroepithelium is likely to trigger a pattern of detrimental events that, directly and/or indirectly, affect the anatomically interconnected hippocampal and cortical areas, thus resulting in tardive clinical dementia. We also delineate future advancement on pharmacological and rehabilitative treatments to improve the olfactory dysfunction in patients recovering even from the acute/mild phase of COVID-19. Collectively, the present review aims at highlighting the physiopathological nexus between COVID-19 anosmia and post-pandemic mental health to favor the development of best-targeted and more effective therapeutic strategies in the fight against the long-term neurological complications associated with SARS-CoV-2 infection.},
}

Humans
*COVID-19/complications/pathology
*Alzheimer Disease/etiology/pathology
*Olfaction Disorders/etiology
SARS-CoV-2
*Cognitive Dysfunction/etiology
Anosmia

@article {pmid41596479,
year = {2026},
author = {Otsuka, Y and Soejima, Y and Nakano, Y and Suyama, A and Takase, R and Oguni, K and Masuda, Y and Omura, D and Sakurada, Y and Matsuda, Y and Hasegawa, T and Honda, H and Tokumasu, K and Ueda, K and Otsuka, F},
title = {Possible Involvement of Hypothalamic Dysfunction in Long COVID Patients Characterized by Delayed Response to Gonadotropin-Releasing Hormone.},
journal = {International journal of molecular sciences},
volume = {27},
number = {2},
pages = {},
doi = {10.3390/ijms27020832},
pmid = {41596479},
issn = {1422-0067},
support = {2025//Ofuji Endocrine Medical Award/ ; 2025//Growth Science Foundation/ ; 2025//Kobayashi-Magobei Foundation/ ; },
mesh = {Humans ; Female ; *COVID-19/complications/metabolism/physiopathology ; Adult ; *Gonadotropin-Releasing Hormone/metabolism ; Retrospective Studies ; Male ; Middle Aged ; Hydrocortisone/blood ; *Hypothalamic Diseases/metabolism ; *Hypothalamus/metabolism/physiopathology ; Hypothalamo-Hypophyseal System/metabolism/physiopathology ; Thyrotropin-Releasing Hormone/metabolism ; Adrenocorticotropic Hormone/blood ; SARS-CoV-2 ; Corticotropin-Releasing Hormone/metabolism ; },
abstract = {Long COVID (LC) may involve endocrine dysfunction; however, the underlying mechanism remains unclear. To examine hypothalamic-pituitary responses in patients with LC, we conducted a single-center retrospective study of patients with refractory LC referred to our University Hospital who underwent anterior pituitary stimulation tests. Between February 2021 and November 2025, 1251 patients with long COVID were evaluated, of whom 207 (19%) had relatively low random ACTH or cortisol levels. Ultimately, 16 underwent anterior pituitary stimulation tests and were included. All tests were performed in an inpatient setting without exogenous steroids. Fifteen patients (six women, mean age 35.6 years) underwent corticotropin-releasing hormone (CRH), thyrotropin-releasing hormone (TRH), and gonadotropin-releasing hormone (GnRH) tests. All patients had mild acute COVID-19, eight had ≥2 vaccinations, and the mean interval from infection was 343 days. Frequent symptoms included fatigue (100%), insomnia (66.7%), headache (60.0%), anorexia/nausea (40.0%), and brain fog (40.0%). Mean early-morning cortisol and 24 h urinary free cortisol were 7.5 μg/dL and 41.0 μg/day, respectively. MRI showed an empty sella in one case. Peak hormonal responses were preserved (ΔACTH 247%, ΔTSH 918%, ΔPRL 820%, ΔFSH 187%, ΔLH 1150%); however, peaks were delayed beyond 60 min in ACTH (13%), LH (33%), and FSH (87%). Notably, significantly delayed elevations remained at 120 min in the responses of TSH (4.1-fold), PRL (1.8-fold), LH (9.3-fold), and FSH (2.8-fold), suggesting possible hypothalamic involvement, particularly in the gonadotropin responses. Additionally, serum IGF-I was lowered (-0.70 SD), while GH response (mean peak 35.5 ng/mL) was preserved by growth hormone-releasing peptide (GHRP)-2 stimulation. Low-dose hydrocortisone and testosterone were initiated for three patients. Although direct viral effects and secondary suppression have been proposed, our findings may suggest that, at least in part, the observed response characteristics are consistent with functional secondary hypothalamic dysfunction rather than irreversible primary injury. These findings highlight the need for objective endocrine evaluation before initiating hormone replacements.},
}

Humans
Female
*COVID-19/complications/metabolism/physiopathology
Adult
*Gonadotropin-Releasing Hormone/metabolism
Retrospective Studies
Male
Middle Aged
Hydrocortisone/blood
*Hypothalamic Diseases/metabolism
*Hypothalamus/metabolism/physiopathology
Hypothalamo-Hypophyseal System/metabolism/physiopathology
Thyrotropin-Releasing Hormone/metabolism
Adrenocorticotropic Hormone/blood
SARS-CoV-2
Corticotropin-Releasing Hormone/metabolism

@article {pmid41595923,
year = {2026},
author = {Bartholmae, M and Gunawardena, T},
title = {Comparison of Mental Illness Comorbidity Pre-Pandemic vs. Pandemic-Era and Associations with Clinical and Demographic Characteristics for Virginia Public Hospital Inpatient Discharges with a Substance Use Disorder.},
journal = {International journal of environmental research and public health},
volume = {23},
number = {1},
pages = {},
doi = {10.3390/ijerph23010129},
pmid = {41595923},
issn = {1660-4601},
support = {Not available - I moved to a different institution and no longer have access to funds//Hampton Roads Community Foundation/ ; },
mesh = {Humans ; *COVID-19/epidemiology/psychology ; Male ; Female ; *Mental Disorders/epidemiology ; Middle Aged ; Adult ; Hospitals, Public/statistics & numerical data ; Comorbidity ; Retrospective Studies ; Cross-Sectional Studies ; Virginia/epidemiology ; *Substance-Related Disorders/epidemiology ; Adolescent ; Young Adult ; Aged ; Patient Discharge/statistics & numerical data ; SARS-CoV-2 ; Inpatients/statistics & numerical data ; Pandemics ; },
abstract = {The rise in mental illnesses after the COVID-19 pandemic is well documented. However, it is not known whether the rates of mental illness comorbidity increased. The objectives of this study were to compare mental illness comorbidity rates before and after the pandemic among inpatients with SUD and to test associations between mental illness comorbidity, physical illness, and demographics. We used a retrospective cross-sectional design in a sample of inpatient discharges (N = 233,017) at Virginia public hospitals from January 2018 to December 2022. We used Z tests to compare rates of mental illness comorbidity pre- and post-pandemic and Chi-square tests to examine associations of mental illness comorbidity with physical illness and demographics. Single and comorbid mental illness significantly increased from pre- to post-pandemic, p < 0.0001. Mental illness comorbidity was significantly associated with sex, age, race, insurance, COVID-19/Long COVID, HIV/AIDS, COPD, hypertension, obesity, CVD, cancer, and diabetes (p < 0.0001). There was a significant increase in mental illness comorbidity, which was significantly associated with age, race, sex, and physical illnesses. Children/adolescents, females, American Indians, and individuals with HIV/AIDS had the highest rates of mental illness comorbidity. Public health action is needed to address the increase in complex medical needs among people with SUD.},
}

Humans
*COVID-19/epidemiology/psychology
Male
Female
*Mental Disorders/epidemiology
Middle Aged
Adult
Hospitals, Public/statistics & numerical data
Comorbidity
Retrospective Studies
Cross-Sectional Studies
Virginia/epidemiology
*Substance-Related Disorders/epidemiology
Adolescent
Young Adult
Aged
Patient Discharge/statistics & numerical data
SARS-CoV-2
Inpatients/statistics & numerical data
Pandemics

@article {pmid41595843,
year = {2025},
author = {Dhaouadi, S and Bouguerra, H and Hechaichi, A and Letaief, H and Safer, M and Aichouch, C and Zouayti, A and Bougatef, M and Neffati, A and El Mili, N and Mhadhbi, R and Bouafif Ép Ben Alaya, N},
title = {Long-Term Health Effects of COVID-19 in Tunisia, 2020-2021.},
journal = {International journal of environmental research and public health},
volume = {23},
number = {1},
pages = {},
doi = {10.3390/ijerph23010049},
pmid = {41595843},
issn = {1660-4601},
mesh = {Humans ; Tunisia/epidemiology ; *COVID-19/epidemiology/complications ; Female ; Male ; Adult ; Middle Aged ; Cross-Sectional Studies ; Aged ; Prevalence ; Young Adult ; Adolescent ; SARS-CoV-2 ; Child ; Aged, 80 and over ; Post-Acute COVID-19 Syndrome ; },
abstract = {Background: Some patients suffer from persistent symptoms following a COVID-19 infection, referred to as long COVID. The aims of the study were to estimate the prevalence of long COVID and study its determinants in Tunisia. Methods: We conducted a nationwide cross-sectional study among a representative sample of COVID-19 survivors residing in Tunisia between June and August 2022. We selected a random sample, stratified by age and region, among residents registered in the national surveillance database with a SARS-CoV-2 positive test taken from September 2020 to September 2021 (n = 479,743). The expected sample size was 384. We defined a patient with long COVID as having at least one self-reported symptom persisting for more than four weeks after the first confirmation of SARS-CoV-2 infection (RT-PCR or Ag-RDT) and not explained by an alternative diagnosis. Trained healthcare workers interviewed consenting respondents by phone using a structured questionnaire. We described continuous variables using median and interquartile range (IQR). We measured the prevalence of long COVID and its 95% confidence interval (95% CI). We estimated the association between explanatory variables (socio-demographic, lifestyle and comorbidities, SARS-CoV-2 history infection, COVID-19 vaccination status) and long COVID using a log-binomial model, reporting adjusted prevalence ratios (a-PR) and its 95% CI. Results: Of 1094 persons contacted, 416 were enrolled (response rate: 38%). Long-COVID prevalence was 64% (267/416); 95% CI [59-69%]. The sex ratio (M:F) was 0.72. Age ranged from 1 to 101 years, with a median of 41 years (IQR:31-55 years). The most common symptoms were fatigue (63%), myalgia/arthralgia (33%), and cognitive symptoms (52%). Median duration of long-COVID symptoms was 11 months (IQR: 3-14 months). In multivariate analysis, experiencing acute COVID-19 (a-PR = 1.5; 95% CI [1.0-2.1]), being a woman of childbearing age (a-PR = 1.2; 95% CI [1.0-1.4]) and residing in the central region (a-PR = 1.5; 95% CI [1.1-2.0]) were significantly associated with a higher prevalence of long COVID. Conclusions: Long COVID is prevalent in Tunisia affecting patients with multiple symptoms initially, those residing in the central region and young women. We recommend to enhance healthcare access and medical follow-up both during and after the infection, focusing on identified risk groups. We also recommend to conduct further research to optimize management of long-COVID patients.},
}

Humans
Tunisia/epidemiology
*COVID-19/epidemiology/complications
Female
Male
Adult
Middle Aged
Cross-Sectional Studies
Aged
Prevalence
Young Adult
Adolescent
SARS-CoV-2
Child
Aged, 80 and over
Post-Acute COVID-19 Syndrome

@article {pmid41595726,
year = {2026},
author = {Arroyo-Romero, S and Gomez-Sanchez, L and Suarez-Moreno, N and Navarro-Caceres, A and Dominguez-Martin, A and Lugones-Sanchez, C and Gonzalez-Sanchez, S and Gomez-Sanchez, M and Rodriguez-Sanchez, E and Garcia-Ortiz, L and Navarro-Matias, E and Gomez-Marcos, MA},
title = {Clinical Manifestations of Subjects with Long COVID and Their Associations with Drug Use: The BioICOPER Study.},
journal = {Biomedicines},
volume = {14},
number = {1},
pages = {},
doi = {10.3390/biomedicines14010192},
pmid = {41595726},
issn = {2227-9059},
support = {PI21/00454//Instituto de Salud Carlos III/ ; RD21/0016/0010//Network for Research on Chronicity, Primary Care, and Health Promotion/ ; GRS 2501/B/22//Junta de Castilla y León/ ; CB22/06/00035//Centro de Investigación Biomédica en Red/ ; },
abstract = {Background/Objectives: Long COVID (LC) is associated with more than 200 symptoms. This study aimed to evaluate the correlation between symptoms clusters and pharmacological treatment in patients with LC and to explore differences by sex. Methods: We conducted a cross-sectional descriptive study including 304 participants diagnosed with LC according to the World Health Organization criteria. Symptoms during the acute phase, at the time of diagnosis of LC, and those persisting across both phases were collected by anamnesis. Symptoms were grouped into six clusters: systemic, neurocognitive, respiratory/cardiovascular, musculoskeletal, neurological/neuromuscular, and psychological/psychiatric. Drug use was assessed through a questionnaire verified by the medical records, including the consumption of cardiovascular drugs, antidepressants/anxiolytics, and anti-inflammatory/analgesics. Results: Patients reported a mean of 5.23 ± 1.10 symptoms in the acute phase, 4.20 ± 1.70 at LC diagnosis, and 3.83 ± 1.80 persisting across both phases. The most consumed pharmacological group was cardiovascular drugs (43.3%), followed by antidepressants/anxiolytics (34.8%). Psychotropic drugs and anti-inflammatory/analgesic drugs showed a positive association with all symptomatic groups (p < 0.05). Cardiovascular drugs showed a positive association with cardiorespiratory (β = 0.19, p < 0.05), neuromuscular (β = 0.11, p < 0.05), and psychological (β = 0.14, p < 0.05) symptoms. Conclusions: Psychotropic and anti-inflammatory/analgesic drugs were positively associated with all symptom clusters, while cardiovascular drugs were associated only with cardiorespiratory, neuromuscular, and psychological symptoms, highlighting the relevance of better characterization of treatment patterns in this population.},
}

@article {pmid41595678,
year = {2026},
author = {Daodu, LP and Raste, Y and Allgrove, JE and Arrigoni, FIF and Kayyali, R},
title = {A Retrospective Observational Study of Pulmonary Impairments in Long COVID Patients.},
journal = {Biomedicines},
volume = {14},
number = {1},
pages = {},
doi = {10.3390/biomedicines14010145},
pmid = {41595678},
issn = {2227-9059},
support = {KU-RCP10656/"Long COVID -Croydon//Croydon Health Services NHS Trust/ ; },
abstract = {Background/Objective: Pulmonary impairments have been identified as some of the most complex and debilitating post-acute sequelae of SARS-CoV-2 infection (PASC) or long COVID. This study identified and characterised the specific forms of pulmonary impairments detected using pulmonary function tests (PFT), chest X-rays (CXR), and computed tomography (CT) scans in patients with long COVID symptoms. Methods: We conducted a single-centre retrospective study to evaluate 60 patients with long COVID who underwent PFT, CXR, and CT scans. Pulmonary function in long COVID patients was assessed using defined thresholds for key test parameters, enabling categorisation into normal, restrictive, obstructive, and mixed lung-function patterns. We applied exact binomial (Clopper-Pearson) 95% confidence intervals to calculate the proportions of patients falling below the defined thresholds. We also assessed the relationships among spirometric indices, lung volumes, and diffusion capacity (DLCO) using scatter plots and corresponding linear regressions. The findings from the CXRs and CT scans were categorised, and their prevalence was calculated. Results: A total of 60 patients with long COVID symptoms (mean age 60 ± 13 years; 57% female) were evaluated. The cohort was ethnically diverse and predominantly non-smokers, with a mean BMI of 32.4 ± 6.3 kg/m[2]. PFT revealed that most patients had preserved spirometry, with mean Forced Expiratory Volume in 1 Second (FEV1) and Forced Vital Capacity (FVC) above 90% predicted. However, a significant proportion exhibited reductions in lung volumes, with total lung capacity (TLC) decreasing in 35%, and diffusion capacity (DLCO/TLCO) decreasing in 75%. Lung function pattern analysis showed 88% of patients had normal function, while 12% displayed a restrictive pattern; no obstructive or mixed patterns were observed. Radiographic assessment revealed that 58% of chest X-rays were normal, whereas CT scans showed ground-glass opacities (GGO) in 65% of patients and fibrotic changes in 55%, along with findings such as atelectasis, air trapping, and bronchial wall thickening. Conclusions: Spirometry alone is insufficient to detect impairment of gas exchange or underlying histopathological changes in patients with long COVID. Our findings show that, despite normal spirometry results, many patients exhibit significant diffusion impairment, fibrotic alterations, and ground-glass opacities, indicating persistent lung and microvascular damage. These results underscore the importance of comprehensive assessment using multiple diagnostic tools to identify and manage chronic pulmonary dysfunction in long COVID.},
}

@article {pmid41594661,
year = {2026},
author = {Förster, CY and Shityakov, S},
title = {A Possible Role for the Vagus Nerve in Physical and Mental Health.},
journal = {Biomolecules},
volume = {16},
number = {1},
pages = {},
doi = {10.3390/biom16010121},
pmid = {41594661},
issn = {2218-273X},
support = {Fo-315/5-1//Deutsche Forschungsgemeinschaft/ ; },
mesh = {Humans ; *Vagus Nerve/physiology/physiopathology ; *Vagus Nerve Stimulation/methods ; *Mental Health ; COVID-19/therapy ; Animals ; SARS-CoV-2 ; Depression/therapy ; },
abstract = {For decades, researchers have explored the therapeutic potential of the vagus nerve through vagus nerve stimulation (VNS). Initially developed for epilepsy, VNS has since been applied to treat resistant depression, stroke recovery, and inflammatory conditions. Transcutaneous VNS (tVNS) now offers a noninvasive alternative, fueling clinical trials in disorders ranging from rheumatoid arthritis and migraines to long COVID-19. Mechanistic studies suggest that afferent and efferent vagal fibers modulate immune responses, mood regulation, and neurotransmitter systems. The SPARC initiative has accelerated mapping of vagal circuits, enabling more precise approaches to stimulation. Despite progress, the results remain mixed: while some patients experience lasting symptom relief, others respond no better than to placebo. Depression studies, in particular, highlight both the promise and the complexity of VNS, as inflammation, motivation circuits, and gut-brain signaling emerge as key modulators. Next-generation closed-loop devices and circuit-specific targeting may improve efficacy and reduce adverse effects. VNS research thus lies at the intersection of neuromodulation, psychiatry, and immunology-offering hope for hard-to-treat conditions, yet demanding rigorous trials to separate myths from medicine. In this article, we review the current clinical and experimental applications of tVNS, analyze its mixed efficacy across psychiatric, immunological, and neurological disorders, and highlight the mechanistic insights, stimulation parameters, and emerging technologies that may shape next-generation therapies.},
}

Humans
*Vagus Nerve/physiology/physiopathology
*Vagus Nerve Stimulation/methods
*Mental Health
COVID-19/therapy
Animals
SARS-CoV-2
Depression/therapy

@article {pmid41593681,
year = {2026},
author = {Feliz, J and Gonçalves, J and Cabedo, C and Brito, J and Gamas, M and Neves, MI and Soares, H},
title = {Long-term sex differences in symptoms and immune profile in long COVID.},
journal = {Biology of sex differences},
volume = {},
number = {},
pages = {},
doi = {10.1186/s13293-026-00825-9},
pmid = {41593681},
issn = {2042-6410},
support = {Grant Agreement No. GA 101159729//European Union's Horizon Europe research and innovation action through the projects MPS_NOVA/ ; Agreement No. GA 101079264//EVCA Grant/ ; LA/P/0087/2020//Research Unit UID/04462: iNOVA4Health and by Associated Laboratory LS4FUTURE/ ; },
abstract = {BACKGROUND: Long COVID (LC) is a post-infectious condition affecting millions worldwide, characterized by persistent multisystem symptoms. Females are disproportionately affected, reporting higher symptom burden, particularly neurocognitive and neurosensory complaints. While short-term immunopathology has been described, the long-term clinical course, immune dysregulation, and sex-specific underpinnings remain poorly understood.

METHODS: We analyzed 34 participants experiencing persisting symptoms from 9 months to 5 years post-SARS-CoV-2 infection, alongside 26 SARS-CoV-2-infected controls without symptoms. Clinical assessments, symptom inventories, comorbidity analysis, and work capacity evaluation were performed. Immune profiling included flow cytometry of CD4⁺ and CD8⁺ T cells, NK cells, and B cells, as well as quantification of plasma cytokines, soluble factors, and cytotoxic molecules, analyzed in a sex-disaggregated manner.

RESULTS: Females with LC exhibited higher symptom burden, particularly persistent fatigue, neurocognitive and neurosensory complaints, which increased with age and tended to increase with disease duration, whereas males showed no clear age- or duration-related patterns. Comorbidities, especially affecting endocrine, metabolic, and circulatory systems, were more frequent in females and aligned with symptom severity. Immune profiling revealed subtle but sex-specific differences: females had reduced CD8⁺ T cell cytotoxic profile, lower NKG2D and granzyme K expression, increased sCD40L and sFAS, and decreased perforin, whereas males displayed elevated TNF-α. NK cell function, B cells, and humoral immunity remained largely intact. Over half of participants reported functional impairments affecting work capacity.

CONCLUSIONS: Even though our cohort is small it suggests that prolonged LC is characterized by sex-specific differences in symptom burden and immune profiles. Reduced cytotoxic CD8⁺ T cell profile in females may contribute to viral persistence and neurological symptoms, whereas elevated inflammatory markers in males suggest distinct immune pathways. These findings highlight the need for sex- and duration-specific management strategies, the identification of biomarkers, and the development of personalized therapies targeting specific LC endotypes.},
}

@article {pmid41592666,
year = {2026},
author = {Ngiam, JN and Wee, LE and Lim, JT and Loy, EX and Koh, MCY and Tay, AT and Lou, HX and Kim, P and Chiew, CJ and Young, BE and Vasoo, S and Lye, DCB and Tan, KB},
title = {Early administration of neutralising monoclonal antibodies and post-acute sequelae of COVID-19.},
journal = {International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases},
volume = {},
number = {},
pages = {108435},
doi = {10.1016/j.ijid.2026.108435},
pmid = {41592666},
issn = {1878-3511},
abstract = {OBJECTIVES: Post-acute sequelae of COVID-19 (PASC) are more common in unvaccinated or immunocompromised individuals. In Singapore, neutralising monoclonal antibodies (mAbs) were offered early in the disease course to such high-risk patients. We evaluated the impact of early mAb use on the risk of post-acute multi-system complications and symptoms.

METHODS: Using national COVID-19 registries and healthcare claims data, we conducted a retrospective cohort study including all Singaporeans who were unvaccinated, partially vaccinated, or immunocompromised at the time of SARS-CoV-2 infection between July 2021 and December 2022. Individuals were stratified by receipt of mAbs. Overlap weighting was applied to balance baseline characteristics. Competing risks regression was used to compare outcomes from 31 to 300 days post-infection, adjusted for demographics, vaccination status, and comorbidities.

RESULTS: Of 19,689 eligible hospitalised individuals, 6.9% received early mAb therapy. While mAb treatment had no significant impact on overall post-acute sequelae (aHR for any sequelae:1.26[0.98-1.63]), we observed an increased risk of autoimmune diseases (aHR=2.20[1.22-3.97]), particularly systemic lupus erythematosus and rheumatoid arthritis). There was also elevated risk of deep venous thrombosis (aHR=1.83[1.03-3.22]), but this was no longer significant after adjusting for prior healthcare utilisation.

CONCLUSIONS: Early mAb therapy did not significantly alter overall PASC risk but was associated with increased autoimmune complications. These findings may highlight the need for long-term safety monitoring in future mAb trials for SARS-CoV-2.},
}

@article {pmid41591677,
year = {2026},
author = {Zheng, M},
title = {Large-Scale Disease-Wide Association Study Identified Predisposition Links Between Influenza and Cardiovascular Diseases.},
journal = {Cardiovascular toxicology},
volume = {26},
number = {2},
pages = {20},
pmid = {41591677},
issn = {1559-0259},
support = {32100739//National Natural Science Foundation of China/ ; },
mesh = {Humans ; *Influenza, Human/epidemiology/diagnosis ; *Cardiovascular Diseases/epidemiology/diagnosis ; Female ; Male ; Middle Aged ; Comorbidity ; Risk Assessment ; Aged ; Adult ; Time Factors ; Risk Factors ; },
abstract = {BACKGROUND: Influenza remains a major global health threat and, akin to "long COVID," has been linked to prolonged multi-organ comorbidities ("long flu"). Cardiovascular diseases (CVDs) are increasingly recognized in the pathogenesis of influenza, yet most prior work emphasizes acute or short-term outcomes and rarely contrasts multiple endpoints over extended horizons.

METHODS: This study conducted a disease-wide association study (DWAS), assembling individuals with clinically coded influenza without pneumonia (n = 5136) and population comparators (n = 314,673). Using age- and sex-adjusted Cox models, this analysis screened 106 comorbid endpoints classified by ICD-10/ICD-O-3 and FinnGen disease taxonomy. Associations were evaluated bidirectionally-before influenza (predisposition) and after influenza (subsequent risk)-within prespecified 1-, 5-, and 15-year time windows.

RESULTS: Influenza showed broad associations spanning circulatory, nervous, endocrine-metabolic, respiratory, musculoskeletal, and other organ systems. CVD endpoints demonstrated the most persistent and directionally consistent DWAS signals. In pre-influenza analyses, greater baseline cardiovascular burden-including heart failure, coronary atherosclerosis, hypertension, major coronary heart disease, atrial fibrillation/flutter, myocardial infarction, stroke, pulmonary embolism, and venous thromboembolism-was associated with higher susceptibility to subsequent influenza. In post-influenza analyses, elevated risks remained for key CVD outcomes-atrial fibrillation/flutter, heart failure, myocardial infarction, and stroke. Non-cardiovascular endpoints (e.g., migraine, sleep apnoea, spinal stenosis, osteoporosis, chronic obstructive pulmonary disease, diabetic nephropathy, and chronic kidney disease) also showed bidirectional associations with influenza, thereby situating CVD within a broader comorbidity and frailty context of influenza.

CONCLUSIONS: In this population-scale DWAS, CVDs emerged as the most significant comorbidities of influenza. Conceptualizing influenza as a "cardiovascular stress test" supports targeted prevention (e.g., vaccination prioritization) and intensified cardiovascular risk management around influenza seasons. While the biological mechanism remains unclear, this study will motivate future studies integrating biomarkers, cardiovascular imaging, and virologic-immunologic profiling to disentangle causal mechanisms.},
}

Humans
*Influenza, Human/epidemiology/diagnosis
*Cardiovascular Diseases/epidemiology/diagnosis
Female
Male
Middle Aged
Comorbidity
Risk Assessment
Aged
Adult
Time Factors
Risk Factors

@article {pmid41590531,
year = {2026},
author = {Rodrigues, CNDS and Angelotto, FR and Diotto, VL and Cristofoletti, DDM and Araújo, TOP and de Lima, MA and Neto, JC and Prestes, J and Navalta, J and Pereira, GB},
title = {Long COVID Does Not Impair Hemodynamic, Vascular, or Autonomic Responses to Maximal Exercise: Sex-Stratified Study in Young Adults.},
journal = {Journal of personalized medicine},
volume = {16},
number = {1},
pages = {},
doi = {10.3390/jpm16010038},
pmid = {41590531},
issn = {2075-4426},
support = {23112.031858/2024-30//Pós-Graduação em Fisiologia Clínica do Exercício do Departamento de Ciências Fisiológicas da Universidade Federal de São Carlos/ ; },
abstract = {Background/Objectives: Long COVID (LC) has been linked to fatigue, exercise intolerance, and autonomic dysfunction, but sex-stratified data on cardiovascular responses to maximal exercise-an essential component of personalized medicine-are scarce. This study aimed to examine hemodynamic, autonomic, and functional responses during and up to 24 h after a cardiopulmonary exercise test (CPET) in young adults with and without Long COVID (LC). Methods: In this cross-sectional study, we assessed 38 physically active adults, who were allocated into four subgroups stratified by clinical condition (LC or control) and biological sex: control-female (CON-F; n = 10), LC-female (LC-F; n = 10), control-male (CON-M; n = 10), and LC-male (LC-M; n = 8). Outcomes included systolic (SBP) and diastolic blood pressure (DBP), heart rate (HR), cardiac output (CO), total (TPR) and peripheral vascular resistance (PVR), pulse wave velocity (PWV), augmentation index (AIx@75), and heart rate variability (HF, LF, LF/HF), assessed at rest, peak effort, recovery (1, 3, 5, 10, 30, and 60 min), and through 24 h ambulatory blood pressure monitoring (ABPM) after CPET. Results: SBP increase appropriately during exercise, with higher peaks in males (p < 0.01), and returned to baseline within 5 min across all groups. HR recovery was preserved; however, LC-F showed lower values than CON-F at 3, 5, and 10 min (126 vs. 144 bpm, p = 0.020; 119 vs. 136 bpm, p = 0.020; 94 vs. 109 bpm, p = 0.011), though all groups normalized by 60 min. PWV, AIx@75, TPR and PVR exhibited expected sex-related patterns without LC-related impairments. HRV indices showed transient post-exercise shifts (HF↓, LF↑, LF/HF↑). Ambulatory monitoring confirmed preserved circadian modulation, with normal systolic dipping (11-13%) and no abnormal nocturnal patterns. Conclusions: Young physically active adults with LC showed preserved hemodynamic, autonomic, and vascular responses during and after maximal exercise. These findings contribute to personalized medicine by showing that individualized, sex-stratified cardiovascular assessments reveal no clinically relevant impairments in this population, supporting tailored clinical decision making and exercise prescription.},
}

@article {pmid41590528,
year = {2026},
author = {Selvi, FR and Longhino, D and Lucca, G and Baglivo, I and Zavarella, MA and Laface, C and Bruno, L and Gamberale, S and Fabbroni, L and Rizzi, A and Aruanno, A and Buonagura, R and Curci, M and Buonomo, A and Viola, M and Ianiro, G and Landi, F and Tosato, M and Gasbarrini, A and Caruso, C},
title = {Investigation of Biomarkers in Allergic Patients with Long COVID.},
journal = {Journal of personalized medicine},
volume = {16},
number = {1},
pages = {},
doi = {10.3390/jpm16010031},
pmid = {41590528},
issn = {2075-4426},
abstract = {Background: Long COVID remains a challenging and heterogeneous condition, with mechanisms that are still incompletely understood. Emerging evidence suggests that patients with allergic disease may experience more persistent post-COVID symptoms, possibly due to immune dysregulation and epithelial barrier fragility. Methods: We carried out an observational, single-center study at the Allergy and Clinical Immunology Unit of Policlinico Universitario A. Gemelli IRCCS (Rome, Italy). Seventeen adults with confirmed allergic disease and long COVID were evaluated between July and December 2024. Biomarkers reflecting allergic inflammation and barrier integrity, blood eosinophil count, total immunoglobulin E (IgE), eosinophil cationic protein (ECP), and serum free light chains (FLCs), were measured and analyzed for interrelationships and symptom correlations. Results: Participants (10 men, 7 women; mean age 43.7 years) showed variable biomarker profiles, consistent with the heterogeneity of allergic inflammation. Mean eosinophil count was 179 ± 72 cells/µL, total IgE 165.4 ± 140.6 kU/L, ECP 64.2 ± 48.5 ng/mL, and the kappa/lambda FLC ratio 1.20 ± 0.69. Notably, elevated kappa FLC levels (>19.4 mg/L) were significantly associated with high ECP (>20 ng/mL) (χ[2] = 10.6, p = 0.001) and increased IgE (>200 kU/L) (χ[2] = 6.0, p = 0.015). Individuals with higher ECP and FLCs more often reported respiratory and systemic symptoms, especially fatigue, dyspnea, and cognitive fog, that persisted beyond six months. Conclusions: These findings suggest that biomarkers of allergic inflammation and barrier dysfunction, particularly ECP and FLCs, may contribute to the persistence of long-COVID symptoms in allergic patients. The observed links between humoral activation, eosinophilic activity, and prolonged symptom burden support a model of sustained inflammation and delayed epithelial recovery. Larger, longitudinal studies including non-allergic controls are warranted to confirm these associations and to explore whether restoring barrier integrity could shorten recovery trajectories in this vulnerable population.},
}

@article {pmid41589860,
year = {2026},
author = {Al-Delaimy, WK and Bruno, W and Shadyab, A and Saquib N, N and Goveas, JS},
title = {Psychological symptoms predict long coronavirus disease 2019: a prospective analysis from the Women's Health Initiative.},
journal = {Menopause (New York, N.Y.)},
volume = {},
number = {},
pages = {},
pmid = {41589860},
issn = {1530-0374},
abstract = {OBJECTIVE: Those with mental illnesses are likely at higher risk of developing coronavirus disease 2019 (COVID-19), and elderly are disproportionately impacted and as a result suffer more from long COVID. The aim of this analysis was to determine the associations of preexisting depressive and anxiety symptoms with developing COVID-19 positivity, long COVID-19, and compliance with the use of protective measures against contracting COVID-19.

METHODS: A subsample (n = 18,820) of the Women's Health Initiative study cohort completed longitudinal questionnaires on depressive and anxiety symptoms between 1993 and 2021 and reported on COVID-19 testing and compliance-related questions in 2020 and 2021. Logistic regression analyses were used to prospectively determine associations of a history of mental health symptoms with COVID-related outcomes.

RESULTS: Reported history of depressive and anxiety symptoms was not associated with COVID-19 positivity. However, higher anxiety scores were associated with higher odds of long COVID (OR = 1.05 [95% CI: 1.03-1.07]). Women with both depressive and anxiety symptoms versus neither symptom had 78% higher odds of long COVID (OR = 1.78 [95% CI: 1.13-2.81 P = 0.001]). The odds of compliance with COVID-19 mitigation measures was significantly lower among women with previous long-term depressive symptoms (OR = 0.67 [95% CI: 0.55-0.82]), with both long-term depressive and anxiety symptoms (OR = 0.75 (95% CI: 0.61-0.93) P < 0.0001), and with higher long-term perceived stress score (OR = 0.94 [95% CI: 0.92-0.97]). However, a higher short-term anxiety score during early COVID was weakly associated with the higher odds of compliance of prevention mitigation measures (OR = 1.03 [95% CI: 1.02-1.03]).

CONCLUSIONS: Older women with past mental health symptoms may be at higher risk of developing long COVID and having lower compliance with COVID prevention measures.},
}

@article {pmid41588020,
year = {2026},
author = {Abbasi, A and Hansen, N and Palade, J and Paredes, D and Meechoovet, B and Van Keuren-Jensen, K and Pirrotte, P and Stringer, WW},
title = {Serum extracellular vesicle RNA profiles in long COVID: insights from exercise-induced gene modulation.},
journal = {Scientific reports},
volume = {16},
number = {1},
pages = {3469},
pmid = {41588020},
issn = {2045-2322},
mesh = {Humans ; *Extracellular Vesicles/genetics/metabolism ; *COVID-19/genetics/blood/virology ; Male ; Female ; Middle Aged ; *Exercise/physiology ; SARS-CoV-2/genetics ; Adult ; Pilot Projects ; Gene Expression Regulation ; },
abstract = {The Persistence of SARS-CoV-2 in tissues has been proposed as a driver of prolonged symptoms in long COVID. Pulmonary rehabilitation with exercise training is a well-established intervention for improving symptoms, functional capacity, and inflammation in chronic cardiorespiratory diseases. To investigate whether long COVID is associated with persistent viral or immune-related signals, we analyzed the long RNA profile of circulating extracellular vesicles (EVs) to determine the presence of virus-related transcripts and assess changes in response to exercise training. Fourteen adults with long COVID participated in this single-center pilot clinical trial and completed a 10-week aerobic exercise training program (twenty 1.5 h sessions). Serum-derived EV RNA profiles were analyzed via sequencing at rest (T0) and peak cardiopulmonary exercise testing (T1), before (V2) and after (V24) exercise training. Differentially expressed genes (DEGs) were identified (q < 0.05), and pathway activation analysis was performed. Serum EVs carried diverse RNA species, including protein-coding RNAs, long non-coding RNAs, short non-coding RNAs, and pseudogenes, with no virus-related RNAs detected. No significant DEGs were identified at rest between pre- and post-training, nor in response to acute exercise at pre-training. However, following training, 53 DEGs were found at peak exercise (V24T1) compared to rest (V24T0), including three upregulated genes (ANK3, FTO, FCN1) and 50 downregulated genes (TOP 5: MYL9, NRGN, H2AC6, MAP3K7CL, B2M). These genes were primarily involved in inflammation and metabolism. Pathway analysis revealed significant regulation of 100 pathways at post-training compared to pre training, predominantly inactivated, including pathways involved in inflammation (STAT3 signaling) and metabolism (O-linked glycosylation). Acute exercise and exercise training modulated EV-associated gene expression in long COVID, primarily through transcriptional downregulation. Suppression of inflammation- and immune-related genes post-training highlights potential molecular mechanisms underlying symptom improvement and identifies candidate biomarkers of recovery biology in long COVID. Importantly, while exercise training did not substantially alter EV RNA content at rest, it enhanced the body's ability to mount a dynamic EV-mediated molecular response during exertion, reflecting improved physiological adaptability.Clinical trial registration number: NCT05398692.},
}

Humans
*Extracellular Vesicles/genetics/metabolism
*COVID-19/genetics/blood/virology
Male
Female
Middle Aged
*Exercise/physiology
SARS-CoV-2/genetics
Adult
Pilot Projects
Gene Expression Regulation

@article {pmid41586458,
year = {2026},
author = {Horton, M and Smith, AB and Milne, R and Winch, D and Rayner, C and Halpin, S and O'Connor, R and Rocha Lawrence, R and Greenwood, DC and Bakerly, ND and Evans, R and Kwon, J and Dawes, H and Wood, C and Williams, P and Master, H and Mansoubi, M and De Kock, JH and Mullard, J and Ormerod, M and Mir, G and Petrou, S and O'Connor, DB and Sivan, M and , },
title = {Large-Scale Psychometric Assessment and Validation of the Modified COVID-19 Yorkshire Rehabilitation Scale Patient-Reported Outcome Measure for Long COVID or Post-COVID Syndrome.},
journal = {Journal of medical virology},
volume = {98},
number = {2},
pages = {e70816},
doi = {10.1002/jmv.70816},
pmid = {41586458},
issn = {1096-9071},
support = {COV-LT2-0016//National Institute for Health and Care Research award/ ; },
mesh = {Humans ; Female ; Male ; *Psychometrics/methods ; *COVID-19/rehabilitation/psychology ; Middle Aged ; *Patient Reported Outcome Measures ; Adult ; Reproducibility of Results ; Aged ; SARS-CoV-2 ; Severity of Illness Index ; Surveys and Questionnaires ; },
abstract = {The C19-YRS was the first condition-specific for long COVID/post-COVID syndrome. Although the original C19-YRS evolved to the modified version (C19-YRSm) based on psychometric evidence, clinical content relevance, as well as feedback from patients and healthcare professionals, it has not been validated through Rasch analysis. The study aim was to psychometrically assess and validate the C19-YRSm using newly collected data from a large-scale, multicenter study (LOCOMOTION). In total, 1278 patients (67% Female; mean age = 48.6, SD 12.7) digitally completed the C19-YRSm. The psychometric properties of the C19-YRSm Symptom Severity (SS) and Functional Disability (FD) subscales were assessed using a Rasch Measurement Theory framework, assessing for individual item model fit, targeting, internal consistency reliability, unidimensionality, local dependency (LD), response category functioning and differential item functioning (DIF) by age group, sex and ethnicity. Rasch analysis revealed robust psychometric properties of both subscales, with each demonstrating unidimensionality, appropriate response category structuring, no floor or ceiling effects, and minimal LD and DIF. Both subscales also displayed good targeting and reliability (SS: Person Separation Index (PSI) = 0.81, Cronbach's α = 0.82; FD: PSI = 0.76, Cronbach's α = 0.81). Although some minor anomalies are apparent, the modifications to the original C19-YRS have strengthened its measurement characteristics and its clinical and conceptual relevance. Trial Registration: NCT05057260, ISRCTN15022307.},
}

Humans
Female
Male
*Psychometrics/methods
*COVID-19/rehabilitation/psychology
Middle Aged
*Patient Reported Outcome Measures
Adult
Reproducibility of Results
Aged
SARS-CoV-2
Severity of Illness Index
Surveys and Questionnaires

@article {pmid41585473,
year = {2026},
author = {Zhang, J and Chen, Y and Zhang, A and Yang, Y and Ma, L and Yu, K and Zhang, W and Ye, X and Zhang, J and Lin, K and Lin, X},
title = {Interpretable machine learning for predicting low-dose methylprednisolone effectiveness in long COVID.},
journal = {iScience},
volume = {29},
number = {2},
pages = {114574},
pmid = {41585473},
issn = {2589-0042},
abstract = {Long COVID is a chronic, multisystem disease with limited response to conventional treatments. While low-dose methylprednisolone has shown effectiveness in some patients, individual responses vary, and accurate predictive tools are lacking. This retrospective study included 330 long COVID patients who received low-dose methylprednisolone treatment across three hospitals. Patients were divided into training (n = 202), test (n = 33), and external validation sets (n = 53, n = 42). Using least absolute shrinkage and selection operator (LASSO) regression, 38 variables were analyzed to develop six machine learning models. The logistic regression (LR) model showed stable performance across all datasets (AUCs: 0.8715, 0.7198, 0.8419, and 0.8676), making it the final model selected. SHapley Additive exPlanations (SHAP) analysis identified seven key variables, which were used to construct a nomogram for predicting treatment efficacy. The LR model and nomogram demonstrated strong predictive performance and clinical interpretability, offering a valuable decision-support tool for individualized treatment of long COVID with low-dose methylprednisolone.},
}

@article {pmid41584202,
year = {2025},
author = {Wen, J and Yuan, L and Zhang, L and Li, L and Chen, J and Zhang, Z and Yan, Y},
title = {Distribution of acute symptoms and long COVID-19 and their association with anxiety and depression 2 years after infection.},
journal = {Frontiers in public health},
volume = {13},
number = {},
pages = {1687444},
pmid = {41584202},
issn = {2296-2565},
mesh = {Humans ; *COVID-19/psychology/epidemiology/complications ; Male ; *Anxiety/epidemiology ; Female ; Retrospective Studies ; Adult ; *Depression/epidemiology ; Cross-Sectional Studies ; Middle Aged ; *Health Personnel/psychology/statistics & numerical data ; Surveys and Questionnaires ; SARS-CoV-2 ; Prevalence ; },
abstract = {BACKGROUND: With the continuing impact of the COVID-19 outbreak, the mental health of infected patients is becoming a widespread concern. However, the relationship between acute-phase symptoms and long COVID-19 symptoms with anxiety and depression 2 years post-infection among healthcare workers remains unclear.

OBJECTIVE: The aim of this study was to investigate the relationship between acute phase symptoms and long COVID-19 symptoms of novel COVID-19 infection and anxiety and depression 2 years after infection.

METHODS: Using a retrospective cohort study and cross-sectional design, this study collected data on acute-phase symptoms, long COVID-19 symptoms, and their levels of anxiety and depression from 1,038 COVID-19 patients by questionnaire. We explored their relationship through logistic regression. We also used RCS curves to explore the nonlinear relationship between acute phase symptoms and long COVID-19 symptoms and anxiety and depression 2 years after infection.

RESULTS: The aim of this study was to investigate the prevalence of common symptoms of long COVID-19 in a sample of medical staff with COVID-19 infection. The study also aimed to explore the relationship between long COVID-19 symptoms and mental health status. The results showed that among patients who tested positive for COVID-19 by December 2022, approximately 34.0% exhibited overall long COVID-19 symptoms 2 years after infection. Decreased concentration and memory were the most common long COVID-19 symptoms, accounting for 12.5% of all COVID-19 patients. In this study, we also explored the relationship between acute-phase symptoms or long COVID-19 symptoms and anxiety and depression 2 years after infection. The findings showed that both acute phase symptoms as well as long COVID-19 symptoms were significantly associated with levels of anxiety and depression 2 years after infection. We also found a nonlinear relationship between the number of long COVID-19 symptoms and anxiety and depression.

CONCLUSION: In summary, the positive correlation between the acute phase of COVID-19 infection and the impact of long COVID-19 symptoms on mental health suggests that focusing on the mental health of patients recovering from the epidemic is critical. Effective psychological interventions should be part of the comprehensive treatment of long COVID-19 to help patients improve their mental health while recovering physically.},
}

Humans
*COVID-19/psychology/epidemiology/complications
Male
*Anxiety/epidemiology
Female
Retrospective Studies
Adult
*Depression/epidemiology
Cross-Sectional Studies
Middle Aged
*Health Personnel/psychology/statistics & numerical data
Surveys and Questionnaires
SARS-CoV-2
Prevalence

@article {pmid41582616,
year = {2026},
author = {Tmava, A and Burstein, EM},
title = {A call for a critical medical anthropology of the COVID-19 pandemic.},
journal = {Anthropology & medicine},
volume = {},
number = {},
pages = {1-7},
doi = {10.1080/13648470.2025.2604010},
pmid = {41582616},
issn = {1469-2910},
abstract = {This paper is a call for a renewed critical medical anthropology (CMA) of the COVID-19 pandemic, one that attends not only to the pandemic's acute phase but also to its enduring afterlife. We argue that COVID-19 persists as a structuring condition that continues to impact individual experiences as well as domestic and global politics and culture. We introduce the concept of 'narrative compression' to describe how public and institutional discourses have foreclosed space for the ongoing suffering of individuals with long COVID and others marginalized by pandemic legacies. By tracing how closure is epistemically and politically produced, this paper reframes COVID-19 as an ambient and persistent crisis. We advocate for an anthropological approach that remains with the pandemic to diagnose its transformations and imagine more accountable health futures.},
}

@article {pmid41583965,
year = {2023},
author = {Lee, H and Seo, Y and Kim, J and Song, HY and Park, J and Yang, Y},
title = {The impact of Long COVID, work stress related to infectious diseases, fatigue, and coping on burnout among care providers in nursing home: A cross-sectional correlation study.},
journal = {Journal of Korean gerontological nursing},
volume = {25},
number = {3},
pages = {271-283},
pmid = {41583965},
issn = {2383-8086},
abstract = {PURPOSE: An increasing number of nursing home are being established because of the increased demand for treatment and care of older adults with chronic diseases related to population aging. This study aimed to examine the impact of long COVID, infectious diseases-related to work stress, fatigue, and coping on burnout among care providers in nursing home during the persistent COVID-19 pandemic.

METHODS: A total of 168 care providers, including nurses, nursing assistants, and caregivers working in nursing home between July 22 and August 12, 2022 were polled by a questionnaire survey. The collected data were analyzed using an independent t-test, one-way analysis of variance, Scheffé test, Pearson correlation coefficient, and multiple regression analyses via SPSS 21.0.

RESULTS: The prevalence of Long COVID-19 among care providers in nursing home was 85.7%, with a mean burnout score of 2.59 out of 5. Work stress related to infectious diseases (β=.27, p=.002) and infection control fatigue (e.g., fatigue related to complexity of nursing duties and shortage in employees [β=.51, p=.019], conflicts caused by uncertain situations and a lack of support [β=.50, p=.012]) were the variables that significantly associated with burnout.

CONCLUSION: It is crucial to actively explore strategies for reducing overall work stress, anxiety, and fatigue, particularly related to infection management to alleviate burnout among care providers in nursing home. Our findings provide fundamental data for the development of interventions and policies to prevent care providers' burnout, thus enabling the provision of high-quality care in nursing home.},
}

@article {pmid41581925,
year = {2026},
author = {Keat, SBK and Khatri, P and Ali, YM and Arachchilage, CH and Demopulos, G and Baillie, K and Miners, KL and Ladell, K and Jones, SA and Davies, HE and Price, DA and Zelek, WM and Morgan, BP and Schwaeble, WJ and Lynch, NJ},
title = {Activation of the Lectin Pathway Drives Persistent Complement Dysregulation in Long COVID.},
journal = {Immunology},
volume = {},
number = {},
pages = {},
doi = {10.1111/imm.70110},
pmid = {41581925},
issn = {1365-2567},
support = {//UK Dementia Research Institute/ ; COV0170//National Institute for Health and Care Research/ ; COV-LT2-0041//National Institute for Health and Care Research/ ; //Omeros Corporation/ ; Balvi B43//PolyBio Research Foundation/ ; 520488//Race against Dementia Alzheimer's Research/ ; },
abstract = {Long COVID affects a substantial proportion of survivors of acute infection with severe acute respiratory syndrome-associated coronavirus-2 (SARS-CoV-2), who suffer a variety of symptoms that limit their quality of life and economic activity. Although the aetiology of long COVID is obscure, it appears to be a chronic inflammatory condition. Complement dysregulation is a prevalent feature of long COVID. Specifically, markers of classical, alternative, and terminal pathway activation are often elevated in patients with this condition. Here, we used a sensitive assay for mannan-binding lectin-associated serine protease-2 (MASP-2)/C1Inh complexes to analyse lectin pathway activation in a previously characterised cohort of patients with long COVID (n = 159) and healthy convalescent individuals with no persistent symptoms after infection with SARS-CoV-2 (n = 76). The data were combined with those from the most predictive complement analytes identified previously to delineate potential biomarkers of long COVID. MASP-2/C1Inh complexes were significantly elevated in patients with long COVID (p = 0.0003). Generalised linear modelling further identified an optimal set of four markers, namely iC3b (alternative pathway), TCC (terminal pathway), MASP-2/C1Inh (lectin pathway), and the complement regulator properdin, which had a receiver operating characteristic predictive power of 0.796 (95% confidence interval = 0.664-0.905). Combinations of the classical pathway markers C4, C1q, and C1s/C1Inh were poorly predictive of long COVID. These findings demonstrate that activation of the lectin complement pathway, which occurs upstream of the alternative and terminal pathways and can be inhibited therapeutically, is a salient feature of long COVID.},
}

@article {pmid41581648,
year = {2026},
author = {Shen, Y and Shahn, Z and Robertson, MM and Gebo, K and Nash, D and , },
title = {Natural History of Self-reported Symptoms Following SARS-CoV-2 Infection: A Target Trial Emulation in a Prospective Community-recruited Cohort.},
journal = {International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases},
volume = {},
number = {},
pages = {108422},
doi = {10.1016/j.ijid.2026.108422},
pmid = {41581648},
issn = {1878-3511},
abstract = {BACKGROUND: Using a prospective, community-recruited cohort with data on background symptom prevalence and repeated longitudinal symptom assessments, we estimated post-infection risks of long COVID symptoms compared with contemporaneous uninfected controls.

METHODS: We analyzed the CHASING COVID Cohort, a U.S. longitudinal study with surveys and serology (March 2020-December 2023). Infection status (January 2021-December 2022) was determined from self-reported PCR/antigen results, serology, or CSTE probable criteria. We emulated 24 monthly target trials comparing individuals newly infected at time zero with those remaining uninfected. Outcomes were new-onset long-COVID symptoms not reported pre-infection, assessed overall and within three clusters (neurological, autonomic, exercise intolerance) at 4-8 and 9-12 months post-infection. Inverse probability of treatment and censoring weights adjusted for confounding and informative loss to follow-up.

RESULTS: The analysis included 1,055 infected and 52,310 uninfected person-trials. At 4-8 months, the adjusted risk of any long-COVID symptom was 22.6% (95% CI, 20.5-24.8) among infected versus 11.3% (11.1-11.5) among uninfected (adjusted risk difference [aRD], 11.3% [9.2-13.5]; adjusted risk ratio [aRR], 2.01 [1.81-2.20]). At 9-12 months, risks were 19.2% (17.0-21.3) vs 12.4% (12.2-12.7) (aRD, 6.7% [4.6-8.9]; aRR, 1.54 [1.37-1.72]). Across all three clusters, infected participants had consistently higher risks at both intervals.

CONCLUSIONS: SARS-CoV-2 infection was associated with elevated risk of new-onset long-COVID symptoms persisting up to 12 months. Using a national community-recruited cohort, contemporaneous uninfected controls, and target-trial emulation clarifies the burden attributable to infection and supports ongoing surveillance and targeted prevention and care.},
}

@article {pmid41580734,
year = {2026},
author = {Fang, H and Wang, Q},
title = {The silent epidemic within the pandemic: pathophysiology and prediction of post-COVID-19 diabetes.},
journal = {Journal of translational medicine},
volume = {},
number = {},
pages = {},
doi = {10.1186/s12967-026-07717-x},
pmid = {41580734},
issn = {1479-5876},
}

@article {pmid41580699,
year = {2026},
author = {Mou, K and Gao, Y and Zhang, Y and Man, S and Chen, Q and Xu, H and Chen, Y and Zhang, M},
title = {Long-term retinal dysfunction following COVID-19 infection: a one-year prospective observational study.},
journal = {BMC ophthalmology},
volume = {},
number = {},
pages = {},
doi = {10.1186/s12886-025-04575-x},
pmid = {41580699},
issn = {1471-2415},
support = {2023HXFH043//1·3·5 project for disciplines of excellence-Clinical Research Fund, West China Hospital, Sichuan University/ ; },
}

@article {pmid41580590,
year = {2026},
author = {Mischke, M and Zaehle, T},
title = {Modulating subjective and objective cognitive state fatigue in long COVID with repetitive anodal tDCS: results from a double-blinded randomized controlled trial.},
journal = {BMC neuroscience},
volume = {},
number = {},
pages = {},
doi = {10.1186/s12868-025-00989-x},
pmid = {41580590},
issn = {1471-2202},
abstract = {BACKGROUND: Cognitive fatigue is a frequently reported and debilitating symptom of long COVID, yet effective therapeutic interventions remain limited. Anodal transcranial direct current stimulation (tDCS) over the dorsolateral prefrontal cortex (dlPFC) has been proposed as a promising approach to modulate fatigue-related neural networks. To comprehensively assess cognitive fatigue, the integration of subjective and objective behavioral and electrophysiological measures of induced state fatigue is essential.

METHODS: This double-blind, randomized, sham-controlled study investigated the effects of four consecutive daily sessions of 30-minute anodal tDCS over the left dlPFC on subjective and objective markers of cognitive state fatigue in individuals with long COVID. The present paper focuses on secondary outcomes, including subjective state fatigue ratings via visual analogue scales, behavioral performance indices, and electrophysiological markers such as temporal alterations of frontal theta and occipital alpha activity as well as p50 sensory gating.

RESULTS: Forty participants received either verum or sham tDCS while completing a gamified adaptive Go/No-Go task. Before and after the stimulation period, cognitive state fatigue was reliably induced using the AX-Continuous Performance Task (AX-CPT). Although tDCS did not significantly affect subjective state-fatigue ratings or behavioral performance, our findings indicate that verum stimulation may stabilize fatigue-related changes in occipital alpha power. No immediate stimulation-related improvements were found in the Go/No-Go task.

CONCLUSIONS: These findings indicate that while tDCS may modulate neurophysiological correlates of cognitive state fatigue, its impact on subjective experience and behavioral performance remain limited under the current protocol. These results, however, underscore the importance of including neurophysiological endpoints in intervention research and highlight the need for developing more robust and individualized stimulation protocols. Future studies should consider extended stimulation regimens, alternative task paradigms, and more sensitive behavioral measures to further elucidate the neuromodulatory potential of tDCS in long COVID-related cognitive fatigue.

TRIAL REGISTRATION: drks.de Identifier: DRKS00031294, date of registration: 17.02.2023.},
}

@article {pmid41578033,
year = {2026},
author = {Aid, M and Boero-Teyssier, V and McMahan, K and Dang, R and Doyle, M and Belabbaci, N and Borducchi, E and Collier, AY and Mullington, J and Barouch, DH},
title = {Author Correction: Long COVID involves activation of proinflammatory and immune exhaustion pathways.},
journal = {Nature immunology},
volume = {},
number = {},
pages = {},
doi = {10.1038/s41590-026-02438-1},
pmid = {41578033},
issn = {1529-2916},
}

@article {pmid41577420,
year = {2026},
author = {Schuster, AM and Alwan, NA and Callard, F and Chen, EYH and Gilbody, S and Graham, BM and Hatch, SL and Jones, E and Jordan, A and Knapp, M and López-Jaramillo, C and Nakimuli-Mpungu, E and Pathare, S and Ressler, KJ and Wessely, S and White, LA and , and Jones, PB},
title = {The implications of the COVID-19 pandemic for clinical mental health care.},
journal = {The lancet. Psychiatry},
volume = {13},
number = {2},
pages = {140-161},
doi = {10.1016/S2215-0366(25)00247-0},
pmid = {41577420},
issn = {2215-0374},
mesh = {Humans ; *COVID-19/psychology/epidemiology ; *Mental Health Services/organization & administration ; *Mental Disorders/therapy/epidemiology ; Pandemics ; SARS-CoV-2 ; Mental Health ; },
abstract = {A Position Paper published in The Lancet Psychiatry in 2020 suggested an agenda for research about the effects of the COVID-19 pandemic on mental health, following which an interdisciplinary Lancet Psychiatry standing commission was established in 2022 to examine the emerging evidence and refine recommendations for more research. In this first Series paper from the standing commission, we focus on changes in the delivery of clinical mental health care during the COVID-19 pandemic. The second paper in the Series focuses on public mental health and policy perspectives, and the third will address neuropsychiatric consequences of infection by SARS-CoV-2. Evidence from high-quality longitudinal studies with pre-pandemic baseline data, controlled intervention trials, or systematic reviews took time to accrue. During the early months of the COVID-19 pandemic, symptoms of anxiety and depression became more prevalent, and many mental health services were compromised by pandemic-related factors; however, whether the COVID-19 pandemic accelerated pre-existing long-term trends of increasing incidence of mental health disorders, especially in children and adolescents, is unclear. Little research has been done in low-income and middle-income countries, or regarding post-COVID-19 condition (also known as long COVID), which emerged as a multisystem condition with mental health implications. Vulnerable populations, including socioeconomically disadvantaged and minoritised groups, faced disproportionate mental health impacts and limited access to care during the COVID-19 pandemic, reflecting systemic, pre-pandemic inequalities. Bold implementation of existing evidence-based mental health support for vulnerable communities, ambitious trials of novel interventions, and systematic pooling of rapidly accumulating evidence about best healh care should be priorities in future pandemics.},
}

Humans
*COVID-19/psychology/epidemiology
*Mental Health Services/organization & administration
*Mental Disorders/therapy/epidemiology
Pandemics
SARS-CoV-2
Mental Health

@article {pmid41576003,
year = {2026},
author = {Novak, P and Systrom, DM and Witte, A and Marciano, SP and Felsenstein, D and Milunsky, JM and Milunsky, A and Krier, J and Fishman, MC},
title = {Shared autonomic phenotype of long COVID and myalgic encephalomyelitis/chronic fatigue syndrome.},
journal = {PloS one},
volume = {21},
number = {1},
pages = {e0341278},
doi = {10.1371/journal.pone.0341278},
pmid = {41576003},
issn = {1932-6203},
mesh = {Humans ; *Fatigue Syndrome, Chronic/physiopathology ; Female ; *COVID-19/physiopathology/complications ; Male ; Middle Aged ; Adult ; Retrospective Studies ; *Autonomic Nervous System/physiopathology ; Phenotype ; SARS-CoV-2 ; },
abstract = {INTRODUCTION: Long COVID and myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) are relatively common and disabling multisystem disorders that share overlapping features, including post-infectious onset and similar clinical manifestations such as brain fog, fatigue, muscle pain, and dysautonomia with orthostatic intolerance. These similarities suggest that Long COVID and ME/CFS may share common pathophysiological mechanisms, though the underlying mechanisms remain poorly understood, partly due to the difficulty in quantifying many of the symptoms.

MATERIALS AND METHODS: This retrospective study evaluated Long COVID and pre-COVID ME/CFS patients who completed autonomic testing between 2018 and 2023 at the Brigham and Women's Faulkner Hospital Autonomic Laboratory. The evaluations included autonomic tests (Valsalva maneuver, deep breathing, tilt-table test, and sudomotor function) with capnography and transcranial Doppler monitoring of cerebral blood flow velocity (CBFv) in the middle cerebral artery, neuropathic assessment through skin biopsies for small fiber neuropathy (SFN), invasive cardiopulmonary exercise testing (ICPET), and laboratory analyses covering metabolic, inflammatory, autoimmune, and hormonal profiles.

RESULTS: A total of 143 Long COVID and 170 ME/CFS patients were analyzed and compared to 73 healthy controls and 290 patients with hypermobile Ehlers-Danlos syndrome (hEDS). Tests revealed extensive similarities between Long COVID and ME/CFS, including reduced orthostatic CBFv (92%/88% in Long COVID/ME/CFS), mild-to-moderate widespread autonomic failure (95%/89%), presence of SFN (67%/53%), postural tachycardia syndrome (POTS) (22%/19%), neurogenic orthostatic hypotension (15%/15%) and preload failure (96%/92%, assessed in 25/66 Long COVID/ME/CFS). Patients with hEDS exhibited more severe peripheral neurodegeneration compared to the other groups. Laboratory tests did not distinguish between the conditions.

CONCLUSION: Both Long COVID and ME/CFS demonstrate dysregulation in cerebrovascular blood flow, autonomic reflexes, and small fiber neuropathy, suggesting that these conditions may share a common underlying pathophysiology. However, differing distributions of findings in patients with hEDS raise the question of whether these conditions represent distinct but overlapping syndromes or reflect a shared underlying pathway. Further research is required to clarify the relationship between these conditions and the potential underlying pathophysiological mechanisms.},
}

Humans
*Fatigue Syndrome, Chronic/physiopathology
Female
*COVID-19/physiopathology/complications
Male
Middle Aged
Adult
Retrospective Studies
*Autonomic Nervous System/physiopathology
Phenotype
SARS-CoV-2

@article {pmid41573552,
year = {2025},
author = {Perico, L and Bovio, A and Tomasoni, S and Trionfini, P and Cerullo, D and Corna, D and Pezzotta, A and Locatelli, M and Alberti, M and Benigni, A and Remuzzi, G},
title = {Acetylsalicylic acid disrupts SARS-CoV-2 spike protein glycosylation and selectively impairs binding to ACE2.},
journal = {Frontiers in immunology},
volume = {16},
number = {},
pages = {1706997},
pmid = {41573552},
issn = {1664-3224},
mesh = {*Spike Glycoprotein, Coronavirus/metabolism ; Animals ; *Angiotensin-Converting Enzyme 2/metabolism/genetics ; Glycosylation/drug effects ; *SARS-CoV-2/drug effects/metabolism ; *Aspirin/pharmacology ; Humans ; Vero Cells ; Mice ; Chlorocebus aethiops ; COVID-19/metabolism/virology ; Mice, Transgenic ; Protein Binding/drug effects ; *COVID-19 Drug Treatment ; },
abstract = {Preclinical and clinical evidence suggested the potential benefits of treatment with acetylsalicylic acid (ASA) in mitigating COVID-19 severity. While available studies largely focused on the intracellular pathways through which ASA impairs viral replication or dampens host immunoresponse stimulated by SARS-CoV-2, whether ASA directly affects the interaction between the viral spike protein and its cellular receptor angiotensin converting enzyme 2 (ACE2) remains unexplored. This question is clinically relevant, as circulating spike S1 has been shown to persist in patients with acute and long COVID-19, where its interaction with the broadly expressed ACE2 drives systemic manifestations and tissue damage. Here, we demonstrate that pre-incubation of the SARS-CoV-2 spike subunit 1 (S1) with ASA dose-dependently impaired ACE2 binding on Vero cells. The functional relevance of this finding was confirmed in transgenic mice with human ACE2, in which intratracheal administration of ASA-treated S1 markedly reduced lung injury, fibrosis, and inflammation compared to untreated S1. Glycoproteomic profiling revealed that ASA altered the glycosylation landscape of S1, particularly N-glycosylation at N61 and O-glycosylation at S325. Site-directed mutagenesis of these two residues confirmed the critical role of their glycosylation in S1-ACE2 binding in vitro. Consistently, the glycosylation-insensitive S1 had limited effect in inducing lung injury, fibrosis, and inflammation in transgenic mice compared to WT S1, phenocopying the protective effects of ASA. These findings unveil a previously unrecognized antiviral activity of ASA, providing a molecular rationale for its repurposing as a low-cost, readily available intervention to prevent the progression from mild to severe COVID-19.},
}

*Spike Glycoprotein, Coronavirus/metabolism
Animals
*Angiotensin-Converting Enzyme 2/metabolism/genetics
Glycosylation/drug effects
*SARS-CoV-2/drug effects/metabolism
*Aspirin/pharmacology
Humans
Vero Cells
Mice
Chlorocebus aethiops
COVID-19/metabolism/virology
Mice, Transgenic
Protein Binding/drug effects
*COVID-19 Drug Treatment

@article {pmid41573029,
year = {2025},
author = {Dirwanto, L and Ali, D and Japaries, W and Agussalim, WS},
title = {Effectiveness of Transcutaneous Electrical Acupoint Stimulation in the Treatment of Post-COVID Severe Dyspnea: A Case Report.},
journal = {Medical acupuncture},
volume = {37},
number = {5},
pages = {408-411},
pmid = {41573029},
issn = {1933-6586},
abstract = {INTRODUCTION: Long COVID, or post-COVID syndrome, refers to signs, symptoms, and conditions that persist or emerge following an acute coronavirus disease (COVID-19) infection. The most frequent symptoms are fatigue and dyspnea, with approximately 10-20% of patients recovering from COVID-19. Currently, there are no specific medical recommendations, except for symptomatic treatment.

OBJECTIVE: To evaluate the use of transcutaneous electrical acupoint stimulation (TEAS) for the treatment of post-COVID severe dyspnea.

METHODOLOGY: This is a case report of successful treatment using TEAS in a patient with severe dyspnea after recovery from COVID-19.

RESULTS: A female adult patient experienced progressive dyspnea after recovering from COVID-19 a year prior. One session of TEAS successfully relieved severe dyspnea. No adverse effects or recurrence of dyspnea were reported at the 6-month follow-up.

CONCLUSION: TEAS is a safe, simple, and effective treatment for overcoming post-COVID severe dyspnea.},
}

@article {pmid41570188,
year = {2025},
author = {Ford, ND and Simeone, RM and Pratt, C and Saydah, S},
title = {Functional Limitations and Illness-Related Absenteeism among School-Aged Children with and without Long COVID, United States, 2022-2023.},
journal = {Emerging infectious diseases},
volume = {31},
number = {14},
pages = {11-19},
doi = {10.3201/eid3114.251035},
pmid = {41570188},
issn = {1080-6059},
mesh = {Humans ; Child ; *Absenteeism ; *COVID-19/epidemiology ; Adolescent ; Male ; Female ; United States/epidemiology ; Cross-Sectional Studies ; Child, Preschool ; SARS-CoV-2 ; Schools ; Pandemics ; },
abstract = {We examined functional limitations and illness-related chronic absenteeism (i.e., missing >18 days of school for health reasons) in a cross-sectional nationally representative sample of 11,057 US children 5-17 years of age who ever or never had long COVID (i.e., symptoms lasting >3 months after COVID-19 illness). Among 4,587 children with prior COVID-19, we estimated whether long COVID was associated with increased illness-related chronic absenteeism by using logistic regression. Our analysis showed that ≈1.4% of school-aged children had long COVID at some point. Among children with prior COVID-19, those who had long COVID at some point more frequently reported functional limitations, such as difficulty with memory, than those who did not have long COVID (18.3% vs. 8.6%). Having long COVID was associated with higher odds of illness-related chronic absenteeism. Children who had long COVID could experience functional limitations and absenteeism. School accommodations might be an option to improve functional limitations.},
}

Humans
Child
*Absenteeism
*COVID-19/epidemiology
Adolescent
Male
Female
United States/epidemiology
Cross-Sectional Studies
Child, Preschool
SARS-CoV-2
Schools
Pandemics

@article {pmid41570186,
year = {2025},
author = {Pratt, CQ and Dalton, AF and Koumans, EH and Agedew, A and Coronado, F and Lundeen, EA and Woodruff, RC and Block, JP and Weiner, M and Cowell, L and Arnold, JD and Saydah, S and , },
title = {Thrombotic Events and Stroke in the Year After COVID-19 or Other Acute Respiratory Infection.},
journal = {Emerging infectious diseases},
volume = {31},
number = {14},
pages = {3-10},
doi = {10.3201/eid3114.250630},
pmid = {41570186},
issn = {1080-6059},
mesh = {Humans ; *COVID-19/complications/epidemiology ; *Stroke/epidemiology/etiology ; Male ; *Thrombosis/epidemiology/etiology ; Female ; *Respiratory Tract Infections/complications/epidemiology ; Middle Aged ; Aged ; Incidence ; SARS-CoV-2 ; Adult ; Risk Factors ; Hospitalization ; Aged, 80 and over ; },
abstract = {Previous studies have documented an increased risk for thrombotic events 30 days after COVID-19 infection, but less is known about this risk beyond 30 days or compared with risk after other infectious acute respiratory illnesses (ARIs). By using PCORnet data from April 1, 2022-April 30, 2023, we compared the incidences of thrombotic events in the year after COVID-19 illness with other ARI diagnoses in hospitalized and nonhospitalized patients. Overall, the risk for any thrombotic event was higher among patients with COVID-19 compared with patients with other ARIs (incidence ratio 1.63; p<0.05). Nonhospitalized patients with COVID-19 had a 73% increased risk for a thrombotic event in the year after acute illness compared with nonhospitalized patients with ARI (p<0.05). The increased risk for thrombotic events in the year after COVID-19 emphasizes the need for stroke awareness for patients and healthcare professionals.},
}

Humans
*COVID-19/complications/epidemiology
*Stroke/epidemiology/etiology
Male
*Thrombosis/epidemiology/etiology
Female
*Respiratory Tract Infections/complications/epidemiology
Middle Aged
Aged
Incidence
SARS-CoV-2
Adult
Risk Factors
Hospitalization
Aged, 80 and over

@article {pmid41570177,
year = {2025},
author = {Fiore, AE},
title = {Progress Toward Understanding Infection-Associated Chronic Conditions and Illnesses.},
journal = {Emerging infectious diseases},
volume = {31},
number = {14},
pages = {1-2},
doi = {10.3201/eid3114.251187},
pmid = {41570177},
issn = {1080-6059},
}

@article {pmid41569391,
year = {2026},
author = {Raymond, KF and Hodge, T and St Jean, B and Liu, BF},
title = {Barriers to Long COVID Care in the U.S.: An Application of Levesque et al.'s Access Framework.},
journal = {Health care analysis : HCA : journal of health philosophy and policy},
volume = {},
number = {},
pages = {},
pmid = {41569391},
issn = {1573-3394},
support = {Pandemic Readiness Initiative//University of Maryland/ ; Pandemic Readiness Initiative//University of Maryland/ ; },
abstract = {Long COVID is a condition that arose during the COVID-19 pandemic in individuals who developed the multi-system chronic condition after a COVID-19 infection. During the pandemic in the United States (U.S.), these "COVID long-haulers" navigated a complex and overburdened health care system in pursuit of diagnoses and treatments. This qualitative secondary analysis used the 2013 Levesque et al. Conceptual Model of Healthcare Access to examine multidimensional health care access issues faced by 29 COVID long-haulers in the U.S. Our analysis showed that long-haulers faced complementary issues from both individual and health systems perspectives related to the inability to get diagnoses or treatments, long waiting times for providers and difficulty reaching services, underinformed providers and biased interpersonal experiences, and struggles with the financial costs of treating the condition, which impacted care decisions. Interviewees also described relying on alternative medicine to provide symptom relief. Overall, this study extends international research by offering a comprehensive examination of Long COVID health care access issues in the U.S. and identifying specific insights related to health care access that made obtaining Long COVID care difficult, such as the mismatch between individual expectations of what health care should look like and how it actually operates. Our use of the full Conceptual Model of Healthcare Access provides new insights into the overlap across layers of access issues and offers suggestions for how public health and clinical health practitioners can collaborate to meet the needs of vulnerable populations such as these in future health emergencies.},
}

@article {pmid41568000,
year = {2025},
author = {Camici, M and Franco, M and Talamanca, L and Petino, M and Paulicelli, J and Scarnecchia, L and Ciavarella, L and Orzilli, T and Balducelli, F and Mazzotta, V and Mastrorosa, I and Cimini, E and Tartaglia, E and Notari, S and Maggi, F and Girardi, E and Baldelli, R and Zuppi, P and Antinori, A},
title = {Salivary cortisol in long COVID: a marker of broader stress system and circadian rhythm dysregulation.},
journal = {Frontiers in cellular and infection microbiology},
volume = {15},
number = {},
pages = {1690698},
pmid = {41568000},
issn = {2235-2988},
mesh = {Humans ; *Hydrocortisone/analysis/metabolism ; *Saliva/chemistry ; Female ; *COVID-19/metabolism/physiopathology/complications ; Middle Aged ; Male ; *Circadian Rhythm/physiology ; Prospective Studies ; Case-Control Studies ; Aged ; Hypothalamo-Hypophyseal System/physiopathology ; Pituitary-Adrenal System/physiopathology ; SARS-CoV-2 ; Biomarkers/analysis ; Adult ; Post-Acute COVID-19 Syndrome ; },
abstract = {INTRODUCTION: Long COVID (LC) has been associated with hypothalamic-pituitary-adrenal (HPA) axis dysfunction, although findings from blood cortisol measurements remain inconsistent. We hypothesized that LC patients exhibit a disrupted diurnal cortisol rhythm and that salivary cortisol (SC) profiling may provide a more accurate assessment of HPA activity.

METHODS: This prospective, single-center, case-control study was conducted at a Long COVID clinic in Rome between February 2023 and March 2024 and included 96 participants evaluated at least 28 days after confirmed SARS-CoV-2 infection. LC was defined as one or more new or persistent symptoms and classified as severe when four or more of the following were present: fatigue, cognitive impairment, exercise intolerance, dyspnea, arthralgia, or dysautonomia. SC was measured at 8:00 AM, 3:00 PM, and 11:00 PM.

RESULTS: The cohort (mean age 58.1 ± 14.8 years; 60% female; all White) included 83 LC patients (80% moderate, 20% severe) and 13 asymptomatic post-COVID (APC) individuals. Compared with healthy controls, both LC and APC groups showed reduced morning SC (p<0.01), flattened diurnal variation, and elevated evening SC, indicating loss of the normal morning peak and nocturnal decline. Blood cortisol levels did not differ among groups, but LC patients had higher ACTH than APC (26 pg/mL vs 13 pg/mL; p<0.01), suggesting compensatory HPA activation. One LC patient (1.2%) was diagnosed with adrenal insufficiency.

DISCUSSION: These exploratory findings suggest a disrupted circadian cortisol rhythm in individuals after COVID-19, with altered HPA axis dynamics that may be associated with disease severity.},
}

Humans
*Hydrocortisone/analysis/metabolism
*Saliva/chemistry
Female
*COVID-19/metabolism/physiopathology/complications
Middle Aged
Male
*Circadian Rhythm/physiology
Prospective Studies
Case-Control Studies
Aged
Hypothalamo-Hypophyseal System/physiopathology
Pituitary-Adrenal System/physiopathology
SARS-CoV-2
Biomarkers/analysis
Adult
Post-Acute COVID-19 Syndrome

@article {pmid41566432,
year = {2026},
author = {Gottlieb, M and Yu, H and Chen, J and Spatz, ES and Gentile, NL and Geyer, RE and Santangelo, M and Malicki, C and Gatling, K and O'Laughlin, KN and Stephens, KA and Elmore, JG and Wisk, LE and L'Hommedieu, M and Rodriguez, RM and Montoy, JCC and Wang, RC and Rising, KL and Kean, E and Dyal, JW and Hill, MJ and Venkatesh, AK and Weinstein, RA and , },
title = {Obesity and Long COVID: intersecting epidemics?.},
journal = {BMC public health},
volume = {},
number = {},
pages = {},
doi = {10.1186/s12889-025-26134-1},
pmid = {41566432},
issn = {1471-2458},
support = {75D30120C08008/CC/CDC HHS/United States ; },
}

@article {pmid41566332,
year = {2026},
author = {Penuelas, VL and Pham, K and Frost, S and Harahap-Carrillo, IS and Vargas, A and Bergersen, KV and He, Y and Nair, MG and Kaul, M and Heinrich, EC},
title = {Long-term impacts of COVID-19 on systemic inflammation and control of breathing reflexes: an observational cohort study.},
journal = {Respiratory research},
volume = {},
number = {},
pages = {},
doi = {10.1186/s12931-025-03473-6},
pmid = {41566332},
issn = {1465-993X},
abstract = {BACKGROUND: The COVID-19 pandemic resulted in over 7 million reported deaths and over 700.4 million reported infections to-date. Many individuals who recover from COVID-19 report prolonged dyspnea, sometimes persisting for months. Furthermore, COVID-19 has been linked to systemic and neuronal inflammation which may have downstream impacts on the neural control of breathing. Therefore, we hypothesized that individuals recovered from COVID-19 may exhibit changes in their ventilatory chemosensitivity to carbon dioxide and hypoxia, and that these changes may be linked to systemic inflammation.

METHODS: To test this hypothesis, we measured baseline ventilatory patterns and chemoreflex sensitivity in individuals recovered from COVID-19 (n = 77) and individuals with no prior COVID-19 infection (n = 41). Peripheral venous blood samples were also collected for inflammatory biomarker expression and profiling.

RESULTS: Recovered participants demonstrated a small but progressive decrease in the hypercapnic ventilatory response under a co-stimulus with hypoxia (control vs. 24-month post-recovery; p = 0.023). Additionally, we identified several significant correlations between plasma inflammatory markers and ventilatory chemoreflex characteristics, including a positive correlation between SAA and CRP and the ventilatory response to hypoxia (p < 0.05 within recovered and control cohorts). Finally, expression of six vascular inflammatory markers (Myoglobin, NGAL, MMP-2, OPN, IGFBP-4, and Cystatin C) was unexpectedly decreased in recovered participants compared to the control cohort for up to one-year post recovery.

CONCLUSIONS: Overall, this data indicates that COVID-19 and other acute viral infections may have a modest impact on the chemoreflex control of breathing as well as systemic inflammatory profiles, and that these changes may be linked to each other. These findings may strengthen our understanding of the pathology of long-COVID symptoms.},
}

@article {pmid41565056,
year = {2026},
author = {Uematsu, T and Nojiri, S and Nagao, M and Ishijima, M and Nishizaki, Y},
title = {Comprehensive analysis of risk factors for Coronavirus disease 2019 infection and post-infection sequelae based on real-world data from a health insurance database in Japan.},
journal = {International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases},
volume = {},
number = {},
pages = {108405},
doi = {10.1016/j.ijid.2026.108405},
pmid = {41565056},
issn = {1878-3511},
abstract = {OBJECTIVES: Using real-world data from Japan, this study aimed to examine disease risks in COVID-19 patients before and after infection.

METHODS: We used the Japanese Health Insurance Database to identify hospitalized patients in Japan aged 60 years who were newly diagnosed with COVID-19 by December 31, 2020. To form the study population, these patients were matched 1:1 with individuals without COVID-19 on the basis of age, sex, and index date. Two analytical approaches were employed: a case-control study using conditional logistic least absolute shrinkage and selection operator (LASSO) regression to identify risk factors for COVID-19 infection and a retrospective cohort study using time-to-event analysis to evaluate the risk of developing sequelae following infection.

RESULTS: Overall, 8,072 patients were included (4,036 in each group). Organic, including symptomatic mental disorders demonstrated the strongest association (odds ratio, 2.276). Following infection, behavioral syndromes associated with physiological disturbances and physical factors exhibited the highest risk of developing new conditions (hazard ratio [HR], 3.523; 95% confidence interval [CI], 2.101-5.907), followed by pulmonary heart disease and diseases of the pulmonary circulation (HR, 2.954; 95% CI, 1.360-6.420).

CONCLUSION: Our findings suggest an association between COVID-19 and mental and behavioral disorders.},
}

@article {pmid41564976,
year = {2026},
author = {Karaviti, D and Charakida, M and Dimopoulou, D and Marmarinos, A and Papadaki, M and Maritsi, D and Spyridis, N and Avgeris, M and Gourgiotis, D and Syggelou, A and Tsolia, M},
title = {Long term cardiovascular effects on COVID-19 infection in children. The need for monitoring.},
journal = {International journal of cardiology},
volume = {},
number = {},
pages = {134188},
doi = {10.1016/j.ijcard.2026.134188},
pmid = {41564976},
issn = {1874-1754},
abstract = {BACKGROUND: Although SARS-CoV-2 infection has been associated with mild illness in children, concerns have emerged regarding potential long-term cardiovascular and systemic effects, even in previously healthy pediatric populations.

OBJECTIVE: The aim of this study is to assess cardiac function and long-term symptoms in children up to one year after COVID-19 infection, and to compare these findings with healthy controls without prior SARS-CoV-2 exposure.

METHODS: In this prospective case-control study, children aged 4-17 years were divided into two groups: those with a confirmed history of COVID-19 (Group 1) and healthy controls (Group 2). Participants underwent echocardiographic evaluation-including global longitudinal strain (GLS) analysis and biochemical testing, including lipid profile and intracellular adhesion molecule -1 (ICAM-1) measurements. A structured symptom survey was used to assess cardiovascular and systemic long-COVID manifestations.

RESULTS: Conventional echocardiographic indices did not differ significantly between groups. However, Group 1 showed a persistent reduction in left ventricular GLS, indicating subclinical myocardial dysfunction (p < 0.05). Long-COVID symptoms were reported in 23.6% of children in Group 1, with fatigue being the most common (16.6%), followed by palpitations (2.0%). Lipid profiles were similar between groups, although children with moderate to severe infections exhibited significantly elevated serum intracellular adhesion molecule-1 (sICAM-1) levels, suggestive of endothelial activation.

CONCLUSION: Even in the absence of overt cardiovascular disease, children with prior SARS-CoV-2 infection experience persistent subclinical cardiac changes and symptoms consistent with Long-COVID. These findings highlight the need for ongoing surveillance and comprehensive cardiovascular assessments in pediatric populations following COVID-19 infection.},
}

@article {pmid41564615,
year = {2026},
author = {Chishtie, FA and Drozd, J and Li, X and Benterki, A and Valluri, SR},
title = {A robust compartmental modeling framework for infectious disease monitoring and analysis via fractional differential equations.},
journal = {Epidemics},
volume = {54},
number = {},
pages = {100887},
doi = {10.1016/j.epidem.2026.100887},
pmid = {41564615},
issn = {1878-0067},
abstract = {This study presents a comprehensive framework for infectious disease monitoring using fractional differential equations, specifically developing the SEIQRDP (Susceptible, Exposed, Infected, Quarantined, Recovered, Deceased, Protected) model. Traditional compartmental models are extended by incorporating fractional calculus, with orders α∈(0,2], which provides enhanced flexibility in capturing memory effects and non-local behaviors inherent in disease transmission dynamics. The framework demonstrates improved accuracy when fitted to Canadian COVID-19 data compared to classical integer-order models, with Wave 1 achieving 22.1% improvement (95% CI: 17.4-26.8%) and Wave 2 achieving 6.2% improvement (95% CI: 3.1-9.3%) in predictive accuracy (average ∼14%). Fractional orders both below and above unity yield superior fits to empirical data depending on epidemic phase, successfully capturing multi-wave dynamics across different pandemic phases. The model incorporates time-dependent parameters to account for varying intervention strategies. Rigorous mathematical analysis including existence, uniqueness, and stability of solutions is provided alongside comprehensive sensitivity analysis. Out-of-sample validation using rolling-origin cross-validation demonstrates robust forecasting performance across 7-, 14-, and 21-day horizons. This research provides public health authorities with an evidence-based tool for epidemic modeling, with proposed extensions for AI-enhanced surveillance, interoperability standards, and Long COVID monitoring discussed as future research directions.},
}

@article {pmid41563438,
year = {2026},
author = {Oliver-Mas, S and Matias-Guiu, JA and Delgado-Alonso, C and Valles-Salgado, M and Gil-Moreno, MJ and López-Carbonero, JI and Fernández-Romero, L and Cuevas, C and Delgado-Álvarez, A and Matias-Guiu, J and Diez-Cirarda, M},
title = {Episodic memory deficits and processes in post-COVID condition.},
journal = {European archives of psychiatry and clinical neuroscience},
volume = {},
number = {},
pages = {},
pmid = {41563438},
issn = {1433-8491},
support = {INT20/00079//Instituto de Salud Carlos III/ ; FI20/000145//Instituto de Salud Carlos III/ ; CD22/00043//Instituto de Salud Carlos III/ ; CM23/00094//Instituto de Salud Carlos III/ ; G63-HEALTHSTARPLUS-HSP4//Fundación para el Conocimiento madri+d/ ; },
abstract = {Cognitive dysfunction is one of the most prevalent symptoms in patients with post-COVID condition (PCC) and episodic memory has been highlighted as one of the most impaired cognitive domains in these patients. However, few studies have specifically assessed episodic memory processes in these patients. This study aims to comprehensively investigate the memory function in patients with PCC. We conducted a cross-sectional study involving 157 patients with PCC and 74 healthy controls. Participants underwent a comprehensive neuropsychological assessment and memory assessment, including the Loewenstein-Acevedo Scale for Semantic Interference and Learning (LASSI-L), the Free and Cued Selective Reminding test (FCSRT), the Open-Trial Selective Reminding Test (OT-SRT), and a Mental Ability Questionnaire (FLEI). We compared groups and evaluated the correlation between episodic memory and neuropsychological and clinical assessments. Patients with PCC showed reduced performance on the LASSI-L, the FCSRT and the OT-SRT compared to controls. The memory scores showed positive moderate correlations with attention tests and positive low correlations with language, visuospatial or executive functions. Subjective memory complaints were related to poorer memory performance. LASSI-L was the test most associated with subjective memory complaints, whereas OT-SRT was the test less influenced by attention tests. The study found multiple memory processes impaired in patients with PCC, specifically in initial encoding, learning information acquisition and storage, and in retrieval, with only partial improvement with cues and recognition, and with significant susceptibility to the effects of retroactive semantic interference. These findings are relevant for characterising the cognitive deficits of patients with PCC and for designing interventional strategies.},
}