@article {pmid42447127,
year = {2026},
author = {Bomans, S and Michotte, N and El M'Rabet, I and Jimenez Garcia, B and Leemans, L and Janssens, P and Hanon, S and De Waele, E and Beckwée, D},
title = {Agreement and reliability between the two-day 6-minute incremental step test and two-day cardiopulmonary exercise test in post COVID-19 condition for assessing post-exertional malaise: The REVEAL-study.},
journal = {PloS one},
volume = {21},
number = {7},
pages = {e0353132},
pmid = {42447127},
issn = {1932-6203},
mesh = {Humans ; Reproducibility of Results ; *Exercise Test/methods ; Cross-Over Studies ; *COVID-19/complications/physiopathology ; Female ; Male ; Adult ; Post-Acute COVID-19 Syndrome ; SARS-CoV-2/isolation & purification ; Middle Aged ; Fatigue/physiopathology ; Oxygen Consumption ; Physical Exertion ; },
abstract = {BACKGROUND: Post-Exertional Malaise (PEM) is a core symptom of post COVID-19 condition (also known as long COVID) affecting millions of people, yet assessment remains challenging. The two-day cardiopulmonary exercise test (CPET) is the current gold standard for objectifying PEM, but its cost and patient burden limit use. The two-day 6-minute incremental step test (6MIST) with wireless wearable sensors could offer a more accessible alternative.

METHODS: This cross-over study (n = 25, one-month washout period) evaluated the level of agreement and reliability between the two-day 6MIST and the two-day CPET for assessing PEM. Each "two-day" test consisted of two identical exercise tests separated by 24 hours to capture worsening of symptoms on day 2. Objective (VO2peak) and subjective (fatigue, neuromuscular complaints and rated perceived exertion) PEM outcomes were collected. Subjective outcomes were measured in relation to the first exercise test of each two-day session; at 15 minutes pretest, 15 minutes posttest and 24 hours posttest, with changes analyzed as Δ1 (baseline to 15 minutes posttest) and Δ2 (15 minutes posttest to 24 hours posttest). Agreement was assessed using Bland-Altman plots and reliability through consistency Intraclass Correlation Coefficients. The study is registered in ClinicalTrials.gov (Ref: NCT06933017).

RESULTS: VO2peak and neuromuscular complaints showed low agreement and reliability between the two tests. Rated perceived exertion showed moderate reliability at all times and fatigue showed moderate reliability for changes after 24h (Δ2).

CONCLUSIONS: Contrary to our hypothesis, the two-day 6MIST shows limited agreement with the two-day CPET overall. However, moderate reliability for rated perceived exertion and fatigue suggests potential for improvement with protocol refinement. Further research is needed to optimize the two-day 6MIST and to develop assessments that capture PEM both within and beyond the 24-hour period.},
}

Humans
Reproducibility of Results
*Exercise Test/methods
Cross-Over Studies
*COVID-19/complications/physiopathology
Female
Male
Adult
Post-Acute COVID-19 Syndrome
SARS-CoV-2/isolation & purification
Middle Aged
Fatigue/physiopathology
Oxygen Consumption
Physical Exertion

@article {pmid42448283,
year = {2026},
author = {Coppens, L and Górska, A and Hotterbeekx, A and Canziani, LM and Mateescu, VO and Gentilotti, E and Pirici, D and Berkell, M and , and Malhotra, S and Taconelli, E and Kumar-Singh, S},
title = {Longitudinal assessment of SARS-CoV-2 Spike and Nucleocapsid antigenemia in the ORCHESTRA Post-COVID cohort.},
journal = {Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases},
volume = {},
number = {},
pages = {},
doi = {10.1016/j.cmi.2026.07.012},
pmid = {42448283},
issn = {1469-0691},
abstract = {OBJECTIVES: Spike antigenemia has been proposed as a mechanism underlying post-COVID condition (PCC). We determined whether persistent free SARS-CoV-2 Spike or Nucleocapsid antigenemia is associated with post-COVID condition (PCC) or systemic inflammation. As a secondary methodological aim, we evaluated whether dithiothreitol (DTT) treatment reliably unmasks antibody-bound Spike.

METHODS: Within the ORCHESTRA project, we quantified free Spike and Nucleocapsid in 200 participants (112 PCC, 58 non-PCC and 30 pre-pandemic controls), analysing 576 samples collected during acute infection (n=99) and at 3, 6, 12, and 18 months post-infection (n=447). Correlations between free Spike and proinflammatory markers were assessed. The effect of 10 mM DTT on Spike detectability was validated prior to analysis.

RESULTS: During acute infection, Nucleocapsid was detectable in nearly all participants (n=98/99), and Spike in 15/99 (15.2%). Low-level antigen persisted in a subset of participants up to 18 months, however, neither free Spike nor Nucleocapsid differed between PCC and controls or were independently associated with PCC (Spike: OR, 0.99; 95% CI, 0.55-1.78; Nucleocapsid: OR, 0.52; 95% CI, 0.14-2.03). At 3-6 months post-infection, free Spike correlated with proinflammatory cytokines, with stronger associations in PCC than controls (all p<0.05). Methodologically, DTT reduced recombinant Spike detectability by 90.9±0.7% at 10 mM (p<0.001) yet increased measured plasma signal 2.6±2.7-fold in pandemic samples and 5.5±2.4-fold in pre-pandemic controls (p<0.001), indicating non-specific assay artifact rather than recovery of antibody-bound antigen.

CONCLUSIONS: Low-level systemic antigen persistence occurs in a subset of individuals but does not differentiate PCC from recovered controls. Early convalescent Spike-cytokine correlations likely reflect transient, host-specific immune activation rather than a persistent viral driver. Furthermore, DTT does not recover true immune-complexed antigen but generates non-specific assay artifacts. These data argue against persistent circulating antigenemia as a primary, generalizable driver of PCC, highlighting the need for cautious biomarker interpretation.},
}

@article {pmid42449996,
year = {2026},
author = {Pesqueira Sanchez, MA and de Necochea Campion, R and Dalhuisen, T and Fehrman, EA and Chhabra, PS and Kelly, JD and Martin, JN and Deeks, SG and Henrich, TJ and Peluso, MJ and LaRosa, SP},
title = {Increased Mannosylation of Extracellular Vesicles in Long COVID Plasma as a Binding Target for Galanthus nivalis Agglutinin (GNA) Affinity Resin.},
journal = {International journal of molecular sciences},
volume = {27},
number = {13},
pages = {},
doi = {10.3390/ijms27135723},
pmid = {42449996},
issn = {1422-0067},
support = {Not Applicable//Aethlon Medical (United States)/ ; Not Applicable//PolyBio Research Foundation/ ; R01AI141003; R01NS136197; K23AI157875//National Institutes of Health (NIH)/ ; },
mesh = {*Extracellular Vesicles/metabolism ; Humans ; Glycosylation ; MicroRNAs/metabolism/genetics/blood ; *Plant Lectins/metabolism/chemistry ; *COVID-19/blood/metabolism ; Post-Acute COVID-19 Syndrome ; *Mannose/metabolism ; SARS-CoV-2/isolation & purification ; Galanthus/chemistry ; Mannose-Binding Lectins ; },
abstract = {There is no proven therapy for Long COVID, a post-acute condition characterized by persistent symptoms following SARS-CoV-2 infection. Extracellular vesicles (EVs) are emerging as mediators of disease pathogenesis through their molecular cargo. We investigated whether EV glycosylation is altered in Long COVID plasma and whether these vesicles can be selectively targeted using a glycan-binding affinity resin. Large (100-500 nm) and small (40-200 nm) EVs were isolated from post-acute COVID-19 plasma and analyzed by nanoparticle flow cytometry to assess surface glycosylation. Small EV capture assays were performed using Galanthus nivalis agglutinin (GNA) affinity resin. Plasma miRNA profiles before and after GNA treatment were evaluated using NanoString nCounter analysis, and potential downstream pathway effects were computationally inferred using validated miRNA-mRNA interactions and PROGENy. Mannose-positive large EVs were significantly increased in Long COVID compared to recovered controls (p < 0.05). GNA-mediated small EV capture correlated with mannose-positive EV abundance (r = 0.341, p < 0.05), and seven miRNAs were significantly reduced following treatment. Computational pathway analysis suggested modulation of key signaling pathways, including JAK-STAT, Estrogen, VEGF, and PI3K. These findings suggest a glycan-associated EV signature in Long COVID and support further investigation of lectin-based capture as a potential strategy to target vesicle-associated molecular cargo.},
}

*Extracellular Vesicles/metabolism
Humans
Glycosylation
MicroRNAs/metabolism/genetics/blood
*Plant Lectins/metabolism/chemistry
*COVID-19/blood/metabolism
Post-Acute COVID-19 Syndrome
*Mannose/metabolism
SARS-CoV-2/isolation & purification
Galanthus/chemistry
Mannose-Binding Lectins

@article {pmid42450602,
year = {2026},
author = {Palladini, M and Mazza, MG and Bravi, B and Bessi, M and De Lorenzo, R and Rovere-Querini, P and Benedetti, F},
title = {Sex-Specific Association Between Acute COVID-19 Systemic Inflammation and Persistent White Matter Pathology and Cognition in Survivors.},
journal = {Biology},
volume = {15},
number = {13},
pages = {},
doi = {10.3390/biology15131054},
pmid = {42450602},
issn = {2079-7737},
abstract = {Six years into the COVID-19 pandemic, evidence is increasingly clear that long COVID affects women disproportionately, with higher rates of persistent cognitive and neurological symptoms. Yet, the biological mechanisms underlying this sex-dimorphic impact remain elusive. We investigated whether the immune storm of acute COVID-19 leaves a silent yet sex-specific scar on white matter integrity that shapes long-term cognitive health. In 60 previously hospitalized COVID-19 survivors, we combined an inflammatory snapshot at admission proxied by the systemic immune-inflammation index (SII) with 3T diffusion MRI and a comprehensive cognitive battery (BACS) acquired three months after recovery. Sex reshaped the inflammation-brain relationship: a higher SII predicted a diffuse alteration pattern within core associative and inter-hemispheric fibres in females only, sparing the male architecture despite a comparable inflammatory burden. In women, white matter damage coupled with poorer psychomotor coordination, and mean diffusivity fully mediated the link, unveiling a female-specific pathway from systemic inflammation to cognitive slowdown. COVID-19 inflammation imprints a durable, sex-sensitive footprint on white matter that selectively undermines psychomotor coordination in female survivors, despite a clinical recovery. This work positions women's white matter as a critical target of post-COVID neuroinflammation and argues for sex-informed monitoring and interventions that explicitly tackle immune-brain crosstalk in long COVID.},
}

@article {pmid42451144,
year = {2026},
author = {Navarro-Cáceres, A and Navarro-Matías, E and Arroyo-Romero, S and Suárez-Moreno, N and Domínguez-Martín, A and Lugones-Sanchez, C and Gonzalez-Sanchez, S and Gómez-Marcos, MA and Gómez-Sánchez, M and Gómez-Sánchez, L and BioICOPER Investigators Group, },
title = {Dietary Mineral Intake and Vascular Health in Patients with Long COVID-19: The BioICOPER Study.},
journal = {Nutrients},
volume = {18},
number = {13},
pages = {},
doi = {10.3390/nu18132140},
pmid = {42451144},
issn = {2072-6643},
support = {PI25/00071//Instituto de Salud Carlos III/ ; IBYAP23_00001//Instituto de Investigación Biomédica de Salamanca/ ; GRS 2976/C/2024, GRS 3007/C/2024, GRS 2714/C/2023, and GRS 2501/B/22//Junta of Castile and León/ ; },
mesh = {Humans ; Male ; Female ; *COVID-19/physiopathology/complications ; Vascular Health ; *Vascular Stiffness ; Middle Aged ; Pulse Wave Analysis ; Aged ; *Minerals/administration & dosage ; Post-Acute COVID-19 Syndrome ; SARS-CoV-2 ; Carotid Intima-Media Thickness ; *Diet ; Carotid-Femoral Pulse Wave Velocity ; Ankle Brachial Index ; },
abstract = {Background/Objectives: Long COVID-19 (LC) has been associated with persistent inflammation and impaired vascular health. Dietary minerals are involved in oxidative stress, endothelial homeostasis, and arterial stiffness; however, their relationship with vascular health in LC remains poorly explored. This study aimed to examine the association between energy-adjusted dietary mineral intake and markers of vascular stiffness and vascular aging in adults with LC, while exploring potential sex-specific patterns. Methods: A total of 304 adults with LC from the BioICOPER study were included. Dietary mineral intake was assessed using a validated 7-day dietary record from the EVIDENT tool and expressed as mineral density per 1000 kcal for the regression analyses. Vascular assessment included carotid intima-media thickness (cIMT), carotid-femoral pulse wave velocity (cfPWV), brachial-ankle pulse wave velocity (baPWV), and the vascular aging index (VAI). Hierarchical multivariable linear regression models, false discovery rate (FDR) correction, restricted cubic spline analyses, sensitivity analyses excluding supplement users, and formal sex × mineral interaction tests were performed. Results: In descriptive adequacy analyses, adequate iron intake was associated with lower baPWV. In energy-adjusted linear regression models, no mineral-outcome association remained statistically significant after FDR correction. In the fully adjusted sensitivity model, zinc density showed a nominal positive association with cfPWV, but this association did not survive FDR correction. Restricted cubic spline analyses suggested possible non-linear associations of magnesium and potassium density with cfPWV and VAI. Formal interaction analyses did not provide robust evidence of sex-related effect modification. Conclusions: After energy adjustment and correction for multiple testing, the evidence for independent linear associations between dietary mineral density and vascular outcomes in adults with LC was limited. These exploratory findings suggest that mineral intake, dietary sources, and non-linear patterns deserve further evaluation in prospective studies and nutritional intervention trials.},
}

Humans
Male
Female
*COVID-19/physiopathology/complications
Vascular Health
*Vascular Stiffness
Middle Aged
Pulse Wave Analysis
Aged
*Minerals/administration & dosage
Post-Acute COVID-19 Syndrome
SARS-CoV-2
Carotid Intima-Media Thickness
*Diet
Carotid-Femoral Pulse Wave Velocity
Ankle Brachial Index

@article {pmid42452430,
year = {2026},
author = {Munzir, SI and Hier, DB and Carrithers, MD},
title = {Distinct Regulatory DNA Methylation Signatures Across Multiple Sclerosis, Neuromyelitis Optica, and Neurological Post-Acute Sequelae of COVID-19.},
journal = {Journal of clinical medicine},
volume = {15},
number = {13},
pages = {},
doi = {10.3390/jcm15134968},
pmid = {42452430},
issn = {2077-0383},
support = {n/a//University of Illinois Chancellor's Fund/ ; n/a//Wershkoff Endowment for Multiple Sclerosis Research/ ; },
abstract = {Background/Objectives: Our prior epigenome-wide association study (EWAS) on multiple sclerosis (MS) identified myeloid-associated methylation signatures and an association with enhancer regions. Here we compared differential DNA methylation across three central nervous system inflammatory disorders: MS, neuromyelitis optica (NMO), and neurologic post-acute sequelae of COVID-19 (neuro-PASC). Methods: Whole-blood DNA was profiled on Infinium MethylationEPIC arrays. Analyses included EWAS at the CpG level, differentially methylation region (DMR) analysis, and gene regulatory-element enrichment using Locus Overlap Analysis (LOLA). Limma linear models were adjusted for race, EPIC array version, age, sex, disease-modifying treatment class, and blood cell composition. Results: All three diseases were associated with broad CpG-level differential methylation. The most robust findings were disease-specific DMR signatures in gene regulatory regions. All three diseases shared Lamin B1-anchored chromatin states as an architectural genomic feature but differed in immune regulatory transcription factor binding sites (TFBS), RNA polymerase (Pol II) occupancy, and DNase accessibility. MS was enriched for TFBS in myeloid CEBPB and SPI1/PU.1 and lymphocyte-associated RUNX3, EBF1, and BATF. MS hypomethylated DMRs were concentrated at active enhancers and myeloid TFBS, suggestive of chronic myeloid activation. NMO showed the clearest promoter and B lymphocyte associated profile. Neuro-PASC was associated with hematopoietic DNase accessibility and TFBS for BATF and EBF1. Conclusions: These results suggest that DNA methylation in MS, NMO, and neuro-PASC differ meaningfully in regulatory architecture rather than conforming to a single shared disease-associated methylation model. A long-term goal is to develop immune therapies for newly recognized diseases such as neuro-PASC.},
}

@article {pmid42452662,
year = {2026},
author = {Değer, M and Kılıç, T and Ulutaş, Z and Tan, MS and Ödümlü, H and Atila, A and Demir, HB and Soysaldı, B and Karaağaç, M and Er, YE and Akdağ, O},
title = {Three- and Nine-Month Follow-Up of Patients with COVID-19: Clinical, Functional, and Radiological Outcomes.},
journal = {Journal of clinical medicine},
volume = {15},
number = {13},
pages = {},
doi = {10.3390/jcm15135202},
pmid = {42452662},
issn = {2077-0383},
abstract = {Background/Objectives: The acute complications of COVID-19 have been well characterized and are frequently associated with increased mortality. Although substantial knowledge regarding long COVID has accumulated since the beginning of the pandemic, important uncertainties remain regarding the long-term clinical, functional, radiological, and metabolic consequences of SARS-CoV-2 infection. Identification of post-COVID-19 complications is therefore essential for appropriate recognition and management. This study aimed to evaluate the long-term complications of COVID-19 at 3 and 9 months after infection. Methods: This prospective study was conducted at Inonu University Turgut Ozal Medical Center. Patients who presented with active post-COVID-19 complaints or for routine follow-up were enrolled. Participants were evaluated at the pulmonology outpatient clinic at 3 and 9 months. At each visit, persistent or new-onset symptoms were assessed, and pulmonary function tests (PFT), the six-minute walk test (6MWT), echocardiography (ECHO), and thoracic computed tomography (CT) were performed as clinically indicated. Patients were stratified into three groups according to the severity of acute illness: outpatient, ward-hospitalized, and ICU-hospitalized. Results: A total of 205 patients (120 male, 85 female) were included. Male patients had significantly higher rates of ward and ICU hospitalization than female patients (p = 0.006). At 9 months, 85.3% of patients had at least one persistent symptom; dyspnea (69.6%), cough (35.6%), and chest pain (32.5%) were the most common. FVC showed a statistically significant increase between months 3 and 9 (p = 0.014), and the 6MWT distance improved significantly (423.56 m vs. 464.10 m; p = 0.008). Ground-glass opacity, present in 90.2% of patients at admission, persisted in 44.3% at 9 months (p < 0.001). Reticular opacities, pleuroparenchymal bands, and mosaic perfusion patterns increased over time. ICU patients had significantly lower ejection fraction values compared with ward and outpatient groups at 9 months (p = 0.046). During follow-up, 13 patients developed pulmonary embolism and 7 developed new-onset diabetes mellitus. Conclusions: Despite the well-characterized acute phase, the long-term sequelae of COVID-19 remain a significant clinical challenge. Identification of late complications is critical for reducing morbidity and understanding the long-term societal and healthcare burden of the pandemic. Multidisciplinary long-term follow-up is warranted, particularly for patients who experienced severe acute illness.},
}

@article {pmid42453233,
year = {2026},
author = {Raina, SK and Kumar, R},
title = {Long TB: Framing post-acute sequelae of tuberculosis as a distinct clinical entity.},
journal = {Journal of family medicine and primary care},
volume = {15},
number = {4},
pages = {1463-1466},
pmid = {42453233},
issn = {2249-4863},
abstract = {Tuberculosis (TB) has historically been declared cured at the point of microbiological clearance. Yet emerging evidence from systematic reviews and cohort studies demonstrates that between 30% and 80% of pulmonary TB survivors experience persistent symptoms, organ damage or functional impairment after treatment completion; a burden that existing outcome metrics fail to capture. We propose the term Long TB, with the formal designation Post-Acute Sequelae of Tuberculosis (PAST-TB), as a conceptual and clinical framework to define, study and address this under-recognised morbidity. Drawing explicit parallels with Long COVID (post-acute sequelae of SARS-CoV-2 or PASC), we argue that the Long TB framing is not merely rhetorical but scientifically grounded, strategically powerful and urgently needed. With approximately 155 million TB survivors alive globally and modelling studies attributing up to 47% of TB-related disability-adjusted life years (DALYs) to the post-treatment period, the case for a systematic post-TB care agenda, anchored by this new terminology is compelling. We attempt to outline the multi-system domains of Long TB, its shared pathological drivers with PASC and the programmatic and research reforms required to move from bacteriological to biological cure as the standard of care.},
}

@article {pmid42454043,
year = {2026},
author = {Wendt, K and Schieck, M and Gille, C and Marschollek, M and Illig, T and Wolff, D and Nee, S},
title = {Biomarkers of post-acute infection syndrome: a systematic literature review.},
journal = {Frontiers in immunology},
volume = {17},
number = {},
pages = {1741761},
pmid = {42454043},
issn = {1664-3224},
mesh = {Humans ; *Biomarkers/metabolism ; Post-Acute COVID-19 Syndrome ; *COVID-19/complications ; *SARS-CoV-2 ; *Fatigue Syndrome, Chronic/diagnosis ; },
abstract = {BACKGROUND: Post-acute infection syndrome (PAIS) remained underrecognized before the COVID-19 pandemic, which further increased exposure by introducing a novel global cause. The global burden of post-acute COVID syndrome (PACS) and myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) alone is estimated at several tens of millions affected worldwide. Biomarker discovery is central to improving PAIS diagnosis and may provide therapeutic targets. This review summarizes current knowledge on biomarkers for PAIS, including PACS and ME/CFS.

METHODS: A systematic literature search was conducted in PubMed and Web of Science. Inclusion criteria were: (1) studies including PAIS patients; (2) reporting laboratory or omics biomarkers; and (3) investigating biomarkers or pathomechanisms of PAIS. Although Guillain-Barré syndrome (GBS) is not PAIS, we have included it as a separate mechanistic comparator due to its prevalence in search results and its clinical and immunological similarities to PAIS.

RESULTS: A total of 142 studies analyzing PAIS biomarkers were included. GBS was analyzed separately and later compared with the other results. Overall, the reviewed studies employed heterogeneous approaches. While similar types of data were frequently investigated, analytical methods varied and often focused only on a subset of molecules. The results indicate that amino acid, energy, and lipid metabolism, microbiome, mitochondrial stress, and miRNA networks are affected. All pathways are connected via NF-κB.

DISCUSSION: PAIS is a multisystem disorder rooted in persistent immune activation, metabolic reprogramming, and systemic inflammation, driven not by active viral infection, but by dysregulated host responses. The NF-κB pathway serves as a unifying hub, connecting molecular, cellular, and clinical phenotypes. Our framework enables a shift from symptom-based to mechanism-based classification, paving the way for biologically grounded interventions.

CONCLUSION: This review synthesizes a broad spectrum of biomarkers in PAIS, integrating findings across pathogens and molecular levels rather than restricting to individual conditions or symptom clusters. This study highlights the differences and commonalities among pathogens and diseases that lead to post-acute sequelae, fills a critical knowledge gap, and provides a foundation for future research and clinical practice. Future studies incorporating multi-omics approaches, longitudinal designs, and larger patient cohorts are needed to validate specific biomarkers and advance the understanding of PAIS.},
}

Humans
*Biomarkers/metabolism
Post-Acute COVID-19 Syndrome
*COVID-19/complications
*SARS-CoV-2
*Fatigue Syndrome, Chronic/diagnosis

@article {pmid42454067,
year = {2026},
author = {Brucker, DL and Paul, S},
title = {Long COVID among adults with pre-existing disabilities: Evidence from the 2022 National Health Interview Survey.},
journal = {Journal of disability policy studies},
volume = {2026},
number = {},
pages = {},
pmid = {42454067},
issn = {1044-2073},
abstract = {Long COVID is an emerging public health issue which may be disproportionately impacting adults who had disabilities before the COVID-19 pandemic. We use data from the 2022 National Health Interview Survey to conduct multivariate analyses to compare the odds of having Long COVID among four different disability subpopulations and their working-age reference groups: 1) working-age Medicare beneficiaries, 2) single working-age adults without children who were receiving SSDI and/or SSI, 3) adults who had disabilities before the age of 22; and 4) adults with Veteran's Administration disability ratings. We find that people with disabilities that started before the age of 22 had significantly higher odds of ever having Long COVID (OR: 2.030, p=.007) compared to their reference group, holding all else constant. We did not find significant differences in the odds of ever having Long COVID for the other three sub-populations we identified. These findings point to the importance of ensuring that the systems that support the economic security, education, employment, and healthcare of people with disabilities with an onset before age 22 address this newly emerging concern.},
}

@article {pmid42454777,
year = {2026},
author = {Vernino, S and Bryarly, M and Robbins, NM and Freeman, R and Gibbons, C and Shibao, CA and Biaggioni, I and Kaufmann, H and Levine, BD},
title = {Autonomic Dysfunction in Long COVID Is Distinct From Pure Autonomic Failure.},
journal = {Journal of the American College of Cardiology},
volume = {88},
number = {2},
pages = {245-247},
doi = {10.1016/j.jacc.2026.03.177},
pmid = {42454777},
issn = {1558-3597},
}

@article {pmid42454778,
year = {2026},
author = {Benditt, DG and Keller, C and Mascarhenas, L and Duval, S and Reyes, JL},
title = {Invisible in Full View: Understanding Quantitative Autonomic Study Outcomes in Long-COVID.},
journal = {Journal of the American College of Cardiology},
volume = {88},
number = {2},
pages = {248-250},
doi = {10.1016/j.jacc.2026.05.015},
pmid = {42454778},
issn = {1558-3597},
}

@article {pmid42454903,
year = {2026},
author = {Tang, B and Yang, X and Tian, W and Zhu, J and Liu, W and Di, M and Liu, H and Liang, Z and Chen, Y and Dong, Y},
title = {Proteomic analysis identifies pathways related to immune dysregulation in patients with hematologic malignancies after COVID-19 infection.},
journal = {Microbiology spectrum},
volume = {},
number = {},
pages = {e0399625},
doi = {10.1128/spectrum.03996-25},
pmid = {42454903},
issn = {2165-0497},
abstract = {Patients with hematologic malignancies (HMs) are particularly vulnerable to coronavirus disease 2019 (COVID-19) because of underlying immune dysfunction and treatment-related immunosuppression. However, proteomic features associated with different clinical trajectories in this population remain insufficiently characterized. We performed serum proteomic analysis in 40 HM patients with COVID-19 and 15 healthy controls. Compared with controls, HM patients showed impaired immune-related responses during the acute phase of COVID-19. Acute-phase proteomic patterns differed across outcome groups; however, because outcome groups were closely intertwined with initial COVID-19 severity, ICU admission, and systemic illness, and because multivariable adjustment was not performed due to the limited sample size, these patterns should be interpreted as severity- and outcome-associated profiles rather than independent trajectory-specific markers. Fatal cases showed evidence of dysregulated immune activation, whereas patients later classified as having long COVID exhibited broader suppression of immune-related pathways. In addition to immune alterations, pathways related to platelet activation and cardiac-related dysfunction were associated with adverse clinical trajectories. Enzyme-linked immunosorbent assay validation supported the association of selected proteins with outcome groups during acute infection. These findings provide a proteomic overview of COVID-19 in HM patients and offer a basis for future mechanistic studies and larger external validation cohorts.IMPORTANCEPatients with hematologic malignancies are highly vulnerable to severe coronavirus disease 2019 (COVID-19), acute death, and long COVID due to preexisting immune dysfunction. However, the proteomic signatures linked to adverse clinical trajectories remain poorly understood. Our serum proteomic study identifies distinct acute-phase immune profiles associated with different outcomes: broad immune suppression characterizes long COVID, while dysregulated immune activation is associated with fatal cases. Platelet activation and cardiac-related pathways are also linked to poor outcomes. These findings provide key molecular insights for this high-risk population, supporting future biomarker development, risk stratification, and targeted clinical management.CLINICAL TRIALSThis study is registered with ClinicalTrials.gov as NCT05683353.},
}

@article {pmid42435405,
year = {2026},
author = {Costa Monteiro, AC and Qadir, N},
title = {Phenotyping Long COVID: Working Toward Personalized Approaches to Recovery.},
journal = {Annals of the American Thoracic Society},
volume = {},
number = {},
pages = {},
doi = {10.1093/annalsats/aaoag194},
pmid = {42435405},
issn = {2325-6621},
}

@article {pmid42436453,
year = {2026},
author = {Rojas, NK and Shafran, R and Stephenson, T and Richards-Belle, A and Ortega-Martin, E and Dalrymple, E and Heyman, I and Newlands, F and McOwat, K and Simmons, R and Pinto Pereira, SM},
title = {Symptom variation up to two years post-SARS-CoV-2 infection in Children and Young People: results from the Children and young people with Long Covid (CLoCk) study.},
journal = {BMC infectious diseases},
volume = {},
number = {},
pages = {},
doi = {10.1186/s12879-026-13951-x},
pmid = {42436453},
issn = {1471-2334},
support = {COV-LT-0022//National Institute for Health and Care Research/ ; 183885//Beryl Alexander Charity/ ; MR/Y009398/1/MRC_/Medical Research Council/United Kingdom ; },
abstract = {BACKGROUND: Post Covid-19 Condition (PCC) can fluctuate over time, yet, no in-depth investigation of the heterogeneous PCC trajectories that can exist in children and young people (CYP) has been undertaken. We aim to examine associations between PCC trajectories in CYP over 2-years following infection and (i) factors prior to the COVID-19 pandemic/infection including socio-demographic variables (e.g., age, sex, ethnicity), health and educational needs status and (ii) factors subsequent to infection including the nature, number, functional impact and severity of symptoms, as well as mental health and wellbeing.

METHODS: 943 PCR-test positive CYP (enrolled January-March 2021) were followed-up over two-years (till January-March 2023). Five PCC trajectory groups were specified: (i) chronic, (ii) recovered, (iii) fluctuating, (iv) late onset and (v) never PCC. These groups were compared in terms of factors at baseline using multinomial logistic regression and concurrent health during the two-year period using Chi-Square/Fisher's Exact tests.

RESULTS: Baseline factors prior to the pandemic/infection such as female sex, older age, poorer pre-infection mental and physical health, prior healthcare use, and educational needs were strongly and consistently associated with adverse PCC trajectories. Compared to those aged 11-to-14-years at infection, those aged 15-to-17-years had a 2.44 (95%CI:1.39,4.26) higher risk of being in the chronic group (compared to the never group). Similarly, the risk of being in the fluctuating group was 1.57 (95%CI:1.04,2.37), the recovered group was 2.08 (95%CI:1.10,3.92) and the late-onset group was 1.50 (95%CI:1.08,2.07). Other sociodemographic factors, such as ethnicity and region of residence, had more modest and inconsistent associations. PCC trajectories differed by concurrent number, frequency, functional impact and severity of symptoms and mental health. CYP with chronic PCC consistently reported a higher median number of symptoms (5+) compared to the other groups (median symptoms ≤ 3). Mental health and wellbeing, of the chronic PCC group was also consistently worse (e.g., 41% of the chronic group consistently were classified as 'cases' on the Strengths and Difficulties scale vs 17%-to-2% of the other groups).

CONCLUSIONS: There were consistent differences between PCC trajectories, in terms of sex, age, pre-infection mental and physical health, healthcare use, and educational needs. Understanding factors associated with PCC trajectory heterogeneity in CYP and how these trajectories differ over time can help with treatment planning.},
}

@article {pmid42437598,
year = {2026},
author = {Egorov, AI and Griffin, SM and Fuzawa, M and Kobylanski, J and Grindstaff, R and Padgett, W and Simmons, SO and Hallinger, DR and Styles, JN and Wickersham, L and Wade, TJ},
title = {Recent SARS-CoV-2 infections and increased antibody responses to viral antigens are associated with greater autoantibody reactivity.},
journal = {Immunology letters},
volume = {},
number = {},
pages = {107212},
doi = {10.1016/j.imlet.2026.107212},
pmid = {42437598},
issn = {1879-0542},
abstract = {BACKGROUND: SARS-CoV-2-induced latent autoimmunity may play a role in long-COVID symptoms. This study explored associations between serum immunoglobulin G (IgG) responses to 18 self-antigens and antibody responses to SARS-CoV-2 and common chronic infections: Epstein-Barr virus (EBV), cytomegalovirus (CMV), Helicobacter pylori, and Toxoplasma gondii.

METHODS: This cross-sectional study used 179 SARS-CoV-2 convalescent serum samples acquired from biobanks and 123 pre-pandemic serum samples. IgG responses to SARS-CoV-2 spike, receptor binding domain, spike subunit 2, and nucleocapsid antigens were measured using an in-house Luminex multiplexed suspension fluorescence immunoassay. IgG responses to four chronic infections were quantified using commercial ELISA kits. Autoantibody responses to 18 self-antigens were simultaneously measured using a commercially available multiplexed Luminex assay; combined autoantibody reactivity was defined as the geometric mean of the 18 individual autoantibody responses.

RESULTS: Combined autoantibody reactivity and responses to several individual self-antigens were significantly higher in SARS-CoV-2 convalescent, seropositive individuals than in seronegative pre-pandemic controls. Associations between CMV, EBV, H. pylori, and T. gondii seropositivity and combined autoantibody reactivity were not statistically significant. Stronger antibody responses to antigens of the SARS-CoV-2 spike protein (S, S2, and RBD) in convalescent individuals were significantly associated with greater combined autoantibody reactivity and increased responses to multiple individual self-antigens. Conversely, antibody responses to antigens of CMV, EBV, H. pylori, and T. gondii in corresponding subsets of seropositive individuals were not associated with combined autoantibody reactivity.

CONCLUSION: SARS-CoV-2 infection and the intensity of IgG responses to the spike protein were associated with increased autoantibody reactivity, a potential indicator of latent autoimmunity.},
}

@article {pmid42444121,
year = {2026},
author = {Case, A and Botdorf, M and Marchesani, N and Leikauf, JE and Letts, R and Maughan, C and Fitzgerald, ML and Higginbotham, M and Swaminathan, AC and Liebovitz, D and Thacker, D and Dandachi, D and Muszynski, JA and Wellnitz, K and Pajor, NM and Jhaveri, R and Gonzalez, SL and Rao, S},
title = {Functional outcomes of children after SARS-CoV-2 infection: An EHR-based cohort study.},
journal = {Journal of pediatric rehabilitation medicine},
volume = {},
number = {},
pages = {18758894261460624},
doi = {10.1177/18758894261460624},
pmid = {42444121},
issn = {1875-8894},
abstract = {BackgroundClinical manifestations of the post-acute sequelae of SARS-CoV-2, or long COVID, have been well-described. However, few pediatric studies explore the impact on everyday function. The objective was to describe functional outcomes for children and youth with long COVID.MethodsA retrospective cohort study of individuals < 21 years of age with COVID-19 infection seeking care at 21 children's hospitals across the United States was conducted. Using a systematic chart review, children with confirmed long COVID were identified by clinician adjudication between March 2020 and December 2022. Outcomes were compared to children with COVID-19 infection without confirmed long COVID. Functional impairments included difficulty participating in school and extracurricular activities, new referrals to rehabilitative therapies, newly modified education plans, and new or worsening mental health symptoms. Descriptive statistics and logistic regression were used to evaluate these outcomes among children with and without long COVID.ResultsAmong 686 children with completed chart review, 651 (95%) had a COVID-19 diagnosis. Functional impairment was documented in 139 (21%) children, of which 59 had clinician-adjudicated long COVID. Compared to infected children without long COVID, children with long COVID had higher odds of school decline (OR 3.5, 95% CI 1.6-7.9, p = 0.002), school support (OR 2.4, 95% CI 1.2-5.0, p = 0.014), and new or worsening behavioral or mental health symptoms (OR 4.6, 95% CI 2.1-9.2, p < 0.001).ConclusionsSignificant functional impairments exist among children and youth following SARS-CoV-2 infection and serve as a reminder to clinicians evaluating children with long COVID to explore everyday function. Future prospective studies with longer follow-up are underway.},
}

@article {pmid42444199,
year = {2026},
author = {Kim, AW and Swana, S and Sokhela, S and Lalla-Edward, S and Manentsa, N and Tsai, AC and Venter, WDF},
title = {Psychiatric symptoms of long COVID among adults: observational case-control study in Johannesburg, South Africa.},
journal = {BJPsych open},
volume = {12},
number = {4},
pages = {e184},
doi = {10.1192/bjo.2026.12049},
pmid = {42444199},
issn = {2056-4724},
abstract = {BACKGROUND: Growing research has underscored the elevated prevalence and burden of psychiatric morbidity among adults living with long COVID. The severity of acute SARS-CoV-2 infection may predict the prevalence and severity of psychiatric symptoms in long COVID. Although Global South countries have faced among the highest incidence rates and burden of COVID-19, little is known about the psychiatric symptoms of long COVID in these regions, especially in Sub-Saharan Africa.

AIMS: This study aimed to (a) compare the prevalence of long-term psychiatric symptoms between acute COVID-19 infection groups, (b) estimate the associations between COVID-19 severity and long-term psychiatric symptoms, (c) determine the association between long COVID symptoms and psychiatric symptoms, and (d) test the potential mediating effect of long COVID symptoms in the association between acute COVID-19 infection and psychiatric symptoms.

METHOD: This case-control study took place in Johannesburg, South Africa, between August 2022 and July 2023. A total of 360 adults were categorised into one of four case groups based on initial COVID-19 symptoms: asymptomatic, symptomatic, admitted to hospital and vaccinated controls.

RESULTS: Prevalence rates of post-traumatic stress disorder (21.1%) and somatic symptoms (22.9%) were elevated. Individuals with symptomatic COVID-19 exhibited the greatest psychiatric morbidity out of all groups, exhibiting the highest levels of depression, suicidality, anxiety, post-traumatic stress disorder, bipolar disorder and somatisation. Acute COVID-19 severity was associated with worse symptoms of depression, somatisation and physical fatigue. Severity of long COVID symptoms was directly associated with psychiatric sequelae.

CONCLUSIONS: These results call attention to the long-term psychiatric sequelae of SARS-CoV-2 infection and early identification and management of emerging psychiatric symptoms in high-risk COVID-19 survivors.},
}

@article {pmid42445202,
year = {2026},
author = {Cerqueira-Silva, T and Goodwin, B and Araújo, C and Silva, JJ and Pereira, BJ and da Silva, ÍBS and Nunes, S and Marinho, A and Barreto, AP and Barreto, M and Chalhoub, M and Caldas, JR and Rao, V and Coelho, C and Rojas-Hidalgo, A and Maracaja-Coutinho, V and Khouri, R and Cardoso, CR and Barral, A and Barral-Netto, M and Tavares, NM and Dan, J and Boaventura, VS},
title = {CD4[+] T cell signature in long COVID: insights from an unvaccinated cohort.},
journal = {Frontiers in immunology},
volume = {17},
number = {},
pages = {1823850},
pmid = {42445202},
issn = {1664-3224},
mesh = {Humans ; *COVID-19/immunology/virology ; *CD4-Positive T-Lymphocytes/immunology ; *SARS-CoV-2/immunology ; Unvaccinated Persons ; Female ; Male ; Post-Acute COVID-19 Syndrome ; Middle Aged ; Brazil ; Adult ; Cohort Studies ; Immunity, Humoral ; },
abstract = {OBJECTIVE: The pathogenesis of Long COVID (LC) remains poorly understood, with the analysis of immune responses often obscured by variables such as vaccination and reinfection. This study aimed to determine the primary immunological footprint of LC by examining a specific cohort that minimizes these confounding factors.

METHODS: We analyzed a Brazilian cohort of patients recruited between September 2020 and February 2021, during the first wave of the pandemic (Wuhan-Hu-1 variant), comprising mostly unvaccinated individuals. We assessed humoral responses to SARS-CoV-2 and latent viruses in 104 patients. Additionally, we investigated the immune signatures of CD4[+] T cells in a subset of 6 LC and 4 recovered control (RC) unvaccinated patients, recruited 1 to 2 months after symptom onset, utilizing a combination of flow cytometry and single-cell RNA sequencing.

RESULTS: Systemic humoral responses to SARS-CoV-2 and reactivated latent viruses were comparable between the LC and RC groups, as were the overall distributions of CD4[+] T cell subsets. However, single-cell RNA sequencing revealed distinct immune signatures. Antigen-responsive CD4[+] T cells in LC patients demonstrated a signature of acute activation, characterized by the upregulation of genes such as CD38 and interferon-stimulated genes, including IFITM1. Furthermore, gene set enrichment analysis indicated that LC patients exhibit increased expression of interferon-alpha/gamma signatures compared to RC. Analysis of the T cell receptor repertoire presented no evidence of clonal expansion.

DISCUSSION: Our findings imply that LC immunopathology is driven by a qualitative T cell dysfunction characterized by CD4[+] non-proliferative activation more than one month after symptom onset. This pattern is consistent with persistent antigen stimuli, though the underlying mechanism and its therapeutic implications require further investigation.},
}

Humans
*COVID-19/immunology/virology
*CD4-Positive T-Lymphocytes/immunology
*SARS-CoV-2/immunology
Unvaccinated Persons
Female
Male
Post-Acute COVID-19 Syndrome
Middle Aged
Brazil
Adult
Cohort Studies
Immunity, Humoral

@article {pmid42446348,
year = {2026},
author = {Kang, AK and Le Huynh, T and Tran, T and Mofina, A},
title = {Role of Occupational Therapy for Persons Experiencing Long COVID: A Rapid Review.},
journal = {Canadian journal of occupational therapy. Revue canadienne d'ergotherapie},
volume = {},
number = {},
pages = {84174261461430},
doi = {10.1177/00084174261461430},
pmid = {42446348},
issn = {1911-9828},
abstract = {BackgroundIndividuals with long COVID experience persisting symptoms that affect daily life, particularly functional performance. Occupational therapists are well positioned to support this population given their expertise across broader health domains.PurposeThis rapid review describes the existing literature on the role of occupational therapy for adults and older adults with long COVID across the healthcare continuum.MethodsA search was conducted across MEDLINE (Ovid), EMBASE, and CINAHL (Ebsco) databases from January 1, 2020, to December 4, 2024.FindingsTwenty-one articles were included for data extraction. The occupational therapy role involved addressing key long COVID symptoms (e.g., fatigue, weakness, and cognitive impairments) that influenced daily occupational performance. Occupational therapy interventions were primarily delivered in rehabilitation settings and included retraining in activities of daily living, cognitive rehabilitation, physical and breathing exercises, patient education, return-to-work planning, and psychosocial support.ConclusionThe occupational therapy role involved addressing long COVID symptoms to regain functional independence to enable occupational engagement, primarily through patient education. Studies focused more on interprofessional, team-based interventions, versus occupational therapy-specific interventions in isolation. This highlights the need for further research on the unique role of occupational therapy within interprofessional teams and along the care continuum for more generalizable findings.},
}

@article {pmid42435145,
year = {2026},
author = {Roche, F and Pichot, V and Bory, C and Bory, N and Hupin, D},
title = {Transcutaneous vagus nerve stimulation for long COVID-associated autonomic dysfunction: mechanistic rationale and emerging clinical evidence.},
journal = {Clinical autonomic research : official journal of the Clinical Autonomic Research Society},
volume = {},
number = {},
pages = {},
pmid = {42435145},
issn = {1619-1560},
}

@article {pmid42426705,
year = {2026},
author = {Biering, K and Schiøttz-Christensen, B and Willert, MV and Nielsen, KJ and Kolstad, HA and Kyndi, M and Vestergaard, JM},
title = {The impact of SARS-CoV-2 infection on work participation, sickness absence and general practitioner consultations in the Danish population - a register-based matched cohort study.},
journal = {BMC public health},
volume = {},
number = {},
pages = {},
doi = {10.1186/s12889-026-28486-8},
pmid = {42426705},
issn = {1471-2458},
abstract = {OBJECTIVES: Many persons infected with SARS-CoV-2 experienced prolonged symptoms after the acute phase of the infection (long-COVID). We aimed to investigate whether SARS-CoV-2 infection increased the risk of long-term sickness absence, low work participation, and high use of general practitioners in persons in the Danish workforce.

METHODS: In a register-based cohort study, we identified 261,325 persons from the workforce who tested positive for SARS-CoV-2 in Denmark. These were matched with persons who tested negative by time, sex, age, and industry and analysed with conditional logistic regression. The outcomes were long-term sickness absence, low work participation and high number of contacts to general practitioners, all measured during year 1 after test. We adjusted for work participation or contacts to general practitioners, both measured during year 1 before test, respectively, and for vaccination status, comorbidity, and educational level. We stratified the result by sex, age, and industry to identify any effect modification by these factors.

RESULTS: Most persons infected with SARS-CoV-2 were not on long-term sickness absence (98.3%). However, compared to persons tested negative, SARS-CoV-2 infected had an increased risk of long-term sickness absence (Odds Ratio (OR):2.92[2.82;3.03]) and low work participation (OR:1.32[1.30;1.34]). The risk was higher among women and middle-aged and older persons. Furthermore, the risk was highest in public administration, education and health services, culture and arts, and lowest in agriculture, forestry and fishing. We found an increased risk of high number of contacts to general practitioners among SARS-CoV-2 infected (OR:1.61[1.60;1.63]), however more uniformly distributed across subgroups.

CONCLUSION: Infection with SARS-CoV-2 was associated with a higher risk of long-term sickness absence, low work participation and high number of contacts to general practitioners during year 1 after test. The associations differed across sex, age and industry, especially in relation to sickness absence.},
}

@article {pmid42428381,
year = {2026},
author = {Muthian, S and Hadjichristofis, M},
title = {Shoulder Injuries Secondary to Proning: Sequelae of Long COVID Syndrome: A Case Report.},
journal = {Journal of orthopaedic case reports},
volume = {16},
number = {7},
pages = {116-120},
pmid = {42428381},
issn = {2250-0685},
abstract = {INTRODUCTION: Prolonged proning is widely used in the management of severe acute respiratory distress syndrome (ARDS), most notably during the COVID-19 pandemic. Although brachial plexus injuries are recognized complications, structural shoulder injuries remain rarely reported.

CASE REPORT: We report a case of a patient who developed a glenoid fracture and persistent shoulder dysfunction following prolonged proning for COVID-19-related ARDS. Clinical assessment, radiological findings, and management strategies are detailed.

DISCUSSION: This case highlights unique mechanical and physiological risk factors for structural shoulder injury during proning, including obesity, diabetic neuropathy, prolonged intensive care unit stay, and positioningrelated stress.

CONCLUSION: Structural glenohumeral injuries should be considered in patients presenting persistent shoulder dysfunction after prolonged proning. Awareness and preventive positioning strategies are essential.},
}

@article {pmid42428921,
year = {2026},
author = {Kassymbek, S and Abduldayeva, A and Safonov, N},
title = {Global prevalence of post-COVID-19 condition (Long COVID): a systematic review and meta-analysis of observational studies.},
journal = {Frontiers in public health},
volume = {14},
number = {},
pages = {1839646},
pmid = {42428921},
issn = {2296-2565},
mesh = {Humans ; *COVID-19/epidemiology/complications ; Prevalence ; Post-Acute COVID-19 Syndrome ; Observational Studies as Topic ; *Global Health/statistics & numerical data ; SARS-CoV-2 ; },
abstract = {BACKGROUND: Long COVID is an umbrella term for persistent, relapsing, or newly developed health problems after SARS-CoV-2 infection, whereas post-COVID-19 condition (PCC) refers more specifically to the World Health Organization clinical case definition. Reported prevalence varies substantially because of differences in terminology, operational definitions, study populations, follow-up duration, hospitalization status, and symptom ascertainment. This systematic review and meta-analysis synthesized global observational evidence on Long COVID/PCC prevalence and examined major sources of variability.

METHODS: A systematic review and meta-analysis was conducted according to PRISMA 2020 principles. PubMed/MEDLINE, Scopus, Web of Science, and the WHO COVID-19 Global Literature Database were searched for studies published from 1 January 2020 to 23 February 2026. Observational studies were eligible if they included individuals with confirmed or probable SARS-CoV-2 infection, reported Long COVID/PCC or persistent post-COVID symptoms at least 4 weeks after acute infection, and provided numerator and denominator data. Terminology and operational case definitions were extracted separately. Prevalence estimates were pooled using a random-effects model with logit transformation and back-transformation. Heterogeneity was assessed using Cochran's Q, I[2], tau[2], and prediction intervals. Subgroup and sensitivity analyses were performed.

RESULTS: Twenty-two studies contributing 27 prevalence estimates and more than 200,000 participants were included. The primary estimate-level pooled prevalence was 30.8% (95% CI 26.8-35.0). Heterogeneity was extreme: Q = 8031.9, df = 26, p < 0.001; I[2] = 99.7%; tau[2] = 0.252 on the logit scale. The prediction interval was 14.0-54.8%. Pooled prevalence was higher among hospitalized cohorts (37.9%, 95% CI 29.5-47.1) than among non-hospitalized, community-based, or mixed cohorts (26.2%, 95% CI 22.0-30.9). WHO-defined PCC yielded lower prevalence (22.8%, 95% CI 14.3-34.4) than broader symptom-based definitions (39.7%, 95% CI 30.5-49.5). Cohort-level sensitivity analysis yielded a similar prevalence of 31.0% (95% CI 26.8-35.4).

CONCLUSION: Long COVID/PCC represents a substantial post-acute public health burden. However, because heterogeneity was extreme, the pooled prevalence should be interpreted as a descriptive summary of heterogeneous observational evidence rather than as a single precise global rate. Standardized definitions, harmonized surveillance, transparent reporting, rehabilitation pathways, and multidisciplinary care models are needed.},
}

Humans
*COVID-19/epidemiology/complications
Prevalence
Post-Acute COVID-19 Syndrome
Observational Studies as Topic
*Global Health/statistics & numerical data
SARS-CoV-2

@article {pmid42431744,
year = {2026},
author = {Guedj, E and Beckman, D},
title = {Dopaminergic vulnerability in long COVID: striatal PET imaging at the brain-body interface.},
journal = {EBioMedicine},
volume = {},
number = {},
pages = {106369},
doi = {10.1016/j.ebiom.2026.106369},
pmid = {42431744},
issn = {2352-3964},
}

@article {pmid42431745,
year = {2026},
author = {Liu, YK and Persaud, D and Vieira, EL and Braga, J and Rusjan, P and Miler, L and Rabin, JS and McCluskey, T and Boileau, I and Chao, T and Bagby, M and Narciso, L and Gray, LR and Vasdev, N and Desmond, K and Kloiber, S and Warsh, J and Husain, MI and Smart, K and Wang, W and Meyer, JH},
title = {Loss of vesicular monoamine transporter 2 in striatum of long COVID and relationship to neuropsychiatric symptoms.},
journal = {EBioMedicine},
volume = {},
number = {},
pages = {106339},
doi = {10.1016/j.ebiom.2026.106339},
pmid = {42431745},
issn = {2352-3964},
abstract = {BACKGROUND: Dopaminergic neurons are vulnerable to injury from gliosis and have high density of ACE2 receptors, but the integrity of dopaminergic neurons has not been investigated in long COVID. This study examined whether vesicular monoamine transporter 2 (VMAT2) binding, index of dopamine-releasing neuron density, is reduced in the striatum in long COVID and associated with neuropsychiatric symptoms.

METHODS: This case-control study (Aug 2022-Apr 2025, Toronto, Canada) included 24 adults with long COVID and 24 age-matched healthy controls, and the healthy control sample was extended to 43 for exploratory analyses. Primary outcome was comparison of (+)[[11]C]DTBZ binding potential (BPND), PET measure of VMAT2 binding, between long COVID and control groups across ventral striatum, dorsal putamen, and dorsal caudate. Secondary outcomes were associations of regional (+)[[11]C]DTBZ BPND with neuropsychiatric measures (apathy, anhedonia, motor retardation) in long COVID.

FINDINGS: (+)[[11]C]DTBZ BPND was significantly lower in 24 individuals with long COVID vs 24 age-matched healthy controls (linear mixed effects model, P = 4 × 10[-5]; vs 43 controls, P = 6 × 10[-4]). Apathy, motor slowing (secondary outcomes) and memory decline (exploratory outcome) correlated with lower (+)[[11]C]DTBZ BPND in ventral striatum, dorsal putamen and caudate, respectively (|r| = 0.48-0.58, P = 0.0029-0.018).

INTERPRETATION: Findings of reduced VMAT2 binding may reflect reduced dopaminergic terminal integrity in long COVID. Loss of dopamine nerve terminals may be contributing to symptom correlates of apathy, motor slowing and memory decline suggesting improved function of dopaminergic synapses as a new therapeutic direction to treat long COVID.

FUNDING: Canadian Institutes of Health Research (191851).},
}

@article {pmid42432030,
year = {2026},
author = {Horberg, MA and Jefferson, C and Watson, E and Kim, S and Deneal, AN and Gebo, KA and Hogan, BC and Humes, E and Althoff, KN},
title = {Effects of HIV status and vaccination on long COVID conditions within an integrated health care system.},
journal = {Communications medicine},
volume = {},
number = {},
pages = {},
doi = {10.1038/s43856-026-01761-w},
pmid = {42432030},
issn = {2730-664X},
support = {U01AI069918//U.S. Department of Health & Human Services | National Institutes of Health (NIH)/ ; },
abstract = {BACKGROUND: COVID infection has been linked to long-term effects known as Long COVID Conditions (PCC), presenting within 30-120 days post-acute COVID infection. Few studies have focused on PCC incidence among people with HIV (PLWH). Additionally, the effect of vaccination, especially among PLWH, is unclear on the risk for PCC. We evaluate PCC incidence among PLWH compared with people without HIV (PWoH), as well as the effect of COVID vaccination, within an integrated closed healthcare system with high ascertainment of COVID-19 testing.

METHODS: Adult patients with a positive polymerase chain reaction test for COVID between 1/1/2020-1/31/2022 were matched PLWH to PWoH by month of test, age, race, sex, vaccination status, using 1:3 variable ratio matching. PCC was defined as presenting with at least one of 17 previously identified conditions incident in the 30-120 days post first positive test date. We determined the effect of COVID vaccination on subsequent development of PCC using an unmatched PLWH/PWoH population analyzed by multivariate regression modeling.

RESULTS: We show that 749 PLWH matched to 2,236 PWoH for PCC incidence evaluation and 492 (PLWH) and 71,844 PWoH for vaccination analysis. PLWH have 25% higher risk of PCC than PWoH. Gastrointestinal and other nervous system disorders are significantly higher among PLWH. Vaccination has significant impact on acute-persistent PCC risk but not late incident PCC without impact by HIV status.

CONCLUSION: PLWH have higher risk of PCC. Vaccination lowers persistent symptom risk, but not late incident PCC risk. Vaccination and vigilance for PCC is encouraged.},
}

@article {pmid42432680,
year = {2026},
author = {Sasso, EM and Eaton-Fitch, N and Thapaliya, K and Marshall-Gradisnik, S},
title = {Neurological impairment in long COVID: implications for neurodegenerative disease.},
journal = {Journal of translational medicine},
volume = {},
number = {},
pages = {},
doi = {10.1186/s12967-026-08607-y},
pmid = {42432680},
issn = {1479-5876},
support = {489798//Stafford Fox Medical Research Foundation/ ; 1199502//National Health and Medical Research Council/ ; 47107//Mason Foundation/ ; 49979//McCusker Charitable Foundation/ ; 4676//Ian and Talei Stewart, the Buxton Foundation/ ; 4579//Blake Beckett Trust Foundation/ ; 4570//Alison Hunter Memorial Foundation/ ; 4575//Change for ME Charity/ ; Dr John Hamwood//Dr John Hamwood/ ; 4879//Henty Community/ ; },
abstract = {BACKGROUND: It has been six years since the COVID-19 pandemic and, despite substantial advances in management, the disease sequelae known as long COVID continues to represent a significant medical and societal burden. Long COVID is characterised by persistent neurological and neurocognitive symptoms, including brain fog, memory deficits, attention impairments, and fatigue, lasting for months after acute SARS-CoV-2 infection.

MAIN BODY: In this review, we collated emerging neurological findings related to long COVID, discussing neurodegenerative processes associated with long COVID, potential clinical implications and research limitations. Neurological and neurocognitive manifestations arise through multiple mechanisms, including direct SARS-CoV-2 invasion of the central nervous system and peripheral lymphocyte infiltration. Additionally, neurovascular damage potentially contributes to neurodegeneration through neuronal injury, impaired neurogenesis, microvascular abnormality and sustained neuroinflammation.

CONCLUSION: Understanding the mechanisms underlying neurological and neurocognitive symptoms is essential for developing long-term monitoring strategies and targeted interventions to mitigate neurocognitive decline in individuals with long COVID.},
}

@article {pmid42433775,
year = {2026},
author = {Abera, EG and Himbaro, SA and Megersa, SW and Ashine, AH and Tukeni, KN and Gebremichael, EH},
title = {Emerging trends in post-COVID immune dysregulation: a narrative review.},
journal = {Annals of medicine and surgery (2012)},
volume = {88},
number = {7},
pages = {4362-4370},
pmid = {42433775},
issn = {2049-0801},
abstract = {BACKGROUND: Long coronavirus disease (COVID), or post-acute sequelae of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, is a multi-system condition associated with persistent immune dysregulation, autoimmunity, and vascular perturbations. Understanding these immunological mechanisms is essential for guiding clinical management and therapeutic strategies.

METHODS: We conducted a narrative review of peer-reviewed human studies published between January 2020 and August 2025, using PubMed/Medline, Scopus, and Web of Science, supplemented by manual searches. Studies reporting immunological assessments in long COVID patients, recovered individuals, or healthy controls were included. Findings were extracted and synthesized thematically across six domains: humoral and cellular immunity, autoimmune signatures, proteomic/metabolic and vascular dysregulation, viral persistence, complement/coagulation/thromboinflammation, and pediatric long COVID.

RESULTS: Long COVID is characterized by persistent low-grade inflammation, T- and B-cell dysregulation, and prolonged adaptive immune activation. Humoral responses remain elevated, while T-cell exhaustion and loss of coordination between immune compartments are common. Autoimmune phenomena, including latent and polyautoimmunity targeting cytokines, thyroid antigens, and interferons, are frequently observed. Proteomic, metabolic, and vascular perturbations, complement activation, and thromboinflammatory processes contribute to ongoing symptoms. Viral persistence and early immune biomarkers predict long COVID development. These immune alterations correlate with fatigue, cognitive impairment, respiratory dysfunction, and reduced quality of life in both adults and children.

CONCLUSION: SARS-CoV-2 infection leaves a lasting immunological footprint marked by chronic inflammation, adaptive immune dysregulation, autoimmunity, and vascular perturbations. Integrating longitudinal immune assessments, biomarker profiling, and early predictive markers is critical for identifying high-risk individuals and informing interventions to reduce long COVID morbidity.},
}

@article {pmid42434549,
year = {2026},
author = {Ruiz-Casas, C and Tarrés-Freixas, F and Roca, N and Pérez, M and Contreras, E and Martín, L and Bernaus, O and Olvera, A and Ruiz-Riol, M and Brander, C and Usai, C and Vergara-Alert, J and Segalés, J},
title = {Persistent neurological and behavioral alterations after SARS-CoV-2 infection in an optimized K18-hACE2 mouse model.},
journal = {Frontiers in microbiology},
volume = {17},
number = {},
pages = {1871084},
pmid = {42434549},
issn = {1664-302X},
abstract = {INTRODUCTION: Persistent neurological symptoms are among the most prevalent and debilitating manifestations of post-COVID-19 Condition (PCC), affecting millions of individuals worldwide. PCC is a chronic multisystemic syndrome that develops in over 30% of adults following acute infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Despite its major clinical and socioeconomic impact, the biological mechanisms underlying PCC remain poorly understood, underscoring the need for robust and translational animal models.

METHODS: We conducted a longitudinal study in K18-hACE2 mice, integrating virological, immunological, histopathological, and behavioral assessments from acute infection through 60 days post-inoculation.

RESULTS: SARS-CoV-2-inoculated mice developed persistent neurobehavioral impairments despite the absence of detectable viral replication in the brain. These alterations were associated with sustained immune dysregulation in both pulmonary and neural tissues, persistent pulmonary pathology, and a reduction in vagus nerve cross-sectional area. Notably, several long-term outcomes exhibited marked sex-dependent differences that mirrored clinical observations in human PCC.

DISCUSSION: Our findings demonstrate that K18-hACE2 mice recapitulate key neurological and immunopathological features of PCC and may constitute a valuable experimental model for investigating the mechanisms underlying PCC-associated neurological sequelae. This model may also facilitate the development and preclinical evaluation of targeted therapeutic interventions.},
}

@article {pmid42434926,
year = {2026},
author = {Yehoshua, A and Black, RM and Di Fusco, M and Carter, B and Sienko, D and Lopez, S and McColgan, MD and Rudolph, AE and Yang, J},
title = {Evaluation of long-term healthcare utilization and costs associated with COVID-19 among adults and children in the US.},
journal = {Journal of medical economics},
volume = {29},
number = {1},
pages = {1942-1954},
doi = {10.1080/13696998.2026.2699643},
pmid = {42434926},
issn = {1941-837X},
mesh = {Humans ; *COVID-19/economics/epidemiology ; Retrospective Studies ; United States ; Female ; Child ; Male ; Adult ; Middle Aged ; Adolescent ; *Patient Acceptance of Health Care/statistics & numerical data ; Insurance Claim Review ; Child, Preschool ; *Health Expenditures/statistics & numerical data ; Aged ; Young Adult ; SARS-CoV-2 ; Post-Acute COVID-19 Syndrome ; },
abstract = {AIMS: This study assessed long-term healthcare resource utilization (HCRU) and direct medical costs associated with COVID-19 among adults and children in the United States. Using a large national claims database, we quantified the incremental healthcare burden during the year following a first COVID-19 diagnosis compared to matched controls without a COVID-19 diagnosis.

MATERIALS AND METHODS: This retrospective cohort study used data from the IQVIA PharMetrics Plus database. Patients with a COVID-19 diagnosis (U07.1) between June 1 and November 30, 2022, were matched 1:1 to non-COVID-19 controls based on age, sex, region, insurance type, Charlson Comorbidity Index, and baseline HCRU. Outcomes were HCRU and all-cause healthcare costs accrued during the post-acute period (≥31 days after first COVID-19 diagnosis), measured cumulatively through 1, 3, 6, 9, and 11 months of follow-up. Generalized linear models estimated cost ratios.

RESULTS: The study included 944,627 patients with a COVID-19 diagnosis (U07.1) and an equal number of matched controls. Compared with matched controls, mean total costs during 11 months of post-acute follow-up were 27% higher among adults ($11,508 vs $9,040; p < 0.001) and 42% higher among pediatric patients with COVID-19 ($3,997 vs $2,812; p < 0.001). Costs were higher for COVID-19 cases at all follow-up time points. Among adults at the 11-month follow-up time, costs increased with acute infection severity, with mean costs of $10,372 for outpatients, $36,848 for hospitalized patients, and $51,643 for ICU patients, compared with $8,617, $16,926, and $17,620, respectively, among matched controls (all p < 0.001). Among adults, cost ratios peaked at 1 month of follow-up (1.32; 95% CI: 1.31-1.33) and declined to 1.15 (95% CI: 1.14-1.15) at 11 months.

CONCLUSIONS: There were significantly higher post-acute HCRU and costs among both adults and pediatrics with a COVID-19 diagnosis compared to matched controls without one, with elevated cost differences persisting up to 12 months post-infection.},
}

Humans
*COVID-19/economics/epidemiology
Retrospective Studies
United States
Female
Child
Male
Adult
Middle Aged
Adolescent
*Patient Acceptance of Health Care/statistics & numerical data
Insurance Claim Review
Child, Preschool
*Health Expenditures/statistics & numerical data
Aged
Young Adult
SARS-CoV-2
Post-Acute COVID-19 Syndrome

@article {pmid42424907,
year = {2026},
author = {Kamseng, P and Chantaramanee, N and Sompan, R and Rareongjai, S},
title = {Integrative hematological and transcriptomic analysis reveals monocyte alterations and molecular signatures of inflammatory-coagulation crosstalk in long COVID.},
journal = {Computational biology and chemistry},
volume = {124},
number = {Pt 2},
pages = {109226},
doi = {10.1016/j.compbiolchem.2026.109226},
pmid = {42424907},
issn = {1476-928X},
abstract = {Long COVID has complicated immunological and coagulation dysregulations. The study explores the pathophysiological pathways by integrating clinical hematological characteristics with transcriptome bioinformatics. In a comparison of 45 patients (21 with Long COVID and 24 asymptomatic controls), the Long COVID cohort demonstrated significantly reduced total WBC counts (p = 0.031) and circulating monocytes (p = 0.008), as well as reduced platelet counts (p = 0.040) and prolonged APTT (p = 0.016). To better understand these findings, transcriptome analysis of the public dataset GSE251849 was performed applying DESeq2, Gene Set Enrichment Analysis (GSEA), and a Protein-Protein Interaction (PPI) network assessed through the Maximal Clique Centrality (MCC) algorithm. Transcriptomic profiling demonstrated significant enrichment of inflammation, cellular stress, and coagulation pathways. The MCC analysis identified IL6, MYC, CDKN1A, SERPINE1, CD44, and PLAUR as the key hub genes. The significant decrease in circulating monocytes, along with upregulation of CD44, indicates monocyte depletion due to enhanced endothelium adherence. Furthermore, the significant upregulation of SERPINE1 and PLAUR underscores the important connection between chronic vascular inflammation and severe fibrinolysis resistance (hypofibrinolysis). These findings establish a strong biological basis for the clinical features of Long COVID, highlighting an immunothrombosis proposed mechanistic model driven by cellular stress and hypofibrinolysis, thus pinpointing prospective targets for future diagnostics and therapeutics.},
}

@article {pmid42425362,
year = {2026},
author = {Acanfora, D and Nolano, M and Acanfora, C and Colella, C and Provitera, V and Caporaso, G and Rengo, G and Incalzi, RA and Casucci, G},
title = {Vagal cholinergic denervation of the gastric mucosa in Long-COVID-19: in vivo evidence of structural autonomic dysfunction.},
journal = {International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases},
volume = {},
number = {},
pages = {108973},
doi = {10.1016/j.ijid.2026.108973},
pmid = {42425362},
issn = {1878-3511},
abstract = {OBJECTIVES: Dysautonomia has been increasingly recognized as a key feature of Long-COVID-19, potentially contributing to persistent gastrointestinal and systemic symptoms. Reduced vagal activity observed in these patients may reflect structural damage to autonomic fibers. We hypothesized that dysautonomic manifestations in Long-COVID-19 are associated with impaired cholinergic innervation of the gastric mucosa.

METHODS: We conducted a case-control study including 12 patients with Long-COVID-19 and 8 control subjects undergoing routine gastroscopy. Gastric mucosal biopsies were analyzed using immunohistochemistry with the pan-neuronal marker protein gene product 9.5 (PGP 9.5) and vasoactive intestinal peptide (VIP) as a marker of cholinergic fibers. Nerve fiber density was quantified in both fundus and antrum samples.

RESULTS: Compared with controls, Long-COVID-19 patients exhibited a significant reduction in mucosal innervation density: 2.1 vs 3.9 nm/µm³ (p<0.01) in the fundus and 1.9 vs 3.9 nm/µm³ (p<0.05) in the antrum. The reduction in cholinergic innervation was more pronounced in the fundus (p<0.01) andalso evident in the antrum (p=0.01). Gastric nerve density correlated with HRV parameters (LF/HF ratio: R=0.50, p<0.05) and NT-proBNP levels (R=0.52, p<0.01).

CONCLUSIONS: Patients with Long-COVID-19 exhibit reduced gastric mucosal cholinergic innervation. This structural autonomic impairment may represent an anatomical substrate underlying dysautonomia in Long-COVID-19.},
}

@article {pmid42426196,
year = {2026},
author = {Wood, H},
title = {Autoantibodies could trigger neurological symptoms of long COVID.},
journal = {Nature reviews. Neurology},
volume = {},
number = {},
pages = {},
pmid = {42426196},
issn = {1759-4766},
}

@article {pmid42426643,
year = {2026},
author = {González-Andrade, F},
title = {Strict long COVID, symptom persistence, and functional decline among community-dwelling older adults in Quito, Ecuador: a cross-sectional study.},
journal = {BMC geriatrics},
volume = {},
number = {},
pages = {},
doi = {10.1186/s12877-026-07976-9},
pmid = {42426643},
issn = {1471-2318},
abstract = {BACKGROUND: Long COVID is an increasingly recognized health concern in older adults, yet data from Latin America remain limited. Older adults may be particularly vulnerable to post-COVID sequelae because of frailty, multimorbidity, and reduced physiological reserve. This study aimed to estimate the prevalence of strict long COVID among older Ecuadorian adults and to characterize persistent post-COVID symptoms, clinical correlates, and functional/cognitive worsening.

METHODS: We conducted a cross-sectional study of 1,050 community-dwelling adults aged 65 years or older with PCR-confirmed SARS-CoV-2 infection in Quito, Ecuador. Data were collected through structured face-to-face interviews and cognitive screening. Strict long COVID was defined as symptoms persisting for more than 12 weeks after SARS-CoV-2 infection. Symptoms lasting 4-12 weeks were classified as persistent post-COVID symptoms but were not considered strict long COVID. Multivariable logistic regression was used to evaluate factors associated with strict long COVID.

RESULTS: The mean age was 74.2 ± 7.5 years, and 565 participants (53.8%) were women. Overall, 191 participants met criteria for strict long COVID, corresponding to a prevalence of 18.2% (95% CI, 16.0-20.6). Persistent post-COVID symptoms lasting 4-6 weeks and 7-12 weeks were reported by 401 (38.2%) and 458 (43.6%) participants, respectively. Participants with strict long COVID had higher frequencies of dyspnea, cognitive impairment, sleep disturbance, myalgia, depression, anxiety, and difficulty sleeping. Functional/cognitive worsening was more frequent among participants with strict long COVID than among those without strict long COVID (53.4% vs. 36.6%; p < 0.001), particularly for walking or climbing stairs. In multivariable analysis, severe or critical acute COVID-19 was independently associated with strict long COVID (adjusted OR, 2.36; 95% CI, 1.62-3.41; p < 0.001). Female sex, age ≥ 81 years, incomplete vaccination, diabetes with organ involvement, hospitalization, and care dependence were not independently associated with strict long COVID.

CONCLUSION: Strict long COVID affected nearly one in five older adults with PCR-confirmed SARS-CoV-2 infection in Quito, Ecuador. Severe or critical acute COVID-19 was the main factor independently associated with strict long COVID, and affected participants had greater functional/cognitive worsening. These findings support integrating post-COVID screening, functional assessment, and geriatric rehabilitation into primary care for older adults in Latin America.},
}

@article {pmid42419335,
year = {2026},
author = {, },
title = {Efficacy and safety of rivaroxaban, colchicine, and famotidine-loratadine with specialist supportive clinical care for fatigue in patients with post-COVID-19 condition in the UK: a multisite, open-label, randomised controlled trial.},
journal = {The Lancet. Infectious diseases},
volume = {},
number = {},
pages = {},
doi = {10.1016/S1473-3099(26)00242-2},
pmid = {42419335},
issn = {1474-4457},
abstract = {BACKGROUND: Post-acute sequelae of COVID-19 or post-COVID-19 condition (also known as long COVID) affects 1-5% of adults globally, most commonly with fatigue, and no evidence-based therapies are available. We aimed to evaluate the efficacy of repurposed medications in fatigue management in adults with long COVID.

METHODS: We did a phase 3, four-group, randomised, controlled, adaptive platform, open-label drug trial nested within a pragmatic, multicentre, cluster-randomised trial of an integrated care pathway (ICP) for long COVID across 12 UK National Health Service (NHS) specialist long COVID care clinics in the UK. Participants had to be adults (>18 years) with long COVID who had not been hospitalised with COVID-19. In addition to NHS specialist-led long COVID care (hereafter, usual care), participants in the ICP trial could receive multiorgan MRI and clinical decision support and/or app-based rehabilitation. Initially, participants in the ICP trial were invited to enrol in the drug trial, but slow recruitment to the drug trial led to establishment of additional drug-only trial sites. Participants enrolled at either ICP trial sites or drug-only trial sites were randomly assigned (1:1:1:1) to receive colchicine 500 μg twice daily, rivaroxaban 10 mg once daily, famotidine 40 mg with loratadine 10 mg once daily, or no drug for 12 weeks. All participants received usual care. Randomisation was done electronically in blocks (various block sizes) and stratified by site, birth sex, ICP trial group allocation, and being a new or previous patient of a drug-only site. The primary endpoint was 12-week fatigue, assessed with the Fatigue Assessment Scale (FAS; with scores ranging from 10 [no fatigue] to 50 [debilitating fatigue], and a >10% change considered clinically meaningful) among randomly assigned individuals who had available baseline and 12-week data, adjusting for baseline fatigue and clinically relevant covariates. Secondary endpoints included 24-week FAS. The nested drug trial is registered, ISRCTN10665760. The trial is complete.

FINDINGS: Of 6035 eligible participants, 778 (383 co-enrolled in the ICP trial and 395 directly enrolled in the drug trial) were randomly assigned between Aug 22, 2022, and Aug 7, 2024 to colchicine (n=192), famotidine-loratadine (n=193), rivaroxaban (n=197), or no drug (usual long COVID care only; n=196). The mean age of participants was 46 years (SD 12·4), 495 (64%) of 778 were female, and 91 (12%) were from a non-White ethnic group. Across all trial groups, there was severe baseline fatigue (mean FAS score 36·8 [SD 7·49]) and a clinically relevant mean FAS reduction of 4·3 points to 32·5 (SD 9·13) at 12 weeks. Adjusted analyses showed small, statistically significant FAS reductions in the colchicine (-1·49 points [95% CI -2·92 to -0·06], p=0·041) and famotidine-loratadine (-1·48 points [-2·88 to -0·08], p=0·038) groups, but not in the rivaroxaban group (-1·06 points [-2·47 to 0·35, p=0·139), compared with no study drug at 12 weeks. However, 24-week FAS scores, 12 weeks after drug cessation, were not significantly different between groups. Treatment was well tolerated, with ten serious adverse events (requiring hospitalisation but unrelated to trial drugs) reported in eight (1·0%) of the 778 participants, five of which were in three participants in the rivaroxaban group.

INTERPRETATION: In participants with long COVID, severe fatigue reduced in all study groups-including the no drug group-over 12 weeks, with small additional reductions in the colchicine and famotidine-loratadine groups compared with the no drug group. Modest effects on FAS were not sustained after drug withdrawal. Long-term long COVID symptom benefit is unlikely with these drugs alone. Future trials could investigate the use of these or other repurposed drugs in specific subgroups of patients with long COVID, combination therapies, and how care is delivered.

FUNDING: UK National Institute for Health and Care Research.},
}

@article {pmid42419817,
year = {2026},
author = {Tamariz, L and Palacio, A},
title = {Author Response to "Dysautonomia in Long COVID: Why Sex Differences Matter in Cardiovascular Risk Assessment".},
journal = {Clinical medicine & research},
volume = {24},
number = {2},
pages = {50-51},
doi = {10.3121/cmr.2026.2146},
pmid = {42419817},
issn = {1554-6179},
}

@article {pmid42419818,
year = {2026},
author = {Mattioli, AV},
title = {Dysautonomia in Long COVID: Why Sex Differences Matter in Cardiovascular Risk Assessment.},
journal = {Clinical medicine & research},
volume = {24},
number = {2},
pages = {49-50},
doi = {10.3121/cmr.2026.2127},
pmid = {42419818},
issn = {1554-6179},
}

@article {pmid42421498,
year = {2026},
author = {Carnevali, F and Muollo, MC and Biagini, L and Rossi, G},
title = {Xenosialylation as immunological chimerism: a host-centered unifying model for viral and post-vaccination immune complications.},
journal = {European cytokine network},
volume = {37},
number = {2},
pages = {55-77},
pmid = {42421498},
issn = {1952-4005},
mesh = {Humans ; Glycosylation ; *COVID-19/immunology/prevention & control ; *SARS-CoV-2/immunology ; *Vaccination/adverse effects ; *COVID-19 Vaccines/immunology/adverse effects ; Neuraminic Acids/immunology ; *Models, Immunological ; Animals ; },
abstract = {Severe immune-mediated complications following viral infections and vaccinations, including COVID-19 and anti-SARS-CoV-2 immunization, display remarkable clinical overlap despite occurring in distinct biological contexts. In a previous hypothesis-driven work, we proposed that metabolic incorporation of the non-human sialic acid N-glycolylneuraminic acid (Neu5Gc) into human glycoconjugates-defined as xenosialylation-may contribute to post-infectious and post-vaccination immune dysregulation. We further suggest that this phenomenon may represent a form of "immunological chimerism", in which host glycoconjugates incorporate non-self molecular structures that predispose the immune system to varying degrees of immune imbalance. In its most severe manifestation, this process may culminate in a profound state of immune dysregulation characterized by loss of immune tolerance, aberrant antibody responses, cytokine storm, and thrombo-inflammatory pathology, which we define as "immunological marasmus". In the present paper, we extend this conceptual framework by integrating glycobiology, Fc immunoglobulin glycosylation, endothelial biology, and sex-dependent immune regulation into a unified, testable immunopathogenic model. We hypothesize that interindividual differences in the extent, tissue distribution, and persistence of xenosialylation may influence susceptibility to exaggerated innate and adaptive immune responses following antigenic challenge. In this context, immune activation may unmask pre-existing xeno-sialylated self-structures embedded within host glycans, promoting varying degrees of glycan dysregulation, autoantibody production, immunothrombosis and chronic inflammatory sequelae. We further propose circulating anti-Neu5Gc antibodies as functional biomarkers for risk stratification and outline preventive strategies based on dietary modulation of xenosialic acid exposure. Taken together, this expanded model provides a potential mechanistic framework for understanding the shared immunological features of post-viral syndromes and vaccine-related adverse immune reactions, while offering a basis for experimental validation and future approaches to personalized risk mitigation.},
}

Humans
Glycosylation
*COVID-19/immunology/prevention & control
*SARS-CoV-2/immunology
*Vaccination/adverse effects
*COVID-19 Vaccines/immunology/adverse effects
Neuraminic Acids/immunology
*Models, Immunological
Animals

@article {pmid42421939,
year = {2026},
author = {Li, E and Shi, M and Huang, S},
title = {New-onset allergic diseases after SARS-CoV-2 infection: mechanistic hypotheses and emerging strategies for risk stratification.},
journal = {Frontiers in immunology},
volume = {17},
number = {},
pages = {1879430},
pmid = {42421939},
issn = {1664-3224},
mesh = {Humans ; *COVID-19/immunology/complications ; *SARS-CoV-2/immunology ; *Hypersensitivity/immunology/epidemiology ; Animals ; Risk Assessment ; },
abstract = {Multinational cohort studies consistently associate SARS-CoV-2 infection with elevated incidence of allergic diseases, with hazard ratios of 2.25 for asthma and 1.23 for allergic rhinitis persisting beyond six months post-infection; whether this excess risk reflects de novo allergic sensitization or preferential unmasking of pre-existing subclinical atopy remains to be established. Yet mechanisms bridging acute viral illness to delayed allergic phenotypes remain incompletely understood. This review synthesizes recent advances across epithelial biology, immunology, and neuroimmune interactions to propose a unified mechanistic framework organized around three interconnected axes. First, epithelial injury during COVID-19 triggers passive IL-33 release while inducing active TSLP and IL-25 production. These alarmins act through mechanistically distinct pathways to converge on type 2 immune priming, which is established and reinforced by epigenetic memory in group 2 innate lymphoid cells and dendritic cells. Second, regulatory T cell depletion and, hypothetically, hematopoietic stem and progenitor cell epigenetic reprogramming driven by acute interleukin-6 elevation may generate immune cell progeny with persistently altered inflammatory responsiveness, while dendritic cells adopt Th2-polarizing phenotypes that lower the threshold for allergic sensitization; the direct contribution of hematopoietic reprogramming to Th2-skewed allergic outcomes remains to be demonstrated. Third, mast cells undergo direct spike protein-mediated activation via angiotensin-converting enzyme 2 receptors, and alarmin-primed mast cells establish bidirectional crosstalk with sensory neurons that amplifies neuroinflammation and links long COVID symptoms to heightened allergic susceptibility. Together, these axes define a post-infectious vulnerability window during which allergen encounters trigger exaggerated type 2 responses. Risk stratification incorporating disease severity, circulating biomarkers including immunoglobulin E and eosinophil counts, and genetic susceptibility variants may identify individuals requiring targeted surveillance, while mechanistically informed interventions such as low-dose interleukin-2, mast cell stabilizers, and alarmin-targeted biologics warrant prospective evaluation in convalescent cohorts.},
}

Humans
*COVID-19/immunology/complications
*SARS-CoV-2/immunology
*Hypersensitivity/immunology/epidemiology
Animals
Risk Assessment

@article {pmid42421948,
year = {2026},
author = {Liu, A and Chen, H and Liu, Q and Al-Azab, M and Shaher, F and Li, J and Liu, T and Yang, M},
title = {Cardiovascular sequelae of Long COVID: immune dysregulation inflammation as central drivers.},
journal = {Frontiers in immunology},
volume = {17},
number = {},
pages = {1815269},
pmid = {42421948},
issn = {1664-3224},
mesh = {Humans ; *COVID-19/immunology/complications ; Post-Acute COVID-19 Syndrome ; *Cardiovascular Diseases/immunology/etiology ; *Inflammation/immunology ; Immunity, Innate ; *SARS-CoV-2/immunology ; Animals ; Adaptive Immunity ; },
abstract = {Long coronavirus disease 2019 (Long COVID-19), also referred to as post-acute sequelae of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, has emerged as a major global health challenge. Common manifestations include fatigue, dyspnea, cognitive dysfunction, and exercise intolerance. Beyond these systemic manifestations, the enduring cardiovascular manifestations are increasingly identified as core characteristics of Long COVID-19 syndromes secondary to SARS-CoV-2 infection, encompassing myocarditis, ischemic and non-ischemic heart disease, arrhythmias, heart failure, and thrombotic events. Accumulating evidence suggests that immune dysregulation and persistent inflammation are central drivers of cardiovascular injury in Long COVID. Persistent activation of innate and adaptive immune pathways fosters endothelial injury, thrombo-inflammation, and adverse myocardial remodeling. In this review, we focus on current clinical and experimental evidence to delineate the immune-mediated mechanisms underlying cardiovascular sequelae in Long COVID and explore potential therapeutic strategies targeting persistent inflammation and immune dysregulation.},
}

Humans
*COVID-19/immunology/complications
Post-Acute COVID-19 Syndrome
*Cardiovascular Diseases/immunology/etiology
*Inflammation/immunology
Immunity, Innate
*SARS-CoV-2/immunology
Animals
Adaptive Immunity

@article {pmid42421959,
year = {2026},
author = {Bansal, A},
title = {Proteomic landscapes of post-COVID condition: biomarkers and translational pathways.},
journal = {Frontiers in immunology},
volume = {17},
number = {},
pages = {1783192},
pmid = {42421959},
issn = {1664-3224},
mesh = {Humans ; *Biomarkers/blood/metabolism ; *Proteomics/methods ; *COVID-19/complications/immunology/metabolism ; Post-Acute COVID-19 Syndrome ; *SARS-CoV-2 ; },
abstract = {Post-COVID condition is a heterogeneous, multi-system sequela of SARS-CoV-2 infection that imposes substantial socioeconomic burden and currently needs validated diagnostic biomarkers or established therapeutic pathways. This brief communication synthesises blood-based proteomic and targeted biomarker evidence and organises it into three overlapping pathophysiological domains: persistent immune dysregulation (IL-6, IL-20, MCP-1 and TNF- α), endothelial dysfunction and disordered haemostasis (VEGF-A, P-selectin, vWF, ICAM-1 and D-dimer); and neurological injury (NFL, GFAP, NAAA, LXN, NBL1, HAGH). Across studies, no single protein provides adequate diagnostic performance; phenotype-linked multi-analyte panels show the greatest promise. Researching post-COVID conditions requires harmonised case definitions, cross-platform validation, and the integration of coagulation assays and extracellular vesicle profiling to improve tissue signal detection.},
}

Humans
*Biomarkers/blood/metabolism
*Proteomics/methods
*COVID-19/complications/immunology/metabolism
Post-Acute COVID-19 Syndrome
*SARS-CoV-2

@article {pmid42422160,
year = {2026},
author = {Duncan, JP and Jackson, M and Cooper, CJ and Anzinger, JJ and Ehikhametalor, K and Facey, KA and Cloherty, G and Tulloch-Reid, MK},
title = {Persistent Neurological Symptoms in Chronic Disease Patients After COVID-19 Infection in Jamaica: A Retrospective Cohort Study Exploring Clinical Manifestations of Long COVID in a Low and Middle Income Country.},
journal = {Health science reports},
volume = {9},
number = {7},
pages = {e72761},
pmid = {42422160},
issn = {2398-8835},
abstract = {BACKGROUND AND AIMS: There is uncertainty about the long term effects of COVID-19 infection. We describe the dominant reported symptoms and their sociodemographic risk factors in a sample of Jamaican patients with non-communicable diseases (NCD) and laboratory determined infection status.

METHODS: A retrospective cohort study (February 20, 2023-September 12, 2023) of patients from the University Hospital of the West Indies (UHWI) were identified through participation in the Caribbean COVID-19 Metabolic Health Study (CCMHS) or ICU admissions between March 2020 and March 2021 with a positive PCR. COVID-19 infection status was based on anti-nucleocapsid (anti-N) antibodies in those without PCR reports. Participants were classified as "Exposed" if they had positive anti-N antibodies or a positive PCR test and "Unexposed" if they had negative anti-N antibodies. Bivariate analyses compared current symptoms and quality of life of exposed and unexposed participants. Logistic regression explored factors associated with memory loss.

RESULTS: Eighty-six persons (62 exposed and 24 unexposed; mean age 54.1 ± 13.4 years; median "time since first COVID-19 diagnosis" 1.9 years) participated in the study. "Not [feeling] quite right" (59.3%), joint pains (46.5%), fatigue (45.4%), numbness/tingling (43.0%), headache (26.7%), and shortness of breath (23.3%) were the most common symptoms that were similarly reported in persons regardless of infection status. Memory loss was more common among exposed participants (41.9% vs. 12.5%, p = 0.01) and among those with COVID-19 infection, self-reported depression/anxiety increased the odds of this symptom (OR 6.7 (1.7-25.7).

CONCLUSION: Cardiopulmonary and musculoskeletal symptoms were common among NCD patients regardless of previous COVID-19 infection. However, memory loss was more common up to 2 years after initial COVID-19 infection. Prospective cohorts of long COVID in subpopulations are critical to elucidating its natural history.},
}

@article {pmid42422161,
year = {2026},
author = {Santis, B and Baldo, F and Vento, G and Nobile, S},
title = {Impact of COVID-19 on Subsequent Lung Function in Childhood: A Systematized Review.},
journal = {Health science reports},
volume = {9},
number = {7},
pages = {e72793},
pmid = {42422161},
issn = {2398-8835},
abstract = {BACKGROUND AND AIMS: The SARS-CoV-2 infection can lead to transiently altered lung function in adults, but data is less clear in children. We aimed to summarize the available evidence about respiratory outcomes after COVID-19 in childhood.

METHODS: We conducted a literature search on post-COVID-19 lung function tests (LFT) on the Medline and Cochrane databases, including studies published between 2019 and 2025.

RESULTS: Three hundred forty-seven publications were identified, and 20 were selected. Results are presented in two sections, based on the duration of follow-up. Most studies included spirometry, whereas many of them presented data from diffusing lung capacity for carbon monoxide, multiple breath nitrogen washout, fractional exhaled nitric oxide, impulse oscillometry, 6-minute walking test, and interrupter resistance. Five papers described no association between COVID-19 and respiratory outcomes, nor a link between the persistence of symptoms and the outcomes. Other authors reported a mild obstructive pattern which showed reversibility post bronchodilators, or a restrictive pattern, particularly when long-COVID was evident. Some papers showed that pulmonary function may be influenced by the initial severity of the SARS-CoV-2 infection.

CONCLUSION: Some studies reported no clear association between lung function impairment and previous history of COVID-19. Other authors reported mild, transient consequences. A small number of papers concluded that severe infection, which is relatively rare in children, might affect pulmonary function. The main limitation of this review was the high heterogeneity of the included studies, especially regarding the COVID-19 severity, the age groups, the LFT details, and the duration of follow-up.},
}

@article {pmid42422442,
year = {2026},
author = {Rodríguez-Pérez, MP and Huertas-Hoyas, E and León-Herrera, S and Gómez-Bravo, R and García-Bravo, C and Rodríguez-Rodríguez, E and Poveda-García, A},
title = {Beyond functional independence: symptom burden and emotional difficulties in pediatric long COVID-a cross-sectional exploratory study.},
journal = {Frontiers in pediatrics},
volume = {14},
number = {},
pages = {1878494},
pmid = {42422442},
issn = {2296-2360},
abstract = {BACKGROUND: Pediatric Long COVID poses significant challenges to daily functioning, yet its real-world impact remains poorly understood. Standard functional independence measures may not fully capture the condition's consequences in developmentally relevant contexts.

METHODS: A cross-sectional exploratory study was conducted with 27 children and adolescents (mean age 15.48 ± 2.31 years; 70.4% female) meeting WHO criteria for Long COVID. Functional independence was assessed using the WeeFIM and emotional functioning with the SDQ. Contextual functioning variables-school attendance, grade repetition, and withdrawal from recreational activities-were collected as exploratory indicators of real-world impact.

RESULTS: Despite high symptom burden-fatigue (81.5%), difficulty concentrating (63.0%), and malaise (55.6%) among the most prevalent, with 88.9% experiencing symptoms for over 24 months-WeeFIM scores were near-ceiling across all domains (total: 114.56 ± 20.71/126). Contextual data revealed substantial real-world impact: only 18.5% attended school regularly, 11.1% had repeated an academic year, and 85.2% had withdrawn from previously enjoyed activities. SDQ total scores fell within the normal range (12.07 ± 5.04), though emotional symptoms were slightly elevated (5.59 ± 2.34). A significant negative correlation was found between SDQ total score and WeeFIM cognition (rho = -0.570, p = 0.0019), and a coherent brain fog-mood-concentration symptom cluster was identified. These results are preliminary, hypothesis-generating findings from a convenience sample and should be interpreted with caution regarding generalizability.

CONCLUSIONS: Children and adolescents with Long COVID may maintain basic functional independence while experiencing significant symptom burden, emotional difficulties, and substantial restrictions in school, recreational, and social domains. These findings highlight the limited sensitivity of standard functional measures and underscore the need for more comprehensive, context-sensitive assessment approaches in pediatric Long COVID practice.},
}

@article {pmid42422532,
year = {2026},
author = {Bao, W and Ye, G and Wang, T and Quan, X and Zhu, Q and Fan, L and Li, H and Zeng, W and Mu, J and Zhu, R and Liu, J and Zhang, Y and Niu, X},
title = {Dynamic multivariate patterns of brain structure-neuropsychiatric symptom associations in long COVID.},
journal = {Brain communications},
volume = {8},
number = {4},
pages = {fcag232},
pmid = {42422532},
issn = {2632-1297},
abstract = {Long COVID presents with heterogeneous and persistent neuropsychiatric symptoms, suggesting possible shared neural underpinnings. However, the dynamic brain structure-symptom relationships and their potential for predicting long-term outcomes remain unclear. We conducted a longitudinal study of 144 individuals with long COVID (mean age: 37.8 ± 10.1 years, 48.6% male). All participants experienced mild COVID-19 and were not hospitalized. Structural MRI and comprehensive psychiatric and cognitive assessments were performed at 1, 2 and 12 months post-infection. A cohort of 68 healthy controls (mean age: 36.0 ± 10.3 years; 41.2% male) completed the same assessment protocol at baseline. Regularized canonical correlation analysis was employed to identify multivariate associations between 13 psychiatric and cognitive measures and both grey matter volume and cortical thickness, and to assess whether early structural features predicted symptom outcomes at 1 year. Neuropsychiatric symptoms were linked to coordinated structural covariance patterns across distributed brain regions in long COVID; these associations strengthened from 1 to 3 months post-infection and were absent in controls. A stable cognitive-affective symptom dimension showed the strongest brain-behaviour coupling. Notably, the neural substrates of this coupling diverged over time: grey matter volume associations remained localized to prefrontal-limbic circuits, whereas cortical thickness associations expanded to frontoparietal regions. Critically, reduced grey matter volume in the right cuneus and superior frontal gyri, along with decreased cortical thickness in the left supramarginal gyrus at 3 months post-infection, were significantly linked to poorer executive function and greater fatigue 1 year later. Our findings delineate evolving neuroanatomical signature of long COVID, where distinct patterns of grey matter volume and cortical thickness underpin a core symptom profile and predict long-term neuropsychiatric symptoms. These results provide insight into the neural mechanisms of long COVID and identify specific targets for monitoring and early intervention.},
}

@article {pmid42422850,
year = {2026},
author = {Vera-López, Á and Tilves-Santiago, D and Ramírez-Sánchez, JM and Docío-Fernández, L and García-Mateo, C and Bustillo-Casado, M and García-Caballero, A},
title = {Improving respiratory disease detection through SSL-enhanced acoustic analysis and exercise-rest measurements.},
journal = {Frontiers in medicine},
volume = {13},
number = {},
pages = {1864436},
pmid = {42422850},
issn = {2296-858X},
abstract = {BACKGROUND: Voice analysis has emerged as a promising non-invasive approach for monitoring respiratory and systemic health conditions. However, subtle physiological alterations are often difficult to capture using recordings collected at rest. In addition, combining traditional acoustic descriptors with modern self-supervised speech representations may provide complementary information for clinical voice analysis.

OBJECTIVES: This study evaluates a generalized screening model integrating stress-induced acoustic analysis with machine learning. We investigate how physical exertion and the fusion of traditional acoustic features with self-supervised learning embeddings (such as wav2vec 2.0 and WavLM) enhance the diagnostic sensitivity of vocal and respiratory signals. Post-Acute Sequelae of SARS-CoV-2 (PASC) is used as a case study to evaluate the proposed framework.

METHODS: Utilizing the DICOPERIA-Voice dataset (n = 154), we collected recordings of sustained vowel phonation (/a/) and voluntary coughing at two clinical moments: resting state and following a physiological stress protocol (six-minute walk and one-minute sit-to-stand tests). We employed a dual-feature extraction strategy, combining traditional acoustic biomarkers with high-dimensional Self-Supervised Learning (SSL) embeddings from wav2vec 2.0, WavLM and HuBERT. Binary classification (PASC vs. Healthy) was performed using Logistic Regression, evaluated via stratified 5-fold cross-validation.

RESULTS: Physical exertion significantly improved classification performance and reduced model variability across all tasks. The fusion of acoustic features, WavLM and wav2vec 2.0 achieved peak F1-scores of 82.2% for vowel phonation and 80.8% for coughing both in post-exercise conditions. A cross-task late fusion model aggregation reached the highest overall performance, with an F1-score of 87.7%.

CONCLUSION: Incorporating Self-Supervised Learning representations into acoustic analysis improves the sensitivity of voice-based screening, while post-exercise measurements further enhance the robustness and consistency of classification. Together, these strategies provide a scalable and objective framework for detecting respiratory and vocal sequelae in chronic or post-viral conditions. With further validation, this approach could be integrated into routine functional assessments, offering a rapid, non-invasive adjunct to clinical decision-making.},
}

@article {pmid42424864,
year = {2026},
author = {Yang, S and Xuan, L},
title = {Comment on "the neuropsychiatric features of long COVID in older adults and the potential association with neuroinflammation: Preliminary observations in a small cohort".},
journal = {Journal of the neurological sciences},
volume = {489},
number = {},
pages = {126076},
doi = {10.1016/j.jns.2026.126076},
pmid = {42424864},
issn = {1878-5883},
}

@article {pmid42415124,
year = {2026},
author = {Sewell, PE and Jensen, C},
title = {Clinical rationale for thymic restoration in adult immunosenescence.},
journal = {Immunity & ageing : I & A},
volume = {},
number = {},
pages = {},
doi = {10.1186/s12979-026-00584-6},
pmid = {42415124},
issn = {1742-4933},
abstract = {Age-related thymic involution is a central feature of immunosenescence and intersects with multiple "hallmarks of aging", including genomic instability, telomere attrition, mitochondrial dysfunction, and chronic inflammation. The decline in thymic epithelial integrity and FOXN1-driven thymopoiesis reduces naïve T-cell output, contracts TCR repertoire diversity, and perturbs central tolerance, contributing to increased susceptibility to infection, cancer, and autoimmunity. These changes occur alongside broader immune-aging phenomena such as inflammaging and frailty and are reflected in poorer vaccine responses and altered outcomes to novel pathogens such as SARS-CoV‑2. This review integrates mechanistic, preclinical, and human data to reassess the adult thymus as a therapeutic target. Higher-confidence domains for thymic restoration include cancer immunosurveillance, infectious disease vulnerability, vaccine responsiveness, and post-treatment immune reconstitution, supported by modeling of age-related disease incidence, transplant and HIV cohorts, and new observational links between radiographic thymic health, mortality, and immunotherapy outcomes. High-plausibility but less directly validated domains include autoimmunity, chronic herpesvirus control, HIV immunological non-responders, and post-acute infection syndromes such as long COVID, which share convergent patterns of T-cell dysfunction and persistent immune activation. The translational landscape spans hormonal and somatotropic modulation (sex steroid ablation, growth hormone/ghrelin), cytokine and growth-factor strategies (IL‑7, IL‑22, KGF/BMP4, FGF21), cell- and tissue-engineering approaches leveraging thymic epithelial stem cells and FOXN1-reprogrammed stromal cells, and gene-therapy concepts such as intrathymic AAV delivery of FOXN1, AIRE, chemokines, and stromal-support pathways. Collectively, these data support the biological plausibility of adult thymus restoration but highlight that robust, domain-specific clinical benefits have not yet been demonstrated in controlled trials. Future work should prioritize harmonized structural and functional biomarkers, domain-focused interventional studies in high-risk populations, and combined strategies that situate thymus-directed interventions within broader efforts to modify immune and organismal aging.},
}

@article {pmid42415194,
year = {2026},
author = {Lehoux, MC and Houle, M and Saey, D and Tétreau, C and Lefebvre, A and Mathieu, E and Drapeau, C},
title = {Evaluating the feasibility and preliminary effects of a group-based telerehabilitation program in individuals with persistent dyspnea after COVID-19 (TEPCO): a pilot randomized controlled study.},
journal = {Pilot and feasibility studies},
volume = {},
number = {},
pages = {},
doi = {10.1186/s40814-026-01876-w},
pmid = {42415194},
issn = {2055-5784},
abstract = {BACKGROUND: Many COVID-19 survivors have been shown to experience at least one persistent symptom or deficit following infection, impacting their functioning and quality of life. However, knowledge about the appropriate care and rehabilitation needs of individuals with Long COVID remains fragmented. More research is needed to understand the impact of rehabilitation or telerehabilitation programs on Long COVID symptoms, quality of life, and work ability. This is a pilot randomized controlled trial to evaluate the feasibility of the study procedures and to compare the preliminary effects of a rehabilitation program delivered remotely (experimental group) or in-person (control group) for an adult (≥ 18 years) with confirmed COVID-19 and persistent dyspnea at least eight weeks post-infection.

METHODS: Participants were randomly assigned to either the telerehabilitation or in-person group using a computer-generated allocation sequence. An 8-week rehabilitation program, including cardiovascular, muscular, balance training, and respiratory exercises, was provided to both groups. Outcomes assessed included feasibility (recruitment rate, dropout rate, adherence rate, occurrence of adverse events, and patient satisfaction). Secondary outcomes comprised preliminary effect measures including exercise capacity, functional capacity, functional independence in daily life, quality of life, and clinical frailty.

RESULTS: Twenty-one participants aged between 29 and 75 (median age 52) were recruited to the study. Thirty-nine (39) eligible individuals were approached, and 22 participants consented to participate in the study (56.4% consent rate). One participant withdrew before the start of the program due to scheduling issues, resulting in 21 participants included in the analysis. Eight participants in the in-person group and ten participants in the telerehabilitation group attended at least 75% of the sessions. No adverse events related to the intervention were reported during the study period. Participants' satisfaction levels were high, with 90% strongly agreeing to the quality of services received in the telerehabilitation group. For the exercise capacity (pedaling time), there was a Group*Time interaction (F(1, 16) = 6.1, ηp[2] = .28) and a main effect of time (F(1, 16) = 20.9, ηp[2] = .57). A main effect of time was also detected for the One-Minute Sit-to-Stand Test (F(1, 16) = 8.1, ηp[2] = .34) in both groups.

CONCLUSIONS: This pilot randomized controlled study demonstrated the feasibility and safety of delivering a supervised group-based rehabilitation intervention remotely compared with in-person delivery to individuals with Long COVID characterized by persistent dyspnea eight weeks post-infection. These findings apply to a relatively young, non-hospitalized population and may not be generalizable to all Long COVID phenotypes. The protocol proved feasible in our clinic, showing favorable recruitment, dropout, and adherence rates, as well as a low occurrence of adverse events and high satisfaction. Preliminary observations on clinical outcomes suggest potential benefits of telerehabilitation compared to in-person delivery; these findings are exploratory and intended to inform future research rather than provide definitive conclusions. Further studies, including larger multicenter RCTs across Québec regions, are needed to evaluate the effects, safety and generalizability of supervised group-based telerehabilitation interventions for individuals with Long COVID.

TRIAL REGISTRATION: ClinicalTrial.gov, NCT06952127. Registered on 28 April 2025-retrospectively registered. https://clinicaltrials.gov/study/NCT06952127.},
}

@article {pmid42415750,
year = {2026},
author = {Onavbavba, G and Badaru, A and Durojaye, AB and Adigwe, OP},
title = {Knowledge, awareness, and perception of healthcare professionals towards Long COVID in Nigeria.},
journal = {Frontiers in public health},
volume = {14},
number = {},
pages = {1768068},
pmid = {42415750},
issn = {2296-2565},
mesh = {Humans ; Nigeria/epidemiology ; Female ; Male ; *COVID-19 ; Cross-Sectional Studies ; *Health Knowledge, Attitudes, Practice ; Adult ; Post-Acute COVID-19 Syndrome ; *Health Personnel/psychology/statistics & numerical data ; Surveys and Questionnaires ; SARS-CoV-2 ; Middle Aged ; Young Adult ; },
abstract = {INTRODUCTION: Long COVID is a complex condition with prolonged symptoms that develop after COVID-19 infection and continue beyond 12 weeks. This study aimed to assess healthcare professionals' knowledge, awareness, and perceptions of Long COVID in Nigeria.

METHODS: A cross-sectional study using multistage random sampling was conducted amongst licensed healthcare professionals in Nigeria, including physicians, pharmacists, nurses, and medical laboratory scientists. A validated questionnaire was administered to practitioners in selected health facilities. Data from 405 respondents were analysed using the Statistical Package for the Social Sciences (SPSS) version 25.

RESULTS: A total of 405 valid responses were obtained, reflecting a response rate of 81%. Male and female participants were of similar proportions, as indicated by 50.1 and 49.9%, respectively. Over a quarter (26.3%) of the sample were not aware of Long COVID, and of the respondents who had heard about the condition, more than half (58.5%) indicated that they obtained their information from the internet. Participants' understanding of Long COVID was assessed to be limited, with a mean knowledge score of 6.38 ± 2.86. As indicated by more than half (50.5%) of the study cohort, there is a lack of prioritisation in the management of post-COVID symptoms in Nigeria, as well as inadequate frameworks to mitigate the effects of the condition (45.1%). Male participants had significantly higher knowledge scores than females, with p = 0.006 and a standardised beta coefficient of 0.158, indicating a small-to-moderate effect size.

CONCLUSION: The study identified knowledge gaps amongst healthcare professionals in Nigeria regarding Long COVID and provides baseline evidence to inform the development of diagnostic, preventive, and context-appropriate management strategies for the condition.},
}

Humans
Nigeria/epidemiology
Female
Male
*COVID-19
Cross-Sectional Studies
*Health Knowledge, Attitudes, Practice
Adult
Post-Acute COVID-19 Syndrome
*Health Personnel/psychology/statistics & numerical data
Surveys and Questionnaires
SARS-CoV-2
Middle Aged
Young Adult

@article {pmid42416120,
year = {2026},
author = {Colgan, DD and Stadler, DD and Grow, T and Ruddick, M and Weimbs, T and Davenport, TE and Zwickey, H},
title = {Telehealth-Based Ketogenic Metabolic Therapy With Lifestyle Interventions for Post-viral Illness: A Research Brief of Patients' Experiences.},
journal = {Journal of patient experience},
volume = {13},
number = {},
pages = {23743735261459218},
pmid = {42416120},
issn = {2374-3735},
abstract = {BACKGROUND/OBJECTIVES: Infection-associated chronic illnesses are associated with substantial functional impairment that limits participation in traditional in-person research. A fully remote, multicomponent intervention that combines ketogenic metabolic therapy (KMT) with behavioral interventions targets several proposed biological mechanisms underlying these conditions. This study aimed to characterize patient-reported experiences with a fully remote intervention that integrated KMT and thiamine supplementation with behavioral strategies, including circadian entrainment and mindfulness-based resilience coaching.

METHODS: In this cross-sectional study, quantitative data were collected via online REDCap surveys. Feasibility and acceptability benchmarks included perceived treatment suitability, relevance, safety, and reported treatment adherence. Optimization items evaluated preferred program duration, dosing, and structure, as well as components that respondents identified as most important for future refinement.

RESULTS: Among an international sample (n=41), all feasibility and acceptability benchmarks were met: 96% reported the intervention was helpful, 96% recommended it, and 75% felt "a lot better" after completion. Respondents provided patient-centered perspectives to optimize the intervention.

CONCLUSIONS: Incorporating patient perspectives is essential for guiding the development of safe, acceptable, and effective treatment strategies for infection-associated chronic illness, including Long COVID. Strong indicators of feasibility, acceptability, and perceived benefits support the rationale for larger controlled trials to investigate clinical efficacy and the underlying mechanistic pathways of multicomponent metabolic interventions.},
}

@article {pmid42418962,
year = {2026},
author = {Rescalvo-Casas, C and Hernando-Gozalo, M and Lledó-García, L and Cuadros-González, J and Pérez-Tanoira, R},
title = {Prevalence and determinants of long COVID and SARS-CoV-2 reinfection in the Spanish adult population: A nationwide public health survey.},
journal = {Medicina clinica},
volume = {166},
number = {9},
pages = {107491},
doi = {10.1016/j.medcli.2026.107491},
pmid = {42418962},
issn = {1578-8989},
abstract = {INTRODUCTION: Long COVID is an emerging public health concern with heterogeneous prevalence. Evidence on the impact of reinfection and vaccination remains limited, especially in Spain.

METHODS: We conducted a prospective online cohort survey between January 2024 and April 2025, gathering data on demographics, vaccination, symptoms, comorbidities, and reinfection history from Spanish adults (n=1018). Long COVID was defined per NICE guidelines as symptoms persisting beyond eight weeks after viral clearance. Multivariate logistic regression identified associated factors.

RESULTS: Of 972 participants (332 men, 640 women), long COVID prevalence was 14.3% (n=139). Female sex (OR: 1.70; 95% CI: 1.10-2.57; p=0.014) and chronic obstructive pulmonary disease (COPD) (OR: 4.14; 95% CI: 1.28-13.42; p=0.018) increased risk. Mixed vaccination schedules raised risk compared to Pfizer-only regimens (OR: 1.30; 95% CI: 1.04-1.62; p=0.020). Reinfection, reported by 47.2%, was also a risk factor (OR: 1.64; 95% CI: 1.12-2.42; p=0.012). Frequent long COVID symptoms included anosmia, dyspnea, pneumonia, and myalgia.

CONCLUSIONS: This national cohort underscores the persistent burden of long COVID in Spain. Female sex, COPD, reinfection, and mixed vaccination schedules are key associated factors, with implications for targeted prevention strategies and vaccination policies.},
}

@article {pmid42419332,
year = {2026},
author = {Walker, TA},
title = {Building the evidence base for long COVID treatments.},
journal = {The Lancet. Infectious diseases},
volume = {},
number = {},
pages = {},
doi = {10.1016/S1473-3099(26)00350-6},
pmid = {42419332},
issn = {1474-4457},
}

@article {pmid42409265,
year = {2026},
author = {Natarajan, N and Ahmed, T and Govindaswamy, B and Manickam, DS and Das, J and Islam, K and Dutta, P},
title = {Macrophage-specific targeting of histone demethylases with small-molecule inhibitors suppresses inflammatory response in vivo.},
journal = {The Journal of biological chemistry},
volume = {},
number = {},
pages = {113315},
doi = {10.1016/j.jbc.2026.113315},
pmid = {42409265},
issn = {1083-351X},
abstract = {Macrophages are versatile immune cells, with the ability to respond to varied intrinsic and extrinsic cues, and transition between inflammatory and pro-reparative phenotypes. A complex network of epigenetic processes, such as DNA methylation, and histone methylation and acetylation, plays key roles in modulating macrophage polarization and inflammatory gene expression. Transcriptional analysis in patients with respiratory failure, long COVID-19, and influenza revealed an augmented expression of chromatin-modifiers including histone demethylases, broadly defined as lysine demethylases (KDMs), in lung macrophages. Therefore, macrophage-specific pharmacological perturbation of these enzymes in vivo holds therapeutic promise in abating inflammation. To investigate the role of KDMs in inflammation, we screened a panel of small-molecule inhibitors of chromatin modifiers for their efficacy in inducing anti-inflammatory macrophage polarization in vitro. We demonstrate that pretreatment with the broad spectrum KDM inhibitor n-octyl-IOX1 and KDM5-specific inhibitor PB-IT resulted in a significant decrease of lipopolysaccharide (LPS)-induced expression of the inflammatory genes Il1b, Il6, Tnfa, and iNos in bone marrow-derived macrophages (BMDM). Subsequent RNA sequencing and CUT&RUN analyses revealed that LPS activation led to distinct transcriptomic and epigenomic alterations including expression of master transcription factors (TFs) BLIMP-1 and GFI1 whereas n-octyl-IOX1 and PB-IT treatments rewired these regulatory networks, thereby impeding inflammatory gene expression and response. To further probe the merit of KDM inhibition in perturbing macrophage-mediated inflammation in vivo, we delivered n-octyl-IOX1 selectively to macrophages in mice using cell-specific, targeted lipidoid nanoparticles. n-octyl-IOX1 encapsulated nanoparticles significantly diminished LPS-mediated peritoneal macrophage expansion and inflammatory gene expression in this cell population, underscoring the importance of macrophage-specific targeting of KDMs with small-molecule inhibitors in inflammatory disease.},
}

@article {pmid42409655,
year = {2026},
author = {Chen, CH and Chen, PC and Liu, XL and Wei, CH and Hsu, YL and Lin, CH and Soong, WJ and Shih-Hsin Wu, L and Tsai, HJ and Chang, SM and Wang, JY},
title = {Post-acute sequelae of COVID in children: Pulmonary assessment using impulse oscillometry and the effect of vaccination.},
journal = {Pediatrics and neonatology},
volume = {},
number = {},
pages = {},
doi = {10.1016/j.pedneo.2026.01.007},
pmid = {42409655},
issn = {2212-1692},
abstract = {BACKGROUND: Post-acute sequelae of SARS-CoV-2 infection (PASC), also known as long COVID syndrome (LCS), is characterized by persistent symptoms following SARS-CoV-2 infection and poses significant health challenges, particularly impacting pulmonary function in children. This study aims to evaluate the effect of COVID-19 vaccination on pulmonary function in children with PASC using standardized spirometry and impulse oscillometry (IOS).

METHODS: This prospective, observational study was conducted from July to September 2022, at the tertiary medical center of a children's hospital in Taiwan. Pediatric patients aged 6 to 18 years diagnosed with PASC were enrolled. Demographic data, vaccination status, and blood test results were collected. Pulmonary function was assessed using spirometry and IOS, measuring parameters such as respiratory resistance (R5, R20) and reactance (X5). Statistical analyses explored the association between IOS results and clinical symptoms, as well as vaccination status.

RESULTS: Among 209 children, 78.7% were vaccinated. IOS detected abnormalities in 74.6%, with 12.0% diagnosed with obstructive lung disease (OLD) and 62.9% with small airway disease (SAD). Fatigue (56.0%) and dyspnea (52.0%) were most common in OLD, while chest pain (45.0%) and cough (41.7%) prevailed in SAD. Vaccinated children showed significantly lower respiratory resistance (R5, R20, p < 0.01) and improved reactance (X5, p < 0.001). Vaccination did not significantly reduce respiratory-related symptoms but it was associated with lower risks of decreased appetite (OR = 0.399) and sleep disturbance (OR = 0.345).

CONCLUSION: COVID-19 vaccination may have a protective effect on pulmonary function in children with PASC, highlighting its mitigation of long-term respiratory complications. Further studies are needed to explore underlying mechanisms.},
}

@article {pmid42410961,
year = {2026},
author = {Almulla, AF and Zhang, Y and Tunvirachaisakul, C and Carvalho, AF and Maes, M},
title = {Increased Insulin Resistance and Hyperglycemia in Long COVID: A Systematic Review and Meta-Analysis.},
journal = {Expert reviews in molecular medicine},
volume = {},
number = {},
pages = {1-46},
doi = {10.1017/erm.2026.10064},
pmid = {42410961},
issn = {1462-3994},
}

@article {pmid42411649,
year = {2026},
author = {Theeler, J and Comellas, AP and Gehl, C and Garvin, L and Garg, A and Fain, SB and Hoth, KF},
title = {Clinical neuropsychological evaluation of patients referred from a post-COVID subspeciality clinic.},
journal = {The Clinical neuropsychologist},
volume = {40},
number = {5},
pages = {1339-1358},
doi = {10.1080/13854046.2025.2536700},
pmid = {42411649},
issn = {1744-4144},
mesh = {Humans ; Female ; *Neuropsychological Tests ; Middle Aged ; Male ; Adult ; *COVID-19/complications/psychology ; *Depression/diagnosis/etiology ; *Anxiety/diagnosis ; *Fatigue/diagnosis/etiology/psychology ; Processing Speed ; Post-Acute COVID-19 Syndrome ; *Cognitive Dysfunction/diagnosis/etiology ; Executive Function/physiology ; },
abstract = {Objective: To describe neuropsychological assessment findings of patients referred from a post-COVID subspecialty clinic. Methods: Clinical data were examined for 54 patients referred between March 2021 and May 2023. Assessment included objective cognitive performance, performance validity testing, self-report of cognitive symptoms (BRIEF-A), depressive and anxiety symptoms (BDI-II/BAI), and fatigue (PROMIS Fatigue-4a). Objective cognitive measures were grouped into domains and examined through (1) one sample t-tests comparing each domain score to the normative mean characterized using Cohen's d, and (2) the frequency of impaired performance and elevated symptoms (±1.5 SD). Clinically elevated symptoms of depression, anxiety, and fatigue were examined. Results: Exclusion criteria resulted in a final sample of 46 (mean age= 48.5; 72% female). The mean cognitive domain scores of the sample all fell within 1 SD of expectations based on normative data. Examination of effect sizes using Cohen's d suggested that verbal comprehension and perceptual reasoning were significantly above the mean (small effect) while executive function, language, and processing speed were reduced (small effect). The Metacognition index of the BRIEF-A was elevated driven by Working Memory (80.5%). Elevated symptoms of depression (59.1%)/anxiety (75.0%) were frequent and not associated with objective cognitive scores. Elevated fatigue (56.5%) was associated with impaired processing speed performance. Conclusions: Individuals with long COVID reported significant difficulty with working memory capacity. Participants demonstrated a pattern of reduced performance in domains of executive function, language, and processing speed, although group means were within 1 SD of normative expectations. Clinically elevated fatigue was associated with reduced processing speed performance.},
}

Humans
Female
*Neuropsychological Tests
Middle Aged
Male
Adult
*COVID-19/complications/psychology
*Depression/diagnosis/etiology
*Anxiety/diagnosis
*Fatigue/diagnosis/etiology/psychology
Processing Speed
Post-Acute COVID-19 Syndrome
*Cognitive Dysfunction/diagnosis/etiology
Executive Function/physiology

@article {pmid42413051,
year = {2026},
author = {Butzin-Dozier, Z and Ji, Y and Deshpande, S and Anzalone, AJ and Wang, LC and Hurwitz, E and Kumar, M and Patel, RC and Sun, J and Robertson, M and Mertens, A and Camacho-Rivera, M and Colford, JM and Hubbard, AE and Madlock-Brown, C},
title = {Black Patients Underdiagnosed With Long COVID In The US Compared With White Patients.},
journal = {Health affairs (Project Hope)},
volume = {45},
number = {7},
pages = {775-781},
doi = {10.1377/hlthaff.2025.00179},
pmid = {42413051},
issn = {2694-233X},
abstract = {Long COVID has debilitating effects but is inconsistently diagnosed because of subjective criteria, limited treatments, and variations in health care access. We analyzed electronic health records from the National Clinical Cohort Collaborative for patients diagnosed with acute COVID-19 in the US between January 2022 and March 2023. Using six race and ethnicity categories, we evaluated 222 symptoms and long COVID diagnoses (International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, code U09.9) within twelve months after infection. We assessed the relationship between race and ethnicity and long COVID diagnosis, adjusting for patient covariates and long COVID symptomatology set to the presence of at least one documented long COVID-associated symptom. Among 2.4 million patients, Black patients were less likely to be diagnosed with long COVID than White patients under a scenario in which a symptom was present and health care monitoring was at least bimonthly. For the remaining racial and ethnic groups, we found no statistically significant differences in long COVID diagnoses compared with White patients. Although the magnitude was small, the difference in diagnosis likelihood suggests the presence of potential diagnostic bias.},
}

@article {pmid42414929,
year = {2026},
author = {Milic, J and Pelizzoni, A and Gozzi, L and Albano, T and Ricciardetto, M and Menozzi, M and Cuomo, G and Mancini, G and Mussini, C and Guaraldi, G},
title = {Reshaping long COVID care through patient-reported needs.},
journal = {BMC infectious diseases},
volume = {},
number = {},
pages = {},
doi = {10.1186/s12879-026-13773-x},
pmid = {42414929},
issn = {1471-2334},
abstract = {BACKGROUND: Long COVID is a multisystem condition characterized by persistent or fluctuating symptoms following acute SARS-CoV-2 infection. Despite increasing scientific evidence, the alignment between patient needs and healthcare delivery remains limited. This study aimed to assess unmet clinical, psychological, and lifestyle needs among individuals previously evaluated at the Modena Long COVID Clinic and to inform a patient-centered redesign of Long COVID services.

METHODS: This observational study included individuals assessed at least once at the Modena Long COVID Clinic (Italy) between August 2020 and July 2025. Participants with valid email and phone contacts were invited to complete an online questionnaire exploring unmet needs across clinical, mental health, welfare, and lifestyle domains. The questionnaire also assessed Long COVID symptom clusters and health-related quality of life (HR-QoL) using the EQ-5D-5 L and EQ-VAS. Data were compared between the first clinical visit (baseline) and the follow-up survey.

RESULTS: Of 707 individuals contacted, 162 (22.9%) completed the survey (median age 56 years; 54.9% male). At follow-up, 80.1% reported at least one Long COVID symptom cluster, with significant increases in musculoskeletal (30.1% vs. 60.8%), neurocognitive (23.5% vs. 52.4%), and psychological (25.3% vs. 51.2%) domains. EQ-5D-5 L scores remained stable (median 83.0 vs. 84.1; p = 0.927), while self-rated health improved (60 vs70; p < 0.001). Unmet needs were common: 22.2% reported insufficient access to specialist consultations, 15.4% lacked psychological support, and 15.5% reported unmet needs for pain management.

CONCLUSIONS: This study identifies substantial gaps between patient needs and existing care structures, emphasizing the need for a dynamic, cluster-based, and patient-centered approach. The results support the redesign of Long COVID services into five operational pillars: functional triage, empowerment and education, integrated cluster clinics, continuity of care through case management, and outcome-based evaluation. Such reorganization may enhance perceived health and well-being even when overall disability remains stable.

TRIAL REGISTRATION: Clinical trial number not applicable.},
}

@article {pmid42414935,
year = {2026},
author = {Vickers, JK and Levitan, EB and Howell, CR and Montgomery, AP and Jones, R and Lund, FE and Erdmann, N},
title = {Differences in diagnostic coding in long COVID: sociodemographic and symptom interference factors.},
journal = {BMC infectious diseases},
volume = {},
number = {},
pages = {},
doi = {10.1186/s12879-026-13943-x},
pmid = {42414935},
issn = {1471-2334},
support = {T32HD071866/NH/NIH HHS/United States ; 3U19AI142737-04S1/NH/NIH HHS/United States ; },
abstract = {PURPOSE: We aimed to test associations of participant-reported Long COVID symptom interference with life activities with Long COVID symptoms, presence of U09.9 Long COVID diagnosis code, demographics, and clinical factors. In a subgroup, we documented coding related to Long COVID and post-exertional malaise in the electronic medical record (EMR).

METHODS: Using a cross-sectional analysis (n = 205) of participant data from a Long COVID survey, we tested associations with Chi-square, Fisher's exact, or Fisher-Freeman-Halton exact statistical tests and Independent Samples T-tests.

RESULTS: Participants were predominately female (67%) with a mean age of 50.9 years. Participants were White (50.0%), African American (47.5%), and Asian (2.5%); 1.5% reported Hispanic ethnicity. 41% of participants reported high Long COVID symptom interference with life activities. Participants who were older (p=.028), were female (p=.002), were obese (p=.049), had worse general health (p<.001), worse physical health (p<.001), had worse mental health (p<.001), and had U09.9 diagnosis (p<.001) were more likely to experience high symptom interference. Among participants with high symptom interference, there were no significant associations with U09.9 diagnosis code. EMR sub-analysis (n = 100) revealed that among participants that reported high symptom interference (n = 39), 64% (n = 25) had a code related to Long COVID.

CONCLUSION: Although we found discrepancies between self-reported measures and EMR coding, we did not find evidence of demographic biases in diagnosis among participants with high symptom interference.

CLINICAL TRIAL NUMBER: Not applicable.},
}

@article {pmid42415070,
year = {2026},
author = {Wunderle, M and Ribeiro, A and Lethen, I and Schmaderer, C and Wallraven, T},
title = {Persistent impairments in muscle function and symptom burden in post-COVID syndrome: a prospective longitudinal study.},
journal = {Journal of translational medicine},
volume = {},
number = {},
pages = {},
doi = {10.1186/s12967-026-08579-z},
pmid = {42415070},
issn = {1479-5876},
abstract = {BACKGROUND: Post-COVID syndrome (PCS) is characterized by persistent heterogeneous symptoms after SARS-CoV-2 infection, yet objective biomarkers for symptom severity and longitudinal disease trajectories remain limited. We aimed to characterize muscle function over time in PCS and examine its relationship with symptom burden and neuroaxonal injury markers.

METHODS: In this prospective observational study, patients fulfilling WHO criteria for PCS underwent standardized assessments at baseline (BL) and six-month follow-up (FU). Muscle function was assessed using a multidimensional handgrip strength (HGS) protocol capturing mean force (Fmean), fatigability (fatigue ratio), and recovery capacity alongside clinical symptom measures. Analyses included longitudinal assessment within the PCS cohort, comparisons with COVID-19 recovered controls, analysis of symptom persistence, and matched cohort analyses including HGS measures and circulating neurofilament light chain (NfL) and glial fibrillary acidic protein (GFAP).

RESULTS: Among 204 participants (102 PCS, 102 recovered controls) PCS patients showed lower Fmean and higher fatigability at BL and FU (both p < 0.01). Muscle function parameters remained largely stable over six months, with only modest improvement in recovery (p = 0.015). HGS parameters correlated with symptom burden (ρ ≈ -0.28 to -0.33), and BL impairments were associated with worse fatigue and depressive symptoms at FU (e.g., Fmean-PHQ-9: β = -0.11, p = 0.022; fatigue ratio-FSS: β = 1.66, p = 0.008). Exploratory analyses suggested slightly higher NfL and GFAP levels in PCS in some models, without consistent associations with muscle function or symptoms.

CONCLUSIONS: HGS is persistently reduced in PCS over at least six months and aligns with symptom burden. Multidimensional HGS assessment may provide a practical objective marker of functional impairment and symptom persistence in PCS. Neuroaxonal injury markers showed modest elevations in PCS in some analyses but appeared unrelated to muscle performance, suggesting partially distinct mechanisms.

TRIAL REGISTRATION: ClinicalTrials.gov, NCT05635552. Registered 1 December 2022 - Retrospectively registered, https://clinicaltrials.gov/study/NCT05635552?term=NCT05635552&rank=1&tab=study.},
}

@article {pmid42415099,
year = {2026},
author = {Wang, K and Lee, CCL and Qu, G and Tang, CTK and Yiu, HHE and Yang, X and Wong, CKM and Wong, SY and Yip, BHK},
title = {Individual preferences for the design of a health coaching-based lifestyle promotion program among middle-aged adults in Hong Kong: a discrete choice experiment.},
journal = {Health and quality of life outcomes},
volume = {},
number = {},
pages = {},
doi = {10.1186/s12955-026-02584-y},
pmid = {42415099},
issn = {1477-7525},
abstract = {OBJECTIVES: Health coaching is an effective approach to motivating lifestyle modifications and preventing the onset of non-communicable diseases. This study aims to examine middle-aged adults' preferences for health coaching programs to improve public acceptance of these programs.

METHODS: A discrete choice experiment (DCE) was conducted among adults aged 35-59 years in Hong Kong who were recruited from a population-based cohort established to evaluate outcomes related to long COVID. The DCE attributes and levels were selected based on a literature review and qualitative interviews (n = 10) with users and providers from a local health coaching program. The selected attributes included program duration, delivery mode of coaching sessions, frequency of coaching sessions, availability of blood tests, core program format, smartwatch usage, and out-of-pocket payment. An online survey with 10 choice sets was conducted to collect participants' choices regarding health coaching services with (copayment scenario, 10 choices) and without out-of-pocket payment (no copayment scenario, 10 choices). A mixed logit model and a latent class model were used for the analysis.

RESULTS: A total of 912 responses were collected, of which 554 valid records were included in the analysis. In the copayment scenario, participants preferred programs that provided a smartwatch and a lower copayment rate. In the no copayment scenario, participants preferred a moderate coaching frequency, communication via phone calls or text messages, and provision of a smartwatch. Distinct preference groups were identified, including those who preferred face-to-face versus remote modes of delivery, high versus low contact frequency, and those who were sensitive versus insensitive to cost.

CONCLUSIONS: Lower copayment and smartwatch provision improve acceptance of health coaching programs. Substantial preference heterogeneity for program duration, health coaching frequency, and delivery mode was found. While material incentives are important for improving acceptance of health coaching, considerable preference heterogeneity for non-monetary attributes suggests that options for health coaching program intensity can be offered along with subsidies or lower out-of-pocket payment to promote these services.},
}

@article {pmid42402140,
year = {2026},
author = {Fésü, D and Horváth, G and Müller, V},
title = {[Long-COVID syndrome and lung-specific abnormalities following COVID-19].},
journal = {Orvosi hetilap},
volume = {167},
number = {27},
pages = {1051-1058},
doi = {10.1556/650.2026.33584},
pmid = {42402140},
issn = {1788-6120},
mesh = {Humans ; *COVID-19/complications/physiopathology ; *Pulmonary Fibrosis/etiology ; Quality of Life ; Post-Acute COVID-19 Syndrome ; *Lung/diagnostic imaging ; SARS-CoV-2 ; Antiviral Agents/therapeutic use ; Respiratory Function Tests ; },
abstract = {Following the acute phase of a SARS-CoV-2 infection, post-COVID - or long-COVID - syndrome may develop. This condition is characterized by unpleasant, persistent or new-onset symptoms following the acute phase of the infection. It might lead to an impaired health-related quality of life of affected patients and may involve multiple organ systems. It often poses diagnostic and therapeutic challenges for the healthcare system, and its exact course and outcomes are not yet fully understood. A multidisciplinary approach is required for diagnosis, including imaging studies (e.g., chest CT), tests to assess functional status (e.g., 6-minute walk test, pulmonary function tests, cardiopulmonary exercise testing) and the evaluation of parameters reported by patients subjectively (e.g., symptom burden, health-related quality of life). As part of long-COVID, lung parenchymal changes or abnormalities resulting from the viral infection can be detected on imaging studies in some cases, referred as post-COVID pulmonary fibrosis. Currently, therapeutic options are limited and largely based on symptomatic or organ-specific approaches. However, antiviral treatments used in the acute phase, such as remdesivir or nirmatrelvir/ritonavir, may be potentially beneficial regarding the development of late complications. Prevention, particularly COVID-19 vaccination, plays a key role, as it has been shown to reduce the risk of severe acute disease and the later probability of long-COVID syndrome. Further long-term patient follow-up is necessary to better understand the pathomechanisms underlying long-term effects of the virus, such as long-COVID and post-COVID pulmonary fibrosis. This article aims to present an up-to-date, comprehensive review of long-COVID syndrome and post-COVID pulmonary fibrosis. Orv Hetil. 2026; 167(27): 1051-1058.},
}

Humans
*COVID-19/complications/physiopathology
*Pulmonary Fibrosis/etiology
Quality of Life
Post-Acute COVID-19 Syndrome
*Lung/diagnostic imaging
SARS-CoV-2
Antiviral Agents/therapeutic use
Respiratory Function Tests

@article {pmid42402260,
year = {2026},
author = {Jo, Y and Hu, Z and Joo, H and Jung, J and Lee, J},
title = {Time to Recovery from Long COVID: A Longitudinal Analysis of Symptom Duration and Risk Factors Using Accelerated Failure Time Models.},
journal = {International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases},
volume = {},
number = {},
pages = {108963},
doi = {10.1016/j.ijid.2026.108963},
pmid = {42402260},
issn = {1878-3511},
abstract = {BACKGROUND: Long COVID comprises heterogeneous symptoms that may persist for months to years after acute SARS-CoV-2 infection. While prevalence is well described, less is known about symptom duration and determinants of recovery.

METHODS: We conducted a multicenter longitudinal cohort study across 12 institutions in Korea (December 2022-March 2025), enrolling adults with confirmed infection and uninfected controls. Participants were followed for up to 22 months with repeated assessments of symptoms, vaccination, and comorbidities. Eight common symptoms were analyzed. Time to resolution was estimated using Kaplan-Meier methods and log-normal accelerated failure time models, adjusting for demographic and clinical factors. Results are reported as time ratios (TRs).

RESULTS: Among 757 infected participants and 558 controls, respiratory and physical symptoms resolved similarly between groups, whereas systemic and neurological symptoms persisted longer in infected individuals. At one year, 20-25% reported fatigue and 15-20% sleep disturbance versus ∼10% and ∼5% in controls. Infection was associated with ∼50% longer duration of fatigue and sleep disturbance. Individuals aged 40-59 recovered more slowly; other factors showed minimal associations.

CONCLUSIONS: Persistent long COVID burden is driven by systemic neuro-related symptoms, highlighting the need for targeted, symptom-specific management strategies.},
}

@article {pmid42403350,
year = {2026},
author = {Dos Santos, ACP and Goulart, CDL and Neves, VR and Milani, M and Silva, E and Almeida-Val, F and Braga, F and Dias, CMCC and Ritt, LEF and Cipriano, GFB and Borghi-Silva, A and Franzoni, LT and Ferrari, F and Cahalin, LP and Stein, R and Cipriano, G},
title = {Regional Disparities in Functional and Socioeconomic Impacts of Long COVID in Brazil: A Cross-Sectional Observational Study.},
journal = {Physiotherapy research international : the journal for researchers and clinicians in physical therapy},
volume = {31},
number = {3},
pages = {e70251},
doi = {10.1002/pri.70251},
pmid = {42403350},
issn = {1471-2865},
support = {//CAPES, CNPQ and FAPDF/ ; },
mesh = {Humans ; Cross-Sectional Studies ; Brazil/epidemiology ; *COVID-19/physiopathology/epidemiology ; Female ; Post-Acute COVID-19 Syndrome ; Male ; Socioeconomic Disparities in Health ; Middle Aged ; Socioeconomic Factors ; Hand Strength ; Adult ; SARS-CoV-2 ; Severity of Illness Index ; },
abstract = {INTRODUCTION AND OBJECTIVE: In low- and middle-income countries such as Brazil, regional inequalities in healthcare access and socioeconomic conditions may exacerbate the functional and occupational consequences of Long COVID. This study explored between-center differences in functional and socioeconomic outcomes among individuals with Long COVID from three Brazilian centers in Brazil, while examining how these findings may have been influenced by acute disease severity, symptom burden, and contextual factors.

METHODS: This was a cross-sectional study conducted with individuals diagnosed with Long COVID from three Brazilian regions (Federal District, Goiás, and Sergipe). Functional limitations were assessed through the 6-Minute Step Test (6MST) and muscle strength via Handgrip Strength (HGS). Additionally, cardiorespiratory responses and work productivity impairments were evaluated.

RESULTS: A total of 142 participants were included: 47 from the Federal District, 59 from Goiás, and 36 from Sergipe. Most participants were classified as non-critical (n = 129), while 13 were classified as critical, all from the Federal District. Significant differences in 6MST performance were observed across regions (p < 0.005). Critical patients exhibited lower SpO2 at rest and peak compared to non-critical patients from Goiás and Sergipe (mean difference: -4%; 95% CI: -6% to -2%). Non-critical patients from Sergipe had higher peak systolic (+25 mmHg; 95% CI: +20 to +30 mmHg) and diastolic blood pressure (+16 mmHg; 95% CI: +14 to +18 mmHg). Critical patients showed work productivity loss (-2.8%; 95% CI: -4.6% to -1.0%) compared to non-critical patients from Goiás. Weak negative correlations were found between peak SpO2 in the 6MST and age (r = -0.25; p = 0.01) and between HGS and HADS scores for anxiety (r = -0.20; p = 0.05) and depression (r = -0.20; p = 0.04).

DISCUSSION: Long COVID was associated with heterogeneous functional and socioeconomic impairments across the evaluated centers; however, these findings should be interpreted cautiously, as regional comparisons were substantially confounded by the unequal distribution of acute disease severity.},
}

Humans
Cross-Sectional Studies
Brazil/epidemiology
*COVID-19/physiopathology/epidemiology
Female
Post-Acute COVID-19 Syndrome
Male
Socioeconomic Disparities in Health
Middle Aged
Socioeconomic Factors
Hand Strength
Adult
SARS-CoV-2
Severity of Illness Index

@article {pmid42404887,
year = {2026},
author = {Ponnachan, P and Dhawlarker, A and Yasmin, H and Shah, A and Malhotra, A and Shastri, A and Al-Ramadi, BK and Kishore, U},
title = {Mechanisms and impact of long COVID: pathophysiology, neuropsychiatric effects and vaccination.},
journal = {Frontiers in immunology},
volume = {17},
number = {},
pages = {1710777},
pmid = {42404887},
issn = {1664-3224},
mesh = {Humans ; *COVID-19/immunology/physiopathology/psychology/complications/prevention & control ; Post-Acute COVID-19 Syndrome ; *SARS-CoV-2/immunology ; *COVID-19 Vaccines/immunology ; Vaccination ; Mental Disorders/etiology ; },
abstract = {Long COVID or post-acute sequelae of COVID-19 is defined as an after-effect of acute COVID-19 infection. Its broad clinical symptoms include brain fog, shortness of breath, fatigue, joint, chest, or muscle pain, dysautonomia and neuropsychiatric symptoms such as anxiety, depression and post-traumatic stress disorder. It is estimated that 1 in every 5 COVID-19 survivors exhibit symptoms within the Long COVID bracket. An array of risk factors such as smoking habit, age, obesity, female sex, and prior hospitalization may increase the probability of a person developing Long COVID. While the underlying mechanisms of Long COVID remain elusive, we examine the various possible pathophysiologies involved in Long COVID. We take up impactful neuropsychiatric issues as another spectrum of Long COVID symptoms and the likely effect of various forms of COVID-19 vaccines. In this review, the focus will be on the main mechanisms associated with the development of long COVID, which include latent Epstein-Barr virus reactivation, molecular mimicry, virus persistence, autoantibodies, and mitochondrial dysfunction. Understanding these mechanisms shed light on the continued persistence of COVID-19 related symptoms long after the resolution of acute infection. For instance, the reactivation of Epstein-Barr virus in the immunocompromised context seen post-acute SARS-CoV-2 infection could lead to the symptoms commonly observed in Long COVID such as fatigue and brain fog. The Epstein-Barr virus could possibly disrupt mitochondrial function, explaining the fatigue commonly observed in Long COVID patients. Other factors such as continued presence of viral particles in specific areas such as the gut may result in continued inflammation, leading to manifestations such as fatigue, cognitive impairment and gastrointestinal dysfunction. Additionally, heightened and persistent presence of autoantibodies post-acute infection results in persistent symptoms and could potentially trigger the onset of autoimmune disorders. We also aim to revisit the diverse and prolonged effects of the COVID-19 pandemic that continue to affect the well-being and quality of human life.},
}

Humans
*COVID-19/immunology/physiopathology/psychology/complications/prevention & control
Post-Acute COVID-19 Syndrome
*SARS-CoV-2/immunology
*COVID-19 Vaccines/immunology
Vaccination
Mental Disorders/etiology

@article {pmid42406565,
year = {2026},
author = {Mugwagwa, T and Marcano Belisario, J and Hartley, L and Phan, NTN and Mokgokong, R},
title = {Evaluation of nirmatrelvir/ritonavir treatment for COVID-19 on health-related outcomes: a global economic value systematic literature review.},
journal = {Journal of medical economics},
volume = {29},
number = {1},
pages = {1875-1897},
doi = {10.1080/13696998.2026.2695551},
pmid = {42406565},
issn = {1941-837X},
mesh = {*Ritonavir/therapeutic use/economics ; Humans ; *COVID-19 Drug Treatment ; Cost-Benefit Analysis ; Quality-Adjusted Life Years ; *Antiviral Agents/economics/therapeutic use ; Cost-Effectiveness Analysis ; Drug Combinations ; COVID-19 ; SARS-CoV-2 ; Lopinavir ; },
abstract = {AIMS: Nirmatrelvir/ritonavir (NMV/r)[i] is an antiviral drug indicated for the treatment of patients with mild to moderate coronavirus disease 2019 (COVID-19) who are at high risk of progressing to severe disease. We performed an updated economic systematic literature review (eSLR) of NMV/r to build upon evidence reported in our previous eSLR and additionally examine the health-related outcomes associated with NMV/r and any potential effect of long COVID.

METHODS: A systematic search of Embase, PubMed, Cochrane, and EconLit and of conference and health technology assessment agency websites was performed to identify economic analyses published between January 2022 and October 2025.

RESULTS: Of the 33 included economic evaluations, most were cost-utility analyses (n = 16) and used an analysis of a short-term decision tree with a long-term Markov model (n = 11). Several types of health-related endpoints were reported by studies, with most including hospital-related endpoints (n = 20), quality-adjusted life-years (QALYs) (n = 18), and death-related endpoints (n = 18). Positive health-related outcomes were associated with NMV/r treatment, including reductions in hospitalizations and deaths and an increase in QALYs. NMV/r treatment was also associated with a reduced number of patients with long COVID complications.

LIMITATIONS: Most studies were conducted in high-income countries, were based on different COVID-19 variants, and were limited in data on the long COVID population.

CONCLUSION: In addition to monetary benefits, NMV/r provides short-term and long-term health-related benefits to patients with mild to moderate COVID-19. This study provides further support for NMV/r as a cost-effective treatment option.},
}

*Ritonavir/therapeutic use/economics
Humans
*COVID-19 Drug Treatment
Cost-Benefit Analysis
Quality-Adjusted Life Years
*Antiviral Agents/economics/therapeutic use
Cost-Effectiveness Analysis
Drug Combinations
COVID-19
SARS-CoV-2
Lopinavir

@article {pmid42409185,
year = {2026},
author = {Nehme, M and Hund-Georgiadis, M and Corral Beamonte, ED and Bridevaux, PO and Hoepner, R and Penner, IK and Strobel, J and Fretz, G and Rovira, MB and Puchades, F and Landi, F and Vasco, PG and Guaraldi, G and Cordero, FM and Sebastianelli, L and Sarmati, L and Berthuy, N and Wojcik, J and Keddad, K and Post, A and Leppert, D and Guessous, I},
title = {Temelimab versus placebo in patients with post-COVID condition.},
journal = {Brain, behavior, and immunity},
volume = {},
number = {},
pages = {106892},
doi = {10.1016/j.bbi.2026.106892},
pmid = {42409185},
issn = {1090-2139},
abstract = {INTRODUCTION: More than 400 million individuals are estimated to have been affected by post-COVID condition or long COVID. This condition can lead to significantly decreased quality of life and increased individual and societal costs. Temelimab, a monoclonal IgG4 backbone antibody targeting HERV-W ENV, may be a potential treatment for post-COVID.

METHODS: In this randomized, double-blind trial, which consisted of a 24-week treatment period, we enrolled adults who had fatigue and persistent symptoms due to post-COVID and were positive for HERV-W-ENV. Participants were randomized (1:1) to receive 54 mg/kg Temelimab or placebo IV once monthly. The primary endpoint was the decline in fatigue (defined as a 3-point decrease on the PROMIS Fatigue SF 7a scale) from baseline to Week 24. Secondary endpoints included changes in cognition, anxiety, depression, functional impairment, quality of life, safety and tolerability of Temelimab.

RESULTS: A total of 203 individuals participated in this study, 72% women, mean age 46 (standard deviation, SD 10) years. The mean initial PROMIS Fatigue SF 7a score was 26.8 (SD 3.4) in the Temelimab group and 27.1 (SD 3.8) in the placebo group. At 24 weeks, there was no difference between Temelimab (3.2 points decrease in the PROMIS score) and placebo (3.8 points decrease). Secondary outcomes also did not show differences between the Temelimab and placebo groups.

CONCLUSION: In adults with persistent symptoms due to post-COVID condition, the use of Temelimab did not show improvement in fatigue compared to placebo (Funded by GeNeuro SA; ClinicalTrials.gov number NCT05497089).

ETHICS AND DISSEMINATION: National authorities for clinical trials on medicinal products and ethical approval was obtained in all participating countries in Europe. Trial registration numbers ClinicalTrials.gov number (NCT05497089), EudraCT (2022-000618-32). Protocol version v5.0, date 23 February 2024; CCER Geneva IRB: 2022-00658.},
}

@article {pmid42399853,
year = {2026},
author = {Cheshire, A and Cartwright, T},
title = {Perceptions, acceptability and experiences of yoga to support long-COVID: a survey of people living with long-COVID.},
journal = {BMC complementary medicine and therapies},
volume = {},
number = {},
pages = {},
doi = {10.1186/s12906-026-05430-2},
pmid = {42399853},
issn = {2662-7671},
abstract = {BACKGROUND: The impact of long-COVID can be substantial for individuals, health systems and the economy, nevertheless, treatment and support options are limited. Yoga offers a potential solution to reduce the burden of long-COVID, demonstrating positive impacts on the biological mechanisms implicated in long-COVID, key long-COVID symptoms and associated mental health challenges. Yoga interventions can also be designed for people with limited physical ability, and online delivery can increase accessibility.

AIM: To understand the perceptions and experiences of yoga among people with long-COVID (PWLC), and assess its potential benefits.

METHODS: An online survey of PWLC, comprised closed and open response questions on: long-COVID symptoms, support needs, perceptions of a yoga intervention and its components and yoga use. Participants (n = 171) were recruited via Prolific. Inclusion criteria were long-COVID (formal diagnosis or self-reported) and living in the UK. Inductive thematic analysis was used for open ended responses.

RESULTS: Analysis identified unmet needs among PWLC that align with the potential benefits of a yoga intervention, particularly in supporting symptom management, self-management and associated psychological symptoms. Additionally, a yoga intervention could provide acknowledgment and support to PWLC who feel despondent about their condition and abandoned by health professionals. Participants reported a high level of interest in a yoga intervention, perceiving it could be of benefit. Barriers to yoga practise included anxiety regarding the group setting, fitting sessions into schedules, lack of energy and concerns about suitability for long-COVID. Those already practising yoga with long-COVID reported that yoga helped to manage symptoms and associated psychological challenges, as well as increasing flexibility and providing a safer alternative to exercise.

CONCLUSIONS: Many PWLC have positive perceptions of yoga and there is a good level of interest in a yoga intervention among this population. These findings suggest that yoga is a suitable intervention for study in future research as well as delivery in the community by qualified yoga instructors with a knowledge of long-COVID - provided that any intervention is appropriately tailored to fit the ability and address the concerns of PWLC. It should be offered in the context of health professional validation of symptoms.},
}

@article {pmid42401313,
year = {2026},
author = {Lkhagvasuren, B and Suematsu, T and Xiangyu, L and Hata, T and Takakura, S and Hiramoto, T and Oka, T and Sudo, N},
title = {Chronic stress primes TLR3-mediated systemic inflammation to produce persistent post-viral fatigue syndrome-like symptoms in mice.},
journal = {Neuroscience},
volume = {},
number = {},
pages = {},
doi = {10.1016/j.neuroscience.2026.07.002},
pmid = {42401313},
issn = {1873-7544},
abstract = {BACKGROUND: This study examined the long-term effects of polyinosinic:polycytidylic acid (poly I:C), a synthetic double-stranded RNA and Toll-like receptor 3 (TLR3) agonist, on behavioral and immune outcomes in chronically stressed mice.

METHODS: Male C57BL/6J mice were exposed to 21 days of wet bedding stress followed by a poly I:C injection. Post viral fatigue syndrome (PVFS)-like symptoms were evaluated over 7 days post-injection using grip strength testing, the forced swim test, von Frey filament testing, the Morris water maze, the open field test, and the social interaction test. Body temperature and locomotor activity were continuously monitored via intraperitoneally implanted dataloggers. Serum concentrations of interleukin-6 (IL-6), IL-10, and C-X-C motif chemokine ligand 10 (CXCL10) were quantified. In separate cohorts, minocycline (a microglial activation inhibitor) or RU486 (a glucocorticoid receptor antagonist) was administered prior to poly I:C injection.

RESULTS: Following IP injection of poly I:C, body temperatures in both stressed and unstressed mice were significantly elevated, indicating a polyphasic febrile response. At 7 days post-injection, stressed mice treated with poly I:C exhibited persistent fatigue, mechanical allodynia, depressive-like behavior, impaired spatial memory, increased anxiety-like behavior, and reduced social interaction. Serum levels of IL-6 and CXCL10 remained elevated and correlated with behavioral outcomes. Pretreatment with minocycline partially attenuated both the behavioral and immune responses, whereas RU486 pretreatment did not.

CONCLUSION: These findings demonstrate that TLR3-mediated systemic inflammation induced by poly I:C produces persistent, multi-domain PVFS-like symptoms in chronically stressed mice. The attenuation by minocycline implicates neuroinflammation as a possible mechanism.},
}

@article {pmid42402067,
year = {2026},
author = {Mullard, J},
title = {Long COVID: Lived Experiences, Diagnosis, Treatment and Care.},
journal = {Health expectations : an international journal of public participation in health care and health policy},
volume = {29},
number = {4},
pages = {e70757},
doi = {10.1111/hex.70757},
pmid = {42402067},
issn = {1369-7625},
}

@article {pmid42399828,
year = {2026},
author = {Appel, S and Coughtrey, AE and Kyrdalen, A and Takeda, A and Newlands, F and Stephenson, T and Shafran, R and Pereira, SMP},
title = {Understanding heterogeneity in paediatric long COVID research: an overview of reviews and recommendations for future pandemics.},
journal = {BMC pediatrics},
volume = {},
number = {},
pages = {},
doi = {10.1186/s12887-026-07276-6},
pmid = {42399828},
issn = {1471-2431},
abstract = {BACKGROUND: Studies of Long COVID or Post-COVID-19 condition in children and young people have varied considerably in their reported prevalences. We aimed to examine the methodological heterogeneity underlying this variability and explore whether methodological characteristics were correlated with reported Long COVID outcome prevalence, in order to inform recommendations to improve reporting in future pandemic-related epidemiological research.

METHODS: We conducted an overview of reviews with a narrative synthesis, identifying systematic reviews and meta-analyses and extracting their included primary studies. We identified reviews of Long COVID in children & young people in PubMed and Embase using a systematic search strategy. We extracted key methodological details including study design, sample size, sample and control group characteristics, data collection and reporting methods, as well as time-point(s) of surveying and frequency of follow-up. We explored correlations between these factors and prevalence of Long COVID via Spearman's rank correlation coefficients or the Kruskal-Wallis test.

RESULTS: 69 studies, from identified reviews, met the inclusion criteria with outcome symptom prevalence varying between 0 and 90% at > 3-months post-COVID-19 infection. Only 19% of studies used an established Long COVID definition to guide analyses. There was substantial heterogeneity in the design and outcome reporting of Long COVID studies. We did not find Long COVID prevalence varied by examined methodological factors (p ≥ 0.08 for all correlations).

CONCLUSION: While substantial methodological heterogeneity was observed across studies of paediatric Long COVID, no statistically significant correlations were identified between examined methodological factors and reported prevalence. Such variability limits comparability across studies and highlights the need for more standardised definitions, outcome measures, and reporting approaches in future pandemic-related epidemiological research: we discuss reporting guidelines and recommendations for future paediatric epidemiological research during a pandemic.},
}

@article {pmid42391726,
year = {2026},
author = {Kaplan, G},
title = {Therapeutic plasma exchange and immunomodulatory strategies in post-infectious syndromes: A review of immune dysregulation in PTLDS, long COVID, ME/CFS, and PANS/PANDAS.},
journal = {Transfusion and apheresis science : official journal of the World Apheresis Association : official journal of the European Society for Haemapheresis},
volume = {65},
number = {4},
pages = {104482},
doi = {10.1016/j.transci.2026.104482},
pmid = {42391726},
issn = {1473-0502},
abstract = {Post-infectious syndromes including post-treatment Lyme disease syndrome (PTLDS), long COVID, myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), and pediatric acute-onset neuropsychiatric syndrome (PANS)/pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) share overlapping clinical phenotypes characterized by fatigue, cognitive dysfunction, sleep disturbance, and neuropsychiatric symptoms. Increasing evidence suggests that immune dysregulation-including persistent inflammation, autoantibody production, and cellular immune dysfunction-may underlie these conditions. This narrative review synthesizes peer-reviewed literature describing immune abnormalities across these syndromes and evaluates the rationale for immunomodulatory therapies, including intravenous immunoglobulin (IVIG), rituximab, and therapeutic plasma exchange (TPE). Evidence supporting immune-targeted treatment strategies is strongest in subsets of patients with identifiable immunologic abnormalities. Notably, the phase III RituxME trial in ME/CFS and a phase II trial of TPE in post-COVID condition both failed to demonstrate efficacy in unselected populations, reinforcing the importance of biomarker-guided patient stratification. TPE functions by removing circulating immune complexes, autoantibodies, and inflammatory mediators, and observational data suggest benefit in patients with demonstrable autoantibody burden. Further controlled studies incorporating immunologic phenotyping and early intervention are needed to define the therapeutic role of immune-directed interventions across these conditions.},
}

@article {pmid42392788,
year = {2026},
author = {Yan, X and Tang, X and Zhang, YZ and Liu, YY and Liu, Y and Pang, WT and Yang, FW and Jin, XY},
title = {[Status analysis of clinical outcome for treatment of long COVID with traditional Chinese and western medicines].},
journal = {Zhongguo Zhong yao za zhi = Zhongguo zhongyao zazhi = China journal of Chinese materia medica},
volume = {51},
number = {7},
pages = {2081-2091},
doi = {10.19540/j.cnki.cjcmm.20251125.501},
pmid = {42392788},
issn = {1001-5302},
mesh = {Humans ; COVID-19 ; Post-Acute COVID-19 Syndrome ; *Drugs, Chinese Herbal/therapeutic use ; SARS-CoV-2/physiology/drug effects ; *COVID-19 Drug Treatment ; *Medicine, Chinese Traditional ; Treatment Outcome ; Pandemics ; *Coronavirus Infections/drug therapy ; },
abstract = {This study sorted out the clinical outcome of traditional Chinese and western medicines in the treatment of long COVID to lay the foundation for the construction of a core indicator set. Search was made on some databases and platforms from their inception to December 2024, which included eight databases of CNKI, Wanfang, SinoMed, VIP, PubMed, Cochrane Library, EMbase, and Web of Science and three clinical research protocol registration platforms, namely the Chinese Clinical Trial Registry(ChiCTR), the International Traditional Medicine Clinical Trial Registry(ITMCTR), and the American Clinical Trial Registry(ClinicalTrials.gov). Two researchers independently extracted the basic information, outcomes, measurement time points, and measurement tools of literature in parallel according to the inclusion and exclusion standards. If there are any differences, a third researcher would make discussions and decisions. A total of 152 studies, including 50 literature studies and 102 protocol studies, were ultimately included. A total of 338 outcomes indicators were reported, with a reporting frequency of 1 633 times. Outcome indicators can be classified into 10 indicator domains based on attributes, including symptoms and signs(694 times, 42.50%), TCM diseases(61 times, 3.74%), security incidents(93 times, 5.70%), etiological detection(23 times, 1.41%), long-term prognosis(72 times, 4.41%), economic indicators(14 times, 0.86%), physical and chemical testing(472 times, 28.90%), quality of life(173 times, 10.59%), major events(16 times, 0.97%), and other indicators(15 times, 0.92%). There were problems in the outcomes indicators of treating long COVID with both traditional Chinese and western medicines, such as significant differences in symptom descriptions, lack of standardization in indicator selection, diverse choices of measurement tools, diverse selection of measurement time, lack of practicality in clinical practice, and non-prominent TCM indicators. These issues led to scattered evidence and the absence of a unified core indicator set to guide clinical research. Further efforts are needed to develop COS of integrated traditional Chinese and western medicine treatments for long COVID, and to enhance the quality of clinical research on long COVID.},
}

Humans
COVID-19
Post-Acute COVID-19 Syndrome
*Drugs, Chinese Herbal/therapeutic use
SARS-CoV-2/physiology/drug effects
*COVID-19 Drug Treatment
*Medicine, Chinese Traditional
Treatment Outcome
Pandemics
*Coronavirus Infections/drug therapy

@article {pmid42393618,
year = {2026},
author = {Guan, N and Turner, G and Hotham, R and Lange, D and Brown, KR and McMullan, C and Hughes, SE and Aiyegbusi, OL and Matthews, K and Jackson, L and Yahyouche, A and Alder, Y and Jeyes, F and Buckland, L and Chong, A and Stanton, D and Calvert, M and Haroon, S},
title = {Self-management of long COVID symptoms with over-the-counter medicines and other non-prescribed therapies: a cross-sectional survey.},
journal = {BMC public health},
volume = {},
number = {},
pages = {},
doi = {10.1186/s12889-026-28017-5},
pmid = {42393618},
issn = {1471-2458},
support = {COV-LT-0013//National Institute for Health and Care Research/ ; COV-LT-0013//UK Research and Innovation/ ; },
abstract = {BACKGROUND: The high prevalence of long COVID globally necessitates investigation into its self-management, especially given the absence of definitive and effective treatments and uneven access to healthcare services.

METHODS: This study surveyed the use of over-the-counter (OTC) medicines, supplements, remedies, and other non-prescription therapies for managing long COVID symptoms in the UK. It aimed to identify the range of treatments used for self-management, explore the sources of these treatments, factors influencing treatment choices, and associated out-of-pocket expenses. A cross-sectional electronic survey was provided to individuals experiencing long COVID. It included questions on the use of OTC medications, supplements, and other therapies, where they were sourced, decision-making influences, and financial costs. Descriptive statistics and thematic analysis were applied to analyse the data.

RESULTS: Among the 193 surveyed participants, significant use of vitamins, minerals, and herbal treatments (88.8%), and analgesics (73.6%) was reported, with 42% exceeding recommended dosages. Some participants sought relief through alternative therapies such as physiotherapy and acupuncture, often incurring significant personal expenses. Choices about self-management were influenced by medical professionals, family, friends, and online sources, including support groups and social media.

CONCLUSIONS: People with long COVID may access a wide range of OTC medicines, dietary supplements, herbal remedies, and non-pharmacological therapies to self-manage symptoms. Healthcare providers should be aware of the use of non-prescribed therapies among long COVID sufferers and consider these in their treatment plans. Public health policies should focus on providing accurate information and guidance for patients self-managing long COVID symptoms.},
}

@article {pmid42395315,
year = {2026},
author = {Turebekova, D and Kosherova, B and Dauletkaliyeva, Z and Shayakhmetova, Y and Marchenko, A and Solyanov, D and Hendrixson, V and Kadyrova, I},
title = {Long COVID and health-related quality of life: a systematic review of immune, inflammatory, and metabolic markers.},
journal = {Frontiers in public health},
volume = {14},
number = {},
pages = {1846407},
pmid = {42395315},
issn = {2296-2565},
mesh = {Humans ; *Quality of Life ; Biomarkers/blood ; *COVID-19/immunology ; *Inflammation/immunology ; Post-Acute COVID-19 Syndrome ; SARS-CoV-2 ; },
abstract = {INTRODUCTION: Long COVID is known to be associated with prolonged multiple organ symptoms and decreased health-related quality of life (HRQoL), but the pathogenesis and relationship between immune, inflammatory, and metabolic biomarkers and HRQoL remains poorly understood. This systematic review aims to synthesize the evidence on the health-related quality of life of patients with Long COVID and to summarize the reported associations between health-related outcomes and biomarkers.

METHODS: We conducted a systematic search in PubMed, Web of Science, and Scopus in search of studies that evaluated immune, inflammatory, or metabolic biomarkers and HRQoL in patients with Long COVID. This review included case-control and cohort studies with a control group. The Rayyan tool was used to select studies, and full-text articles were evaluated for compliance with the criteria. Information was obtained on biomarkers, analytical methods, tools for assessing the HRQoL, and the relationship between HRQoL and biomarkers. Due to the high heterogeneity of the methods, the results were summarized in a descriptive form.

RESULTS: Ten studies were included, involving 1,078 patients with Long COVID and 768 healthy controls. Most studies that used various methods to assess HRQoL consistently reported long-term deterioration after COVID, with the greatest deterioration observed in the areas of physical functioning, vitality, fatigue, daily activities, pain, discomfort, and respiratory distress. The most frequently measured markers were related to inflammation and endothelial/coagulation pathways, including CRP, hsCRP, IL-6, TNF-α, D-dimer, and VCAM-1. Autoimmune, metabolic, intestinal barrier, and omics-based markers were measured less frequently, but indicated phenotype-specific biological heterogeneity. Only a few studies have identified a direct link between biomarkers and HRQoL. Lower HRQoL indicators were associated with increased neurotoxicity, decreased calcium levels, systemic inflammation, endothelial dysfunction, and signals from individual autoantibodies.

CONCLUSION: Our results indicate that Long COVID is consistently associated with a long-term decline in HRQoL, especially in the physical and functional areas. The available data indicate the presence of a strong signal regarding inflammatory processes and endothelial coagulation, while autoimmune, metabolic, and genetic data indicate phenotype-specific heterogeneity.

Unique identifier: CRD420251239371, URL: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD420251239371.},
}

Humans
*Quality of Life
Biomarkers/blood
*COVID-19/immunology
*Inflammation/immunology
Post-Acute COVID-19 Syndrome
SARS-CoV-2

@article {pmid42396378,
year = {2026},
author = {Murlimanju, BV and Shenoy, MP and Ullal, SD and Vadgaonkar, R},
title = {Perception of body donation among the Phase-1 medical students, a questionnaire-based study.},
journal = {F1000Research},
volume = {15},
number = {},
pages = {133},
doi = {10.12688/f1000research.175620.3},
pmid = {42396378},
issn = {2046-1402},
mesh = {Humans ; *Students, Medical/psychology ; Female ; Cadaver ; Surveys and Questionnaires ; Male ; Cross-Sectional Studies ; *Tissue and Organ Procurement ; *Health Knowledge, Attitudes, Practice ; Young Adult ; Adult ; COVID-19 ; },
abstract = {BACKGROUND: This study aimed to examine the knowledge, attitude, and perception of body donation among Phase-1 medical students at our institution. The objectives were to assist teachers in providing insight into the perception of this among students.

METHODS: This was a cross-sectional, institution-based, time-bound study comprising 29 validated questions regarding comprehensive aspects of body donation. There were 396 medical students in Phase-1 from admissions for two consecutive years.

RESULTS: Most students (94.4%) were aware of the source of cadavers in the dissection hall, which were either donated or unclaimed bodies from the hospital. However, 38.9% of them were unaware of the guidelines for body donation, and 79% were ignorant of the documents required to pledge. However, 84.3% were aware that it was mandatory to sign a pledge form. The time frame to procure the dead body to the department of anatomy of the institution was not known to 79% of the participants, and 93.2% of the participants opined that corpses from other neighboring states could be accepted. Opinions regarding the acceptance of donated bodies afflicted with long COVID were supported by 218 (55.1%), not supported by 47 (11.9%), and neutral by 131 (33.1%) participants in this study.

CONCLUSION: Specific knowledge gaps were encountered, including the timeframe, logistics, and legal issues in procuring the body. Since medical students play an important role in this societal motivation, it is suggested that a scientific session be planned in the curriculum of Phase-1 regarding the protocol of body donation. Apart from providing insights, this study also accomplishes the United Nations' sustainable development goal-4 in offering quality medical education. This study, apart from providing insights, also accomplishes the United Nation's sustainable development goal-4 in offering quality medical education.},
}

Humans
*Students, Medical/psychology
Female
Cadaver
Surveys and Questionnaires
Male
Cross-Sectional Studies
*Tissue and Organ Procurement
*Health Knowledge, Attitudes, Practice
Young Adult
Adult
COVID-19

@article {pmid42396494,
year = {2026},
author = {Tasnim, H and Forrest, S and Hofmeyr, S and Friedman, A and Etemadpour, R and Andrews, A and Cannon, J and Moses, M and Mehdikhani, H},
title = {Spatial Immune Model of Alveolar Lung Infection (SIMALI) Identifies Structural Determinants of Lung Inflammation.},
journal = {Research square},
volume = {},
number = {},
pages = {},
doi = {10.21203/rs.3.rs-9986593/v1},
pmid = {42396494},
issn = {2693-5015},
abstract = {Inflammation and lung damage in response to respiratory viral infection is a major cause of morbidity and mortality. How specialized lung alveolar structures contribute to variation in inflammatory lung damage observed in patients is a gap in current knowledge. Filling this gap is important for understanding how respiratory infections can lead to persistent and chronic sequelae after acute viral infection, including post-acute sequelae of COVID-19, or "long COVID". Few computational models have incorporated the spatial complexity of alveolar sacs, key sites where infection and inflammation damage lung function. We propose a novel computational model, SIMALI, which represents a sample of the lung's alveolar space as a structured 3D lattice of alveoli composed of air and epithelial cells surrounded by structural lung tissue through which virus and inflammation diffuse. SIMALI extends a previous agent-based model by adding key structural components of the lung, including physiological percentages of infectable cells and differential diffusion of virus through air and lung tissue. SIMALI's simulation predictions are validated against the spatial-temporal growth of lung lesions from Computed Tomography (CT) scans of patients with SARS-CoV-2 infection. By combining parameters validated in a prior study with alveolar structure, the model accurately predicts the typical growth of lung inflammation observed in patient CT scans. SIMALI demonstrates how the spatial architecture of alveolar sacs and the distribution of infectable cell types in the lung constrain the spread of virus and inflammation. Furthermore, SIMALI simulations show how the initial deposition of foci of viral infection distributed across alveolar sacs is an important mechanistic cause of variation in lung damage due to inflammation. The spatial SIMALI model demonstrates a key role for the structure of the alveolar space in driving inflammatory responses. Lung alveolar structure, combined with variation in immune response and the amount and location of initial viral deposition in the lung, all contribute to the highly variable damage to lung recapitulating variation observed across patients with SARS-CoV-2 infection.},
}

@article {pmid42398146,
year = {2026},
author = {Hackshaw, KV and Osuna-Diaz, MM and Sebastian, KR and Nuguri, SM and Castellvi, SL and Yu, L and Mikulik, Z and Giusti, MM and Brode, WM and Rodriguez-Saona, L},
title = {Symptom, functional, and medication overlap between long COVID and fibromyalgia.},
journal = {Clinics (Sao Paulo, Brazil)},
volume = {81},
number = {},
pages = {101046},
doi = {10.1016/j.clinsp.2026.101046},
pmid = {42398146},
issn = {1980-5322},
abstract = {BACKGROUND: Long COVID (LC/PASC) and Fibromyalgia (FM) share prominent pain, fatigue, and cognitive symptoms and are often difficult to distinguish clinically. The authors compared LC/PASC and FM using harmonized questionnaires assessing symptoms, function, and medication burden to quantify phenotype overlap and inform biomarker development.

METHODS: The authors analyzed a harmonized dataset including LC/PASC participants and FM-only comparators. Measures included age, sex, BMI, FIQR/SIQR-equivalent, BDI, CSI, MPQ, VAS pain, medication burden derived from free-text entries, and descriptive SF-36 domains.

RESULTS: The sample included 54 LC/PASC and 889 FM-only visits. LC/PASC participants were older and less often female. Across symptom and function measures, partial overlap was observed, with domain-specific differences. Medication burden was common; FM showed greater centrally acting medication use. SF-36 domains showed broad similarity with domain-specific differences.

CONCLUSIONS: In this preliminary, hypothesis-generating comparison, LC/PASC and FM demonstrate partial and domain-specific overlap across questionnaire measures, while differences in medication exposure may influence symptom reporting and limit direct clinical comparisons. These findings support the need for prospective studies integrating objective biomarkers with standardized clinical phenotyping.},
}

@article {pmid42382648,
year = {2026},
author = {Chipol-Ceja, RL and Morales-Romero, J and Rivero-López, CA and Pérez-Callejas, MDS and López-Ortiz, G and Del Carpio-Orantes, L and Spinoso-Torres, CI and González-Periañez, S and Rodríguez-Cordoba, MJ and Ovando-Diego, L and Zurutuza-Lorméndez, JI},
title = {SARS-CoV-2 reinfection: a possible contributing factor to long COVID in children and adolescents.},
journal = {Frontiers in pediatrics},
volume = {14},
number = {},
pages = {1691052},
pmid = {42382648},
issn = {2296-2360},
abstract = {BACKGROUND: Following the end of the COVID-19 pandemic, attention shifted towards patients who developed sequelae, persistent symptoms, or relapsing or remitting symptoms of new conditions after a prior history of acute SARS-CoV-2 infection. The objective of the present study was to identify the prevalence, clinical characteristics, and potential associated factors of long COVID in children treated during the pandemic in a primary care unit.

METHODS: A cross-sectional analytical study was conducted from January to December 2022. Children under 18 years of age and their parents were included in the study if they had been treated at the Mexican Social Security Institute. Two distinct manifestations of long COVID were considered: (a) "persistence", defined as continuous symptoms beginning in the acute phase and lasting for more than 3 months; and (b) "post-COVID conditions", defined as new or recurrent symptoms lasting for more than 3 months, appearing after the acute episode, and not associated with any active disease or infectious condition. An exploratory binary logistic regression analysis was performed to identify associated factors, using an odds ratio (OR) as the measure of association.

RESULTS: The study included 349 children and adolescents. The prevalence of long COVID was 11.8% (95%CI 7.8%-17.5%). For "persistence", the most frequent symptoms were cough (50%) and rhinorrhea (15.4%); for "post-COVID conditions", the most common symptoms were myalgia (33.3%), asthenia and irritability (26.7% each), and constipation (20%). Multivariate analysis revealed that the associated factors for individuals aged over 8 years were a history of reinfection (OR 9.7, 95%CI 1.6-58) and BMI at the time of the survey (OR 1.1, 95%CI 1.0-1.2), while for those aged under 8 years, the associated factor was male sex (OR 4.7, 95%CI 1.3-17.3). It is important to emphasize that these results are the product of an exploratory analysis and aim to create and test new hypotheses.

CONCLUSIONS: For healthcare professionals, it is crucial to consider the possibility of long COVID, as this study indicated that approximately 12% of children and adolescents may be affected. Further research is necessary to better understand and manage long COVID in pediatric populations and to investigate the association between reinfections and their increased prevalence.},
}

@article {pmid42384384,
year = {2026},
author = {Vanova, M and Patel, AMR and Scott, I and Gilpin, G and Manning, EN and Ash, C and Wittenberg, P and Lim, J and Hoare, Z and Evans, R and Bray, N and Kipps, CM and Devine, C and Ahmed, S and Dunne, R and Koniotes, A and Warren, C and Chan, D and Suarez-Gonzalez, A},
title = {Cognitive Rehabilitation and Functional Outcomes in Long COVID-Related Cognitive Impairment: A Randomized Clinical Trial.},
journal = {JAMA network open},
volume = {9},
number = {7},
pages = {e2620687},
pmid = {42384384},
issn = {2574-3805},
mesh = {Humans ; Female ; Middle Aged ; *COVID-19/complications/psychology ; Cognitive Training ; Male ; *Cognitive Dysfunction/rehabilitation/etiology ; Single-Blind Method ; Adult ; Post-Acute COVID-19 Syndrome ; SARS-CoV-2 ; Treatment Outcome ; Cognitive Enhancement ; },
abstract = {IMPORTANCE: Cognitive impairment is common in long COVID and severely affects daily life, with no proven treatments to date.

OBJECTIVE: To evaluate the ability of cognitive rehabilitation (CR) to improve goal attainment, cognitive, and clinical outcomes in individuals with cognitive impairment as part of long COVID.

This multicenter, single-blind, 2-arm, parallel-group randomized clinical trial was conducted at 3 sites in England between February 2023 and March 2024. Participants were adults aged 30 to 60 years with prior COVID-19 infection and objective cognitive impairment (≥1 SD below age norm in ≥2 cognitive domains). A sample size of 88 participants (44:44) was required to detect a conservative effect of 0.7 on the goal attainment score at 3 months.

INTERVENTIONS: Participants were randomized (1:1) to CR or treatment as usual (TAU). CR consisted of 10 individual 1-hour sessions conducted once per week with a trained researcher, applying evidence-based strategies to 3 individually selected, personally meaningful functional goals. TAU was variable, with most participants having access to specialist memory clinics.

MAIN OUTCOME AND MEASURES: The primary outcome consisted of participant-reported goal-attainment scores at 3 months after randomization measured by the Bangor Goal-Setting Interview. Analysis was conducted on an intention-to-treat basis using multilevel mixed-effects models with 2-sided 95% CIs and 5% significance.

RESULTS: A total of 78 participants (24 male [30.8%] and 54 female [69.2%]; mean [SD] age, 47.3 [7.2] years) were randomized, including 38 individuals in CR and 40 individuals in TAU groups. At 3 months after randomization, goal attainment was significantly greater in the CR compared with the TAU group (adjusted mean difference, 2.88 [95% CI, 2.03-3.73]; P < .001; Cohen d = 1.57), with CR providing a large and clinically meaningful treatment effect. This was sustained at 6 months, with a lower effect size (adjusted mean difference, 1.72 [95% CI, 0.86-2.57]; P < .001; Cohen d = 0.91).

CONCLUSIONS AND RELEVANCE: In this study, individualized, goal-oriented CR led to significant and sustained improvements in goal attainment in people with long COVID-related cognitive impairment. These findings may guide and inform the provision of CR treatments and services for people living with long COVID.

TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT05731570.},
}

Humans
Female
Middle Aged
*COVID-19/complications/psychology
Cognitive Training
Male
*Cognitive Dysfunction/rehabilitation/etiology
Single-Blind Method
Adult
Post-Acute COVID-19 Syndrome
SARS-CoV-2
Treatment Outcome
Cognitive Enhancement

@article {pmid42389520,
year = {2026},
author = {Nicaise, C and Bulpa, P and Jamoulle, M},
title = {Autoantibody-mediated pain in long COVID: evidence from multiple lines.},
journal = {Frontiers in immunology},
volume = {17},
number = {},
pages = {1840110},
pmid = {42389520},
issn = {1664-3224},
}

@article {pmid42376966,
year = {2026},
author = {Rhodes, T and Cowan, H and Clarke, Z and Fernes, P and Mcfarland, S and Ward, H},
title = {Young People Navigating the Looping Effects of Long Covid: Exhausting Agency and the 'Ongoing After' of Pandemic.},
journal = {Sociology of health & illness},
volume = {48},
number = {6},
pages = {e70210},
pmid = {42376966},
issn = {1467-9566},
support = {135315//National Institute for Health and Care Research/ ; },
mesh = {Humans ; *COVID-19/psychology ; Post-Acute COVID-19 Syndrome ; Pandemics ; Adolescent ; Female ; Male ; SARS-CoV-2 ; Qualitative Research ; Social Support ; Young Adult ; *Coronavirus Infections/psychology ; *Pneumonia, Viral/psychology ; },
abstract = {Seeing beyond the COVID-19 pandemic as an extraordinary spectacle situated in the past, we draw on qualitative research with young people to trace experiences of Long Covid as 'looping effects' of entangling physical and social impacts which intersect with, and extend, those of pandemic. Navigating the capacity to do ordinary things becomes highly contingent, and exhausting work, in the face of Long Covid. The physical impacts of illness, including fatigue, are materialised in altering biographical and social relationships, and managing the 'social life' of Long Covid is a key concern. The lifetimes of Long Covid and pandemic also feed into one another. Configurations of the COVID-19 pandemic as a thing of the past, and social responses felt discounting of the Long Covid experience, enact ongoing illness as 'out of sync', and contribute as elements of exhausted agency and extended precarity. The social impacts of the pandemic looping with Long Covid become iterations without clear end; events ongoing in the living present. Understanding how Long Covid extends the 'ongoing after' of pandemic highlights the need for lasting social support for affected young people.},
}

Humans
*COVID-19/psychology
Post-Acute COVID-19 Syndrome
Pandemics
Adolescent
Female
Male
SARS-CoV-2
Qualitative Research
Social Support
Young Adult
*Coronavirus Infections/psychology
*Pneumonia, Viral/psychology

@article {pmid42377750,
year = {2026},
author = {Floridia, M and Weimer, LE and Palange, P and Ciardi, MR and Rovere-Querini, P and Bonfanti, P and Tosato, M and Barisione, E and Lacedonia, D and Gnerre, P and Parati, G and Onder, G and , },
title = {Factors affecting exercise performance at the 6-min walk test in long-COVID: a multicenter study from Italy.},
journal = {Internal and emergency medicine},
volume = {},
number = {},
pages = {},
pmid = {42377750},
issn = {1970-9366},
support = {I85F21003410005//Ministero della Salute/ ; },
abstract = {The cofactors potentially affecting exercise performance after COVID-19 are still incompletely investigated. The contribution of several clinical and demographic variables to the exercise capacity measured with the 6-min walk test was assessed in multivariable analyses that used the absolute distance walked in 6 min (6MWD) and an impaired performance (6MWD < 60% of the predicted value) as study outcomes. The variables considered were age, sex, preexisting comorbidities, COVID-19 severity, pandemic phase, treatments administered in acute phase, SARS-CoV-2 vaccination, reinfection, time from acute infection, and presence of 30 persisting symptoms. The mean 6MWD recorded among 686 patients at a mean interval of 184 days from COVID-19 was 474 m, with 8.3% of them presenting values below 60% of the predicted value. 6MWD was affected by sex, comorbidities, COVID-19 severity, and some persisting symptoms. The estimated effect sizes were -29.9 m for severe/critical acute disease, between -26 and -87 m for six comorbidities (atrial fibrillation, renal failure, chronic liver disease, chronic pulmonary disease, ischemic heart disease, diabetes) and between -21 and -99 m for four persisting symptoms (nausea/vomiting, paresthesia, depressed mood, dyspnea). The 6MWD increased by 2.6 m per month elapsed from acute infection. A 6MWD < 60% was associated with female sex, more intensive respiratory support, four comorbidities (atrial fibrillation, renal failure, chronic pulmonary disease and ischemic heart disease), and two persisting symptoms (nausea/vomiting and palpitations/tachycardia). Exercise performance after COVID-19 is affected by multiple factors, with estimated effect sizes that are clinically relevant. The results also suggest some spontaneous improvement over time.},
}

@article {pmid42380873,
year = {2026},
author = {Wang, XF and Huang, S and Xu, Y and Zou, Y and Zhang, P and Xie, Y and Tsuang, WM},
title = {Multimorbidity patterns and phenotype transitions in patients with clinician-coded long COVID: a multicenter US electronic health record cohort study.},
journal = {BMC infectious diseases},
volume = {},
number = {},
pages = {},
doi = {10.1186/s12879-026-13897-0},
pmid = {42380873},
issn = {1471-2334},
support = {1R01GM152717-01//National Institute of Health/ ; },
abstract = {BACKGROUND: Long COVID is clinically heterogeneous, but longitudinal changes in documented chronic disease burden and transitions in multimorbidity phenotypes after infection are not well characterized in routine care.

METHODS: We considered 425,614 patients with clinician-coded long COVID (ICD-10-CM U09.9) and a definable COVID-19 index date between October 1, 2021 and September 16, 2024 using deidentified electronic health record data from Epic Cosmos, a multicenter US network. Pre-index and post-index windows were defined as days - 365 to - 1 and days 91 to 455 relative to infection, respectively; follow-up was available through December 15, 2025. Chronic condition groups derived from ICD-10-CM codes were compared across windows using adjusted generalized estimating equation models. K-modes clustering was used to identify multimorbidity phenotypes, and multinomial regression was used to estimate adjusted transition probabilities.

RESULTS: Two pre-index phenotypes were identified: low burden (87.9%) and multimorbid (12.1%). Four post-index phenotypes emerged: low burden (63.3%), multimorbid/systemic (21.0%), respiratory-dominant (4.3%), and high-utilization/low-coded multimorbidity (11.3%). Higher baseline multimorbidity was associated with greater probability of transition to the multimorbid/systemic phenotype, whereas respiratory-dominant and high-utilization phenotypes arose from both baseline groups. Increases were concentrated in neurologic/autonomic, respiratory, hypercoagulable, endocrine/metabolic, sleep-related, and symptom-based domains. The high-utilization/low-coded phenotype was younger, predominantly female, and had greater emergency department and outpatient use. Fewer changes reached statistical significance in children than in adults.

CONCLUSIONS: Among patients with clinician-coded long COVID, chronic disease burden increased after infection and diversified into interpretable post-index phenotypes with distinct utilization profiles, supporting phenotype-informed follow-up and health system planning.},
}

@article {pmid42380995,
year = {2026},
author = {Delano, P and Serra-Suton, V and Benavides, FG and Utzet, M},
title = {Prolonged return to work and hampered work ability: insights from a scoping review on the impact of long COVID on healthcare workers job performance.},
journal = {BMC health services research},
volume = {},
number = {},
pages = {},
doi = {10.1186/s12913-026-15032-w},
pmid = {42380995},
issn = {1472-6963},
abstract = {BACKGROUND: Healthcare workers (HCWs) may have a higher risk of developing long COVID due to greater exposure to COVID-19, with symptoms extending beyond the acute phase impacting their daily living activities and job performance.

AIMS: To systematically map the existing literature on the impact of long COVID on HCWs' job performance, focusing on their time to return to work and work ability.

METHODS: A scoping review following PRISMA-ScR guidance included peer-reviewed studies in English or Spanish (January 2020-December 2024). Four databases were searched. Experimental, epidemiological and qualitative studies were eligible. Two reviewers independently screened records. Methodological quality was appraised using the Mixed-Methods Appraisal tool (MMAT).

RESULTS: Nineteen studies were included, mainly European and predominantly cross-sectional. Long COVID was most often defined as symptoms lasting ≥ 3 months. Among HCWs with prior infection or whole-staff samples, prevalence ranged from 10% to 74%, with multiple reports above 50%. Thirteen studies evaluated RTW, with 19-63% resumed work within six months, commonly with restrictions, while around one in five remained unable to work in some cohorts. Full-time employment decreased markedly (e.g., 57% pre-infection vs 31% at follow-up). Between 16% and 40% required workplace adjustments such as reduced hours, reassignment, or avoidance of night shifts. Sixteen studies reported diminished work ability compared with pre-infection or unaffected peers. Greater symptom burden, particularly cognitive impairment and fatigue, consistently predicted poorer outcomes. One study estimated a mean of 223 days to reach current work-ability levels. Older age, depression, comorbidity, and acute disease severity were recurrent associated factors while evidence for gender and job category was inconsistent.

CONCLUSIONS: Long COVID delays RTW and reduces work ability in HCWs. Health services should plan long-term occupational follow-up, flexible reintegration pathways, and targeted accommodations while higher-quality longitudinal research refines risk and prognosis.},
}

@article {pmid42381644,
year = {2026},
author = {Caruana, FF and Gelbard, A and Francis, D and Pitman, MJ and Kennedy, EP and Blumin, J and Bock, J and Clary, M and Axelson, Q and Matrka, L and McGarey, P and Daniero, J and Weissbrod, P and Yiu, Y and Gorelik, D and Morrison, RJ and Soliman, S},
title = {Voice Outcomes of Patients Intubated for Critical COVID Illness: A Multicenter Study.},
journal = {OTO open},
volume = {10},
number = {3},
pages = {e70234},
pmid = {42381644},
issn = {2473-974X},
abstract = {OBJECTIVE: Characterize the long-term vocal outcomes of patients who required ICU care for COVID-19 infection.

STUDY DESIGN: Prospective cohort study.

SETTING: Multi-institutional North American Airway Collaborative Study.

METHODS: Patients with a COVID-19 diagnosis requiring ICU admission were identified via ICD-10 codes and recruited after discharge to complete patient-reported outcome measures (PROM) in voice (Voice Handicap Index: VHI-10), communication (Communicative Participation Item Bank: CPIB), and breathing (Clinical COPD Questionnaire: CCQ). Multivariate analysis investigated the association between clinical variables and PROMs.

RESULTS: 308 patients enrolled; 271 were admitted with COVID to the ICU. 221 were intubated (81.5%); 50 patients admitted to the ICU did not require intubation (18.5%). Mean follow-up was 489 days after discharge (95% CI: 452-526). Mean intubation duration was 17 days (95% CI: 15-19). Median endotracheal tube (ETT) size was 7.5. Intubation was associated with higher VHI-10 score (15 vs 10; P = .01) and lower CPIB score (27 vs 30; P < .01). When controlling for ETT size, multivariate analysis did not show a relationship between intubation duration and VHI-10 or CPIB scores but was associated with worse CCQ score (P = .04).

CONCLUSION: Survivors of COVID infection requiring ICU admission and intubation have persistent functional impairments in voicing and breathing more than 1 year after their hospitalization. While COVID survivorship and "long COVID" have centered on neuropsychiatric and metabolic outcomes, this study highlights the unappreciated negative impact of endotracheal intubation on voice and communication related to this illness and reinforces the relationship between duration of intubation and subjective dyspnea after surviving critical illness.},
}

@article {pmid42371502,
year = {2026},
author = {Lodemann, P and Tsuprykov, O and Lawaczeck, R},
title = {The Time Course of Serum Iron and Serum Ferritin Concentrations Post-COVID-19 and Influenza Vaccinations.},
journal = {Case reports in infectious diseases},
volume = {2026},
number = {},
pages = {8662747},
pmid = {42371502},
issn = {2090-6625},
abstract = {INTRODUCTION: Temporal responses of serum iron and ferritin in COVID-19 infection and vaccination remain insufficiently characterized. This case report presents their timeline after SARS-CoV-2 and influenza vaccinations and may serve as a model for future studies. The approach can be extended to cohort studies or investigations of other acute-phase reactants. A vaccination protocol with a defined timeline can provide a template for COVID-19 and long COVID studies.

CASE PRESENTATION: Blood samples were collected from vaccination through 6 weeks postvaccination, focusing on iron metabolism. Prevaccination values served as baseline controls. SARS-CoV-2 mRNA vaccination was administered together with routine seasonal influenza vaccination. Previous influenza vaccinations in this patient were not associated with systemic symptoms such as dizziness or fever; in contrast, the present case exhibited clear reactions, suggesting that the observed alterations in serum iron and ferritin are attributable to the SARS-CoV-2 vaccine. The vaccination induced an abrupt decrease in serum iron and a concomitant increase in ferritin. While ferritin returned to baseline within 6 weeks, iron levels steadily increased to approximately 1.8-fold above baseline values but remaining within the reference interval.

DISCUSSION: The observed decrease in serum iron reflects an iron-withholding response, a well-established host defense mechanism during infections that limits pathogen proliferation. The increase in ferritin requires further interpretation. A hypothesis is presented, but further data are needed to support this mechanism. In future cohort studies, the protocol should include individual prevaccination values so that an additional control group is not necessary.

CONCLUSION: Immune reactions to vaccines can trigger transient changes in serum iron and ferritin that resemble the acute-phase response observed during infections. This case may serve as a template for studying the kinetics of immune responses, where t = 0 is defined by the vaccination time and each patient serves as own control when prior data are available.},
}

@article {pmid42371512,
year = {2026},
author = {Cezar da Cruz, D and Haertl, K and Tomlin, GS and Yu, CH and Hernández-Lanas, O and Haigh, J},
title = {Mapping the occupational therapy process in response to COVID-19 and long COVID: A scoping review.},
journal = {The British journal of occupational therapy},
volume = {89},
number = {7},
pages = {435-448},
pmid = {42371512},
issn = {1477-6006},
abstract = {BACKGROUND: COVID-19 and long COVID have had an impact worldwide on people's participation in occupations. Occupational therapists play a role in supporting individuals' recovery and participation in daily life.

OBJECTIVE: This present study undertook a scoping review of research on COVID-19 and long COVID to map the occupational therapy process with this population, including evaluation, intervention and outcomes.

METHODOLOGY: Three online databases were searched to identify research papers published between 2020 and 2023 from all countries, published in English, Portuguese, or Spanish. From 455 texts, 25 studies were selected for this review.

RESULTS: Studies were conducted across varied healthcare settings, mainly inpatient hospitals. Participants ranged from children to older adults, with adults being the most represented group. Standardised assessments included occupational history, activities, body functions, cognition and emotional regulation. Interventions were educational, compensatory, restorative or acquisitional, with outcomes focused on daily living activities, performance skills and client factors.

CONCLUSION: Our review underscores the need for more comprehensive documentation of occupational therapy effectiveness, particularly in unpredictable circumstances such as COVID.},
}

@article {pmid42376237,
year = {2026},
author = {Matias-Guiu, JA and Arelin, K and Serrano, PJ and Wacker, A and Sória, MG and Burkart, M and Zifko, U},
title = {A randomised, placebo-controlled, triple-blind clinical trial to investigate the efficacy of Ginkgo biloba extract EGb 761[®] in cognitive impairment associated with post COVID-19 syndrome-the EGb COCOS protocol.},
journal = {Frontiers in human neuroscience},
volume = {20},
number = {},
pages = {1658342},
pmid = {42376237},
issn = {1662-5161},
abstract = {BACKGROUND: Cognitive impairment is frequent in post-COVID-19 syndrome (PCS). The understanding of the pathogenesis is still limited. Key factors such as neuroinflammation, neurovascular dysfunction, and disruption of cellular energy metabolism have been identified. There are no evidence-based treatments targeting the pathologic mechanisms of cognitive impairment associated with PCS available to date. Thus, treatment is directed towards symptom relief. EGb 761[®], a dry extract from the leaves of Ginkgo biloba has anti-neuroinflammatory properties, improves microcirculation and neuronal mitochondrial function. Clinical efficacy in the treatment of cognitive impairment has been demonstrated. It is therefore reasonable to assume that the extract might be beneficial for use in cognitive impairment associated with PCS. Case series of patients with PCS reported significant improvement in cognitive function within 6 months of treatment. The EGb 761[®] Post COVID Cognitive Impairment Study (EGb COCOS) aims to establish whether EGb 761[®] is an effective treatment for cognitive impairment in PCS.

METHODS: In this prospective, multicentre, randomised, placebo-controlled, triple-blind trial, treatment effects and safety of EGb 761[®] in patients with cognitive impairment associated with PCS will be investigated. Eligible patients aged ≥18 years with a history of probable or confirmed SARS-CoV-2 infection, diagnosis of PCS with cognitive symptoms that have been present for at least 2 months, objective cognitive impairment, and mild-to-moderate anxiety or depressive symptoms will be enrolled. Participants (n = 400 planned) will be randomised to oral, 12-week treatment with EGb 761[®] (240 mg) or matching placebo once daily. The effect of EGb 761[®] will be assessed on cognitive, neuropsychiatric, neurosensory, and functional outcomes. The analysis will be exploratory in nature, since generally accepted and validated primary endpoints have not been established. For safety, the incidence of adverse events (AEs) and serious AEs will be recorded.

DISCUSSION: The results of this trial will show for the first time whether EGb 761[®] is an effective treatment for cognitive impairment in PCS.

CLINICAL TRIAL REGISTRATION: https://euclinicaltrials.eu/ctis-public/view/2024-517199-39-00?lang=en, Identifier CTIS2024-517199-39-00.},
}

@article {pmid42376321,
year = {2026},
author = {Telles, AFC and Menezes Junior, BS and Dos Santos, CA and Sena, LOC and Alves, MRM and Moraes, MLAM and Cipolotti, R},
title = {Genetic association between LONG COVID and TMPRSS2 polymorphisms (rs12329760 and rs2070788) in Brazilian healthcare professionals.},
journal = {Frontiers in cellular and infection microbiology},
volume = {16},
number = {},
pages = {1731318},
pmid = {42376321},
issn = {2235-2988},
mesh = {Humans ; *Polymorphism, Single Nucleotide ; Brazil/epidemiology ; Female ; *Serine Endopeptidases/genetics ; Adult ; *COVID-19/genetics/epidemiology ; Post-Acute COVID-19 Syndrome ; *Health Personnel ; Male ; *Genetic Predisposition to Disease ; Genome-Wide Association Study ; Middle Aged ; Young Adult ; Genotype ; Adolescent ; SARS-CoV-2 ; },
abstract = {Long COVID syndrome has a multifactorial cause that is not fully understood and may be influenced by both external and intrinsic factors. In this context, a Genome-Wide Association Study (GWAS) was proposed to evaluate the association between Single Nucleotide Polymorphisms (SNPs) in TMPRSS2 (rs12329760 and rs2070788) and the occurrence of Long COVID in 363 Brazilian healthcare professionals, recruited using a non-probabilistic method. The study employed a self-report questionnaire to collect sociodemographic and clinical data from both the acute and chronic phases and also collected oral mucosa cells for genotypic analysis by qPCR using Taqman probes. The categorized information was analyzed using the PSPP software using Pearson's chi-square test in three genetic statistical models: additive, dominant, and recessive. Assessing long COVID in general, only clinical variables such as increased susceptibility, presence of symptoms, and severity influenced the occurrence of the syndrome. When specifying the main reported symptom, brain fog, females and young adults (18 to 29 years old) are the most vulnerable, and rs2070788 in the recessive model proved to be relevant. This association is more evident when evaluating only the symptomatic group in the post-COVID period, as the additive model also influences the groups. rs12329760 showed no relevant influence on the groups. Therefore, this study provides unprecedented evidence of the association between brain fog and rs2070788, requiring case-control studies to better clarify how this association occurs.},
}

Humans
*Polymorphism, Single Nucleotide
Brazil/epidemiology
Female
*Serine Endopeptidases/genetics
Adult
*COVID-19/genetics/epidemiology
Post-Acute COVID-19 Syndrome
*Health Personnel
Male
*Genetic Predisposition to Disease
Genome-Wide Association Study
Middle Aged
Young Adult
Genotype
Adolescent
SARS-CoV-2

@article {pmid42363551,
year = {2026},
author = {Wen, J and Chen, Y and Zhang, J and Tan, Z and Xia, Z and Yang, S and Liu, H},
title = {Genetic evidence that advanced COVID-19 accelerates longitudinal brain atrophy: A Mendelian randomization study.},
journal = {Medicine},
volume = {105},
number = {26},
pages = {e49310},
pmid = {42363551},
issn = {1536-5964},
mesh = {Humans ; *COVID-19/genetics/complications ; Mendelian Randomization Analysis ; Genome-Wide Association Study ; *Brain/pathology/diagnostic imaging ; Atrophy/genetics ; Magnetic Resonance Imaging ; SARS-CoV-2 ; Aging/genetics ; Polymorphism, Single Nucleotide ; Genetic Predisposition to Disease ; Longitudinal Studies ; },
abstract = {Coronavirus disease 2019 (COVID-19) was reported to persist long-term in the brain and leave several long-term neurologic sequelae. However, the causal relationship between COVID-19 and brain aging is still unknown. The genome-wide association study (GWAS) data on COVID-19 phenotypes (susceptibility, hospitalization, and severity), involving a total of 5,779,391 participants, were collected from the COVID-19 Host Genetics Initiative. In addition, GWAS data on longitudinal changes in 15 brain structures, assessed via magnetic resonance imaging across the lifespan, were sourced from the ENIGMA Consortium and involved 15,640 participants. Two-sample Mendelian randomization was conducted to infer the causal relationship between COVID-19 and longitudinal brain changes. Multi-trait GWAS meta-analysis, colocalization, and fine-mapping analyses were performed to identify shared genetic etiologies. H3K27me3 ChIP-seq was used to evaluate the regulatory effect of colocalized loci. Two-step Mendelian randomization was applied to explore potential mediating mechanisms across multi-omics layers, including proteomics, metabolomics, and immunomics. Our results showed that COVID-19 hospitalization (β = -262.405, P = .041) and severity (β = -177.676, P = .049) were genetically associated with atrophied volume of total brain during longitudinal change. This suggests that individuals with advanced COVID-19 may be more susceptible to accelerated global brain aging. Caudate was genetically affected by all COVID-19 phenotypes. Seven variants were shared between advanced COVID-19 and global brain aging. rs117169628 was colocalized between advanced COVID-19 and global brain aging, and exerted an inhibitory effect on CDH15 expression, further strengthening the causality. Six metabolites, 1 protein, and 1 immune trait were identified as potential mediators. Our study indicates that advanced COVID-19 might be genetically associated with accelerated brain aging. Brain health should be paid more attention in long COVID-19.},
}

Humans
*COVID-19/genetics/complications
Mendelian Randomization Analysis
Genome-Wide Association Study
*Brain/pathology/diagnostic imaging
Atrophy/genetics
Magnetic Resonance Imaging
SARS-CoV-2
Aging/genetics
Polymorphism, Single Nucleotide
Genetic Predisposition to Disease
Longitudinal Studies

@article {pmid42364466,
year = {2026},
author = {Bandeira Barboza, AP and Monteiro, RL and Muschi, AL and Dos Santos Silva, AR and Silva, DAD and Silveira, RC and Alencar Silva, CS and de Castro, GS and Santana, JV and Soares Silva, RDS and Cerri, GG and Rodrigues Pereira, AJ and Beco, MA and Romitelli, G and Veneziani, JR and Santos Silva, EMD and Barboza, ADS and Mattar, LL and Sabino, EC and Ribeiro, RS and Costa, SF},
title = {Artificial intelligence-enhanced nurse navigation for monitoring and care of long COVID.},
journal = {International journal of medical informatics},
volume = {219},
number = {},
pages = {106557},
doi = {10.1016/j.ijmedinf.2026.106557},
pmid = {42364466},
issn = {1872-8243},
abstract = {INTRODUCTION: Long COVID is a multisystem condition with challenging diagnosis. Nurse-navigation, a patient-centered intervention, can enhance education and care access. Analyzing patient-nurse text message exchanges using natural language processing (NLP) enables automated extraction of clinical information, potentially supporting early identification of long COVID. We aimed to evaluate a digital nurse navigation platform integrating a predictive model for long COVID identification as a triage-assisting tool and to assess user acceptance.

METHODS: This observational study included patients and healthcare professionals diagnosed with COVID-19 from January to July 2024. Participants received nurse-navigation support for 16 weeks with monthly interactions via a WhatsApp-integrated platform. Structured sociodemographic and clinical data were combined with text-message insights using NLP techniques such as term frequency-inverse document frequency (TF-IDF), and analyzed using language models (Gemini 1.5 Pro, BERTimbau) and probabilistic linkage. The dataset was split into 70% training and 30% testing, and eight machine learning models were evaluated. Performance metrics included accuracy, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under the receiver operating characteristic curve (AUROC). User satisfaction was assessed with the Net Promoter Score (NPS).

RESULTS: Among 177 participants, 141 (78%) were female, with an overall mean age of 51 years. A total of 7,016 messages were processed. Long COVID was identified in 60 participants (33%), most frequently reporting memory loss, dyspnea, cognitive fatigue, and hair loss. Participants received structured education, and 20 were referred for further evaluation. The XGBoost-minor model achieved the highest classification performance with an accuracy of 72%, sensitivity of 38%, specificity of 88%, PPV of 63%, NPV of 74%, and AUROC 0.59. Predictive factors included age, COVID-19 episodes, vaccination, comorbidities, and respiratory symptoms. The NPS was 92, indicating strong endorsement.

CONCLUSION: An AI-enhanced triage process within nurse navigation represents a promising and scalable strategy to support the identification and monitoring of patients at risk for long COVID.},
}

@article {pmid42367370,
year = {2026},
author = {Tan, HL and Rosser, E and Hernandez, AL and Fei, YC and Azola, A and Parker, A and Galiatsatos, P and Smith, CL and Shea, P and Cox, AL and Klein, SL and Morgan, R},
title = {"That's not my silo": Navigating fragmented long COVID care in the mid-Atlantic United States.},
journal = {SSM. Qualitative research in health},
volume = {9},
number = {},
pages = {},
pmid = {42367370},
issn = {2667-3215},
abstract = {BACKGROUND: Long COVID is a chronic illness affecting multiple organ systems, which can be at odds with a highly specialized and siloed U.S. healthcare system. Patients frequently see multiple specialists for diverse symptoms, creating substantial coordination challenges.

METHODS: We conducted a qualitative study using semi-structured interviews with 69 U.S. Mid-Atlantic adults diagnosed with or suspected of having Long COVID, recruited through a Long COVID clinic, MyChart patient-portal outreach, and snowball sampling. Interviews were conducted via Zoom, phone, or in person, audio-recorded, transcribed, and analyzed using the Framework Approach.

RESULTS: Participants described significant difficulty navigating a fragmented healthcare system characterized by siloed care, communication breakdowns, long wait times, and unclear provider responsibilities, as well as difficulties obtaining a diagnosis. When coordination failed, patients were often forced to organize and direct their own healthcare, a task that was cognitively and physically taxing, particularly for those experiencing brain fog and fatigue, and, for some, ultimately led to delaying or forgoing care.

CONCLUSION: Strengthening care coordination for Long COVID could reduce patient burden and improve access to care. Needed strategies include standardized diagnostic definitions, enhanced primary care roles, interoperable referral pathways, and institutional case conferencing to clarify provider responsibilities. Patient navigators, expanded telehealth options, and community-based support, especially culturally tailored services for disproportionately affected groups, may further reduce fragmentation, scheduling strain, and inequities. Addressing these systemic barriers is essential to creating a more efficient, patient-centered care experience in which patients are no longer responsible for coordinating their own complex care.},
}

@article {pmid42369154,
year = {2026},
author = {Salomão, R and Pasquarelli-do-Nascimento, G and Ananias, M and Assis, V and Ferreira, LGJ and da Silva Almeida, I and Silva, L and Tostes, K and Sorroche, BP and Arantes, LMRB and Magalhães, KG and García, LT and Rocha Costa, R and Quagliotti Durigan, JL and Marqueti, RC},
title = {Longitudinal trajectories of hematological indices and serum metalloproteinases-2 and 9 over 1 year after moderate and severe COVID-19.},
journal = {Frontiers in medicine},
volume = {13},
number = {},
pages = {1824883},
pmid = {42369154},
issn = {2296-858X},
abstract = {INTRODUCTION: The long-term clinical burden of Coronavirus disease (COVID-19) remains substantial, yet one-year cohort evidence linking blood-based biomarkers to persistent sequelae is limited.

METHODS: We conducted a longitudinal study in adults aged 18-80 years who were classified as moderate or severe COVID-19 or non-COVID-19 controls. Blood was collected at four time points through 360 days after infection or hospital discharge. Cytokines were quantified by flow cytometry. MMP-2 and MMP-9 levels and activity were assessed by gelatin zymography. Hematological parameters were measured in an accredited clinical laboratory. Longitudinal effects were evaluated using generalized estimating equations.

RESULTS: Compared with moderate cases and controls, participants who experienced severe acute disease showed persistent immune dysregulation and systemic inflammation at approximately 1 year, with higher concentrations of inflammatory mediators and cytokines and sustained elevations in MMP-2 and MMP-9. Complete blood count-derived indices were also altered over time in severe cases, including the aggregate index of systemic inflammation, the C-reactive protein to lymphocyte ratio, the neutrophil to platelet ratio, and the systemic inflammation response index, together with red cell distribution width, while renal function tests, hepatic enzymes, and muscle injury markers were largely stable across groups.

DISCUSSION: These findings delineate a persistent inflammatory and matrix-remodeling signature up to 1 year after severe COVID-19, based on longitudinal biomarker profiles rather than symptom-defined long COVID-19 outcomes. This biomarker panel may help to inform future studies of post-acute risk stratification and targeted interventions, but prospective prognostic validation and clinical endpoint data are still required.

CLINICAL TRIAL REGISTRATION: https://clinicaltrials.gov/study/NCT04961255?term=NCT04961255&rank=1, NCT04961255.},
}

@article {pmid42370768,
year = {2026},
author = {Applewhite, TL},
title = {Idiopathic anaphylaxis and histamine dysregulation: Revisiting pathophysiologic assumptions.},
journal = {The Nurse practitioner},
volume = {51},
number = {7},
pages = {42-45},
doi = {10.1097/01.NPR.0000000000000455},
pmid = {42370768},
issn = {1538-8662},
mesh = {Humans ; *Anaphylaxis/physiopathology/nursing/immunology ; *Histamine/immunology ; Immunoglobulin E/immunology ; },
abstract = {Idiopathic anaphylaxis (IA) is a diagnosis of exclusion, and the etiology remains elusive. Research on immunoglobulin E (IgE)-mediated anaphylaxis has identified histamine as the immune system mediator, but dietary histamine's potential role in IA is often overlooked. For some individuals, excessive histamine may cause IA and mimic signs and symptoms of IgE-mediated anaphylaxis.1 This review provides an overview of IA and the potential role of histamine in symptom manifestation. It aims to enhance awareness and provide nurse practitioners with insights into the complexities of managing IA, emphasizing the importance of considering dietary factors in patient care and treatment strategies.},
}

Humans
*Anaphylaxis/physiopathology/nursing/immunology
*Histamine/immunology
Immunoglobulin E/immunology

@article {pmid42371051,
year = {2026},
author = {Müller, B and Balz, U and Bartels, K and Eggers, F and Löbermann, M and Nostitz, L and Schmidt, J and Schwarz, C and Wossidlo, C and Reisinger, EC and Kropp, P},
title = {Post-COVID: a specific neuropsychological profile in performance deficits.},
journal = {Journal of neural transmission (Vienna, Austria : 1996)},
volume = {},
number = {},
pages = {},
pmid = {42371051},
issn = {1435-1463},
abstract = {BACKGROUND: SARS-CoV-2 is frequently associated with cognitive impairment. When symptoms persist for more than four weeks after acute infection, a Long-COVID condition is diagnosed. When persisting more than 12 weeks, Post-COVID ist diagnosed. Cognitive complaints commonly include impairments in attention, memory, and executive functions. However, precise data on the specific pattern and extent of these deficits remain limited.

METHODS: Results: Conclusions: The findings indicate that attentional impairments are more prevalent than memory deficits in this Post-COVID cohort. Furthermore, distinct cognitive profiles can be identified using cluster analysis, ranging from globally impaired to cognitively preserved subgroups. These results may be relevant for clinical characterization and rehabilitation planning in Post-COVID conditions.

METHODS: We examined 88 patients (mean age 50.9 years, 80.7% female) diagnosed with COVID symptoms according to the WHO-criteria. Neuropsychological assessment was performed using a standardized test battery covering attentional performance, working memory, and executive functions. A cluster analysis was conducted to identify subgroups based on cognitive performance profiles.

RESULTS: Overall, 55.7% of patients showed below-average attentional performance, whereas memory deficits were less frequent (33.0%). Impairments in executive functions were similarly distributed across the sample. Cluster analysis yielded a three-cluster solution. Cluster 1 (34.1%) was characterized by pronounced impairments across all cognitive domains. Cluster 2 (20.0%) showed generally below-average cognitive performance; however, verbal fluency was preserved at or above average in all participants. In Cluster 3 (17.6%) more than 50% of patients in performed within average to above-average ranges across all cognitive domains.

CONCLUSIONS: The findings indicate that attentional impairments are more prevalent than memory deficits in this Post-COVID cohort. Furthermore, distinct cognitive profiles can be identified using cluster analysis, ranging from globally impaired to cognitively preserved subgroups. These results may be relevant for clinical characterization and rehabilitation planning in Post-COVID conditions.},
}

@article {pmid42362970,
year = {2026},
author = {Said, N and Jones, I and Anderson-Baucum, EK and Evans-Molina, C},
title = {SARS-CoV-2 and diabetes: a post-pandemic reappraisal.},
journal = {Diabetologia},
volume = {},
number = {},
pages = {},
pmid = {42362970},
issn = {1432-0428},
support = {I01BX001733//U.S. Department of Veterans Affairs/ ; P30DK097512/DK/NIDDK NIH HHS/United States ; R01DK093954/DK/NIDDK NIH HHS/United States ; R01DK127308/DK/NIDDK NIH HHS/United States ; },
abstract = {The COVID-19 pandemic was a dynamic and often confusing period for clinical and biomedical research. As severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spread globally, knowledge accumulated rapidly through publications that were frequently based on preliminary or sometimes conflicting evidence, yet these papers played a critical role in shaping evolving medical, research and societal responses. Early in the pandemic, diabetes emerged as one of the strongest predictors of severe COVID-19 outcomes and mortality, placing it at the centre of early risk-stratification and therapeutic frameworks and prompting urgent efforts to understand the biological basis of these associations. As the pandemic progressed, reports of new-onset diabetes following COVID-19 infection raised the possibility of a bidirectional relationship between SARS-CoV-2 infection and diabetes. In this review, we provide a post-pandemic reappraisal of the clinical and experimental literature examining the intersection of COVID-19 and diabetes. We summarise proposed pathophysiological mechanisms, including the effects of SARS-CoV-2 infection in the pancreas and on peripheral insulin-sensitive tissues. We review key meta-analyses assessing the association between COVID-19 and incident type 1 and type 2 diabetes and highlight strengths and weaknesses of the epidemiologic studies underpinning these findings. We highlight the highest-quality evidence from prospective cohorts, as well as relevant clinical trials and registry-based studies that emerged from this collective experience. We discuss emerging relationships between long COVID and diabetes and the effect of vaccination on diabetes risk following SARS-CoV-2 infection. Finally, we identify critical knowledge gaps and outline priorities for ongoing and future studies needed to resolve remaining uncertainties.},
}

@article {pmid42363216,
year = {2026},
author = {Zhang, X and Rajaraman, PK and Comellas, AP and Hoffman, EA and Yang, T and Guo, J and Lin, CL},
title = {Bronchovascular texture pattern on quantitative CT reveals airway and vascular remodeling in post-COVID-19 Lungs.},
journal = {Respiratory research},
volume = {},
number = {},
pages = {},
doi = {10.1186/s12931-026-03784-2},
pmid = {42363216},
issn = {1465-993X},
support = {NIH R01-HL168116/NH/NIH HHS/United States ; ED P116S210005//Department of Education, United States/ ; },
abstract = {BACKGROUND: The long-term consequences of COVID-19 remain poorly understood.

PURPOSE: To assess CT image-based biomarkers and clinical symptoms in COVID-19 survivors approximately 3-4 years after infection.

MATERIALS AND METHODS: Eighty post-COVID-19 participants (81% infected with the pre-Alpha strain) underwent pulmonary function tests (PFTs) and inspiratory/expiratory CT at approximately 5 months (Visit 1, V1) and 3-4 years (Visit 2, V2) after infection. At V2, participants completed the St. George's Respiratory Questionnaire (SGRQ), Leicester Cough Questionnaire (LCQ), Fatigue Severity Scale (FSS), modified Medical Research Council Dyspnea Scale (mMRC), and a study-specific symptom and medical history questionnaire. Seventy-eight healthy individuals served as controls. Image-based biomarkers included airway diameter, airway wall thickness, functional small airway disease percentage (fSAD%), ground-glass opacity percentage (GGO%), and bronchovascular percentage (Bronchovascular%).

RESULTS: Post-COVID-19 participants exhibited normal predicted PFT values, but consistently lower DLCO compared with healthy controls at both visits. At V2, they also reported significantly worse SGRQ scores than the general population, indicating reduced quality of life. Although the elevated fSAD% and GGO% observed at V1 largely resolved by V2, several biomarkers of airway and vascular remodeling persisted, including increased Bronchovascular%, airway narrowing and wall thickening, and a compositional shift from large to small airways and a shift from small to large vessels. Persistent symptoms-such as fatigue, brain fog, cough, and hypertension-were associated with these structural abnormalities.

CONCLUSION: Airway and vascular structural abnormalities persisted in COVID-19 survivors 3-4 years after infection and were associated with ongoing symptoms and reduced quality of life.},
}