@article {pmid42018905,
year = {2026},
author = {Silva, JAD and Barbosa, MEJDP and Sena, MM and Sousa, VMF and Vieira, NFC},
title = {[Implications of the COVID-19 pandemic on the health behaviors of adolescent and young parents: integrative review].},
journal = {Ciencia & saude coletiva},
volume = {31},
number = {3},
pages = {e12012024},
doi = {10.1590/1413-81232026313.12012024},
pmid = {42018905},
issn = {1678-4561},
mesh = {Humans ; *COVID-19/epidemiology/psychology ; Adolescent ; *Health Behavior ; *Parents/psychology ; Mental Health ; Socioeconomic Factors ; Health Services Accessibility ; Risk-Taking ; },
abstract = {The study aims to identify the implications of the COVID-19 pandemic on the health behaviors of adolescent and young parents, highlighting parenthood and their impacts on the health and well-being. This is an integrative literature review, carried out by searching for scientific publications indexed in the following databases: Virtual Health Library (BVS), Medical Literature Analysis and Retrieval System Online (MedLine/PubMed), Scopus and Web of Science (WOS). As a result, after reading 137 titles and abstracts and 69 full articles, 7 articles were selected for the final sample. The results of the included articles were grouped into two analytical categories: cross-cutting themes, which contemplate the implications resulting from COVID-19, such as impacts on mental and emotional health, socioeconomic aspects and access to health and education services. The second category was composed of specific themes addressed individually in each study, such as immunization, maternal and child health and food insecurity. From the analysis, a significant increase in risk behaviors and vulnerabilities suffered by young parents and adolescents was identified, with future implications for health and well-being, in addition to economic, emotional and social challenges.},
}

Humans
*COVID-19/epidemiology/psychology
Adolescent
*Health Behavior
*Parents/psychology
Mental Health
Socioeconomic Factors
Health Services Accessibility
Risk-Taking

@article {pmid42018907,
year = {2026},
author = {Mangas, GM and Rodriguez, JGV and Santos, JARBD and Souza, FNB and Silva, LFLD and Azevedo Junior, GL and Chivaca, A and Jessen, NPJ and Oliveira, Â and Mesquita, ET},
title = {Fundamentals of Acute Pericarditis: State of the Art.},
journal = {Arquivos brasileiros de cardiologia},
volume = {123},
number = {2},
pages = {e20240572},
pmid = {42018907},
issn = {1678-4170},
mesh = {Humans ; *Pericarditis/etiology/diagnosis/therapy/physiopathology ; Acute Disease ; COVID-19/complications ; },
abstract = {Acute pericarditis is an inflammation of the pericardium, the lining that surrounds the heart. It is the most common inflammatory heart condition. The disease frequently affects young adults and can manifest with varying severity. Pericarditis can have diverse causes, including viral infections, autoimmune diseases, post-infarction conditions, and, more recently, SARS-CoV-2 infections or COVID-19 vaccines. In developing countries, especially in Africa, tuberculosis is the leading cause of pericarditis, often associated with HIV. Diagnosis is based on clinical criteria, such as chest pain and electrocardiographic changes, and it can be supported by imaging studies such as echocardiography, cardiac magnetic resonance imaging, and computed tomography. Identification of etiology is crucial to personalized treatment, although the specific cause is often unidentified. New research has highlighted the role of the NLRP3 inflammasome in the pathophysiology of pericarditis, which may pave the way for new therapies. Furthermore, technological advancements and artificial intelligence are discussed as promising tools to improve the management of pericarditis.},
}

Humans
*Pericarditis/etiology/diagnosis/therapy/physiopathology
Acute Disease
COVID-19/complications

@article {pmid42019647,
year = {2026},
author = {Nieuwland, JM and Scaramuzza, A and Bugiani, M and van de Berg, WDJ and Middeldorp, J},
title = {Human brain matters: Navigating the neuropathology of COVID-19.},
journal = {Brain pathology (Zurich, Switzerland)},
volume = {},
number = {},
pages = {e70101},
doi = {10.1111/bpa.70101},
pmid = {42019647},
issn = {1750-3639},
support = {//European research project NEUROCOV, funded by Horizon Europe (EU)/ ; },
abstract = {Infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused millions of deaths worldwide. Although the incidence of severe acute cases has declined, the prevalence of long COVID, also known as post-acute sequelae of COVID-19 (PASC), is rising. The pathological mechanisms underlying severe COVID-19, along with the relationship to neurological disorders and potential risk for neurodegeneration, remain poorly understood. The aim of this narrative review is to summarize neuropathological features described in postmortem human COVID-19 brains (n = 352). Furthermore, analysis of biofluids and neuroimaging from PASC patients underline long-term changes in the proteome and CNS response following the infection. Postmortem brain studies from severe COVID-19 patients highlight disruption of the fluid-brain barriers and vascular dysregulation defined by endothelial inflammation and disruption, hemorrhages, and hypoxic-ischemic damage. Neuroinflammation, including astrogliosis, microglia nodules and infiltration of adaptive immune cells, has been reported in the olfactory bulb, medulla oblongata, midbrain and cerebellum. Neuronal damage was demonstrated in the hippocampus, midbrain and cerebellum in severe COVID-19 and protein aggregation was observed in the midbrain and entorhinal cortex. Neuropathological burden and elevated blood and/or cerebrospinal fluid (CSF) levels of proinflammatory cytokines (e.g. IL-6) and neuro-axonal proteins (e.g. NfL) correlated with severity of anosmia, memory deficits, and cerebellar ataxia. Elderly patients and/or patients with underlying neurological diseases were more susceptible and had worsened symptoms. Potential disease mechanisms underlying neurological symptoms observed in severe COVID-19 are vascular and fluid-brain barrier abnormalities, chronic neuroinflammation, persistent axonal damage and protein aggregation. In PASC patients, an altered biofluid proteome with increased neuronal proteins and pro-inflammatory cytokines was observed. The pathological burden in affected brain regions may contribute to manifestations such as anosmia, memory deficits, and cerebellar ataxia.},
}

@article {pmid42021240,
year = {2026},
author = {Moufawad, M and DeLapp, S and Rhodes, ST and Rose, KL and Domoff, SE and Kells, M and Hunger, JM and Wallace, L and Brewer, S and Coleman, A and Rakowski, A and Aguilar, N and Hahn, SL},
title = {A systematic review of social media use among rural US adolescents and associated health outcomes.},
journal = {BMC public health},
volume = {26},
number = {1},
pages = {},
pmid = {42021240},
issn = {1471-2458},
mesh = {Humans ; *Social Media/statistics & numerical data ; Adolescent ; *Rural Population/statistics & numerical data ; United States/epidemiology ; COVID-19/epidemiology ; *Adolescent Behavior/psychology ; Media Exposure ; Digital Media ; },
abstract = {BACKGROUND: Understanding social media use among rural adolescents is important because they are a geographically and socially isolated population which may impact how they use social media and affect the impacts of use. The goal of this study was to systematically review and evaluate the literature on rural US adolescent social media use. Specifically, what is known about their social media use, amount and type of use, and the associations between social media use and health outcomes. METHODS: A systematic search was conducted on seven databases: PubMed, CINAHL, SCOPUS, PsycINFO (ProQuest), Web of Science, Embase, and Google Scholar. Studies were eligible for inclusion if they sampled rural US populations, sampled adolescents (ages 10–19), and had at least one of the following as an outcome: how much adolescents use social media, how adolescents are using social media including content, and/or whether social media use was associated with a health outcome. RESULTS: A total of 34 articles matched the inclusion criteria and were included in analysis (N = 22,315). Results suggest that rural US adolescents use social media to the same extent as non-rural adolescents. Rural adolescents with marginalized identities rely on social media to form connections with those with shared identities outside of their geographic area. Social media also fostered an environment for harmful connections, as numerous studies reported cyberbullying. In respect to mental health, using social media was found to be an avenue for coping with anxiety during the COVID-19 pandemic; however, increased time spent on social media did not reduce existing feelings of nervousness, anxiety, depression, or stress in the pandemic. Interventional studies indicated that social media was successfully used as a tool to disseminate health information and provide support to marginalized groups amongst the already hard-to-reach population of rural adolescents. CONCLUSIONS: This systematic review highlights the lack of research dedicated to social media use amongst rural US adolescents, despite high prevalence of use. More research on the specific popularity of platforms and content consumed is needed to understand the nuanced effects of social media and to further investigate social media usage as a potential intervention target for this geographically and socially isolated population.},
}

Humans
*Social Media/statistics & numerical data
Adolescent
*Rural Population/statistics & numerical data
United States/epidemiology
COVID-19/epidemiology
*Adolescent Behavior/psychology
Media Exposure
Digital Media

@article {pmid42021332,
year = {2026},
author = {Halder, P and Debnath, A and Achary, T and Mondal, A and Dhandapani, G and Mandal, I and Saha, S and Nongkynrih, B and Thakur, JS},
title = {Systematic review and meta-analysis on depression burden among Type 2 diabetes patients in India.},
journal = {Diabetology & metabolic syndrome},
volume = {18},
number = {1},
pages = {},
pmid = {42021332},
issn = {1758-5996},
abstract = {BACKGROUND: Depression and Type 2 Diabetes Mellitus (T2DM) are closely linked health challenges in India, which currently has more than 101 million people living with diabetes. This systematic review and meta-analysis aimed to determine the pooled prevalence of depression among Indian T2DM patients, highlight regional differences, and identify associated risk factors. METHODS: Following PRISMA guidelines, a thorough search was conducted across PubMed, Embase, Scopus, and Web of Science for studies published until February 3, 2025. Random-effects models were applied to calculate pooled prevalence, while subgroup analyses assessed variations by geographic region, diagnostic tool, and study setting. Heterogeneity was quantified using I[2] statistics. Publication bias was evaluated using funnel plots and Egger’s regression, with trim-and-fill analysis performed when bias was detected. Meta-regression examined the impact of covariates such as sample size, mean age, diabetes duration, hypertension, and urban residence. RESULTS: A total of 59 studies with 24,073 participants were included. The pooled prevalence of depression among T2DM patients was 38% (95% CI: 33–42%), derived using a random-effects model to account for the substantial heterogeneity observed across studies (I[2] = 98.28%). This estimate reflects a statistical synthesis across studies with widely varying diagnostic tools, cutoff thresholds, and clinical settings, and should be interpreted as an approximation of the burden rather than a precise national prevalence figure. Mild, moderate, and severe depression accounted for 24%, 14%, and 14% of cases respectively. Regional variation was observed, with Western India showing the highest prevalence (48%) and multicenter studies the lowest (27%). Prevalence differed by diagnostic tool: CIDI-SF (20%), PHQ-9 (34%), and BDI (72% with lenient cutoffs). Hospital-based studies reported higher prevalence (42%) compared to community-based ones (28%). Females had a greater burden (39%) than males (31%). No significant differences were found between pre- and post-COVID-19 studies. Sensitivity analyses confirmed robustness of estimates. Meta-regression identified diabetes duration as a significant predictor (p = 0.026). CONCLUSION: Nearly two in five Indian T2DM patients experience depression, emphasizing the urgent need for standardized screening and integration of mental health care into India’s National Program for Non-Communicable Diseases.},
}

@article {pmid42021395,
year = {2026},
author = {Chen, Y and Zheng, J and Wang, H and Wu, Z},
title = {Advance in the Kawasaki disease related coronary artery aneurysms: knowledge mapping, trends, and research frontiers.},
journal = {Journal of cardiothoracic surgery},
volume = {21},
number = {1},
pages = {},
pmid = {42021395},
issn = {1749-8090},
mesh = {*Mucocutaneous Lymph Node Syndrome/complications ; Humans ; *Coronary Aneurysm/etiology ; Bibliometrics ; *Biomedical Research/trends ; },
abstract = {BACKGROUND: Kawasaki disease (KD) is the leading cause of acquired heart disease in children. In untreated cases, coronary artery aneurysms (CAAs) may develop in up to 25% of patients. As the most significant long-term sequelae of KD, Kawasaki disease-related coronary artery aneurysms (KD-CAAs) contribute substantially to long-term cardiac morbidity and mortality. To date, few bibliometric study has specifically focused on this area.

METHODS: We conducted a search in the Web of Science Core Collection (WOSCC) for papers related to KD-CAAs published between 2005 and 2024, and performed visual analysis using CiteSpace, VOSviewer, and the "biblioshiny" web interface from the "bibliometrix" package in R. A total of 1018 publications were retrieved, which collectively received 25,068 citations, averaging 24.62 citations per paper.

RESULTS: A steady increase was shown in the cumulative number of publications. The highest productivity was observed in the United States of America (USA), followed by Japan, China, and Canada. The University of California system was identified as the most productive institution, and Pediatric Cardiology was recognized as the journal with the most publications. Burns Jane C, Tremoulet Adriana H, and McCrindle Brian W were found to be the most prolific authors, while Newburger Jane W was identified as the most co-cited author. It was revealed by keyword cluster analysis that KD-CAAs research was organized into ten distinct clusters, and three major research hotspots were highlighted: molecular pathogenesis and therapeutic resistance pathways, long-term vascular sequelae and management, and the impact of coronavirus disease 2019 (COVID-19). A shift in research focus from fundamental disease mechanisms toward long-term patient follow-up and multidisciplinary clinical collaboration was indicated by keyword burst detection, and this shift was reflected in terms such as "long-term management" and "health professionals".

CONCLUSIONS: Research on KD-CAAs requires further breakthroughs in molecular mechanisms and enhanced interdisciplinary integration. The resulting visualizations offer an efficient framework for identifying emerging trends and critical advances in KD-CAAs research.},
}

*Mucocutaneous Lymph Node Syndrome/complications
Humans
*Coronary Aneurysm/etiology
Bibliometrics
*Biomedical Research/trends

@article {pmid42022217,
year = {2026},
author = {Carissa Aurelia, L and Selva, KJ and Chung, AW},
title = {Building better antibody responses: The interplay of infection, vaccination, and immune imprinting.},
journal = {PNAS nexus},
volume = {5},
number = {4},
pages = {pgag110},
pmid = {42022217},
issn = {2752-6542},
abstract = {Antibodies are critical for protection against a range of viral respiratory diseases, including SARS-CoV-2, but the induction of durable and potent antibody responses continues to be a challenge. Beyond neutralization, there is growing appreciation for the potential protective role of Fc-mediated functions, especially against immune-evasive variants. Induction of polyfunctional antibody responses is a complex multifactorial process that is shaped by interactions between various antibody features, viral properties, and host factors. Here, we review lessons learned from the COVID-19 pandemic regarding how prior infection and different vaccination strategies can modulate plasma and mucosal antibody profiles, including isotypes, immunoglobulin G subclasses, Fc glycosylation, and consequently, antibody functions. Additionally, we discuss the challenges of immune imprinting and its effects upon antibody responses to viral variants. This review provides insights into optimizing antibody-based strategies for COVID-19 prevention and treatment, emphasizing the need for further research to understand the mechanisms behind effective antibody responses and their impact upon clinical outcomes.},
}

@article {pmid42022434,
year = {2026},
author = {Julius, N and John, M and Emmanuel, N},
title = {Public Health Achievements in Rwanda: A 21st Century Transformation.},
journal = {Public health challenges},
volume = {5},
number = {2},
pages = {e70225},
pmid = {42022434},
issn = {2769-2450},
abstract = {This narrative review documents how Rwanda has transformed in public health extraordinarily post the 1994 Genocide against the Tutsi, placing it as an exemplary model for health care systems resilience in low-income countries. The review is based on the World Health Organization building blocks to look at the strategic changes that have led to measurable gains in the health of Rwandan people. Good centralized leadership and control have been key to this accomplishment. This made it possible to decentralize service delivery, build excellent health information systems, and invest money in the health workforce. A key part of the transformation is universal health coverage (UHC), especially mutuelle de santé, which increased coverage from 27% in 2004 to more than 85%, hence cutting down out of pocket costs, which improved equity. Integration and use of community health workers (CHWs) have been instrumental in expansion of primary care to the population mostly in rural settings, improving maternal and child life, tuberculosis (TB) treatment through direct observed therapy (DOT), and disease surveillance. These coordinated actions have resulted in substantial reductions in mortality from infectious diseases (HIV/AIDS, TB, and malaria), maternal and child health indicators, and the gradual integration of services for noncommunicable diseases and mental health. Rwanda's health system was stress tested and proved its effectiveness in the COVID-19 and Marburg outbreaks, proving exceptional planning and rapid response capacities. Despite Rwanda's achievement, obstacles still persist, such as reliance on foreign funds, limited human resources lowering the quality-of-service delivery, and mental health challenges still in existence. Rwanda's experience illustrates that a proactive government, citizen participation, and research-based innovation may produce rapid and significant overall health gains, providing a valuable model for similar situations to other countries.},
}

@article {pmid42024317,
year = {2026},
author = {Brunner, M and Preckel, F and Götz, T and Lüdtke, O and Keller, L},
title = {High math anxiety is associated with lower math achievement across 90 countries: An individual participant data meta-analysis of representative student and adult samples.},
journal = {Psychological bulletin},
volume = {152},
number = {2},
pages = {207-253},
doi = {10.1037/bul0000514},
pmid = {42024317},
issn = {1939-1455},
support = {//German Research Foundation/ ; },
mesh = {Humans ; *Mathematics ; *Anxiety/psychology/epidemiology ; Adult ; Female ; *Academic Success ; *Students/psychology/statistics & numerical data ; Male ; *COVID-19 ; },
abstract = {Math anxiety and math achievement are reciprocally related, which likely impacts individuals' agency; their educational and career trajectories in science, technology, engineering, and mathematics fields; and countries' economic growth in these areas. Previous meta-analyses on this relationship have faced limitations from studies by using small convenience samples and have encountered methodological issues, such as variance restriction, low statistical power, and ecological bias. To address these challenges, the present research synthesis is the first to use a comprehensive collection of representative individual participant data from international large-scale assessments. This analysis incorporated cumulative evidence from 1980 to 2022, including 452 probability samples from 90 countries, and covered student and adult populations. The meta-analytic average correlation between math anxiety and math achievement was r = -.26. Moderator analyses revealed novel evidence that this relationship is sensitive to both construct characteristics and individual and contextual factors. Specifically, the negative relationship was weaker for the worry facet of math anxiety compared to its affective and cognitive interference facets, and it was weaker following the onset of the COVID-19 pandemic in 2020. Additionally, the negative relationship was stronger for individuals with average and high levels of math achievement and in countries with higher gross domestic product per capita. Gender differences in the relationship were largely negligible after 2010, although female individuals exhibited a stronger negative relationship in the 1980s and 1990s than male individuals. In summary, synthesizing individual participant data from international large-scale assessments provided novel, nuanced, and robust evidence for research, practice, and policy. (PsycInfo Database Record (c) 2026 APA, all rights reserved).},
}

Humans
*Mathematics
*Anxiety/psychology/epidemiology
Adult
Female
*Academic Success
*Students/psychology/statistics & numerical data
Male
*COVID-19

@article {pmid42024896,
year = {2026},
author = {Raina, SK},
title = {Methodological considerations regarding comparison group verification in maternal COVID-19 research.},
journal = {The Indian journal of medical research},
volume = {163},
number = {3},
pages = {420},
pmid = {42024896},
issn = {0971-5916},
}

@article {pmid42025371,
year = {2026},
author = {Imai, Y},
title = {Viral infection and establishing new therapeutic platforms- On the occasion of receiving the 16th Setsuro Ebashi award.},
journal = {Journal of pharmacological sciences},
volume = {161},
number = {2},
pages = {25-27},
doi = {10.1016/j.jphs.2026.03.002},
pmid = {42025371},
issn = {1347-8648},
mesh = {Humans ; *Awards and Prizes ; COVID-19 ; SARS-CoV-2 ; Pandemics ; Angiotensin-Converting Enzyme 2 ; Animals ; Immunity, Innate ; Influenza, Human/immunology ; },
abstract = {During the past quarter century, a series of global pandemics-caused by coronaviruses (SARS-CoV, MERS-CoV, SARS-CoV-2) and influenza A (H1N1, H5N1)-has underscored that viral infection is not merely a transient invasion but a systemic and temporal perturbation of the host life system. My research has sought to elucidate the principles by which the host organism senses, integrates, and regulates responses to viral stress, spanning molecular to organismal levels. Key discoveries include the identification of ACE2 as the functional receptor for SARS-CoV and a critical regulator of disease severity; elucidation of innate-immune overactivation ("cytokine storm") as a driver of fatal pathology; identification of lipid-mediated RNA regulation that restrains excessive inflammation; and discovery of neuro-immune and epigenetic mechanisms linking acute infection to long-term dysfunction. These findings reveal infection as a multi-layered biological reprogramming process involving immunity, metabolism, the nervous system, and chromatin architecture. Building on this mechanistic foundation, we established data-driven infrastructures-AI-assisted predictive models and Medical MLOps systems-that integrate clinical and molecular data for personalized infection medicine. This perspective summarizes the evolution of this integrative research and discusses future directions toward precision therapeutics for acute and post-infectious syndromes.},
}

Humans
*Awards and Prizes
COVID-19
SARS-CoV-2
Pandemics
Angiotensin-Converting Enzyme 2
Animals
Immunity, Innate
Influenza, Human/immunology

@article {pmid42025580,
year = {2026},
author = {Shukla, SK and Singh, A and Yadav, R and Kumar, A},
title = {Advances in molecular diagnostic strategies during the SARS-CoV-2 pandemic.},
journal = {Expert review of molecular diagnostics},
volume = {26},
number = {4},
pages = {293-308},
doi = {10.1080/14737159.2026.2665263},
pmid = {42025580},
issn = {1744-8352},
mesh = {Humans ; *COVID-19/diagnosis/epidemiology/virology ; *SARS-CoV-2/genetics/isolation & purification ; *Molecular Diagnostic Techniques/methods ; Pandemics ; COVID-19 Testing/methods ; COVID-19 Nucleic Acid Testing/methods ; Rapid Diagnostic Tests ; Pandemic Preparedness ; CRISPR-Cas Systems ; },
abstract = {INTRODUCTION: The SARS-CoV-2 pandemic provided critical insights into pandemic preparedness. The community spread can be slowed down or contained through effective, rapid, and robust diagnosis of infected individuals.

AREA COVERED: During the pandemic, substantial advances were made in developing rapid and cost-effective diagnostic approaches. Self-collected gargle samples offer clear advantages over conventional NSP/OPS methods by reducing reliance on trained personnel and personal protective equipment. Colorimetric assays further improve accessibility, enabling rapid, instrument-free, and visually interpretable detection at low cost. CRISPR-based diagnostics present a promising alternative to RT-PCR, facilitating scalable mass screening with reduced technical dependence. Concurrently, optimization of RT-PCR workflows-particularly through minimization of pre-PCR steps-can enhance speed and affordability. The integration of digital technologies and artificial intelligence further leverages diagnostic capabilities. Despite this, improved regulatory frameworks and resilient supply chains are critical for ensuring scalable, equitable access, and effective pandemic preparedness.

EXPERT OPINION: Global efforts were made to develop sensitive, rapid, cost-effective, and noninvasive technologies to identify the pandemic virus; however, variations in sensitivity/specificity and limited sample size validation hampered their utility in routine diagnostics. The COVID-19 pandemic has ended, but global efforts are still needed to combat the early infection of subsequent waves or similar disease waves.},
}

Humans
*COVID-19/diagnosis/epidemiology/virology
*SARS-CoV-2/genetics/isolation & purification
*Molecular Diagnostic Techniques/methods
Pandemics
COVID-19 Testing/methods
COVID-19 Nucleic Acid Testing/methods
Rapid Diagnostic Tests
Pandemic Preparedness
CRISPR-Cas Systems

@article {pmid42027925,
year = {2026},
author = {Mullen, L and Kobokovich Mui, A and Watson, C and Heymann, D and McCloskey, B and Hughes, G and Bonell, C},
title = {Effectiveness of public health measures and strategies to reduce risk of spread of respiratory pathogens at sporting mass gatherings: systematic literature review.},
journal = {Frontiers in public health},
volume = {14},
number = {},
pages = {1789413},
pmid = {42027925},
issn = {2296-2565},
mesh = {Humans ; *Sports ; *Respiratory Tract Infections/prevention & control ; *Public Health ; *Mass Gatherings ; *COVID-19/prevention & control ; },
abstract = {OBJECTIVES: To determine the type and effectiveness of public health interventions implemented at sporting mass gatherings to mitigate respiratory infectious disease spread and understand how feasible and acceptable the interventions were to implement.

DESIGN: Systematic review.

DATA SOURCES: Medline, EMBASE, Cochrane Library, Scopus, Web of Science, Global Health, Epistemonikos, Global Index Medicus, WHO Library, WHO IRIS, IOC and FIFA were search in June 2023 and July 2025.

Studies that assessed public health strategies for sporting mass gatherings aiming to reduced respiratory infections were included. Publications prior to 2000, predictive modeling studies, commentaries, editorials, literature reviews, pre-prints and studies that did not retrospectively discuss official sporting events were excluded.

RESULTS: Thirty-four articles assessing 37 sporting MGs were included. The most common MGs assessed were the Olympic Games (n = 10). Almost all articles described multi-layered intervention packages including bubble approaches, routine testing, country entry screening, masking, physical distancing and/or isolation and quarantine. Based on an effectiveness framework developed for this study, 23 articles described effective intervention packages, three described non-effective packages and six were indeterminate. Feasibility concerns appeared a challenge for MGs with many spectators and linked to scalability issues. Acceptability factors were likely influenced by perceptions of increased work burden, compliance levels and stakeholder engagement.

CONCLUSION: This systematic review provides the first opportunity to comprehensively map pre-pandemic and pandemic-era planning for sporting MGs and underscores the importance of multilayered, context-specific intervention packages which may meaningfully reduce the risk of respiratory disease spread.

CRD42023433619.},
}

Humans
*Sports
*Respiratory Tract Infections/prevention & control
*Public Health
*Mass Gatherings
*COVID-19/prevention & control

@article {pmid42027972,
year = {2025},
author = {Amiri-Dashatan, N and Koushki, M and Parsamanesh, N and Ahmadi, N and Chiti, H and Rezaei, M and Razzaghi, Z and Robati, RM},
title = {COVID-19: A Systematic Review of Metabolomics Data and Predicting Potential Biomarkers Based on Pathway Analysis.},
journal = {Tanaffos},
volume = {24},
number = {1},
pages = {9-29},
pmid = {42027972},
issn = {1735-0344},
abstract = {The COVID-19 pandemic is a worldwide disaster in medicine, public health, and the economy. Many details of COVID-19 are currently unknown. This study aims to offer dysregulated metabolic profiles as potential biomarkers for SARS-CoV-2 infection by analyzing identified COVID-19 metabolites. We searched PubMed, Web of Science, EMBASE, and Scopus for metabolomics studies on COVID-19 patients. Studies investigating COVID-19 metabolite changes and utilizing mass spectrometry-based techniques are included. Two reviewers separately retrieved pertinent data for each selected publication. Differences of opinion among the reviewers were settled via conversation, and a final judgment was obtained. The online MetaboAnalyst 3.0 was used to conduct the pathway analysis of COVID-19. This study comprised 31 investigations with QUADOMICS quality evaluation. We isolated modified metabolites that have been found in at least three other investigations. The metabolomics data in response to SARS-CoV-2 alter at the metabolite expression level, leading to dysregulation of major metabolic pathways, including carbohydrates, amino acids, and lipids associated with COVID-19. The pathway analysis of metabolic reprogramming across different biological samples demonstrated a significant role in amino acid metabolism, including phenylalanine, tyrosine, and tryptophan production, in the severity of COVID-19. This review showed dysregulated metabolic profiling for identifying individuals with high severity of COVID-19. These results provide an understanding of metabolic pathways and how dysregulated metabolic profiling reflects the severity of COVID-19 in the general population. The high frequency of changed metabolites might be used as COVID-19 biomarkers for early detection, and significant metabolic routes could reveal new information about pathogenesis and lead to potential treatment targets.},
}

@article {pmid42028925,
year = {2026},
author = {Silva, LI and Gonzalez-Zambrano, CM and Ferreira, VCMP and Corrêa, FC and Dias-Melicio, LA},
title = {MicroRNAs in Acute COVID-19 and Long COVID: Dysregulation, Pathogenic Roles, and Clinical Implications.},
journal = {Journal of immunology research},
volume = {2026},
number = {1},
pages = {e5862241},
pmid = {42028925},
issn = {2314-7156},
support = {001//Coordenação de Aperfeiçoamento de Pessoal de Nível Superior/ ; },
mesh = {Humans ; *COVID-19/genetics/immunology ; *MicroRNAs/genetics/immunology ; *SARS-CoV-2 ; Post-Acute COVID-19 Syndrome ; Biomarkers ; Extracellular Vesicles ; Gene Expression Regulation ; Inflammation/genetics ; Pandemics ; *Betacoronavirus ; },
abstract = {MicroRNAs (miRNAs) are key post-transcriptional regulators of gene expression with central roles in immune responses, inflammation, and viral pathogenesis. Increasing evidence indicates that severe acute respiratory syndrome coronavirus (SARS-CoV-2) infection induces marked dysregulation of host and viral miRNAs (v-miRNAs), contributing to disease severity during acute COVID-19 and to the persistent manifestations observed in long COVID (LC). This narrative review critically synthesizes current evidence on miRNA dysregulation across the acute and post-acute phases of COVID-19, highlighting their pathogenic roles, clinical relevance, and existing knowledge gaps. During acute infection, altered miRNA profiles-including those associated with immune activation, endothelial dysfunction, and immunothrombosis-reflect both host responses and viral strategies of immune modulation, including miRNAs carried by extracellular vesicles (EVs) and SARS-CoV-2-derived v-miRNAs. In LC, emerging data suggest that persistent miRNA alterations are associated with unresolved inflammation, pulmonary dysfunction, neurological symptoms, and vascular injury, although available studies remain limited and heterogeneous. Overall, miRNAs represent promising biomarkers and potential therapeutic targets in COVID-19; however, robust longitudinal and mechanistic studies are urgently needed to clarify their causal roles and translational utility in post-acute disease.},
}

Humans
*COVID-19/genetics/immunology
*MicroRNAs/genetics/immunology
*SARS-CoV-2
Post-Acute COVID-19 Syndrome
Biomarkers
Extracellular Vesicles
Gene Expression Regulation
Inflammation/genetics
Pandemics
*Betacoronavirus

@article {pmid42033452,
year = {2026},
author = {Mok, TC and Mok, CC},
title = {Vaccination in systemic lupus erythematosus.},
journal = {Human vaccines & immunotherapeutics},
volume = {22},
number = {1},
pages = {2663637},
pmid = {42033452},
issn = {2164-554X},
mesh = {Humans ; *Lupus Erythematosus, Systemic/immunology/complications/drug therapy ; *Vaccination/methods ; COVID-19 Vaccines/immunology/administration & dosage ; Pneumococcal Vaccines/immunology/administration & dosage ; Influenza Vaccines/immunology/administration & dosage ; Immunosuppressive Agents/therapeutic use ; },
abstract = {Despite advancement in anti-microbial therapies, infection remains the leading cause of mortality in systemic lupus erythematosus (SLE). Vaccination is a major strategy in reducing infection risk. Recent studies suggest most SLE patients are able to mount an adequate immune response to the SARS-CoV2 vaccines but lower immunogenicity is observed with influenza and pneumococcal vaccination. Current evidence does not indicate an increased risk of SLE flares after administration of common vaccines. Live vaccines are less preferred to inactivated or recombinant vaccines in SLE patients receiving immunosuppression. However, the decision to vaccinate should be individualized according to risk and benefit evaluation. Vaccination in patients with SLE should best be performed during periods of low disease activity or remission. In patients receiving intense immunosuppression or biologic/targeted therapies, particularly B-cell depletion, vaccine responses are expected to be attenuated. Adjunctive measures such as booster dose of vaccines, passive immunization and microbial prophylaxis may be considered.},
}

Humans
*Lupus Erythematosus, Systemic/immunology/complications/drug therapy
*Vaccination/methods
COVID-19 Vaccines/immunology/administration & dosage
Pneumococcal Vaccines/immunology/administration & dosage
Influenza Vaccines/immunology/administration & dosage
Immunosuppressive Agents/therapeutic use

@article {pmid42033494,
year = {2026},
author = {Chakraborty, B and Singh, T},
title = {mRNA vaccines for viral diseases: mechanism, advances, and future perspective.},
journal = {Molecular biology reports},
volume = {53},
number = {1},
pages = {},
pmid = {42033494},
issn = {1573-4978},
mesh = {Humans ; COVID-19 Vaccines/immunology ; mRNA Vaccines/immunology ; *Virus Diseases/prevention & control/immunology ; SARS-CoV-2/immunology ; *COVID-19/prevention & control/immunology ; *Viral Vaccines/immunology ; Animals ; Vaccine Development ; *RNA, Messenger/immunology/genetics ; Vaccines, Synthetic/immunology ; },
abstract = {The rapid development and global distribution of messenger ribonucleic acid (mRNA) vaccines against Coronavirus Disease 2019 (COVID-19) indicated an important shift in vaccine science and public health response. Unlike traditional vaccines that rely on live-attenuated or inactivated pathogens, mRNA vaccines use synthetic mRNA encoding the antigen, allowing host cells to produce the antigen and elicit strong immune responses. The success of mRNA vaccines against Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has gradually increased global curiosity in applying this technology to treat other diseases. This review discusses the scientific basis of mRNA vaccines, including their mechanism of action, advantages in antigen design, expandable manufacturing, and modern delivery systems such as organic, inorganic, and hybrid. Beyond COVID-19, mRNA vaccines are being studied for other viral diseases, including influenza, Human Immunodeficiency Virus (HIV), Zika, and dengue. The intrinsic flexibility and speed of mRNA technology make it a valuable platform for next-generation pandemic preparedness and new therapeutic development. Despite these advantages, many challenges exist, including mRNA instability, cold-chain storage requirements, regulatory issues, and concerns regarding global vaccine availability and acceptance. Overcoming these will be critical for the full long-term potential of mRNA vaccines as a sustainable and transformative platform for global health. This review highlights recent advances, current challenges, and future perspectives of mRNA vaccine technology for viral diseases.},
}

Humans
COVID-19 Vaccines/immunology
mRNA Vaccines/immunology
*Virus Diseases/prevention & control/immunology
SARS-CoV-2/immunology
*COVID-19/prevention & control/immunology
*Viral Vaccines/immunology
Animals
Vaccine Development
*RNA, Messenger/immunology/genetics
Vaccines, Synthetic/immunology

@article {pmid42034588,
year = {2026},
author = {Shang, J and Cui, H and Shu, C and Zheng, L and Liu, F and Peng, Y and Wei, Z and Ni, X and Liu, J},
title = {Comprehensive overview of triclosan neurotoxicity and construction of adverse outcome pathways using a systems toxicology approach: Triclosan-induced attention-deficit hyperactivity disorder as an example.},
journal = {Ecotoxicology and environmental safety},
volume = {316},
number = {},
pages = {120169},
doi = {10.1016/j.ecoenv.2026.120169},
pmid = {42034588},
issn = {1090-2414},
mesh = {*Triclosan/toxicity ; *Attention Deficit Disorder with Hyperactivity/chemically induced ; Humans ; Animals ; *Adverse Outcome Pathways ; *Neurotoxicity Syndromes/etiology ; *Anti-Infective Agents, Local/toxicity ; Risk Assessment ; *Environmental Pollutants/toxicity ; },
abstract = {Triclosan (TCS) is widely applied to daily necessities as a chemical bacteriostatic agent. Environmental TCS levels have increased significantly following the coronavirus disease 2019 pandemic, posing a potential threat to humans and ecosystems. Epidemiological investigations and toxicological studies have shown that long-term TCS exposure can damage human tissues and organs and induce neurodevelopmental disorders in offspring. However, studies on the mechanisms underlying its neurotoxicity and toxicity risk assessments are limited. This review summarizes the status of environmental and human TCS exposure and systematically outlines its neurotoxic effects. To further elucidate the mechanisms underlying TCS neurotoxicity, using TCS-induced attention-deficit hyperactivity disorder (ADHD) as an example, we constructed an adverse outcome pathway (AOP) framework based on a systematic toxicology approach. We found that TCS increased the expression of cannabinoid receptor 1, which activates the "neuroactive ligand-receptor interaction" pathway, leading to ADHD-like behaviors, including cognitive, learning, and memory deficits, by modulating chemical synaptic transmission and neurotransmitter levels. The AOP framework was further used to assess the associated neurodevelopmental toxicity risks of TCS, contributing to a better understanding of its characteristics and safety. Thus, future research on the mechanisms underlying TCS toxicity and issues related to its detection and regulation should be emphasized.},
}

*Triclosan/toxicity
*Attention Deficit Disorder with Hyperactivity/chemically induced
Humans
Animals
*Adverse Outcome Pathways
*Neurotoxicity Syndromes/etiology
*Anti-Infective Agents, Local/toxicity
Risk Assessment
*Environmental Pollutants/toxicity

@article {pmid42034797,
year = {2026},
author = {Balak, N and Broekman, M and Samprón, N and Tsianaka, E and Sandvik, U and Bolger, C and Soleman, J and Visocchi, M and Agboola, KM and Syrmos, N and Vulekovic, P and Mathiesen, T and Ganau, M and , },
title = {Ethical aspects of waiting lists in neurosurgery.},
journal = {Acta neurochirurgica},
volume = {168},
number = {1},
pages = {},
pmid = {42034797},
issn = {0942-0940},
mesh = {Humans ; *Waiting Lists ; *Elective Surgical Procedures/ethics ; *Neurosurgical Procedures/ethics ; COVID-19 ; *Health Services Accessibility/ethics ; Ethical Dilemmas ; Pandemics ; SARS-CoV-2 ; },
abstract = {PURPOSE: Long waiting times for elective surgery have been a persistent problem in many countries since well before the COVID-19 pandemic. This study aims to describe the extent of waiting lists&times for elective neurosurgery and discuss the potential ethical dilemmas they pose.

METHODS: A narrative review was conducted on waiting lists & times in neurosurgery using PubMed and the Web of Science Core Collection.

RESULTS: The majority of the available data on elective surgery waiting times and lists are based on analyses of non-neurosurgical interventions. These are generally high-volume surgical procedures, such as cataract surgery, hip replacement, and knee replacement. Elective surgery waiting times challenge the clinical application of the bioethical principles of beneficence, nonmaleficence, autonomy, and justice. Extensive waiting may prolong time to benefit or even lead to harm. Moreover, failure to receive timely care runs counter to patients' autonomous wishes to be treated without delay. Finally, different principles of distributive justice are likely to contradict each other under the conditions of restrained access to care that exist when patients must wait for care. It is essential to ensure that patients on waiting lists receive fair access to health care services.

CONCLUSION: This analysis indicates that long waiting lists potentially violate three of the four basic biomedical principles proposed by Beauchamp and Childress. The fourth principle, justice, is also challenged and remains to be analyzed in reference to underlying ethical principles. From an ethical perspective, waiting lists create accountability at the governmental, institutional, and physician levels, although not to an equal degree.},
}

Humans
*Waiting Lists
*Elective Surgical Procedures/ethics
*Neurosurgical Procedures/ethics
COVID-19
*Health Services Accessibility/ethics
Ethical Dilemmas
Pandemics
SARS-CoV-2

@article {pmid42035205,
year = {2026},
author = {Yuan, MQ and Pan, YF and Zhang, ZY and Wu, YX and Zhu, KD and Wang, ZR and Zhang, ZY and Xiong, JQ and Xu, Z and Huang, L and Wang, FS and Shi, L},
title = {Therapeutic potential of mesenchymal stromal cells in COVID-19: a meta-analysis of clinical trials conducted since the pandemic onset.},
journal = {Stem cell research & therapy},
volume = {17},
number = {1},
pages = {},
pmid = {42035205},
issn = {1757-6512},
support = {No. 2022YFA1105604//National Key Research and Development Program of China/ ; },
mesh = {Humans ; *COVID-19/therapy/mortality/epidemiology ; *Mesenchymal Stem Cell Transplantation/methods ; *Mesenchymal Stem Cells/cytology ; *SARS-CoV-2 ; Clinical Trials as Topic ; Pandemics ; Treatment Outcome ; },
abstract = {BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection can induce immune dysregulation and multi-organ injury; mesenchymal stromal cell (MSC) therapy has shown promise in clinical trials for COVID-19 and may have broader applicability to pneumonia induced by respiratory viruses (e.g., the influenza virus). This meta-analysis synthesized the available comparative clinical evidence on the safety and efficacy of MSCs in patients with moderate to critical COVID-19 and examined the reported outcomes relevant to Long-COVID.

METHODS: We searched the PubMed, Embase, and CNKI databases for original, comparative studies in moderate, severe, or critical COVID-19 published up to September 2, 2024. Twenty-four eligible studies (13 RCTs and 11 non-randomized controlled trials; n = 1080) were included in the mortality meta-analysis. Patients were assigned to either the intervention group (MSC therapy plus standard care) or the control group (standard care with or without placebo). The primary efficacy outcome was all-cause mortality, while the primary safety outcomes were adverse events (AEs) and serious adverse events (SAEs). Secondary outcomes included clinical recovery, hospitalization metrics, chest imaging, and inflammatory biomarkers. We performed a pooled meta-analysis on mortality with subgroup analyses (by disease severity, administration route, dosing frequency, and study design), assessment of publication bias (using funnel plots and Egger's test), and evaluation of the quality of evidence via the GRADE approach. AEs/SAEs were analyzed using meta-analysis and descriptive statistics, while other secondary outcomes were summarized descriptively.

RESULTS: MSC therapy significantly reduced all-cause mortality (MSC: 26.4% vs control: 31.9%; fixed-effect OR = 0.74, 95% CI 0.55-0.99), with low heterogeneity (I[2] = 2.8%, P =0.422[Q-test]) and no publication bias. The quality of evidence was moderate (according to the GRADE assessment). The subgroup analysis revealed a significant survival benefit in severe/critical patients (OR = 0.73, 95% CI 0.54-0.98) but not in studies that included moderate cases (OR = 0.91, 95% CI 0.23-3.65). No significant heterogeneity was found across study designs, administration routes, or dosing frequencies, which confirmed the robustness of the primary findings while indicating insufficient evidence to determine the optimal regimen. The secondary outcomes suggested improvements in clinical recovery, pulmonary function, and pro-/anti-inflammatory cytokine balance in patients that received MSC therapy. Limited studies with long-term follow-up indicated potential benefits for Long-COVID outcomes (e.g., fatigue, quality of life, residual CT abnormalities, and exercise tolerance). No significant differences were observed in AEs or SAEs post-MSC infusion, which suggested that MSC therapy was well tolerated.

CONCLUSION: This meta-analysis indicated that MSC therapy may reduce mortality in patients with severe or critical COVID-19, demonstrating a favorable safety profile and potential benefits for Long-COVID and other viral pneumonias. Further large-scale, rigorous RCTs and mechanistic studies are warranted to strengthen the evidence base and standardize MSC administration regimens (source, dosing, frequency, and intervals) for managing COVID-19, Long-COVID, and other viral pneumonias.},
}

Humans
*COVID-19/therapy/mortality/epidemiology
*Mesenchymal Stem Cell Transplantation/methods
*Mesenchymal Stem Cells/cytology
*SARS-CoV-2
Clinical Trials as Topic
Pandemics
Treatment Outcome

@article {pmid42035616,
year = {2026},
author = {Kimura, R and Hayashi, Y and Fujimoto-Sato, Y and Ishii, H and Suzuki, Y and Katayama, K and Mizukoshi, F and Ryo, A and Kimura, H},
title = {Decoding viral evolution through integrative bioinformatics: From genomes to global health.},
journal = {Virology},
volume = {620},
number = {},
pages = {110920},
doi = {10.1016/j.virol.2026.110920},
pmid = {42035616},
issn = {1096-0341},
mesh = {*Computational Biology/methods ; Humans ; *Evolution, Molecular ; *Genome, Viral ; Phylogeny ; Global Health ; *Viruses/genetics/classification ; SARS-CoV-2/genetics ; Animals ; },
abstract = {Bioinformatics has transformed modern virology by linking genomic variation to epidemiology, protein structure, and public health action. This review integrates core analytical frameworks-sequence alignment and genome annotation; maximum-likelihood and Bayesian phylogenetic/phylodynamic inference; codon-based selection and recombination analyses; and AI-assisted structural prediction combined with deep mutational scanning (DMS)-to convert viral sequences into mechanistic and predictive insight. We emphasize how global surveillance ecosystems (GISRS, GISAID, and Nextstrain) and sustained regional programs reveal genotype turnover, antigenic drift, and seasonality in RSV, HPIV, norovirus, and SARS-CoV-2, enabling near real-time lineage tracking and vaccine-strain deliberation. Mapping positively selected residues and recombination breakpoints onto three-dimensional protein structures clarifies immune escape in key surface glycoproteins (e.g., RSV F/G, HPIV HN/F, norovirus VP1) and strengthens genotype-phenotype interpretation. Comparative reinfection patterns-lifelong immunity in measles versus recurrent RSV/HPIV infections-illustrate how evolutionary rate and antigenic constraint shape population immunity and control strategies. Despite major advances, progress remains constrained by geographic sampling bias, incomplete metadata, uneven computational capacity, and uncertainties in molecular clocks, recombination inference, and machine-learning predictions. The field is now moving toward predictive virology, integrating AI-enabled structural modeling, mutational fitness landscapes, and clinical-immunological metadata within real-time analytical platforms to anticipate immune-escape trajectories. Prioritizing pediatric respiratory pathogens alongside influenza and coronaviruses, and reinforcing equitable data-sharing and governance, will be essential for globally inclusive, forward-looking viral surveillance and intervention.},
}

*Computational Biology/methods
Humans
*Evolution, Molecular
*Genome, Viral
Phylogeny
Global Health
*Viruses/genetics/classification
SARS-CoV-2/genetics
Animals

@article {pmid42038565,
year = {2026},
author = {Baldo, KAT and King, RAN and San Juan, FGF and Dungog, CC and Solidum, JGN and Ceriales, JA and Dela Cruz, MCP and Ho, FDV and Picart, N and Plantado, ANR and Perez, J and Garcia, JP and Lapeña, JFF and Paz-Pacheco, E and Tantengco, OAG},
title = {Epidemiology, Diagnosis, and Management of Thyroid Cancer in the Philippines.},
journal = {Indian journal of surgical oncology},
volume = {17},
number = {3},
pages = {484-498},
pmid = {42038565},
issn = {0975-7651},
abstract = {Thyroid cancer incidence is rising in the Philippines, warranting attention due to unique risk factors and growing economic implications. This review examines the epidemiological trends, diagnosis, treatment, impact of COVID-19, and economic burden associated with thyroid cancer in the Philippines. We conducted a literature search in Scopus and HERDIN to synthesize the existing data on the epidemiology, diagnosis, and management of thyroid cancer in the Philippines. Filipinos exhibit a higher prevalence of BRAFV600E mutations, and thyroid cancer is more common among females and older individuals. Diagnostic procedures include risk assessment, family history evaluation, neck examination, hormone tests, neck ultrasonograms, thyroid scans, and biopsies guided by the Bethesda System. Treatment primarily involves surgery, which is determined by risk classification and disease extent. Total or near-total thyroidectomy is recommended for most cases, followed by postoperative management tailored to individual patient factors. Anaplastic thyroid cancer may require multimodal approaches. The COVID-19 pandemic disrupted healthcare access, leading to delays in thyroid cancer treatment and challenges in monitoring, prompting the adoption of telemedicine. However, the pandemic's psychological impact on thyroid cancer survivors is concerning. The economic burden remains substantial despite health insurance programs. In conclusion, thyroid cancer in the Philippines necessitates enhanced prevention, early detection, determination of risk factors, risk stratification, and treatment strategies. The COVID-19 pandemic emphasized the need for adaptable healthcare systems. This study summarized the epidemiology, diagnosis, and management of thyroid cancer in the Philippines. Implementation of existing policies and further research on the Filipino population is vital to address this growing health concern and ensure improved outcomes for thyroid cancer patients.},
}

@article {pmid42038922,
year = {2025},
author = {Kiran, MA and Saeed, S and Bin Nafisah, A and Alqarni, A and Alotaibi, AH and Alqahtan, AS and Aljadaan, H and Osayl, HB and Alsane, M and Alsuhail, N and Alrawaf, N and Albalawi, RS and Alanazi, SA and Aloufi, R},
title = {Impact of The COVID-19 Pandemic on Salivary Gland-related Healthcare Interventions; A Systematic Review And Meta-analysis :.},
journal = {Galen medical journal},
volume = {14},
number = {},
pages = {e3970},
pmid = {42038922},
issn = {2322-2379},
abstract = {BACKGROUND: The emergence of SARS-CoV-2 variants has raised concerns regarding their potential impact on perioperative outcomes. Its effect on patients undergoing surgery for salivary gland diseases remains unclear. This systematic review and meta-analysis aimed to evaluate the impact of the COVID-19 pandemic on salivary gland-related healthcare interventions, including cancer treatments, sialendoscopy procedures, and parotid surgery outcomes.

MATERIALS AND METHODS: Following PRISMA guidelines, a systematic search was conducted in PubMed, Embase, and Web of Science (2019-2025) for studies reporting pre- and during-COVID data. Two reviewers independently screened records, extracted data, and assessed risk of bias using the Newcastle-Ottawa Scale. A random-effects meta-analysis was performed to pool odds ratios (ORs) for intervention outcomes.

RESULTS: Four studies (n=7,740 participants) were included. The pooled OR for salivary gland interventions during versus pre-COVID was 1.08 (95% CI: 0.88-1.33, P=0.45), indicating no significant change, with moderate heterogeneity (I²=46%). Subgroup analyses revealed increased odds of wound dehiscence post-parotid surgery (OR=4.40, 95% CI: 1.18-16.40) but no significant differences in delayed cancer diagnosis or urgent sialendoscopy.

CONCLUSION: The COVID-19 pandemic did not significantly alter overall salivary gland intervention rates or adverse events, though some procedural complications increased non-significantly. Limited evidence underscores the need for larger, standardized studies. While this shows that surgeons maintained quality of practice in this era during the COVID-19.},
}

@article {pmid42039182,
year = {2026},
author = {Lap, CR and van Houten, M and Bogaert, D and Biesbroek, G},
title = {A perfect storm: the immunological and pathophysiological landscape of pediatric post-COVID-19 condition.},
journal = {Frontiers in immunology},
volume = {17},
number = {},
pages = {1794596},
pmid = {42039182},
issn = {1664-3224},
mesh = {Humans ; *COVID-19/immunology/complications ; *SARS-CoV-2/immunology ; Child ; Post-Acute COVID-19 Syndrome ; Immunity, Innate ; Dysbiosis/immunology ; Adolescent ; },
abstract = {Pediatric Post-COVID Condition (PPCC) represents a significant and complex long-term sequela of SARS-CoV-2 infection, affecting a subset of children and adolescents even after mild acute disease. While acute COVID-19 is generally milder in children due to a more robust innate immune response, the mechanisms driving the persistence of symptoms in PPCC remain incompletely understood and likely multifactorial. This narrative review synthesizes current epidemiological data and explores the "perfect storm" of immunological and pathophysiological alterations underpinning the condition. We examine critical hypotheses including a dysregulated immune response characterized by altered T-cell subsets, monocyte activation, and autoantibody production. We discuss the potential role of persistent SARS-CoV-2 viral reservoirs in "sanctuary sites" like the gastrointestinal tract and the reactivation of latent viruses such as Epstein-Barr virus (EBV). Furthermore, the review details downstream pathogenic pathways, including vascular endothelial inflammation (thrombo-inflammation), neuroinflammation, and metabolic dysfunctions affecting the mitochondria and tryptophan-kynurenine pathway. Finally, we address the role of microbiome dysbiosis in perpetuating systemic inflammation and the gut-lung axis dysfunction. Given the heterogeneity of clinical presentations, we conclude that PPCC is likely a syndrome of overlapping biological phenotypes. Future research must prioritize identifying these specific biological endotypes to develop targeted diagnostic and therapeutic strategies for the pediatric population.},
}

Humans
*COVID-19/immunology/complications
*SARS-CoV-2/immunology
Child
Post-Acute COVID-19 Syndrome
Immunity, Innate
Dysbiosis/immunology
Adolescent

@article {pmid42041273,
year = {2026},
author = {Silveira, JM and Nakaishi, APM and da Silva, MG and Dos Santos, DO and Gastaldi, AC},
title = {Effects of Exercise-Based Pulmonary Rehabilitation in Patients with Long COVID: A Systematic Review and Meta-Analysis.},
journal = {Advances in respiratory medicine},
volume = {94},
number = {2},
pages = {},
pmid = {42041273},
issn = {2543-6031},
mesh = {Humans ; *COVID-19/rehabilitation/complications/physiopathology ; *Exercise Therapy/methods ; Quality of Life ; Post-Acute COVID-19 Syndrome ; Exercise Tolerance ; SARS-CoV-2 ; Randomized Controlled Trials as Topic ; },
abstract = {Background/Objective: A substantial proportion of infected individuals develop persistent symptoms after the acute phase of COVID-19, regardless of initial disease severity. Long COVID (LC) remains a public health challenge characterized by impaired functional exercise capacity (FEC) and quality of life (QoL). We systematically synthesized evidence on the effects of in-person outpatient pulmonary rehabilitation (OPR) with individualized and supervised exercise in adults with LC. Methods: Following PROSPERO (CRD42023389365), this study reviewed randomized controlled trials (RCTs) and observational cohort studies (OCSs) published between November 2019 and January 2026 in MEDLINE/PubMed, Web of Science, PEDro, and EMBASE. Results: Fifteen studies (n = 803) were included. OPR improved FEC (6MWT; MD: 53.72 m, 95% CI 43.69-63.75) and 30″SST (MD: 4.68, 95% CI 3.59-5.77) and reduced exertional dyspnea. RCTs showed benefits in physical (MD: 8.04, 95% CI 3.02-13.05) and mental QoL (MD: 6.60, 95% CI 2.01-11.18) and dyspnea impact, with inconsistent PF findings. Fatigue showed a trend toward improvement but was measured using heterogeneous patient-reported tools in RCTs and OCSs. Conclusions: Supervised PR improves FEC, QoL, and dyspnea in individuals with LC. In patients with fatigue/PEM, systematic assessment and continuous symptom monitoring are essential. High-quality controlled studies are needed to strengthen evidence and clinical guide.},
}

Humans
*COVID-19/rehabilitation/complications/physiopathology
*Exercise Therapy/methods
Quality of Life
Post-Acute COVID-19 Syndrome
Exercise Tolerance
SARS-CoV-2
Randomized Controlled Trials as Topic

@article {pmid42041392,
year = {2026},
author = {Markwitz, M and Welc, N and Kępińska, K and Bowszyc-Dmochowska, M and Dmochowski, M},
title = {Non-COVID-19 Vaccinations and the Induction of Autoantibodies in Pemphigus Diseases: A Review of the Speculative Issue and Our Clinical-Laboratory Experience.},
journal = {Antibodies (Basel, Switzerland)},
volume = {15},
number = {2},
pages = {},
pmid = {42041392},
issn = {2073-4468},
abstract = {Background: Pemphigus diseases are rare autoimmune blistering disorders mediated by pathogenic autoantibodies directed mainly against desmoglein 1 and desmoglein 3. Although most cases are considered idiopathic, external triggers that can disrupt immune tolerance have been described. Vaccination has been discussed as a potential precipitating factor in autoimmune skin diseases. However, the relationship between vaccination and the induction of pemphigus-related autoantibodies has not been comprehensively summarized. Methods: We conducted a narrative review of all available studies published in the last 25 years identified through medical databases, excluding studies on COVID-19 vaccinations. Reports describing either new-onset pemphigus or exacerbation of preexisting pemphigus with a temporal association to vaccination were included. Clinical characteristics, vaccine type, latency period, direct immunofluorescence findings, and ELISA results for desmoglein autoantibodies were analyzed. In addition, we present our own clinical-laboratory experience illustrating this issue. Results: The current evidence consists predominantly of case reports and small case series. Published cases describe pemphigus vulgaris and pemphigus foliaceus occurring after vaccinations against influenza, hepatitis B, tetanus, diphtheria, pertussis, rabies, and other routinely administered immunizations. The latency period most often ranged from several days to a few weeks. Immunopathological findings were consistent with classical pemphigus diseases, including intercellular IgG deposits in the epidermis and circulating autoantibodies against desmoglein 1 and/or desmoglein 3. Our patient was a 78-year-old woman who developed cutaneous form of pemphigus vulgaris, diagnosed with direct immunofluorescence (DIF) and multiplex ELISA, 10 days after diphtheria-tetanus-pertussis vaccination. The patient had a positive family history of autoimmune blistering disease, namely mucous membrane pemphigoid. Conclusions: Based on the currently available evidence, a direct causal relationship between vaccination and pemphigus diseases cannot be established. Nevertheless, accumulated clinical and serological observations suggest that vaccination may act as a triggering factor in genetically or immunologically predisposed individuals, possibly by amplifying pre-existing subclinical autoreactive immune responses. Further population-based and mechanistic studies are required to clarify this association, while the overall benefits of vaccination remain substantial.},
}

@article {pmid42041609,
year = {2026},
author = {Breaux, AM and Miller, GR and Cooper, HD and Bembenick, KN and Reddy, A and Ahmadzadeh, S and Shekoohi, S and Kaye, AD},
title = {Critical Care Sedation: Emerging Clinical Considerations and Risks of Volatile Anesthetics for Sedation: A Narrative Review.},
journal = {Diseases (Basel, Switzerland)},
volume = {14},
number = {4},
pages = {},
pmid = {42041609},
issn = {2079-9721},
abstract = {Volatile anesthetics have steadily become more popular in intensive care units for sedation for reasons related to their beneficial pharmacokinetic and pharmacodynamic properties. Common anesthetics such as isoflurane and sevoflurane rapidly reach sedative levels in the body, but they are also rapidly eliminated, allowing for quick recovery. These agents have minimal impact on the liver and kidneys, which makes them attractive options when compared to other agents including opioids, benzodiazepines, ketamine, and propofol. Use of delivery systems like AnaConDa[®] (Anaesthetic Conserving Device; Sedana Medical AB, Danderyd, Sweden) has enabled providers to easily use these agents in the Intensive Care Unit (ICU). In this regard, they have recently provided additional beneficial consideration during intravenous drug shortages seen during the COVID-19 pandemic and at other times. These agents have shown organ-protective effects in the kidneys and lungs, which may even reduce the total time spent in the ICU. Pharmacodynamically, these anesthetics mediate their effects through central nervous system ion channels to exert analgesic and anxiolytic actions, thereby minimizing effects in the kidneys and lungs. These agents are primarily eliminated via exhalation, which makes them potential options for those with liver or kidney failure. This narrative review examines current efficacy and risks of using volatile anesthetics for sedation in the ICU setting and clinical roles for the future.},
}

@article {pmid42041712,
year = {2026},
author = {Vo, AH and Libmann, M and Carson, D and Wang, K and Puri, S and Butowski, N and Winters-Stone, K},
title = {A Scoping Review of Exercise Oncology in the Primary Brain Tumor Patient-Caregiver Dyad.},
journal = {Current oncology (Toronto, Ont.)},
volume = {33},
number = {4},
pages = {},
pmid = {42041712},
issn = {1718-7729},
mesh = {Humans ; *Brain Neoplasms/therapy/psychology ; *Caregivers/psychology ; *Exercise Therapy/methods ; Quality of Life ; Exercise ; },
abstract = {BACKGROUND: Primary malignant brain tumors (PBT) impose substantial burdens on patients and caregivers. Caregivers are essential in the delivery of outpatient care for patients with PBT but experience high levels of fatigue, distress, and health decline. Although exercise is known to improve outcomes in cancer patients, interventions tailored specifically to the PBT patient-caregiver dyad remain limited. Dyadic intervention, as well as exercise oncology, are emerging areas of active research in neuro-oncology. This scoping review incorporates both principles to evaluate the existing literature on exercise interventions on primary brain tumor patient-caregiver dyads.

METHODS: We conducted a comprehensive search of MEDLINE (PubMed), Embase, CINAHL (EBSCO), Rehabilitation & Sports Medicine (EBSCO), and Cochrane Central (Ovid) in December 2025 for studies involving exercise interventions that included adult PBT patients and caregivers.

RESULTS: Of the 1126 records screened, eight studies were included: four yoga-based interventions (three feasibility trials and one ongoing multicenter RCT), one pilot ski-based intervention, and three aerobic and resistance training-based interventions (two qualitative and one ongoing trial). The interventions were safe and feasible, with high adherence and retention. The preliminary reported benefits included improvements in fatigue, sleep, quality of life, and caregiver distress for the dyads. Videoconference delivery was effective, particularly during the COVID-19 pandemic. The eight included studies comprised 5-67 dyads, with four being single-arm feasibility studies.

CONCLUSIONS: Current literature on dyadic exercise intervention in neuro-oncology consists primarily of small-scale feasibility and pilot studies. Initial findings have demonstrated that such interventions are safe. However, preliminary efficacy remains limited due to the risk of bias and lack of statistical power. Larger randomized clinical trials with objective endpoints are needed to define efficacy and guide evidence-based protocols.},
}

Humans
*Brain Neoplasms/therapy/psychology
*Caregivers/psychology
*Exercise Therapy/methods
Quality of Life
Exercise

@article {pmid42041941,
year = {2026},
author = {Ramos-Nino, ME},
title = {Triple Latency as a Driver of Chronic Inflammation: An Integrative View of HSV, EBV, and CMV Persistence in Immunocompetent Hosts.},
journal = {Clinics and practice},
volume = {16},
number = {4},
pages = {},
pmid = {42041941},
issn = {2039-7275},
abstract = {Background: Herpes simplex virus (HSV), Epstein-Barr virus (EBV), and cytomegalovirus (CMV) establish lifelong latency in sensory neurons, lymphoid tissue, and myeloid-endothelial cells, respectively. A substantial proportion of adults worldwide are infected with all three viruses and may experience concurrent herpesvirus latency, yet they have largely been studied independently. This review examined whether latent and intermittently reactivating herpesviruses share overlapping inflammatory signatures and whether their combined presence contributes to chronic inflammatory burden. Methods: A narrative integrative review was conducted using MEDLINE, Embase, and Google Scholar (inception-October 2025). Evidence from thirty-one cohort studies and mechanistic investigations spanning virology, immunology, neurology, and clinical medicine was synthesized. Results: Herpesvirus reactivation rates ranged from 23% in general Intensive Care Unit (ICU) populations to 85% in severe COVID-19. Concurrent reactivation of multiple viruses occurred in 34-63% of critically ill patients and was associated with worse clinical outcomes. Notably, simultaneous CMV and EBV reactivation independently predicted mortality (adjusted hazard ratio, 3.17; 95% CI, 1.41-7.13). Across infections, overlapping inflammatory biomarkers, including IL-6, TNF-α, CRP, and PGE2, were consistently elevated, reflecting convergent activation of IFN and NF-κB signaling pathways. Mechanistic studies suggest cross-compartment immune priming, where CMV-driven T-cell exhaustion facilitates EBV reactivation, and viral cytokine signaling enhances HSV-associated neuroinflammation. Conclusions: HSV, EBV, and CMV triple latency may represent an underrecognized contributor to chronic inflammation in immunocompetent hosts. Understanding this multi-virus inflammatory network may inform mechanistic research, biomarker-guided risk stratification, and therapeutic strategies targeting convergent inflammatory pathways. Prospective interventional studies incorporating concurrent multi-virus monitoring are needed to clarify causal relationships.},
}

@article {pmid42041954,
year = {2026},
author = {Liu, Y and Khatchadourian, C and Sanders, L and Eweroke, Q and Warner-McCutcheon, C and Lewis, J and Santos, J and Venketaraman, V},
title = {Systematic Review: The Impact of COVID-19 Vaccination on Myocarditis Risk and Recovery.},
journal = {Clinics and practice},
volume = {16},
number = {4},
pages = {},
pmid = {42041954},
issn = {2039-7275},
support = {R15 HL143545/HL/NHLBI NIH HHS/United States ; },
abstract = {Background: Myocarditis is an uncommon but recognized adverse event following mRNA COVID-19 vaccination, with risk varying by age, sex, dose number, and vaccine product. Clarifying the magnitude of risk, clinical course, and recovery-relative to myocarditis following SARS-CoV-2 infection-is essential for risk-benefit assessment and public health guidance. Methods: We performed a systematic PubMed and Embase search (January 2020-December 2024) and synthesized cohort, registry, and surveillance data on myocarditis incidence and outcomes following mRNA COVID-19 vaccination. Outcomes included incidence, observed-to-expected (OE) or incidence rate (IRRs) ratios, hospitalization, and short-term recovery. Study selection followed PRISMA 2020 systematic review guidelines. Results: Myocarditis following mRNA COVID-19 vaccination was identified as a rare adverse event, most commonly occurring after the second dose and in younger male individuals. Across multiple cohort and registry-based studies, cases were generally mild and self-limited, with most patients recovering without complication. In contrast, myocarditis following SARS-CoV-2 infection was consistently associated with more severe outcomes, including higher rates of hospitalization and mortality. Conclusions: Vaccine-associated myocarditis is rare, typically mild, and self-limited, with excellent short-term recovery; vaccinated individuals also exhibit lower odds of in-hospital death and intubation. In contrast, infection-associated myocarditis is more frequent and severe. Overall, the benefit-risk profile of mRNA vaccination remains strongly favorable.},
}

@article {pmid42042039,
year = {2026},
author = {Chang, H and Wu, CS and Yeh, TY and Ko, WC},
title = {Tea Polyphenols in the COVID-19 Era: Mechanistic Insights and Translational Challenges.},
journal = {Current issues in molecular biology},
volume = {48},
number = {4},
pages = {},
pmid = {42042039},
issn = {1467-3045},
support = {Not applicable//Renal Care Research and Health Promotion Association, New Taipei City/ ; },
abstract = {The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has driven the global COVID-19 pandemic, imposing a tremendous burden on public health. As the virus continually evolves through rapid mutations, the pandemic has transitioned into a prolonged endemic phase. Despite the development of novel drugs and vaccines, clinical outcomes remain suboptimal for vulnerable populations, including the elderly and those with comorbidities or compromised immunity. Tea polyphenols, a class of structurally diverse and bioactive nutraceuticals, may modulate viral entry, replication, and host inflammatory pathways implicated in disease progression through pleiotropic effects on viral attachment, membrane fusion, intracellular replication, and proteolytic processing. Here, we provide an updated chemo-biological perspective on the antiviral and immunomodulatory mechanisms of tea polyphenols against SARS-CoV-2. Current evidence highlights their potential to serve as promising candidates for further mechanistic and translational investigation as adjunctive strategies and nutraceuticals for COVID-19 management. Importantly, no large-scale randomized controlled trials have yet demonstrated clinical benefit of tea polyphenols in COVID-19.},
}

@article {pmid42042775,
year = {2026},
author = {Damnjanović, K and Djurov, K and Galic, M and Lisul, B and Mocanu, IV and Shukla, S and Enstone, A and Dai, L and Vrdelja, M and Batselova, H and Drăgănescu, A and Tešović, G},
title = {Vaccine Confidence and Vaccine Hesitancy in Several Countries in Southeastern Europe in Past 10 Years: A Structured Review of Published Literature.},
journal = {Vaccines},
volume = {14},
number = {4},
pages = {},
pmid = {42042775},
issn = {2076-393X},
support = {N/A//Merck Sharp & Dohme LLC/ ; },
abstract = {OBJECTIVES: Despite vaccination being the most effective way of preventing infections and vaccination rates recovering worldwide after the COVID-19 pandemic, vaccine hesitancy persists. Some factors, such as psychological and social barriers, can negatively impact views on vaccines and can contribute to vaccine hesitancy. The primary objective of this structured literature review is to investigate the available evidence relating to factors affecting vaccine hesitancy within several countries in Southeastern Europe.

METHODS: An electronic database search was conducted to identify studies assessing the public and healthcare professionals' (HCPs) attitudes towards vaccination in Southeastern Europe. These searches were supplemented with grey literature searches. Included studies were conducted in Bulgaria, Croatia, Romania, Serbia, and Slovenia between 1 January 2012 and 31 December 2022.

RESULTS: Of the 35 studies identified from the database searches, the most prominent theme observed across Romania, Croatia, and Bulgaria was low confidence in COVID-19 vaccines. Across all age groups, COVID-19 vaccine confidence in these regions was highly dependent on whether individuals thought vaccines were safe and effective, as well as their general trust in vaccines. Confidence in COVID-19 vaccines was seen as relatively high, with attitudes towards routine and elective vaccines being generally positive amongst the general public and HCPs, in Romania, Croatia, Serbia and Slovenia. However, uncertainty around the effectiveness of the vaccine still exists. In Bulgaria, trust in routine and elective vaccines remained low in the general public. Complacency and financial constraints were also identified as underlying causes of vaccine hesitancy.

CONCLUSIONS: The main cause behind vaccine hesitancy in several countries in Southeastern Europe is distrust in vaccine effectiveness and safety. These key findings can be utilised to support evidence-based decisions regarding where to focus resources to improve public and HCP perception of vaccines in Southeastern Europe.},
}

@article {pmid42042784,
year = {2026},
author = {Runzer-Colmenares, FM and Cahuapaza-Gutierrez, NL and Calderon-Hernandez, CC and Umeres-Bravo, MM},
title = {Effects of Respiratory Vaccines in Older Adults with Cardiovascular Diseases: A Scoping Review.},
journal = {Vaccines},
volume = {14},
number = {4},
pages = {},
pmid = {42042784},
issn = {2076-393X},
abstract = {Background/Objectives: Vaccination against respiratory viruses-such as respiratory syncytial virus (RSV), pneumococcal disease, influenza, and COVID-19-may reduce the risk of adverse outcomes in older adults with cardiovascular disease. This study conducted a scoping review of the effects of respiratory vaccines in older adults with cardiovascular disease. Methods: We included studies evaluating adults aged ≥ 60 years with cardiovascular disease who received different types of respiratory vaccines. Eligible designs comprised clinical trials, observational cohort studies, and other relevant studies. Editorials, commentaries, and non-original publications were excluded. A comprehensive and targeted literature search was conducted in PubMed, Scopus, EMBASE, and Web of Science from database inception through January 2026. Results: A total of 25 studies were included, encompassing 1,782,787 adults aged ≥ 60 years with cardiovascular disease who received various respiratory vaccines. RSV vaccines were associated with a lower incidence of cardiorespiratory hospitalization and stroke among vaccinated individuals. Pneumococcal vaccines showed that sequential dual vaccination strategies were associated with a lower risk of cardiovascular events. Influenza vaccination was associated with improved cardiovascular outcomes, lower mortality, and reduced adverse events. COVID-19 vaccines were associated with reductions in mortality and hospitalizations. These benefits are particularly relevant in an older population with a high burden of comorbidities; therefore, complete vaccination schedules, including booster doses, should be considered a central strategy for prevention and comprehensive management in this high-risk group. Conclusions: Vaccination against respiratory viruses in older adults with cardiovascular disease demonstrates an overall favorable/acceptable profile of efficacy and safety, with reductions in mortality, hospitalizations, and cardiovascular events, without a significant increase in serious adverse events.},
}

@article {pmid42042800,
year = {2026},
author = {Lopes de Abreu, AJ and Mpande, CAM and Song, Y and Nicholson, MW and Nannei, C and Friede, M},
title = {Unpacking the mRNA Supply Chain: Challenges and Opportunities for Global Health.},
journal = {Vaccines},
volume = {14},
number = {4},
pages = {},
pmid = {42042800},
issn = {2076-393X},
abstract = {The COVID-19 pandemic highlighted both the transformative potential of mRNA vaccines and the structural challenges associated with their supply chains. Unlike traditional vaccine platforms, mRNA vaccines depend on highly specialized raw materials, including plasmid DNA (pDNA), nucleotides, enzymes, and lipid nanoparticles (LNP), that are produced by a limited number of global suppliers. These dependencies, combined with platform-specific manufacturing processes and stringent cold chain requirements, introduce vulnerabilities across production, distribution, and regulatory oversight. This narrative review examines the distinctive features of mRNA vaccine supply chains and identifies key challenges and opportunities across three interconnected domains: manufacturing systems, logistics and distribution, and regulatory governance. Drawing on literature published between January 2021 and March 2026, the review synthesizes evidence on supply chain bottlenecks revealed during the COVID-19 pandemic, including upstream raw-material dependencies, limitations in manufacturing scale-up, cold chain constraints, and regulatory fragmentation. Particular attention is given to the implications of these challenges for low- and middle-income countries, where infrastructure, technical capacity, and regulatory resources may limit participation in mRNA vaccine production and deployment. The review also highlights emerging strategies to strengthen supply chain resilience, including diversification of input suppliers, development of regional manufacturing hubs, improvements in vaccine thermostability, regulatory harmonization initiatives, and the use of digital technologies for supply chain management. By integrating insights from manufacturing, logistics, and regulatory perspectives, this study contributes to a better understanding of the structural characteristics shaping mRNA vaccine supply chains and identifies priority areas for strengthening global preparedness for future health emergencies.},
}

@article {pmid42042827,
year = {2026},
author = {Aljohani, M},
title = {Seasonal Influenza Vaccine Uptake, Acceptance and Willingness to Vaccinate in Post-COVID-19 Vaccine Era Among Adult High-Risk Groups in Gulf Cooperation Council Countries (GCC): A Narrative Review of the Literature.},
journal = {Vaccines},
volume = {14},
number = {4},
pages = {},
pmid = {42042827},
issn = {2076-393X},
abstract = {BACKGROUND/OBJECTIVES: Reports on seasonal influenza vaccine (SIV) coverage in Gulf Cooperation Council (GCC) countries showed lower than targeted coverage among high-risk populations both before and after the COVID-19 pandemic and subsequent COVID-19 vaccine release. This narrative review aims to synthesise SIV coverage following the introduction of COVID-19 vaccines among at-risk groups in the GCC region.

METHODS: Database searches included PubMed and Google Scholar for articles assessing SIV uptake, acceptance, hesitancy, and intention to vaccinate among adults in high-risk groups in GCC countries, with data collected after the introduction of COVID-19 vaccines.

RESULTS: SIV uptake ranged from 1.8% among pregnant women to 64.1% among dialysis patients in Saudi Arabia. Healthcare workers (HCWs) demonstrated the highest overall coverage, reaching 64.5% for annual uptake in Bahrain, with 79% of HCWs in Saudi Arabia intending to vaccinate. Prevalent barriers included low risk perception and consideration of influenza as a mild disease not necessitating SIV uptake, as well as vaccine effectiveness and safety concerns. Previous vaccination, physician advice, and policy or mandates for HCWs were identified as frequent facilitators of uptake.

CONCLUSION: Suboptimal uptake was reported among most high-risk groups in GCC countries. Health Belief Model components and physician involvement appear to have a significant impact on vaccine uptake among the intended population. More emphasis should be directed toward effective risk communication and action cues methods to enhance uptake among high-risk groups. Future research is needed to cover understudied areas like the elderly aged ≥ 65 years, cancer and other high-risk groups, in addition to further studies for GCC countries other than Saudi Arabia in the post-COVID-19 vaccine period.},
}

@article {pmid42042830,
year = {2026},
author = {Bellavite, P and Di Fede, G and Mantovani, M and Zanolin, E},
title = {Autoimmune Features of Post-COVID-19 Vaccination Syndrome and Their Impacts on the Renin-Angiotensin System.},
journal = {Vaccines},
volume = {14},
number = {4},
pages = {},
pmid = {42042830},
issn = {2076-393X},
abstract = {One of the most critical aspects of post-acute COVID-19 syndrome (PACS) and post-acute COVID-19 vaccination syndrome (PACVS) is the presence of autoantibodies. These autoantibodies are directed against various receptors in the autonomic and cardiovascular systems, including those targeting proteins of the renin-angiotensin system (RAS). The RAS plays a central role in regulating vascular homeostasis, inflammation, and endothelial function. During SARS-CoV-2 infection, the interaction of the spike (S) protein with angiotensin-converting enzyme 2 (ACE2) can alter the balance of the RAS, favoring an imbalance towards the ACE/Angiotensin II/AT1R axis, known for its pro-inflammatory, pro-thrombotic, and vasoconstrictive properties. Similar pathological mechanisms also come into play in response to vaccinations that use the S protein as an antigen. Studies conducted by other groups and us on patients with PACS and PACVS have revealed the presence of autoantibodies directed against these RAS components and the mechanisms by which these antibodies can worsen the clinical situation. In particular, anti-ACE2, presumably formed by the anti-idiotype network or molecular mimicry, is correlated with PACVS symptoms in many patients. Furthermore, the presence of anti-MAS1 antibodies can reduce the efficiency of the ACE2/Angiotensin-(1-7)/MAS1 axis, which normally acts as a counter-regulator. Considering this evidence, an analysis of RAS molecules and the autoantibodies implicated in reactions to them may be useful for evaluating a state of persistent dysregulation associated with post-vaccination symptoms such as asthenia, headache, skin edema and bruising, cardiovascular alterations, and neurovegetative manifestations. Finally, we offer insights into diagnosing these multifaceted syndromes and working hypotheses to guide research into possible therapeutic approaches.},
}

@article {pmid42043214,
year = {2026},
author = {Natarajan, M and Jayashankar, B and Nataraj, R},
title = {Placental Vulnerability to SARS-CoV-2: Viral Entry Pathways and Immune Activation.},
journal = {Viruses},
volume = {18},
number = {4},
pages = {},
pmid = {42043214},
issn = {1999-4915},
mesh = {Humans ; Female ; Pregnancy ; *Virus Internalization ; *Placenta/virology/immunology ; *SARS-CoV-2/physiology ; *COVID-19/immunology/virology ; *Pregnancy Complications, Infectious/immunology/virology ; Angiotensin-Converting Enzyme 2 ; Infectious Disease Transmission, Vertical ; Spike Glycoprotein, Coronavirus/metabolism ; },
abstract = {Pregnancy represents a distinct immunological and physiological state that modifies maternal susceptibility to SARS-CoV-2 and influences the clinical and biological course of COVID-19. Accumulating evidence indicates that the interaction between viral entry determinants, gestation-specific immune modulation, placental endocrine-angiogenic pathways, and systemic inflammatory responses underlies the characteristic manifestations of SARS-CoV-2 infection during pregnancy. This review consolidates current understanding of SARS-CoV-2 viral structure, receptor biology, and the gestational regulation of key entry cofactors, including ACE2, TMPRSS2, NRP1, CTSL and FURIN, within reproductive and placental tissues. The review further integrates documented mechanisms of cytokine-mediated immune dysregulation, endothelial injury, thrombo-inflammation, and steroidogenic alteration observed in affected pregnancies, and examines their contribution to placental malperfusion, preeclampsia-like presentations, fetal growth abnormalities and preterm birth. Published molecular and computational studies characterising trophoblast antiviral defenses, receptor expression patterns, and structural determinants of Spike-ACE2 affinity are synthesised to contextualise the biological basis of placental susceptibility and the rarity of confirmed transplacental transmission. Current evidence on maternal clinical outcomes, fetal and neonatal consequences, vaccination efficacy, therapeutic considerations and contemporary management guidelines is also critically reviewed. By integrating molecular, immunological, pathological and clinical insights, this article provides a comprehensive framework for understanding the interaction between SARS-CoV-2 infection and pregnancy-specific physiology, with implications for risk assessment, preventive strategies and maternal-fetal care.},
}

Humans
Female
Pregnancy
*Virus Internalization
*Placenta/virology/immunology
*SARS-CoV-2/physiology
*COVID-19/immunology/virology
*Pregnancy Complications, Infectious/immunology/virology
Angiotensin-Converting Enzyme 2
Infectious Disease Transmission, Vertical
Spike Glycoprotein, Coronavirus/metabolism

@article {pmid42043241,
year = {2026},
author = {Tasker, S and Spiri, AM and Hartmann, K and Addie, DD and Belák, S and Bergmann, M and Egberink, H and Frymus, T and Hofmann-Lehmann, R and Marsilio, F and Pennisi, MG and Thiry, E and Truyen, U and Boucraut-Baralon, C and Möstl, K and Hosie, MJ},
title = {Update on Treatment of Feline Infectious Peritonitis: European Advisory Board on Cat Diseases (ABCD) Guidelines.},
journal = {Viruses},
volume = {18},
number = {4},
pages = {},
pmid = {42043241},
issn = {1999-4915},
mesh = {Animals ; Cats ; *Feline Infectious Peritonitis/drug therapy/diagnosis/virology ; *Antiviral Agents/therapeutic use/administration & dosage ; Adenosine Monophosphate/analogs & derivatives/therapeutic use ; Alanine/analogs & derivatives/therapeutic use ; Europe ; Coronavirus, Feline/drug effects ; Adenosine/analogs & derivatives ; Cytidine/analogs & derivatives ; Hydroxylamines ; },
abstract = {Feline infectious peritonitis (FIP) is a disease arising as a result of feline coronavirus infection. It used to be regarded a fatal disease, with euthanasia commonly recommended following diagnosis due to its very poor prognosis. The availability of effective antiviral therapies, particularly nucleoside analogues such as oral GS-441524, has fundamentally changed the outlook for cats with FIP. FIP is now a treatable and frequently curable disease. In these revised guidelines, the European Advisory Board on Cat Diseases (ABCD) presents an update on the treatment of FIP, incorporating the findings of new studies including the range of available treatments (such as GS-441524, remdesivir and molnupiravir (EIDD-2801) and its active metabolite EIDD-1931), which varies globally, as well as suggestions for monitoring and prognostic indicators. Tables are used to present easy-to-find information on antiviral and supportive treatments for cats with FIP. GS-441524 is the most extensively studied antiviral for FIP with treatment success rates often exceeding 90%. Remdesivir is primarily reserved as an injectable antiviral for severely affected cats unable to tolerate oral medication; it is usually replaced by oral medication as soon as, and when, possible. Although 84-day treatment courses have historically been used, emerging evidence suggests that shorter regimens of 42 days can be equally effective.},
}

Animals
Cats
*Feline Infectious Peritonitis/drug therapy/diagnosis/virology
*Antiviral Agents/therapeutic use/administration & dosage
Adenosine Monophosphate/analogs & derivatives/therapeutic use
Alanine/analogs & derivatives/therapeutic use
Europe
Coronavirus, Feline/drug effects
Adenosine/analogs & derivatives
Cytidine/analogs & derivatives
Hydroxylamines

@article {pmid42043247,
year = {2026},
author = {Mahajan, S and Mahajan, S and Kaushik, N},
title = {Integrative Insights into the Immunopathogenesis and Organ-Specific Immunological Mechanisms of Long COVID: A Narrative Review.},
journal = {Viruses},
volume = {18},
number = {4},
pages = {},
pmid = {42043247},
issn = {1999-4915},
mesh = {Humans ; *COVID-19/immunology/pathology ; Post-Acute COVID-19 Syndrome ; SARS-CoV-2/immunology ; Immunity, Innate ; Adaptive Immunity ; },
abstract = {Long COVID (LC), also referred to as post-acute sequelae of SARS-CoV-2 infection, is characterized by persistent symptoms originating 3 months following acute COVID-19, lasting for at least two months and frequently affecting individuals who initially experienced mild to moderate disease. The clinical spectrum is heterogeneous, involving respiratory, cardiovascular, neurological, renal, gastrointestinal, and endocrine systems, thereby posing substantial diagnostic and therapeutic challenges. Despite extensive investigation, the precise immunopathogenic mechanisms underlying LC remain incompletely defined. Accumulating evidence suggests that LC is driven by a multifactorial interplay of persistent viral antigen reservoirs, chronic immune activation, dysregulated innate and adaptive immune responses, autoimmunity, endothelial dysfunction, microvascular injury, and aberrant tissue repair. These systemic immune perturbations manifest variably across different organs, contributing to the diverse clinical phenotypes observed. However, mechanistic clarity is hindered by heterogeneity in study designs, limited longitudinal data, and the absence of standardized immunological profiling. This narrative review provides integrative insights into the immunopathogenesis of LC, synthesizing current evidence on systemic immune dysregulation and organ-specific immunological mechanisms. A conceptual framework is proposed to facilitate a structured understanding of this complex syndrome and to guide future research toward targeted immunomodulatory strategies.},
}

Humans
*COVID-19/immunology/pathology
Post-Acute COVID-19 Syndrome
SARS-CoV-2/immunology
Immunity, Innate
Adaptive Immunity

@article {pmid42043661,
year = {2026},
author = {Pashapour, H and Nikfarjam, A and Ghaffari, M and Kavousi, A and Aslani, N and Karami, M},
title = {Good Practices for Managing Acute Respiratory Viral Infections at Aerial Entry Points: A Scoping Review.},
journal = {Journal of epidemiology and global health},
volume = {16},
number = {1},
pages = {},
pmid = {42043661},
issn = {2210-6014},
support = {43013183//Shahid Beheshti University of Medical Sciences/ ; },
mesh = {Humans ; *Quarantine/methods ; *Contact Tracing/methods ; *COVID-19/prevention & control/epidemiology ; *Respiratory Tract Infections/prevention & control ; Disease Outbreaks/prevention & control ; *Virus Diseases/prevention & control ; },
abstract = {BACKGROUND: Aerial entry points are critical in the international spread of infectious diseases, underscoring the need for effective management of acute respiratory viral infections (ARVIs). Recent global outbreaks, including COVID‑19, have highlighted the importance of strengthened public health measures at air borders. However, evidence on ARVI management strategies at these points remains fragmented. This scoping review mapped and synthesized existing approaches to quarantine protocols, contact‑tracing methods, and advanced or innovative technologies used at aerial entry points. METHODS: We conducted a scoping review following the Arksey and O’Malley framework, refined by Levac et al., and reported in accordance with PRISMA ScR guidelines. Scientific databases were systematically searched for English language studies published between 2003 and 2024 that described the management of ARVIs at air borders. Data from eligible studies were charted and analyzed using thematic analysis to identify and categorize quarantine approaches, contact tracing strategies, and advanced or innovative technologies applied in these settings. RESULTS: A total of 80 studies were included in the review, addressing diseases such as COVID 19, influenza, SARS, and Ebola. Most studies were conducted in high income countries and in regions of Southeast Asia and the Western Pacific. Various quarantine approaches were identified, including mandatory quarantine, risk based quarantine, and home based isolation strategies. Contact tracing methods ranged from traditional manual approaches using passenger information to technology supported systems that improved the speed of identifying exposed individuals. Several studies reported the use of advanced digital technologies such as digital health passports, geofencing monitoring systems, and electronic reporting platforms to support monitoring, compliance, and data management during public health responses at air borders. CONCLUSION: The findings highlight the diverse range of quarantine protocols, contact tracing approaches, and emerging technological tools used to manage ARVIs at air borders. Despite these developments, evidence regarding the effectiveness and long term implementation of these strategies remains limited. Further research is needed to strengthen the evidence base and support evidence informed policies for managing respiratory infectious diseases at international points of entry.},
}

Humans
*Quarantine/methods
*Contact Tracing/methods
*COVID-19/prevention & control/epidemiology
*Respiratory Tract Infections/prevention & control
Disease Outbreaks/prevention & control
*Virus Diseases/prevention & control

@article {pmid42044369,
year = {2026},
author = {Banerjee, P and Holly, L},
title = {Everyday Digital Technology Use and Youth Health: Scoping Review of Longitudinal Studies.},
journal = {JMIR public health and surveillance},
volume = {12},
number = {},
pages = {e85094},
pmid = {42044369},
issn = {2369-2960},
mesh = {Humans ; Adolescent ; Longitudinal Studies ; *Digital Technology/statistics & numerical data ; Digital Media ; *Adolescent Health/statistics & numerical data ; Social Media/statistics & numerical data ; Child ; Young Adult ; COVID-19/epidemiology ; Digital Health ; },
abstract = {BACKGROUND: Everyday digital technologies such as social media, gaming, and internet use are deeply integrated into the lives of children, adolescents, and young adults. While these platforms can foster connection, learning, and entertainment, concerns have grown about their potential to influence mental, physical, and social well-being. Research on this topic has expanded rapidly over the past decade, yet much of it remains cross-sectional, limiting insights into long-term outcomes. Longitudinal studies are essential to capture evolving patterns of digital engagement, identify causal relationships, and guide effective policies and interventions that support youth in navigating digital environments. In particular, evidence is needed to distinguish between beneficial and harmful forms of digital engagement, such as social connection versus problematic use, and to understand how these impacts differ across diverse populations and contexts. The COVID-19 pandemic further accelerated young people's technology use, underscoring the urgency of examining both risks and opportunities. This review, therefore, synthesizes longitudinal research to map trends, identify knowledge gaps, and inform future directions.

OBJECTIVE: The study aimed to systematically identify and map longitudinal studies examining associations between everyday digital technology use (eg, social media, gaming, and internet use) and the health and well-being of youth (25 years or younger) and to chart the types of evidence available by technology category, outcomes, and geographical setting in order to highlight key gaps for future research.

METHODS: A systematic search of PubMed, Embase, and PsycArticles (2014-2024) was conducted and reported in accordance with PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews). Data extraction covered demographics, digital technology categories, and health outcomes. Studies were grouped into 6 key themes: social media use and mental health, digital addiction and behavioral outcomes, physical activity and digital technology, digital health technologies and cognitive development, parental influence and digital technology, and digital well-being and risk behaviors.

RESULTS: Of the 456 studies identified, 267 were longitudinal studies relevant to our research aims. Internet use (n=201 studies), social media (n=140 studies), and gaming (n=83 studies) dominated the themes. Mental health was the most frequently assessed outcome, with a focus on anxiety and depression. Geographically, 15% (40/267) of studies originated from low- and middle-income countries, with the majority from high-income settings such as the United States (n=76 studies) and Australia (n=15 studies). Nearly half (131/267, 49%) were published post 2020, reflecting heightened interest during the COVID-19 pandemic.

CONCLUSIONS: Longitudinal evidence on everyday digital technology use and youth health is growing but remains concentrated in mental health outcomes and high-income settings, with notable gaps in physical health, educational outcomes, and equity-focused research. These findings highlight the need for more diverse, methodologically robust longitudinal studies to inform context-sensitive policies and interventions that balance the risks and benefits of digital engagement for young people.},
}

Humans
Adolescent
Longitudinal Studies
*Digital Technology/statistics & numerical data
Digital Media
*Adolescent Health/statistics & numerical data
Social Media/statistics & numerical data
Child
Young Adult
COVID-19/epidemiology
Digital Health

@article {pmid42044651,
year = {2026},
author = {Agyemang, C and Tetteh, J and Mbaye, MN and Lamptey, R and Seidu, S and Khunti, K and Kengne, AP},
title = {Burden and determinants of diabetes in sub-Saharan Africa.},
journal = {The lancet. Diabetes & endocrinology},
volume = {14},
number = {6},
pages = {498-511},
doi = {10.1016/S2213-8587(26)00065-3},
pmid = {42044651},
issn = {2213-8595},
mesh = {Humans ; Africa South of the Sahara/epidemiology ; *Cost of Illness ; COVID-19/epidemiology ; *Diabetes Mellitus, Type 2/epidemiology/etiology ; Prevalence ; },
abstract = {The prevalence of type 2 diabetes is rising rapidly across sub-Saharan Africa; however, its epidemiology, clinical phenotypes, and underlying mechanisms remain insufficiently characterised. This first paper in a Series on diabetes in sub-Saharan Africa synthesises current evidence on the burden, distribution, and determinants of diabetes, including emerging phenotypes and the roles of early life adversity, psychosocial stress, and interactions with infectious disease. We also identify major gaps in surveillance systems, research capacity, prevention, and clinical management across the region. Sub-Saharan Africa is experiencing one of the fastest global increases in diabetes, with the highest proportion of undiagnosed cases and a projected steep rise in intermediate hyperglycaemia and diabetes by 2050. Urbanisation, ageing, obesity, and lifestyle transitions are major contributors; however, a substantial proportion of type 2 diabetes occurs in lean individuals (BMI <25 kg/m[2]), particularly in rural settings, suggesting distinct metabolic and developmental pathways not captured by models derived from high-income countries. Bidirectional interactions between diabetes and malaria, tuberculosis, HIV, or COVID-19 make disease trajectories complex. Persistent gaps in surveillance, a reliance on modelled estimates, low genomic representation, and constrained access to modern diabetes medications hinder progress. Strengthening health system capacity, improving data infrastructure, and investing in regionally driven research are essential to develop effective, context-specific interventions and advance precision medicine tailored to sub-Saharan African populations.},
}

Humans
Africa South of the Sahara/epidemiology
*Cost of Illness
COVID-19/epidemiology
*Diabetes Mellitus, Type 2/epidemiology/etiology
Prevalence

@article {pmid42045685,
year = {2026},
author = {Mehdizadeh, M and Zhang, FW and Yu, LC and Li, JH and Posso, AN and Mustoe, AK and Escobar-Domingo, MJ and Foppiani, J and Karinja, S and Lee, BT},
title = {Telemedicine in Plastic Surgery: A Systematic Review and Meta-analysis of Utilization and Outcomes Pre- and Post-pandemic.},
journal = {Aesthetic plastic surgery},
volume = {50},
number = {13},
pages = {5712-5720},
pmid = {42045685},
issn = {1432-5241},
mesh = {Humans ; *Telemedicine/statistics & numerical data ; *COVID-19/epidemiology/prevention & control ; Patient Satisfaction/statistics & numerical data ; *Surgery, Plastic/methods ; *Plastic Surgery Procedures/methods ; Health Services Accessibility ; Pandemics ; SARS-CoV-2 ; },
abstract = {BACKGROUND: Telemedicine revolutionized healthcare post-COVID-19 by expanding virtual care across consultations, post-operative care, and inter-physician collaboration. However, its impact on adoption and effectiveness in plastic surgery remains underexplored. This study systematically compares pre- and post-pandemic telemedicine in plastic surgery, focusing on outcomes, accessibility, and patient satisfaction to inform best practices.

METHODS: A systematic review was conducted using PubMed, Medline, and Web of Science, following PRISMA guidelines, for articles published through November 2024. Extracted data included author, year, country, subspecialty, pandemic classification, sample size, demographics, utilization, barriers, travel time/distance, satisfaction, complications, and appointment duration. Meta-analyses calculated pooled estimates with 95% confidence intervals. Meta-regression and Welch's t-test assessed pre- versus post-pandemic differences. Analyses were performed in R 4.4.1.

RESULTS: Of 450 identified publications, 72 met inclusion criteria, encompassing 9435 subjects (mean age: 47.99). 89.3% (95% CI 59.3-96.2%) of patients reported willingness to reuse telemedicine, and the pooled satisfaction rate was 83.9% (95% CI 79.4-88.5; p < 0.05). Meta-analysis showed significant reductions in travel time (120 min; p < 0.05) and distance (187.1 km; p < 0.05). Five studies reported a mean appointment duration of 16.07 min. Complications were rare (7.7%; 95% CI 2.9-18.6%; p < 0.05). Post-pandemic satisfaction score was lower (81.1 vs. 91.2; p = 0.0315), likely reflecting increased utilization and technological barriers. Other outcomes, including complication rates and willingness to reuse telemedicine, showed no significant difference (p > 0.05).

CONCLUSION: Telemedicine plays an evolving role in plastic surgery, reducing travel burden and maintaining safety. However, lower post-pandemic satisfaction highlights the need to improve accessibility and technology to optimize outcomes.

LEVEL OF EVIDENCE III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .},
}

Humans
*Telemedicine/statistics & numerical data
*COVID-19/epidemiology/prevention & control
Patient Satisfaction/statistics & numerical data
*Surgery, Plastic/methods
*Plastic Surgery Procedures/methods
Health Services Accessibility
Pandemics
SARS-CoV-2

@article {pmid42046671,
year = {2026},
author = {Hudu, SA and Jimoh, AO},
title = {Operational zoonotic containment of Middle East respiratory syndrome coronavirus in Saudi Arabia: An implementation-oriented One Health genomic framework.},
journal = {Veterinary world},
volume = {19},
number = {3},
pages = {1322-1341},
pmid = {42046671},
issn = {0972-8988},
abstract = {Middle East respiratory syndrome coronavirus (MERS-CoV) remains a persistent zoonotic threat more than a decade after its first detection, with Saudi Arabia continuing to be the global epicenter of human infections and the main reservoir interface through dromedary camels. Despite ongoing surveillance, advances in molecular diagnostics, and research on vaccines and therapeutics, sporadic zoonotic spillovers and healthcare-associated outbreaks still occur, showing that current prevention strategies are still not enough. This review compiles current evidence from epidemiological studies, camel reservoir research, genomic monitoring, and public health reports published between 2012 and April 2025 to identify the key gaps preventing effective containment. Special focus is given to recent genomic discoveries, including post-2022 clade B sublineages, recombination events, and spike protein changes that might affect transmission and the effectiveness of countermeasures. Available data suggest that MERS-CoV epidemiology is driven by repeated camel-to-human transmission, followed by occasional amplification in healthcare settings rather than sustained community spread. High seroprevalence and frequent detection of viral RNA in juvenile camels, seasonal gathering in markets, and extensive animal movement networks contribute to ongoing viral circulation at the animal-human interface. Genomic studies consistently show close phylogenetic relationships between camel and human isolates, confirming recurrent zoonotic transmissions. However, fragmented surveillance systems, delayed genomic data integration, inconsistent biosecurity practices, and limited field evidence for camel vaccination pose major barriers to control. Additionally, hospital outbreaks continue to occur due to delayed diagnosis, overcrowding, and incomplete adherence to infection-prevention protocols, underscoring the need for improved clinical preparedness. Based on the integrated synthesis of epidemiological, veterinary, and genomic evidence, this review proposes an implementation-focused One Health genomic framework tailored to the Saudi context. The proposed roadmap highlights real-time connection of human and camel surveillance, expands genomic sequencing capacity, targets vaccination strategies in camels and high-risk human populations, standardizes biosecurity measures in markets and abattoirs, and strengthens infection control systems in healthcare facilities. Alignment with national governance structures and Saudi Vision 2030 offers a practical pathway for coordinated multi-sectoral action. This review concludes that MERS-CoV is unlikely to be eradicated soon, but it can be effectively managed through a genomics-enabled, operational One Health approach that combines surveillance, vaccination, clinical preparedness, and policy coordination. The model outlined here provides a scalable way to reduce zoonotic spillover risk and strengthen readiness against future coronavirus and emerging zoonotic threats.},
}

@article {pmid42046765,
year = {2026},
author = {Matenga-Ikihele, A and Asafo, F and Tuesday, R and Netzler, N and Puliuvea, C and Percival, T},
title = {Pacific-Led Responses to COVID-19: Lessons for Future Pandemic Preparedness.},
journal = {Journal of the Royal Society of New Zealand},
volume = {56},
number = {2},
pages = {e70049},
pmid = {42046765},
issn = {1175-8899},
abstract = {The COVID-19 pandemic exposed deep inequities in health systems globally and in Aotearoa New Zealand, with Pacific communities experiencing a disproportionate burden of illness, economic hardship, and social disruption. Despite these challenges, Pacific communities demonstrated resilience, culturally grounded leadership, and the ability to meet community needs through collective action. This qualitative review of peer-reviewed literature, government reports, and community-led research identified five interconnected themes: (1) community partnerships; (2) Pacific-centred approaches; (3) clear and trusted communication; (4) digital inclusion and literacy skills; and (5) economic support and sustainability. From these themes, key enablers were identified, which included community leadership, trusted communication strategies, and agile local systems, alongside barriers such as underinvestment, digital exclusion, reliance on unpaid labour, and limited inclusion of Pacific leadership in early planning. The findings highlight that Pacific-led systems are not supplementary but an essential public health infrastructure. Embedding these approaches within national emergency planning, through sustainable funding, formal governance roles, and strengthened digital inclusion, offers a pathway to a more equitable, trusted, and resilient pandemic response.},
}

@article {pmid42047168,
year = {2026},
author = {Uzer, F and Erendor, F and Sanlioglu, S},
title = {SARS-CoV-2 Variants and Immune Evasion: Mapping the Future of Vaccine Design.},
journal = {Reviews in medical virology},
volume = {36},
number = {3},
pages = {e70157},
pmid = {42047168},
issn = {1099-1654},
mesh = {Humans ; *Immune Evasion ; *SARS-CoV-2/immunology/genetics ; *Spike Glycoprotein, Coronavirus/immunology/genetics/chemistry ; *COVID-19/immunology/prevention & control/virology ; *COVID-19 Vaccines/immunology ; Vaccine Development ; Evolution, Molecular ; Mutation ; Animals ; },
abstract = {The evolutionary trajectory of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has progressed through several distinct phases since its zoonotic emergence, transitioning from initial human adaptation to an era of rapid antigenic drift and complex immune evasion. As of early 2026, the global landscape is dominated by highly evolved sublineages of the Omicron (B.1.1.529) variant, including the JN.1-descendent subvariants NB.1.8.1 and XFG. This review provides a comprehensive overview of the molecular mechanisms driving viral fitness, with a primary focus on the structural transformations within the spike (S) protein's receptor-binding domain (RBD), N-terminal domain (NTD), and S2 subunit. We examine the biophysical impacts of pivotal mutations, such as E484 K, K417 N, and F486P, alongside the phenomenon of convergent evolution and epistatic compensation. Furthermore, we provide an integrated analysis of current knowledge regarding the evolving dynamics of humoral and cellular immunity, exploring the challenges posed by immune imprinting and the decline of neutralizing antibody titers against antigenically distant strains. A comparative discussion of SARS-CoV-2 and seasonal influenza highlights divergent evolutionary paces but converging regulatory frameworks for annual vaccine updates. Finally, the current status of next-generation vaccine platforms is evaluated, specifically mosaic nanoparticles and mucosal delivery systems, which aim to provide pan-sarbecovirus protection and interrupt transmission. These insights are integrated into a policy framework focused on annual strain selection and enhanced genomic surveillance for sustainable long-term pandemic management.},
}

Humans
*Immune Evasion
*SARS-CoV-2/immunology/genetics
*Spike Glycoprotein, Coronavirus/immunology/genetics/chemistry
*COVID-19/immunology/prevention & control/virology
*COVID-19 Vaccines/immunology
Vaccine Development
Evolution, Molecular
Mutation
Animals

@article {pmid42047233,
year = {2026},
author = {Bashir, HM and Ciftci, D},
title = {Impact of COVID-19 on female reproductive health and communication post-pandemic: A scoping review.},
journal = {African journal of reproductive health},
volume = {30},
number = {8},
pages = {102-118},
doi = {10.29063/ajrh2026/v30i8.10},
pmid = {42047233},
issn = {1118-4841},
mesh = {Humans ; *COVID-19/epidemiology/psychology ; Female ; *Reproductive Health ; SARS-CoV-2 ; *Health Communication ; Pandemics ; },
abstract = {The COVID-19 pandemic significantly affected Female Reproductive Health (FRH), intensifying physiological and psychological conditions such as amenorrhea and postpartum related issues. While clinical studies have well-documented these impacts on FRH, no studies empirically tested health communication interventions, revealing a significant research gap. This scoping review bridges this gap, mapping evidence on the impact of COVID-19 on FRH and probing the untapped potential of communication strategies to mitigate these impacts. Following PRISMA-ScR guidelines, we systematically searched PubMed, PsycINFO, BMJ Global Health, and Frontiers (2021-2024) for peer-reviewed studies. The 13 included studies documented menstrual irregularities in 50-67% of women post-infection/vaccination, fertility rate declines of 18 per 100,000 women, and postpartum depression prevalence of 25.27%. Eligibility criteria included Women of reproductive age (15-49 years) affected by COVID-19's impact and implemented strategies addressing these impacts post-pandemic. We proposed integrating robust trauma-informed communication road map such as digital health literacy programs and community-led strategic initiatives.},
}

Humans
*COVID-19/epidemiology/psychology
Female
*Reproductive Health
SARS-CoV-2
*Health Communication
Pandemics

@article {pmid42047332,
year = {2026},
author = {Paik, S and Um, S and Kim, IS and Park, EJ and Kim, KT and Basu, J and Oh, DC and Jo, EK},
title = {Exploiting autophagy-targeting natural compounds for potential antimicrobial actions.},
journal = {Autophagy},
volume = {22},
number = {8},
pages = {1762-1787},
doi = {10.1080/15548627.2026.2662426},
pmid = {42047332},
issn = {1554-8635},
mesh = {*Autophagy/drug effects ; Humans ; Animals ; *Anti-Infective Agents/pharmacology ; *Biological Products/pharmacology ; Host-Directed Therapy ; Signal Transduction/drug effects ; },
abstract = {Natural products are biologically active compounds used for therapeutic interventions for various diseases, particularly infections. Autophagy is an intracellular catabolic pathway involving lysosomal degradation and is closely associated with immunological pathways, effectively combating bacterial, viral, fungal, and parasitic infections. Accumulating evidence suggests that autophagy activation or inhibition by natural products promotes antimicrobial responses against various pathogens. Numerous natural products can modulate autophagy through diverse signaling pathways, suggesting their potential as a host-directed therapeutic strategy that may complement conventional drug regimens or help mitigate drug resistance in various infectious diseases. However, it remains largely unclear whether these effects are mediated by direct modulation of autophagy or indirectly through associated mechanisms, including enhanced immune defense, attenuation of pathological inflammation, or crosstalk with other organelle functions. Additionally, multiple pathogens can evade host responses; thus, autophagy activation may inadvertently create favorable conditions for certain pathogens. This review discusses the current knowledge of natural products in terms of their antimicrobial actions through autophagy regulation, particularly the roles of distinct natural product classes, such as polyphenols, alkaloids, terpenoids, quinones, peptides, and macrolides in modulating autophagy for potentially contributing to control various infectious diseases. Exploring the intricate molecular interplay between natural products and autophagy in limiting infections may provide valuable insights that could inform the development of innovative host-directed antimicrobial treatments based on autophagy regulation.Abbreviations: 3-MA: 3-methyladenine; AM: alveolar macrophages; AMP: antimicrobial peptides; AMPK: 5' adenosine monophosphate-activated protein kinase; ARDS: acute respiratory distress syndrome; ART: artemisinin; ASFV: African swine fever virus; ATG: autophagy related; AZM: azithromycin; BafA1: bafilomycin A1; BECN1: beclin 1; BMDM: bone marrow-derived macrophage; BNIP3: BCL2 interacting protein 3; BNIP3L: BCL2 interacting protein 3 like; CALCOCO2/NDP52: calcium binding and coiled-coil domain 2; CAMKK2: calcium/calmodulin-dependent protein kinase kinase 2; CBD: cannabidiol; CF: cystic fibrosis; CGA: chlorogenic acid; CGAS: cyclic GMP-AMP synthase; CHUK/IKKα: component of inhibitor of nuclear factor kappa B kinase complex; CLP: cecal ligation and puncture; CLR: clarithromycin; CMA: chaperone-mediated autophagy; CoV: coronavirus; DHT: dihydrotanshinone I; EGCG: epigallocatechin-3-gallate; EIF2A: eukaryotic translation initiation factor 2A; EIF2AK2: eukaryotic translation initiation factor 2 alpha kinase 2; ESKAPE: Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter spp.; ESRRA: estrogen related receptor alpha; FOXO1: forkhead box O1; FUNDC1: FUN14 domain containing 1; HBV: hepatitis B virus; HCV: hepatitis C virus; HDT: host-directed therapy; HIV: human immunodeficiency virus; HMGB1: high mobility group box 1; HSV: herpes simplex virus; IAV: influenza A virus; ICT: isocryptotanshinone; IFN: interferon; IKBKB/IKKβ: inhibitor of nuclear factor kappa B kinase subunit beta; IL: interleukin; INH: isoniazid; IRF3: IFN regulatory factor 3; KEAP1: kelch like ECH associated protein 1; LAMP: lysosomal associated membrane protein; LAP: LC3-associated phagocytosis; LPS: lipopolysaccharide; MAP1LC3/LC3: microtubule associated protein 1 light chain 3; MAPK: mitogen-activated protein kinase; MDM: monocyte-derived macrophage; MDR: multidrug-resistant; MON: monotropein; Mtb: Mycobacterium tuberculosis; MTOR: mechanistic target of rapamycin kinase; mtROS: mitochondrial ROS; NET: neutrophil extracellular trap; NFE2L2/Nrf2: NFE2 like bZIP transcription factor 2; NFKB/NF-κB: nuclear factor kappa B; NLRP3: NLR family pyrin domain containing 3; NLRX1: NLR family member X1; NOTCH1: notch receptor 1; NTM: nontuberculous mycobacteria; OMS: ohmyungsamycin; PAK1: p21 (RAC1) activated kinase 1; PINK1: PTEN induced kinase 1; PKM/PKM2: pyruvate kinase M1/2; PLD: phospholipase D; PM: peritoneal macrophage; PPM1A: protein phosphatase, Mg2+/Mn2+ dependent 1A; PRKN/parkin: parkin RBR E3 ubiquitin protein ligase; PtdIns3K: phosphatidylinositol 3-kinase; PtdIns3P: phosphatidylinositol-3-phosphate; PTEN: phosphatase and tensin homolog; RB1CC1/FIP200: RB1 inducible coiled-coil 1; RELA/p65: RELA proto-oncogene, NF-kB subunit; RIF: rifampicin; ROS: reactive oxygen species; RSV: resveratrol; RUBCN/rubicon: rubicon autophagy regulator; SAR: selective autophagy receptor; SIRT: sirtuin; STING1: stimulator of interferon response cGAMP interactor 1; STX17: syntaxin 17; Tat: trans-activator of transcription; TB: tuberculosis; TBK1: TANK binding kinase 1; TFEB: transcription factor EB; TLR: toll like receptor; TNA: tanshinone IIA; TNF: tumor necrosis factor; UA: ursolic acid; ULK1/Atg1: unc-51 like autophagy activating kinase 1; UPR: unfolded protein response; UVRAG: UV radiation resistance associated; VAMP8: vesicle associated membrane protein 8; VDR: vitamin D receptor; WIPI2: WD repeat domain, phosphoinositide interacting 2; ZFYVE1/DFCP1: zinc finger FYVE-type containing 1; ZIKV: Zika virus.},
}

*Autophagy/drug effects
Humans
Animals
*Anti-Infective Agents/pharmacology
*Biological Products/pharmacology
Host-Directed Therapy
Signal Transduction/drug effects

@article {pmid42048372,
year = {2026},
author = {Braga, A and Fialho, SCAV and Martins, CAO and Duvivier, KM and Callado, GY and Araujo Júnior, E and de Rezende-Filho, J},
title = {Maternal vaccination in the immunization era: implementation, uptake, and emerging vaccines.},
journal = {Journal of perinatal medicine},
volume = {54},
number = {6},
pages = {962-973},
pmid = {42048372},
issn = {1619-3997},
mesh = {Humans ; Female ; Pregnancy ; *Vaccination/methods ; *Pregnancy Complications, Infectious/prevention & control ; *Immunization Programs ; *Vaccines ; },
abstract = {Maternal immunization has ascended as a cornerstone of contemporary strategies aimed at safeguarding pregnant women, fetuses, and children in early childhood against vaccine-preventable diseases. The profound physiological and immunological adaptations inherent to gestation heighten maternal susceptibility to infectious morbidity, while several pathogens, including influenza, pertussis, COVID-19, rubella, and respiratory syncytial virus (RSV), pose significant risks of adverse maternal, fetal, and neonatal outcomes. Although an extensive body of evidence attests to the safety and effectiveness of maternal vaccines, global uptake among pregnant people remains markedly uneven and, in many settings, critically suboptimal. A nuanced understanding of national and international immunization programs, along with their structural and sociocultural challenges, is imperative to strengthen perinatal health protection. This narrative review synthesizes evidence drawn from peer-reviewed scientific literature, global health agency publications, and official national immunization guidelines. Extracted data were complemented by analyses of the immunological landscape of pregnancy, current vaccine recommendations, established safety profiles, and maternal immunization schedules across high-, middle-, and low-income countries. Particular emphasis was placed on the vaccines most consistently recommended during pregnancy, namely influenza, Tdap, COVID-19, and RSV, as well as on contextual determinants influencing vaccine hesitancy, access barriers, and global disparities in coverage.},
}

Humans
Female
Pregnancy
*Vaccination/methods
*Pregnancy Complications, Infectious/prevention & control
*Immunization Programs
*Vaccines

@article {pmid42048529,
year = {2026},
author = {Ventriglio, A and Torales, J and Castaldelli-Maia, JM and Caycho-Rodríguez, T and Hualparuca-Olivera, L and Bhugra, D},
title = {The past, present and future of Social Psychiatry.},
journal = {International review of psychiatry (Abingdon, England)},
volume = {38},
number = {1-3},
pages = {6-16},
doi = {10.1080/09540261.2025.2523454},
pmid = {42048529},
issn = {1369-1627},
mesh = {Humans ; *Community Psychiatry/trends/history ; *Models, Biopsychosocial ; History, 20th Century ; History, 21st Century ; *Social Determinants of Health ; COVID-19 ; *Mental Disorders/therapy ; },
abstract = {In psychiatry, tensions have often arisen between biological and social approaches, despite their interconnection. Social psychiatry has evolved alongside changing understandings of mental health and its ties to broader social and geopolitical determinants. Global factors such as economic inequality, migration, and social exclusion are increasingly recognized as key influences on mental health outcomes. Nonetheless, challenges like stigma, lack of access, and resource limitations persist. The Biopsychosocial Model remains central to social psychiatry, offering an integrated framework that considers biological, psychological, and social dimensions. This comprehensive perspective ensures that interventions target not only symptoms but also contextual factors contributing to mental illness. The future of social psychiatry will be shaped by heightened awareness of social determinants, particularly amid global crises like war or COVID-19. Consistent application of the biopsychosocial model in clinical settings is essential. Policy advocacy focused on housing, employment, and inclusive care-alongside cultural sensitivity and the use of digital tools-will be vital. Moreover, enhancing psychiatric education and fostering interdisciplinary collaboration will be key to addressing social determinants across all levels of mental health care.},
}

Humans
*Community Psychiatry/trends/history
*Models, Biopsychosocial
History, 20th Century
History, 21st Century
*Social Determinants of Health
COVID-19
*Mental Disorders/therapy

@article {pmid42048993,
year = {2026},
author = {Amiral, J and Seghatchian, J},
title = {An in-depth synthetic wrap on the immune-hemostatic axis in human disease.},
journal = {Transfusion and apheresis science : official journal of the World Apheresis Association : official journal of the European Society for Haemapheresis},
volume = {65},
number = {3},
pages = {104441},
doi = {10.1016/j.transci.2026.104441},
pmid = {42048993},
issn = {1473-0502},
mesh = {Humans ; *COVID-19/immunology/blood ; *Hemostasis/immunology ; *SARS-CoV-2 ; Inflammation/immunology ; Renin-Angiotensin System/immunology ; },
abstract = {Human defense systems (immunity, inflammation, hemostasis, fibrinolysis, and the renin-angiotensin-aldosterone system) have co-evolved to provide multilayered protection against infections, trauma, malignancies, and metabolic disturbances. In humans, these systems reach exceptional regulatory sophistication and are coordinated through integrated immunological and hemostatic mechanisms forming the frontline of defense. While highly efficient under physiological conditions, these networks can become dysregulated when challenged by overwhelming pathological stimuli. The COVID-19 pandemic exemplified these vulnerabilities, revealing profound inter-individual variability in immune activation that shaped susceptibility, disease progression, and outcomes. Similar variability extends to autoimmune disorders, cancer, and neurodegenerative diseases, where immunity and hemostasis govern detection, response, and chronicity. Artificial-intelligence models now propose an "immunological age," reflecting cumulative immune behavior and predictive disease risk. Nevertheless, pathologies may escape immune-hemostatic control and become refractory to therapy, leading to severe complications or fatal outcomes, as emphasized previously. This review synthesizes current understanding of the molecular, cellular, and systemic interplays linking immunity, inflammation, hemostasis, fibrinolysis, and RAAS. We highlight how these interdependent pathways shape disease expression across infections, autoimmunity, sepsis, malignancy, and cardiometabolic syndromes. In addition, we examine emerging laboratory biomarkers, such as NETs, Annexin A1, micro-RNAs, sACE2, and procoagulant platelets, that now provide unprecedented insights into immunothrombosis and thrombo-inflammation. By integrating mechanistic biology with diagnostic innovation, this narrative presents a unified perspective on immune-hemostatic interactions and outlines how these insights may reshape therapeutic strategies and precision medicine.},
}

Humans
*COVID-19/immunology/blood
*Hemostasis/immunology
*SARS-CoV-2
Inflammation/immunology
Renin-Angiotensin System/immunology

@article {pmid42049130,
year = {2026},
author = {de la Mota, S and Suchet, L and van Wijk, M and Stibbs, DJ and Silva Couto, P and Rafiq, QA},
title = {On the road to in vivo CAR-T success: Comparing promising viral and non-viral vectors.},
journal = {Biotechnology advances},
volume = {90},
number = {},
pages = {108907},
doi = {10.1016/j.biotechadv.2026.108907},
pmid = {42049130},
issn = {1873-1899},
mesh = {Humans ; *Immunotherapy, Adoptive/methods ; *Genetic Vectors/genetics ; *Receptors, Chimeric Antigen/genetics/immunology/therapeutic use ; Animals ; Genetic Therapy/methods ; Nanoparticles ; Gene Transfer Techniques ; Viruses/genetics ; Lentivirus/genetics ; },
abstract = {Chimeric antigen receptor (CAR)-T-cell therapies have demonstrated substantial efficacy in haematological malignancies, with multiple products approved for clinical use. However, broader application remains limited by severe toxicities, reduced efficacy toward solid tumours, and the high cost and complexity of ex vivo manufacturing. The autologous nature of most current therapies contributes to variable product quality, lengthy vein-to-vein times, and restricted patient access. In vivo CAR-T therapy has emerged as a potential solution, aiming to generate functional CAR-T-cells within the patient, with several platforms progressing into early Phase I clinical trials. This approach eliminates reliance on patient-derived starting material, reduces manufacturing failure rates, and offers the prospect of off-the-shelf availability at lower cost. Central to in vivo CAR-T development is selecting an appropriate gene delivery platform. Viral vectors, including lentiviral, adenoviral, and adeno-associated viral systems, have an established role in ex vivo CAR-T manufacturing and in vivo gene therapies. Non-viral vectors, such as lipid nanoparticles (LNP) and polyplexes, have garnered increasing attention due to their high packaging capacity, potential for redosing, and validation in large-scale production, as exemplified by mRNA-LNP vaccines against COVID-19. Recently, the in vivo CAR-T engineering toolbox has expanded with DNA-based LNP platforms capable of stably integrating CAR transgenes via transposon systems, fourth-generation T-cell-targeted lentiviral systems that minimise CAR display on vector particles and aberrant splicing, and emerging genome-editing technologies. This review compares viral and non-viral vectors for in vivo CAR-T therapy, evaluating their relative advantages and limitations in terms of safety, efficacy, scalability, analytical methods, regulatory implementation and commercial feasibility.},
}

Humans
*Immunotherapy, Adoptive/methods
*Genetic Vectors/genetics
*Receptors, Chimeric Antigen/genetics/immunology/therapeutic use
Animals
Genetic Therapy/methods
Nanoparticles
Gene Transfer Techniques
Viruses/genetics
Lentivirus/genetics

@article {pmid42050447,
year = {2026},
author = {El-Saed, A and Al-Fayez, S and AlAmeer, K and Zunitan, MA and Othman, F and Farahat, F and Fletcher, T and Okwor, T and Mahamed, H and Hurwitz, HH and Willet, V and Alshamrani, MM and Baller, A},
title = {Secondary attack rates after mpox exposure in multiple settings during the 2022-2024 pandemic: a systematic review.},
journal = {BMC infectious diseases},
volume = {26},
number = {1},
pages = {},
pmid = {42050447},
issn = {1471-2334},
mesh = {Humans ; *SARS-CoV-2/genetics ; *COVID-19/epidemiology/transmission/virology ; *Pandemics ; },
abstract = {BACKGROUND: Estimating secondary attack rates is essential for assessing the spread potential of mpox during an outbreak. The objective of the study was to assess secondary attack rates after mpox exposure in multiple settings worldwide.

METHODS: A systematic review was conducted for studies published between May 2022 and September 2024 and reporting mpox exposure data. The levels and types of exposure were defined as per the study description.

RESULTS: A total of 62 studies including 8712 mpox exposures were included. Out of 8712 exposures, 239 were associated with mpox infection (secondary attack rate of 2.74%). The rates were highest in household setting (4.02%), intermediate in congregate/community setting (2.50%), and lowest in healthcare setting (0.81%). The rates were highest in the African region (8.00%), intermediate in the European region (4.23%), and lowest in the American region (1.10%). Clade data were available in 17 (27.42%) studies; mainly clade IIb (15 studies) and to less extent clades Ia and Ib (one study each). Secondary attack rates were higher among individuals reporting sexual contact (11.35%) compared with non-sexual contact (1.34%, p < 0.001). Non-sexual contact exposures (83.17%) were more frequent (p < 0.001) than sexual contact exposures (13.66%, p < 0.001).

CONCLUSIONS: The overall mpox secondary attack rate in the published data from the 2022-2024 multi-country outbreak is relatively low (< 3%). While exposures involving non-sexual contact were more prevalent in all settings, sexual contact was responsible for the majority of secondary infections in household and congregate/community settings. The findings may guide mpox preventive and control activities in different settings.

CLINICAL TRIAL: Not applicable.},
}

Humans
*SARS-CoV-2/genetics
*COVID-19/epidemiology/transmission/virology
*Pandemics

@article {pmid42050591,
year = {2026},
author = {Tan, E and Loveys, K and Ali, W and McKinlay, CJD and Dalziel, SR},
title = {Digital tools for recruitment and retention of participants in paediatric clinical research: a scoping review.},
journal = {Trials},
volume = {27},
number = {1},
pages = {},
pmid = {42050591},
issn = {1745-6215},
support = {19/003//Health Research Council of New Zealand/ ; 17/614//Health Research Council of New Zealand/ ; },
mesh = {Adolescent ; Child ; Child, Preschool ; Humans ; Biomedical Research/methods ; COVID-19/epidemiology ; *Digital Health ; *Digital Media ; Pandemics ; *Patient Selection ; *Pediatrics/methods ; SARS-CoV-2 ; Social Media ; *Clinical Trials as Topic ; },
abstract = {BACKGROUND: Digital tools are increasingly used to support recruitment and retention of participants in paediatric research, particularly since the COVID-19 pandemic. However, the extent of the evidence supporting this method in paediatric populations has yet to be evaluated. This scoping review aimed to review the literature on digital tools for recruitment and/or retention of participants in paediatric research, including emerging evidence following the pandemic.

METHODS: A scoping review was conducted following Joanna Briggs Institute methodology. We included peer-reviewed quantitative, qualitative, and mixed-method studies evaluating a digital tool for recruitment or retention in paediatric research in any patient population aged <13 years. Records were identified from systematic database searches with a librarian (EMBASE, MEDLINE, CINAHL), limited to English, from 2013 onwards (last search 03/07/2024), and manual searches. Records were screened and extracted independently in duplicate. The data were charted and narratively summarised.

RESULTS: Sixty-one out of 4988 records were included. Most evaluations used an observational design; only 5 (8%) involved a randomised experiment. The host studies were mostly aiming to recruit children aged 5-12 years (n = 42; 69%), with a predominantly health promotion (n = 18; 30%), developmental (n = 12; 20%), or oncology (n = 9; 15%) focus. Most studies used multi-component digital interventions for recruitment (n = 39/53; 74%) or retention (n = 17/31; 55%). Social media (n = 33/52; 62%) and websites (n = 19/53; 36%) were most commonly used for recruitment, whereas text/instant messaging (n = 17/31; 55%) and email (n = 11/31; 36%) were the most common retention strategies. The estimates of recruitment and retention rates, and reach per digital tool varied widely between studies. Strategies in underserved populations reflected those used most commonly overall. Multi-component digital strategies were found to support a high rate of retention (84.1-90.7%) during pandemic restrictions.

CONCLUSIONS: This scoping review highlights the broad array of digital tools that have been used to support recruitment and retention in studies of infants and children, including in subgroups of underserved populations and in response to the COVID-19 pandemic. Most evaluations were observational and examined multi-component digital interventions. The lack of studies with a robust analytical design in the literature signals a need for further high-quality, randomised, within-study evaluations following standardised reporting criteria.

REGISTRATION: The protocol was registered on the Open Science Framework (OSF) at https://osf.io/ybfhr/ . Registered on July 5 2024.},
}

Adolescent
Child
Child, Preschool
Humans
Biomedical Research/methods
COVID-19/epidemiology
*Digital Health
*Digital Media
Pandemics
*Patient Selection
*Pediatrics/methods
SARS-CoV-2
Social Media
*Clinical Trials as Topic

@article {pmid42051502,
year = {2026},
author = {Huang, S and Zhang, X and Luo, W and Yao, Y and Hu, J and Wang, X and Xin, H},
title = {Drugs against broad-spectrum of coronaviruses.},
journal = {Frontiers in immunology},
volume = {17},
number = {},
pages = {1728474},
pmid = {42051502},
issn = {1664-3224},
mesh = {Humans ; *Antiviral Agents/therapeutic use/pharmacology ; *SARS-CoV-2/drug effects ; *COVID-19 Drug Treatment ; Medicine, Chinese Traditional ; Animals ; Coronavirus/drug effects ; COVID-19/virology ; },
abstract = {The continuous emergence of severe acute respiratory type 2 coronavirus (SARS-CoV-2) variants (e.g., Omicron) and the threat of future emerging coronavirus pandemics highlight the urgent need for broad-spectrum antiviral strategies. While various therapeutics exist, a systematic integration of diverse treatment modalities remains lacking. This review introduces a comprehensive conceptual framework that compares and integrates four major therapeutic categories: small-molecule drugs (targeting viral enzymes), macromolecular drugs (including peptides and polymers), Traditional Chinese Medicine (TCM, focusing on holistic regulation and active ingredients), and carrier vector vaccines. Beyond traditional pharmacology, we further incorporate the emerging role of Artificial Intelligence (AI) and computational screening in accelerating the discovery of broad-spectrum inhibitors. The primary goal of this article is to: (1) critically analyze the distinct antiviral mechanisms, advantages, and limitations of each category; (2) explore synergistic combination therapies (e.g., combining antiviral drugs with immunomodulators or TCM) to overcome drug resistance; and (3) provide a strategic reference for developing "pan-coronavirus" therapeutics that are resilient against viral mutations.},
}

Humans
*Antiviral Agents/therapeutic use/pharmacology
*SARS-CoV-2/drug effects
*COVID-19 Drug Treatment
Medicine, Chinese Traditional
Animals
Coronavirus/drug effects
COVID-19/virology

@article {pmid42051540,
year = {2026},
author = {Jin, H and An, Y and Huang, J and Luo, T and Wu, X},
title = {Pathophysiological mechanisms of post-exertional malaise: an integrative analysis based on the metabolism-immune-neuro interaction model.},
journal = {Frontiers in immunology},
volume = {17},
number = {},
pages = {1774310},
pmid = {42051540},
issn = {1664-3224},
mesh = {Humans ; *COVID-19/immunology/complications/metabolism ; Post-Acute COVID-19 Syndrome ; Mitochondria/metabolism ; *Fatigue Syndrome, Chronic/immunology/physiopathology/metabolism ; *SARS-CoV-2/immunology ; Neuroimmunomodulation ; Animals ; Exercise ; Reactive Oxygen Species/metabolism ; Energy Metabolism ; },
abstract = {Post-exertional malaise (PEM) is a common core symptom in various chronic debilitating conditions, such as Post COVID-19 Condition (PCC, also known as Long COVID) and Chronic Fatigue Syndrome (CFS). It is characterized by the delayed and persistent exacerbation of symptoms following even mild physical or cognitive activities. This review presents a systematic review of the pathophysiological mechanisms involved in PEM, proposing a dynamic framework of multi-system interactions that may lead to homeostatic imbalance. The etiology of PEM is multifactorial, potentially involving factors such as the persistent presence of pathogens, exposure to environmental toxins, and genetic predisposition. Collectively, these factors may establish a vulnerable baseline that heightens the body's physiological response to stressors, such as exercise, potentially triggering a pathological reaction. First, mitochondrial dysfunction and metabolic abnormalities may act as potential initiating factors in PEM, manifesting as impaired ATP synthesis, overproduction of reactive oxygen species (ROS), and the accumulation of metabolic byproducts. It is crucial to emphasize that exercise itself induces a 'toxic excitatory effect,' whereby healthy individuals enhance mitochondrial function and antioxidant defenses through physical activity. However, in individuals predisposed to PEM, due to underlying pathological conditions (e.g., sequelae of viral infections), this adaptive process is disrupted, preventing effective restoration of mitochondrial homeostasis and may initiate a potential vicious cycle of dysfunction. Second, ROS and mitochondrial DNA (mtDNA), as damage-associated molecular patterns (DAMPs), along with pathogen-associated molecular patterns (PAMPs), may activate the NLRP3 inflammasome and induce the release of pro-inflammatory cytokines such as IL-1β, IL-6, and TNF-α, potentially transforming localized metabolic stress into a systemic inflammatory response. Subsequently, peripheral inflammation may be transmitted to the central nervous system through disruption of the blood-brain barrier and vagal nerve pathways, activating glial cells and initiating neuroinflammation. This process may ultimately affect the brain's interoceptive network, particularly the insular cortex, resulting in altered perception and processing of signals related to fatigue and pain. Furthermore, mitochondrial dysfunction in neurons may contribute to central energy depletion, which may impair synaptic plasticity and induce cognitive deficits and brain fatigue. Ultimately, this review proposes that PEM may arise from a complex interplay among mitochondrial dysfunction, immune activation, and neuroinflammation, which together form a self-perpetuating loop of "energy exhaustion - inflammation amplification," potentially contributing to the chronic and multi-system nature of PEM symptoms. The integrated "metabolism-immune-neuro" interaction model presented in this article may provide a potential comprehensive framework for understanding PEM and highlights the need for a multi-target, collaborative intervention approach that may help disrupt the pathological cycle.},
}

Humans
*COVID-19/immunology/complications/metabolism
Post-Acute COVID-19 Syndrome
Mitochondria/metabolism
*Fatigue Syndrome, Chronic/immunology/physiopathology/metabolism
*SARS-CoV-2/immunology
Neuroimmunomodulation
Animals
Exercise
Reactive Oxygen Species/metabolism
Energy Metabolism

@article {pmid42051939,
year = {2026},
author = {do Nascimento, BB and Silva, BGB and de Souza, LA and Andrade, JCBN and de Sá Del Fiol, F},
title = {From Widespread Use to Loss of Effectiveness: The Consequences of Inappropriate Azithromycin Prescriptions During the COVID-19 Pandemic-A Systematic Review and Meta-Analysis.},
journal = {International journal of microbiology},
volume = {2026},
number = {},
pages = {8643896},
pmid = {42051939},
issn = {1687-918X},
abstract = {OBJECTIVES: We are aimed at evaluating whether the widespread use of azithromycin during the COVID-19 pandemic led to a significant increase in bacterial resistance compared with the prepandemic period and estimating the magnitude of this effect through a systematic review and meta-analysis.

METHODS: This systematic review followed the PRISMA 2020 guidelines and Cochrane Handbook (Page,2021). Observational studies published between 2015 and 2025 reporting azithromycin resistance before and after the COVID-19 pandemic were identified. Odds ratios (ORs) were pooled using a random-effects model. Methodological quality was assessed using the Newcastle-Ottawa scale.

RESULTS: Eight studies met the eligibility criteria and were included in the quantitative synthesis. The meta-analysis demonstrated a significant increase in azithromycin resistance in the postpandemic period, with a pooled OR of 2.71 (95% CI: 2.04-3.59). Substantial heterogeneity was observed (I [2] = 73.5%), justifying the use of a random-effects model.

CONCLUSIONS: The findings provide robust evidence that the excessive and largely empirical use of azithromycin during the COVID-19 pandemic contributed to a global rise in bacterial resistance. Strengthening antimicrobial stewardship policies is essential to preserve the clinical effectiveness of macrolides during future public health emergencies.},
}

@article {pmid42051949,
year = {2026},
author = {Mugundan, UM and Saravanan, V and Rajanandh, MG},
title = {Could excessive zinc supplementation during pregnancy cause menkes disease? A hypothesis worth investigating.},
journal = {Frontiers in pediatrics},
volume = {14},
number = {},
pages = {1734361},
pmid = {42051949},
issn = {2296-2360},
abstract = {BACKGROUND: Copper is an essential micronutrient critical for fetal neurodevelopment, haematopoiesis, angiogenesis, and immune function, with maternal transfer-particularly in the third trimester-playing a key role in establishing fetal copper stores. Disruption of this process, due to genetic defects or micronutrient imbalance, can lead to significant neonatal complications.

OBJECTIVE: This review examines the potential role of excessive maternal zinc supplementation as an underrecognized environmental modifier in Menkes disease (MD), an X-linked disorder caused by mutations in the ATP7A copper transporter. We hypothesize that in fetuses with ATP7A dysfunction, elevated maternal zinc intake may further impair copper absorption and placental transfer through competitive antagonism, thereby exacerbating fetal copper deficiency and influencing disease severity or onset.

EVIDENCE: Limited clinical data in pregnant women demonstrate that zinc supplementation can reduce maternal and fetal copper levels, supported by consistent findings from animal models and case reports indicating disrupted copper homeostasis. However, no large-scale or disease-specific studies have evaluated this interaction in relation to Menkes disease or neonatal outcomes.

CONCLUSION: Given the widespread use of zinc supplementation, particularly during the COVID-19 era, its impact on fetal copper status in genetically susceptible populations warrants urgent investigation. Targeted retrospective analyses and well-designed prospective studies are needed to validate this hypothesis. A re-evaluation of prenatal micronutrient strategies with emphasis on trace element balance may improve risk stratification and optimize maternal-fetal health outcomes.},
}

@article {pmid42052276,
year = {2026},
author = {Han, S and Qin, T and Feng, Z},
title = {Artificial intelligence and synthetic biology in traditional Chinese medicine: revolutionizing public health applications.},
journal = {Frontiers in plant science},
volume = {17},
number = {},
pages = {1789960},
pmid = {42052276},
issn = {1664-462X},
abstract = {Traditional Chinese Medicine (TCM) has played a vital role in public health throughout history, particularly evidenced during the COVID-19 pandemic, where it demonstrated both accessibility and clinical efficacy. However, TCM faces critical challenges, including unsustainable medicinal resources, ambiguous multi-target mechanisms, and a lack of standardized clinical evaluation systems. Addressing these issues requires interdisciplinary integration, particularly between synthetic biology and artificial intelligence (AI). Synthetic biology offers solutions to resource scarcity and production standardization by enabling the sustainable biosynthesis of active compounds. Meanwhile, AI enhances TCM research through bioinformatics-driven compound prediction, machine learning-assisted quality control, and network pharmacology-based mechanism elucidation. AI also improves diagnostic reproducibility, aligning with synthetic biology's precision-driven framework. Together, these technologies facilitate the transformation of TCM from an experience-based practice into a standardized, evidence-based public health intervention. This review highlights the synergistic potential of AI and synthetic biology in overcoming TCM's modernization barriers. By leveraging AI for data-driven drug discovery and synthetic biology for scalable production, TCM can achieve sustainable development while retaining its therapeutic value. Future efforts should focus on enhancing AI interpretability, expanding biological databases, and optimizing cross-disciplinary collaboration to fully realize this integration.},
}

@article {pmid42052932,
year = {2024},
author = {Williams, TR and Bass, JE and Swain, M and Jennings, D and Wyatt, WN and Foster, S},
title = {Unpacking the stress of 2020: Black Americans cope with systemic trauma.},
journal = {Clinical psychology & psychotherapy},
volume = {31},
number = {1},
pages = {e2944},
doi = {10.1002/cpp.2944},
pmid = {42052932},
issn = {1099-0879},
support = {//American Association of University Women/ ; },
mesh = {Humans ; *Black or African American/psychology ; *COVID-19/psychology/ethnology ; United States ; *Adaptation, Psychological ; *Psychological Trauma/psychology/ethnology/therapy ; *Stress, Psychological/psychology/ethnology ; Racism/psychology ; Grief ; Posttraumatic Growth, Psychological ; },
abstract = {The year 2020 was a challenging and traumatic year for Americans, especially Black Americans. Many Black people quickly succumbed to Coronavirus Disease 2019 (COVID-19). This paper describes systemic trauma as a lens to conceptualize the effects of COVID-19, racial stress and trauma, and grief. A recount of the events during the year 2020 is reviewed. Racism towards Black people was at an all-time high. Complicated and collective grief was ever-present. As a by-product of COVID-19, economic and health disparities resurfaced to further complicate Black people's well-being. Systemic trauma is described as a comprehensive and inclusive framework that captures the intensity and depth of the trauma Black Americans experienced. We argue that culturally appropriate interventions are needed to help Black people continue to heal from the distress of 2020. Race-informed trauma treatment is a culturally appropriate intervention that facilitates healing, improves the quality of life, and fosters posttraumatic growth for Black Americans. We offer race-informed treatment as a theoretical orientation that can facilitate healing and posttraumatic growth for Black people.},
}

Humans
*Black or African American/psychology
*COVID-19/psychology/ethnology
United States
*Adaptation, Psychological
*Psychological Trauma/psychology/ethnology/therapy
*Stress, Psychological/psychology/ethnology
Racism/psychology
Grief
Posttraumatic Growth, Psychological

@article {pmid42053299,
year = {2026},
author = {Darko, E and Akortia, D and Nkrumah, G and Opoku Agyapong, F and Twumasi-Ankrah, S and Owusu-Ansah, M and Glazik, R and Shaw, A and Grassly, N and Owusu-Dabo, E and Adu-Sarkodie, Y and Owusu, M},
title = {Environmental surveillance of pathogens in Africa.},
journal = {Applied and environmental microbiology},
volume = {92},
number = {5},
pages = {e0193225},
pmid = {42053299},
issn = {1098-5336},
support = {INV-INV-076273//Bill and Melinda Gates Foundation/ ; },
mesh = {Africa/epidemiology ; *Environmental Monitoring/methods ; Viruses/isolation & purification ; Bacteria/isolation & purification ; Humans ; Fungi/isolation & purification ; },
abstract = {The control of infectious diseases depends on effective diagnostics and interventions. In Africa, resource limitations hinder clinical surveillance. Environmental surveillance (ES), particularly wastewater surveillance, offers a cost-effective alternative. While globally expanding, its application in Africa remains limited. This review aimed to describe published studies in Africa that have utilized ES for the detection of infectious pathogens of public health importance in Africa. The study employed a rapid review approach to synthesize evidence on ES of infectious pathogens in Africa, following guidance from the Cochrane Rapid Reviews Methods. Articles from major databases, including Scopus, PubMed, Science Direct, and Cochrane, were screened using Catchii.org. Duplicates were removed, and data were extracted into Excel, and study quality was appraised using the AXIS tool and a modified Newcastle-Ottawa Scale. The search strategy identified 2,189 articles, of which 90 were found to be eligible. We identified 47 microbial species that have been reported across studies. These consisted of 46.8% bacteria (n = 22), 36.2% viruses (n = 17), 4.3% fungi (n = 2), and 12.7% parasites (n = 6). Among viruses identified, SARS-CoV-2 was the most common, followed by rotaviruses and polioviruses. Vibrio cholerae was mostly reported among bacterial pathogens. The most common sampling method was grab sampling (n = 85, 94.4%), while two-phase separation (n = 22, 37.3%) and filtration (n = 11, 39.3%) were the most frequently used concentration methods for viral and bacterial detection, respectively. ES of infectious pathogens in Africa remains limited. There is a need to expand this to enhance pathogen monitoring, transmission insights, and preparedness for emerging variants.},
}

Africa/epidemiology
*Environmental Monitoring/methods
Viruses/isolation & purification
Bacteria/isolation & purification
Humans
Fungi/isolation & purification

@article {pmid42053373,
year = {2026},
author = {Pfannschmidt, V and Röhren, F and Stollenwerk, A and Leonhardt, S},
title = {A systematic review of pandemic ventilator designs.},
journal = {Biomedizinische Technik. Biomedical engineering},
volume = {},
number = {},
pages = {},
pmid = {42053373},
issn = {1862-278X},
abstract = {This paper presents a systematic literature research and review of ventilator systems developed during the COVID-19 pandemic. Peer-reviewed journal and conference articles published through January 16th, 2025 were screened, and eligible systems were classified by actuation principle. Performance criteria were derived from Emergency Use Authorization requirements and used to generate a score-based ranking for each class. Performance was analyzed within and across classes to identify the situations in which each actuation principle is most advantageous. As an indicator of study quality, we evaluated the testing modalities reported for each device. Valve-based ventilators emerged as the most mature class in terms of ventilation functionality and testing. An emerging class of bag-based systems performed remarkably well compared with established valve- and blower-based designs. Across all three classes, the most frequent shortcomings concerned oxygen dosage of the inspired gas and the implementation of monitoring and alarm functions. Finally, we provide recommendations on development processes, testing procedures, and mitigation of supply-chain vulnerabilities that may support ventilator development in future pandemics.},
}

@article {pmid42053725,
year = {2026},
author = {Ardizzone, A and Agoy, CA and Carota, G and Altruda, I and Erba, I and Del Re, M and Esposito, E and Caruso, G},
title = {Assessing the Risk of Myocarditis Post-COVID-19 Vaccination: A Systematic Review of Case Reports from 2023 to 2025.},
journal = {Cardiovascular toxicology},
volume = {26},
number = {5},
pages = {},
pmid = {42053725},
issn = {1559-0259},
mesh = {Humans ; *Myocarditis/chemically induced/therapy/diagnosis/epidemiology ; *COVID-19 Vaccines/adverse effects ; Male ; Adolescent ; Risk Factors ; Risk Assessment ; Young Adult ; Female ; *Vaccination/adverse effects ; *COVID-19/prevention & control ; Child ; Adult ; Case Reports as Topic ; Middle Aged ; },
abstract = {COVID-19 vaccines covered a crucial role in mitigating the pandemic; however, rare adverse events such as myocarditis continue to raise safety concerns. This systematic review evaluated whether the clinical profile and outcomes of COVID-19 vaccine–associated myocarditis (CVAM) have changed in the post-2022 era. Following PRISMA guidelines, case reports published between 2023 and 2025 were identified through Web of Science, Embase, and PubMed (MEDLINE). Twenty-eight articles describing 35 patients were included. CVAM predominantly affected males, with the highest frequency among adolescents aged 10–19 years, and most cases occurred after the second vaccine dose, typically within two weeks. Chest pain was the most common presenting symptom, followed by tachycardia, fever, and dyspnea. Elevated cardiac biomarkers, electrocardiographic abnormalities, and myocardial edema on cardiac magnetic resonance imaging were frequently observed, with reduced left ventricular ejection fraction in a subset of patients. Management ranged from nonsteroidal anti-inflammatory drugs and colchicine to immunosuppressive therapy and mechanical circulatory support in severe cases. Although many patients experienced clinical improvement, fatal cases were documented, and follow-up revealed persistent late gadolinium enhancement and recurrent arrhythmias in several individuals, indicating incomplete myocardial recovery. Unlike earlier reviews reporting largely mild and self-limiting disease, this 2023–2025 case series documents fatal outcomes, persistent myocardial fibrosis, and recurrent arrhythmias, suggesting that CVAM may lead to long-term cardiac sequelae in a subset of patient. These findings indicate that contemporary clinical spectrum of CVAM may be broader and more severe than previously recognized, underscoring the need for prolonged surveillance and updated management strategies.},
}

Humans
*Myocarditis/chemically induced/therapy/diagnosis/epidemiology
*COVID-19 Vaccines/adverse effects
Male
Adolescent
Risk Factors
Risk Assessment
Young Adult
Female
*Vaccination/adverse effects
*COVID-19/prevention & control
Child
Adult
Case Reports as Topic
Middle Aged

@article {pmid42054706,
year = {2026},
author = {Vilaseca, A and Toledano, M and Flanagan, EP},
title = {Complexities in evaluation and management of infectious myelopathies.},
journal = {Current opinion in infectious diseases},
volume = {39},
number = {3},
pages = {227-239},
doi = {10.1097/QCO.0000000000001204},
pmid = {42054706},
issn = {1473-6527},
mesh = {Humans ; Myelitis/diagnosis/virology ; *COVID-19/complications/epidemiology ; *Spinal Cord Diseases/diagnosis/virology ; SARS-CoV-2 ; Magnetic Resonance Imaging ; Neuromuscular Diseases ; Central Nervous System Viral Diseases ; },
abstract = {PURPOSE OF REVIEW: To review recent advances in infectious myelopathies and integrate them into a practical, syndrome-based approach that supports early recognition, guides testing, and avoids pitfalls.

RECENT FINDINGS: Advances in MRI pattern recognition and pathogen-specific diagnostics have refined the evaluation of infectious myelopathies, with strategies tailored to geographic epidemiology, host susceptibility, and distinction from immune-mediated causes. During the COVID-19 pandemic, SARS-CoV-2-associated myelopathy emerged as a rare para- or postinfectious cause of myelitis. The pandemic coincided with a decline in enterovirus outbreaks and acute flaccid myelitis, which are now re-emerging, underscoring the importance of epidemiologic surveillance. Metagenomic next-generation sequencing is useful in suspected infectious myelopathy because it can identify unexpected pathogens from cerebrospinal fluid, but its imperfect sensitivity and contamination risk mean it should complement rather than replace conventional testing. Growing recognition of compartmentalized central nervous system inflammation and cerebrospinal fluid viral escape in HIV myelopathy has shifted management toward antiretroviral resistance patterns and treatment optimization. Therapeutic advances remain limited and largely pathogen-specific, although targeted approaches such as mogamulizumab for HTLV-1-associated myelopathy are promising.

SUMMARY: Recent progress in infectious myelopathies has been driven by improved pathogen detection and more tailored diagnostic strategies, although treatment advances are beginning to emerge.},
}

Humans
Myelitis/diagnosis/virology
*COVID-19/complications/epidemiology
*Spinal Cord Diseases/diagnosis/virology
SARS-CoV-2
Magnetic Resonance Imaging
Neuromuscular Diseases
Central Nervous System Viral Diseases

@article {pmid42055480,
year = {2026},
author = {Lu, X and Shi, Y and Chen, L and Jiang, X and Wang, Z and Tu, Y},
title = {Recombinant human interleukin-7 for patients with infection-associated lymphopenia: a systematic review and meta-analysis.},
journal = {Respiratory medicine},
volume = {257},
number = {},
pages = {108858},
doi = {10.1016/j.rmed.2026.108858},
pmid = {42055480},
issn = {1532-3064},
mesh = {Humans ; *Interleukin-7/therapeutic use ; *Lymphopenia/drug therapy/etiology/mortality ; *COVID-19/complications/mortality ; *Sepsis/complications ; Recombinant Proteins/therapeutic use ; Lymphocyte Count ; Randomized Controlled Trials as Topic ; Length of Stay ; SARS-CoV-2 ; Intensive Care Units ; *COVID-19 Drug Treatment ; },
abstract = {PURPOSE: This study aims to evaluate the efficacy of recombinant human interleukin-7 (rhIL-7) in treating lymphopenia and related clinical outcomes in patients with infection-associated lymphopenia through a meta-analysis.

METHODS: A Literature retrieval was conducted across databases, including the Cochrane Library, Web of Science, PubMed, Embase, SinoMed, CNKI, Wanfang, and VIP from the inception until October 2025. Randomized controlled trials of rhIL-7 for the treatment of lymphopenia were screened and identified for eligibility. Primary outcomes included absolute lymphocyte counts (ALC), mortality, intensive care unit (ICU) length of stay, and incidence of secondary infections.

RESULTS: Four studies were included, covering sepsis and COVID-19. In septic patients, rhIL-7 significantly increased ALC (MD = 1.33 at 3 weeks; 95% CI [0.29, 2.38]; MD = 1.14 at 4 weeks; 95% CI [0.02, 2.25]), CD4[+] T-cell counts (MD = 0.56 at 3 weeks; 95% CI [0.08, 1.05]) and CD8[+] T-cell counts (MD = 0.40 at 2 weeks; 95% CI [0.05, 0.76]). However, rhIL-7 failed to reduce mortality (RR = 1.01; 95% CI [0.36, 2.81]) or the incidence of secondary infections (RR = 1.05; 95% CI [0.48, 2.30]) in patients with sepsis. In patients with COVID-19, rhIL-7 did not significantly increase ALC at 30 days (MD = 0.46; 95% CI [-0.15, 1.08]) or reduce mortality (RR = 0.85; 95% CI [0.55, 1.33]), but it did significantly reduce the incidence of secondary infections (RR = 0.58; 95% CI [0.46, 0.74]; p < 0.0001). A combined analysis revealed that rhIL-7 significantly increased ALC (MD = 1.15 at 3 weeks; 95% CI [0.47, 1.84]; MD = 0.80 at 4 weeks; 95% CI [0.24, 1.36]) and reduced the risk of secondary infections (RR = 0.64; 95% CI [0.50, 0.81]), but had no effect on mortality or ICU length of stay.

CONCLUSION: RhIL-7 effectively ameliorates sepsis-associated lymphopenia but does not improve prognosis. Although rhIL-7 reduces the incidence of secondary infections in COVID-19 patients, confounding factors related to the pandemic context must be taken into account.},
}

Humans
*Interleukin-7/therapeutic use
*Lymphopenia/drug therapy/etiology/mortality
*COVID-19/complications/mortality
*Sepsis/complications
Recombinant Proteins/therapeutic use
Lymphocyte Count
Randomized Controlled Trials as Topic
Length of Stay
SARS-CoV-2
Intensive Care Units
*COVID-19 Drug Treatment

@article {pmid42055829,
year = {2026},
author = {Shammout, M and Abdullah, J and Shammout, A and Williams, R and Mcmillan, K},
title = {A call for fixed standards: a decade of orthognathic surgery, biting into revision rates and metalwork removal.},
journal = {The British journal of oral & maxillofacial surgery},
volume = {64},
number = {6},
pages = {457-463},
doi = {10.1016/j.bjoms.2026.03.011},
pmid = {42055829},
issn = {1532-1940},
mesh = {Humans ; *Hardware Removal/statistics & numerical data ; *Bone Plates ; *Orthognathic Surgical Procedures/instrumentation/standards ; Retrospective Studies ; *Reoperation/statistics & numerical data ; Female ; Male ; Titanium ; Adult ; *Device Removal/statistics & numerical data ; Benchmarking ; },
abstract = {The removal rate of titanium miniplates following orthognathic surgery varies widely (3.2-27.5%) due to inconsistent study designs and mixed samples. Plate removal is not routinely conducted in the UK. A 2019-2020 meta-analysis reported a 13.4% removal rate, though regular audits are uncommon. This study evaluates whether audit of local plate removal rates against established benchmarks merits encouragement. A retrospective review was conducted of orthognathic surgery at a tertiary centre (2014-2024). Procedures included Le Fort osteotomy, bilateral sagittal split osteotomy (BSSO), bimaxillary osteotomy (BIMAX), genioplasty, and other mandibular osteotomies. All patients received two postoperative doses of dexamethasone and intravenous antibiotics. Data collected included demographics, smoking status, surgical site, re-plating, and antibiotic use. The primary outcome was return to theatre (RTT) for plate removal or replacement. Chi squared, Fisher's exact, and binomial tests were used to assess statistical significance. Over 10 years, 417 patients underwent 429 orthognathic procedures, including 12 revisions to achieve the desired skeletal and orthodontic outcome. Overall, metalwork removal/adjustment occurred in 46 cases, predominantly within the first year, with infection identified as the leading cause. The removal rate was 10.7% (46/429), consistent with the 13.4% benchmark (p = 0.12). Yearly rates generally aligned with the benchmark, except in 2021, when deviations were likely to have been influenced by COVID-19-related disruptions. Smoking (p = 1.0) and oral antibiotics on discharge (p = 0.09) were not significantly associated with plate removal rates. These findings validate the 13.4% benchmark for metalwork removal. Routine audit and inter-unit collaboration are vital for refining benchmarks and improving patient care.},
}

Humans
*Hardware Removal/statistics & numerical data
*Bone Plates
*Orthognathic Surgical Procedures/instrumentation/standards
Retrospective Studies
*Reoperation/statistics & numerical data
Female
Male
Titanium
Adult
*Device Removal/statistics & numerical data
Benchmarking

@article {pmid42056917,
year = {2026},
author = {Bergqvist, E and Valerio-Shewmaker, M and Swartz, M and Patel, J and Padilla, L and Amavisca, XF and Gandhi, H and Messiah, SE},
title = {Association of race, ethnicity, and pediatric long COVID and MIS-C: a systematic review and meta-analysis.},
journal = {BMC infectious diseases},
volume = {26},
number = {1},
pages = {},
pmid = {42056917},
issn = {1471-2334},
mesh = {Humans ; *COVID-19/ethnology/epidemiology/complications ; Post-Acute COVID-19 Syndrome ; Child ; *Systemic Inflammatory Response Syndrome/ethnology/epidemiology ; SARS-CoV-2 ; *Ethnicity/statistics & numerical data ; Socioeconomic Disparities in Health ; *Racial Groups ; White ; },
abstract = {BACKGROUND: Pediatric long COVID and other post-COVID conditions, particularly in relation to racial, ethnic, and household social determinants, are not yet well understood. This study aims to synthesize evidence on racial and ethnic disparities in pediatric long COVID and related conditions like MIS-C.

METHODS: A systematic review and meta-analysis were performed on studies reporting post-COVID conditions and outcomes by race and ethnicity. Studies were identified through comprehensive database searches, screened for relevance, and assessed for quality. Data on race, ethnicity, and social determinants were extracted and analyzed using random-effects models to estimate pooled odds ratios. Sensitivity analyses were performed to address potential publication bias.

RESULTS: Non-Hispanic Black children had significantly higher odds of ICU admission (OR 1.89, 95% CI 1.01-3.28), MIS-C development (OR 2.37, 95% CI 1.43-3.90), and PIMS-TS (OR 16.28, 95% CI 9.24-28.70) compared to Non-Hispanic White children. Although Hispanic children showed a protective effect against severe MIS-C (OR 0.77, 95% CI 0.64-0.93), their MIS-C incidence remained higher (OR 2.70, 95% CI 1.10-6.65). Elevated risks of MIS-C death were observed for Asian/Pacific Islander (OR 6.79, 95% CI 1.2-38.52) and Alaskan Indian/Native American children (OR 4.07, 95% CI 3.4-44.53). Additionally, Asian children had increased odds of PIMS-TS (OR 6.42, 95% CI 2.70-15.27), while groups labeled as 'Other' were at higher odds for both PIMS-TS (OR 9.75, 95% CI 3.04-31.30) and MIS-C (OR 2.36, 95% CI 1.18-4.71).

CONCLUSIONS: Significant racial and ethnic disparities in pediatric long COVID, and MIS-C outcomes emphasize the need for targeted interventions addressing social and healthcare inequities.

CLINICAL TRIAL NUMBER: Not applicable.},
}

Humans
*COVID-19/ethnology/epidemiology/complications
Post-Acute COVID-19 Syndrome
Child
*Systemic Inflammatory Response Syndrome/ethnology/epidemiology
SARS-CoV-2
*Ethnicity/statistics & numerical data
Socioeconomic Disparities in Health
*Racial Groups
White

@article {pmid42057724,
year = {2026},
author = {Hay, JA and Larremore, DB and Aatresh, AV and Kissler, S},
title = {Integrating viral kinetics into routine outbreak surveillance: challenges, opportunities and lessons from COVID-19.},
journal = {Philosophical transactions of the Royal Society of London. Series B, Biological sciences},
volume = {381},
number = {1949},
pages = {},
doi = {10.1098/rstb.2024.0347},
pmid = {42057724},
issn = {1471-2970},
support = {//National Science Foundation/ ; /WT_/Wellcome Trust/United Kingdom ; },
mesh = {*COVID-19/virology/epidemiology ; Humans ; *SARS-CoV-2/physiology ; Pandemics ; Kinetics ; },
abstract = {Viral kinetics provide crucial insights into the biology and epidemiology of infections, with direct implications for basic science, therapeutics development and policy. The COVID-19 pandemic showcased the power of viral kinetics surveillance and modelling; however, our understanding of viral kinetics has been limited to retrospective analyses, convenience samples and bespoke models. To strengthen responses to ongoing and emerging outbreaks, we argue that viral kinetics should be a core component of pathogen surveillance. Building upon insights gained during the COVID-19 pandemic, we review ways that continuous viral kinetic surveillance supports infectious disease response by informing epidemiological parameters, development and deployment of therapeutics, and adaptive policy design. To achieve this, various challenges must be addressed regarding data standards, study design and communication. We advocate for the creation of a global, living library of viral kinetics data, with associated data sharing standards, modelling toolkits and on-demand epidemiological reports. Successfully integrating viral kinetics into active disease surveillance efforts will support both active outbreak response and improve the knowledge base vital for pandemic preparedness. This article is part of the Theo Murphy meeting issue 'Evaluating anti-infective drugs'.},
}

*COVID-19/virology/epidemiology
Humans
*SARS-CoV-2/physiology
Pandemics
Kinetics

@article {pmid42057741,
year = {2026},
author = {Mtei, M and Hien Trang, TP and Navarro-Torné, A and Douglas, IJ and Schultze, A},
title = {Approaches to observational study designs and analytical options to evaluate the safety of multi-dose vaccines: a systematic review.},
journal = {Expert review of vaccines},
volume = {25},
number = {1},
pages = {2667740},
doi = {10.1080/14760584.2026.2667740},
pmid = {42057741},
issn = {1744-8395},
mesh = {Humans ; *Observational Studies as Topic/methods ; *Research Design ; *Vaccines/administration & dosage/adverse effects ; *COVID-19 Vaccines/administration & dosage/adverse effects ; *Vaccination/adverse effects/methods ; },
abstract = {INTRODUCTION: Observational studies require careful considerations when evaluating the safety of multidose vaccines. We reviewed design and analytical approaches in observational studies evaluating the safety of multidose vaccines in the post-licensure phase.

METHODS: EMBASE, MEDLINE, Web of Science, and Scopus (2018-2022) were searched for hypothesis-testing studies evaluating the safety of multidose vaccines. Key features from frequently used designs were extracted.

RESULTS: Among 123 eligible studies, cohort (46%) and self-controlled case series (SCCS)/self-controlled risk interval (SCRI) (40%) followed by case-control (12%) were the most common designs, and 15% of studies used multiple designs. Among cohort studies evaluating multiple doses, vaccination date (36%) and cohort entry with time-updated exposure status (32%) were frequent approaches used to define time zero. Twenty-eight percent of cohort studies did not report time zero; all but one evaluated COVID-19 vaccine effect on post-delivery and fertility-related outcomes. For SCCS/SCRI, 64% of studies accounted for event-dependent exposures, mainly by including pre-exposure periods (53%) and modified SCCS model (48%), while 20% employed multiple correction strategies. Among studies using multiple designs, 68% reached consistent conclusions.

CONCLUSIONS: SCCS/SCRI and cohort designs dominate multidose vaccine safety studies. Clear reporting on time zero in pregnancy and fertility-related cohort studies, and on addressing event-dependent exposures in SCCS/SCRI studies is needed, along with guidance on interpreting results from multiple designs.},
}

Humans
*Observational Studies as Topic/methods
*Research Design
*Vaccines/administration & dosage/adverse effects
*COVID-19 Vaccines/administration & dosage/adverse effects
*Vaccination/adverse effects/methods

@article {pmid42058503,
year = {2026},
author = {Dimnjaković, J and Buble, T and Brborović, O},
title = {Observational studies on the association of outpatient antidiabetic medication use and COVID-19 outcomes: are the findings more relevant to diabetes management than to COVID-19 pathology? A mini-review.},
journal = {Frontiers in clinical diabetes and healthcare},
volume = {7},
number = {},
pages = {1760695},
pmid = {42058503},
issn = {2673-6616},
abstract = {At the start of the COVID-19 pandemic, there were concerns that some antidiabetic medications might worsen outcomes, though anti-inflammatory properties suggested possible benefits. Many observational studies examined antidiabetic medications use and COVID-19 outcomes. Meta-analyses showed that insulin was linked to worse outcomes, while metformin, sodium-glucose cotransporter 2 (SGLT-2) inhibitors, and glucagon-like peptide-1 (GLP-1) agonists were associated with better outcomes. Findings on dipeptidyl peptidase-4 (DPP-4) inhibitors, pioglitazone, and sulfonylureas were mixed-showing neutral, beneficial, or negative effects. However, randomized controlled trials (RCTs) testing these medications after SARS-CoV-2 infection found no effect on COVID-19 outcomes, implying that their anti-inflammatory effects do not translate into meaningful clinical benefits during acute infection. This discrepancy prompts questioning what observational studies actually measured. Given that many studies applied robust statistical methods, their results are unlikely solely due to confounding or indication bias. We hypothesize that these studies reveal broader cardiovascular effects and illuminate diabetes management more than they inform COVID-19 pathology. Their findings align with current 2022 American Diabetes Association/European Association for the Study of Diabetes (ADA/EASD) consensus guidelines for the management of type 2 diabetes mellitus endorsing metformin, SGLT-2 inhibitors, and GLP-1 agonists as first-line therapies, recommending cautious early insulin use, and reserving DPP-4 inhibitors, sulfonylureas, and pioglitazone for selective cases. This is applicable regardless of COVID-19 status. Further research should determine whether infection-related clinical endpoints, such as mortality or hospitalization from COVID-19 or other infections, might serve as valid surrogate markers for cardiovascular outcomes.},
}

@article {pmid42058812,
year = {2026},
author = {Ibrahim, Y and Qureshi, A and Jackson, M and Zovich, B and Freeland, C and Flomo, M and Alik, K and Yakubov, R and Chen, LH and Yeboah, PK and Cohen, C},
title = {Why does hepatitis B remain underprioritized? A view through lived experience.},
journal = {World journal of methodology},
volume = {16},
number = {2},
pages = {114604},
pmid = {42058812},
issn = {2222-0682},
abstract = {Nearly 259 million people are living with chronic hepatitis B globally, with just 7 million of them receiving life-saving treatment. In 2022, 83% of all viral hepatitis deaths were attributed to hepatitis B. Despite the availability of effective vaccines, diagnostics, and treatments, hepatitis B continues to be underprioritized on the global health agenda. Stigma and discrimination have been pervasive and entrenched in numerous countries, resulting in economic and social setbacks for people living with hepatitis B. Through the personal stories of several individuals living with hepatitis B worldwide, this article explores the question: Why does hepatitis B remain underprioritized? It walks through the roadblocks hindering the progress towards hepatitis B elimination efforts and draws lessons from other diseases - such as human immunodeficiency virus, coronavirus disease 2019, and Ebola, where advocacy, political commitment, and sustained funding led to meaningful progress in prevention, diagnosis, and treatment. This evidence-backed perspective is based on decades-long efforts of the Hepatitis B Foundation, collaborating with international partners to prevent new infections, documenting the lived experiences of those living with hepatitis B and supporting them, and advocating for better care and policies affecting those impacted by the disease. Beyond identifying persistent challenges to eliminating hepatitis B, the article succinctly issues a call to action for greater investment, cross-sector collaboration, integration of disease programs to improve efficiency, and inclusion of patient-reported outcomes in hepatitis B management and evaluation, to better support those living with hepatitis B.},
}

@article {pmid42059835,
year = {2026},
author = {Ávila-Aguero, ML and Brenes-Chacon, H and Falleiros-Arlant, LH and Brea-Del Castillo, J and Soriano-Fallas, A and Naranjo-Zúñiga, G and Sáez-Llorens, X and Gentile, A and Lopez-Medina, E and Muñoz, FM},
title = {COVID-19 in pediatrics in Latin America: six years later.},
journal = {Expert review of vaccines},
volume = {25},
number = {1},
pages = {2667741},
doi = {10.1080/14760584.2026.2667741},
pmid = {42059835},
issn = {1744-8395},
mesh = {Humans ; *COVID-19/prevention & control/epidemiology ; Latin America/epidemiology ; *Immunization Programs ; Child ; Pandemics/prevention & control ; Vaccination Coverage ; Vaccination/statistics & numerical data ; SARS-CoV-2 ; COVID-19 Vaccines/administration & dosage ; Child Health ; Infant ; },
abstract = {INTRODUCTION: Six years later, the impact of the COVID-19 pandemic on children in Latin America remains profound. Even though they were considered less susceptible to the disease, infants have emerged as one of the most affected populations, with the pandemic exposing deep inequities and magnifying vulnerabilities. This paper is presented as a perspective from SLIPE on COVID-19, providing expert insight into the current epidemiological situation in the region.

AREAS COVERED: This review analyzes the effects of the COVID-19 pandemic on children's health and wellbeing, education, and immunization efforts. Vaccination coverage against COVID-19 in children is suboptimal, particularly among those with high-risk underlying conditions, and the disruption of routine immunization programs has led to outbreaks of vaccine preventable diseases in the region.

EXPERT OPINION: Addressing these challenges requires strengthening both COVID-19 vaccination strategies for high-risk pediatric populations and routine childhood immunization programs, along with effective communication to combat misinformation, prioritization of educational recovery, social protection, and resilient health systems. Recovery must focus on closing inequity gaps and placing children at the center of public policy to safeguard their future.},
}

Humans
*COVID-19/prevention & control/epidemiology
Latin America/epidemiology
*Immunization Programs
Child
Pandemics/prevention & control
Vaccination Coverage
Vaccination/statistics & numerical data
SARS-CoV-2
COVID-19 Vaccines/administration & dosage
Child Health
Infant

@article {pmid42059914,
year = {2026},
author = {Lobaina, D and Llorens, C and Eldawy, N and Kosseifi, G and Puvvala, A and Srivastav, M and Miron, E and Frishman, M and Nasr, M and Jhumkhawala, V and Jimenez, S and Etzel, M and Knecht, M and Mejia, M and Sacca, L},
title = {The Role of Telehealth in Decreasing Barriers in Accessing Primary and Specialized Care Services in U.S. Rural and Underserved Communities: A Scoping Review.},
journal = {Telemedicine journal and e-health : the official journal of the American Telemedicine Association},
volume = {32},
number = {8},
pages = {811-826},
doi = {10.1177/15305627261443159},
pmid = {42059914},
issn = {1556-3669},
mesh = {Humans ; *Telemedicine/organization & administration ; *Health Services Accessibility/organization & administration ; United States ; COVID-19/epidemiology ; Access to Primary Care ; *Medically Underserved Area ; Social Determinants of Health ; *Primary Health Care/organization & administration ; Rural Population ; SARS-CoV-2 ; Pandemics ; Digital Health ; *Rural Health Services/organization & administration ; },
abstract = {BACKGROUND: Telehealth has emerged as a promising strategy to mitigate access barriers, particularly following rapid expansion during the COVID-19 pandemic; however, evidence on its role across care settings and populations remains fragmented. This scoping review synthesizes United States (U.S.)-based evidence on the role of telehealth in improving access to primary and specialized medical care for underserved, rural, and hard-to-reach adult populations.

METHODS: Guided by the Arksey and O'Malley framework and PRISMA-ScR guidelines, peer-reviewed studies were identified through PubMed, Embase, and the Cochrane Library. Eligible studies examined telehealth use in adult U.S. populations and reported outcomes related to health care access, social determinants of health (SDoH), or implementation strategies. Data were charted and synthesized narratively, with implementation approaches categorized using the ERIC framework.

RESULTS: Of 9,212 records identified, 242 studies met inclusion criteria. Telehealth was associated with comparable or improved access and clinical outcomes across primary care, specialty care, behavioral health, palliative care, and perioperative settings. Commonly addressed SDoH and demographic characteristics included age, race/ethnicity, socioeconomic status, insurance coverage, geography, and digital access. While telehealth reduced barriers related to transportation, travel burden, and scheduling flexibility, disparities persisted for older adults, individuals with limited English proficiency, and those with low digital literacy or broadband access. Implementation strategies most frequently involved adapting interventions to local context, iterative evaluation, and clinician support, whereas financial and infrastructure-level strategies were less commonly reported.

CONCLUSIONS: Extant literature suggests that telehealth has broad and firm support for its role in reducing access barriers and improving health outcomes across a wide range of conditions and populations. Therefore, future community-based approaches should focus on integrating telehealth into existing care delivery systems, tailoring interventions to the needs and preferences of different populations, and addressing structural barriers such as digital access, health literacy, and reimbursement to ensure sustained implementation.},
}

Humans
*Telemedicine/organization & administration
*Health Services Accessibility/organization & administration
United States
COVID-19/epidemiology
Access to Primary Care
*Medically Underserved Area
Social Determinants of Health
*Primary Health Care/organization & administration
Rural Population
SARS-CoV-2
Pandemics
Digital Health
*Rural Health Services/organization & administration

@article {pmid42060541,
year = {2026},
author = {Sanchez Villalobos, N and van Loenen, T and Ngongalah, L and Connolly, MA and Stein, ML and Rovers, CP and Timen, A},
title = {Hybrid Care Modifications in the Delivery of Nonpandemic Care During the COVID-19 Pandemic: Scoping Review.},
journal = {Journal of medical Internet research},
volume = {28},
number = {},
pages = {e84756},
pmid = {42060541},
issn = {1438-8871},
mesh = {Humans ; COVID-19/epidemiology ; Europe/epidemiology ; Pandemics ; *Delivery of Health Care/organization & administration ; *Telemedicine/organization & administration ; Digital Health/organization & administration ; },
abstract = {BACKGROUND: The COVID-19 pandemic had an unprecedented impact on the delivery of health care, with digital interventions accelerating more than ever before. However, evidence of how hybrid care models, combining digital health interventions with in-person care, were implemented during the pandemic remains scattered. Understanding hybrid care models is imperative to build resilient health systems that can ensure access to care during crisis situations.

OBJECTIVE: The study aimed to examine the implementation of hybrid care modifications to support the delivery of nonpandemic health care services in Europe during the COVID-19 pandemic.

METHODS: A scoping review was conducted following PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines. Systematic searches were conducted in PubMed or MEDLINE, Embase, CINAHL, Web of Science, and PsycINFO on May 22, 2024, and updated on January 14, 2026. Studies were eligible if they included primary data on the use of digital care modifications implemented or scaled up during the COVID-19 pandemic for the delivery of nonpandemic health care services in Europe. Non-peer-reviewed publications and studies with a primary focus on mental health or pediatric care were excluded. Quality appraisal was conducted using the Mixed Methods Appraisal Tool. Descriptions of digital care modifications were inductively analyzed and used to create digital flows, combining telehealth systems, digital interventions, and care functions. Digital care modifications were categorized according to their hybrid care implementation (digital-only or hybrid). Study evaluations were extracted using the Kirkpatrick model.

RESULTS: A total of 189 studies were included for analysis. Studies covered evidence from 2020 to 2024, a total of 23 countries, and 37 health care disciplines. Hybrid care implementation was reported in over 60% (115/189) of the studies, describing various forms of digital and in-person care. Care modifications incorporating in-person and digital care components were more commonly described in specialty care contexts. A total of 68 distinct digital flows were identified, with a limited number of telehealth systems allowing substantial variety in both interventions and care functions. Prominent digital flows included the use of online platforms to support video and messaging for follow-up care. Over half of the studies did not describe any kind of evaluation.

CONCLUSIONS: This review has shown how few telehealth systems were able to support a variety of care functions in the delivery of nonpandemic care throughout the COVID-19 pandemic, underscoring their practical versatility. Integrating digital health as part of hybrid care models is essential in designing care pathways that can adapt to different contexts, including future health crises. Although a comprehensive search was conducted, the heterogeneous reporting of care modifications may have influenced the interpretation of the findings. In the future, research may expand the application of hybrid care models to innovative strategies for effective crisis management.},
}

Humans
COVID-19/epidemiology
Europe/epidemiology
Pandemics
*Delivery of Health Care/organization & administration
*Telemedicine/organization & administration
Digital Health/organization & administration

@article {pmid42060826,
year = {2026},
author = {Bawne, G and Coenen, L and Nutma, E and Middeldorp, J and Lorenowicz, MJ},
title = {When Viruses Talk through Extracellular Vesicles: a New Perspective on Sars-Cov-2-Induced Neurodegeneration.},
journal = {Journal of extracellular vesicles},
volume = {15},
number = {5},
pages = {e70272},
pmid = {42060826},
issn = {2001-3078},
mesh = {Humans ; *Extracellular Vesicles/metabolism/virology ; *COVID-19/complications/metabolism/virology ; *Neurodegenerative Diseases/virology/metabolism/etiology ; *SARS-CoV-2 ; MicroRNAs/metabolism/genetics ; Animals ; Alzheimer Disease/metabolism/virology ; },
abstract = {SARS-CoV-2 infection is linked to persistent neurological symptoms Post-Acute Sequelae SARS-CoV-2 (neuro-PASC) and elevated risk of neurodegenerative disease, but molecular events connecting acute viral injury to long-term CNS dysfunction remain unclear. Here, we advance a perspective that Extracellular Vesicles (EVs) act as active mediators bridging SARS-CoV-2 infection and neurodegenerative processes. As nanoscale messengers capable of crossing the blood-brain barrier, EVs can transmit post-viral signals and orchestrate multi-target gene regulation in recipient cells through their microRNA (EV-miRNA) cargo. Our integrative analysis suggests that EV-miRNAs dysregulated in acute COVID-19, Alzheimer's Disease (AD), and Parkinson's Disease (PD) converge on pathways governing neurovascular integrity, redox and metabolic homeostasis, and neuronal proteostasis. We propose that sustained dysregulation of these interconnected modules-driven by EV-mediated signalling-may underlie the perpetuation of neuro-PASC and accelerate neurodegeneration in susceptible individuals. Viewing EVs as mechanistic agents that both transmit and amplify pathogenic cues reframes them as actionable targets for intervention and risk stratification. This perspective calls for translational frameworks that leverage EVs to illuminate, predict, and modify the trajectory of post-viral neurodegeneration.},
}

Humans
*Extracellular Vesicles/metabolism/virology
*COVID-19/complications/metabolism/virology
*Neurodegenerative Diseases/virology/metabolism/etiology
*SARS-CoV-2
MicroRNAs/metabolism/genetics
Animals
Alzheimer Disease/metabolism/virology

@article {pmid42061613,
year = {2026},
author = {Kaur, H and Gupta, P and Dhaliwal, M and Chakrabarti, A},
title = {Fungal infections in diabetes mellitus.},
journal = {Indian journal of medical microbiology},
volume = {61},
number = {},
pages = {101130},
doi = {10.1016/j.ijmmb.2026.101130},
pmid = {42061613},
issn = {1998-3646},
mesh = {Humans ; Antifungal Agents/therapeutic use ; *Mycoses/diagnosis/drug therapy ; *Diabetes Complications/microbiology ; *Diabetes Mellitus/microbiology/immunology ; Mucormycosis ; Risk Factors ; COVID-19 ; },
abstract = {PURPOSE: Diabetes mellitus is recognised as a global health problem and has increasingly been associated with fungal infections, as an independent risk factor. Diabetic patients are predisposed to both superficial as well as invasive fungal disease, and account for substantial morbidity and mortality. Recent pandemic of COVID-19 underlined the global problem of mucormycosis, however, the burden of fungal infections among diabetics has a much broader horizon. This review aims to summarise the spectrum of fungal infections encountered among diabetic patients, along with elucidating immunopathogenesis and clinical challenges encountered in diagnosis and management of such infections.

METHODS: We conducted a narrative review of all published literature focusing on spectrum of fungal infections, immunopathogenesis and clinical challenges encountered in diagnosis and management, among diabetic patients.

RESULTS: Diabetes mellitus facilitates the acquisition and progression of fungal infections via multiple coordinated mechanisms viz. hyperglycemia, impaired immune (innate and adaptive) response, altered microenvironment and endothelial dysfunction. These changes in the milieu contribute to pervasive clinical presentations, ranging from cutaneous and oral candidiasis to invasive fungal diseases like mucormycosis, aspergillosis and cryptococcosis. Besides predisposing to fungal infections, diabetes also serves as a prognostic factor and has been noted to worsen the outcome. Furthermore, the altered microenvironment affects the pharmacokinetics of antifungal drugs and can also reduce the efficacy of antifungal regime, further convoluting and worsening the progression of disease.

CONCLUSION: Early diagnosis and management of fungal infections is necessary to mitigate the associated morbidity and mortality among diabetic patients. A multidisciplinary approach is imperative as diabetes hampers the effectiveness of conventional antifungal regimens and facilitates antifungal resistance. Regular monitoring of glycaemic index and compliance for drugs, along with lifestyle modifications desired for optimal levels, is pre-requisite for antifungal therapy to exhibit desired action.},
}

Humans
Antifungal Agents/therapeutic use
*Mycoses/diagnosis/drug therapy
*Diabetes Complications/microbiology
*Diabetes Mellitus/microbiology/immunology
Mucormycosis
Risk Factors
COVID-19

@article {pmid42061662,
year = {2026},
author = {Mahooti, M and Safaei, F and Abdolalipour, E and Ahmadbeigi, G and Shokouhi, H and Fallah, T and Zare, D},
title = {Short-chain fatty acid-producing probiotics: an effective approach for modulating gut dysbiosis and mitigating inflammatory responses.},
journal = {Microbial pathogenesis},
volume = {216},
number = {},
pages = {108520},
doi = {10.1016/j.micpath.2026.108520},
pmid = {42061662},
issn = {1096-1208},
mesh = {*Probiotics/therapeutic use ; Humans ; *Fatty Acids, Volatile/metabolism/biosynthesis ; *Inflammation/prevention & control ; *Dysbiosis/therapy/microbiology ; *Gastrointestinal Microbiome/drug effects ; Animals ; COVID-19 ; Diabetes Mellitus, Type 2 ; Neoplasms ; Obesity ; Cardiovascular Diseases ; },
abstract = {Alterations in the intestinal microbiome participate with inflammatory responses and associate with pathological outcomes, along with changing the production of myriad metabolites such as short-chain fatty acids. A growing body of evidences have indicated that different dietary components, like polyphenols, may also increase short-chain fatty acids production by gut microbiota, playing a preventative role against various diseases, such as type 2 diabetes (T2D), obesity, cardiovascular diseases (CVD), and even mitigate inflammation attributed to disorders like those observed in COVID-19 and even cancer. Some infectious illnesses alter the microbiome, resulting in a decrease in the production of fermentative products, such as short-chain fatty acids. Managing the microbiome with probiotics to compensate the changes caused by these diseases leads to improvements in the microbiome and a reduction in inflammation. This reduction may even have positive effects in managing cancer. In this review, we compile cutting-edge discoveries on probiotic-derived SCFAs, highlighting their mechanisms associated with their prophylactic and therapeutic potential and their impact across infectious and non-infectious diseases, particularly in mitigating inflammation. Therefore, this review seeks to facilitate the development, evaluation, and clinical implementation of SCFAs-based interventions in future studies, particularly in preventive and therapeutic clinical settings.},
}

*Probiotics/therapeutic use
Humans
*Fatty Acids, Volatile/metabolism/biosynthesis
*Inflammation/prevention & control
*Dysbiosis/therapy/microbiology
*Gastrointestinal Microbiome/drug effects
Animals
COVID-19
Diabetes Mellitus, Type 2
Neoplasms
Obesity
Cardiovascular Diseases

@article {pmid42061834,
year = {2026},
author = {Leonforte, F and Nicosia, V and Comite, P and Morlino, G and Mistretta, A},
title = {Media Exposure and Its Association With Vaccine Attitudes, Intentions, and Hesitancy: Systematic Review.},
journal = {Journal of medical Internet research},
volume = {28},
number = {},
pages = {e74280},
pmid = {42061834},
issn = {1438-8871},
mesh = {Humans ; Media Exposure ; *Vaccination Hesitancy/psychology ; *COVID-19/prevention & control ; *Intention ; Vaccination ; SARS-CoV-2 ; Female ; *Health Knowledge, Attitudes, Practice ; Adult ; COVID-19 Vaccines ; },
abstract = {BACKGROUND: Vaccine hesitancy, amplified by the COVID-19 "infodemic," has emerged as a pressing public health challenge. Communication strategies are pivotal for enhancing vaccine literacy, countering misinformation, and sustaining immunization programs.

OBJECTIVE: This systematic review evaluates the association between communication channels and vaccine hesitancy and adherence, while examining the moderating role of sociodemographic factors.

METHODS: A PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses)-compliant search was conducted across PubMed, Scopus, and Web of Science, yielding 17,407 records screened according to predefined eligibility criteria (peer-reviewed studies with N>1000 adults assessing communication media targeting vaccine hesitancy and adherence, excluding pediatric, health care-specific, and non-English research). After full-text assessment, studies were appraised using the Modified Medical Education Research Study Quality Instrument for methodological quality and the Joanna Briggs Institute Critical Appraisal Checklist, ROBIN-I (Risk of Bias in Nonrandomized Studies of Interventions), or RoB 2.0 (Risk-of-Bias 2.0 tool for randomized trials) tools for risk of bias.

RESULTS: Thirty-six studies were included (26 cross-sectional, 4 quasi-experimental, 4 randomized controlled trials, 1 cohort, and 1 global analysis). Randomized and nonrandomized experimental studies demonstrated that tailored communication strategies delivered via radio, web platforms, and social media significantly improved vaccine acceptance. Adaptive public health campaigns achieved up to an 8% weekly increase in uptake in Madagascar (relative risk 1.08; 95% CI 1.01-1.15) and a 7.8% higher vaccination rate among Nigerian adults at first follow-up compared with controls. Digital and social media campaigns effectively reduced hesitancy and enhanced trust among hesitant pregnant women in the United States. Sociodemographic factors significantly moderated communication outcomes: a COVID-19 chatbot proved most effective among individuals with lower education and minority backgrounds, while religiosity (b=0.17; 95% CI 0.05-0.30; t810=2.80; P=.005) and cultural congruence (odds ratio 1.89; P<.01) influenced message credibility and engagement, respectively. The persuasive effect of online memes on COVID-19 vaccine intentions was not significantly influenced by gender (P=.83), age (P=.60), or political orientation (P=.44). Age-specific effects were observed, with greater responsiveness to a social media campaign among adults aged 25-34 years and reduced hesitancy among older groups. Multiple cross-sectional studies indicated higher adherence among audiences exposed to traditional media (television, radio, newspapers) and lower trust among social media users. Other studies suggested significant influences of gender, age, socioeconomic status, education level, and political orientation.

CONCLUSIONS: By synthesizing fragmented evidence, this review provides a systematic examination of the interplay between multichannel media and vaccine acceptance. It diverges from existing literature by integrating both traditional and digital media perspectives through the lens of sociodemographic moderation. This work offers a critical framework for public health interventions, advocating for rigorous longitudinal research to establish definitive causal links between communication and behavior. Consequently, these findings support a "precision" communication model, enabling the development of culturally congruent strategies tailored to specific recipient profiles to bolster vaccine adherence.

TRIAL REGISTRATION: PROSPERO CRD42025637441; https://tinyurl.com/4r9w83kw.},
}

Humans
Media Exposure
*Vaccination Hesitancy/psychology
*COVID-19/prevention & control
*Intention
Vaccination
SARS-CoV-2
Female
*Health Knowledge, Attitudes, Practice
Adult
COVID-19 Vaccines

@article {pmid42065140,
year = {2026},
author = {Thompson, CR and Adams, ER and Fletcher, TE},
title = {Diagnostics and the 100-day mission: why preparedness cannot wait.},
journal = {Transactions of the Royal Society of Tropical Medicine and Hygiene},
volume = {120},
number = {8},
pages = {898-900},
doi = {10.1093/trstmh/trag052},
pmid = {42065140},
issn = {1878-3503},
support = {//University of Liverpool/ ; //Liverpool School of Tropical Medicine/ ; //Liverpool John Moores University/ ; //Liverpool City Council/ ; //Liverpool City Region Combined Authority/ ; //Liverpool University Hospital Foundation/ ; //Trust and Knowledge Quarter Liverpool/ ; },
mesh = {Humans ; Global Health ; Pandemic Preparedness ; *Pandemics/prevention & control ; *COVID-19/diagnosis ; Public Health Infrastructure ; },
abstract = {The 2025 International Panel for Pandemic Surveillance Report and the G7 100-day mission emphasise rapid deployment of diagnostics, but preparatory infrastructure is vital to achieve this goal. Drawing on lateral flow development and haemorrhagic fever case studies, we highlight the requirement for pre-established diagnostic building blocks, including monoclonal antibodies, antigens, biological reference materials and regulatory pathways. Persistent funding imbalances and inequitable global investment threaten timely outbreak response. Sustained preparedness investment, strengthened biobanking and equitable access frameworks will ensure that diagnostics can be delivered within meaningful response timelines.},
}

Humans
Global Health
Pandemic Preparedness
*Pandemics/prevention & control
*COVID-19/diagnosis
Public Health Infrastructure

@article {pmid42066776,
year = {2026},
author = {Akil, H and Maras, PM and Turner, CA},
title = {Stress fitness: A neuroscientific approach to building emotional resilience.},
journal = {Neuron},
volume = {114},
number = {13},
pages = {2298-2314},
doi = {10.1016/j.neuron.2026.03.032},
pmid = {42066776},
issn = {1097-4199},
mesh = {Humans ; *Resilience, Psychological ; *Stress, Psychological/psychology/physiopathology ; *COVID-19/psychology ; *Emotions/physiology ; Animals ; *Anxiety Disorders/psychology ; },
abstract = {Across the globe, rates of mood and anxiety disorders have been increasing steadily, a trend accelerated by the COVID-19 pandemic. Stress triggers these disorders, precipitating initial episodes and provoking relapses. In this perspective, we argue that the stress system is not merely a threat mechanism but also an ongoing and active monitor of the environment and that resilience is not simply the lack of sensitivity to stress but an active function with an intrinsic neurobiology. Through the interplay of genetic, developmental, and experiential mechanisms, individuals evolve their own "stress-resilience algorithm" that determines their stress reactivity and the resulting adaptive or maladaptive consequences. This algorithm represents a dynamic, lifelong process that is often self-reinforcing. We underscore the importance of focusing on prevention by assessing and enhancing an individual's "stress fitness." This perspective offers a new conceptualization of the neurobiology of stress and resilience as a framework for basic and translational neuroscience research aimed at confronting the challenges of stress disorders.},
}

Humans
*Resilience, Psychological
*Stress, Psychological/psychology/physiopathology
*COVID-19/psychology
*Emotions/physiology
Animals
*Anxiety Disorders/psychology

@article {pmid42067236,
year = {2026},
author = {Tolchard, J and Le Marchand, T and Aspers, RLEG and Batta, G and Bechinger, B and Brath, U and Chasapi, SA and Čikoš, A and Ecsedi, K and Favier, A and Ferreira, ASD and Fiala, R and Georgiopoulou, PD and Gómez, JS and Jaudzems, K and Karlsson, G and Kentgens, APM and Lambregts, SFH and Morelli, F and Mulder, FAA and Natarajan, SV and Persson, C and Pierattelli, R and Pons, M and Raya, J and Redfield, C and Smrečki, V and Spyroulias, GA and Trébosc, J and Vallet, A and van Heijenoort, C and van Ingen, H and Vosegaard, T and Wirmer-Bartoschek, J and Schwalbe, H and Lesage, A and Pintacuda, G},
title = {Moving NMR infrastructures to remote access capabilities.},
journal = {Progress in nuclear magnetic resonance spectroscopy},
volume = {152-153},
number = {},
pages = {101595},
doi = {10.1016/j.pnmrs.2026.101595},
pmid = {42067236},
issn = {1873-3301},
abstract = {Traditionally, Nuclear Magnetic Resonance (NMR) infrastructures have relied on in-person access, requiring researchers to travel to centralized facilities to conduct experiments. However, recent advancements in remote access technologies, accelerated by the constraints imposed by the COVID-19 pandemic, have demonstrated the feasibility and strategic benefits of transitioning NMR operations toward remote accessibility. This review examines the key challenges and opportunities associated with remote access to NMR instrumentation, including standardized protocols for sample handling, secure authentication mechanisms, real-time instrument control, and data management. By establishing a unified framework for remote access, we aim to enhance the sustainability and accessibility of NMR facilities. Our findings highlight the necessity for collaborative efforts to develop best practices that ensure reproducibility, high-quality data acquisition, and equitable access to NMR infrastructure on a global scale.},
}

@article {pmid42067749,
year = {2026},
author = {Sharma, B and Smith, R and E Pennell, C},
title = {Global Trends in Maternal Mortality and Efforts to Improve Maternal Outcomes Through Sociomedical Interventions.},
journal = {Reproductive sciences (Thousand Oaks, Calif.)},
volume = {33},
number = {5},
pages = {950-960},
pmid = {42067749},
issn = {1933-7205},
mesh = {*Maternal Mortality/trends ; Humans ; Female ; Pregnancy ; COVID-19 ; Developing Countries ; *Global Health ; },
abstract = {Maternal mortality continues to be a major global health concern that disproportionately affects low- and middle-income countries (LMICs), with the World Health Organisation (WHO) estimating a maternal death occurring every two minutes. The data-sparse LMICs employ a multitude of estimation approaches to gauge maternal mortality ratios (MMR); however, their classification of deaths and reproducibility of estimates remain open to discussion. Despite a considerable reduction of MMR levels since 2000, more recently, the MMR levels in countries including the US have resurged due to the sociomedical crises brought about by the COVID-19 pandemic. The United Nations' Sustainable Development Goal (SDG) 3.1 aims to achieve global maternal mortality ratios of less than 70 per 100,000 live births and below 140 per 100,000 live births at the national level by 2030. However, recent projections indicate it will remain unmet by a margin of a million maternal deaths. Many LMICs apply the three-delays framework of maternal deaths that requires verbal autopsy to be used in tandem with the identification of maternal deaths. The three-delays model devised in the mid-1990s allows LMICs to gear their resources towards specific intervention points. A significant portion of the existing literature has focused on the description of the magnitude of the issue and the factors precipitating maternal deaths. Innovative solutions have recently been implemented, such as repurposing military helicopters to reduce the delays in managing obstetric complications. Similarly, prospective studies are required to devise ways to address the sociomedical mechanisms underlying maternal deaths.},
}

*Maternal Mortality/trends
Humans
Female
Pregnancy
COVID-19
Developing Countries
*Global Health

@article {pmid42067830,
year = {2026},
author = {Youssef, DM and Al-Shehabi, H and Johann, S and Kitts, J and Bauer, M and Montt-Maray, E and Bcheraoui, CE},
title = {Public health emergency response through field epidemiology training and rapid response teams - a scoping review.},
journal = {BMC public health},
volume = {26},
number = {1},
pages = {},
pmid = {42067830},
issn = {1471-2458},
mesh = {Humans ; *Epidemiology/education ; *Public Health/education ; Public Health Infrastructure ; },
abstract = {BACKGROUND: Public Health Emergency Workforce (PHEW) plays a significant role in the detection and rapid response to emerging diseases, thus helping countries manage global threats. In line with the International Health Regulations' call for strengthening national capacities, field epidemiology training programs (FETPs) and rapid response teams (RRTs) have been developed to enhance countries' preparedness and response capacities. This scoping review synthesizes the evidence on available FETPs and RRTs and on their effectiveness as well as the challenges they face.

METHODS: A scoping review was conducted using EMBASE, Ovid Medline and Scopus databases in addition to the grey literature for studies published after year 2000, in the English language. Studies were selected by two independent reviewers and data were extracted into an excel sheet. Included manuscripts were analyzed through a narrative synthesis.

RESULTS: Four thousand one hundred ten studies were identified from the three peer-reviewed databases and six articles from the grey literature. Finally, 67 studies were included in the review comprising 47 identified through our search and 20 sourced from the references. The studies on PHEW training included FETPs encompassing those with laboratory and veterinary focus, and training on rapid response. Enhancement in learning acquired, course satisfaction, application of skills in workplace and engagements in key emergency response activities were found. However, lack of funding and a standardized curriculum were still among the most common challenges facing FETPs and RRTs.

CONCLUSION: While PHEW training including FETPs and RRTs are essential for building resilience against health threats, financial challenges, lack of standardized curricula and operating procedures hinders their effectiveness. Integrating One Health and laboratory skills into FETPs are vital, as seen during the COVID-19 pandemic response. Governments should work towards increasing funding and incentivizing graduate retention. They should also collaborate with organizations such as the International Association of National Public Health Institutes (IANPHI) and the Global Field Epidemiology Partnership (GFEP) to establish standardized curricula for FETP and RRT.},
}

Humans
*Epidemiology/education
*Public Health/education
Public Health Infrastructure

@article {pmid42068116,
year = {2026},
author = {Peart, SR and Haj-Yahya, R and Nugent, M and Ganbold, O and Harbinson, L and Jly, C and Manley, BJ and Whitehead, CL},
title = {Preterm Birth and Perinatal Mortality During the COVID-19 Pandemic Period: A Systematic Review and Meta-Analysis.},
journal = {Journal of paediatrics and child health},
volume = {62},
number = {6},
pages = {924-935},
pmid = {42068116},
issn = {1440-1754},
mesh = {Humans ; *Premature Birth/epidemiology ; *COVID-19/epidemiology ; Pregnancy ; *Perinatal Mortality/trends ; Female ; Infant, Newborn ; Stillbirth/epidemiology ; Pandemics ; },
abstract = {BACKGROUND: Preterm birth rates may have been affected during the COVID-19 pandemic but the impact of this on perinatal morbidity is unknown.

AIM: To review the impact of the COVID-19 pandemic on rates of preterm birth and perinatal mortality.

METHODS: Medline, Embase, and online pre-prints were searched from Jan 2020 to Oct 2022. Case-control, cohort studies and reports comparing rates of preterm birth, stillbirth and neonatal death before and during the COVID-19 pandemic period were included. The pooled odds ratio (OR) for preterm birth, stillbirth and neonatal death was calculated using a random effects model. The primary outcome was the rate of preterm birth, stillbirth and neonatal death in the pre-pandemic and pandemic periods.

RESULTS: 100 studies were included. Compared with pre-pandemic periods, there was a decrease in preterm births during the pandemic period: OR 0.95 (95% CI 0.94-0.97) I [2]  = 0.93, with the greatest reduction for births < 28 weeks' gestation in high-income countries: OR 0.92 (95% CI 0.88-0.96), I [2]  = 0.46. There was a reduction in neonatal deaths in high-income countries: OR 0.78 (95% CI 0.64-0.95), I [2]  = 0.4. In low- and middle-income countries the stillbirth rate increased during the pandemic compared with the pre-pandemic period: OR 1.18 (95% CI 1.02-1.36), I [2]  = 0.86.

CONCLUSION: The COVID-19 pandemic was associated with a reduction in preterm births and neonatal deaths. Further research is needed to investigate the mechanisms underlying these findings. Stillbirth rates increased in low- and middle-income countries where access to healthcare may have been restricted and strategies to address this in future pandemics are warranted.},
}

Humans
*Premature Birth/epidemiology
*COVID-19/epidemiology
Pregnancy
*Perinatal Mortality/trends
Female
Infant, Newborn
Stillbirth/epidemiology
Pandemics

@article {pmid42068729,
year = {2026},
author = {Menin, IBF and Dias, ADC and da Rosa, MI and Colonetti, T and Grande, AJ},
title = {COVID-19 vaccine hesitancy among people with epilepsy: an updated systematic review and meta-analysis.},
journal = {Seizure},
volume = {138},
number = {},
pages = {198-211},
doi = {10.1016/j.seizure.2026.04.007},
pmid = {42068729},
issn = {1532-2688},
mesh = {Humans ; *Epilepsy/psychology ; *Vaccination Hesitancy/psychology ; *COVID-19 Vaccines ; *COVID-19/prevention & control ; Vaccination/psychology ; },
abstract = {OBJECTIVE: To systematically review and meta-analyze COVID-19 vaccine hesitancy among individuals with epilepsy.

METHODS: Following PRISMA 2020 guidelines, we searched Cochrane CENTRAL, MEDLINE, EMBASE, CINAHL, LILACS, PsycINFO databases, and grey literature through February 6, 2026. We included studies addressing COVID-19 vaccination hesitancy in adults with epilepsy, with no date or language restrictions. Two reviewers independently screened articles, extracted data, and assessed quality using the Newcastle-Ottawa Scale (NOS). Meta-analyses were conducted using random-effects models, with heterogeneity assessed using I² statistics. The certainty of evidence was evaluated using the GRADE criteria.

RESULTS: Fourteen studies comprising 4230 participants were included. Overall vaccination willingness was 51.7% (95% CI: 36.6-68.8%, I²=98%). Among unvaccinated individuals, 44.2% (95% CI: 26.6-61.8%, I²=95%) expressed willingness to be vaccinated. Well-controlled epilepsy was associated with higher vaccination rates (OR 1.91, 95% CI: 1.49-2.46, I²=0%). Conversely, frequent seizures (daily/weekly) were associated with lower vaccination likelihood (OR 0.52, 95% CI: 0.35-0.76, I²=0%). The primary reasons for vaccine hesitancy were fear of seizure worsening (23.8-88.5% across studies) and concerns about side effects (13.0-53.0%). Methodological quality was generally poor, with only one study rated as "satisfactory" using NOS criteria. GRADE assessment indicated very low certainty of evidence due to serious risk of bias, inconsistency, and imprecision.

CONCLUSIONS: COVID-19 vaccine hesitancy remains present in people with epilepsy, primarily driven by concerns about seizure exacerbation. Individuals with well-controlled epilepsy show higher vaccination acceptance. Healthcare providers should address specific concerns about seizure control while emphasizing vaccine safety data. High-quality prospective studies using validated instruments are recommended.},
}

Humans
*Epilepsy/psychology
*Vaccination Hesitancy/psychology
*COVID-19 Vaccines
*COVID-19/prevention & control
Vaccination/psychology

@article {pmid42068781,
year = {2026},
author = {Chang, SY and Hsieh, CY and Lee, WY and Hung, HM and Lee, HF and Hsu, HC},
title = {The career choices of nursing students after the COVID-19 pandemic: A scoping review.},
journal = {International journal of nursing studies},
volume = {180},
number = {},
pages = {105547},
doi = {10.1016/j.ijnurstu.2026.105547},
pmid = {42068781},
issn = {1873-491X},
mesh = {Humans ; *Career Choice ; *Coronavirus Infections/epidemiology ; *COVID-19/epidemiology ; Pandemics ; *Pneumonia, Viral/epidemiology ; *Students, Nursing/psychology ; },
abstract = {BACKGROUND: The COVID-19 pandemic disrupted nursing education worldwide, limiting clinical learning opportunities and increasing psychological stress. These challenges forced nursing students to make career decisions in uncertain, risky, and changing social environments.

OBJECTIVE: To explore the scope, influencing factors, and strategies related to nursing students' career choices after the pandemic.

DESIGN: A scoping review following Arksey and O'Malley's framework.

METHODS: Six databases were searched without restrictions on language or publication date. Seventeen studies involving 5167 nursing students from Asia, Europe, and the Middle East were included. Data were analyzed thematically to identify career intentions, influencing factors, and development strategies.

RESULTS: Most nursing students intended to remain in the profession, although their intentions varied by country and over time. Key positive influences included strengthened professional identity, societal recognition, and supportive learning environments. Negative influences included perceived occupational risk, inadequate compensation, and reduced clinical experience. Recommended strategies included flexible teaching approaches, enhanced clinical preparation, psychological support, and policy measures to improve working conditions and enhance professional image.

CONCLUSIONS: Despite these significant challenges, many nursing students showed resilience and a willingness to remain in nursing. Investment in education, mentorship, and workforce policy is vital to sustain the nursing workforce and strengthen healthcare resilience in the face of future crises.},
}

Humans
*Career Choice
*Coronavirus Infections/epidemiology
*COVID-19/epidemiology
Pandemics
*Pneumonia, Viral/epidemiology
*Students, Nursing/psychology

@article {pmid42069208,
year = {2026},
author = {Singh, Y and Gupta, A and Gupta, S and Goud, P and Pandey, SN and Goyal, K and Kumbhar, PS and Singh, SK and Dua, K and Gupta, G},
title = {Pentraxin-3 as a diagnostic and prognostic biomarker in inflammatory lung diseases.},
journal = {Clinica chimica acta; international journal of clinical chemistry},
volume = {589},
number = {},
pages = {121044},
doi = {10.1016/j.cca.2026.121044},
pmid = {42069208},
issn = {1873-3492},
mesh = {Humans ; Pentraxins ; *Serum Amyloid P-Component/analysis/metabolism ; *C-Reactive Protein/analysis/metabolism ; Biomarkers/blood/analysis ; Prognosis ; COVID-19 ; SARS-CoV-2 ; *Pneumonia, Viral/diagnosis/blood ; Pandemics ; },
abstract = {Inflammatory lung diseases, including community-acquired pneumonia, acute respiratory distress syndrome (ARDS), severe viral pneumonia (including COVID-19), ventilator-associated pneumonia, and exacerbations of chronic obstructive pulmonary disease (COPD), necessitate prompt diagnostic and prognostic assessments accompanied by microbiological confirmation of the causative pathogen. Conventional biomarkers, including C-reactive protein and procalcitonin, are insufficient to distinguish between localized pulmonary and systemic inflammation. This narrative review summarizes the studies on Pentraxin-3 (PTX3), a locally synthesized, extrahepatic acute-phase protein secreted by endothelial cells, epithelial cells, and myeloid leukocytes at sites of inflammation, as a diagnostic and prognostic biomarker in the continuum of inflammatory lung diseases. Plasma PTX3 indicates systemic endothelial activation and disease severity, whereas bronchoalveolar lavage PTX3 concentrations provide compartment-specific diagnostic data, identify follow-up infections, and allow therapeutic escalation in relation to the disease phenotype. Nevertheless, clinical laboratory implementation involves matrix-specific reference levels, analytical validation containing limits of detection/quantification, precision, linearity, and interfering studies according to CLSI, commutable calibrators, and traceability hierarchies. The pre-analytical procedure is standardized, and platform-independent decision limits through harmonized assays, preparation of external quality assessment, and compatibility of acute-care turnaround times are required to implement multicenter PTX3 in routine clinical laboratory diagnostics.},
}

Humans
Pentraxins
*Serum Amyloid P-Component/analysis/metabolism
*C-Reactive Protein/analysis/metabolism
Biomarkers/blood/analysis
Prognosis
COVID-19
SARS-CoV-2
*Pneumonia, Viral/diagnosis/blood
Pandemics

@article {pmid42069590,
year = {2026},
author = {Yeh, CF and Ianalieva, L and Wong, HK and Wu, CC and Yang, KC},
title = {Nanomedicine-based theranostics in atherosclerotic cardiovascular diseases.},
journal = {Journal of biomedical science},
volume = {33},
number = {1},
pages = {},
pmid = {42069590},
issn = {1423-0127},
support = {111-2314-B-002-069 MY3, 112-2314-B-002-277 MY3, 112-2918-I-002-002, 112-2926-I-002-511-G (KCY)//National Science and Technology Council/ ; NHRI-EX113-11213BI (KCY)//National Health Research Institutes/ ; IBMS-CRC111-P01 (KCY), AS-TM-113-01-02 (KCY), AS-GC-110-L06 (KCY, SYC)//Academia Sinica/ ; VN112-06, VN-113-03, 112-S0307, 112-S0311, 113-S0196, 113-IF0002, 113-E0008 (KCY)//National Taiwan University Hospital/ ; 110F005-112-M2 (KCY)//National Taiwan University College of Medicine, National Taiwan University Hospital and Min-Sheng General Hospital/ ; NSCCMOH-131-41, 111C101-051, 112C101-031 (KCY)//of National Taiwan University College of Medicine and National Taiwan University Hospital/ ; 112L7849, 113L7832 (KCY)//National Taiwan University/ ; NTU ABRC TCE//NTU Advanced Biomedical Research Center, Taiwan Centers of Excellence/ ; },
mesh = {Humans ; *Theranostic Nanomedicine/methods ; *Atherosclerosis/therapy/diagnosis ; COVID-19/prevention & control ; *Nanomedicine ; Animals ; SARS-CoV-2 ; *Cardiovascular Diseases/therapy ; },
abstract = {Current treatment for atherosclerotic cardiovascular diseases (ASCVD) mainly focuses on the modification of systemic risk factors, such as hyperglycemia and hyperlipidemia. Despite significant efforts and expanse, achieving early and proper diagnosis of ASCVD to improve clinical outcomes remains challenging, and vascular-targeted therapies or genetic editing, while ideal, are still limited. The development of nanomedicine-based mRNA vaccines for SARS-CoV-2 has demonstrated the potential of nanotechnology to target previously inaccessible molecules. Precision therapies by nanomedicine targeting specific tissues/molecules hold potential for new treatment paradigms by precisely modulating disease-causing molecular pathways within diseased tissues, including dysfunctional vasculature. By leveraging insights into the pathogenic contributors of atherogenesis, researchers have optimized nanoplatforms' composition, synthesis strategies, and surface design to enhance therapeutic efficacy and enable early diagnosis. Herein, we present an updated overview of therapeutic and diagnostic strategies using nanomedicine for ASCVD, and explore future research directions and innovative approaches for nanomedicine-driven theranostics in cardiovascular care.},
}

Humans
*Theranostic Nanomedicine/methods
*Atherosclerosis/therapy/diagnosis
COVID-19/prevention & control
*Nanomedicine
Animals
SARS-CoV-2
*Cardiovascular Diseases/therapy

@article {pmid42070118,
year = {2026},
author = {Kusuma, NHS and Irnandi, DF and Pakpahan, C and An Nguyen, TT},
title = {Masturbation as a sexual and psychological coping strategy in long-distance relationships: a systematic review.},
journal = {The journal of sexual medicine},
volume = {23},
number = {5},
pages = {},
doi = {10.1093/jsxmed/qdag121},
pmid = {42070118},
issn = {1743-6109},
mesh = {Humans ; *Masturbation/psychology ; *Adaptation, Psychological ; Female ; Personal Satisfaction ; Male ; *Sexual Behavior/psychology ; COVID-19/psychology ; *Sexual Partners/psychology ; *Interpersonal Relations ; Coping Skills ; },
abstract = {INTRODUCTION: Long-distance relationships (LDRs) reduce opportunities for physical intimacy, often prompting individuals to seek alternative sexual activities such as masturbation. Although common, its influence on sexual satisfaction, sexual health, psychological well-being, and relational stability in LDRs remains understudied. Moreover, cultural and population differences shape diverse meanings and perspectives on masturbation.

OBJECTIVES: We employed a systematic review approach to explore the role of masturbation within long-distance relationships. Specifically, this review aims to examine how masturbation is associated with sexual, relational, and psychological outcomes and how these perspectives vary across cultural contexts.

METHODS: A systematic review was conducted following the PRISMA guidelines, compiling both quantitative and qualitative studies on masturbation as an alternative sexual activity in LDRs as well as its implications for sexual satisfaction, relationship satisfaction, and psychological well-being.

RESULTS: Fourteen studies were eligible for further analysis in which men reported higher frequencies of masturbation compared to women, with significant increases observed in the context of long-distance relationships and during COVID-19 quarantine periods. Men were mainly motivated by biological release, orgasm, and stress reduction, often with pornography, whereas women reported broader motives such as relaxation, better sleep, stress relief, and emotional closeness. The effects on sexual satisfaction were mixed: masturbation was reported to be associated with greater body awareness, self-esteem, and relational harmony, yet excessive frequency was linked to lower satisfaction and arousal. Mutual, technology-mediated practices helped maintain intimacy, while excessive solitary use undermined relationship quality. From a sexual health perspective, moderate masturbation may be associated with indirect benefits through improved body awareness, whereas frequent use was linked to poorer experiences. Psychologically, it served as a coping strategy for sleep and stress, but excessive engagement increased anxiety and reduced emotional well-being.

CONCLUSION: Masturbation appears to be a common and potentially adaptive alternative sexual activity in the context of LDRs and during the COVID-19 pandemic. However, in Eastern contexts, its meaning and impact are strongly shaped by sociocultural and religious norms.},
}

Humans
*Masturbation/psychology
*Adaptation, Psychological
Female
Personal Satisfaction
Male
*Sexual Behavior/psychology
COVID-19/psychology
*Sexual Partners/psychology
*Interpersonal Relations
Coping Skills

@article {pmid42070964,
year = {2026},
author = {Kamel, EM and Khadrawy, SM and Allam, AA and Ahmed, NA and Aba Alkhayl, FF and Lamsabhi, AM},
title = {Targeting the Elongin BC-BC-Box Interface: Structural Insights, Peptidic Disruptors and Emerging Small-Molecule Strategies.},
journal = {Chemical biology & drug design},
volume = {107},
number = {5},
pages = {e70307},
doi = {10.1111/cbdd.70307},
pmid = {42070964},
issn = {1747-0285},
support = {IMSIU-DDRSP2601//Imam Mohammad Ibn Saud Islamic University (IMSIU)/ ; },
mesh = {Humans ; *Elongin/metabolism/chemistry/antagonists & inhibitors ; *Peptides/chemistry/pharmacology/metabolism ; *Small Molecule Libraries/chemistry/pharmacology/metabolism ; Protein Binding/drug effects ; },
abstract = {Protein-protein interactions (PPIs) that orchestrate ubiquitin-dependent signaling have long challenged drug discovery because their interfaces are typically large and hydrophobic. The heterodimeric adaptor Elongin BC (ELOB/ELOC) defies this stereotype: its BC-box-binding groove is a deep, rigid pocket that anchors dozens of cellular and viral partners to cullin-RING ligases and to transcriptional machinery. Recent structural and chemical-biology breakthroughs have converted this once "undruggable" site into a tractable target. A sub-nanomolar peptide derived from the chromatin factor EPOP has been shown to displace native BC-box proteins, trigger apoptosis in multiple cancer lines, and unveil a transcriptomic signature that converges on MYC and cell-cycle control. Parallel fragment screens and crystallography have mapped adjacent hot spots suitable for small-molecule growth, while functional genomics highlights Elongin BC as a pan-cancer dependency and an unexpected regulator of the SARS-CoV-2 co-receptor TMPRSS2. This review synthesizes the structural principles of BC-box recognition, the current state of peptide and fragment-based inhibitors, and the biological consequences of disrupting the Elongin BC hub. We discuss therapeutic prospects in oncology and virology, outline key challenges-delivery, selectivity, and resistance-and propose future directions ranging from stapled-peptide optimization to covalent fragment tethering and PROTAC strategies. Together, these advances position Elongin BC inhibition at the forefront of next-generation PPI drug discovery, offering a unified approach to modulate ubiquitin signaling, epigenetic regulation, and viral entry through a single conserved pocket.},
}

Humans
*Elongin/metabolism/chemistry/antagonists & inhibitors
*Peptides/chemistry/pharmacology/metabolism
*Small Molecule Libraries/chemistry/pharmacology/metabolism
Protein Binding/drug effects

@article {pmid42071153,
year = {2026},
author = {Gomes, JP},
title = {Genome Sequencing in Infectious Disease Outbreaks.},
journal = {Advances in experimental medicine and biology},
volume = {1504},
number = {},
pages = {357-371},
pmid = {42071153},
issn = {0065-2598},
mesh = {Humans ; *Disease Outbreaks ; *Whole Genome Sequencing/methods ; *Genome, Viral ; *COVID-19/epidemiology/virology/transmission ; *SARS-CoV-2/genetics/pathogenicity ; *Genome, Bacterial ; *Communicable Diseases/epidemiology/genetics/transmission ; Animals ; High-Throughput Nucleotide Sequencing/methods ; },
abstract = {Genome sequencing has become a crucial tool in the management and understanding of infectious disease outbreaks. By decoding the entire genetic material of pathogens, this technology allows scientists to track the spread and evolution of infectious agents with unprecedented precision. During an outbreak, one of the key applications of genome sequencing is in tracing the transmission pathways of the disease. By comparing the genetic sequences of pathogens from different patients and sources, epidemiologists can determine the source of the outbreak and how the disease is spreading through populations. In addition, genome sequencing has the potential to identify mutations that may affect transmissibility, virulence, or resistance to treatment, providing critical insights for public health responses, for instance enabling targeted interventions, such as specific treatments or vaccines. During the last years, this was particularly evident for multiple internationally occurring severe outbreaks caused by either bacteria or virus, with special emphasis during the COVID-19 pandemic, where genome sequencing played a vital role in monitoring the emergence of new variants and informing vaccine strategies. As sequencing technologies continue to advance and associated costs decline, their integration into public health strategies will be essential for more effective control and prevention of infectious disease outbreaks in the future.},
}

Humans
*Disease Outbreaks
*Whole Genome Sequencing/methods
*Genome, Viral
*COVID-19/epidemiology/virology/transmission
*SARS-CoV-2/genetics/pathogenicity
*Genome, Bacterial
*Communicable Diseases/epidemiology/genetics/transmission
Animals
High-Throughput Nucleotide Sequencing/methods

@article {pmid42072232,
year = {2026},
author = {Franco, A and Angelone, F and Calderone, D and Ponsiglione, AM and Romano, M and Ricciardi, C and Amato, F},
title = {Telemedicine and 5G Technologies: A Systematic Global Review of Applications over the Past Decade.},
journal = {Bioengineering (Basel, Switzerland)},
volume = {13},
number = {4},
pages = {},
pmid = {42072232},
issn = {2306-5354},
support = {E63C22002040007//RESTART - RESearch and innovation on future Telecommunications systems and networks, to make Italy more smART/ ; },
abstract = {This systematic review analyzes how the introduction and progressive deployment of 5G networks have influenced the evolution of telemedicine between 2014 and 2024, focusing on their impact on performance, accessibility, and the feasibility of advanced clinical applications across the pre-COVID-19, COVID-19, and post-COVID-19 periods. The review was conducted in accordance with PRISMA guidelines and included publications retrieved from SCOPUS, PubMed, and Web of Science using a PICO-based search strategy. Studies were selected based on predefined inclusion and exclusion criteria, and extracted data included clinical parameters, network characteristics such as bandwidth and latency, geographic setting, and type of telemedicine service. A total of 45 studies met the inclusion criteria, with most published between 2020 and 2024. The most frequently reported applications were telediagnosis, particularly robotic ultrasound, followed by telesurgery and teleconsultation. The low latency enabled by 5G networks supported complex telesurgical procedures over distances exceeding 5000 km, while in ultra-remote areas, hybrid solutions combining 5G and fiber-optic networks were often adopted to ensure stable connections. The integration of robotic platforms and AI-based tools further enhanced the precision and reliability of remote procedures. Overall, 5G technology has significantly advanced telemedicine by enabling real-time, high-quality care over long distances, improving access to specialist services and supporting more equitable and efficient digital healthcare delivery, particularly in underserved regions.},
}

@article {pmid42074180,
year = {2026},
author = {Mosteanu, IM and Parliteanu, OA and Mahler, B and Mitrea, A and Clenciu, D and Stefan, AG and Timofticiuc, DCP and Stoichita, A and Popoviciu, MS and Reurean Pintilei, DV and Rosu, MM and Radu Gheonea, TC and Vladu, BE and Boldeanu, L and Mota, E and Efrem, IC and Vladu, IM and Mota, M},
title = {Diabetes Mellitus and COVID-19 in Adults: A Systematic Review of Pathophysiological Connections, Clinical Outcomes, and Therapeutic Considerations.},
journal = {International journal of molecular sciences},
volume = {27},
number = {8},
pages = {},
pmid = {42074180},
issn = {1422-0067},
support = {NA//University of Medicine and Pharmacy of Craiova/ ; },
mesh = {Humans ; *COVID-19/complications/epidemiology/therapy/physiopathology ; SARS-CoV-2/isolation & purification ; Adult ; *Diabetes Mellitus/physiopathology ; Hyperglycemia ; *Diabetes Mellitus, Type 2/complications ; },
abstract = {The disproportionately severe disease course of diabetic patients with SARS-CoV-2 infection was repeatedly observed by clinicians during the COVID-19 pandemic. The overlap between metabolic impairment, viral pathophysiology, and chronic inflammation created a pattern that urged deeper examination. The aim of this paper was to review and synthesize evidence regarding the interaction between diabetes mellitus and COVID-19. We synthesized evidence across mechanistic pathways (immune dysregulation, chronic inflammation, ACE2/DPP-4-related signaling, endothelial dysfunction, and pancreatic involvement) and key clinical outcomes (severity, intensive care unit (ICU) admission, mortality, dysglycaemia/new-onset diabetes, and DKA). This systematic search was conducted in PubMed, Clinical Key, and Google Scholar. The eligibility criteria included papers on adults (≥18 years) with pre-existing diabetes mellitus (type 1 or type 2) or newly diagnosed diabetes/hyperglycemia and confirmed SARS-CoV-2 infection, published between January 2020 and October 2025, in English language. The PRISMA guidelines were used for data extraction. We identified 412 articles, out of which only 30 met all the inclusion criteria. Diabetes was consistently evoked as a major risk factor for severe COVID-19, being associated with higher susceptibility to pneumonia, respiratory failure, ICU admission, and mortality. The explanation lies in the impaired immune system, endothelial dysfunction, and metabolic repercussions imposed by hyperglycemia. Several antidiabetic drugs appeared protective in multiple cohorts. In conclusion, the accumulated evidence underscores the tight interplay between metabolic disease and COVID-19. Essentially, the clinical management of these patients would be a thoughtful selection of antidiabetic therapy and close metabolic monitoring.},
}

Humans
*COVID-19/complications/epidemiology/therapy/physiopathology
SARS-CoV-2/isolation & purification
Adult
*Diabetes Mellitus/physiopathology
Hyperglycemia
*Diabetes Mellitus, Type 2/complications

@article {pmid42074269,
year = {2026},
author = {Rangel, K and Villas-Bôas, MHS and De-Simone, SG},
title = {Advances in Ozone-Based Inactivation of SARS-CoV-2: An Updated Review.},
journal = {International journal of molecular sciences},
volume = {27},
number = {8},
pages = {},
pmid = {42074269},
issn = {1422-0067},
support = {#200.960-2022//Carlos Chagas Filho Foundation for Research Support of the State of Rio de Janeiro (FAPERJ)/ ; #30515- 2020-5//Brazilian Council for Scientific Research (CNPq)/ ; },
mesh = {*Ozone/pharmacology ; Humans ; *SARS-CoV-2/drug effects ; COVID-19/prevention & control/virology ; Disinfection/methods ; *Disinfectants/pharmacology ; Pandemics/prevention & control ; *Virus Inactivation/drug effects ; *Betacoronavirus/drug effects ; },
abstract = {The onset of the COVID-19 pandemic prompted the rapid development and deployment of novel strategies and methodologies to manage the dissemination of microorganisms. Understanding the crucial role that contaminated surfaces play in the spread of viruses highlights the importance of having effective cleaning and disinfection protocols in place for inanimate objects. A variety of antimicrobial agents have shown strong effectiveness against the SARS-CoV-2 virus. Various factors can impact on the performance of these agents. As a result, technologies utilizing ozone's microbicidal effects have been developed or improved for cleaning indoor areas, surfaces, and materials, despite ozone's diverse uses being known for years. Ozone offers the advantage of adaptability for both gaseous and aqueous use, depending on the nature of the decontaminated surfaces. Moreover, ozone-infused water is ecologically benign, possesses microbial-fighting capabilities, and synergistically reinforces the biocidal action of other chemical disinfectants. This review aims to summarize the efforts dedicated to harnessing gaseous and aqueous ozone as a valuable means to eliminate the SARS-CoV-2 virus from environments, surfaces, clinical equipment, and office supplies. This review sourced evidence-based articles from electronic databases, including MEDLINE (via PubMed), EMBASE, the Cochrane Library (CENTRAL), and preprint repositories. The findings illustrated that ozone could serve as an additional tool for curbing the proliferation of COVID-19 and other viral infections. Additionally, we elucidated the operational attributes of ozone, the variables that influence its disinfection potency, and the mechanisms of its virucidal action. Notably, this review does not encompass the disinfection of the COVID-19 virus in wastewater.},
}

*Ozone/pharmacology
Humans
*SARS-CoV-2/drug effects
COVID-19/prevention & control/virology
Disinfection/methods
*Disinfectants/pharmacology
Pandemics/prevention & control
*Virus Inactivation/drug effects
*Betacoronavirus/drug effects

@article {pmid42074690,
year = {2026},
author = {Lucaciu, FC and Wellmann, N and Mihai, AM and Sima, A and Rosca, O and Suba, MI and Tarau, A and Bosoanca, A and Marc, M},
title = {Post-COVID Respiratory Sequelae in COPD: Mucus Plugging, Infectious Complications, and Risk-Stratified Follow-Up.},
journal = {Journal of clinical medicine},
volume = {15},
number = {8},
pages = {},
pmid = {42074690},
issn = {2077-0383},
abstract = {Context/Objectives: In patients with COPD (chronic obstructive pulmonary disease), SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) infection represents an overlap of viral injury on a lung already affected by pathological mucus, altered mucociliary clearance, chronic inflammation, and impaired antiviral immunity. Methods: A focused narrative review (2020-2025) was conducted using clinical, experimental, and consensus evidence. The evidence was synthesized qualitatively, with priority given to cohort studies, meta-analyses, and mechanism-focused studies with clinical relevance. Results: Mucus obstruction ("mucus plugs") is frequent in COPD (41-67%) and is associated with unfavorable outcomes. COPD also increases the risk of post-COVID respiratory sequelae. Bacterial coinfection at presentation is uncommon (3-5%), whereas secondary bacterial infections are more frequent (14-18%), especially in severe disease requiring intensive care, where VA-LRTI/VAP (ventilator-associated lower respiratory tract infection/ventilator-associated pneumonia) become predominant. Sepsis, whether viral or mixed, reflects disease severity and may contribute to functional decline and susceptibility to reinfections; however, the concept of a post-acute "sepsis legacy" in COPD after COVID-19 should currently be regarded as a clinically plausible but still emerging hypothesis rather than an established COPD-specific outcome. During recovery, acute exacerbation risk rises to 5.6% versus 3.9%, peaking in the first 30 days after severe disease (aHR ≈ 8.14). Persistent dyspnea and reduced DLCO (diffusing capacity for carbon monoxide) suggest ARDS-related injury, tissue remodeling, and microvascular dysfunction. Conclusions: In COPD, post-COVID respiratory sequelae result from the interaction of mucus, immunity, and infectious/sepsis-related complications. The first post-discharge month is a critical period requiring careful risk stratification and targeted follow-up.},
}

@article {pmid42075512,
year = {2026},
author = {Alexandru, GC and Gligor, LN and Chioran, D and Roi, CI and Riviș, M and Pricop, MO and Urîtu, A and Pacnejer, AM and Manea, HC and Olariu, TR},
title = {Post-COVID-19 Jaw Osteonecrosis: A Narrative Review.},
journal = {Medicina (Kaunas, Lithuania)},
volume = {62},
number = {4},
pages = {},
pmid = {42075512},
issn = {1648-9144},
mesh = {Humans ; *COVID-19/complications ; *Osteonecrosis/etiology/therapy ; Risk Factors ; *Jaw Diseases/etiology/therapy ; SARS-CoV-2 ; Mucormycosis/complications ; Bisphosphonate-Associated Osteonecrosis of the Jaw ; },
abstract = {Background and Objectives: Osteonecrosis of the jaw (ONJ) occurring after infection with SARS-CoV-2 has emerged as an increasingly reported complication in the post-COVID-19 era. Post-COVID-19 osteonecrosis of the jaw (PC-ONJ) has been described in association with both COVID-19-associated mucormycosis (CAM) and non-fungal phenotypes. This narrative review aims to synthesize and critically analyze the available evidence regarding terminology and classification, epidemiology and risk factors, pathophysiological mechanisms, clinical and imaging characteristics, diagnostic challenges, and management strategies relevant to oral and maxillofacial surgery practice. Materials and Methods: An extensive literature search was conducted in the PubMed/MEDLINE, Scopus, Web of Science, ScienceDirect, and Google Scholar databases. The search targeted peer-reviewed publications published between 2020 and 2025, reflecting the post-pandemic emergence of this clinical spectrum. Original studies, systematic and narrative reviews, multicenter case series, consensus guidelines, and well-documented case reports were considered. Results: Available data, largely derived from case reports and small series, demonstrate a predominance of maxillary involvement and frequent association with diabetes mellitus and systemic corticosteroid therapy. Proposed mechanisms include COVID-19-associated endothelial dysfunction, microvascular thrombosis, immune dysregulation, metabolic imbalance, and treatment-related effects. Clinically, patients may present with persistent orofacial pain, tooth mobility, exposed or probeable bone, and frequent sinonasal extension, with symptoms sometimes preceding bone exposure. Diagnostic challenges arise from the overlap with medication-related osteonecrosis of the jaw (MRONJ), osteoradionecrosis (ORN), and chronic osteomyelitis. Imaging is essential for assessing disease extent but remains insufficient for etiologic differentiation, making histopathological examination and targeted microbiological investigations necessary, particularly to exclude invasive fungal infection. Conclusions: Management must be etiology-driven. CAM requires urgent antifungal therapy combined with surgical debridement, whereas non-fungal forms are generally managed with conservative surgery and appropriate antimicrobial stewardship. Standardized diagnostic criteria and prospective multicenter studies are needed to reduce nosological ambiguity and optimize clinical decision-making in this emerging post-viral condition.},
}

Humans
*COVID-19/complications
*Osteonecrosis/etiology/therapy
Risk Factors
*Jaw Diseases/etiology/therapy
SARS-CoV-2
Mucormycosis/complications
Bisphosphonate-Associated Osteonecrosis of the Jaw

@article {pmid42075521,
year = {2026},
author = {Balan, A and Graham, G and Sorin, H and Marcu, M and Gheorghe, N and Gabriela, M and Florescu, AR and Popa, AM and Lascu, A and Mot, CI and Mihaicuta, S and Frent, SM},
title = {Efficacy and Safety of Vagus Nerve Stimulation for Hospitalized COVID-19 Patients: A Systematic Review and Methodological Evaluation of Randomized Controlled Trials.},
journal = {Medicina (Kaunas, Lithuania)},
volume = {62},
number = {4},
pages = {},
pmid = {42075521},
issn = {1648-9144},
mesh = {Humans ; Randomized Controlled Trials as Topic ; *Vagus Nerve Stimulation/methods/adverse effects ; *COVID-19/therapy ; Hospitalization ; Treatment Outcome ; SARS-CoV-2 ; },
abstract = {Background and Objectives: Coronavirus disease 2019 (COVID-19) is characterized by excessive inflammatory responses, including the so-called cytokine storm, which contributes substantially to morbidity and mortality in hospitalized patients. The vagus nerve, through the cholinergic anti-inflammatory pathway, represents a theoretically attractive therapeutic target for modulating systemic inflammation. Vagus nerve stimulation (VNS) has emerged as a potential adjunctive treatment for COVID-19, with several randomized controlled trials (RCTs) investigating its efficacy on inflammatory biomarkers and clinical outcomes. The quality of this evidence base has not been rigorously evaluated. This systematic review critically appraises all available RCT evidence for VNS in hospitalized COVID-19 patients. Materials and Methods: We systematically searched PubMed, Scopus, Cochrane (CENTRAL), and Web of Science from database inception to January 2026, for RCTs evaluating any form of VNS (invasive, non-invasive, cervical, or auricular) in hospitalized patients with confirmed acute COVID-19. Two reviewers independently screened titles, abstracts, and full texts according to pre-specified eligibility criteria. Risk of bias was assessed using the Cochrane Risk of Bias 2 (RoB 2) tool, with assessments initially performed using multiple artificial intelligence tools and subsequently validated by the authors in accordance with PRISMA 2020 guidelines. Given substantial heterogeneity and high risk of bias, narrative synthesis was performed rather than meta-analysis. Also, GRADE assessment was performed. Results: From 437 records identified, six RCTs comprising 221 patients met the inclusion criteria. Five trials (83%) were rated as high risk of bias, primarily due to inadequate blinding, substantial baseline imbalances, significant missing data and extensive multiple testing without statistical correction. The single double-blind trial with a credible sham control (Rangon et al.) found null results across all outcomes, including clinical progression, ICU transfer, and mortality, while the five "high" risk-of-bias trials generally reported positive findings on various inflammatory markers and clinical outcomes. One trial (Corrêa et al.) measured heart rate variability as a direct indicator of vagal activation and found no change despite claiming anti-inflammatory effects, contradicting the proposed mechanism of action. Significant cognitive findings from an interim analysis (Uehara et al., n = 21) disappeared in the larger completed trial (Corrêa et al., n = 52), providing empirical demonstration of false positive findings in small, underpowered studies. Conclusions: Currently available evidence supporting the use of VNS for acute COVID-19 remains scarce; however, the physiological rationale remains sound, although the absence of reliable target engagement markers in the included studies limits confidence in this treatment method. Large-scale, double-blind, sham-controlled trials are required before VNS can be firmly recommended for COVID-19 management.},
}

Humans
Randomized Controlled Trials as Topic
*Vagus Nerve Stimulation/methods/adverse effects
*COVID-19/therapy
Hospitalization
Treatment Outcome
SARS-CoV-2

@article {pmid42075693,
year = {2026},
author = {Amusan, OT and Guo, H},
title = {CMGC Kinases in Viral Infection and Human Disease.},
journal = {Pathogens (Basel, Switzerland)},
volume = {15},
number = {4},
pages = {},
pmid = {42075693},
issn = {2076-0817},
support = {R21CA303392//National Institute of Health/ ; P20GM134974//National Institute of Health/ ; },
mesh = {Animals ; Humans ; Host-Pathogen Interactions ; Receptor Cross-Talk ; *Signal Transduction ; *Virus Diseases/enzymology ; Phosphorylation ; *Protein Serine-Threonine Kinases/metabolism ; },
abstract = {Cellular processes rely heavily on protein phosphorylation, a mechanism essential for organismal physiology and pathology. The CMGC family comprises a large group of serine/threonine kinases defined by a conserved catalytic core and closely related kinase domains. While several CMGC members have been extensively studied, others, including the RCK and CDKL subfamilies, remain less studied. Here, we synthesize current knowledge of CMGC kinases, emphasizing their structural organization, mechanisms of activation, and roles in infection and disease. CMGC kinases such as CDKs and DYRKs are activated downstream of growth factor signaling to drive proliferative programs. In contrast, other CMGC members respond to cellular stress signals, including stress cytokines, and function during quiescence or adverse conditions to regulate antiproliferative and pro-survival pathways. Through these context-dependent activities, CMGCs govern fundamental cellular processes, including growth, metabolism, transcription, and genome integrity. Although individual CMGC kinases operate within distinct signaling cascades, substantial crosstalk exists among their pathways. Both DNA and RNA viruses exploit host CMGC networks to reprogram the intracellular environment and enhance replication. While CMGC-virus interactions are often proviral, specific CMGC-mediated antiviral responses have been described, notably in SARS-CoV-2 infection. Collectively, CMGC kinases occupy a central position in cellular homeostasis and disease.},
}

Animals
Humans
Host-Pathogen Interactions
Receptor Cross-Talk
*Signal Transduction
*Virus Diseases/enzymology
Phosphorylation
*Protein Serine-Threonine Kinases/metabolism

@article {pmid42075711,
year = {2026},
author = {Khan, MA and Khan, MH and Allemailem, KS},
title = {Mitogen-Activated Protein Kinases: Therapeutic Signaling Catalysts in Viral Immune Evasion.},
journal = {Pathogens (Basel, Switzerland)},
volume = {15},
number = {4},
pages = {},
pmid = {42075711},
issn = {2076-0817},
mesh = {Humans ; *Immune Evasion ; *Mitogen-Activated Protein Kinases/metabolism/immunology ; *Virus Diseases/immunology/drug therapy/virology ; SARS-CoV-2/immunology ; Signal Transduction ; Antiviral Agents/therapeutic use/pharmacology ; Animals ; *MAP Kinase Signaling System/immunology ; COVID-19/immunology ; Host-Pathogen Interactions/immunology ; },
abstract = {The mitogen-activated protein kinase (MAPK) pathways, ERK, JNK, and p38, are key regulators of immune responses during viral infections. These signaling cascades control cytokine production, T cell activity, and antigen presentation. However, many viruses can hijack MAPK pathways to avoid immune detection, promote their replication, and establish chronic infection. In this review, we discuss how different viruses, including HSV-1, HBV, HCMV, and SARS-CoV-2, manipulate MAPK signaling to alter host cell functions. A particular focus is given to the CD1d-iNKT cell axis, which plays a critical role in early antiviral responses but is often disrupted through MAPK-dependent mechanisms. We explore how changes in MAPK signaling affect antigen-presenting cells, drive T cell exhaustion, and reprogram immune cell metabolism, factors that contribute to viral immune evasion. The review also examines therapeutic strategies aimed at targeting MAPKs to improve antiviral immunity. These include small-molecule inhibitors and immune modulators that may enhance antiviral responses while limiting side effects. We emphasize the importance of context, as MAPK-targeted therapies must be carefully timed and tailored to avoid suppressing protective immunity or triggering unwanted inflammation. Overall, this review highlights the therapeutic potential and challenges of targeting MAPK pathways in viral infections and encourages further research into selective, host-directed antiviral strategies.},
}

Humans
*Immune Evasion
*Mitogen-Activated Protein Kinases/metabolism/immunology
*Virus Diseases/immunology/drug therapy/virology
SARS-CoV-2/immunology
Signal Transduction
Antiviral Agents/therapeutic use/pharmacology
Animals
*MAP Kinase Signaling System/immunology
COVID-19/immunology
Host-Pathogen Interactions/immunology

@article {pmid42075977,
year = {2026},
author = {Büyüker, SM and Khan, KA and Khalil, AQK and Khan, I and Jahan, S and Adil, M and Al-Rohily, KM and Al-Khamees, AH and Khalil, AAK},
title = {Elaeocarpus sylvestris (Lour.) Poir.: Phytochemistry and Pharmacological Potential-A Review.},
journal = {Molecules (Basel, Switzerland)},
volume = {31},
number = {8},
pages = {},
pmid = {42075977},
issn = {1420-3049},
mesh = {Humans ; *Plant Extracts/chemistry/pharmacology ; *Phytochemicals/chemistry/pharmacology ; Antiviral Agents/chemistry/pharmacology ; *Elaeocarpaceae/chemistry ; Antioxidants/chemistry/pharmacology ; Animals ; Anti-Inflammatory Agents/chemistry/pharmacology ; Flavonoids/chemistry/pharmacology ; COVID-19 Drug Treatment ; Antineoplastic Agents, Phytogenic/chemistry/pharmacology ; },
abstract = {Elaeocarpus sylvestris (Lour.) Poir., an evergreen tree native to East and Southeast Asia, has gained increasing scientific attention owing to its broad pharmacological properties. Traditionally used in East Asian medicine to treat inflammation, fever, and infectious diseases, modern research has revealed diverse bioactivities, including potent antioxidant, anti-inflammatory, antiviral, anticancer, antidiabetic, and immunomodulatory effects. This therapeutic potential is primarily attributed to its rich phytochemical composition, particularly polyphenols such as geraniin, 1,2,3,4,6-penta-O-galloyl-β-D-glucose and quercetin. This review particularly focuses on the chemistry of E. sylvestris, summarizing structurally elucidated compounds, including hydrolysable tannins, flavonoids, and triterpenoids, along with recent insights into the structure-activity relationships that underpin these antiviral, antioxidant, and anticancer activities. Recent studies have demonstrated substantial antiviral efficacy of E. sylvestris extracts and isolated compounds against major human pathogens, including herpesviruses, influenza A virus, and SARS-CoV-2, supported by in silico, in vitro, in vivo, and early-phase clinical evaluations. Its cosmeceutical applications, including antioxidant, skin-whitening, and blue-light protective effects, further highlight its multifunctional potential. To our knowledge, this is the first comprehensive review summarizing the phytochemistry, pharmacological activities, therapeutic potential, and cosmeceutical applications of E. sylvestris. Despite these promising findings, challenges remain in elucidating precise molecular mechanisms, pharmacokinetics, and clinical validation. This review identifies current research gaps and future directions necessary to advance E. sylvestris as a scientifically validated natural therapeutic resource.},
}

Humans
*Plant Extracts/chemistry/pharmacology
*Phytochemicals/chemistry/pharmacology
Antiviral Agents/chemistry/pharmacology
*Elaeocarpaceae/chemistry
Antioxidants/chemistry/pharmacology
Animals
Anti-Inflammatory Agents/chemistry/pharmacology
Flavonoids/chemistry/pharmacology
COVID-19 Drug Treatment
Antineoplastic Agents, Phytogenic/chemistry/pharmacology