@article {pmid42334213,
year = {2026},
author = {Bermejo-Jambrina, M and Paužuolis, M and Kimpel, J and Gerold, G},
title = {Double trouble: how co- and superinfections shape viral dynamics and host responses.},
journal = {Journal of virology},
volume = {100},
number = {7},
pages = {e0205525},
pmid = {42334213},
issn = {1098-5514},
mesh = {*Superinfection/virology/immunology ; *Coinfection/virology/immunology ; Humans ; *Host-Pathogen Interactions/immunology ; Virus Replication ; *Virus Diseases/virology/immunology ; Animals ; },
abstract = {Concurrent infection of humans by multiple distinct viruses is a common biological phenomenon with important consequences for virus-host interactions. While coinfection refers to the simultaneous infection of an individual or cell with two or more viruses, superinfection denotes the establishment of a secondary infection following a primary one, in which the initial infection influences the susceptibility, replication, or outcome of the secondary infection. Virus-virus interactions can be antagonistic, facilitative, dependent/assisted, or neutral. Antagonistic interactions include superinfection exclusion, whereby a primary virus prevents or restricts secondary infection of the same cell, securing access to host resources and stabilizing replication while limiting genetic and viral diversity. In contrast, facilitative viral interactions arise when one virus disrupts tissue barriers, suppresses immune responses, or remodels cellular pathways, thereby increasing susceptibility to additional viral infections. These interactions intersect with fundamental viral strategies, including the generation of genetically diverse RNA virus quasispecies that promote rapid adaptation and the deployment of DNA virus immunoevasins that interfere with antigen presentation and host immune recognition. While each of these processes has been extensively studied individually, their combined impact during coinfection remains poorly defined. In this review, we synthesize current knowledge on virus-virus interactions, viral diversity, and immune evasion in the context of multi-viral infections. We focus on how interactions at cellular and tissue levels shape infection outcomes, influence viral evolution, and contribute to virus-host coevolution. Finally, we also highlight key gaps in our understanding of viral interference and cooperation and discuss emerging approaches needed to define the spatiotemporal dynamics of coinfection in vivo.},
}

*Superinfection/virology/immunology
*Coinfection/virology/immunology
Humans
*Host-Pathogen Interactions/immunology
Virus Replication
*Virus Diseases/virology/immunology
Animals

@article {pmid42334562,
year = {2026},
author = {Khudair, M and Swift, SL and Dienes, K and Kannan, YA and Vedhara, K},
title = {Factors associated with vaccination intentions and uptake among pregnant women in the UK: A scoping review.},
journal = {Human vaccines & immunotherapeutics},
volume = {22},
number = {1},
pages = {2687220},
pmid = {42334562},
issn = {2164-554X},
mesh = {Humans ; Female ; Pregnancy ; United Kingdom ; *Vaccination/psychology/statistics & numerical data ; *Pregnant People/psychology ; *Vaccination Hesitancy/psychology/statistics & numerical data ; *Health Knowledge, Attitudes, Practice ; *Patient Acceptance of Health Care/psychology ; *Intention ; },
abstract = {This scoping review aimed to identify factors associated with vaccination decisions among pregnant women in the UK, guided by the SAGE matrix on vaccine hesitancy, and explored differences between qualitative and quantitative findings and between vaccine intentions (attitudes) and actual uptake (behaviors). Embase®, MEDLINE®, PsycInfo, Web of Science, and Cochrane were searched; rapid review methodologies were applied. From 2,326 records, 49 primary studies were included (published 2010-2025). We identified 222 qualitative factors from 32 studies, and 114 quantitative factors from 30 studies. Qualitative studies frequently reported individual and group influences, particularly beliefs and attitudes about vaccine effectiveness and safety, and the role of healthcare professionals in decision-making. Quantitative studies highlighted sociodemographic influences, including older age, ethnicity, and lower social/economic deprivation. Factors found to be associated with vaccination intention vs. uptake were inconsistent, though these findings should be interpreted cautiously given the modest number of studies addressing this issue.},
}

Humans
Female
Pregnancy
United Kingdom
*Vaccination/psychology/statistics & numerical data
*Pregnant People/psychology
*Vaccination Hesitancy/psychology/statistics & numerical data
*Health Knowledge, Attitudes, Practice
*Patient Acceptance of Health Care/psychology
*Intention

@article {pmid42335758,
year = {2026},
author = {Liu, Z and Wang, X and Hu, Y and Duan, X and Xu, S and Ge, Q and Zhu, W and Zhao, J and Yao, Y and Wang, W},
title = {Burden of infection and hospitalization from respiratory syncytial virus-associated acute lower respiratory tract infections in Chinese children: Modeling of national, regional, and provincial estimates.},
journal = {Vaccine},
volume = {88},
number = {},
pages = {128875},
doi = {10.1016/j.vaccine.2026.128875},
pmid = {42335758},
issn = {1873-2518},
mesh = {Child, Preschool ; Humans ; Infant ; Infant, Newborn ; China/epidemiology ; Cost of Illness ; COVID-19/epidemiology ; *Hospitalization/statistics & numerical data ; Incidence ; *Respiratory Syncytial Virus Infections/epidemiology ; Respiratory Syncytial Virus, Human ; *Respiratory Tract Infections/epidemiology/virology ; Risk Factors ; Seasons ; },
abstract = {BACKGROUND: Respiratory syncytial virus (RSV) is a major cause of acute lower respiratory tract infections (ALRIs) in children. To guide policymaking on controlling RSV-associated ALRIs (RSV-ALRIs) in China, we estimated the national, regional, and provincial burdens of RSV-ALRIs and associated hospitalizations for children under 5 years old.

METHODS: We systematically identified publications about RSV-ALRIs in China with epidemiological data before 2020. We compared seasonality data from this period with data during the COVID-19 epidemic. We built a dataset to assess RSV-ALRI burden by age and region, using a generalized linear mixed-effects model and a conceptual proportionality framework to assess hospitalization rates. A risk factor-based model were used to estimate regional and provincial RSV-ALRI incidence.

FINDINGS: Children aged 0 to 12 months had the highest risk of RSV-ALRI and associated hospitalization. Provincial variations existed, with some southern provinces exhibiting higher incidence and some western provinces higher hospitalization rates. The COVID-19 epidemic shifted RSV hospitalization peaks to early autumn (Guangdong, Shanghai), whereas Hubei and Shandong demonstrated delayed peak onset compared with the pre-pandemic period.

INTERPRETATION: Our study of the burden RSV-ALRIs in China identified obvious heterogeneity by age and region. These findings highlight the need for targeted RSV vaccination strategies and resource allocation prioritizing high-risk groups and areas.

FUNDING: This work was supported by the Shanghai Municipal Science and Technology Major Project (Grant No. ZD2021CY001), the National Natural Science Foundation of China (Grant No. 82073612), and Shanghai New Three-year Action Plan for Public Health (GWVI-1, GWVI-11.1-03 and GWVI-11.1-01).},
}

Child, Preschool
Humans
Infant
Infant, Newborn
China/epidemiology
Cost of Illness
COVID-19/epidemiology
*Hospitalization/statistics & numerical data
Incidence
*Respiratory Syncytial Virus Infections/epidemiology
Respiratory Syncytial Virus, Human
*Respiratory Tract Infections/epidemiology/virology
Risk Factors
Seasons

@article {pmid42336668,
year = {2026},
author = {Hasmee, N and Joshi, H and Gurung, M and Singh, B and Naseema, S},
title = {Optimising ICU supply chains: Evidence-based strategies for efficiency, resilience and patient safety-a structured narrative review.},
journal = {BMJ open quality},
volume = {15},
number = {2},
pages = {},
pmid = {42336668},
issn = {2399-6641},
mesh = {Humans ; *Intensive Care Units/organization & administration ; *Patient Safety/standards ; COVID-19/epidemiology ; *Efficiency, Organizational ; SARS-CoV-2 ; Evidence-Based Practice ; },
abstract = {Inventory management in intensive care units (ICUs) plays a critical role in ensuring uninterrupted patient care, yet it remains an underprioritised component of healthcare operations. This narrative review explores current challenges and evidence-based strategies for optimising ICU supply chains. Issues such as unpredictable demand, manual stock tracking, procurement inefficiencies and limited staff training often contribute to stockouts, expired supplies and delayed interventions. The COVID-19 pandemic further exposed systemic vulnerabilities, emphasising the need for resilient, technology-driven supply systems. A comprehensive literature search (2004-2025) was conducted across PubMed, Scopus, Web of Science and Google Scholar using keywords related to ICU inventory, artificial intelligence (AI) forecasting, radio frequency identification (RFID), procurement and digital health logistics. Findings were synthesised into thematic categories addressing core problems and interventions. Key strategies include implementing automated tracking systems, adopting AI-driven demand forecasting, standardising procurement policies, training ICU staff in inventory best practices and establishing emergency buffer stock. Emerging technologies such as digital twins and blockchain are highlighted for their potential to enhance transparency, responsiveness and planning accuracy. Additionally, fostering multisourcing supplier partnerships and optimising ICU storage space can further enhance system agility and reduce waste. In conclusion, ICU supply chains must evolve from reactive, manual systems to proactive, data-driven frameworks. Hospitals should invest in digital infrastructure, staff training and ethical procurement models to build resilient, cost-effective and patient-centred supply chains.},
}

Humans
*Intensive Care Units/organization & administration
*Patient Safety/standards
COVID-19/epidemiology
*Efficiency, Organizational
SARS-CoV-2
Evidence-Based Practice

@article {pmid42337147,
year = {2026},
author = {Lansayan, J and Chin, KL and AbuBakar, S and Zainal, N},
title = {Clinical Manifestations and Immunological Impacts in Co-Infections and Sequential Infections of SARS-CoV-2 and Arboviruses.},
journal = {Current microbiology},
volume = {83},
number = {8},
pages = {},
pmid = {42337147},
issn = {1432-0991},
support = {MO002D-2021//Ministry of Higher Education, Malaysia/ ; MO002D-2021//Ministry of Higher Education, Malaysia/ ; MO002D-2021//Ministry of Higher Education, Malaysia/ ; MO002D-2021//Ministry of Higher Education, Malaysia/ ; },
mesh = {Humans ; *Coinfection/immunology/virology ; *COVID-19/immunology ; *Arbovirus Infections/immunology/pathology/virology/diagnosis ; SARS-CoV-2/immunology ; Arboviruses/immunology ; Cross Reactions ; Antibody-Dependent Enhancement ; Pandemics ; },
abstract = {Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and arboviruses represent major global public health threats, each with distinct epidemiological and pathogenic profiles that often overlap in endemic regions. Reports of co-infection and cross-reactivity between these viruses highlight the need for deeper understanding of their interactions. Co-infections pose diagnostic challenges due to overlapping clinical symptoms and immune modulation, which may exacerbate disease severity. Moreover, antibodies generated from prior virus infections may influence the outcome of subsequent infections through mechanisms such as cross-reactivity and antibody-dependent enhancement (ADE). This review summarises current knowledge on the clinical manifestations and immunological consequences of co- and subsequent infections involving SARS-CoV-2 and arboviruses. Emphasis is placed on underlying pathophysiological mechanisms, including cross-reactivity and ADE, that shape host immune responses. Understanding these interactions is essential for improving diagnostic accuracy and guiding public health strategies to mitigate the risks associated with co-infections and sequential viral infections.},
}

Humans
*Coinfection/immunology/virology
*COVID-19/immunology
*Arbovirus Infections/immunology/pathology/virology/diagnosis
SARS-CoV-2/immunology
Arboviruses/immunology
Cross Reactions
Antibody-Dependent Enhancement
Pandemics

@article {pmid42338490,
year = {2026},
author = {Nirala, S and Huang, C and Mu, Q},
title = {TORCH infections at the maternal-fetal placental transmission: an overview of multi-omics, pathogenesis and innate immune defense.},
journal = {Frontiers in cellular and infection microbiology},
volume = {16},
number = {},
pages = {1817189},
pmid = {42338490},
issn = {2235-2988},
mesh = {Humans ; Female ; Pregnancy ; *Infectious Disease Transmission, Vertical ; *Immunity, Innate ; *Placenta/virology/immunology/parasitology ; *Pregnancy Complications, Infectious/immunology/virology ; Multiomics ; Host-Pathogen Interactions/immunology ; Toxoplasmosis/transmission/immunology ; Rubella/transmission/immunology ; Toxoplasma/immunology/pathogenicity ; Animals ; Proteomics ; Zika Virus Infection/transmission/immunology ; SARS-CoV-2/immunology ; Maternal-Fetal Exchange/immunology ; },
abstract = {The maternal-fetal interface represents a dynamic immunological frontier where pregnancy outcomes are determined by the delicate balance between host defense and microbial pathogenesis. Vertical transmission of pathogens across the placental barrier can lead to devastating consequences including fetal loss, stillbirth, prematurity, and congenital anomalies. The classic TORCH acronym encompasses Toxoplasma gondii, Other agents, Rubella virus, Cytomegalovirus, and Herpes simplex virus, though emerging viruses including Zika virus and SARS-CoV-2 have expanded this spectrum. This review synthesizes current understanding of molecular mechanisms underlying vertical transmission, emphasizing the placenta's multi-layered defense system encompassing the syncytiotrophoblast physical barrier, specialized decidual immune cell populations including decidual natural killer cells and macrophages, and constitutive antimicrobial signaling pathways focusing on the placenta's multi-layered defense system encompassing the syncytiotrophoblast physical barrier, specialized decidual immune cell populations including decidual natural killer cells and macrophages, and constitutive antimicrobial signaling pathways. Concurrently, we examine pathogen strategies to subvert these defenses through receptor manipulation, immune evasion, and intracellular replication niches. A major focus is dedicated to the impact of proteomics and single-cell multi-omics in deconvoluting the host-pathogen interactome and identifying biomarkers of fetal injury. Recent seroprevalence studies demonstrate that younger women represent the most susceptible population to acute TORCH infections, highlighting the need for targeted screening programs. This synthesis provides a framework for developing precision diagnostics and targeted interventions to prevent vertical transmission and reduce the global burden of congenital infections.},
}

Humans
Female
Pregnancy
*Infectious Disease Transmission, Vertical
*Immunity, Innate
*Placenta/virology/immunology/parasitology
*Pregnancy Complications, Infectious/immunology/virology
Multiomics
Host-Pathogen Interactions/immunology
Toxoplasmosis/transmission/immunology
Rubella/transmission/immunology
Toxoplasma/immunology/pathogenicity
Animals
Proteomics
Zika Virus Infection/transmission/immunology
SARS-CoV-2/immunology
Maternal-Fetal Exchange/immunology

@article {pmid42339932,
year = {2026},
author = {Theodoro, EL and Prediger, KM and Damacena, MA and Silva, CVD and Cano, RDN and Uehara, SCDSA},
title = {Oral manifestations associated with long COVID: a scoping review.},
journal = {Revista brasileira de enfermagem},
volume = {79},
number = {},
pages = {e20250198},
pmid = {42339932},
issn = {1984-0446},
mesh = {Humans ; Post-Acute COVID-19 Syndrome ; *COVID-19/complications ; *Mouth Diseases/etiology/epidemiology ; Quality of Life ; SARS-CoV-2 ; Female ; },
abstract = {OBJECTIVES: to map scientific evidence on oral manifestations originating during long COVID.

METHODS: this is a scoping review based on the method described by JBI. Primary articles published in Portuguese, English, and Spanish between March 2020 and December 2024 were included from the PubMed, Web of Science, Virtual Health Library, Scopus, Excerpta Medica dataBASE, and Scientific Electronic Library Online databases, and a descriptive analysis was performed.

RESULTS: of the 15 studies analyzed, the most frequent oral manifestations of long COVID were taste alterations, xerostomia, difficulty chewing, gingival bleeding, periodontitis, and changes in the teeth.

CONCLUSIONS: an association between long COVID and various oral manifestations was evidenced, impacting the quality of life of patients. Factors such as age, comorbidities, and social inequalities influence the persistence of these manifestations, with a higher prevalence in women. Multiprofessional collaboration and clearer guidelines are essential to improve dental care.},
}

Humans
Post-Acute COVID-19 Syndrome
*COVID-19/complications
*Mouth Diseases/etiology/epidemiology
Quality of Life
SARS-CoV-2
Female

@article {pmid42340118,
year = {2026},
author = {Poder, TG and Camara, MA and Bouchard, PA and Lellouche, F},
title = {Pricing Policy for Medical Oxygen and Potential Savings.},
journal = {Journal of evaluation in clinical practice},
volume = {32},
number = {4},
pages = {e70510},
pmid = {42340118},
issn = {1365-2753},
mesh = {Humans ; *Cost Savings ; *Costs and Cost Analysis ; *Oxygen/economics/therapeutic use ; *Oxygen Inhalation Therapy/economics ; Quebec ; },
abstract = {BACKGROUND: Medical oxygen is essential in modern medicine.

AIMS: This study analyzes the pricing policies and costs of medical oxygen in Quebec, provides elements of international comparison, and explores the potential savings through the optimization of oxygen therapy practices.

MATERIALS AND METHODS: It combines a narrative literature review, an analysis of administrative and financial documents, as well as administrative data obtained from representatives of the healthcare sector in Quebec.

RESULTS: The literature review highlights the challenges of producing, storing, and distributing medical oxygen, which have been accentuated by the COVID-19 pandemic. A very large disparity in pricing policies is also noted among healthcare systems, especially when cylinders are predominantly used. In Quebec, costs vary according to production methods, logistics, and contractual clauses. Optimizing oxygen therapy practices would allow significant savings, particularly by reducing oxygen consumption through various strategies.

DISCUSSION: The study shows the complexity of managing medical oxygen costs, amplified by limited competition and rigid contractual clauses. International comparison highlights the importance of infrastructure, while optimizing oxygen therapy practices offers significant savings potential. To reduce costs, it is recommended to improve distribution management, adopt more flexible contractual clauses, and strengthen competition.

CONCLUSION: To optimize medical oxygen use, actions to undertake from managers and clinicians are highlighted.},
}

Humans
*Cost Savings
*Costs and Cost Analysis
*Oxygen/economics/therapeutic use
*Oxygen Inhalation Therapy/economics
Quebec

@article {pmid42340456,
year = {2026},
author = {Tahmtan, A and Nissapatorn, V and Saravanabhavan, SS and Taherkhani, S and Aghcheli, B},
title = {Viral Infections and Neurodegenerative Diseases: Reinterpreting the Crosstalk Through a Dual-Role Lens.},
journal = {Current microbiology},
volume = {83},
number = {8},
pages = {},
pmid = {42340456},
issn = {1432-0991},
mesh = {Humans ; *Neurodegenerative Diseases/virology/therapy ; Genetic Vectors/genetics ; *Virus Diseases/complications/virology/therapy ; Genetic Therapy/methods ; Animals ; Gene Therapy Agents ; },
abstract = {Neurodegenerative diseases (NDDs) are multifactorial disorders with increasing evidence implicating viral infections in their pathogenesis. However, current reviews often catalog virus-disease associations without integrating this evidence into a unified conceptual model that also accounts for the therapeutic potential of viral platforms. This review investigates recent literature to propose a "dual-role" model for viruses in NDDs. We analyze how diverse viruses (e.g., HSV-1, HIV, EBV, and SARS-CoV-2) converge on shared pathogenic pathways, including protein misfolding, chronic neuroinflammation, and mitochondrial dysfunction, across different NDDs. Paradoxically, engineered viral vectors derived from neurotropic viruses are being investigated as tools for targeted gene therapy. To address these therapeutic applications of viruses, this review also provides an in-depth report of the various viral vector technologies developed. The approaches involved in designing rationally engineered viral vectors based on various adeno-associated virus serotypes through rational design, directed evolution and machine learning strategies, as well as the lentiviral and herpes simplex virus-based platform are described. Different strategies that have been used to incorporate large and/or small payloads such as gene replacement, RNA interference, microRNA cassettes, CRISPR-based gene editing (base editing, prime editing, CRISPRa and CRISPRi) and the double AAV systems to deliver larger transgene cassette have also been reviewed. This review further includes various routes of administration including intrathecal, intracerebroventricular and convection-enhanced delivery with the use of Focused Ultrasound. The constraints imposed by the Blood-Brain Barrier are discussed, especially the approach using receptor-mediated transcytosis for crossing. The review also critically evaluates obstacles toward clinical translation of viral vectors due to various factors including immunogenicity, the presence of pre-existing neutralising antibodies and dose-dependent toxicity, illustrated by the fatal outcome of ASPIRO and DMD trials. Finally, this review concludes with other promising non-viral approaches such as lipid nanoparticle and extracellular vesicles. Future research needs include long-term studies to investigate causality and extensive safety optimization of viral vectors.},
}

Humans
*Neurodegenerative Diseases/virology/therapy
Genetic Vectors/genetics
*Virus Diseases/complications/virology/therapy
Genetic Therapy/methods
Animals
Gene Therapy Agents

@article {pmid42340792,
year = {2026},
author = {Elgazzar, YA and Abdelrazek, M and Ghozzy, OAM and Mashhour, K and Elhady, MA and Amro, OAEA and Mokhtar, HM and Abdellatif, KAK and Mohamed, MM and Alsharif, MB and Mawkili, H and Hendi, AM and Dhayihi, TM and Adawy, Z and Ali, RF},
title = {CT-Assessed Sarcopenia Combined with Laboratory Inflammatory Markers for Outcome Prediction in Critically Ill, Pulmonary, and Geriatric Patients: A Systematic Review and Meta-Analysis.},
journal = {La Clinica terapeutica},
volume = {177},
number = {4},
pages = {903-915},
doi = {10.7417/CT.2026.2085},
pmid = {42340792},
issn = {1972-6007},
mesh = {Humans ; *Sarcopenia/diagnostic imaging/blood/mortality ; *Tomography, X-Ray Computed ; *Critical Illness ; Biomarkers/blood ; Prognosis ; Aged ; C-Reactive Protein/analysis ; *Lung Diseases/blood/complications/mortality ; Length of Stay ; Respiration, Artificial/statistics & numerical data ; Predictive Value of Tests ; *Inflammation/blood ; },
abstract = {BACKGROUND: Sarcopenia, assessed via computed tomography (CT), is an emerging prognostic tool in critically ill, pulmonary, and geriatric patients. Laboratory inflammatory markers such as C-reactive protein (CRP), interleukin-6 (IL-6), and neutrophil-to-lymphocyte ratio (NLR) are routinely obtained in these populations. Whether CT-assessed sarcopenia combined with laboratory markers offers superior prognostic accuracy over either measure alone remains unclear.

OBJECTIVES: To systematically evaluate the prognostic value of CT-assessed sarcopenia, alone or combined with laboratory inflammatory/nutritional markers, for predicting mortality, mechanical ventilation duration, and ICU length of stay in critically ill, pulmonary, and geriatric patients.

METHODS: MEDLINE/PubMed, Scopus, Embase, and Cochrane Library were searched from inception to December 2024. Observational studies (prospective or retrospective cohorts, case-control) that reported CT-based sarcopenia assessment alongside at least one laboratory inflammatory marker and at least one clinical outcome were included. Two reviewers independently screened studies, extracted data, and assessed methodological quality using the Newcastle-Ottawa Scale (NOS). Random-effects meta-analysis was performed; heterogeneity was assessed using the I² statistic.

RESULTS: Twenty-five studies encompassing 12,347 patients were identified. The pooled odds ratio for mortality in sarcopenic versus non-sarcopenic patients was 2.28 (95% CI: 1.83-2.83; I² = 22.1%) across critically ill ICU cohorts. In COVID-19 pulmonary populations, pooled OR for in-hospital mortality with low skeletal muscle mass was 5.84 (95% CI: 1.07-31.83). CT-derived muscle measurements correlated inversely with CRP (r = -0.315), fibrinogen (r = -0.392), D-dimers (r = -0.363), and WBC count (r = -0.287). Combined CT-sarcopenia and inflammatory marker models outperformed conventional scoring systems (APACHE II, SOFA, CURB-65, PSI).

CONCLUSIONS: CT-assessed sarcopenia, when integrated with laboratory inflammatory markers, provides a robust, mechanistically grounded, and clinically accessible multimodal prognostic framework across critically ill, pulmonary, and geriatric populations.},
}

Humans
*Sarcopenia/diagnostic imaging/blood/mortality
*Tomography, X-Ray Computed
*Critical Illness
Biomarkers/blood
Prognosis
Aged
C-Reactive Protein/analysis
*Lung Diseases/blood/complications/mortality
Length of Stay
Respiration, Artificial/statistics & numerical data
Predictive Value of Tests
*Inflammation/blood

@article {pmid42341950,
year = {2026},
author = {Giunta, S and Sabbatinelli, J and Olivieri, F and Giuliani, A},
title = {Aging-related autonomic nervous system imbalance and adrenergic regulation of immunity: Implications for inflammaging, autoimmunity, and long COVID.},
journal = {Frontiers in neuroendocrinology},
volume = {82},
number = {},
pages = {101269},
doi = {10.1016/j.yfrne.2026.101269},
pmid = {42341950},
issn = {1095-6808},
mesh = {Humans ; Post-Acute COVID-19 Syndrome ; *Aging/immunology ; *Autoimmunity/immunology/physiology ; *COVID-19/immunology/physiopathology ; *Autonomic Nervous System/immunology/physiopathology ; *Inflammation/immunology/physiopathology ; Animals ; SARS-CoV-2 ; Th17 Cells/immunology ; },
abstract = {The autonomic nervous system (ANS) plays a central role in immune homeostasis by integrating sympathetic and parasympathetic signals that regulate inflammation, immune cell trafficking, and tolerance. Aging is associated with a progressive autonomic imbalance characterized by sympathetic overactivation, reduced parasympathetic tone, and impaired β-adrenergic signaling in immune cells, which together contribute to inflammaging and immune dysregulation. In this review, we discuss how aging-related alterations in adrenergic pathways affect immune cell differentiation and cytokine networks, with particular emphasis on β2-adrenergic control of the Th17/regulatory T cell balance through cAMP-dependent mechanisms interacting with cytokine-driven STAT signaling. Chronic sympathetic stimulation and β-adrenergic desensitization weaken these regulatory constraints, favoring pro-inflammatory immune trajectories and loss of immune tolerance. Finally, we propose Long COVID as a paradigmatic condition in which pre-existing inflammaging and autonomic vulnerability are amplified by viral infection, leading to persistent inflammation, impaired immune regulation, and increased susceptibility to autoimmune manifestations.},
}

Humans
Post-Acute COVID-19 Syndrome
*Aging/immunology
*Autoimmunity/immunology/physiology
*COVID-19/immunology/physiopathology
*Autonomic Nervous System/immunology/physiopathology
*Inflammation/immunology/physiopathology
Animals
SARS-CoV-2
Th17 Cells/immunology

@article {pmid42342266,
year = {2026},
author = {Xu, J and Kathiresan, T and Siddiqui, A and Mazzone, SB and Vogel, A},
title = {Cough biomarkers for diagnosis and monitoring of respiratory disease: a systematic review.},
journal = {European respiratory review : an official journal of the European Respiratory Society},
volume = {35},
number = {180},
pages = {},
pmid = {42342266},
issn = {1600-0617},
mesh = {Humans ; *Cough/diagnosis/physiopathology/etiology ; Biomarkers ; Predictive Value of Tests ; *Respiratory Tract Diseases/diagnosis/physiopathology ; *Acoustics ; Prognosis ; },
abstract = {Cough is a common and physiologically informative component of respiratory morbidity, but its potential for diagnosing and monitoring disease is not thoroughly investigated. This systematic review synthesised the literature on algorithmic and statistical models analysing cough acoustics for diagnosing or monitoring respiratory conditions. Following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, five databases (PubMed, Embase, Scopus, Web of Science and CENTRAL) were systematically searched for studies published from January 2010 to June 2025. Eligible studies performed quantitative acoustic feature analysis of human coughs using statistical, machine learning or deep learning models and reported diagnostic or prognostic performance. 89 studies from 34 countries were assessed, covering cough detection (n=31), disease classification (n=55) and disease severity prediction (n=3), reflecting potential applications in disease monitoring. Deep learning approaches, especially convolutional and recurrent networks, were predominant (n=56) and tended to achieve the higher accuracies, although machine learning ensemble methods and logistic regression also demonstrated strong performance, particularly with well-engineered features. Across different diseases, sensitivities and specificities were often reported to be ≥90%, notably for tuberculosis, asthma and COVID-19. However, methodological weaknesses were common, with only 11.2% of studies introducing external validation, 71.1-87.6% demonstrating high risk of bias (according to PROBAST-AI) and most based on small, homogeneous or crowdsourced cohorts with limited generalisability. These limitations contribute to inflated internal performance and uncertainty about real-world applicability. Cough acoustic biomarkers hold promise as an adjunctive tool for screening and longitudinal monitoring in low-resource environments. Nevertheless, widespread implementation will require large, multicentre validation, standardised calibration, bias control and incorporation into privacy-preserving workflows.},
}

Humans
*Cough/diagnosis/physiopathology/etiology
Biomarkers
Predictive Value of Tests
*Respiratory Tract Diseases/diagnosis/physiopathology
*Acoustics
Prognosis

@article {pmid42342297,
year = {2026},
author = {Yasam, SK and Vignesh, N and Rajagopal, S},
title = {Advances in ferroptosis research and applications.},
journal = {International review of cell and molecular biology},
volume = {405},
number = {},
pages = {149-186},
doi = {10.1016/bs.ircmb.2025.12.004},
pmid = {42342297},
issn = {1937-6448},
mesh = {*Ferroptosis/drug effects/physiology ; Humans ; Animals ; COVID-19/metabolism/pathology/virology ; Iron/metabolism ; Lipid Peroxidation ; SARS-CoV-2 ; Neoplasms/pathology/metabolism ; Neurodegenerative Diseases/pathology/metabolism ; Pulmonary Fibrosis/pathology/metabolism ; Renal Insufficiency, Chronic/metabolism/pathology ; },
abstract = {Ferroptosis is an iron-dependent form of regulated cell death driven by lipid peroxidation and redox imbalance. It has emerged as a pivotal mechanism implicated in various diseases, including cancer, chronic kidney diseases (CKD), neurodegenerative disorders, pulmonary fibrosis, chronic wounds, and viral infections such as COVID-19. This chapter presents a comprehensive overview of the molecular underpinnings of ferroptosis, emphasizing its key regulators-iron metabolism, lipid peroxidation pathways, and antioxidant defenses such as GPX4 and system Xc[-]. We explore recent advances highlighting the therapeutic potential of ferroptosis modulation across multiple pathological contexts. In cancer, ferroptosis inducers have shown efficacy in overcoming drug resistance and enhancing immunotherapy. In contrast, inhibition of ferroptosis offers protective effects in neurodegenerative diseases, ischemia-reperfusion injury, and chronic inflammatory conditions. Applications in nanomedicine have further enabled targeted delivery of ferroptosis modulators, expanding their clinical relevance. The chapter also discusses emerging roles of ferroptosis in wound healing, CKD and pulmonary fibrosis, with particular attention to COVID-19-related lung injury. Finally, we evaluate current therapeutic strategies, safety considerations, and potential clinical applications, along with future directions including biomarker development and personalized medicine. Our aim is to provide a unified perspective on ferroptosis as a disease-modifying mechanism and to highlight its growing importance as a therapeutic target across diverse clinical disciplines.},
}

*Ferroptosis/drug effects/physiology
Humans
Animals
COVID-19/metabolism/pathology/virology
Iron/metabolism
Lipid Peroxidation
SARS-CoV-2
Neoplasms/pathology/metabolism
Neurodegenerative Diseases/pathology/metabolism
Pulmonary Fibrosis/pathology/metabolism
Renal Insufficiency, Chronic/metabolism/pathology

@article {pmid42342836,
year = {2026},
author = {Schuele, L and Nzoyikorera, N and Udahemuka, JC and Cassidy, H and Murhula Masirika, L and Nieuwenhuijse, DF and Nduwimana, C and Molenkamp, R and Nyandwi, J and Boter, M and Minega Ndoli, J and Zaeck, LM and Musabyimana, JP and de Vries, RD and Mbiribindi, JB and Siangoli, FB and Otani, S and Aarestrup, FM and Koopmans, M and Ndishimye, P and Oude Munnink, BB},
title = {Capacity building for genomic surveillance of mpox and other emerging diseases in resource-limited settings within the African Great Lakes region.},
journal = {Communications medicine},
volume = {6},
number = {1},
pages = {},
pmid = {42342836},
issn = {2730-664X},
abstract = {Genomic surveillance has become an indispensable tool for the identification of pathogens and tracking of transmission chains. Building upon the global sequencing and surveillance infrastructure developed and expanded during the COVID-19 pandemic, these capacities are now being adapted to track other pathogens in low- and middle-income countries which remain disproportionately affected by infectious diseases. This is evident in the recent and unprecedented spread of mpox virus in regions experiencing multiple concurrent infectious disease outbreaks, highlighting the need for broad, adaptable diagnostic detection and sequencing capacity. In this Perspective, we describe the applications, insights, and challenges encountered during ongoing capacity building efforts for the characterization of the mpox outbreak and other emerging pathogens in the African Great Lakes Region.},
}

@article {pmid42342874,
year = {2026},
author = {Locci, M and Pardi, N},
title = {Immunological mechanisms of mRNA vaccines for infectious diseases.},
journal = {Nature},
volume = {654},
number = {8120},
pages = {892-901},
pmid = {42342874},
issn = {1476-4687},
mesh = {Animals ; Humans ; Adaptive Immunity ; Adjuvants, Immunologic ; *Communicable Diseases/immunology ; COVID-19/prevention & control/immunology ; COVID-19 Vaccines/immunology ; Immunity, Innate ; Immunogenicity, Vaccine ; *mRNA Vaccines/immunology ; Nanoparticles/chemistry ; *RNA, Messenger/immunology/chemistry/genetics ; Vaccines, Synthetic/immunology/chemistry ; Liposomes ; },
abstract = {Nucleoside-modified mRNA-lipid-nanoparticle (mRNA-LNP) vaccines confer a high level of protection against severe COVID-19 and, since their first authorization for human use in 2020, have saved millions of lives. The efficacy of this vaccine platform relies on the induction of powerful and coordinated innate and adaptive immune responses. A deep understanding of the mechanisms of action by which mRNA-LNP vaccines drive protective immunity is crucial for advancing the development of next-generation mRNA vaccines with improved immunogenicity and tolerability. A flurry of recent studies has shed light on aspects of this vaccine modality's modus operandi. Nonetheless, key gaps in knowledge remain, including understanding how LNPs are sensed by the immune system and exert their adjuvant activity, identifying the specific signals and cellular pathways critical for eliciting protective immune responses and determining whether it is feasible to uncouple vaccine immunogenicity and reactogenicity. Here we review the known and unknown features of the immunological mechanisms of mRNA-LNP vaccines for infectious diseases. Furthermore, we discuss how the components of this vaccine platform can be modified to fine-tune immune responses against challenging pathogens for which effective vaccines do not exist or need improvement.},
}

Animals
Humans
Adaptive Immunity
Adjuvants, Immunologic
*Communicable Diseases/immunology
COVID-19/prevention & control/immunology
COVID-19 Vaccines/immunology
Immunity, Innate
Immunogenicity, Vaccine
*mRNA Vaccines/immunology
Nanoparticles/chemistry
*RNA, Messenger/immunology/chemistry/genetics
Vaccines, Synthetic/immunology/chemistry
Liposomes

@article {pmid42342927,
year = {2026},
author = {Li, X and Kang, M and Jiao, XY and Merits, A and Veit, M and Rey, FA and Dai, H and Wang, XY and He, WT and Holmes, EC and Varjak, M and Mahalingam, S and Wang, D and Jiang, Z and Wang, S and Li, X and Peng, Z and He, N and Su, S},
title = {Addressing the zoonotic threat of merbecoviruses.},
journal = {Nature microbiology},
volume = {11},
number = {7},
pages = {1774-1785},
pmid = {42342927},
issn = {2058-5276},
mesh = {Animals ; Humans ; Receptors, Virus/metabolism ; *Zoonoses/virology/transmission ; Virus Internalization ; *Coronavirus Infections/virology/prevention & control/transmission/epidemiology/diagnosis ; *Viral Zoonoses/virology/prevention & control/transmission ; *Coronavirus/genetics/classification/physiology/pathogenicity ; Angiotensin-Converting Enzyme 2/metabolism ; },
abstract = {Merbecovirus is a subgenus of betacoronaviruses and exhibits high genetic diversity with a capacity for cross-species transmission. However, beyond Middle East respiratory syndrome coronavirus (MERS-CoV), our knowledge of the ecology and pathogenic potential of these viruses remains limited. Merbecoviruses were once thought to rely exclusively on dipeptidyl peptidase 4 for cell entry, but recent discoveries have revealed that several members can also engage with angiotensin-converting enzyme 2 or aminopeptidase N, expanding their receptor repertoire and potential host range. Here we summarize recent advances in understanding of the receptor usage of merbecoviruses and examine how these insights inform pandemic preparedness and risk assessment. We discuss the development of targeted diagnostics, broad-spectrum antivirals and vaccines, including pan-coronavirus strategies. Together, these advances provide a foundation for predictive surveillance and rational countermeasure design, enabling earlier detection and more effective containment of future merbecovirus spillover events before they escalate into epidemics.},
}

Animals
Humans
Receptors, Virus/metabolism
*Zoonoses/virology/transmission
Virus Internalization
*Coronavirus Infections/virology/prevention & control/transmission/epidemiology/diagnosis
*Viral Zoonoses/virology/prevention & control/transmission
*Coronavirus/genetics/classification/physiology/pathogenicity
Angiotensin-Converting Enzyme 2/metabolism

@article {pmid42344053,
year = {2026},
author = {Nichols, E and Arhin-Wiredu, K and Bratton, S and Cercone, E and Longa Chanda, S and Cobos Muñoz, D and Ebonwu, J and Espinosa-Bode, A and Handzel, E and Kapombe, P and Martin, D and Moolenaar, R and Muhwava, W and Atuheire, EB},
title = {Integrating mortality surveillance as a routine component of national essential public health functions: a blueprint for action.},
journal = {BMJ public health},
volume = {4},
number = {2},
pages = {e003392},
pmid = {42344053},
issn = {2753-4294},
abstract = {The COVID-19 pandemic and other recent public health responses have highlighted significant challenges in global mortality data collection, with approximately 40% of deaths unregistered and fragmented reporting systems hampering public health responses. This paper supports the establishment of routine mortality surveillance as a core function of essential public health services, emphasising the need for integration with civil registration and vital statistics (CRVS) systems. By leveraging existing frameworks and proposing a Theory of Change (ToC), we outline critical linkages between CRVS and mortality surveillance that enhance data accuracy, timeliness and utility for public health decision-making. The paper provides examples across key enablers-policies, agreements and legislation; infrastructure; governance, funding and resources; and people and organisational culture-that facilitate these linkages. We also present examples from initiatives like the Africa CDC's Mortality Surveillance Programme to illustrate effective strategies in low- and middle-income countries (LMICs). The ToC serves as a blueprint for stakeholders to implement strategic interventions aimed at overcoming barriers to linking systems and data integration and utilisation. Ultimately, this paper underscores the importance of coordinated efforts among national public health agencies, civil registration authorities and other stakeholders to improve mortality data systems globally. By addressing these systemic challenges through enhanced collaboration and technological innovation, we can significantly advance public health outcomes and policy formulation in response to future health crises.},
}

@article {pmid42344113,
year = {2026},
author = {Mohamed, RA and Huitao, S and Si, M and Jinguan, Z and Mabrouk, MS},
title = {An End-to-End Modular Blueprint for Rapid mRNA Vaccine Development, Computational Design, Functional Validation, and Scalable Delivery Against Evolving Pathogens.},
journal = {In silico pharmacology},
volume = {14},
number = {2},
pages = {173},
pmid = {42344113},
issn = {2193-9616},
abstract = {The rapid emergence of new pathogens evolving viral variants. Underscores the need for agile vaccine platforms capable of outpacing infectious threats. Building on the success of mRNA vaccine technology during the COVID-19 pandemic. We integrated computational precision tool to help the young Scientifics map the vaccine design. It is not a validated lab protocol nor does it report experimental results. Instead, it offers a stepwise conceptual roadmap to guide future wet-lab research. We also outline in silico workflow encompassing antigen selection, consensus sequence generation. The first step in the workflow is to check the conserved antigenic domains and epitopes. Bioinformatic analysis supported antigen identifying and its targets using appropriate tools, followed by consensus sequence creation through multiple sequence alignment using specific platforms. mRNA constructs were optimized via codon adaptation, GC content balancing, and secondary structure analysis. Delivery strategies also were briefly assessed between the FDA approved systems. Lipid nanoparticle formulation, were incorporated into the design to theoretically enhance stability and cellular uptake. Robust protein expression both in vitro and in vivo assessments further suggested the immunogenic potential along with providing a computational basis for future preclinical evaluation. This study review provides a step-by-step protocol that clarifies and simplifies the design process for linear mRNA constructs. The framework translates complex design considerations into actionable, sequential guidelines, enabling researchers to rationally design vaccine candidates in silico. Certainly, we support accelerated design efforts against current threats, while also serving as a preparedness blueprint for future pandemics.},
}

@article {pmid42344246,
year = {2026},
author = {Birhman, N and Kharkwal, G and Roy, S and Shaikh, N and Velamuri, PS and Lata, H and Saxena, A and Satija, A and Singh, KJ and Madan, T and Kishore, J and Kanti, P and Anand, T},
title = {Occupational health and safety in the wake of COVID-19: insights from India's workforce.},
journal = {Frontiers in public health},
volume = {14},
number = {},
pages = {1807940},
pmid = {42344246},
issn = {2296-2565},
mesh = {Humans ; *COVID-19/epidemiology/prevention & control ; *Occupational Health ; India/epidemiology ; Working Conditions ; *Health Personnel/psychology ; SARS-CoV-2 ; Occupational Exposure/prevention & control ; Frontline Workers ; Pandemics ; Workplace ; },
abstract = {INTRODUCTION: Occupational health and safety (OHS) practices witnessed profound changes worldwide during the COVID-19 pandemic. The pandemic exposed critical vulnerabilities in workplace preparedness, particularly among workers in high-exposure and essential service sectors.

METHODS: A systematic review was conducted following PRISMA guidelines using PubMed, Google Scholar, DOAJ, ResearchGate, and gray literature sources. Studies published between January 2020 and December 2024 focusing on occupational exposure, workplace transmission, OHS guidelines, and workforce health during COVID-19 were included.

RESULTS: Healthcare workers experienced the highest occupational risk due to sustained patient contact and aerosol-generating procedures, accompanied by significant psychological distress and burnout. Essential workers, manufacturing sectors, retail workers, educators, and informal sector workers also faced substantial occupational and socioeconomic challenges. Workplace interventions including engineering controls, administrative controls, PPE use, vaccination strategies, and digital surveillance tools reduced workplace transmission. Remote-enabled sectors demonstrated lower infection risk but increased mental health concerns.

DISCUSSION: The COVID-19 pandemic transformed traditional OHS frameworks by integrating infectious disease preparedness, vaccination strategies, mental health support, and workplace surveillance into occupational safety systems. The findings emphasize the need for integrated, adaptive, and equitable OHS frameworks aligned with public health preparedness to strengthen workforce resilience against future pandemics.},
}

Humans
*COVID-19/epidemiology/prevention & control
*Occupational Health
India/epidemiology
Working Conditions
*Health Personnel/psychology
SARS-CoV-2
Occupational Exposure/prevention & control
Frontline Workers
Pandemics
Workplace

@article {pmid42344751,
year = {2026},
author = {Toboltoc, PC and Gagiu, I and Lukusa, AL and Vekony, A},
title = {Hemato-Oncology Care During and After the COVID-19 Pandemic: Changes in Treatment Pathways, Patient Flow, and Durable Organizational Adaptations.},
journal = {Cureus},
volume = {18},
number = {6},
pages = {e111331},
pmid = {42344751},
issn = {2168-8184},
abstract = {The COVID-19 pandemic disrupted cancer care at every level of the clinical pathway, but its effect on hemato-oncology was distinctive because patients with hematologic malignancies often require urgent diagnosis, frequent hospital visits, transfusion support, intensive therapy, transplantation, cellular therapy, and infection-sensitive follow-up. This narrative review examines the pandemic as a disruption of hemato-oncology care delivery rather than only as a source of excess infection-related morbidity. It synthesizes evidence on diagnostic access, patient flow, treatment prioritization, infection-control circuits, day-hospital organization, inpatient access, telemedicine and hybrid follow-up, supportive care, vaccination, antiviral pathways, and high-complexity care delivery. The review distinguishes between temporary crisis restrictions, harmful diagnostic and therapeutic delays, and durable organizational adaptations that may remain relevant after the acute pandemic period. Evidence from cancer-service disruption studies, hemato-oncology outcome registries, telemedicine cohorts, and European hematopoietic cell transplantation activity surveys indicates that hemato-oncology care pathways were reorganized and selectively redirected during the pandemic, while selected components recovered through structured triage, protected circuits, remote review of stable patients, and individualized timing of transplantation and cellular therapy. The post-pandemic priority is not to preserve restrictive crisis practice, but to retain the organizational discipline generated by the crisis: protected diagnostic capacity, risk-stratified access, selective hybrid care, rapid infectious-risk assessment pathways, disciplined day-hospital scheduling, and reserved in-person capacity for unstable, procedure-dependent, or curative-intent patients. These adaptations should be maintained only insofar as they improve access, safety, and continuity of care without normalizing delayed diagnosis or undertreatment of aggressive disease.},
}

@article {pmid42344914,
year = {2026},
author = {Batool, R},
title = {From Jenner to genomics: the unfolding future of vaccinology.},
journal = {Frontiers in immunology},
volume = {17},
number = {},
pages = {1860464},
pmid = {42344914},
issn = {1664-3224},
mesh = {Humans ; *Vaccinology/trends/methods ; Genomics ; *COVID-19/immunology/prevention & control ; Animals ; COVID-19 Vaccines/immunology ; *SARS-CoV-2/immunology ; Vaccine Development ; History, 20th Century ; Vaccines/immunology ; Vaccines, DNA/immunology ; History, 21st Century ; },
abstract = {The development of the smallpox vaccine two centuries ago laid the foundation for modern vaccinology. Smallpox, once a major killer in human history, was eradicated globally in 1980. This breakthrough encouraged the development of contemporary vaccine technologies, including inactivated, recombinant, viral vector, and mRNA platforms. Owing to developments in genetics, bioinformatics, and molecular biology, personalised vaccines have been made possible. Advances in the field of immunology facilitated an accelerated response to the COVID-19 pandemic. This perspective synthesises key developments and technological advances in the field of global immunisation. The author sheds light on emerging tools, transformative platforms, and long-term directions in vaccine science research.},
}

Humans
*Vaccinology/trends/methods
Genomics
*COVID-19/immunology/prevention & control
Animals
COVID-19 Vaccines/immunology
*SARS-CoV-2/immunology
Vaccine Development
History, 20th Century
Vaccines/immunology
Vaccines, DNA/immunology
History, 21st Century

@article {pmid42345054,
year = {2026},
author = {Calcaterra, G and Oreto, L and Perrone, M and Chessa, M and Bianco, F and Borrelli, N and Leonardi, B and Moscatelli, S and Ciliberti, P and Sabatino, J and Guccione, P and Martino, F and Thiene, G and Di Salvo, G and Bassareo, PP},
title = {[Kawasaki disease: the update of American Heart Association guidelines. What adult cardiologists need to know].},
journal = {Giornale italiano di cardiologia (2006)},
volume = {27},
number = {7},
pages = {479-488},
doi = {10.1714/4722.47387},
pmid = {42345054},
issn = {1972-6481},
mesh = {Adult ; Child ; Child, Preschool ; Humans ; American Heart Association ; Cardiologists ; Diagnosis, Differential ; Immunoglobulins, Intravenous/therapeutic use ; *Mucocutaneous Lymph Node Syndrome/diagnosis/therapy/complications/physiopathology ; Practice Guidelines as Topic ; United States ; },
abstract = {The recent document from the American Heart Association updates the guidelines on the diagnosis and management of Kawasaki disease (KD), a severe acute systemic inflammatory and febrile illness with mucocutaneous manifestations and lymph node involvement primarily affecting children under 5 years of age. Coronary artery involvement, with dilation and aneurysms in approximately 25% of patients, and cardiovascular system involvement make KD the most common systemic vasculitides and the leading cause of acquired heart disease in pre-school children living in developed countries. Classic KD is diagnosed based on established clinical and laboratory criteria, which exclude other similar conditions. The etiology and pathogenesis of KD remain unknown, with the disease affecting genetically susceptible children through an immune-mediated mechanism. The leading theory is that an unidentified trigger initiates a multi-organ inflammatory pathological cascade, sometimes resulting in incomplete or atypical forms in younger patients. For this reason, the American guidelines review KD diagnostic criteria, cardiac imaging techniques (echocardiography, coronary computed tomography, magnetic resonance imaging), specific therapies (intravenous immunoglobulin, aspirin, and additional treatments for resistant cases), management of myocardial infarctions, and the transition of care from pediatric to adult age. This review article also highlights future research areas, the role of inflammation, the development of differential diagnostic algorithms for multisystem inflammatory syndrome in children associated with SARS-CoV-2 infection, and the use of new oral anticoagulants. Lastly, the most recent data on the long-term course of the disease and the regression of coronary aneurysms are revisited.},
}

Adult
Child
Child, Preschool
Humans
American Heart Association
Cardiologists
Diagnosis, Differential
Immunoglobulins, Intravenous/therapeutic use
*Mucocutaneous Lymph Node Syndrome/diagnosis/therapy/complications/physiopathology
Practice Guidelines as Topic
United States

@article {pmid42345733,
year = {2026},
author = {Ionescu, A and Mihăilescu, A and Dumache, R and Capcelea, A and Turceanu, AD and Albulescu, N and Săndesc, MA},
title = {Perioperative Anemia, Transfusion Practices, and Patient Blood Management: Lessons from the COVID-19 Pandemic.},
journal = {Hematology reports},
volume = {18},
number = {3},
pages = {},
pmid = {42345733},
issn = {2038-8322},
abstract = {The COVID-19 pandemic exposed vulnerabilities in global blood supply systems and accelerated the adoption of patient blood management (PBM) strategies aimed at optimizing transfusion practices in surgical care. Perioperative anemia is a key contributor to adverse outcomes and is frequently treated with allogeneic blood transfusion (ABT), which carries infectious and immunologic risks. Iron deficiency remains the most common and potentially correctable cause of perioperative anemia. This narrative review examines various approaches to perioperative anemia, strategies to minimize reliance on ABT, and alternatives within the PBM paradigm. Evidence supports the use of iron therapy, erythropoiesis-stimulating agents, antifibrinolytic strategies, and blood conservation techniques to reduce transfusion requirements and improve clinical outcomes. Lessons from the COVID-19 pandemic highlight PBM as a framework to enhance transfusion safety and sustainability. Broader implementation of PBM may improve patient outcomes, reduce unnecessary transfusions, and preserve scarce blood resources.},
}

@article {pmid42345852,
year = {2026},
author = {Ferrara, F and De Berardinis, F and Scognamiglio, M and Zovi, A},
title = {The Shifting Paradigm of Monoclonal Antibodies in COVID-19 Management: From Early Triumphs to Viral Resistance and Future Perspectives.},
journal = {Antibodies (Basel, Switzerland)},
volume = {15},
number = {3},
pages = {},
pmid = {42345852},
issn = {2073-4468},
abstract = {BACKGROUND: Monoclonal antibodies (mAbs) initially played a major role in outpatient COVID-19 management by providing rapid passive immunity and reducing progression to severe disease. However, continuous SARS-CoV-2 evolution progressively compromised the effectiveness of several anti-spike products. This narrative review summarizes the trajectory of COVID-19 mAbs across three phases: early clinical efficacy, loss of efficacy due to immune escape, and future directions.

METHODS: We conducted a narrative review focusing on mechanisms of action, pivotal clinical trials, and real-world effectiveness of neutralizing anti-spike mAbs and host-directed immunomodulatory mAbs. Emphasis was placed on the impact of variants-especially Omicron-on susceptibility and clinical use, as well as on emerging next-generation platforms.

RESULTS: First-generation neutralizing mAbs substantially reduced the hospitalization rates during the Alpha and Delta waves, while immunomodulatory mAbs became standard options for the hyperinflammatory phase in hospitalized patients. With the emergence of Omicron and its sub-lineages, extensive immune escape led to marked reductions in neutralization for many earlier anti-spike agents and consequent restrictions in use. Later-generation approaches targeting more conserved epitopes provided temporary solutions but were also challenged by ongoing antigenic drift. Host-directed immunomodulators retained clinical relevance because their mechanism is independent of viral spike mutations.

CONCLUSIONS: The clinical role of monoclonal antibodies in COVID-19 has been dynamic and increasingly constrained by viral evolution. Future strategies should prioritize broadly neutralizing antibodies targeting conserved epitopes, innovative delivery platforms, and integration with real-time surveillance to preserve clinical utility in the endemic phase and improve preparedness for future outbreaks.},
}

@article {pmid42345854,
year = {2026},
author = {Lim, XR and Teo, RXW and Par, RYX and Leung, BPL},
title = {Anti-Type I Interferon Autoantibodies in COVID-19 and Systemic Lupus Erythematosus: A Comparative Review.},
journal = {Antibodies (Basel, Switzerland)},
volume = {15},
number = {3},
pages = {},
pmid = {42345854},
issn = {2073-4468},
abstract = {Type I interferons (IFN-I), including IFN-α, IFN-β, and IFN-ω, are central to antiviral defence and immune regulation. Autoantibodies targeting IFN-I (anti-IFN-I AAbs) have emerged as key pathogenic factors in severe coronavirus disease 2019 (COVID-19) and are detectable in systemic lupus erythematosus (SLE), a prototypic IFN-driven autoimmune disease. Here we compare the prevalence and clinical impact of anti-IFN-I autoantibodies (Aabs) in COVID-19 and SLE based on a structured review of 53 studies from 2014 to 2025 and highlight the clinical associations and therapeutic opportunities presented by these autoantibodies. In COVID-19, neutralising anti-IFN-α and/or anti-IFN-ω AAbs were consistently associated with severe disease and impaired antiviral responses, particularly in older male populations. In SLE, anti-IFN-α AAbs were variably detected; neutralising antibodies were associated with reduced interferon gene signatures in some cohorts but inconsistent correlations with disease activity. Therapeutically, anti-IFN-I AAbs in COVID-19 may inform risk stratification and early antiviral strategies, whereas in SLE, IFN-α blockade, including IFN-α kinoid vaccination, demonstrates modulation of IFN signatures but variable clinical benefit. Notably, these findings reveal an immunological paradox: the same neutralising mechanism that impairs antiviral defence in COVID-19 may attenuate chronic IFN-driven inflammation in SLE. Taken together, anti-IFN-I AAbs exert context-dependent effects: pathogenic in acute viral infection yet potentially modulatory in chronic IFN-driven autoimmunity. Prospective longitudinal studies are required to further clarify their translational utility and long-term clinical impact.},
}

@article {pmid42346165,
year = {2026},
author = {Ntais, C and Chatziprodromidou, IP},
title = {COVID-19 and Interacting Public Health Threats in Europe During 2020-2025: A Narrative Review.},
journal = {Epidemiologia (Basel, Switzerland)},
volume = {7},
number = {3},
pages = {},
pmid = {42346165},
issn = {2673-3986},
abstract = {Between 2020 and 2025, Europe has faced multiple interacting public health threats shaped by and following the COVID-19 pandemic. Alongside COVID-19, the region experienced other infectious disease events, including monkeypox, measles resurgence, legionellosis and acute hepatitis of unknown origin in children. At the same time, non-communicable disease burdens, including obesity, type II diabetes mellitus, disruption of chronic disease care, mental health disorders and increased problematic digital use, intensified during and after the pandemic period. Antimicrobial resistance (AMR) remained a major cross-cutting threat because it undermines the effective treatment of infections and weakens emergency preparedness. This narrative review synthesizes peer-reviewed articles and selected reports from international organizations for the 2020-2025 period, using COVID-19 as the organizing context for examining interconnected infectious, chronic and system-level threats. Across these topics, recurring themes included vaccination gaps, fragmented surveillance, disruption of routine care, health system inequities, misinformation and insufficient preparedness for cross-border threats. The review supports integrated surveillance, continuity plans for essential services, stronger vaccination and risk-communication strategies and sustained AMR stewardship within a One Health framework. Coordinated action across public health, primary care, mental health and chronic disease policy is essential for future resilience.},
}

@article {pmid42346828,
year = {2026},
author = {Cacciatore, S and Abbatecola, G and Calvani, R and Veronese, N},
title = {Effectiveness and Safety of Ozone Therapy in Humans: An Umbrella Review of Systematic Reviews with Meta-Analyses of Randomized Clinical Trials.},
journal = {Medical sciences (Basel, Switzerland)},
volume = {14},
number = {2},
pages = {},
pmid = {42346828},
issn = {2076-3271},
mesh = {Humans ; *Ozone/therapeutic use/adverse effects ; Randomized Controlled Trials as Topic ; COVID-19/therapy ; Systematic Reviews as Topic ; *Chronic Periodontitis/therapy/drug therapy ; Treatment Outcome ; Meta-Analysis as Topic ; Diabetic Foot/therapy ; SARS-CoV-2 ; },
abstract = {BACKGROUND/OBJECTIVES: Ozone therapy has been proposed across multiple clinical conditions based on hormetic, antioxidant, and immunomodulatory effects, but its efficacy and safety remain controversial. We conducted an umbrella review to appraise the effectiveness and safety of ozone therapy using evidence from meta-analyses of randomized controlled trials (RCTs).

METHODS: We searched MEDLINE, Web of Science, Embase, and the Cochrane Library from inception to 14 February 2025, with an updated search performed on 9 May 2026. Eligible studies were systematic reviews with meta-analyses comparing ozone therapy with non-active controls, including placebo, sham, saline, or standard care. Methodological quality was evaluated with AMSTAR-2 and certainty of evidence with GRADE.

RESULTS: Of 1243 records identified, seven meta-analyses representing four clinical indications (chronic periodontitis, COVID-19, diabetic foot ulcers, and impacted mandibular third-molar surgery) were included. In chronic periodontitis, evidence was mixed: one meta-analysis found no significant adjunctive benefit, whereas a more recent meta-analysis reported improvements in probing depth and gingival index, but not in bleeding on probing, plaque index, or clinical attachment level. For COVID-19, ozone therapy reduced PCR positivity at follow-up (RR 0.07; 95% CI 0.01-0.34), although this was considered a clinically non-important surrogate endpoint, and showed no significant benefit for hospital stay, intensive care unit admission, or mortality. For diabetic foot ulcers, ozone therapy was not superior to control treatment for ulcer healing (RR 1.69; 95% CI 0.90-3.17) or reduction in ulcer area. In third-molar surgery, ozone therapy did not reduce swelling or improve mouth opening, but was associated with improved short-term quality of life and reduced analgesic use. Safety outcomes were inconsistently reported, and available data did not allow firm conclusions regarding adverse events. The certainty of evidence was low or very low for all outcomes.

CONCLUSIONS: Despite mechanistic plausibility, current meta-analytic evidence from RCTs remains inconsistent, methodologically fragile, and largely based on low- or very low-certainty findings. Routine clinical use is not justified pending adequately powered, blinded RCTs with standardized dosing and delivery, patient-centered endpoints, and rigorous safety monitoring.},
}

Humans
*Ozone/therapeutic use/adverse effects
Randomized Controlled Trials as Topic
COVID-19/therapy
Systematic Reviews as Topic
*Chronic Periodontitis/therapy/drug therapy
Treatment Outcome
Meta-Analysis as Topic
Diabetic Foot/therapy
SARS-CoV-2

@article {pmid42347188,
year = {2026},
author = {Bambara, S and Isingizwe, MC and Adegboyega, TT and Mutesa, L},
title = {A Systematic Review of Gastrointestinal and Respiratory Pathogen Detection in Wastewater in Africa, with Focus on Rwanda: Implications for Early Warning and Public Health Surveillance.},
journal = {Pathogens (Basel, Switzerland)},
volume = {15},
number = {6},
pages = {},
pmid = {42347188},
issn = {2076-0817},
mesh = {Humans ; Rwanda/epidemiology ; *Wastewater/virology/microbiology ; *Respiratory Tract Infections/epidemiology/virology/microbiology ; *Public Health Surveillance ; Public Health ; Wastewater-Based Epidemiological Monitoring ; },
abstract = {In Africa, the disease burden of diarrheal and respiratory diseases is amplified by limited surveillance capacity, diagnostic limitations, and socioeconomic inequalities. In rapidly urbanizing settings such as Kigali (Rwanda), integrating wastewater-based epidemiology (WBE) into existing surveillance systems offers a promising strategy for generating real-time epidemiological intelligence, identifying community-level hotspots, and addressing gaps in traditional reporting systems. Gastrointestinal and respiratory infections remain major causes of morbidity and mortality globally, particularly in low- and middle-income countries (LMICs), where traditional clinical surveillance systems frequently underreport the true disease burden. This systematic review synthesizes current evidence on the detection of gastrointestinal and respiratory pathogens in wastewater and evaluates the utility of WBE for early warning and public health action. A narrative review approach was used to identify peer-reviewed literature, global health reports, and surveillance studies focusing on the wastewater detection of gastrointestinal and respiratory pathogens. Databases including PubMed, Scopus, and Google Scholar were searched for studies published between 2000 and 2026. The search yielded 1247 records, of which 312 duplicates were removed. After title/abstract screening, 228 full-text articles were retrieved and assessed for eligibility. After a detailed evaluation, 108 studies were excluded for the following reasons: absence of pathogen-specific wastewater data (n = 46), a focus on environmental monitoring without public health relevance (n = 25), insufficient methodological description (n = 21), or other eligibility limitations such as a lack of primary data (n = 16). WBE provides a non-invasive, cost-effective approach for monitoring symptomatic and asymptomatic infections. Challenges involve variability in sampling, environmental factors affecting viral decay, and differences in laboratory workflows. WBE is a powerful complement to traditional infectious disease surveillance, offering early warning capabilities, population-level coverage, and real-time insights into pathogen circulation. Integrating WBE into surveillance programs, especially in LMICs such as Rwanda, can significantly strengthen epidemic preparedness, guide resource allocation, and improve outbreak response. Sustained investment in laboratory capacity, standardized protocols, and multisector collaboration is essential to fully leverage WBE for public health protection.},
}

Humans
Rwanda/epidemiology
*Wastewater/virology/microbiology
*Respiratory Tract Infections/epidemiology/virology/microbiology
*Public Health Surveillance
Public Health
Wastewater-Based Epidemiological Monitoring

@article {pmid42347608,
year = {2026},
author = {Jang, HY and Ko, Y and Han, SY},
title = {Understanding Healthcare Workers' COVID-19 Vaccination Decision-Making as a Dynamic Process: A Qualitative Meta-Synthesis.},
journal = {Vaccines},
volume = {14},
number = {6},
pages = {},
pmid = {42347608},
issn = {2076-393X},
support = {HY- 202200000003466//Hanyang University/ ; },
abstract = {Background/Objectives: Healthcare workers play a critical role in vaccination programs, yet vaccine hesitancy has been widely reported even among this group during the Coronavirus disease 2019 (COVID-19) pandemic. Previous studies have primarily focused on identifying factors associated with vaccine acceptance, offering limited insight into the processes underlying decision-making. This study aimed to synthesize qualitative studies on healthcare workers' COVID-19 vaccination experiences to develop a comprehensive understanding of their decision-making processes. Methods: A qualitative meta-synthesis was conducted using the thematic synthesis approach proposed by Thomas and Harden. Electronic databases including PubMed, Embase, and CINAHL were searched for qualitative studies published up to February 2026. Thirteen studies were included following PRISMA guidelines. Data were analyzed through line-by-line coding, followed by the development of descriptive and analytical themes. Results: Four analytical themes were identified: (1) vaccination as a dynamic risk-benefit negotiation process, (2) trust as a central mechanism shaping information interpretation, (3) socially embedded and relationally negotiated decision-making, and (4) moral identity as a driver of vaccination behavior. Healthcare workers' vaccination decision-making was not a static choice but an evolving process shaped by continuous appraisal of risks and benefits, filtered through trust in information and institutions, influenced by social interactions, and guided by professional identity and ethical responsibility. Conclusions: Healthcare workers' vaccination decision-making is a multidimensional process embedded in cognitive, social, and ethical contexts. Interventions should move beyond individual-level approaches and instead focus on building trust, leveraging social networks, and reinforcing professional identity with implications for future public health crises.},
}

@article {pmid42347619,
year = {2026},
author = {Kong, F and Wu, N and Liang, S and Yan, Y},
title = {Next-Generation Vaccine Design for Porcine Enteric Coronaviruses: Aligning Antigenic Breadth, Mucosal Immunity, and Translational Evaluation.},
journal = {Vaccines},
volume = {14},
number = {6},
pages = {},
pmid = {42347619},
issn = {2076-393X},
support = {LH2022C070//Heilongjiang Provincial Natural Science Foundation of China/ ; },
abstract = {Porcine enteric coronaviruses (PECs), including porcine epidemic diarrhea virus (PEDV), transmissible gastroenteritis virus (TGEV), porcine deltacoronavirus (PDCoV), and swine acute diarrhea syndrome coronavirus (SADS-CoV), remain major causes of neonatal diarrhea, dehydration, mortality, and economic loss in swine production. Despite substantial progress in vaccine development, durable field protection is still inconsistent. In this narrative review, this narrative review synthesizes current knowledge on PEC vaccine design from three connected perspectives: antigenic breadth, mucosal immunity, and translational evaluation. The economic and virological context of PEC vaccine development is first summarized, including the recurrent production burden of PECs, coronavirus genome organization, structural proteins, and the central role of the spike protein in receptor engagement, membrane fusion, and neutralizing antibody induction. Key issues are then discussed, including how spike diversity, conformational stability, epitope accessibility, glycan shielding, and antigen matching influence protective breadth; why intestinal secretory IgA, mucosal immune-cell trafficking, local memory responses, and lactogenic immunity should be prioritized as biologically relevant endpoints; and how delivery route, adjuvant selection, and platform design shape response quality. Current evidence on recombinant protein, viral-vectored, nanoparticle, virus-like particle, probiotic, plant-derived, and mRNA-based approaches is compared with attention to both promise and current evidentiary and translational limitations. The available literature suggests that future progress in PEC vaccinology is likely to depend less on platform novelty alone than on integrated vaccine designs that align antigen selection, mucosal delivery, maternal-neonatal protection, heterologous challenge, manufacturability, and field applicability.},
}

@article {pmid42347657,
year = {2026},
author = {Frączek, B and Pieniawska-Śmiech, K and Babicki, M and Balcer, B and Dolata, N and Pokorna-Kałwak, D and Kłoda, K},
title = {Maternal Vaccine Acceptance and Attitudes Before and After the COVID-19 Pandemic: A Narrative Literature Review.},
journal = {Vaccines},
volume = {14},
number = {6},
pages = {},
pmid = {42347657},
issn = {2076-393X},
abstract = {OBJECTIVES: This study aims to assess the acceptance of vaccinations among pregnant women, particularly against influenza, pertussis, COVID-19, and RSV, and to identify factors influencing their willingness to get vaccinated. It also seeks to evaluate the impact of the COVID-19 pandemic on maternal attitudes and behaviors regarding vaccination.

METHODS: The analysis involved a review of existing literature and studies to evaluate the level of vaccine acceptance among pregnant women before and after the COVID-19 pandemic. Factors contributing to vaccine hesitancy, including misinformation, lack of knowledge, and the influence of healthcare professionals, were examined.

RESULTS: The findings indicated that, despite scientific evidence supporting the safety and efficacy of vaccines during pregnancy, public concerns remain about their impact on the developing fetus. The outbreak of the COVID-19 pandemic has increased awareness of the risk of infectious diseases, but at the same time, its impact on vaccination rates among pregnant women is ambiguous and geographically diverse. Misinformation and decreased access to healthcare during the pandemic negatively affected vaccine uptake. Trustworthy information provided by healthcare professionals emerged as a key factor in promoting vaccine acceptance.

CONCLUSIONS: To improve vaccination rates among pregnant women, it is essential to provide clear, evidence-based information through healthcare professionals, particularly those directly caring for pregnant women. Educational campaigns should address concerns calmly and without judgment, emphasizing the safety and benefits of vaccinations. Enhanced access to healthcare and vaccinations, along with strategic information dissemination, can significantly improve vaccine acceptance during pregnancy. Lessons learned from past pandemics should be incorporated into the development of healthcare strategies aimed at implementing recommended vaccinations for pregnant women in the future.},
}

@article {pmid42347672,
year = {2026},
author = {Aljadeeah, S and Payedimarri, AB and Dochez, C and Kielmann, K and Wirtz, VJ and Hargreaves, S and Ravinetto, R},
title = {Access to Vaccines Among Asylum Seekers, Refugees, and Undocumented Migrants Across the Migratory Cycle in the European Union, European Economic Area, Switzerland and the United Kingdom: A Scoping Review.},
journal = {Vaccines},
volume = {14},
number = {6},
pages = {},
pmid = {42347672},
issn = {2076-393X},
abstract = {Introduction: Inequities in access to medicines persist for asylum seekers, refugees, and undocumented migrants in Europe. For vaccines, access gaps not only exist for these groups in childhood routine immunization, but also for life-course and catch-up vaccinations. As part of a broader project examining access to medicines and vaccines for migrants across all stages of the migration cycle, this scoping review synthesizes evidence on the determinants of access to vaccines. Methods: We conducted a scoping review across PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Database of Systematic Reviews, Scopus, and grey literature sources, covering the period 2000-2024. Sources were eligible if they addressed access to vaccines among migrants. We examined access to vaccines along the life course, and across phases of the migratory cycle, including departure, transit, reception and settlement, and return or deportation. Results: A total of 47 research studies and grey literature reports were included. Most studies focused on migrants in reception and settlement (destination) settings, with only twelve sources addressing other phases of the migratory cycle. Across European countries, migrants were frequently reported to have lower uptake of routine vaccines (e.g., measles-mumps-rubella (MMR), polio, diphtheria-tetanus-pertussis (DTP), and human papillomavirus (HPV)) and COVID-19 vaccines than host populations. The most frequently reported barriers were related to migrants' legal status, administrative requirements, and lack of documentation, alongside poor affordability of vaccination, limited awareness of their rights, and mistrust in the health system. Conclusions: Health systems need to adopt innovative approaches to expand vaccine access for migrant populations. Further, protecting confidentiality is essential for building trust and reducing ethical and legal risks. Flexible and coordinated vaccination strategies are required to address migrants' mobility across the different migration stages and settings. Our findings appeal for sustained improvements in access to vaccines among migrants in Europe, contingent on strong policy commitments to equity, data protection, and the adoption of life-course and catch-up vaccination strategies.},
}

@article {pmid42348970,
year = {2026},
author = {Zhang, W and Yuan, W and Yuan, C and Cheng, Y and Zhang, D and Cao, X and Ding, C},
title = {Shared and context-specific mechanisms of T cell exhaustion in chronic viral infections and cancer: Transcriptional, metabolic, epigenetic, and therapeutic perspectives.},
journal = {Cytokine & growth factor reviews},
volume = {90},
number = {},
pages = {88-106},
doi = {10.1016/j.cytogfr.2026.06.004},
pmid = {42348970},
issn = {1879-0305},
mesh = {Humans ; *T-Cell Exhaustion ; *Neoplasms/immunology/therapy/genetics/metabolism ; Epigenesis, Genetic ; *Virus Diseases/immunology/genetics/therapy ; Animals ; Transcription, Genetic ; *T-Lymphocytes/immunology ; *COVID-19/immunology/genetics/therapy ; SARS-CoV-2/immunology ; },
abstract = {T cells are crucial for defending against viral infection and cancer by eliminating infected or transformed cells and establishing immune memory. However, persistent antigenic stimulation in chronic infections or tumors drives T cells into a dysfunctional state known as exhaustion. This state is characterized by reduced proliferation and effector functions, upregulation of inhibitory receptors like PD-1, LAG-3, and CTLA-4, and alterations in transcriptional, epigenetic, and metabolic programs. T cell exhaustion is driven by both intrinsic factors, including changes in transcription factor networks and metabolic dysfunction, and extrinsic factors, such as continuous antigen exposure and an immunosuppressive microenvironment. Key molecules like PD-1, TOX, and TCF-1 are central to this process, though the complex interactions between intrinsic and extrinsic signals in chronic viral infections and cancers remain poorly understood. This review summarized T cell exhaustion in chronic viral infections, such as HIV, HBV, and SARS-CoV-2, as well as in tumors, emphasizing shared mechanisms and context-specific differences. We focused on the roles of transcriptional networks, metabolic changes, immune checkpoints, and exhaustion-related signaling. Additionally, we discussed emerging therapeutic strategies, such as immune checkpoint inhibitors, CAR-T cell therapies, cytokine supplementation, and metabolic interventions, based on recent high-impact studies. By integrating insights from both chronic infection and cancer, this review aims to identify common principles of T cell exhaustion and propose strategies to improve clinical outcomes in chronic viral diseases and cancer immunotherapy.},
}

Humans
*T-Cell Exhaustion
*Neoplasms/immunology/therapy/genetics/metabolism
Epigenesis, Genetic
*Virus Diseases/immunology/genetics/therapy
Animals
Transcription, Genetic
*T-Lymphocytes/immunology
*COVID-19/immunology/genetics/therapy
SARS-CoV-2/immunology

@article {pmid42349034,
year = {2026},
author = {Abdel-Moneim, AS and Al-Balushi, MS and Al-Jabri, AA},
title = {Post-COVID-19 immune dysregulation and autoimmune sequelae.},
journal = {Virology},
volume = {623},
number = {},
pages = {111017},
doi = {10.1016/j.virol.2026.111017},
pmid = {42349034},
issn = {1096-0341},
mesh = {Humans ; *COVID-19/immunology/complications ; *SARS-CoV-2/immunology ; *Autoimmunity ; *Autoimmune Diseases/immunology/virology/etiology ; Post-Acute COVID-19 Syndrome ; Autoantibodies/immunology ; Gastrointestinal Microbiome/immunology ; Dysbiosis/immunology ; Molecular Mimicry ; },
abstract = {SARS-CoV-2 infection induces profound immune dysregulation, including hyperinflammation, lymphopenia, and innate/adaptive immune imbalance. In some individuals, these responses persist beyond viral clearance, creating conditions that may disrupt immunological self-tolerance and precipitate autoimmune phenomena. We critically review mechanistic and clinical evidence linking SARS-CoV-2 infection to autoimmunity. Viral entry via ACE2/TMPRSS2, endothelial injury, and renin-angiotensin system dysregulation generates a pro-inflammatory milieu. Immune pathways, including molecular mimicry, bystander activation, epitope spreading, and persistent antigenic stimulation, can trigger the activation of autoreactive lymphocytes. Emerging evidence further implicates SARS-CoV-2-associated oral-gut microbiome dysbiosis and alterations in tryptophan and arginine metabolic checkpoints as contributors to chronic inflammatory signaling and impaired tolerance maintenance. We propose a mechanistic cascade from viral infection to dysbiosis to metabolic perturbation to loss of tolerance to autoantibody generation. Clinical manifestations encompass neurological, hematological, endocrine, and systemic autoimmune syndromes, with evidence of autoantibody emergence and post-COVID-19 immune sequelae. SARS-CoV-2 acts as an amplifier of autoimmune reaction in genetically susceptible hosts. Understanding these mechanisms is critical for identifying at-risk individuals and informing preventive and therapeutic strategies for post-COVID-19 autoimmune sequelae.},
}

Humans
*COVID-19/immunology/complications
*SARS-CoV-2/immunology
*Autoimmunity
*Autoimmune Diseases/immunology/virology/etiology
Post-Acute COVID-19 Syndrome
Autoantibodies/immunology
Gastrointestinal Microbiome/immunology
Dysbiosis/immunology
Molecular Mimicry

@article {pmid42349233,
year = {2026},
author = {Lv, F and Chen, Y and Xia, Y},
title = {Neurological sequelae of Long COVID: Pathophysiological mechanisms, diagnostic advances, and therapeutic perspectives.},
journal = {Journal of neuroimmunology},
volume = {419},
number = {},
pages = {579010},
doi = {10.1016/j.jneuroim.2026.579010},
pmid = {42349233},
issn = {1872-8421},
mesh = {Humans ; *COVID-19/complications/physiopathology/therapy/psychology/immunology ; Post-Acute COVID-19 Syndrome ; *Nervous System Diseases/diagnosis/therapy/etiology/physiopathology ; Animals ; },
abstract = {SARS-CoV-2 infection may result in persistent neuropsychiatric symptoms beyond the acute phase, often discussed under the umbrella term "Long COVID". These manifestations commonly include mood disturbances, post-traumatic stress symptoms, cognitive impairment, sleep disturbances, and fatigue, with substantial effects on daily functioning and quality of life. Despite these concerns, the pathophysiological mechanisms underlying these sequelae remain poorly understood, and the lack of specific biomarkers hampers the development of targeted interventions. This review synthesizes recent advances in the clinical presentation, underlying mechanisms, diagnostic approaches, and therapeutic strategies for neuropsychiatric sequelae of Long COVID. We also discuss current challenges and outline future research priorities to facilitate the establishment of standardized diagnostic criteria and the development of effective, mechanism-based therapies.},
}

Humans
*COVID-19/complications/physiopathology/therapy/psychology/immunology
Post-Acute COVID-19 Syndrome
*Nervous System Diseases/diagnosis/therapy/etiology/physiopathology
Animals

@article {pmid42349528,
year = {2026},
author = {Elgendi, MM and Stewart, SH and Sherry, S and Deacon, SH},
title = {Did COVID-19 change the trajectory of children's internalising symptoms? A meta-analysis of longitudinal studies and moderating factors.},
journal = {Journal of affective disorders},
volume = {413},
number = {},
pages = {122168},
doi = {10.1016/j.jad.2026.122168},
pmid = {42349528},
issn = {1573-2517},
mesh = {Humans ; *COVID-19/psychology ; Longitudinal Studies ; Child ; *Anxiety/psychology/epidemiology ; Adolescent ; *Depression/psychology/epidemiology ; Child, Preschool ; Female ; Male ; },
abstract = {The COVID-19 pandemic disrupted children's and adolescents' daily lives worldwide, raising concerns about changes in internalising symptoms. Prior reviews have documented elevated depression and anxiety symptoms during the pandemic, but cross-sectional designs have limited conclusions about within-person change and its moderators. To address this gap, we conducted a meta-analysis of longitudinal studies assessing internalising symptoms before and during the COVID-19 pandemic. Eighty peer-reviewed studies (187 effect sizes) contributed data from youth aged 5-17 years across 20 countries. Standardized mean change (SMC) effect sizes were synthesised using random-effects models with robust variance estimation. Guided by Bronfenbrenner's ecological systems theory, we examined moderators spanning individual, family/school, contextual, and temporal domains. Overall, internalising symptoms increased modestly from pre- to peri-pandemic assessments (SMC = 0.32, 95% CI [0.11, 0.53]; multilevel SMC = 0.34, 95% CI [0.15, 0.53]). Effects varied widely across studies (I[2] = 97.9%), indicating highly heterogeneous symptom trajectories, and suggesting that pooled estimates should be interpreted cautiously. Larger increases were observed in studies including parent-report measures and in contexts of full school closures and highly stringent government responses. Age, gender/sex, region, COVID prevalence, and assessment timing were not significant moderators. Although there were larger increases for composite scores across broad internalising and depressive symptoms than for anxiety or stress, there were no statistically robust between-domain differences. Together, these results indicate that internalising symptoms increased modestly during the COVID-19 pandemic, but that youth experiences were highly context-dependent, underscoring the importance of considering ecological conditions-such as school closures and policy responses-when evaluating pandemic-related mental health change.},
}

Humans
*COVID-19/psychology
Longitudinal Studies
Child
*Anxiety/psychology/epidemiology
Adolescent
*Depression/psychology/epidemiology
Child, Preschool
Female
Male

@article {pmid42350210,
year = {2026},
author = {Marchesi, F and Girmenia, C and Trecarichi, EM and Piciocchi, A and Busca, A and Candoni, A and Cattaneo, C and Delia, M and Del Principe, MI and Fianchi, L and Gentile, G and Fracchiolla, NS and Tumbarello, M and Vignetti, M and Venditti, A and Pagano, L},
title = {Antibacterial, antifungal and antiviral prophylaxis and vaccination strategies in adult patients with acute myeloid and promyelocytic leukemia: An expert panel consensus from the GIMEMA group.},
journal = {Blood reviews},
volume = {77},
number = {},
pages = {101412},
doi = {10.1016/j.blre.2026.101412},
pmid = {42350210},
issn = {1532-1681},
mesh = {Humans ; *Antifungal Agents/therapeutic use ; *Leukemia, Myeloid, Acute/drug therapy/complications ; *Anti-Bacterial Agents/therapeutic use ; *Antiviral Agents/therapeutic use ; *Leukemia, Promyelocytic, Acute/drug therapy/complications ; *Vaccination/methods ; Adult ; *Antibiotic Prophylaxis/methods ; *Bacterial Infections/prevention & control ; Mycoses/prevention & control ; },
abstract = {Infections are a leading cause of morbidity, mortality, and treatment delays in AML and APL. While international guidelines emphasize intensive chemotherapy, they often overlook less intensive regimens, rely on outdated data, and ignore rising MDR infections. A GIMEMA survey across Italian centers revealed significant heterogeneity in antimicrobial prophylaxis, and vaccination practices. An expert panel reviewed 2012-2025 English literature with focus on infections via Delphi/nominal group methods, achieving ≥70% consensus. Prophylaxis with fluoroquinolones showed low agreement (28%) for intensive chemotherapy and venetoclax-based regimens due to no survival benefit, MDR pressure and microbiota disruption; not recommended for low-intensity/palliative care. Posaconazole is advised for intensive chemotherapy with or without FLT3 inhibitors, venetoclax-based regimens, HMA with or without ivosidenib (first 4 cycles), but not APL/palliative care. Antiviral prophylaxis is recommended for APL receiving arsenic trioxide; limited evidence elsewhere. The panel supports universal pneumococcal, influenza, SARS-CoV-2 and herpes zoster vaccination. Overall, these consensus statements aim to harmonize practice and highlight key areas requiring specifically designed prospective studies.},
}

Humans
*Antifungal Agents/therapeutic use
*Leukemia, Myeloid, Acute/drug therapy/complications
*Anti-Bacterial Agents/therapeutic use
*Antiviral Agents/therapeutic use
*Leukemia, Promyelocytic, Acute/drug therapy/complications
*Vaccination/methods
Adult
*Antibiotic Prophylaxis/methods
*Bacterial Infections/prevention & control
Mycoses/prevention & control

@article {pmid42350880,
year = {2026},
author = {Filippatos, F and Kakleas, K and Michos, A},
title = {Immunopathogenesis and Cytokine Pathways in Reactive Infectious Mucocutaneous Eruption (RIME) in Pediatric Population: Infectious Triggers and Molecular Insights.},
journal = {Clinical reviews in allergy & immunology},
volume = {69},
number = {1},
pages = {},
pmid = {42350880},
issn = {1559-0267},
mesh = {Humans ; *Cytokines/metabolism/immunology ; Child ; *Mucositis/immunology/diagnosis ; Immunity, Innate ; Signal Transduction ; Innate Immunity Recognition ; },
abstract = {Reactive infectious mucocutaneous eruption (RIME) is increasingly recognized as a pediatric syndrome in which severe mucositis follows a recent infection and cutaneous involvement is usually limited. Although Mycoplasma pneumoniae remains the prototype trigger, influenza, SARS-CoV-2, adenovirus, respiratory syncytial virus, and other respiratory pathogens can produce a similar clinical phenotype. This narrative review summarizes pediatric RIME/MIRM literature and selected adult or comparator-disease evidence when direct pediatric data are unavailable, explicitly distinguishing direct RIME evidence from extrapolated mechanisms. This review synthesizes current evidence on the immunopathogenesis of RIME in children, with emphasis on how pathogen-specific factors intersect with innate and adaptive immune pathways to drive mucosal injury. We discuss the central roles of epithelial sensing, inflammasome activation, cytokine amplification, neutrophil recruitment, and T-cell polarization, and we relate these mechanisms to the severe oral, ocular, and anogenital disease that often defines pediatric presentations. We also integrate emerging proteomic data showing recurring molecular programs, including acute-phase and complement activation, neutrophil-associated epithelial injury, and interferon-inducible antiviral responses. In addition, we review the possible contribution of genetic susceptibility, especially variation in innate immune sensors and cytokine signaling pathways, to disease severity and recurrence. Finally, we address the main diagnostic challenges, histopathologic and imaging findings, differential diagnosis from Stevens-Johnson syndrome, erythema multiforme, and Kawasaki disease, and the implications of these insights for risk stratification and treatment. Taken together, current evidence supports RIME as a pathogen-triggered, mucosa-predominant inflammatory syndrome in which exaggerated host responses, rather than pathogen presence alone, shape the clinical phenotype.},
}

Humans
*Cytokines/metabolism/immunology
Child
*Mucositis/immunology/diagnosis
Immunity, Innate
Signal Transduction
Innate Immunity Recognition

@article {pmid42351066,
year = {2026},
author = {Tolera, ST and Zerihun, E and Hunduma, G and Letta, S},
title = {Application of health belief model (HBM) in health sciences and medical researches: systematic review on African and Asian countries.},
journal = {BMC public health},
volume = {26},
number = {1},
pages = {},
pmid = {42351066},
issn = {1471-2458},
mesh = {Humans ; Africa ; Asia ; *Health Belief Model ; *Biomedical Research ; },
abstract = {BACKGROUND: The Health Belief Model (HBM) is a widely used psychological framework for explaining and predicting individual's health related attitudes, belief, and behaviors. Although the model has been applied across various fields of health and medical sciences, the extent of its global use, particularly across African and Asian countries has not been well documented.

OBJECTIVE: This systematic review aimed to assess the application of HBM in health sciences and medical research conducted between 2010 and 2025 in Africa and Asian countries.

METHODS: The review followed the updated Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Searches were conducted using keywords "Health Belief Model" combined with Boolean operators (AND, OR) across major databases, including PubMed, CINAHL, Web of Science, Scopus, Cochrane Library and PsycINFO. Eligible studies included peer-reviewed research articles applying the HBM within African and Asian contexts.

RESULT: From a total of 1,421 identified records, 77 studies met the inclusion criteria. Of these, 61% (n = 47) were conducted in Africa countries and 39% (n = 30) in Asian countries. Most studies (64.94%) employed cross-sectional quantitative design, while 12% used mixed-methods approaches. Random controlled trial account for 9.11% of studies, quasi-experimental design for 7%, and qualitative approaches (including focus groups and in-depth interviews) for 6%. Overall, 85.71% of the studies applied all core components of HBM. Fifteen studies examined COVID-19 vaccine acceptance, nine focused on HIV/AIDS testing, counseling and prevention, and eleven studies explored non-communicable diseases prevention. Additionally, six studies assessed women's adherence to breast cancer screening, and four studies examined cervical cancer screening behaviours using HBM.

CONCLUSION: A current systematic review demonstrates that the HBM remain a valuable framework for understanding and influencing health behaviors across diverse settings. Its application in Africa and Asian research highlights its usefulness in guiding targeted interventions that address perceived susceptibility, severity, benefits, barriers, and cues to action, ultimately contributing to improved health outcomes.},
}

Humans
Africa
Asia
*Health Belief Model
*Biomedical Research

@article {pmid42351103,
year = {2026},
author = {De Vita, E and Arzilli, G and Gesualdo, F and Casigliani, V and Pasquale, M and Cruschelli, G and Tecchio, F and Tosi, F and Porretta, AD and Romersi, D and Buquicchio, C and Rizzo, C},
title = {Mapping risk communication practices in public health emergencies: a scoping review and comparison with Italian regional pandemic plans.},
journal = {BMC public health},
volume = {26},
number = {1},
pages = {},
pmid = {42351103},
issn = {1471-2458},
support = {CUP I57G22000460005//Ministero della Salute/ ; },
mesh = {Humans ; *Communication ; *COVID-19/epidemiology/prevention & control ; Emergencies ; Italy/epidemiology ; *Pandemic Preparedness ; *Pandemics ; *Public Health ; },
abstract = {BACKGROUND: Effective risk communication is a cornerstone of public health emergency preparedness and response. The COVID-19 pandemic and other recent crises have highlighted both the centrality of communication in sustaining trust and compliance, and the persistent gap between theoretical frameworks and operational practice.

METHODS: Within the framework of the CreSP project (Comunicare il Rischio nelle Emergenze per la Sanità Pubblica), we conducted a scoping review to map international evidence on risk communication in public health emergencies, comparing it with Italian regional pandemic preparedness plans. Following PRISMA-ScR guidelines, we searched PubMed, Scopus, and Web of Science (1 January 2019-16 May 2024). Peer-reviewed studies addressing health risk communication in emergencies were included. In parallel, 18 Italian regional pandemic plans were identified and analysed using a structured checklist derived from inductive thematic analyses.

RESULTS: Of the 12,479 records identified, 173 studies were included. Most publications originated from high-income countries and focused on COVID-19 pandemic response. Mass communication strategies, especially via social media, predominated, while targeted and participatory approaches were less frequent. The emergency response phase was far more represented than the preparedness or post-emergency phases. Key principles such as timeliness, transparency, and trust were widely discussed across studies, whereas equity, citizen engagement, and infodemic management were less consistently operationalised. Analysis of Italian regional pandemic plans revealed substantial heterogeneity. Although communication was universally acknowledged as important, it was often framed as top-down information dissemination. Structured mechanisms for monitoring, evaluation, citizen participation, and infodemic management were inconsistently addressed.

CONCLUSIONS: Although the concept of emergency risk communication is well-developed, its implementation varies across different levels of governance. The misalignment between scientific evidence and institutional frameworks-particularly regarding inclusivity, participatory models, and infodemic management-underscores the need for a more integrated and standardised national approach. Incorporating communication into preparedness infrastructures, supported by measurable indicators and workforce capacity building, is essential to strengthen resilience, equity, and public trust in the event of future emergencies.},
}

Humans
*Communication
*COVID-19/epidemiology/prevention & control
Emergencies
Italy/epidemiology
*Pandemic Preparedness
*Pandemics
*Public Health

@article {pmid42351227,
year = {2026},
author = {Kumar, N and Khandavalli, N and Avedissian, SN and Chand, HS and Acharya, A and Byrareddy, SN},
title = {Translational insights into Long-COVID: evaluation of preclinical animal models along the lung-brain-immune axis with focus on Golden Syrian Hamsters.},
journal = {Journal of neuroinflammation},
volume = {23},
number = {1},
pages = {},
pmid = {42351227},
issn = {1742-2094},
support = {R01 DA052845/DA/NIDA NIH HHS/United States ; R01 DA059874/DA/NIDA NIH HHS/United States ; R01 DA061678/DA/NIDA NIH HHS/United States ; DA052845, DA059874, DA061678/NH/NIH HHS/United States ; },
mesh = {Animals ; Cricetinae ; Humans ; *Brain/immunology/pathology/virology ; *Disease Models, Animal ; *Lung/immunology/pathology/virology ; Mesocricetus ; *Post-Acute COVID-19 Syndrome/immunology/pathology ; *Translational Research, Biomedical/methods ; },
abstract = {Long-COVID, also referred to as post-acute sequelae of COVID-19 (PASC), is a heterogeneous disorder encompassing more than 200 reported symptoms that commonly affect the respiratory and nervous systems. Emerging clinical evidence indicates that unresolved lung inflammation, vascular injury, and immune dysregulation drive sustained neuroinflammation and impaired neurocognitive function in Long-COVID patients. Given the ethical and logistical constraints of human studies, biologically relevant animal models are essential for understanding the mechanisms and for evaluating therapeutic strategies against Long-COVID. In this review, we synthesize current evidence from preclinical animal models of Long-COVID, with a particular emphasis on the Golden Syrian Hamsters. Golden Syrian Hamsters are naturally susceptible to SARS-CoV-2 infection without the need for genetic modification and recapitulate key features of human disease, including robust viral replication, pulmonary pathology, and inflammatory response during acute infection. Importantly, accumulating evidence demonstrates that Golden Syrian Hamsters develop persistent post-acute abnormalities along the lung-brain-immune axis, including impaired alveolar repair, fibrotic lung remodeling, neuroinflammation, viral or antigen persistence, and behavioral alterations that parallel core features of Long-COVID. We compare the strengths and limitations of Golden Syrian Hamsters with other commonly used pre-clinical animal models including mice, and non-human primates, highlighting differences in translational relevance, feasibility, and ability to model chronic lung-brain-immune axis dysfunction. While there are limitations, particularly regarding limited availability of immunological reagents and validated cognitive and behavioral assays, the Golden Syrian Hamsters offers a balanced and accessible platform for mechanistic studies of PASC. Overall, this review positions Golden Syrian Hamster as a robust translational model for investigating lung-brain-immune axis pathology in Long-COVID and for advancing the development of targeted therapeutic interventions.},
}

Animals
Cricetinae
Humans
*Brain/immunology/pathology/virology
*Disease Models, Animal
*Lung/immunology/pathology/virology
Mesocricetus
*Post-Acute COVID-19 Syndrome/immunology/pathology
*Translational Research, Biomedical/methods

@article {pmid42351549,
year = {2026},
author = {Shati, A and Abdulmutaali, A and Alsaeed, N},
title = {Respiratory Disease Detection: A Systematic Review of AI-Based Approaches, from Audio and Visual Unimodal Methods to Multimodal Integration.},
journal = {Diagnostics (Basel, Switzerland)},
volume = {16},
number = {12},
pages = {},
pmid = {42351549},
issn = {2075-4418},
support = {RA.KKU/2/46/1446H//The Deanship of Research and Graduate Studies at King Khalid University/ ; },
abstract = {Background: Respiratory diseases (RDs), including asthma, COVID-19, chronic obstructive pulmonary disease (COPD), and pneumonia, remain a major global health challenge, contributing substantially to global morbidity and mortality. Conventional diagnosis relies heavily on clinicians' expertise to interpret respiratory sounds and radiographic images, a process that can be subjective, time-consuming, and prone to inter-observer variability. Recent advances in artificial intelligence (AI) and machine learning (ML) have enabled automated diagnostic approaches that can improve the efficiency, consistency, and scalability of respiratory disease detection. However, existing research remains fragmented across different data modalities. Methods: This review systematically analyzes recent studies on AI-based respiratory disease detection using both visual modalities (e.g., chest X-rays, computed tomography (CT) scans, and ultrasound) and audio modalities (e.g., cough and breath sounds). To provide a comprehensive perspective, the reviewed literature is organized using a unified taxonomy that categorizes existing approaches into three main groups: audio-based, visual-based, and audio-visual-based methods. In addition, two conceptual frameworks are proposed to illustrate representative pipelines for audio-based and visual-based respiratory disease classification. Results: The analysis reveals that most existing studies focus on single-modality approaches, while multimodal integration remains relatively underexplored. Only a limited number of studies combine audio and visual data within unified frameworks, primarily due to the scarcity of synchronized multimodal datasets collected from the same patients. The proposed taxonomy and conceptual frameworks provide a structured basis for comparing existing methods, identifying methodological trends, and highlighting key research gaps in multimodal respiratory disease detection. Conclusions: Future research should prioritize the development of multimodal datasets, robust evaluation protocols, and interpretable and lightweight AI models suitable for real-world clinical deployment. Advancing multimodal integration has the potential to significantly enhance the accuracy, reliability, and clinical applicability of AI-driven respiratory disease diagnosis systems.},
}

@article {pmid42351791,
year = {2026},
author = {Zdrobe, Z and Tornyi, I and Sárközi, AT and Horváth, I},
title = {The Complement System and Its Role in Eosinophilic Inflammation in Respiratory Diseases.},
journal = {Biomedicines},
volume = {14},
number = {6},
pages = {},
pmid = {42351791},
issn = {2227-9059},
abstract = {The complement system is a key link between innate and adaptive immunity, contributing to pathogen elimination, immune regulation, and tissue homeostasis. Its activation is not only crucial in infections, such as COVID-19, but also plays a major role in the pathomechanism of several non-infectious respiratory diseases, such as asthma, COPD, sarcoidosis and lung cancer. Complement components can modulate the quality of the adaptive immune responses, including through the regulation of T2 immunity and eosinophilic inflammation, thereby linking natural defense to complex immune processes. In recent years, it has become increasingly clear that dysregulated complement activity contributes to inflammation, thrombosis and tissue damage in a wide range of respiratory diseases. The study of the various components of this cascade system may therefore be promising from both a diagnostic and therapeutic point of view. Some of its components may serve as biomarkers for distinguishing between different phenotypes of certain lung diseases, while their targeted inhibition or modulation may open the way towards new treatment options. A better understanding of the complement system's integrative and regulatory role not only allows for a deeper insight into immunological interactions but may also bring us closer to phenotype-oriented, immunology-based pulmonology, which may have real clinical benefits in the future.},
}

@article {pmid42352300,
year = {2026},
author = {Beyoğlu, D and Idle, JR},
title = {The Gut-Lung Microbiome Crosstalk and Pulmonary Disease.},
journal = {Biomolecules},
volume = {16},
number = {6},
pages = {},
pmid = {42352300},
issn = {2218-273X},
mesh = {Animals ; Humans ; Dysbiosis ; *Gastrointestinal Microbiome ; *Lung/microbiology/metabolism ; *Lung Diseases/microbiology/metabolism ; *Microbiota ; },
abstract = {Both the gut and the lungs possess a microbiome, a community of commensal bacteria, archaea, fungi, and viruses that perform important housekeeping functions in those organs. The colonic microbiome primarily ferments indigestible dietary fibers into essential short-chain fatty acids, synthesizes essential vitamins, regulates the mucosal immune system, and forms a protective barrier against pathogenic colonization. The lung microbiome maintains respiratory health primarily by regulating mucosal immunity, providing a physical barrier against invading pathogens, and producing beneficial metabolites. Several colonic microbiota metabolites, including the short-chain fatty acids acetate, propionate, and butyrate, together with the tryptophan metabolites indole-3-acetate and indole-3-propionate, secondary bile acids, and the polyamines spermidine and putrescine, are transported to the lungs via the gut-lung axis. These colonic microbiota biomolecules suppress lung inflammation, strengthen immune homeostasis, and reduce the severity of respiratory diseases. In contrast, lung microorganisms and their metabolites can travel to the gut via the gut-lung axis, influencing intestinal immune responses and potentially leading to an imbalance of gut microorganisms or dysbiosis. This means that respiratory diseases may lead to digestive issues, intestinal inflammation and chronic diseases. Here, we have reviewed this crosstalk and its impact on the principal pulmonary diseases: asthma, chronic obstructive pulmonary disease, cystic fibrosis, bronchogenic carcinoma, COVID-19, interstitial lung diseases, pneumonia, and tuberculosis. It is concluded that the gut microbiome plays a significant part in lung health and disease. Diet, tobacco smoking and electronic cigarette vaping all impact both the gut and lung microbiomes.},
}

Animals
Humans
Dysbiosis
*Gastrointestinal Microbiome
*Lung/microbiology/metabolism
*Lung Diseases/microbiology/metabolism
*Microbiota

@article {pmid42353563,
year = {2026},
author = {Liu, J and Mao, N and Cui, Y and Bao, Y and Tang, C},
title = {Research Progress on Coronary Artery Injury and Myocardial Ischemia in Multisystem Inflammatory Syndrome in Children.},
journal = {Current issues in molecular biology},
volume = {48},
number = {6},
pages = {},
pmid = {42353563},
issn = {1467-3045},
abstract = {Multisystem inflammatory syndrome in children (MIS-C) is a severe systemic inflammatory complication triggered by prior SARS-CoV-2 infection. It predominantly affects the cardiovascular system, and coronary artery injury, myocardial dysfunction, and myocardial ischemia are closely associated with disease severity and clinical outcomes. This article reviews the immunopathological characteristics and clinical manifestations of MIS-C-related coronary artery lesions, including coronary artery dilation and aneurysm formation, as well as the key pathophysiological mechanisms leading to myocardial ischemia. Based on recent clinical and translational research, we summarize current approaches to diagnosis, risk stratification, acute medical management, and long-term follow-up strategies. By synthesizing updated evidence, this review aims to provide theoretical support and practical clinical guidance for the early identification, timely intervention, and optimized management of affected children, ultimately improving their long-term cardiovascular prognosis.},
}

@article {pmid42353688,
year = {2026},
author = {Wahnou, H and El Kebbaj, R and Demoré, B and Limami, Y and Duval, RE},
title = {Current State of the Fight Against Antimicrobial Resistance: What Are the Different Strategies for Tomorrow?.},
journal = {Antibiotics (Basel, Switzerland)},
volume = {15},
number = {6},
pages = {},
pmid = {42353688},
issn = {2079-6382},
abstract = {Antimicrobial resistance (AMR) is a leading global cause of death, with recent World Health Organization (WHO) data revealing that one in six laboratory-confirmed bacterial infections shows resistance to at least one antibiotic treatment. This review comprehensively analyzes the AMR landscape in 2026, detailing its evolution, mechanisms, and the innovative strategies being deployed to combat it. Driven by Darwinian selection and accelerated by factors like antibiotic overuse during the Coronavirus Disease 2019 (COVID-19) pandemic (predominantly in hospitalized patients with suspected bacterial co-infection), AMR is propelled by a diverse molecular arsenal in bacteria. Key mechanisms include enzymatic drug inactivation (e.g., the diversifying β-lactamase superfamily), target site modification (e.g., mcr genes conferring colistin resistance), efflux pumps, and biofilm formation. The rapid global spread of these traits is facilitated by a dynamic "mobilome", a network of plasmids and transposons that shuttle resistance genes between species. This crisis has sparked a major scientific mobilization. Advances include the discovery of novel antibiotic scaffolds like lariocidin and the regulatory approval of critical new antibiotic/inhibitor combinations such as sulbactam/durlobactam and aztreonam/avibactam, which target highly resistant Gram-negative bacteria. Moreover, the first-in-class antibiotic gepotidacin offers a new option for urinary tract infections. Beyond traditional drugs, the pipeline is diversifying to include phage therapy, antivirulence strategies, and artificial intelligence-guided drug discovery. This diversification is critical as it helps preserve the effectiveness of existing Medically Important Antimicrobials (MIAs), those deemed essential for human medicine, by providing alternative or adjunctive treatment options. However, scientific innovation alone is insufficient. This review argues that lasting success requires parallel progress in global policy and infrastructure. Strategic priorities beyond 2026 must include finalizing and funding updated global action plans, strengthening real-time surveillance and diagnostic capacity, especially in low-resource settings, and implementing new economic models to de-risk antibiotic development. Embedding effective antimicrobial stewardship within universal health coverage and pandemic preparedness plans is crucial. Ultimately, defeating AMR demands an unprecedented, coordinated global effort that outpaces the relentless adaptability of bacterial pathogens.},
}

@article {pmid42354127,
year = {2026},
author = {Piva, M and Martelossi-Cebinelli, G and Mendes-Pierotti, S and Chinen, WH and Cardines, PHF and Martinez, RM and Georgetti, SR and Baracat, MM and Vicentini, FTMC and Verri, WA and Casagrande, R},
title = {Flavonoids as Nutraceuticals to Treat Inflammatory Diseases: Focusing on Quercetin, Kaempferol, Luteolin, Apigenin, Epicatechin and Their Effects on Hepatic, Nervous, and Pulmonary Systems.},
journal = {Foods (Basel, Switzerland)},
volume = {15},
number = {12},
pages = {},
pmid = {42354127},
issn = {2304-8158},
support = {Grant call #067/2024//Fundação Araucária/ ; #309633/2021-4, #405027/2021-4, #307852/2019-9; #481049/2012-6; #427946/2018-2 and # 405848/2025-0//Conselho Nacional de Desenvolvimento Científico e Tecnológico/ ; finance code 001//Coordenação de Aperfeicoamento de Pessoal de Nível Superior/ ; n/a//Fundação de Amparo à Pesquisa do Estado de São Paulo/ ; dotação orçamentária #4560.19.571.06.6153; eprotocolo 21.234.745-0//Secretaria de Estado da Ciência, Tecnologia, e Ensino Superior (SETI)/ ; },
abstract = {The immune response is essential in the protection of our body against pathogens; however, the inflammatory response caused by the immune system can become a disease itself. In fact, anti-inflammatory and immune-suppressive drugs are applied to limit the immune response to treat inflammatory diseases. Flavonoids are plant-derived polyphenols extensively investigated for their anti-inflammatory and antioxidant properties in inflammatory diseases. Studies applying isolated compounds as well as using supplements as nutraceuticals based on flavonoids have been conducted. Our review systematically analyzed the top five studied flavonoids between 2020 and 2025: quercetin (1742 articles), kaempferol (642), luteolin (589), apigenin (419), and epicatechin (354), highlighting their major therapeutic applications in diseases affecting the liver (12%), nervous system (11%), and lungs (10%). Mechanistically, these compounds act as multi-target agents mainly by inhibiting NF-κB and inducing Nrf2-dependent antioxidant programs. Application of advanced delivery systems, which increase oral bioavailability by up to 20-fold, overcomes pharmacokinetic bottlenecks. Clinical highlights demonstrated promising therapeutic effects, including reduced intrahepatic lipid accumulation in non-alcoholic fatty liver disease patients following quercetin supplementation (11.5% to 9.6%) and accelerated SARS-CoV-2 clearance after quercetin phytosome administration. The translation of flavonoids into standardized clinical therapies remains limited by the lack of large-scale, well-controlled clinical trials.},
}

@article {pmid42354220,
year = {2026},
author = {Messova, AM and Ganiyeva, I and Abdrakhmanova, ST and Tuleubayeva, A and Sanbayev, M and Makibayeva, MG and Tamadon, A},
title = {Autoimmune Thyroid Diseases After COVID-19 Infection: A Systematic Review of Clinical Manifestation and Outcomes.},
journal = {International journal of environmental research and public health},
volume = {23},
number = {6},
pages = {},
pmid = {42354220},
issn = {1660-4601},
mesh = {Humans ; *COVID-19/complications ; *Graves Disease/etiology ; *Hashimoto Disease/etiology ; SARS-CoV-2 ; *Thyroiditis, Autoimmune/etiology ; },
abstract = {Background: Increasing evidence suggests that COVID-19 can induce or exacerbate autoimmune disorders, including immune-mediated thyroid dysfunction. The most common autoimmune thyroid diseases are Graves' disease and Hashimoto's thyroiditis; the mechanisms by which viral infections like SARS-CoV-2 trigger these diseases are not fully understood. Objectives: This study aims to systematically review published clinical evidence on the presentation, laboratory characteristics, and outcomes of autoimmune thyroid diseases after COVID-19 infection. Methods: The review followed the PRISMA 2020 framework. Scopus, Web of Science, and PubMed were searched for English-language studies between January 2020 and December 2025 using the terms COVID-19, SARS-CoV-2, autoimmune thyroiditis, Graves' disease, Hashimoto's thyroiditis, and autoimmune thyroid disease. Results: In total, 46 studies (five cohort studies and 41 case reports/series) involving 3856 patients were analyzed. The findings indicate that a significant increase in TPOAb prevalence occurs post-COVID-19 infection (15.7% vs. 7.7% in controls). New-onset Graves' disease (GD) post-COVID-19 presented with higher fT3/fT4 ratios and more aggressive thyrotoxicosis compared to non-viral cases. Rare but severe manifestations included thyrotoxic periodic paralysis, Hashimoto's encephalopathy, and dilated cardiomyopathy. Conclusions: SARS-CoV-2 may act as a trigger for autoimmune thyroid diseases, particularly in moderate-to-severe infections; however, the strength of this association warrants further investigation with controlled prospective data. Standard therapy remains effective, but thyroid function monitoring is advisable during post-COVID-19 recovery. An interdisciplinary approach is essential for early diagnosis and management of systemic complications.},
}

Humans
*COVID-19/complications
*Graves Disease/etiology
*Hashimoto Disease/etiology
SARS-CoV-2
*Thyroiditis, Autoimmune/etiology

@article {pmid42354473,
year = {2026},
author = {De Micco, F and Di Palma, G and Ferorelli, D and Giacomobono, F and Lima Arrais Ribeiro, I and Nóbrega, JBMD and Scendoni, R},
title = {Patient Safety Implications of Opportunistic Pathogens and Healthcare-Associated Infections in COVID-19 Patients: A Narrative Review.},
journal = {Healthcare (Basel, Switzerland)},
volume = {14},
number = {12},
pages = {},
pmid = {42354473},
issn = {2227-9032},
abstract = {The COVID-19 pandemic has highlighted the increased vulnerability of hospitalized patients to healthcare-associated infections (HAIs), which significantly impact patient safety and clinical outcomes. This narrative review summarizes the main opportunistic pathogens associated with HAIs in COVID-19 patients, with particular focus on multidrug-resistant organisms such as Klebsiella pneumoniae, Pseudomonas aeruginosa, Acinetobacter baumannii, Staphylococcus aureus, and Candida spp. The review also examines key aspects of antimicrobial resistance, prevention and control strategies, and medico-legal implications. The evidence supports the need for a multifaceted approach based on antibiotic stewardship, infection prevention guidelines, and multidisciplinary clinical risk management.},
}

@article {pmid42354881,
year = {2026},
author = {Precup, CV and Mateescu, DM and Enache, A and Buhas, CL and Muresan, CO},
title = {SARS-CoV-2 Persistence and Cardiovascular Sequelae in the Post-COVID Era: A Public Health Microbiology Perspective on Sudden Cardiac Death and Pulmonary Thromboembolism.},
journal = {Microorganisms},
volume = {14},
number = {6},
pages = {},
pmid = {42354881},
issn = {2076-2607},
support = {Victor Babeș University of Medicine and Pharmacy Timișoara//Victor Babeș University of Medicine and Pharmacy Timișoara/ ; },
abstract = {Post-acute sequelae of SARS-CoV-2 infection (PASC) extend well beyond the acute respiratory phase, with accumulating virological evidence that SARS-CoV-2 RNA, viral antigens, and proteolytic fragments may persist in cardiovascular and other extrapulmonary tissues, although the extent to which such detection represents replication-competent reservoirs versus residual viral material with uncertain pathological relevance remains under active investigation. Sudden cardiac death (SCD) and fatal pulmonary thromboembolism (PTE) have emerged as forensically and epidemiologically significant outcomes in individuals with prior infection, situated at the intersection of microbiology, public health, and forensic medicine. To synthesize current evidence on the virological mechanisms by which SARS-CoV-2 may contribute to post-acute sudden cardiac death (SCD) and pulmonary thromboembolism (PTE), the population-level epidemiology of these outcomes, and their implications for public health surveillance and forensic practice, we conducted a narrative review of PubMed (MEDLINE), Scopus, and Web of Science Core Collection. The search covered publications from January 2020 to December 2025 and focused on SARS-CoV-2 cellular tropism and tissue persistence, immune-mediated and thromboinflammatory mechanisms, excess cardiovascular and thromboembolic mortality, and autopsy-based pathological findings. After de-duplication of 1837 initially identified records (412 duplicates removed) and screening of 1425 unique records, 78 studies were retained for final synthesis based on virological, epidemiological, and forensic relevance. SARS-CoV-2 enters cardiomyocytes, pericytes, and vascular endothelial cells through ACE2-dependent mechanisms, with cathepsin L compensating for the limited cardiac expression of TMPRSS2. Viral RNA and antigen have been detected in cardiovascular and other extrapulmonary tissues months after symptom onset in selected autopsy series, although persistent detection of viral components does not necessarily indicate ongoing productive infection or direct tissue injury. Endothelial dysfunction, neutrophil extracellular trap (NET) formation, complement activation, and persistent thromboinflammation have been proposed as plausible mechanistic substrates for arrhythmogenic remodelling and thromboembolic events, although definitive causal pathways remain incompletely understood. Population-based studies document persistent excess cardiovascular mortality across multiple jurisdictions, with hazard ratios for pulmonary embolism remaining elevated months after acute infection, particularly in unvaccinated individuals. Autopsy series identify mixed pathological patterns including focal lymphocytic infiltrates, microvascular thrombosis, contraction-band necrosis, and cardiomyocyte vacuolation, although fulminant lymphocytic myocarditis fulfilling Dallas criteria remains uncommon. A microbiology-informed framework uniting tissue-based viral detection, standardized cardiac and pulmonary sampling protocols, and prospective post-mortem registries is needed to better characterize the potential contribution of SARS-CoV-2 to post-acute cardiovascular mortality and to support cause-of-death certification, public health surveillance, and medicolegal practice in the post-pandemic era. Many of the proposed mechanisms remain under active investigation, and definitive causal relationships between viral persistence and adverse cardiovascular outcomes have not yet been conclusively established.},
}

@article {pmid42354940,
year = {2026},
author = {Mpakosi, A and Cholevas, V and Lianou, A and Tziraki, F and Vogiatzis, I and Cholevas, S and Tzouvelekis, I and Mironidou-Tzouveleki, M and Tsante, KA and Tsakri, D and Petrakis, V and Ioannou, P and Bonovas, S and Sokou, R and Tsantes, AG},
title = {Targeting Zoonotic Spillover Drivers for Global Pandemic Prevention: A Narrative Review.},
journal = {Microorganisms},
volume = {14},
number = {6},
pages = {},
pmid = {42354940},
issn = {2076-2607},
abstract = {Zoonoses account for the majority of recognized mammalian viral spillover events, primarily originating from bats, rodents, and primates. Human activities have significantly accelerated these transmissions. This narrative review synthesizes the evolutionary, ecological, pathogen-related, and anthropogenic drivers of viral zoonotic spillover to identify critical leverage points for pandemic prevention. A narrative literature review was conducted. The analysis focused on factors enabling animal pathogens to transform into human pathogens, examining host species, pathogen traits, human-animal interactions, and environmental impacts. Pathogen transformation depends on host traits, contact frequency, and viral characteristics. Anthropogenic drivers-including livestock expansion, the bushmeat trade, wet markets, and the exotic pet industry-significantly elevate spillover risks. Effective pandemic prevention requires targeted interventions at the wildlife-livestock-human interfaces. A holistic, multidisciplinary collaboration between national governments and international organizations is essential to mitigate future risks.},
}

@article {pmid42355811,
year = {2026},
author = {Khawandi, J and Choaib, A and Azzam, M and Oudit, GY and Patel, K and Nazzal, J and Khader, AA and Kawtharany, H and Al Zabibi, MA and Ahmad, J and Kivan, H and Al Hussein, S and Rehman, AU and Piché, A and Vasquez Camargo, A and McNaughton, C and Lam, GY and Kamrul, R and Afzal, S and Schunemann, HJ and Wiercioch, W and Nieuwlaat, R and Brignardello-Petersen, R and Falcone, EL and Mustafa, RA},
title = {Echocardiogram Testing in Patients with Post-COVID-19 Condition: A Systematic Review and Meta-Analysis.},
journal = {Journal of clinical medicine},
volume = {15},
number = {12},
pages = {},
pmid = {42355811},
issn = {2077-0383},
support = {2223-HQ-000415//Public Health Agency of Canada/ ; },
abstract = {Background: Post-COVID-19 condition (PCC) is a complication following acute COVID-19 infection, which may lead to long-term cardiac abnormalities. This review aimed to assess the prevalence of structural/functional deviations in echocardiography in individuals with PCC compared to patients without PCC. Methods: We searched three databases. Two reviewers independently screened articles using LASER Al and extracted relevant data using a piloted Excel sheet. We performed meta-analysis using OpenMeta and RevManWeb and a subgroup analysis based on patients' settings during acute COVID-19. We assessed the risk of bias using the Hoy et al. tool and the certainty using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. Results: We included 16 studies that reported on differences in echocardiographic findings in patients with or without PCC. Individuals with PCC were more likely to have structural/functional deviations in echocardiographic readings of unclear clinical significance, particularly those who were hospitalized during acute COVID-19. The overall certainty of the evidence was very low due to the high risk of bias, indirectness, and imprecision. Conclusions: This review provides insight into the use of echocardiograms and the frequency of test deviations in individuals with PCC. Despite existing evidence, there is a need for future studies to assess the diagnostic test accuracy of echocardiograms in PCC.},
}

@article {pmid42356418,
year = {2026},
author = {Posta, E and Gyarmati, E and Majoros, L and Fekete, I and Varkonyi, I and Zold, E and Barta, Z},
title = {Across Kingdoms: The Bacteriome, Mycobiome, and Virome in Autoimmune Diseases: Mechanistic Insights, Therapeutic Perspectives, and the Emerging Role of COVID-19.},
journal = {Nutrients},
volume = {18},
number = {12},
pages = {},
pmid = {42356418},
issn = {2072-6643},
mesh = {Humans ; *COVID-19/immunology ; *Autoimmune Diseases/microbiology/immunology/virology/therapy ; SARS-CoV-2 ; *Virome ; Dysbiosis/immunology ; *Gastrointestinal Microbiome/immunology ; },
abstract = {Autoimmune and immune-mediated inflammatory diseases (IMIDs) develop when genetically and environmentally susceptible hosts lose stable immune tolerance. The gut ecosystem is increasingly recognized as a biologically active interface in this process. Its bacterial, fungal, and viral components may shape mucosal and systemic immunity through antigenic stimulation, barrier regulation, and metabolite-dependent signaling, although the strength of evidence is uneven: bacteriome data are currently the most mature, whereas mycobiome, virome, and phageome findings remain more disease-specific and emerging. Dysbiosis may influence autoimmunity through overlapping routes, including epithelial barrier failure, altered short-chain fatty acid, bile acid, and tryptophan metabolism, molecular mimicry, and cross-kingdom microbial interactions. Nutrition is central to this network because dietary substrates determine microbial growth, metabolic output, epithelial integrity, and immune-cell differentiation. In this narrative review, we integrate evidence on disease-associated bacteriome, mycobiome, and virome patterns in systemic autoimmune diseases, with emphasis on rheumatoid arthritis, systemic lupus erythematosus, Sjögren's syndrome, systemic sclerosis, spondyloarthritis, vasculitides, and idiopathic inflammatory myopathies. COVID-19 is considered not as a proven causal driver of autoimmunity, but as an example of an environmental and infectious insult capable of perturbing microbiome-barrier-immune communication. Finally, we discuss diet-based and microbiome-targeted approaches, including probiotics, prebiotics, synbiotics, and postbiotics, as adjunctive strategies that may help restore microbial resilience and immune balance. A better understanding of the diet-microbiome-host immunity axis may support more personalized preventive and therapeutic concepts in autoimmune disease.},
}

Humans
*COVID-19/immunology
*Autoimmune Diseases/microbiology/immunology/virology/therapy
SARS-CoV-2
*Virome
Dysbiosis/immunology
*Gastrointestinal Microbiome/immunology

@article {pmid42356487,
year = {2026},
author = {Chiririwa, H},
title = {Selected Cannabinoids, Cannabimimetic Agents and Artemisia Combinations as Theoretical Adjunct Strategies Against COVID-19.},
journal = {Pharmaceuticals (Basel, Switzerland)},
volume = {19},
number = {6},
pages = {},
pmid = {42356487},
issn = {1424-8247},
abstract = {COVID-19 has spurred much interest in complementary and alternative agents for therapeutic purposes having antiviral and immunomodulatory effects. In these, natural products and bioactive compounds from plants have been at the center of attention due to their easy access, relatively low risk and long history of use in traditional medicine. This paper reviews in detail and critically assesses the scientific data that presently proposes the use of certain cannabinoids, cannabimimetic compounds and Artemisia species in the treatment and prevention of COVID-19. It gives an account of medicinal approaches to cannabinoids like cannabidiol (CBD), Δ9-tetrahydrocannabinol (THC) alongside other minor cannabinoids and synthetic and naturally-occurring cannabimimetics. The paper reports the potential of Artemisia annua and other species as treatments, especially focusing on their antiviral, anti-regulatory, anti-inflammatory and immunomodulating properties. It highlights the molecular interactions with SARS-CoV-2 targets as well as cytokine regulation and modulation of oxidative stress pathways, with special emphasis on these areas. The paper raises multiple issues like preclinical and clinical studies, safety aspects, regulatory hurdles and drawbacks related to the use of these natural compounds. After analyzing all the available data, the article entertains the idea of a cannabinoid-Artemisia combination as a supportive or adjunct therapy in COVID-19 treatment. It also points out that the clinical trials are insufficient concerning the establishment of effectiveness, determination of the appropriate dosage and assurance of the long-term safety of the treatment.},
}

@article {pmid42357296,
year = {2026},
author = {Dos Santos, RPN and Betancourt Roldan, DC and Guven, M and Leite, LC and Furlan, FJM and da Silva, GRM and de Oliveira, VAP and Capriglione, CDS and da Silva, JP and Pinto, JC and Eş, I and Balbino, TA},
title = {Microfluidic-Driven Assembly of RNA Nanocomplexes: Design, Process Control and Translational Perspectives in Oncology.},
journal = {Pharmaceutics},
volume = {18},
number = {6},
pages = {},
pmid = {42357296},
issn = {1999-4923},
support = {124C536//Scientific and Technological Research Council of Turkey/ ; YTB//Presidency for Turks Abroad and Related Communities/ ; },
abstract = {RNA-based therapeutics are becoming increasingly important in oncology, particularly following the rapid development of mRNA technologies during the COVID-19 pandemic, but their success strongly depends on how efficiently they can be delivered to target cells. Microfluidic technologies have redefined the design and manufacturing of RNA-based nanocomplexes, as they enable precise control over physicochemical features that are critical for clinical translation in oncology. This review examines recent developments in microfluidic-assisted synthesis of RNA nanocarriers, with a focus on cancer applications. Through a detailed analysis of material systems, device architectures, and formulation strategies, we explore how laminar flow environments enable reproducible encapsulation, tunable particle size, and improved payload stability. We examine the microfluidic assembly of lipid nanoparticles and polymeric carriers for RNA delivery, highlighting strategies to enhance durability, bioavailability, and cellular uptake. Advancements in process optimization, including flow parameter refinement and inline monitoring, are discussed alongside the influence of device geometries on mixing dynamics and nucleation. Beyond formulation, we explore the integration of microfluidics with tumor-on-chip platforms to evaluate transport, penetration, and therapeutic response in physiologically relevant cancer models. By connecting technological innovation with preclinical application, this work outlines the trajectory toward next-generation, personalized RNA nanomedicines enabled by microfluidic precision.},
}

@article {pmid42357309,
year = {2026},
author = {Porta, EOJ and AlKharboush, DF and Jackson, L and Pang, F and Darin, A and Louka, J and Quamruzzaman, M and Shi, X and Wells, G and Kozielski, F},
title = {Targeting SARS-CoV-2 Non-Structural Proteins: A Blueprint for Next-Generation Small-Molecule Coronavirus Antivirals.},
journal = {Pharmaceutics},
volume = {18},
number = {6},
pages = {},
pmid = {42357309},
issn = {1999-4923},
support = {MR/X013995/1/MRC_/Medical Research Council/United Kingdom ; },
abstract = {The SARS-CoV-2 non-structural proteome remains the most clinically validated and strategically important landscape for direct-acting small-molecule antiviral drug discovery. The success of inhibitors targeting the main protease (M[pro], Nsp5) and RNA-dependent RNA polymerase (RdRp, Nsp12) has firmly established viral replication enzymes as tractable, druggable, and therapeutically relevant targets, while setting clear benchmarks for translational antiviral development. Building on this foundation, a second wave of non-structural protein (Nsp) targets has emerged with increasing translational promise, including the papain-like protease (PL[pro]), the bifunctional Nsp14 proofreading and capping machinery, Nsp16 2'-O-methyltransferase, Nsp13 helicase, and Nsp15 endoribonuclease. In parallel, additional components such as Nsp1 and the Mac1 domain of Nsp3 continue to expand the antiviral design space, although they remain at earlier stages of chemical validation. In this review, we comprehensively assess SARS-CoV-2 non-structural proteins through a medicinal chemistry and translational lens, with an emphasis on structural tractability, mechanism of action, quality of chemical matter, cellular and in vivo antiviral evidence, evolutionary conservation, resistance liabilities, and developability. Particular attention is given to the features that distinguish tool compounds from genuinely actionable leads and to the opportunities for rational combination regimens that extend beyond first-generation protease- and polymerase-centred therapy. Collectively, the non-structural proteome offers the strongest foundation for next-generation and potentially broader-spectrum coronavirus antivirals with improved resilience to viral evolution.},
}

@article {pmid42357322,
year = {2026},
author = {Porta, EOJ and AlKharboush, DF and Jackson, L and Pang, F and Darin, A and Louka, J and Shi, X and Wells, G and Kozielski, F},
title = {Targeting SARS-CoV-2 Structural and Accessory Proteins: Emerging Opportunities for Small-Molecule Coronavirus Antivirals.},
journal = {Pharmaceutics},
volume = {18},
number = {6},
pages = {},
pmid = {42357322},
issn = {1999-4923},
support = {MR/X013995/1/MRC_/Medical Research Council/United Kingdom ; },
abstract = {Although antiviral development against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been dominated by replication-directed strategies, structural and accessory proteins offer a complementary and increasingly important opportunity for small-molecule intervention. These proteins control key processes outside the core replication machinery, including viral entry, membrane remodelling, virion assembly, egress, and host immune modulation, thereby expanding the mechanistic scope of antiviral design. However, many of these targets are membrane-associated, oligomeric, conformationally dynamic, or function through protein-protein interactions, creating distinct challenges in target validation, assay design, and chemical optimisation. In this review, we comprehensively and critically evaluate the structural and accessory proteomes of SARS-CoV-2, with a strict focus on small-molecule tractability and translational relevance. We highlight the most credible direct-acting opportunities, focusing on the membrane (M), envelope (E), and nucleocapsid (N) structural proteins, together with the accessory protein open reading frame 3a (ORF3a), for which emerging chemical matter strengthens confidence in druggability. In contrast, Spike (S) and several host-interface accessory proteins, including ORF6, ORF8, ORF9b, and ORF10, are best viewed as more selective or earlier-stage opportunities that require stronger on-target chemical validation. Emphasis is placed on structural accessibility, mechanism-based assay systems, evidence quality, cellular and in vivo activity, and developability constraints relevant to exposure at the infection site. Rather than replacing replication-directed antivirals, these non-canonical targets are best considered adjunctive or complementary components of future combination strategies designed to broaden antiviral coverage, enhance robustness, and improve pandemic preparedness.},
}

@article {pmid42357443,
year = {2026},
author = {Zhao, S and Lin, Z and Wang, M},
title = {Positive-Strand RNA Viral RdRps: From Structure Conservation and Activity Assay to Drug Development.},
journal = {Molecules (Basel, Switzerland)},
volume = {31},
number = {12},
pages = {},
pmid = {42357443},
issn = {1420-3049},
mesh = {*RNA-Dependent RNA Polymerase/chemistry/antagonists & inhibitors/metabolism/genetics ; *Antiviral Agents/pharmacology/chemistry/therapeutic use ; Humans ; *Drug Development ; *Positive-Strand RNA Viruses/enzymology/drug effects/genetics ; RNA Replication/drug effects ; Virus Replication/drug effects ; SARS-CoV-2/enzymology/drug effects ; },
abstract = {Positive-strand RNA viruses represented by SARS-CoV-2 and DENV spread globally with high infectivity and frequent mutations, posing a severe threat to human health. However, specific and effective antiviral drugs remain limited. RNA-dependent RNA polymerase (RdRp) plays a critical role in the genome replication of RNA viruses and shows high structural conservation. No homologous protein exists in human cells, making RdRp an effective, safe, and broad-spectrum antiviral target. Therefore, establishing an RdRp activity assay for drug development based on its mechanism is of great significance. This paper summarizes the structural characteristics of RdRp and the methods for constructing RdRp activity assay, especially for cell-free activity assay. In addition, several reported RdRp inhibitors and their pharmaceutical progress are also reviewed, aiming to provide a reference for the development of novel antiviral drugs targeting RdRp.},
}

*RNA-Dependent RNA Polymerase/chemistry/antagonists & inhibitors/metabolism/genetics
*Antiviral Agents/pharmacology/chemistry/therapeutic use
Humans
*Drug Development
*Positive-Strand RNA Viruses/enzymology/drug effects/genetics
RNA Replication/drug effects
Virus Replication/drug effects
SARS-CoV-2/enzymology/drug effects

@article {pmid42357608,
year = {2026},
author = {Domingo, JL},
title = {Toxicants, Exposome, and Hantavirus Disease: A One Health Perspective.},
journal = {Viruses},
volume = {18},
number = {6},
pages = {},
pmid = {42357608},
issn = {1999-4915},
mesh = {Humans ; *Hantavirus Infections/transmission/epidemiology/virology ; Orthohantavirus ; Animals ; Climate Change ; *One Health ; *Environmental Exposure/adverse effects ; *Exposome ; SARS-CoV-2 ; COVID-19 ; Zoonoses/virology ; },
abstract = {Although hantaviruses have traditionally been considered geographically restricted rodent-borne pathogens, globalization, climate change, ecosystem disruption, and environmental contamination may collectively favor novel transmission scenarios and altered epidemiological patterns. The experience gained during the SARS-CoV-2 pandemic showed the importance of environmental determinants, airborne exposure, and host susceptibility factors in emerging viral diseases. In this context, increasing but still indirect evidence suggests that environmental toxicants and the exposome may modulate susceptibility to hantavirus infection and influence disease severity. The proposed mechanisms include oxidative stress, endothelial dysfunction, pulmonary inflammation, and immune dysregulation, rather than direct causal effects of toxicants on infection itself. This article discusses current knowledge regarding interactions among toxic environmental exposures, climate change, and hantavirus disease, with special emphasis on Andes orthohantavirus (ANDV), the principal hantavirus known to exhibit person-to-person transmission. The article integrates recent evidence within the One Health framework and highlights future research priorities linking environmental toxicology, zoonotic disease ecology, and global environmental change.},
}

Humans
*Hantavirus Infections/transmission/epidemiology/virology
Orthohantavirus
Animals
Climate Change
*One Health
*Environmental Exposure/adverse effects
*Exposome
SARS-CoV-2
COVID-19
Zoonoses/virology

@article {pmid42357652,
year = {2026},
author = {Jia, T and Huang, Z and Xia, N and Yuan, Q},
title = {Broad Neutralizing Antibodies Against SARS-CoV-2: Current Progress and Engineering Strategies.},
journal = {Viruses},
volume = {18},
number = {6},
pages = {},
pmid = {42357652},
issn = {1999-4915},
support = {824B2066//National Natural Science Foundation of China/ ; 92369110//National Natural Science Foundation of China/ ; 82272305//National Natural Science Foundation of China/ ; },
mesh = {*Antibodies, Neutralizing/immunology/therapeutic use ; Humans ; *SARS-CoV-2/immunology/genetics ; *Antibodies, Viral/immunology/therapeutic use ; *COVID-19/immunology/prevention & control ; Spike Glycoprotein, Coronavirus/immunology/genetics ; Animals ; Epitopes/immunology ; Single-Domain Antibodies/immunology ; Protein Engineering ; Mutation ; },
abstract = {The high-frequency mutation characteristics of SARS-CoV-2 have posed formidable challenges to the development of vaccines and therapeutic agents. Neutralizing antibodies, which serve as effective tools for prevention and control, have undergone continuous updates and iterations in response to viral mutations. This article provides a comprehensive review of researchers' efforts to achieve both high neutralizing potency and high mutation tolerance in SARS-CoV-2-targeting neutralizing antibodies. Building on the characteristics of conventional antibodies directed against distinct epitopes on the S protein, it further discusses the research on nanobodies, antibody cocktails, multi-specific antibodies, and other antibody formats and engineering approaches, including artificial intelligence-enabled optimization. Each antibody-based strategy targeting SARS-CoV-2 has its own distinctive advantages and potential applications, providing an integrated perspective to support the continued development of antiviral neutralizing antibodies.},
}

*Antibodies, Neutralizing/immunology/therapeutic use
Humans
*SARS-CoV-2/immunology/genetics
*Antibodies, Viral/immunology/therapeutic use
*COVID-19/immunology/prevention & control
Spike Glycoprotein, Coronavirus/immunology/genetics
Animals
Epitopes/immunology
Single-Domain Antibodies/immunology
Protein Engineering
Mutation

@article {pmid42359054,
year = {2026},
author = {Dinç, HÖ and Saribaş, S and Kocazeybek, B},
title = {The immunopathological spectrum of COVID-19: from cytokine storm to autoimmunity-a systematic review.},
journal = {Frontiers in medicine},
volume = {13},
number = {},
pages = {1864452},
pmid = {42359054},
issn = {2296-858X},
abstract = {INTRODUCTION: This systematic review aimed to provide a comprehensive evaluation of the immunopathological mechanisms associated with SARS-CoV-2 infection and COVID-19 vaccination based on current evidence. Particular emphasis was placed on cytokine storm, endothelial dysfunction, complement activation, and autoimmune processes in COVID-19 pathogenesis.

METHODS: The study was conducted as a systematic literature review in accordance with PRISMA guidelines. English-language research articles published between 2020 and 2026 were identified through a structured search of the Scopus database. A total of 1,331 records were screened, and 53 studies were included based on predefined inclusion and exclusion criteria. The findings were systematically categorized according to major immunopathological mechanisms.

RESULTS: The included studies indicate that endothelial dysfunction (24.5%) and cytokine dysregulation (18.9%) are the most frequently reported mechanisms in COVID-19 immunopathogenesis. Autoimmune responses (15.1%), complement activation (17%), and immune complex-mediated inflammation also play significant roles. Elevated levels of proinflammatory cytokines, lymphopenia, and markers of vascular injury were consistently associated with increased disease severity and mortality. In addition, persistent immunological alterations and autoantibody production were observed in a subset of patients during the post-COVID period.

CONCLUSION: COVID-19 pathogenesis is driven by complex and interconnected immunopathological mechanisms rather than viral effects alone. Hyperinflammation, endothelial dysfunction, complement activation, and autoimmune processes are key determinants of disease severity and clinical outcomes. These findings underscore the importance of targeted immunomodulatory strategies and provide a comprehensive framework for future research.},
}

@article {pmid42359168,
year = {2026},
author = {Mundt, B and Kant, R and Grzybek, M},
title = {Viral pathogens in urban rats: A one health systematic review of global surveillance evidence.},
journal = {One health (Amsterdam, Netherlands)},
volume = {23},
number = {},
pages = {101468},
pmid = {42359168},
issn = {2352-7714},
abstract = {BACKGROUND: Commensal rats (Rattus norvegicus and Rattus rattus) thrive in urban environments worldwide, where they live near humans and may act as reservoirs for viral pathogens of public health relevance. Although rats are increasingly recognised as sentinels of urban environmental health, the diversity and distribution of viral infections circulating in urban rat populations remain incompletely characterised within a One Health framework.

OBJECTIVES: This systematic review synthesises global evidence on viral pathogens detected in urban rats, focusing on rat hepatitis E virus/Rocahepevirus ratti and human-associated hepatitis E virus/Paslahepevirus balayani where distinguishable, Seoul virus (SEOV), SARS-CoV-2, and additional viral taxa identified through targeted surveillance or, in rare cases, metagenomic approaches.

METHODS: Following PRISMA 2020 guidelines, five electronic databases were searched for primary studies reporting viral detection in urban Rattus spp. Eligible studies underwent screening, structured data extraction and quality appraisal. Viral prevalence was summarised descriptively by pathogen and geographic region.

RESULTS: A total of 70 studies met the inclusion criteria, spanning Europe, Asia, North America, South America and the Caribbean. HEV and SEOV were the most frequently reported viruses, with prevalence varying widely between regions. HEV prevalence ranged from low levels in parts of Europe and Asia to high levels in North America. SEOV was detected across all regions, with particularly high prevalence in parts of Asia and the Americas. SARS-CoV-2 was not detected in European rats but was reported at low to moderate prevalence in the Americas. Numerous additional viral pathogens were identified.

CONCLUSIONS: Urban rats globally harbour diverse viral communities, including pathogens with zoonotic potential. Surveillance remains uneven and methodologically heterogeneous. Integrating rat biomonitoring into coordinated One Health surveillance systems is critical to strengthen early warning capacity and mitigate zoonotic risk.},
}

@article {pmid42361431,
year = {2026},
author = {Bourgon, C and Moseman, EA},
title = {On or within: spatial determinants of antigen handling in the nasal turbinates.},
journal = {Current opinion in immunology},
volume = {101},
number = {},
pages = {102808},
pmid = {42361431},
issn = {1879-0372},
support = {R01 AI179729/AI/NIAID NIH HHS/United States ; R01 NS121067/NS/NINDS NIH HHS/United States ; R21 DC021260/DC/NIDCD NIH HHS/United States ; },
mesh = {Humans ; Animals ; *Turbinates/immunology ; *Nasal Mucosa/immunology ; *SARS-CoV-2/immunology ; *COVID-19/immunology/prevention & control ; *Antigens/immunology ; Lymph Nodes/immunology ; *COVID-19 Vaccines/immunology ; Immunity, Mucosal ; },
abstract = {The SARS-CoV-2 pandemic has renewed interest in mucosal vaccines, yet these approaches have long struggled to generate durable protection against airway pathogens. A key limitation is the incomplete understanding of how upper airway antigens are handled to shape immune response quality and durability. Antigens located within the airspace or on the mucosal surface can be directly sampled by mucosal-associated lymphoid tissues (MALTs), such as Nasal-associated lymphoid tissue (NALT) in mice, or tonsils in humans. Because MALTs lack afferent lymphatics, antigen entry occurs primarily across a specialized epithelium. In contrast, antigens that arise within the mucosa following barrier breach are captured by immune cells and lymphatics for delivery to draining lymph nodes. This framework suggests that 'on the mucosa' antigens preferentially engage MALTs, whereas 'within the mucosa' antigens are handled by lymph nodes. However, the rules governing antigen handling within the nasal cavity remain poorly defined, limiting rational mucosal vaccine design.},
}

Humans
Animals
*Turbinates/immunology
*Nasal Mucosa/immunology
*SARS-CoV-2/immunology
*COVID-19/immunology/prevention & control
*Antigens/immunology
Lymph Nodes/immunology
*COVID-19 Vaccines/immunology
Immunity, Mucosal

@article {pmid42361718,
year = {2026},
author = {Sanga, NA and Oranzie, M and January, JL and Cox, M and Januarie, KC and Cupido, C and Tovide, OO and Pokpas, K and Douman, SF and Iwuoha, EI},
title = {Bioelectrochemical Sensing Dynamics of SARS-CoV-2 Biomarkers.},
journal = {Bioelectrochemistry (Amsterdam, Netherlands)},
volume = {172},
number = {},
pages = {109368},
doi = {10.1016/j.bioelechem.2026.109368},
pmid = {42361718},
issn = {1878-562X},
mesh = {*Biosensing Techniques/methods ; Humans ; *Electrochemical Techniques/methods ; *SARS-CoV-2/isolation & purification/genetics/immunology ; Spike Glycoprotein, Coronavirus/analysis ; Biomarkers/analysis ; *COVID-19/diagnosis/virology ; RNA, Viral/analysis ; Phosphoproteins/analysis ; Coronavirus Nucleocapsid Proteins/analysis ; },
abstract = {The SARS-CoV-2 outbreak has underscored the urgent need for rapid, sensitive and accessible diagnostic technologies. This review provides a comprehensive overview of recent advances in nucleic acid- and antibody-based bioelectrochemical detection strategies for SARS-CoV-2, targeting the nucleocapsid (N) protein, spike (S) protein, the receptor binding domain (RBD) antigens and the viral RNA genome. Particular emphasis is placed on aptasensor, immunosensor and genosensor, highlighting biosensor design strategies and associated advantages and limitations. Key analytical parameters, such as sensitivity, detection limit, response time, transduction mechanisms and integrated nanomaterials are compared and discussed. Future perspectives on the innovative nucleic acid- and antibody-based point-of-care biosensors for SARS-CoV-2 are presented.},
}

*Biosensing Techniques/methods
Humans
*Electrochemical Techniques/methods
*SARS-CoV-2/isolation & purification/genetics/immunology
Spike Glycoprotein, Coronavirus/analysis
Biomarkers/analysis
*COVID-19/diagnosis/virology
RNA, Viral/analysis
Phosphoproteins/analysis
Coronavirus Nucleocapsid Proteins/analysis

@article {pmid42362025,
year = {2026},
author = {Liaw, PC and Zarychanski, R and Lawler, PR and Lother, SA and Mendelson, AA},
title = {The evolving role of heparin in sepsis: therapeutic potential in the age of immunothrombosis.},
journal = {Journal of thrombosis and haemostasis : JTH},
volume = {24},
number = {9},
pages = {3102-3115},
doi = {10.1016/j.jtha.2026.06.017},
pmid = {42362025},
issn = {1538-7836},
mesh = {Humans ; *Heparin/therapeutic use/adverse effects ; *Sepsis/drug therapy/immunology/blood ; *Anticoagulants/therapeutic use/adverse effects ; COVID-19/immunology/complications/blood ; *Thromboinflammation/drug therapy/immunology ; Animals ; *COVID-19 Drug Treatment ; Extracellular Traps/drug effects/immunology ; SARS-CoV-2 ; Blood Coagulation/drug effects ; Anti-Inflammatory Agents/therapeutic use ; Treatment Outcome ; },
abstract = {Sepsis is a life-threatening syndrome caused by a dysregulated host response to infection and remains a leading cause of global morbidity and mortality. Despite decades of research, most biologically targeted therapies have failed to improve survival, highlighting the need for new treatment strategies that address the complex pathophysiology of sepsis. A defining feature of sepsis is immunothrombosis, characterized by widespread activation of inflammation and coagulation, endothelial injury, platelet activation, and neutrophil extracellular trap (NET) formation, resulting in both macrovascular thrombosis and microvascular occlusion. Heparin is commonly used as an anticoagulant and has re-emerged as a potential therapeutic agent for sepsis due to its pleiotropic properties that extend beyond anticoagulant effects. Heparin exhibits anti-inflammatory and antimicrobial activities, inhibits immune activation, neutralizes damage-associated molecular patterns, and modulates NET-mediated pathology. Clinical evidence for efficacy in sepsis remains limited, and no adequately powered randomized trials have confirmed a net survival benefit of therapeutic-dose heparin. This may reflect historical challenges with trial methodology and the heterogeneous nature of human sepsis. Data from COVID-19-associated sepsis suggest that severity may influence outcomes, with potential benefits in earlier disease stages and possible harm in advanced stages. Emerging interest in nonanticoagulant heparin derivatives and biomarker-guided patient selection may offer scientific opportunities to optimize therapeutic benefit while minimizing bleeding, but these approaches remain investigational. This review synthesized current mechanistic, preclinical, and clinical evidence supporting heparin-based strategies in sepsis and emphasizes that therapeutic use beyond standard thromboprophylaxis should be evaluated in clinical trials before being applied in practice.},
}

Humans
*Heparin/therapeutic use/adverse effects
*Sepsis/drug therapy/immunology/blood
*Anticoagulants/therapeutic use/adverse effects
COVID-19/immunology/complications/blood
*Thromboinflammation/drug therapy/immunology
Animals
*COVID-19 Drug Treatment
Extracellular Traps/drug effects/immunology
SARS-CoV-2
Blood Coagulation/drug effects
Anti-Inflammatory Agents/therapeutic use
Treatment Outcome

@article {pmid42362430,
year = {2026},
author = {Wei, HY and Lin, CY and Lin, YJ and Huang, SC and Shih, YL and Lin, FT and Yang, CH},
title = {Evolution of COVID-19 antiviral interventions in Taiwan, 2022-2025: Insights from public health policy.},
journal = {Journal of the Formosan Medical Association = Taiwan yi zhi},
volume = {},
number = {},
pages = {},
doi = {10.1016/j.jfma.2026.06.042},
pmid = {42362430},
issn = {0929-6646},
abstract = {This study reviewed the use of COVID-19 antiviral agents in Taiwan (2022-2025), focusing on how policy changes influenced drug deployment, and explored trends in outpatient visits, hospitalizations, emergency department visits, and mortality. Policy changes and usage patterns of Remdesivir, Molnupiravir, and Nirmatrelvir/Ritonavir, were tracked using the Stockpile Management Information System (SMIS). As policies shifted to focus on the treatment of mild-to-severe cases in high-risk groups, the percentages of both oral antivirals and Remdesivir use increased. Remdesivir use (among hospitalized patients and emergency departments visits) rose from 10% in 2022 to 20% during COVID resurgence in 2025. Among adults aged ≥65 years, the oral antiviral utilization percentage remained stable at 53-54% after March 2023 based on total healthcare visits, and reached 65-69% when using outpatient visits as the denominator. As vaccine coverage expanded and herd immunity increased through 2022-2024, Taiwan's population developed robust hybrid immunity, hospitalizations and deaths declined substantially in subsequent epidemic waves. This analysis of the utilization percentages of COVID-19 antiviral drugs may serve as a valuable reference for future drug procurement and resource allocation. Timely, and adaptive deployment of antiviral agents remains critical for mitigating public health and healthcare system burdens during large-scale epidemics.},
}

@article {pmid42362970,
year = {2026},
author = {Said, N and Jones, I and Anderson-Baucum, EK and Evans-Molina, C},
title = {SARS-CoV-2 and diabetes: a post-pandemic reappraisal.},
journal = {Diabetologia},
volume = {69},
number = {9},
pages = {2396-2407},
pmid = {42362970},
issn = {1432-0428},
support = {R01 DK127308/DK/NIDDK NIH HHS/United States ; I01BX001733//U.S. Department of Veterans Affairs/ ; I01 BX001733/BX/BLRD VA/United States ; P30DK097512/DK/NIDDK NIH HHS/United States ; P30 DK097512/DK/NIDDK NIH HHS/United States ; R01 DK093954/DK/NIDDK NIH HHS/United States ; R01DK127308/DK/NIDDK NIH HHS/United States ; R01DK093954/DK/NIDDK NIH HHS/United States ; },
mesh = {Humans ; *COVID-19/epidemiology/complications ; SARS-CoV-2 ; *Diabetes Mellitus, Type 2/epidemiology ; *Diabetes Mellitus, Type 1/epidemiology ; Pandemics ; *Diabetes Mellitus/epidemiology ; },
abstract = {The COVID-19 pandemic was a dynamic and often confusing period for clinical and biomedical research. As severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spread globally, knowledge accumulated rapidly through publications that were frequently based on preliminary or sometimes conflicting evidence, yet these papers played a critical role in shaping evolving medical, research and societal responses. Early in the pandemic, diabetes emerged as one of the strongest predictors of severe COVID-19 outcomes and mortality, placing it at the centre of early risk-stratification and therapeutic frameworks and prompting urgent efforts to understand the biological basis of these associations. As the pandemic progressed, reports of new-onset diabetes following COVID-19 infection raised the possibility of a bidirectional relationship between SARS-CoV-2 infection and diabetes. In this review, we provide a post-pandemic reappraisal of the clinical and experimental literature examining the intersection of COVID-19 and diabetes. We summarise proposed pathophysiological mechanisms, including the effects of SARS-CoV-2 infection in the pancreas and on peripheral insulin-sensitive tissues. We review key meta-analyses assessing the association between COVID-19 and incident type 1 and type 2 diabetes and highlight strengths and weaknesses of the epidemiologic studies underpinning these findings. We highlight the highest-quality evidence from prospective cohorts, as well as relevant clinical trials and registry-based studies that emerged from this collective experience. We discuss emerging relationships between long COVID and diabetes and the effect of vaccination on diabetes risk following SARS-CoV-2 infection. Finally, we identify critical knowledge gaps and outline priorities for ongoing and future studies needed to resolve remaining uncertainties.},
}

Humans
*COVID-19/epidemiology/complications
SARS-CoV-2
*Diabetes Mellitus, Type 2/epidemiology
*Diabetes Mellitus, Type 1/epidemiology
Pandemics
*Diabetes Mellitus/epidemiology

@article {pmid42363391,
year = {2026},
author = {Kazmi, SM and Khan, MO and Safdar, SN and Ahmad, S and Ghazi, KR and Bakhshi, SK},
title = {The Evolution of Patient Safety Practices Over the Last Two Decades.},
journal = {JPMA. The Journal of the Pakistan Medical Association},
volume = {76(Suppl 1)},
number = {3},
pages = {S131-S135},
doi = {10.47391/JPMA.AKU-10Surg-24},
pmid = {42363391},
issn = {0030-9982},
mesh = {Humans ; *Patient Safety/standards ; COVID-19 ; Pandemics ; SARS-CoV-2 ; Artificial Intelligence ; Electronic Health Records ; Digital Health ; Telemedicine ; },
abstract = {Patient safety has undergone significant evolution over the past two decades, driven by a shift towards systemsbased approaches, the adoption of technological solutions, and a growing global commitment to improving healthcare outcomes. Early milestones (2000- 2010) saw the establishment of key safety protocols, including the "To Err is Human" report and the World Health Organisation's global initiatives. The following decade (2011-2020) marked the widespread integration of electronic health records and simulation-based training. The coronavirus disease-2019 pandemic presented unique challenges, including healthcare resource shortages and increased errors, but also accelerated innovations, such as telehealth and clinical decision-support tools. More recently, artificial intelligence has emerged as a powerful tool for enhancing patient safety, offering predictive capabilities and personalised care. However, barriers such as organisational resistance, resource constraints and inconsistent data-collection remain. Looking ahead, fostering a culture of safety, collaboration and continuous innovation is essential to address systemic gaps, and to ensure safer healthcare practices globally.},
}

Humans
*Patient Safety/standards
COVID-19
Pandemics
SARS-CoV-2
Artificial Intelligence
Electronic Health Records
Digital Health
Telemedicine

@article {pmid42364134,
year = {2026},
author = {Vacaru, RP and Didilescu, AC and Scannapieco, FA},
title = {Oral Health, Periodontitis, and Respiratory Diseases: Biological Pathways.},
journal = {Journal of periodontal research},
volume = {},
number = {},
pages = {},
doi = {10.1111/jre.70126},
pmid = {42364134},
issn = {1600-0765},
abstract = {Poor oral hygiene and periodontitis influence lung diseases such as pneumonia, chronic obstructive pulmonary disease (COPD), COVID-19, and asthma. The normal lung is not sterile, with a distinct microbial ecosystem that is spatially varied along the respiratory tract. The biogeography of the lung microbiome is balanced between microbial microaspiration from the oral-pharynx and clearance. The mouth is an important reservoir for respiratory pathogens including Streptococcus pneumoniae, Haemophilus influenzae, Pseudomonas aeruginosa, and Staphylococcus aureus, as well as oral microbes (Porphyromonas, Prevotella, Fusobacterium, etc.). Poor oral hygiene and periodontitis increase the bacterial load that can be aspirated, and the host produces pro-inflammatory components that enhance microbial virulence and compromize epithelial integrity. Both poor oral hygiene and periodontitis have been associated with pneumonia, particularly in hospitals and nursing home settings. Periodontitis may also facilitate viral pneumonia (including COVID-19) by altering receptor expression and immune function. Periodontitis correlates with COPD severity and exacerbation frequency through pathways involving matrix metalloproteinases and cytokines. Periodontitis also is associated with asthma and acute exacerbations. Inflammation shapes the lung microbiome by impacting microbial nutrient availability through vascular leakage, inducing changes to epithelial cells which facilitate bacterial adherence, and inducing the production of cytokines, leading to mucus overproduction, inhibition of phagocytosis, and enhancement of microbial pathogen virulence. Multiple biological pathways have been examined in vitro that suggest how "the oral-lung axis" influences pneumonia, COPD, and asthma. Periodontal treatment and effective oral hygiene should be well integrated into medical care to prevent and manage respiratory diseases.},
}

@article {pmid42364372,
year = {2026},
author = {Tomassini, L and Onofri, M and Gambelunghe, C and Fedeli, P and Scendoni, R and Pini, N and Lancia, M},
title = {Toward methodological standardization in forensic immunohistochemistry: a critical appraisal of 144 post-mortem studies and a proposed evaluative framework.},
journal = {Legal medicine (Tokyo, Japan)},
volume = {84},
number = {},
pages = {102894},
doi = {10.1016/j.legalmed.2026.102894},
pmid = {42364372},
issn = {1873-4162},
mesh = {Humans ; *Immunohistochemistry/standards/methods ; *Forensic Pathology/methods/standards ; Autopsy/methods ; Quality Control ; },
abstract = {Immunohistochemistry (IHC) is widely applied in post-mortem forensic investigations. Its evidentiary value depends critically on methodological standardization. Following PRISMA guidelines and PROSPERO registration (CRD420251063965), we systematically searched PubMed, Scopus, and Web of Science for original IHC studies on human autopsy material. A total of 144 studies were included and evaluated against six predefined methodological criteria (M1-M6) addressing slide interpretation metrics, multi-reader assessment, observer blinding, concordance reporting, quality control, and predefined positivity thresholds. IHC was applied across diverse forensic domains, most frequently in traumatic brain injury (16%), sudden cardiac death (14%), COVID-19-related death (13%), and wound vitality/wound dating (11%). Quantitative or semi-quantitative slide reading (M1) was adopted in 75.7% of studies, and quality control measures (M5) in 52.8%. By contrast, blinded reading (M3) was implemented in only 40% of applicable studies, inter-observer concordance (M4) in 10%, and predefined positivity thresholds (M6) in only 4.2% of studies. Only 38.9% of studies met three or more methodological criteria, and a single study satisfied all six criteria. Forensic IHC demonstrates broad application and considerable inferential ambition, but its methodological foundations remain inconsistently consolidated. We propose that future forensic IHC studies place greater emphasis on analytical validation, standardized interpretation criteria, assessment of observer agreement, and systematic reporting of relevant pre-analytical variables in order to improve reproducibility and comparability.},
}

Humans
*Immunohistochemistry/standards/methods
*Forensic Pathology/methods/standards
Autopsy/methods
Quality Control

@article {pmid42364454,
year = {2026},
author = {Madia, VN and Patacchini, E and Saccoliti, F and Zarbo, L and Arpacioglu, M and Costi, R and Di Santo, R},
title = {Twin engines of viral replication: Medicinal chemistry insights on SARS-CoV-2 nsp12 and nsp13.},
journal = {European journal of medicinal chemistry},
volume = {317},
number = {},
pages = {119083},
doi = {10.1016/j.ejmech.2026.119083},
pmid = {42364454},
issn = {1768-3254},
mesh = {*Viral Nonstructural Proteins/antagonists & inhibitors/metabolism/chemistry ; *Antiviral Agents/pharmacology/chemistry ; *Virus Replication/drug effects ; Humans ; *SARS-CoV-2/drug effects ; Coronavirus RNA-Dependent RNA Polymerase/antagonists & inhibitors ; Chemistry, Pharmaceutical ; RNA-Dependent RNA Polymerase/antagonists & inhibitors/metabolism ; *Betacoronavirus/drug effects/physiology ; RNA Helicases/antagonists & inhibitors/metabolism ; Small Molecule Libraries/chemistry/pharmacology ; Enzyme Inhibitors/pharmacology/chemistry ; Methyltransferases ; },
abstract = {The SARS-CoV-2 pandemic highlighted the urgent need for antivirals targeting essential viral enzymes. Herein, we critically examine the current landscape of small molecule inhibitors targeting the highly conserved non-structural protein 12 (nsp12), the RNA-dependent RNA polymerase, and non-structural protein 13 (nsp13), the helicase, both critical for viral genome replication. Structural and mechanistic features that inform rational inhibitor design, including active sites and cofactor interactions, are discussed. For nsp12, nucleoside analogues derived from a drug repurposing strategy, as well as emerging non-nucleoside inhibitors targeting allosteric sites, are evaluated. Development of ATPase and helicase inhibitors for nsp13 is at an earlier stage, but promising scaffolds have been revealed through high-throughput and structure-based screening. An in-depth analysis of small molecule inhibitors from synthetic and natural sources is presented for both enzymes, highlighting key limitations and strategic directions to advance the development of next-generation antivirals against SARS-CoV-2 through targeted modulation of nsp12 and nsp13.},
}

*Viral Nonstructural Proteins/antagonists & inhibitors/metabolism/chemistry
*Antiviral Agents/pharmacology/chemistry
*Virus Replication/drug effects
Humans
*SARS-CoV-2/drug effects
Coronavirus RNA-Dependent RNA Polymerase/antagonists & inhibitors
Chemistry, Pharmaceutical
RNA-Dependent RNA Polymerase/antagonists & inhibitors/metabolism
*Betacoronavirus/drug effects/physiology
RNA Helicases/antagonists & inhibitors/metabolism
Small Molecule Libraries/chemistry/pharmacology
Enzyme Inhibitors/pharmacology/chemistry
Methyltransferases

@article {pmid42366006,
year = {2026},
author = {Bush, SH and Kabir, M and French Merkley, V and Sikora, L and Agar, M and Hosie, A and Featherstone, I and Isenberg, S and Lawlor, P},
title = {Clinical checklists of multicomponent non-pharmacological interventions for delirium management in adult patients in non-ICU inpatient healthcare settings: a rapid review.},
journal = {BMJ open},
volume = {16},
number = {6},
pages = {e105740},
pmid = {42366006},
issn = {2044-6055},
mesh = {Humans ; *Delirium/therapy/prevention & control ; *Checklist ; Inpatients ; Adult ; },
abstract = {OBJECTIVES: To identify clinical checklists of multicomponent non-pharmacological interventions for the prevention and treatment of delirium used in non-intensive care unit inpatient healthcare settings, their content and reported implementation.

DESIGN: Rapid review.

DATA SOURCES: Medline, Embase, PsycINFO, CINAHL and Cochrane CENTRAL were searched from 1 January 1999 to 31 March 2022 and updated on 16 January 2025. A comprehensive grey literature search, including websites of guideline development groups and international delirium organisations, was conducted on 26 and 27 February 2024.

ELIGIBILITY CRITERIA: We included records reporting the use of a 'clinical checklist' used by the healthcare team, family carers or adult patient (≥18 years) to prompt and document multicomponent non-pharmacological interventions for the prevention or treatment of delirium. Publication language was restricted to English and French.

DATA EXTRACTION AND SYNTHESIS: Using rapid review methodology, two independent reviewers screened the included records. A single reviewer undertook the data extraction, with a third independent reviewer verifying the data extraction for completeness. All included studies were assessed using the JBI critical appraisal tools according to the study design. A narrative synthesis was used to summarise the findings.

RESULTS: From the database searches, 4796 records were identified. After the removal of duplicates, 3513 records underwent title and abstract screening, with 344 records undergoing full-text screening. A final 32 records were included. From the grey literature search, 6593 records were reviewed for relevance, from which 62 records were included in full-text screening. No grey literature records were of high enough quality to be included. All studies were published in English, with most studies conducted in the USA, n=12/32 (37.5%). The 32 studies were quasi-experimental (n=18), randomised controlled trials (n=8), qualitative (n=4), expert opinion (n=1) and policy/consensus guidelines (n=1). Clinical checklists included structured protocols, algorithms and order sets, which were paper-based or part of electronic delirium order sets. People with dementia participated as key stakeholders for a guidance document during the COVID-19 pandemic, but the target population was not included in the development phase of other checklists. Target users of clinical checklists were usually healthcare staff and trained volunteers and rarely family carers and study intervention nurses. Four of the 32 studies included all 10 National Institute for Health and Care Excellence clinical factors/preventive strategies for non-pharmacological interventions. For the remaining 28 studies, missing domains varied and included: therapeutic/cognitive activity, hydration, nutrition, constipation, urinary catheterisation, hypoxia, infection, pain and medication review. Only two studies involved family carers as active partners in patient care. Reported formal economic analysis was limited.

CONCLUSIONS: Codesign of future clinical checklists should involve patients and family carers. Further research is needed on the feasibility of using clinical checklists by all members of the interprofessional team and family carers, the factors needed to ensure high levels of adherence and sustainability of multicomponent non-pharmacological interventions for delirium management, in addition to economic evaluations.

PROSPERO REGISTRATION: CRD42022342328.},
}

Humans
*Delirium/therapy/prevention & control
*Checklist
Inpatients
Adult

@article {pmid42366185,
year = {2026},
author = {Benson, B and Taheri, M and Suleman, S and Paslawski, T and O'Brien, JM and Cruz, M and Sullivan, P and Khan, S and Boden, C and Abramyk, C and Reimche, E and Valiani, S and McIlduff, C and , },
title = {Patient- and Family-Centered Care, Communication, and Relationship Development Along a Technological Continuum in the ICU: A Scoping Review.},
journal = {Critical care explorations},
volume = {8},
number = {7},
pages = {e1429},
pmid = {42366185},
issn = {2639-8028},
mesh = {Humans ; *Intensive Care Units/organization & administration ; *Patient-Centered Care/organization & administration ; *Communication ; *COVID-19 ; *Professional-Family Relations ; SARS-CoV-2 ; Pandemics ; },
abstract = {OBJECTIVES: Effective multidirectional and longitudinal communication is essential to patient- and family-centered care (PFCC) in the ICU. While communication technologies have the potential to facilitate effective communication, their utilization, especially during the COVID-19 pandemic, has been variable. This scoping review answers the following research questions: What communication tools, strategies, and programs have been used in ICUs? What are their reported effects on PFCC and multidirectional communication? To what extent do these studies consider equity, diversity, and inclusion principles?

DATA SOURCES: The scoping review followed Arksey and O'Malley's (2005) framework and adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. We conducted a search covering the period from 2007 to 2024, focusing on the concepts of communication, ICU, and PFCC in OVID Medline, EBSCO CINAHL, and OVID Embase. Relevant studies were screened and reported in this review.

STUDY SELECTION: Searches identified 3280 unique sources, which were screened at a three-stage asynchronous review. A total of 131 articles were included in this review.

DATA EXTRACTION: Communication tools, strategies, and programs were categorized into technology-based and non-technology-based interventions. Technology-based interventions included eight subcategories such as data-enabled devices, electrolarynx, and eye trackers. Non-technology-based strategies included 13 subcategories such as family meetings, diaries, and dedicated personnel.

DATA SYNTHESIS: Positive outcomes were reported in 82% of studies for both technology-based and non-technology-based communication tools, strategies, and programs on PFCC.

CONCLUSION: Most technology and non-technology communication tools, strategies, and programs positively impact communication and PFCC in the ICU. However, only 4% of studies focused on equity, diversity, and inclusion in the evaluation, design, or development of their intervention, indicating a need for further research in this area.},
}

Humans
*Intensive Care Units/organization & administration
*Patient-Centered Care/organization & administration
*Communication
*COVID-19
*Professional-Family Relations
SARS-CoV-2
Pandemics

@article {pmid42366188,
year = {2026},
author = {Ralethoko, N and Letumanyane, K},
title = {A comparative assessment of road traffic injury patterns in KwaZulu-Natal and the Western Cape before, during and after COVID-19 (2019-2023).},
journal = {International journal of injury control and safety promotion},
volume = {33},
number = {3},
pages = {429-444},
doi = {10.1080/17457300.2026.2691909},
pmid = {42366188},
issn = {1745-7319},
mesh = {*COVID-19/epidemiology ; South Africa/epidemiology ; *Accidents, Traffic/statistics & numerical data/mortality/trends ; Humans ; *Wounds and Injuries/epidemiology ; Male ; Female ; },
abstract = {Road traffic injuries (RTIs) are a significant cause of death in South Africa; however, the effects of the COVID-19 pandemic on provincial RTI patterns remain insufficiently explored. This systematic review compared RTI patterns in KwaZulu-Natal and the Western Cape across pre-COVID-19 (2019), during-COVID-19 (2020-2021), and post-COVID-19 (2022-2023) periods. A systematic search of five electronic databases and grey literature sources was conducted, with 90 sources included following an adapted PRISMA 2020 framework. Findings were analysed using a descriptive comparative approach and synthesised through narrative synthesis guided by the framework proposed by Popay et al. (2006). In KwaZulu-Natal, fatalities declined from 2,331 in 2019 to 2,031 in 2020 before returning to slightly below baseline levels (2,229) in 2023. In contrast, fatalities in the Western Cape increased from 1,013 in 2019 to 1,158 in 2020, declined slightly in 2021, and increased further to 1,371 in 2023. Males aged 25-39 years and pedestrians remained the most affected groups across all study periods. The findings suggest that both pandemic-related behavioural changes and persistent structural and system-level factors may have contributed to the observed provincial differences in RTI patterns.},
}

*COVID-19/epidemiology
South Africa/epidemiology
*Accidents, Traffic/statistics & numerical data/mortality/trends
Humans
*Wounds and Injuries/epidemiology
Male
Female

@article {pmid42366377,
year = {2026},
author = {Antón-Ruiz, JA and Bernabé, M and Heredia-Oliva, E},
title = {Prevalence of depression, anxiety, and stress among university students in the post-COVID-19 period: a systematic review and meta-analysis.},
journal = {BMC psychology},
volume = {14},
number = {1},
pages = {},
pmid = {42366377},
issn = {2050-7283},
mesh = {Humans ; *COVID-19/psychology/epidemiology ; *Students/psychology/statistics & numerical data ; *Anxiety/epidemiology ; *Stress, Psychological/epidemiology ; Universities ; *Depression/epidemiology ; Prevalence ; },
abstract = {BACKGROUND: The COVID-19 pandemic has had lasting effects on university students' mental health. While numerous studies have examined depression, anxiety, and stress during the pandemic, the post-pandemic burden of these conditions remains unclear. This systematic review and meta-analysis aimed to estimate the pooled prevalence of depression, anxiety, and stress among university students during the post-COVID-19 period.

METHODS: A systematic search of PubMed, Web of Science, MEDLINE, and Scopus was conducted from inception to August 2025 following PRISMA guidelines (OSF: 10.17605/OSF.IO/S3R2E). Cross-sectional studies published between 2022 and 2025 reporting the prevalence of depression, anxiety, and/or stress among university students using validated assessment tools were included. Study quality was assessed using the Joanna Briggs Institute checklist. Single-arm meta-analyses of proportions were performed using logit transformation. Subgroup analyses by geographic region, meta-regression, sensitivity analyses, and publication bias assessments were conducted.

RESULTS: Sixty-three studies involving more than 255,000 university students across multiple global regions were included. The pooled prevalence of overall depression was 45.1% (95% CI: 38.5% to 51.8%), with prevalence estimates of 21.9% for mild, 12.8% for moderate, and 4.1% for severe depression. The pooled prevalence of overall anxiety was 43.6% (95% CI: 35.3% to 52.3%), with 23.1% mild, 13.7% moderate, and 6.1% severe anxiety. Overall stress prevalence was 45.6% (95% CI: 32.9% to 58.8%), while high perceived stress affected 14.5% of students. Significant regional variations were observed for depression and anxiety. Meta-regression indicated no consistent temporal trends, although prevalence varied by sample size and, for moderate and severe anxiety, by publication year. Sensitivity analyses confirmed robust findings. Publication bias was detected in mild depression, mild anxiety, and severe anxiety subgroups.

CONCLUSIONS: Depression, anxiety, and stress remain highly prevalent among university students in the post-pandemic period, highlighting a sustained mental health burden. Most studies were cross-sectional and relied on self-reported measures, with variability in sample sizes and sociocultural contexts, hindering comparability and generalizability. Despite these constraints, these findings highlight the urgent need for targeted mental health screening, preventive strategies, and accessible psychological support services within higher education settings.},
}

Humans
*COVID-19/psychology/epidemiology
*Students/psychology/statistics & numerical data
*Anxiety/epidemiology
*Stress, Psychological/epidemiology
Universities
*Depression/epidemiology
Prevalence

@article {pmid42367802,
year = {2026},
author = {Fu, J and Mi, Z and Li, Z},
title = {SARS-CoV-2-host and interactions: the dual roles of E3 ubiquitin ligases and ubiquitin-like modification mechanisms in viral infection.},
journal = {Frontiers in immunology},
volume = {17},
number = {},
pages = {1796416},
pmid = {42367802},
issn = {1664-3224},
mesh = {Humans ; *COVID-19/enzymology/immunology/virology ; *SARS-CoV-2/enzymology/pathogenicity/physiology ; *Ubiquitin-Protein Ligases/immunology/metabolism ; *Ubiquitins/immunology/metabolism ; *Host-Pathogen Interactions/immunology ; Virus Replication/immunology ; Immune Evasion/immunology ; Ubiquitination/immunology ; Animals ; Apoptosis/immunology ; },
abstract = {Following the global outbreak of the COVID-19 pandemic, the interactions between SARS-CoV-2 and host cells have attracted widespread attention. As crucial intracellular enzymes, E3 ubiquitin ligases are involved in numerous physiological processes, including protein degradation, cell cycle regulation, and immune responses. Recent studies have demonstrated that E3 ubiquitin ligases play a pivotal role in the interplay between SARS-CoV-2 and the host. Through interactions with host E3 enzymes, SARS-CoV-2 regulates key processes such as viral replication, immune evasion, and apoptosis. For instance, viral proteins can bind to E3 enzymes to modulate host immune responses and inhibit interferon production, thereby promoting persistent infection. Conversely, E3 enzymes can also regulate the viral life cycle and host cell survival by mediating targeted protein degradation. This mini-review summarizes the roles of E3 ubiquitin ligases in SARS-CoV-2 infection, introduces E3 ligase-mediated ubiquitin-like modifications, and discusses their underlying mechanisms at the virus-host interface. Furthermore, we highlight future research directions and potential therapeutic strategies. Understanding the functions of E3 ubiquitin ligases not only provides novel insights into the pathogenesis of SARS-CoV-2 but also offers promising targets for the development of antiviral therapeutics.},
}

Humans
*COVID-19/enzymology/immunology/virology
*SARS-CoV-2/enzymology/pathogenicity/physiology
*Ubiquitin-Protein Ligases/immunology/metabolism
*Ubiquitins/immunology/metabolism
*Host-Pathogen Interactions/immunology
Virus Replication/immunology
Immune Evasion/immunology
Ubiquitination/immunology
Animals
Apoptosis/immunology

@article {pmid42368852,
year = {2026},
author = {Endara-Mina, J and Escudero, CJ and Intriago, C and Coloma-Ramirez, L and Cabrera, W and Gonzaga, R and Fuentes, S and Chicaiza, D and Carvajal, C and Lopez-Carrera, R and Baño-Jimenez, B and Ruilova, J and Atahualpa, E and Aldaz, J and Quishpe, M and Simbaña-Rivera, K},
title = {Associated thromboembolic events to the post COVID syndrome: a systematic review and meta-analysis.},
journal = {Frontiers in cardiovascular medicine},
volume = {13},
number = {},
pages = {1742868},
pmid = {42368852},
issn = {2297-055X},
abstract = {BACKGROUND: The COVID-19 pandemic has imposed a substantial worldwide health burden; a fraction of people develops post-COVID syndrome, in which symptoms persist long after the initial phase of infection. Although these individuals may be more susceptible to developing thromboembolic events, the extent and significance of this link remain uncertain. This systematic review and meta-analysis sought to explore the prevalence of thromboembolic events in people with post-COVID syndrome, therefore addressing knowledge gaps and providing critical information for therapeutic management.

METHODS: Following PRISMA principles, a thorough search across numerous databases-including Medline, Web of Science, Scopus, Dimensions, the Virtual Health Library, the British Library, and Google Scholars-was performed. Analytical cross-sectional, case-control, and cohort studies on individuals with post-COVID syndrome were considered eligible research. Meta-analysis was performed using Review Manager 5.4.1, with a random-effects model providing hazard ratios (HR) and 95% confidence intervals (CI) for specific thromboembolic events.

RESULTS: The initial database search yielded 1,617 publications, 1,021 of which passed title and abstract screening after duplicates were removed. Following a full-text analysis of 83 publications, 20 met the inclusion criteria, with 5 included in the quantitative synthesis and 15 in the qualitative synthesis.

CONCLUSION: Emphasizing ramifications for clinical therapy, particularly among vascular surgeons, this thorough review and meta-analysis exposes a significant thromboembolic risk among patients with post-COVID syndrome. The outcomes highlight the need for early detection, proactive monitoring, and tailored preventive treatments, including anticoagulant drugs.

https://www.crd.york.ac.uk/PROSPERO/view/CRD42023441556, PROSPERO CRD42023441556.},
}

@article {pmid42368930,
year = {2026},
author = {Miao, R and Wang, J and Huang, Y and Zhang, X and Lei, P and Li, D and Chen, C and Lu, Y},
title = {Optimizing COVID-19 vaccination strategies for high-risk populations: potential and challenges of combining heterologous boosting with respiratory mucosal delivery.},
journal = {Frontiers in public health},
volume = {14},
number = {},
pages = {1849650},
pmid = {42368930},
issn = {2296-2565},
mesh = {Humans ; *COVID-19/prevention & control/immunology ; *COVID-19 Vaccines/administration & dosage/immunology ; SARS-CoV-2/immunology ; Immunity, Mucosal ; *Immunization, Secondary/methods ; *Respiratory Mucosa/immunology ; *Vaccination/methods ; },
abstract = {Despite the decline of the global peak of COVID-19, SARS-CoV-2 continues to circulate, evolve, and undergo immune escape, posing persistent threats, particularly to older adults, individuals with comorbidities, and immunocompromised populations. Although existing vaccination strategies have substantially reduced the risks of severe disease, hospitalization, and death, their ability to block infection and transmission remains limited, and protection wanes over time. Current heterologous booster strategies still rely largely on combinations of different parenteral vaccine platforms. Although these regimens can enhance systemic humoral and cellular immunity, they are insufficient to robustly induce upper respiratory mucosal immunity, thereby limiting their role in early infection control and interruption of transmission. Because respiratory mucosal vaccines target the natural entry site of SARS-CoV-2, they have the potential to induce secretory IgA, tissue-resident memory immune cells, and local immune memory, offering distinct advantages in compensating for the shortcomings of conventional heterologous boosting. Combining heterologous boosting with respiratory mucosal delivery may further enhance the control of viral infection, early replication, and subsequent transmission while preserving systemic immunity, thereby providing more comprehensive immune protection for high-risk populations. However, this strategy still faces challenges related to mucosal barriers, delivery efficiency, adjuvant safety, manufacturing scale-up, and incomplete clinical evaluation frameworks. Future high-quality studies focusing on high-risk populations are needed to clarify its value in preventing infection, protecting against severe disease, and providing long-term protection.},
}

Humans
*COVID-19/prevention & control/immunology
*COVID-19 Vaccines/administration & dosage/immunology
SARS-CoV-2/immunology
Immunity, Mucosal
*Immunization, Secondary/methods
*Respiratory Mucosa/immunology
*Vaccination/methods

@article {pmid42369559,
year = {2026},
author = {Xu, W and Wang, J and Liu, X and Lu, M and Zhang, Z and Li, L},
title = {mRNA vaccines against viral pathogens: molecular design, delivery systems, and clinical applications.},
journal = {Frontiers in microbiology},
volume = {17},
number = {},
pages = {1821852},
pmid = {42369559},
issn = {1664-302X},
abstract = {As a next-generation vaccine technology, mRNA vaccines mark a transformative advancement in vaccinology research. Their key strengths lie in rapid development cycles, high-efficiency manufacturing processes, robust immunogenic properties, and adaptable design frameworks. For infectious disease prevention, mRNA-based immunizations targeting SARS-CoV-2, such as the mRNA-1273 vaccine, have shown promising results in clinical evaluations. Validated efficacy metrics and safety profiles have supported their regulatory approval for public use. Additionally, mRNA platforms have shown substantial therapeutic potential against respiratory syncytial virus. However, this technology still faces multiple challenges, including poor stability, limited delivery efficiency, high production costs, unclear mechanisms of adverse reactions. Distinct from existing literature that primarily focuses on COVID-19 or specific delivery technologies, this review provides a comprehensive, integrated framework covering molecular design, delivery systems, and clinical translation across multiple viral pathogens, while also critically analyzing current controversies and future directions. This review aims to provide a comprehensive reference for researchers and clinicians in related fields.},
}

@article {pmid42369668,
year = {2026},
author = {Peter, S and Mohana, T and Anandhi, D and Priya, VS and Sleeba, RK and Haridas, HP and Mohanan, MT and Thoduvayil, S and Mathew, S and Santhamma, DM and Divakaran, DR},
title = {ACE/ACE2 axis in cardiovascular disease and COVID-19: Molecular insights and therapeutic perspectives.},
journal = {Journal of cardiovascular and thoracic research},
volume = {18},
number = {1},
pages = {15-25},
pmid = {42369668},
issn = {2008-5117},
abstract = {The renin-angiotensin system (RAS) plays a central role in regulating blood pressure and cardiovascular health. Angiotensin-converting enzyme (ACE) facilitates the conversion of angiotensin I to angiotensin II, a potent vasoconstrictor that contributes to hypertension and heart failure. Conversely, ACE2 converts angiotensin II into angiotensin-(1-7), a vasodilator with protective cardiovascular effects. An imbalance between ACE and ACE2 activities has been increasingly associated with the progression of cardiovascular diseases and complications related to COVID-19. This review analyzed 100 relevant studies published up to May 2024, identified through a comprehensive literature search on PubMed and Scopus. The findings highlighted that dysregulation of the ACE/ACE2 axis exacerbates cardiovascular dysfunction. The interaction of SARS-CoV-2 with ACE2 reduces its protective function, intensifying inflammatory responses and leading to complications such as lung injury and heart failure. Additionally, genetic polymorphisms in ACE and ACE2 influence individual susceptibility and severity of COVID-19. Promising therapeutic strategies, including ACE2-based peptides and angiotensin II receptor modulators, are under investigation but require further clinical validation. Targeting the ACE/ACE2 axis could provide effective treatment options for cardiovascular disease and COVID-19-related complications, warranting further in-depth research.},
}

@article {pmid42370216,
year = {2026},
author = {Karasneh, D and Patel, M and Hasan, SS and Conway, BR and Sadeq, AA and Aldeyab, MA},
title = {Impact of the COVID-19 pandemic on systemic anti-cancer therapy in patients with breast cancer: a systematic review and meta-analysis.},
journal = {Journal of pharmaceutical policy and practice},
volume = {19},
number = {1},
pages = {2684148},
pmid = {42370216},
issn = {2052-3211},
abstract = {BACKGROUND: The COVID-19 pandemic caused significant disruptions in oncology services worldwide. Breast cancer care depends on timely and coordinated treatment pathways. This review assessed changes in systemic anti-cancer therapy, including chemotherapy, endocrine therapy, targeted therapy, and immunotherapy. Secondary outcomes included treatment delays, short-term mortality, and hospital admissions.

METHODS: We conducted a systematic review and meta-analysis following PRISMA guidelines. The protocol was registered with PROSPERO (CRD42024542702). We searched PubMed, Scopus, Web of Science, and CINAHL for studies published between March 2020 and August 2024. We included original studies comparing adult breast cancer patients treated before and during the pandemic. Patients of any stage and sex were eligible. We assessed risk of bias and used a random-effects model to present pooled proportions and odds ratios (ORs) with 95% confidence intervals (CIs).

RESULTS: Forty-eight studies were included in the review, and 35 in the meta-analysis. Chemotherapy use increased from 35% before the pandemic to 42% during the pandemic. This rise was driven by an increase in neoadjuvant chemotherapy, from 18% to 22%, while adjuvant chemotherapy remained stable. Endocrine therapy increased from 35% to 42%. Neoadjuvant endocrine therapy rose from 2% to 10%, whereas adjuvant endocrine therapy declined from 46% to 43%. Targeted therapy and immunotherapy showed minimal change. The pooled OR for short-term mortality was 0.81 (95% CI: 0.56-1.15). Hospital admission estimates showed wide confidence intervals, reflecting heterogeneity.

CONCLUSION: The pandemic led to notable shifts in systemic treatment patterns, particularly an increase in the use of neoadjuvant strategies. Short-term mortality did not significantly differ between periods. The study findings should be interpreted with caution due to variability in studies. Health systems require robust pharmaceutical policies and resilient triage frameworks to ensure continuity of cancer treatment during future crises.},
}

@article {pmid42370424,
year = {2026},
author = {Ratautas, D and Serapinas, S and Stakelytė, D and Guobužaitė, S and Danytė, A and Dagys, M},
title = {Quo Vadis, Electrochemical DNA Biosensor? Lessons from Three Decades of SNP Sensing.},
journal = {ACS sensors},
volume = {11},
number = {7},
pages = {5296-5314},
doi = {10.1021/acssensors.6c01221},
pmid = {42370424},
issn = {2379-3694},
support = {S-LJ-26-02//Lietuvos Mokslo Taryba/ ; },
mesh = {*Polymorphism, Single Nucleotide ; *Biosensing Techniques/methods ; *Electrochemical Techniques/methods ; *DNA/genetics/analysis ; Humans ; *COVID-19/diagnosis/virology/genetics ; SARS-CoV-2/genetics/isolation & purification ; Nucleic Acid Hybridization ; },
abstract = {Electrochemical DNA biosensors have been studied for over three decades, producing thousands of publications and a sophisticated engineering toolkit. However, a broad clinical adoption remains limited. The COVID-19 pandemic served as a stress test-global demand, unprecedented funding, accelerated regulatory pathways, and a clearly defined genomic target-yet electrochemical nucleic acid biosensors played no meaningful role in the diagnostic response, indicating that the barriers to translation are structural. Here, rather than cataloguing sensing formats, we analyze the field framing progress through three interacting constraints focusing on single-nucleotide polymorphism (SNP) sensing: the biological realities of nucleic acid targets, the physical limits of surface-based hybridization, and the clinical/market environment that governs adoption. We find that many advances optimize analytical performance under laboratory conditions while leaving application complexity largely unresolved. Yet, viable niches emerge at the intersection of low information complexity and operational urgency-rapid pharmacogenomic genotyping, now driven by directive clinical guidelines, and infection diagnostics, where simplicity matters more than sophistication. A broader redirection emerges when DNA acts not as the analyte but as a functional tool: Electrochemical aptamer-based sensors are entering commercial markets; nuclease and enzymatic activity profiling exploits the regime where these sensors perform best; and therapeutic oligonucleotides-invisible to standard sequencing workflows-map naturally onto the platform's strengths. The field's most transferable contribution may not be DNA detection itself, but the programmable molecular interfaces it has developed.},
}

*Polymorphism, Single Nucleotide
*Biosensing Techniques/methods
*Electrochemical Techniques/methods
*DNA/genetics/analysis
Humans
*COVID-19/diagnosis/virology/genetics
SARS-CoV-2/genetics/isolation & purification
Nucleic Acid Hybridization

@article {pmid42370758,
year = {2026},
author = {Ogungbite, AB and Sibiya, M},
title = {A Narrative Review of Artificial Intelligence for Drug Repurposing: Lessons From COVID-19 and Oncology (2020-2025).},
journal = {CPT: pharmacometrics & systems pharmacology},
volume = {15},
number = {7},
pages = {e70272},
pmid = {42370758},
issn = {2163-8306},
mesh = {*Drug Repositioning/methods/trends ; Humans ; *Artificial Intelligence/trends ; COVID-19 ; SARS-CoV-2 ; Machine Learning ; *COVID-19 Drug Treatment ; Antineoplastic Agents/therapeutic use ; Deep Learning ; *Neoplasms/drug therapy ; Medical Oncology/methods/trends ; Natural Language Processing ; },
abstract = {Drug repurposing presents a cost-effective and time-efficient strategy to identify new therapeutic applications for existing drugs. Recent advances in artificial intelligence, including machine learning, deep learning, knowledge graphs, and natural language processing, have revolutionized this field by enabling automated discovery of drug-disease associations. This review examines the role of artificial intelligence in drug repurposing, drawing insights from two critical case areas: Coronavirus disease 2019 and oncology. We explore current trends, methodological frameworks, and technological innovations in artificial intelligence-driven drug repurposing, as well as challenges and emerging future directions. The findings of this paper underscore the transformative potential of artificial intelligence in biomedical research and justify its continued integration in pharmaceutical pipelines.},
}

*Drug Repositioning/methods/trends
Humans
*Artificial Intelligence/trends
COVID-19
SARS-CoV-2
Machine Learning
*COVID-19 Drug Treatment
Antineoplastic Agents/therapeutic use
Deep Learning
*Neoplasms/drug therapy
Medical Oncology/methods/trends
Natural Language Processing

@article {pmid42371105,
year = {2026},
author = {Nofal, S and Al-Said, O and Alnimer, K and Sarah, JM and Alam, TA and Ali, O and Abuquteish, D},
title = {Efficacy and safety of Ensitrelvir in COVID-19 patients: a systematic review and meta-analysis with focus on viral clearance and RNA change.},
journal = {European journal of clinical pharmacology},
volume = {82},
number = {7},
pages = {},
pmid = {42371105},
issn = {1432-1041},
mesh = {Humans ; *COVID-19 Drug Treatment ; *Antiviral Agents/therapeutic use/adverse effects/administration & dosage ; RNA, Viral/blood ; SARS-CoV-2/drug effects ; Randomized Controlled Trials as Topic ; COVID-19/virology ; Treatment Outcome ; Indazoles ; Triazines ; Triazoles ; },
abstract = {BACKGROUND: Coronavirus Disease (COVID-19), which is caused by SARS-CoV-2 virus, led to a worldwide pandemic in late 2019, thus challenged the healthcare infrastructure across the world, creating an urgent need for the development of effective antiviral medications to handle its spread and evolving strains.

OBJECTIVE: This Meta-Analysis aims to investigate the overall efficacy and safety of Ensitrelvir.

METHODS: We conducted a systematic review and meta-analysis, according to PRISMA guidelines, searching web databases for relevant literature. We limited our eligibility to randomized clinical trials involving mild-to-moderate COVID-19 patients.

RESULTS: Our study included four randomized controlled trials involving a total of 2,890 patients. For patients with mild-to-moderate Covid-19, treatment with Ensitrelvir (125 mg or 250 mg) was associated with significantly improved outcomes compared to placebo across several metrics: higher viral clearance was observed for 125 mg [MD = - 37.74, P < 0.00001] and 250 mg [MD = - 35.02, P < 0.00001]; greater reductions in viral RNA were achieved by 125 mg [MD = -1.41, P < 0.00001] and 250 mg [MD = -1.37, P < 0.00001]; and a significantly lower proportion of patients maintained a positive viral titer at 125 mg [RR 0.08, P < 0.00001, I[2] = 82%] and 250 mg [RR 0.10, P < 0.00001, I[2] = 16%]. Ultimately, there were no significant differences in reported outcomes between the 125 mg and 250 mg Ensitrelvir dosage groups.

CONCLUSION: This systematic review and meta-analysis support Ensitrelvir efficacy and safety in promoting rapid viral clearance and greater reduction in viral RNA in mild-to-moderate or asymptomatic COVID-19 patients, justifying its integration into outpatient treatment protocols while emphasizing the need for further large-scale, variant-inclusive studies to validate and extend these findings.

REGISTRATION: PROSPERO (CRD420251030953).},
}

Humans
*COVID-19 Drug Treatment
*Antiviral Agents/therapeutic use/adverse effects/administration & dosage
RNA, Viral/blood
SARS-CoV-2/drug effects
Randomized Controlled Trials as Topic
COVID-19/virology
Treatment Outcome
Indazoles
Triazines
Triazoles

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

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

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

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

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

@article {pmid42374300,
year = {2026},
author = {Kennard, A and Kılıç, A and Alsugeir, D and Hamada, Y and Rangaka, MX},
title = {A systematic review of the determinants of vaccine hesitancy in the UK: Implications for future TB vaccine adoption.},
journal = {BMC public health},
volume = {26},
number = {1},
pages = {},
pmid = {42374300},
issn = {1471-2458},
mesh = {Humans ; *Vaccination Hesitancy/statistics & numerical data/psychology ; United Kingdom ; *Tuberculosis Vaccines/administration & dosage ; *Tuberculosis/prevention & control ; },
abstract = {BACKGROUND: Tuberculosis (TB) is a deadly yet vaccine-preventable disease mostly affecting adolescents and adults. Novel TB vaccines are now emerging, particularly for these populations; however, vaccine hesitancy, characterised by delays, doubts or refusal to seek or accept vaccines, poses a challenge for sufficient adoption once these vaccines become available. Thus, this review systematically explored system- and individual-level determinants of vaccine hesitancy among adults in the UK, interpreting implications for the adoption of novel TB vaccines.

METHODS: Five databases systematically searched for studies from 2020 - 2024 reporting qualitative outcomes on determinants of vaccine hesitancy among people living in the UK. Thematic analysis mapped extracted data onto a framework combining the Strategic Advisory Group of Experts (SAGE) model to explore system-level factors (e.g., vaccine-specific influences) and the Perceptions and Practicalities Approach (PaPA) to explore individual-level factors (e.g., perceptual influences) of vaccine hesitancy. The Mixed Methods Appraisal Tool was used to assess study quality.

RESULTS: 29 qualitative and 21 mixed methods studies; 87.5% investigated hesitancy to COVID-19 vaccines. All SAGE themes were identified at the system level, most notably vaccine novelty, the media environment and health system experiences. At individual-level, all PaPA themes emerged, with vaccine-specific beliefs and knowledge most frequently identified. Overall, themes varied across the lifespan, with adolescents influenced mainly by media and social norms, and older adults by safety concerns and trust in health professionals.

CONCLUSIONS: Vaccine hesitancy determinants interacted and were compounded in vulnerable subgroups, while post-pandemic disruptions to TB services may undermine adoption of novel TB vaccines. Addressing these challenges requires multi-level strategies centred on trusted, culturally sensitive communication. Delivery through routine, school and community-based programs aligns with evidence from high-incidence settings and highlights the need for coordinated action by policymakers and healthcare providers.},
}

Humans
*Vaccination Hesitancy/statistics & numerical data/psychology
United Kingdom
*Tuberculosis Vaccines/administration & dosage
*Tuberculosis/prevention & control

@article {pmid42374517,
year = {2026},
author = {Harvey, E and Van Brussel, K and Holmes, EC},
title = {Empowering One Health with metagenomics.},
journal = {One health outlook},
volume = {8},
number = {1},
pages = {},
pmid = {42374517},
issn = {2524-4655},
support = {GNT2017197//National Health and Medical Research Council/ ; },
abstract = {In an increasingly connected world a global One Health approach to the management of human, animal and ecosystem health will be critical to effective infectious disease responses. The emergence and rapid global spread of several emerging and re-emerging pathogens in the past decade has highlighted the need for rapid, sensitive and accurate diagnostics. Metagenomics, while commonly used for research purposes for almost two decades, entered the global spotlight during the COVID-19 pandemic. In this review we discuss the impacts that metagenomic studies have had on our understanding of origins, aetiology and ecology of infectious diseases within a One Health context. We also discuss the role of metagenomics in the future of diagnostics and disease surveillance, and outline the challenges and limitations of current metagenomic methods.},
}

@article {pmid42374546,
year = {2026},
author = {Stroobants, T and Willemart, C and Walravens, M and Veeckmans, G and Ligthart, S and Hoste, E and Benoit, DD and Berghe, TV and Jorens, PG},
title = {Clinical implications of ferroptosis in critical illness: a narrative review.},
journal = {Journal of intensive care},
volume = {14},
number = {1},
pages = {},
pmid = {42374546},
issn = {2052-0492},
support = {BOF-IMPULS//University of Antwerp/ ; 1SH9524N//Fund for Scientific Research (FWO) Flanders/ ; },
abstract = {Despite major advances in care for patients admitted to the intensive care unit (ICU), mortality remains high and functional outcomes for ICU survivors are often poor. The persistent burden underscores the need for innovative, mechanism-based approaches. Precision medicine has emerged as a promising paradigm in critical illness, and regulated cell death (RCD) may offer a novel entry point for targeted interventions. Among the various RCD pathways, ferroptosis, an iron-dependent form of RCD driven by excessive lipid peroxidation within cellular membranes, has gained increasing attention. Its mechanistic distinctiveness from other RCDs and potential reversibility make it particularly relevant in acute, dynamic disease states. In this narrative review, we explore the role of ferroptosis in critical care, focusing on high-impact conditions such as sepsis, COVID-19, ischaemia-reperfusion injury, and neurological emergencies. We outline the molecular mechanisms of ferroptosis and discuss how it may contribute to organ dysfunction across systems. While most insights to date stem from preclinical models, emerging clinical data suggest translational potential. We highlight key studies, discuss current limitations in detection and therapeutic targeting, and consider how the evaluation of ferroptosis could help shape the future of precision medicine in the ICU.},
}

@article {pmid42374888,
year = {2026},
author = {Talabani, B and Hanif, S and Ramzan, K and Mohammed, F and Naseem, A and Alauddin, E},
title = {Improving COVID-19 Vaccine Uptake Among Ethnic Minority Communities in Wales: A Community-Based Approach.},
journal = {Immunology and cell biology},
volume = {104},
number = {7},
pages = {700-707},
pmid = {42374888},
issn = {1440-1711},
mesh = {Humans ; *COVID-19/prevention & control/epidemiology ; *COVID-19 Vaccines/administration & dosage ; *Ethnicity ; Islam ; *Minority Groups ; Vaccination ; Vaccination Hesitancy ; Wales/epidemiology ; },
abstract = {During the COVID-19 pandemic, misinformation and vaccine hesitancy disproportionately affected ethnic minority communities across the United Kingdom, including in Wales. Muslim Doctors Cymru (MDC), a grassroots coalition of Muslim healthcare professionals, played a pivotal role in countering this challenge. This paper describes the strategies and impact of MDC's work in addressing health misinformation, building trust, and promoting vaccine uptake among ethnic minority communities in Wales. Through culturally sensitive engagement, multilingual public health messaging, and close collaboration with mosques, community leaders, and local media, MDC delivered targeted outreach that bridged gaps between public health authorities and underserved populations. This case study draws on a grassroots-efforts approach to tackling vaccine inequity using community-based approaches. Findings highlight the importance of culturally competent healthcare communication and the value of community-led initiatives in improving public health outcomes during crises. MDC's model offers a replicable framework for addressing health inequalities and misinformation in diverse populations.},
}

Humans
*COVID-19/prevention & control/epidemiology
*COVID-19 Vaccines/administration & dosage
*Ethnicity
Islam
*Minority Groups
Vaccination
Vaccination Hesitancy
Wales/epidemiology

@article {pmid42376297,
year = {2026},
author = {Mao, X and Cai, M and Fan, B},
title = {Lung organoids for respiratory diseases: overcoming translational hurdles in drug discovery and safety assessment.},
journal = {Frontiers in bioengineering and biotechnology},
volume = {14},
number = {},
pages = {1859058},
pmid = {42376297},
issn = {2296-4185},
abstract = {Respiratory diseases, encompassing chronic inflammatory conditions, interstitial fibrotic disorders, acute infectious diseases, and pulmonary malignancies, represent a profound global health burden with unacceptably high morbidity and mortality rates. Historically, the pharmaceutical pipeline for respiratory therapeutics has suffered staggering attrition rates during clinical development. This is primarily due to the fundamental inability of conventional two-dimensional cell cultures and in vivo animal models to faithfully recapitulate the complex three-dimensional architecture, multicellular heterogeneity, and human-specific physiological dynamics of the pulmonary system. To bridge this critical translational gap, lung organoids-self-organizing, three-dimensional microphysiological constructs derived from pluripotent or adult stem cells-have emerged as a useful human-cell-based platform. This comprehensive review critically evaluates current lung organoid technologies, elucidating their derivation pathways and capacity for high-fidelity disease modeling. We analyze their application in dissecting the pathogenesis of chronic obstructive pulmonary disease, idiopathic pulmonary fibrosis, viral infections including SARS-CoV-2, and non-small cell lung cancer. Furthermore, we highlight their important role in predictive toxicology for assessing environmental inhalation hazards, cosmetic safety, and drug-induced lung injury, aligning with evolving regulations prioritizing alternatives to animal testing. Despite their immense potential, widespread clinical and industrial translation is currently impeded by biological bottlenecks: the absence of functional vascularization, incomplete immune integration, and reliance on undefined xenogeneic matrices. We systematically examine bioengineering strategies addressing these limitations-including synthetic hydrogels, microfluidic organ-on-a-chip platforms, and 3D bioprinting-to overcome translational hurdles, accelerate precision medicine, and improve respiratory pharmacology.},
}

@article {pmid42376726,
year = {2026},
author = {Abdul Rahman, H and Zahari, NH},
title = {The Silent Crisis: Loneliness in Older Adults-A Critical Review of Impacts, Strategies and Path Forward.},
journal = {Scandinavian journal of caring sciences},
volume = {40},
number = {3},
pages = {e70292},
doi = {10.1111/scs.70292},
pmid = {42376726},
issn = {1471-6712},
mesh = {Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; COVID-19/psychology ; *Loneliness/psychology ; *Social Isolation/psychology ; },
abstract = {BACKGROUND: Loneliness, distinct from social isolation, is a subjective sense of social disconnection exacerbating a public health crisis among older adults. Affecting ~33% of community-dwelling individuals aged 50-80 years post-COVID-19, it rivals smoking in mortality risk and drives cognitive, cardiovascular, and mental health declines. This review synthesises evidence to inform clinical strategies.

METHODS: A critical review of per-reviewed meta-analyses, RCTs, and prospective cohorts literature (2019-2025) was conducted for adults aged 50 years and above. Studies were selected using validated loneliness or social isolation measures, with quality appraised via AMSTAR-2, Cochrane RoB 2, and Newcastle-Ottawa Scale; 34 studies met eligibility criteria from an initial yield of 1,847 records.

RESULTS: Prevalence of loneliness stands at 29% isolation by 2024, highest among those with poor health (53%-75%), unemployment (52%), solitary living, and ages 50-64. Loneliness elevates all-cause mortality (32%), dementia (50%-59%), cardiovascular events (29%-32%), depression (40%), and anxiety (35%). Mechanisms include increased inflammation (↑CRP, IL-6), HPA dysregulation, immune compromise, hippocampal atrophy, and behavioural lapses. Interventions like CBT/reminiscence therapy, multicomponent programs, animal therapy, exercise, and digital platforms have been shown to reduce loneliness, though primary care implementation lags due to screening/referral barriers. Tools such as the UCLA Loneliness Scale enable feasible assessment.

CONCLUSIONS: Loneliness as a geriatric syndrome demands mandated screening, provider education, and reimbursement reforms. Coordinated healthcare-community efforts could avert substantial morbidity/mortality, addressing gaps in long-term outcomes and cost-effectiveness research.},
}

Aged
Aged, 80 and over
Female
Humans
Male
Middle Aged
COVID-19/psychology
*Loneliness/psychology
*Social Isolation/psychology

@article {pmid42376837,
year = {2026},
author = {Tafazoli, A and Dowran, R},
title = {Syncytia Formation in the Pathogenesis of SARS-CoV-2 Infection: Lessons from Viral Infections.},
journal = {Viral immunology},
volume = {39},
number = {6},
pages = {232-240},
doi = {10.1177/08828245261433819},
pmid = {42376837},
issn = {1557-8976},
mesh = {Humans ; *Giant Cells/virology/immunology ; *COVID-19/virology/immunology/pathology ; Spike Glycoprotein, Coronavirus/genetics/immunology/metabolism ; *SARS-CoV-2/pathogenicity/genetics/immunology/physiology ; Virus Internalization ; Immunity, Innate ; Mutation ; Animals ; },
abstract = {It is widely known that numerous enveloped viruses can produce multinucleated cells (syncytia) as a result of viral entry-related membrane fusion events. By protecting the virus from the host's immune reaction, these syncytia are thought to promote viral reproduction. Syncytia are collections of merged cells. A viral spike protein (S) on the surface of an infected cell interacts with receptors on nearby cells to cause the syncytia response. The innate immune system's response to viruses affects how syncytia form. Some interferon-stimulated genes change the membrane in a way that reduces the likelihood of fusion. The severe acute respiratory syndrome coronavirus (SARS-CoV-2) virus is quickly changing; also, several mutations occurred in its S protein. Individually and together, the Alpha, Beta, Gamma, and Delta variants carry mutations that significantly affect S function and syncytia formation. The function of syncytia in newly emerging variant diseases is still unknown, though. Syncytia could cause disease through promoting viral transmission, cytopathicity, immunological evasion, and inflammatory responses. The SARS-CoV-2 S protein variations include several changes that improve receptor interactions, fusogenicity, and antibody reactivity. A wide range of clinical symptoms, including moderate febrile sickness, severe respiratory distress, and occasionally deadly lung damage, can be brought on by an infection with SARS-CoV-2. Several of these lung illnesses (MERS-CoV) are linked to both the Middle East Respiratory Syndrome (MERS) and the severe acute respiratory syndrome coronavirus (SARS-CoV). Compared to acute respiratory syndromes, the lung thrombosis brought on by Coronavirus disease 2019 (COVID-19) is incredibly severe. In this review we focused on innate immunological elements that prevent syncytia from forming and the molecular triggers of S-mediated fusion.},
}

Humans
*Giant Cells/virology/immunology
*COVID-19/virology/immunology/pathology
Spike Glycoprotein, Coronavirus/genetics/immunology/metabolism
*SARS-CoV-2/pathogenicity/genetics/immunology/physiology
Virus Internalization
Immunity, Innate
Mutation
Animals

@article {pmid42377214,
year = {2026},
author = {Tanriover, MD and Forsyth, K and He, Q and Diavatopoulos, DA and Orozco Fernández, R and Hozbor, DF and Middleton, DB and Muloiwa, R and Muñoz, FM and Ong-Lim, A and Tan, TQ and Heininger, U},
title = {Immunological insights into why pertussis continues to be endemic.},
journal = {Human vaccines & immunotherapeutics},
volume = {22},
number = {1},
pages = {2692306},
pmid = {42377214},
issn = {2164-554X},
mesh = {*Whooping Cough/epidemiology/immunology/prevention & control ; Humans ; *Bordetella pertussis/immunology/genetics ; *Pertussis Vaccine/immunology/administration & dosage ; *Endemic Diseases/prevention & control ; Th1 Cells/immunology ; Th17 Cells/immunology ; Vaccines, Acellular/immunology ; Th2 Cells/immunology ; },
abstract = {Pertussis (whooping cough) is a vaccine-preventable bacterial disease caused by Bordetella pertussis. Despite widespread vaccination, cases have increased globally since the 1990s, with notable outbreaks in 2012, 2016, and following the COVID-19 pandemic. Persistent endemicity and periodic epidemics are driven by limited prevention of nasal colonization, waning immunity after vaccination or natural infection, and pathogen adaptation. Differences between acellular (aP) and whole-cell (wP) vaccines reflect distinct immune profiles, with aP vaccines favoring Th2 responses and wP vaccines inducing Th1/Th17 responses and tissue-resident memory T cells. Circulating strains have evolved under vaccine pressure, including shifts in ptxP, ptxA and prn alleles, increasing pertussis toxin production, emergence of pertactin-deficient variants, and rising macrolide resistance linked to 23S rRNA mutations. Optimizing current vaccine strategies and developing next-generation vaccines that improve durable, Th1/Th17-polarized immunity and reduce transmission are essential for enhanced pertussis control.},
}

*Whooping Cough/epidemiology/immunology/prevention & control
Humans
*Bordetella pertussis/immunology/genetics
*Pertussis Vaccine/immunology/administration & dosage
*Endemic Diseases/prevention & control
Th1 Cells/immunology
Th17 Cells/immunology
Vaccines, Acellular/immunology
Th2 Cells/immunology

@article {pmid42377340,
year = {2026},
author = {Rodríguez-Rodríguez, E and Rodríguez-Rodríguez, P and Jiménez-Ortega, AI and Aparicio, A},
title = {[Nutrition, microbiota and respiratory infections: key aspects of their interaction].},
journal = {Nutricion hospitalaria},
volume = {43},
number = {Spec No4},
pages = {54-57},
doi = {10.20960/nh.06966},
pmid = {42377340},
issn = {1699-5198},
mesh = {Humans ; *Respiratory Tract Infections/immunology/microbiology/prevention & control ; *Nutritional Status ; Probiotics ; *Diet ; COVID-19/immunology ; Prebiotics ; *Gastrointestinal Microbiome ; *Microbiota ; },
abstract = {Introduction: respiratory infections (RI) have experienced a rebound following the lifting of COVID-19 restrictions, constituting a major public health problem. Diet and nutritional status are determining factors in the competence of the immune system, where the gut-lung axis has been identified as a key mechanism in regulating the immune response against these processes. Objectives: to analyze the scientific evidence on the role of diet and microbiota in the prevention and evolution of respiratory infections. Methods: narrative review of recent scientific literature on nutrients, dietary patterns, gut microbiota, and their relationship with respiratory immunity. Results: various nutrients such as fiber, n-3 polyunsaturated fatty acids, vitamins, minerals, and polyphenols, as well as the use of probiotics, modulate the gut microbiota and promote the production of metabolites, especially short-chain fatty acids (SCFAs), with immunomodulatory effects. These mechanisms contribute to improving the pulmonary immune response and reducing the incidence and severity of RI. Conclusions: a balanced and high-nutrient-density diet, rich in prebiotic and probiotic compounds, can contribute to strengthening the immune response and decreasing vulnerability to respiratory infections.},
}

Humans
*Respiratory Tract Infections/immunology/microbiology/prevention & control
*Nutritional Status
Probiotics
*Diet
COVID-19/immunology
Prebiotics
*Gastrointestinal Microbiome
*Microbiota

@article {pmid42378128,
year = {2026},
author = {Escobar, M and Arenas, Á and Perdomo-Luna, C and Londoño, D and Molano, JC and Nieto, M and Borrero, E and Vanegas, E},
title = {Is mental health in Colombia a right or a privilege?.},
journal = {Biomedica : revista del Instituto Nacional de Salud},
volume = {46},
number = {2},
pages = {219-227},
pmid = {42378128},
issn = {2590-7379},
mesh = {Colombia/epidemiology ; Humans ; *COVID-19/epidemiology/psychology ; *Mental Disorders/epidemiology/therapy ; *Mental Health ; *Mental Health Services/organization & administration ; Health Services Accessibility ; Armed Conflicts ; Social Stigma ; Healthcare Disparities ; SARS-CoV-2 ; Right to Health ; Pandemics ; },
abstract = {This article offers a vision of the mental health situation in Colombia, highlighting its growing relevance in the public sphere and the specific challenges facing the country. It analyzes the impact of the armed conflict and the COVID-19 pandemic on the mental health of the Colombian population, focusing on how these situations have exacerbated pre-existing problems. Additionally, the existence of significant barriers to accessing specialized services is highlighted, such as stigma, lack of trained personnel, and high costs associated with the treatment of mental disorders. Therefore, the need to address inequalities in mental health care is raised, both nationally and internationally. Finally, recommendations are proposed to improve prevention, community care and access to mental health services in Colombia.},
}

Colombia/epidemiology
Humans
*COVID-19/epidemiology/psychology
*Mental Disorders/epidemiology/therapy
*Mental Health
*Mental Health Services/organization & administration
Health Services Accessibility
Armed Conflicts
Social Stigma
Healthcare Disparities
SARS-CoV-2
Right to Health
Pandemics

@article {pmid42378358,
year = {2026},
author = {Atencio, MA and Luini, JA and Cappella, RB and Mattei, L and Giuffre, CV and Pereyra Huertas, J and Scherñuk Schroh, MP and Davit Baridón, NS and Boscardin, C and Esandi, ME and Duran, LG},
title = {Effectiveness of strategies to prevent burnout syndrome in hospital-based healthcare personnel: an overview of systematic reviews.},
journal = {Revista de la Facultad de Ciencias Medicas (Cordoba, Argentina)},
volume = {83},
number = {2},
pages = {e49503},
pmid = {42378358},
issn = {1853-0605},
mesh = {Humans ; *Burnout, Professional/prevention & control ; *Personnel, Hospital/psychology ; *COVID-19/psychology ; *Health Personnel/psychology ; SARS-CoV-2 ; },
abstract = {INTRODUCTION: Burnout syndrome (BO) significantly affects healthcare personnel, especially in hospital settings. The COVID-19 pandemic has intensified this issue, highlighting the need for effective preventive strategies.

OBJECTIVES: To synthesize available evidence on the effectiveness of individual, organizational, and combined strategies to prevent or reduce BO in hospital-based healthcare personnel.

MATERIALS AND METHODS: A systematic search was conducted in PubMed, Cochrane Library, Epistemonikos, and the Virtual Health Library for systematic reviews published between January 1, 2014, and January 15, 2024. Reviews with or without meta-analyses were included if they evaluated preventive interventions for BO and contained at least one primary study. Reviews focused solely on stress, well-being, or anxiety without specific BO outcomes were excluded. Two reviewers independently extracted data on study characteristics, types of interventions, measurement tools, and outcomes. A de novo extraction of 107 primary studies was also performed.

RESULTS: Twenty-seven systematic reviews were included. The most frequently evaluated interventions were mindfulness, cognitive-behavioral therapy, workload reduction, and professional coaching. Structured, in-person interventions generally showed greater effectiveness. Organizational strategies yielded mixed results.

CONCLUSION: Both individual and organizational interventions can reduce BO in healthcare professionals. Structured, face-to-face, and multifaceted approaches appear to be more effective. High-quality research is needed, with emphasis on implementation strategies tailored to clinical contexts.},
}

Humans
*Burnout, Professional/prevention & control
*Personnel, Hospital/psychology
*COVID-19/psychology
*Health Personnel/psychology
SARS-CoV-2

@article {pmid42379196,
year = {2026},
author = {Blakney, AK and Top, KA and Cowling, BJ and Larson, HJ and Shattock, RJ and Sadarangani, M},
title = {Safety and efficacy of mRNA vaccines: a mechanistic and public health perspective.},
journal = {Lancet (London, England)},
volume = {408},
number = {10551},
pages = {275-288},
doi = {10.1016/S0140-6736(26)00512-X},
pmid = {42379196},
issn = {1474-547X},
mesh = {Humans ; *COVID-19/prevention & control/immunology ; *COVID-19 Vaccines/adverse effects/immunology ; *mRNA Vaccines/adverse effects/immunology ; Public Health ; *Vaccine Efficacy ; *Vaccines, Synthetic/adverse effects/immunology ; },
abstract = {mRNA vaccines represent a transformative advance in vaccinology, combining rapid development timelines, scalable manufacturing, and strong immunogenicity with a favourable safety profile. Global deployment of mRNA vaccines during the COVID-19 pandemic provided an unprecedented real-world evaluation of this platform, with billions of doses administered across diverse populations. In this Review, we critically examine the safety and efficacy of mRNA vaccines from mechanistic, preclinical, clinical, and public health perspectives. We outline the biological basis of mRNA vaccines, including their transient cytoplasmic expression, lack of genomic integration, and rapid clearance, distinguishing them clearly from other gene therapies. We synthesise evidence on vaccine components, manufacturing quality controls, and regulatory standards that underpin safety, alongside data from randomised trials, post-authorisation surveillance, and active pharmacovigilance systems. We also review real-world effectiveness across age groups, pregnancy, and populations that are immunocompromised, along with the effects on transmission. Last, we address public perception and vaccine confidence, and discuss implications for next-generation mRNA vaccines, including strategies to reduce reactogenicity, improve breadth and durability of immunity, enhance global access, and support sustainable public trust. Together, the accumulated evidence affirms mRNA vaccines as a safe, effective, and adaptable platform with enduring relevance for future infectious disease prevention and public health preparedness, and for the treatment of cancer and autoimmunity.},
}

Humans
*COVID-19/prevention & control/immunology
*COVID-19 Vaccines/adverse effects/immunology
*mRNA Vaccines/adverse effects/immunology
Public Health
*Vaccine Efficacy
*Vaccines, Synthetic/adverse effects/immunology

@article {pmid42379531,
year = {2026},
author = {Alsulami, AS and Al-Kuraishy, HM and Al-Gareeb, AI and Abdelnaby, MA and Haggag, MM and El-Saber Batiha, G},
title = {Pathophysiology of silent hypoxia in COVID-19: Truth and mystery.},
journal = {Respiratory medicine},
volume = {261},
number = {},
pages = {109013},
doi = {10.1016/j.rmed.2026.109013},
pmid = {42379531},
issn = {1532-3064},
mesh = {Humans ; *COVID-19/complications/physiopathology ; *Hypoxia/physiopathology/etiology/virology ; SARS-CoV-2 ; Pandemics ; Respiratory Distress Syndrome/physiopathology ; Carotid Body/physiopathology ; Acute Lung Injury/physiopathology ; },
abstract = {Coronavirus disease 2019 (COVID-19) is a highly infectious viral disease caused by the SARS-CoV-2. COVID-19 commonly leads to mild flu-like illness in most of cases. However, severe COVID-19-induced pneumonia and associated acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) may lead to ventilation-perfusion mismatch and the development of silent hypoxia. Silent hypoxemia is observed in critically COVID-19 patients without signs of subjective dyspnea that is often linked with poor clinical outcomes. Proposed mechanisms include impairment of peripheral carotid chemoreceptors, attenuation of the sensitivity of the respiratory center, and the development of acute vascular distress syndrome (AVDS). However, it should be noted that while AVDS is supported by imaging and pathological evidence, the roles of carotid body dysfunction and other proposed mechanisms remain incompletely validated and require further investigation. The pathophysiology of silent hypoxia in COVID-19 and other viral infections is a complex condition. Accordingly, this review aims to explain and discuss the pathophysiology of silent hypoxia, and its critical role in COVID-19.},
}

Humans
*COVID-19/complications/physiopathology
*Hypoxia/physiopathology/etiology/virology
SARS-CoV-2
Pandemics
Respiratory Distress Syndrome/physiopathology
Carotid Body/physiopathology
Acute Lung Injury/physiopathology

@article {pmid42380588,
year = {2026},
author = {Singh, A and Tekade, M and Nagaraja, S and Bharti, A and Tekade, RK},
title = {Advancements in RNA-based therapies from bench to bedside.},
journal = {npj drug discovery},
volume = {3},
number = {1},
pages = {},
pmid = {42380588},
issn = {3005-1452},
abstract = {RNA research has advanced rapidly, becoming a key component of modern therapeutics. This review outlines key milestones and innovations from antisense oligonucleotides and RNA interference to mRNA therapies and aptamers that have enabled targeted treatments for diverse diseases. The success of COVID-19 mRNA vaccines highlighted the remarkable clinical potential of RNA-based technologies. Emphasis is placed on delivery technologies, landmark approvals, and ongoing trials shaping the future of RNA-based medicine.},
}

@article {pmid42380995,
year = {2026},
author = {Delano, P and Serra-Suton, V and Benavides, FG and Utzet, M},
title = {Prolonged return to work and hampered work ability: insights from a scoping review on the impact of long COVID on healthcare workers job performance.},
journal = {BMC health services research},
volume = {26},
number = {1},
pages = {},
pmid = {42380995},
issn = {1472-6963},
mesh = {Humans ; *COVID-19/epidemiology ; Frontline Workers ; *Health Personnel/statistics & numerical data ; Post-Acute COVID-19 Syndrome ; *Return to Work/statistics & numerical data ; SARS-CoV-2 ; Time Factors ; *Work Performance/statistics & numerical data ; },
abstract = {BACKGROUND: Healthcare workers (HCWs) may have a higher risk of developing long COVID due to greater exposure to COVID-19, with symptoms extending beyond the acute phase impacting their daily living activities and job performance.

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

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

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

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

Humans
*COVID-19/epidemiology
Frontline Workers
*Health Personnel/statistics & numerical data
Post-Acute COVID-19 Syndrome
*Return to Work/statistics & numerical data
SARS-CoV-2
Time Factors
*Work Performance/statistics & numerical data