@article {pmid41263792,
year = {2025},
author = {Tokarska-Domżałowicz, W and Zdżalik-Bielecka, D},
title = {[At the intersection of immunology and oncology: TAM receptors in the regulation of immune responses and tumorigenesis-related processes].},
journal = {Postepy biochemii},
volume = {71},
number = {3},
pages = {238-251},
doi = {10.18388/pb.2021_619},
pmid = {41263792},
issn = {0032-5422},
mesh = {Humans ; *Neoplasms/immunology/metabolism ; *Receptor Protein-Tyrosine Kinases/immunology/metabolism/antagonists & inhibitors ; Axl Receptor Tyrosine Kinase ; Tumor Microenvironment/immunology ; c-Mer Tyrosine Kinase/immunology/metabolism ; Intercellular Signaling Peptides and Proteins/metabolism/immunology ; *Proto-Oncogene Proteins/immunology/metabolism ; Immunity, Innate ; Protein S/metabolism/immunology ; COVID-19/immunology ; },
abstract = {TAM receptor tyrosine kinases (TYRO3, AXL, MER) and their ligands, protein S (PROS1) and growth inhibition-specific protein 6 (GAS6), play a key role in maintaining homeostasis and regulating the immune response through involvement in efferocytosis, i.e., phagocytic removal of apoptotic cells and suppression of the innate immune response. Thus, their dysfunction leads, among others, to the development of autoimmune diseases. In turn, excessive production of TAM receptors correlates with the invasive phenotype of cancer cells, metastasis, drug resistance, and poor prognosis for patients with cancer. Moreover, activation of these receptors contributes to the promotion of an immunosuppressive tumor microenvironment and evading the immune response by cancer cells. Interestingly, recent studies suggest that these receptors are also involved in the cellular entry of viruses such as Zika or SARS-CoV-2. Therefore, in recent years, various therapeutic strategies targeting TAM receptors have been intensively developed, and their effectiveness has been assessed in numerous preclinical and clinical studies.},
}

Humans
*Neoplasms/immunology/metabolism
*Receptor Protein-Tyrosine Kinases/immunology/metabolism/antagonists & inhibitors
Axl Receptor Tyrosine Kinase
Tumor Microenvironment/immunology
c-Mer Tyrosine Kinase/immunology/metabolism
Intercellular Signaling Peptides and Proteins/metabolism/immunology
*Proto-Oncogene Proteins/immunology/metabolism
Immunity, Innate
Protein S/metabolism/immunology
COVID-19/immunology

@article {pmid41262872,
year = {2025},
author = {Lv, X and Ji, L and Cao, W and Xue, Y and Dai, H and Zhang, S},
title = {Revisiting lung cancer immunotherapy in the era of long COVID: mechanistic insights and therapeutic implications.},
journal = {Frontiers in cellular and infection microbiology},
volume = {15},
number = {},
pages = {1657691},
pmid = {41262872},
issn = {2235-2988},
mesh = {Humans ; *COVID-19/immunology/complications ; *Immunotherapy/methods ; *Lung Neoplasms/therapy/immunology ; SARS-CoV-2/immunology ; Tumor Microenvironment/immunology ; Immune Checkpoint Inhibitors/therapeutic use ; },
abstract = {In the post-COVID-19 era, understanding the long-term impact of Long COVID on the immune system is essential for deciphering its influence on lung cancer pathogenesis and immunotherapeutic efficacy. This review comprehensively examines how persistent COVID-19 sequelae-manifested as chronic inflammation, pulmonary fibrosis, cytokine dysregulation, and T-cell exhaustion can reshape the lung cancer microenvironment. In addition, the emerging roles of memory B cells and altered neutrophil function in promoting tumorigenesis are discussed. Importantly, we analyze recent clinical evidence suggesting that COVID-19 vaccination may enhance the efficacy of immune checkpoint inhibitors, potentially by modulating host immunity. By integrating mechanistic insights with clinical observations, this review aims to illuminate the challenges and opportunities at the intersection of Long COVID and lung cancer treatment, thereby fostering the development of personalized therapeutic strategies in the post-pandemic era.},
}

Humans
*COVID-19/immunology/complications
*Immunotherapy/methods
*Lung Neoplasms/therapy/immunology
SARS-CoV-2/immunology
Tumor Microenvironment/immunology
Immune Checkpoint Inhibitors/therapeutic use

@article {pmid41262458,
year = {2025},
author = {Gao, Z and Gao, Y and Wang, S and Li, X and Cao, W and Deng, W and Yao, L and Wei, X and Zhang, Z and Wang, S and Zhang, Y and Li, M and Xie, Y},
title = {Application progress and biosafety challenges of gene editing and synthetic biotechnology in diagnosis, treatment and prevention of infectious diseases.},
journal = {Biosafety and health},
volume = {7},
number = {5},
pages = {312-322},
pmid = {41262458},
issn = {2590-0536},
abstract = {Global infectious disease prevention faces escalating challenges due to the continual emergence of novel pathogens and rapid viral mutations. Synthetic biology has revolutionized this field by enabling precise diagnostics, innovative vaccine platforms, and targeted therapeutics, yet it simultaneously raises concerns regarding dual-use potential, biosafety, and ethical governance. This systematic review (2015-2025, PubMed, Web of Science, Scopus) focuses on CRISPR-based diagnostics, synthetic vaccines, and engineered probiotics. CRISPR/Cas systems such as DETECTR (Cas12a) and SHERLOCK (Cas13a) demonstrate high sensitivity and rapid pathogen detection (e.g., SARS-CoV-2, Ebola), but their misuse could enhance pathogen virulence or enable bioweapon development. mRNA and viral vector vaccines offer flexible and rapid responses to emerging infections but encounter limitations in molecular stability, delivery system toxicity, and ecological safety. Engineered probiotics, designed as "living therapeutics," can detect pathogens and modulate immune responses, yet pose potential risks of horizontal gene transfer and host-specific variability. Overall, while synthetic biology provides transformative tools for infectious disease control, it necessitates robust global regulatory frameworks, standardized biosafety practices, and ethical oversight to ensure responsible and sustainable application.},
}

@article {pmid41260170,
year = {2025},
author = {Martins, AJE and Dos Santos, TP and Santos, WGS and Triozzi, E and Moraes-Vieira, PM},
title = {Host immunometabolic regulation through viral sensing pathways.},
journal = {Current opinion in microbiology},
volume = {88},
number = {},
pages = {102683},
doi = {10.1016/j.mib.2025.102683},
pmid = {41260170},
issn = {1879-0364},
abstract = {Viruses are intracellular pathogens that have profoundly influenced biological evolution and continue to threaten global health through outbreaks such as influenza and COVID-19. Their ability to evade host immunity stems from evolutionary adaptations that manipulate cellular defense mechanisms. A critical aspect of virus-host interactions involves cellular receptors, which facilitate viral entry and trigger immune signaling. Among these, pattern recognition receptors (PRRs) and other proteins serve as key sensors of viral components, coordinating immune responses while reprogramming host metabolism to sustain antiviral defenses. However, many viruses hijack these metabolic changes to enhance replication, evade immune surveillance, or dysregulate cytokine production. This review explores how host cell virus-sensitive proteins, particularly PRRs and metabolically active proteins, modulate cellular metabolism during infection, shaping immune outcomes and revealing potential therapeutic targets for antiviral intervention.},
}

@article {pmid41259568,
year = {2025},
author = {Santos, BJ and Nascimento, EAND and Reis, LOD and Lima, JB and Lima, BB and Ramos, LFP},
title = {Neurological manifestations associated with SARS-CoV-2 infection in pediatric patients: a systematic review.},
journal = {Revista paulista de pediatria : orgao oficial da Sociedade de Pediatria de Sao Paulo},
volume = {43},
number = {},
pages = {e2024293},
doi = {10.1590/1984-0462/2025/43/2024293},
pmid = {41259568},
issn = {1984-0462},
mesh = {Humans ; *COVID-19/complications ; Child ; *Nervous System Diseases/virology/etiology ; Adolescent ; Child, Preschool ; Infant ; Infant, Newborn ; SARS-CoV-2 ; },
abstract = {OBJECTIVE: To conduct a systematic review to identify neurological symptoms associated with SARS-CoV-2 in patients aged zero to 19 years, highlighting the main symptoms and addressing the existing gap in age range coverage in current studies.

DATA SOURCE: This study was registered in the International Prospective Register of Systematic Reviews - PROSPERO (CRD42024520151) and adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses - PRISMA (2020) guidelines. Observational and interventional studies, including randomized clinical trials, investigating neurological manifestations in children and adolescents with confirmed SARS-CoV-2 infection were included. Searches were conducted in the United States National Library of Medicine/Medical Literature Analysis and Retrieval System Online (PubMed/MEDLINE), Cochrane Library, and Virtual Health Library (VHL) using Health Science Descriptors/Medical Subject Headings (DeCS/MeSH) terms in English, Spanish, and Portuguese, covering January 2020 to January 2024.

DATA SYNTHESIS: The search identified 1283 records, of which 302 were excluded (outside of scope), 688 were removed after title/abstract screening, and 95 duplicates were discarded. Fulltext analysis of 198 articles resulted in the selection of 25 eligible studies. The most frequently reported neurological manifestations included seizures, headache, altered levels of consciousness, olfactory and gustatory disturbances, encephalopathy, and acute cerebrovascular diseases.

CONCLUSIONS: Neurological manifestations of COVID-19 in children are relatively common, ranging from mild symptoms such as headache and taste/smell disturbances to severe complications like seizures, stroke, altered consciousness, and encephalopathy. Prevalence varies across studies, underscoring the need for further research to clarify underlying mechanisms.},
}

Humans
*COVID-19/complications
Child
*Nervous System Diseases/virology/etiology
Adolescent
Child, Preschool
Infant
Infant, Newborn
SARS-CoV-2

@article {pmid41258672,
year = {2025},
author = {Oquendo, MA and Barrigon, ML and Baca-Garcia, E},
title = {Psychiatry at the turn of the century and a vision for future developments.},
journal = {International review of psychiatry (Abingdon, England)},
volume = {},
number = {},
pages = {1-15},
doi = {10.1080/09540261.2025.2591200},
pmid = {41258672},
issn = {1369-1627},
abstract = {From 1995 to 2025, psychiatry evolved from a primarily syndromic discipline toward a field increasingly shaped by neuroscience, digital technology, globalization, and shifting social expectations surrounding mental health. This transformation included major advances in diagnostic frameworks, brain imaging and genomics, psychopharmacology, evidence-based psychotherapies, and global mental health initiatives. The COVID-19 pandemic accelerated the adoption of telepsychiatry and exposed critical gaps in mental health infrastructure, while growing recognition of health disparities brought social determinants and equity to the forefront of research and clinical priorities.},
}

@article {pmid41262109,
year = {2025},
author = {Lawrason, S and Manley, Z and Lomness, A and Hole, R},
title = {Remote support for individuals with intellectual disabilities living independently: a scoping review.},
journal = {International journal of developmental disabilities},
volume = {71},
number = {7},
pages = {953-970},
pmid = {41262109},
issn = {2047-3877},
abstract = {OBJECTIVES: The purpose of this project was to conduct a scoping review to understand factors related to remote support provision among individuals with intellectual disabilities in independent living.

METHODS: A systematic search was employed among eight large databases, yielding 207 articles. Following a two-phase screening process, 22 articles were included in this review. Data were charted and summarized according to types of remote support, outcomes, best practices, barriers and facilitators, and ethical considerations.

RESULTS: Overall, remote support provision was associated with positive outcomes (e.g. academic skills). Most studies used mobile apps or video self-modeling/prompting. Training for support workers facilitates use, and privacy concerns should be addressed among organizations.

DISCUSSION: Given the shift to online technology over the Covid-19 pandemic, remote support can complement in-person support when used skillfully and appropriately. Importantly, remote support should be individualized for each person. Greater research is needed using diverse study designs, assessing perceptions of support providers, and on remote support that enables live communication between users and providers.},
}

@article {pmid41258629,
year = {2025},
author = {Asiama, RK},
title = {An econometric examination of vaccine hesitancy among residents and their dependents in urban Ghana.},
journal = {Health economics review},
volume = {15},
number = {1},
pages = {100},
pmid = {41258629},
issn = {2191-1991},
abstract = {PURPOSE: Vaccine hesitancy among the population raises concern for health policymakers because it threatens the attainment of herd immunity, which is necessary to keep the society healthy and manage public health spending. However, a problem arises when there is hesitancy by economic agents and their dependents, even when the resource is freely available. This policy problem is analyzed in the context of Ghana's major urban area, Accra, where a cross-section of urban parents are surveyed regarding vaccine hesitancy and whether it extends to their children, with special reference to the COVID-19 vaccine.

METHODOLOGY: Data on preferences of residents regarding the choice for their dependents to receive the vaccine gathered in 2022. The data was obtained through a cross-sectional online survey of 2000 urban parents in Accra, Ghana. The paper estimates logit and probit regression models and their associated marginal effects to examine the willingness of respondents to allow their children to take the vaccine and the extent of influence of attitudinal and demographic characteristics of respondents.

FINDINGS: The results first show that urban respondents who had tested for COVID-19, taken the vaccine and were willing to pay for the COVID-19 vaccine are more likely to allow their children to take the vaccine. More so, urban respondents concerned about age group vulnerability of their children, not suffering permanently health conditions, and being infected by others are also more likely to allow their children to take the COVID-19 vaccine.

PRACTICAL IMPLICATIONS: Based on the findings, this paper recommends to policymakers to strengthen education efforts, with special encouragement for parents to get their children vaccinated. Vaccines are meant to provide immunity to the populace and its hesitancy among the population sets back the public health objective of achieving herd immunity and building a robust pharmaceutical industry while increasing the risk of poor public services and higher public health spending.

ORIGINALITY/VALUE: This paper offers a novel lens on the sustainability of public health expenditure by examining vaccine hesitancy during a pandemic that caught populations unprepared and distrustful. Using evidence from urban Ghana, it shows how reluctance to accept free vaccines reveals the hidden social costs and governance gaps in public health delivery-an overlooked dimension in discussions of health financing in developing countries.},
}

@article {pmid41258470,
year = {2025},
author = {Oh, DY and Hölzer, M and Börnigen, D and Paraskevopoulou, S and Duwe, S and Budt, M and Kerber, R and Mikolajewska, A and Böttcher, S and Seifried, J and Haas, W and Dürrwald, R and Fuchs, S and Kröger, S and von Kleist, M and Wolff, T and Mielke, M and , },
title = {A public health perspective of SARS-CoV-2 evolution and surveillance strategies in Germany from 2020 to 2023.},
journal = {Communications medicine},
volume = {5},
number = {1},
pages = {468},
pmid = {41258470},
issn = {2730-664X},
support = {D82015, sub-projects C1.1 and C.1.2//Bundesministerium für Gesundheit (Federal Ministry of Health, Germany)/ ; ECDC/HERA/2021/008 ECD.12222//European Centre for Disease Prevention and Control (ECDC)/ ; 101113012//European Centre for Disease Prevention and Control (ECDC)/ ; },
abstract = {This review summarizes key virological parameters of SARS-CoV-2, the clinical spectrum of COVID-19, antiviral options, resistance, and the evolution of SARS-CoV-2 during the first four years of the pandemic. It draws on evidence that has been continuously updated throughout the pandemic by the interdisciplinary working group 'SARS-CoV-2 Diagnostics and Evolution' at Robert Koch Institute (RKI), Germany's national public health institute. We describe basic SARS-CoV-2 characteristics and highlight notable virus variants from 2020 to mid-2023. During this period, the nationwide collection of SARS-CoV-2 genomes provided a substantial resource for monitoring viral lineage frequencies and mutations. We summarize this dataset to underscore the importance of virological surveillance in the context of public health and pandemic preparedness.},
}

@article {pmid41255507,
year = {2025},
author = {Ibraheem, N and Mohamed, M and Abdelglil, M and Hasan, MR and Rahman, ME},
title = {Telemedicine-Based Virtual Stone Clinics for Renal Colic: Cost-Benefit Insights and Adoption Barriers.},
journal = {Cureus},
volume = {17},
number = {11},
pages = {e97028},
pmid = {41255507},
issn = {2168-8184},
abstract = {Telemedicine in urology has gained substantial attention, accelerating in adoption due to the COVID-19 pandemic and its potential to bridge significant gaps in healthcare access, particularly given that 62% of U.S. counties lack a urologist. This narrative review outlines its applications, cost benefits, and adoption barriers. Studies demonstrate high patient satisfaction, especially for postoperative consultations and prostate-specific antigen (PSA) tracking. Virtual care is highly effective for managing conditions like nephrolithiasis and benign ureteric colic; one quality improvement study focusing on ureteric colic successfully avoided 71.1% of face-to-face follow-ups while maintaining high safety and patient satisfaction (93.1%). The financial advantages are significant, with virtual stone clinics reducing waiting times and saving patients an average of $147 to $186 per visit by minimizing travel costs and time away from work. Despite these benefits, widespread adoption faces hurdles. Key challenges include a lack of patient trust in virtual sessions compared to in-person care, particularly among minority groups. Furthermore, technological barriers, such as inadequate digital literacy and a lack of broadband access, disproportionately affect elderly and ethnic minority populations, which risks exacerbating existing health disparities. Telemedicine is also limited by its unsuitability for conditions requiring a physical examination. Addressing these obstacles is essential to ensuring virtual care remains an affordable and equitable component of future healthcare.},
}

@article {pmid41254919,
year = {2025},
author = {Li, Y and Liu, X and Guo, Z and Lai, L and Bryant, RA and Zhang, T and Song, H and Mi, T and Ren, Z},
title = {Comparative Efficacy and Attrition Rates of Psychosocial Interventions for Individuals Affected by the COVID-19 Pandemic: A Network Meta-Analysis.},
journal = {Stress and health : journal of the International Society for the Investigation of Stress},
volume = {41},
number = {6},
pages = {e70124},
doi = {10.1002/smi.70124},
pmid = {41254919},
issn = {1532-2998},
support = {22&ZD187//Major Program of the National Social Science Foundation of China/ ; },
mesh = {Humans ; *COVID-19/psychology ; Network Meta-Analysis as Topic ; *Psychosocial Intervention/methods/statistics & numerical data ; *Stress, Psychological/therapy ; *Anxiety/therapy ; *Depression/therapy ; *Patient Dropouts/statistics & numerical data/psychology ; Yoga ; Cognitive Behavioral Therapy ; *Psychotherapy ; SARS-CoV-2 ; Treatment Outcome ; },
abstract = {The comparative examination of psychosocial interventions' efficacy and attrition rates in addressing COVID-19's psychological consequences is still limited. This study examined the efficacy and attrition rates of psychosocial interventions among individuals impacted by the COVID-19 pandemic. Systematic searches were conducted to identify randomised controlled trials targeting COVID-19-affected groups. Data on symptoms of anxiety, depression, and stress, as well as attrition rates, were analysed using frequentist random-effects network meta-analyses. One hundred and forty-two studies with 20,470 participants were included. Emotional freedom technique, art-based therapy, stress management, mindfulness- and acceptance-based intervention, positive psychotherapy, yoga therapy, and cognitive behavioural therapy showed significant effects in reducing anxiety symptoms compared with no treatment and treatment as usual. For depressive symptoms, positive psychotherapy, mindfulness- and acceptance-based intervention, cognitive behavioural therapy, and yoga therapy demonstrated significant superiority over no treatment or treatment as usual, with positive psychotherapy also outperforming expressive writing. Regarding stress symptoms, multi-component therapy and yoga therapy produced greater improvements than no treatment, and positive psychotherapy surpassed expressive writing. In terms of attrition rates, resilience training, art-based therapy and yoga therapy had higher dropout rates than no treatment and several other interventions. Sensitivity analyses yielded largely consistent results, confirming the robustness of the main findings. The confidence ranged from moderate to very low. Publication bias was not observed. This study illuminates and compares the efficacy and attrition rate of several psychosocial interventions in attenuating mental health symptoms among COVID-19-affected individuals. The impact of COVID-19 on people remains ongoing, and the findings of this study can also serve as a reference for selecting the best therapeutic options for mental health symptoms in future public health crises.},
}

Humans
*COVID-19/psychology
Network Meta-Analysis as Topic
*Psychosocial Intervention/methods/statistics & numerical data
*Stress, Psychological/therapy
*Anxiety/therapy
*Depression/therapy
*Patient Dropouts/statistics & numerical data/psychology
Yoga
Cognitive Behavioral Therapy
*Psychotherapy
SARS-CoV-2
Treatment Outcome

@article {pmid41254751,
year = {2025},
author = {Rezoagli, E and Nova, A and Carteaux, G and Giani, M and Grieco, DL and Pettenuzzo, T and Lucchini, A and Navalesi, P and Antonelli, M and Foti, G and Bellani, G and Piquilloud, L},
title = {A clinical guide to non-invasive respiratory support in acute respiratory failure: ventilation settings, technical optimization and clinical indications.},
journal = {Critical care (London, England)},
volume = {29},
number = {1},
pages = {496},
pmid = {41254751},
issn = {1466-609X},
support = {Institutional funds//Università degli Studi di Milano-Bicocca/ ; },
mesh = {Humans ; *Noninvasive Ventilation/methods/standards ; COVID-19 ; *Respiratory Insufficiency/therapy ; Continuous Positive Airway Pressure/methods ; SARS-CoV-2 ; },
abstract = {Non-invasive respiratory support including high flow nasal therapy (HFNT), continuous positive airway pressure (CPAP) and Bilevel positive airway pressure (BiPAP), exerts distinct physiological effects and requires specific settings and technicalities. HFNT, delivered through dedicated nasal cannulas, provides low levels of positive airway pressure, anatomical dead space washout, allows good patient tolerance and can be used during CPAP or BiPAP breaks. CPAP and BiPAP, administered through various interfaces (e.g., facemasks, oro-nasal masks, or helmets), can deliver higher positive pressure, thereby increasing end-expiratory lung volume, reducing intrapulmonary shunt and oxygenation, with potential benefits on respiratory mechanics as well. BiPAP also delivers pressure support, aiding CO2 clearance and respiratory muscle unloading, which is especially useful in hypercapnic respiratory failure. Increased intrathoracic pressure also reduces right ventricle preload and left ventricle afterload, which is beneficial in patients with impaired left ventricular function. Non-invasive respiratory support indications depend on the cause of acute respiratory failure. In hypercapnic respiratory failure with respiratory acidosis, BiPAP via facemask is strongly recommended to prevent intubation and reduce mortality. In cardiogenic pulmonary edema, either CPAP or BiPAP is recommended, while HFNT can be useful for patients requiring prolonged support or when CPAP/BiPAP is not tolerated even after ventilator and interface settings optimization. In de-novo acute hypoxemic respiratory failure, HFNT should be considered as the first-line treatment, regardless of the aetiology: however, in COVID-19-related AHRF CPAP can be considered to avoid intubation. The choice of non-invasive respiratory support interface in both cardiogenic and non-cardiogenic AHRF should aim at minimizing leaks, optimizing CO2 clearance, and maximizing patient tolerance. Monitoring is essential during non-invasive respiratory support to assess patient's response to treatment and to avoid delaying invasive respiratory support when needed, particularly in hypoxemic patients to avoid intubation delays and prevent patient-self-inflicted lung injury: physiological parameters, clinical scores, and lung ultrasound may help assess the risk of NIV failure. Monitoring tidal volume is valuable but challenging because of leaks. Though not widely used, esophageal pressure monitoring can assess patient effort and transpulmonary pressure. Additionally, electrical impedance tomography is an emerging tool for detecting asynchronous breathing and pendelluft phenomena.},
}

Humans
*Noninvasive Ventilation/methods/standards
COVID-19
*Respiratory Insufficiency/therapy
Continuous Positive Airway Pressure/methods
SARS-CoV-2

@article {pmid41254702,
year = {2025},
author = {Qin, J and Wang, G and Han, D},
title = {Methylprednisolone versus dexamethasone in hospitalized patients with severe COVID-19: a systematic review and meta-analysis of randomized controlled trials.},
journal = {Systematic reviews},
volume = {14},
number = {1},
pages = {228},
pmid = {41254702},
issn = {2046-4053},
mesh = {Humans ; *Dexamethasone/therapeutic use ; *COVID-19 Drug Treatment ; *Methylprednisolone/therapeutic use ; Randomized Controlled Trials as Topic ; Hospitalization ; COVID-19/mortality ; SARS-CoV-2 ; Length of Stay ; *Glucocorticoids/therapeutic use ; *Anti-Inflammatory Agents/therapeutic use ; },
abstract = {BACKGROUND: The aim of this systematic review was to compare the efficacy of methylprednisolone and dexamethasone in severe COVID-19 hospitalized patients.

METHODS: We conducted systematic searches of MEDLINE, Embase, the Cochrane Library, and clinicaltrials.gov without language restrictions. Randomized controlled trials (RCTs) on the treatment of severe COVID-19 with methylprednisolone, compared with dexamethasone, were included. Findings were summarized as risk ratios (RR) and mean differences (MD) with 95% confidence intervals (CI). The certainty of evidence was assessed using the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) framework, categorized as "high," "moderate," "low," or "very low" quality.

RESULTS: Five RCTs (enrolling 1102 participants) met the inclusion criteria. There was no statistically significant difference in 28-day mortality (RR 0.81, 95% CI 0.58 to 1.14; GRADE = high), length of hospital stay (MD 0.67 days, 95% CI -1.77 to 3.10 days; moderate), intensive care unit (ICU) admission (RR 1.20, 95% CI 0.85 to 1.69; high), and invasive ventilation (RR 0.87, 95% CI 0.42 to 1.79; high) between the two groups. Overall, using the GRADE framework, 3 pooled analyses were rated as high quality, with 1 rated as moderate quality.

CONCLUSIONS: Methylprednisolone demonstrated similar therapeutic effects compared to dexamethasone in hospitalized patients with severe COVID-19.},
}

Humans
*Dexamethasone/therapeutic use
*COVID-19 Drug Treatment
*Methylprednisolone/therapeutic use
Randomized Controlled Trials as Topic
Hospitalization
COVID-19/mortality
SARS-CoV-2
Length of Stay
*Glucocorticoids/therapeutic use
*Anti-Inflammatory Agents/therapeutic use

@article {pmid41254586,
year = {2025},
author = {Amini-Rarani, M and Rezaei, S and Azami-Aghdash, S and Bashzar, S and Allahverdi, S and Mohseni, M},
title = {The prevalence of stress during the COVID-19 pandemic: an umbrella review.},
journal = {BMC public health},
volume = {25},
number = {1},
pages = {4022},
pmid = {41254586},
issn = {1471-2458},
}

@article {pmid41254571,
year = {2025},
author = {Ma, K and Christensen, M and Turnbull, M},
title = {Comparative synthesis of sociocultural and political influences (SPIs) on COVID-19 vaccine hesitancy: an interdisciplinary systematic review.},
journal = {BMC public health},
volume = {25},
number = {1},
pages = {4019},
pmid = {41254571},
issn = {1471-2458},
}

@article {pmid41253021,
year = {2025},
author = {Ilboudo, DP and Simpore, A and Sawadogo, J and Ouattara, AK and Ouedraogo, AR and Zongo, L and Yonli, AT and Zouré, AA and Zohoncon, TM and Djigma, FW and Obiri-Yeboah, D and Ouedraogo, CM and Simpore, J},
title = {Acceptance, hesitancy, and ethical challenges of the COVID-19 vaccine in sub-Saharan Africa: a systematic review and meta-analysis.},
journal = {Vaccine},
volume = {69},
number = {},
pages = {127966},
doi = {10.1016/j.vaccine.2025.127966},
pmid = {41253021},
issn = {1873-2518},
abstract = {BACKGROUND: In light of the public health emergency brought about by the novel coronavirus, health authorities actively promoted vaccination against SARS-CoV-2. The COVID-19 pandemic has brought to the forefront critical questions concerning individual freedoms and the right to consent or decline vaccination. To better anticipate and manage future epidemics, it is essential to engage in thoughtful philosophical and ethical reflection-particularly regarding the legitimacy and implications of vaccine passport policies.

OBJECTIVES: This study aimed to assess COVID-19 vaccine acceptance and hesitancy in Sub-Saharan Africa, identify reasons for refusal, and examine the ethical legitimacy of imposing a "green pass" for vaccination for foreign travel.

METHODS: A meta-analysis was conducted from January 2021 to April 2025 in sub-Saharan African countries, in five databases (PubMed, Science Direct, Google Scholar, African Journal Online, and HINARI) to identify studies related to acceptance and hesitancy toward COVID-19 vaccines in the general population and among healthcare professionals. This study was registered under the PROSPERO database (CRD420251060375) and used the PRISMA guidelines. The "proportional effect size" of acceptance and hesitancy was calculated using a random-effects meta-analysis with STATA 17 software. Funnel plots and Egger's tests were used to assess publication bias.

RESULTS: A total of 40 studies involving 107,478 participants across 23 African countries were included. The pooled rates of vaccine acceptance and hesitancy were, respectively: 54.73 [95 % CI: 50.54 %-58.89 %], and 34.96 % [95 % CI: 27.95 %-42.30 %]. Eastern Africa had the highest acceptance rate (60.44 %), and lower rate observed in West Africa (52.22 %). Reasons for hesitancy included misinformation, distrust of new vaccines, fear of side effects, suspicion of authorities, and opposition to mandatory vaccination certificates.

CONCLUSION: The pandemic has brought to the fore fundamental issues relating to the right to accept or refuse vaccination. To prepare for the management of future epidemics, it is necessary to reflect on the ethics of requiring a vaccine passport.},
}

@article {pmid41252782,
year = {2025},
author = {Minari, TP},
title = {Repercussions of racial, gender, and class inequities on food and nutrition conditions: Implications for public health.},
journal = {Nutrition (Burbank, Los Angeles County, Calif.)},
volume = {142},
number = {},
pages = {112995},
doi = {10.1016/j.nut.2025.112995},
pmid = {41252782},
issn = {1873-1244},
abstract = {BACKGROUND: Food and nutrition are shaped by power structures that perpetuate historical injustices. In marginalized and low-income contexts, racial, gender, and class inequities restrict access to adequate and culturally appropriate food, with serious public health impacts. These disparities are reinforced by colonial legacies, institutional racism, gender oppression, and neoliberal policies that commodify nourishment and erase traditional knowledge. This study examines how these intersecting oppressions shape global nutrition inequities and proposes transformative, justice-oriented approaches in public health.

METHODS: A critical review was conducted using an intersectional and decolonial framework informed by public health, sociology, feminist theory, and Southern epistemologies. Articles published between 2010 and 2025 were retrieved from Scopus, PubMed, SciELO, and Web of Science. A total of 46 studies of varying methodological designs were included in the final analysis.

RESULTS: Racialized poverty and structural racism are central drivers of food insecurity. Gendered care burdens and the feminization of food-related labor disproportionately affect marginalized women. Traditional and community-based food knowledge is often excluded from policy frameworks. Transgender and gender-diverse populations remain largely invisible in nutrition research. Obesity, malnutrition, and social inequality form a syndemic relationship, exacerbated by the COVID-19 pandemic and the fragility of social protection systems.

CONCLUSION: Recognizing food as a political and relational right is essential to advance social justice, epistemic diversity, and emancipatory futures. The findings underscore the urgency of transforming public health paradigms to confront structural determinants of malnutrition and obesity, promote food sovereignty, and center marginalized communities as co-creators of dignified and sustainable food systems.},
}

@article {pmid41251998,
year = {2026},
author = {Kouroutzis, I and Tzenetidis, V and Papathanasiou, IV and Mantzaris, D and Apostolakis, I and Chandrinou, A and Gortzis, L and Sarafis, P and Malliarou, M},
title = {Telenursing and Telehealth. Navigating the Digital Transformation in Healthcare and Ethical Challenges: A Narrative Review.},
journal = {Advances in experimental medicine and biology},
volume = {1489},
number = {},
pages = {109-116},
pmid = {41251998},
issn = {0065-2598},
mesh = {Humans ; *Telemedicine/ethics ; *COVID-19/epidemiology ; Artificial Intelligence/ethics ; *Delivery of Health Care/ethics ; SARS-CoV-2 ; Confidentiality/ethics ; Informed Consent/ethics ; Computer Security/ethics ; Pandemics ; },
abstract = {INTRODUCTION: The COVID-19 pandemic has reinforced the need for digital transformation in health, bringing about the development of national strategies, new possibilities, but also challenges. The use of digital technologies and artificial intelligence enables accurate and personalized healthcare, while telenursing can provide groundbreaking services that enable the improvement of the quality of healthcare and the efficient resource management remotely.

THE AIM: Of this literature review is to present how telenursing can transform the delivery of healthcare and what the ethical challenges by its implementation.

METHODOLOGY: A narrative review was performed using key words of "telenursing" or "telehealth" and "ethical challenges" for free full text reviews published in PubMed, Web of Science, Scopus databases from 2004 to the present to encompass the most recent research findings, to summarize existing knowledge while focusing on answering the research question what are the ethical challenges that are presented by their implementation.

RESULTS: Several ethical issues in telenursing, telehealth, telecare, and artificial intelligence include informed consent, patient privacy and confidentiality, data protection and security, malpractice and liability, equitable access, quality of care, and the professional-patient relationship.

CONCLUSIONS: As artificial intelligence will progressively, part of nurses' clinical practice in their telenursing or telehealth services provision, it is crucial to address ethical considerations related to privacy, transparency, patient autonomy, and health equity to care provided using AI-driven telenursing and telehealth services.},
}

Humans
*Telemedicine/ethics
*COVID-19/epidemiology
Artificial Intelligence/ethics
*Delivery of Health Care/ethics
SARS-CoV-2
Confidentiality/ethics
Informed Consent/ethics
Computer Security/ethics
Pandemics

@article {pmid41251134,
year = {2025},
author = {Braun, N},
title = {[A review of security, safety, and duality issues in the field of biology].},
journal = {Comptes rendus biologies},
volume = {348},
number = {},
pages = {265-274},
doi = {10.5802/crbiol.188},
pmid = {41251134},
issn = {1768-3238},
mesh = {Humans ; COVID-19/epidemiology ; *Security Measures ; France/epidemiology ; *Biology ; SARS-CoV-2 ; *Safety ; Pandemics ; Synthetic Biology ; },
abstract = {At a time when biological research is booming, driven by the explosion in synthetic biology and sequencing capabilities, as well as the phenomenal biological data these fields generate, debates are raging among experts and in society at large.The major pandemic crisis triggered by SARS-CoV-2 has resurrected debates about laboratory safety and our ability to respond to biological risks. Current geopolitical instability is also prompting us to take a closer look at the threats posed by the potential use of biological weapons.Therefore, the question of the acceptable risk of biological research arises, which must take into consideration, on the one hand, the importance of research for our health, environment and quality of life, and, on the other hand, our ability to take into account safety, security and dual-use issues. The aim of this review is to take stock of the risks identified and the measures taken in France to limit them.},
}

Humans
COVID-19/epidemiology
*Security Measures
France/epidemiology
*Biology
SARS-CoV-2
*Safety
Pandemics
Synthetic Biology

@article {pmid41251047,
year = {2025},
author = {Jiang, S and Lu, Z},
title = {mRNA-LNP vaccines: rational design, delivery optimization, and clinical translation.},
journal = {Journal of materials chemistry. B},
volume = {},
number = {},
pages = {},
doi = {10.1039/d5tb01972a},
pmid = {41251047},
issn = {2050-7518},
abstract = {Messenger RNA (mRNA) vaccines face core challenges including low-delivery efficiency and immunogenicity, limiting their wide-ranging applications in infectious disease prevention and cancer therapy. Lipid nanoparticles (LNPs), the most clinically validated non-viral delivery platform, address these challenges by encapsulating and protecting mRNA, promoting cellular uptake, and mediating endosomal escape. mRNA-LNP vaccines leverage a "rapid design + flexible production" advantage, decisively demonstrated by the success of COVID-19 vaccines such as BNT162b2. This review systematically analyzes mRNA-LNP vaccine development, focusing on core optimization strategies: (1) mRNA sequence engineering (nucleoside modification and UTR/poly(A) tail optimization) to enhance stability and translation efficiency; (2) LNP formulation (component ratio optimization, SPOT strategies, etc.) to modulate immune responses and enable organ targeting; and (3) LNP surface functionalization (with small molecules, peptides, and antibodies) for precise specific cell or organ targeting. Although multiple candidate vaccines for infectious disease prevention and cancer treatment have entered clinical trials, their clinical translation is still limited by insufficient targeting accuracy, potential immunogenicity and toxicity, and the challenge of universal delivery systems. Future breakthroughs require the integration of multidisciplinary innovations, focusing on the development of degradable lipids and novel targeting ligands to improve delivery precision, the application of more biocompatible polymers (such as pSar and POx) to replace PEG to enhance safety, and the use of artificial intelligence (AI) to accelerate LNP formulation design and performance prediction. This review summarizes the key optimization strategies and clinical progress and explores future directions to overcome the existing bottlenecks and promote mRNA-LNP technology as the cornerstone of next-generation precision medicine.},
}

@article {pmid41250010,
year = {2025},
author = {Warigon, C},
title = {Media reporting trends on disease outbreaks of COVID-19, polio, and cholera in Nigeria: a scoping review.},
journal = {BMC public health},
volume = {25},
number = {1},
pages = {4005},
pmid = {41250010},
issn = {1471-2458},
mesh = {Nigeria/epidemiology ; Humans ; *COVID-19/epidemiology ; *Cholera/epidemiology ; *Disease Outbreaks/statistics & numerical data ; *Mass Media/trends/statistics & numerical data ; *Poliomyelitis/epidemiology ; },
abstract = {Disease outbreaks are ubiquitous and pose significant challenges to public health, especially in developing countries like Nigeria, which has a population of over 200 million people with a fragile healthcare system. The outbreak of COVID-19 in late 2019, which subsequently became a global pandemic, has had a profoundly adverse impact on Nigeria's public health system. Conversely, until its certification by the WHO African Region in 2020, Nigeria was considered a Polio-endemic country. Similarly, Cholera is a recurrent epidemic in Nigeria. It remains an incessant and seasonal public health issue, bedeviling Nigerian society, especially in regions that struggle with inadequate water and sanitation facilities, which are widespread. In Africa's most populous nation, the media have been indispensable and powerful during emergencies, such as disease outbreaks. Consequently, media coverage and reports of COVID-19, Polio, and Cholera in Nigeria are critical areas that provide clear perspectives and require attention, as the media can inform and shape public perception during such outbreaks. This study, therefore, explored the reporting trends on disease outbreaks of COVID-19, Polio, and Cholera in Nigeria. The study was guided by the Arksey and O'Malley framework for Scoping reviews. Out of 250 articles initially identified, 98 met the inclusion criteria, with 79 accessible for analysis. Findings reveal that 90% of studies focused on COVID-19, with comparatively less attention given to other significant outbreaks such as Cholera (6%) and Polio (4%). It was also found that the majority (76%) of the studies only paid little attention to the intervention strategies for managing Polio, Cholera, and COVID-19 19, which the Nigerian mass media dominantly reported, and that most of the studies were on conventional media (newspapers, magazines, radio, and TV) coverage. Significant gaps were found in the reporting of advocacy and behaviour change to mitigate the spread of diseases. There was inadequate evidence on the patterns and directions of media coverage of Polio and Cholera due to the under-coverage of the two diseases. The study concludes that media coverage of disease outbreaks, when sourced from top-rated journals, undoubtedly provides valuable insights into the media's coverage of public health interventions for managing future epidemics.},
}

Nigeria/epidemiology
Humans
*COVID-19/epidemiology
*Cholera/epidemiology
*Disease Outbreaks/statistics & numerical data
*Mass Media/trends/statistics & numerical data
*Poliomyelitis/epidemiology

@article {pmid40409286,
year = {2025},
author = {Reisinger, EC and Geerdes-Fenge, H and Wossidlo, C and Arndt, H},
title = {Long/Post-Covid - An Interdisciplinary Challenge.},
journal = {RoFo : Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin},
volume = {197},
number = {12},
pages = {1388-1394},
doi = {10.1055/a-2578-1363},
pmid = {40409286},
issn = {1438-9010},
mesh = {Humans ; *COVID-19/complications/therapy/epidemiology ; Post-Acute COVID-19 Syndrome ; *Interdisciplinary Communication ; Patient Care Team ; *Intersectoral Collaboration ; },
abstract = {In this overview we summarize the current state of scientific knowledge on the epidemiology, etiology, clinical symptoms and therapy of post-COVID disease.The study is based on a search of the scientific literature available on PubMed and on our own clinical experience in the post-COVID outpatient clinic.The prevalence of post-COVID disease varies greatly depending on the survey method used. The symptoms of post-COVID are manifold, but fatigue, cardiopulmonary complaints, cognitive deficit, and pain syndromes are prominent. There are currently no surefire symptoms or specific markers that prove the presence of the disease. Therefore, diagnosis is often based on an exclusion of other diagnoses, which requires good interdisciplinary cooperation. Therapy for post-COVID disease is also not specific but is always individual and symptom-oriented. There have been various attempts to explain the pathogenesis of post-COVID, but the mechanisms behind the development of the condition have not yet been conclusively clarified. Persistence of the virus or of viral proteins may cause protracted infection or autoimmunity. Infection and inflammation of the endothelium of the small vessels and the hypercoagulation associated with this may lead to local cytokine dysregulation and organ damage. Further clarification of the pathogenesis of post-COVID and the establishment of effective diagnostic tools and therapeutic approaches are urgently needed. · Post-COVID is a commonly reported condition with variable symptoms. · Interdisciplinary exclusion of other diagnoses and therapy planning are important. · Clarification of pathogenesis and establishment of diagnostic markers are urgently needed. · Reisinger EC, Geerdes-Fenge H, Wossidlo C et al. Long/Post-Covid - An Interdisciplinary Challenge. Rofo 2025; 197: 1388-1393.},
}

Humans
*COVID-19/complications/therapy/epidemiology
Post-Acute COVID-19 Syndrome
*Interdisciplinary Communication
Patient Care Team
*Intersectoral Collaboration

@article {pmid41249078,
year = {2025},
author = {Banach, M and Toth, PP and Ahn, HJ and Bielecka-Dabrowa, A and Cicero, AFG and Covic, A and Dalakoti, M and Escobar, C and Fogacci, F and Gaita, D and Gaita, L and Jóźwiak, J and Latkovskis, G and Lewek, J and Ntaios, G and Okopień, B and Pećin, I and Pella, D and Penson, PE and Proietti, M and Sadowski, J and Solnica, B and Sosnowska, B and Viigimaa, M and Lip, GYH and , },
title = {Lipid management for primary and secondary stroke prevention consensus paper of the International Lipid Expert Panel (ILEP).},
journal = {Progress in cardiovascular diseases},
volume = {},
number = {},
pages = {},
doi = {10.1016/j.pcad.2025.11.003},
pmid = {41249078},
issn = {1873-1740},
abstract = {Ischemic stroke is a significant global health challenge, accounting for approximately 66 % of all strokes worldwide. Recent data indicates that stroke was the third leading cause of death (10.7 % of all deaths), following ischemic heart disease and COVID-19. In 2021, nearly 94 million people were living with the consequences of a stroke, and about 12 million new cases were reported. Major risk factors for stroke include high systolic blood pressure, exposure to ambient particulate matter, smoking, and elevated levels of low-density lipoprotein cholesterol (LDL-C), with LDL-C contributing to nearly one-third of all ischemic strokes. In primary prevention, many at-risk individuals have undiagnosed or poorly managed lipid disorders, including elevated lipoprotein(a). The challenge persists in secondary prevention, where up to 40 % of individuals at risk of recurrent ischemic stroke experience a recurrence within five years. A key reason for this is the inadequate diagnosis and management of lipid disorders, underscoring the necessity for early and intensive (upfront) combination lipid-lowering therapy (LLT) to meet treatment goals promptly after an event. Unfortunately, data indicates that up to 40 % of post-stroke patients receive no LLT, and many more receive inadequate treatment. Additionally, existing guidelines for LLT in both primary and secondary stroke prevention are often inconsistent and outdated. Similarly, the understanding of the effects of LDL-C and LLT on the risks of haemorrhagic stroke and dementia remains limited, emphasizing the need for clear and practical guidance. Thus, within this Consensus Paper we aimed to provide consistent, easy-to-follow, and practical guidance on lipid targets, along with clear pathways for effectively treating patients with lipid disorders who are at risk for stroke and those who have experienced one. This approach is intended to help reduce the risk of recurrent ischemic strokes and their associated complications.},
}

@article {pmid41248320,
year = {2025},
author = {Kim, C and Austin, R and Wurtz, R and Delaney, CW and Rajamani, S},
title = {Applications of Artificial Intelligence in the Control of Infectious Diseases in the Post-COVID Era: Scoping Review.},
journal = {JMIR nursing},
volume = {8},
number = {},
pages = {e84242},
doi = {10.2196/84242},
pmid = {41248320},
issn = {2562-7600},
mesh = {Humans ; *Artificial Intelligence ; *COVID-19/epidemiology/prevention & control ; *Communicable Disease Control/methods ; Pandemics/prevention & control ; SARS-CoV-2 ; },
abstract = {BACKGROUND: The COVID-19 pandemic exposed systemic vulnerabilities in public health infrastructure, underscoring the urgency for innovation in disease surveillance and emergency response. Artificial intelligence (AI) has emerged as a promising tool to enhance the accuracy, efficiency, and scalability of public health interventions. Yet, there remains a limited understanding of how AI has been applied in real-world infectious disease control and who is contributing to its development and implementation.

OBJECTIVE: This scoping review aimed to map current applications of AI in public health practice for infectious disease control since 2020. Specifically, it examined (1) the types of AI tools in use, (2) their purposes and implementation contexts, and (3) the professional and institutional actors leading these efforts, including the role of nurses.

METHODS: Using the Joanna Briggs Institute's population, concept, and context framework, a structured search in Ovid MEDLINE was conducted, which was guided by the "5Cs" framework for health emergency preparedness from the World Health Organization (WHO). The search focused on English-language, peer-reviewed studies from 2020 that used AI tools for infectious disease control within real-world public health practice. Nonoriginal articles, simulation-only studies, and studies that lacked real-world implementation were excluded.

RESULTS: Out of 600 screened studies in Ovid MEDLINE, 10 met the inclusion criteria. Two major AI types were identified: machine learning (ML) algorithms and language-based tools such as chatbots and large language models. ML tools supported outbreak detection, risk stratification, and resource allocation, while language-based tools promoted health communication, particularly around immunization and HIV prevention. Studies were conducted in a diverse range of countries, including several low- and middle-income countries, and used national datasets or surveillance systems. Despite nurses comprising half of the global health workforce, no nursing-affiliated authors were found among first or corresponding authors, and no nurses were represented in the broader authorship of the included studies.

CONCLUSIONS: AI technologies are being increasingly applied to support public health responses to infectious diseases, with applications ranging from predictive analytics to real-time public engagement. However, adoption remains limited in scale, scope, and professional diversity. The near-total absence of nursing participation in AI-related public health research is particularly striking and represents a missed opportunity for inclusive innovation. Strengthening implementation research and advancing informatics education among nursing professionals are critical next steps to ensure that AI tools reflect the realities of public health practice and promote equitable outcomes.},
}

Humans
*Artificial Intelligence
*COVID-19/epidemiology/prevention & control
*Communicable Disease Control/methods
Pandemics/prevention & control
SARS-CoV-2

@article {pmid41247781,
year = {2025},
author = {Henrich, TJ and Montgomery, CP and Graf, J and Ismali, N and Mohandas, S and Suthar, MS and Brim, H and Coffin, JM and Pagaria, A and Guzmán Rivera, J and Vudali, U and Keim, P and Zhong, G and McGrath, R and Edwards, B and García-Sastre, A and Gennaro, ML},
title = {The role of co-infection in the pathogenesis of acute SARS-CoV-2 infection and development of post-acute sequelae: A perspective.},
journal = {eLife},
volume = {14},
number = {},
pages = {},
doi = {10.7554/eLife.106308},
pmid = {41247781},
issn = {2050-084X},
mesh = {Humans ; *COVID-19/complications/pathology/virology ; *Coinfection/virology ; *SARS-CoV-2 ; Post-Acute COVID-19 Syndrome ; Bacterial Infections/complications ; },
abstract = {A major health challenge resulting from the COVID-19 pandemic is the manifestation of post-acute sequelae of SARS-CoV-2 (PASC). PASC (or long COVID) is a collective term used for clinical symptoms, various pathologies, and life-quality-changing functional impairment that persist for months to years after the initial SARS-CoV-2 infection. The mechanisms underlying PASC are not understood, although advances have been made in identifying factors that may contribute to long-term pathology. Recent data have emerged, showing an association between SARS-CoV-2 viral persistence and non-SARS-CoV-2 infections (pre-existing, viral reactivation, or new infections) in facilitating or mediating PASC. However, the heterogeneous nature and timing of co-infections have made it challenging to understand, interpret, and contextualize their contribution to PASC. Here, we summarize the impact of potential viral, bacterial, and fungal infections on SARS-CoV-2 pathogenesis, with a focus on their possible roles in the development of PASC. We also provide a framework to understand the mechanisms of PASC and inform basic, translational, and clinical research initiatives, including RECOVER, a large and ongoing research initiative to understand, treat, and prevent long COVID.},
}

Humans
*COVID-19/complications/pathology/virology
*Coinfection/virology
*SARS-CoV-2
Post-Acute COVID-19 Syndrome
Bacterial Infections/complications

@article {pmid41246243,
year = {2025},
author = {Kaaniche, FM and Zouari, F and Jerbi, S and Dahech, I and Abdellatif, A and Taher, YB and Feki, W and Hakim, Z and Briki, S and Dlensi, D and Allala, R},
title = {[Specific features of multisystem inflammatory syndrome in adults related to SARS-CoV-2].},
journal = {The Pan African medical journal},
volume = {52},
number = {},
pages = {29},
doi = {10.11604/pamj.2025.52.29.47987},
pmid = {41246243},
issn = {1937-8688},
mesh = {Humans ; *COVID-19/diagnosis/complications/therapy/physiopathology ; *Systemic Inflammatory Response Syndrome/diagnosis/therapy/physiopathology/virology ; Adult ; Prognosis ; Adrenal Cortex Hormones/administration & dosage ; Immunoglobulins/administration & dosage ; },
abstract = {Multisystem inflammatory syndrome in adults (MIS-A) is a rare and severe entity occurring after SARS-CoV-2 infection, and it is often underrecognized in adults. The purpose of this study is to describe the clinical, paraclinical, therapeutic, and prognostic characteristics of MIS-A through a structured review of the literature. A search was conducted in PubMed, Scopus, and Web of Science databases up to May 2024. Articles included were clinical case reports or case series of MIS-A in adults. Eighteen (18) articles were included. MIS-A mainly manifests as persistent fever, multiorgan involvement, marked inflammatory response, and frequently negative SARS-CoV-2 PCR but positive serology. Treatment is based on immunoglobulins, corticosteroids, and, in some cases, anti-IL-6 therapy. Although rare, MIS-A represents a medical emergency to be considered in the aftermath of COVID-19 infection, even in asymptomatic cases. Diagnosis is based on nonspecific clinical and biological criteria, which makes recognition challenging. Early immunomodulatory treatment can improve prognosis.},
}

Humans
*COVID-19/diagnosis/complications/therapy/physiopathology
*Systemic Inflammatory Response Syndrome/diagnosis/therapy/physiopathology/virology
Adult
Prognosis
Adrenal Cortex Hormones/administration & dosage
Immunoglobulins/administration & dosage

@article {pmid41245505,
year = {2025},
author = {Taylor, HL and Cuadros, P and Gee, M and Menachemi, N},
title = {The unintended health effects of US COVID-19 lockdowns: a systematic review.},
journal = {Health affairs scholar},
volume = {3},
number = {11},
pages = {qxaf208},
doi = {10.1093/haschl/qxaf208},
pmid = {41245505},
issn = {2976-5390},
abstract = {INTRODUCTION: US lockdowns and school closures implemented during the COVID-19 pandemic were intended to mitigate viral transmission and protect public health. However, the broader health effects of these interventions remain unclear.

METHODS: We conducted a systematic review of peer-reviewed studies that assessed the impact of US lockdowns and school closures on health-related outcomes excluding COVID-19 transmission and mortality.

RESULTS: A total of 132 studies met inclusion criteria, yielding 454 unique outcomes. Lockdowns and school closures were associated with detrimental health effects in the majority of outcomes analyzed, including over 90% of mental health, obesity-related, and health-related social need outcomes (child development/education, employment, access to food, and economic/financial stability). Analyses focused on vulnerable populations, such as racial and ethnic minorities, low-income groups, and individuals with disabilities, were significantly more likely to report detrimental outcomes than the general population.

CONCLUSION: Given how lockdowns and school closures may affect population well-being, policymakers should carefully weigh both the benefits and harms of these interventions, including how they may affect vulnerable populations. We conclude with policy recommendations to mitigate ongoing harms and inform more evidence-based decision-making.},
}

@article {pmid41245378,
year = {2025},
author = {Al-Aqqad, N and McCarthy, LJ and Roura, M},
title = {The bidirectional effects of the COVID-19 pandemic on the social determinants of health among refugees and internally displaced persons in low and lower-middle income countries: A systematic review of qualitative studies.},
journal = {Journal of migration and health},
volume = {12},
number = {},
pages = {100369},
doi = {10.1016/j.jmh.2025.100369},
pmid = {41245378},
issn = {2666-6235},
abstract = {BACKGROUND: This systematic review aims to synthesize the available qualitative evidence on the bidirectional effects of the COVID-19 pandemic on the social determinants of health among refugees and internally displaced persons in low and lower-middle income countries.

METHODS: A systematic search of peer-reviewed articles published in English was conducted in August 2025 using five databases: PubMed, Scopus, PsycINFO, Embase, and ASSIA. The Critical Appraisal Skills Program qualitative studies checklist was used to assess the quality of qualitative and mixed-methods studies. The Dahlgren and Whitehead model of the social determinants of health was used as a reference framework for data extraction and analysis. The themes that emerged during the data extraction process were used to create an adapted framework.

RESULTS: Out of 12,607 studies found, 32 studies were included for review. The COVID-19 pandemic had profound effects on most of the social determinants of health among refugees and internally displaced persons in low and lower-middle income countries. Also, unfavorable health determinants of refugees and internally displaced persons residing in these countries made them more susceptible to COVID-19.

DISCUSSION: The COVID-19 pandemic had bidirectional effects on refugees' and internally displaced persons' social determinants of health. The pandemic negatively affected their work conditions, economic status, education, and healthcare access. On the other hand, lack of access to clean water, crowded housing, and poor health literacy level affected their compliance with protective measures making them more prone to COVID-19 infection.},
}

@article {pmid41244103,
year = {2025},
author = {Yue, Y and Han, X and Chen, Q and Dai, L and Ai, Q and Zhang, Z and Ma, F and Gao, J},
title = {The effect of pulmonary rehabilitation for post-acute sequelae of SARS-CoV-2 infection in patients: a systematic review and meta-analysis.},
journal = {Frontiers in rehabilitation sciences},
volume = {6},
number = {},
pages = {1634351},
doi = {10.3389/fresc.2025.1634351},
pmid = {41244103},
issn = {2673-6861},
abstract = {BACKGROUND: Post-acute sequelae of SARS-CoV-2 infection (PASC), also known as long COVID, are characterized by persistent symptoms such as fatigue, dyspnea, and reduced functional capacity. Pulmonary rehabilitation (PR) is recommended for chronic respiratory conditions, but its effectiveness in PASC, particularly across different delivery modes, remains uncertain.

OBJECTIVE: To assess the impact of PR, including telerehabilitation and in-person modalities, on physical function, dyspnea, pulmonary function, fatigue, and quality of life in patients with PASC.

METHODS: We conducted a systematic search of PubMed, Embase, the Cochrane Library, and Web of Science from inception to March 25 for controlled clinical trials assessing the effects of PR in PASC patients. Two independent reviewers performed study selection and data extraction. The risk of bias was assessed using the Cochrane Risk of Bias Tool, and data were analyzed using Review Manager (RevMan) 5.4.1. Effect sizes were reported as mean differences (MD) or standardized mean differences (SMD) with 95% confidence intervals (CI).

RESULTS: Ten randomized controlled trials involving 673 participants were included. Most studies were judged to have a moderate risk of bias. Compared with usual care, PR significantly improved six-minute walk distance (MD: 76.85 meters; 95% CI: 57.35-96.36; p < 0.001), maximal inspiratory pressure (MD: 17.63 cmH₂O; 95% CI: 4.50-30.76; p = 0.009), fatigue (SMD: -1.15; 95% CI: -1.83 to -0.48; p < 0.001), and quality of life (SMD: 1.73; 95% CI: 0.56-2.91; p = 0.004). No statistically significant improvement was found for dyspnea (MD: -0.41; 95% CI: -1.51 to -0.68; p = 0.46). Subgroup analyses showed no significant differences between telerehabilitation and in-person PR across all outcomes, including exercise capacity (p = 0.84), dyspnea (p = 0.86), fatigue (p = 0.93), and quality of life (p = 0.44).

CONCLUSIONS: PR improves physical and functional outcomes in patients with PASC. Telerehabilitation offers a clinically equivalent alternative to in-person PR, supporting its broader implementation.},
}

@article {pmid39221683,
year = {2025},
author = {Malay, S and Madabhavi, IV and Tripathi, A},
title = {SARS-CoV-2 JN.1 variant: a short review.},
journal = {Monaldi archives for chest disease = Archivio Monaldi per le malattie del torace},
volume = {95},
number = {3},
pages = {},
doi = {10.4081/monaldi.2024.2981},
pmid = {39221683},
issn = {2532-5264},
mesh = {Humans ; *SARS-CoV-2/genetics/pathogenicity ; *COVID-19/virology/epidemiology/diagnosis ; Mutation ; },
abstract = {The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a single-stranded, positive-sense RNA virus. The SARS-CoV-2 virus is evolving continuously, and many variants have been detected over the last few years. SARS-CoV-2, as an RNA virus, is more prone to mutating. The continuous evolution of the SARS-CoV-2 virus is due to genetic mutation and recombination during the genomic replication process. Recombination is a naturally occurring phenomenon in which two distinct viral lineages simultaneously infect the same cellular entity in an individual. The evolution rate depends on the rate of mutation. The rate of mutation is variable among the RNA viruses, with the SARS-CoV-2 virus exhibiting a lower rate of mutation than other RNA viruses. The novel 3'-to-5' exoribonuclease proofreading machinery is responsible for a lower rate of mutation. Infections due to SARS-CoV-2, influenza, and respiratory syncytial virus have been reported from around the world during the same period of fall and winter, resulting in a "tripledemic". The JN.1 variant, which evolved from the predecessor, the Omicron variant BA.2.86, is currently the most dominant globally. The impact of the JN.1 variant on transmissibility, disease severity, immune evasion, and diagnostic and therapeutic escape will be discussed.},
}

Humans
*SARS-CoV-2/genetics/pathogenicity
*COVID-19/virology/epidemiology/diagnosis
Mutation

@article {pmid41242507,
year = {2025},
author = {Singh, R and Pradhan, A and Roy, D and Arya, M and Chakravarti, R and Dutta, D and Kundu, A and Bhaduri, S and Singh, P and Ahmed, KT and Bhattacharya, B},
title = {Emerging Molecular Targets and Natural Therapeutics for Idiopathic Pulmonary Fibrosis: Insights into Mechanisms, Risks, and COVID-19 Links.},
journal = {Respiratory medicine},
volume = {},
number = {},
pages = {108519},
doi = {10.1016/j.rmed.2025.108519},
pmid = {41242507},
issn = {1532-3064},
abstract = {Pulmonary fibrosis, often termed as idiopathic pulmonary fibrosis (IPF), is a leading cause of death for patients with lung damage, acute respiratory distress syndrome, and even Coronavirus disease. This article focuses on key factors, such as transforming growth factor, fibroblast growth factors, Neurogenic locus notch homolog (Notch), and Sonic hedgehog, involved in the progression of IPF. Historically, our understanding of IPF's impacts on the immune system that was limited due to the complexity. Recent reports, however provided valuable insights into defence mechanisms and factors. We highlight various factors of pulmonary fibrosis. Here, we will discuss the impact of diverse risk factors, including anticancer agents such as bleomycin and methotrexate; mineral silica; and metals like arsenic, aluminium and copper, which have been identified as potential triggers of pulmonary fibrosis. Current treatment strategies for IPF are not fully effective, and the mechanism of the disease remains poorly understood. This review will also discuss the role of natural phytocompounds, including steroidal saponin, stilbenoid polyphenol resveratrol, safflomin of Carthamus tinctorius or safflower yellow, along with several genetic modulation approaches in addressing IPF. Finally, we examine the aspects and associations of IPF and SARS-CoV-2 to better understand disease severity, causes, and associated comorbidities.},
}

@article {pmid41242463,
year = {2025},
author = {Blavier, J and Esposito, G and Twizere, JC and Percipalle, P},
title = {Targeting viral replication complexes with mRNA-encoded nanobodies: a new frontier for antiviral design.},
journal = {Drug discovery today},
volume = {},
number = {},
pages = {104531},
doi = {10.1016/j.drudis.2025.104531},
pmid = {41242463},
issn = {1878-5832},
abstract = {Emerging and re-emerging RNA viruses continue to challenge global health preparedness, underscoring the need for broad-spectrum antivirals that can be rapidly deployed. We propose a family-specific antiviral design strategy that targets conserved replication-transcription complexes (RTCs) using nanobodies delivered as mRNA therapeutics. This approach overcomes the long-standing limitation of intracellular delivery of antibody-based biologics. By expressing antiviral nanobodies directly inside infected cells via lipid-nanoparticle-encapsulated mRNA, it becomes possible to disrupt essential protein-protein interactions within viral RTCs. Using SARS-CoV-2 non-structural protein 9 (NSP9) as a proof-of-concept, we show that stabilizing non-functional NSP9 oligomers can inhibit viral replication. This combined nanobody-mRNA technology provides a versatile platform for rapid antiviral development across virus families.},
}

@article {pmid41242396,
year = {2025},
author = {Sharma, R and Walia, A and Lakhanpal, D},
title = {Human metapneumovirus: an underdiagnosed public health threat.},
journal = {Infectious diseases now},
volume = {},
number = {},
pages = {105189},
doi = {10.1016/j.idnow.2025.105189},
pmid = {41242396},
issn = {2666-9919},
abstract = {Human metapneumovirus (hMPV), a negative-sense RNA virus in the Pneumoviridae family, has emerged as a major yet under-recognized cause of acute respiratory infections worldwide. Since its identification in 2001, hMPV has shown steady genetic evolution into genotypes A and B, with newer sublineages such as A2.2.1, A2.2.2, and B2 currently detected across continents. A recent global rise in hMPV detections, detailed in reports from China, Europe, and the USA, likely reflects both expanded testing and the re-establishment of seasonal circulation following the COVID-19 pandemic. Co-infections with respiratory viruses, including RSV and influenza, contribute to severe clinical outcomes and hospital burden. Multiplex RT-PCR remains the most sensitive and widely used diagnostic method for detection of hMPV, outperforming conventional PCR approaches, while metagenomic sequencing and CRISPR-based assays are primarily research tools. Diagnostic sensitivity also varies with sample source, and access to advanced technologies remains globally uneven. Despite its growing clinical impact, no approved antiviral is available. Promising candidates, including monoclonal antibodies against the fusion protein, siRNA therapies, and mRNA-based vaccines, are in the early stages of development. This review encompasses recent evidence on hMPV epidemiology, molecular evolution, diagnostic approaches, and therapeutic and vaccine development, underscoring a need for sustained surveillance, equitable diagnostic capacity, and proactive vaccine research more effectively addressing a largely overlooked respiratory pathogen.},
}

@article {pmid41241149,
year = {2025},
author = {Park, WH},
title = {The Mitochondrial Nexus: Dysfunction, Inhibition, and Therapeutic Frontiers in Lung Disease.},
journal = {Respiratory medicine},
volume = {},
number = {},
pages = {108506},
doi = {10.1016/j.rmed.2025.108506},
pmid = {41241149},
issn = {1532-3064},
abstract = {Mitochondria are increasingly recognized as central arbiters of cellular fate, placing them at the nexus of pulmonary health and disease. Beyond their canonical role in adenosine triphosphate (ATP) synthesis, these organelles are critical hubs for redox signaling, metabolic homeostasis, and programmed cell death. Mitochondrial dysfunction-a multifaceted condition characterized by impaired bioenergetics, excessive reactive oxygen species (ROS) production, aberrant dynamics, and defective quality control via mitophagy-is a unifying pathogenic feature in chronic lung diseases, including chronic obstructive pulmonary disease (COPD), idiopathic pulmonary fibrosis (IPF), and pulmonary arterial hypertension (PAH). This dysfunction is also a critical determinant of severity in acute conditions like acute lung injury (ALI) and COVID-19 and is a key mechanistic driver of Long COVID. This review synthesizes the core mechanisms of mitochondrial impairment, delineates their specific contributions to this spectrum of pulmonary pathologies, and discusses the burgeoning field of mitochondria-targeted therapeutics. Strategies ranging from targeted antioxidants and metabolic modulators to novel regenerative approaches like mitochondrial transplantation are highlighted, with an expanded discussion on their limitations, challenges, and clinical implications. By framing mitochondrial integrity as a critical determinant of pulmonary disease, we underscore a pivotal axis for future diagnostic and therapeutic innovation.},
}

@article {pmid41239836,
year = {2025},
author = {Liu, M and Zhang, L and Huang, S and Xu, Y and Jin, C},
title = {Application of Super-Resolution Microscopy in Virology Research: Principles, Technological Advances, and Analysis of the Viral Life Cycle.},
journal = {Journal of biophotonics},
volume = {},
number = {},
pages = {e202500461},
doi = {10.1002/jbio.202500461},
pmid = {41239836},
issn = {1864-0648},
support = {2021YFF0700305//National Key Research and Development Program of China/ ; 2024C03218//Zhejiang Provincial Leading Geese Program/ ; },
abstract = {Super-resolution microscopy (SRM) has exerted a pivotal influence on virology by surpassing the diffraction limits of conventional optical microscopy, enabling unprecedented visualization of viral structures and dynamics. Techniques such as stimulated emission depletion, photoactivated localization microscopy, stochastic optical reconstruction microscopy, and structured illumination microscopy facilitate nanoscale imaging of viruses, providing critical insights into the viral life cycle and virus-host interactions. We examine the principles and advancements in SRM techniques and their applications in virology. We discuss the development and selection of fluorescent probes, highlighting specific labeling methods. Key applications of SRM are illustrated through case studies of viruses such as influenza, HIV, and SARS-CoV-2, demonstrating the technology's impact on understanding viral mechanisms. We also explore future developments in SRM, including enhanced spatial and temporal resolution, and integration with technologies such as single-molecule imaging and fluorescence resonance energy transfer, positioning SRM as a pivotal tool for advancing viral research and therapeutic development.},
}

@article {pmid41239485,
year = {2025},
author = {Gao, G and Lin, R and Ma, D},
title = {Human metapneumovirus: pathogenesis, epidemiology, diagnostic technologies, and potential intervention strategies.},
journal = {Virology journal},
volume = {22},
number = {1},
pages = {376},
pmid = {41239485},
issn = {1743-422X},
support = {ESY-GSP-YXPT-A02//Guangdong High-level Hospital Construction Fund/ ; ESY-GSP-YXPT-A02//Guangdong High-level Hospital Construction Fund/ ; JCYJ20220530155415035//Science and Technology Foundation of Shenzhen City/ ; 2023A1515220134//Guangdong Basic and Applied Basic Research Foundation-Enterprise Joint Fund/ ; },
mesh = {Humans ; *Metapneumovirus/pathogenicity/genetics/immunology ; *Paramyxoviridae Infections/diagnosis/epidemiology/prevention & control/virology/therapy/drug therapy ; *Respiratory Tract Infections/virology/diagnosis/epidemiology/prevention & control ; Antiviral Agents/therapeutic use ; Viral Vaccines/immunology ; Molecular Epidemiology ; },
abstract = {Human metapneumovirus (HMPV) is a notable viral pathogen that is responsible for respiratory tract infections in infants, young children, elderly individuals, and immunocompromised individuals. Particularly in the post-COVID-19 era, HMPV has gradually surpassed other respiratory viruses and continues to pose a threat to human health. While substantial progress has been made in understanding the mechanisms of HMPV infection in the host, as well as in terms of diagnostic and prevention methods, no effective vaccines or specific antiviral drugs against HMPV have yet been approved. In this review, we summarize the structure of HMPV and its pathogenic mechanisms; discuss the molecular epidemiology and diagnostic techniques related to HMPV; and summarize the latest advances in the prevention and treatment of HMPV infections, particularly the development of neutralizing antibodies, vaccines, and antiviral drugs. Finally, we discuss the prospects and challenges that lie ahead for HMPV research and clinical interventions.},
}

Humans
*Metapneumovirus/pathogenicity/genetics/immunology
*Paramyxoviridae Infections/diagnosis/epidemiology/prevention & control/virology/therapy/drug therapy
*Respiratory Tract Infections/virology/diagnosis/epidemiology/prevention & control
Antiviral Agents/therapeutic use
Viral Vaccines/immunology
Molecular Epidemiology

@article {pmid41239375,
year = {2025},
author = {Twagirumugabe, T and Gashame, DF and Uwamahoro, DL and Riviello, E},
title = {Advanced non-invasive respiratory support in resource-constrained settings: a narrative review.},
journal = {Critical care (London, England)},
volume = {29},
number = {1},
pages = {492},
pmid = {41239375},
issn = {1466-609X},
mesh = {Humans ; COVID-19/therapy ; *Noninvasive Ventilation/methods/economics ; Developing Countries ; *Respiratory Insufficiency/therapy ; *Health Resources/supply & distribution ; },
abstract = {Advanced non-invasive respiratory support techniques include high flow oxygen, continuous positive airway pressure, and non-invasive ventilation. Given their relative simplicity and lower resource intensity as compared with invasive mechanical ventilation, these mechanisms of respiratory support represent an attractive opportunity for use in patients with acute respiratory failure in resource-constrained settings. High flow oxygen in particular has the potential to provide high levels of respiratory support with relatively low levels of human and other resources to a wide variety of patients with respiratory failure, including those with delirium or obtundation. Even after the COVID-19 pandemic, during which utilization of these techniques increased in high-income countries, low and lower-middle income countries still have little access to advanced non-invasive respiratory support. Evidence from high-income countries and limited evidence from low-income countries suggest that these respiratory support methods may be particularly beneficial in resource-constrained settings; however, the evidence also suggests that the populations chosen and particularly the attention and resources invested in implementation are critical in ensuring the safety and effectiveness of non-invasive support. While non-invasive respiratory support does not require the complex training and monitoring needed for invasive support (e.g. specific risks associated with the endotracheal tube, sequelae of sedation, complex ventilator modes), it nonetheless requires resources in order to be applied effectively. Particular domains that need careful consideration are: clinical systems of care; oxygen consumption and connector compatibilities; human resources and training; location within the hospital; acceptability; cost; and device characteristics. In addition, ongoing research is needed that includes randomized controlled trials with attention to context, so that clinicians in resource-constrained settings can apply relevant evidence for non-invasive respiratory support for patients in their settings.},
}

Humans
COVID-19/therapy
*Noninvasive Ventilation/methods/economics
Developing Countries
*Respiratory Insufficiency/therapy
*Health Resources/supply & distribution

@article {pmid41238304,
year = {2025},
author = {Trabocchi, A},
title = {The peptidomimetic approach for the design of viral protease inhibitors.},
journal = {The Enzymes},
volume = {58},
number = {},
pages = {93-128},
doi = {10.1016/bs.enz.2025.06.007},
pmid = {41238304},
issn = {0423-2607},
mesh = {*Peptidomimetics/pharmacology/chemistry ; Humans ; *Drug Design ; *Viral Protease Inhibitors/pharmacology/chemistry/chemical synthesis ; SARS-CoV-2/enzymology/drug effects ; Zika Virus/enzymology/drug effects ; *Antiviral Agents/pharmacology/chemistry ; Viral Nonstructural Proteins/antagonists & inhibitors ; Dengue Virus/enzymology/drug effects ; Coronavirus 3C Proteases/antagonists & inhibitors ; },
abstract = {The transformation of peptides into drug leads is an established approach in medicinal chemistry and drug discovery. Peptidomimetics are designed to mimic the bioactivity of peptides while addressing their limitations, such as poor metabolic stability and low bioavailability, thus resulting in improved receptor affinity and selectivity. Over last decades, a range of synthetic strategies has emerged to improve the pharmacological properties of these molecules through local and global conformational restrictions and introducing secondary structure mimetics. Herein the essential tools and methodologies in peptidomimetic design are reported with highlights to their therapeutic relevance, particularly in antiviral drug development. Peptidomimetics have shown notable success in targeting viral proteases as key enzymes involved in the life cycle of several pathogenic viruses. Case studies involving peptidomimetic inhibitors of HIV protease, HCV NS3/4A protease, SARS-CoV-2 main protease (3CLpro), and the NS2B-NS3 proteases of Zika and Dengue viruses are reported highlighting the efficacy of this approach, emphasizing the potential of peptidomimetic drugs as powerful tools in the treatment of infectious diseases.},
}

*Peptidomimetics/pharmacology/chemistry
Humans
*Drug Design
*Viral Protease Inhibitors/pharmacology/chemistry/chemical synthesis
SARS-CoV-2/enzymology/drug effects
Zika Virus/enzymology/drug effects
*Antiviral Agents/pharmacology/chemistry
Viral Nonstructural Proteins/antagonists & inhibitors
Dengue Virus/enzymology/drug effects
Coronavirus 3C Proteases/antagonists & inhibitors

@article {pmid41238303,
year = {2025},
author = {Bonardi, A},
title = {Computational approaches for designing viral protease inhibitors.},
journal = {The Enzymes},
volume = {58},
number = {},
pages = {59-91},
doi = {10.1016/bs.enz.2025.06.005},
pmid = {41238303},
issn = {0423-2607},
mesh = {Humans ; *Drug Design ; *Viral Protease Inhibitors/chemistry/pharmacology ; *Antiviral Agents/pharmacology/chemistry ; SARS-CoV-2/enzymology/drug effects ; *Viral Proteases/chemistry/metabolism ; Drug Discovery ; Machine Learning ; Computational Biology/methods ; },
abstract = {Viral proteases are critical enzymes that play essential roles in the replication of viruses such as Human Immunodeficiency, Hepatitis C, SARS-CoV-2, Zika, Dengue, West Nile, Yellow Fever, Japanese and Saint Louis Encephalitis, Tick-Born Encephalitis, Chikungunya, and others. Designing potent inhibitors against these proteases has been a major therapeutic strategy to control and treat these viral infections. Computational approaches, including structure-based drug design, ligand-based drug design, machine learning and artificial intelligence-based techniques, have significantly accelerated the discovery and optimization of viral protease inhibitors. This chapter provides an in-depth review of the computational methodologies employed in the development of inhibitors for these major viral targets, highlighting case studies for each virus, discussing strategies to overcome resistance, and exploring future directions in antiviral drug discovery.},
}

Humans
*Drug Design
*Viral Protease Inhibitors/chemistry/pharmacology
*Antiviral Agents/pharmacology/chemistry
SARS-CoV-2/enzymology/drug effects
*Viral Proteases/chemistry/metabolism
Drug Discovery
Machine Learning
Computational Biology/methods

@article {pmid41238302,
year = {2025},
author = {Supuran, CT and Pisano, L},
title = {Challenges for developing selective viral protease inhibitors as antiinfectives.},
journal = {The Enzymes},
volume = {58},
number = {},
pages = {319-335},
doi = {10.1016/bs.enz.2025.06.009},
pmid = {41238302},
issn = {0423-2607},
mesh = {Humans ; *Viral Protease Inhibitors/pharmacology/chemistry/therapeutic use ; *Antiviral Agents/pharmacology/chemistry ; SARS-CoV-2/drug effects/enzymology ; Drug Design ; Drug Development ; COVID-19 Drug Treatment ; *Viral Proteases/metabolism ; Animals ; },
abstract = {The biochemical machinery of most viruses comprises proteases which are crucial for their life cycle. In the last decades, proteases from pathogenic viruses started to be considered as potential drug targets, and this led to the development of several classes of effective antivirals used for the management of HIV, HCV and SARS CoV 2 infections. More than 25 clinically used protease inhibitors (PIs) are now available for the management of these three infections, but many other viruses encode for proteases which started to be considered only recently as potential drug targets. They include enterovirises, filoviruses such as Zika, Dengue and West Nile viruses, Chikungunya and other togaviruses, Ebola, Marbug and many other hemorrhagic viruses. The proteases of many such pathogens have been cloned, characterized and in some cases also crystallized in complex with inhibitors, but no compounds progressed yet to clinical trials. There are several relevant challenges in designing PIs as novel antivirals, such as: (i) the drug design strategies of peptidomimetic inhibitors, which are many times complex and expensive; (ii) the difficulties in identifying non-peptidomimetic PIs; (iii) the selectivity for the target versus host proteases of the identified PIs; (iv) their metabolism, absorption and in vivo antiviral activity, and, most importantly, (v) the emergence of drug/multidrug resistance due to the high mutation rates of many viruses. Many of these challenges started to be approached by innovative strategies which will be duscussed in the chapter.},
}

Humans
*Viral Protease Inhibitors/pharmacology/chemistry/therapeutic use
*Antiviral Agents/pharmacology/chemistry
SARS-CoV-2/drug effects/enzymology
Drug Design
Drug Development
COVID-19 Drug Treatment
*Viral Proteases/metabolism
Animals

@article {pmid41238299,
year = {2025},
author = {Elsawi, AE and Tawfik, HO and Eldehna, WM},
title = {Coronaviruses papain-like proteases and their inhibitors.},
journal = {The Enzymes},
volume = {58},
number = {},
pages = {209-249},
doi = {10.1016/bs.enz.2025.06.006},
pmid = {41238299},
issn = {0423-2607},
mesh = {Humans ; *Coronavirus Papain-Like Proteases/antagonists & inhibitors/metabolism/chemistry ; *Antiviral Agents/pharmacology ; Virus Replication/drug effects ; *Protease Inhibitors/pharmacology/chemistry ; Animals ; },
abstract = {The multipurpose enzyme papain-like protease (PLpro) is crucial for both immune evasion and viral multiplication. The replication-transcription complex is formed when PLpro, encoded by nonstructural protein 3 (nsp3), cleaves the viral polyprotein to release nsp1 through nsp4. Furthermore, by eliminating ubiquitin and ISG15 from key immune signaling proteins, such as IRF3, STING, and MDA5, PLpro impairs host antiviral defenses by reducing type I interferon responses. The catalytic triad and several functional domains, including the flexible BL2 loop that regulates access to the viral polyprotein substrate and inhibitor, as well as the SUb1 and SUb2 binding sites for ISG15/Ub recognition, are structural features of PLpro. Due to these features, PLpro is a desirable target for both allosteric and active-site inhibition. Numerous prospective inhibitors have been identified through drug repurposing and natural product screening, supported by structural and computational analyses that highlight key interaction sites. The biological significance, structural intricacy, and therapeutic potential of PLpro as a dual-action antiviral target, which can inhibit viral replication and restore host immune function, are highlighted in this chapter.},
}

Humans
*Coronavirus Papain-Like Proteases/antagonists & inhibitors/metabolism/chemistry
*Antiviral Agents/pharmacology
Virus Replication/drug effects
*Protease Inhibitors/pharmacology/chemistry
Animals

@article {pmid41238297,
year = {2025},
author = {Supuran, CT and Capasso, C},
title = {Coronaviruses main proteases and their inhibitors.},
journal = {The Enzymes},
volume = {58},
number = {},
pages = {183-208},
doi = {10.1016/bs.enz.2025.07.005},
pmid = {41238297},
issn = {0423-2607},
mesh = {Humans ; *SARS-CoV-2/enzymology/drug effects ; *Antiviral Agents/pharmacology/chemistry/therapeutic use ; *Protease Inhibitors/pharmacology/chemistry/therapeutic use ; *COVID-19 Drug Treatment ; *Coronavirus 3C Proteases/antagonists & inhibitors/metabolism/chemistry ; Drug Discovery ; COVID-19/virology ; Peptidomimetics/pharmacology ; },
abstract = {The SARS-CoV-2 main protease (M[pro]) plays a pivotal role in the viral life cycle by cleaving polyproteins pp1a and pp1ab into functional non-structural proteins (NSPs), including components essential for RNA replication, such as nsp7, nsp8, and RNA-dependent RNA polymerase. The high sequence conservation across coronaviruses and absence of closely related human proteases make M[pro] an attractive target for selective antiviral interventions. Recent efforts in drug discovery have led to the development of a wide spectrum of M[pro] inhibitors, including covalent peptidomimetics (e.g., nirmatrelvir) and non-covalent small molecules with enhanced pharmacological profiles, such as ensitrelvir. Structure-based drug design, fragment-based drug discovery (FBDD), high-throughput screening (HTS), and in silico approaches have contributed to identification of novel scaffolds and optimization of binding interactions within the catalytic pocket. Non-covalent inhibitors offer reversible binding mechanisms that reduce off-target effects and are particularly promising for clinical translation. However, challenges such as the limited oral bioavailability of peptidomimetic compounds, metabolic instability, and emerging resistance highlight the need for further optimization. Ongoing research is exploring prodrug strategies, advanced delivery systems, and combinatorial regimens that integrate M[pro] inhibitors with other antivirals to achieve synergistic effects and suppress resistance. This chapter provides a comprehensive overview of the current landscape of M[pro]-targeted therapeutics and emphasizes their potential role in future pandemic preparedness.},
}

Humans
*SARS-CoV-2/enzymology/drug effects
*Antiviral Agents/pharmacology/chemistry/therapeutic use
*Protease Inhibitors/pharmacology/chemistry/therapeutic use
*COVID-19 Drug Treatment
*Coronavirus 3C Proteases/antagonists & inhibitors/metabolism/chemistry
Drug Discovery
COVID-19/virology
Peptidomimetics/pharmacology

@article {pmid41238295,
year = {2025},
author = {Rusconi, S and Paoletti, N and Supuran, CT},
title = {HIV protease and its inhibition.},
journal = {The Enzymes},
volume = {58},
number = {},
pages = {129-149},
doi = {10.1016/bs.enz.2025.06.001},
pmid = {41238295},
issn = {0423-2607},
mesh = {*HIV Protease Inhibitors/pharmacology/chemistry/therapeutic use ; Humans ; *HIV Protease/metabolism/chemistry ; Drug Resistance, Viral ; *HIV-1/enzymology/drug effects ; HIV Infections/drug therapy/virology ; },
abstract = {The HIV protease (HPR) is a virus-specific aspartic protease responsible for processing the polyproteins of gag and gag-pol during virion maturation and for the proliferation of HIV. The activity of HPR is essential for virus infectivity, thus it is an important target for the development of anti-HIV drugs. HPR is only one major viral protease, since there are other proteases, which are specific to HCV or SARS-CoV-2 and are therapeutic targets as well. HPR inhibitors in combination with other classes of anti-HIV drugs are one of the main components of an effective anti-HIV therapy. Nevertheless, upon several circumstances, HIV can develop a discrete pattern of resistance towards one or several HPR inhibitors through the phenomenon of cross-resistance. The aim of our work is to illustrate various features of HPR: its structure, the various mechanisms which lead to its inhibition, the HPR inhibitors which are used in the clinical arena, and the pathways involved in drug resistance, plus the mechanisms to overcome it.},
}

*HIV Protease Inhibitors/pharmacology/chemistry/therapeutic use
Humans
*HIV Protease/metabolism/chemistry
Drug Resistance, Viral
*HIV-1/enzymology/drug effects
HIV Infections/drug therapy/virology

@article {pmid41238294,
year = {2025},
author = {Pisano, L and Supuran, CT},
title = {Viral proteases as targets for antivirals drugs.},
journal = {The Enzymes},
volume = {58},
number = {},
pages = {1-18},
doi = {10.1016/bs.enz.2025.06.002},
pmid = {41238294},
issn = {0423-2607},
mesh = {*Antiviral Agents/pharmacology/therapeutic use ; Humans ; *Viral Proteases/metabolism ; *Viral Protease Inhibitors/pharmacology/therapeutic use ; Animals ; SARS-CoV-2/enzymology/drug effects ; Virus Diseases/drug therapy ; *Viral Proteins/antagonists & inhibitors/metabolism ; },
abstract = {The biochemical machinery of all viruses comprises enzymes able to cleave polyproteins formed after the transcription of the viral genetic material, which belong to the protease class. Viral proteases known so far belong to the aspartic, serine and cysteine protease classes, with no viral metalloprotease described to date. The tridimensional structure, biochemical properties and susceptibility to be inhibited by various classes of compounds for many such enzymes have been investigated in detail in the last decades. Many antiviral drugs target viral proteases which produce diseases in mammals, but such enzymes are also present in viruses which attack plants or bacteria, and potential applications for such enzymes or their inhibition started to be considered in recent years. The aspartic protease encoded in the HIV genome, the serine proteases found in various HCV serotypes and more recently the two cystein proteases from coronaviruses, including SARS CoV 2, are targeted by clinically used drugs belonging to the protease inhibitors, which effectively interrupt the life cycle of the virus, alone or in combination therapies with other antivirals and showed a relevant clinical success. Many other less investigated viruses encode for proteases belonging to the three classes mentioned above and they started to be investigated for obtaining novel antivirals for the management of Dengue, Zika, West Nile and other flaviviruses infections but also Chikungunya, Ebola, Marbug and various other filoviruses, for which few therapeutic options are available to date.},
}

*Antiviral Agents/pharmacology/therapeutic use
Humans
*Viral Proteases/metabolism
*Viral Protease Inhibitors/pharmacology/therapeutic use
Animals
SARS-CoV-2/enzymology/drug effects
Virus Diseases/drug therapy
*Viral Proteins/antagonists & inhibitors/metabolism

@article {pmid41237896,
year = {2025},
author = {Kolodziej, LM and Grootegoed, LC and van Buul, LW and Spijker, R and Schinkel, CJ and de Jong, MD and Leeflang, MM and Kuil, SD},
title = {The impact of respiratory viruses on older adults in long-term care facilities: a scoping review.},
journal = {Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases},
volume = {},
number = {},
pages = {},
doi = {10.1016/j.cmi.2025.11.002},
pmid = {41237896},
issn = {1469-0691},
abstract = {BACKGROUND: Evidence on the clinical impact of seasonal respiratory viruses in long-term care facilities (LTCFs) is limited.

OBJECTIVES: To provide an overview of the evidence available on the clinical impact of seasonal respiratory viruses on older adults in LTCFs worldwide.

DATA SOURCES: Medline (OVID Medline ALL) and Embase (Embase.com) until 13 May 2025.

STUDY ELIGIBILITY CRITERIA: Original research articles involving LTCF residents with at least one laboratory-confirmed viral respiratory tract infection (RTI), excluding SARS-CoV-2 and pandemic influenza, reporting any RTI-associated clinical outcome.

PARTICIPANTS: LTCF residents (mean or median age >60 years).

METHODS OF DATA SYNTHESIS: An evidence gap map was created to visualise the distribution of evidence across viruses and outcomes. Where possible, outcome proportions (defined as the number of cases with the outcome divided by the total number of cases) were extracted from the included studies. These were summarised and visualised in dot plots with medians and interquartile ranges (IQRs) per virus.

RESULTS: 117 studies were included. The majority of the studies focused on influenza viruses and conventional outcomes including attack rate, lower respiratory tract infection (LRTI), hospitalisation, and mortality. Evidence was limited for human rhinovirus, parainfluenza viruses, enterovirus, adenovirus, and endemic human coronaviruses, as well as for outcomes such as aggravation of underlying diseases and patient-centred outcomes, including quality of life and functional status. Human metapneumovirus (hMPV) was associated with the highest rate of LRTI (median 0.50; IQR 0.45-0.75) as well as the highest mortality rate (median 0.17; IQR 0.10-0.37) found in this study, although based on small numbers of confirmed cases.

CONCLUSIONS: Substantial knowledge gaps remain regarding the impact of seasonal respiratory viruses on older adults in LTCFs. In order to inform decision-making regarding viral RTI management in this population, future studies should prioritise underrepresented viruses including hMPV and incorporate patient-centred outcomes.},
}

@article {pmid41237560,
year = {2025},
author = {Anson, K and Patel, S},
title = {Misinformaion and its impact on measles vaccine hesitancy in the pediatric population: A scoping review.},
journal = {Journal of pediatric nursing},
volume = {86},
number = {},
pages = {136-147},
doi = {10.1016/j.pedn.2025.11.008},
pmid = {41237560},
issn = {1532-8449},
abstract = {OBJECTIVE: This scoping review is a synthesis of what is known in the literature about the relationship between misinformation and measles, mumps, and rubella (MMR) vaccine hesitancy.

METHODS: A scoping review using Arksey and O'Malley's framework was completed. PubMed, Academic Search Complete, CINHAL, and EBSCOHost were searched for literature published from January 2020 to December 2024 in English on MMR vaccine hesitancy and misinformation.

RESULTS: Initial search resulted in 141 articles. After removing duplicates and articles not meeting inclusion criteria, 23 studies were retained for analysis. Misinformation promulgated in social and religious groups, social media, internet searches, and movies impacted measles vaccine hesitancy. Declining vaccination rates corresponded with circulating social media posts promoting misinformed beliefs towards the MMR vaccine. Interventions targeting vaccine hesitancy have used a variance of communication strategies with limited success. Unfortunately, the COVID-19 pandemic media response decreased institutional trust and increased trust in misinformation, despite evidence to the contrary.

CONCLUSION: Despite scientific demonstration of immunizations benefits, little work has been attempted to understand how and why vaccine decisions are being made, including the effect of misinformation. Research gaps include the pervasiveness of misinformation, the limited efficacy of communication interventions on changing vaccine intention, and the lack of a cohesive theoretical framework.

PRACTICAL IMPLICATIONS: Nurses remain at the crux of vaccination decisions with a unique role in educating parents. Future research should focus on understanding parental MMR vaccine decisions guided by a theoretical framework examining the impact unique social interactions of common beliefs have on decision-making.},
}

@article {pmid41237540,
year = {2025},
author = {Devsam, B and Bortolussi, K and Tippins, J and Vasiliadis, S and Danchin, M and O'Neill, J and Attwell, K and Kaufman, J},
title = {The experience of seeking & granting special medical exemptions for mandated vaccines: A scoping review.},
journal = {Vaccine},
volume = {68},
number = {},
pages = {127935},
doi = {10.1016/j.vaccine.2025.127935},
pmid = {41237540},
issn = {1873-2518},
abstract = {BACKGROUND: Medical exemptions to mandated vaccines are permitted for contraindications, such as anaphylaxis and immunosuppression. However, clinicians encounter 'special medical exemptions' when the medical reason for requiring an exemption falls outside strict criteria. Processes for seeking, assessing, and granting these exemptions are often unclear and vary across jurisdictions.

AIM: To map the published literature on the experiences of parents, caregivers, or individuals seeking special medical exemptions for mandated childhood vaccines, occupational vaccines for healthcare workers, and COVID-19 vaccines, as well as the experiences of clinicians assessing and granting such exemptions globally.

METHODS: A scoping review was conducted using PRISMA-ScR and JBI methodology. Databases searched included Embase, Medline, CINAHL, PsycInfo, PubMed, Web of Science, and Google Scholar. Qualitative, quantitative, review articles, and grey literature were included. Screening and data extraction were completed in Covidence by two independent reviewers. Data were analysed using descriptive and inductive content analysis.

RESULTS: Eighteen articles met inclusion criteria. Key findings were: (1) special medical exemptions are inconsistently granted; (2) individuals seeking special medical exemptions often support vaccination broadly, but express context-specific health concerns; (3) evidence on how vaccines affect the medical conditions underlying exemption requests were often lacking, leaving key gaps for decision-making not addressed by current criteria; (4) trust in clinicians who prioritised individual health needs over strict policy shaped families' subsequent vaccine decision; and (5) special medical exemptions can have wider implications from an individual or interpersonal level to a broader community and policy level.

CONCLUSION: Special medical exemptions currently lack definitional clarity and standardised criteria, leading to inconsistent and potentially inequitable exemption decisions. More research is needed to inform evidence-based guidance that balances public health protection with individual clinical complexity. Clearer policy frameworks and clinician support are essential to ensure fair and transparent exemptions processes.},
}

@article {pmid41235245,
year = {2025},
author = {Chen-Camaño, R and DeAntonio, R and López-Vergès, S},
title = {T-cell exhaustion in COVID-19: what do we know?.},
journal = {Frontiers in immunology},
volume = {16},
number = {},
pages = {1678149},
pmid = {41235245},
issn = {1664-3224},
mesh = {Humans ; *COVID-19/immunology ; *SARS-CoV-2/immunology ; *T-Lymphocytes/immunology ; T-Cell Exhaustion ; },
abstract = {T-cell exhaustion is a terminal state of immune dysfunction characterized by impaired proliferation and effector functions, diminished cytokine secretion, and sustained expression of inhibitory receptors. In coronavirus disease 2019 (COVID-19), increasing evidence links exhausted T-cell phenotypes with poor clinical outcomes, including severe disease, delayed viral clearance, and persistent symptoms associated with Long COVID. Exhaustion results from prolonged antigenic stimulation and inflammatory signals and is marked by transcriptional reprogramming, metabolic and epigenetic dysregulation, and co-expression of inhibitory receptors such as programmed cell death protein-1 (PD-1), T-cell immunoglobulin and mucin-domain containing-3 (TIM-3), and cytotoxic T-lymphocyte-associated protein 4 (CTLA-4). Notably, exhausted phenotypes in COVID-19 frequently coexist with hyperactivation, raising the unresolved question of whether inhibitory receptor expression reflects transient activation or irreversible dysfunction. Emerging therapeutic strategies to reverse these dysfunctional states include immune checkpoint inhibitors, cytokine modulation, metabolic interventions, and epigenetic therapies, although their clinical translation remains at an early stage. Critical research gaps include the scarcity of longitudinal data, incomplete profiling of T-cell subsets across disease stages during COVID-19 and Long COVID-19, and contradictory evidence of vaccine-induced exhaustion with limited understanding of its consequences. This non-systematic literature review synthesizes current advances in COVID-19 immunopathology and therapeutic strategies, underscoring that understanding T-cell exhaustion is crucial to improving outcomes and shaping next-generation immunotherapies and vaccines.},
}

Humans
*COVID-19/immunology
*SARS-CoV-2/immunology
*T-Lymphocytes/immunology
T-Cell Exhaustion

@article {pmid41235244,
year = {2025},
author = {Wang, D and Zhang, F},
title = {CKD-related impairment in humoral and cellular immune response and potential correlation with long COVID-19: a systematic review.},
journal = {Frontiers in immunology},
volume = {16},
number = {},
pages = {1690298},
pmid = {41235244},
issn = {1664-3224},
mesh = {Humans ; *COVID-19/immunology/prevention & control ; *Immunity, Humoral ; *Renal Insufficiency, Chronic/immunology/therapy ; *Immunity, Cellular ; *SARS-CoV-2/immunology ; *COVID-19 Vaccines/immunology ; Antibodies, Viral/blood/immunology ; Vaccination ; },
abstract = {INTRODUCTION: Patients with chronic kidney disease (CKD) are at high risk of morbidity and mortality from SARS-CoV-2 infection (COVID-19). However, their immune response to vaccination may vary among individuals. The purpose of this review was to identify characteristics of alterations in humoral and cellular immune responses to the vaccination, and to provide insights into their immune dysfunctions for a better care of acute COVID-19 and prevention of long COVID-19.

METHODS: PubMed, Embase, Scopus, Web of science and Cochrane Central were systematically searched. Eligible publications included clinical studies reporting immune response to COVID-19 vaccination in CKD patients without dialysis or KT, CKD patients undergoing dialysis, as well as CKD patients with KT. Demographics, measurements and results of their humoral and cellular response were evaluated, and the quality of studies were assessed using the Joanna Briggs Institute (JBI) critical appraisal tool and the Newcastle-Ottawa quality assessment scale (NOS).

RESULTS: A total of 31 eligible studies were identified. A decreased proportion of patients with KT showed anti-S IgG positivity after the 2[nd] (67%) and 3[rd] (56.6%) dose of vaccination. Similarly, a decreased proportion of these patients presented S-specific T-cell response after the 2[nd] (17.7%) and 3[rd] (12.9%) dose. Though lower anti-S IgG titers in patients with CKD or on dialysis, as well as T-cell response in patients on dialysis were reported to be lower after the 2[nd] or 3[rd] dose of vaccination, conflicting results were reported by other studies. Limited studies on correlated change between humoral and cellular immune response revealed a low rate of co-presence of the two in patients with dialysis, though antibody level was correlated with rate of cellular response, while no such correlation was revealed in patients with KT.

CONCLUSION: The study provides crucial information on features of humoral and cellular immune responses to COVID-19 vaccinations in CKD patients, and suggests possible directions for strategy of management such as antibody monitoring, additional booster dose or immunomodulatory therapies not only for acute COVID-19 but also for long COVID-19.},
}

Humans
*COVID-19/immunology/prevention & control
*Immunity, Humoral
*Renal Insufficiency, Chronic/immunology/therapy
*Immunity, Cellular
*SARS-CoV-2/immunology
*COVID-19 Vaccines/immunology
Antibodies, Viral/blood/immunology
Vaccination

@article {pmid41234979,
year = {2025},
author = {Liu, Y},
title = {What Has SARS-CoV-2 Taught Us About Evolution?.},
journal = {Cureus},
volume = {17},
number = {10},
pages = {e94502},
pmid = {41234979},
issn = {2168-8184},
abstract = {Over the past five and a half years, SARS-CoV-2 has demonstrated in real time many concepts and principles of evolutionary biology. Soon after it was disseminated globally, the virus underwent adaptive radiation, resulting in the generation of multiple dominant variants. Later variants drove earlier ones to extinction in a series of selective sweeps. The nature of adaptation was shifting molecular specialization, with the spike protein losing binding affinity toward bat cells to gain affinity toward human cells, losing replicative fitness in lung cells to gain fitness in nasal cells. Evolution of the spike protein was constrained between two beneficial results: enhancing receptor binding and evading neutralizing antibodies. Because there are limited ways of functional improvement, multiple variants converged on the same spike mutations, with higher-impact mutations fixed before lower-impact mutations, giving a new meaning to diminishing-returns epistasis. Later genetic changes became repetitive and cyclical. The Delta variant represented an evolutionary dead end. Evolution of the virus also demonstrated punctuated equilibrium, with saltatory changes producing highly mutated variants, which subsequently experienced gradual structural and functional drifts. While structural proteins experienced strong positive and purifying selections, nonstructural and accessory proteins accumulated neutral and deleterious mutations, most of which remain unfixed. Selection of adaptive missense mutations resulted in deoptimization of codon usage. These phenomena point to Muller's ratchet in action. The higher codon usage score in the initial Omicron variant was probably due to long-term preservation of the virus in an immunocompromised host, where low immune pressure prevented genetic degradation.},
}

@article {pmid41234654,
year = {2025},
author = {Kadivarian, S and Rostamian, M and Kooti, S and Dashtbin, S and Hosseinabadi, S and Abiri, R and Alvand, A},
title = {Diagnostic value comparative analysis of the commercial kits for the detection of SARS-CoV-2 in clinical samples: a systematic review and meta-analysis.},
journal = {Iranian journal of microbiology},
volume = {17},
number = {5},
pages = {669-681},
pmid = {41234654},
issn = {2008-3289},
abstract = {BACKGROUND AND OBJECTIVES: Rapid and accurate identification of suspicious SARS-CoV-2 patients is essential in controlling the infection. Numerous commercial kits are developed which target diverse regions of the SARS-CoV-2 virus genome. This systematic review addresses the lack of comprehensive analyses comparing the diagnostic value of commercial kits for SARS-CoV-2 detection. We aimed to compare diagnostic value of commercial SARS-CoV-2 kits in clinical samples using a systematic review and meta-analysis method.

MATERIALS AND METHODS: A comprehensive search was conducted on main databases of Medline (PubMed), Embase, Web of Science and Scopus from 2019 to October 2021 using the appropriate keywords. Systematic Reviews and Meta-Analysis guideline PRISMA checklist was used to select eligible studies.

RESULTS: The most frequent introduced kits were from USA (33 cases) and China (27). Among all studies, 11, 9 and 7 papers had assessed FDA -CDC, Sansure and Allplex kits, respectively. The majority of the kits were based on RT-PCR (52 cases) and the most frequent genes target was N protein (63 cases). The overall sensitivity of the kits was 80.5%. The lowest sensitivity was reported for Daan Kit, while the highest sensitivity was seen for many kits. The specificity of the kits ranged from 87.9% to 99.8% and the overall specificity was 97.9%. Both PPV and NPV of the kits ranged from 87.9% to 99.8% for PPV and 82.9% to 99.8% for NPV.

CONCLUSION: Based on DOR obtained from three different formulas, GeneFinder, InBios, NxTAG, Simplexa and FDA-CDC kit have better detection performance. The GeneFinder Kit appears to be among the more suitable options regarding cost-effectiveness for each reaction.},
}

@article {pmid41233199,
year = {2025},
author = {Lertamornkitti, N and Britton, PN},
title = {Measles is misery: A brief update for paediatricians.},
journal = {Paediatric respiratory reviews},
volume = {},
number = {},
pages = {},
doi = {10.1016/j.prrv.2025.10.003},
pmid = {41233199},
issn = {1526-0550},
abstract = {Measles is an important vaccine-preventable disease that has re-emerged in recent years. Since the COVID-19 pandemic, interruptions to routine immunisation programs and declining vaccine coverage have altered the incidence and patterns of respiratory virus infections. Global outbreaks have intensified, and vaccine hesitancy is recognised as major health threat. Revisiting the clinical presentation of measles is crucial for early diagnosis and to reduce transmission of this highly contagious infection. As serious respiratory and neurological complications can follow natural infection and no specific antiviral therapy is available, vaccination remains the most effective strategy for prevention and control.},
}

@article {pmid41232510,
year = {2025},
author = {Korber, B and Fischer, W and Theiler, J},
title = {Real-time monitoring of SARS-CoV-2 evolution during the COVID-19 pandemic.},
journal = {Cell host & microbe},
volume = {33},
number = {11},
pages = {1802-1806},
doi = {10.1016/j.chom.2025.10.013},
pmid = {41232510},
issn = {1934-6069},
mesh = {*COVID-19/virology/epidemiology ; *SARS-CoV-2/genetics ; Humans ; *Evolution, Molecular ; Pandemics ; Mutation ; },
abstract = {The global response to COVID-19 during the pandemic resulted in an unprecedented view of viral evolution. Here, we discuss both the capacity of the scientific community to monitor viral evolution on a global scale in real time and the mutational mechanisms and selective forces that shaped the evolution of SARS-CoV-2.},
}

*COVID-19/virology/epidemiology
*SARS-CoV-2/genetics
Humans
*Evolution, Molecular
Pandemics
Mutation

@article {pmid41232270,
year = {2025},
author = {Liu, B and Liu, C and Sunggip, C and Pu, G and Deng, D},
title = {Viruses in gastrointestinal cancers: Molecular pathogenesis, oncogenic mechanisms, and translational perspectives.},
journal = {Molecular aspects of medicine},
volume = {106},
number = {},
pages = {101415},
doi = {10.1016/j.mam.2025.101415},
pmid = {41232270},
issn = {1872-9452},
abstract = {Viral pathogens are one of the most significant causes of human carcinogenesis, contributing to up to 15-20 % of worldwide cancers. The gastrointestinal (GI) tract is one of the most vulnerable human organ system to virus-mediated tumorigenesis as a result of frequent exposure to viral infections and various immunological processes. The present review aims to describe the dual roles of viral infections in the development of gastrointestinal cancers (GICs), with a focus on Human Immunodeficiency Virus (HIV) and Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). HIV represents an oncological challenge in the era of effective antiretroviral therapy (ART), where significant immune dysfunction, persistent inflammation, and gut microbiome disruption render infected patients more susceptible to various GICs. On the other hand, SARS-CoV-2 is an emerging viral pathogen whose potential role in oncogenesis remains controversial yet biologically plausible. In this context, SARS-CoV-2 tropism to the gastrointestinal tissues and its capacity to drive cytokine storms, profound dysbiosis, and immune exhaustion raise significant questions regarding its potential to act as a pro-tumorigenic factor. Discussing mechanistic insights from well-known oncogenic viral pathogens, the present review describes the direct and indirect mechanisms by which these two major viruses may affect GI tumorigenesis. Moreover, this review translates these mechanisms into clinical perspectives, underscoring implications for diagnostics, prevention, and therapeutic strategies, while highlighting urgent research priorities for long-term surveillance and biomarker discovery. It highlights the importance of continuous scientific awareness to address the increasing cancer risks presented by emerging and re-emerging viruses through bridging virology and oncology.},
}

@article {pmid41231197,
year = {2025},
author = {Bermúdez Endrino, LM and Berral García, A and Gómez Peña, B and Uclés-Torrente, MDM and Aparicio-Martinez, P},
title = {Efficacy of technology interventions in preventing depression among older adults experiencing social isolation: a systematic review and meta-analysis.},
journal = {Aging & mental health},
volume = {},
number = {},
pages = {1-13},
doi = {10.1080/13607863.2025.2585501},
pmid = {41231197},
issn = {1364-6915},
abstract = {OBJECTIVES: The global rise in the aging population, intensified by the COVID-19 pandemic, has increased loneliness, social isolation, and depression among older adults. This review aimed to examine the relationships between these psychological challenges and to assess the effectiveness of Information and Communication Technology (ICT)-based interventions in mitigating them.

METHOD: A systematic review and meta-analysis were conducted following PRISMA guidelines. Studies published within the last five years were retrieved from PubMed, Web of Science, Scopus, and CINAHL. Methodological quality was assessed using CONSORT and STROBE, and quantitative synthesis was performed with RevMan 5.4.1.

RESULTS: Thirteen studies, including experimental and observational designs, met the inclusion criteria; 61.5% analysed pandemic effects and 38.5% evaluated ICT interventions. Depression, loneliness, and social isolation were strongly associated, with the pandemic worsening outcomes, while pre-pandemic isolation predicted poorer mental health. ICT interventions significantly reduced depression (78% reduction; 95% CI 0.15-0.33; OR = 0.22) and anxiety (80% reduction; 95% CI 0.10-0.32; OR = 0.20), though their impact on social isolation was limited (95% CI 0.87-1.19; OR = 1.07).

CONCLUSION: ICT interventions effectively reduce depression and anxiety but have limited effects on social isolation, highlighting the need for long-term evaluation and community-based strategies to improve emotional well-being in older adults.},
}

@article {pmid41228476,
year = {2025},
author = {Rizzi, M and Manzoni, P and Germano, C and Quevedo, MF and Sainaghi, PP},
title = {Lactoferrin, a Natural Protein with Multiple Functions in Health and Disease.},
journal = {Nutrients},
volume = {17},
number = {21},
pages = {},
pmid = {41228476},
issn = {2072-6643},
mesh = {*Lactoferrin/therapeutic use/metabolism/physiology/pharmacology ; Humans ; COVID-19 ; Biomarkers/metabolism ; SARS-CoV-2 ; Enterocolitis, Necrotizing/drug therapy ; },
abstract = {Lactoferrin is a multifunctional glycoprotein showing multiple biological properties (antimicrobial, antiviral, antioxidant, antigenotoxic, prebiotic, probiotic) that play an essential role in maintaining host physiological homeostatic condition by exerting immunomodulatory and anti-inflammatory activities. Thanks to these biological properties, lactoferrin has widely been studied as a therapeutic agent in gastroenteric diseases, neonatal sepsis and necrotizing enterocolitis, lung diseases, and COVID-19, showing very heterogeneous results based on the disease considered and the population studied. Since lactoferrin is one of the main components of neutrophils' secondary granules, it has also been investigated as a potential disease-monitoring biomarker, especially for diseases in which inflammation is a key component. This narrative review offers updated and comprehensive insights into the available literature on lactoferrin biology, biological properties, and clinical utility.},
}

*Lactoferrin/therapeutic use/metabolism/physiology/pharmacology
Humans
COVID-19
Biomarkers/metabolism
SARS-CoV-2
Enterocolitis, Necrotizing/drug therapy

@article {pmid41228189,
year = {2025},
author = {Sorina, E and Novacescu, D and Barb, AC and Ciolofan, A and Dumitru, CS and Zara, F and Patrascu, R and Enache, A},
title = {From Burnout to Resilience: Addressing Moral Injury in Nursing Through Organizational Innovation in the Post-Pandemic Era.},
journal = {Healthcare (Basel, Switzerland)},
volume = {13},
number = {21},
pages = {},
pmid = {41228189},
issn = {2227-9032},
abstract = {The COVID-19 pandemic has profoundly amplified burnout and moral injury among nurses, exposing structural vulnerabilities in healthcare systems and accelerating workforce attrition. Beyond the acute crisis, nurses continue to face chronic staff shortages, overwhelming workloads, and unresolved ethical tensions that compromise both well-being and quality of care. Synthesis of recent meta-analyses in this review indicates that nurse burnout during the pandemic ranged between 30% and 50%, illustrating the magnitude of the problem. Particular attention is given to innovative organizational strategies that foster resilience, including workload redistribution, enhanced professional autonomy, supportive leadership, and the integration of digital technologies such as telecare. Comparative perspectives across healthcare systems illustrate how policy reforms, staffing models, and ethical frameworks can mitigate psychological distress and strengthen organizational resilience. By reframing burnout and moral injury not only as individual challenges but as systemic phenomena requiring structural solutions, this review emphasizes the imperative of multilevel interventions. Building resilient nursing workforces through innovation, leadership, and evidence-based policies is essential for sustaining high-quality patient care in the post-pandemic era.},
}

@article {pmid41228128,
year = {2025},
author = {Shah, ST and Ali, Z and Waqar, M and Kim, A},
title = {Federated Learning in Public Health: A Systematic Review of Decentralized, Equitable, and Secure Disease Prevention Approaches.},
journal = {Healthcare (Basel, Switzerland)},
volume = {13},
number = {21},
pages = {},
pmid = {41228128},
issn = {2227-9032},
support = {TP-2025-RS-2024-00437191//MSIT/ ; SBA-QT240015//National Research Foundation (NRF)/ ; },
abstract = {Background and Objectives: Public health needs collaborative, privacy-preserving analytics, but centralized AI is constrained by data sharing and governance. Federated learning (FL) enables training without moving sensitive data. This review assessed how FL is used for disease prevention in population and public health, and mapped benefits, challenges, and policy implications. Methods: Following PRISMA 2020, we searched PubMed, Scopus, Web of Science, IEEE Xplore, and Google Scholar for peer reviewed English-language studies from January 2020-30 June 2025, applying FL to surveillance, outbreak detection, risk prediction, or policy support. Two reviewers screened and extracted data with third-reviewer arbitration. Quality was appraised with a tool adapted from MMAT and AI reporting frameworks. No meta-analysis was performed. Results: Of 5230 records identified (4720 after deduplication), 200 full texts were assessed and 19 were included. Most used horizontal FL across multiple institutions for communicable diseases, COVID-19, tuberculosis and some chronic conditions. Reported gains included privacy preservation across sites, better generalizability from diverse data, near real-time intelligence, localized risk stratification, and support for resource planning. Common barriers were non-IID data, interoperability gaps, compute and network limits in low-resource settings, unclear legal pathways, and concerns about fairness and transparency. Few studies linked directly to formal public-health policy or low-resource deployments. Conclusions: FL is promising for equitable, secure, and scalable disease-prevention analytics that respect data sovereignty. Priorities include robust methods for heterogeneity, interoperable standards, secure aggregation, routine fairness auditing, clearer legal and regulatory guidance, and capacity building in underrepresented regions.},
}

@article {pmid41228085,
year = {2025},
author = {Lai, YH and Chang, MY and Wang, CC},
title = {Applying Meta-Analytic Structural Equation Modeling to Examine the Relationships Among Work Stress, Job Burnout, and Turnover Intention in Taiwanese Nurses.},
journal = {Healthcare (Basel, Switzerland)},
volume = {13},
number = {21},
pages = {},
pmid = {41228085},
issn = {2227-9032},
abstract = {Background/Objectives: Nursing staff are essential to healthcare delivery, yet Taiwan has experienced a significant rise in nurse turnover in recent years. Retention has thus become a critical concern for healthcare institutions. Identifying the factors influencing nurses' turnover intentions (TIs) and improving workplace conditions may help to reduce attrition. This study investigates the relationships among TI, work stress (WS), and job burnout (JB), examining variations across healthcare settings and comparing the periods before and after the COVID-19 pandemic. Methods: This study systematically reviews 28 studies published between 2011 and 2025, retrieved from Taiwan's Master's and Doctoral Thesis Knowledge Value Added System, Airiti Library, and Google Scholar. The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA) guidelines. The data were analyzed using a combined approach of meta-analysis and structural equation modeling. Results: The findings of this study indicate that WS has a statistically significant impact on TI (path coefficient = 0.281, 95% CI: 0.102 to 0.459, p = 0.002). Similarly, JB significantly influences TI (path coefficient = 0.342, 95% CI: 0.163 to 0.520, p < 0.001). WS also has a strong and significant effect on JB (path coefficient = 0.612, 95% CI: 0.485 to 0.739, p < 0.001). These results suggest that WS has a particularly strong effect on JB among nurses working in non-medical center hospitals in Taiwan. Additionally, no significant differences were found in the relationships among TI, WS, and JB before and after the COVID-19 pandemic. Conclusions: Based on the findings of this study, it is recommended that healthcare administrators closely monitor the stress experienced by nursing staff and identify the key factors that lead to WS and JB. Developing targeted policies for different healthcare settings may help to reduce nurses' intentions to leave their jobs.},
}

@article {pmid41228047,
year = {2025},
author = {Pizarro-Mena, R and Rotarou, ES and Baracaldo-Campo, HA and Duran-Aguero, S and Parra-Soto, S and Retamal-Walter, F and Wachholz, PA and Maranzano, S and Tirro, V and Aguilar-Navarro, S and Barrientos-Calvo, I and Carpio-Arias, V and Botello, C and López, MF and Mukamal, R and Tieppo, A and Cigarroa, I and Medola, F and Riveros-Basoalto, G},
title = {Implementation of Telehealth Among Older People: A Challenge and Opportunity for Latin America and the Caribbean-A Literature Review.},
journal = {Healthcare (Basel, Switzerland)},
volume = {13},
number = {21},
pages = {},
pmid = {41228047},
issn = {2227-9032},
abstract = {Although the COVID-19 pandemic negatively affected the health and quality of life of older people (OP), it provided an opportunity for the implementation of telehealth in the areas of Gerontology and Geriatrics, globally and in the countries of Latin America and the Caribbean, which enabled the continuity of healthcare interventions. Therefore, this literature review aimed to (a) conceptualize telehealth in OP through the lens of Gerontology and Geriatrics; (b) analyze the implementation, facilitators, and barriers of telehealth for OP during the COVID-19 pandemic at both global and Latin American and Caribbean regional levels; (c) identify lessons learned and considerations for improving implementation and reducing barriers to telehealth for OP; and (d) discuss challenges related to the integration of telehealth for OP in the region. The databases consulted were PubMed, Scopus, and Scielo; scientific articles in both English and Spanish were considered, including research conducted globally and in Latin American and Caribbean countries that contributed to the objectives of the literature review; the search was conducted from the year 2020 onwards. In addition, government documents and non-governmental technical guidelines from countries in the region were included, whether they focused specifically on older populations or the general population; the search was not limited to a specific time period. Initially, in our search strategy, 1631 scientific articles and 20 governmental and non-governmental documents were identified for the literature review. After eliminating duplicate and applying the inclusion and exclusion criteria, 84 documents were selected for the literature review (46 analyzed the implementation, barriers, and facilitators of telehealth during the COVID-19 pandemic). This literature review presents a conceptual analysis of the implementation and facilitators of, as well as barriers to, telehealth among OP during the COVID-19 pandemic from the perspective of healthcare providers and OP themselves. The paper synthesizes a number of international and Latin American experiences and proposes several recommendations for the implementation of telehealth for OP in the Latin American and Caribbean region. Despite the ongoing challenges regarding telehealth research and training, this review describes telehealth for OP as an intervention approach that improves the provision of holistic care, favoring OP autonomy, functionality, and overall quality of life. This review also proposes telehealth as a regular intervention approach to clinical practice in Gerontology and Geriatrics in the region. Collaborative endeavors are needed to further regulate and promote public policy on telehealth, telemedicine and telerehabilitation for OP.},
}

@article {pmid41226854,
year = {2025},
author = {Zakynthinos, GE and Kokkinos, NK and Tzima, IG and Dimeas, IE and Gialamas, I and Gerostathis, A and Katsarou, O and Tsatsaragkou, A and Kalogeras, K and Oikonomou, E and Siasos, G},
title = {One Enzyme, Many Faces: The Expanding Role of DPP3 in Cardiovascular and Critical Care.},
journal = {Journal of clinical medicine},
volume = {14},
number = {21},
pages = {},
pmid = {41226854},
issn = {2077-0383},
abstract = {Dipeptidyl peptidase 3 (DPP3) is a zinc-dependent aminopeptidase that is found in several places and is thought to be a cytosolic enzyme that helps break down peptides. Recent studies, however, have revealed its extensive therapeutic relevance upon release into circulation, functioning not only as a biomarker for cellular injury but also as an active modulator of cardiovascular homeostasis and critical disease. High levels of circulating DPP3 (cDPP3) have been linked to the causes of cardiogenic shock, septic shock, acute coronary syndromes, heart failure, and serious viral diseases like COVID-19. Its enzymatic breakdown of angiotensin II disrupts vascular tone and myocardial contractility, leading to hemodynamic instability and multi-organ failure. In numerous cohorts, cDPP3 levels reliably correspond with disease severity, acute renal damage, and death, but dynamic trajectories yield superior predictive information relative to single assessments. In addition to risk stratification, translational studies utilizing rodent and porcine models illustrate that antibody-mediated inhibition of cDPP3 with the humanized monoclonal antibody Procizumab reinstates cardiac function, stabilizes renal perfusion, diminishes oxidative stress and inflammation, and enhances survival. First-in-human experiences in patients with refractory septic cardiomyopathy have further emphasized its therapeutic promise. DPP3 is a good example of a biomarker and a mediator in cardiovascular and critical care. Its growing clinical and translational profile makes cDPP3 a strong predictor of bad outcomes and a prospective target for treatment. Ongoing clinical trials using Procizumab will determine if neutralizing cDPP3 can lead to enhanced outcomes in individuals with cardiogenic and septic shock. This review outlines the physiological mechanisms, clinical implications, and emerging therapeutic potential of DPP3 in cardiovascular and critical care. Ongoing trials with Procizumab will clarify whether neutralizing cDPP3 can improve outcomes in patients with cardiogenic and septic shock.},
}

@article {pmid41226731,
year = {2025},
author = {Varghese, S and Al-Hassani, I and Al-Aani, U and Rob, NJ and Al-Mannai, S and Jaguri, A and Yousif, RA and Al-Mulla, A and Palayangal, FF and Laws, S and Al-Ali, D and Zakaria, D},
title = {Long-Term Complications of Multisystem Inflammatory Syndrome in Children and Adults Post-COVID-19: A Systematic Review.},
journal = {International journal of molecular sciences},
volume = {26},
number = {21},
pages = {},
pmid = {41226731},
issn = {1422-0067},
mesh = {Humans ; *COVID-19/complications ; *Systemic Inflammatory Response Syndrome/complications/therapy/etiology ; Child ; Adult ; SARS-CoV-2 ; },
abstract = {The SARS-CoV-2 pandemic has posed global medical challenges due to its ability to affect multiple organ systems. Among the post-COVID-19 complications, multisystem inflammatory syndrome has emerged as a severe condition affecting both children (MIS-C) and adults (MIS-A). This review aims to compile and analyze published data to investigate clinical characteristics, laboratory findings, and outcomes of MIS post-COVID-19. A comprehensive search of various databases was conducted to identify studies reporting MIS-related complications in pediatric and adult populations post-COVID-19 infection. Screening, data extraction, and cross-checking were performed by two independent reviewers. Only 64 studies met our inclusion criteria, and compiled results revealed that cardiac complications were the predominant manifestation followed by gastrointestinal, hematologic, neurological, and mucocutaneous involvement. Laboratory findings consistently demonstrated elevated inflammatory markers including CRP, ferritin, D-dimer, and IL-6. Most patients required hospitalization, and many needed intensive care; treatment typically involved IVIG, corticosteroids, and biologic therapies. While most patients recovered, a subset experienced persistent complications. These findings highlight the importance of early recognition, multidisciplinary management, and structured follow-up for MIS. Future research is warranted to clarify the underlying mechanisms, risk factors, and long-term outcomes associated with MIS in post-COVID-19 patients.},
}

Humans
*COVID-19/complications
*Systemic Inflammatory Response Syndrome/complications/therapy/etiology
Child
Adult
SARS-CoV-2

@article {pmid41226415,
year = {2025},
author = {Zolotarenko, AD and Poghosyan, HM and Sheptiy, VV and Bruskin, SA},
title = {COVID-19 Hijacking of the Host Epigenome: Mechanisms, Biomarkers and Long-Term Consequences.},
journal = {International journal of molecular sciences},
volume = {26},
number = {21},
pages = {},
pmid = {41226415},
issn = {1422-0067},
support = {123120500032-9//Ministry of Science and Higher Education of the Russian Federation/ ; },
mesh = {Humans ; *COVID-19/genetics/virology/immunology/pathology ; *SARS-CoV-2/physiology ; *Epigenesis, Genetic ; *Epigenome ; Biomarkers/metabolism ; Immunity, Innate ; *Host-Pathogen Interactions/genetics ; MicroRNAs/genetics ; DNA Methylation ; },
abstract = {The epigenetics of COVID-19 is a rapidly expanding field that reveals how the SARS-CoV-2 virus initiates alterations in the host's genome, influencing the susceptibility to infection, the disease severity, and long-term consequences, known as "long COVID." In this review, we describe the mechanisms utilized by the virus to manipulate the host epigenome, suppressing antiviral responses and creating a favorable environment for viral replication. We also highlight virus-induced epigenetic changes across diverse cell populations that contribute to COVID-19 pathogenesis. Notably, the virus reprograms hematopoietic stem and progenitor cells, leading to long-lasting alterations in innate immunity, a phenomenon known as "trained immunity." These epigenetic modifications are maintained in differentiated daughter cells and may explain the persistent inflammation and other symptoms of long COVID. Furthermore, we discuss emerging epigenetic biomarkers of disease severity, including methylation signatures in genes such as AIM2, HLA-C, and PARP9, as well as dysregulated miRNA profiles. Understanding this complex interplay between the virus and the host's epigenetic landscape is crucial for developing new therapeutic approaches that target specific epigenetic modifications to suppress pathological processes and improve clinical outcomes for COVID-19 patients.},
}

Humans
*COVID-19/genetics/virology/immunology/pathology
*SARS-CoV-2/physiology
*Epigenesis, Genetic
*Epigenome
Biomarkers/metabolism
Immunity, Innate
*Host-Pathogen Interactions/genetics
MicroRNAs/genetics
DNA Methylation

@article {pmid41225670,
year = {2025},
author = {Wolfe, H and Shepherd, CB and Lee, R and Oliver-Pyatt, W},
title = {Real-world patient outcomes for telehealth-delivered, remote eating disorder treatment: a scoping review.},
journal = {Journal of eating disorders},
volume = {13},
number = {1},
pages = {259},
pmid = {41225670},
issn = {2050-2974},
abstract = {BACKGROUND: Only 30% of individuals with eating disorders receive specialized treatment. While preliminary evidence suggests that telehealth-delivered, remote eating disorder treatment may offer improved accessibility with similar effectiveness to in-person treatment, research on these services remains limited, particularly regarding the communities that are disproportionately affected by barriers to standard care. This scoping review sought to map the existing research on real-world patient outcomes in remote eating disorder treatment, identify knowledge gaps, and prioritize areas for future studies.

METHODS: This review followed the Joanna Briggs Institute methodology for scoping reviews. It comprises observational evaluations of telehealth-delivered, remote eating disorder treatment conducted in routine clinical settings. An electronic database search was performed in PsycINFO, PubMed, and ProQuest Dissertations & Theses Global in August 2024 and updated in September 2025.

RESULTS: Following the search and screening process, 27 articles, comprising six case reports and 21 cohort/case series designs, were deemed eligible for inclusion. Remote treatments evaluated differed across level of care, therapeutic modalities, provider types, dosage, and adjunctive technologies used. Just under half of the studies compared outcomes from remote and in-person treatment, while the remainder examined remote treatment alone. Articles were published between 2011 and 2025 and, when excluding case reports, nearly 60% evaluated programs that rapidly transitioned to remote delivery due to COVID-19. While demographic reporting was limited and inconsistent, available information indicated that participants ranged from three to 75 years old and were predominantly White, cisgender women/females diagnosed with anorexia nervosa. Though preliminary, findings tentatively suggest that remote eating disorder treatment can yield improvements across core outcome domains, largely comparable to in-person settings. Less is known about how outcomes may differ across demographic groups.

CONCLUSIONS: Overall, this body of literature remains small and characterized by limitations and inconsistencies, including differences in the treatment services evaluated as well as disparities in study design, methodology, and reporting. Utilization of remote treatment by historically excluded groups remains low, calling for further reflection around its accessibility for target communities. Additional studies with more rigorous, intentional designs are needed. The field would also benefit from standardization in relation to data collection and reporting to allow for better synthesis of findings.},
}

@article {pmid41225329,
year = {2025},
author = {Kabadayı, G and Atay, Ö and Baysal Bakır, D and Yağmur, H and Kaşıkçı Mermer, ET and Okur Acar, S and Öztürk Yılmaz, Ş and Hazan, F and Gözmen, S and Uzuner, N},
title = {Expanding the clinical spectrum of Cernunnos/XLF deficiency: a literature review of a rare cause of severe combined immunodeficiency including a novel case.},
journal = {BMC immunology},
volume = {26},
number = {1},
pages = {89},
pmid = {41225329},
issn = {1471-2172},
mesh = {Humans ; *Severe Combined Immunodeficiency/genetics/diagnosis/therapy ; Infant ; *DNA-Binding Proteins/genetics/deficiency ; Male ; Hematopoietic Stem Cell Transplantation ; Mutation ; *DNA Repair Enzymes/genetics ; Female ; Genetic Association Studies ; },
abstract = {BACKGROUND: Severe combined immunodeficiency (SCID) is a congenital immunodeficiency characterized by significant numerical or functional defects in T lymphocytes and is often accompanied by B lymphocyte dysfunction. It presents early in life with severe, recurrent opportunistic infections. Early diagnosis and hematopoietic stem cell transplantation (HSCT) are vital for patient survival. Cernunnos/XLF deficiency is an autosomal recessive form of SCID caused by mutations in the NHEJ1 gene, which plays a critical role in repairing DNA double-strand breaks. First described in 2006, this condition remains exceedingly rare, with only about 55 cases reported to date. This study aimed to describe a novel infant with Cernunnos/XLF deficiency and to review previously reported patients carrying the same variant, thereby expanding the clinical spectrum of this rare disease.

METHODS: With written informed consent, we retrospectively evaluated a pediatric patient with Cernunnos/XLF deficiency followed at our clinic. Demographic, clinical, laboratory, and radiological findings were reviewed. The diagnosis was based on clinical and immunological features and confirmed via clinical exome sequencing. A literature review was conducted to compare the genotype-phenotype correlations of previously reported patients carrying the same NHEJ1 variant.

RESULTS: We report an infant who was hospitalized at 6.5 months of age with a preliminary diagnosis of meningitis and was subsequently diagnosed with Cernunnos/XLF deficiency. The patient exhibited microcephaly, growth retardation, recurrent infections, prolonged SARS-CoV-2 PCR positivity, and localized BCGitis following live Bacillus Calmette-Guérin (BCG) vaccination. Immunological evaluation revealed T- and B-cell lymphopenia and hypogammaglobulinemia. Genetic testing confirmed a homozygous nonsense mutation in NHEJ1. HSCT from a matched sibling donor was performed.

CONCLUSION: This study describes a rare case of Cernunnos/XLF deficiency diagnosed in early infancy, underscoring the value of early recognition and the critical role of genetic testing and HSCT. It also expands the clinical spectrum of the disease and provides a comparative perspective with previously reported patients carrying the same mutation. In infants presenting with unexplained infections or complications related to live vaccines, inborn errors of immunity should be considered. Our findings emphasize the importance of timely diagnosis and comprehensive, multidisciplinary follow-up, particularly in patients with additional complications.},
}

Humans
*Severe Combined Immunodeficiency/genetics/diagnosis/therapy
Infant
*DNA-Binding Proteins/genetics/deficiency
Male
Hematopoietic Stem Cell Transplantation
Mutation
*DNA Repair Enzymes/genetics
Female
Genetic Association Studies

@article {pmid41225237,
year = {2025},
author = {Bordoloi, S and Singh, SC and Bayry, J},
title = {COVID-19-associated Autoimmune and Inflammatory Diseases: Molecular Mechanisms and the Role of IVIG Therapy.},
journal = {Clinical reviews in allergy & immunology},
volume = {68},
number = {1},
pages = {99},
pmid = {41225237},
issn = {1559-0267},
mesh = {Humans ; *COVID-19/immunology/complications/therapy ; *Immunoglobulins, Intravenous/therapeutic use ; *SARS-CoV-2/immunology ; *Autoimmune Diseases/immunology/therapy/etiology ; COVID-19 Drug Treatment ; *Inflammation/immunology ; },
abstract = {The emergence of SARS-CoV-2 has not only reshaped our understanding of viral pathogenesis but also highlighted its capacity to trigger autoimmune and inflammatory diseases. Accumulating evidence indicates that SARS-CoV-2 infection can lead to a broad spectrum of immune-mediated complications, ranging from well-defined conditions such as Guillain-Barré syndrome, multisystem inflammatory syndrome in children (MIS-C), and systemic lupus erythematosus, to the development of diverse autoantibodies and atypical inflammatory phenotypes. This review synthesizes the current clinical and experimental evidence linking COVID-19 to autoimmune and inflammatory sequelae. We have provided a structured overview on the multifactorial mechanisms underpinning this immune dysregulation, including molecular mimicry, epitope spreading, bystander activation, cytokine storm, host genetic predisposition, and viral genomic variability. Additionally, we discussed the contribution of gut dysbiosis and metabolic reprogramming in shaping aberrant immune responses following infection. Special attention is given to the therapeutic potential of intravenous immunoglobulin (IVIG), which has shown promise in mitigating hyperinflammation and modulating autoimmunity in affected individuals. IVIG can provide therapeutic benefits by diverse mutually nonexclusive mechanisms. By integrating emerging insights across clinical immunology, virology, and host-pathogen interactions, this review aims to advance our understanding of COVID-19-induced immune complications and therapeutic strategies to manage post-COVID autoimmune and inflammatory syndromes.},
}

Humans
*COVID-19/immunology/complications/therapy
*Immunoglobulins, Intravenous/therapeutic use
*SARS-CoV-2/immunology
*Autoimmune Diseases/immunology/therapy/etiology
COVID-19 Drug Treatment
*Inflammation/immunology

@article {pmid41224444,
year = {2026},
author = {Limbach, KE and Fan, D and Melstrom, LG},
title = {Remote Telemonitoring and Telehealth in Surgical Oncology.},
journal = {Hematology/oncology clinics of North America},
volume = {40},
number = {1},
pages = {79-88},
doi = {10.1016/j.hoc.2025.07.007},
pmid = {41224444},
issn = {1558-1977},
mesh = {Humans ; *Telemedicine ; *Surgical Oncology/methods ; *COVID-19/epidemiology ; *Neoplasms/surgery ; Quality of Life ; SARS-CoV-2 ; Monitoring, Physiologic/methods ; },
abstract = {Remote monitoring and telehealth platforms have been of increasing interest since the beginning of the Corona Virus disease-2019 pandemic, with rising rates of implementation. Surgical oncology patients are a unique population that may derive a particular benefit from the use of such technology, which has been shown to be feasible and acceptable to patients and providers. Previous studies have shown benefits in quality of life and symptom severity as well as a decreased readmission rate in select surgical oncology clinical settings; however, further research is ongoing to more specifically determine how the use of remote telemonitoring will affect clinical outcomes including complications and cost.},
}

Humans
*Telemedicine
*Surgical Oncology/methods
*COVID-19/epidemiology
*Neoplasms/surgery
Quality of Life
SARS-CoV-2
Monitoring, Physiologic/methods

@article {pmid41224425,
year = {2025},
author = {Rowland, B and Sunkara, P and Hicks, MH and Khanna, AK},
title = {Remote Patient Monitoring to Support Rapid Discharge-Wearables.},
journal = {Advances in anesthesia},
volume = {43},
number = {1},
pages = {127-138},
doi = {10.1016/j.aan.2025.07.010},
pmid = {41224425},
issn = {1878-0415},
mesh = {Humans ; *Patient Discharge ; *COVID-19 ; *Wearable Electronic Devices ; Monitoring, Physiologic/methods ; Telemedicine ; Remote Patient Monitoring ; },
abstract = {The ability to remotely monitor patients after hospital discharge with near real-time feedback with an integrated health network represents a technological advancement that has shown promising results across surgical and medical domains including improvements in hospital length of stay, unplanned readmission, and mortality. COVID-19 and improvements in monitoring technology has catalyzed the increased use and evaluation of remote monitoring. In this article, we provide a landscape of remote monitoring and its role in postdischarge care to date across medical and surgical domains in adult medicine. We also address implementation, research, and ethical considerations for remote monitoring in clinical care.},
}

Humans
*Patient Discharge
*COVID-19
*Wearable Electronic Devices
Monitoring, Physiologic/methods
Telemedicine
Remote Patient Monitoring

@article {pmid41224292,
year = {2025},
author = {Browne, S and Kelly, MP and Bowers, B and Kuhn, I and Duschinsky, R and Daniels, C and Barclay, S},
title = {General practitioner care of residential aged care facility residents at end of life: a systematic literature review and narrative synthesis.},
journal = {BMJ open},
volume = {15},
number = {11},
pages = {e104243},
pmid = {41224292},
issn = {2044-6055},
mesh = {Humans ; *Terminal Care ; *Homes for the Aged ; *General Practitioners ; *Nursing Homes ; Aged ; *Palliative Care ; },
abstract = {OBJECTIVES: In 2023, 21% of deaths occurred in residential aged care facilities (RACFs), a setting expected to play an increasing role in palliative and end-of-life care (PEoLC). General practitioners (GPs) oversee and deliver PEoLC in residential and nursing homes, yet little is known about their practice. We conducted a systematic review of the published evidence concerning how GPs provide this care: what they do and the quality, challenges and facilitators of that care.

DESIGN: Systematic review and narrative synthesis using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses.

DATA SOURCES: Medline, Embase, CINAHL, PsycINFO, Web of Science, Scopus and NHS Evidence and grey literature via Google Scholar were searched through 9 October 2024.

ELIGIBILITY CRITERIA: We included studies presenting new empirical data from qualitative, quantitative or mixed methods, were published in the English language and conducted in the UK, the European Union, Australia, New Zealand and Canada. We excluded studies with no new empirical data, discussion papers, conference abstracts, opinion pieces, study participants under 18 years old and in care settings other than RACF.

DATA EXTRACTION AND SYNTHESIS: One independent reviewer used standardised methods to search and screen study titles for inclusion. This reviewer assessed all abstracts of the included papers, and a second independent reviewer screened 60% of the abstracts to validate inclusion. Risk of bias was assessed using Gough's Weight of Evidence assessment. Thematic analysis was used to describe the contents of the included papers; a narrative synthesis approach was taken to report the findings at a more conceptual level.

RESULTS: The search identified 5936 titles: 35 papers were eligible and included in the synthesis. This is a nascent evidence base, lacking robust research designs and characterised by small sample sizes; the results describe the factors observed to be important in the delivery of care. Care provision is extremely variable; no models of optimal care have been put forward or tested. Challenges to care provision occur at every level of the care system. At macro level, service-level agreements and policies vary: at meso level, team-working, communication technology solutions and equipment availability vary: at micro level, GPs' interests in providing PEoLC vary as does their training. No study addresses residents' and relatives' experiences and expectations of GPs' involvement in PEoLC in RACFs.

CONCLUSIONS: The limited evidence base highlights that GP care at end of life for RACF residents varies greatly, with enablers and challenges at all levels in the existing care systems. Little research has examined GP PEoLC for RACF residents in its own right; insight is derived from studies that report on this issue as an adjunct to the main focus. With national policies focused on moving more PEoLC into community settings, these knowledge deficits require urgent attention.},
}

Humans
*Terminal Care
*Homes for the Aged
*General Practitioners
*Nursing Homes
Aged
*Palliative Care

@article {pmid41224245,
year = {2025},
author = {Kurz, X and Cohet, C and Perez-Gutthann, S and Rao, S and Gardarsdottir, H},
title = {Strengthening Pharmacoepidemiology in a Changing Research Environment: The European Network of Centres for Pharmacoepidemiology and Pharmacovigilance (ENCePP).},
journal = {Pharmacoepidemiology and drug safety},
volume = {34},
number = {11},
pages = {e70263},
pmid = {41224245},
issn = {1099-1557},
mesh = {*Pharmacoepidemiology/methods/organization & administration/trends ; *Pharmacovigilance ; Humans ; Europe/epidemiology ; COVID-19/epidemiology ; },
abstract = {Key changes in the pharmacoepidemiological research environment had a significant influence on the activities of the European Network of Centres for Pharmacoepidemiology and Pharmacovigilance (ENCePP) over the last decade. These changes included the SARS-CoV-2 pandemic, the increased access to anonymized real-world data (RWD) sources, the integration of real-world evidence (RWE) into regulatory and public health decision-making, and the emergence of new technologies and methods. This paper describes how ENCePP has evolved in this changing environment to strengthen pharmacoepidemiological methods and practice in Europe and globally. It also provides future perspectives for the network. Through a collaborative approach in non-interventional research, ENCePP will collectively continue to promote excellence for RWE generation, supporting the safe and effective use of medicines.},
}

*Pharmacoepidemiology/methods/organization & administration/trends
*Pharmacovigilance
Humans
Europe/epidemiology
COVID-19/epidemiology

@article {pmid41224205,
year = {2025},
author = {Ebrahimi, F and Ebrahimi, R and Beer, M and Schönenberger, CM and Ewald, H and Briel, M and Janiaud, P and Hirt, J and Hemkens, LG},
title = {Colchicine for the secondary prevention of cardiovascular events.},
journal = {The Cochrane database of systematic reviews},
volume = {11},
number = {11},
pages = {CD014808},
pmid = {41224205},
issn = {1469-493X},
mesh = {Humans ; *Colchicine/administration & dosage/adverse effects/therapeutic use ; Randomized Controlled Trials as Topic ; *Secondary Prevention/methods ; Myocardial Infarction/prevention & control/mortality ; Stroke/prevention & control/mortality ; *Cardiovascular Diseases/prevention & control/mortality ; Cause of Death ; Hospitalization/statistics & numerical data ; Middle Aged ; Quality of Life ; Bias ; Aged ; Percutaneous Coronary Intervention/statistics & numerical data ; },
abstract = {RATIONALE: People with cardiovascular disease are at risk of recurrent major adverse cardiovascular events, and chronic low-grade inflammation may be a major underlying factor. Treatment with low-dose colchicine has been proposed for the secondary prevention of cardiovascular events in individuals at high cardiovascular risk. A previous Cochrane review showed considerable uncertainty regarding the benefits and harms of this approach.

OBJECTIVES: To evaluate the benefits and harms of low-dose colchicine in the prevention of cardiovascular events in adults with a history of stable CVD or following myocardial infarction or stroke.

SEARCH METHODS: We conducted a comprehensive search of the literature until February 2025 using Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, the drugs@FDA database, references of key papers, and references of included studies.

ELIGIBILITY CRITERIA: Randomised controlled trials (RCTs) comparing the use of low-dose colchicine for a minimum of six months versus any control intervention in patients of any age with cardiovascular disease (i.e. history of stable cardiovascular disease, previous myocardial infarction or stroke).

OUTCOMES: Our critical outcomes were all-cause mortality, myocardial infarction, and serious adverse events. Our important outcomes were cardiovascular mortality, stroke, all-cause hospitalisations, coronary revascularisation (percutaneous coronary intervention (PCI)/angioplasty or coronary artery bypass graft (CABG)), quality of life, and gastrointestinal adverse events (i.e. diarrhoea, nausea, abdominal pain, or vomiting).

RISK OF BIAS: Two authors independently assessed the risk of bias using the Cochrane RoB2 tool.

SYNTHESIS METHODS: We conducted meta-analyses using the random-effects model. We generated forest plots to facilitate visualisation of the data. We did not perform any subgroup analysis. We used GRADE to assess the certainty of evidence for all critical outcomes and for cardiovascular mortality, stroke, and coronary revascularisation. This was carried out by two review authors working independently.

INCLUDED STUDIES: We included 12 studies involving 22,983 randomised participants. The follow-up in the studies ranged from 6 to 80 months. Overall, 11,524 participants were assigned to low-dose colchicine treatment and 11,459 were assigned to a control intervention, which constituted either usual care plus placebo or usual care only. The doses of colchicine used were 0.5 mg once or twice daily. At baseline, the mean age of participants ranged from 57 to 74 years. Most participants (79.4%) were male.

SYNTHESIS OF RESULTS: There is high-certainty evidence that low-dose colchicine treatment reduces the risk of myocardial infarction, with a risk ratio (RR) of 0.74 (95% confidence interval (CI) 0.57 to 0.96; 22,153 participants, 8 studies; I[2] = 51%), yielding an absolute risk reduction of 9 fewer events (95% CI 16 fewer to 2 fewer) per 1000 patients, when the myocardial infarction rate is about 4% (36 events per 1000 patients) in the control group. There is also high-certainty evidence that low-dose colchicine reduces the risk of stroke with a RR of 0.67 (95% CI 0.47 to 0.95; 22,483 participants, 10 studies; I[2] = 40%), yielding an absolute risk reduction of 8 fewer events (95% CI 12 fewer to 1 fewer) per 1000 patients, when the stroke rate is about 2% (22 events per 1000 patients) in the control group. There is high-certainty evidence that the use of low-dose colchicine does not increase the rate of serious adverse events (RR 0.98, 95% CI 0.94 to 1.02; 15,677 participants, 4 studies; I[2] = 0%). However, gastrointestinal adverse events were more common under treatment with colchicine (RR 1.68, 95% CI 1.11 to 2.57; 22,185 participants, 10 studies; I[2] = 91%). For all other outcomes assessed, the evidence is of moderate certainty. Colchicine probably results in little to no difference in all-cause mortality (RR 1.01, 95% CI 0.84 to 1.21; 22,747 participants, 10 studies; I[2] = 1%; moderate-certainty evidence), in cardiovascular mortality (RR 0.94, 95% CI 0.73 to 1.22; 22,271 participants; 8 studies; I[2] = 13%; moderate-certainty evidence), and coronary revascularisation (RR 0.83, 95% CI 0.64 to 1.08; 13,705 participants, 5 studies; I[2] = 40%; moderate-certainty evidence). There is no evidence about the benefits or harms of colchicine on quality-of-life or on the risk of all-cause hospitalisation.

AUTHORS' CONCLUSIONS: People with cardiovascular disease using low-dose colchicine as secondary prevention for at least six months benefit from reduced rates of myocardial infarction and stroke, without an increase in serious adverse events. Moderate-certainty evidence did not show a benefit from low-dose colchicine for the risk of mortality (i.e. all-cause and cardiovascular mortality) or coronary revascularisation rates. Colchicine use was associated with an increased risk of gastrointestinal adverse events, which were typically described as mild and transient in nature. Additional studies are warranted to investigate the benefits and harms of low-dose colchicine in relevant subgroups and in specific indications, such as long-term use in individuals with stable coronary artery disease versus limited-time use following acute coronary syndrome.

FUNDING: Review author FE was supported by the Margot und Erich Goldschmidt & Peter René Jacobson Foundation. Review author CMS was supported by the Janggen Pöhn Foundation and the Swiss National Science Foundation (MD-PhD grant Number: 323530_221860).

REGISTRATION: This review is based on its protocol, which is available via DOI 10.1002/14651858.CD014808, and a previous review, which is available via DOI 10.1002/14651858.CD011047.pub2.},
}

Humans
*Colchicine/administration & dosage/adverse effects/therapeutic use
Randomized Controlled Trials as Topic
*Secondary Prevention/methods
Myocardial Infarction/prevention & control/mortality
Stroke/prevention & control/mortality
*Cardiovascular Diseases/prevention & control/mortality
Cause of Death
Hospitalization/statistics & numerical data
Middle Aged
Quality of Life
Bias
Aged
Percutaneous Coronary Intervention/statistics & numerical data

@article {pmid41224139,
year = {2025},
author = {Li, X and Oberlander, TF and Lebel, C},
title = {Natural experiments: Disasters and disease outbreaks as models of perinatal hardship and its effects on child brain and behavior.},
journal = {Neuroscience and biobehavioral reviews},
volume = {180},
number = {},
pages = {106475},
doi = {10.1016/j.neubiorev.2025.106475},
pmid = {41224139},
issn = {1873-7528},
abstract = {Human brain development begins in utero and is influenced by the environment. Numerous studies show effects of perinatal maternal psychological distress (e.g., depression) on child brain and behavior. Less attention has been paid to exposure to external real-world stressors (e.g., objective hardship), which are independent of individual characteristics. We systematically reviewed 39 human studies on perinatal maternal stress from natural disasters and disease outbreaks and associations with children's brain structure and function, behavior, and mental health. Studies have mainly focused on the 1998 Quebec Ice Storm or the COVID-19 pandemic, with a handful from other natural disasters. Prenatal maternal objective hardship is related to brain volumes and functional connectivity, though studies have been small and in overlapping samples; no studies to date have examined postnatal maternal objective hardship and brain. Disaster- and disease-related perinatal hardship is related to multiple domains of neurodevelopmental outcomes, including temperament, cognition, and behaviour, with generally negative outcomes (more hardship predicts worse cognition/behaviour). Early gestational exposure is more associated with cognition, though more research is needed to understand windows of vulnerability. The apparent effects of prenatal objective stress on child behavior may occur in part through child brain alterations. Future studies with larger samples are needed, particularly to understand the effects of exposure timing and type, to further investigate sex differences, and to clarify the role of postnatal maternal objective hardship. The COVID-19 pandemic presents a unique opportunity to do this, and several ongoing studies are likely to provide valuable insight in the coming years.},
}

@article {pmid41223978,
year = {2025},
author = {Spanoghe, M and Antonacci, T and Schneider, N and Molmans, THJ},
title = {Viewpoint | linking long Covid and AD(H)D through neuroimmune dysfunction: A translational framework proposal for precision medicine.},
journal = {Brain, behavior, and immunity},
volume = {131},
number = {},
pages = {106181},
doi = {10.1016/j.bbi.2025.106181},
pmid = {41223978},
issn = {1090-2139},
}

@article {pmid41223552,
year = {2025},
author = {Sharma, D and Sinha, R and Multisanti, CR and Faggio, C},
title = {From personal hygiene products to health threats: Triclosan and its impact on endocrine health.},
journal = {The Science of the total environment},
volume = {1006},
number = {},
pages = {180856},
doi = {10.1016/j.scitotenv.2025.180856},
pmid = {41223552},
issn = {1879-1026},
abstract = {Daily exposure to diverse emerging environmental pollutants raises significant concern, particularly regarding endocrine-disrupting chemicals such as triclosan (TCS). Notably, in the post-COVID-19 pandemic, strategies to manage the disease have increased the use of products formulated with antibacterial compounds like TCS. TCS has been used worldwide as a broad-spectrum antibacterial agent over the past four decades. Owing to its antibacterial and antifungal properties, it is an ingredient in an array of commercial products, such as personal care, medical, acrylic, veterinary, and household items. Recent data reveal its frequent presence and widespread exposure in natural environments and human tissues. Studies across multiple species provide compelling evidence of its endocrine-disrupting effects, especially concerning reproductive hormones. Several proposed mechanisms of action include interference with hormone metabolism, disruption of hormone-receptor binding, and inhibition of steroidogenic enzyme activity. This review aims to elucidate the sources, bioaccumulation patterns, and endocrine-disrupting effects of TCS in humans. Further extrapolating and discussing the impact on non-target organisms, including aquatic species and rodents. Thus, it will help in guiding further research and related underlying mechanisms.},
}

@article {pmid41223394,
year = {2025},
author = {Zamora, FV and Santos, ACFF and Zamora, AV and Galvao, LKCS and Pimenta, NDS and Salles, JPCEA and Carneiro, VB and Starling, CEF},
title = {Hyperbaric Oxygen Treatment for Long-COVID syndrome: A Systematic Review of Current Evidence on Cognitive Decline.},
journal = {Undersea & hyperbaric medicine : journal of the Undersea and Hyperbaric Medical Society, Inc},
volume = {52},
number = {3},
pages = {327-335},
pmid = {41223394},
issn = {1066-2936},
mesh = {Humans ; *Hyperbaric Oxygenation/methods ; *Cognitive Dysfunction/therapy/etiology ; *COVID-19/complications ; Executive Function ; Post-Acute COVID-19 Syndrome ; Attention ; Randomized Controlled Trials as Topic ; Fatigue/therapy ; },
abstract = {INTRODUCTION: There is no established specific treatment for long-COVID syndrome (LCS), yet hyperbaric oxygen (HBO2) treatment has been studied as a potential option. Therefore, we conducted a systematic review to evaluate the benefits of HBO2 treatment in LCS patients.

METHODS: We systematically searched PubMed, Embase, and Cochrane databases until April 2024. Risk of bias and GRADE quality assessment were evaluated. This study was registered in the International Prospective Register of Systematic Reviews (PROSPERO) with ID CRD42024530421.

RESULTS: Seven studies from seven countries, divided into RCTs and observational studies, included 199 participants. HBO₂ treatment protocols included breathing 100% oxygen at 2.0 ATA until 2.5 ATA; the number of sessions varied from ten to 60 depending on the patient's comorbidities and symptoms. Memory, executive function, attention, fatigue, and pain level improved with HBO2 treatment. The intervention had minimal side effects, and none were serious.

CONCLUSION: HBO₂ treatment might be a potential option and safe treatment in LCS patients. However, further research should be focused on evaluating its efficacy in a larger number of patients through randomized studies.},
}

Humans
*Hyperbaric Oxygenation/methods
*Cognitive Dysfunction/therapy/etiology
*COVID-19/complications
Executive Function
Post-Acute COVID-19 Syndrome
Attention
Randomized Controlled Trials as Topic
Fatigue/therapy

@article {pmid41223266,
year = {2025},
author = {Camacho-García, M and Serrano-Macías, M and Ortega-Martin, E and Alvarez-Galvez, J},
title = {Drivers of health polarization during the COVID-19 pandemic: A systematic review.},
journal = {Science advances},
volume = {11},
number = {46},
pages = {eady5064},
pmid = {41223266},
issn = {2375-2548},
mesh = {Humans ; *COVID-19/epidemiology/psychology ; *Public Health ; Pandemics ; SARS-CoV-2 ; Politics ; Socioeconomic Factors ; Social Media ; Communication ; Trust ; },
abstract = {Health polarization has emerged as a critical factor shaping public health attitudes and behaviors, particularly during crises such as the COVID-19 pandemic. This study provides a systematic review of the key determinants driving health polarization, highlighting the complex interplay of political, social, economic, and psychological factors. By synthesizing findings from 90 studies, we identify six primary drivers: political ideology and partisanship, misinformation and disinformation, social media structures and dynamics, trust in health institutions and professionals, risk and public health perceptions, and socioeconomic factors. Our analysis reveals how these determinants reinforce societal divisions, exacerbate health inequalities, and influence adherence to public health measures. Furthermore, we discuss the implications of these findings for designing effective interventions that address the root causes of health polarization. Understanding the mechanisms underlying these divisions is essential for mitigating their negative impact on public health and fostering more cohesive, evidence-based health communication strategies.},
}

Humans
*COVID-19/epidemiology/psychology
*Public Health
Pandemics
SARS-CoV-2
Politics
Socioeconomic Factors
Social Media
Communication
Trust

@article {pmid41223086,
year = {2025},
author = {Udi, Y and Aitchison, JD and Rout, MP and Obado, S},
title = {Breaking Barriers: Respiratory Viral Strategies Targeting the Host's Nuclear Pore Complex and Nuclear Transport Pathways.},
journal = {Molecular biology of the cell},
volume = {},
number = {},
pages = {mbcE25070322},
doi = {10.1091/mbc.E25-07-0322},
pmid = {41223086},
issn = {1939-4586},
abstract = {From stealthy infiltrators to blunt-force saboteurs, many human viruses-perhaps all-disrupt nuclear transport to control host gene expression, suppress immune responses, and redirect cellular resources toward their own replication. Among them, respiratory viruses stand out for their global impact and relentless evolution, from seasonal scourges to pandemic threats. Focusing on adenoviruses, influenza, rhinoviruses, RSV and SARS-CoV-2, we explore a series of molecular case studies that reveal both shared strategies and the diverse molecular innovations these respiratory pathogens use to subvert the nuclear transport machinery. We organize these tactics into six recurring strategies: NPC docking and nuclear entry, inhibition of immune-factor import, hijacking nuclear protein transport and karyopherins, sabotage of host mRNA export, degradation of FG-Nups, and exploitation of mitotic nuclear envelope breakdown. These insights not only illuminate fundamental virus-host conflicts but may also point the way toward new therapeutic vulnerabilities in the viruses' attack strategies.},
}

@article {pmid41222338,
year = {2025},
author = {Serrano-Lázaro, A and Portillo-Cortez, K and de la Mora Mojica, MB and Durán-Álvarez, JC},
title = {A Review on ZnO Nanostructures for Optical Biosensors: Morphology, Immobilization Strategies, and Biomedical Applications.},
journal = {Nanomaterials (Basel, Switzerland)},
volume = {15},
number = {21},
pages = {},
pmid = {41222338},
issn = {2079-4991},
abstract = {ZnO nanostructures have attracted attention as transducer materials in optical biosensing platforms due to their wide bandgap, defect-mediated photoluminescence, high surface-to-volume ratio, and tunable morphology. This review examines how the dimensionality of ZnO nanostructures affects biosensor performance, particularly in terms of charge transport, signal transduction, and biomolecule immobilization. The synthesis approaches are discussed, highlighting how they influence crystallinity, defect density, and surface functionalization potential. The impact of immobilization strategies on sensor stability and sensitivity is also assessed. The role of ZnO in various optical detection schemes, including photoluminescence, surface plasmon resonance (SPR), localized (LSPR), fluorescence, and surface-enhanced Raman scattering (SERS), is reviewed, with emphasis on label-free and real-time detection. Representative case studies demonstrate the detection of clinically and environmentally relevant targets, such as glucose, dopamine, cancer biomarkers, and SARS-CoV-2 antigens, with limits of detection in the pico- to femtomolar range. Recent developments in ZnO-based hybrid systems and their integration into fiber-optic and microfluidic platforms are explored as scalable solutions for portable, multiplexed diagnostics. The review concludes by outlining current challenges related to reproducibility, long-term operational stability, and surface modification standardization. This work provides a framework for understanding structure-function relationships in ZnO-based biosensors and highlights future directions for their development in biomedical and environmental monitoring applications.},
}

@article {pmid41221170,
year = {2025},
author = {Seo, SH and Song, MK},
title = {Advancements and challenges in next-generation mRNA vaccine manufacturing systems.},
journal = {Clinical and experimental vaccine research},
volume = {14},
number = {4},
pages = {299-307},
pmid = {41221170},
issn = {2287-3651},
abstract = {The coronavirus disease 2019 pandemic has accelerated the global adoption and development of messenger RNA (mRNA) vaccine technology. While traditional manufacturing approaches rely on centralized and batch-based processes that are limited in scalability and accessibility, recent innovations in modular, decentralized, and continuous-flow production systems offer promising alternatives. This review summarizes the evolution of mRNA manufacturing, examines technological advances such as BioNTech's BioNTainer and Quantoom's Ntensify, and critically evaluates persistent barriers including raw material supply, regulatory compliance, sustainability, and cold-chain requirements. The implementation of artificial intelligence, thermostable formulations, and self-amplifying mRNA technologies are discussed as future directions. Collectively, these innovations offer a pathway to equitable, scalable, and rapid vaccine deployment in the context of both pandemics and routine immunization.},
}

@article {pmid41220927,
year = {2025},
author = {Cai, J and Chen, C and Wang, J and Zhang, X and Cui, Y and Zhu, Q and Sun, H},
title = {PROTAC: a revolutionary technology propelling small molecule drugs into the next golden age.},
journal = {Frontiers in oncology},
volume = {15},
number = {},
pages = {1676414},
pmid = {41220927},
issn = {2234-943X},
abstract = {Proteolysis Targeting Chimera (PROTAC) is a heterobifunctional molecule comprising three core components: a target protein ligand (typically a small-molecule inhibitor), a linker, and an E3 ubiquitin ligase ligand. By harnessing the specificity of the endogenous ubiquitin-proteasome system (UPS), PROTACs induce ubiquitination and subsequent degradation of target proteins. This technology constitutes an advanced therapeutic strategy for selective protein degradation, thereby expanding the horizons of drug design. Its significant therapeutic potential extends to treating cancers, viral infections (e.g., HIV and SARS-CoV-2), and chronic diseases. Recent clinical studies on compounds such as ARV-471 have yielded encouraging results, validating the efficacy of this approach. Over the past decade, PROTAC technology has garnered widespread attention in biomedicine for its promise in developing novel targeted therapies. This review will elucidate the broad therapeutic prospects and future challenges of PROTACs by detailing their mechanism of action, recent advances, progress in targeted therapy research, and current clinical trial landscape.},
}

@article {pmid41220708,
year = {2025},
author = {Zaiser, C and Pahlenkemper, M and Brandt, G and Ballero Reque, C and Sabel, L and Laskowski, NM and Paslakis, G},
title = {Feeding the feelings: gender differences in emotional eating during COVID-19: a systematic review and meta-analysis.},
journal = {Frontiers in nutrition},
volume = {12},
number = {},
pages = {1680872},
pmid = {41220708},
issn = {2296-861X},
abstract = {CONTEXT: The COVID-19 pandemic intensified mental health issues and increased emotional eating (EE), a coping mechanism, where food is consumed in response to emotions rather than hunger. During the pandemic, gender-specific EE patterns were observed, with women reporting elevated EE levels in response to stress, anxiety, and depression due to various social and psychological factors.

OBJECTIVES: This study primarily focused on examining gender differences in EE during the COVID-19 pandemic. As a secondary outcome, it aimed to explore predictors of EE.

DATA SOURCES AND EXTRACTION: This systematic review was pre-registered (PROSPERO CRD42023421727) and adhered to PRESS and PRISMA guidelines. Studies published between March 2020 and August 2024 were identified across Scopus, Web of Science, PubMed, and PsycINFO. The quality assessment was performed using the "Critical Appraisal Checklist for Analytical Cross-Sectional Studies." The meta-analysis was conducted following MOOSE guidelines.

DATA ANALYSIS: Of 14,347 studies identified, 30 met inclusion criteria (only if population ≥18 years, without clinical diagnoses, gender-specific analysis regarding EE, observational studies with original data collection during COVID-19 pandemic), with 16 incorporated into the meta-analysis. Gender significantly moderated pandemic-related stress. Higher EE scores in women were linked to isolation and caregiving responsibilities, while men's EE often appeared as reward-seeking. Across diverse measures and regions, women consistently exhibited higher EE scores (Cohen's d = 0.39). Young adults and students showed a stronger association with EE, suggesting heightened vulnerability. Key predictors included increased food intake, COVID-19-related stress and lifestyle changes, sleep quality, and physical activity.

CONCLUSION: The predominance of cross-sectional designs limits the ability to draw causal conclusions, and selection bias in studies, often targeting specific groups, restricts generalizability. Future longitudinal studies are needed to assess causality and explore the inferences to additional factors, such as socioeconomic status and mental health. Gender-sensitive interventions are suggested to address EE risks, particularly in women.

PROSPERO (CRD42023421727). https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023421727.},
}

@article {pmid41220463,
year = {2025},
author = {Alakeel, AN and Alskait, BK and Binshafi, GB and AlAmro, HA and Alkharji, SK and Elsherbini, M and Aleid, NA and Alfrayan, RA},
title = {The Impact of Telehealth Adoption on Patient Outcomes: A Systematic Review.},
journal = {Cureus},
volume = {17},
number = {10},
pages = {e94328},
pmid = {41220463},
issn = {2168-8184},
abstract = {Telehealth adoption gained popularity during the coronavirus disease 2019 (COVID-19) pandemic and had substantial and various impacts on patient outcomes depending on the specific environment, healthcare system, and quality of telehealth services supplied. Hence, this systematic review explored those impacts and their sustainability post-pandemic. To conduct this systematic review, a thorough literature search was undertaken in electronic databases such as PubMed, Medline, Web of Science, Google Scholar, databases, Embase, and PsycINFO using relevant keywords. We included articles written in English and published in the last 10 years that reported on the impact of telehealth adoption on various patient outcomes and the impact of sustainability post-pandemic. The findings of this systematic review highlight the remarkable impact of telehealth adoption on patient outcomes and the sustainability of these initiatives post-pandemic. Telehealth has proven to enhance various aspects of healthcare, spanning from prevention to follow-up. Another effect of telehealth adoption is the significant reduction in hospitalizations. Furthermore, telehealth profoundly impacts hospital stays, leading to a decrease in all-cause hospital days per patient by 1.07 (95% confidence interval (CI): 1.76 to 0.39) days and a shorter mean hospital stay for condition-related hospitalizations by 89% (95% CI 1.42 to 0.36), providing evidence of efficient healthcare delivery. There was also a reduction in mortality rates for patients receiving telemedicine interventions. Telehealth is also cost-effective while remaining highly effective. Patient satisfaction is another key outcome of telehealth adoption observed. The convenience and reduced expenses of telehealth have garnered positive feedback from patients, reinforcing the desirability of telehealth as a viable alternative to in-person visits. Despite these numerous benefits, barriers and disparities in telehealth adoption and utilization persist, especially in rural hospitals that face challenges, including a lack of Health Information Exchange (HIE) capacity, limited patient engagement capabilities, and the absence of financial reimbursement. This systematic review underscores the remarkable impact of telehealth adoption on patient outcomes and its sustainability post-pandemic. However, barriers and disparities still exist, requiring attention to ensure equitable access to telehealth services. The evidence supports the continued development and implementation of telehealth initiatives to improve healthcare delivery and patient outcomes post-pandemic.},
}

@article {pmid41220300,
year = {2025},
author = {Dagenais, C and Proulx, M and Hot, A and McSween-Cadieux, E and Villemin, R and Gautier, L and de Araujo Oliveira, SR and Cloos, P and Traverson, L and Zinszer, K and Ridde, V},
title = {How to formulate high-quality lessons learned: a rapid review.},
journal = {Global health action},
volume = {18},
number = {1},
pages = {2546691},
pmid = {41220300},
issn = {1654-9880},
support = {F32 DC000190/DC/NIDCD NIH HHS/United States ; },
mesh = {Humans ; *COVID-19/epidemiology ; SARS-CoV-2 ; Pandemics ; },
abstract = {Lessons learned convey information and experiences that were studied when carrying out projects or policies, in order to improve procedures and practices to better cope with future similar problems in other contexts. Although the term lessons learned appears in the titles of thousands of scientific articles, most do not describe how these lessons were produced or the level of rigor involved in their development. As part of a project aimed at deriving lessons from hospitals' resilience during the COVID-19 pandemic in five countries (the HoSPiCOVID project), we sought to systematised the process of producing these lessons. To do so, we conducted a rapid review to identify the best ways of developing quality lessons learned (QLLs). A QLL results from a systematic process of collecting, compiling, and analysing data derived from a research project. The rapid review follows the same key steps as a systematic review, adapted to a more accelerated and pragmatic format. From 1,881 documents initially identified, 18 were retained. Their analysis identified three principles to guide the process of developing QLLs: 1) Creating a supportive climate; 2) Choosing the right leaders or facilitators for the process; and 3) Engaging in a scientific approach. Based on these findings, we developed a guide comprising 11 steps, structured into two main phases: preparatory steps for QLL development, and steps for identifying and formulating QLLs. This guide offers a structured process for teams seeking to enhance the rigor, clarity, and potential transferability of the lessons they formulate.},
}

Humans
*COVID-19/epidemiology
SARS-CoV-2
Pandemics

@article {pmid41220197,
year = {2025},
author = {De Wals, P and Quach, C},
title = {Off-Label use of vaccines may save lives and money: lessons from the province of Quebec, Canada.},
journal = {Expert review of vaccines},
volume = {24},
number = {1},
pages = {1-13},
doi = {10.1080/14760584.2025.2589214},
pmid = {41220197},
issn = {1744-8395},
mesh = {Humans ; Quebec ; *Off-Label Use/economics ; *Vaccines/administration & dosage/economics/adverse effects ; Immunization Programs/economics ; *Vaccination/economics ; COVID-19 Vaccines/administration & dosage ; COVID-19/prevention & control ; },
abstract = {INTRODUCTION: In Canada, vaccines are authorized by Health Canada but publicly funded programs are of provincial/territorial jurisdiction. Off-label (OL) use of vaccines has been frequently implemented in Quebec over the last 30 years.

AREAS COVERED: The first part of this manuscript describes 11 recommendations from the Quebec Immunization Committee on meningococcal, pneumococcal, hepatitis A and B, HPV, rotavirus, and COVID-19 vaccines that were clearly OL. In the second part, challenges associated with OL use are discussed, including (i) the justifications of OL recommendations, (ii) the level of supporting scientific evidence, (iii) effectiveness and safety considerations, (iv) vaccine confidence and acceptability, (v) liability risks and informed consent.

EXPERT OPINION: With one exception, OL vaccine use in Quebec was successful. Reducing the number of doses or recommending the use of two different vaccines in a single immunization regimen (one vaccine having a much lower purchase cost than the other) allowed for more cost-effective immunization programs. Another OL's justification was to increase protection, by extending the age limit or interval between doses, or allowing an interchangeability of available vaccines. OL vaccine use should always be considered when properly justified by scientific evidence and vaccinology principles, and carefully evaluated when implemented.},
}

Humans
Quebec
*Off-Label Use/economics
*Vaccines/administration & dosage/economics/adverse effects
Immunization Programs/economics
*Vaccination/economics
COVID-19 Vaccines/administration & dosage
COVID-19/prevention & control

@article {pmid41220194,
year = {2025},
author = {Liu, R and Shao, W and Ye, Q},
title = {Resurgence of Mycoplasma pneumoniae Infections in the Post-COVID-19 Era: Epidemiology, Therapeutic Challenges, and Mitigation Strategies.},
journal = {APMIS : acta pathologica, microbiologica, et immunologica Scandinavica},
volume = {133},
number = {11},
pages = {e70092},
doi = {10.1111/apm.70092},
pmid = {41220194},
issn = {1600-0463},
support = {LKLY25H200004//the Joint Fund of Zhejiang Provincial Natural Science Foundation of China/ ; GZY-KJS-ZJ-2025-015//Joint TCM Science & Technology Projects of National Demonstration Zones for Comprehensive TCM Reform/ ; LR24H200001//the Zhejiang Provincial Outstanding Youth Science Foundation/ ; },
mesh = {Humans ; *Pneumonia, Mycoplasma/epidemiology/drug therapy/therapy/prevention & control ; *COVID-19/epidemiology ; Anti-Bacterial Agents/therapeutic use ; *Mycoplasma pneumoniae/drug effects ; SARS-CoV-2 ; Drug Resistance, Bacterial ; },
abstract = {This study aims to review recent literature on the delayed re-emergence of Mycoplasma pneumoniae (MP) and to discuss its epidemiological characteristics, treatment strategies, and future research directions for global MP prevention and control. Through a systematic review of the recent relevant literature, the epidemiological changes in MP and the rate of increase in drug resistance during and after the COVID-19 pandemic were analyzed. Moreover, the main treatment strategies for MP, including traditional antibiotics, immunomodulators, and combination therapy, were comprehensively analyzed. The results demonstrated that nonpharmacological interventions (NPIs) implemented during the COVID-19 pandemic exerted a marked reduction in MP detection rates. However, subsequent to the progressive relaxation of NPI measures, a resurgence of MP infections has been observed across multiple global regions, accompanied by an escalating prevalence of antimicrobial resistance-particularly concerning macrolide antibiotics. The investigation further conducted systematic analyses of current therapeutic regimens for MP infection, providing critical evaluations of their respective clinical advantages and limitations in practical application. This study proposes strategies for MP's delayed recirculation control amidst its changing epidemiology and drug resistance, offering a scientific basis and practical suggestions for global MP prevention.},
}

Humans
*Pneumonia, Mycoplasma/epidemiology/drug therapy/therapy/prevention & control
*COVID-19/epidemiology
Anti-Bacterial Agents/therapeutic use
*Mycoplasma pneumoniae/drug effects
SARS-CoV-2
Drug Resistance, Bacterial

@article {pmid41219464,
year = {2025},
author = {Byrne, D and Gale, C and Canty, N and Meehan, J and Dumitriu, D and Yonts, A and Mulkey, SB and Molloy, EJ},
title = {Neurological and neurodevelopmental effects of Covid and MIS-C on children.},
journal = {Pediatric research},
volume = {},
number = {},
pages = {},
pmid = {41219464},
issn = {1530-0447},
abstract = {Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has been shown to cause a unique disease phenotype in the paediatric population compared to adults, following the emergence of Multisystem Inflammatory Syndrome of Children (MIS-C) and Paediatric Inflammatory Multisystem Syndrome Temporally Associated with SARS-CoV-2 (PIMS-TS). Over the course of the pandemic, neurological symptoms associated with SARS-CoV-2 have been reported in the paediatric population. The neurological and neurodevelopmental sequelae of both acute SARS-CoV-2 infection and MIS-C/PIMS-TS in the paediatric population are not well understood. Little is known about the underlying pathophysiology and the potential neurovirulence of SARS-CoV-2. Further awareness and research are needed on the neurological sequelae and long-term consequences of SARS-CoV-2 on the developing brain. IMPACT: Detailed review of the current knowledge on neurological and neurodevelopmental effects of SARS-CoV-2 and MIS-C on the paediatric population. Emphasise the importance of acknowledging the potential direct effects of SARS-CoV-2 and MIS-C on neurological and neurodevelopmental outcomes. Highlight the need for further research and inclusion of paediatric patients in follow up studies of long-term effects of SARS-CoV-2 and MIS-C focusing on neurodevelopmental and neurological sequelae.},
}

@article {pmid41218870,
year = {2025},
author = {He, XY and Li, XH and Tong, ZH},
title = {[Cognitive impairment in long COVID: advances in pathological mechanisms and exercise rehabilitation interventions].},
journal = {Zhonghua jie he he hu xi za zhi = Zhonghua jiehe he huxi zazhi = Chinese journal of tuberculosis and respiratory diseases},
volume = {48},
number = {11},
pages = {1087-1095},
doi = {10.3760/cma.j.cn112147-20250610-00315},
pmid = {41218870},
issn = {1001-0939},
support = {2023YFC0872500//National Key Research and Development Program/ ; Ggyfz202503//Reform and Development Program of Beijing Institute of Respiratory Medicine/ ; },
mesh = {Humans ; *COVID-19/complications/psychology ; *Cognitive Dysfunction/rehabilitation/etiology ; *Exercise Therapy ; SARS-CoV-2 ; Post-Acute COVID-19 Syndrome ; Quality of Life ; },
abstract = {Since the outbreak of the novel coronavirus (COVID-19) pandemic, long-term effects of the virus, known as long-COVID, has emerged. It is a chronic syndrome following infection. It is estimated that around 20% of COVID-19 survivors worldwide experience cognitive dysfunction. This is characterized by impairments in executive function, attention, memory, and other cognitive domains, and can have a significant impact on quality of life and social functioning. This article systematically reviewed recent studies and summarized the potential pathological mechanisms underlying cognitive dysfunction in long COVID, including neuroinflammation, glial cell dysregulation, involvement of the olfactory pathway and limbic system, autoimmunity and viral reactivation, cerebrovascular and blood-brain barrier damage, as well as abnormalities in neurotrophic factors and synaptic plasticity. Additionally, it explored the effects of exercise rehabilitation and multidimensional comprehensive rehabilitation strategies. The aim was to provide theoretical and scientific foundations for optimizing intervention programs for cognitive dysfunction in long COVID and for formulating clinical guidelines and public health policies.},
}

Humans
*COVID-19/complications/psychology
*Cognitive Dysfunction/rehabilitation/etiology
*Exercise Therapy
SARS-CoV-2
Post-Acute COVID-19 Syndrome
Quality of Life

@article {pmid41218570,
year = {2025},
author = {Ledderer, L and Nielsen, KH and Skodborg, L and Fage-Butler, A},
title = {Public trust and mistrust of COVID-19 vaccines: A systematic meta-narrative review.},
journal = {Vaccine},
volume = {69},
number = {},
pages = {127947},
doi = {10.1016/j.vaccine.2025.127947},
pmid = {41218570},
issn = {1873-2518},
abstract = {INTRODUCTION: Trust played a fundamental role in vaccine decision-making and uptake during the COVID-19 pandemic. The purpose of this study is to explore how public trust was conceptualized, operationalized, and implicated in vaccine uptake research on COVID-19 vaccines.

METHODS: Using a systematic meta-narrative review, we searched literature around trust/distrust, science and COVID-19 vaccines. This involved identifying research areas, aims, methods, and sample sizes for each study while inductively/deductively exploring six narratives of trust - attitudinal, cognitive, affective, contingent, contextual, and communicated - developed in a previous study to synthesize findings across diverse disciplines and methodologies.

RESULTS: The final sample consisted of 79 peer-reviewed studies on trust in relation to COVID-19 vaccination. Our analysis revealed a degree of methodological uniformity as most were quantitative survey-based investigations conducted in Europe and the United States with trust typically operationalized through Likert-scale measures assessing attitudes toward science, scientists, public health authorities, and the vaccines themselves. Conceptual diversity was also evident as although trust was treated as a key explanatory factor in nearly all studies, its referents varied widely, from institutions and information sources to personal dispositions and social dynamics. Similarly, the implications of trust ranged from vaccination intention and motivation to hesitancy and actual uptake. The meta-narrative framework highlighted that attitudinal and contingent trust dominated the literature, while cognitive and affective dimensions were mainly underexplored. Despite the methodological dominance of quantitative approaches, this standardization offers strengths of comparability and policy relevance, but the limited exploration of emotional, relational, and communicative aspects of trust points to missed opportunities for more nuanced understanding.

CONCLUSION: The meta-narrative approach provided a valuable tool for synthesizing conceptual pluralism. Our findings suggest that trust in vaccination is not a singular construct, but a constellation of interrelated attitudes and judgments shaped by context, communication, and experience, each with implications for public health.},
}

@article {pmid41218566,
year = {2025},
author = {Jimeno, J and Varona, JF and Lopez-Martin, JA and Izquierdo-Useros, N and Molina Molina, E and Guisado-Vasco, P and Sachse, M and Risco, C and Losada, A and Fudio, S and Luepke, E and Nieto, A and Gomez, J and Aviles, P and Cuevas, C and Bouhaddou, M and Sola, I and Krogan, NJ and Enjuanes, L and Fernandez-Sousa, JM and GarcÍa-Sastre, A and White, K},
title = {Pharmacological reprogramming of plitidepsin as a SARS-CoV-2 inhibitor.},
journal = {Molecular aspects of medicine},
volume = {106},
number = {},
pages = {101412},
doi = {10.1016/j.mam.2025.101412},
pmid = {41218566},
issn = {1872-9452},
abstract = {Selective pressures in the ocean promote the evolution of potent molecules that may be useful in therapeutic settings. Tunicates provide a rich source of bioactive molecules that have been shown to have anti-neoplastic and anti-microbial activities. Plitidepsin, a natural marine cyclic depsipeptide originally isolated from the tunicate Aplidium albicans, was originally developed as an anti-tumor drug, and has been approved for use in Australia in patients with advanced pretreated myeloma. Early in the SARS-CoV-2 pandemic, plitidepsin was shown to have potent preclinical efficacy against the virus, suggesting that it could be repurposed for the treatment of COVID-19. This review summarizes the clinical development of plitidepsin first as an anti-tumor drug, before providing a recapitulation of current efforts to repurpose the molecule as an antiviral therapy. The pharmacokinetic and pharmacodynamic data on plitidepsin will be analyzed, and the various experimental lines of evidence in support of the molecule's multifactorial mechanism of action will be explored. Finally, the available data on the use of plitidepsin in patients with COVID-19 will be presented, including results from a Phase I proof-of-concept study, real-world data from immunocompromised patients, and a look of results from a Phase III clinical trial that confirms the working hypothesis.},
}

@article {pmid41217408,
year = {2025},
author = {Desai, S and Rath, C and Bhandarkar, N and Jape, G and Rao, S},
title = {Virtual Reality Experience to Relieve Stress, Burnout, Fatigue, and Anxiety in Healthcare Professionals: A Systematic Review.},
journal = {Journal of healthcare management / American College of Healthcare Executives},
volume = {70},
number = {6},
pages = {416-434},
pmid = {41217408},
issn = {1096-9012},
mesh = {Humans ; *Burnout, Professional/prevention & control/therapy/psychology ; *Health Personnel/psychology ; *Anxiety/therapy/prevention & control ; *Virtual Reality ; COVID-19/epidemiology ; *Fatigue/prevention & control/therapy ; *Stress, Psychological/therapy/prevention & control ; },
abstract = {GOAL: Healthcare professionals (HCPs) working long shifts are prone to physical, emotional, and psychological stress leading to harmful effects on their mental health, an issue compounded by the COVID-19 pandemic. Novel efforts such as virtual reality (VR)-based immersion have been explored to mitigate this problem in HCPs. However, the studies vary in their clinical settings, scales used for measuring outcomes related to mental health, sample size, and other relevant parameters. We conducted a systematic review (SR) to collate all available evidence on the feasibility and efficacy of VR-based interventions for reducing stress, burnout, fatigue, and anxiety in HCPs.

METHODS: We searched major databases for comprehensive literature on HCP mental well-being measures in September 2023 and February 2024. Risk of bias was assessed using the Effective Public Health Practice Project (EPHPP) quality assessment tool, and PRISMA guidelines were used for reporting this SR.

PRINCIPAL FINDINGS: A total of 17 studies out of 1,422 citations were included in the final analysis. The number of study participants ranged from 14 to 219 (1,053 total). Seven studies were randomized controlled trials, and the rest were pre-post intervention studies. Meta-analysis was not feasible because the included studies were heterogeneous in their study settings, methodology, and assessed mental health domain. Based on the EPHPP tool, one study had a strong global rating, two had a moderate rating, and 14 had a weak rating.

PRACTICAL APPLICATIONS: VR-based interventions during break times appear to be feasible and useful in addressing HCP stress, burnout, fatigue, and anxiety. However, limited high-quality studies warrant caution in interpretation.},
}

Humans
*Burnout, Professional/prevention & control/therapy/psychology
*Health Personnel/psychology
*Anxiety/therapy/prevention & control
*Virtual Reality
COVID-19/epidemiology
*Fatigue/prevention & control/therapy
*Stress, Psychological/therapy/prevention & control

@article {pmid41217254,
year = {2025},
author = {Lee, DH and Lee, W and Bach, H},
title = {Nanomedicine in the development of vaccines against Herpesviridae: a narrative review.},
journal = {Nanomedicine (London, England)},
volume = {},
number = {},
pages = {1-21},
doi = {10.1080/17435889.2025.2587714},
pmid = {41217254},
issn = {1748-6963},
abstract = {The Herpesviridae family, more commonly known as herpesviruses, includes the Alphaherpesvirinae, Betaherpesvirinae, and Gammaherpesvirinae subfamilies, each with unique clinical presentations. Herpesvirus infections are a major public health concern. Current management approaches for herpesviruses primarily focus on antiviral or symptomatic treatment, with few licensed vaccines. Recent advancements in nanotechnology applied to the COVID-19 pandemic have created new opportunities to develop vaccines using nanomedicine to prevent herpesvirus infections. The authors reviewed 62 papers studying nanomedicine applications for vaccine development for herpesviruses. Nanoparticle-based vaccine delivery strategies may be feasible and practical options for herpesvirus prevention.},
}

@article {pmid41216008,
year = {2025},
author = {Abbas, U and Kumar, H and Hussain, N and Ahmed, I and Laghari, RN and Tanveer, M and Hadif, M and Fatima, K and Khalid, MU and Anwar, K and Khan, M},
title = {Immune dysregulation in type 2 diabetes mellitus: Implications for tuberculosis, COVID-19, and HIV/AIDS.},
journal = {Infectious medicine},
volume = {4},
number = {4},
pages = {100211},
pmid = {41216008},
issn = {2772-431X},
abstract = {Diabetes mellitus (DM) is a complex and multifactorial disorder associated with elevated blood sugar levels, poor insulin sensitivity, and inadequate insulin production. It has a major impact on the immune system, making a person more susceptible to and influenced by a variety of infectious illnesses. This narrative review summarizes the relationship between chronic inflammation and high glucose levels in DM, on susceptibility and outcomes in endemic infectious diseases. We focused on impact of DM on disease progression, and treatment response in these infections. Literature was identified through searches of PubMed, Scopus, and Google Scholar, focusing on epidemiologic, clinical, and mechanistic studies. The evidences suggest that immune modulation in DM has profound inverse relations with the outcome of infectious diseases including tuberculosis, COVID-19, and HIV/AIDS. DM increases the risk of developing severe forms of infectious diseases due to downregulation of the immune system which is associated with glycemic control. There is a need to understand the relationship between DM and immunological control for developing methods to reduce these risks and improve outcomes for the affected population.},
}

@article {pmid41214693,
year = {2025},
author = {Sad, SA and Iftikhar, L and Chamout, M},
title = {Revisiting HPV vaccination post-COVID: geopolitical, sociocultural, and ethical disparities in global health.},
journal = {International journal for equity in health},
volume = {24},
number = {1},
pages = {308},
pmid = {41214693},
issn = {1475-9276},
abstract = {BACKGROUND: HPV vaccines have been revolutionary in preventing HPV-related cervical cancer and reshaping the cervical cancer screening guidelines in the past decades. Yet, challenges persist in achieving universal accessibility and utilization. Since the COVID-19 pandemic, shifts have emerged in HPV vaccine research, implementation strategies, and the determinants shaping uptake and delivery, particularly from a global equity perspective.

METHODS: This is a scoping review examining English-language, peer-reviewed articles published following the onset of the COVID-19 pandemic until the end of 2024. It focuses on the human papillomavirus (HPV) vaccine and factors influencing its uptake. Articles were retrieved from PubMed and Embase databases and screened for relevance using predefined search terms.

RESULTS: Out of 2755 articles, 349 were included. We identified that most peer-reviewed articles focus on interventions and implementation strategies more than acknowledging geopolitical affairs, gender specificity, religious and ethical dimensions, medical mistrust, or healthcare discrimination. Most of the articles were cross-sectional in nature and most were funded by the National Cancer Institute. Interestingly, we found no peer-reviewed articles on the intersectionality of Judaism and HPV vaccine uptake, with a limited number on Islamic, Christian, or other religious intersectionality. Articles addressing how low- and middle-income countries could be equipped to develop and manage their own vaccine programs and manufacturing were largely absent; instead, cost-effectiveness research focused primarily on the vaccine’s ability to reduce disease burden.

CONCLUSION: Post-pandemic research on HPV vaccination indicates that levels of hesitancy and uptake have remained relatively stable. However, the literature highlights persistent inconsistencies in how the vaccine is prioritized across communities, healthcare professionals, and health systems. Messaging regarding its importance for cancer prevention remains fragmented, while cost barriers and the absence of the vaccine from many national immunization schedules continue to limit access. Notably, ethical, religious, and cultural considerations receive limited attention in current research, despite the pandemic underscoring the global significance of these factors in shaping health behaviors. These findings suggest a need to re-examine how HPV vaccination is framed and advanced as a public health priority within diverse sociocultural and systemic contexts.},
}

@article {pmid41214450,
year = {2025},
author = {Badra, R and Zhang, W and Tam, JSL and Webby, R and Van Der Werf, S and Nikisins, S and Cullinane, A and Gharaibeh, S and Njouom, R and Peiris, M and Kayali, G and Heraud, JM},
title = {A Systematic Review of New, Enhanced Surveillance Systems and Methodologies for Zoonotic Influenza Viruses in Animals and Human-Animal Interface.},
journal = {Influenza and other respiratory viruses},
volume = {19},
number = {11},
pages = {e70178},
pmid = {41214450},
issn = {1750-2659},
support = {203434270/WHO_/World Health Organization/International ; },
mesh = {Humans ; Animals ; *Influenza, Human/epidemiology/virology/transmission/prevention & control ; *Zoonoses/epidemiology/virology ; *Epidemiological Monitoring ; *Orthomyxoviridae Infections/epidemiology/virology/veterinary ; Global Health ; *Viral Zoonoses/epidemiology/virology ; Pandemics ; *Orthomyxoviridae/isolation & purification ; },
abstract = {In 2009, the World Health Organization (WHO) developed a public health research agenda for influenza to guide researchers and outline directions and priority areas for research on influenza aiming at reducing the burden of seasonal epidemic influenza and the risk and impact of pandemic influenza. The agenda was updated in 2017, but since then, important research has been conducted, and major changes have occurred to the global health landscape impacted mainly by the COVID-19 pandemic. Therefore, there is a need to assess advances in zoonotic influenza surveillance methods reported between 2017 and 2024 in order to highlight key achievements and identify remaining gaps that limit their broader implementation, hence informing an update of the research agenda. We conducted a comprehensive literature review of zoonotic influenza surveillance and monitoring, focusing on novel and enhanced methodologies reported globally between 2017 and 2024. A systematic analysis was performed following PRISMA guidelines on 7490 peer-reviewed manuscripts from 2017 to 2024 retrieved from PubMed, of which 164 records were included in this review. Analysis of the information collected indicated several advances and gaps at different levels of surveillance and unmet public health needs. Most countries do not have active and comprehensive surveillance programs for zoonotic influenza at the human-animal interface, which underestimates the true burden of zoonotic influenza diseases. The review concludes with a set of high-priority research recommendations focused on filling gaps in One Health data integration, validation, and field deployment of novel diagnostic technologies, wider adoption of noninvasive and environmental surveillance approaches, and stronger linkage of methodological innovations to risk assessment and policy action. In light of the recent upsurge in H5N1 activity and cross-species transmission, the WHO has convened multiple R&D Blueprint consultations over the past year to prioritize research and development for H5N1 candidate vaccines, diagnostics, and pandemic preparedness. These ongoing initiatives underscore the critical importance of strengthening surveillance at the human-animal interface.},
}

Humans
Animals
*Influenza, Human/epidemiology/virology/transmission/prevention & control
*Zoonoses/epidemiology/virology
*Epidemiological Monitoring
*Orthomyxoviridae Infections/epidemiology/virology/veterinary
Global Health
*Viral Zoonoses/epidemiology/virology
Pandemics
*Orthomyxoviridae/isolation & purification

@article {pmid41214236,
year = {2025},
author = {Uraki, R and Korber, B and Diamond, MS and Kawaoka, Y},
title = {SARS-CoV-2 variants: biology, pathogenicity, immunity and control.},
journal = {Nature reviews. Microbiology},
volume = {},
number = {},
pages = {},
pmid = {41214236},
issn = {1740-1534},
abstract = {More than 5 years have passed since the emergence of the novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), yet this virus continues to circulate globally, undergoing evolutionary changes. The effective control of SARS-CoV-2 necessitates an understanding of its antigenicity, replicative capacity, pathogenicity and transmissibility, as well as the development of preventive and treatment options. In this Review, we describe the origins and evolution of SARS-CoV-2, and outline variant and subvariant-specific characteristics. We also discuss the challenges faced in implementing prevention and treatment methods, such as the emergence of antigenically distinct variants and the phenomenon of immune imprinting. This Review provides insights into combating the ongoing COVID-19 pandemic and guidance for future research and vaccine development efforts.},
}

@article {pmid41213787,
year = {2025},
author = {Adusei-Mensah, F and Olubamwo, O and Olaleye, S and Akter, L and Balogun, OS and Moshoeshoe, RJ and Awoniyi, L and Olawuni, A and Kauhanen, J},
title = {Updating the impact of mRNA COVID-19 vaccine exposure during pregnancy on obstetric and neonatal outcomes.},
journal = {Taiwanese journal of obstetrics & gynecology},
volume = {64},
number = {6},
pages = {957-970},
doi = {10.1016/j.tjog.2025.07.022},
pmid = {41213787},
issn = {1875-6263},
mesh = {Humans ; Pregnancy ; Female ; *COVID-19 Vaccines/adverse effects/administration & dosage ; *COVID-19/prevention & control ; Infant, Newborn ; *Pregnancy Outcome/epidemiology ; *Pregnancy Complications, Infectious/prevention & control ; Premature Birth/epidemiology ; SARS-CoV-2 ; Fetal Distress/epidemiology ; Congenital Abnormalities/epidemiology ; Vaccination ; },
abstract = {Being a new vaccine platform, continuous monitoring of the mRNA COVID-19 vaccines in pregnant women is of critical importance. This systematic review and meta-analysis evaluate the maternal and neonatal outcomes associated with mRNA COVID-19 vaccination during pregnancy. We conducted a systematic search of PubMed, Embase, Cochrane Library, and clinical trial registries for studies published between December 2020 and July 2024. Studies were included if they assessed obstetric and neonatal outcomes following mRNA COVID-19 vaccination in pregnant women. Data were extracted and analyzed using a random-effects model to calculate pooled odds ratios (ORs) and 95 % confidence intervals (CIs). Fifteen studies met the inclusion criteria, encompassing 42,944 vaccinated and 183,733 unvaccinated pregnant women. mRNA vaccination was associated with a significant reduction in preterm delivery (OR 0.743, 95 % CI 0.607-0.911), fetal distress (OR 0.699, 95 % CI 0.546-0.893), neonatal congenital abnormalities (OR 0.712, 95 % CI 0.570-0.889), and NICU admissions (OR 0.718, 95 % CI 0.617-0.836). However, a slight increase in gestational diabetes risk was observed (OR 1.107, 95 % CI 1.054-1.162). mRNA COVID-19 vaccines are safe during pregnancy and associated with reduced risks of adverse obstetric and neonatal outcomes. An observed marginal increase in gestational diabetes risk underscores the need for continuous monitoring. These findings support the inclusion of pregnant women in vaccination campaigns and inform public health policies and clinical practices to improve maternal and neonatal health outcomes.},
}

Humans
Pregnancy
Female
*COVID-19 Vaccines/adverse effects/administration & dosage
*COVID-19/prevention & control
Infant, Newborn
*Pregnancy Outcome/epidemiology
*Pregnancy Complications, Infectious/prevention & control
Premature Birth/epidemiology
SARS-CoV-2
Fetal Distress/epidemiology
Congenital Abnormalities/epidemiology
Vaccination

@article {pmid41213387,
year = {2025},
author = {Rong, H and Ren, J and Wu, Q and Zhu, H and Dong, C and Wang, G},
title = {Repurposing niclosamide for COVID-19: Synergistic strategies of nanotechnology and novel materials to enhance antiviral efficacy.},
journal = {Microbial pathogenesis},
volume = {210},
number = {},
pages = {108169},
doi = {10.1016/j.micpath.2025.108169},
pmid = {41213387},
issn = {1096-1208},
abstract = {The persistent prevalence of COVID-19 and its emerging variants continues to threaten global health security. While most of these viruses have been controlled through medications or vaccines, the increasing number of SARS-CoV-2 variants and the inequitable access to vaccines across nations remain significant challenges for epidemiological management. Niclosamide, an FDA-approved anthelmintic drug, exhibits broad-spectrum antitumor, antibacterial, and antiviral properties, yet suffers from poor bioavailability. Repurposing niclosamide in combination with advanced material technologies may offer a promising therapeutic strategy. To optimize its future clinical applications, we summarize the antiviral mechanisms of niclosamide and emphasize strategies such as nanotechnology and novel material design to enhance its bioavailability and stability. Additionally, we discuss the latest clinical trial outcomes of niclosamide. Looking ahead, with the ongoing advancements in material synthesis, the synergistic integration of nano-hybridization and innovative material systems for niclosamide is poised to become a pivotal tool in epidemiological management and combating viral threats, providing an innovative, accessible, and cost-effective solution for pandemic control.},
}

@article {pmid41213341,
year = {2025},
author = {Xavier, D and Silva, W and Correa, F and Porto, I and Soares, L and Melgaço, G and Oliveira, V and Lima, V and Oliveira, M},
title = {Experience of Parenting Children and Adolescents with Cystic Fibrosis: A Systematic Review of Qualitative Studies and Meta-Synthesis.},
journal = {Respiratory medicine},
volume = {},
number = {},
pages = {108485},
doi = {10.1016/j.rmed.2025.108485},
pmid = {41213341},
issn = {1532-3064},
abstract = {BACKGROUND: Caring for children with cystic fibrosis (CF) poses significant emotional and practical challenges for parents and caregivers. Understanding their experiences is crucial to improving care.

METHODS: A systematic review was conducted of qualitative studies on the experiences of parents and caregivers of children and adolescents with CF. Multiple databases were searched. Studies were independently screened and appraised. A meta-synthesis approach was used to integrate the findings.

RESULTS: Key themes were identified in 27 studies, mainly from English-speaking countries: impact of diagnosis, routine care demands, healthcare relationships, faith, adolescent transition, support systems, uncertain future, palliative care, and COVID-19 challenges. Caregivers face emotional distress, guilt, and burden, along with the limitations of the healthcare system and social stigma. Optimism about treatments coexisted with fear and uncertainty. Adolescent transition brought challenges in terms of autonomy and adherence to treatment. Spirituality was both a coping tool and a source of conflict.

CONCLUSIONS: Caregiving for children and adolescents with CF is complex and multifaceted. Clear communication, continuous psychosocial support, and respect for both emotional and spiritual needs are vital, especially upon receiving the diagnosis and during adolescence. Open discussions on sensitive topics, such as palliative care, can improve caregiver experiences and outcomes.},
}

@article {pmid41212631,
year = {2025},
author = {Goodfellow, H and Blandford, A and Bradbury, K and Gomes, M and Hamilton, F and Henley, W and Stevenson, F and Fernandez-Reyes, D and Hurst, J and Heightman, M and Pfeffer, P and Ricketts, W and Singh, R and Hylton, H and Linke, S and Bindman, J and Robson, C and Walker, S and Ismaila, H},
title = {Development and implementation of a digital health intervention in routine care for long COVID patients: a comprehensive synopsis.},
journal = {Health and social care delivery research},
volume = {13},
number = {39},
pages = {1-27},
doi = {10.3310/GJHG0331},
pmid = {41212631},
issn = {2755-0079},
mesh = {Humans ; *COVID-19/rehabilitation ; Male ; Female ; Telemedicine/organization & administration ; Middle Aged ; SARS-CoV-2 ; Adult ; Patient Reported Outcome Measures ; United Kingdom ; Aged ; State Medicine ; Digital Health ; },
abstract = {BACKGROUND: By July 2020, large numbers of post-COVID patients were experiencing symptoms for weeks or months, but traditional National Health Service models of rehabilitation service delivery could not meet demand.

OBJECTIVES: Design and deploy a digital health intervention to provide digitally delivered, remotely supported rehabilitation to long COVID patients on complicated and evolving pathways.

METHODS: The multidisciplinary team combined established research methods based on engineering and computer science (considering safety, stability and user requirements) with those based on biomedical and health service research (considering effectiveness and population impact). Qualitative data comprised recordings of meetings between study team members and clinicians and semistructured interviews with clinician and patient users. Quantitative data comprised referral, registration and usage rates; demographic and clinical characteristics of patients; and patient-reported outcome measures.

RESULTS: We created a modifiable digital health intervention, 'Living With COVID Recovery[TM] developed by Living With Ltd', London, UK, that continues to be used by National Health Service trusts. The digital health intervention included integration into a clinical pathway, a clinician-facing dashboard, two-way messaging and a patient-facing app with information and evidence-based treatments. We aimed to register 1000 users. By study completion on 20 December 2022, there were 9781 patients invited, of whom 7679 (78.5%) had registered, at 33 National Health Service clinics.

LIMITATIONS: Data came from patients at long COVID clinics, however data were unlikely to be representative of people with long COVID. We could not observe clinics under lockdown and had limited access to patient digital health intervention users or to people not engaging with the digital health intervention. Patient user data were incomplete, with inconsistent patient-reported outcome measure and other questionnaire data completion and no data on initial severity of disease, vaccination status, comorbidities or other individual circumstances.

CONCLUSIONS: Long COVID can be extremely debilitating, comparable to stage IV lung cancer in relation to fatigue and health-related quality of life. Care and rehabilitation should address the management of fatigue and reflect the impact of social disadvantage on symptom severity. With sufficient resources, a digital health intervention can be developed quickly and effectively using agile methodology and bringing together a genuinely multidisciplinary team, including, importantly, an industry partner. Digital health intervention product design and deployment are both important in getting National Health Service trusts, healthcare professionals and patients to engage with a digital health intervention. Projects should work closely with all user groups. Lockdown and the unmet need of a new patient group encouraged those who might otherwise have been reluctant to try a digital health intervention. Many patients and clinics accepted this digital remote support, which helped patients feel cared for while reducing strain on health services. This may encourage acceptance of other digital health intervention, although medical record integration remains a deterrent to clinics.

FUTURE WORK: This research focused on the development, deployment and evaluation of a digitally enabled rehabilitation programme for long COVID. Clinical effectiveness will be assessed within the Symptoms, Trajectory, Inequalities and Management: Understanding Long-COVID to Address and Transform Existing Integrated Care Pathways (UCL, London, UK) study.

FUNDING: This synopsis presents independent research funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme as award number NIHR132243.},
}

Humans
*COVID-19/rehabilitation
Male
Female
Telemedicine/organization & administration
Middle Aged
SARS-CoV-2
Adult
Patient Reported Outcome Measures
United Kingdom
Aged
State Medicine
Digital Health

@article {pmid41212573,
year = {2025},
author = {Alali, M},
title = {Pediatric Hepatitis-Associated Aplastic Anemia.},
journal = {Pediatric annals},
volume = {54},
number = {11},
pages = {e400-e403},
doi = {10.3928/19382359-20250910-02},
pmid = {41212573},
issn = {1938-2359},
mesh = {Humans ; *Anemia, Aplastic/therapy/diagnosis/etiology ; Child ; *Hepatitis/complications ; },
abstract = {Hepatitis-associated aplastic anemia (HAAA) is a rare but life-threatening disorder that requires early recognition and intervention. Pediatricians play a critical role in identifying cases where acute hepatitis transitions to severe bone marrow failure. This review presents the diagnostic and therapeutic complexities associated with HAAA, emphasizing the importance of a multidisciplinary approach. Key topics include the pathophysiology of immune-mediated marrow suppression, diagnostic strategies (eg, immunophenotyping, bone marrow biopsy), and management approaches (eg, immunosuppressive therapy, hematopoietic stem cell transplantation). The review also highlights emerging evidence on viral triggers, such as severe acute respiratory syndrome coronavirus 2, and underscores the need for heightened clinical awareness and standardized treatment strategies.},
}

Humans
*Anemia, Aplastic/therapy/diagnosis/etiology
Child
*Hepatitis/complications