Search Results (1,179)

Background/Objectives: A subset of individuals develops persistent symptoms following SARS-CoV-2 infection, including musculoskeletal (MSK) manifestations, a condition known as long COVID (LC). Emerging hypotheses suggest that chronic low-grade inflammation in LC may impair bone metabolism and compromise joint health. However, empirical evidence is limited, and the impact of LC on MSK health, particularly bone and joint integrity, is poorly understood. To determine the influence of LC on MSK function, including bone health, body composition, and joint integrity. Methods: A 12-month longitudinal prospective cohort feasibility study was conducted involving 45 adults with LC and 40 well-recovered (WR) post-COVID-19 controls. Baseline and follow-up assessments included dual-energy X-ray absorptiometry (DXA) for bone mineral density (BMD) and total body composition (TBC), alongside ultrasound of the hand and knee joints to evaluate intra-articular changes. Results: The LC group had more fat in the gynoid, android, and leg regions at each assessment point compared to the controls (p < 0.01). LC showed a significantly lower knee synovial hypertrophy at the baseline, 13.3% compared to WR 45% (p = 0.001), and a marginal improvement in hand synovial hypertrophy, over 12 months, from a median of 2 (IQR 1;5) to 1 (IQR 0;3) (p = 0.012), as observed via MSK ultrasound. No notable differences were found between groups regarding BMD, either in the LC group compared to the control group or overtime. Conclusions: This cohort study of LC adults and controls found no evidence of rapid bone loss; however, adiposity and joint symptoms suggest the need for ongoing monitoring. Future research should focus on MSK markers, muscle function, advanced imaging, and improving MSK health. Full article

Long COVID is frequently accompanied by enduring neurocognitive and physical symptoms that substantially affect quality of life. Cognitive complaints—including difficulties in memory, attention, and executive functioning—often co-occur with physical manifestations such as fatigue, dyspnea, and headache. Despite growing research, openly available datasets integrating demographic, cognitive, and physical symptom profiles assessed during chronic phases of Long COVID remain scarce. Here, we present two complementary self-report datasets collected ≥6 months after the most recent COVID-19 infection. The first dataset (“Neuro–Long COVID-212”) includes demographic information, binary neurocognitive symptom indicators, and a 14-item Post-COVID Cognitive Impairment Scale assessing memory and attention complaints. The second dataset (“Neuro–Long COVID–210”) provides a broad range of physical symptoms—operationally defined as somatic and neurological complaints (e.g., fatigue, pain, sleep disturbance, anosmia/ageusia)—recorded as binary indicators (present/absent). Data were collected online via the Porsline platform using individualized links, with remote researcher support to ensure accuracy. Quality assurance procedures included duplicate-response removal, consistency checks, and transparent handling of missing values. The datasets are released in Excel (.xlsx) format, fully de-identified and accompanied by a detailed data dictionary to facilitate reuse. These datasets enable reproducibility, secondary analyses, and meta-analyses on cognitive and physical outcomes in Long COVID, and may inform future cross-disciplinary rehabilitation research. Full article

Background and Objectives: Reports of respiratory function in COVID-19 survivors are still rare, especially in children. This study aims to determine the prevalence and prognostic factors that influence long-term respiratory function in children after COVID-19. Materials and Methods: An observational analytical study with a retrospective cohort design was conducted between January and June 2024. The subjects were pediatric patients aged 5–18 years with confirmed history of COVID-19. Respiratory function was evaluated with spirometry. The analyzed prognostic factors included clinical classification of COVID-19, gender, age, comorbidities, history of ventilator support, history of hospitalization and persistent symptoms. Results: A total of 100 subjects were included in this study. The subjects were 53% female, 52% aged ≥ 12–18 years, and 76% had at least one comorbidity, the most common being obesity (27%). The majority (73%) had a history of mild COVID-19, and 78% were not hospitalized. The prevalence of impaired lung function was 47%, dominated by restrictive lung pattern. The prevalence of long COVID was 18%, with the most common symptom being fatigue (13%). The presence of persistent symptom is significantly associated with abnormal spirometry result (p = 0.03, RR 1.99; 95% CI 1.38–2.87). Undernourished status and moderate-to-severe and critical COVID-19 significantly influence long-term respiratory function with p = 0.002, aOR 5.64; CI 95% 1.89–16.85 and p = 0.006, aOR 5.18; and CI 95% 1.59–16.89, respectively. Conclusions: The prevalence of impaired lung function in children after COVID-19 was 47%. Persistent symptoms, undernourished status, and moderate-to-critical severity of COVID-19 were found to be associated with impaired long-term respiratory function in post-COVID-19 pediatric patients. Further prospective studies are needed to confirm these findings and clarify causal mechanisms. Full article

Long COVID, a condition marked by persistent symptoms following COVID-19 infection, poses significant challenges in regard to clinical management. While emerging pharmacological treatments have demonstrated limited benefits in isolated studies, clinical experience and the literature suggest that low-dose naltrexone (LDN) may be a promising therapeutic option. Therefore, in this systematic review, we aim to synthesise findings from the available literature and evaluate the overall safety and efficacy of LDN as a potential treatment for long COVID. A literature search was conducted using a combination of key terms—‘COVID’, ‘COVID-19’, ‘SARS-COV-2’, and ‘Naltrexone’— and the following databases: MEDLINE, Web of Science (Clavirate), Embase, Scopus, Cochrane Central Register of Controlled Trials (CENTRAL), and Cumulative Index in Nursing and Allied Health Literature (CINAHL). The methodology is available on the PROSPERO database (CRD42025630362). Screening identified five eligible articles. Four studies were included, but only two provided comparable data suitable for meta-analysis. Meta-analysis demonstrated statistically significant improvements in fatigue, brain fog, and headaches. Preliminary evidence suggests LDN has potential benefits in the treatment of long COVID, particularly with respect to fatigue, brain fog, and headaches, but more robust studies, such as randomised controlled trials, are urgently needed to confirm LDN’s safety and efficacy. Full article

The cumulative global incidence of long COVID is around 400 million individuals, yet effective treatment options remain limited. A recent systematic review published in 2025 highlighted promising results for non-invasive brain stimulation in alleviating long COVID symptoms. Given the growing use of repetitive transcranial magnetic stimulation (rTMS) for people with long COVID, a focused meta-analysis on the therapeutic effectiveness of rTMS is warranted. To address this gap, this protocol outlines the planned procedures for a systematic review and meta-analysis. A comprehensive search will be conducted across CINAHL Ultimate, MEDLINE, ScienceDirect, and Scopus. Retrieved studies will be managed using Rayyan, with two independent reviewers screening titles and abstracts, followed by full-text review. Data extraction will follow PRISMA and Cochrane guidelines using a standardised form, with dual independent extraction and reconciliation of discrepancies. Risk of bias will be assessed using Cochrane RoB 2.0. Meta-analytical procedures will include calculation of standardised effect sizes (e.g., Hedges’ g), use of random-effects models, and assessment of heterogeneity via I², Cochran’s Q, and tau². Subgroup and moderator analyses will explore variations in rTMS protocols, participant characteristics, and symptom domains. Sensitivity analyses and meta-regression will be conducted where data permit. Results will be visualised using forest and funnel plots, and the GRADE framework will be used to assess the quality of evidence. Full article

Post-acute sequelae of SARS-CoV-2 infection (PASC) frequently includes persistent fatigue and cognitive dysfunction, but the relationship between these symptoms remains poorly defined. In this prospective observational study at the Henry Ford St. John Long COVID Clinic (LCC) from July 2023 to March 2025, we assessed fatigue severity using the Fatigue Assessment Scale (FAS) and examined its relationship with depression and cognitive symptoms. New patients completed demographic and clinical questionnaires, Patient Health Questionnaire (PHQ)-9, and Montreal Cognitive Assessment (MoCA) at their first LCC visit. Among 41 patients, 35 (85.4%) met the inclusion criteria for fatigue (FAS ≥ 22), with 18 (51.5%) experiencing severe fatigue (FAS > 34). Severe fatigue was significantly associated with shortness of breath, chest pain, and depression. Patients experiencing severe fatigue had significantly higher median PHQ-9 scores (12.5) compared to those with mild to moderate fatigue (5.0, p < 0.001). However, there were no significant differences in MoCA scores between these groups. Our study suggests a strong relationship between fatigue and depression in patients with PASC, emphasizing the importance of integrated physical and psychological healthcare. Moreover, since cognitive performance does not vary with fatigue levels, all PASC patients with cognitive dysfunction should receive routine cognitive screenings, regardless of the severity of their fatigue. Full article

There is a subgroup of people infected with the SARS-CoV-2 virus who manifest lingering sequelae (LongC), with neurological symptoms (nLongC). We recruited 86 COVID-19 volunteers, 35 of whom were fully recovered (Cov) and 51 who had neurological symptoms (nLongC) 4–53 months after infection and compared them to 51 healthy pre-pandemic controls (HC). Thirty-five percent of nLongC individuals carried the apolipoprotein E4 (APOE4) gene, compared to 11% of Cov. Four plasma proteins, interleukin 1 beta (IL-1β), interleukin 8 (IL-8), glial fibrillary acidic protein (GFAP), and hemopexin, continued to be elevated in both Cov and nLongC compared to HC. Soluble CD14 was elevated in nLongC but not Cov. As a group, IL-1β decreased over time in Cov but not nLongC. Two of the elevated proteins, IL-8 and GFAP, correlated with age, with both Cov and nLongC showing higher levels than HC. Using a combination of four plasma proteins, along with age, body mass index, and APOE4 presence, we were able to achieve an area under the curve (AUC) of 0.81. These results suggest that SARS-CoV-2 infection causes a low-grade inflammatory process that, even months or years after infection, does not return to pre-COVID-19 levels, which may contribute to neurologic sequelae and accelerated aging. Full article

Background: Long COVID, or post-acute sequelae of SARS-CoV-2 infection (PASC), affects millions globally, with persistent symptoms impacting quality of life. This meta-analysis synthesizes prospective cohort studies to estimate the prevalence of Long COVID symptoms and identify risk factors. Methods: We systematically searched PubMed for prospective cohort studies (2020–2025) on Long COVID, focusing on prevalence and risk factors. Studies with ≥100 participants and follow-up ≥3 months were included. Data were extracted on symptom prevalence (e.g., fatigue, dyspnoea) and risk factors (e.g., sex, hospitalization). Random-effects models were used to pool prevalence and odds ratios (OR). Risk of bias was assessed using the Newcastle–Ottawa Scale (NOS). Results: Fourteen prospective studies (n = 168,679) were included. Pooled prevalence of Long COVID was 18.0% (95% CI: 12.5–23.5%, I² = 9.8%) among survivors followed for ≥6 months. Fatigue (41.0%, 95% CI: 33.2–49.4%) and dyspnoea (22.5%, 95% CI: 15.6–29.8%) were the most common symptoms. Female sex (OR = 1.52, 95% CI: 1.25–1.92) and prior hospitalization (OR = 2.35, 95% CI: 1.98–2.90) were significant risk factors. High heterogeneity (I² > 90%) was noted. Conclusions: Long COVID affects over one-fifth of SARS-CoV-2 survivors, with fatigue and dyspnoea persisting in many. Female sex and severe acute infection increase risk. Standardized definitions and longer follow-up are needed. Full article

After SARS-CoV-2 infection, a subset of patients experience persistent cardiac symptoms, yet data on long-term cardiac involvement and clinical outcomes in the post-COVID-19 condition remain limited. This study aimed to investigate myocardial abnormalities using advanced cardiovascular magnetic resonance (CMR) imaging techniques in patients with ongoing cardiac symptoms for at least three months following COVID-19 diagnosis, and to assess their clinical outcomes. Between January 2021 and March 2022, 94 post-COVID-19 patients were examined at a median of 99 days (IQR 92–110) after diagnosis and compared to 100 controls. The CMR assessment included the left ventricular ejection fraction (LVEF), myocardial T2 signal, late gadolinium enhancement (LGE), and myocardial strain parameters. Follow-up for major adverse cardiac events (MACEs) was conducted at a median of 269 days (IQR 144–352). While no significant differences in LVEF were observed, post-COVID-19 patients demonstrated significantly reduced peak radial and circumferential strain values, suggesting subclinical myocardial dysfunction. Additionally, these patients exhibited a higher event rate compared to controls (0.063 vs. 0; p = 0.029). These findings indicate that patients with cardiac symptoms following COVID-19 may exhibit subtle but measurable myocardial changes and an increased risk of adverse outcomes. The observed alterations in myocardial strain most likely reflect mild, subclinical myocardial involvement within the spectrum of post-COVID-19 effects, rather than a direct cause of persistent symptoms. Further research is warranted to determine the prognostic significance of these findings. Full article

Background: Erectile dysfunction (ED) is one of the manifestations of long COVID-19 and in most cases has an endothelial and neurogenic nature. Many experimental and clinical investigations have revealed the high efficacy of transcutaneous electrical nerve stimulation (TENS) of the pudendal nerve and low-level laser therapy (LLLT) in the treatment of ED. Purpose: To compare LLLT and TENS, and investigate the dynamics of their efficacy when combined in the treatment of patients with post-COVID-19 ED using the International Index of Erectile Function-15 (IIEF-15). Materials and Methods: This interventional, randomized controlled trial enrolled 82 patients with ED following COVID-19. All patients had their first ED diagnosis after COVID-19 within one month of the onset of respiratory symptoms. The duration of patients’ ED was not less than six months, but less than one year. Patients were divided into four groups, one of which received sham LLLT and TENS (n = 20). The remaining patients underwent effective treatment using LLLT (n = 21), TENS (n = 21), and combined LLLT and TENS (n = 20). To study the effectiveness of the treatment, IIEF-15 and an assessment of tactile sensation in the genital area before and after the treatment, as well as 3 months after the end of the treatment, were used. Results: Both LLLT and TENS had a significant effect in improving erectile function, of 38% (p ≤ 0.01) and 27% (p ≤ 0.01), respectively. The improvement in erectile function after LLLT was higher than after TENS by 8.2% (p ≤ 0.05), but the combination of these methods exceeds the result of using LLLT alone by 20% (p ≤ 0.01). The reduction in hypoesthesia after LLLT did not exceed 17.4% (p ≤ 0.05). However, after TENS, the reduction in hypoesthesia reached 48.7% (p ≤ 0.01), and with a combination of the two methods, it reached 60.9% (p ≤ 0.01). Treatment outcomes in LLLT, TENS, and LLLT + TENS groups were stable for 3 months. Conclusions: According to IIEF-15 dynamics, LLLT and TENS are both very beneficial in treatment of post-COVID-19 ED, with LLLT showing a moderately better outcome than TENS. LLLT and TENS were found to have significant positive therapeutic effects on orgasm, sexual desire, and sexual satisfaction, among other aspects of sexual function. Nevertheless, the combination of LLLT and TENS proved to be much more successful in enhancing all IIEF domains, expanding the therapeutic effect spectrum, and improving the TENS effect following LLLT application. Only after TENS did genital hypoesthesia reliably regress, and the effect was amplified when TENS and LLLT were combined. Full article

Background/Objectives: Individuals experiencing long COVID (LC) frequently report orthostatic intolerance symptoms, which may be linked to autonomic and cardiovascular dysfunction. The active standing test provides a simple, clinically relevant means to assess these impairments. This systematic review aims to determine the use of the active standing orthostatic stress test in evaluating cardiovascular, autonomic, and respiratory responses in people experiencing LC. Methods: A systematic search, according to PRISMA guidelines, was conducted in PubMed, MEDLINE, EMBASE, CINAHL, and Scopus for articles published between 2020 and 2025. This study was registered in PROSPERO CRD-42024615872. Studies were included if they used the active standing test, enrolled adults (≥18 years), included both long COVID and healthy control groups, used continuous beat-to-beat measurements, and reported physiological outcomes. Risk of bias was assessed using the nine-point Newcastle–Ottawa Scale. Results: Three studies (216 participants experiencing LC and 186 controls) met the inclusion criteria. Across studies, LC individuals consistently exhibited elevated heart rate in both supine and standing positions. However, blood pressure findings were more variable: only one study reported 13% of participants met orthostatic hypotension criteria, while another found significant increases in diastolic blood pressure during standing. Long COVID groups also showed reduced heart rate variability compared to controls. Conclusions: Individuals experiencing LC show elevated heart rate and impaired autonomic function during active standing, with subgroup-specific blood pressure changes. These alterations may contribute to dizziness, fatigue, and reduced activity tolerance. Incorporating active standing into clinical assessment could aid early identification of autonomic dysfunction and inform rehabilitation strategies, though more research is urgently needed. Full article

Long-COVID and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome are disabling diseases characterised by ongoing fatigue, post-exertional malaise, cognitive impairment, and autonomic dysfunction. Myalgic Encephalomyelitis/Chronic Fatigue Syndrome typically follows viral infections, whereas Long-COVID exclusively follows SARS-CoV-2 infection, with overlapping but distinct features. This review uses comprehensive searches of online databases to compare their clinical presentations, pathophysiologies, and treatments. Both Long-COVID and ME/CFS appear to involve multifactorial mechanisms, including viral persistence, immune dysregulation, endothelial dysfunction, and autoimmunity, though their relative contributions remain uncertain. Symptom management strategies are consistent, however. Cognitive behaviour therapy has been successful, and there are minimal drug treatments. Graded exercise therapy occupies a contested place, recommending individualised pacing and multidisciplinary rehabilitation. Common and exclusive mechanisms must be identified to formulate valuable therapies. A more significant body of research focusing on immune dysfunction as a pathogenic mechanism for advancing the disease and enabling more effective therapies and diagnostics is needed. Full article

The COVID-19 pandemic was responsible for an unprecedented increase in psychological problems among post-secondary students worldwide. Drawing on data from a repeated cross-sectional (RCS) project, this study investigated changes in psychological symptoms, emotional regulation (cognitive reappraisal and emotional suppression), and academic, social, and personal–emotional college adjustment, and associations between these variables among students in two countries during the phases of lockdown (2021), lifting of restrictions (2022), and the endemic phase (2023). University students in Canada (n = 1014) and Spain (n = 447) completed online surveys during these periods. Students in both countries reported significant declines in perceived COVID-19 stress across the pandemic phases. In comparison with pre-pandemic rates, elevated psychological symptoms remained constant. There were some country differences, but sex differences were consistent. Psychological symptoms mediated the association between cognitive reappraisal and the adjustment measures among Canadian students during each pandemic period. Alternatively, they mediated the linkages of maladaptive emotional suppression with academic, social, and personal–emotional functioning of Spanish students at every phase, but only during the lifting of restrictions and the endemic phase for Canadian students. The results indicate the complexity of country and context in the role of emotional regulation during uncontrollable conditions and provide directions for intervention in stressful situations, including adjustment to university and future disastrous environmental events. Full article

Background/Objectives: Following the global spread of SARS-CoV-2, there was an urgent need for vaccine development to support immune protection. This study aimed to evaluate the impact of active and hybrid immunity on the durability of immunoglobulin G (IgG), neutralizing antibodies, and cellular immune responses over a two-year period. Methods: This longitudinal study was conducted from February 2021 to December 2023 at the Public Health Institute in Ostrava, Czech Republic. Anti-S IgG was measured using ELISA (Euroimmun), neutralizing antibodies via an in-house virus neustralization test (VNT), and cellular immune response using the IGRA test (ELISA, Euroimmun). Participants also completed a questionnaire on demographics, COVID-19 history, symptoms, and vaccination. Statistical analysis included descriptive and non-parametric tests (Mann–Whitney U, Kruskal–Wallis) at a 5% significance level. Results: The cohort included 149 individuals, 97.3% of whom were vaccinated with Comirnaty (Pfizer/BioNTech). A total of 17% had confirmed infection prior to vaccination and showed up to two-fold higher neutralizing antibody levels (p < 0.001) within 2–6 weeks postvaccination. Postvaccination infection was reported in 35% of participants. Although antibody levels declined over the 2–100 week period, participants remained seropositive across all three parameters. Cellular immune response (interferon-γ) remained consistently high throughout follow-up. Conclusions: The study demonstrates long-term durability of IgG and neutralizing antibodies and confirms durable cellular immunity up to two years postvaccination. Hybrid immunity significantly enhanced neutralizing antibody levels, supporting its added value in protective immunity against SARS-CoV-2. Full article

This study investigated the long-term trends in human parainfluenza virus (HPIV) types 1, 2, and 3 in Korea by year, age group, and season. A total of 23,284 nasopharyngeal swabs collected from patients with respiratory symptoms at a tertiary hospital in Korea between 2007 and 2024 were tested for HPIV using real-time reverse-transcription polymerase chain reaction. Of the 23,284 specimens tested, 481 were positive for HPIV-1, 164 for HPIV-2, and 1102 for HPIV-3. HPIV-3 showed the highest incidence between 2010 and 2016, a decline after 2018, a sharp decline during the 2020 COVID-19 pandemic, and a resurgence in 2021. HPIV-1 and HPIV-2 incidence fluctuated between 2007 and 2019, followed by a sharp decline in 2020. HPIV-3 activity peaked in spring and summer, whereas HPIV-1 and HPIV-2 peaked in autumn. For all three types, infection rates were generally highest among children aged 1–12 years, followed by those in infants, but infection rates varied significantly by type, year, season, and age group. These findings emphasize targeted pediatric prevention, predictive modeling of seasonal peaks, and continued molecular surveillance to clarify the genetic and antigenic diversity of HPIV types after the pandemic, supporting the Sustainable Development Goals (SDG 3 for Good Health and Well-Being). Full article