All articles published by MDPI are made immediately available worldwide under an open access license. No special
permission is required to reuse all or part of the article published by MDPI, including figures and tables. For
articles published under an open access Creative Common CC BY license, any part of the article may be reused without
permission provided that the original article is clearly cited. For more information, please refer to
https://www.mdpi.com/openaccess.
Feature papers represent the most advanced research with significant potential for high impact in the field. A Feature
Paper should be a substantial original Article that involves several techniques or approaches, provides an outlook for
future research directions and describes possible research applications.
Feature papers are submitted upon individual invitation or recommendation by the scientific editors and must receive
positive feedback from the reviewers.
Editor’s Choice articles are based on recommendations by the scientific editors of MDPI journals from around the world.
Editors select a small number of articles recently published in the journal that they believe will be particularly
interesting to readers, or important in the respective research area. The aim is to provide a snapshot of some of the
most exciting work published in the various research areas of the journal.
Since 1996, MDPI has been committed to supporting the research community by providing the latest research freely available and making relevant and useful research available as quickly as possible. The world is current experiencing a pandemic of COVID-19, and researchers are working extremely hard to understand it and find a cure.
The values MDPI holds strongly are particularly important at the moment, and we will continue to publish relevant, peer-reviewed research as quickly as possible in open access format. This means that it will immediately be available for researchers, health professionals, and the general public to read, distribute, and reuse. We believe that scientific advancements will be crucial to overcoming this pandemic, and will do everything we can to support researchers working looking for solutions.
This page contains a variety of information related to COVID-19 available from MDPI, including journal articles, special issues, and preprints, among others.
The overlapping circulation of influenza (Flu), severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2; SC2), and respiratory syncytial virus (RSV) continues to challenge clinical laboratories, particularly in settings with limited automation and fragmented healthcare coverage. This study expanded the CDC Flu-SC2 assay by incorporating
[...] Read more.
The overlapping circulation of influenza (Flu), severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2; SC2), and respiratory syncytial virus (RSV) continues to challenge clinical laboratories, particularly in settings with limited automation and fragmented healthcare coverage. This study expanded the CDC Flu-SC2 assay by incorporating a laboratory-developed test (LDT) for RSV A/B detection into a fully automated quadruplex RT-qPCR (LDRA) on the Panther Fusion® Open Access™ system. The design, based on more than 8000 RSV genomic sequences targeting the conserved M gene, achieved optimal amplification efficiencies (97–105%) and full multiplex compatibility. Analytical assessment established limits of detection between 9.6 and 37.8 copies per reaction, absence of cross-reactivity with 30 respiratory pathogens, and inclusivity for 32 viral variants. Commutability and diagnostic performance among the LDRA, CE IVD-marked Allplex™ SARS-CoV-2/FluA/FluB/RSV, and US IVD-marked Panther Fusion® SARS-CoV-2/Flu A/B/RSV Assays were evaluated using 405 nasopharyngeal UTM-preserved swabs. The LDRA demonstrated excellent concordance (overall agreement ≥ 98%, κ > 0.95), strong diagnostic accuracy, and reliable detection of mixed infections. This quadruplex provides a fully automated, rapid, and accurate solution for the simultaneous detection of influenza A, influenza B, SARS-CoV-2, and RSV viruses, enhancing molecular diagnostic capacity and supporting equitable, timely clinical decision-making in middle-income healthcare systems such as that of the Dominican Republic.
Full article
Urban heat islands pose intensifying threats to public health, equity, and urban livability as climate change amplifies temperature extremes. This systematic review synthesizes evidence from 33 primary studies (2021–2025) examining health impacts, mitigation strategies, and policy integration. The analysis focuses on interaction mechanisms,
[...] Read more.
Urban heat islands pose intensifying threats to public health, equity, and urban livability as climate change amplifies temperature extremes. This systematic review synthesizes evidence from 33 primary studies (2021–2025) examining health impacts, mitigation strategies, and policy integration. The analysis focuses on interaction mechanisms, specifically how mitigation strategies differentially reduce health burdens across vulnerable populations, to advance systems-level understanding of urban heat dynamics. Following PRISMA guidelines, the review examined these mechanisms across three interconnected domains: health burdens, physical mitigation effectiveness, and post-pandemic policy synergies. Findings reveal profound inequities in heat exposure and associated health outcomes, with disadvantaged populations experiencing 26–45% higher heat-related mortality risk and 3–4 °C greater exposure than affluent communities, even after controlling for income. Physical mitigation strategies show measurable effectiveness, providing 1–6 °C cooling from green infrastructure and 2–22 °C from cool surfaces. Optimal interventions vary by socioeconomic context, with urban trees being more effective in disadvantaged areas, while cool roofs are better suited to affluent zones. COVID-19 natural experiments demonstrated 30–50% anthropogenic heat reductions, revealing strategic opportunities for integrating heat mitigation with 15-Minute City planning and work-from-home normalization. Effective implementation requires moving beyond isolated interventions toward spatially differentiated, equity-centered strategies aligned across planning, transportation, and governance domains. The post-pandemic period presents a critical window for embedding heat mitigation into broader urban transformation agendas.
Full article
Background: The effect of intrauterine exposure to SARS-CoV-2 infection during pregnancy on neurodevelopment and growth trajectories during the first year of life remains under investigation. Methods: We retrospectively reviewed the electronic medical records of all pregnant women who received care at Mayo Health
[...] Read more.
Background: The effect of intrauterine exposure to SARS-CoV-2 infection during pregnancy on neurodevelopment and growth trajectories during the first year of life remains under investigation. Methods: We retrospectively reviewed the electronic medical records of all pregnant women who received care at Mayo Health System and tested positive for SARS-CoV-2 (RT-PCR) from March 2020 through October 2021 and examined the effects of fetal sex and trimester of maternal SARS-CoV-2 infection on the risk of neurodevelopmental disorder diagnosis and growth trajectories of head circumference (HC) and body weight (BW) percentiles over the first year of life using linear mixed models. Results: We observed that a higher percentage of male infants (n = 357), compared to females (n = 344), have neurodevelopmental disorders (10.9% vs. 5.2%, p = 0.008), and infants exposed to maternal SARS-CoV-2 infection in the second (n = 183) or third trimester (n = 358) have a higher prevalence of neurological diagnoses compared to those exposed in the first trimester (n = 160) (1st vs. 2nd vs. 3rd trimester: 0% vs. 0.9% vs. 0.7%, respectively, p = 0.037). In addition, female infants, compared to males, had significantly lower BW (B = −0.04, p < 0.0001) and HC (B = −0.06, p < 0.0001) percentile growth trajectories over the first year of life. Moreover, infants exposed to maternal SARS-CoV-2 infection in the second trimester had a significantly lower BW percentile growth trajectory (B = −0.01, p = 0.006), while infants exposed to maternal SARS-CoV-2 infection in the third trimester had a significantly lower HC percentile growth trajectory (B = −0.02, p = 0.02). Conclusions: In utero exposure to maternal SARS-CoV-2 infection could have long-term effects on growth trajectories, depending on the infant’s sex and timing of exposure.
Full article
Background and Objectives: Secondary bacterial infection drives poor outcomes in older adults with COVID-19, but age-specific microbiology and its interaction with severity scores are not well defined. We characterized respiratory and pleural pathogens, resistance profiles, and their impact on day-5 SOFA/APACHE II in
[...] Read more.
Background and Objectives: Secondary bacterial infection drives poor outcomes in older adults with COVID-19, but age-specific microbiology and its interaction with severity scores are not well defined. We characterized respiratory and pleural pathogens, resistance profiles, and their impact on day-5 SOFA/APACHE II in octogenarians versus younger adults. Methods: We performed a retrospective cohort study of adults with RT-PCR-confirmed coronavirus disease 2019 (COVID-19) at a tertiary infectious diseases center (≥80 years, n = 152; <65 years, n = 327). Respiratory and pleural samples were processed according to EUCAST standards. Identification employed matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS). Pathogen distributions, susceptibilities, and rates of superimposed pneumonia, empyema, and bacteremia were compared by age, and associations between secondary pneumonia, day-5 SOFA/APACHE II, and 28-day mortality were analyzed. Results: Sputum was obtained in 67.1% of older and 65.7% of younger adults, with numerically higher culture positivity in older patients (73.5% vs. 65.1%). Pathogen spectra were similar, dominated by Streptococcus pneumoniae (24.0% vs. 24.3%), methicillin-susceptible Staphylococcus aureus (MSSA) (18.7% vs. 20.7%), methicillin-resistant Staphylococcus aureus (MRSA) (9.3% vs. 6.4%), and Klebsiella pneumoniae, including extended-spectrum β-lactamase (ESBL)-producing strains. Empyema was more frequent in octogenarians (7.9% vs. 3.1%), and pleural cultures were usually positive. Meropenem retained 100% activity against ESBL-producing K. pneumoniae and Pseudomonas in both strata. In ≥80-year-olds, superimposed pneumonia was associated with higher day-5 SOFA (6.6 vs. 5.5) and APACHE II (24.3 vs. 21.0) scores and markedly increased 28-day mortality (37.5% vs. 9.8%). Conclusions: In octogenarians with COVID-19, secondary bacterial pneumonia and empyema are frequent, microbiologically similar to younger adults, and strongly amplify organ dysfunction and mortality even with largely preserved carbapenem susceptibility.
Full article
by
Mmamudi Anna Makhafola, Clarissa Marcelle Naidoo, Chikwelu Lawrence Obi, Benson Chuks Iweriedor, Oyinlola Oluwunmi Olaokun, Earl Prinsloo, Muhammad Sulaiman Zubair and Nqobile Monate Mkolo
Despite growing interest in South African medicinal plants, advanced metabolomic workflows that integrate positive (ESI+) and negative (ESI−) ionization modes in UPLC-MS/MS remain sparsely applied to South African flora, and especially to Acorus calamus and Lippia javanica species. Herein, application of a dual-polarity
[...] Read more.
Despite growing interest in South African medicinal plants, advanced metabolomic workflows that integrate positive (ESI+) and negative (ESI−) ionization modes in UPLC-MS/MS remain sparsely applied to South African flora, and especially to Acorus calamus and Lippia javanica species. Herein, application of a dual-polarity (positive (ESI+) and negative (ESI−) ionization modes) using an untargeted UPLC–MS/MS workflow, integrated with HEK293T cytotoxicity screening, to map their metabolomes, and rank potential signature metabolites for targeted antiviral follow-up. SwissADME supported in silico drug-likeness. Neither plant extract was cytotoxic across the concentration range, with absorbance-based cell viability of 73.82% for L. javanica and 77.23% for A. calamus at 250 µg/mL, and fluorescence-based cell viability ≥59.87% and ≥55.89%, respectively. Dual-polarity expanded coverage with ESI− yielded 312 features, compared with 225 with ESI+, consistent with the predominance of acidic phenolics in plant species. Unsupervised and supervised models segregated the plant species (PCA PC1/PC2 variance: ESI+ 89.4%/3.0%; ESI− 93.5%/1.8%; R2X(cum) = 0.799). Differential analysis identified 118 significant features in ESI+ with 80 up-regulated, 38 down-regulated, and 139 in ESI− with 96 up-regulated, 43 down-regulated. The ESI− showed the wider dynamic range. Chemotypes enriched among significant metabolites include flavonols of 3-O-methylkaempferol, apigenin, and conjugates of Pollenin A, iridoid glycosides of oleoside, forsythoside B, and jasmonate-pathway oxylipins of 7-epi-12-hydroxyjasmonic acid and its glucoside. These also include caryoptosidic acid and catechin-7-glucoside, which are ionized in both modes, pinning the increase in biomarker robustness. In conclusion, a dual-mode UPLC–MS/MS approach, integrated with cytotoxicity exploration, delivers a complementary metabolome coverage and a safety awareness for shortlisting of potential signature metabolites from L. javanica and A. calamus. Moreover, in vitro inhibition of SARS-CoV-2 papain-like protease (PLpro) by these plants links chemical signatures to antiviral relevance. Shortlisted significant metabolites that demonstrated favorable drug-likeness include flavonol scaffolds of 3-O-methylkaempferol, Pollenin A, and jasmonate-pathway derivatives of 7-epi-12-hydroxyjasmonic acid. Moreover, the dual ionization mode may eliminate ionization bias, broaden metabolome coverage, and yield a mechanism-ready shortlist of metabolites from South African medicinal plants for downstream antiviral investigation.
Full article
Lower respiratory infections (LRIs) are responsible for significant morbidity and mortality in Ecuador; however, evidence to support prevention strategies is limited. This study aimed to identify age-specific trends, spatial patterns, and sociodemographic risk factors of LRI mortality in Ecuador between 2012–2022, utilizing national
[...] Read more.
Lower respiratory infections (LRIs) are responsible for significant morbidity and mortality in Ecuador; however, evidence to support prevention strategies is limited. This study aimed to identify age-specific trends, spatial patterns, and sociodemographic risk factors of LRI mortality in Ecuador between 2012–2022, utilizing national mortality data sourced from the Ecuadorian National Institute for Statistics and Censuses (INEC). Age-sex-specific trend analysis was performed using Joinpoint regression. LRI age-standardized mortality rates (ASMRs) were mapped by province of death, and percentage change was calculated between 2012 and 2019. Multivariable logistic regression was performed to assess risk factors pre- and post-2020. A change in trend in LRI mortality rate, from a decreasing trend to a marginal increasing trend, was identified for both genders in children aged 0–4 and 5–15 years. There were significant increasing trends for males (2014–2019 APC: 2.21%, 95% CI: 0.57, 6.70) and females (2016–2019 APC: 4.62%, 95% CI: 0.84, 10.58) aged ≥ 70 years. From 2012 to 2019, the highest average LRI ASMR was in Guayas (30.90 deaths per 100,000 inhabitants), and the greatest percentage increase was observed in Orellana (419.54%). Before 2020, LRI mortality, compared to deaths of other causes, was significantly associated with sex, age, education, ethnicity, place of death and climate region, with major shifts post COVID-19 pandemic.
Full article
The first webinar in the series, held on 17 April 2020, saw both Prof. Dr. Antoine Flahault, Director of the Institute of Global Health, University of Geneva, Switzerland, and Prof. Dr. Evelyne Bischof, Associate Professor, Shanghai University of Medicine and Health Sciences, Shanghai, China and Research physician, University Hospital of Basel, Basel, Switzerland speak on this topic.
The second webinar in the series, entitled “Coronaviruses: history, replication, innate immune antagonism”, saw Prof. Dr. Susan R. Weiss, Professor of Microbiology, Perelman School of Medicine, University of Pennsylvania speak on this topic.
WEBINAR 3: Could the COVID-19 Crisis be the Opportunity to Make Cities Carbon Neutral, Liveable and Healthy
The third webinar in this series was presented by Prof. Dr. Mark Nieuwenhuijsen, a world leading expert in environmental exposure assessment, epidemiology, and health risk/impact assessment with a strong focus and interest on healthy urban living.
WEBINAR 4: COVID-19 - Global Supply Chains and the SDGs
For the fourth webinar of this series, Prof. Dr. Max Bergman, Dr. Dorothea Schostok and Prof. Dr. Patrick Paul Walsh gave a presentation on Global Supply Chains and the SDGs.
WEBINAR 5: The New Role of Family Physicians in Times of COVID-19
The fifth webinar of the COVID-19 Series saw Prof. Dr. Christos Lionis discuss the new role of family physicians that emerged during the COVID-19 pandemic.
WEBINAR 6: Survey on Symptoms/Signs, Protective Measures, Level of Awareness and Perception Regarding COVID-19 Outbreak among Dentists
In the sixth webinar of this series, Prof. Dr. Guglielmo Campus and Prof. Dr. Maria Grazia present and discuss the risk and the preventions that can and should be taken by dentists during this pandemic.
WEBINAR 7: Living with COVID-19: An Early Intervention Therapeutic Strategy to Control the Pandemic
The seventh webinar of the COVID-19 series, Dr. Hamid Merchant discussed the different therapeutic strategies that can be adopted in the early stages of the infection.
WEBINAR 8: Impact of COVID-19 on Routine Immunization, Reproduction and Pregnancy Outcome
For the eighth COVID-19 webinar, Prof. Dr. Jon Øyvind Odland discussed the effect that COVID-19 seems to have on pregnant women; whereas Prof. Dr. Giovanni Gabutti discussed the role of routine immunization as a way of fighting COVID-19.
