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Background: The COVID-19 pandemic exposed major deficiencies in global health governance, including fragmented authority, inequitable resource distribution, and weak compliance mechanisms. Although the WHO Pandemic Agreement (2025) addresses several of these gaps, significant operational and institutional challenges remain. This study aims to develop
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Background: The COVID-19 pandemic exposed major deficiencies in global health governance, including fragmented authority, inequitable resource distribution, and weak compliance mechanisms. Although the WHO Pandemic Agreement (2025) addresses several of these gaps, significant operational and institutional challenges remain. This study aims to develop and empirically validate a Global Governance for Health (GGFH) Framework that strengthens leadership, financing, equity, and legal accountability across global, regional, and national levels. Methods: A three-round Delphi study was conducted. Thirty-one experts from diverse sectors, including public health, international law, economics, environment, and diplomacy, evaluated 32 structured governance statements across seven domains. Experts rated all statements using a 7-point Likert scale. Consensus was determined using a strict threshold median ≥ 6; SD ≤ 1.35; ≥75% agreement. Open-text comments were systematically reviewed through thematic analysis. All statements were systematically mapped to the WHO Pandemic Agreement articles to identify areas lacking operational clarity or enforceability. Results: All seven governance domains achieved consensus by Round 3. High agreement emerged on strengthening WHO leadership, implementing sustainable and equitable financing mechanisms, embedding LMIC representation, establishing legal preparedness and capacity-building, and integrating independent accountability tools. Correlation and interdependence analyses demonstrated that governance goals form an integrated, mutually reinforcing system, with financing, equity, and legal frameworks identified as core enablers of effective treaty implementation. Conclusions: The Delphi process validated a comprehensive and operational Global Governance for Health Framework. The GGFH complements the WHO Pandemic Agreement by addressing its unresolved governance, financing, and equity limitations and offers a structured roadmap to guide global pandemic preparedness and treaty implementation.
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Emőke Henrietta Kovács, Máté Rottler, Zoltán Ruszkai, Csanád Geréd, Tamás Kiss, Margit Csata, Barbara Réger, Rita Jakabfi-Csepregi, István Papp, Caner Turan, Péter Hegyi, János Fazakas, Zsolt Molnár and Krisztián Tánczos
Biomedicines2026, 14(1), 254; https://doi.org/10.3390/biomedicines14010254 (registering DOI) - 22 Jan 2026
Background/Objectives: Severe COVID-19 is marked by IL-6-driven inflammation, endothelial injury, and dysregulated coagulation. Although IL-6 antagonists improve clinical outcomes, their effects on the temporal evolution of coagulation and fibrinolysis remain insufficiently defined. This study characterizes inflammatory, endothelial, coagulation, and fibrinolytic trajectories following
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Background/Objectives: Severe COVID-19 is marked by IL-6-driven inflammation, endothelial injury, and dysregulated coagulation. Although IL-6 antagonists improve clinical outcomes, their effects on the temporal evolution of coagulation and fibrinolysis remain insufficiently defined. This study characterizes inflammatory, endothelial, coagulation, and fibrinolytic trajectories following IL-6 receptor blockade in critically ill COVID-19 patients. Methods: In this prospective, exploratory multicenter case series (ClinicalTrials.gov NCT05218369), 15 ICU patients with PCR- or antigen-confirmed COVID-19 received tocilizumab per protocol. Serial sampling at five timepoints (T0–T4) included routine laboratories, comprehensive viscoelastic hemostatic assays (ClotPro®), and ELISA-based endothelial and fibrinolytic biomarkers. Analyses were primarily descriptive, emphasizing temporal patterns through boxplots; paired Wilcoxon tests with FDR correction contextualized within-patient changes. Results: Patients exhibited marked inflammation, hyperfibrinogenemia, endothelial activation, and delayed fibrinolysis at baseline. IL-6 blockade induced rapid suppression of CRP and PCT, progressive declines in fibrinogen, and modest platelet increases. In contrast, vWF antigen and activity further increased, indicating persistent endothelial dysfunction. Viscoelastic testing showed preserved thrombin generation and sustained high clot firmness, while biochemical markers (rising PAI-1, modest PAP increase, and progressively increasing D-dimer) and VHA indices suggested ongoing antifibrinolytic activity despite resolution of systemic inflammation. Conclusions: IL-6 antagonism was associated with rapid attenuation of systemic inflammation but was not accompanied by normalization of endothelial activation or fibrinolytic resistance. The observed hemostatic profile was consistent with attenuation of inflammation-associated coagulation features, while endothelial and prothrombotic alterations appeared to persist during follow-up, warranting further investigation in larger controlled studies.
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The concentration of extracellular vesicles (EVs) in the peripheral blood of COVID-19 patients is increased. Nevertheless, their potential role in the transmission of infection remains unclear. This study was performed to determine whether EVs produced by the sub-genomic replicon system developed in Baby
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The concentration of extracellular vesicles (EVs) in the peripheral blood of COVID-19 patients is increased. Nevertheless, their potential role in the transmission of infection remains unclear. This study was performed to determine whether EVs produced by the sub-genomic replicon system developed in Baby Hamster Kidney (BHK-21) cells could transfer SARS-CoV-2 replicon RNA, leading to the establishment of a viral replication system in human cells. Purified EVs from the SARS-CoV-2 sub-genomic replicon cell line BHK-21 were cultured with a naive human cell line. The success of EV-mediated transfer of SARS-CoV-2 replicon RNA and its productive replication was assessed using G-418 selection, a luciferase assay, immunostaining, and Western blot. We found that the A549 cell line cultured with EVs isolated from SARS-CoV-2 BHK-21 replicon cells developed G-418-resistant cell colonies. SARS-COV-2 RNA replication in A549 cells was confirmed by nano luciferase, Nsp1 protein. SARS-CoV-2 RNA replication causes massive morphological changes. Treatment of cells with the FDA-approved Paxlovid demonstrated a dose-dependent inhibition of viral replication. We isolated two human epithelial cell lines (gastrointestinal and neuroblastoma) and one vascular endothelial cell line that stably support high-level replication of SARS-CoV-2 sub-genomic RNA. Viral elimination did not revert the abnormal cellular shape, vesicle accumulation, syncytia formation, or EV release. Our study’s findings highlight the potential implications of EV-mediated transfer of replicon RNA to permissive cells. The replicon model is a valuable tool for studying virus-induced reversible and irreversible cellular reprogramming, as well as for testing novel therapeutic strategies for SARS-CoV-2.
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Clementina M. van Rijn, Marta Godoy-González, Sol Fernández-Gonzalo, Pierre Souren, Malcolm G. Coulthard, David J. Howard and Marijtje L. A. Jongsma
J. Clin. Med.2026, 15(2), 898; https://doi.org/10.3390/jcm15020898 (registering DOI) - 22 Jan 2026
Background: Long-term cognitive impairment is common among ICU patients who required invasive mechanical ventilation (IMV). Its etiology is likely multifactorial. This preregistered study examined the association between the duration of IMV and cognitive function post-ICU, as well as the moderating effects of age
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Background: Long-term cognitive impairment is common among ICU patients who required invasive mechanical ventilation (IMV). Its etiology is likely multifactorial. This preregistered study examined the association between the duration of IMV and cognitive function post-ICU, as well as the moderating effects of age and cognitive reserve. Methods: A secondary analysis was conducted using data from a published study of COVID-19 ICU survivors. One year after discharge, participants underwent a neuropsychological assessment. Linear regression models were used to evaluate associations between the variables. Results: Among patients who received IMV via endotracheal intubation, ventilation duration was not significantly associated with cognitive performance. In contrast, among tracheostomized patients, longer IMV duration was associated with better cognitive outcomes (Cohen’s f2 = 0.21). Age had a small negative main effect; in combination with IMV duration, f2 increased to 0.31. Cognitive reserve showed a strong positive association with cognitive outcome; in combination with IMV duration, f2 increased to 0.67. The interaction terms were negligible in both cases. Conclusions: We hypothesize that, compared to endotracheal intubation, IMV via tracheostoma may not only reduce the need for sedation, but also provide a more efficient respiratory support, therefore contributing to positive cognitive outcomes. However, IMV via tracheostomy still represents a form of positive pressure ventilation (PPV), which carries risks, such as ventilator-induced lung injury and reduced cardiac output and brain perfusion. These concerns about PPV, combined with our findings, indicate that alternative, non-invasive modes, such as negative pressure ventilation (NPV), warrant evaluation in future trials.
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In the aftermath of the COVID-19 pandemic, instructors in higher education have reported a decline in foundational reading habits, particularly in STEM courses where dense, technical texts are common. This study examines a low-barrier instructional intervention that used generative AI (GenAI) to support
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In the aftermath of the COVID-19 pandemic, instructors in higher education have reported a decline in foundational reading habits, particularly in STEM courses where dense, technical texts are common. This study examines a low-barrier instructional intervention that used generative AI (GenAI) to support pre-class preparation in two upper-division biology courses. Weekly AI-generated audio overviews—“podcasts”—were paired with timed, textbook-based online quizzes. These tools were not intended to replace reading, but to scaffold engagement, reduce preparation anxiety, and promote early familiarity with course content. We analyzed student engagement, perceptions, and performance using pre/post surveys, quiz scores, and exam outcomes. Students reported that the podcasts helped manage time constraints, improved their readiness for lecture, and increased their motivation to read. Those who consistently completed the quizzes performed significantly better on closed-book, in-class exams and earned higher final course grades. Our findings suggest that GenAI tools, when integrated intentionally, can reintroduce structured learning behaviors in post-pandemic classrooms. By meeting students where they are—without compromising cognitive rigor—audio-based scaffolds may offer inclusive, scalable strategies for improving academic performance and reengaging students with scientific content in an increasingly attention-fragmented educational landscape.
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Michael Rovithis, Sofia Koukouli, Anastasia Konstantinou, Maria Moudatsou, Nikos Rikos, Manolis Linardakis, Konstantinos Piliotis and Areti Stavropoulou
Healthcare2026, 14(2), 279; https://doi.org/10.3390/healthcare14020279 (registering DOI) - 22 Jan 2026
Background/Objectives: Professional quality of life influences patient care, staff well-being, and organizational efficacy. The COVID-19 pandemic placed pressure on healthcare professionals, disrupting their professional quality of life and imposing a psychological burden. In Greece, these issues were intensified by a decade of economic
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Background/Objectives: Professional quality of life influences patient care, staff well-being, and organizational efficacy. The COVID-19 pandemic placed pressure on healthcare professionals, disrupting their professional quality of life and imposing a psychological burden. In Greece, these issues were intensified by a decade of economic crisis, marked by constrained healthcare budget, personnel shortages, and insufficient resources. This study investigates the pandemic’s impact on the professional quality of life of Greek healthcare professionals to support targeted interventions. Methods: A cross-sectional study was conducted using descriptive statistics. The participants were a convenience sample of 246 healthcare professionals from a Greek regional university hospital with at least one year of experience and who had worked with COVID-19-positive or potentially exposed but asymptomatic patients. Data were collected between March and June 2021 using the Professional Quality of Life Scale (version 5). Results: Of the 246 participants, 81.3% were women and 33.8% were aged 50 or older. Moderate concern and fear regarding COVID-19 were reported, with 34.6% extremely afraid of transmitting the virus to family or friends and 22.8% to patients or their families. Overall professional quality of life was moderate: compassion satisfaction was moderate to high, while burnout and secondary traumatic stress were moderate to low. Higher compassion satisfaction was linked to holding a position of responsibility. Burnout was associated with having children, permanent employment, years of experience, and increased pandemic-related fear. Higher secondary traumatic stress was associated with older age, more years of experience, and greater pandemic-related fear. Conclusions: These findings support international research and highlight that the moderate levels observed indicate intrinsic motivation based on professionalism in patient care, providing evidence of resilience and coping mechanisms that reduce psychological consequences on well-being due to the pandemic.
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submission deadline 31 Jan 2026
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Keywords: microthrombi; STEMI; long COVID; COVID related acute coronary syndromes; cardiovascular effects of COVID; biology; immune response; genetics; endothelial health
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.
