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SARS-CoV-2 Infection: Focus on Pathophysiological Characteristics, Complications and Effects of...
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SARS-CoV-2 Infection: Focus on Pathophysiological Characteristics, Complications and Effects of Vaccinations

A special issue of Biomedicines (ISSN 2227-9059). This special issue belongs to the section "Microbiology in Human Health and Disease".

Deadline for manuscript submissions: 31 August 2025 | Viewed by 19522

Special Issue Editors

Dr. Barbara Brogna

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Guest Editor
Unit Interventional and Emergency Radiology, AORN, San Giuseppe Moscati Hospital, Contrada Amoretta, 83100 Avellino, Italy
Interests: chest imaging; COVID-19; gastrointestinal imaging; emergency
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Marina Piscopo

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Guest Editor
Department of Biology, University of Naples Federico II, 80138 Napoli, NA, Italy
Interests: histones; sperm proteins; environmental pollution; heavy metals; reproductive health; sperm chromatin; epigenetic modifications; marine organisms; human spermatogenesis
Special Issues, Collections and Topics in MDPI journals
Dr. Carlo Brogna

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Guest Editor
Department of Research, Craniomed Group Facility Srl., 20091 Bresso, Italy
Interests: acetylcholine; bacteriophage; toxin; viruses; coronavirus; bacteria

Special Issue Information

Dear Colleagues,

This Special Issue aims to include high-quality works on both the pathophysiological characteristics and complications of SARS-CoV-2 infections during the different phases of the pandemic, with particular emphasis on pandemic risk assessment, the role of predictive and prognostic biomarkers, if there is a link between autoimmunity and long COVID, the role of the gut and lung microbiome, and the role of imaging and artificial intelligence.

Dr. Barbara Brogna
Prof. Dr. Marina Piscopo
Dr. Carlo Brogna
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Biomedicines is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • SARS-CoV-2 complications
  • SARS-CoV2 prognostic and predictive biomarkers
  • long COVID-19 and autoimmune disease
  • COVID-19 and microbiome
  • artificial intelligence

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Published Papers (4 papers)

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Research

18 pages, 1416 KiB  
Article
Herpes Zoster Reactivation Following COVID-19 and the Risk of Renal, Infectious, and Autoimmune Complications: A Global Propensity-Matched Cohort Study
by Ming-Hung Chien, Joshua Wang, Kuo-Cheng Lu and Chien-Lin Lu
Biomedicines 2025, 13(7), 1628; https://doi.org/10.3390/biomedicines13071628 - 2 Jul 2025
Viewed by 277
Abstract
Background: Herpes zoster (HZ), resulting from the reactivation of latent varicella-zoster virus, has been increasingly observed in individuals following COVID-19. Given the shared immunological disturbances between the two conditions, this study aimed to investigate whether HZ following COVID-19 is associated with an elevated [...] Read more.
Background: Herpes zoster (HZ), resulting from the reactivation of latent varicella-zoster virus, has been increasingly observed in individuals following COVID-19. Given the shared immunological disturbances between the two conditions, this study aimed to investigate whether HZ following COVID-19 is associated with an elevated risk of renal, infectious, and autoimmune complications. Methods: This retrospective cohort study utilized data from the TriNetX global federated health network, encompassing over 9 million adults diagnosed with COVID-19 between January 2020 and January 2022. Patients who developed HZ within one year following COVID-19 diagnosis were compared to 1:1 propensity score-matched controls without HZ. Time-to-event analyses over a three-year follow-up period were conducted to estimate the risks of major adverse kidney events (MAKE; defined as acute kidney injury, dialysis dependence, or severely reduced kidney function with eGFR <30 mL/min/1.73 m2), sepsis, systemic lupus erythematosus (SLE), and rheumatoid arthritis (RA), using Kaplan–Meier survival curves and Cox proportional hazards models. Results: HZ following COVID-19 was significantly associated with increased risks of all four outcomes: MAKE (HR 1.940, 95% CI: 1.866–2.017), sepsis (HR 2.362, 95% CI: 2.250–2.479), SLE (HR 2.667, 95% CI: 2.254–3.156), and RA (HR 2.484, 95% CI: 2.267–2.730). Subgroup analyses identified older age, diabetes, impaired renal function, and elevated inflammatory markers as key risk-enhancing factors. Conclusions: HZ following COVID-19 may serve as a clinical indicator of systemic immune dysregulation and is independently associated with increased long-term risks of renal, infectious, and autoimmune sequelae. Enhanced monitoring of this high-risk population is warranted. Full article
(This article belongs to the Special Issue SARS-CoV-2 Infection: Focus on Pathophysiological Characteristics, Complications and Effects of Vaccinations)
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10 pages, 253 KiB  
Article
The Clinical Impact of the Omicron Variant on Octogenarian Hospitalized COVID-19 Patients: The Results from CoviCamp Cohort
by Pierantonio Grimaldi, Mariantonietta Pisaturo, Antonio Russo, Salvatore Martini, Francesca Ambrisi, Filomena Milite, Giovanni Di Caprio, Fabio Giuliano Numis, Ivan Gentile, Vincenzo Sangiovanni, Vincenzo Esposito, Rossella Pacilio, Giosuele Calabria, Raffaella Pisapia, Canio Carriero, Alfonso Masullo, Elio Manzillo, Grazia Russo, Roberto Parrella, Sebastiano Leone, Michele Gambardella, Antonio Ponticiello and Nicola Coppolaadd Show full author list remove Hide full author list
Biomedicines 2025, 13(7), 1563; https://doi.org/10.3390/biomedicines13071563 - 26 Jun 2025
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Abstract
Introduction: This study aims to investigate the clinical impact of Omicron Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2) infection on the clinical presentation of Coronavirus Disease 2019 (COVID-19) in the very old (≥80 years old) population. Methods: All patients aged 80 years or older, hospitalized [...] Read more.
Introduction: This study aims to investigate the clinical impact of Omicron Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2) infection on the clinical presentation of Coronavirus Disease 2019 (COVID-19) in the very old (≥80 years old) population. Methods: All patients aged 80 years or older, hospitalized from March 2020 to June 2023 with a SARS-CoV-2 infection in one of the 17 COVID-19 units in eight cities of Campania, southern Italy, were enrolled in a multicenter, observational, retrospective study. Results: 341 patients ≥ 80 years of age were included: 80 of them in the Omicron and 261 in the non-Omicron period. Patients admitted during the Omicron period were older (p = 0.0001) and more comorbid, showing more frequently arterial hypertension (p = 0.018), cardiovascular disease (p = 0.0001), chronic kidney disease (CKD) (p = 0.002), chronic obstructive pulmonary disease (COPD) (p = 0.001), and active cancer (p = 0.0001). Severe and critical outcomes were observed more often in the non-Omicron variant (p = 0.0001). Patients in the Omicron group did not show a significantly prolonged hospitalization time (p = 0.063) or a higher likelihood of death during hospitalization (p = 0.097). Discussion: In our study, despite the greater frailty of patients hospitalized during the Omicron period, the disease appeared less severe compared to previous waves, suggesting that the lower severity of the disease could be attributed to virological rather than population characteristics. These findings underscore the importance of prevention strategies for older people, as the administration of vaccination and early antiviral therapies in at-risk subjects. Full article
(This article belongs to the Special Issue SARS-CoV-2 Infection: Focus on Pathophysiological Characteristics, Complications and Effects of Vaccinations)
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13 pages, 943 KiB  
Article
Prevalence, Evolution and Prognostic Factors of PASC in a Cohort of Patients Discharged from a COVID Unit
by Mariantonietta Pisaturo, Antonio Russo, Pierantonio Grimaldi, Caterina Monari, Simona Imbriani, Klodian Gjeloshi, Carmen Ricozzi, Roberta Astorri, Caterina Curatolo, Roberta Palladino, Francesco Caruso, Francesca Ambrisi, Lorenzo Onorato and Nicola Coppola
Biomedicines 2025, 13(6), 1414; https://doi.org/10.3390/biomedicines13061414 - 9 Jun 2025
Viewed by 428
Abstract
Background and Aim: PASC is a potentially debilitating clinical condition consisting of different general symptoms experienced by about 10% of patients with previous SARS-CoV-2 infection. Our study analyses a cohort of patients with a history of hospitalization for COVID-19 and aims to [...] Read more.
Background and Aim: PASC is a potentially debilitating clinical condition consisting of different general symptoms experienced by about 10% of patients with previous SARS-CoV-2 infection. Our study analyses a cohort of patients with a history of hospitalization for COVID-19 and aims to evaluate prognostic factors for experiencing PASC and to investigate the characteristics of patients experiencing PASC symptoms. Methods: This is an observational, monocentric retrospective study including all adult patients admitted to our COVID unit from 28 February 2020 to 30 April 2022, discharged alive, and having performed at least one follow-up visit at our post-COVID outpatient clinic after a minimum of three months from discharge. Patients who experienced persistent clinical manifestations or the development of new symptoms three months after the initial SARS-CoV-2 infection, with these symptoms lasting for at least two months with no other explanation, were defined as having PASC. Results: A total of 429 patients were discharged alive from our COVID Unit and 244 patients performed at least one follow-up visit in our outpatient clinic. Of these, 134 patients did not experience PASC, while 110 patients experienced PASC. Long-COVID patients were more frequently female (43.6% vs. 31.3%, p = 0.048), more frequently presented throat pain and headache at hospital admission (respectively 8.9% vs. 2.5%, p = 0.041 and 15.8% vs. 5%, p = 0.007), and were more likely to have a history of type 2 diabetes mellitus (25.5% vs. 13%, p =0.013). At the multivariable analysis, female gender, type 2 diabetes, and headache at admission were factors associated with PASC. All 46 patients who performed at least two different admissions in our outpatient clinic were divided in two groups: the first including the 16 patients who experienced a reduction or a resolution of symptoms related to COVID-19, the second comprising the 30 patients who experienced clinical worsening or persisting symptoms. Smoking habit was more represented among patients with stable or worsening symptoms (42.3% vs. 7.7%, p = 0.042); myalgias at admission were more frequent in the clinical worsening group (27.6% vs. 0%, p= 0.039); and a larger amount of patients who reported neuropsychiatric symptoms and respiratory symptoms were in the stable or worsening PASC symptoms group. Discussion: In conclusion, this study underscores the complexity of PASC, identifying female sex, Type 2 diabetes, and certain acute COVID-19 symptoms as potential predisposing factors for its development. PASC still represents a substantial public health challenge, and ongoing efforts are essential to better understand its underlying mechanisms and improve patient outcomes. Full article
(This article belongs to the Special Issue SARS-CoV-2 Infection: Focus on Pathophysiological Characteristics, Complications and Effects of Vaccinations)
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19 pages, 852 KiB  
Article
Autoantibodies Targeting G-Protein-Coupled Receptors and RAS-Related Molecules in Post-Acute COVID Vaccination Syndrome: A Retrospective Case Series Study
by Mauro Mantovani, Paolo Bellavite, Serafino Fazio, Giuseppe Di Fede, Marco Tomasi, Daniele Belli and Elisabetta Zanolin
Biomedicines 2024, 12(12), 2852; https://doi.org/10.3390/biomedicines12122852 - 15 Dec 2024
Cited by 1 | Viewed by 17992
Abstract
Background/Objectives: While post-acute COVID-19 syndrome is well known and extensively studied, the post-acute COVID vaccination syndrome (PACVS) is a more recent nosological entity that is poorly defined at the immunopathological level, although it shares many symptoms with the sequelae of viral infections. [...] Read more.
Background/Objectives: While post-acute COVID-19 syndrome is well known and extensively studied, the post-acute COVID vaccination syndrome (PACVS) is a more recent nosological entity that is poorly defined at the immunopathological level, although it shares many symptoms with the sequelae of viral infections. Methods: This single-center retrospective study reports a case series of 17 subjects vaccinated with mRNA or adenoviral vector vaccines who were healthy before vaccination and had never been infected with SARS-CoV-2 but who presented with symptoms similar to PACVS for a median time of 20 months (min 4, max 32). The medical records of all patients referred to our outpatient clinic over a one-year period were retrospectively analyzed. Results: In this group, serological tests showed that, in addition to positivity for anti-spike protein antibodies, a high percentage of subjects were positive for antibodies against G protein-coupled receptors and molecules involved in the response to SARS-CoV-2. In a panel of 16 autoantibodies tested, a few were positively associated with some of the symptoms reported by patients: anti-ATR1 with lymphadenopathy and/or tonsillitis; anti-ACE2 with skin symptoms such as ecchymosis, skin oedema, and rash; anti-MAS1 with widespread burning sensation; and anti-STAB1 with skin oedema and rash. Anti-ADRA2A were negatively associated with memory loss and/or mental fog. ACE2 correlated with the serum levels of anti-S antibodies, supporting the hypothesis of an anti-idiotype mechanism in the immunopathogenesis of PACVS. Conclusions: This exploratory analysis suggests that the levels of autoantibodies directed against ACE2, and probably also MAS1 and STAB1, may serve as biomarkers for PACVS. Full article
(This article belongs to the Special Issue SARS-CoV-2 Infection: Focus on Pathophysiological Characteristics, Complications and Effects of Vaccinations)
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