Search Results (88)

Background/Objectives: Long COVID-19 (LC-19), also known as Post-Acute COVID-19 Syndrome (PACS), is a chronic condition some people experience after an initial SARS-CoV-2 infection. The etiology of this complex, multifactorial disease remains largely unknown, although various theories have been propounded. This study aims to profile and compare the metabolic activity of cells of normal and LC-19 patients. Methods: A cohort of 20 individuals, 10 with LC-19 and 10 without LC-19, was selected based on their post-COVID-19 symptomatology. Saliva was tested for opportunistic viruses like Epstein–Barr virus (EBV) and Human Herpesvirus 6 (HHV-6). Lymphoblastoid cell lines derived from blood were analyzed using the Biolog Phenotype Mammalian Microarrays (PM-M1, PM-M6, and PM-M7) to assess metabolic activity across a wide array of growth substrates and effector molecules. Results: Unique metabolic profiles emerged across the controls and LC-19 groups. The SARS-CoV-2 infection causes an over two-fold enhanced utilization of glycolytic and anaerobic substrates and a reduced response to growth factors and effectors. The increased energy source utilization assessed in PM-M1 is unsustainable, and the LC-19 groups demonstrate this with a clear correlation with the number of LC-19 symptoms, demonstrating a trend consistent with metabolic reprogramming. The infection also results in a reduced response to growth factors and effectors, assessed in PM-M6 and PM-M7, with the level of reduction commensurate with the symptom burden. Conclusions: The data from the patient groups were analyzed and compared to construct a metabolic profile unique to individuals who developed LC-19, which could, in the future, be used for diagnosis and to identify targets for therapeutic intervention. Our study identified an LC-19-specific metabolic profile indicative of adaptive responses to stress, cellular dysfunction, and prolonged inflammation, leading to the reprogramming of bioenergetic pathways. Full article

Background: Climate change has contributed to the global resurgence of dengue, with a spike of more than 14.4 million dengue cases. This study aimed to analyze the association between dengue frequency with climatic factors, circulating serotypes, and disease severity in northwestern Mexico. Methods: A retrospective time-series study was conducted using dengue molecular diagnostic data reported between September 2017 and January 2025 by the Laboratorio de Apoyo a la Vigilancia e Investigación Epidemiológica del Centro de Investigación Biomédica de Occidente, Mexico. Data included dengue frequency, serotype distribution, and clinical severity across seven states in northwestern Mexico (Colima, Guanajuato, Jalisco, Michoacán, Nayarit, Sinaloa, and Sonora). Meteorological data were obtained from the Automatic Meteorological Stations of the National Water Commission. Associations between dengue frequency and climatic variables were evaluated using linear regression models. Statistical analyses were performed using SPSS v24 and R v3.5. Results: In Jalisco, minimum, mean and maximum temperatures, as well as precipitation, were significant predictors of dengue cases, explaining approximately 21.7% of the variance (adjusted R² = 0.217, p < 0.001). In Colima and Michoacán, precipitation showed no predictive value. In Guanajuato, the maximum temperature was excluded from the model (adjusted R² = 0.226). Models for Nayarit, Sinaloa, and Sonora excluded two or more climatic variables, with adjusted R² values of 0.111, 0.151, and 0.049, respectively. Conclusions: Climatic conditions and epidemiological time trends explain a modest proportion of dengue cases in northwestern Mexico, with the strongest association observed in Jalisco. Additional determinants, including vector ecology, host immunity, circulating serotypes, population mobility, and public health interventions, should be considered to better understand dengue dynamics. Full article

Measles remains a major global public health challenge as declining vaccination coverage fuels outbreaks worldwide. Although pneumonia is the most recognized respiratory complication, spontaneous air leak syndrome—including pneumomediastinum, subcutaneous emphysema, and pneumoperitoneum—is rarely documented. We report the case of a 9-year-old previously healthy girl with no documented measles–rubella vaccination who presented with fever, maculopapular exanthem, Koplik spots, and persistent cough. Measles was confirmed by both immunoglobulin M enzyme-linked immunosorbent assay and real-time reverse transcription polymerase chain reaction. She developed sudden cervicothoracic swelling and chest pain. Chest radiography revealed pneumomediastinum and subcutaneous emphysema; computed tomography confirmed extensive air leak including pneumoperitoneum. Flexible bronchoscopy and upper gastrointestinal endoscopy excluded structural airway and esophageal injury. Laboratory evaluation revealed elevated hepatic transaminases, gamma-glutamyl transferase, lactate dehydrogenase, and D-dimer. Conservative management with high-flow supplemental oxygen and clinical surveillance led to progressive resolution. The patient was discharged on hospital day three, asymptomatic and breathing room air. This case highlights the spectrum of air leak complications in measles and supports conservative management in hemodynamically stable pediatric patients when structural injury has been excluded. Full article

Objective: Hepatitis B virus (HBV) is a globally distributed infectious disease affecting the liver. This literature review aims to summarize all available relevant information on the PubMed database about HBV’s connection to the microbiome and to consider possible treatment adjuncts. Materials and methods: Database used: PubMed. Keywords used: “HBV”, “Hepatitis B”, “microbiome”. In the PubMed database, 179 research publications were identified using these keywords; 69 studies were excluded as they were irrelevant or retracted. Of the remaining, 110 were analyzed in this literature review, and four additional literature sources were used to supply background information and context. Information was summarized. The analysed studies in total included 14,814 participants (excluding animal studies), of whom 8564 were HBV-infected individuals. Results: Results characterizing abundance or decrease in specific bacterial, viral, and fungal species are heterogeneous; multiple studies support that the HBV patient oral and fecal microbiome is different from that in healthy controls (HCs) and varies throughout disease progression. The HBV seems to transform the microbiome negatively, leading to dysbiosis and decreased microbial diversity in most studies. Evidence links HBV microbiome changes with influence on HbeAg seroconversion, HBV-DNA load, metabolic pathways, liver cirrhosis, and hepatocellular carcinoma. The research proposes that members of microbiota could potentially promote or protect against liver injury in HBV. Four studies proposed that the plasma virome in HBV patients was primarily composed of members of the Anelloviridae. One study researched a parasite (Entamoeba gingivalis) in HBV patients. Two studies analyzed HBV patients’ fungal profiles. Conclusions: Microbiota research, although promising, at the present moment is heterogeneous. HBV patients’ microbiota is distinguishable from HCs, and multiple studies have tried to identify the HBV characteristic microbiome; however, more precise information is needed to draw conclusions. Fecal microbiota transplantation and probiotics have the potential to be therapy adjuncts for HBV patients, but more research is needed. Full article

Background: Dengue virus (DENV) does not have any effective antiviral therapy. The Cinnamomum verum has cinnamic acid and oleic acid that could inhibit important viral proteins. Aim: To compare their inhibitory capacity with the key DENV proteins through molecular docking, molecular dynamics and in silico ADMET. Methods: Phytochemical profiling of the ethanolic extract of the bark was done by GCMS. AutoDock Vina (version 1.2.0) was used to dock cinnamic acid and oleic acid to key proteins of DENV (NS5, NS3, and envelope) in the presence of ribavirin as the reference. The best complexes were then subjected to 50 ns of molecular dynamics simulation and stability measured by RMSD, RMSF, Rg, SASA, hydrogen bonding and RDF. Validated in silico tools were used to predict the ADMET properties. Results: Analysis of GC–MS revealed cinnamic acid (85.92%) and oleic acid (5.33%). The outcome of docking was that the cinnamic acid had the greatest affinity with NS5 (−5.970 kcal/mol) and the capsid protein (−5.755 kcal/mol), and oleic acid showed the highest affinity with the capsid (−6.150 kcal/mol) and then with NS5 (−5.209 kcal/mol). Both ligands had a relatively weak interaction with NS3. Simulation of the molecular dynamics showed the stability of the top complexes, especially the cinnamic acid–NS5 complex, that retained low RMSD (1.6–1.9 A), stable Rg and SASA profiles, and continued hydrogen bonding during the 50 ns period. The use of cinnamic acid in ADMET projections was more preferable, as it was more soluble, orally bioavailable (0.91), and drug-like (QED 0.65), but oleic acid revealed higher lipophilicity and lower drug-like properties (QED 0.29). Conclusions: Cinnamic acid showed specificity towards the NS5 proteins with the help of stable dynamics and good predicted pharmacokinetics, which are features that make it a promising multi-target anti-DENV scaffold. Oleic acid exhibited poor affinity and poor pharmacokinetic properties. The findings are predictive and must be validated using biochemical, cellular, and toxicological means to prove the antiviral efficacy and safety. Full article

Introduction: Trace elements such as zinc, selenium, iron, copper, and manganese play a vital role in human health—especially in how the immune system responds and how the body handles viral infections. These trace elements have complex and sometimes context-dependent effects: while they can strengthen the body’s defenses, imbalances may promote viral replication and worsen tissue damage. Methods: Relevant articles discussed in this narrative review were identified through searches in major databases, including PubMed, Scopus, and Web of Science, primarily those published from 2020 onwards. Discussion: In this review, we examine key findings on how trace elements influence antioxidant defense, modulate viral replication, and regulate cytokine signaling, considering the context of innate immunity and the pathology of viral diseases. We discuss their impact on major infections such as HIV, viral hepatitis, and coronaviruses, highlighting how deficiencies or excesses of certain minerals can affect disease severity, immune responses, and clinical outcomes. The therapeutic use of trace element supplementation is also examined, emphasizing the importance of maintaining proper balance to avoid harmful effects. Conclusions: These findings contribute to a deeper understanding of the complex relationship between micronutrients and viral infections, which can inform the development of more effective prevention and treatment strategies. This review underscores the need for further clinical and experimental studies to define optimal levels of these elements in different health and disease scenarios. Full article

Background/Objectives: This study aimed to determine the prevalence of persistent symptoms and the radiological and laboratory evolution at 6 months and 5 years after discharge in patients hospitalized for SARS-CoV-2 pneumonia during the first wave of the pandemic in Spain and to estimate the healthcare impact of their follow-up. Methods: A retrospective longitudinal observational study was conducted at the “Hospital Central de la Defensa”. A total of 200 patients aged >18 years with a diagnosis of SARS-CoV-2 pneumonia were screened. Clinical, radiological, and laboratory data were collected from electronic medical records. Patients with symptoms or radiological abnormalities at discharge underwent in-person evaluations, while the remainder were assessed by telephone. Results: A total of 182 patients met the inclusion and exclusion criteria. Of these, 112 were assessed in the outpatient setting; 60.7% required in-person evaluations, with normal pulmonary auscultation in 93.6%, complete radiological resolution in 85%, and normalized laboratory parameters in almost all cases. At 6 months, 26.5% presented at least one residual symptom, whereas only three patients (4.5%) reported symptoms at 5 years. No risk factors associated with symptom persistence were identified. The estimated cumulative healthcare cost was EUR 21,627.50. Conclusions: Among patients hospitalized for SARS-CoV-2 pneumonia during the first wave of the pandemic, 26.7% and 4.46% presented at least one persistent symptom at 6 months and 5 years after discharge, respectively. Full article

Background: Zoonotic spillover events with pandemic potential are increasingly associated with environmental change, ecosystem disruption, and intensified human–animal interactions. Although the specific origin and timing of future pandemics remain uncertain, there is a clear need to complement traditional preparedness strategies with approaches that support earlier anticipation and prevention. Objectives: This study aims to propose a conceptual approach to reframe pandemic preparedness toward proactive surveillance and spillover prevention. Methods: We introduce a tachyon-inspired conceptual approach, using a thought experiment based on hypothetical faster-than-light particles to illustrate anticipatory observation of pandemic emergence. The framework is informed by interdisciplinary literature on emerging infectious diseases, One Health surveillance, predictive epidemiology, and public-health preparedness. Results: The proposed approach highlights the importance of proactive, integrated surveillance systems that combine human, animal, and environmental data. Key elements include the use of advanced analytical tools such as neural networks, early characterization of population risk profiles, strengthened public-health infrastructure, coordinated governance, adaptable financial resources, and a resilient healthcare workforce. The integration of animal welfare considerations, translational research, and planetary health principles is emphasized as central to reducing spillover risk. Conclusions: Tachyon-inspired thinking offers a conceptual tool to support a shift from reactive pandemic response toward proactive anticipation and prevention. Embedding integrated surveillance and One Health principles into public-health systems may enhance early detection capacity and contribute to mitigating the impact of future pandemics. Full article

Background: Respiratory syncytial virus (RSV) pneumonia is an underrecognized cause of critical illness in adults. However, the influence of biological sex on intensive care unit (ICU) outcomes in this population remains unclear. Due to limited case numbers and incomplete covariate data, this study was designed as exploratory and hypothesis-generating. Methods: We conducted a retrospective exploratory cohort study using the MIMIC-IV database and identified 105 adult ICU patients with laboratory-confirmed RSV pneumonia. Clinical variables included sex, age, ICU length of stay, use of mechanical ventilation, and weaning status. Exploratory multivariable logistic regression was performed to assess associations with in-hospital mortality and weaning success, acknowledging substantial missingness of comorbidity data, severity scores, and treatment variables. This limited adjustment for confounding and statistical power. Results: Overall, in-hospital mortality was 33.3%. Mortality was significantly higher among women than men (51.6% vs. 7.0%; p < 0.001), although the absolute number of deaths in men was very small. In adjusted models, female sex (OR 14.6, 95% CI 1.58–135.3, p = 0.018), reflecting model instability due to sparse events, as well as longer ICU stay (OR 1.22 per day, p = 0.001) were independently associated with higher mortality. Female sex was also associated with lower odds of successful weaning (OR 0.07, 95% CI 0.01–0.63, p = 0.018). These effect estimates must be interpreted cautiously due to the very small number of deaths in men and the resulting wide confidence intervals. Age and ventilation duration were not significant predictors. Conclusions: In this preliminary ICU cohort, female sex and prolonged ICU stay were linked to higher mortality and lower weaning success in adults with RSV pneumonia. However, given the very small number of events—particularly among male patients—together with the modest sample size, limited covariate availability, and unstable effect estimates, the findings should be viewed as exploratory rather than confirmatory. Larger, well-powered, prospective multicenter studies are needed to validate and further characterize potential sex-related differences in outcomes of RSV-associated critical illness. Full article

Background: The continuous emergence of SARS-CoV-2 variants represents a major public health concern. Next-generation sequencing (NGS) enables genomic surveillance, facilitating the detection and monitoring of mutations that impact viral evolution. Methods: In this study, full-length SARS-CoV-2 genomes were analyzed between February 2022 and March 2024 as part of routine genomic surveillance conducted in Verona, Italy. Mutations in the envelope (E), membrane (M), and nucleocapsid (N) structural proteins were investigated. Only substitutions with a total prevalence of greater than 1% in the study dataset were considered. Results: A total of 178 mutations were identified across the three proteins (E: 16; M: 33; N: 129), of which 18 met the inclusion threshold (E: 3; M: 5; N: 10). Mutations were classified according to temporal dynamics as fixed, emerging, or transient. Throughout the study period, fixed mutations were consistently prevalent, emerging mutations appeared later but persisted with an ascending trend, while transient mutations displayed a single frequency peak before disappearing. Several mutations were reported with potential structural or functional relevance based on the existing literature, while others remain of unknown significance. Conclusions: The mutational patterns detected in this study broadly reflect global evolutionary trends of SARS-CoV-2. These findings emphasize the importance of continued genomic surveillance and underline the need for integrated experimental approaches to clarify the biological and epidemiological impact of poorly characterized mutations. Full article

Background/Objectives: Respiratory syncytial virus (RSV) significantly affects young children. In 2020, at the beginning of the COVID-19 pandemic, widespread public health measures temporarily interrupted RSV transmission. However, by mid-2021, an atypical resurgence of RSV was observed. The objective of this study was to compare the clinical and epidemiological characteristics of RSV infections in children before and during the second half of the SARS-CoV-2 pandemic in Mexico. Methods: A comparative ambispective longitudinal epidemiological study was conducted using two distinct cohorts: one from 2010 to 2013 and another from 2021 to 2023. The study included children under five years of age diagnosed with RSV-related pneumonia. Statistical analyses included Student’s t-tests, chi-square tests, and logistic regression to identify risk factors associated with severe pneumonia. Incidence density was calculated as the number of RSV-positive pneumonia cases per 10 new pneumonia admissions per month. Results: The mean age of affected children increased from 10 to 15 months. RSV activity began earlier in 2021, emerging during the summer months, and showed a higher incidence than in previous seasons. RSV type B was significantly more common during the pandemic period (58.5% vs. 3.8%), and the proportion of co-infections also increased (60% vs. 39%), indicating a change in the viral landscape. Conclusions: These findings indicate a shift in RSV seasonality toward summer and autumn, increased case incidence, and infections in older children. These observations underscore the need for ongoing surveillance to better understand evolving RSV patterns, especially in the context of complex public health scenarios like the COVID-19 pandemic. Full article

Background: Tuberculosis (TB) remains a public health concern in Saudi Arabia, where primary care physicians play a crucial role in early detection and infection control. This study assessed physicians’ knowledge, attitudes, and practices (KAP) regarding TB infection control in Riyadh. Methods: A cross-sectional survey was conducted among 205 physicians in primary healthcare centers using a validated electronic questionnaire. Knowledge scores were classified as good (≥8/14 correct) or poor (<8). Descriptive statistics and chi-square/t-tests were applied. Results: The mean knowledge score was 8.5 (SD = 2.1); 57.1% of physicians demonstrated good knowledge. Knowledge was significantly associated with specialization (p = 0.049), position (p = 0.031), and monthly patient load (p = 0.031). While 92.7% correctly identified airborne transmission, only 30.7% knew when a TB patient becomes noninfectious. Most participants (80%) had not received TB-related training in the past year. Conclusions: Primary care physicians in Riyadh show moderate knowledge and positive attitudes, but important gaps remain in diagnostic clarity and infection control timelines. Strengthening continuous medical education and integrating TB-specific modules into the Saudi national TB control program are essential to standardize practices and improve patient outcomes. Full article

Background: Dengue fever is an arboviral infection transmitted by Aedes mosquitoes that has recently become a public health concern also in Europe, causing many outbreaks of autochthonous cases. Methods: We retrospectively retrieved dengue cases in returning travelers from tropical areas diagnosed at the Luigi Sacco Hospital between January 2018 and December 2024. All patients with positive serology for DENV (IgM alone or IgM and IgG or neutralizing antibodies detection) and/or positive real-time polymerase chain reaction (RT-PCR) for DENV RNA on plasma and urine were considered. Analyses were descriptive. Results: This analysis included 159 travelers with confirmed (n = 138; 86.8%) or probable (n = 21; 13.2%) dengue fever. The median age was 38 years (interquartile range [IQR] 30–50); 87 (54.7%) were females. The median time between symptom onset and seeking medical attention was four days (IQR 3–6); 29.6% required hospitalization, with a median stay of four days (IQR 0–5). The most common symptoms included fever (100%), myalgia (52.2%), and headache (49.1%). Laboratory findings revealed thrombocytopenia (53.8%), leukopenia (64.1%), elevated ALT (51.9%), and LDH (60.2%). Among the confirmed cases, 128 (92.8%) were diagnosed with RT-PCR. Serotypes 1 and 2 were the most prevalent (28.9% and 27.3%, respectively). Most cases were classified as dengue without warning signs (150, 94.3%), eight cases (5.0%) as dengue with warning signs, and one as severe dengue. Conclusions: Dengue fever is an important cause of fever among travelers returning to Italy from endemic areas. Although severe dengue is rare among travelers, further prospective studies need to address this issue. Diagnosis should be pursued by using molecular tools because of cross-reactivity with other arboviruses. Full article

Background: Although the safety of COVID-19 vaccines has been demonstrated in clinical trials, real-world pharmacovigilance remains essential to detect rare or unexpected adverse events following immunization (AEFI). In Mexico, the national AEFI surveillance system is in place, yet there is limited analysis of state-level data. Objective: To characterize AEFI related to five COVID-19 vaccines and identify factors associated with AEFI type and seriousness in Nuevo León, Mexico. Methods: A retrospective analysis of the State of Nuevo León AEFI database was conducted, including all AEFI reports between December 2020 and June 2022 (n = 2213). Data included patient sex, age, vaccine type (Pfizer/BioNTech, AstraZeneca, Sinovac, Moderna, CanSino), number of doses (1 or ≥2), symptom categories, and AEFI seriousness. Symptoms were classified as local or systemic and grouped by organ systems. Descriptive analysis and binary multivariate logistic regression were used to examine associations between demographic and vaccine-related factors with AEFI type and severity. Odds ratios (OR) with 95% confidence intervals (CI) were estimated. Results: Most AEFI reports involved females aged 19–59 years and occurred after the first vaccine dose. The most frequently reported unexpected adverse events (UAEs) were mild to moderate, including injection-site reactions, headache, chills, fatigue, nausea, fever, dizziness, weakness, myalgia, and tachycardia. The Pfizer/BioNTech vaccine was associated with higher odds of arm pain and lower odds of hemorrhagic events. Receiving ≥2 doses increased the odds of arm pain and systemic symptoms. Less than 3% of AEFIs were classified as serious. Older adults (≥65 years) and second vaccine doses were associated with increased odds of a serious AEFI, while female sex and receiving the Pfizer/BioNTech vaccine were associated with reduced odds. Conclusions: In Nuevo León, most AEFIs related to COVID-19 vaccination were mild to moderate and resolved without complications. Serious AEFIs were uncommon, with older age and second doses associated with higher risk, and female sex and Pfizer/BioNTech vaccination associated with lower risk. These findings provide a local perspective on vaccine safety that complements national and international evidence. Full article