Search Results (6,788)

To contrast the COVID-19 pandemic brought by the corona virus SARS-CoV-2, two mRNA-based anti-COVID-19 vaccines (by Pfizer-BioNTech and Moderna) were made available relatively quickly and deployed worldwide based on an emergency approval. Being considered vulnerable and at risk of infection, cancer patients have been prioritized for COVID-19 vaccination and vaccinated repeatedly because of the short time protection provided by these vaccines. Recently, a surge in the incidence and rapid progression of cancers has been observed in many countries, which could (at least partially) represent cancers undiagnosed or untreated during the pandemic. It has also been suggested that the SARS-CoV-2 itself or even the anti-COVID-19 mRNA vaccines could have contributed to the recurrence and worse clinical outcome in cancer patients, given the high incidence of COVID-19 in hospitalized patients and that these patients have been vaccinated with priority several times and in a short period. Although it appears extremely unlikely that SARS-CoV-2 and anti-COVID-19 mRNA vaccines elicit genotoxic events and cause neo-cancerogenesis in a short time, they could still cause non-genotoxic pro-carcinogenic effects by triggering an exaggerated inflammatory reaction, compromising immune homeostasis, stimulating cell proliferation, and negatively affecting cellular stress response and damage repair machinery. This could result in the promotion of regrowth of dormant micrometastases or relapses of stable minimal residual disease. Such a harmful outcome may likely result from a synergy between the virus and the vaccine, especially in multi-vaccinated and multi-infected individuals. Here, I bring the cell pathologist’s point of view and discuss the multiple possible mechanisms by which the virus and the anti-COVID-19 mRNA vaccine might favor tumorigenesis. While a causal link cannot be established at this stage, knowledge of potential carcinogenic risks could help doctors and health policymakers take the best actions to protect vulnerable patients and convince the vaccine developer to design a vaccine free from such harm. Full article

Objective. Limited evidence is available concerning the surgical outcomes of patients with congenital gastrointestinal malformations and perioperative SARS-CoV-2 infection. This study examines the scientific evidence on SARS-CoV-2 infection and congenital gastrointestinal malformations requiring surgery in children. Material and Methods. We performed a systematic review of studies reporting data on children with congenital gastrointestinal malformations and SARS-CoV-2 infection, published in international databases (PubMed and Embase) from pandemic inception up to August 2024. Studies not reporting data on the SARS-CoV-2 infection status on patients with congenital digestive malformation were excluded. We assessed the quality of the included studies according to the Joanna Institute (JBI) appraisal checklist, adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, and registered the protocol with the PROSPERO database (CRD42024550744). Results. From the 902 titles retrieved, eight observational studies met the inclusion criteria comprising 29 patients from countries with different socioeconomic statuses. Most patients were neonates (75%) with a median age of 3 days at diagnosis and male to female ratio of 2:1. In total, 18 (62%) presented upper gastrointestinal tract anomalies, including esophageal atresia ± tracheoesophageal fistula (n = 10, 34.48%), duodenal atresia (n = 3, 10.3%), and congenital hypertrophic pyloric stenosis (n = 5, 17.2%). Lower digestive tract malformations (11, 38%) included anorectal malformations (n = 6, 20.6%), intestinal atresia (n = 3, 10.3%), Hirschsprung disease (n = 1, 3.44%), and Meckel’s diverticulum (n = 1, 3.44%). Surgeries were primarily emergency or urgent procedures and only pyloromyotomy (5/5) was consistently operated minimally invasively. SARS-CoV-2 infection was identified mainly on routine screening (>95%). Of 29 patients, 85% were discharged home, and no postoperative surgical mortality and significant complications directly associated with COVID-19 were identified, although routine postoperative morbidity not linked to SARS-CoV-2 was observed. Conclusions. Pediatric patients with congenital gastrointestinal malformationsand perioperative SARS-CoV-2 infection typically have mild illness and favorable surgical outcomes. SARS-CoV-2 positivity alone should not delay essential surgery when infection control measures are ensured. Standardized, multicenter studies are needed to clarify perioperative risks to and inform management of this high-risk group. Full article

Background: The epidemiology of influenza was disrupted during the COVID-19 pandemic. Following the relaxation of non-pharmaceutical interventions, influenza viruses have re-emerged and caused epidemics with shifts in age distribution and seasonality. This study aimed to characterise the post-pandemic epidemiology of influenza infections among children in Xi’an, China. Methods: A retrospective analysis of laboratory-confirmed paediatric influenza cases spanning three periods [pre-pandemic (1 January 2010–22 January 2020), intra-pandemic (23 January 2020–8 January 2023), and post-pandemic (9 January 2023–31 August 2025)] was conducted. Age-specific incidences were determined by subtypes (lineage) and compared across periods. Seasonal parameters were estimated using a generalised linear model with harmonic terms. Associations between influenza infection and risk of co-detection with other respiratory pathogens were assessed using logistic regression models. Results: Influenza peak activity in the post-pandemic period was 10-fold higher than in the intra-pandemic period. The mean age of infected children increased by 1.4 years (95% CI: 1.2–1.7), shifting towards school-aged children (6–17 years). The seasonal pattern re-established with an earlier peak (13.9 weeks earlier than the pre-pandemic period, 95% CI: 10.4–15.2) and increased amplitude (10-fold and 4-fold higher than the intra- and pre-pandemic periods, respectively). It was observed that A(H1N1)pdm09 positivity was elevated in preschool and school-aged children, whereas B/Victoria infections showed renewed susceptibility among infants [0–5 months vs. 6–35 months vs. 3–5 years vs. 6–17 years: 11.0% (95% CI: 5.1–19.8) vs. 2.8% (1.9–4.0) vs. 4.0% (3.2–5.0) vs. 5.2% (4.5–6.0); p = 0.00014]. Influenza infection was associated with higher risk of bacterial co-detection with Streptococcus pneumoniae (aOR = 1.52, 95% CI: 1.22–1.91) and Haemophilus influenzae (aOR = 1.46, 95% CI: 1.19–1.80), but lower risk of co-detection with SARS-CoV-2 (aOR = 0.52, 95% CI: 0.27–0.99), RSV (aOR = 0.29, 95% CI: 0.11–0.79), and parainfluenza viruses (aOR = 0.16, 95% CI: 0.04–0.65). Conclusions: The post-pandemic landscape of paediatric influenza in Xi’an has undergone substantial reconfiguration, characterised by intensified activity, altered seasonality, and a marked shift in age distribution. The increased bacterial co-detection points out the potential for more severe respiratory co-infections. These findings highlight the importance of optimising vaccination timing and prompting school-aged-children-targeted immunisation programmes in the post-pandemic era. Full article

This review aims to discuss the apparent reduction in pulmonary cancer incidence in the general population during and shortly after the COVID-19 pandemic from a biological and pathophysiological mechanistic point of view. While the epidemiological evidence points to a disruption in the early- and mid-stage diagnostic process, which causes a shift to late-stage lung cancer discovery with no impact on its actual prevalence, an alternative hypothesis based on the intersection of viral and cancer biology could have a real effect on lung carcinogenesis as an independent phenomenon. By weaving together population-level trends, mechanistic insights, and translational oncology, we discuss whether the pandemic-associated decline in lung cancer diagnoses reflects primarily a temporary diagnostic artifact or whether it also reveals biologically relevant intersections between SARS-CoV-2 and pulmonary oncogenesis. The COVID-19 pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has exerted profound and multifaceted effects on global healthcare systems, altering patterns of disease detection, management, and outcomes across nearly all medical disciplines. These disruptions generated what has been termed a “diagnostic deficit”, producing a backlog of undetected cancers that have only partially been recovered in subsequent years. This phenomenon, sometimes described as a “COVID-19 debt” in oncology, is thought to contribute to excess late-stage diagnoses and potentially worse medium-term survival outcomes. Beyond the disruption of medical systems, the pandemic also raised a more speculative but biologically intriguing question: could SARS-CoV-2 infection itself, through direct or indirect mechanisms, influence lung cancer biology? Our review aims to critically synthesize the evidence across seven domains to address this dual hypothesis. (1) We examine the observed effects of the pandemic on cancer incidence, highlighting global registry and health-system data; (2) we review SARS-CoV-2 infection biology, including viral entry, replication, protein functions, and treatment implications; (3) we summarize the pathogenesis of lung cancer; (4) we explore the role of immune checkpoints in tumor immune evasion, followed by (5) analyses of immune dysregulation in acute infection and (6) in long COVID; and (7) finally, we evaluate proposed oncogenic mechanisms of SARS-CoV-2, integrating molecular virology with cancer immunology. We conclude that the “diagnostic deficit” phenomenon was a reality during and immediately post-pandemic. However, a definitive answer to the questions related to the impact of the infection as an independent phenomenon would require advanced research information covering the biology of the viral infection and lung cancer oncogenesis: processes that are not currently implemented in routine clinical laboratory investigations. Full article

The epidemiology of respiratory viruses shifted considerably following the COVID-19 pandemic and the subsequent rollback of non-pharmaceutical interventions (NPIs). The initial global containment strategies implemented during the SARS-CoV-2 outbreak profoundly altered viral transmission dynamics and circulation patterns. As the World Health Organization (WHO) declared COVID-19 no longer a public health emergency in May 2023, viral circulation began reverting to pre-pandemic trends. This retrospective observational study examined the evolving epidemiological patterns of respiratory infections during and after the lifting of NPI, assessing associated clinical manifestations and their relationship with patient-specific risk factors. Data were collected from 307 patients tested between October 2021 and December 2024 using a respiratory multiplex PCR at the Rodolphe Mérieux Laboratory in Lebanon. Results revealed a reemergence of pre-pandemic seasonal trends for most viruses. Rhinovirus remained the most prevalent pathogen, likely due to the absence of a vaccine. Respiratory syncytial virus (RSV) and Influenza A resumed their characteristic winter peaks, while human metapneumovirus (HMPV) showed no co-infections, suggesting viral interference. The persistence of Influenza A and SARS-CoV-2 appeared influenced by vaccine coverage, viral mutations, and environmental factors. Multiplex PCR testing proved to be a valuable yet costly tool for both diagnosis and epidemiological surveillance. Overall, this study highlights the importance of continued viral monitoring in the post-NPI period, reflecting both the effectiveness of NPIs in limiting viral spread and the importance of ensuring wider access to advanced diagnostic methods. 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

The coronavirus disease 2019 (COVID-19) pandemic has revealed a close and multifaceted relationship between viral infection, systemic inflammation, and cardiovascular health. Among the cardiac complications of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), atrial fibrillation (AF)—especially new-onset atrial fibrillation (NOAF)—has emerged as a major determinant of disease severity and prognosis. Clinical studies and meta-analyses show that 5–10% of hospitalized COVID-19 patients develop AF, with markedly higher rates in critically ill individuals. Both pre-existing and NOAF are independently associated with increased risks of intensive care admission, mechanical ventilation, thromboembolic events, and mortality. The underlying mechanisms involve a combination of cytokine-mediated inflammation, endothelial dysfunction, microvascular injury, and dysregulation of the renin–angiotensin–aldosterone system (RAAS). Viral downregulation of angiotensin-converting enzyme 2 (ACE2) receptors contributes to myocardial fibrosis, while hypoxia, oxidative stress, and autonomic imbalance further promote electrical remodeling and arrhythmogenesis. Post-infectious studies indicate that atrial structural changes and autonomic dysfunction may persist for months, predisposing survivors to recurrent arrhythmias. Technological advances in telecardiology and digital medicine have provided new tools for early detection and long-term monitoring. Wearable electroencephalography (ECG) devices, implantable loop recorders (ILRs), and artificial intelligence (AI)-based diagnostic algorithms enable continuous rhythm surveillance and individualized management, improving outcomes in post-COVID patients. This review summarizes current evidence on the epidemiology, pathophysiology, clinical implications, and monitoring strategies of AF in COVID-19. It underscores the importance of integrating telemedicine and AI-assisted diagnostics into cardiovascular care to mitigate the long-term arrhythmic and systemic consequences of SARS-CoV-2 infection. Full article

Background: In the post-pandemic era, respiratory viruses continue to cause substantial morbidity and mortality among hospitalized adults. SARS-CoV-2 and influenza remain the most common pathogens, while RSV and rhinovirus have re-emerged as relevant causes of severe illness. This study compared the characteristics and outcomes of virus-specific infections detected by multiplex real-time PCR over two consecutive seasons. Methods: This retrospective cohort study was conducted at a 1010-bed tertiary-care hospital in Türkiye between June 2022 and June 2024. Adults hospitalized with at least one respiratory virus detected by MRT-PCR were included. Demographic, clinical, and laboratory data were analyzed. Pathogen-specific comparisons were limited to monoinfections, and predictors of in-hospital mortality were identified using multivariable logistic regression. Results: Among 518 admissions, influenza (33.6%) and SARS-CoV-2 (29.3%) were the predominant pathogens, followed by rhinovirus (11.2%), RSV (6.6%), and other respiratory viruses (19.6%). Overall in-hospital mortality was 26.6%. Mortality differed across virus groups in unadjusted analyses, being highest in SARS-CoV-2 and RSV and lowest in rhinovirus. Non-survivors were older, more comorbid, more often immunosuppressed, and more likely to require oxygen therapy or ICU care at sampling. In multivariable analysis, independent predictors of mortality were ICU location at sampling (aOR 5.52), oxygen requirement (aOR 3.39), immunosuppression (aOR 3.67), older age (per 10-year increase: aOR 1.25), and secondary bacterial infection (aOR 7.00). Viral etiology, including SARS-CoV-2, was not independently associated with mortality after adjustment. Conclusions: Among hospitalized adults, mortality was driven primarily by host-related factors and secondary bacterial infection rather than by viral etiology. These findings highlight the need for strengthened adult immunization programs, reliable respiratory virus surveillance, the prevention of bacterial superinfection, and the development of and equitable access to effective vaccines and antiviral therapies to reduce severe outcomes in high-risk adults. Full article

Wastewater monitoring is a well-established form of community-based public health surveillance technology that gained renewed attention during the COVID-19 pandemic as an early warning system for SARS-CoV-2 infection trends. For monitoring data to be effectively translated into public health action, however, communication strategies that address public risk perceptions and foster cooperation are essential. This study focuses on wastewater monitoring in the context of COVID-19 and provides an evidential basis for developing targeted public health messages by segmenting the population into risk perception profiles. A survey of 332 Colorado residents was analyzed using latent class analysis (LCA), revealing four profiles: the worrisome (48%), the practical (19%), the community-oriented (11%), and the minimally concerned (22%). LCA with covariate analysis showed that communal coping orientation, belief in misinformation, and attitudes and knowledge of wastewater monitoring, along with age, education, and political ideology, were associated with these profiles. Findings highlight how communication strategies for community-based public health surveillance can be tailored to different population subgroups. Full article

The ability of a virus to adapt is key to its survival, and this is achieved through mutation, which allows the virus to change and adapt to new environments. To capture the full extent of SARS-CoV-2 diversity in Asturias, samples obtained from nasopharyngeal swabs were characterised using whole-genome sequencing. Between 2020 and July 2024, a total of 4001 sequences were analysed and 5302 mutations were identified. An increase in the positivity rate was observed between 2022 and 2024 in children under 1 year of age. During this period, 55 new circulating variants belonging to 41 pangolin lineages were detected: 24 originated throughout the world and 31 in Asturias (10 detected only in the region, 8 in the rest of Spain, and 13 around the world). A total of 31 new non-synonymous mutations were fixed in the viral population 250 ± 46 (93–620) days after their appearance. During seasonal SARS-CoV-2 circulation, surveillance systems developed during the pandemic continue to detect new indigenous and imported variants without indicating an increase in severity. Full article

Background: Saliva sampling is increasingly used for respiratory virus diagnostics in dentistry and oral medicine due to patient comfort and reduced exposure risk. How routine behaviors—mechanical oral hygiene, rinsing, and food intake—affect short-term SARS-CoV-2 detectability remains insufficiently characterized for clinical workflows. Methods: In this international two-center pilot study, twelve RT-PCR-confirmed COVID-19 patients provided paired mouth-rinse saliva samples and pharyngeal swabs at predefined time points. The study assessed (I) an intensified 3 min mechanical oral hygiene protocol (toothbrushing of teeth, gingiva, tongue, and palate, followed by toothpaste–saliva gargling); (II) repeated short mouth rinses; and (III) postprandial sampling. Viral RNA was quantified by RT-PCR; Ct-trajectories were analyzed intra-individually. Results: Cycle threshold (Ct) values from pharyngeal swabs remained relatively stable over time, whereas mouth-rinse samples exhibited notable fluctuations throughout the 24 h period. An average increase of 3 Ct units was observed three minutes after the final mouth rinse (T24+3). Meal ingestion was associated with increased Ct values, rising by 4–5 units for pharyngeal swabs and 3–11 units for mouth rinses immediately after eating. Conclusions: In clinical dental settings, saliva diagnostics are feasible but acutely modulated by common behaviors. Mechanical oral hygiene, brief rinsing, and food intake can transiently reduce detectable oral SARS-CoV-2 RNA, with potential implications for timing of sampling, chairside triage, and infection-control protocols. This pilot study provides initial evidence supporting the development of standardized pre-analytical instructions (e.g., fasting window, pre-rinse policy, and sampling timing relative to oral hygiene and meals) to enhance the reliability of saliva-based testing in dental care. Full article

During the early months of the COVID-19 pandemic, treatment protocols varied substantially among countries and even between hospitals. This study compared the clinical characteristics, management strategies, and outcomes of hospitalized COVID-19 patients treated in tertiary centers in Türkiye and Bosnia and Herzegovina. We retrospectively analyzed 1338 adults hospitalized with laboratory-confirmed SARS-CoV-2 infection: 657 patients in Tuzla (Bosnia and Herzegovina, June–December 2020) and 681 in İstanbul (Turkiye, April–May 2020). Demographic, clinical, and laboratory data, treatment details (including favipiravir use), need for invasive or non-invasive mechanical ventilation, and in-hospital mortality were extracted from medical records. Patients in Bosnia and Herzegovina were older (61.6 ± 14.4 vs. 56.9 ± 15.8 years; p < 0.001) and had longer hospital stays (9.0 ± 5.5 vs. 7.7 ± 6.1 days; p < 0.001). In the Bosnian cohort, leukocyte, neutrophil, platelet, ferritin, CRP, troponin, creatinine, AST, and ALT levels were significantly higher, whereas hemoglobin and D-dimer levels were lower. The need for ventilatory support was greater in Bosnia and Herzegovina (15.1% vs. 12.2%, p < 0.001), and overall mortality was higher (25.7% vs. 9.3%, p < 0.001). No mortality difference was observed between patients treated and not treated with favipiravir. Despite similar inclusion criteria, patients in Bosnia and Herzegovina exhibited more severe disease, greater organ involvement, and higher mortality than those in Turkiye. Favipiravir use did not influence survival. Inter-country comparisons highlight how differing patient profiles and treatment protocols may impact COVID-19 outcomes; however, interpretation should consider that the two centers contributed data from different phases of the 2020 pandemic, and that country-level differences in circulating variants, healthcare capacity, hospital strain, and evolving clinical guidelines may also have influenced the observed patterns. Full article

The coronavirus disease 2019 (COVID-19) pandemic in Tocantins, Brazil, exhibited distinct phases between 2020 and 2025, with high mortality concentrated in 2020–2021 and subsequent stabilization at residual levels. Using epidemiological data, statistical modeling, and genomic surveillance, we show that the crisis peaked in 2021, coinciding with the circulation of Gamma and Delta, when health system capacity was severely strained. From 2022 onwards, the spread of Omicron led to record incidence but proportionally low mortality, reflecting accumulated immunity, vaccination, and improved clinical management. Vaccination represented the turning point, reducing hospitalizations and deaths by over 90% and driving a clear decoupling between incidence and severity. Interrupted time-series and generalized additive model (GAM) analyses confirmed sustained reductions in transmission and severity associated with mass immunization. Genomic sequencing of 3941 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) genomes identified 166 lineages and successive variant replacements, culminating in the predominance of LP.8.1.4 in 2025. To our knowledge, this is one of the few integrated, long-term analyses (2020–2025) combining epidemiological and genomic data, capturing the full succession of variants up to LP.8.1.4 and highlighting Tocantins as a strategic “variant corridor” linking Brazil’s North and Central-West regions. These findings underscore the dual role of vaccination and genomic surveillance in shaping the epidemic trajectory and the importance of sustaining both strategies to mitigate future health crises. Full article

Background: During the SARS-CoV-2 pandemic, many women were infected or received vaccinations against the virus before or during their pregnancy. Little is known about the possible consequences of vaccination or infection on obstetric outcomes, as well as antibody levels against other infectious agents, such as the TORCH pathogens. Methods: A total of 136 pregnant women were included in our study between March 2022 and February 2024. The concentrations of antibodies against nucleocapsid (NCP), the spike protein of SARS-CoV-2, as well as IgG and IgM antibodies against TORCH, were assessed in the maternal and umbilical cord blood. Results: The patients were grouped into the following categories according to responses given in the questionnaire and antibody titer: controls (neither infected nor vaccinated; N = 17), infected only (N = 35), vaccinated only (N = 21), acutely infected (N = 15), and both vaccinated and experienced a COVID-19 infection (N = 47). No differences between the groups in terms of pregnancy outcomes were found. The presence of IgG antibodies against NCP or spike protein in maternal blood was dependent on the patient’s vaccination status or previous infection, correlating with that in cord blood. The level of maternal IgG against spike protein correlated negatively with TORCH antibodies. Conclusions: The present study demonstrates the infection- and vaccination-dependent formation of SARS-CoV-2-specific antibodies in the mother and their transfer to the unborn child. Further studies are necessary to investigate the interaction between SARS-CoV-2-specific antibodies and antibodies formed by infection (e.g., CMV) or vaccination against other pathogens in the mother and transmitted transplacentally to the unborn child. Full article

This study investigated proteomic differences in nasopharyngeal swabs of SARS-CoV-2-infected patients from Manaus (Brazil) who were hospitalized during the devastating first wave of the COVID-19 pandemic, before the emergence of the deadly P1 SARS-CoV-2 strain. LC-MS/MS proteomic analysis compared 16 matched COVID-19 patient profiles: eight survivors and eight fatalities. A total of 1604 proteins were identified in fatality swabs, and 981 in the swabs of survivors. Our study provides new insights into the cellular mechanisms underlying first-wave COVID-19 deaths from Manaus and identifies hypoxia-related HYOU1, endothelial injury-associated S100A10, and some viral replication proteins (DDX1/17, XPO1) as potential biomarkers of fatal infections. The proteomic profiles of the swabs taken from patients that died collectively suggest that many of the first wave COVID-19 fatalities in Manaus suffered immune-system collapse. Survivor patient swabs showed elevated levels of immune defense proteins (FN1, C4BPA, IGKV1-5), indicating effective antiviral responses. Gene ontology analysis revealed dysregulated secretory pathways in fatalities and did not detect the defense-response pathways in fatality-group datasets that were observed in survivor protein datasets. Interestingly, the NOS2 protein, previously associated with first-wave fatalities, was found exclusively in our fatality swabs. Full article