Search Results (2,605)

Background: Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs) are often used in hypertensive patients. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus responsible for the coronavirus disease 2019 (COVID-19) pandemic, binds the ACE2 receptor on the cell surface. This study aimed to identify the risk factors influencing COVID-19 infection in hypertensive patients. Methods: This is a part of a single-center, retrospective, observational study investigating patients ≥ 20 years old at Kenwakai Hospital (Nagano, Japan). COVID-19 was diagnosed by polymerase chain reaction. All patients received antihypertensive drugs. Results: Among 316 patients (mean age, 75.0 ± 13.4 years; men, 55.1%), COVID-19 was diagnosed in 39 (12.3%). Multiple logistic regression analysis after adjustment for age, sex, and smoking status identified increased serum creatinine (Scr) as a significant risk factor for COVID-19 (odds ratio [OR] 1.10; 95% confidence interval [CI] 1.00–1.20; p = 0.046). Conversely, lower serum chloride was associated with COVID-19 (OR 0.92; 95% CI 0.85–0.99; p = 0.047). There was no significant association between COVID-19 and the use of ACEIs and ARBs. Conclusions: Scr was independently associated with COVID-19 risk, whereas ACEI/ARB use was not associated with COVID-19 risk in Japanese hypertensive patients, suggesting that these users need not discontinue or change their treatment. The study population included a very high proportion of patients with advanced chronic kidney disease, which makes the cohort substantially different from the general hypertensive population. However, our results can help guide targeted treatment strategies, improving patient outcomes in healthcare settings. Full article

Background/Objectives: Cancer patients are highly susceptible to infectious diseases due to malignancy- and treatment-induced immunosuppression. The coronavirus disease 2019 (COVID-19) pandemic highlighted this vulnerability, particularly in aggressive tumors such as triple-negative breast cancer (TNBC) and clear cell renal cell carcinoma (ccRCC). However, the molecular mechanisms linking cancer progression with COVID-19 severity remain poorly defined. This study aimed to identify shared molecular signatures between COVID-19 and TNBC, breast cancer, and ccRCC using integrative bioinformatics approaches. Methods: A comprehensive in silico case–control analysis was conducted using publicly available GEO transcriptomic datasets (GSE164805, GSE139038, GSE45498, and GSE105261). Differentially expressed genes (DEGs) were identified by comparing mild and severe COVID-19 cases with each cancer type. Protein–protein interaction (PPI) networks were constructed to identify hub genes, followed by Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses. Regulatory networks involving microRNAs (miRNAs) and transcription factors (TFs) were also examined. Results: Shared hub genes were identified across COVID-19 and cancer datasets, including IGF1, MMP9, and NOTCH1 in TNBC; TOP2A, PXN, and CCNB1 in breast cancer; and ASPM and TTK in ccRCC. These genes are linked to immune regulation, inflammation, cell cycle control, and tumor progression. Enrichment analyses revealed convergent pathways such as MAPK signaling, cytokine–cytokine receptor interaction, Ras signaling, and proteoglycans in cancer. Key regulatory molecules, including miR-145-5p, miR-192-5p, miR-335-5p, and transcription factors NFKB1, BRCA1, and TP53, modulated both viral and oncogenic processes. Severe COVID-19 was associated with enhanced inflammatory and proliferation-related signaling across all cancer types. Conclusions: This integrative, severity-stratified analysis identifies shared molecular and regulatory features linking severe COVID-19 with aggressive cancers, highlighting persistent immune activation and altered immune communication as common underlying themes without implying causality or clinical outcome effects. These findings provide a systems-level, hypothesis-generating framework for understanding virus–cancer interactions and may inform future biomarker discovery and immune-focused therapeutic strategies in vulnerable cancer populations. Full article

Background: Knee osteoarthritis causes considerable pain and disability. Telerehabilitation has emerged as a promising treatment option, especially after the Coronavirus Disease 2019 pandemic, but it still faces challenges regarding solid scientific evidence about its multiple benefits. This systematic review aimed to analyze the reported beneficial effects of telerehabilitation based on therapeutic exercise for the management of knee osteoarthritis. Methodsː PubMed, PEDro, Web of Science and Cochrane Library databases were used to identify eligible studies. This review followed the PRISMA guidelines and was registered at PROSPERO (n° CRD42024579836). The selected studies underwent a qualitative assessment using the Modified Jadad Score. Results: Ten studies, including a total of 1354 participants, were included. From the selected studies, a wide variety of outcome measures emerged to evaluate the efficacy of telerehabilitation in the relief of pain and its clinical consequences. Seven studies specifically assessed pain, with four showing significant improvements in pain reduction in the intervention group compared with the control group. Telerehabilitation was found to be more effective or non-inferior to traditional rehabilitation in relieving pain, as reported across various pain scales. Limitations include the heterogeneity of interventions, the exclusion of non-recent studies, and the exclusive focus on therapeutic exercise. Conclusionsː The results of this systematic review suggest that telerehabilitation provides pain relief, improves physical function, and enhances quality of life, while preliminary evidence indicates potential cost-related advantages. However, some studies did not find TR to be superior to control interventions, highlighting mixed evidence. Additional high-quality studies are required to better support this promising rehabilitation approach. Full article

Complete or partial loss of smell (anosmia), sometimes in association with distorted olfactory perceptions (parosmia), is a common neurological symptom affecting nearly 60% of patients suffering from post-acute neurological sequelae of COronaVIrus Disease of 2019 (COVID-19) syndrome, called long COVID. Severe Acute Respiratory Syndrome CoronaVirus 2 (SARS-CoV-2) may gain access from the nasal cavity to the brain (neurotropism), and the olfactory route has been proposed as a peripheral site of virus entry. COVID-19 is a risk factor for developing Alzheimer’s Disease (AD), an age-dependent and progressive neurodegenerative disorder characterized in affected patients by early olfaction dysfunction that precedes signs of cognitive decline associated with neurodegeneration in vulnerable brain regions of their limbic system. Here, we summarize the recent literature data supporting the causal correlation between the persistent olfactory deterioration following SARS-CoV-2 infection and the long-delayed manifestation of AD-like memory impairment. SARS-CoV-2 infection of the olfactory neuroepithelium is likely to trigger a pattern of detrimental events that, directly and/or indirectly, affect the anatomically interconnected hippocampal and cortical areas, thus resulting in tardive clinical dementia. We also delineate future advancement on pharmacological and rehabilitative treatments to improve the olfactory dysfunction in patients recovering even from the acute/mild phase of COVID-19. Collectively, the present review aims at highlighting the physiopathological nexus between COVID-19 anosmia and post-pandemic mental health to favor the development of best-targeted and more effective therapeutic strategies in the fight against the long-term neurological complications associated with SARS-CoV-2 infection. Full article

The COVID-19 pandemic has profoundly affected societies around the world. Although the emergency phase of coronavirus disease 2019 (COVID-19) has ended, the threat it poses remains persistent. This review aims to clarify the mechanisms of SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) infection to support effective management of the disease. A central focus is the host cellular response to the viral infection, with particular emphasis on the role of cytokines. Cytokines play a dual role in antiviral defense: they contribute to the inhibition of viral replication and facilitate the clearance of pathogens, yet dysregulated cytokine responses can result in severe immunopathology. Interferons (type I, type II, and type III) and other cytokines are pivotal in activating intracellular antiviral mechanisms and in orchestrating the recruitment of immune cells through extracellular signaling. Effective immune responses to viral infections are governed not only by primary immune cells—such as dendritic cells, T lymphocytes, and B lymphocytes—but also by the local cytokine milieu shaped by infected and neighboring cells. Given the presence of endogenous inhibitors and autoantibodies in vivo, it is essential to evaluate the functional activity of cytokines in clinical samples. We propose a novel approach to quantify biologically active cytokine levels. Full article

During the Coronavirus Disease 2019 (COVID-19) pandemic, global awareness of infectious diseases increased markedly. Many infectious diseases are transmitted through direct or indirect contact with biological fluids containing pathogens such as viruses and bacteria. This risk is particularly pronounced in environments used by large numbers of unspecified individuals. Public restrooms, therefore, raise significant hygienic concerns, as toilet seats may serve as vectors for indirect transmission. To mitigate this risk, this study proposes a novel toilet seat equipped with an automatic cleaning function. Specifically, after use, the seat surface is automatically wiped by a cleaning cloth, eliminating the need for manual cleaning by staff. A fundamental operational concept is established, emphasizing the determination of an appropriate cleaning initiation timing that allows the cleaning sequence to be completed without compromising user convenience. Based on this concept, a belt–pulley type prototype is developed, and the effectiveness of the proposed cleaning sequence is verified. Subsequently, the prototype is further improved through the introduction of a flexible-rack mechanism. The control methodology, including the design of the electronic circuitry, is described in detail. Using the improved prototype, extensive simulations and experimental evaluations were conducted. The results showed that battery capacity declined at an approximately constant rate of 3% per 10 cycles, with about 70% remaining after 100 cycles. In addition, a single reciprocating cleaning cycle removed over 95% of artificially applied stains across the entire toilet seat. Additional evaluation results are presented in detail. Full article

The Coronavirus Disease 2019 (COVID-19) pandemic and its prolonged effects have been widely discussed on social media, and these discussions have been analyzed in various studies. A long-term analysis of Twitter (now “X”) posts regarding COVID-19 vaccination is essential for informing policy and improving public health communication strategies. In addition, to prevent the spread of infectious diseases, it is crucial to rapidly promote vaccination while mitigating the impact of negative sentiment toward vaccination on social media platforms. Therefore, identifying the key factors behind negative discussions is important for guiding policy decisions and shaping responses. In this study, we collected Japanese tweets (posts) containing the words “Corona” and “vaccine” that were posted from February 2021 to December 2022. The results indicate that negative sentiment was primarily driven by concerns about adverse reactions and general fear and anxiety, which were particularly prominent before vaccination for the general public began, as well as mentions of pain during and after vaccination. While concerns about adverse reactions persisted throughout the analysis period, their prominence decreased over time as positive reactions became more frequent. Our findings provide insights into the characteristics and key factors behind negative discussions on COVID-19 vaccination in the Japanese context and may help improve public health communication strategies. Full article

Objectives: The purpose of this study was to evaluate the trends and changes in the time to medical imaging in the emergency department (ED) for patients with cardiopulmonary symptoms during the coronavirus disease 2019 (COVID-19) pandemic. Methods: The retrospective observational study was conducted from the clinical database of a tertiary academic teaching hospital. Patients with cardiopulmonary symptoms (chest pain, dyspnea, palpitation and syncope) who visited an adult ED between January 2018 and December 2021 were included. The primary outcome was the time to medical imaging, including chest X-ray (CXR), chest computed tomography (CT), and focused cardiac ultrasound (FOCUS). The primary exposure was the date of the ED visit during the COVID-19 pandemic (from 1 March 2020 to 31 December 2021). Results: Among the 28,213 patients, 17,260 (61.2%) were in the pre-COVID-19 group, and 10,953 (38.8%) were in the COVID-19 group. The time to medical imaging was delayed in the COVID-19 group compared with the pre-COVID-19 group: the time to FOCUS was 9 min, the time to CXR was 6 min, and the time to chest CT was 115 min. Conclusions: We found that the time to medical imaging for patients with cardiopulmonary symptoms who visited the ED was significantly delayed during the COVID-19 pandemic. Full article

Background: Psychological services within hospitals are essential to delivering integrated, patient-centred care, yet in many health systems they remain fragmented, variably organised, or confined to specific medical specialties. The Clinical Psychology Unit of the Fondazione Policlinico Universitario Agostino Gemelli, Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS), represents one of the few examples of a hospital-wide psychological governance model in Italy, but its organisational structure and longitudinal activity have not previously been systematically described. Objective: This study (I) describes the organisational design and operational components of the Gemelli Unit; (II) compares it with international organisational models using a typological framework; and (III) examines its resilience and adaptive capacity during the coronavirus disease 2019 (COVID-19) pandemic. Methods: A descriptive–narrative approach was adopted, integrating institutional documentation, routinely collected service data (2019–2024), anonymised case vignettes, and a structured comparison with national and international psychological care structures. The analysis was informed by theoretical models of integrated health-care delivery and by Donabedian’s structure–process–outcome framework. Results: Between 2019 and 2024, psychological interventions increased from 28,878 to 47,076 (+63%), with a post-pandemic average of 41,868 annual interventions. In 2024, the Unit supported 2150 patients and 340 healthcare professionals, with psycho-oncology accounting for approximately one-third of all activities. The model integrates clinical activity, staff support, conflict management, research, and training under a centralised governance structure, ensuring hospital-wide coverage and coordinated referral pathways. The comparative analysis identified four international organisational types—department-based, liaison/specialty-based, structured health-system, and academic–clinical hybrid—highlighting the hybrid and transversal nature of the Gemelli Unit and its capacity to maintain and adapt services during the COVID-19 emergency. Conclusions: The Gemelli Unit represents a distinctive hospital-wide organisational model that combines centralised governance, transversal deployment, personalised care, and structured support for healthcare professionals. These characteristics position it as a potentially transferable benchmark for health systems seeking to integrate psychological care into core organisational and clinical processes. Future work should prioritise the development of standardised outcome indicators and national frameworks to support the evaluation and harmonisation of hospital-based psychological services. Full article

The coronavirus disease 2019 (COVID-19) pandemic remains a significant public health threat globally with significant socio-economic impacts. People living with human immunodeficiency virus (HIV) (PLWH) have a high risk of severe outcomes of COVID-19 due to immunosuppression. Clinical manifestation of COVID-19 in HIV patients largely remains unclear. We carried out a pilot study to investigate the clinical laboratory data and circulating cytokines in PLWH infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), in Tatarstan, Russia. Serum samples were collected from three groups: PLWH with COVID-19 (PLWH/COVID-19), COVID-19-only, and uninfected controls. We found an increased risk of severe COVID-19 in PLWH/COVID-19 patients compared to COVID-19-only. Four fatal cases were in PLWH/COVID-19, while there was no fatality in COVID-19-only. Pro-inflammatory cytokines, such as IL-5, IL-6, IL-9, and IL-15, were elevated in PLWH/COVID-19 compered to COVID-19-only. These preliminary findings highlight the potential for more severe COVID-19 in PLWH/COVID-19 where pro-inflammatory cytokines could play pathogenic role. Full article

Coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2, has posed major risks for healthcare workers (HCWs) worldwide. This study assessed the prevalence of infection and its relationship with demographic and clinical characteristics among HCWs at the University of Puerto Rico Adult Hospital. A total of 132 individuals were enrolled, of whom six tested positive (4.55%). The study population was predominantly female (78.8%) with a mean age of 41 years, and although men showed higher odds of infection (OR = 3.98), the difference was not significant. Symptom presence was strongly associated with infection: 7.4% of symptomatic participants tested positive compared to none of the asymptomatic (p < 0.001). Symptom count was also predictive, with those reporting three to four symptoms showing the highest positivity rate (14.8%) and those with five to ten symptoms at 6.7%. Specific symptoms including muscle pain (OR = 21.04, p = 0.002), taste loss (OR = 24.20, p = 0.002), smell loss (OR = 15.25, p = 0.024), and fever (OR = 20.50, p = 0.016) were significantly linked to infection, while others such as headache and congestion were not. These findings underscore the utility of symptom-based monitoring in occupational health, though the single-site design, modest sample size, reliance on self-report, and early pandemic diagnostic limitations may have led to underestimation of true cases. Full article

Background/Objectives: The coronavirus disease 2019 (COVID-19) pandemic imposed an unprecedented global health and economic burden, prompting rapid implementation of diverse public health interventions. This review aimed to synthesize global evidence on the cost-effectiveness of key COVID-19 control strategies, including vaccination, testing, and social distancing and to identify methodological, contextual, and equity-related determinants of their economic value. Methods: A narrative literature review was conducted using peer-reviewed studies published between January 2020 and September 2025 and indexed in PubMed, Scopus, and Web of Science. Eligible studies included economic evaluations and modeling analyses addressing COVID-19 interventions in healthcare, community, or educational settings. Data on costs, outcomes, and methodological features were extracted and synthesized descriptively. Results: Across 74 included studies, vaccination—particularly with messenger RNA (mRNA) platforms—emerged as the most cost-effective intervention across all settings, often cost-saving among high-risk populations. Combined or layered strategies integrating vaccination, testing, and selective social distancing consistently outperformed single interventions in both health and economic outcomes. Early and targeted implementation yielded the highest cost-effectiveness by preventing exponential transmission and healthcare overload. However, heterogeneity in modeling assumptions, analytic perspectives, and outcome measures limited comparability. Few studies applied extended or distributional cost-effectiveness frameworks to address equity, while indirect and long-term effects such as productivity losses and “long COVID” were frequently omitted. Conclusions: COVID-19 interventions are most efficient when early, targeted, and adaptive to local epidemiologic conditions. Integrating equity, methodological consistency, and broader societal impacts into future evaluations will strengthen evidence-based, economically sustainable pandemic preparedness and response strategies. Full article

Background: Pediatric urinary tract infections (UTIs) are increasingly complicated to treat due to antimicrobial resistance (AMR). The coronavirus disease 2019 (COVID-19) pandemic has led to substantially reduced pediatric antibiotic prescribing, but its impact on resistance trends remains unclear. This study aimed to investigate the AMR trends in urinary pathogens from children under 24 months of age hospitalized with febrile UTI during the pre-, during-, and post-COVID-19 pandemic periods. Methods: We conducted a retrospective study of children aged <24 months who were hospitalized at a tertiary center in Korea between 2008 and 2023 for first febrile UTI. The patients were stratified by age (<100 days vs. 100 days to 24 months) and pandemic period (pre-, during-, and post-COVID-19). Interrupted time-series (ITS) analysis and multivariable logistic regression were used to assess the temporal trends and predictors of ciprofloxacin nonsusceptibility. Results: Ciprofloxacin susceptibility decreased significantly during the pandemic, especially among infants < 100 days. ITS analysis demonstrated an immediate 12.1% increase in ciprofloxacin nonsusceptibility at pandemic onset, which persisted thereafter. Extended-spectrum β-lactamase production was the strongest predictor of ciprofloxacin resistance. Conclusions: These findings suggest that adult antibiotic use and clonal dissemination may contribute to the persistence and spread of AMR, highlighting the need for integrated stewardship and genomic surveillance. Full article

The coronavirus disease 2019 (COVID-19) pandemic highlighted the critical need for scalable, timely, and unbiased methods to monitor disease transmission at the population level. Wastewater-based epidemiology (WBE) provides an effective method for monitoring severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission by detecting viral RNA shed into the sewage system. Because it does not rely on individual testing, WBE can offer timely, cost-effective, and community-level insights into infection trends. In this study, we present a hierarchical Beta-Binomial model that integrates SARS-CoV-2 RNA concentration in wastewater with reported COVID-19 case counts to enhance the monitoring of community-level transmission dynamics. The model incorporates wastewater viral loads as a predictor and reported cases as the response, while adjusting for testing volume to account for biases introduced by fluctuations in testing practices. This approach enables reliable estimation of the effective reproduction number ($R_t$), even in the absence of consistent reporting of clinical data. Applied to twenty counties in California, our modeling framework demonstrates the potential of wastewater surveillance to inform public health decision making, particularly in locations with sparse clinical data. Full article

Background/Objectives: Coronavirus disease 2019 (COVID-19) has emerged as a multisystem disorder, with acute kidney injury (AKI) representing a frequent and severe complication associated with poor outcomes. This study assessed the incidence, risk factors, and outcomes of AKI in patients with severe COVID-19 across three pandemic waves. Methods: We retrospectively analyzed 561 patients with severe COVID-19 admitted to a tertiary hospital between March 2020 and December 2021. AKI was defined and staged according to KDIGO 2012 criteria. Demographic, clinical, laboratory, and imaging data were evaluated using univariate and multivariable logistic regression and ROC curve analyses to identify predictors of AKI. Results: AKI occurred in 71 patients (12.65%), most frequently during the third wave (40.9%). Stage 1 accounted for 62% of cases, while 23.9% progressed to stage 3 and 10% required dialysis. Compared with patients without AKI, those with AKI had longer hospital stays (15 vs. 11 days), more intense inflammatory responses (CRP 91.7 vs. 63.3 mg/L, p = 0.002), and higher mortality (35.2% vs. 10.2%, p < 0.001). Multivariable analysis identified elevated serum myoglobin (OR = 1.010, p = 0.001), prolonged corticosteroid therapy (OR = 1.096, p = 0.035), and lower hemoglobin (OR = 0.375, p < 0.001) as independent factors of AKI. Conclusions: AKI in severe COVID-19 is multifactorial, reflecting the interplay of systemic inflammation, cytolysis, coagulopathy, and renal microvascular dysfunction. The risk increases with higher myoglobin levels, longer corticosteroid exposure, and lower hemoglobin, highlighting the need for early identification and preventive strategies in high-risk patients. Full article