Development and preliminary clinical verification of an immune age model based on peripheral immune cells.

Initially identified as a respiratory illness, COVID-19 has increasingly been linked to a range of neurologic complications, including myelitis, acute disseminated encephalomyelitis, and Guillain-Barré syndrome. Potential signals of central nervous system involvement-either during active infection or in the postinfectious period-include ataxia and cognitive changes. Though rarely observed in the setting of COVID-19 infection, these neurologic symptoms can be serious, and therefore, providers should maintain a high index of suspicion for central nervous system involvement in patients with current or recent COVID-19 infection. This article presents a rare case of concurrent cerebellitis and corpus callosum cytotoxicity after SARS-CoV-2 infection.

The volume, conductivity and scatter(VCS) based technology developed in the automated hematology analysers provides cellular and functional changes that occur during various infections which elicit responses from different leucocytes to fight the pathogen. COVID-19 infection, a pandemic that affected the world was associated with significant mortality and morbidity. On the other hand, dengue infection is endemic in many parts of India and known for frequent outbreaks. We aimed at a comparative analysis of leucocyte-VCS parameters in SARS-CoV-2 and dengue infections as diagnostic tool. A retrospective study of two hundred cases where CBC with VCS parameters of COVID-19 or dengue positive cases for a period of 6 months were studied. The CBC was performed on automated Beckman Coulter DxH 800/900 automated CBC analysers and the VCS properties of neutrophils, lymphocytes, eosinophils, and monocytes were compared between the two infections and changes were documented. The study included a total of two hundred patients comprising of 100 COVID-19 and 100 dengue cases, respectively. COVID-19 infection was found to be associated with higher WBC count, absolute neutrophil count, and platelet count. In dengue, there was thrombocytopenia, higher absolute lymphocyte, and monocyte count with lower WBC count. COVID-19 showed a higher neutrophil volume and conductivity and dengue showed higher neutrophil scatter parameters. Higher monocyte conductivity was seen in dengue, but mean conductivity and scatter were raised in COVID-19. The ROC curves for relevant parameters showed a lower value implying that none of these parameters can be used individually to predict the severity of the diseases. Significant changes in neutrophils, lymphocytes and monocytes were seen between two infections. When individually analysed, high WBC count and NLR, lymphopenia was noted in COVID-19 and leucopenia, lymphocytosis, thrombocytopenia was seen in dengue. Among VCS parameters, since no single parameter emerged as a predictive tool, individual parameter's predictive accuracy using modelling in adjunct with various parameters can be evaluated for predicting the severity of the disease in the future.

Clinical evidence on BCG vaccination and COVID-19 infection: A systematic review.

Background: COVID-19 infection is caused by a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Many efforts were put to effectively treat the disease, but the number of comparative studies on how different antivirals and immunomodulators impact inflammatory markers in SARS-CoV-2–infected subjects is limited. The objective of this exploratory study was to investigate inflammation-mediated changes in COVID-19 patients in relation to the treatment, based on real-world clinical data. Methods: Fifty consecutive patients with COVID-19 confirmed by reverse transcription-polymerase chain reaction were recruited to the study. The data were retrieved from medical records and comprised medical history, including comorbidities, concomitant therapy, laboratory test results, and clinical outcomes. Charlson Comorbidity Index was calculated for each patient. Lung involvement was evaluated using chest x-ray and/or computed tomography of the chest. The laboratory tests included complete blood count, lactate dehydrogenase, C-reactive protein, procalcitonin (PCT), and Interleukin (IL)-6. Results: Remdesivir was administered in 33 patients, molnupiravir in 8 patients, and baricitinib in 3 patients. The concentration of PCT, maximum IL-6 concentration, and maximum PLT level were significantly different between the molnupiravir subgroup, the no-treatment subgroup, and other treatment subgroups ( P =0.028, P =0.002, and P =0.009). The extent of lung involvement was significantly lower in the molnupiravir subgroup when compared with remdesivir- and baricitinib-treated patients. Conclusions: We showed that inflammation-mediated markers in hospitalized COVID-19 patients were related to clinical symptoms and varied across treatment groups.

Healthcare workers (HCWs) are continuously exposed to stress and potentially traumatic experiences, as during the COVID-19 pandemic. This research aims to investigate the correlates and predictors of Post-traumatic growth (PTG), a positive outcome following adversity, in a group of HCWs during the COVID-19 pandemic. Cross-sectional design. The sample included 168 HCWs (almost 43% were nurses working in hospitals or aging facilities) who were assessed with the PTG Inventory (PTGI) and other indicators of psychological distress (DASS-21) and well-being such as the Positive and Negative Affect Schedule (PANAS), the Mental Health Continuum Short-Form (MHC-SF), and the Satisfaction with Life Scale (SWLS). Regression analyses were calculated to evaluate the relationships among variables. PTG Inventory positively correlated with SWLS (r = 0.256, p < 0.001) and MHC (r = 0.315, p < 0.001), but no correlations with anxiety and depression emerged. Female gender (β = 0.248, p = 0.001), COVID-19 infection (β = 0.222, p = 0.003), and MHC Total score (β = 0.294, p = 0.008) predicted PTGI. Additionally, a significant curvilinear U-shaped relationship existed between DASS-stress and PTGI levels (β = 0.541, p = 0.021), meaning that PTG was lower at a medium level of stress. During the pandemic PTGI in HCWs was more directly predicted by well-being indicators than distress. Prioritizing their well-being, especially in times of crises, could aid in managing stress and trauma in healthcare settings.

mRNA COVID-19 vaccination induces minimal IgA in saliva in the absence of prior clinical or subclinical infection.

Clozapine's immune-modulating effects, including neutropenia and suppression of adaptive immunity, have raised concerns about its potential impact on SARS-CoV-2 infection risk and COVID-19 severity in individuals with treatment-resistant schizophrenia. Findings in the literature remain inconsistent. First, we conducted a longitudinal retrospective study in which we analysed 995 outpatients with severe mental disorders receiving antipsychotic treatment to assess the association between clozapine use and SARS-CoV-2 infection and disease severity. Secondly, we performed a systematic review of the literature and searched for studies published up to July 2025 examining the link between clozapine exposure and SARS-CoV-2 infection. Eight cohort studies plus our dataset were meta-analysed using a random-effects model. In our cohort, clozapine users demonstrated a higher rate of SARS-CoV-2 infection (18% vs. 10%, p < 0.001) and increased COVID-19 severity compared to non-users. The meta-analysis comprised 155,945 participants, with individual study ORs ranging from 0.40 to 2.80. The pooled random-effects OR was 1.53 (95% CI: 1.02-2.30, p = 0.044), indicating a significant association between clozapine exposure and increased infection risk. However, high heterogeneity (I² = 91.2%) suggests variation in effects across studies. Clozapine treatment is associated with an increased risk and severity of SARS-CoV-2 infection. Although meta-analytic results support this association, substantial heterogeneity in pooled estimates highlights the need for further research to clarify underlying clinical and methodological factors influencing risk.

SARS-CoV-2 disease (COVID-19) is increasingly recognized as a thromboinflammatory vascular disorder characterized by dysregulated complement activation, endothelial injury, and sustained hypercoagulability. This review examines emerging evidence that extracellular vesicles act as key intermediaries linking complement activation to coagulation in acute and postacute COVID-19 infection. Recent studies demonstrate that extracellular vesicles released from platelets, endothelial cells, and neutrophils are markedly increased in COVID-19 and exhibit a combined procoagulant and complement-active phenotype. Sub-lytic complement attack, particularly membrane attack complex (MAC) deposition, triggers phosphatidylserine exposure and extracellular vesicle shedding, generating vesicles that support thrombin generation and propagate complement activity in the circulation. Extracellular vesicle-associated complement components, including C1q, C3 fragments, MASP2, and preassembled MACs, promote tissue factor decryption, platelet activation, and assembly of the prothrombinase complex, establishing a self-amplifying thromboinflammatory loop. Proteomic profiling further reveals compartment-specific extracellular vesicle signatures, with systemic extracellular vesicles enriched in complement and coagulation pathways. Importantly, complement-bearing and tissue factor-bearing extracellular vesicles persist beyond acute infection and are increasingly implicated in postacute sequelae of COVID-19. Extracellular vesicles serve as mobile platforms integrating complement activation with coagulation, providing a mechanistic framework for acute and chronic immunothrombosis in COVID-19. Targeting extracellular vesicle-mediated complement-coagulation crosstalk may offer novel diagnostic and therapeutic opportunities.

Consumers Perception of the Count On Me NC Program During the COVID-19 Pandemic.

Objective:To compare the effects of remote interactive voice therapy versus traditional in-person therapy on treatment adherence and clinical outcomes in patients with voice disorders. Methods:A retrospective historical control study was conducted, categorizing patients into three groups based on distinct periods of COVID-19 prevention policies: the 2019 traditional therapy group（n=82）, the 2021 traditional therapy group（n=43）, and the 2022 remote therapy group（n=54）. Adherence differences were analyzed by geographic subgroup（Guangzhou vs. non-Guangzhou）, and improvements in Voice Handicap Index（VHI）, jitter, and shimmer were compared pre-and post-treatment. Results:Adherence: The overall〓adherence rate in the 2022 remote therapy group（38.89%） was higher than in the 2019（31.71%） and 2021（23.26%） traditional groups, although the difference was not statistically significant（P>0.05）. Notably, non-Guangzhou patients exhibited significantly higher adherence with remote therapy（2022: 45.45%） compared to traditional therapy（2019: 5.00%; 2021: 0）（P<0.01 for both comparisons）. Efficacy: Among patients with good adherence, all three groups showed significant improvements in VHI, jitter, and shimmer（all P<0.01）. Further analysis revealed no statistically significant differences in the magnitude of improvement between the 2022 remote group and the 2019/2021 traditional groups（all P>0.05）, indicating comparable therapeutic efficacy. Conclusion:Remote interactive voice therapy significantly enhances adherence among non-local patients, with equivalent efficacy to traditional in-person therapy. This approach provides an effective solution to overcome spatial and temporal barriers in voice rehabilitation, and holds important practical significance for optimizing voice disorder management strategies and improvinghealthcare service accessibility.

In this study, (76) cases of confirmed COVID-19 patients were included, of them, (38) severe cases and (38) non severe cases. There were many demographic data included in the present study includes; age, sex, geographic distribution, ABO system, vaccine. All of 76 cases of COVID-19 subjected to detection of ELISA FOXP3 concentration. Out of 38 cases of severe COVID-19, there were 23(30.3%) male and 15(19.8%) female. Out of 38 cases of non-severe COVID-19, there were 24(31.6%) male and 14(18.4%) female. The cases of COVID-19 categorized according to age(years) into 4 categories from 18 to 96 years, and the results show 35(46%) of the non-severe case in 18-40 years, while most severe cases in 41-96 years. The cases of COVID-19 categorized according to geographic distribution into 2 categories Village areas and Urban areas, the results show 29(38.8) of the non-severe case in Urban areas, while most severe cases in Village areas. The cases of COVID-19 categorized according to vaccine into 2 categories vaccinated and non-vaccinated, the results show 23(30.2%) of the non-severe case in Vaccinated, while most severe cases in Non-Vaccinated.

Cardiovascular disease is a risk factor for severe COVID-19 (ie, hospitalization or death). Whether better cardiovascular health (CVH) is associated with lower risk of severe COVID-19 among adults without cardiovascular disease is unknown. We aimed to test if the American Heart Association's Life's Essential 8 (LE8) metric and its components were associated with severe COVID-19 in the C4R (Collaborative Cohort of Cohorts for COVID-19 Research) consortium. Participants with cardiovascular disease were excluded. Two waves of questionnaires, events surveillance, and a serosurvey identified COVID-19 infections. Associations of incident severe COVID-19 with continuous LE8, categorical LE8 (low [<50], moderate [50 to <80], and high [≥80] CVH), and individual LE8 components, were tested in adjusted cause-specific hazards models. Among 29 740 participants in 9 cohorts (mean age, 66±14 years; 61% women; 35% White race; 22% Black race; 34% Hispanic ethnicity), there were 681 severe COVID-19 cases between March 1, 2020, and February 28, 2023. There was a 20% lower hazard of severe COVID-19 per each 1-SD higher LE8 (adjusted hazard ratio [aHR], 0.80 [95% CI, 0.73-0.88]). Relative to low CVH, high CVH was associated with lower risk of severe COVID-19 (aHR, 0.54 [95% CI, 0.37-0.78]); this was not seen for moderate CVH (aHR, 0.81 [95% CI, 0.64-1.04]). Of LE8 components, better physical activity, body mass index, blood pressure, and sleep were associated with a lower hazard of severe COVID-19. Better CVH was associated with lower severe COVID-19 risk among cardiovascular disease-free adults. Whether CVH optimization could mitigate adverse risk from COVID-19 and other harmful viruses warrants further investigation.

The COVID-19 pandemic abruptly disrupted the lives of 1.7 million children and adolescents in Austria. School closures, social distancing, and limited leisure activities substantially affected daily routines and emotional well-being. This study examined age- and gender-related differences in anxiety and depression following COVID-19 infection in Austrian youth. A cross-sectional online survey conducted between March and October 2021 included 1495 families with children aged 4–18 years who had been infected during the early phase of the pandemic. Parents completed the DISYPS-III screening for anxiety and depression. Depression scores were elevated in younger children aged 4–10 years. Boys aged 11–13 years showed slightly higher anxiety and depression levels than girls. School-related stress was associated with poorer mental health outcomes, and longer quarantine duration correlated with higher symptom levels. The findings highlight age-specific vulnerabilities and the strong impact of school-related stress on mental health during public health crises.

COVID-19 infection is associated with anti-M alloantibody development in pediatric patients: immunological characteristics and clinical implications for transfusion safety.

The COVID-19 pandemic has shown high mortality and morbidity among pregnant women worldwide. This study aimed to estimate the case fatality rate and identify risk factors among pregnant women with COVID-19 infection admitted to the ICU and isolation centers in Al-Bayda, Derna, and Tobrouk, Libya, from 2020 to 2021. A case series study was conducted reviewing records of pregnant women admitted to isolation centers for COVID-19 infection. Statistical analysis was performed using SPSS 23.0. COVID-19 in pregnancy demonstrated a high maternal mortality rate of 14.3% and a high rate of fetal loss at 25%. Lower hemoglobin levels, higher leukocyte count, and elevated erythrocyte sedimentation rate were significantly associated with complicated cases. COVID-19 in pregnancy has a high maternal mortality rate and a high rate of fetal loss. The finding of hemoglobin, leukocyte count, and erythrocyte sedimentation rate differences is worthy of further research in predicting mortality and disease severity for similar infections among pregnant women.

Brain fog has raised significant public health concerns as a common neurocognitive impairment in the post-COVID-19 condition, involving memory loss, poor concentration, and language difficulties. However, their neural mechanisms remain unclear, and objective resting-state fMRI-based diagnostic tools are still lacking. To address these challenges, we first recruited 72 patients who experienced persistent brain fog symptoms following COVID-19 infection, along with 68 post-COVID participants without brain fog (PC-noBF), and collected resting-state functional magnetic resonance imaging (rs-fMRI) data from all participants. The interpretable graph neural network model BrainGNN was employed to model and classify individual brain networks, utilizing functional connectivity graphs constructed from the Automated Anatomical Labeling (AAL) atlas. Using out-of-fold predictions from 5-fold cross-validation, BrainGNN achieved an accuracy of 75.71% (Bootstrap 95% CI: 68.57%-82.86%) and an area under the ROC curve (AUC) of 76.07% (Bootstrap 95% CI: 73.93%-88.48%). Furthermore, on an independent test set, BrainGNN outperformed traditional machine learning methods and other GNN models, achieving an accuracy of 82.14% and an AUC of 82.82% (classification threshold: 0.5). Moreover, the model identified several key brain regions-bilateral insula, bilateral Heschl's gyri, and the left superior temporal gyrus-as potential neurobiological markers. Notably, in post-hoc analyses, the ALFF and ReHo values of the left insula were significantly associated with scores related to language and memory symptoms. These findings collectively underscore the effectiveness and interpretability of the proposed approach in identifying functional markers of brain fog. This study not only demonstrates the potential of individual-level identification of brain fog using resting-state fMRI empowered by interpretable GNN, but also reveals its capacity to provide novel insights into the neurobiological mechanisms underlying COVID-19-related cognitive impairment.

To evaluate the impact of the COVID-19 pandemic on outpatient follow-up and clinical outcomes of People Living with HIV (PLHIV) at a specialized infectious diseases clinic in southeastern Brazil. A retrospective analysis was conducted using medical records and responses to a structured questionnaire from PLHIV followed between March 2020 and December 2021. Clinical and laboratory data (CD4 count, viral load, and antiretroviral therapy changes) were reviewed, and questionnaire responses were used to assess COVID-19 history, vaccination, and mental health symptoms. A total of 125 patients were included (mean age 38.6-years; 64.1% male). Prior to the pandemic, 80.3% had CD4 counts > 200 cells/µL and 82.1% had undetectable viral load, increasing to 89.7% and 84.6%, respectively, during the pandemic. Twenty-six patients (22.2%) changed their antiretroviral regimen, mainly due to switching to the nationally recommended first-line therapy. Among the 55 respondents to the questionnaire, 13 (24%) reported confirmed COVID-19 infection; of these, 2 (15.4%) required hospitalization. Overall, 53 (96.4%) reported having received the COVID-19 vaccination. Symptoms of depression and anxiety were reported by 27.7% and 45.4% of participants, respectively. Despite the logistic challenges associated with the COVID-19 pandemic, viral suppression, immunologic recovery, and retention in care remained stable in this selected cohort of patients with continuous follow-up, reflecting the resilience of the healthcare service and sustained treatment adherence.

Utility of the Shock Index at ICU admission as a prognostic tool in patients with COVID-19-related ARDS: Implications for nursing practice.

SARS-CoV-2 vaccination during pregnancy reduces COVID-19 risk in infancy. Whether maternal vaccination before pregnancy similarly protects infants against COVID-19 is unknown. We examined the effectiveness of maternal messenger RNA SARS-CoV-2 vaccination before and during pregnancy in preventing COVID-19 in infants aged 0-6months born between July 1, 2021, and June 30, 2023, at Kaiser Permanente Northern California. Maternal vaccination status was categorized as vaccinated during pregnancy, during a prepregnancy interval (0-<3, 3-<6, 6-12, and >12months prepregnancy), or unvaccinated. Secondary analyses examined the effectiveness of vaccination by trimester. COVID-19 was defined by positive SARS-CoV-2 PCR result or diagnostic code, and COVID-19-related hospitalizations were confirmed by medical record review. Vaccine effectiveness (VE) was examined by Cox regression models adjusted for maternal and infant characteristics, calculated as (1 - hazard ratio) × 100%. Among 78 644 infants, 3648 (4.6%) had COVID-19 infection and 76 (0.1%) experienced COVID-19-related hospitalization before age 6months. For the 4 prepregnancy vaccination intervals, estimates for VE against COVID-19 infection ranged from -14.9% (95% CI, -32.8% to 0.5%) for less than 3months prepregnancy to 23.6% (-14.3% to 49%) for more than 12months prepregnancy. VE anytime during pregnancy was 7.5% (-2% to 16.2%) against infant COVID-19 infection and 52.9% (11.1%-75.1%) against infant COVID-19-related hospitalization. Effectiveness of third-trimester vaccination was 19.2% (8.6%-28.6%) against infant COVID-19 infection and 64.6% (12.3%-85.7%) against infant COVID-19-related hospitalizations. Maternal vaccination during the third trimester was protective against infant COVID-19 infections. Maternal vaccination during pregnancy, particularly during the third trimester, was effective against infant COVID-19-related hospitalizations. Vaccination before pregnancy did not protect infants.