Research 1st – September 2026

ME/CFS and Long Covid (miscellaneous)

1. Regulatory cycles of orexin and glucagon-Like peptide-1 in postviral syndromes. (Endocr Rev, 2026). 50 points

• The review proposes that impaired orexin (OX) neuropeptide signaling contributes to postviral endocrine and metabolic dysfunction in postacute sequelae of COVID-19 (PASC) and myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS).
• It highlights the role of OX in regulating glucose metabolism, HPA axis activity, and systemic homeostasis, with attention to sex differences in expression and function related to postviral syndromes.
• Emerging therapeutic strategies discussed include GLP-1 receptor agonists and drugs targeting the OX system, offering potential treatments for neuroendocrine-metabolic dysfunction in PASC, ME/CFS, and related postviral conditions.

2. Virus reactivation in acute and long COVID-19. (Nature, 2026). 50 points

• Significant reactivation of Herpesviridae and Anelloviridae occurs during acute COVID-19, correlating with disease severity, immune effects, and clinical outcomes in hospitalized patients.
• Viral reactivation is frequent in immunocompetent individuals during severe illness and is associated with increased systemic inflammation, challenging the view that it is primarily due to immunosuppression.
• Persistence of viral reactivation is observed in convalescence, with Anelloviridae reactivation linked to long COVID, providing potential biomarkers for prognosis and treatment strategies.

3. Expression levels of SARS-CoV-2 IgM, IgG, and neutralizing antibodies in a Chinese cohort and detection of peptide-specific antibodies in COVID-19 patients. (BMC Infect Dis, 2026). 45 points

• The study identified age- and gender-related variations in SARS-CoV-2 antibody responses, with higher IgG levels in females and increased IgM with age, while IgG and neutralizing antibodies declined with age.
• Neurological symptoms in COVID-19 were linked to elevated IgG and neutralizing antibody titers, indicating a stronger humoral response in neurotropic infections.
• Bioinformatic and serological analyses revealed cross-reactive antibodies against viral-human homologous peptides, suggesting a potential role for autoimmunity in Long COVID pathogenesis.

4. Data-driven subtypes of internalizing and functional somatic symptoms: A hybrid mixture modeling approach. (Gen Hosp Psychiatry, 2026). 45 points

• Six distinct symptom-based classes were identified in a large population sample, showing mixed internalizing disorder and functional disorder symptoms rather than disorder-specific profiles.
• The Cognition/Fatigue and Depression classes exhibited the highest comorbidity between internalizing and functional disorders, with the Depression class associated with the greatest functional impairment.
• Findings suggest that non-specific symptoms contribute to comorbidity by lowering diagnostic thresholds, highlighting the value of symptom-level analysis for identifying clinically relevant subgroups.

5. Cerebral arteriopathy and its role in persistent post-COVID headache and brain fog: a quantitative study. (Eur Arch Psychiatry Clin Neurosci, 2026). 40 points

• Persistent post-COVID brain fog is associated with anterior circulation arteriopathy and hypoperfusion, as indicated by higher anterior-FCASS scores in patients with brain fog compared to controls.
• Severity of brain fog correlates with posterior circulation arteriopathy severity (posterior-FCASS), while post-COVID headaches do not show a strong association with intracranial vessel changes.
• The study highlights cerebrovascular involvement as a potential mechanism underlying long-COVID neurological symptoms, particularly brain fog.

6. Risk of new-onset obstructive sleep apnea up to 4.5 years after COVID-19 in the urban population. (Sci Rep, 2026). 40 points

• SARS-CoV-2 infection is independently associated with an increased risk of developing new-onset obstructive sleep apnea (OSA) up to 4.5 years post-infection, with higher risk observed in both hospitalized and non-hospitalized COVID-19 patients compared to controls.
• After OSA onset, hospitalized COVID-19 patients showed increased risks of heart failure and pulmonary hypertension, while non-hospitalized COVID-19 patients had a higher risk of obesity.
• These findings highlight the importance of targeted screening for OSA in high-risk populations following COVID-19 infection.

7. Cardiovascular, Renal, and Pulmonary Risks of Long COVID: A Retrospective Cohort Study Stratified by Age and Sex. (J Am Heart Assoc, 2026). 40 points

• Clinically recognized Long COVID is associated with increased risk of adverse cardiovascular, renal, and pulmonary outcomes across all adult age groups.
• Relative risks for these outcomes are disproportionately higher in younger adults, particularly young women for cardiovascular and renal issues and young men for pulmonary problems.
• Prior SARS-CoV-2 vaccination did not consistently reduce the risk of cardiovascular, renal, and pulmonary outcomes in Long COVID patients.

8. Microvascular remodeling and endothelial dysfunction across the post-COVID-19 spectrum: a prospective observational case-control study. (BMC Med, 2026). 40 points

• Post-COVID-19 syndrome (PCS) patients exhibit persistent endothelial dysfunction, demonstrated by reduced venular flicker-induced dilation and narrower retinal arterioles compared to recovered and never-infected individuals.
• Retinal vessel analysis (RVA) effectively discriminates PCS patients with ME/CFS, correlating microvascular alterations with symptom severity, especially neurocognitive symptoms, and elevated inflammatory markers.
• Findings highlight RVA as a non-invasive tool for monitoring endothelial health and cardiovascular risk in post-viral syndromes, linking microvascular changes to ongoing inflammation and chronic symptom burden.

9. Risk factors of long COVID among discharged patients with omicron infection in Changzhi, China: a retrospective cohort study. (Front Public Health, 2026). 40 points

• 6% of hospitalized COVID-19 patients in Changzhi, China, reported long COVID symptoms ≥3 months after discharge, with fatigue, muscle weakness, sleep difficulties, brain fog, and cough being most common.
• Severe COVID-19, overweight status, having ≥7 acute-phase symptoms, and being a farmer increased long COVID risk, while immunosuppressant therapy was associated with lower risk.
• Age ≥50 years and underweight status were linked to higher risk of muscle weakness, highlighting specific risk factors for post-COVID chronic conditions.

10. Comparison of new and recurring post-acute infection syndrome – results from a German population-based cohort. (Sci Rep, 2026). 40 points

• This study compared symptoms, impairment, and duration between first and recurring post-acute infectious syndrome (PAIS) episodes in a large German cohort, finding that recurring PAIS without full recovery leads to more symptoms, longer duration, and greater impairment.
• Symptom patterns were broadly similar between first and recurring PAIS episodes, but recurring cases with incomplete recovery experienced worse outcomes.
• Recurring PAIS cases constitute a substantial proportion of PAIS in 2024/25, highlighting the clinical significance of managing infection-associated chronic conditions.

11. A cardiometabolic perspective on post-exertional malaise in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and Long COVID. (Cardiovasc Diabetol, 2026). 40 points

• The study proposes a conceptual approach to investigate post-exertional malaise (PEM) by longitudinally assessing post-exertional physiological trajectories in ME/CFS and Long COVID patients.
• It emphasizes the importance of considering disease severity and underlying cardiometabolic health factors, such as obesity and type 2 diabetes, in understanding PEM.
• This framework aims to improve patient stratification and guide future mechanistic and interventional research on infection-associated chronic conditions involving multisystem and cardiometabolic consequences.

12. Rehabilitation needs of long COVID patients in British Columbia. (PM R, 2026). 35 points

• Among long COVID patients assessed 3-6 months post infection, 98% exceeded at least one rehabilitation threshold, with 85% needing multiple types of rehabilitation.
• The most common rehabilitation needs were pulmonary rehabilitation (83%), mental health support (78%), and neurorehabilitation (70%), reflecting significant symptom burden and functional impairment.
• Use of objective and patient-reported outcome thresholds can effectively identify high-need patients and guide timely, evidence-based referrals for specialized rehabilitation care.

13. Long COVID longitudinal symptoms burden clusters within a national community-based cohort. (BMC Infect Dis, 2026). 35 points

• Three distinct longitudinal long COVID symptom clusters were identified: highest, moderate, and lowest burden, with the highest-burden cluster exhibiting persistent multisystem symptoms including fatigue, cognitive difficulties, and mobility limitations.
• Older age, female sex, mental health disorders, and immunodeficiency were significantly associated with membership in the highest-burden symptom cluster.
• Within the highest-burden cluster, three symptom phenotypes were characterized: multisystemic dysfunction, psychiatric/neurological dysfunction, and physical/respiratory dysfunction, highlighting the heterogeneity of long COVID.

14. Blinded two-year longitudinal evaluation of SARS-CoV-2 antigenemia in long COVID. (Clin Microbiol Infect, 2026). 35 points

• SARS-CoV-2 antigens persist in plasma up to 1 year post-infection in a minority of individuals, with detection rates declining significantly by 18-24 months.
• Antigenemia occurs in both Long COVID and fully recovered individuals, with no association to persistent symptoms, antibody levels, or vaccination status.
• The presence of circulating SARS-CoV-2 antigens is not supported as a biomarker for clinical monitoring or treatment decisions in Long COVID.

15. Association of kynurenine metabolites with cognitive and psychological symptoms in post COVID-19 condition: A case-control study. (J Psychosom Res, 2026). 35 points

• Individuals with chronic post COVID condition (PCC) showed worse general cognitive function and higher psychological distress compared to recovered controls about 75 weeks post-infection.
• Higher kynurenine levels correlated with better cognitive function across both PCC and recovered groups, but the kynurenic acid/kynurenine ratio had opposite associations with cognitive function in PCC versus controls.
• The quinolinic acid/kynurenine ratio was linked to lower psychological distress in PCC but showed no association in recovered controls, suggesting distinct kynurenine pathway involvement in PCC neurocognitive and psychological symptoms.

16. Longitudinal observation of persistent Long COVID symptoms and health-related quality of life in an adult German cohort. (BMC Infect Dis, 2026). 35 points

• The study found that more than a year after acute COVID-19 infection, Long COVID symptoms such as fatigue, palpitations, and concentration impairment remain persistent and intense in a German cohort.
• Symptom prevalence decreased in only 3 of 27 symptoms, and symptom intensity decreased in 15 of 27 symptoms with small changes, while health-related quality of life showed a statistically significant but not clinically meaningful decline.
• These findings highlight the ongoing burden of Long COVID and the need for comprehensive therapeutic approaches to address persistent symptoms and quality of life impairment.

17. Respiratory symptoms up to 18 months after COVID-19 – a longitudinal observational study. (Respir Res, 2026). 35 points

• Respiratory symptoms after acute COVID-19 were highly prevalent in both hospitalised and non-hospitalised adults and associated with poorer physical function, patient-reported outcomes, and reduced diffusing lung capacity (DLCO).
• Both symptomatic and asymptomatic groups showed improvement over time, but those with respiratory symptoms remained more impaired at follow-up.
• Presence of respiratory symptoms at the first follow-up was the strongest predictor of persistent symptoms at the second follow-up.

18. Micronutrition as a Therapeutic Strategy for Mitochondrial Dysfunction in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome and Fibromyalgia: A Narrative Review. (Nutrients, 2026). 35 points

• The review examines mitochondrial dysfunction and related pathways as key mechanisms in fibromyalgia and ME/CFS, focusing on micronutritional interventions targeting these pathways.
• It evaluates the mechanistic plausibility and limited clinical efficacy evidence of various micronutrients, including NAD+ precursors, B vitamins, magnesium, and coenzyme Q10, among others.
• The abstract outlines plans for a future randomized, double-blind, placebo-controlled trial in fibromyalgia patients to validate micronutritional treatment effects on fatigue.

19. Intravenous immunoglobulin treatment for long COVID: a case report of clinical and immunological findings. (Lancet Infect Dis, 2026). 30 points

• High-dose intravenous immunoglobulin therapy was associated with sustained clinical recovery from long COVID symptoms, including normalization of fatigue and neurocognitive performance, over one year in a patient with elevated autoantibodies against G protein-coupled receptors.
• Immunological changes during treatment included reduction of CD8+ T cell-monocyte complexes, spontaneous IFNγ and TNF production, endothelial inflammation markers, and circulating autoantibody levels, indicating modulation of post-viral immune dysregulation.
• The findings suggest that pathogenic T cell-monocyte interactions may contribute to long COVID and that immunomodulation could be a potential therapeutic approach for selected patients.

20. Health-Related Quality of Life of Adults With Long COVID: A Cross-Sectional Study in Primary Care. (J Clin Nurs, 2026). 30 points

• Adults with Long COVID 2 years or more after mild-to-moderate COVID-19 infection showed significantly lower health-related quality of life (HRQOL) scores compared to those without persistent symptoms.
• Long COVID was linked to impairments in anxiety/depression, pain/discomfort, and usual activities, with poorer HRQOL more pronounced among women, older adults, non-White individuals, those with chronic diseases, and lower education levels.
• The study supports the need for targeted, multidisciplinary interventions and rehabilitation services in primary care to address long-term health problems following COVID-19.

21. From research method to community resource: Co-developing a body mapping toolkit for peer support with Long Covid patients. (Soc Sci Med, 2026). 30 points

• The study developed a Body Mapping Toolkit for Long Covid patients through collaboration with a patient-led organization, using participatory and arts-based methods to capture holistic illness experiences shaped by social, cultural, and economic contexts.
• Online body mapping workshops provided a safe, accessible space for patients with severe symptoms to creatively process and share their experiences, supporting both research and peer support within the Long Covid community.
• The work highlights the value of co-producing knowledge with patients and demonstrates how creative methods can enhance understanding and support for chronic infection-associated conditions like Long Covid.

22. Analysis of epidemiological characteristics and influencing factors of Long COVID syndrome among university students in the post-pandemic era. (Front Public Health, 2026). 30 points

• Among university students with prior COVID-19 infection, 33.33% developed Long COVID syndrome, with alopecia, memory decline, and sleep disturbances as the most common symptoms.
• Depressive symptoms were positively associated with Long COVID syndrome, showing a strong adjusted odds ratio of 8.235.
• The incidence of Long COVID syndrome in university students is comparable to the general population, indicating a need for focused clinical and public health strategies.

23. Medical invalidation is associated with structural barriers in postacute immune mediated syndromes based on patient perspectives in Germany. (Sci Rep, 2026). 30 points

• The study found that 87% of individuals with post-acute immune-mediated syndromes (PAIMS) experienced difficulties accessing appropriate treatment, with major barriers including lack of available therapies and not being taken seriously by medical personnel.
• Perceived medical invalidation was moderate and similar across Long COVID, ME/CFS, and post-acute COVID-19 vaccination syndrome groups, occurring notably in healthcare, authorities, and workplace interactions.
• The findings emphasize significant structural barriers in PAIMS care and the need for improved clinical education, care coordination, and institutional recognition of these chronic conditions.

24. Case Report: Post-mortem analysis of long-term inflammation after mild COVID-19. (Front Immunol, 2026). 30 points

• Post-mortem analysis of lung, heart, and brain tissues from individuals recovered from mild COVID-19 over 250 days prior revealed persistent SARS-CoV-2 nucleocapsid antigen and organ-specific immune alterations.
• Lung and heart tissues showed a coordinated, self-sustaining inflammatory response, while brain tissue exhibited vascular dysfunction and altered neuroimmune homeostasis.
• The study provides spatially resolved evidence of sub-clinical long-term tissue sequelae and immune dysregulation underlying post-acute COVID-19 syndrome (PACS).

25. Quality and reliability of short videos about long COVID on bilibili and tiktok: cross-sectional study under health community construction background in China. (BMC Public Health, 2026). 30 points

• The study found that long COVID-related videos on Bilibili had significantly higher quality and reliability scores than those on TikTok, with professional-source videos showing the highest quality.
• Professional source was the strongest independent predictor of video quality, while video duration and shares had only weak associations, and other engagement metrics showed no significant influence.
• The overall quality of long COVID videos was suboptimal, highlighting the need for improved platform review mechanisms and promotion of evidence-based information for better public health communication.

26. Persistent cytolytic CD8⁺ T cells recognize SARS-CoV-2 and herpesvirus epitopes in long COVID. (Cell Rep Med, 2026). 30 points

• During severe COVID-19, EBV-specific CD8+ T cells show a stem-like state, while CMV-specific CD8+ T cells are terminally differentiated and cytolytic.
• In long COVID (LC) individuals, CMV-specific CD8+ T cells shift to a T central memory (Tcm) bias, and CD8+ T cells specific for SARS-CoV-2, CMV, and EBV are terminally differentiated, exhausted, and cytolytic.
• Persistent cytolytic granzyme B-expressing CD8+ T cells, especially in LC women, may contribute to long COVID pathogenesis by failing to downregulate cytolytic effector expression after acute viremia.

27. β-Cell Dysfunction in COVID-19 and Post-COVID Syndrome: Molecular Mechanisms Linking Inflammation, Oxidative Stress, and Insulin Secretion. (Int J Mol Sci, 2026). 30 points

• SARS-CoV-2 infection disrupts glucose homeostasis through pancreatic β-cell dysfunction, insulin resistance, chronic inflammation, oxidative stress, mitochondrial dysfunction, and hypoxia-related signaling.
• Post-COVID metabolic abnormalities can range from transient dysglycemia to new-onset diabetes mellitus and metabolic syndrome.
• Understanding these mechanisms may aid in risk stratification, early intervention, and development of therapies to preserve β-cell function and metabolic health.

28. Cognition-Linked Monocyte State Reveals Altered Myeloid-Lymphoid Coordination in Neuro-PASC. (Int J Mol Sci, 2026). 30 points

• Neurologic post-acute sequelae of SARS-CoV-2 infection (Neuro-PASC) in older adults are associated with altered monocyte mitochondrial redox state and disrupted monocyte-to-lymphocyte mitochondrial coordination.
• Cognitive performance in Neuro-PASC patients shows an inverse relationship with monocyte mitochondrial ATP synthase/Complex V pathway activity, contrasting with non-Neuro-PASC individuals.
• A 13-gene monocyte signature linked to cognition and immune coordination distinguishes Neuro-PASC, highlighting immune perturbations potentially underlying persistent cognitive dysfunction.

29. Serum Proteomic Profiling Reveals Renin-Associated Immune and Cytoskeletal Dysregulation in Post-COVID-19 Condition Patients with Secondary Adrenal Insufficiency. (J Proteome Res, 2026). 30 points

• Elevated upright renin in post-COVID-19 condition with secondary adrenal insufficiency (PCC+SAI) is associated with increased BMI, lipids, renin, aldosterone, and altered aldosterone-to-renin ratio.
• Proteomic analysis identified 20 differentially expressed proteins linked to immune response, complement and coagulation cascades, and MAPK signaling pathways in high-renin PCC+SAI patients.
• Findings suggest immune dysregulation, complement activation, and cytoskeletal remodeling as key mechanisms in endocrine-immune interactions underlying postviral sequelae in PCC+SAI.

30. The Impact of Pulmonary Rehabilitation in Patients with Post-COVID-19 Syndrome: A Systematic Review. (Med Sci (Basel), 2026). 30 points

• Pulmonary rehabilitation significantly improves exercise capacity, respiratory and peripheral muscle strength, quality of life, dyspnea, and fatigue in patients with post-COVID-19 syndrome.
• Benefits of pulmonary rehabilitation are primarily due to physical reconditioning and muscle training rather than major structural pulmonary changes.
• Telerehabilitation is an effective alternative for delivering pulmonary rehabilitation in post-COVID-19 syndrome management.

31. Long-term chest CT abnormalities up to 4.5 years after COVID-19 hospitalization and their association with dyspnea and fatigue: a prospective cohort study. (Respir Res, 2026). 25 points

• Chest CT abnormalities after COVID-19 hospitalization showed a decrease in ground glass opacities and mosaic attenuation but an increase in parenchymal bands over 4.5 years, with minimal changes after 12 months.
• Initial disease severity and older age were strong predictors of persistent CT abnormalities.
• Persistent CT abnormalities had weak correlations with ongoing dyspnea and fatigue at 4.5 years post-hospitalization.

32. Prevalence and characteristics of persistent symptoms following hospitalization for COVID-19: a cross-sectional follow-up study. (BMC Infect Dis, 2026). 25 points

• Persistent symptoms were observed in 64.9% of hospitalized COVID-19 patients after the quarantine period, with cough, weakness, and diffuse body/muscle/joint pain being the most common.
• Significant reductions occurred in symptoms such as fever, sore throat, headache, diarrhea, and abdominal pain after the acute phase.
• The study highlights the need for post-discharge follow-up and supportive care to address ongoing respiratory, fatigue, and musculoskeletal symptoms in COVID-19 recovery.

33. Psychological and medical outcomes of post-COVID-19 patients: A longitudinal study. (J Psychosom Res, 2026). 25 points

• People with post-COVID-19 condition showed reduced fatigue, depression, anxiety, and post-traumatic stress symptoms (PTSS) from 3-6 months to 9-16 months after virological recovery.
• Baseline PTSS and resilience significantly predicted anxiety and depressive symptoms at long-term follow-up in post-COVID-19 patients.
• Monitoring psychological health during clinical follow-up is important to identify individuals at risk of chronic anxiety and depression after COVID-19.

34. Cognitive-behavioral therapy for post COVID-19 condition: A pilot randomized controlled trial. (J Psychosom Res, 2026). 25 points

• A pilot randomized controlled trial found that cognitive-behavioral therapy (CBT) significantly reduced fatigue in individuals with post COVID-19 condition (PCC) compared to a wait-list control.
• The wait-list control group experienced a significant increase in overall somatic symptom burden, while CBT showed mixed results for respiratory symptoms.
• The study demonstrated good feasibility and treatment satisfaction for CBT in PCC, supporting further research with larger randomized controlled trials.

35. Sex-stratified neuropsychiatric manifestations of post-COVID-19 condition: A Japanese National Registry of clinical and patient-reported outcomes (PSCORE-J). (Gen Hosp Psychiatry, 2026). 25 points

• The study established and characterized neuropsychiatric manifestations of post-COVID-19 condition (PCC) using Japan’s first nationwide registry combining clinical assessments and patient-reported outcomes.
• Neurological symptoms were the most common manifestations in PCC cases, which also showed higher physical and psychiatric comorbidities, impaired quality of life, and work discontinuation.
• Patient perception of life changes and a composite psychological burden score were strongly associated with physician-diagnosed PCC, highlighting the importance of integrating subjective and objective measures to identify neuropsychiatric burden.

36. Quality of life of people with and without respiratory complications in post-COVID-19 syndrome: a retrospective study. (Rev Bras Enferm, 2026). 25 points

• People with post-COVID-19 respiratory complications showed significantly lower quality of life (QoL) scores across all SF-36 domains compared to those without complications.
• Respiratory symptoms, activity limitations, and psychosocial impacts were more severely impaired in affected individuals, as measured by the St George’s Respiratory Questionnaire.
• An inverse correlation between SF-36 and SGRQ scores highlights the clinical relevance of multidisciplinary respiratory rehabilitation to improve QoL in post-COVID-19 patients.

37. Physical activity in post-COVID-19 condition: A cross-sectional study. (PLoS One, 2026). 25 points

• Adults with post-COVID-19 condition (PCC) exhibit low overall physical activity, with median moderate and vigorous activity times of 45.9 and 0.16 minutes per day, respectively, measured objectively by accelerometry.
• Chronic symptomatic disease other than PCC and fatigue are associated with lower physical activity levels, while higher functional capacity and educational attainment correlate with higher activity and more favorable intensity gradients.
• Identified factors influencing physical activity in PCC patients may inform therapeutic strategies, though causal relationships cannot be established from this cross-sectional analysis.

38. Kinetics of the PASC Index in Long COVID. (PLoS One, 2026). 25 points

• The study applied the PASC index to track Long COVID symptoms over 12 months in adults with confirmed COVID-19, finding that 26.2% met Long COVID criteria at least once during follow-up.
• The proportion of participants meeting the Long COVID threshold declined from 27% at 1 month to 18% at 12 months, but this change was not statistically significant.
• Symptom burden remained relatively stable over time within individuals, with limited within-person change in PASC index scores despite fluctuations in threshold status.

39. Total blood volume and red blood cell volume are not associated with orthostatic intolerance in adults with myalgic encephalomyelitis/chronic fatigue syndrome. (Physiol Rep, 2026). 25 points

• In ME/CFS patients, static blood-volume abnormalities, including hypovolemia and red blood cell volume deficiency, were not associated with orthostatic abnormalities measured by a standardized lean test.
• Postural orthostatic syndrome of hypocapnia (POSH) was the most common lean-test abnormality, occurring in 40.8% of participants.
• Findings suggest that orthostatic intolerance in ME/CFS may involve autonomic, vascular, respiratory, or cerebrovascular factors rather than blood volume deficits alone.

40. Prevalence and risk factors of adverse work outcomes among manufacturing workers with Long COVID in Malaysia – A nationwide study. (PLoS One, 2026). 25 points

• Among Malaysian manufacturing workers with Long COVID, 24.7% experienced poor work-related quality of life, with 12.8% reporting sickness absenteeism and 42.4% sickness presenteeism.
• Risk factors for adverse work outcomes included older age, smoking, multiple Long COVID symptoms, shift work, hazardous chemical exposure, confined space entry, excessive noise, manual handling, and lack of sickness absence policy.
• Informing employers about Long COVID symptoms was protective, underscoring the need for targeted workplace interventions and supportive occupational health policies.

41. Post-acute symptom persistence following SARS-CoV-2, RSV, and influenza in children: A retrospective cohort study. (Medicine (Baltimore), 2026). 25 points

• Persistent symptoms 4 to 6 weeks after acute infection were common and similarly prevalent in children with RSV (24.0%), SARS-CoV-2 (22.0%), and influenza (21.2%).
• Post-acute symptom profiles differed by virus and age: RSV caused respiratory and feeding difficulties in infants, SARS-CoV-2 led to neurocognitive and systemic complaints in school-aged children, and influenza resulted in sustained systemic symptoms.
• Predictors of post-acute symptoms included hypoxemia for RSV and older age plus hospitalization for SARS-CoV-2, highlighting virus- and age-specific patterns of post-acute morbidity.

42. Psychological interventions for individuals with long COVID: a systematic review and meta-analysis. (Health Psychol Rev, 2026). 25 points

• Psychological interventions for long COVID significantly reduce anxiety, depression, and fatigue symptoms.
• These interventions also lead to significant improvements in self-perceived health-related quality of life.
• The findings highlight the potential role of psychological treatments in managing persistent symptoms associated with long COVID.

43. Shared genetic risk between functional somatic syndromes, internalizing disorders, and immune-mediated diseases: a twin-sibling study. (Brain Behav Immun, 2026). 25 points

• Functional somatic syndromes and internalizing disorders show heritability ranging from 15 to 44%, with unique environmental factors explaining 49-84% of variance; immune-mediated diseases have a heritability of 37% and 63% unique environmental influence.
• Fibromyalgia exhibits the strongest genetic correlation with immune-mediated diseases (rA = 0.52), while IBS, ME/CFS, and major depression show modest correlations, and anxiety disorders show minimal genetic overlap.
• The study indicates that immune-related genetic risk factors contribute to the etiology of fibromyalgia and, to a lesser extent, other functional somatic syndromes and major depression, highlighting relevance to infection-associated chronic conditions.

44. Host-virus resilience networks and viral inflammaging circuits in aging and long COVID: a CMV-centered perspective. (Front Cell Infect Microbiol, 2026). 25 points

• Aging and long COVID are characterized by disrupted host homeostasis involving chronic inflammation, immune remodeling, metabolic dysfunction, and impaired stress adaptation, which may increase susceptibility to Cytomegalovirus (CMV) reactivation.
• The review proposes a systems-level framework of host-virus resilience networks, where interconnected immune, metabolic, epigenetic, and stress-response pathways maintain CMV latency, and their age-related decline facilitates viral reactivation.
• CMV reactivation is linked to immune aging and chronic inflammation through viral inflammaging circuits, suggesting a role for CMV in driving immune dysregulation relevant to infection-associated chronic conditions like long COVID.

45. Targeting Bioenergetic, Redox and Prostaglandin Pathways in Long COVID-Associated Post-Exertional Malaise and Brain Fog: A Nutraceutical Translational Hypothesis. (Nutrients, 2026). 25 points

• The review proposes a mechanism-based translational framework suggesting that a pathway-targeted nutraceutical program may modulate mitochondrial bioenergetics, redox regulation, and neurovascular inflammation in Long COVID-related post-exertional malaise and cognitive dysfunction.
• Candidate nutraceuticals include coenzyme Q10, alpha-lipoic acid, selenium, sulforaphane, resveratrol, Boswellia serrata, luteolin, and eicosapentaenoic acid, aimed at supporting bioenergetic/redox balance and prostaglandin/resolution pathways.
• The framework emphasizes the need for demonstration of formulation quality, pharmacokinetic feasibility, target engagement, and safety, and proposes a staged translational research program to generate testable hypotheses rather than asserting clinical efficacy.

46. Can We Use the Maximum Phonation Time as a Screening of Pulmonary Forced Vital Capacity in Post-COVID-19 Syndrome Patients? (J Voice, 2024). 20 points

• The study evaluated the accuracy of maximum phonation time (MPT) and number counting tests to estimate forced vital capacity (FVC) in post-COVID-19 syndrome patients, finding moderate discriminatory power with about 70% accuracy.
• Approximately 24% of patients showed impaired FVC, which correlated with significantly lower MPT and counting values, but these tests had high sensitivity and negative predictive value with low specificity and positive predictive value.
• MPT and counting tests alone are not reliable indicators of pulmonary function in this population; additional criteria are needed to improve diagnostic accuracy and guide further investigations.

47. Cerebrovascular recovery drives restoration of neurometabolite levels after mild COVID-19. (J Cereb Blood Flow Metab, 2026). 20 points

• SARS-CoV-2 infection leads to prolonged cerebrovascular reactivity (CVR) delay in gray and white matter that gradually shortens over 3 to 59 months post mild COVID-19 infection.
• Shorter CVR delay correlates with improved neurometabolite markers (total choline, creatine, N-acetylaspartate) in the thalamic region, indicating recovery of neuronal health.
• The study highlights a protracted but spontaneous resolution of cerebrovascular dysfunction following mild COVID-19, relevant to understanding neurocognitive post-acute sequelae (PASC).

48. Assessing autonomic nervous system imbalance in long COVID-19 patients through heart rate variability during tilt testing. (Sci Rep, 2026). 20 points

• Long COVID-19 patients exhibit significant autonomic dysfunction during tilt table testing, including reduced heart rate variability and abnormal blood pressure responses to postural changes.
• The study identifies a blunted sympathetic response and impaired autonomic adaptation to orthostatic stress in long COVID-19, with persistent instability in heart rate and delayed blood pressure recovery.
• These findings emphasize the clinical relevance of autonomic dysregulation in long COVID-19 and support the use of tilt testing for diagnosis and targeted cardiovascular interventions.

49. Persistent neuromuscular dysfunction in long COVID: A quantitative and single fiber EMG follow-up study. (Neurophysiol Clin, 2026). 20 points

• Long COVID patients showed a decrease in myopathic changes on quantitative EMG over time, but single fiber EMG abnormalities and clinical symptoms persisted after an average follow-up of 1.38 years.
• Motor unit potential amplitudes and durations increased in multiple muscles, indicating ongoing neuromuscular dysfunction despite stable fatigue scores.
• The study highlights persistent neuromuscular abnormalities as a component of long COVID, suggesting multiple mechanisms contribute to chronic symptoms.

50. Longitudinal trajectories of neurologic symptoms and cognitive associations at 36-months post-hospitalization for COVID-19. (Front Neurol, 2026). 20 points

• Neurological symptoms such as fatigue, memory/concentration difficulties, and sleep disturbances can persist or worsen up to 36 months after COVID-19 hospitalization, with symptom co-occurrence increasing over time.
• Distinct longitudinal symptom trajectories (stable, worsening, improving) were identified and linked to baseline demographics, comorbidities, and acute disease severity.
• Associations between specific cognitive domains (executive function, memory, attention) and neurological symptoms evolved over time, highlighting the heterogeneous and dynamic nature of Neuro-PASC.

51. Post-COVID conditions: co-occurrence of symptoms and challenges for comprehensive care. (Rev Esc Enferm USP, 2026). 20 points

• Post-COVID conditions exhibit a heterogeneous and multisystemic symptom profile associated with demographic factors, prior hospitalization severity, and increased healthcare demand.
• Female gender is linked to higher frequency of hair loss, young adults report more headaches, and muscle weakness correlates with acute phase hospitalization.
• Moderate symptom co-occurrences include paresthesia in limbs, joint pain with myalgia, anxiety with depressive and sleep symptoms, and gastrointestinal with dizziness symptoms.

52. Key comorbidities in the development of post-COVID conditions: diabetes mellitus, hypertension, and obesity. (Rev Esc Enferm USP, 2026). 20 points

• The study found that post-COVID condition (PCC) symptoms vary with chronic comorbidities: non-diabetic individuals had 50% less headache and 64% less sore throat, hypertensive patients had twice the prevalence of muscle weakness or loss of strength, and obese individuals experienced more diarrhea and upper limb tingling/throbbing.
• There is a bidirectional relationship between PCC and pre-existing chronic conditions, highlighting how specific comorbidities influence the manifestation of PCC symptoms.
• The findings provide detailed insight into the interaction between infection-associated chronic conditions and the symptom profile of PCC in primary health care patients.

53. Exploring long covid care pathways in the UK NHS: a qualitative study of healthcare professionals’ experiences. (BMJ Open, 2026). 20 points

• NHS professionals managing long covid face diagnostic uncertainty due to lack of definitive biomarkers, relying on exclusionary testing and subjective severity assessments.
• General practitioners serve as key coordinators, triaging patients into fragmented specialist services, with treatment focused on non-pharmacological rehabilitation rather than medical cures.
• Variability in monitoring and follow-up creates a continuity gap post-discharge, highlighting the need for standardized assessment tools, integrated interdisciplinary clinics, and improved post-discharge tracking.

54. Are hemoglobin-derived peptides involved in the neuropsychiatric symptoms caused by SARS-CoV-2 infection? (Braz J Psychiatry, 2022). 20 points

• Post-COVID-19 syndrome includes neuropsychiatric sequelae such as depression, anxiety, cognitive disorders, and dementia linked to SARS-CoV-2 infection.
• Hemoglobin-derived peptides, increased due to early erythrocytic death in COVID-19, may influence cognition, memory, anxiety, and depression through non-canonical peptidergic pathways.
• The review highlights a potential role of hemoglobin-derived molecules in COVID-19 neuropathology, suggesting new directions for research and clinical strategies.

55. Medical uncertainty, structural inequities and disease: The experiences of long-COVID among racialized immigrants and racialized non-immigrants in Canada. (Soc Sci Med, 2026). 20 points

• The study finds that uncertainties surrounding long COVID exacerbate existing inequities by limiting access to essential health, socio-economic, and political resources for racialized immigrants and non-immigrants in Peel Region.
• Long COVID uncertainties contribute to new forms of social suffering by delegitimizing and neglecting the illness, affecting knowledge production, societal awareness, and policy development.
• The research highlights the compounded impact of long COVID on marginalized groups, emphasizing the need to address these inequities in health and social policy responses.

56. Patient-made knowledge networks: Long COVID discourse, epistemic injustice, and online community formation. (Soc Sci Med, 2026). 20 points

• Long COVID was initially defined and legitimized by patients on Twitter before medical recognition, with analysis of 2.8 million tweets revealing seven discourse themes including symptom documentation and medical dismissal.
• The study identifies four distinct user roles and shows that knowledge sharing and community building drive network formation, characterizing the Long COVID Twitter space as an epistemic community.
• Patient-led social media efforts contributed to rapid WHO recognition of Long COVID, highlighting how marginalized groups can construct alternative knowledge systems and influence health policy.

57. Risk factors for post-COVID-19 condition among previously hospitalized COVID-19 patients: a systematic review and meta-analysis. (Front Public Health, 2026). 20 points

• Female sex, greater acute disease severity or advanced respiratory support, ICU admission, no or incomplete vaccination, and hypertension are consistently associated with higher odds of post-COVID outcomes in previously hospitalized patients.
• The study highlights the importance of risk-based post-discharge follow-up for patients hospitalized with COVID-19 to address long-term morbidity.
• Evidence is limited by heterogeneous outcome definitions and a small number of studies for several risk factors, indicating variability in current research findings.

58. Long COVID-19 in Hospitalized and Ambulatory Children in Jamaica. (Pediatr Infect Dis J, 2026). 15 points

• Acute symptoms including vomiting, abdominal pain, ageusia, anosmia, fatigue, confusion, brain fog, and multisystem inflammatory syndrome in children (MIS-C) were identified as predictors of pediatric Long COVID in Jamaica.
• Multivariable analysis highlighted MIS-C, vomiting, and ageusia as significant composite predictors of Long COVID in children.
• The high incidence rate of 47.3% underscores the importance of addressing Long COVID in resource-constrained settings.

59. Prevalence and factors associated with anxiety and depression after COVID-19. (Rev Lat Am Enfermagem, 2026). 15 points

• The study found a high prevalence of anxiety (46.45%) and depression (22.31%) in patients four months after recovering from COVID-19.
• Anxiety and depression were associated with psychosocial factors such as fear of reinfection, previous mental disorders, family history of chronic diseases, low family income, and presence of comorbidities; employment was protective against anxiety.
• These findings highlight the need for targeted mental health screening and care strategies in the post-COVID-19 population.

60. What Are the Barriers and Supports to a Return to Health From Long COVID? A Qualitative Study Designed, Developed, and Conducted by Individuals With Lived Experience of Long COVID. (Qual Health Res, 2025). 15 points

• The study identified six major themes and 21 subthemes related to barriers and supports for recovery in individuals living with long COVID, based on qualitative data from patient-led focus groups and interviews.
• Findings highlight challenges within medical systems, mental health impacts, financial concerns, energy management, and feelings of disregard, emphasizing the need for patient-centered care and support.
• Results provide essential recommendations to improve healthcare, planning, and policy for long COVID patients, facilitating their return to social, family, and employment activities.

61. Brain [18F]FDG-PET in Encephalitis and Postinfectious Neurocognitive Syndromes. (PET Clin, 2026). 15 points

• Brain [18F]FDG PET detects metabolic abnormalities in inflammatory brain diseases, enhancing diagnostic sensitivity especially in autoimmune encephalitis.
• FDG PET may aid biological stratification and differential diagnosis in post-COVID and related postinfectious syndromes.
• TSPO PET provides mechanistic insights into neuroimmune activation but is primarily used in research settings.

62. Brain [18F]FDG-PET in Subjective Cognitive Complaints: From Diagnostic Gap to Neurobiological Insight. (PET Clin, 2026). 15 points

• Subjective cognitive complaints vary and can be associated with normal to abnormal cognitive test results, with FDG PET used to investigate metabolic substrates in subjective cognitive decline related to Alzheimer’s disease.
• Studies indicate potential metabolic-network abnormalities in mild traumatic brain injury and long COVID, though these findings come from heterogeneous populations.
• Interpretation of metabolic abnormalities in these conditions requires cautious integration within multimodal and clinically characterized frameworks.

63. Post-COVID varicella-zoster virus reactivation: lowering the immunological threshold for latency breakdown. (Front Cell Infect Microbiol, 2026). 15 points

• SARS-CoV-2 infection is associated with a modest increase in herpes zoster (HZ) incidence, especially after severe COVID-19 or hospitalization, within early post-infection periods.
• The proposed mechanism involves SARS-CoV-2-induced immune disruption, including cellular immune impairment, interferon dysregulation, and inflammation, which may reduce the host’s ability to maintain varicella-zoster virus latency.
• Post-COVID HZ may reflect disrupted host-virus balance in vulnerable individuals, but causation is not established; further prospective studies with immune profiling are needed.

64. Microvascular Dysfunction and Redox Imbalance in Long COVID. (Microcirculation, 2026). 10 points

• Patients with Long COVID exhibit microvascular dysfunction characterized by impaired Flow-Mediated Skin Fluorescence (FMSF) parameters, including blunted ischemic responses and delayed recovery after hyperemia.
• This microvascular impairment is associated with a reduced NAD⁺/NADH ratio, lower NADP levels, and altered NAD⁺ metabolism, indicating a cellular redox imbalance.
• FMSF combined with targeted NAD⁺ metabolite profiling offers a clinically applicable approach to detect microvascular dysfunction linked to altered NAD⁺ metabolism in Long COVID.

65. Understanding the lived experiences of individuals with post-acute sequelae of SARS-CoV-2 infection (PASC) in Rwanda: a phenomenological qualitative study. (BMJ Open, 2026). 10 points

• The study qualitatively explores the lived experiences of individuals with post-acute sequelae of SARS-CoV-2 infection (PASC) in Rwanda, revealing significant physical, emotional, and socioeconomic burdens.
• Participants experienced persistent symptoms such as fatigue, breathlessness, and memory loss, leading to financial hardship, social isolation, and mental health challenges due to inability to work and limited healthcare support.
• Findings highlight the need for PASC-specific healthcare provider education, public awareness, and integrated psychosocial support to address diagnostic uncertainty, stigma, and the multifaceted impact of PASC in low-resource settings.

66. Behavioral and electrophysiological evidence of residual cognitive impairment in post-covid brain fog: a visual P300 study. (Brain Cogn, 2026). 10 points

• COVID-19-related brain fog is associated with reduced P3b mean amplitudes during higher cognitive load tasks, indicating attentional and memory processing deficits.
• These cognitive impairments persist for an average of 22.58 months after symptom resolution, suggesting long-term attentional resource deficits.
• The study highlights dysfunction in cortical regions involved in higher-level cognition, relevant to understanding chronic cognitive effects post-COVID-19 infection.

67. Functional impact of long Covid on work performance and return to work: a cross-sectional study. (Rev Saude Publica, 2026). 10 points

• Long Covid is associated with reduced work performance in 43.9% and difficulty returning to work in 22.2% of affected individuals in São Paulo.
• Advanced age and severe functional impairment significantly increase the risk of poorer work performance and difficulty returning to work among long Covid patients.
• Functional status assessments (Katz, Lawton, WHO-DAS, SARC-F) highlight the impact of moderate to severe functional limitations on work-related outcomes in long Covid.

68. Prevalence and determinants of long COVID and SARS-CoV-2 reinfection in the Spanish adult population: A nationwide public health survey. (Med Clin (Barc), 2026). 10 points

• Long COVID prevalence in a Spanish adult cohort was 14.3%, with female sex, chronic obstructive pulmonary disease (COPD), reinfection, and mixed vaccination schedules identified as significant risk factors.
• Reinfection was reported by 47.2% of participants and was associated with an increased risk of long COVID (OR: 1.64).
• Common long COVID symptoms included anosmia, dyspnea, pneumonia, and myalgia, highlighting ongoing clinical challenges in infection-associated chronic conditions.

69. Bidirectional Associations Between Autonomic Function, Sleep Quality, and Daily Fatigue and Energy Symptoms in Long COVID: Longitudinal Digital Health Study. (JMIR Cardio, 2026). 10 points

• Sleep duration and REM sleep showed significant within-person day-to-day associations with next-day fatigue in individuals with long COVID.
• Higher average nocturnal heart rate variability (HRV-RMSSD) was associated with consistently lower fatigue and higher energy levels between individuals.
• The study identified a postexertional malaise pattern where the protective effect of longer sleep on fatigue was reduced on more active days.

70. The Impact of Long COVID on Cognitive Functioning. (J Intell, 2026). 10 points

• Long COVID is associated with impaired processing speed and executive functioning, along with increased mental fatigue and subjective cognitive difficulties compared to recovered and uninfected individuals.
• Depressive symptoms and symptom impact ratings significantly predict mental fatigue and self-reported cognitive difficulties in individuals with long COVID.
• The study highlights the importance of using both subjective and objective cognitive assessments to capture distinct aspects of cognitive functioning in long COVID patients.

71. Measuring subjective cognitive complaints with covid-19 brain fog using the subjective scale to investigate cognition (SSTICS). (Appl Neuropsychol Adult, 2024). 5 points

• The study used the Subjective Scale to Investigate Cognition (SSTICS) to assess cognitive complaints in 68 post-COVID-19 patients, finding high internal consistency (Cronbach’s alpha=0.951) and identifying groups with good, medium, and poor cognitive functioning.
• Subjective cognitive complaints correlated with quarantine duration, loss of smell, and symptoms such as tiredness and aches, with over 10% of patients reporting mild to serious deficits in memory, attention, language, executive function, or praxis.
• The findings highlight the persistence and nature of cognitive impairments (“brain fog”) following COVID-19, emphasizing the need for targeted assessment of these neuropsychiatric sequelae.

72. Comparing ME/CFS following mononucleosis with Long COVID. (Chronic Illn, 2026). 5 points

• The study compared symptom burden, coping strategies, depression, anxiety, and functional status between Long COVID patients and those with moderate or severe ME/CFS following infectious mononucleosis.
• Long COVID symptom burden was found to be intermediate, less than severe ME/CFS but more than moderate ME/CFS.
• These findings contribute to understanding the behavioral and pathophysiological underpinnings of post-viral chronic illnesses.

RECOVER studies

1. Characterization and validation of EHR computable phenotypes for Long COVID using patient-reported symptoms: insights from the nationwide RECOVER program. (J Am Med Inform Assoc, 2026). 60 points

• A machine-learning algorithm trained on EHR data accurately identified patients with highly symptomatic Long COVID, achieving an AUC of 0.80 and a precision-recall curve of 0.58.
• Key EHR features associated with Long COVID included diagnoses of shortness of breath, malaise and fatigue, cardiac dysrhythmias, treatments with albuterol, gabapentin, or duloxetine, and elevated heart rate.
• The model supports improved identification of Long COVID patients for clinical screening, trial recruitment, and etiologic research.

2. Nirmatrelvir-ritonavir targeting viral persistence in post-COVID-19 condition (long COVID) in the USA (RECOVER-VITAL): a randomised, double-blind, placebo-controlled, phase 2 trial. (Lancet Infect Dis, 2026). 60 points

• A randomized, double-blind, placebo-controlled trial found no statistically significant benefit of nirmatrelvir-ritonavir treatment for 15 or 25 days on long COVID symptoms across cognitive, autonomic, or exercise phenotypes.
• No differences were observed in primary or secondary outcomes, and no safety concerns were identified during the study.
• The findings highlight the need for alternative approaches to assess and treat the symptom burden of long COVID.

3. Metabolic, viral, and immune phenotypes in long COVID. (Front Endocrinol (Lausanne), 2026). 35 points

• Long COVID is associated with increased T cell glycolytic activity and elevated T-cell DPP-4 (CD26) activity, which correlates with symptom severity.
• Individuals with Long COVID exhibit subtle impairments in glucose tolerance, altered serum leptin, reduced lean mass, and lower femoral bone mineral density.
• SARS-CoV-2 viral RNA was not detected in subcutaneous adipose tissue, indicating that viral persistence in this tissue does not drive metabolic changes in Long COVID.

4. Pregnancy Outcomes in Individuals With Long COVID. (Obstet Gynecol, 2026). 35 points

• Likely Long COVID classification before or during pregnancy was not associated with preterm birth or most adverse pregnancy outcomes in the primary analysis.
• In sensitivity analysis among treated participants, likely Long COVID was associated with an increased risk of hypertensive disorders of pregnancy.
• Participants with likely Long COVID had higher prepregnancy BMI and more adverse social determinants of health compared to those with Long COVID-indeterminate status.

5. Early HHV-6 IgG and IgA responses during acute SARS-CoV-2 infection in relation to long COVID: a multicohort observational study. (EBioMedicine, 2026). 30 points

• Early herpesvirus-directed IgA responses, especially against beta-herpesviruses, increase during acute SARS-CoV-2 infection without corresponding IgG or IgM increases.
• Long COVID is associated with specific herpesvirus antibody patterns, notably elevated HHV-6 IgA and HHV-1/HHV-2 IgG responses.
• Distinct HHV-6 IgG and IgA antibody programs correlate differently with symptom burden and demographic factors, suggesting heterogeneity in long COVID linked to herpesvirus humoral immunity.