Research 1st – August 2026

ME/CFS and Long Covid (miscellaneous)

1. Integrated care pathway in individuals with Long COVID: STIMULATE-ICP, a cluster-randomized, phase 3 trial. (Nat Med, 2026). 70 points

• A phase 3 cluster-randomized trial evaluated integrated care pathway (ICP) interventions including multi-organ MRI and digital rehabilitation for Long COVID (LC) patients in England.
• Fatigue scores improved across all groups at 12 weeks, with no significant additional benefit from multi-organ MRI or digital rehabilitation compared to usual care.
• Multidisciplinary holistic clinical care reduces fatigue in LC, and digital rehabilitation may aid longer-term management; no serious adverse events were reported.

2. Systemic atopy and upper-airway disease define susceptibility to incident asthma after COVID-19 in Korea. (Nat Commun, 2026). 60 points

• Pre-existing systemic atopy and/or upper-airway diseases significantly increase the risk of incident asthma after COVID-19 infection, with a hazard ratio of 1.66 compared to matched controls.
• Asthma risk rises with the number of pre-existing allergic or upper-airway conditions, indicating a dose-response relationship.
• These findings highlight the importance of targeted surveillance for post-COVID asthma in individuals with allergic and upper-airway phenotypes.

3. Reduced Adenosine Triphosphate-to-Phosphocreatine Ratios in Neuropsychiatric Post-COVID Condition: Evidence From 31P Magnetic Resonance Spectroscopy. (Biol Psychiatry, 2026). 50 points

• Patients with post-COVID condition (PCCo) exhibit significantly reduced brain ATP/phosphocreatine ratios, particularly in the cingulate cortex, indicating impaired cerebral high-energy phosphate metabolism.
• Lower ATP/PCr ratios in the anterior cingulate cortex correlate with cognitive impairment, linking mitochondrial dysfunction to cognitive disturbances in PCCo.
• Altered intracellular pH regulation and bioenergetic homeostasis were observed in PCCo patients, supporting mitochondrial dysfunction as a key pathophysiological mechanism relevant to infection-associated chronic conditions.

4. Ursodeoxycholic acid and long COVID in steatotic liver disease: a nationwide cohort study. (Clin Mol Hepatol, 2026). 50 points

• Pre-infection use of ursodeoxycholic acid (UDCA) in patients with steatotic liver disease (SLD) was not associated with a reduced risk of most long COVID outcomes.
• UDCA use showed a protective association with atrial fibrillation but was linked to increased risks of type 2 diabetes mellitus and epilepsy post-COVID-19.
• Findings highlight the need for cautious interpretation due to potential residual confounding and surveillance bias in this nationwide retrospective cohort study.

5. VSL#3® supplementation improves fatigue in long COVID: results from the DELong#3 randomized placebo-controlled trial. (Br J Biomed Sci, 2026). 45 points

• VSL#3® probiotic supplementation significantly improved fatigue and quality of life in patients with long COVID compared to placebo, with benefits persisting after treatment ended.
• The treatment was associated with enrichment of beneficial gut bacteria such as Bifidobacterium, Lactobacillus, Ruminococcus, and Coprococcus, alongside modulation of inflammatory and immune pathways.
• Coordinated changes in microbiota-derived metabolites, immune markers, and clinical outcomes suggest microbiota-targeted interventions may be a promising approach for managing long COVID symptoms.

6. Characterization of post-COVID syndrome by self-perceived symptom severity stratified by infection wave: beyond COVID, a prospective, multicenter cohort study in Germany. (Infection, 2026). 40 points

• The study found that 72% of participants reported at least one persistent symptom 3 months after SARS-CoV-2 infection, with fatigue, concentration disorders, and dyspnoea being the most common.
• Female sex, lower education, and shorter time since infection were linked to higher rates and severity of persistent symptoms.
• Participants infected with Omicron variants BA.1 and BA.2 exhibited lower rates and severity of post-COVID syndrome symptoms compared to other variants.

7. Long COVID symptoms before and 3-35 months after SARS-CoV-2 infection in a Norwegian prospective cohort study, symptoms over the pandemic, and different virus variants. (Int J Infect Dis, 2026). 40 points

• Long COVID symptoms such as worsening health, memory and concentration problems, dyspnea, fatigue, and smell/taste changes persisted up to 35 months after SARS-CoV-2 infection.
• Symptom prevalence decreased over the pandemic, with lower rates reported after infection during the Omicron-dominated period compared to earlier variants.
• The study highlights the need for ongoing monitoring of long-term symptoms and the impact of emerging SARS-CoV-2 variants.

8. Workforce exit and work productivity loss in adults with and without post-COVID-19 condition: The PRIME post-COVID cohort study. (Int J Infect Dis, 2026). 40 points

• Adults with post-COVID-19 condition (PCC) showed a higher 2-year workforce exit rate (17%) compared to recovered (10%) and never PCC (9%) groups.
• PCC was associated with up to three times higher absenteeism and presenteeism, increased work incapacity (46% in non-employed), and greater financial strain (54% in non-employed).
• The study highlights significant long-term impacts of PCC on work participation and productivity, emphasizing the need for targeted support and interventions.

9. Low serum selenium combined with SELENOP-autoantibodies are associated with persistent fatigue after SARS-CoV-2 infection. (Redox Biol, 2026). 40 points

• Persistent fatigue after SARS-CoV-2 infection was reported by 23.1% of participants on average 21.9 months post-infection in a population-based study of 750 adults.
• Low selenium and SELENOP levels combined with SELENOP-specific autoantibodies were associated with approximately a twofold higher prevalence of persistent fatigue.
• Individually, low selenium, low SELENOP, or SELENOP autoantibodies showed no strong association with persistent fatigue, highlighting the significance of their combined presence.

10. Bidirectional associations between chronic diseases and Long COVID: a population-based cohort and interrupted time-series analysis. (Front Public Health, 2026). 40 points

• Pre-existing chronic non-communicable diseases (NCDs) such as COPD, asthma, and chronic kidney disease are associated with increased odds of Long COVID, and Long COVID is linked to higher incidence of these conditions post-2020.
• Type 2 diabetes (T2D) incidence increased significantly after March 2020, with individuals having a high polygenic risk score for severe COVID-19 showing increased odds of new-onset T2D.
• The study supports bidirectional associations between COVID-19 and NCDs, including T2D, highlighting the interplay between infection and chronic disease development.

11. Efficacy of a psychotherapeutic group intervention for patients with Post-COVID-19 condition: a randomized controlled trial (PsyLoCo study). (BMC Psychol, 2026). 40 points

• A randomized waitlist-controlled crossover study found no significant efficacy of a 10-session group psychotherapeutic intervention over treatment as usual in reducing somatic symptom burden, depressive symptoms, or anxiety in adults with Post-COVID-19 condition (PCS).
• Baseline symptom severity strongly predicted post-treatment outcomes, and childhood maltreatment did not moderate the intervention effect.
• The study suggests future group psychotherapies for PCS should consider individualized adaptations and outcome measures beyond global symptom severity to better capture clinically meaningful changes.

12. Psychometric Properties of the EQ-5D-5L in Post-COVID-19 Condition: Results From the Long CORFU Study. (Value Health, 2026). 35 points

• The EQ-5D-5L demonstrated sufficient psychometric properties for assessing health-related quality of life in post-COVID-19 condition (PCC) patients, with some limitations in capturing health status in those with more severe symptoms.
• The instrument showed strong correlations between its index and visual analog scale, and moderate correlation with self-rated health, with usual activities and mobility explaining most variance in health status.
• The EQ-5D-5L was unable to reliably detect changes in health status over time in PCC patients, indicating limited responsiveness to change.

13. Laryngeal Dysfunction Following COVID-19: A TriNetX Retrospective Cohort Study. (Laryngoscope, 2026). 35 points

• COVID-19 infection is associated with a significantly increased incidence of new-onset laryngeal dysfunction, including chronic cough, dysphagia, voice disorders, vocal fold paralysis, and laryngeal spasm, with incidence peaking 1-2 years post-infection.
• Hospitalization and mechanical ventilation during COVID-19 are linked to higher rates of dysphagia, voice disorders, and vocal cord paralysis, while vaccination status is associated with increased rates of chronic cough and voice disorders.
• The study highlights the long-term impact of COVID-19 on laryngeal function, relevant to understanding infection-associated chronic conditions affecting the respiratory and vocal systems.

14. Characteristics, all-cause healthcare resource utilisation, and costs among high-risk adults with long COVID during Omicron predominance, 2022-2023: a retrospective cohort study using UK primary care data. (BMC Health Serv Res, 2026). 35 points

• Nearly half (49.0%) of adults with confirmed or probable COVID-19 during the UK Omicron period experienced long COVID, though very few had formal diagnostic or referral codes.
• Long COVID was associated with substantial healthcare resource utilization, including high rates of primary care consultations and hospitalizations, with increased costs especially in older adults and those eligible for two booster doses.
• The findings emphasize the significant clinical and economic burden of long COVID on the UK healthcare system and social care, highlighting the need for targeted management strategies.

15. Post-Acute Sequelae of COVID-19 Across 15 Major Health Domains and 67 Diseases in Individuals With Depressive Disorder: A Korean Nationwide Cohort Study. (J Korean Med Sci, 2026). 35 points

• SARS-CoV-2 infection in individuals with depressive disorder is associated with an increased risk of post-acute sequelae across 14 of 15 major health domains and 35 of 67 specific conditions, including infections, respiratory disorders, and circulatory symptoms.
• The risk of post-acute sequelae peaks within the first 3 months after infection and declines over time, with severe COVID-19 cases showing higher risks, notably for blood disorders and self-harm.
• These findings highlight the need for targeted surveillance and tailored interventions to address long-term health consequences in this vulnerable population.

16. Making Invisible Illnesses Visible: Recognizing and Responding to Infection-Associated Chronic Conditions. (Clin Infect Dis, 2026). 35 points

• The abstract highlights the emergence of post-COVID conditions (PCCs) and their relation to infection-associated chronic conditions and illnesses (IACCIs) such as ME/CFS and Lyme disease-associated chronic symptoms, which share symptom profiles and pathophysiologic abnormalities.
• It emphasizes a patient-centered care approach involving validation, multidisciplinary management, and symptom-focused treatment, alongside opportunities to improve clinical practice through new CMS codes, extended visits, and welcoming care environments.
• The abstract calls for improved surveillance, harmonized research, and inclusive trial designs to better define disease burden and accelerate therapeutic development for IACCIs.

17. A systematic scoping review and conceptual analysis of new-onset fibromyalgia manifestations after non-hospitalized COVID-19: empirics, definitions, methodologies, pathophysiology, mapping of literature, and knowledge gaps. (J Transl Med, 2026). 35 points

• The review identifies an overlap between Long Covid (LC), chronic fatigue syndrome, and fibromyalgia, but the molecular mechanisms underlying these conditions remain unclear.
• Research on LC is fragmented due to inconsistent definitions and methodologies, highlighting the need for standardized approaches and rigorous epidemiological studies.
• The review proposes an integrative mechanism for LC as a non-autoimmune connective tissue disease, explaining neuropsychiatric and psychosomatic symptoms and guiding future hypothesis-driven research.

18. Facility-measured sleep electroencephalographic microstructures in long COVID. (Sleep, 2026). 30 points

• Long COVID (LC) and myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) exhibit distinct pathological sleep EEG microstructure changes, including abnormal spindle-slow oscillation coupling and altered spindle frequency dynamics.
• Early spindle-SO coupling phase in LC correlates with worse subjective sleep quality, linking EEG microstructural abnormalities to fatigue and non-restorative sleep symptoms.
• Findings illuminate the pathobiology of post-infectious brain activity alterations relevant to infection-associated chronic conditions like LC and ME/CFS.

19. Post-infectious psychiatric symptoms and diagnoses in children and adolescents following COVID-19. (BMC Psychiatry, 2026). 30 points

• COVID-19 infection in children and adolescents was associated with increased post-COVID psychiatric symptoms, including attention difficulties and irritability, with 56.1% reporting symptoms and 52.2% of those without prior psychiatric history developing new symptoms.
• Higher anxiety and depression scores were significantly linked to prematurity, birth complications, and pre-existing psychiatric conditions, identifying these as key risk factors for post-COVID psychiatric morbidity.
• The Revised Child Anxiety and Depression Scale (RCADS) demonstrated high sensitivity and specificity for screening post-COVID psychiatric symptoms, supporting its use for targeted interventions in this population.

20. Association of long-COVID with major adverse cardiovascular events and mortality: a real-world data cohort study. (BMC Cardiovasc Disord, 2026). 30 points

• The study found that patients with long COVID had a significantly higher risk of major adverse cardiovascular events (MACE), with an overall hazard ratio of 4.48 compared to those without long COVID.
• Specific cardiovascular conditions such as coronary artery disease and stroke showed particularly elevated risks in the long COVID cohort, with hazard ratios of 6.48 and 3.46, respectively.
• All-cause mortality was also significantly increased in patients with long COVID, with a hazard ratio of 1.53.

21. Loss of vesicular monoamine transporter 2 in striatum of long COVID and relationship to neuropsychiatric symptoms. (EBioMedicine, 2026). 30 points

• Dopaminergic neuron density, measured by VMAT2 binding in the striatum, is significantly reduced in individuals with long COVID compared to healthy controls.
• Reduced VMAT2 binding correlates with neuropsychiatric symptoms in long COVID, including apathy, motor slowing, and memory decline.
• Findings suggest that loss of dopamine nerve terminals may contribute to long COVID symptoms, indicating potential therapeutic targets to improve dopaminergic synapse function.

22. The association between smoking and COVID-19 symptoms, severity, and post-COVID-19 symptoms: a cross-sectional survey study. (Front Public Health, 2026). 30 points

• The study identified that during the fourth COVID-19 infection wave, there was a higher percentage of symptom-free individuals and shorter disease duration.
• Logistic regression revealed that single individuals were four times more susceptible to COVID-19 symptoms than married ones, and males were twice as likely to present symptoms compared to females.
• Post-COVID-19 symptoms were more prevalent in men and individuals with asthma, highlighting the need for targeted prevention and emergency response strategies.

23. Clinical practice guideline for long COVID prevention and treatment. (Eur Respir J, 2026). 30 points

• The guideline provides 10 evidence-based recommendations for prevention and treatment of long COVID, including vaccination or antiviral use during acute COVID-19 to prevent long COVID.
• It advises against using nirmatrelvir/ritonavir and glucocorticoids for treating persistent respiratory symptoms and olfactory disorders in long COVID patients.
• Recommendations support multispecies probiotics, cognitive behavioural therapy for fatigue, and personalized rehabilitation after excluding post-exertional malaise, with evidence certainty ranging from very low to moderate.

24. Post-COVID-19 onset of allergic conditions in a propensity-matched cohort of children and adults. (Ann Allergy Asthma Immunol, 2026). 30 points

• COVID-19 infection is associated with a significantly increased risk of developing multiple allergic conditions, including atopic dermatitis, asthma, food allergies, rhinoconjunctivitis, medication allergies, and urticaria, within 18 months post-infection.
• The association between COVID-19 and allergic conditions is observed in both children and adults, with some variation in specific conditions by subgroup.
• Findings suggest a mechanistic link between COVID-19 infection and type 2 helper T cell-skewed immune responses, highlighting the importance of monitoring for allergic diseases after infection.

25. Beyond brain fog: viral proteins as convergent drivers of neuroinflammation and proteinopathy. (Curr Opin Virol, 2026). 30 points

• Post-viral neurological syndromes involve soluble viral proteins acting as neurotoxins that activate shared host pathways, notably glial TLR4/TLR2 signaling and disruption of proteostasis.
• Activation of TLR4/TLR2 triggers chronic neuroinflammation, while proteostasis disruption promotes neurodegenerative proteinopathies such as alpha-synuclein and tau aggregation.
• This mechanistic framework links diverse viral families to post-viral syndromes and highlights potential pan-viral therapeutic targets including TLR inhibitors and autophagy activators.

26. Implications of RNA virus persistence for post-acute sequelae and chronic inflammatory syndromes. (Nat Immunol, 2026). 30 points

• The study discusses evidence that non-retroviral RNA viruses, traditionally seen as causing acute infections, can persist in hosts through viral products such as replication-competent genomes, proteins, mutated viruses, or non-standard genomes.
• Viral persistence involves ongoing host interaction and is often linked to prolonged tissue inflammation and chronic disease development.
• The research explores how viral persistence may contribute to post-acute sequelae and increase susceptibility to chronic inflammatory syndromes.

27. The use of patient-reported outcome questionnaires in patients with post-COVID-19 condition: a systematic review and meta-analysis. (Fam Pract, 2026). 30 points

• The review found that patients with post-COVID-19 condition (PCC) exhibit a higher prevalence of abnormal patient-reported outcome measures (PROMs) questionnaire results compared to controls, regardless of acute COVID-19 infection setting.
• No studies reported diagnostic test accuracy for PROMs in PCC, and the overall certainty of evidence was low due to high risk of bias, indirectness, and imprecision.
• The findings highlight the importance of using PROMs to assess PCC and the need for further validation of these questionnaires in this condition.

28. In-Vitro Evaluation of HIV/SARS-CoV-2 Co-Infection Mediated Proteomic Changes in Astrocytes and Pericytes Reveals Altered Signaling Pathways Associated With Neurodegenerative Disorders. (J Med Virol, 2026). 30 points

• SARS-CoV-2 can replicate in multiple brain cell types, including microglia, astrocytes, and pericytes, both with and without HIV co-infection, affecting host cell entry factors and inflammatory cytokines.
• Conditioned media from HIV, SARS-CoV-2, and co-infected astrocytes and pericytes exhibit neurotoxicity, suggesting potential mechanisms for neuro-PASC exacerbation in people with HIV.
• Proteomic and gene set enrichment analyses reveal that HIV/SARS-CoV-2 co-infection dysregulates lipid, energy, and immune metabolism pathways linked to neurodegenerative diseases, indicating possible pathways for chronic neuroinflammation and neurodegeneration.

29. Cervical sympathetic block to treat Long COVID: a scoping review. (Reg Anesth Pain Med, 2026). 30 points

• Cervical sympathetic block (CSB) shows potential to improve fatigue, brain fog, and autonomic symptoms in Long COVID patients, with some effects lasting up to one year.
• Cognitive and psychiatric symptom improvements were variable, and olfactory recovery depended on symptom severity.
• Evidence is preliminary, based on small and heterogeneous studies, highlighting the need for controlled trials to confirm efficacy and define patient selection.

30. Correlates of fatigue in SARS-CoV-2-positive and -negative adolescents and young adults: Repeated cross-sectional analyses from a prospective cohort study. (J Psychosom Res, 2026). 25 points

• Fatigue in adolescents and young adults with acute SARS-CoV-2 infection and controls is strongly associated with concurrent symptoms, poor sleep quality, negative emotions, and reduced quality of life.
• Immunological and autonomic associations with fatigue are absent during early convalescence but emerge six months post-infection, with similar patterns observed in SARS-CoV-2-negative controls.
• The study suggests that correlates of fatigue may change over time, aligning with neuroscientific models of persistent symptoms and sustained arousal, though causality and directionality are not established.

31. Exploring the implementation of a long COVID rehabilitation intervention: a mixed-methods process evaluation. (BMC Health Serv Res, 2026). 25 points

• The study evaluated the delivery and implementation of a Danish community-based long COVID rehabilitation intervention, including reach, fidelity, dose, and adaptation processes.
• Key intervention activities were consistently delivered, with most patients receiving a combination of individual and group sessions, particularly energy management groups, over a median rehabilitation period of 183 days.
• Implementation was influenced by contextual factors such as flexible delivery within a structured framework, knowledge of long COVID, and organizational support, highlighting considerations for adapting and transferring rehabilitation interventions across healthcare settings.

32. Integrative hematological and transcriptomic analysis reveals monocyte alterations and molecular signatures of inflammatory-coagulation crosstalk in long COVID. (Comput Biol Chem, 2026). 25 points

• Long COVID patients exhibit reduced total white blood cell and monocyte counts, decreased platelet counts, and prolonged activated partial thromboplastin time, indicating hematological dysregulation.
• Transcriptome analysis reveals enrichment of inflammation, cellular stress, and coagulation pathways, with key hub genes including IL6, MYC, CDKN1A, SERPINE1, CD44, and PLAUR.
• Findings suggest an immunothrombosis mechanism in Long COVID driven by monocyte depletion, endothelial adherence, chronic vascular inflammation, and hypofibrinolysis, providing targets for diagnostics and therapeutics.

33. Association between COVID-19 infection, elevated C-reactive protein, and neuropsychiatric symptoms in individuals with metabolic and cardiovascular comorbidities. (Metab Brain Dis, 2026). 25 points

• Individuals with pre-existing comorbidities such as obesity, systemic arterial hypertension, and diabetes mellitus show higher prevalence and elevated serum C-reactive protein levels after COVID-19 infection.
• Elevated systemic inflammation (high CRP) in post-COVID-19 patients correlates with increased stress, anxiety, and depression severity, especially in those with hypertension and obesity.
• The study highlights the exacerbation of neuropsychiatric symptoms linked to inflammation in individuals with chronic conditions following SARS-CoV-2 infection.

34. Health-related quality of life among patients with long COVID according to the presence of a diagnosis of functional somatic disorder: A cross-sectional study. (PLoS One, 2026). 25 points

• Quality of life (QoL) is markedly impaired in patients seeking care for long COVID, with median physical and mental component scores below normal ranges.
• Diagnosis of functional somatic disorder (FSD) was not significantly associated with differences in physical or mental QoL scores after adjusting for confounders.
• Lower QoL scores were linked to higher depressive and anxiety symptoms, lower physical activity, pain, female gender, hospitalization during acute COVID-19, and longer symptom duration.

35. Postural control and trunk mobility impairments in adults with long COVID: A cross-sectional study using computerized posturography and clinical biomechanical tools. (PLoS One, 2026). 25 points

• Adults with Long COVID exhibit significantly impaired postural stability, including larger sway area, higher sway velocity, and lower stability index compared to healthy controls.
• Trunk range of motion and isometric muscle strength are reduced in Long COVID, with fatigue severity and physical function independently predicting postural instability.
• The study highlights the importance of integrated rehabilitation targeting trunk biomechanics and symptom management in Long COVID-associated neuromuscular impairments.

36. Dynamic microclot profiling: thromboelastography advances precision management in long COVID and myalgic encephalomyelitis/chronic fatigue syndrome. (Blood Coagul Fibrinolysis, 2026). 25 points

• Persistent fibrinoid microclots are a key pathophysiological feature shared by Long COVID and ME/CFS, contributing to impaired microcirculation and a hypercoagulable state.
• Thromboelastography (TEG) shows potential as a diagnostic tool by detecting increased clot strength and reduced fibrinolysis in Long COVID, though standardization and protocol challenges remain.
• Therapeutic approaches targeting microclots, including anticoagulants and fibrinolytics, show promise but require further validation in clinical trials.

37. Systems neuroendocrinology in ME/CFS and long COVID: a chronobiological framework for hormone-based research. (Front Neuroendocrinol, 2026). 25 points

• The review highlights neuroendocrine dysfunction in ME/CFS and Long COVID, emphasizing disrupted hormone output, receptor expression, and endocrine biorhythms.
• Sex hormone signaling is identified as a critical vulnerability, especially due to the female predominance and complex reproductive hormone regulation in these conditions.
• The study advocates for chronobiology-aware, time-structured hormone sampling and multi-omic, multi-system approaches to better understand dynamic endocrine mechanisms and symptom variability.
• Ramsay Awardee Jonas Bergquist is an author.

38. Aging-related autonomic nervous system imbalance and adrenergic regulation of immunity: Implications for inflammaging, autoimmunity, and long COVID. (Front Neuroendocrinol, 2026). 25 points

• Aging induces autonomic imbalance with sympathetic overactivation and reduced parasympathetic tone, impairing β-adrenergic signaling in immune cells and contributing to inflammaging and immune dysregulation.
• Altered β₂-adrenergic pathways disrupt the Th17/regulatory T cell balance via cAMP and STAT signaling, promoting pro-inflammatory immune responses and loss of immune tolerance.
• Long COVID exemplifies how viral infection exacerbates pre-existing autonomic and inflammatory dysfunction, resulting in persistent inflammation and heightened autoimmune susceptibility.

39. Altered TRPM3-Dependent Cytosolic and Mitochondrial Calcium Influx in Natural Killer Cells of Post-COVID-19 Condition Patients. (Eur J Immunol, 2026). 20 points

• Post-COVID-19 condition (PCC) is associated with impaired TRPM3 ion channel function in natural killer (NK) cells, leading to altered cytoplasmic and mitochondrial calcium (Ca2+) mobilization.
• PCC patients exhibit significantly reduced passive cytosolic Ca2+ influx and TRPM3-dependent Ca2+ mobilization, alongside increased passive mitochondrial Ca2+ mobilization.
• These disruptions in Ca2+ signaling may contribute to immune dysfunction and bioenergetic disturbances underlying the pathomechanism of PCC.

40. Arterial Stiffness, Clinical-Functional Outcomes, and Quality of Life in Post-COVID-19 Patients: A Cross-Sectional Study. (Arq Bras Cardiol, 2026). 20 points

• Post-COVID-19 patients exhibit increased arterial stiffness, elevated central and peripheral blood pressure, and worse clinical-functional performance including fatigue, dyspnea, and sleep quality compared to controls.
• Arterial stiffness in post-COVID-19 patients is independently associated with age and systolic blood pressure rather than post-COVID-19 status itself.
• The observed functional impairments in post-COVID-19 patients likely result from multifactorial mechanisms involving hemodynamic alterations and aging.

41. Haptoglobin Phenotypes Stratify Post-Exertional Cognitive Dysfunction Associated with Altered Cerebral Oxygenation and Metabolic Signatures in Long COVID. (Int J Mol Sci, 2026). 20 points

• Hp phenotypes stratify Long COVID subgroups, with Hp2 allele carriers showing greater fatigue, poorer physical function, and more severe post-exertional cognitive dysfunction compared to Hp1-1 individuals.
• Hp1-1 individuals exhibit cognitive resilience and higher post-exertional cerebral oxygen extraction, while Hp2 carriers display distinct metabolic profiles linked to poorer cognitive performance.
• Hp phenotypes may serve as candidate biomarkers for biological stratification in Long COVID, highlighting potential mechanisms underlying symptom variability.

42. Sphingolipid and glycerophospholipid profiling in post-acute sequelae of SARS-CoV-2 infection. (Sci Rep, 2026). 20 points

• The study investigated bioactive lipid dysregulation, specifically sphingolipids and glycerophospholipids, in serum samples from acute COVID-19 patients and those who developed post-acute sequelae of SARS-CoV-2 infection (PASC).
• No significant differences in sphingolipid or glycerophospholipid species were found between COVID-19 and PASC groups, but phosphatidylglycerol (PG) showed potential as a distinguishing bioactive lipid at specific time points.
• Findings are exploratory due to small PASC sample size and require confirmation in larger, independently validated cohorts.

43. Bidirectional relationship between depression and long COVID symptoms: findings from the Sulcovid-19 longitudinal survey. (BMC Public Health, 2026). 20 points

• Prior depression is associated with a 60 percentage point higher prevalence of Long COVID in adults from southern Brazil.
• Long COVID increases the probability of depression after SARS-CoV-2 infection by 65%.
• The study underscores the need to investigate Long COVID’s implications and develop effective therapeutic strategies.

44. Post-COVID-19 immune dysregulation and autoimmune sequelae. (Virology, 2026). 20 points

• SARS-CoV-2 infection causes immune dysregulation that can persist after viral clearance, potentially triggering autoimmune phenomena through mechanisms such as molecular mimicry, bystander activation, and epitope spreading.
• The infection induces a pro-inflammatory environment via viral entry pathways, endothelial injury, and renin-angiotensin system disruption, contributing to chronic inflammation and loss of immunological tolerance.
• Clinical evidence links SARS-CoV-2 to diverse autoimmune syndromes and post-COVID-19 immune sequelae, highlighting its role as an amplifier of autoimmunity in genetically susceptible individuals.

45. Neurological sequelae of Long COVID: Pathophysiological mechanisms, diagnostic advances, and therapeutic perspectives. (J Neuroimmunol, 2026). 20 points

• SARS-CoV-2 infection can lead to persistent neuropsychiatric symptoms such as mood disturbances, post-traumatic stress, cognitive impairment, sleep disturbances, and fatigue, significantly impacting daily functioning and quality of life.
• The pathophysiological mechanisms and specific biomarkers for these Long COVID neuropsychiatric sequelae remain poorly understood, limiting targeted treatment development.
• The review highlights advances in clinical presentation, mechanisms, diagnostics, and therapies, and emphasizes the need for standardized diagnostic criteria and mechanism-based treatments.

46. Convergent genetic and structural parameters of cardiovascular disease related insights of post-acute COVID-19. (Biochem Biophys Res Commun, 2026). 20 points

• GWAS identified multiple genetic loci associated with post-acute sequelae of COVID-19 (PASC) linked to arrhythmia, myocardial remodeling, vascular signaling, and cardiometabolic regulation.
• Integration with cardiac transcriptomics from a SARS-CoV-2-infected hamster model revealed 15 genes with convergent genetic and transcriptional evidence, highlighting distinct mechanistic classes of gene regulation in PASC.
• Structural and molecular dynamics analyses showed variant-specific effects on myocardial stress adaptation, sarcomeric mechanics, vascular signaling, and cardiac electrical stability, supporting a model of inherited susceptibility interacting with post-infectious cardiac remodeling in chronic cardiovascular dysfunction.

47. The Impact of Long COVID on the Female Reproductive System: A Narrative Review. (Int J Mol Sci, 2026). 20 points

• Long COVID is associated with various menstrual changes and potential impacts on ovarian reserve, though evidence is inconsistent and mostly suggests transient effects.
• Proposed mechanisms for reproductive effects include immune dysregulation, inflammation, oxidative stress, endothelial dysfunction, and hypothalamic-pituitary-ovarian axis disturbance.
• Current evidence does not show adverse effects of COVID-19 vaccination on ovarian reserve or fertility, but long-term impacts on ovarian aging and endometrial function remain unclear due to limited follow-up.

48. Peripheral blood cytokines during early and post-acute stages of SARS-CoV-2 infection are associated with disease severity and long-term symptoms. (Front Immunol, 2026). 20 points

• Early and post-acute peripheral blood cytokine concentrations, including HGF, IL-18, IL-1RA, IP-10, VEGF-A, and MIP-1α, positively correlate with increasing COVID-19 severity in U.S. Veterans.
• Changes in cytokine levels over time, such as increases in EGF, MIP-1β, and RANTES and decreases in MIP-1α and Eotaxin, are associated with milder disease and absence of long-term symptoms.
• Persistent cytokine responses over time are linked to the presence of long COVID symptoms, indicating a potential immunological basis for infection-associated chronic conditions.

49. Randomised controlled trial assessing the efficacy of balance acceptance and commitment therapy (ACT) for post-COVID syndrome: a study protocol. (BMJ Open, 2026). 20 points

• The study protocol outlines a randomized controlled trial evaluating Balance-ACT, an adapted acceptance and commitment therapy intervention, for adults with post-COVID syndrome (PCS) to improve health-related quality of life.
• Balance-ACT consists of 10 therapist-delivered sessions over 13 weeks and will be compared to treatment as usual, with outcomes assessed up to 20 weeks post-randomization.
• The trial will assess efficacy, cost-effectiveness, and mechanisms of change related to psychological flexibility and physical health, addressing the complex physical and psychological needs of PCS patients.

50. Neurodegenerative and Cognitive Consequences of Long COVID. (Int J Mol Sci, 2026). 20 points

• SARS-CoV-2 infection is linked to long-term cognitive deficits, mood changes, and increased risk of neurodegenerative disorders and dementia in COVID-19 survivors.
• Mechanisms such as immune hyperstimulation, CNS inflammation, coagulopathy, and blood-brain barrier dysfunction may underlie acute and chronic neurological effects of COVID-19.
• Patients with pre-existing cognitive or neuropsychiatric conditions have poorer outcomes after SARS-CoV-2 infection, highlighting the clinical significance of infection-associated chronic brain disorders.

51. MEDICAL AND SOCIAL REHABILITATION OF ELDERLY PATIENTS WITH POST-COVID SYNDROME AND COPD: THE EXPERIENCE OF KYRGYZSTAN. (Georgian Med News, 2026). 20 points

• Patients with both COPD and post-COVID syndrome showed the highest inflammatory markers, severe lung function decline, and greater functional limitations, highlighting the compounded impact of these conditions.
• High-altitude patients experienced additional challenges such as lower oxygen saturation, increased inflammation, and higher fatigue, indicating the influence of chronic hypoxia on disease severity.
• Rehabilitation outcomes were better in urban areas with more accessible specialized services, underscoring the need for tailored, region-specific rehabilitation strategies and improved healthcare infrastructure.

52. Knowledge, Attitudes, and Practices of Physicians in Pakistan Toward COVID-19 and Long COVID: A Cross-Sectional Survey. (Asia Pac J Public Health, 2026). 15 points

• Physician knowledge of acute COVID-19 in Pakistan was generally adequate (74.4%), but knowledge of Long COVID was substantially lower (30.8%).
• Most physicians recognized common Long COVID symptoms (94.9%), yet fewer understood its formal definition (37.6%), indicating gaps in awareness.
• Female physicians showed higher Long COVID knowledge, while those with over 10 years of experience had lower knowledge, suggesting targeted education is needed to improve post-COVID condition management.

53. Incidence of long COVID-related consultations in family medicine in Switzerland: a cross-sectional study within the Sentinella network. (Swiss Med Wkly, 2026). 15 points

• The incidence of long COVID-related consultations in Swiss family medicine practices was low, with a median of 3 per 1000 consultations for general internists and 0 for paediatricians.
• General internists reported more long COVID consultations than paediatricians, and physicians in central Switzerland had higher incidence rates compared to other regions.
• The study highlights a discrepancy between the low consultation incidence and higher estimated prevalence of long COVID, suggesting diagnostic challenges and the need for better criteria and support in primary care.

54. Subjective cognitive complaints and emotional symptoms after COVID-19: preliminary data in a sample of Puerto Rican adults. (Arch Clin Neuropsychol, 2026). 15 points

• COVID-19 symptom burden and pre-morbid health conditions were the primary correlates of self-reported cognitive and emotional symptoms in Puerto Rican adults with prior COVID-19.
• Cognitive complaints were strongly associated with emotional symptoms, independent of symptom burden.
• Age, education, and hospitalization status showed no significant associations with cognitive or emotional symptoms in this sample.

55. Patient burden of chemosensory dysfunction and long COVID. (Dan Med J, 2026). 15 points

• Only 43% of individuals with sudden chemosensory dysfunction (CD) during COVID-19 reported full recovery after four years, with persistent dysfunction most common in those aged 45-59 years.
• Persistent CD was significantly associated with long COVID symptoms such as fatigue, memory difficulties, and insomnia, each affecting over 30% of this group.
• Quality of life was more impacted in physical well-being than emotional well-being among those with persistent CD, underscoring the need for long-term clinical attention to post-viral CD.

56. Development of the long COVID – 6 dimensions quality of life (LC-6D-QoL) scale: a Delphi study. (J Patient Rep Outcomes, 2026). 15 points

• A 16-item, patient-focused scale (LC-6D-QoL) was developed through expert consensus to assess quality of life in Long COVID, addressing multi-systemic symptoms including dysautonomia and affective-sexual life impact.
• The scale covers six dimensions: general health, physical health, mental health, daily functioning, social relationships and support, and economic/work-related aspects, capturing aspects often missed by generic tools.
• The study provides an expert-informed foundation for future validation of this scale to improve patient-centered assessment of Long COVID’s complex impact.

57. SARS-CoV-2 and Cancer Biology: Exploring the Mechanistic Links. (Cancer Rep (Hoboken), 2026). 15 points

• SARS-CoV-2 infection and Long COVID induce persistent inflammatory and immune alterations overlapping with cancer-related pathways, including chronic IL-6/STAT3 and NF-κB signaling, immune dysregulation, and oxidative stress.
• Current evidence does not support SARS-CoV-2 as a direct oncogenic virus but suggests inflammatory stress responses may influence tumor progression or recurrence through indirect mechanisms.
• The long-term impact of SARS-CoV-2-induced biological changes on human cancer development remains uncertain, highlighting the need for longitudinal studies integrating molecular and clinical cancer outcomes.

58. Anxiety-Depressive Disorders in 200 Patients with Post-COVID-19 Syndrome: Prevalence and Predictors from a Cross-Sectional Study. (Medicina (Kaunas), 2026). 10 points

• Anxiety and depression were prevalent in approximately 40% of individuals with post-COVID-19 syndrome, as measured by HADS, GAD-7, and BDI scales.
• The risk of depression was three times higher in post-COVID-19 patients with diabetes, and exceeded 90% in smoking women with both post-COVID-19 syndrome and diabetes.
• These findings emphasize the importance of preventive psychological care and targeted screening for anxiety and depressive disorders in post-COVID-19 patients, especially those with multimorbidity.

59. Reliability and Validity of the Simple Qi Deficiency Score in Patients with Post-COVID-19 Condition. (Medicina (Kaunas), 2026). 10 points

• The study validated the “Qi deficiency score,” a patient-reported outcome measure for assessing Qi deficiency in long COVID patients, showing modest internal consistency and structural validity.
• The score demonstrated strong positive correlation with fatigue and depression scales and a negative correlation with quality of life, indicating its relevance to post-COVID-19 fatigue symptoms.
• The simple Qi deficiency score may be a useful tool for evaluating traditional medicine syndromes related to infection-associated chronic fatigue in post-COVID-19 condition.

60. What is the Role of “the Psyche”? Long COVID and ME/CFS as Test Cases for Evidence-Based and Patient-Centered Psychiatry and Psychotherapy. (Psychiatr Prax, 2026). 5 points

• The essay argues against attributing psychological factors to Long Covid (LC) and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) due to risks such as harmful therapies and invalidation of patient experiences.
• It highlights that many arguments for psychological contributions to these conditions are nonspecific or lack sufficient empirical support.
• The authors advocate for cautious, evidence-based, and patient-centered psychiatric and psychotherapeutic approaches, emphasizing the importance of physical diagnostics and treatment.

61. Post-COVID-19 Thyroid Dysfunction and Autoimmune Ultrasound Changes: A 12-Month Prospective Cohort Study. (Medicina (Kaunas), 2026).

• A subset of patients hospitalized with COVID-19 developed biochemical and structural thyroid changes, including subacute thyroiditis (6.0%) and newly detected autoimmune thyroiditis (13.1%) during a 12-month follow-up.
• Most thyroid abnormalities were mild, self-limited, and showed interindividual variability, with ultrasound patterns of autoimmune thyroiditis increasing over time even in patients with minimal biochemical abnormalities.
• The study supports targeted thyroid monitoring after COVID-19, especially for patients with persistent symptoms, borderline TSH levels, or ultrasound signs of autoimmune thyroiditis.

62. Cardiac Magnetic Resonance Imaging Study on Cardiovascular Involvement >60 Days Post COVID-19 Recovery. (J Assoc Physicians India, 2026).

• Cardiac magnetic resonance imaging of 54 COVID-19-recovered patients showed no significant increase in cardiac abnormalities compared to 50 healthy controls, with only 1.85% exhibiting mild myocardial changes.
• Native T1 and T2 values and late gadolinium enhancement did not differ significantly between post-COVID patients and controls, indicating minimal long-term cardiac involvement.
• The study suggests a lower incidence of cardiovascular comorbidities related to long COVID in the Indian population compared to Western reports.

63. Towards a Less Ideal Theory About Well-being-The Case of Post COVID Condition. (J Bioeth Inq, 2026).

• The study explores the relationship between functioning, as assessed by the International Classification of Functioning, Disability and Health (ICF), and well-being in patients with severe Post COVID-19 Condition (PCC).
• It compares individual-centered theories of well-being with relational bioethics approaches to provide a more comprehensive understanding of well-being in PCC patients.
• The paper suggests integrating multiple theoretical perspectives to enhance the understanding of patient outcomes in rehabilitation medicine for PCC.

RECOVER studies

1. Developing a platform protocol for clinical trials evaluating interventions that target proposed mechanisms of Long COVID: RECOVER-VITAL. (Clin Trials, 2026). 30 points

• The RECOVER-VITAL study protocol was developed to rigorously investigate potential interventions for Long COVID, focusing on viral persistence, reactivation, and immune dysregulation.
• The initial trial tested two durations of the antiviral nirmatrelvir/ritonavir to evaluate its effect on Long COVID symptom clusters including autonomic dysfunction, cognitive dysfunction, and exercise intolerance.
• The protocol includes patient-reported primary outcomes and performance-based secondary outcomes, providing a platform for efficient execution of current and future Long COVID clinical trials.

2. Glucose metabolism across COVID-19 and long COVID: a longitudinal study. (J Endocr Soc, 2026). 20 points

• In a prospective cohort with pre-infection baseline data, HbA1c and cardiometabolic biomarkers remained stable up to 12 months after SARS-CoV-2 infection.
• The 10-year atherosclerotic cardiovascular disease (ASCVD) risk increased slightly post-infection, despite stable metabolic markers.
• Persistent metabolic syndrome was more frequent in participants with more severe long COVID, though new-onset metabolic syndrome incidence was similar across long COVID groups.

3. The GRACE Cycle: A General Large-Language-Model Framework for Phenotype Discovery with Unknown Cluster Number. (Res Sq, 2026). 10 points

• The GRACE Cycle framework uses large-language-model-assisted iterative refinement to discover clinically meaningful phenotypes without pre-specifying the number of clusters, validated across heterogeneous biomedical datasets.
• In the NIH RECOVER cohort, GRACE identified three distinct Long COVID subphenotypes linked to a dysautonomia gradient and reduced physical activity, highlighting a post-viral fatigue axis.
• GRACE also identified motor subtypes in Parkinson’s disease from wearable gait data, demonstrating external validation and applicability to chronic disease phenotyping with wearable sensors.