Updated 7 March 2025

Postoperative cardiopulmonary complications in children with preoperative Omicron SARS-CoV-2 variants infection: a single-center retrospective cohort study
Omicron infection may heighten the risk of pulmonary complications in children undergoing elective non-cardiac surgery. It is advisable to schedule elective surgery at least 4 weeks after infection of Omicron variants. BMC pediatrics 3 March 2025

SARS-CoV-2 Infection and Childhood Islet Autoimmunity
This cohort study examines whether there is a temporal association between SARS-CoV-2 infection and the development of islet autoimmunity among Australian children with a first-degree relative with type 1 diabetes. JAMA 3 March 2025

Consumer experience of an Australian multidisciplinary Long COVID Clinic that incorporates personalised exercise prescription: A qualitative analysis
The majority of participants found that the Long COVID Recovery Clinic, which incorporates both supervised exercise and pacing, is acceptable and would recommend it to others. From the consumer perspective, the Long COVID Recovery Clinic aids recovery alongside GP management through a combination of peer support and an individually tailored programme. Health expectations 28 February 2025

The role of masks and respirators in preventing respiratory infections in healthcare and community settings
extensive evidence generated during the covid-19 pandemic confirms the superiority of respirators and supports the use of masks and respirators in the community during periods of high epidemic activity. Some gaps in research remain, including economic analyses, research in special population groups for whom masking is challenging, and research on countering disinformation. BMJ 27 February 2025

Real-world effectiveness and safety of oral Azvudine versus Paxlovid for COVID-19 in patients with kidney disease: a multicenter, retrospective, cohort study
This study is the first to report that the safety and effectiveness of Azvudine are not inferior to those of Paxlovid in COVID-19 patients with KD. This study provides additional treatment options for COVID-19 patients with KD. BMC infectious diseases 25 February 2025

COVID-19 infection is a significant risk factor for death in patients presenting with acute cholecystitis: a secondary analysis of the ChoCO-W cohort study
Key Findings:

• COVID-19 infection increased mortality risk by five times in patients with acute cholecystitis.
• Postoperative complications elevated the odds of death sixfold.
• Early laparoscopic cholecystectomy significantly reduced mortality by 86%.
• Surgical Impact: Survivors were more likely to have undergone urgent laparoscopic surgery, suggesting it as a safer intervention during the pandemic.
• Clinical Relevance: COVID-19 was confirmed as an independent predictor of death, highlighting the need for urgent intervention in stable patients with acute cholecystitis.

World journal of emergency surgery 25 February 2025

Biomarker states and risk of death among individuals hospitalized with SARS-CoV-2 infection
Distinct sub-phenotypes based on biomarker profiles were identified among patients hospitalized with SARS-CoV-2 infection, and certain phenotypes are associated with greater risk of 30-day mortality. BMC infectious diseases 24 February 2025

The impact of long COVID on heart rate variability: a cross-sectional study
Mild-to-moderate patients with COVID-19 in young to middle age may develop autonomic dysfunction one month after infection. BMC infectious diseases 24 February 2025

COVID-19 vaccination and odds of post–COVID-19 condition symptoms in children aged 5 to 17 years
The findings of this study suggest that mRNA COVID-19 vaccination may be a protective factor against  post–COVID-19 condition (PCC) in children following SARS-CoV-2 infection. JAMA 24 February 2025

Sudden cardiac arrest among young competitive athletes before and during the COVID-19 Pandemic
Early reports during the COVID-19 pandemic raised concerns that young athletes with COVID-19 would be at increased risk of myocarditis and sudden cardiac arrest (SCA) or sudden cardiac death (SCD). This cohort study found no increase in SCA/SCD in young competitive athletes in the US during the COVID-19 pandemic, suggesting that reports asserting otherwise were overestimating the cardiovascular risk of COVID-19 infection, vaccination, and myocarditis. JAMA 24 February 2025

Hospitalizations and mortality among older adults with and without restricted access to Nirmatrelvir-Ritonavir
The authors identified 1,620 884 Ontarians aged 65 to 74 years during the study period most (87.5%) received at least 2 COVID-19 vaccines. Findings indicated that a more than doubled rate of nirmatrelvir-ritonavir prescriptions was not associated with reductions in hospitalizations or mortality among highly vaccinated older adults in Ontario. JAMA 19 February 2025

The impact of COVID vaccination on incidence of long COVID and healthcare resource utilisation in a primary care cohort in England, 2021–2022
Vaccination against COVID-19 may reduce the risk of long COVID in both immunocompetent and immunocompromised patients. However, no association was found between frequency of primary care visits and vaccination among patients diagnosed in 2021. Future studies with larger sample size, higher vaccine uptake, and longer study periods during the pandemic are needed to further quantify the impact of vaccination on long COVID. BMC infectious diseases 13 February 2025

Oral COVID-19 antiviral prescribing in Australian general practice – a retrospective observational study
Oral COVID-19 antiviral prescribing volumes in general practice may serve as an indicator of periods of increased transmission of COVID-19, through increases in prescribing activity. Telehealth exceeding face-to-face for oral COVID-19 antiviral prescribing supports continued access to telehealth to reduce exposure to COVID-19 and provide time-critical access to treatment. Australian journal of primary health 11 February 2025

Assessment of psychosocial aspects in adults in post-COVID-19 condition: the EURONET-SOMA recommendations on core outcome domains for clinical and research use
The recommended core domains help to increase consistency in a biopsychosocial approach to post-COVID-19 condition across investigations, improve synergies, and facilitate decision-making when comparing different interventional approaches. It allows to better identify relevant subgroups in heterogeneous post-COVID-19 condition populations offering practical tools for routine clinical practice through the clinical core set. BMC Medicine 11 February 2025

Prophylaxis for renal patients at risk of COVID-19 infection: results from the intranasal niclosamide randomised, double blinded, placebo controlled arm of the PROTECT-V platform trial
Intranasal niclosamide did not reduce risk of symptomatic COVID-19 infection in this cohort compared to placebo. BMC infectious diseases 11 February 2025

Healthcare utilization patterns before and after a long COVID diagnosis: a case-control study
Long COVID patients increased outpatient healthcare utilization following a diagnosis, switching from acute care settings. The change in service settings among this population suggests that diagnosis could lead to better patient management. Healthcare utilization among these patients is high, underscoring the need to understand the Long COVID burden on healthcare systems with population-level data. BMC public health 10 February 2025

The source of coronavirus anxiety: a longitudinal network analyses of the symptoms in the coronavirus anxiety scale (CAS) and their associations with depression, anxiety, stress and alcohol use
The Covid-19 Pandemic and subsequent actions taken by national/international organizations has generated a large amount of anxiety which may roam into the realm of pathology– COVID Anxiety. To measure this phenomenon, measures such as the CAS have been developed. The CAS being a self-report measure of anxiety-related physiologically symptoms that are aroused by information and thoughts related to COVID-19. However, as the CAS is fairly new it requires validation and examination. Current psychology 8 February 2025

Factors associated with the transmission of the delta SARS-CoV-2 variant in households: the Israeli COVID-19 Family Study (ICoFS)
Understanding how interpersonal interactions and immunological factors shape SARS-CoV-2 transmission in households is crucial for designing control measures. The auhors developed a Bayesian data augmentation transmission model to evaluate the effects of isolation, parental care, and vaccine-induced immunity on Delta variant transmission from the follow-up of 1,093 Israeli households (July–August 2021). Among the 2883 household contacts, 1096 (38%) were infected. Children were 38% (CI: 7-81) more likely to be infected than adults. Isolation measures reduced transmission by 52% (CI: 46-57). Transmission was 39% (CI: 11-76) higher between children and adult females than males. Vaccine effectiveness was 78% (CI: 54-90), 85% (CI: 70-94), and 73% (CI: 49-88) for one, two, and three doses of recent vaccination (< 90 days), respectively but dropped to 18% (CI: (-6)-36) for two doses administered more than 90 days ago. Household member interactions significantly shaped transmission, and isolation measures effectively reduced transmission. Journal of infectious disease 8 February 2025

Pediatric gastrointestinal tract outcomes during the postacute phase of COVID-19
In this cohort study, the increased risk of GI tract symptoms and disorders was associated with the documented SARS-CoV-2 infection in children or adolescents during the postacute or chronic phase. Clinicians should note that lingering GI tract symptoms may be more common in children after documented SARS-CoV-2 infection than in those without documented infection. JAMA 7 February 2025

Prevalence of cardiovascular symptoms in post-acute COVID-19 syndrome: a meta-analysis
These findings indicate that 15% of COVID-19 patients experience cardiovascular sequelae. Furthermore, COVID-19 infection significantly increases the likelihood of developing these sequelae compared to uninfected individuals. Future research should prioritize investigating the underlying pathological mechanisms and developing targeted preventive and management strategies. BMC medicine 6 February 2025

Two-year trajectory of functional recovery and quality of life in post-intensive care syndrome: a multicenter prospective observational study on mechanically ventilated patients with coronavirus disease-19
Critically ill patients had Post-intensive care syndrome (PICS) for a long period and followed different trajectories for each impairment component. Based on trajectories, known PICS risk factors such as prolonged ventilation and delirium were associated with impaired recovery, while extracorporeal membrane oxygenation (ECMO) and the presence of family were associated with recovery from PICS. In critically ill COVID-19 patients, delirium management and family interventions may play an important role in promoting recovery from PICS. Journal of intensive care 6 February 2025

Evaluation of a pragmatic approach to predicting COVID-19-positive hospital bed occupancy
The model produced useful predictions of COVID-19-positive bed occupancy prior to the emergence of the Omicron variant, but accuracy deteriorated after this. In practice, the model offers a pragmatic approach to predicting bed occupancy within a pandemic wave. However, this approach requires continual monitoring of errors to ensure that the periods of poor performance are identified quickly. BMJ Health care informatics 5 February 2025

Long COVID prevalence and associated activity limitation in US children
In 2023, post–COVID condition (PCC) continued to affect US children at similar levels as 2022 and to have similar sociodemographic patterns. The large proportion of children experiencing PCC with any activity limitation highlights the need to examine the severity of activity limitation, functional outcomes, and days lost from school. JAMA 3 February 2025

Effectiveness of a personalised self-management intervention for people living with long covid (Listen trial): pragmatic, multicentre, parallel group, randomised controlled trial
The personalised self-management support intervention of the Listen trial resulted in non-significant short term improvements in routine activities when compared with usual care. Improvements in emotional wellbeing, fatigue, quality of life, and self-efficacy for people living with long covid were also reported. Physical health and social engagement were not affected by the trial intervention. The limited understanding of how much change is clinically meaningful in this population along with the unblinded design, the use of self-referral as a recruitment method and variable usual care may have introduced unintended bias and thus limits robust conclusions about this intervention. Further research is required to fully establish the impact of the intervention. BMJ medicine 31 January 2025

Measures to prevent and control COVID-19 in skilled nursing facilities: A scoping review
These findings indicate that many preventive measures were implemented in skilled nursing facilities, but few had clear evidence of effectiveness; future implementation should be commensurate with demonstrated effectiveness. JAMA 31 January 2025

Lessons from the COVID-19 pandemic: Safety practices and insights from Aboriginal elders, organisations and communities
The COVID-19 pandemic in Australia highlighted the strengths of Aboriginal and Torres Strait Islander communities and organisation However, it also exposed significant challenges relating to equity, equality, and ethical decision-making, underscoring the need for Aboriginal community-based research to gain a better understanding of the pandemic's impact. International journal of disaster risk reduction 30 January 2025

Putting international practice into action: the first case of lung transplantation for COVID-19 in Victoria, Australia
Lessons from practice

• Lung transplantation is a potential curative therapy for coronavirus disease 2019 (COVID-19)-related lung injury that does not improve with optimal medical therapy and mechanical ventilation.
• Short term survival and functional outcomes are similar between COVID-19 and non-COVID-19 lung transplantation.
• Red blood cell and platelet transfusions should be minimised if transplantation is to be considered to minimise human leukocyte antigen sensitisation.
• Awake extracorporeal membrane oxygenation allows patients to be involved in decision-making discussions and engage in physiotherapy.

MJA 30 January 2025

Decentralised COVID-19 molecular point-of-care testing: lessons from implementing a primary care-based network in remote Australian communities
To inform future infectious disease pandemic preparedness and responses, the authors used an adapted POC testing framework, based on the World Health Organization health system building blocks to systematically review program documents, including standard operating procedures, internal team communications, and formal program updates to partners. The review process identified, collated and documented key recommendations. The updated framework, which now includes workforce and training, results support, and reflects an enhanced focus on the community as central to program effectiveness. MJA 29 January 2025

Severity and long-term mortality of COVID-19, Influenza, and Respiratory Syncytial Virus
This cohort study showed that, during the 2022 to 2023 season, infection with SARS-CoV-2 was associated with more severe disease outcomes than influenza or RSV, whereas differences were less pronounced during the 2023 to 2024 season. During both seasons, RSV remained a milder illness, whereas COVID-19 was associated with higher long-term mortality. Vaccination attenuated differences in disease severity and long-term mortality. JAMA 27 January 2025

COVID-19 on patients with immune-mediated rheumatic disease: a comparative study of disease activity, fatigue, and psychological distress over six months
Post-COVID-19  immune-mediated rheumatic disease (IMRD) patients exhibited significant fatigue, depression, anxiety, and stress, which can be mistaken for disease activity, despite having similar disease activity scores. The variability in reports on IMRD flares and the potential triggering of SARS-CoV-2 for autoimmune manifestations underscore the need for detailed clinical assessment and a comprehensive approach to managing them. Advances in rheumatology 22 January 2025

Sex differences in Long COVID
In this prospective cohort study of the NIH RECOVER-Adult cohort, female sex was associated with an increased risk of long COVID compared with male sex, and this association was age, pregnancy, and menopausal status dependent. These findings highlight the need to identify biological mechanisms contributing to sex specificity to facilitate risk stratification, targeted drug development, and improved management of long COVID. JAMA 22 January 2025

Experiences of intimate-partner violence and violence from a family member during COVID-19 among LGBTQ adults in Australia
The risks of violence from an intimate partner or family member among LGBTQ individuals were high during the pandemic in Australia, regardless of lockdown measures. The findings underscore the importance of efforts to understand the systemic factors influencing IPV and violence from a family member within the LGBTQ community and address the enduring impacts of the pandemic. Journal of family violence 15 January 2025

Prevalence and correlates of severe anxiety among front-line nurses during and after the COVID-19 pandemic: a large-scale multi-center study
The study underscores the importance of understanding and addressing severe anxiety among frontline nurses during and after the COVID-19 pandemic. Future research should delve into long-term psychological effects and implement effective intervention measures to support nurses’ mental health. BMC nursing 15 January 2025

Blood absolute lymphocyte count and trajectory are important in understanding severe COVID-19
Lymphopenia was predictive of severe COVID-19 outcomes, particularly when persistent or new during hospitalization. A better understanding of the underlying risk factors for lymphopenia will help illuminate disease pathogenesis and guide management strategies. BMC infectious diseases 15 January 2025

Clinical outcomes of COVID-19 in patients with liver cirrhosis - a propensity-matched analysis from a multicentric Brazilian cohort
This study has shown that COVID-19 inpatients with cirrhosis had significantly higher incidence of severe outcomes, as well as higher frequency of institution of palliative care when compared to matched controls. These findings underscore the need for these patients to receive particular attention from healthcare teams and allocated resources. BMC infectious diseases 15 January 2025

Comparative analysis of C-Reactive protein levels among Non-comorbid, Comorbid, and Multimorbid Hospitalized COVID-19 patients
Elevated C-reactive protein (CRP) levels in COVID-19 patients with comorbidities like diabetes, hypertension, ischemic heart disease, and chronic kidney disease were strongly associated with increased disease severity, including higher ventilation requirements and mortality. BMC infectious diseases 14 January 2025

Effectiveness and user experience of nose and throat swabbing techniques for SARS-CoV-2 detection: results from the UK COVID-19 National Testing Programme
User experience analyses supported a preference for nose-only swabbing. Nose-only swabbing for lateral flow devices (LFDs) provided sufficient diagnostic accuracy, supporting its use as a viable option in the COVID-19 National Testing Programme. Less invasive swabbing approaches are important to maximize testing accessibility and alongside other behavioral interventions, increase user uptake. BMC global and public health 13 January 2025

Six-month outcomes in the long-term outcomes after the multisystem inflammatory syndrome in children study
Results of this cohort study suggest that although children and young adults with Multisystem inflammatory syndrome in children (MIS-C) can have severe disease during the acute phase, most recovered quickly and had a reassuring midterm prognosis. JAMA 13 January 2025

Safety and immunogenicity of SARS-CoV-2 spike receptor-binding domain and N-terminal domain mRNA vaccine
mRNA-1283 was well tolerated and exhibited improved immunogenicity compared to mRNA-1273. Journal of infectious diseases 10 January 2025

Effectiveness of mRNA COVID-19 vaccines and hybrid immunity in preventing SARS-CoV-2 infection and symptomatic COVID-19 among adults in the United States
Adults with both prior infection and recent vaccination had high protection against infection and symptomatic illness. Recent vaccination alone provided moderate protection. Journal of infectious diseases 8 January 2025

Role of social determinants of health in COVID-19 recovery: A qualitative study
The findings suggest that social determinants of health (SDOH) both support and hinder recovery from COVID-19 and may inform how health systems integrate social and medical care. JAMA 6 January 2024

Risk factors for bloodstream infection in COVID-19 patients in intensive care units: a systematic review and meta-analysis
The authors identified 10 risk factors for intensive care unit - bloodstream infection (ICU-BSI) in COVID-19 patients. In future studies, these factors can be combined to establish a more comprehensive and accurate prediction model for ICU-BSI in COVID-19 patients. Targeted measures can be taken earlier to control BSI. BMC infectious diseases 3 January 2025

Kidney function decline after COVID-19 infection
Findings of this study suggest an association between COVID-19 and accelerated kidney function decline, especially among people who were hospitalized; these people need closer monitoring of kidney function for early diagnosis and management of chronic kidney disease. JAMA 26 December 2024

Combination of spatial transcriptomics analysis and retrospective study reveals liver infection of SARS-COV-2 is associated with clinical outcomes of COVID-19
This study provides clinical evidence for liver infection with SARS-CoV-2, insight into the impact of SARS-CoV-2 on the liver, and a potential way to evaluate the risk of death via assessing serum ALB concentration fluctuations in patients with COVID-19. eBioMedicine 21 December 2024

Protective role of school climate for impacts of COVID-19 on depressive symptoms and psychotic experiences among adolescents: a population-based cohort study
The negative mental health effects of the pandemic were significantly mitigated among adolescents experiencing a supportive school climate. A positive school climate can protect adolescent mental health during challenging social conditions, such as pandemics. Psychological medicine 20 December 2024

Brief outpatient rehabilitation program for Post–COVID-19 condition: A randomized clinical trial
The findings of this trial suggest that brief outpatient rehabilitation based on a cognitive and behavioral approach is effective and safe for patients with Post–COVID-19 condition (PCC). JAMA 19 December 2024

2024 update of the RECOVER-adult long COVID research index
The 2024 long COVID (LC)  research index for adults builds on the 2023 index with additional data and symptoms to help researchers classify symptomatic LC and its symptom subtypes. Continued future refinement of the index will be needed as the understanding of LC evolves. JAMA 18 December 2024

Prevalence of post-acute sequelae of SARS-CoV-2 infection in people living with HIV: a systematic review with meta-analysis
Current evidence indicates that the prevalence of Long COVID in adults living with HIV may be high, suggesting the need for increased awareness and education of healthcare providers and policy makers. Evidence on whether HIV positivity increases the risk of Long COVID is limited and inconclusive, highlighting a need for further research to clarify this potential association. eClinicalMedicine 17 December 2024

Decline of antibodies to major viral and bacterial respiratory pathogens during the COVID-19 pandemic
Surges in infections caused by respiratory pathogens have been documented in multiple settings after relaxation of pandemic restrictions. Antibodies to major antigens from respiratory syncytial virus and Group A Streptococcus waned significantly in a longitudinal adult cohort throughout the pandemic. This waning may have contributed to the pathogen-surges that followed. Journal of infectious diseases 14 December 2024

Mental health symptoms and burdens after a SARS-CoV-2 infection
The results suggest that mental health care should focus on individuals who suffer from a severe acute COVID-19 infection or have a history of mental illness. BMC public health 13 December 2024

Association between COVID-19 infection and new-onset dementia in older adults: a systematic review and meta-analysis
Under normal circumstances, the authors believe that COVID-19 infection is likely to be a risk factor for developing new-onset dementia (NOD) in older adults over time. While the increased NOD risk due to COVID-19 infection appears to be similar to that associated with other respiratory infections, it warrants and necessitates investigation with longer observations. BMC geriatrics 13 December 2024

Prevalence of Post–COVID-19 condition and activity-limiting Post–COVID-19 condition among adults
In this cross-sectional study, updated national prevalence estimates of post–COVID-19 condition (PCC) (ever and current) and new estimates of activity-limiting PCC are provided. JAMA 13 December 2024

BNT162b2 XBB vaccine for COVID-19 among children 5-17 years of age
These results suggest that the BNT162b2 XBB vaccine provided protection against COVID-19–associated hospitalization and ED or urgent care visits among children 5 to 17 years of age during the 2023-2024 season with estimated vaccine effectiveness point estimates ranging from 63% to 73%. JAMA 12 December 2024

Clinical phenotype of COVID-19 vaccine-associated myocarditis in Victoria, 2021–22: a cross-sectional study
The known: COVID-19 vaccines are associated with a slightly increased risk of myocarditis.
The new: In Victoria, COVID-19 vaccine-associated myocarditis was generally milder than for other myocarditis forms. Electrocardiographic abnormalities were more frequent in male patients and those aged 24 years or younger; cardiac MRI abnormalities were not seen in patients for whom troponin levels were increased threefold or less.
The implications: Young men are at particular risk of COVID-19 vaccine-associated myocarditis, and warrant close follow-up to determine long term outcomes. A threefold or greater increase in troponin level may be a clinically useful predictor of cardiac MRI abnormalities. MJA 10 December 2024

Knowledge about COVID-19 vaccines among Aboriginal and Torres Strait Islander people, and attitudes to and behaviours regarding COVID-19 and influenza vaccination: a survey
The known: Aboriginal and Torres Strait Islander people were among the first groups in Australia to be targeted for vaccination against coronavirus disease 2019 (COVID-19.
The new: Our survey indicated that most Aboriginal and Torres Strait Islander people believed the COVID-19 vaccines to be very or extremely trustworthy (71%) and very or extremely effective (73%), but levels varied by sex and location.
The implications: Health messages in future pandemics should be tailored to the concerns of their target audiences, particularly those of Aboriginal and Torres Strait Islander women and people living in regional and remote areas. MJA 10 December 2024

Prolonged SARS-CoV-2 shedding in a lung transplant recipient: time for flexibility in infection prevention?
Lessons from practice

• Protracted viral shedding is relatively common in immunocompromised hosts and existing de-isolation guidelines may result in impractical long periods of isolation.
• Existing coronavirus disease 2019 (COVID-19) diagnostics, including rapid antigen tests, polymerase chain reaction cycle threshold value and culturable virus, are imperfect surrogates for infectivity; however, collectively can play a role in assessing prolonged viral shedding.
• Pragmatic de-isolation strategies are required for patients with prolonged SARS-CoV-2 infections.

MJA 10 December 2024

Barriers, facilitators and next steps for sustaining and scaling virtual hospital services in Australia: a qualitative descriptive study
The known: The Australian health care system requires innovative approaches to meet the rising demand for services. Virtual hospital (VH) models of care have shown promise in improving care efficiency and experiences while maintaining patient outcomes.
The new: Barriers to and facilitators of implementing and delivering VH services and gaps in evidence and practice were identified, setting a research and practice agenda for ongoing improvement.
The implications: Successful practices can be adopted by organisations looking to implement new VH services or improve existing VH services. Future research and policy changes should address gaps in evidence and practice; this should include the evaluation of care models and technologies, and development of funding models for VH services. MJA 9 December 2024

Long COVID appears to be driven by ‘long infection’. Here’s what the science says
Around 5–10% of people with COVID infections go on to experience long COVID, with symptoms lasting three months or more. MJA insight 9 December 2024

Effectiveness of the BNT162b2 XBB.1.5-adapted vaccine against COVID-19 hospitalization related to the JN.1 variant in Europe: a test-negative case-control study using the id.DRIVE platform
BNT162b2 XBB.1.5-adapted vaccine provided protection against JN.1-related hospitalization, regardless of prior vaccination history, with no evidence of waning through five months. These data support yearly vaccination against COVID-19 to prevent severe illness during the respiratory virus season. eClinicalMedicine 7 December 2024

The relationship between predisposing risk factors and COVID-19: An observational study
The study shows that the severity of the disease increased as the number of risk factors increased. This information can help in taking early and active measures in these groups of patients with multiple comorbid illnesses. Cureus 3 December 2024

Fostamatinib for hospitalized adults with COVID-19 and hypoxemia: A randomized clinical trial
In this randomized clinical trial of adults hospitalized with COVID-19 and hypoxemia, fostamatinib did not increase the number of oxygen-free days compared with placebo. These results do not support the hypothesis that fostamatinib improves outcomes among adults hospitalized with hypoxemia during the Omicron era. JAMA 3 December 2024

Castleman disease following post-coronavirus disease 2019 multisystem inflammatory syndrome in adults
Lessons from practice

• Consider Castleman disease in patients re-presenting with similar symptoms as post-coronavirus disease 2019 multisystem inflammatory syndrome in adults.
• Non-caseating granulomas have a wide range of differentials; including infections, vasculitis, occupational diseases and haematological aetiologies.
• Excisional lymph node biopsy is the gold standard to diagnose unexplained lymphadenopathy.
• Enlargement of cherry angiomas is a sign of Castleman disease.

BMJ 1 December 2024

Bivalent Omicron BA.1 vaccine booster increases memory B cell breadth and neutralising antibodies against emerging SARS-CoV-2 variants
These results suggest that the bivalent vaccine confers an advantage against future novel variants due to increased frequency of broadly reactive RBD-specific B cells. eBioMedicine 28 November 2024

Interventions for the management of long covid (post-covid condition): living systematic review
Moderate certainty evidence suggests that cognitive behavioural therapy (CBT)  and physical and mental health rehabilitation probably improve symptoms of long covid. BMJ 27 November 2024

mRNA COVID-19 vaccine safety among children and adolescents: a Canadian National Vaccine Safety Network cohort study
The  findings suggest that reported health events, including myocarditis/pericarditis, vary by pediatric age group. Vaccinated adolescents reported health events more frequently following the second mRNA COVID-19 vaccine dose, while younger age groups did not report events more frequently than their unvaccinated counterparts. The Lancet regional health – Americas 27 November 2024

Experiences and perspectives of the COVID-19 pandemic and vaccinations in culturally and linguistically diverse (CALD) populations in Australia: A qualitative study
This research paper highlights the issues experienced by culturally and linguistically diverse (CALD) members during the COVID-19 pandemic and vaccination rollout. Cureus 26 November 2024

COVID-19 vaccine reactogenicity among young children
No unexpected reactions were identified. Similar to the authors study, data from clinical trials and V-safe found that irritability was the most common systemic reaction among children aged 6 months to younger than 2 years, followed by fever and fatigue or sleepiness. JAMA 25 November 2024

Towards a cure for long COVID: the strengthening case for persistently replicating SARS‐CoV‐2 as a driver of post‐acute sequelae of COVID‐19
Evidence is mounting that at least some of the potential mechanisms driving long COVID mentioned herein (immune and inflammatory dysregulation, microbiota dysbiosis, autoimmunity and endothelial dysfunction) may themselves have the common denominator of persistent SARS‐CoV‐2 infection. This has several important implications: 

• Prioritise long COVID: the notion of “long infection” should help further demystify long COVID, validating individuals who live with this illness (and post‐acute infection syndromes in general) and have it move into the mainstream of surveillance and strategies for diagnosis, treatment and prevention.
• Ramp‐up existing antiviral approaches: existing approaches, including vaccines and therapies, appear to decrease the risk of long COVID and should be more actively included in trials for long COVID. This recognition and the potential cost‐effectiveness implications should prompt reassessment of eligibility requirements for access to therapies and vaccines to promote their use in younger people and to individuals even with milder forms of acute infection.
• Urgently develop new antiviral approaches and long COVID diagnostics: there is now increased impetus for the development of improved therapeutics and vaccines for SARS‐CoV‐2 in addition to definitive biological long COVID diagnostic tests to complement clinical diagnoses.
• Strengthen prevention approaches: long COVID incidence remains high, and this carries a large health, labour and economic impact. It is therefore critical that sustainable prevention strategies are strengthened, especially in higher transmission‐risk settings. Major recent advances towards safer indoor air environments offer one clear avenue to achieve this.

MJA 25 November 2025

Maternal COVID-19 infection and risk of respiratory distress syndrome among newborns: a systematic review and meta-analysis
Newborns born to mothers with COVID-19 have a substantially increased risk of developing respiratory distress syndrome (RDS) These findings emphasize the need for vigilant monitoring and appropriate management of pregnant women with COVID-19 to mitigate adverse neonatal outcomes. BMC infectious diseases 19 November 2024

Role of 2-Deoxy-D-Glucose in enhancing the efficacy of standard of care for moderate to severe COVID-19: A comparative analysis of clinical outcomes
2-DG demonstrates significant efficacy as an adjunct therapy for moderate to severe COVID-19, reducing both time to clinical improvement (5.2 vs. 7.5 days, p < 0.001) and hospital stay duration. Additionally, fewer adverse events were reported, and viral clearance rates were higher in the 2-DG group. These findings highlight 2-DG’s potential to improve clinical outcomes in COVID-19 care,. Cureus 19 November 2024

Cross-sectional and longitudinal genotype to phenotype surveillance of SARS-CoV-2 variants over the first four years of the COVID-19 pandemic
The emergence of many SARS-CoV-2 lineages documented at the end of 2023 was found to be initially associated with lowered neutralisation responses. This continued to be countered by the gradual maturation of cross-reactive neutralisation responses over time. The later appearance and dominance of the divergent JN.1 lineage cannot be attributed to a lack of neutralisation responses alone, and our data supports that its dominance is a culmination of both lowered neutralisation and changes in ACE2/TMPRSS2 entry preferences. eBioMedicine 15 November 2024

Postural orthostatic tachycardia syndrome after COVID-19 vaccination: A systematic review
The risk of POTS following COVID-19 vaccination is lower than that observed post-SARS-CoV-2 infection; however, existing studies are limited by small sample sizes and methodological variability. BMC cardiovascular disorders 14 November 2024

Humoral and cellular responses to a fifth bivalent SARS-CoV-2 vaccine dose in patients with immune-mediated inflammatory diseases on tumour necrosis factor inhibitors: a prospective cohort study
In patients on tumour necrosis factor inhibitors (TNFi) with hybrid immunity, there was no immunological benefit of an updated fifth SARS-CoV-2 booster dose. Stable CD8 cellular responses following four doses indicate established protective immunity. Patients whose only risk factor is TNFi may in future follow vaccine recommendations for the general population. The Lancet regional health - Europe 14 November 2024

Association of mRNA COVID-19 vaccination and reductions in Post-COVID Conditions following SARS-CoV-2 infection in a US prospective cohort of essential workers
COVID-19 vaccination protected against development of post-COVID conditions (PCC) among persons with mild infection during both Delta and Omicron variant predominance, supporting vaccination as an important tool for PCC prevention. Journal of infectious diseases 13 November 2024

Rheumatoid arthritis and COVID-19 outcomes: a systematic review and Meta-analysis
Rheumatoid arthritis patients have a significantly greater risk of COVID-19 infection, hospitalization, ICU admission, and death than individuals without rheumatoid arthritis. However, rheumatoid arthritis did not show a significant association with the risk of severe COVID-19. These findings underscore the need for tailored management strategies and vigilant monitoring of COVID-19 outcomes in rheumatoid arthritis patients. BMC rheumatology 12 November 2024

Trends in alcohol use after the COVID-19 pandemic: A national cross-sectional study
The study included 24 965 respondents from 2018, 30 829 from 2020, and 26 806 from 2022. Compared with 2018, there were absolute increases in any alcohol use in 2020 and 2022. Numerical increases in any alcohol use occurred in 2020 and 2022 versus 2018 among all subgroups. Annals of internal medicine 12 November 2024

A substitution at the cytoplasmic tail of the spike protein enhances SARS-CoV-2 infectivity and immunogenicity
This study offers mechanistic insight into the constantly increasing transmissibility of SARS-CoV-2 Omicron variants and provides a meaningful optimisation strategy for vaccine development against SARS-CoV-2. eBioMedicine 11 November 2024

The COVID-19 pandemic and patient expectations about recovery from acute respiratory failure
In this cohort study, the authors found no clinically meaningful change in expectations about recovery during the COVID-19 pandemic among survivors of non–COVID-19 acute respiratory failure (ARF); expectations were high and similar to previously described expectations in survivors of ARF. JAMA 8 November 2024

Global landscape of COVID-19 vaccination programmes for older adults: a descriptive study
Progress of COVID-19 vaccination programmes for older adults is uneven across countries, emphasising an ongoing challenge to achieve vaccine equity for this high-risk age group. Therefore, it is essential to establish robust and timely vaccination surveillance systems, especially to facilitate data-driven policies that promote COVID-19 vaccination campaigns worldwide. The Lancet – healthy longevity 7 November 2024

Impact of JN.1 booster vaccination on neutralisation of SARS-CoV-2 variants KP.3.1.1 and XEC
The XEC S protein retains the ability to efficiently engage ACE2 and drive cell entry, although entry into Calu-3 lung cells was reduced. Both KP.3.1.1pp and XECpp were generally less well neutralised compared with JN.1pp, indicating elevated immune evasion. Importantly, JN.1 booster vaccination considerably improved neutralisation of all lineages tested and therefore will likely increase protection against hospitalisation and post-COVID sequelae from infection caused by KP.3.1.1 and XEC. The Lancet infectious diseases 7 November 2024

Neurodevelopment in the first 2 years of life following prenatal exposure to maternal SARS-CoV-2 infection
In this longitudinal cohort study of multiple aspects of child neurodevelopment between ages 6 and 24 months, negligible associations between prenatal exposure to SARS-CoV-2 infection and child outcomes were observed. Follow-up research is warranted to determine whether these predominantly null effects persist into later childhood. JAMA 7 November 2024 

Global landscape of COVID-19 vaccination programmes for older adults: a descriptive study
Progress of COVID-19 vaccination programmes for older adults is uneven across countries, emphasising an ongoing challenge to achieve vaccine equity for this high-risk age group. Therefore, it is essential to establish robust and timely vaccination surveillance systems, especially to facilitate data-driven policies that promote COVID-19 vaccination campaigns worldwide. The Lancet – healthy longevity 7 November 2024

Long-term risk of autoimmune and autoinflammatory connective tissue disorders following COVID-19
This retrospective cohort study with an extended follow-up period found associations between COVID-19 and the long-term risk of various autoimmune and autoinflammatory connective tissue disorders. Long-term monitoring and care of patients is crucial after COVID-19, considering demographic factors, disease severity, and vaccination status, to mitigate these risks. JAMA 6 November 2024

Safety of simultaneous vs sequential mRNA COVID-19 and inactivated influenza vaccines: A randomized clinical trial
The findings support simultaneous administration of mRNA COVID-19 and inactivated influenza vaccines as an acceptable option to achieve timely vaccination. JAMA 6 November 2024

Virological characteristics of the SARS-CoV-2 XEC variant
Altogether, here we showed that XEC exhibited higher pseudovirus infectivity and higher immune evasion than KP.3. Particularly, XEC exhibited more robust immune resistance to KP.3.3 BTI sera than KP.3.1.1. This data suggest that the higher Re of XEC than KP.3.1.1 is attributed to this property and XEC will be a predominant SARS-CoV-2 variant in the world in the near future. The Lancet infectious diseases 6 November 2024

Long COVID and recovery from Long COVID: quality of life impairments and subjective cognitive decline at a median of 2 years after initial infection
Long COVID is associated with long-term subjective cognitive decline and diminished quality of life. Clinically significant cognitive complaints, fatigue, and pain were present even in those who reported they had recovered from Long COVID. These findings have implications for the sustainability of participation in work, education, and social activities. BMC infectious diseases 5 November 2024

Hospital COVID-19 burden and adverse event rates
The results of this study suggest a need for greater resilience in hospitals to prevent declines in patient safety and effectiveness of care during increases in demand, such as from pandemics, natural disasters, or other causes. JAMA 4 November 2024

The economic burden of long COVID in Australia: more noise than signal?
The known: Robust evidence on the economic burden of long COVID in Australia is limited.
The new: Long COVID potentially peaked in late July or early August 2022, based on COVID‐19 case numbers for the period January 2021 to April 2023. The estimated cost of long COVID in 2022 was about $1.7 billion to $6.3 billion — a fraction of a percentage point of Australia's gross domestic product. Labour market analysis indicates that more working age Australians than expected may now be unable to work, potentially because of long COVID.
The implications: Long COVID likely had a small but perceptible impact on the Australian economy, which can provide insights for shaping Australia's policy response. MJA 4 November 2024

Beyond acute infection: mechanisms underlying post-acute sequelae of COVID-19 (PASC)
Summary

• Immune dysregulation is a key aspect of post-acute sequelae of coronavirus disease 2019 (PASC), also known as long COVID, with sustained activation of immune cells, T cell exhaustion, skewed B cell profiles, and disrupted immune communication thereby resulting in autoimmune-related complications.
• The gut is emerging as a critical link between microbiota, metabolism and overall dysfunction, potentially sharing similarities with other chronic fatigue conditions and PASC.
• Immunothrombosis and neurological signalling dysfunction emphasise the complex interplay between the immune system, blood clotting, and the central nervous system in the context of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.
• Clear research gaps in the design of PASC studies, especially in the context of longitudinal research, stand out as significant areas of concern.

MJA 3 November 2024

Factors associated with general practitioner-led diagnosis of long COVID: an observational study using electronic general practice data from Victoria and New South Wales, Australia
The known: Long COVID is a growing concern worldwide. Research outside Australia has identified demographic factors and pre-existing conditions as potential risk factors for long COVID.
The new: In an Australian population, patients who were female, aged 40–59 years or of high socio-economic status, and those who had a pre-existing mental health condition, respiratory condition, cancer or musculoskeletal condition, had an increased risk of general practitioner-led diagnosis of long COVID.
The implications: Identification of predisposing risk factors is essential to inform early intervention and management strategies for those at greatest risk of long COVID and to help alleviate the burden of long COVID on the health care system. MJA 3 November 2024

Hospital costs of COVID-19, post-COVID-19 condition and other viral pneumonias: a cost comparison analysis
The known: International research indicates that hospital admissions for COVID-19 are costlier than admissions for other viral pneumonias, but detailed economic analysis from the Australian context has been lacking.
The new: During the original and Delta waves of the pandemic, admissions for COVID-19 incurred 29% higher costs than those for other viral pneumonias. The costs of admissions that included intensive care were six times higher than those that were managed on general wards.
The implications: Acute COVID-19 and post-COVID-19 condition cases have had a significant financial impact on Australian hospitals. Further analysis is required to identify trends over time in the context of increased vaccination rates and subsequent variants of severe acute respiratory syndrome coronavirus 2. MJA 3 November 2024

Persistent symptoms after COVID-19: an Australian stratified random health survey on long COVID
The known: Persistent symptoms can occur following COVID-19 and may be associated with ongoing impairment.
The new: A survey of adults in Victoria, Australia, who had had a confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection showed that one in seven reported persistent new symptoms and being less than 80% recovered three months after the infection (meeting the survey criteria for clinical long COVID). One in five of those with clinical long COVID reported at least moderate impairment at 12 months after the infection.
The implications: Although more recent SARS-CoV-2 variants are less virulent, infections are likely to continue to cause persistent symptoms, and a minority of those affected will experience decreased function. Improved community understanding of long COVID is required, and health systems need to develop clear pathways for treating patients, especially for those with persistent impairment. MJA 3 November 2024