Updated 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

Incidence of post-acute COVID-19 symptoms across healthcare settings in seven countries: an international retrospective cohort study using routinely-collected data
Post-acute COVID-19 symptoms, as listed by the WHO, were commonly observed following COVID-19 infection. However, even after standardising research methods, there was significant heterogeneity in the incidence rates from different healthcare settings and geographical locations. This is the first international study of the epidemiology of post-acute COVID-19 symptoms using the WHO-listed symptoms. Its findings contibute to understand the epidemiology of this condition from a multinational approach. eClinicalMedicine 29 October 2024

Experiences of Australian adults with disabilities living with government supports in the home during the COVID-19 pandemic

• Adults with disabilities who lived with government supports in their homes experienced declining mental health and life satisfaction when COVID-19 stay-at-home orders, also known as ‘lockdowns’, were introduced in Australia.  
• Informal and paid supports were highly valued by these adults throughout the COVID-19 pandemic but were not always available.
• Resources for future health crises should be co-designed in collaboration with end-users (adults with disabilities as well as their supporters).

Disability & society 27 October 2024

Risk factors for in-hospital mortality in older patients with acute respiratory distress syndrome due to COVID-19: a retrospective cohort study
In cases of COVID-19-related acute respiratory distress syndrome (C-ARDS) in older patients, the decision to initiate invasive mechanical ventilation (IMV) should always be individualized therefore, the use of alternative oxygen delivery systems as the first-line approach can be considered. BMC geriatrics 26 October 2024

Revealing transparency gaps in publicly available COVID-19 datasets used for medical artificial intelligence development—a systematic review
During the COVID-19 pandemic, artificial intelligence (AI) models were created to address health-care resource constraints. Previous research shows that health-care datasets often have limitations, leading to biased AI technologies. This systematic review assessed datasets used for AI development during the pandemic, identifying several deficiencies. The lancet digital health 31 October 2024 

Incidence of post-acute COVID-19 symptoms across healthcare settings in seven countries: an international retrospective cohort study using routinely-collected data
Post-acute COVID-19 symptoms, as listed by the WHO, were commonly observed following COVID-19 infection. However, even after standardising research methods, there was significant heterogeneity in the incidence rates from different healthcare settings and geographical locations. This is the first international study of the epidemiology of post-acute COVID-19 symptoms using the WHO-listed symptoms. Its findings contribute to understand the epidemiology of this condition from a multinational approach. Limitations of this study include the lack of consensus of the post-acute COVID-19 definition, as well as the difficulty to capture the impact on daily life of the post-acute COVID-19 symptoms in the available datasets. eClinicalMedicine 31 October 2024

Effects of Buprenorphine, Methadone, and substance-use on COVID-19 morbidity and mortality
Active substance use was associated with increased morbidity in COVID-19 infection. medications for opioid use disorder (MOUD) was not associated with worse COVID-19 outcomes compared to other opioids. Future studies focused on MOUD treatments that reduce morbidity may help improve clinical outcomes in COVID-19. Journal of addiction medicine 30 October 2024

N95 filtering facepiece respirator reuse, extended use, and filtration efficiency
The authors found the number of shifts of reuse and respirator model were associated with reduced filtration efficiency (FE). While associated with minimal reduction in FE after 1 shift, after 3 shifts almost one-third of respirators did not filter 95% of particles. JAMA 29 October 2024

Body mass index and postacute sequelae of SARS-CoV-2 infection in children and young adults
In this cohort study, elevated body mass index (BMI) was associated with a significantly increased post-acute sequelae of SARS-Cov-2 infection (PASC) risk in a dose-dependent manner, highlighting the need for targeted care to prevent chronic conditions in at-risk children and young adults. JAMA 28 October 2024

Hospitalization for COVID-19, other respiratory infections, and post-acute patient-reported symptoms
This cohort study found that postacute infection syndrome (PAIS)  is not unique to COVID-19; it can also occur in people with other severe lower respiratory tract infections (LRTIs). However, compared with other LRTIs, COVID-19 appeared to impose an extra burden of neurological, cognitive, and fatigue symptoms. These findings highlight the similarities and differences between post–COVID-19 condition (PCC) and PAIS triggered by other pathogens, which will inform tailored clinical management and offer mechanistic insights into these previously overlooked syndromes. Limitations include potential residual confounding, the healthier profile of UKB participants vs the general population, and the lack of repeated-measure data for symptom trajectories. JAMA 25 October 2024  

Efficacy and safety of asunercept, a CD95L-selective inhibitor, in hospitalised patients with moderate-to-severe COVID-19: ASUNCTIS, a multicentre, randomised, open-label, controlled, phase 2 trial
The phase 2 ASUNCTIS study assessed the efficacy and safety of asunercept, a fully human CD95 (Fas) ligand-binding protein, in hospitalised patients with moderate-to-severe coronavirus disease (COVID-19) to assess the clinical benefit of CD95 ligand inhibition in this viral disease. The primary endpoint of time to sustained clinical improvement for distinct asunercept arms compared to standard of care (SOC) failed to meet statistical significance. The compound was safe and well tolerated. eClinicalMedicine 24 October

Atorvastatin and telmisartan do not reduce nasopharyngeal carriage of SARS-CoV-2 in mild or moderate COVID-19 in a phase IIb randomized controlled trial
Among adults with mild to moderate COVID-19 infection, the addition of telmisartan or atorvastatin, to the standard LPVr treatment is not associated with a better virological or clinical outcome.  Nature 23 October 2024  

Gastrointestinal pathophysiology in long COVID: Exploring roles of microbiota dysbiosis and serotonin dysregulation in post-infectious bowel symptoms 
In this review, we highlight the key findings in post-COVID bowel symptoms and explore possible mechanisms underlying the pathophysiology of the illness. These mechanisms include mucosal inflammation, gut barrier dysfunction, and microbiota dysbiosis during viral infection. Viral shedding through the GI route may be the primary factor causing the alteration of the microbiome ecosystem, particularly the virome. Recent evidence in experimental models suggested that microbiome dysbiosis could be further aggravated by epithelial barrier damage and immune activation.  Life Sciences 23 October 2024 

Influence of park visitation on physical activity, well-being and social connectedness among Australians during COVID-19
These findings highlight the role of parks in positively influencing health-related outcomes and the ‘dosage’ of park use needed to attain health benefits. Health promotion international 22 October 2024

COVID-19 vaccine effectiveness against SARS-CoV-2-confirmed hospitalisation in the eastern part of the WHO European Region (2022–2023): a test-negative case-control study from the EuroSAVE network
During nearly two years of Omicron circulation in the eastern WHO European Region, COVID-19 vaccination reduced the risk of hospitalisations by more than half for 6 months following vaccination. The Lancet regional health – Europe 22 October 2024

Reevaluation of prognostic and severity indicators for COVID-19 patients in the emergency department
The NEWS and CCEDRRN COVID-19 Mortality Score were reconfirmed for early and rapid predicting the poor prognosis and severity of COVID-19 patients in ED, especially the CCEDRRN COVID-19 Mortality Score with the highest discrimination capacity, and NLR was more appropriate for predicting the severity.
Annals of Medicine 22 October 2024 

Prevalence of Toxoplasma gondii infection in covid-19 patients: a systematic review and meta-analysis
The results of this study showed that there is a significant relationship between toxoplasmosis and COVID-19, which has been proven in toxoplasmosis and some underlying diseases. On the other hand, the severity of symptoms in patients with simultaneous toxoplasmosis and COVID-19 due to an increase in the amount of cytokines, including gamma interferon, has been observed. According to the findings of this study, the prevalence of COVID-19 is higher in individuals with toxoplasmosis. Microbial Pathogenesis 21 October 2024 

The impact of the COVID-19 pandemic on recovery from substance use disorder: Findings from a qualitative study
Many individuals already in SUD recovery before COVID-19 remained in recovery despite the challenges of pandemic era. The role of peer support in recovering individuals managing negative emotions caused by COVID-19 is considered. Substance use research and treatment 18 October 2024

Are covid-19 tests still working?
“The vast majority of currently circulating variants (including the so called FLiRT variants fuelling the current wave) are descendants of the omicron variant—and existing evidence suggests that rapid antigen tests still perform well at identifying omicron (versus non-omicron) variants,” Sundaram says, citing work done by the FDA on omicron variants as late as 2022.3  Sundaram and others tell The BMJ that many of the mutations that define variants aren’t expected to change the sensitivity of the tests. That’s partly because these mutations often affect the spike protein of the virus, whereas the tests, for the most part, target proteins that are much more preserved over time. BMJ 17 October 2024 

Next-generation SARS-CoV-2 vaccine formulations and alternative routes of administration
The development of SARS-CoV-2 next-generation vaccines with the potential for increased effectiveness, durability, breadth, and ability to decrease transmission are of public health importance. We highlight alternative routes of administration of next-generation SARS-CoV-2 vaccines such as mucosal and intradermal administration. Journal of infectious diseases 16 October 2024

In utero exposure to maternal COVID-19 and offspring neurodevelopment through age 24 Months
In this cohort study of pregnant individuals and offspring, exposure to maternal COVID-19 was not associated with abnormal neurodevelopmental screening results through 24 months’ post partum. Continued study of diverse groups of children is needed because, among other factors, evidence suggests sensitivity of the developing fetal brain to maternal immune activation. JAMA 16 October 2024

Relative effectiveness and waning of a third dose of mRNA COVID-19 vaccine in Medicare beneficiaries aged 65 years and older during the BA.1/BA.2 Omicron period
A third dose COVID-19 vaccine provided significant added benefit against COVID-19-related hospitalization and death, even for beneficiaries with prior medically attended COVID-19 diagnoses. This added benefit decreased after 4 months. Journal of infectious diseases 15 October 2024

SARS-CoV-2 infection and new-onset Type 2 Diabetes among pediatric patients, 2020 to 2022
In this retrospective cohort study of children and adolescents aged 10 to 19 years, the risk of an incident diagnosis of  type 2 diabetes (T2D)  was greater following a COVID-19 diagnosis than in children diagnosed with  other respiratory infections (ORIs). Further study is required to determine whether diabetes persists or reverses later in life. JAMA 14 October 2024

Longitudinal assessment of health-related quality of life after SARS-CoV-2 infection and the associations with clinical and social characteristics in a general practice population
The negative association post-COVID conditions (PCC) has with both mental and physical health-related quality of life (HRQoL) for at least six months, calls for more research to support patients with PCC. Health and quality of life outcomes 9 October 2024

SARS-CoV-2 antigen rapid detection tests: test performance during the COVID-19 pandemic and the impact of COVID-19 vaccination
The decline in  rapid detection tests (RDTs) sensitivity throughout the pandemic can primarily be attributed to the reduced prevalence of symptomatic infections among vaccinated individuals and individuals infected with Omicron VOC. RDTs remain valuable for detecting SARS-CoV-2 in symptomatic individuals and offer potential for detecting other respiratory pathogens in the post-pandemic era, underscoring their importance in infection control efforts. eBioMedicine 9 October 2024

COVID-19 disease incidence and severity in previously infected unvaccinated compared with previously uninfected vaccinated persons
The incidence rate (per 1000 person-days) of breakthrough infection among vaccinated individuals was similar to reinfection rate among unvaccinated individuals. The incidence rate of hospitalization/death was higher after reinfection compared with rate after breakthrough infection. The incidence of hospitalization/death is significantly higher after reinfection among unvaccinated individuals compared with breakthrough infection after vaccination. Journal of infectious diseases 8 October 2024

Post–COVID-19 condition fatigue outcomes among Danish residents
The burden of post–COVID-19 condition fatigue was highest among patients with more severe cases of infection and was long-lasting, suggesting that patients with severe acute infection may benefit from clinical follow-up for fatigue. JAMA 7 October 2024

Timing of total joint arthroplasty post-COVID-19: an evaluation of the optimal window to minimize perioperative risks
Patients with a positive COVID-19 diagnosis within 12 weeks of Total hip arthroplasty (THA) or total knee arthroplasty (TKA) carried a significantly higher risk for postoperative complications and mortality. In addition, a Charlson Comorbidity Index (CCI) score > 3 is also a significant risk factor. These findings emphasize the importance of vigilant preoperative screening and risk stratification in the era of COVID-19. Arthroplasty 4 October 2024

Lithium Aspartate for Long COVID fatigue and cognitive dysfunction: A randomized clinical trial
The findings of this trial suggest that lithium aspartate, 10 to 15 mg/d, is ineffective for neurologic post–COVID-19 condition fatigue and cognitive dysfunction; the effect of higher dosages needs to be assessed in another randomized clinical trial. JAMA 2 October 2024

National Institutes of Health COVID-19 Treatment Guidelines Panel: Perspectives and lessons learned
The purpose of this article is to expand on the experiences of the NIH COVID-19 Treatment Guidelines Panel (the Panel) over the past 4 years, summarize the Panel’s final recommendations for COVID-19, highlight some challenges and unanswered questions about COVID-19 management, and inform future responses to public health emergencies. Annals of internal medicine 1 October 2024

Tracking COVID-19 infections using survey data on rapid at-home tests
his study suggests that nonprobability survey data can be used to estimate the temporal evolution of test-confirmed infections during an emerging disease outbreak. Self-reporting tools may enable government and health care officials to implement accessible and affordable at-home testing for efficient infection monitoring in the future JAMA 30 September 2024

Cigarette smoking status and COVID-19 hospitalization in the context of cannabis use: An electronic health record cohort study in northern California
Highlights

• Former and current cigarette smoking were risk factors for COVID-19 hospitalization.
• No detected link between the co-use of cigarettes and cannabis and COVID-19 hospitalization.
• Current cigarette smoking was a risk factor for COVID-19 hospitalization when the cannabis use status was unknown. 
• The association between cigarette smoking and COVID-19 hospitalization varied by cannabis use.
• The result highlights the importance of considering both cigarette smoking and cannabis use when investigator risk factors of COVID-19 outcomes.

Addictive behaviors reports 26 September 2024

Rates of sudden unexpected infant death before and during the COVID-19 pandemic 
This cross-sectional study found increased rates of both sudden infant death syndrome (SIDS)  and sudden unexpected infant death (SUID) during the COVID-19 pandemic, with a significant shift in epidemiology from the prepandemic period noted in June to December 2021. These findings support the hypothesis that off-season resurgences in endemic infectious pathogens may be associated with SUID rates, with RSV rates in the US closely approximating this shift. Further investigation into the role of infection in SUID and SIDS is needed. JAMA 26 September 2024

Emerging SARS-CoV-2 resistance after antiviral treatment
In this study, the emergence of SARS-CoV-2 strains with resistance to nirmatrelvir after treatment was rare, irrespective of virologic rebound. JAMA 25 September 2024

Impact of the COVID-19 pandemic on health-care use among patients with cancer in England, UK: a comprehensive phase-by-phase time-series analysis across attendance types for 38 cancers
The UK's COVID-19 pandemic lockdown affected cancer health service access negatively. Many groups of individuals with cancer had declines in attendance volume and consultation rate across the phases of the pandemic. A decrease in attendances might lead to delays in cancer diagnoses, treatment, and follow-up, putting such groups of individuals at higher risk of negative health outcomes, such as cancer-specific mortality. The authors discuss the factors potentially responsible for explaining changes in service provision trends and provide insight to help inform clinical follow-up for groups of individuals at risk, alongside potential future policy changes in the care of such patients. The Lancet digital health 25 September 2024

Humoral immunity after mRNA SARS-CoV-2 omicron JN.1 vaccination
Bretovameran, an mRNA vaccine adapted to the spike protein of the omicron JN.1 variant, increased anti-spike IgG in all vaccinated people at 13 days after vaccination and strengthened neutralising responses against circulating SARS-CoV-2-variants except KP.3. The Lancet infectious diseases 25 September 2024

Safety and immunogenicity of a single-dose omicron containing COVID-19 vaccination in adolescents: an open label, single-arm, phase 2/3 trial
In vaccine-naive, SARS-CoV-2-positive adolescents, single-dose mRNA-1273.222 was effective against COVID-19 based on successful immunobridging to the two-dose mRNA-1273 primary series in young adults. The findings support a simplified single-dose vaccination schedule with variant-containing mRNA vaccines, regardless of previous vaccination status. The Lancet infectious diseases 24 September 2024

Positive Autism screening rates in toddlers born during the COVID-19 pandemic
In this cohort study of 2 groups of children with prenatal pandemic exposure and/or exposure to maternal SARS-CoV-2 infection, neither exposure was associated with greater Modified Checklist for Autism in Toddlers, Revised (M-CHAT-R) positivity. JAMA 23 September 2024

Changes in memory and cognition during the SARS-CoV-2 human challenge study
These results support larger cross sectional findings indicating that mild Wildtype SARS-CoV-2 infection can be followed by small changes in cognition and memory that persist for at least a year. The mechanistic basis and clinical implications of these small changes remain unclear. eClinicalMedicine 21 September 2024

Lessons learnt from the first two SARS-CoV-2 Omicron waves of the COVID-19 pandemic in six remote Aboriginal and Torres Strait Islander communities in Queensland, Australia: a retrospective epidemiological review 

• The known: Over the course of the COVID-19 pandemic, there have been heightened concerns for the health and wellbeing of First Nations people across Australia.
• The new: This descriptive study was a retrospective epidemiological review of the impact of COVID-19 on six remote First Nations communities in Queensland and their community-led public health responses.
• The implications: A community-led approach should be prioritised in other public health responses throughout First Nations communities.

MJA 19 September 2024

Acceptance of SARS-CoV-2 surveillance testing among patients receiving dialysis: A cluster randomized trial
In this cluster randomized trial evaluating 2 SARS-CoV-2 testing strategies in dialysis facilities, test acceptance was low, and a dynamic testing strategy anchored to COVID-19 infection prevalence did not outperform a static testing strategy of every 2 weeks. JAMA 19 September 2024