#Losartan and #prednisolone for #postCOVID syndrome and cardiac inflammation: a randomized, double-blind, placebo-controlled trial

 

Abstract

Persistent cardiac symptoms are common in post-COVID syndrome, even without structural heart disease. Evidence implicates immune dysregulation, endothelial dysfunction and low-grade cardiovascular inflammation. Yet no targeted treatment exists. Myoflame-19 is a multicenter, double-blind clinical trial of 279 participants with inflammatory cardiac involvement defined by cardiovascular magnetic resonance, randomized 1:1 to losartan plus prednisolone (n = 139) or matching placebos (n = 140) for 16 weeks. The modified intention-to-treat population comprised 124 and 122 participants. The primary endpoint, change in left ventricular (LV) ejection fraction, was neutral: between-group difference 0.74 percentage points (pp), 95%CI −0.14 to 1.62, p = 0.10, unpaired t-test; supportive baseline-adjusted ANCOVA 0.99, 95%CI 0.15-1.83, p = 0.021. Among prespecified secondary endpoints, several symptom and imaging measures showed numerical differences favoring intervention, including Average Symptom Score components (modified Canadian Chest Pain Scale −4.8 pp, 95%CI −17.3 to 7.6; NYHA class −8.1 pp, −20.6 to 4.3; Long COVID symptom burden −7.7 pp, −18.9 to 3.6), native T1 and T2 values (native T1 −2.46 ms, −8.35 to 3.42; native T2 −0.31 ms, −1.16 to 0.53), and LV end-diastolic volume ( + 1.45 ml/m², −0.09 to 3.00); however, confidence intervals included the null value and these findings should be regarded as hypothesis-generating.Treatment was safe and well-tolerated. These findings indicate a neutral treatment effect on the primary endpoint. They inform targeted immunomodulation and design of future trials in post-COVID syndrome and inflammatory cardiac involvement. Trial registration: EudraCT 2022-001682-12; NCT05619653.

Source: 

Link: https://www.nature.com/articles/s41467-026-75991-w

____

#SARS-CoV-2 #Surveillance in Free-Ranging #Wildlife in New England and #Virginia, #USA, 2022–2025

 

Abstract

Since its emergence in 2019, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has infected a wide range of animal species, including wildlife. Although SARS-CoV-2 infection has been widely reported in wildlife, particularly in white-tailed deer (WTD; Odocoileus virginianus) across the United States, data on viral circulation in New England wildlife remain limited. Here, we investigated active SARS-CoV-2 infection and serological evidence of previous exposure in free-ranging wildlife from New England and Virginia. We examined samples from 1646 animals representing 29 wildlife species, collected through wildlife rehabilitation centers, clinics, and hunter harvests in New England and Virginia between 2022 and 2025. SARS-CoV-2 RNA was detected in three WTD from Massachusetts and Vermont. Phylogeographic analysis showed that the Vermont WTD SARS-CoV-2 sequences were closely related to contemporaneous human SARS-CoV-2 sequences from the same region, consistent with a possible human-to-deer spillover event. Serological screening by ELISA detected SARS-CoV-2 reactive samples in nine individuals from three species, including Eastern cottontail (Sylvilagus floridanus), Eastern coyote (Canis latrans), and raccoon (Procyon lotor), providing putative evidence of prior SARS-CoV-2 exposure. However, neutralizing antibodies against the SARS-CoV-2 Omicron variant were detected in only a single Eastern cottontail. Overall, these findings indicate sporadic SARS-CoV-2 detection and limited serological evidence of prior exposure among wildlife sampled in New England and Virginia, and highlight the importance of continued surveillance to detect spillover events, monitor viral evolution, and assess the potential risks associated with wildlife reservoirs.

Source: 

Link: https://www.mdpi.com/1999-4915/18/8/832

____

#Taiwan, As the #COVID19 #epidemic escalates, public is urged to get vaccinated as soon as possible (CDC, July 28 '26): 117% rise in cases compared last week

 

    The Centers for Disease Control (CDC) stated today (28th) that the domestic COVID-19 epidemic continues to rise and has entered the epidemic period. 

    In addition, it coincides with the summer vacation travel peak season, which increases the risk of disease transmission. 

    The CDC calls on the public to take precautions such as washing hands frequently, wearing masks, and getting vaccinated. 

    When entering and leaving medical care institutions, in crowded places where it is not possible to maintain an appropriate distance or in poorly ventilated places, or when in close contact with the elderly or people with weakened immune systems, it is recommended to wear masks. 

    If you have a fever or respiratory symptoms, it is recommended to stay at home as much as possible and avoid unnecessary outings. 

    People with severe risk factors should seek medical attention as soon as possible if they have suspected symptoms so that doctors can diagnose and treat them early and prescribe antiviral drugs to reduce the risk of complications or death after infection.

    According to data from the Taiwan Centers for Disease Control (CDC), the COVID-19 epidemic in Taiwan is on the rise. 

    In the 29th week (July 19-25), there were 10,605 outpatient and emergency room visits related to COVID-19, a 117.4% increase compared to the previous week (July 12-18). 

    Last week (July 21-27), there were 42 new locally transmitted severe cases and 2 new locally transmitted deaths. 

    Since October 2025, there have been a cumulative total of 203 locally transmitted cases of COVID-19 complicated by severe illness, with 25 deaths. 

    The majority of severe cases are among those aged 65 and above (73.4%) and those with a history of chronic diseases (83.7%). 

    90.6% of these cases have not received the COVID-19 vaccine this season. 

    In the past four weeks, the most prevalent local variant strain has been NB.1.8.1. 

    Clinical manifestations are mainly upper respiratory symptoms, including sore throat, cough, nasal congestion, runny nose, fever, fatigue, headache, and muscle aches. 

    The global positivity rate has recently risen, with all regions except Southeast Asia and Africa showing an upward trend; neighboring countries/regions such as China, Hong Kong, Japan, and the United States are also experiencing an increase in cases. 

    Currently, the predominant circulating variant globally is NB.1.8.1 (58.76%), followed by XFG (19.07%) and JN.1 (15.46%).

    The Taiwan Centers for Disease Control (CDC) indicated that as of July 26, 2026, approximately 1.742 million COVID-19 vaccinations have been administered this season, with vaccination rates for those aged 65 and above at 21.01% for the first dose and 0.56% for the second dose. 

    Data shows that severe cases in Taiwan are still predominantly among those aged 65 and above and those with a history of chronic diseases, and over 90% of these individuals have not received the COVID-19 vaccine this season. 

    Considering the escalating COVID-19 situation in Taiwan and the recent upward trend in the global positivity rate, the government has extended the expanded government-funded COVID-19 vaccination program until September 28, 2026. 

    Domestic COVID-19 vaccine stocks are sufficient, with 437,000 doses remaining (including approximately 435,000 doses of Moderna vaccine and approximately 2,000 doses of Novavax vaccine). 

    The Novavax vaccine expires on July 31st of this year. Those who have not yet received this season's COVID-19 vaccine are urged to get vaccinated as soon as possible. Furthermore, three high-risk groups—those aged 65 and above, indigenous people aged 55 and above, and those with compromised immune systems—are advised to receive their second dose as soon as possible if they have already received one dose and the interval is 6 months (180 days) to further enhance their protection and effectively reduce the risk of severe illness or death.

    The Centers for Disease Control (CDC) stated that in response to the recent surge in COVID-19 cases, it has comprehensively reviewed and consolidated domestic medical supplies. There are still 168,000 doses of the publicly funded oral antiviral drug Paxlovid and 17,000 doses of Xocova. There are also 153,000 doses of injectable Remdesivir in stock. 

    For information on COVID-19 vaccination sites, contracted hospitals for publicly funded oral antiviral drugs, and the latest epidemic prevention policies, please visit the CDC's website (https://www.cdc.gov.tw) under the "COVID-19 Prevention Zone" or call the toll-free epidemic prevention hotline 1922 (or 0800-001922). 

    In addition, approximately 630,000 home rapid COVID-19 test kits are available to meet the public's needs. Information can be found on the Food and Drug Administration's "Home COVID-19 Test Kit Supply Information Zone" (https://reurl.cc/XxWbbM), or by visiting pharmacies, convenience stores, or other sales channels.

Source: 

Link: https://www.cdc.gov.tw/Bulletin/Detail/HqTIUKC58EK9fO9AVWU3Cg?typeid=9

____

The #Environmental Polycyclic Aromatic Hydrocarbon (PAH) #Benzopyrene (BP) Alters #SARS-CoV-2 #Pathogenesis in a Mouse #Model of Disease

 

Abstract

Since emerging in late 2019, SARS-CoV-2 has caused over 7 million deaths globally and remains a public health concern. Understanding SARS-CoV-2 pathogenesis is vital, especially as factors like environmental exposures are still poorly understood. Polycyclic aromatic hydrocarbons (PAHs), like benzo[a]pyrene (BP), found in pollutants like cigarette smoke, diesel exhaust, and charcoal-broiled steaks, are known to injure the lungs. We aimed to evaluate if BP exacerbates SARS-CoV-2 pathogenesis in a mouse model of disease. One day following intranasal administration of BP (20 mg/kg) or vehicle control, we infected male and female K18-hACE2 mice with ancestral SARS-CoV-2 and assessed lung viral load, weight change, clinical scores, immune cell recruitment, and survival in the presence and absence of BP exposure. We found that BP-exposed mice had decreased survival compared to mock-exposed mice. Additionally, BP did not alter innate or adaptive immune cell populations in the lungs of SARS-CoV-2-infected mice. These findings suggest that PAH exposure exacerbates severe COVID-19 outcomes by unknown mechanisms, highlighting the need to further explore environmental impacts on SARS-CoV-2 infection.

Source: 

Link: https://www.mdpi.com/1999-4915/18/8/823

____

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    Virus Res

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    PubMed         Abstract available

Characterization and evolutionary history of novel #SARS-CoV-2-related viruses in #bats from #Cambodia

 

Abstract

Circulating bat coronaviruses present a significant pandemic threat, yet our understanding of their genetic diversity and evolutionary dynamics remains limited. Over 3 years, we sampled 1,462 bats in Cambodia’s Steung Treng province, identifying extensive and diverse coronaviruses co-circulation. Using metatranscriptomic and amplicon sequencing, we generated 33 complete sarbecovirus genomes sequences, revealing novel lineages that cluster into four distinct groups, each associated with different Rhinolophus bat species. Our analysis highlights rapid migration and recombination of sarbecovirus lineages over short distances and timescales. Of note, the receptor-binding domains of two novel viral groups exhibit high similarity to SARS-CoV-2, and pseudovirus assays confirmed the ability of this spike protein to mediate entry into cells expressing human ACE2, suggesting a potential zoonotic risk. The observed genetic diversity underscores the urgent need for continuous surveillance to identify high-risk animal-to-human interfaces and inform pandemic preparedness.

Source: 

Link: https://www.nature.com/articles/s41467-026-75954-1

____

#SARS-CoV-2 BA.3.2.2 is more evasive of #neutralisation by #plasma from young #children

 

{Excerpt}

(...)

These findings suggest that susceptibility to emerging SARS-CoV-2 variants could diverge across age groups with different exposure histories. Adults in the USA and other countries have accumulated broader immunity through repeated infection and vaccination across antigenically distinct lineages, starting with the ancestral strain, whereas younger children and infants possess narrower exposure histories that are largely shaped by recent variants. The continued surveillance of SARS-CoV-2 variants should consider age-stratified differences in immunity, to anticipate or explain disproportionate burden of infections in some populations. Furthermore, studies of potential age-specific vaccine formulations targeting different variants are warranted, to investigate whether age-specific target selection could lead to broader protection across subpopulations with known differences in their exposure histories and susceptibility to co-circulating variants.

(...)

Source: 

Link: https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(26)00349-X/fulltext?rss=yes

____

#Taiwan, Domestic #COVID19 activity continues to rise, population is urged to get vaccinated (CDC, July 21 '26): NB.1.8.1 variant dominant

 

{Excerpt}

(...)

    According to data from the Taiwan Centers for Disease Control and Prevention (CDC), the COVID-19 epidemic in Taiwan continues to rise and has reached the epidemic threshold, entering its epidemic period. 

    In week 28 (July 12-18), there were 4,766 outpatient and emergency room visits, a 66.5% increase compared to the previous 7 days (July 5-11). 

    Last week (July 14-20), there were 25 new locally transmitted severe cases and 5 new locally transmitted deaths. 

    Since October 2025, a total of 161 local cases of COVID-19 complicated with severe illness have been reported, including 23 deaths. 

    The majority of severe cases were among those aged 65 and above (74.5%) and those with a history of chronic diseases (83.9%). 

    92.5% of these cases were not vaccinated against COVID-19 this season. 

    Clinical manifestations were mainly upper respiratory symptoms, including sore throat, cough, nasal congestion, runny nose, fever, fatigue, headache, and muscle aches. 

    A very small number of cases experienced temporary loss or dullness of smell or taste. 

    In the past four weeks, the dominant local variant strain has been NB.1.8.1. 

    The global positivity rate has recently increased slightly, with the exception of the Western Pacific Region, which is showing an upward trend, while other regions have shown a downward or stable trend. 

    The epidemic is rising in neighboring countries/regions such as China, Hong Kong, Japan, and South Korea. 

    Currently, the dominant global variant strain is NB.1.8.1 (58.76%), followed by XFG (19.07%) and JN.1 (15.46%).

(...)

Source: 

Link: https://www.cdc.gov.tw/Bulletin/Detail/u3YrvIQXQrOtbJXDXxFxQg?typeid=9

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Multiorgan #Outcomes Following #BNT162b2 #mRNA #Vaccination vs #SARS-CoV-2 #Infection: A 30-Million-Person Real-World Cohort Analysis

 

Abstract

SARS-CoV-2 infection and BNT162b2 mRNA vaccination carry distinct cardiovascular risk profiles, yet direct comparative evidence across all immunological exposure groups and both sexes remains limited. Using the TriNetX Research Network (December 2020–December 2024), we stratified 30.3 million individuals into four mutually exclusive cohorts: uninfected/unvaccinated controls (G1), infected/unvaccinated (G2), vaccinated-only (G3), and hybrid immunity (G4). Fifty prespecified cardiovascular, cerebrovascular, and mortality outcomes were evaluated across four temporal windows (0–3, 3–6, 6–9, and >9 months) with analyses stratified by biological sex. SARS-CoV-2 infection was associated with 3- to 5-fold increases in cardiovascular events during the acute phase, including myocarditis (males: RR 4.44; females: RR 5.59) and all-cause mortality (males: RR 4.53), with risks persisting beyond nine months. BNT162b2 vaccination conferred 65-76% reductions in major adverse cardiovascular events (0–3 months). Post-infection vaccination (hybrid immunity) provided an additional 36–38% MACE reduction; males exhibited late pericarditis elevation beyond nine months. Completing the two-dose primary series maximally reduced mortality (by 77%) and myocarditis (by 62%) versus single dosing. In this US cohort, SARS-CoV-2 infection confers substantially greater and more sustained cardiovascular risk than BNT162b2 vaccination across all comparisons and both sexes, consistent with a favorable cardiovascular risk-benefit profile for vaccination.

Source: 

Link: https://www.nature.com/articles/s41541-026-01528-3

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#Genomic Characterization of #SARS-CoV-2 #NB.1.8.1 and #PQ.2 from the #Infants and Young #Children with #Gastrointestinal Symptoms

 

Abstract

Purpose: 

This study investigated the viral genomic characteristics of infants and young children who presented to our hospital with gastrointestinal symptoms during a local COVID-19 epidemic and were confirmed to have SARS-CoV-2 infection.

Patients and methods: 

Between May and August 2025, pharyngeal swab samples were collected from four infants and young children who presented to the outpatient department of Meizhou People’s Hospital in Meizhou, with gastrointestinal symptoms. Nucleic acid testing and whole-genome sequencing were performed. The viral mutation profile was analyzed, and the potential impact of mutations on protein function was predicted.

Results: 

Pangolin typing identified the NB.1.8.1 variant in three patients and the PQ.2 variant in one patient. Genome sequences from three of the four viral variants displayed varying degrees of mutation. The nonsynonymous mutations for both variants were concentrated in the spike protein. A comparison with the parental XDV.1.5.1 lineage revealed 14 specific mutations, with 7 nonsynonymous sites conserved across all gene sequences. Five of these mutation sites, NSP12: D284Y, ORF3a: L46F, ORF3a: F207C, N: Q9H, and N: Q384H, were predicted to be functionally deleterious and structurally destabilizing.

Conclusion: 

SARS-CoV-2 variants from specimens obtained from four infants and young children exhibited varying degrees of mutation, providing evidence for the ongoing evolution of emerging variants in pediatric patients. However, monitoring genomic changes of circulating variants requires further clinical specimens, which contributes to understanding the dynamic changes at mutation sites, thereby supporting epidemic prevention and control.

Source: 

Link: https://www.dovepress.com/genomic-characterization-of-sars-cov-2-nb181-and-pq2-from-the-infants--peer-reviewed-fulltext-article-IDR

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Immune correlates of #risk for #SARS-CoV-2 #infection in #children: a prospective, community-based cohort study

 

Abstract

Few studies have characterized immune correlates of SARS-CoV-2 infection risk in children, particularly those with hybrid immunity from vaccination and prior infection. We conduct a prospective community-based cohort study of 1509 U.S. children (2022–2024), performing weekly SARS-CoV-2 PCR testing and measuring baseline binding and neutralizing antibody titers against multiple variants. Higher antibody levels, notably nucleocapsid-binding and Omicron-specific neutralizing antibodies, are significantly associated with reduced risk of SARS-CoV-2 infection after adjusting for age, recent infection, exposure settings, and temporal trends (adjusted hazard ratios ranging from 0.60 to 0.87 per positive unit difference in log10-fold antibody level (AU/mL)). Secondary analyses suggest these findings are robust to multiple stratifications of SARS-CoV-2 immune status, are relevant across different pediatric age groups, and appear to apply to both overall and symptomatic infection risk. Together, the results suggest that specific antibodies can predict relative infection risk in pediatric populations with diverse immune histories. Understanding these immune correlates may inform tailored vaccination strategies and risk assessments as SARS-CoV-2 continues to evolve.

Source: 

Link: https://www.nature.com/articles/s41467-026-74684-8

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#Nirmatrelvir for acute #COVID19 to prevent #longCOVID (PANORAMIC Norway): a double-blind, randomised, placebo-controlled trial

 

Summary

Background

Long-term symptoms are common after acute COVID-19, particularly fatigue, cognitive problems, and dyspnoea. Cohort studies have suggested that antiviral treatment of acute COVID-19 might prevent development of post-COVID-19 condition (also known as long COVID), but the efficacy of antivirals has yet to be verified in prospective studies. We aimed to investigate whether treatment of acute SARS-CoV-2 infection with nirmatrelvir–ritonavir would reduce the risk of long COVID.

Methods

In this double-blind, randomised, placebo-controlled trial, participants were recruited from the municipal health-care service at three sites in Norway (Bergen, Oslo, and Ålesund). Non-hospitalised adults aged 18–65 years with SARS-CoV-2 infection confirmed by PCR or lateral flow test and symptoms for 5 days or fewer were eligible for inclusion. Key exclusion criteria included pregnancy or lactation, chronic renal impairment or chronic liver dysfunction, and any person judged by the investigator to need nirmatrelvir–ritonavir treatment due to increased risk of hospitalisation or death. Participants were allocated in a 1:1 ratio to receive oral 300 mg nirmatrelvir and 100 mg ritonavir, or placebo, twice a day for 5 days using a pre-generated randomisation list without stratification or block adjustment. Participants, clinicians, and the study team were masked to treatment allocation. The primary outcome was long COVID, defined as patient-reported fatigue, dyspnoea, and/or cognitive symptoms at 3 months’ follow-up. Safety was analysed as a secondary outcome, and included adverse events, hospital admissions, and deaths. Both the primary outcome and safety were assessed in the intention-to-treat population. The trial is registered with ClinicalTrials.gov (NCT05852873) and is now closed to new participants.

Findings

Between May 12, 2023, and June 11, 2025, we enrolled 144 participants, of whom 66 were assigned to nirmatrelvir–ritonavir and 78 to placebo. In the protocol we planned to enrol 2000 participants, but the trial was stopped prematurely by the steering committee due to insufficient recruitment. Among the 143 participants who completed follow-up, the risk of long COVID at 3 months was significantly reduced in the nirmatrelvir–ritonavir group (17 [26%] of 66) compared with the placebo group (33 [43%] of 77), corresponding to a relative risk after imputation of data for the single missing value in the placebo group of 0·60 (95% CI 0·37–0·98; p=0·039). In the nirmatrelvir–ritonavir group, five patients discontinued treatment due to adverse events. The most common adverse events in the nirmatrelvir–ritonavir group were change in taste or smell (57 [86%] of 66 in the nirmatrelvir–ritonavir group vs 14 [18%] of 78 in the placebo group) and nausea or vomiting (19 [29%] vs eight [10%]). Inversely, palpitations were more common in the placebo group (ten [13%] of 78) than in the nirmatrelvir-ritonavir group (two [3%] of 66). No severe adverse events were reported.

Interpretation

Treatment with nirmatrelvir–ritonavir for acute COVID-19 was associated with a significant reduction in the risk of long COVID at 3 months’ follow-up. The limited sample size precludes firm conclusions, and further clinical trials are warranted.

Funding

National Health Authorities’ KlinBeForsk programme, Western Norway Regional Health Authority, Helse Møre og Romsdal Hospital Trust, and The Influenza Centre, Haukeland University Hospital and University of Bergen, Bergen, Norway.

Source: 

Link: https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(26)00244-6/fulltext?rss=yes

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