Retinal microvascular alterations consistent with endothelial dysregulation in paediatric post-COVID-19 syndrome: A prospective matched-cohort study - Scientific Reports

Persistent symptoms following SARS-CoV-2 infection in children remain poorly understood, and objective biological correlates are scarce. The vascular endothelium is considered a central target of post-viral dysregulation, yet paediatric evidence for microvascular involvement is limited. Retinal imaging enables non-invasive assessment of microvascular structure and function and may help to clarify whether endothelial dysregulation is present in children with post-COVID-19 syndrome (PCS). Retinal vessel diameters and flicker-induced vasoreactivity were assessed at baseline and after a median of 14 weeks. Compared with matched healthy controls, multivariable analyses showed that PCS independently predicted wider central retinal arteriolar equivalent (CRAE + 28.1 μm, 95% CI 21.7–34.5, p < 0.001) and central retinal venular equivalent (CRVE + 21.7 μm, 95% CI 15.8–27.7, p < 0.001), with a higher arteriolar-to-venular ratio (AVR + 0.038 units, 95% CI 0.012–0.064, p = 0.005). These findings suggest a distinct microvascular pattern in children with PCS that is consistent with endothelial dysregulation months after infection. While no significant group-level changes were observed at follow-up, children with particularly large venular diameters and reduced flicker responses showed the greatest improvement. Longer follow-up intervals predicted decreasing venular diameter, and reductions in symptom burden correlated with increasing AVR over time. Together, these results indicate heterogeneous, time-dependent changes in microvascular parameters. Retinal vessel analysis may provide a useful, non-invasive approach to characterising vascular involvement in paediatric PCS and improving understanding of post-viral sequelae.

Frontiers | Prioritizing long COVID related single nucleotide polymorphisms by mining genome-wide association studies of COVID-19 susceptibility and hospitalization

Long coronavirus disease (COVID) presents a significant public health challenge, characterized by over 200 reported symptoms across multiple organ systems. G...

Transdisziplinäres Expert:innen-Statement: Pflegeleitfaden für Menschen mit schwerem ME/CFS in der häuslichen Versorgung

Novel activity and participation scales for children, adolescents, and young adults with postacute infection and vaccination syndromes and/or ME/CFS - European Journal of Pediatrics

Children, adolescents, and young adults (CYP) with postacute infection and vaccination syndromes (PAIVS), and/or myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), experience profound loss in activity and participation. We introduce and psychometrically validate two new brief, age-adapted, and domain-specific questionnaires for clinical use assessing activity and participation in this vulnerable patient group. For this, 91 patients (aged 10–25 years) were assessed at the Munich Chronic Fatigue Center (MCFC) from 12/2022 to 11/2024. We designed the MCFC Activity Scale and MCFC Participation Scale and assessed construct validity using confirmatory factor analysis for both questionnaires. Reliability was evaluated via Cronbach’s α. Factor-based MCFC Activity and Participation Scores (0–100) were derived and correlated with Bell Score, FSS, DSQ-PEM, and SF-12 Component Summary Scales (PCS and MCS). Discrimination for ME/CFS was evaluated using ROC analyses. Participants (mean age 15.6 ± 2.4 years) were predominantly female (64%). 65% were diagnosed with ME/CFS. The MCFC Activity Scale showed excellent one-factor fit (comparative fit index, CFI = 1.00) and good internal consistency (α = 0.82). The MCFC Participation Scale showed good internal consistency (α = 0.85) and acceptable one-factor fit (CFI = 0.817). Factor-based activity and participation were strongly correlated yet distinct (r = 0.73). Derived MCFC Activity and Participation Scores differed significantly by ME/CFS diagnosis (p ≤ 0.009). Scores correlated with Bell Score, FSS, DSQ-PEM, and SF-12 PCS (all p ≤ .002). For ME/CFS discrimination, the Activity Score achieved an AUC = 0.78 and the Participation Score an AUC = 0.72.Conclusion: The Activity Scale demonstrated strong construct validity. The Participation Scale showed good internal consistency. Both scores demonstrated good convergent validity with established patient-reported outcome measures, supporting clinical utility. They may serve as pragmatic screening tools for this vulnerable patient group.

Frontiers | Elevated serum levels of interleukin-11 and matrix metalloproteinase-9 in myalgic encephalomyelitis/chronic fatigue syndrome

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a disease of unknown etiology associated with chronic severe fatigue and neurological symptoms...