Long COVID affects an estimated 10-20% of SARS-CoV-2 survivors with heterogeneous, multi-system symptoms persisting for months to years, contributing to significant workforce disruption and reduced functional capacity. This exploratory study identified symptom clusters following SARS-CoV-2 infection, examined associated personal and clinical characteristics, and assessed work status across clusters. Among 273 individuals from a single clinical site, we used baseline surveys to capture long COVID symptoms and 2-week follow-up surveys to assess work status, and applied K-means clustering to identify symptom groupings. Three preliminary clusters emerged: Cluster 1 ("brain fog"), characterized by fatigue (96%), difficulty remembering (97%), and difficulty concentrating (94%); Cluster 2 ("undifferentiated"), with low prevalence across all symptoms; and Cluster 3 ("persistent acute"), marked by cough (92%), congestion (80%), headaches (78%), and body aches (78%). Notably, among Cluster 1 ("brain fog") respondents, 44% reported not working, and approximately half attributed their work absence to COVID-related symptoms. These hypothesis-generating findings suggest that neurocognitive symptom clusters may be associated with greater work absence in some individuals, though the small number of respondents limits firm conclusions. The findings suggest that targeted occupational rehabilitation strategies may warrant further investigation as potential strategies for individuals experiencing post-infectious cognitive impairment following SARS-CoV-2 infection.

Coxiella burnetii (C. burnetii), a Gram-negative obligate intracellular bacterium, is the etiological agent of Q fever. Timely diagnosis and initiation of appropriate therapy are critical for favorable clinical outcomes, particularly in cases of acute Q fever. This report describes a case of C. burnetii infection in a 35-year-old male electrical grid engineer who presented with a 4-day history of febrile illness, peaking at 40.0 °C. Associated symptoms included night sweats, chills, anorexia, nausea, non-productive cough, and chest tightness. During hospitalization, the patient also developed headache and vomiting. Metagenomic next-generation sequencing (mNGS) of peripheral blood identified C. burnetii as the causative pathogen. The patient was treated with oral doxycycline (100 mg twice daily) for 14 days and levofloxacin (500 mg once daily) for 5 days. Following antimicrobial therapy, the patient's symptoms resolved rapidly, with no clinical evidence of relapse or progression to chronic Q fever during follow-up. This report describes a case of Q fever diagnosed by mNGS. The case highlights the diagnostic value of mNGS in patients presenting with febrile illness of unknown origin. It also serves as a reminder to clinicians that, even in regions where Q fever is enzootic in animals but no human cases have been reported, the possibility of human infection should not be overlooked.

Air pollution is a major global health threat, with children and young people (CYP) among the most vulnerable. Delhi (India) and Dhaka (Bangladesh) are two of the world's most polluted cities, with persistently high levels of fine particulate matter (PM2.5). This study aimed to generate CYP-centered evidence on the real-time impacts of air pollution in these cities by comparing health, well-being, and daily activities during periods of high air pollution and good air quality, while also capturing CYP's ideas for air quality management. A cross-sectional, real-time digital survey was conducted in Delhi on January 9-10 and 15 March 2025, and in Dhaka on January 21-22 and March 13-16, 2025. For both cities, the January dates correspond to a period with high air pollution (PM2.5 > 55.5 µg/m3) and the March dates to good air quality (PM2.5 ≤ 35.4 µg/m3). Participants included CYP aged 13-29 years and parents of children under 18. Recruitment was carried out online. Data on health symptoms, well-being (general feelings and sleep quality), and daily activity disruptions were analyzed using descriptive statistics, chi-square tests, and regression models adjusted for demographics. Responses to open-ended questions were thematically coded. A total of 814 eligible responses were collected (Delhi = 365; Dhaka = 449). High-pollution days were associated with significantly higher reports of itchy eyes, respiratory difficulties, headaches, skin irritation or rash, diarrhoea or vomiting, low mood, anxiety or stress, and difficulty concentrating. These associations remained significant after adjusting for demographics. Disruptions to daily activities also increased, including reduced physical activity and greater odds of being late or missing school or work, meetings, social events, and healthcare, as well as a greater need for family assistance (adjusted odds ratios approximately 3.8 to 4.8). In Delhi, changes were more pronounced across most outcomes, particularly a sharper drop in physical activity. In Dhaka, the same pattern was observed, along with additional increases in sore throat, cough, food insecurity, and difficulty accessing clean water. Participants' suggestions clustered around five themes: cleaner environments, stronger communities, improved healthcare and education, pollution and technology solutions, and other ideas. High air pollution was linked to widespread impacts on health, well-being, and daily routines among CYP. Their proposed solutions offer insights for participatory and equitable approaches to urban air quality management.

Blood groups significantly influence individuals' immune responses and the severity of diseases. This study examined the association between ABO blood groups and clinical features, comorbidities, and outcomes in COVID-19 patients in southeast Iran. This retrospective cross-sectional study included 894 RT-PCR-confirmed COVID-19 patients admitted to two referral hospitals in southeast Iran (April-September 2020). Medical records were reviewed for demographic data, ABO blood groups, clinical features, comorbidities, and outcomes. Disease severity was classified using NIH criteria. Chi-square, Kruskal-Wallis, and multivariable logistic regression (adjusted for age, sex, and comorbidities) were used for analysis. The mean age was 37.36 ± 14.63 years, and 53.1% were female. The mean number of symptoms varied significantly across ABO blood groups (P = 0.014), with group AB showing the lowest values. Hospitalization rates also differed (P = 0.003), being highest in group O. Significant associations were observed between blood groups and fever/chills, cough, rhinorrhea, headache, and gastrointestinal symptoms (all P < 0.05). Comorbidities were more frequent in group O (P = 0.005), particularly cardiovascular disease (P = 0.037). Blood group AB remained independently associated with fewer symptoms after adjustment (aOR = 0.68, 95% CI 0.47-0.98). ABO blood groups were associated with clinical presentation and comorbidities in COVID-19 patients. Blood group O showed higher rates of comorbidities and hospitalization, while blood group AB had a milder symptom profile.

Mounier Kuhn Syndrome (MKS) is a rare chronic condition characterized by dilatation of the trachea and the major bronchi. The clinical presentation is variable, ranging from asymptomatic mild symptoms to severe diseases that can result in death. MKS often presents with chronic cough, dyspnea, and recurrent upper respiratory tract infections. Radiological imaging is important in diagnosing the condition to identify dilatation of the trachea and major bronchi with posterior tracheal diverticuli. The HRCT scan modality clearly demonstrates these features radiologically. Bronchoscopy can be used for diagnostic and therapeutic purposes. HRCT is also used to evaluate potential complications. The treatment for symptomatic individuals is conservative management. In this report, we describe the case of a 50-year-old man who presented with a productive cough for three weeks associated with headache, vomiting, and dizziness. He was found to have a grade II digital clubbing. Chest HRCT revealed tracheobronchomegaly with posterior tracheal diverticuli and bilateral distal bronchiectasis. Diagnostic bronchoscopy revealed a widened trachea with a distorted webbed appearance of the posterior and lateral walls, and bronchial secretions in the left lower lobe. A biofire test for the pneumonia panel revealed an active Haemophilus influenzae infection. The patient also had a malarial co-infection prior to admission. The patient completed an antimalarial regimen, intravenous antibiotics, and mucolytics, and was discharged upon improvement.