{"title":"Chronic cutaneous and mucosal mucormycosis: <i>Rhizopus arrhizus</i> as a major pathogenic fungus.","authors":"Xingyu Li, Chang Miao, Jinlei Yu, Fang Liu, Zhenlai Zhu, Jixin Gao, Dong Yan, Luming Hai, Gang Wang, Yubo Ma, Yanyang Guo, Meng Fu","doi":"10.1080/22221751.2025.2477653","DOIUrl":"10.1080/22221751.2025.2477653","url":null,"abstract":"<p><p>Chronic cutaneous mucormycosis is a rare condition distinct from the acute form, characterized by a prolonged, indolent course and varied clinical presentations. This study presents a 5-year experience from a tertiary dermato-mycology clinic, identifying six cases, the majority of whom were immunocompetent, with trauma history reported in four patients. The median duration from symptom onset to diagnosis was 60 months. The primary pathogens identified were <i>Rhizopus arrhizus</i>, <i>Mucor variabilis</i>, and <i>Lichtheimia ramosa</i>. Histopathological analysis demonstrated the absence of fungal angioinvasion, a hallmark of acute mucormycosis, which likely accounts for the slower progression observed in chronic cases. Systemic Amphotericin B treatment achieved favourable outcomes in most patients though significant morbidity persisted in some cases. This case series underscores the clinical and pathological distinctions of chronic cutaneous mucormycosis, highlighting the potential influence of host factors and environmental conditions on chronicity. The predominance of <i>Rhizopus arrhizus</i> suggests that chronicity is driven more by hostpathogen interactions than fungal species-specific factors. Increased recognition of the atypical clinical features, such as diverse cutaneous manifestation and slower progression course, as well as the utilization of diagnostic tools including histopathology, fungal culture, and advanced molecular techniques, is essential for the timely diagnosis of this rare presentation.</p>","PeriodicalId":11602,"journal":{"name":"Emerging Microbes & Infections","volume":" ","pages":"2477653"},"PeriodicalIF":8.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921161/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mahmoud Bayoumi, Ramya S Barre, Ruby A Escobedo, Vinay Shivanna, Nathanial Jackson, Chengjin Ye, Adolfo García-Sastre, Ahmed Mostafa, Luis Martinez-Sobrido
{"title":"Identification of amino acid residues in polymerase PB2 responsible for differential replication and pathogenicity of avian influenza virus H5N1 isolated from human and cattle in Texas, US.","authors":"Mahmoud Bayoumi, Ramya S Barre, Ruby A Escobedo, Vinay Shivanna, Nathanial Jackson, Chengjin Ye, Adolfo García-Sastre, Ahmed Mostafa, Luis Martinez-Sobrido","doi":"10.1080/22221751.2025.2542247","DOIUrl":"10.1080/22221751.2025.2542247","url":null,"abstract":"<p><p>Highly pathogenic avian influenza viruses (HPAIV) pose serious public health concerns. In March 2024, a first-time outbreak of HPAIV H5N1 in dairy cattle herds was reported in the United States (US). Since then, the virus has continued to spread in cattle herds and spilt over into humans. We recently showed that the first human isolate reported in the US in Texas (HPhTX) from a dairy worker in an affected cattle farm has enhanced replication kinetics and pathogenicity in mice compared to a closely related bovine isolate (HPbTX). Herein, we show that HPhTX has enhanced polymerase activity, compared with HPbTX, in human cells and that the polymerase basic 2 (PB2) protein is the main factor responsible for this difference. Through single and combined site-directed mutagenesis and swapping the three amino acids different between HPhTX and HPbTX, we found that PB2 mutation E627K is the major contributor to the enhanced polymerase activity of HPhTX. E362G substitution in HPhTX PB2 affected the polymerase, although to a lesser extent than E627K. Moreover, M631L mutation in HPhTX PB2 enhanced polymerase activity. Rescue of a loss-of-function recombinant HPhTX (rHPhTX) containing mutations at residues 627 and 362, alone or in combination, revealed a contribution of PB2 E362G and K627E in morbidity, mortality, and viral replication as compared to rHPhTX wild-type (WT), and significantly reduced viral pathogenicity to levels comparable to rHPbTX WT. These findings indicate that HPAIV H5N1 of cattle origin has post-transmission amino acid changes that increase viral replication in human cells and pathogenicity in mice.</p>","PeriodicalId":11602,"journal":{"name":"Emerging Microbes & Infections","volume":" ","pages":"2542247"},"PeriodicalIF":7.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12372494/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144759379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Taewoo Kim, Bobby Brooke Herrera, Beth Chaplin, Kailee Naito-Keoho, Jerry Ogwuche, Atiene S Sagay, Charlotte Ajeong Chang, Donald J Hamel, Wei-Kung Wang, Phyllis J Kanki
{"title":"Preexisting yellow fever virus and West Nile virus immunity and pregnancy outcomes in a Nigerian cohort with endemic orthoflavivirus exposure.","authors":"Taewoo Kim, Bobby Brooke Herrera, Beth Chaplin, Kailee Naito-Keoho, Jerry Ogwuche, Atiene S Sagay, Charlotte Ajeong Chang, Donald J Hamel, Wei-Kung Wang, Phyllis J Kanki","doi":"10.1080/22221751.2025.2544720","DOIUrl":"10.1080/22221751.2025.2544720","url":null,"abstract":"<p><p>Yellow fever virus (YFV) and West Nile virus (WNV) co-circulate with other arboviruses, including Zika (ZIKV), dengue (DENV), and chikungunya virus (CHIKV), in sub-Saharan Africa. Associations between preexisting YFV and WNV immunity with symptoms and adverse infant outcomes among pregnant women exposed to orthoflaviviruses are unknown. We retrospectively studied a prospective cohort of pregnant women enrolled between 2019 and 2022 in Jos, Nigeria. Rapid tests identified ZIKV, DENV, and CHIKV IgM/IgG reactivity for enrolment; 216 women underwent Western blot for YFV and WNV IgG. Logistic regression evaluated associations between arboviral seropositivity and maternal symptoms or adverse infant outcomes. Sequential serology of mother-infant pairs estimated the persistence of passively transferred maternal YFV antibodies. YFV IgG was detected in 50.5% (109/216) and WNV IgG in 5.1% (11/216) of maternal samples. YFV and WNV seropositivity was significantly associated with maternal symptoms (OR = 2.02, 95% CI: 1.35-3.02, <i>P</i> = 0.001), as was YFV seropositivity alone (OR = 1.77, 95% CI: 1.21-2.61, <i>P</i> < 0.004). CHIKV IgM reactivity was significantly associated with abnormal infant outcomes (OR = 2.38, 95% CI: 1.43-4.02, <i>p</i> = 0.001), but not ZIKV and DENV IgM reactivity. Passive maternal YFV IgG waned in infants at a median of 3.1 months (IQR: 1.65-5.35 months) after birth. YFV and WNV seropositivity was associated with maternal symptoms but not with adverse infant outcomes. Rapid waning of maternal YFV IgG highlights infant vulnerability and supports enhanced surveillance and maternal immunization strategies.</p>","PeriodicalId":11602,"journal":{"name":"Emerging Microbes & Infections","volume":" ","pages":"2544720"},"PeriodicalIF":7.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12372486/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144820934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Cattle H5N1 outbreak in US driven by cow's \"cross-nursing\" behaviour: elucidating a novel transmission mechanism.","authors":"Shu Hu, Jie Cui","doi":"10.1080/22221751.2025.2547736","DOIUrl":"10.1080/22221751.2025.2547736","url":null,"abstract":"","PeriodicalId":11602,"journal":{"name":"Emerging Microbes & Infections","volume":" ","pages":"2547736"},"PeriodicalIF":7.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12395605/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144845034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Simon Valayer, Marie Alexandre, Mélanie Prague, Abdoul Habib Beavogui, Seydou Doumbia, Mark Kieh, Brian Greenwood, Bailah Leigh, Marie Poupelin, Christine Schwimmer, Samba O Sow, Irina Maljkovic Berry, Jens H Kuhn, Daniela Fusco, Natasha Dubois Cauwelaert, Deborah Watson-Jones, Rodolphe Thiébaut, Yves Lévy, Yazdan Yazdanpanah, Laura Richert, Edouard Lhomme
{"title":"Evaluation of waning of IgG antibody responses after rVSVΔG-ZEBOV-GP and Ad26.ZEBOV, MVA-BN-Filo Ebola virus disease vaccines: a modelling study from the PREVAC randomized trial.","authors":"Simon Valayer, Marie Alexandre, Mélanie Prague, Abdoul Habib Beavogui, Seydou Doumbia, Mark Kieh, Brian Greenwood, Bailah Leigh, Marie Poupelin, Christine Schwimmer, Samba O Sow, Irina Maljkovic Berry, Jens H Kuhn, Daniela Fusco, Natasha Dubois Cauwelaert, Deborah Watson-Jones, Rodolphe Thiébaut, Yves Lévy, Yazdan Yazdanpanah, Laura Richert, Edouard Lhomme","doi":"10.1080/22221751.2024.2432353","DOIUrl":"10.1080/22221751.2024.2432353","url":null,"abstract":"<p><p>rVSVΔG-ZEBOV-GP and Ad26.ZEBOV, MVA-BN-Filo are WHO-prequalified vaccination regimens against Ebola virus disease (EVD). Challenges associated with measuring long-term clinical protection warrant the evaluation of immune response kinetics after vaccination. Data from a large phase 2 randomized double-blind clinical trial (PREVAC) were used to evaluate waning of anti-Ebola virus (EBOV) glycoprotein (GP<sub>1,2</sub>) antibody concentrations after rVSVΔG-ZEBOV-GP or Ad26.ZEBOV, MVA-BN-Filo vaccination with linear mixed-effect regression models. After a post-vaccination peak, each vaccination strategy was associated with a decrease of anti-EBOV GP<sub>1,2</sub> antibody concentrations with distinct kinetics, highlighting a less-rapid decline in antibody levels after vaccination by rVSVΔG-ZEBOV-GP. One year after administration of the vaccine, antibody concentrations were higher in children compared to adults for both vaccines, although with different effect sizes: 1.74-fold higher concentrations (95% confidence interval [CI] [1.48; 2.02]) for children 12-17 years old to 3.10-fold higher concentrations (95% CI [2.58; 3.69]) for those 1-4 years old compared to adults for Ad26.ZEBOV, MVA-BN-Filo versus 1.36-fold (95% CI [1.12; 1.61]) to 1.41-fold (95% CI [1.21; 1.62]) higher than these values for adults, with relatively small changes from one age category of children to another, for rVSVΔG-ZEBOV-GP. Antibody concentrations also differed according to geographical location, pre-vaccination antibody concentration, and sex. In combination with knowledge on memory response, characterization of the major determinants of immune response durability of both vaccinations may guide future EVD control protocols.<b>Trial registration:</b> ClinicalTrials.gov identifier: NCT02876328.</p>","PeriodicalId":11602,"journal":{"name":"Emerging Microbes & Infections","volume":" ","pages":"0"},"PeriodicalIF":8.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11632942/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142667123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Xiao-Lin Qin, Yang Chen, Xing-Zhong Wu, Wen-Tao Chen, Yao-Hua Xue, Jin-Mei Huang, San-Mei Tang, Yin-Yuan Lan, Zhan-Qin Feng, Han Zhou, Zi-Yan Zhang, Qing-Xian Zhan, Kui Cheng, He-Ping Zheng
{"title":"Emerging epidemic of the Africa-type plasmid in penicillinase-producing <i>Neisseria gonorrhoeae</i> in Guangdong, China, 2013-2022.","authors":"Xiao-Lin Qin, Yang Chen, Xing-Zhong Wu, Wen-Tao Chen, Yao-Hua Xue, Jin-Mei Huang, San-Mei Tang, Yin-Yuan Lan, Zhan-Qin Feng, Han Zhou, Zi-Yan Zhang, Qing-Xian Zhan, Kui Cheng, He-Ping Zheng","doi":"10.1080/22221751.2024.2440489","DOIUrl":"10.1080/22221751.2024.2440489","url":null,"abstract":"<p><p>The prevalence of penicillinase-producing <i>Neisseria gonorrhoeae</i> (PPNG) is a crucial public health concern because of its resistance to penicillin and cephalosporins. From 2013 to 2022, a total of 1748 <i>N. gonorrhoeae</i> isolates from Guangdong, China, were examined for their antibiotic susceptibility and molecular epidemiological characteristics. PPNG prevalence increased markedly from 37.25% to 63.87%. This increase was accompanied by a shift in predominant plasmid types carried by PPNG isolates: the rate of PPNG isolates carrying the Africa-type plasmid increased from 18.42% to 91.55%, whereas the rate of isolates carrying the Asia-type plasmid decreased from 81.58% to 7.58%. The prevalence of <i>bla</i><sub>TEM-135</sub>, which is linked to cephalosporin resistance, declined from 52.63% to 4.37%, whereas that of <i>bla</i><sub>TEM-1</sub> increased from 47.37% to 86.88%, and new <i>bla</i><sub>TEM</sub> variants emerged (10.99% by 2022). Most <i>bla</i><sub>TEM-1</sub> (88.26%) and new <i>bla</i><sub>TEM</sub> alleles (83.70%) were associated with the Africa-type plasmid, whereas 86.79% of <i>bla</i><sub>TEM-135</sub> alleles were linked to the Asia-type plasmid. Resistance to ceftriaxone was higher in the Asia-type group (11.67%) than in the Africa-type, Toronto/Rio-type and non-PPNG groups. Genotyping identified diverse sequence types (STs) among PPNGs, in which MLST ST7363, NG-STAR ST2477, NG-MAST ST17748, and NG STAR CC1124 were predominant. This study underscores the rising prevalence of PPNG in Guangdong driven by clonal expansion and changing plasmid dynamics, affecting cephalosporin resistance and highlighting the need for continued surveillance and research into effective treatment strategies.</p>","PeriodicalId":11602,"journal":{"name":"Emerging Microbes & Infections","volume":" ","pages":"2440489"},"PeriodicalIF":8.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142794617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A KSHV-targeted small molecule efficiently blocks SARS-CoV-2 infection via inhibiting expression of EGFR and Cyclin A2.","authors":"Zhongwei Dong, Xinyu Wang, Gaowei Hu, Qingye Huang, Yulin Zhang, Yuping Jia, Shujuan Du, Caixia Zhu, Fang Wei, Daizhou Zhang, Yuyan Wang, Qiliang Cai","doi":"10.1080/22221751.2024.2440490","DOIUrl":"10.1080/22221751.2024.2440490","url":null,"abstract":"<p><p>The Coronavirus Disease 2019 (COVID-19) pandemic has led to numerous cases of co-infection with SARS-CoV-2 and other viruses, including Kaposi's sarcoma-associated herpesvirus (KSHV), worldwide. This co-infection has increased patient mortality due to the lack of efficient bi-targeted drugs. Cambogin, a bioactive natural product, has been shown to effectively induce regression of KSHV-latently infected tumours in xenograft mice models; however, its impact on SARS-CoV-2 infection remains unclear. Here, we report that Cambogin targets 46 host genes commonly affected by both SARS-CoV-2 and KSHV infections, as identified through bioinformatics analysis. These genes are related with 14 key upstream signalling pathways, particularly those involved in inflammation regulation, protein phosphorylation, metabolic processes, and cellular stress response. Within the transcriptional factor (TF)-miRNA co-regulatory network, ten out of 46 hub-target genes are closely linked to Cambogin and KSHV/SARS-CoV-2. Importantly, Cambogin not only efficiently blocks the replication and virion production of SARS-CoV-2 <i>in vitro</i> and <i>in vivo</i> by reducing the expression of EGFR and Cyclin A2, but also simultaneously inhibits both SARS-CoV-2 infection and the growth of KSHV-induced tumours <i>in vivo</i> using a murine xenograft model. These findings provide an alternative strategy for the potential use of Cambogin in the treatment of SARS-CoV-2 patients, particularly those with KSHV co-infection.</p>","PeriodicalId":11602,"journal":{"name":"Emerging Microbes & Infections","volume":" ","pages":"2440490"},"PeriodicalIF":8.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11660446/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142799711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Wenfei Zhu, Lei Yang, Xue Han, Min Tan, Shumei Zou, Xiyan Li, Weijuan Huang, Xiaoxu Zeng, Dayan Wang
{"title":"Origin, pathogenicity, and transmissibility of a human isolated influenza A(H10N3) virus from China.","authors":"Wenfei Zhu, Lei Yang, Xue Han, Min Tan, Shumei Zou, Xiyan Li, Weijuan Huang, Xiaoxu Zeng, Dayan Wang","doi":"10.1080/22221751.2024.2432364","DOIUrl":"10.1080/22221751.2024.2432364","url":null,"abstract":"<p><p>Subtype H10 viruses are known to infect humans in Africa, Oceania, and Asia. In 2021, 2022, and recently in April 2024, a novel H10N3 subtype avian influenza virus was found cause human infection with severe pneumonia. Herein, we comprehensively studied the phylogenetic evolution and biological characteristics of the newly emerged influenza A(H10N3) virus. We found that the human isolated H10N3 virus was generated in early 2019 in domestic poultry. The viruses bound to salic acid α2, 3 receptors, indicating their insufficient ability to infect humans. Although a low pathogenic avian influenza virus, the human isolated H10N3 virus exhibited robust pathogenicity in both BALB/c and C57BL/6 mice, with MLD<sub>50</sub> 1000 times higher than a homologous environmental isolate. The human isolated H10N3 also showed respiratory droplet transmissibility in ferrets. Considering the continuous circulation in avian populations and repeated transmission to humans, strengthened surveillance of H10 subtype viruses in poultry should be put into effect.</p>","PeriodicalId":11602,"journal":{"name":"Emerging Microbes & Infections","volume":" ","pages":"2432364"},"PeriodicalIF":8.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11632946/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142727106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Katharina Grikscheit, Annemarie Berger, Holger Rabenau, Niko Kohmer, Katharina S Appel, Margarete Scherer, Robert Bals, Sabine Blaschke, Axel Hamprecht, Sina M Hopff, Dagmar Krefting, Patrick Meybohm, Carolin Nürnberger, Peter Heuschmann, Caitlin Pley, Susana M Nunes de Miranda, Edgar Dahl, Björn Jensen, Thomas Illig, Gabriele Anton, Jörg Janne Vehreschild, Sandra Ciesek
{"title":"Occurrence and clinical correlates of SARS-CoV-2 viremia in two German patient cohorts.","authors":"Katharina Grikscheit, Annemarie Berger, Holger Rabenau, Niko Kohmer, Katharina S Appel, Margarete Scherer, Robert Bals, Sabine Blaschke, Axel Hamprecht, Sina M Hopff, Dagmar Krefting, Patrick Meybohm, Carolin Nürnberger, Peter Heuschmann, Caitlin Pley, Susana M Nunes de Miranda, Edgar Dahl, Björn Jensen, Thomas Illig, Gabriele Anton, Jörg Janne Vehreschild, Sandra Ciesek","doi":"10.1080/22221751.2025.2459137","DOIUrl":"10.1080/22221751.2025.2459137","url":null,"abstract":"<p><p>Viremia defined as detectable SARS-CoV-2 RNA in the blood is a potential marker of disease severity and prognosis in COVID-19 patients. Here, we determined the frequency of viremia in serum of two independent COVID-19 patient cohorts within the German National Pandemic Cohort Network (German: <b>Na</b>tionales <b>P</b>andemie <b>Ko</b>horten <b>N</b>etzwerk, NAPKON) with diagnostic RT-PCR against SARS-CoV-2. A cross-sectional cohort with 1122 COVID-19 patients (German: <b><i>S</i></b><i>ektoren<b>ue</b>bergreifende <b>P</b>latform</i>, SUEP) and 299 patients recruited in a high-resolution platform with patients at high risk to develop severe courses (German: <b><i>H</i></b><i>och<b>a</b>ufloesende <b>P</b>lattform</i>, HAP) were tested for viremia. Our study also involved a comprehensive analysis and association of serological, diagnostic, and clinical parameters of the NAPKON medical dataset. Prevalence of viremia at the recruitment visit was 12.8% (SUEP) and 13% (HAP), respectively. Serological analysis revealed that viremic patients had lower levels of SARS-CoV-2 specific antibodies as well as lower neutralizing antibodies compared to aviremic patients. Viremia was associated with severity (<0.0001 SUEP; 0.002 HAP) and mortality of COVID-19 (both cohorts <0.0001) compared to aviremic patients. While rare, viremia was also detected in patients with mild disease (0.7%). In patients of the SUEP cohort with acute kidney disease (<i>p</i> = 0.0099) and hematooncological conditions (<i>p</i> = 0.0091), viremia was detected more frequently. Compared to the aviremic group, treatment with immunomodulating drugs as well as elevated levels of inflammatory markers in the blood was more frequent in the viremic group. In conclusion, our analysis revealed that detectable viremia correlates with hyperinflammatory conditions and higher risk for severe COVID-19 disease.</p>","PeriodicalId":11602,"journal":{"name":"Emerging Microbes & Infections","volume":" ","pages":"2459137"},"PeriodicalIF":8.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11812106/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}