Reviews in Medical Virology最新文献

{"title":"West Nile Neuroinvasive Disease: Current Management, Emerging Therapies and Future Clinical Trial Priorities.","authors":"Ambrogio Curtolo, Dimitra Kontogiannis, Tommaso Ascoli Bartoli, Gaetano Maffongelli, Maria Virginia Tomassi, Nazario Bevilacqua, Patrizia De Marco, Cosmo Del Borgo, Miriam Lichtner, Serena Vita","doi":"10.1002/rmv.70182","DOIUrl":"10.1002/rmv.70182","url":null,"abstract":"<p><p>West Nile virus (WNV) is a climate-sensitive, mosquito-borne flavivirus that has become endemic in Europe, with Italy, particularly the Lazio region, emerging as a significant epicentre. While most infections are asymptomatic, less than 1% of cases progress to West Nile neuroinvasive disease (WNND), which carries a case fatality rate of up to 17% in vulnerable populations. Despite the rising global incidence, clinical management remains primarily supportive, as no antiviral agents or vaccines are currently licenced for human use. Pharmacological research has yielded inconsistent results. Corticosteroids show no significant survival benefit, and ribavirin is discouraged due to potential toxicity and lack of in vivo efficacy. Although interferon-α2b and intravenous immunoglobulin (IVIG) demonstrated promising results in preclinical models, human clinical trials have been inconclusive. More recently, remdesivir and repurposed drugs like nitazoxanide and teriflunomide have emerged as potential candidates, though they require validation through controlled trials. Future therapeutic success likely depends on early intervention (within 7-10 days of symptom onset) and multitargeted combination approaches that address viral replication, immune modulation, and neuroprotection. There is an urgent need for adequately powered clinical trials and the acceleration of human vaccine development to mitigate the impact of this expanding public health threat.</p>","PeriodicalId":21180,"journal":{"name":"Reviews in Medical Virology","volume":"36 4","pages":"e70182"},"PeriodicalIF":5.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13354516/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148423400","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":"Immunological Interactions Between Gammadelta T Cells and West Nile Virus in the Infected Host.","authors":"E Cimini, E Tartaglia, F Cristofanelli, S Gili, F Maggi","doi":"10.1002/rmv.70176","DOIUrl":"10.1002/rmv.70176","url":null,"abstract":"<p><p>Between mosquitoes and birds, West Nile virus (WNV) is a neurotropic flavivirus, an arthropod-borne pathogen involved in an enzootic cycle. Additionally, it can infect both people and horses, leading to severe illness. Since 1999, WNV has spread across North and South America, including Mexico and the Caribbean. It is endemic in several regions of Europe, Africa, the Middle East, and Asia. WNV affects the central nervous system (CNS), causing severe disease in a small percentage of infected individuals, especially in immunocompromised or elderly hosts. This re-emerging pathogen was identified during an outbreak in July 2025 in the Lazio region of Italy, rekindling interest in an area where the virus had not circulated for some time and raising several questions about the WNV vector and its spread. Gammadelta T (γδ T) lymphocytes are innate cells that can respond rapidly and non-specifically to viral infections and other pathogens, thereby linking innate and adaptive immunity. Several studies in mice and humans suggest they play distinct roles in controlling WNV infection by communicating with other immune cells, underscoring their antiviral role, which is essential for containing viral dissemination in the host. This review will discuss recent studies on the role of γδ T cells in viral pathogenesis and in protective immunity during WNV infection.</p>","PeriodicalId":21180,"journal":{"name":"Reviews in Medical Virology","volume":"36 4","pages":"e70176"},"PeriodicalIF":5.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13250970/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148212426","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":"Impact of Male Human Papillomavirus (HPV) Vaccination on HPV Infection and HPV-Related Diseases: A Systematic Review.","authors":"Anna Beltrame, Racheal S Dube Mandishora, Wei Vivian Wang, Wenyi Fan, Mary Katherine Haver, Anna R Giuliano","doi":"10.1002/rmv.70171","DOIUrl":"10.1002/rmv.70171","url":null,"abstract":"<p><p>Human papillomavirus (HPV) is the most common sexually transmitted infection worldwide and is responsible for anogenital warts and several cancers. Although the effectiveness of female HPV vaccination has been well established since its introduction in 2006, no systematic review has specifically evaluated the impact of male vaccination programs introduced in 2011. We synthesised real-world evidence on gender-neutral vaccination (GNV), identifying 17 studies reporting rates of HPV infection, anogenital warts, and HPV-related cancers during the pre- and post-GNV periods among males in high-income countries. Overall, we found limited but consistent evidence of benefit in males, although some of the observed reductions may also reflect herd immunity effects from earlier female-only HPV vaccination programs. Only two studies evaluated temporal trends in HPV infection, both demonstrating reductions in vaccine-targeted genotypes, although important methodological limitations restrict generalisability. Eight studies reported consistent declines in anogenital warts among adolescents and young adults, supporting a beneficial population-level impact of GNV. Analyses of HPV-related cancers showed an overall increasing incidence, likely reflecting long latency periods. However, some studies reported encouraging declines in cancer incidence among younger age groups. Oropharyngeal incidence decreased by 11%-19% among U.S. males aged 20-44 years, and penile cancer incidence decreased by 6%-38% among those aged 15-34 years. In Texas, penile and anal cancer incidence decreased by 35% and 16%, respectively, among males 20 years or older, while in Austria, anal cancer incidence decreased by 38% among men aged 30-39 years. Given the relatively recent introduction of male vaccination programs, longer follow-up is required to fully assess their impact. Studies in low- and middle-income countries are urgently needed.</p>","PeriodicalId":21180,"journal":{"name":"Reviews in Medical Virology","volume":"36 4","pages":"e70171"},"PeriodicalIF":5.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148101812","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":"Dysregulated Metabolism in People Living With HIV in the Modern ART-Era: A Systematic Review of Targeted Metabolomics Studies.","authors":"Levanco K Asia, Du Toit Loots, Shayne Mason, Esme Jansen Van Vuren, Monray E Williams","doi":"10.1002/rmv.70179","DOIUrl":"10.1002/rmv.70179","url":null,"abstract":"<p><p>HIV remains a significant public health issue, with 1.3 million new infections and 630,000 deaths annually, and 40.8 million people living with HIV (PLHIV) globally in 2024. Although antiretroviral therapy (ART) suppresses viral replication, it does not eradicate the virus, and metabolic dysregulation persists despite treatment. Metabolomics allows for a detailed investigation of these alterations; however, targeted metabolomics studies in ART-treated PLHIV are limited, and there is no consensus on consistently dysregulated metabolites in PLHIV compared to healthy controls (HCs). This systematic review aimed to identify frequently investigated metabolites and key metabolic alterations in ART-treated PLHIV. A search strategy was designed for this study. PubMed, Scopus, and Web of Science were searched to identify relevant articles. We collected all search results in a reference manager and assessed titles and abstracts, as well as the full-text of the articles, for inclusion eligibility according to PRISMA guidelines. A total of 3217 studies were identified, of which 15 studies met the inclusion criteria. The review included 15 studies, comprising 886 PLHIV and 389 HCs. The most investigated metabolites were glutamine, tryptophan (Trp), kynurenine (Kyn), Kyn/Trp ratio, glycine, and ornithine. Consistent trends showed lower glutamine and glycine, and higher Kyn/Trp and ornithine, in PLHIV compared to HCs. Notably, metabolic dysregulation persisted in PLHIV despite viral suppression. Furthermore, studies conducted in the Global North more frequently reported metabolic dysregulation in PLHIV relative to HCs, compared with studies from the Global South, potentially reflecting regional variation or methodological differences. These findings offer insight into the targeted metabolic profiles of ART-treated PLHIV using metabolomics and suggest that metabolites such as glutamine, glycine, Kyn/Trp ratio and ornithine may play important roles in understanding HIV-1 pathogenesis in the modern ART-era.</p>","PeriodicalId":21180,"journal":{"name":"Reviews in Medical Virology","volume":"36 4","pages":"e70179"},"PeriodicalIF":5.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13335820/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148397529","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":"Risk Factors for Mortality in Patients With Novel Bunyavirus Infection: A Systematic Review and Meta-Analysis.","authors":"Shan Niu, Xu Dong, Yaqin Feng, Zhimei Wu, Zengye Chen","doi":"10.1002/rmv.70146","DOIUrl":"10.1002/rmv.70146","url":null,"abstract":"<p><p>The pathogenesis of novel bunyavirus infection remains unclear, and severe cases progress rapidly with a relatively high case fatality rate, posing a serious threat to patient health. The study aimed to analyse the mortality rate and risk factors of novel Bunyavirus infection. We searched both English and Chinese databases from their inception until April 2025. Inclusion criteria were original cohort or case-control studies of patients with novel bunyavirus infection in which the clinical outcome was death. All included information was independently reviewed by at least two reviewers. Meta-analysis was conducted using R version 4.4.3 with the 'meta' and 'metafor' packages. A total of 31 studies involving 4682 patients were included in this systematic review. The pooled mortality rate for novel Bunyavirus infections was 23% (95% Confidence Interval (CI): 20%-27%). The following were identified as significant risk factors for mortality: age (Odds Ratio (OR) = 1.06, 95% CI = (1.01, 1.12)), haemorrhagic manifestations (OR = 10.37, 95% CI = (1.18, 91.05)), Glasgow Coma Scale scores (OR = 0.76, 95% CI = (0.66, 0.86)), neurological symptoms (OR = 6.04, 95% CI = (2.42, 15.07)), consciousness disorders (OR = 2.98, 95% CI = (1.26, 7.03)), Activated Partial Thromboplastin Time (OR = 1.07, 95% CI = (1.02, 1.13)), Thrombin Time (OR = 1.13, 95% CI = (1.03, 1.25)), Viral load (OR = 2.42, 95% CI = (1.89, 3.10)), Haematocrit-Serum albumin (OR = 1.14, 95% CI = (1.04, 1.26)), Aspartate aminotransferase/Alanine aminotransferase (OR = 2.88, 95% CI = (1.17, 7.06)), Lactate dehydrogenase (OR = 1.00, 95% CI = (1.00, 1.01)). This meta-analysis identified multiple factors associated with increased mortality from novel bunyavirus infection. Due to the substantial heterogeneity among the included studies, further high-quality research is needed to confirm these findings and establish a consensus.</p>","PeriodicalId":21180,"journal":{"name":"Reviews in Medical Virology","volume":"36 3","pages":"e70146"},"PeriodicalIF":6.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692011","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":"Virus-Like Nanoparticles for Vaccine Development and Drug Delivery.","authors":"De-Feng Li, Mei-Feng Yang, Ning-Ning Yue, Long-Bin Huang, Chen Kong, Yuan Zhang, Cheng-Mei Tian, Hai-Lan Zhao, Qian-Jun Luo, Hua-Lin Ma, Jian-Yao Wang, Dao-Ru Wei, Li-Sheng Wang, Jian-Ping Lu, Yu-Jie Liang, Jun Yao","doi":"10.1002/rmv.70139","DOIUrl":"10.1002/rmv.70139","url":null,"abstract":"<p><p>Virus-like nanoparticles (VLPs) are naturally occurring polymeric nanomaterials formed by the self-assembly of one or more viral capsid proteins (CPs). VLPs have garnered significant attention in a wide range of nanotechnology-based diagnostics and therapies, including immunotherapy and drug delivery. VLPs are Exhibiting high biocompatibility and biodegradability, alone with uniform structure and controlled assembly, VLPs represent a complex and versatile therapeutic platform. This review provides an overview of the fundamental aspects of VLPs, including their types, structures, immune mechanisms, as well as expression and purification method. Recent advances in the development and application of engineered VLPs for drug delivery, gene therapy, immunology studies and multifunctional therapeutics are discussed. This paper also summarised research advances in the use of virus-like particles as chimaeric vectors and highlights their potential as efficient delivery vehicles. Finally, we present several successful examples of VLPs-based drug delivery system and provide a comprehensive analysis of VLPs that takes advantage of both viral and non-viral delivery methods for efficient theranostic application.</p>","PeriodicalId":21180,"journal":{"name":"Reviews in Medical Virology","volume":"36 3","pages":"e70139"},"PeriodicalIF":5.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147779186","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":"The Expanding Organ Tropism of Herpes Simplex Virus Type 1.","authors":"Areli J Navarro, Ignacio A Pasten, Dayesi López-Hernández, Susan M Bueno, Alexis M Kalergis, Pablo A González","doi":"10.1002/rmv.70155","DOIUrl":"10.1002/rmv.70155","url":null,"abstract":"<p><p>Herpes simplex virus type 1 (HSV-1) infection is highly prevalent, with more than 70% of the global population seropositive. HSV-1 commonly infects the skin, eyes, and neurons, as well as immune cells such as dendritic cells; however, an expanding tissue tropism is observed, suggesting that its clinical impact may be vastly underestimated. This calls for a critical reappraisal of the risks posed by this ubiquitous virus. Here, we discuss current findings linking HSV-1 to a broad spectrum of organs, including the heart, lungs, intestines, and liver, as well as several clinical effects and diseases, which demand an in-depth analysis of HSV-1 pathogenesis with a critical focus on its pressing clinical implications. Recognising the broad disease spectrum of HSV-1 could help better guide diagnosis and treatment, given the availability of antiviral treatments for this virus.</p>","PeriodicalId":21180,"journal":{"name":"Reviews in Medical Virology","volume":"36 3","pages":"e70155"},"PeriodicalIF":5.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147779903","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":"Mpox Clinical Outcomes in People With and Without HIV Treated With Tecovirimat: A Systematic Review.","authors":"Santenna Chenchula, Krishna Chaitanya Amerneni, Padmavathi Rajakarunakaran, Anitha Kuttiappan, Sunil Kumar Gupta, Satya Prakash, Sri Varshini Talagampala, Mohan Krishna Ghanta, Madhavrao Chavan","doi":"10.1002/rmv.70152","DOIUrl":"10.1002/rmv.70152","url":null,"abstract":"<p><p>Mpox poses heightened risks for immunocompromised individuals, particularly people with HIV (PWH), yet evidence on clinical outcomes and antiviral treatment remains limited. We conducted a systematic review in accordance with PRISMA guidelines, searching MEDLINE, Scopus, and the Cochrane Library from inception through October 2025. Fourteen studies comprising 8867 patients were included. A recently published randomized controlled trial evaluating tecovirimat for mpox was also considered to contextualise the findings. Owing to substantial clinical and methodological heterogeneity, data were synthesised narratively using the Synthesis Without Meta-analysis (SWiM) framework. Across studies, mpox severity followed a clear CD4-dependent gradient. People without HIV (PWoH) and PWH with relatively preserved immune function (generally CD4 ≥ 200 cells/μL) typically experienced milder, self-limiting disease, with treatment failure rates below 5%. In contrast, PWH with CD4 counts < 200 cells/μL, particularly those < 100 cells/μL, demonstrated substantially higher rates of necrotic lesions, proctitis, hospitalisation, delayed viral clearance, and mortality. Treatment failure in this subgroup ranged from 15% to 30%, and all confirmed cases of tecovirimat resistance (3 of 18 tested) occurred in patients with CD4 counts < 100 cells/μL. Observational studies suggested that earlier initiation of tecovirimat (≤ 7 days from symptom onset) was associated with more favourable clinical trajectories. However, randomised controlled trial evidence has not demonstrated a clear efficacy signal, and prolonged treatment courses (21-28 days) were frequently required in patients with advanced HIV, reflecting persistent disease rather than established antiviral benefit. Tecovirimat was generally well tolerated, with mild adverse events reported in approximately 20%-25% of patients and no serious adverse events definitively attributed to therapy across the included studies. Overall, immunological status rather than HIV serostatus alone appeared to be the principal determinant of mpox severity and clinical outcomes, underscoring the importance of CD4-guided management strategies and targeted resistance surveillance in immunocompromised populations.</p>","PeriodicalId":21180,"journal":{"name":"Reviews in Medical Virology","volume":"36 3","pages":"e70152"},"PeriodicalIF":5.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147699621","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":"Enterovirus D68 and Acute Neurologic Outcomes: A Systematic Review and Meta-Analysis (2010-2025).","authors":"Asif Naeem, Muhammad Masroor Alam, Musaed Alharbi, Maymunah Hakami, Nabeel Alzahrani, Seena Thomas, Sameera Aljohani, Mohammad Bosaeed","doi":"10.1002/rmv.70147","DOIUrl":"10.1002/rmv.70147","url":null,"abstract":"<p><p>Enterovirus D68 (EV-D68) has been implicated in clusters of acute flaccid myelitis (AFM) and severe respiratory illness; however, the magnitude and consistency of association across settings and over time remain uncertain. We quantified the association between EV-D68 detection and acute neurologic outcomes (particularly AFM) and explored design- and time-related heterogeneity. Following PRISMA 2020 and MOOSE guidance, we systematically identified observational studies reporting associations between EV-D68 detection and neurologic outcomes. Random effects meta-analysis was performed using REML with Knapp-Hartung adjustment; heterogeneity was summarised with τ² and I². Prespecified moderators were examined with meta-regression. Small-study effects were evaluated using contour-enhanced funnel plots, Egger and Peters tests, and PET-PEESE bias-adjusted models. PROSPERO registration: 1152300. Across 98 studies, the pooled odds ratio (OR) was 1.39 (95% CI 1.14-1.69), with high heterogeneity (I² = 98.9%; prediction interval 0.24-8.15). By design, respiratory surveillance studies showed stronger association (OR 1.59, 95% CI 1.35-1.86, k = 78) whereas AFM case-control studies did not (OR 0.86, 95% CI 0.40-1.86, k = 20). In multivariable meta-regression, study design and calendar year explained about 47% of inter-study variance. Predicted ORs declined from 2014 to 2022 across regions. Funnel asymmetry and small-study effects were suggested; PET-PEESE bias-adjusted estimates remained above the null. The EV-D68 outcome association is context-dependent and time-varying. Surveillance datasets enriched during outbreak waves drive the pooled signal, while AFM case-control designs yield attenuated estimates after adjustment. Standardising diagnostics and integrating design-specific surveillance will improve risk estimation and AFM preparedness.</p>","PeriodicalId":21180,"journal":{"name":"Reviews in Medical Virology","volume":"36 3","pages":"e70147"},"PeriodicalIF":6.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147820287","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":"Epidemiological Changes in Mycoplasma pneumoniae Infections in Children and Adolescents Before and After COVID-19: A Systematic Review and Meta-Analysis.","authors":"Hao Gou, Yiman Zhai, Qinyue Yu, Yan Liu, Hongyun Zhou, Qiong Zhao","doi":"10.1002/rmv.70151","DOIUrl":"10.1002/rmv.70151","url":null,"abstract":"<p><p>Mycoplasma pneumoniae (M. pneumoniae) is a major cause of respiratory tract infections in children and adolescents, yet its epidemiological burden before, during, and after the COVID-19 pandemic remains unclear. This meta-analysis, which searched Web of Science, Embase, PubMed, and Cochrane Library for reports published up to December 25, 2025, aimed to evaluate trends in the prevalence of M. pneumoniae infections across these three periods to guide clinical practice and public health responses. A total of 70 studies were included, and methodological quality was assessed using the Joanna Briggs Institute criteria. The pooled prevalence of M. pneumoniae infections before, during, and after COVID-19 was calculated in R 4.5.0, with Freeman-Tukey double arcsine transformation for extreme proportions. The prevalence of M. pneumoniae infections before COVID-19, during COVID-19, and after COVID-19 was 21.72% (95% CI: 17.09, 26.73), 10.73% (95% CI: 7.57, 14.35), and 28.64% (95% CI: 22.74, 34.93), respectively. Age-stratified analysis revealed the highest prevalence consistently in children > 6 years (pre-pandemic: 46.35%; during-pandemic: 27.32%; post-pandemic: 41.36%) and the lowest in infants < 1 year (8.21%, 4.87%, and 7.81%, respectively). Seasonally, pre-pandemic prevalence peaked in summer (33.34%) and autumn (31.00%). During the pandemic, overall rates declined but remained highest in autumn (15.51%). Post-pandemic, prevalence rebounded broadly, peaking in autumn (37.97%). In conclusion, this study summarises M. pneumoniae trends in children and adolescents before and after COVID-19, indicating a delayed resurgence following the pandemic, and highlights the need for further research to explain these patterns and improve future pandemic preparedness.</p>","PeriodicalId":21180,"journal":{"name":"Reviews in Medical Virology","volume":"36 3","pages":"e70151"},"PeriodicalIF":5.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147691957","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}