Evidence map›Paper›PMID 42043637›Full record

ArticleJournal of clinical immunology2026

Immune Dysregulation and Persistent Symptoms: Insights into T Cell Dynamics in Post-COVID among Athletes from the CoSmo-S Study.

Miriam Ringleb, Daniel Alexander Bizjak, Andreas Michael Nieß, Hannah Notbohm, Hans-Georg Predel, Christian Puta, Jürgen Michael Steinacker, Manuel Widmann, Jonas Zacher, Wilhelm Bloch and 1 more

Abstract read
In one paragraph

Article in Journal of clinical immunology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Miriam RinglebDepartment of Sports Medicine and Health Promotion, Friedrich-Schiller-University Jena, Jena, Germany. m.ringleb@dshs-koeln.de.ORCID http://orcid.org/0009-0009-0833-4367
Daniel Alexander BizjakDivision of Sports and Rehabilitation Medicine, Department of Internal Medicine, Ulm University Medical Center, Ulm, Germany.ORCID http://orcid.org/0000-0003-4075-0204
Andreas Michael NießDepartment of Sports Medicine, Medical Clinic, University Hospital Tübingen, Tübingen, Germany.ORCID http://orcid.org/0000-0002-6145-7069
Hannah NotbohmDepartment for Molecular and Cellular Sports Medicine, Institute of Cardiovascular Research and Sports Medicine, German Sport University Cologne, Cologne, Germany.ORCID http://orcid.org/0000-0002-0565-8130
Hans-Georg PredelDepartment for Preventive and Rehabilitative Sports and Performance Medicine, Institute of Cardiovascular Research and Sports Medicine, German Sport University Cologne, Cologne, Germany.ORCID http://orcid.org/0000-0002-6643-4464
Christian PutaDepartment of Sports Medicine and Health Promotion, Friedrich-Schiller-University Jena, Jena, Germany.ORCID http://orcid.org/0000-0003-3936-4605
Jürgen Michael SteinackerDivision of Sports and Rehabilitation Medicine, Department of Internal Medicine, Ulm University Medical Center, Ulm, Germany.ORCID http://orcid.org/0000-0001-8901-9450
Manuel WidmannDepartment of Sports Medicine, Medical Clinic, University Hospital Tübingen, Tübingen, Germany.ORCID http://orcid.org/0000-0001-7779-9920
Jonas ZacherDepartment for Preventive and Rehabilitative Sports and Performance Medicine, Institute of Cardiovascular Research and Sports Medicine, German Sport University Cologne, Cologne, Germany.ORCID http://orcid.org/0000-0002-9687-5746
Wilhelm BlochDepartment for Molecular and Cellular Sports Medicine, Institute of Cardiovascular Research and Sports Medicine, German Sport University Cologne, Cologne, Germany.ORCID http://orcid.org/0000-0003-1786-8853
Florian JavelleNeuroPsychoImmunology Research Unit, Department for Molecular and Cellular Sports Medicine, Institute of Cardiovascular Research and Sports Medicine, German Sport University Cologne, Cologne, Germany.ORCID http://orcid.org/0000-0003-4240-2588

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundOver 10% of all SARS-CoV-2 infections lead to persistent symptoms, a condition called post-COVID condition (PCC). For elite athletes, whose performance is central, PCC poses significant challenges. It is suggested that immune cells, particularly regulatory and effector T cells, play a key role in symptom persistence nonetheless it has not yet been investigated.

objectiveThis study investigates immune dynamics after SARS-CoV-2 infection and assesses whether symptom persistence is accompanied by T cell dysregulation in highly trained athletes.

methodsThirty-six highly trained athletes were included in this study after experiencing SARS-CoV-2 infection. Athletes’ data were analyzed 2–4 weeks after infection (T0) and 3–4 months later (T1). They were categorized into two groups: those with persistent symptoms (PS) and those without (SF). Their immune cell distribution was assessed via flow cytometry.

resultsIn the PS group, there was an increase in T helper (Th) cell 17 and Th2 cells from T0 to T1, whereas in the SF group, these cell types either decreased or remained unchanged, respectively. Furthermore, Th1 cells decreased and natural (NK) cells increased from T0 to T1 in the PS group, while no changes were observed in the SF group. No changes were observed in Tregs nor in other cell types.

conclusionThis dysregulation of the immune system toward humoral immunity indexed by a rise in Th2 and Th17 cells and a decrease in Th1 cells over time could be indicative of a possible virus persistence contributing to persistent symptoms. CLINICAL

trial registrationThe study has been registered in the German Clinical Trials Register (DRKS00023717).

Indexed as

AthletesCOVID-19SARS-CoV-2T-LymphocytesAdultFemaleHumansKiller Cells, NaturalMalePost-Acute COVID-19 SyndromeTh17 CellsTh1 CellsTh2 CellsT-Lymphocytes, RegulatoryYoung AdultAthletesEffector T cellsImmune dysregulationPost-COVID conditionTregs

Identifiers

PMID42043637
PMCPMC13128693

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.