Evidence map›Paper›PMID 42354937›Full record

ArticleMicroorganisms2026

Immunological Mechanisms and Machine Learning Applications in Post-COVID-19 Syndrome: A Narrative Review.

Leonid P Churilov, Anna Starshinova, Igor Kudryavtsev, Artem Rubinstein, Olesya Koroteeva, Anastasia Kulpina, Varvara A Ryabkova, Adilya Sabirova, Polina Sobolevskaia, Tamara Fedotkina and 1 more

Abstract read
In one paragraph

Article in Microorganisms, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. Article
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.

Leonid P ChurilovInstitute of Medicine, Department of Pathology, St. Petersburg State University, 199034 St. Petersburg, Russia.ORCID 0000-0001-6359-0026
Anna StarshinovaFaculty of Mathematics and Computer Science, St. Petersburg State University, 199034 St. Petersburg, Russia.ORCID 0000-0002-9023-6986
Igor KudryavtsevAlmazov National Medical Research Centre, 197341 St. Petersburg, Russia.
Artem RubinsteinAlmazov National Medical Research Centre, 197341 St. Petersburg, Russia.ORCID 0000-0002-8493-5211
Olesya KoroteevaAlmazov National Medical Research Centre, 197341 St. Petersburg, Russia.
Anastasia KulpinaInstitute of Medicine, Department of Pathology, St. Petersburg State University, 199034 St. Petersburg, Russia.
Varvara A RyabkovaInstitute of Medicine, Department of Pathology, St. Petersburg State University, 199034 St. Petersburg, Russia.ORCID 0000-0001-6973-9901
Adilya SabirovaInstitute of Medicine, Department of Pathology, St. Petersburg State University, 199034 St. Petersburg, Russia.
Polina SobolevskaiaInstitute of Medicine, Department of Pathology, St. Petersburg State University, 199034 St. Petersburg, Russia.
Tamara FedotkinaSechenov Institute of Evolutionary Physiology and Biochemistry of the Russian Academy of Sciences, 194223 St. Petersburg, Russia.ORCID 0000-0002-2723-4590
Dmitry KudlayDepartment of Pharmacology, Institute of Pharmacy, I.M. Sechenov First Moscow State Medical University, 119435 Moscow, Russia.ORCID 0000-0003-1878-4467

Funding

Ministry of Science and Higher Education 075-15-2025-013
6 · The paper itself

Abstract

Post-COVID-19 syndrome (PCS), also referred to as post-acute sequelae of SARS-CoV-2 infection (PASC), represents a heterogeneous set of persistent clinical manifestations developing after acute infection. These conditions are associated with immune dysregulation, autonomic imbalance, impaired thymic function, and possible viral persistence.

objectiveThis study aims to systematically synthesise current evidence on the immunopathogenesis of PCS and to critically evaluate the application of artificial intelligence (AI) and machine learning (ML) approaches for its prediction and clinical stratification.

methodsA PRISMA 2020-informed systematic review was conducted using PubMed/MEDLINE, Scopus, Web of Science, elibrary.ru and Embase databases (January 2020-December 2025). Studies addressing immunopathological mechanisms and AI/ML applications in PCS were selected based on predefined eligibility criteria. Risk of bias in prediction studies was assessed using the PROBAST tool. Due to heterogeneity, a structured qualitative synthesis was performed. Current evidence indicates that PCS may result from sustained systemic inflammation, cytokine dysregulation, autoimmunity, and delayed restoration of T-cell homeostasis, including reduced thymic output of naïve T lymphocytes. Persistent thymic dysfunction may contribute to prolonged immune imbalance, increased susceptibility to secondary infections, and reactivation of latent viruses. AI/ML approaches-including gradient boosting, ensemble learning, deep neural networks, and natural language processing-have demonstrated promising performance across multimodal datasets. However, significant limitations were identified, including small sample sizes, overfitting, lack of external validation, and heterogeneity in outcome definitions.

conclusionsThe integration of immunopathological insights with data-driven modelling highlights the potential of combined approaches for improving PCS risk stratification. However, current AI models remain insufficiently validated for clinical implementation. Future research should prioritise methodological standardisation, external validation, and incorporation of mechanistically informed biomarkers.

Indexed as

artificial intelligenceautoimmunitydisease predictionlong COVIDlymphocyte subsetsmachine learningneuroendocrine regulationPRISMAsystematic review

Identifiers

PMID42354937
PMCPMC13305436

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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.