{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T00:27:02Z","timestamp":1778632022534,"version":"3.51.4"},"reference-count":64,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,11,19]],"date-time":"2024-11-19T00:00:00Z","timestamp":1731974400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Intern Med"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Bacillus Calmette\u2013Gu\u00e9rin (BCG) injected during the COVID\u201019 convalescence period was safe and enhanced recovery from anosmia and dysgeusia in the acute phase.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To report the long\u2010term results of the BATTLE trial, BCG vaccine in adults with mild COVID\u201019.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Design: Double\u2010blind, placebo\u2010controlled, randomized (1:1) clinical trial. Intervention: BCG intradermal vaccine and placebo. Patients: A total of 157 BCG and 142 placebo recipients participated in the 6\u2010month follow\u2010up, and 97 BCG and 95 placebo recipients participated in the 12\u2010month follow\u2010up. Measurements: Long COVID symptoms and mechanistic analyses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>BCG reduced hearing problems at 6 months (odds ratio [OR]\u00a0=\u00a00.26) and sleeping, concentration, memory, and vision problems at 12 months (OR\u00a0=\u00a00.45, 0.36, 0.38, and 0.36, respectively). Sensitivity analyses confirmed that long COVID\u201019 symptoms were reduced at the 6\u2010 and 12\u2010month follow\u2010ups (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.010 and 0.031, respectively). BCG's crossover interaction paradoxically increased hair loss in women and decreased it in men at 6 months (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.032). BCG immunomodulation is likely mediated through inhibition of Fas ligand expression in the blood and increased induction of IL6, IL10, interferon\u2010induced transmembrane protein 3, and angiotensin\u2010converting enzyme 2 in cultured human macrophages.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Long\u2010term follow\u2010up of the BATTLE trial participants revealed that BCG protects against long COVID development if administered within the COVID\u201019 convalescence period. The response to BCG was subject\u2010specific, including a paradoxical crossover interaction based on sex. Limitations: Not tested for previous mycobacterial exposure; loss to follow\u2010up, particularly at 12 months.<\/jats:p><\/jats:sec>","DOI":"10.1111\/joim.20033","type":"journal-article","created":{"date-parts":[[2024,11,19]],"date-time":"2024-11-19T13:23:17Z","timestamp":1732022597000},"page":"60-78","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Therapeutic BCG vaccine protects against long COVID: The BATTLE randomized clinical trial"],"prefix":"10.1111","volume":"297","author":[{"given":"Mehrsa","family":"Jalalizadeh","sequence":"first","affiliation":[{"name":"UroScience State University of Campinas, Unicamp  Campinas S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keini","family":"Buosi","sequence":"additional","affiliation":[{"name":"UroScience State University of Campinas, Unicamp  Campinas S\u00e3o Paulo 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