Publikationen im NUM
Hier finden Sie eine Liste der Publikationen, die im Zusammenhang mit dem Netzwerk Universitätsmedizin in der ersten und zweiten Förderphase entstanden sind.
M. Schmidt,
S. Gebauer,
A. Bartholmes,
D. Kadioglu,
J. Kleesiek,
B. Hamm,
T. J. Vogl,
T. Penzkofer,
A. M. Bucher and
H. Storf,
"CODEX Meets RACOON - A Concept for Collaborative Documentation of Clinical and Radiological COVID-19 Data",
Studies in health technology and informatics,
vol. 296,
pp. 58-65,
Aug.
2022.
Abstract:
Within the scope of the two NUM projects CODEX and RACOON we developed a preliminary technical concept for documenting clinical and radiological COVID-19 data in a collaborative approach and its preceding findings of a requirement analysis. At first, we provide an overview of NUM and its two projects CODEX and RACOON including the GECCO data set. Furthermore, we demonstrate the foundation for the increased collaboration of both projects, which was additionally supported by a survey conducted at University Hospital Frankfurt. Based on the survey results mint Lesion™, developed by Mint Medical and used at all project sites within RACOON, was selected as the "Electronic Data Capture" (EDC) system for CODEX. Moreover, to avoid duplicate entry of GECCO data into both EDC systems, an early effort was made to consider a collaborative and efficient technical approach to reduce the workload for the medical documentalists. As a first effort we present a preliminary technical concept representing the current and possible future data workflow of CODEX and RACOON. This concept includes a software component to synchronize GECCO data sets between the two EDC systems using the HL7 FHIR standard. Our first approach of a collaborative use of an EDC system and its medical documentalists could be beneficial in combination with the presented synchronization component for all participating project sites of CODEX and RACOON with regard to an overall reduced documentation workload.
| DOI: | 10.3233/shti220804 |
| Datei: | https://pubmed.ncbi.nlm.nih.gov/36073489/ |
Abstract:
Within the scope of the two NUM projects CODEX and RACOON we developed a preliminary technical concept for documenting clinical and radiological COVID-19 data in a collaborative approach and its preceding findings of a requirement analysis. At first, we provide an overview of NUM and its two projects CODEX and RACOON including the GECCO data set. Furthermore, we demonstrate the foundation for the increased collaboration of both projects, which was additionally supported by a survey conducted at University Hospital Frankfurt. Based on the survey results mint Lesion™, developed by Mint Medical and used at all project sites within RACOON, was selected as the "Electronic Data Capture" (EDC) system for CODEX. Moreover, to avoid duplicate entry of GECCO data into both EDC systems, an early effort was made to consider a collaborative and efficient technical approach to reduce the workload for the medical documentalists. As a first effort we present a preliminary technical concept representing the current and possible future data workflow of CODEX and RACOON. This concept includes a software component to synchronize GECCO data sets between the two EDC systems using the HL7 FHIR standard. Our first approach of a collaborative use of an EDC system and its medical documentalists could be beneficial in combination with the presented synchronization component for all participating project sites of CODEX and RACOON with regard to an overall reduced documentation workload.
A. Mardiko,
S. Heinemann,
A. Bludau,
H. Kaba,
A. Leha,
N. von Maltzahn,
N. Mutters,
R. Leistner and
S. Scheithauer,
"COVID-19 vaccination strategy for hospital staff in Germany: a cross-sectional study in March–April 2021",
J Hosp Infect,
vol. 126,
pp. 87-92,
Aug.
2022.
| DOI: | 10.1016/j.jhin.2022.05.012 |
A. Mardiko,
S. Heinemann,
A. Bludau,
H. Kaba,
A. Leha,
N. von Maltzahn,
N. Mutters,
R. Leistner and
S. Scheithauer,
"COVID-19 vaccination strategy for hospital staff in Germany: a cross-sectional study in March–April 2021",
J Hosp Infect,
vol. 126,
pp. 87-92,
Aug.
2022.
| DOI: | 10.1016/j.jhin.2022.05.012 |
[en]
T. Meyer,
P. Stubbemann,
C. Thibeault,
O. Staudacher,
D. Niemeyer,
J. Jansen,
B. Mühlemann,
J. Doehn,
C. Tabeling,
C. Nusshag,
C. Hirzel,
D. S. Sanchez,
A. Nieters,
A. Lother,
D. Duerschmied,
N. Schallner,
J. Lieberum,
D. August,
S. Rieg,
V. Falcone,
H. Hengel,
U. Kölsch,
N. Unterwalder,
R. Hübner,
T. C. Jones,
N. Suttorp,
C. Drosten,
K. Warnatz,
T. Spinetti,
J. C. Schefold,
T. Dörner,
L. E. Sander,
V. Corman,
U. Merle,
P. Group,
F. Kurth,
H. Bernuth,
C. Meisel and
C. Goffinet,
"Early and rapid identification of COVID-19 patients with neutralizing type I interferon auto-antibodies",
J. Clin. Immunol.,
vol. 42,
no. 6,
pp. 1111—1129,
Aug.
2022.
Springer Science and Business Media LLC.
Abstract:
PURPOSE: Six to 19% of critically ill COVID-19 patients display circulating auto-antibodies against type I interferons (IFN-AABs). Here, we establish a clinically applicable strategy for early identification of IFN-AAB-positive patients for potential subsequent clinical interventions. METHODS: We analyzed sera of 430 COVID-19 patients from four hospitals for presence of IFN-AABs by ELISA. Binding specificity and neutralizing activity were evaluated via competition assay and virus-infection-based neutralization assay. We defined clinical parameters associated with IFN-AAB positivity. In a subgroup of critically ill patients, we analyzed effects of therapeutic plasma exchange (TPE) on the levels of IFN-AABs, SARS-CoV-2 antibodies and clinical outcome. RESULTS: The prevalence of neutralizing AABs to IFN-$\alpha$ and IFN-$ømega$ in COVID-19 patients from all cohorts was 4.2% (18/430), while being undetectable in an uninfected control cohort. Neutralizing IFN-AABs were detectable exclusively in critically affected (max. WHO score 6-8), predominantly male (83%) patients (7.6%, 18/237 for IFN-$\alpha$-AABs and 4.6%, 11/237 for IFN-$ømega$-AABs in 237 patients with critical COVID-19). IFN-AABs were present early post-symptom onset and at the peak of disease. Fever and oxygen requirement at hospital admission co-presented with neutralizing IFN-AAB positivity. IFN-AABs were associated with lower probability of survival (7.7% versus 80.9% in patients without IFN-AABs). TPE reduced levels of IFN-AABs in three of five patients and may increase survival of IFN-AAB-positive patients compared to those not undergoing TPE. CONCLUSION: IFN-AABs may serve as early biomarker for the development of severe COVID-19. We propose to implement routine screening of hospitalized COVID-19 patients for rapid identification of patients with IFN-AABs who most likely benefit from specific therapies.
| DOI: | 10.1007/s10875-022-01252-2 |
| Pubmed: | 35511314 |
Abstract:
PURPOSE: Six to 19% of critically ill COVID-19 patients display circulating auto-antibodies against type I interferons (IFN-AABs). Here, we establish a clinically applicable strategy for early identification of IFN-AAB-positive patients for potential subsequent clinical interventions. METHODS: We analyzed sera of 430 COVID-19 patients from four hospitals for presence of IFN-AABs by ELISA. Binding specificity and neutralizing activity were evaluated via competition assay and virus-infection-based neutralization assay. We defined clinical parameters associated with IFN-AAB positivity. In a subgroup of critically ill patients, we analyzed effects of therapeutic plasma exchange (TPE) on the levels of IFN-AABs, SARS-CoV-2 antibodies and clinical outcome. RESULTS: The prevalence of neutralizing AABs to IFN-$\alpha$ and IFN-$ømega$ in COVID-19 patients from all cohorts was 4.2% (18/430), while being undetectable in an uninfected control cohort. Neutralizing IFN-AABs were detectable exclusively in critically affected (max. WHO score 6-8), predominantly male (83%) patients (7.6%, 18/237 for IFN-$\alpha$-AABs and 4.6%, 11/237 for IFN-$ømega$-AABs in 237 patients with critical COVID-19). IFN-AABs were present early post-symptom onset and at the peak of disease. Fever and oxygen requirement at hospital admission co-presented with neutralizing IFN-AAB positivity. IFN-AABs were associated with lower probability of survival (7.7% versus 80.9% in patients without IFN-AABs). TPE reduced levels of IFN-AABs in three of five patients and may increase survival of IFN-AAB-positive patients compared to those not undergoing TPE. CONCLUSION: IFN-AABs may serve as early biomarker for the development of severe COVID-19. We propose to implement routine screening of hospitalized COVID-19 patients for rapid identification of patients with IFN-AABs who most likely benefit from specific therapies.
[en]
K. Hirschbühl,
T. Schaller,
B. Märkl,
R. Claus,
E. Sipos,
L. Rentschler,
A. Maccagno,
B. Grosser,
E. Kling,
M. Neidig,
T. Kröncke,
O. Spring,
G. Braun,
H. Bösmüller,
M. Seidl,
I. Esposito,
J. Pablik,
J. Hilsenbeck,
P. Boor,
M. Beer,
S. Dintner and
C. Wylezich,
"High viral loads: what drives fatal cases of COVID-19 in vaccinees? – an autopsy study",
Modern Pathology,
vol. 35,
no. 8,
pp. 1013—1021,
Aug.
2022.
Abstract:
The rate of SARS-CoV-2 infections in vaccinees has become a relevant serious issue. This study aimed to determine the causes of death, histological organ alteration, and viral spread in relation to demographic, clinical-pathological, viral variants, and vaccine types for deceased individuals with proven SARS-CoV-2 infection after vaccination who died between January and November 2021. Twenty-nine consecutively collected cases were analyzed and compared to 141 nonvaccinated control cases. Autopsies were performed on 16 partially and 13 fully vaccinated individuals. Most patients were elderly and suffered from several relevant comorbidities. Real-time RT-PCR (RT-qPCR) identified a significantly increased rate of generalized viral dissemination within organ systems in vaccinated cases versus nonvaccinated cases (45% vs. 16%, respectively; P = 0.008) mainly with Ct-values of higher than 25 in non-respiratory samples. However, vaccinated cases also showed high viral loads, reaching Ct-values below 10, especially in the upper airways and lungs. This was accompanied by high rates of pulmonal bacterial or mycotic superinfections and the occurrence of immunocompromising factors, such as malignancies, immunosuppressive drug intake, or decreased immunoglobulin levels. All these findings were particularly accentuated in partially vaccinated patients compared to fully vaccinated individuals. The virus dissemination observed in our case study may indicate that patients with an impaired immune system have a decreased ability to eliminate the virus. However, the potential role of antibody-dependent enhancement must also be ruled out in future studies. Fatal cases of COVID-19 in vaccinees were rare and often associated with severe comorbidities or other immunosuppressive conditions.
| DOI: | 10.1038/s41379-022-01069-9 |
| Datei: | https://www.nature.com/articles/s41379-022-01069-9 |
Abstract:
The rate of SARS-CoV-2 infections in vaccinees has become a relevant serious issue. This study aimed to determine the causes of death, histological organ alteration, and viral spread in relation to demographic, clinical-pathological, viral variants, and vaccine types for deceased individuals with proven SARS-CoV-2 infection after vaccination who died between January and November 2021. Twenty-nine consecutively collected cases were analyzed and compared to 141 nonvaccinated control cases. Autopsies were performed on 16 partially and 13 fully vaccinated individuals. Most patients were elderly and suffered from several relevant comorbidities. Real-time RT-PCR (RT-qPCR) identified a significantly increased rate of generalized viral dissemination within organ systems in vaccinated cases versus nonvaccinated cases (45% vs. 16%, respectively; P = 0.008) mainly with Ct-values of higher than 25 in non-respiratory samples. However, vaccinated cases also showed high viral loads, reaching Ct-values below 10, especially in the upper airways and lungs. This was accompanied by high rates of pulmonal bacterial or mycotic superinfections and the occurrence of immunocompromising factors, such as malignancies, immunosuppressive drug intake, or decreased immunoglobulin levels. All these findings were particularly accentuated in partially vaccinated patients compared to fully vaccinated individuals. The virus dissemination observed in our case study may indicate that patients with an impaired immune system have a decreased ability to eliminate the virus. However, the potential role of antibody-dependent enhancement must also be ruled out in future studies. Fatal cases of COVID-19 in vaccinees were rare and often associated with severe comorbidities or other immunosuppressive conditions.
P. Fervers,
J. Kottlors,
T. Persigehl,
S. Lennartz,
V. Maus,
S. Fischer,
H. Styczen,
C. Deuschl,
M. Schlamann,
A. Mpotsaris,
S. Zubel,
M. Schroeter,
D. Maintz,
G. R. Fink and
N. Abdullayev,
"Meaningful use of imaging resources to rule out cerebral venous sinus thrombosis after ChAdOx1 COVID-19 vaccination: Evaluation of the AHA diagnostic algorithm with a clinical cohort and a systematic data review.",
Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia,
Aug.
2022.
Abstract:
Vaccin-induzierte immunthrombotische Thrombozytopenie (VITT) mit cerebraler venöser Thrombose (CVST) ist eine unwahrscheinliche (0.0005%), aber möglicherweise tödliche Komplikation nach ChAdOx1 Impfung. Andererseits gehört Kopfschmerzen zu den häufigsten Nebenwirkungen von ChAdOx1 (29,3%). Im September 2021 schlug die American Heart Association (AHA) einen diagnostischen Workflow vor, um die risikoadaptierte Verwendung von bildgebenden Ressourcen für Patienten mit neurologischen Symptomen nach ChAdOx1 zu erleichtern. Wir wollten den AHA-Workflow in einem retrospektiven Patientenkohort bewerten, der nach ChAdOx1 an vier primären Pflegekrankenhäusern in Deutschland präsentiert. Wissenschaftliche Literatur wurde für Fallberichte von VITT mit CVST nach ChAdOx1, veröffentlicht bis 1. September 2021. Einhundertdreizehn aufeinanderfolgende Patienten (77 weiblich, mittleres Alter 38,7 +/- 11,9 Jahre) wurden an unseren Instituten bewertet, darunter ein Fall von VITT mit CVST. Weitere 228 Fallberichte von VITT mit CVST werden in jüngster Literatur veröffentlicht, die Thrombozyten-Thema (225/227 berichtet) und erhöhte d-Dimer-Spiegel (100/101 berichtet) teilen. Der AHA-Workflow hätte alle VITT-Fälle mit CVST (100% Empfindlichkeit) erkannt, die für die Diagnose (NND) benötigte Anzahl betrug 1:113. Die anfängliche Auswertung von Thrombocytopenie oder erhöhten d-Dimer-Spiegeln hätte den NND auf 1:68 reduziert, ohne dass die Empfindlichkeit gekostet wäre. Daher schlagen wir vor, dass bei normalen Thrombozyten- und d-Dimerenspiegeln der Zugang zu weiteren Diagnostiken durch die etablierten klinischen Überlegungen unabhängig von der Impfungsgeschichte begrenzt werden sollte.
| DOI: | 10.1016/j.jocn.2022.05.031 |
Abstract:
Vaccin-induzierte immunthrombotische Thrombozytopenie (VITT) mit cerebraler venöser Thrombose (CVST) ist eine unwahrscheinliche (0.0005%), aber möglicherweise tödliche Komplikation nach ChAdOx1 Impfung. Andererseits gehört Kopfschmerzen zu den häufigsten Nebenwirkungen von ChAdOx1 (29,3%). Im September 2021 schlug die American Heart Association (AHA) einen diagnostischen Workflow vor, um die risikoadaptierte Verwendung von bildgebenden Ressourcen für Patienten mit neurologischen Symptomen nach ChAdOx1 zu erleichtern. Wir wollten den AHA-Workflow in einem retrospektiven Patientenkohort bewerten, der nach ChAdOx1 an vier primären Pflegekrankenhäusern in Deutschland präsentiert. Wissenschaftliche Literatur wurde für Fallberichte von VITT mit CVST nach ChAdOx1, veröffentlicht bis 1. September 2021. Einhundertdreizehn aufeinanderfolgende Patienten (77 weiblich, mittleres Alter 38,7 +/- 11,9 Jahre) wurden an unseren Instituten bewertet, darunter ein Fall von VITT mit CVST. Weitere 228 Fallberichte von VITT mit CVST werden in jüngster Literatur veröffentlicht, die Thrombozyten-Thema (225/227 berichtet) und erhöhte d-Dimer-Spiegel (100/101 berichtet) teilen. Der AHA-Workflow hätte alle VITT-Fälle mit CVST (100% Empfindlichkeit) erkannt, die für die Diagnose (NND) benötigte Anzahl betrug 1:113. Die anfängliche Auswertung von Thrombocytopenie oder erhöhten d-Dimer-Spiegeln hätte den NND auf 1:68 reduziert, ohne dass die Empfindlichkeit gekostet wäre. Daher schlagen wir vor, dass bei normalen Thrombozyten- und d-Dimerenspiegeln der Zugang zu weiteren Diagnostiken durch die etablierten klinischen Überlegungen unabhängig von der Impfungsgeschichte begrenzt werden sollte.
[eng]
D. Jonigk,
C. Werlein,
G. Baretton,
P. Barth,
R. M. Bohle,
A. Büttner,
R. Büttner,
R. Dettmeyer,
P. Eichhorn,
S. Elezkurtaj,
I. Esposito,
K. Evert,
M. Evert,
F. Fend,
N. Gaßler,
S. Gattenlöhner,
M. Glatzel,
H. Göbel,
E. Gradhand,
T. Hansen,
A. Hartmann,
A. Heinemann,
F. L. Heppner,
J. Hilsenbeck,
D. Horst,
J. C. Kamp,
G. Mall,
B. Märkl,
B. Ondruschka,
J. Pablik,
S. Pfefferle,
A. Quaas,
H. Radbruch,
C. Röcken,
A. Rosenwald,
W. Roth,
M. Rudelius,
P. Schirmacher,
J. Slotta-Huspenina,
K. Smith,
L. Sommer,
K. Stock,
P. Ströbel,
S. Strobl,
U. Titze,
G. Weirich,
J. Weis,
M. Werner,
C. Wickenhauser,
T. Wiech,
P. Wild,
T. Welte,
S. Stillfried and
P. Boor,
"Organ manifestations of COVID-19: what have we learned so far (not only) from autopsies?",
Virchows Archiv: An International Journal of Pathology,
vol. 481,
no. 2,
pp. 139—159,
Aug.
2022.
| DOI: | 10.1007/s00428-022-03319-2 |
[en]
M. Schons,
L. Pilgram,
J. Reese,
M. Stecher,
G. Anton,
K. S. Appel,
T. Bahmer,
A. Bartschke,
C. Bellinghausen,
I. Bernemann,
M. Brechtel,
F. Brinkmann,
C. Brünn,
C. Dhillon,
C. Fiessler,
R. Geisler,
E. Hamelmann,
S. Hansch,
F. Hanses,
S. Hanß,
S. Herold,
R. Heyder,
A. Hofmann,
S. M. Hopff,
A. Horn,
C. Jakob,
S. Jiru-Hillmann,
T. Keil,
Y. Khodamoradi,
M. Kohls,
M. Kraus,
D. Krefting,
S. Kunze,
F. Kurth,
W. Lieb,
L. J. Lippert,
R. Lorbeer,
B. Lorenz-Depiereux,
C. Maetzler,
O. Miljukov,
M. Nauck,
D. Pape,
V. Püntmann,
L. Reinke,
C. Römmele,
S. Rudolph,
J. Sass,
C. Schäfer,
J. Schaller,
M. Schattschneider,
C. Scheer,
M. Scherer,
S. Schmidt,
J. Schmidt,
K. Seibel,
D. Stahl,
F. Steinbeis,
S. Störk,
M. Tauchert,
J. J. Tebbe,
C. Thibeault,
N. Toepfner,
K. Ungethüm,
I. Vadasz,
H. Valentin,
S. Wiedmann,
T. Zoller,
E. Nagel,
M. Krawczak,
C. Kalle,
T. Illig,
S. Schreiber,
M. Witzenrath,
P. Heuschmann,
J. J. Vehreschild and
N. R. Group,
"The German National Pandemic Cohort Network (NAPKON):
rationale, study design and baseline characteristics",
Eur. J. Epidemiol.,
vol. 37,
no. 8,
pp. 849—870,
Aug.
2022.
Springer Science and Business Media LLC.
Abstract:
The German government initiated the Network University Medicine (NUM) in early 2020 to improve national research activities on the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) pandemic. To this end, 36 German Academic Medical Centers started to collaborate on 13 projects, with the largest being the National Pandemic Cohort Network (NAPKON). The NAPKON's goal is creating the most comprehensive Coronavirus Disease 2019 (COVID-19) cohort in Germany. Within NAPKON, adult and pediatric patients are observed in three complementary cohort platforms (Cross-Sectoral, High-Resolution and Population-Based) from the initial infection until up to three years of follow-up. Study procedures comprise comprehensive clinical and imaging diagnostics, quality-of-life assessment, patient-reported outcomes and biosampling. The three cohort platforms build on four infrastructure core units (Interaction, Biosampling, Epidemiology, and Integration) and collaborations with NUM projects. Key components of the data capture, regulatory, and data privacy are based on the German Centre for Cardiovascular Research. By April 01, 2022, 34 university and 40 non-university hospitals have enrolled 5298 patients with local data quality reviews performed on 4727 (89%). 47% were female, the median age was 52 (IQR 36-62-) and 50 pediatric cases were included. 44% of patients were hospitalized, 15% admitted to an intensive care unit, and 12% of patients deceased while enrolled. 8845 visits with biosampling in 4349 patients were conducted by April 03, 2022. In this overview article, we summarize NAPKON's design, relevant milestones including first study population characteristics, and outline the potential of NAPKON for German and international research activities.Trial registration https://clinicaltrials.gov/ct2/show/NCT04768998 . https://clinicaltrials.gov/ct2/show/NCT04747366 . https://clinicaltrials.gov/ct2/show/NCT04679584.
| DOI: | 10.1007/s10654-022-00896-z |
| Pubmed: | 35904671 |
Abstract:
The German government initiated the Network University Medicine (NUM) in early 2020 to improve national research activities on the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) pandemic. To this end, 36 German Academic Medical Centers started to collaborate on 13 projects, with the largest being the National Pandemic Cohort Network (NAPKON). The NAPKON's goal is creating the most comprehensive Coronavirus Disease 2019 (COVID-19) cohort in Germany. Within NAPKON, adult and pediatric patients are observed in three complementary cohort platforms (Cross-Sectoral, High-Resolution and Population-Based) from the initial infection until up to three years of follow-up. Study procedures comprise comprehensive clinical and imaging diagnostics, quality-of-life assessment, patient-reported outcomes and biosampling. The three cohort platforms build on four infrastructure core units (Interaction, Biosampling, Epidemiology, and Integration) and collaborations with NUM projects. Key components of the data capture, regulatory, and data privacy are based on the German Centre for Cardiovascular Research. By April 01, 2022, 34 university and 40 non-university hospitals have enrolled 5298 patients with local data quality reviews performed on 4727 (89%). 47% were female, the median age was 52 (IQR 36-62-) and 50 pediatric cases were included. 44% of patients were hospitalized, 15% admitted to an intensive care unit, and 12% of patients deceased while enrolled. 8845 visits with biosampling in 4349 patients were conducted by April 03, 2022. In this overview article, we summarize NAPKON's design, relevant milestones including first study population characteristics, and outline the potential of NAPKON for German and international research activities.Trial registration https://clinicaltrials.gov/ct2/show/NCT04768998 . https://clinicaltrials.gov/ct2/show/NCT04747366 . https://clinicaltrials.gov/ct2/show/NCT04679584.
S. Stillfried,
B. Freeborn,
S. Windeck and
P. Boor,
"Update zur kooperativen autopsiebasierten Forschung in der deutschen Pathologie, Neuropathologie und Gerichtsmedizin",
Die Pathologie,
vol. 43,
no. Suppl 1,
pp. 101—105,
Aug.
2022.
Abstract:
Obduktionen sind ein wichtiges Instrument zum Verständnis von Krankheiten, einschließlich COVID-19. Das im April 2020 eingerichtete und gestartete Deutsche Register für COVID-19-Obduktionen (DeRegCOVID) dient als elektronisches Rückgrat des Nationalen Obduktionsnetzwerks (NATON), das Anfang 2022 im Anschluss an DEFEAT PANDEMIcs gestartet worden ist. Die vernetzte, kollaborative Obduktionsforschung des NATON-Konsortiums wird durch eine beispiellose Zusammenarbeit von 138 Personen an mehr als 35 universitären und nichtuniversitären Obduktionszentren ermöglicht, durch die Daten, einschließlich Daten zu Biomaterialien aus Pathologie, Neuropathologie und Rechtsmedizin, im DeRegCOVID gesammelt sowie gewebebasierte Forschung und Methodenentwicklung betrieben werden. Aus den teilnehmenden Obduktionszentren sind inzwischen mehr als 145 Publikationen hervorgegangen, die verschiedene grundlagenwissenschaftliche und klinische Aspekte von COVID-19 beleuchten, z. B. thromboembolische Ereignisse, Organtropismus, Nachweismethoden von SARS-CoV‑2 oder die Infektiosität von SARS-CoV‑2 bei der Obduktion. Die teilnehmenden Zentren haben den hohen Wert der Autopsie und der aus der Autopsie gewonnenen Daten und Biomaterialien für die moderne Medizin unter Beweis gestellt. Die geplante langfristige Fortführung und Weiterentwicklung des Registers und Netzwerks und die offene und partizipative Gestaltung ermöglichen es, alle interessierten Partner miteinzubeziehen.
| DOI: | 10.1007/s00292-022-01117-w |
| Datei: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9483541/ |
Abstract:
Obduktionen sind ein wichtiges Instrument zum Verständnis von Krankheiten, einschließlich COVID-19. Das im April 2020 eingerichtete und gestartete Deutsche Register für COVID-19-Obduktionen (DeRegCOVID) dient als elektronisches Rückgrat des Nationalen Obduktionsnetzwerks (NATON), das Anfang 2022 im Anschluss an DEFEAT PANDEMIcs gestartet worden ist. Die vernetzte, kollaborative Obduktionsforschung des NATON-Konsortiums wird durch eine beispiellose Zusammenarbeit von 138 Personen an mehr als 35 universitären und nichtuniversitären Obduktionszentren ermöglicht, durch die Daten, einschließlich Daten zu Biomaterialien aus Pathologie, Neuropathologie und Rechtsmedizin, im DeRegCOVID gesammelt sowie gewebebasierte Forschung und Methodenentwicklung betrieben werden. Aus den teilnehmenden Obduktionszentren sind inzwischen mehr als 145 Publikationen hervorgegangen, die verschiedene grundlagenwissenschaftliche und klinische Aspekte von COVID-19 beleuchten, z. B. thromboembolische Ereignisse, Organtropismus, Nachweismethoden von SARS-CoV‑2 oder die Infektiosität von SARS-CoV‑2 bei der Obduktion. Die teilnehmenden Zentren haben den hohen Wert der Autopsie und der aus der Autopsie gewonnenen Daten und Biomaterialien für die moderne Medizin unter Beweis gestellt. Die geplante langfristige Fortführung und Weiterentwicklung des Registers und Netzwerks und die offene und partizipative Gestaltung ermöglichen es, alle interessierten Partner miteinzubeziehen.
G. Scharf,
S. Meiler,
F. Zeman,
J. Schaible,
F. Poschenrieder,
C. Knobloch,
H. Kleine,
S. E. Scharf,
J. Dinkel,
C. Stroszczynski,
N. Zorger and
O. W. Hamer,
"Combined Model of Quantitative Evaluation of Chest Computed Tomography and Laboratory Values for Assessing the Prognosis of Coronavirus Disease 2019",
RoFo : Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin,
vol. 194,
no. 7,
pp. 737-746,
Jul.
2022.
Abstract:
To assess the prognostic power of quantitative analysis of chest CT, laboratory values, and their combination in COVID-19 pneumonia. Retrospective analysis of patients with PCR-confirmed COVID-19 pneumonia and chest CT performed between March 07 and November 13, 2020. Volume and percentage (PO) of lung opacifications and mean HU of the whole lung were quantified using prototype software. 13 laboratory values were collected. Negative outcome was defined as death, ICU admittance, mechanical ventilation, or extracorporeal membrane oxygenation. Positive outcome was defined as care in the regular ward or discharge. Logistic regression was performed to evaluate the prognostic value of CT parameters and laboratory values. Independent predictors were combined to establish a scoring system for prediction of prognosis. This score was validated on a separate validation cohort. 89 patients were included for model development between March 07 and April 27, 2020 (mean age: 60.3 years). 38 patients experienced a negative outcome. In univariate regression analysis, all quantitative CT parameters as well as C-reactive protein (CRP), relative lymphocyte count (RLC), troponin, and LDH were associated with a negative outcome. In a multivariate regression analysis, PO, CRP, and RLC were independent predictors of a negative outcome. Combination of these three values showed a strong predictive value with a C-index of 0.87. A scoring system was established which categorized patients into 4 groups with a risk of 7 %, 30 %, 67 %, or 100 % for a negative outcome. The validation cohort consisted of 28 patients between May 5 and November 13, 2020. A negative outcome occurred in 6 % of patients with a score of 0, 50 % with a score of 1, and 100 % with a score of 2 or 3. The combination of PO, CRP, and RLC showed a high predictive value for a negative outcome. A 4-point scoring system based on these findings allows easy risk stratification in the clinical routine and performed exceptionally in the validation cohort. · A high PO is associated with an unfavorable outcome in COVID-19. · PO, CRP, and RLC are independent predictors of an unfavorable outcome, and their combination has strong predictive power. · A 4-point scoring system based on these values allows quick risk stratification in a clinical setting. · Scharf G, Meiler S, Zeman F et al. Combined Model of Quantitative Evaluation of Chest Computed Tomography and Laboratory Values for Assessing the Prognosis of Coronavirus Disease 2019. Fortschr Röntgenstr 2022; 194: 737 - 746.
| DOI: | 10.1055/a-1731-7905 |
| Datei: | https://pubmed.ncbi.nlm.nih.gov/35272354/ |
Abstract:
To assess the prognostic power of quantitative analysis of chest CT, laboratory values, and their combination in COVID-19 pneumonia. Retrospective analysis of patients with PCR-confirmed COVID-19 pneumonia and chest CT performed between March 07 and November 13, 2020. Volume and percentage (PO) of lung opacifications and mean HU of the whole lung were quantified using prototype software. 13 laboratory values were collected. Negative outcome was defined as death, ICU admittance, mechanical ventilation, or extracorporeal membrane oxygenation. Positive outcome was defined as care in the regular ward or discharge. Logistic regression was performed to evaluate the prognostic value of CT parameters and laboratory values. Independent predictors were combined to establish a scoring system for prediction of prognosis. This score was validated on a separate validation cohort. 89 patients were included for model development between March 07 and April 27, 2020 (mean age: 60.3 years). 38 patients experienced a negative outcome. In univariate regression analysis, all quantitative CT parameters as well as C-reactive protein (CRP), relative lymphocyte count (RLC), troponin, and LDH were associated with a negative outcome. In a multivariate regression analysis, PO, CRP, and RLC were independent predictors of a negative outcome. Combination of these three values showed a strong predictive value with a C-index of 0.87. A scoring system was established which categorized patients into 4 groups with a risk of 7 %, 30 %, 67 %, or 100 % for a negative outcome. The validation cohort consisted of 28 patients between May 5 and November 13, 2020. A negative outcome occurred in 6 % of patients with a score of 0, 50 % with a score of 1, and 100 % with a score of 2 or 3. The combination of PO, CRP, and RLC showed a high predictive value for a negative outcome. A 4-point scoring system based on these findings allows easy risk stratification in the clinical routine and performed exceptionally in the validation cohort. · A high PO is associated with an unfavorable outcome in COVID-19. · PO, CRP, and RLC are independent predictors of an unfavorable outcome, and their combination has strong predictive power. · A 4-point scoring system based on these values allows quick risk stratification in a clinical setting. · Scharf G, Meiler S, Zeman F et al. Combined Model of Quantitative Evaluation of Chest Computed Tomography and Laboratory Values for Assessing the Prognosis of Coronavirus Disease 2019. Fortschr Röntgenstr 2022; 194: 737 - 746.
K. O. Yusuf,
O. Miljukov,
A. Schoneberg and
S. Hanß,
"Consistency as a Data Quality Measure for German Corona Consensus items mapped from National Pandemic Cohort Network data collections.",
Methods Inf Med,
Jul.
2022.
| DOI: | 10.1055/a-2006-1086 |
T. Bahmer,
"Severity Score-Based Study of Predictors and Clinical Correlates of Post-COVID Syndrome (PCS) in the German Population",
Jul.
2022.
| DOI: | 10.1016/j.eclinm.2022.101549 |
M. Schons,
L. Pilgram and
J. Reese,
"The German National Pandemic Cohort Network (NAPKON): rationale, study design and baseline characteristics.",
European Journal of Epidemiology 37(8),
Jul.
2022.
| DOI: | 10.1007/s10654-022-00896-z |
[eng]
T. Aschman,
R. Mothes,
F. L. Heppner and
H. Radbruch,
"What SARS-CoV-2 does to our brains",
Immunity,
vol. 55,
no. 7,
pp. 1159—1172,
Jul.
2022.
| DOI: | 10.1016/j.immuni.2022.06.013 |
[eng]
C. Pomara,
M. Salerno,
A. Miani and
P. Piscitelli,
"Autopsies in COVID-related deaths: The need for following the model of German COVID-19 autopsy registry",
The Lancet Regional Health. Europe,
vol. 17,
pp. 100392,
Jun.
2022.
| DOI: | 10.1016/j.lanepe.2022.100392 |
H. Meyer,
F. Benkert,
N. Bailis,
M. Lerche,
T. Denecke and
A. Surov,
"Low skeletal muscle mass defined by thoracic CT as a prognostic marker in acute pulmonary embolism",
Nutrition (Burbank, Los Angeles County, Calif.),
vol. 98,
pp. 111622,
Jun.
2022.
Abstract:
Sarcopenia defined as low skeletal muscle mass (LSMM) is associated with several clinically relevant factors in people who are critically ill. The aim of the present study was to analyze the role of LSMM derived from thoracic computed tomography (CT) for prediction of mortality and prognosis of acute pulmonary embolism (PE). The clinical database of our department was retrospectively screened for patients with acute PE between 2013 and 2017. Overall, 234 patients were included in the analysis. LSMM was assessed on axial slides at the thoracic vertebra 5 (Th5) level of contrast-enhanced pulmonary angiography thoracic CT. The skeletal muscle index (SMI) was calculated by adjusting the muscle area to height. All-cause 30-d mortality was used as a primary outcome. Overall, 64 participants (27.4% of the sample) died. SMI was slightly higher for survivors than non-survivors (57.7 ± 11.9 versus 55.6 ± 14.3 cm2/m2; P = 0.07). SMI was associated with 30-d mortality in univariate as well as multivariate analysis (respective hazard ratios and 95% CI: 1.06, 1.03-1.09; 1.08, 1.04-1.11). SMI at Th5 derived from thoracic CT has a relevant effect on 30-d mortality in people with acute PE and should be included in the clinical routine.
| DOI: | 10.1016/j.nut.2022.111622 |
| Datei: | https://pubmed.ncbi.nlm.nih.gov/35436690/ |
Abstract:
Sarcopenia defined as low skeletal muscle mass (LSMM) is associated with several clinically relevant factors in people who are critically ill. The aim of the present study was to analyze the role of LSMM derived from thoracic computed tomography (CT) for prediction of mortality and prognosis of acute pulmonary embolism (PE). The clinical database of our department was retrospectively screened for patients with acute PE between 2013 and 2017. Overall, 234 patients were included in the analysis. LSMM was assessed on axial slides at the thoracic vertebra 5 (Th5) level of contrast-enhanced pulmonary angiography thoracic CT. The skeletal muscle index (SMI) was calculated by adjusting the muscle area to height. All-cause 30-d mortality was used as a primary outcome. Overall, 64 participants (27.4% of the sample) died. SMI was slightly higher for survivors than non-survivors (57.7 ± 11.9 versus 55.6 ± 14.3 cm2/m2; P = 0.07). SMI was associated with 30-d mortality in univariate as well as multivariate analysis (respective hazard ratios and 95% CI: 1.06, 1.03-1.09; 1.08, 1.04-1.11). SMI at Th5 derived from thoracic CT has a relevant effect on 30-d mortality in people with acute PE and should be included in the clinical routine.
H. Meyer,
F. Benkert,
N. Bailis,
M. Lerche and
A. Surov,
"Role of visceral fat areas defined by thoracic CT in acute pulmonary embolism",
The British journal of radiology,
vol. 95,
no. 1134,
pp. 20211267,
Jun.
2022.
Abstract:
Visceral adipose tissue (VAT) has been established as an important parameter of body composition. It can be assessed by imaging modalities like computed tomography (CT). The purpose of the present study was to analyse the prognostic role of VAT derived from thoracic CT in patients with acute pulmonary embolism (PE). The clinical database of our center was retrospectively screened for patients with acute PE between 2014 and 2017. Overall, 184 patients were included into the analysis. VAT was assessed on axial slices of the thoracic CT at the level of the first lumbar vertebra. Clinical scores, serological parameters, need for intubation, ICU admission and 30 days mortality were assessed. Using the previously reported threshold of 100 cm² for visceral obesity definition 136 (73.9%), patients were considered as visceral obese. There was a moderate correlation between VAT and BMI (r = 0.56, p < 0.0001). There was also a moderate correlation between VAT and body height (r = 0.41, p =< 0.0001). Of all investigated clinical scores relating to acute PE, only the GENEVA score correlated weakly with VAT (r = 0.15, p = 0.04). There were significant correlations between VAT and creatinine (r = 0.38, p < 0.0001) and Glomerular filtration rate (r = -0.21, p = 0.005). No associations were identified for VAT and mortality or visceral obesity and mortality. VAT was not associated with mortality in patients with acute pulmonary embolism. Visceral obesity is frequent in patients with acute pulmonary embolism but it is not associated with mortality.
| DOI: | 10.1259/bjr.20211267 |
| Datei: | https://pubmed.ncbi.nlm.nih.gov/35286158/ |
Abstract:
Visceral adipose tissue (VAT) has been established as an important parameter of body composition. It can be assessed by imaging modalities like computed tomography (CT). The purpose of the present study was to analyse the prognostic role of VAT derived from thoracic CT in patients with acute pulmonary embolism (PE). The clinical database of our center was retrospectively screened for patients with acute PE between 2014 and 2017. Overall, 184 patients were included into the analysis. VAT was assessed on axial slices of the thoracic CT at the level of the first lumbar vertebra. Clinical scores, serological parameters, need for intubation, ICU admission and 30 days mortality were assessed. Using the previously reported threshold of 100 cm² for visceral obesity definition 136 (73.9%), patients were considered as visceral obese. There was a moderate correlation between VAT and BMI (r = 0.56, p < 0.0001). There was also a moderate correlation between VAT and body height (r = 0.41, p =< 0.0001). Of all investigated clinical scores relating to acute PE, only the GENEVA score correlated weakly with VAT (r = 0.15, p = 0.04). There were significant correlations between VAT and creatinine (r = 0.38, p < 0.0001) and Glomerular filtration rate (r = -0.21, p = 0.005). No associations were identified for VAT and mortality or visceral obesity and mortality. VAT was not associated with mortality in patients with acute pulmonary embolism. Visceral obesity is frequent in patients with acute pulmonary embolism but it is not associated with mortality.
L. Triefenbach,
R. Otto,
J. Bienzeisler,
A. Kombeiz,
S. Ehrentreich,
R. Röhrig and
R. W. Majeed,
"Establishing a data quality baseline in the AKTIN Emergency Department Data Registry – A secondary use perspective",
Stud Health Technol Inform.,
vol. 294,
no. 25,
pp. 209-213,
Mai
2022.
| DOI: | https://doi.org/10.3233/shti220439 |
| Pubmed: | 35612058 |
L. Fiedler-Lacombe,
E. Heim,
H. Valentin,
H. Rau,
A. Blumentritt,
D. Stahl,
M. Kraus and
B. Lorenz-Depiereux,
"Herausforderungen des Einwilligungsmanagements von Minderjährigen bei Kohortenstudien",
16. DVMD-Fachtagung,
Mai
2022.
H. Rau,
A. Blumentritt and
D. Stahl,
"Qualitätsgesichertes Management von Einwilligungserklärungen – Ein Appell zur Nutzung elektronischer Einwilligungserhebungen für zeitkritische klinische Forschung. 16. DVMD-Fachtagung, 12.05.2022",
Mai
2022.
H. Rau,
A. Blumentritt and
D. Stahl,
"Unabhängige Treuhandstelle der Universitätsmedizin Greifswald K.d.ö.R. Qualitätsgesichertes Management von Einwilligungserklärungen – Ein Appell zur Nutzung elektronischer Einwilligungserhebungen für zeitkritische klinische Forschung",
16. DVMD-Fachtagung,
Mai
2022.
E. Heim,
H. Valentin,
H. Rau,
A. Blumentritt,
D. Stahl,
M. Stecher,
M. Kraus and
B. Lorenz-Depiereux,
"Widerrufs- und Ausschlussmanagement unter Berücksichtigung komplexer Konstellationen in der COVID-19-Forschung am Beispiel NUM",
16. DVMD-Fachtagung,
Mai
2022.
[en]
E. Wyler,
K. Eschke,
G. Teixeira Alves,
S. Peidli,
F. Pott,
J. Kazmierski,
L. Michalick,
O. Kershaw,
J. Bushe,
P. Pennitz,
D. Postmus,
C. Goffinet,
J. Kreye,
S. M. Reincke,
H. Prüss,
N. Blüthgen,
A. D. Gruber,
W. M. Kuebler,
M. Witzenrath,
M. Landthaler,
G. Nouailles and
J. Trimpert,
"Key benefits of dexamethasone and antibody treatment in COVID-19 hamster models revealed by single-cell transcriptomics",
Mol. Ther.,
vol. 30,
no. 5,
pp. 1952—1965,
Mai
2022.
Elsevier BV.
Abstract:
For coronavirus disease 2019 (COVID-19), effective and well-understood treatment options are still scarce. Since vaccine efficacy is challenged by novel variants, short-lasting immunity, and vaccine hesitancy, understanding and optimizing therapeutic options remains essential. We aimed at better understanding the effects of two standard-of-care drugs, dexamethasone and anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies, on infection and host responses. By using two COVID-19 hamster models, pulmonary immune responses were analyzed to characterize effects of single or combinatorial treatments. Pulmonary viral burden was reduced by anti-SARS-CoV-2 antibody treatment and unaltered or increased by dexamethasone alone. Dexamethasone exhibited strong anti-inflammatory effects and prevented fulminant disease in a severe disease model. Combination therapy showed additive benefits with both anti-viral and anti-inflammatory potency. Bulk and single-cell transcriptomic analyses confirmed dampened inflammatory cell recruitment into lungs upon dexamethasone treatment and identified a specifically responsive subpopulation of neutrophils, thereby indicating a potential mechanism of action. Our analyses confirm the anti-inflammatory properties of dexamethasone and suggest possible mechanisms, validate anti-viral effects of anti-SARS-CoV-2 antibody treatment, and reveal synergistic effects of a combination therapy, thus informing more effective COVID-19 therapies.
| DOI: | 10.1016/j.ymthe.2022.03.014 |
| Pubmed: | 35339689 |
Abstract:
For coronavirus disease 2019 (COVID-19), effective and well-understood treatment options are still scarce. Since vaccine efficacy is challenged by novel variants, short-lasting immunity, and vaccine hesitancy, understanding and optimizing therapeutic options remains essential. We aimed at better understanding the effects of two standard-of-care drugs, dexamethasone and anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies, on infection and host responses. By using two COVID-19 hamster models, pulmonary immune responses were analyzed to characterize effects of single or combinatorial treatments. Pulmonary viral burden was reduced by anti-SARS-CoV-2 antibody treatment and unaltered or increased by dexamethasone alone. Dexamethasone exhibited strong anti-inflammatory effects and prevented fulminant disease in a severe disease model. Combination therapy showed additive benefits with both anti-viral and anti-inflammatory potency. Bulk and single-cell transcriptomic analyses confirmed dampened inflammatory cell recruitment into lungs upon dexamethasone treatment and identified a specifically responsive subpopulation of neutrophils, thereby indicating a potential mechanism of action. Our analyses confirm the anti-inflammatory properties of dexamethasone and suggest possible mechanisms, validate anti-viral effects of anti-SARS-CoV-2 antibody treatment, and reveal synergistic effects of a combination therapy, thus informing more effective COVID-19 therapies.
J. Gruendner,
N. Deppenwiese,
M. Folz,
T. Köhler,
B. Kroll,
H. Prokosch,
L. Rosenau,
M. Rühle,
M. Scheidl,
C. Schüttler,
B. Sedlmayr,
A. Twrdik,
A. Kiel and
R. W. Majeed,
"The Architecture for a feasibility query portal for distributed COVID-19 Fast Healthcare Interoperability Resources (FHIR) patient data repositories: Design and Implementation Study",
JMIR Medical Informatics,
vol. 10,
no. 5,
pp. e36709,
Mai
2022.
| DOI: | https://doi.org/10.2196/36709 |
| Pubmed: | 35486893 |
[en]
H. Prokosch,
T. Bahls,
M. Bialke,
J. Eils,
C. Fegeler,
J. Gruendner,
B. Haarbrandt,
C. Hampf,
W. Hoffmann,
H. Hund,
M. Kampf,
L. A. Kapsner,
P. Kasprzak,
O. Kohlbacher,
D. Krefting,
J. M. Mang,
M. Marschollek,
S. Mate,
A. Müller,
F. Prasser,
J. Sass,
S. Semler,
H. Stenzhorn,
S. Thun,
S. Zenker and
R. Eils,
"The COVID-19 Data Exchange Platform of the German university
medicine",
Stud. Health Technol. Inform.,
vol. 294,
pp. 674—678,
Mai
2022.
Abstract:
COVID-19 has challenged the healthcare systems worldwide. To quickly identify successful diagnostic and therapeutic approaches large data sharing approaches are inevitable. Though organizational clinical data are abundant, many of them are available only in isolated silos and largely inaccessible to external researchers. To overcome and tackle this challenge the university medicine network (comprising all 36 German university hospitals) has been founded in April 2020 to coordinate COVID-19 action plans, diagnostic and therapeutic strategies and collaborative research activities. 13 projects were initiated from which the CODEX project, aiming at the development of a Germany-wide Covid-19 Data Exchange Platform, is presented in this publication. We illustrate the conceptual design, the stepwise development and deployment, first results and the current status.
Abstract:
COVID-19 has challenged the healthcare systems worldwide. To quickly identify successful diagnostic and therapeutic approaches large data sharing approaches are inevitable. Though organizational clinical data are abundant, many of them are available only in isolated silos and largely inaccessible to external researchers. To overcome and tackle this challenge the university medicine network (comprising all 36 German university hospitals) has been founded in April 2020 to coordinate COVID-19 action plans, diagnostic and therapeutic strategies and collaborative research activities. 13 projects were initiated from which the CODEX project, aiming at the development of a Germany-wide Covid-19 Data Exchange Platform, is presented in this publication. We illustrate the conceptual design, the stepwise development and deployment, first results and the current status.
S. Hopff,
K. Tilch,
M. Kraus,
B. Lorenz-Depiereux,
G. Anton,
K. Appel,
T. Bahmer,
A. Bartschke,
C. Bellinghausen,
I. Bernemann,
M. Brechtel,
C. Brünn,
C. Fiessler,
R. Geisler,
S. Hansch,
F. Hanses,
S. Hanß,
R. Heyder,
A. Hoffmann,
A. Horn,
C. Jakob,
S. Jiru-Hillmann,
T. Keil,
Y. Khodamoradi,
M. Kohls,
D. Krefting,
S. Kunze,
F. Kurth,
W. Lieb,
L. J. Lippert,
R. Lorbeer,
L. Lysyakova,
C. Maetzler,
O. Miljukov,
M. Nauck,
L. Pilgram,
V. Püntmann,
J. Reese,
L. Reinke,
S. Rudolph,
J. Sass,
C. Schäfer,
J. Schaller,
M. Schattschneider,
C. Scheer,
M. Scherer,
J. Schmidt,
S. Schmidt,
M. Schons,
K. Seibel,
D. Stahl,
M. Stecher,
F. Steinbeis,
S. Störk,
M. Tauchert,
C. Thibeault,
N. Töpfner,
K. Ungethüm,
H. Valentin,
S. Wiedmann,
T. Zoller,
R. Berner,
M. Krawczak,
E. Nagel,
T. Illig,
S. Schreiber,
M. Witzenrath,
P. Heuschmann and
J. J. Vehreschild,
"Ethical and coordinative challenges in setting up a national cohort study exemplified by the German National Pandemic Cohort Network (NAPKON)",
Oral presentation Kongress ECCMID 04/2022,
Apr.
2022.
[en]
R. Ameratunga,
S. Woon,
M. N. Sheppard,
J. Garland,
B. Ondruschka,
C. X. Wong,
R. A. H. Stewart,
M. Tatley,
S. R. Stables and
R. D. Tse,
"First Identified Case of Fatal Fulminant Necrotizing Eosinophilic Myocarditis Following the Initial Dose of the Pfizer-BioNTech mRNA COVID-19 Vaccine (BNT162b2, Comirnaty): an Extremely Rare Idiosyncratic Hypersensitivity Reaction",
Journal of Clinical Immunology,
vol. 42,
no. 3,
pp. 441-447,
Apr.
2022.
Abstract:
Transient myopericarditis has been recognised as an uncommon and usually mild adverse event predominantly linked to mRNA-based COVID-19 vaccines. These have mostly occurred in young males after the second dose of mRNA COVID-19 vaccines.
| DOI: | 10.1007/s10875-021-01187-0 |
| Datei: | https://doi.org/10.1007/s10875-021-01187-0 |
Abstract:
Transient myopericarditis has been recognised as an uncommon and usually mild adverse event predominantly linked to mRNA-based COVID-19 vaccines. These have mostly occurred in young males after the second dose of mRNA COVID-19 vaccines.
[eng]
S. Stillfried,
R. D. Bülow,
R. Röhrig,
P. Boor and
D. C. COVID-19 Autopsies (DeRegCOVID),
"First report from the German COVID-19 autopsy registry",
The Lancet Regional Health. Europe,
vol. 15,
pp. 100330,
Apr.
2022.
| DOI: | 10.1016/j.lanepe.2022.100330 |
L. Rosenau,
R. W. Majeed,
J. Ingenerf,
A. Kiel,
B. Kroll,
T. Köhler,
H. Prokosch and
J. Gruendner,
"Generation of a Fast Healthcare Interoperability Resources (FHIR)-based Ontology for federated Feasibility Queries in the context of COVID-19: An automated approach",
JMIR Med Inform,
vol. 10,
no. 4,
pp. e35789,
Apr.
2022.
| DOI: | https://doi.org/10.2196/35789 |
[eng]
F. Heinrich,
K. Roedl,
D. Jarczak,
H. Goebels,
A. Heinemann,
U. Schäfer,
F. Ludwig,
M. Bachmann,
B. Bein,
C. F. Weber,
K. Sydow,
M. Bota,
H. Paschen,
A. Weerth,
C. Veit,
O. Detsch,
P. Brand,
S. Kluge,
B. Ondruschka and
D. Wichmann,
"New Insights in the Occurrence of Venous Thromboembolism in Critically Ill Patients with COVID-19-A Large Postmortem and Clinical Analysis",
Viruses,
vol. 14,
no. 4,
pp. 811,
Apr.
2022.
Abstract:
Critically ill COVID-19 patients are at high risk for venous thromboembolism (VTE), namely deep vein thrombosis (DVT) and/or pulmonary embolism (PE), and death. The optimal anticoagulation strategy in critically ill patients with COVID-19 remains unknown. This study investigated the ante mortem incidence as well as postmortem prevalence of VTE, the factors predictive of VTE, and the impact of changed anticoagulation practice on patient survival. We conducted a consecutive retrospective analysis of postmortem COVID-19 (n = 64) and non-COVID-19 (n = 67) patients, as well as ante mortem COVID-19 (n = 170) patients admitted to the University Medical Center Hamburg-Eppendorf (Hamburg, Germany). Baseline patient characteristics, parameters related to the intensive care unit (ICU) stay, and the clinical and autoptic presence of VTE were evaluated and statistically compared between groups. The occurrence of VTE in critically ill COVID-19 patients is confirmed in both ante mortem (17%) and postmortem (38%) cohorts. Accordingly, comparing the postmortem prevalence of VTE between age- and sex-matched COVID-19 (43%) and non-COVID-19 (0%) cohorts, we found the statistically significant increased prevalence of VTE in critically ill COVID-19 cohorts (p = 0.001). A change in anticoagulation practice was associated with the statistically significant prolongation of survival time (HR: 2.55, [95% CI 1.41-4.61], p = 0.01) and a reduction in VTE occurrence (54% vs. 25%; p = 0.02). In summary, in the autopsy as well as clinical cohort of critically ill patients with COVID-19, we found that VTE was a frequent finding. A change in anticoagulation practice was associated with a statistically significantly prolonged survival time.
| DOI: | 10.3390/v14040811 |
Abstract:
Critically ill COVID-19 patients are at high risk for venous thromboembolism (VTE), namely deep vein thrombosis (DVT) and/or pulmonary embolism (PE), and death. The optimal anticoagulation strategy in critically ill patients with COVID-19 remains unknown. This study investigated the ante mortem incidence as well as postmortem prevalence of VTE, the factors predictive of VTE, and the impact of changed anticoagulation practice on patient survival. We conducted a consecutive retrospective analysis of postmortem COVID-19 (n = 64) and non-COVID-19 (n = 67) patients, as well as ante mortem COVID-19 (n = 170) patients admitted to the University Medical Center Hamburg-Eppendorf (Hamburg, Germany). Baseline patient characteristics, parameters related to the intensive care unit (ICU) stay, and the clinical and autoptic presence of VTE were evaluated and statistically compared between groups. The occurrence of VTE in critically ill COVID-19 patients is confirmed in both ante mortem (17%) and postmortem (38%) cohorts. Accordingly, comparing the postmortem prevalence of VTE between age- and sex-matched COVID-19 (43%) and non-COVID-19 (0%) cohorts, we found the statistically significant increased prevalence of VTE in critically ill COVID-19 cohorts (p = 0.001). A change in anticoagulation practice was associated with the statistically significant prolongation of survival time (HR: 2.55, [95% CI 1.41-4.61], p = 0.01) and a reduction in VTE occurrence (54% vs. 25%; p = 0.02). In summary, in the autopsy as well as clinical cohort of critically ill patients with COVID-19, we found that VTE was a frequent finding. A change in anticoagulation practice was associated with a statistically significantly prolonged survival time.
[en]
J. M. Brandner,
P. Boor,
L. Borcherding,
C. Edler,
S. Gerber,
A. Heinemann,
J. Hilsenbeck,
A. Kasajima,
L. Lohner,
B. Märkl,
J. Pablik,
A. S. Schröder,
J. Slotta-Huspenina,
L. Sommer,
J. Sperhake,
S. Stillfried and
S. Dintner,
"Contamination of personal protective equipment during COVID-19 autopsies",
Virchows Archiv,
vol. 480,
no. 3,
pp. 519—528,
Mä.
2022.
| DOI: | 10.1007/s00428-021-03263-7 |
| Datei: | https://doi.org/10.1007/s00428-021-03263-7 |
[en]
A. W. Wolff,
B. Haller,
A. F. Demleitner,
E. Westenberg and
P. Lingor,
"Impact of the COVID-19 pandemic on patients with Parkinson's
Disease from the perspective of treating physicians-A nationwide
cross-sectional study",
Brain Sci.,
vol. 12,
no. 3,
pp. 353,
Mä.
2022.
MDPI AG.
Abstract:
The COVID-19 pandemic has posed challenges to maintaining medical care for patients with Parkinson's disease (PD). The Parkinson's Disease during the COVID-19 Pandemic (ParCoPa) survey was conducted as an online, nationwide, cross-sectional survey from December 2020 to March 2021 and aimed to assess the impact of the pandemic on the medical care of PD patients from the physicians' perspective. Invitations containing a randomly generated registration code were mailed to healthcare professionals from sixty-seven specialty centers in Germany. Confounders for the worsening of subjective treatment quality, perceived health risk due to the profession, and adequate protective measures against SARS-CoV-2 were assessed using logistic regression analysis. Of all forty physicians who responded, 87.5% reported a worsening of motor and nonmotor symptoms in their patients, 97.5% experienced cancellation of appointments, and difficulties in organizing advanced and supplementary therapies were reported by over 95%. Participants offered alternative consultation options, mostly in the form of telephone (77.5%) or online (64.1%) consultations, but telephone consultations were the most accepted by patients ("broadly accepted", 40.0%). We identified pandemic-related deficits in providing care for patients with PD and areas of improvement to ensure continued care for this vulnerable patient population.
Abstract:
The COVID-19 pandemic has posed challenges to maintaining medical care for patients with Parkinson's disease (PD). The Parkinson's Disease during the COVID-19 Pandemic (ParCoPa) survey was conducted as an online, nationwide, cross-sectional survey from December 2020 to March 2021 and aimed to assess the impact of the pandemic on the medical care of PD patients from the physicians' perspective. Invitations containing a randomly generated registration code were mailed to healthcare professionals from sixty-seven specialty centers in Germany. Confounders for the worsening of subjective treatment quality, perceived health risk due to the profession, and adequate protective measures against SARS-CoV-2 were assessed using logistic regression analysis. Of all forty physicians who responded, 87.5% reported a worsening of motor and nonmotor symptoms in their patients, 97.5% experienced cancellation of appointments, and difficulties in organizing advanced and supplementary therapies were reported by over 95%. Participants offered alternative consultation options, mostly in the form of telephone (77.5%) or online (64.1%) consultations, but telephone consultations were the most accepted by patients ("broadly accepted", 40.0%). We identified pandemic-related deficits in providing care for patients with PD and areas of improvement to ensure continued care for this vulnerable patient population.
[eng]
S. Stillfried,
R. D. Bülow,
R. Röhrig,
P. Meybohm,
P. Boor and
D. C. COVID-19 Autopsies (DeRegCOVID),
"Intracranial hemorrhage in COVID-19 patients during extracorporeal membrane oxygenation for acute respiratory failure: a nationwide register study report",
Critical Care (London, England),
vol. 26,
no. 1,
pp. 83,
Mä.
2022.
Abstract:
BACKGROUND: In severe cases, SARS-CoV-2 infection leads to acute respiratory distress syndrome (ARDS), often treated by extracorporeal membrane oxygenation (ECMO). During ECMO therapy, anticoagulation is crucial to prevent device-associated thrombosis and device failure, however, it is associated with bleeding complications. In COVID-19, additional pathologies, such as endotheliitis, may further increase the risk of bleeding complications. To assess the frequency of bleeding events, we analyzed data from the German COVID-19 autopsy registry (DeRegCOVID). METHODS: The electronic registry uses a web-based electronic case report form. In November 2021, the registry included N = 1129 confirmed COVID-19 autopsy cases, with data on 63 ECMO autopsy cases and 1066 non-ECMO autopsy cases, contributed from 29 German sites. FINDINGS: The registry data showed that ECMO was used in younger male patients and bleeding events occurred much more frequently in ECMO cases compared to non-ECMO cases (56% and 9%, respectively). Similarly, intracranial bleeding (ICB) was documented in 21% of ECMO cases and 3% of non-ECMO cases and was classified as the immediate or underlying cause of death in 78% of ECMO cases and 37% of non-ECMO cases. In ECMO cases, the three most common immediate causes of death were multi-organ failure, ARDS and ICB, and in non-ECMO cases ARDS, multi-organ failure and pulmonary bacterial ± fungal superinfection, ordered by descending frequency. INTERPRETATION: Our study suggests the potential value of autopsies and a joint interdisciplinary multicenter (national) approach in addressing fatal complications in COVID-19.
| DOI: | 10.1186/s13054-022-03945-x |
Abstract:
BACKGROUND: In severe cases, SARS-CoV-2 infection leads to acute respiratory distress syndrome (ARDS), often treated by extracorporeal membrane oxygenation (ECMO). During ECMO therapy, anticoagulation is crucial to prevent device-associated thrombosis and device failure, however, it is associated with bleeding complications. In COVID-19, additional pathologies, such as endotheliitis, may further increase the risk of bleeding complications. To assess the frequency of bleeding events, we analyzed data from the German COVID-19 autopsy registry (DeRegCOVID). METHODS: The electronic registry uses a web-based electronic case report form. In November 2021, the registry included N = 1129 confirmed COVID-19 autopsy cases, with data on 63 ECMO autopsy cases and 1066 non-ECMO autopsy cases, contributed from 29 German sites. FINDINGS: The registry data showed that ECMO was used in younger male patients and bleeding events occurred much more frequently in ECMO cases compared to non-ECMO cases (56% and 9%, respectively). Similarly, intracranial bleeding (ICB) was documented in 21% of ECMO cases and 3% of non-ECMO cases and was classified as the immediate or underlying cause of death in 78% of ECMO cases and 37% of non-ECMO cases. In ECMO cases, the three most common immediate causes of death were multi-organ failure, ARDS and ICB, and in non-ECMO cases ARDS, multi-organ failure and pulmonary bacterial ± fungal superinfection, ordered by descending frequency. INTERPRETATION: Our study suggests the potential value of autopsies and a joint interdisciplinary multicenter (national) approach in addressing fatal complications in COVID-19.
[eng]
N. Wanner,
G. Andrieux,
P. Badia-I-Mompel,
C. Edler,
S. Pfefferle,
M. T. Lindenmeyer,
C. Schmidt-Lauber,
J. Czogalla,
M. N. Wong,
Y. Okabayashi,
F. Braun,
M. Lütgehetmann,
E. Meister,
S. Lu,
M. L. M. Noriega,
T. Günther,
A. Grundhoff,
N. Fischer,
H. Bräuninger,
D. Lindner,
D. Westermann,
F. Haas,
K. Roedl,
S. Kluge,
M. M. Addo,
S. Huber,
A. W. Lohse,
J. Reiser,
B. Ondruschka,
J. P. Sperhake,
J. Saez-Rodriguez,
M. Boerries,
S. S. Hayek,
M. Aepfelbacher,
P. Scaturro,
V. G. Puelles and
T. B. Huber,
"Molecular consequences of SARS-CoV-2 liver tropism",
Nature Metabolism,
vol. 4,
no. 3,
pp. 310—319,
Mä.
2022.
| DOI: | 10.1038/s42255-022-00552-6 |
D. Stahl,
"Vollelektronische Erfassung von Einwilligungen (Informed Consents) mittels Tablets. Lohfert – Preis.",
no. https://www.christophlohfert-stiftung.de/panorama/ausschreibung-fuer-den-lohfert-preis-2022-beendet/,
Feb.
2022.
[eng]
P. Georg,
R. Astaburuaga-García,
L. Bonaguro,
S. Brumhard,
L. Michalick,
L. J. Lippert,
T. Kostevc,
C. Gäbel,
M. Schneider,
M. Streitz,
V. Demichev,
I. Gemünd,
M. Barone,
P. Tober-Lau,
E. T. Helbig,
D. Hillus,
L. Petrov,
J. Stein,
H. Dey,
D. Paclik,
C. Iwert,
M. Mülleder,
S. K. Aulakh,
S. Djudjaj,
R. D. Bülow,
H. E. Mei,
A. R. Schulz,
A. Thiel,
S. Hippenstiel,
A. Saliba,
R. Eils,
I. Lehmann,
M. A. Mall,
S. Stricker,
J. Röhmel,
V. M. Corman,
D. Beule,
E. Wyler,
M. Landthaler,
B. Obermayer,
S. Stillfried,
P. Boor,
M. Demir,
H. Wesselmann,
N. Suttorp,
A. Uhrig,
H. Müller-Redetzky,
J. Nattermann,
W. M. Kuebler,
C. Meisel,
M. Ralser,
J. L. Schultze,
A. C. Aschenbrenner,
C. Thibeault,
F. Kurth,
L. E. Sander,
N. Blüthgen,
B. Sawitzki and
P. S. Group,
"Complement activation induces excessive T cell cytotoxicity in severe COVID-19",
Cell,
vol. 185,
no. 3,
pp. 493-512,
Feb.
2022.
| DOI: | 10.1016/j.cell.2021.12.040 |
H. Meyer,
A. Wienke and
A. Surov,
"Computed tomography-defined body composition as prognostic markers for unfavourable outcomes and in-hospital mortality in coronavirus disease 2019",
Journal of cachexia, sarcopenia and muscle,
vol. 13,
no. 1,
pp. 159-168,
Feb.
2022.
Abstract:
Low skeletal muscle mass (LSMM) and visceral fat areas can be assessed by cross-sectional images. These parameters are associated with several clinically relevant factors in various disorders with predictive and prognostic implications. Our aim was to establish the effect of computed tomography (CT)-defined LSMM and fat areas on unfavourable outcomes and in-hospital mortality in coronavirus disease 2019 (COVID-19) patients based on a large patient sample. MEDLINE library, Cochrane, and Scopus databases were screened for the associations between CT-defined LSMM as well as fat areas and in-hospital mortality in COVID-19 patients up to September 2021. In total, six studies were suitable for the analysis and included into the present analysis. The included studies comprised 1059 patients, 591 men (55.8%) and 468 women (44.2%), with a mean age of 60.1 years ranging from 48 to 66 years. The pooled prevalence of LSMM was 33.6%. The pooled odds ratio for the effect of LSMM on in-hospital mortality in univariate analysis was 5.84 [95% confidence interval (CI) 1.07-31.83]. It was 2.73 (95% CI 0.54-13.70) in multivariate analysis. The pooled odds ratio of high visceral fat area on unfavourable outcome in univariate analysis was 2.65 (95% CI 1.57-4.47). Computed tomography-defined LSMM and high visceral fat area have a relevant association with in-hospital mortality in COVID-19 patients and should be included as relevant prognostic biomarkers into clinical routine.
| DOI: | 10.1002/jcsm.12868 |
| Datei: | https://pubmed.ncbi.nlm.nih.gov/35018725/ |
Abstract:
Low skeletal muscle mass (LSMM) and visceral fat areas can be assessed by cross-sectional images. These parameters are associated with several clinically relevant factors in various disorders with predictive and prognostic implications. Our aim was to establish the effect of computed tomography (CT)-defined LSMM and fat areas on unfavourable outcomes and in-hospital mortality in coronavirus disease 2019 (COVID-19) patients based on a large patient sample. MEDLINE library, Cochrane, and Scopus databases were screened for the associations between CT-defined LSMM as well as fat areas and in-hospital mortality in COVID-19 patients up to September 2021. In total, six studies were suitable for the analysis and included into the present analysis. The included studies comprised 1059 patients, 591 men (55.8%) and 468 women (44.2%), with a mean age of 60.1 years ranging from 48 to 66 years. The pooled prevalence of LSMM was 33.6%. The pooled odds ratio for the effect of LSMM on in-hospital mortality in univariate analysis was 5.84 [95% confidence interval (CI) 1.07-31.83]. It was 2.73 (95% CI 0.54-13.70) in multivariate analysis. The pooled odds ratio of high visceral fat area on unfavourable outcome in univariate analysis was 2.65 (95% CI 1.57-4.47). Computed tomography-defined LSMM and high visceral fat area have a relevant association with in-hospital mortality in COVID-19 patients and should be included as relevant prognostic biomarkers into clinical routine.
M. Neidhardt,
S. Gerlach,
R. Mieling,
M. Laves,
T. Weiß,
M. Gromniak,
A. Fitzek,
D. Möbius,
I. Kniep,
A. Ron,
J. Schädler,
A. Heinemann,
K. Püschel,
B. Ondruschka and
A. Schlaefer,
"Robotic Tissue Sampling for Safe Post-Mortem Biopsy in Infectious Corpses",
IEEE Transactions on Medical Robotics and Bionics,
vol. 4,
no. 1,
pp. 94—105,
Feb.
2022.
| DOI: | 10.1109/TMRB.2022.3146440 |
[eng]
J. Jansen,
K. C. Reimer,
J. S. Nagai,
F. S. Varghese,
G. J. Overheul,
M. Beer,
R. Roverts,
D. Daviran,
L. A. S. Fermin,
B. Willemsen,
M. Beukenboom,
S. Djudjaj,
S. Stillfried,
L. E. Eijk,
M. Mastik,
M. Bulthuis,
W. d. Dunnen,
H. Goor,
J. Hillebrands,
S. H. Triana,
M. Timm,
B. T. Berge,
M. Broek,
Q. Nlandu,
J. Heijnert,
E. M. J. Bindels,
R. M. Hoogenboezem,
F. Mooren,
C. Kuppe,
P. Miesen,
K. Grünberg,
T. Ijzermans,
E. J. Steenbergen,
J. Czogalla,
M. F. Schreuder,
N. Sommerdijk,
P. Boor,
V. G. Puelles,
J. Floege,
T. B. Huber,
C. M. consortium,
R. P. Rij,
I. G. Costa,
R. K. Schneider,
B. Smeets and
R. Kramann,
"SARS-CoV-2 infects the human kidney and drives fibrosis in kidney organoids",
Cell Stem Cell,
vol. 29,
no. 2,
pp. 217—231.e8,
Feb.
2022.
Abstract:
Kidney failure is frequently observed during and after COVID-19, but it remains elusive whether this is a direct effect of the virus. Here, we report that SARS-CoV-2 directly infects kidney cells and is associated with increased tubule-interstitial kidney fibrosis in patient autopsy samples. To study direct effects of the virus on the kidney independent of systemic effects of COVID-19, we infected human-induced pluripotent stem-cell-derived kidney organoids with SARS-CoV-2. Single-cell RNA sequencing indicated injury and dedifferentiation of infected cells with activation of profibrotic signaling pathways. Importantly, SARS-CoV-2 infection also led to increased collagen 1 protein expression in organoids. A SARS-CoV-2 protease inhibitor was able to ameliorate the infection of kidney cells by SARS-CoV-2. Our results suggest that SARS-CoV-2 can directly infect kidney cells and induce cell injury with subsequent fibrosis. These data could explain both acute kidney injury in COVID-19 patients and the development of chronic kidney disease in long COVID.
| DOI: | 10.1016/j.stem.2021.12.010 |
Abstract:
Kidney failure is frequently observed during and after COVID-19, but it remains elusive whether this is a direct effect of the virus. Here, we report that SARS-CoV-2 directly infects kidney cells and is associated with increased tubule-interstitial kidney fibrosis in patient autopsy samples. To study direct effects of the virus on the kidney independent of systemic effects of COVID-19, we infected human-induced pluripotent stem-cell-derived kidney organoids with SARS-CoV-2. Single-cell RNA sequencing indicated injury and dedifferentiation of infected cells with activation of profibrotic signaling pathways. Importantly, SARS-CoV-2 infection also led to increased collagen 1 protein expression in organoids. A SARS-CoV-2 protease inhibitor was able to ameliorate the infection of kidney cells by SARS-CoV-2. Our results suggest that SARS-CoV-2 can directly infect kidney cells and induce cell injury with subsequent fibrosis. These data could explain both acute kidney injury in COVID-19 patients and the development of chronic kidney disease in long COVID.
C. Schug,
F. Geiser,
N. Hiebel,
P. Beschoner,
L. Jerg-Bretzke,
K. Weidner,
E. Morawa and
Y. Erim,
"Sick Leave and Intention to Quit the Job among Nursing Staff in German Hospitals during the COVID-19 Pandemic",
International Journal of Environmental Research and Public Health,
vol. 19,
no. 4,
pp. 1947,
Feb.
2022.
| DOI: | 10.3390/ijerph19041947 |
| Datei: |  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8872054/pdf/ijerph-19-01947.pdf |
Z. Wang,
A. Cryar,
O. Lemke,
P. Tober-Lau,
D. Ludwig,
E. Helbig,
S. Hippenstiel,
L. Sander,
D. Blake,
C. Lane and
D. Stahl,
"A multiplex protein panel assay for severity prediction and outcome prognosis in patients with COVID-19: An observational multi-cohort study",
EClinicalMedicine,
vol. 49,
pp. 101495,
2022.
| DOI: | 10.1016/j.eclinm.2022.101495 |
V. Demichev and
et al,
"A proteomic survival predictor for COVID-19 patients in intensive care",
PLOS Digital Health,
vol. 1,
pp. e0000007,
2022.
| DOI: | 10.1371/journal.pdig.0000007 |
S. Würstle,
J. Erber,
M. Hanselmann and
D. Stahl,
"A telemedicine-guided self-collection approach for PCR-based SARS-CoV-2 testing: Comparative study",
JMIR Formative Research,
vol. 6,
no. 1,
2022.
| DOI: | 10.2196/32564 |
| Datei: | https://doi.org/10.2196/32564 |
M. Wygrecka,
A. Birnhuber,
B. Seeliger,
L. Michalick,
O. Pak,
A. Schultz,
F. Schramm,
M. Zacharias,
G. Gorkiewicz,
S. David,
T. Welte,
J. Schmidt,
N. Weissmann,
R. Schermuly,
G. Barreto,
L. Schaefer,
P. Markart,
M. Brack,
S. Hippenstiel,
F. Kurth,
L. Sander,
M. Witzenrath,
W. Kuebler,
G. Kwapiszewska and
K. Preissner,
"Altered fibrin clot structure and dysregulated fibrinolysis contribute to thrombosis risk in severe COVID-19",
Blood Adv,
vol. 6,
no. 3,
pp. 1074—1087,
2022.
| DOI: | 10.1182/bloodadvances.2021004816 |
D. Gagiannis,
V. G. Umathum,
W. Bloch,
C. Rother,
M. Stahl,
H. M. Witte,
S. Djudjaj,
P. Boor and
K. Steinestel,
"Antemortem vs Postmortem Histopathologic and Ultrastructural Findings in Paired Transbronchial Biopsy Specimens and Lung Autopsy Samples From Three Patients With Confirmed SARS-CoV-2",
American Journal of Clinical Pathology,
vol. 157,
no. 1,
pp. 54—63,
Jan.
2022.
Abstract:
Respiratory failure is the major cause of death in coronavirus disease 2019 (COVID-19). Autopsy-based reports describe diffuse alveolar damage (DAD), organizing pneumonia, and fibrotic change, but data on early pathologic changes and during progression of the disease are rare.We prospectively enrolled three patients with COVID-19 and performed full clinical evaluation, including high-resolution computed tomography. We took transbronchial biopsy (TBB) specimens at different time points and autopsy tissue samples for histopathologic and ultrastructural evaluation after the patients’ death.Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was confirmed by reverse transcription polymerase chain reaction and/or fluorescence in situ hybridization in all TBBs. Lung histology showed reactive pneumocytes and capillary congestion in one patient who died shortly after hospital admission with detectable virus in one of two lung autopsy samples. SARS-CoV-2 was detected in two of two autopsy samples from another patient with a fulminant course and very short latency between biopsy and autopsy, showing widespread organizing DAD. In a third patient with a prolonged course, autopsy samples showed extensive fibrosis without detectable virus.We report the course of COVID-19 in paired biopsy specimens and autopsies, illustrating vascular, organizing, and fibrotic patterns of COVID-19–induced lung injury. Our results suggest an early spread of SARS-CoV-2 from the upper airways to the lung periphery with diminishing viral load during disease.
| DOI: | 10.1093/ajcp/aqab087 |
| Datei: | https://doi.org/10.1093/ajcp/aqab087 |
Abstract:
Respiratory failure is the major cause of death in coronavirus disease 2019 (COVID-19). Autopsy-based reports describe diffuse alveolar damage (DAD), organizing pneumonia, and fibrotic change, but data on early pathologic changes and during progression of the disease are rare.We prospectively enrolled three patients with COVID-19 and performed full clinical evaluation, including high-resolution computed tomography. We took transbronchial biopsy (TBB) specimens at different time points and autopsy tissue samples for histopathologic and ultrastructural evaluation after the patients’ death.Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was confirmed by reverse transcription polymerase chain reaction and/or fluorescence in situ hybridization in all TBBs. Lung histology showed reactive pneumocytes and capillary congestion in one patient who died shortly after hospital admission with detectable virus in one of two lung autopsy samples. SARS-CoV-2 was detected in two of two autopsy samples from another patient with a fulminant course and very short latency between biopsy and autopsy, showing widespread organizing DAD. In a third patient with a prolonged course, autopsy samples showed extensive fibrosis without detectable virus.We report the course of COVID-19 in paired biopsy specimens and autopsies, illustrating vascular, organizing, and fibrotic patterns of COVID-19–induced lung injury. Our results suggest an early spread of SARS-CoV-2 from the upper airways to the lung periphery with diminishing viral load during disease.
L. Buhr,
S. Schicktanz and
E. Nordmeyer,
"Attitudes Toward Mobile Apps for Pandemic Research Among Smartphone Users in Germany: National Survey",
JMIR Mhealth Uhealth,
vol. 10,
no. 1,
pp. e31857,
2022.
| DOI: | 10.2196/31857 |
S. Schulz and
et al,
"Augmented Neutralization of SARS-CoV-2 Omicron Variant by Boost Vaccination and Monoclonal Antibodies",
European journal of immunology,
2022.
| DOI: | 10.1002/eji.202249841 |
B. Schmid,
M. Griesel,
A. Fischer,
C. S. Romero,
M. Metzendorf,
S. Weibel and
F. Fichtner,
"Awake Prone Positioning, High-Flow Nasal Oxygen and Non-Invasive Ventilation as Non-Invasive Respiratory Strategies in COVID-19 Acute Respiratory Failure: A Systematic Review and Meta-Analysis",
J Clin Med,
vol. 11,
no. 2,
pp. 391,
2022.
| DOI: | 10.3390/jcm11020391 |
A. F. Demleitner,
A. Wolff,
J. Erber and
et al,
"Best practice approaches to outpatient management of people living with Parkinson's disease during the COVID-19 pandemic",
J Neural Transm (Vienna),
vol. 129,
no. 11,
pp. 1377-1385,
2022.
| DOI: | https://doi.org/10.1007/s00702-022-02484-7 |
[eng]
H. Bräuninger,
B. Stoffers,
A. D. E. Fitzek,
K. Meißner,
G. Aleshcheva,
M. Schweizer,
J. Weimann,
B. Rotter,
S. Warnke,
C. Edler,
F. Braun,
K. Roedl,
K. Scherschel,
F. Escher,
S. Kluge,
T. B. Huber,
B. Ondruschka,
H. Schultheiss,
P. Kirchhof,
S. Blankenberg,
K. Püschel,
D. Westermann and
D. Lindner,
"Cardiac SARS-CoV-2 infection is associated with pro-inflammatory transcriptomic alterations within the heart",
Cardiovascular Research,
vol. 118,
no. 2,
pp. 542—555,
Jan.
2022.
| DOI: | 10.1093/cvr/cvab322 |