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.
S. Woon,
M. Sheppard and
et al,
"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",
J Clin Immunol,
2022.
| DOI: | 10.1007/s10875-021-01187-0 |
S. Von Stillfried,
R. Bülow,
R. Röhrig,
P. Boor and
D. Collaborators,
"First report from the German COVID-19 autopsy registry",
The Lancet Regional Health - Europe,
pp. 100330,
2022.
| DOI: | 10.1016/j.lanepe.2022.100330 |
[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.
Abstract:
BACKGROUND: Autopsies are an important tool in medicine, dissecting disease pathophysiology and causes of death. In COVID-19, autopsies revealed e.g., the effects on pulmonary (micro)vasculature or the nervous system, systemic viral spread, or the interplay with the immune system. To facilitate multicentre autopsy-based studies and provide a central hub supporting autopsy centres, researchers, and data analyses and reporting, in April 2020 the German COVID-19 Autopsy Registry (DeRegCOVID) was launched. METHODS: The electronic registry uses a web-based electronic case report form. Participation is voluntary and biomaterial remains at the respective site (decentralized biobanking). As of October 2021, the registry included N=1129 autopsy cases, with 69271 single data points including information on 18674 available biospecimens gathered from 29 German sites. FINDINGS: In the N=1095 eligible records, the male-to-female ratio was 1·8:1, with peaks at 65-69 and 80-84 years in males and \textgreater85 years in females. The analysis of the chain of events directly leading to death revealed COVID-19 as the underlying cause of death in 86% of the autopsy cases, whereas in 14% COVID-19 was a concomitant disease. The most common immediate cause of death was diffuse alveolar damage, followed by multi-organ failure. The registry supports several scientific projects, public outreach and provides reports to the federal health authorities, leading to legislative adaptation of the German Infection Protection Act, facilitating the performance of autopsies during pandemics. INTERPRETATION: A national autopsy registry can provide multicentre quantitative information on COVID-19 deaths on a national level, supporting medical research, political decision-making and public discussion. FUNDING: German Federal Ministries of Education and Research and Health.Hintergrund: Obduktionen sind ein wichtiges Instrument in der Medizin, um die Pathophysiologie von Krankheiten und Todesursachen zu untersuchen. Im Rahmen von COVID-19 wurden durch Obduktionen z.B. die Auswirkungen auf die pulmonale Mikrovaskulatur, das Nervensystem, die systemische Virusausbreitung, und das Zusammenspiel mit dem Immunsystem untersucht. Um multizentrische, auf Obduktionen basierende Studien zu erleichtern und eine zentrale Anlaufstelle zu schaffen, die Obduktionszentren, Forscher sowie Datenanalysen und -berichte unterstützt, wurde im April 2020 das deutsche COVID-19-Autopsieregister (DeRegCOVID) ins Leben gerufen.Methoden: Das elektronische Register verwendet ein webbasiertes elektronisches Fallberichtsformular. Die Teilnahme ist freiwillig und das Biomaterial verbleibt am jeweiligen Standort (dezentrales Biobanking). Im Oktober 2021 umfasste das Register N=1129 Obduktionsfälle mit 69271 einzelnen Datenpunkten, die Informationen über 18674 verfügbare Bioproben enthielten, die von 29 deutschen Standorten gesammelt wurden.Ergebnisse: In den N=1095 ausgewerteten Datensätzen betrug das Verhältnis von Männern zu Frauen 1,8:1 mit Spitzenwerten bei 65-69 und 80-84 Jahren bei Männern und \textgreater85 Jahren bei Frauen. Die Analyse der Sequenz der unmittelbar zum Tod führenden Ereignisse ergab, dass in 86 % der Obduktionsfälle COVID-19 die zugrunde liegende Todesursache war, während in 14 % der Fälle COVID-19 eine Begleiterkrankung war. Die häufigste unmittelbare Todesursache war der diffuse Alveolarschaden, gefolgt von Multiorganversagen. Das Register unterstützt mehrere wissenschaftliche Projekte, die Öffentlichkeitsarbeit und liefert Berichte an die Bundesgesundheitsbehörden, was zu einer Anpassung des deutschen Infektionsschutzgesetzes führte und die Durchführung von Obduktionen in Pandemien erleichtert.Interpretation: Ein nationales Obduktionsregister kann multizentrische quantitative Informationen über COVID-19-Todesfälle auf nationaler Ebene liefern und damit die medizinische Forschung, die politische Entscheidungsfindung und die öffentliche Diskussion unterstützen.Finanzierung: Bundesministerien für Bildung und Forschung und für Gesundheit.
| DOI: | 10.1016/j.lanepe.2022.100330 |
Abstract:
BACKGROUND: Autopsies are an important tool in medicine, dissecting disease pathophysiology and causes of death. In COVID-19, autopsies revealed e.g., the effects on pulmonary (micro)vasculature or the nervous system, systemic viral spread, or the interplay with the immune system. To facilitate multicentre autopsy-based studies and provide a central hub supporting autopsy centres, researchers, and data analyses and reporting, in April 2020 the German COVID-19 Autopsy Registry (DeRegCOVID) was launched. METHODS: The electronic registry uses a web-based electronic case report form. Participation is voluntary and biomaterial remains at the respective site (decentralized biobanking). As of October 2021, the registry included N=1129 autopsy cases, with 69271 single data points including information on 18674 available biospecimens gathered from 29 German sites. FINDINGS: In the N=1095 eligible records, the male-to-female ratio was 1·8:1, with peaks at 65-69 and 80-84 years in males and \textgreater85 years in females. The analysis of the chain of events directly leading to death revealed COVID-19 as the underlying cause of death in 86% of the autopsy cases, whereas in 14% COVID-19 was a concomitant disease. The most common immediate cause of death was diffuse alveolar damage, followed by multi-organ failure. The registry supports several scientific projects, public outreach and provides reports to the federal health authorities, leading to legislative adaptation of the German Infection Protection Act, facilitating the performance of autopsies during pandemics. INTERPRETATION: A national autopsy registry can provide multicentre quantitative information on COVID-19 deaths on a national level, supporting medical research, political decision-making and public discussion. FUNDING: German Federal Ministries of Education and Research and Health.Hintergrund: Obduktionen sind ein wichtiges Instrument in der Medizin, um die Pathophysiologie von Krankheiten und Todesursachen zu untersuchen. Im Rahmen von COVID-19 wurden durch Obduktionen z.B. die Auswirkungen auf die pulmonale Mikrovaskulatur, das Nervensystem, die systemische Virusausbreitung, und das Zusammenspiel mit dem Immunsystem untersucht. Um multizentrische, auf Obduktionen basierende Studien zu erleichtern und eine zentrale Anlaufstelle zu schaffen, die Obduktionszentren, Forscher sowie Datenanalysen und -berichte unterstützt, wurde im April 2020 das deutsche COVID-19-Autopsieregister (DeRegCOVID) ins Leben gerufen.Methoden: Das elektronische Register verwendet ein webbasiertes elektronisches Fallberichtsformular. Die Teilnahme ist freiwillig und das Biomaterial verbleibt am jeweiligen Standort (dezentrales Biobanking). Im Oktober 2021 umfasste das Register N=1129 Obduktionsfälle mit 69271 einzelnen Datenpunkten, die Informationen über 18674 verfügbare Bioproben enthielten, die von 29 deutschen Standorten gesammelt wurden.Ergebnisse: In den N=1095 ausgewerteten Datensätzen betrug das Verhältnis von Männern zu Frauen 1,8:1 mit Spitzenwerten bei 65-69 und 80-84 Jahren bei Männern und \textgreater85 Jahren bei Frauen. Die Analyse der Sequenz der unmittelbar zum Tod führenden Ereignisse ergab, dass in 86 % der Obduktionsfälle COVID-19 die zugrunde liegende Todesursache war, während in 14 % der Fälle COVID-19 eine Begleiterkrankung war. Die häufigste unmittelbare Todesursache war der diffuse Alveolarschaden, gefolgt von Multiorganversagen. Das Register unterstützt mehrere wissenschaftliche Projekte, die Öffentlichkeitsarbeit und liefert Berichte an die Bundesgesundheitsbehörden, was zu einer Anpassung des deutschen Infektionsschutzgesetzes führte und die Durchführung von Obduktionen in Pandemien erleichtert.Interpretation: Ein nationales Obduktionsregister kann multizentrische quantitative Informationen über COVID-19-Todesfälle auf nationaler Ebene liefern und damit die medizinische Forschung, die politische Entscheidungsfindung und die öffentliche Diskussion unterstützen.Finanzierung: Bundesministerien für Bildung und Forschung und für Gesundheit.
F. Steinbeis,
P. Knape,
M. Mittermaier,
E. Helbig,
P. Tober-Lau,
C. Thibeault,
L. Lippert,
W. Xiang,
M. Müller-Plathe,
S. Steinbrecher and
D. Stahl,
"Functional limitations 12 months after SARS-CoV-2 infection correlate with initial disease severity: An observational study of cardiopulmonary exercise capacity testing in COVID-19 convalescents",
Respir Med,
vol. 202,
pp. 106968,
2022.
| DOI: | 10.1016/j.rmed.2022.106968 |
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 |
A. Kühnapfel,
K. Horn,
U. Klotz,
M. Kiehntopf,
M. Rosolowski,
M. Loeffler,
N. Suttorp,
M. Witzenrath and
M. Scholz,
"Genetic Regulation of Cytokine Response in Patients with Acute Community-Acquired Pneumonia",
Genes (Basel),
vol. 13,
no. 1,
pp. 111,
2022.
| DOI: | 10.3390/genes13010111 |
A. Kühnapfel,
K. Horn,
U. Klotz,
M. Kiehntopf,
M. Rosolowski,
M. Loeffler,
N. Suttorp,
M. Witzenrath and
M. Scholz,
"Genetic Regulation of Cytokine Response in Patients with Acute Community-Acquired Pneumonia. Genes (Basel).",
2022.
[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.
R. Dannebaum,
P. Suwalski,
H. Asgharian,
Z. G. Du,
H. Lin,
J. Weiner,
M. Holtgrewe,
C. Thibeault,
M. Müller,
X. Wang and
D. Stahl,
"Highly multiplexed immune repertoire sequencing links multiple lymphocyte classes with severity of response to COVID-19",
EClinicalMedicine,
vol. 48,
pp. 101438,
2022.
| DOI: | 10.1016/j.eclinm.2022.101438 |
R. Dannebaum,
P. Suwalski,
H. Asgharian,
Z. G. Du,
J. Weiner,
M. Holtgrewe,
C. Thibeault,
M. Müller,
X. Wang,
J. Saccomanno,
J. Doehn,
R. Hübner,
N. Suttorp,
M. Witzenrath,
S. Hippenstiel,
L. E. Sander,
F. Kurth,
P. Group,
H. Lin,
Z. Karadeniz,
B. Hinzmann,
A. Blüher,
S. Siemann,
D. Telman,
C. Skurk,
W. Poller,
D. Beule,
T. Guettouche,
U. Landmesser,
J. Berka,
K. Luong,
F. Rubelt and
B. Heidecker,
"Highly multiplexed immune repertoire sequencing links multiple lymphocyte classes with severity of response to COVID-19.",
EClinicalMedicine.2022;48:101438,
2022.
K. Hönzke,
B. Obermayer,
C. Mache,
D. Fathykova,
M. Kessler,
S. Dökel,
E. Wyler,
M. Baumgardt,
A. Löwa,
K. Hoffmann and
D. Stahl,
"Human lungs show limited permissiveness for SARS-CoV-2 due to scarce ACE2 levels but virus-induced expansion of inflammatory macrophages",
Eur Respir J,
vol. 60,
no. 6,
pp. 2102725,
2022.
| DOI: | 10.1183/13993003.02725-2021 |
K. Hönzke,
B. Obermayer,
C. Mache,
D. Fathykova,
M. Kessler and
e. a. Dökel,
"Human lungs show limited permissiveness for SARS-CoV-2 due to scarce ACE2 levels but virus-induced expansion of inflammatory macrophages",
Eur Respir J,
vol. 60,
no. 6,
pp. 2102725,
2022.
| DOI: | 10.1183/13993003.02725-2021 |
[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.
B. Sedlmayr,
M. Sedlmayr,
C. Schüttler and
et al,
"Improving collaborative COVID-19 research of University Hospitals in Germany: Formative usability evaluation of the CODEX-Feasibility Portal",
Appl Clin Inform,
vol. 13,
pp. 400—409,
2022.
| DOI: | 10.1055/s-0042-1744549 |
P. R. Wratil,
N. A. Schmacke,
A. Osterman and
et al,
"In-depth profiling of COVID-19 risk factors and preventive measures in healthcare workers",
Infection,
vol. 50,
2022.
| DOI: | 10.1007/s15010-021-01672-z |
N. Dragano,
M. Reuter,
A. Peters,
M. Engels,
B. Schmidt,
K. Greiser,
B. Bohn,
S. Riedel-Heller,
A. Karch,
R. Mikolajczyk,
G. Krause,
O. Lang,
L. Panreck,
M. Rietschel,
H. Brenner,
B. Fischer,
C. Franzke,
S. Gastell,
B. Holleczek,
K. Jöckel,
R. Kaaks,
T. Keil,
A. Kluttig,
O. Kuß,
N. Legath,
M. Leitzmann,
W. Lieb,
C. Meinke-Franze,
K. Michels,
N. Obi,
T. Pischon,
I. Feinkohl,
S. Rospleszcz,
T. Schikowski,
M. Schulze,
A. Stang,
H. Völzke,
S. Willlich,
K. Wirkner,
H. Zeeb and
K. Berger,
"Increase in mental disorders during the COVID-19 pandemic - the role of occupational and financial strains. An analysis of the German National Cohort (NAKO) Study",
Deutsches Ärzteblatt International,
vol. 119,
pp. 179–187,
2022.
| DOI: | 10.3238/arztebl.m2022.0133 |
A. Bludau,
S. Heinemann,
A. Mardiko,
H. Kaba,
A. Leha,
N. von Maltzahn,
N. Mutters,
R. Leistner,
F. Mattner and
S. Scheithauer,
"Infection control strategies for patients and accompanying persons during the COVID-19 pandemic in German hospitals: a cross-sectional study in March-April 2021",
The Journal of hospital infection,
vol. 125,
pp. 28—36,
2022.
| DOI: | 10.1016/j.jhin.2022.03.014 |
A. Bludau,
S. Heinemann,
A. Mardiko,
H. Kaba,
A. Leha,
N. von Maltzahn,
N. Mutters,
R. Leistner,
F. Mattner and
S. Scheithauer,
"Infection control strategies for patients and accompanying persons during the COVID-19 pandemic in German hospitals: a cross-sectional study in March–April 2021",
Journal of Hospital Infection,
vol. 125,
pp. 28-36,
2022.
| DOI: | 10.1016/j.jhin.2022.03.014. |
A. Bludau,
S. Heinemann,
A. Mardiko,
H. Kaba,
A. Leha,
N. von Maltzahn,
N. Mutters,
R. Leistner,
F. Mattner and
S. Scheithauer,
"Infection control strategies for patients and accompanying persons during the COVID-19 pandemic in German hospitals: a cross-sectional study in March–April 2021",
Journal of Hospital Infection,
vol. 125,
pp. 28-36,
2022.
| DOI: | 10.1016/j.jhin.2022.03.014. |
A. Bludau,
S. Heinemann,
A. A. Mardiko,
H. E. J. Kaba,
A. Leha,
N. Maltzahn,
N. T. Mutters,
R. Leistner,
F. Mattner and
S. Scheithauer,
"Infection control strategies for patients and accompanying persons during the COVID-19 pandemic in German hospitals: a cross-sectional study in March–April 2021",
Journal of Hospital Infection,
2022.
| DOI: | 10.1016/j.jhin.2022.03.014 |
| Datei: | https://doi.org/10.1016/j.jhin.2022.03.014 |
T. Houwaart,
S. Belhaj,
E. Tawalbeh,
D. Nagels,
Y. Fröhlich,
P. Finzer,
P. Ciruela,
A. Sabrià,
M. Herrero,
C. Andrés,
A. Antón,
A. Benmoumene,
D. Asskali,
H. Haidar,
J. von Dahlen,
J. Nicolai,
M. Stiller,
J. Blum,
C. Lange,
C. Adelmann,
B. Schroer,
U. Osmers,
C. Grice,
P. Kirfel,
H. Jomaa,
D. Strelow,
L. Hülse,
M. Pigulla,
P. Kreuzer,
A. Tyshaieva,
J. Weber,
T. Wienemann,
M. Kohns Vasconcelos,
K. Hoffmann,
N. Lübke,
S. Hauka,
M. Andree,
C. Scholz,
N. Jazmati,
K. Göbels,
R. Zotz,
K. Pfeffer,
J. Timm,
L. Ehlkes,
A. Walker,
A. Dilthey and
German COVID-19 OMICS Initiative (DeCOI),
"Integrated genomic surveillance enables tracing of person-to-person SARS-CoV-2 transmission chains during community transmission and reveals extensive onward transmission of travel-imported infections, Germany, June to July 2021",
Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin,
vol. 27,
no. 43,
2022.
| DOI: | 10.2807/1560-7917.ES.2022.27.43.2101089 |
T. Houwaart,
S. Belhaj,
E. Tawalbeh,
D. Nagels,
Y. Fröhlich,
P. Finzer,
P. Ciruela,
A. Sabrià,
M. Herrero,
C. Andrés,
A. Antón,
A. Benmoumene,
D. Asskali,
H. Haidar,
J. von Dahlen,
J. Nicolai,
M. Stiller,
J. Blum,
C. Lange,
C. Adelmann,
B. Schroer,
U. Osmers,
C. Grice,
P. Kirfel,
H. Jomaa,
D. Strelow,
L. Hülse,
M. Pigulla,
P. Kreuzer,
A. Tyshaieva,
J. Weber,
T. Wienemann,
M. Kohns Vasconcelos,
K. Hoffmann,
N. Lübke,
S. Hauka,
M. Andree,
C. Scholz,
N. Jazmati,
K. Göbels,
R. Zotz,
K. Pfeffer,
J. Timm,
L. Ehlkes,
A. Walker,
A. Dilthey and
German COVID-19 OMICS Initiative (DeCOI),
"Integrated genomic surveillance enables tracing of person-to-person SARS-CoV-2 transmission chains during community transmission and reveals extensive onward transmission of travel-imported infections, Germany, June to July 2021",
Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin,
vol. 27,
no. 43,
2022.
| DOI: | 10.2807/1560-7917.ES.2022.27.43.2101089 |
H. Torsten,
B. Samir,
T. Emran,
N. Dirk,
F. Yara,
F. Patrick,
C. Pilar,
S. Aurora,
H. Mercè,
A. Cristina,
A. Andrés,
B. Assia,
A. Dounia,
H. Hussein,
Janina,
N. Jessica,
S. Mygg,
B. Jacqueline,
L. Christian,
A. Carla,
S. Britta,
O. Ute,
G. Christiane,
K. P. P.,
J. Hassan,
S. Daniel,
H. Lisanna,
P. Moritz,
K. Pascal,
T. Alona,
W. Jonas,
W. Tobias,
K. V. Malte,
H. Katrin,
L. Nadine,
H. Sandra,
A. Marcel,
S. C. Juergen,
J. Nathalie,
G. Klaus,
Z. Rainer,
P. Klaus,
T. Joerg,
E. Lutz,
W. Andreas,
D. A. T. and
G. C. O. I. (DeCOI),
"Integrated genomic surveillance enables tracing of person-to-person SARS-CoV-2 transmission chains during community transmission and reveals extensive onward transmission of travel-imported infections, Germany, June to July 2021.",
Eurosurveillance,
2022.
| DOI: | 10.2807/1560-7917.ES.2022.27.43.2101089 |
| Datei: | https://doi.org/10.2807/1560-7917.ES.2022.27.43.2101089 |
A. Müller,
H. Haneke,
V. Kirchberger,
G. Mastella,
M. Dommasch,
U. Merle,
O. Heinze,
A. Siegmann,
C. Spinner,
A. Buiatti,
K. Laugwitz,
G. Schmidt and
E. Martens,
"Integration of mobile sensors in a telemedicine hospital system: Remote-monitoring in COVID-19 patients",
Journal of Public Health,
vol. 30,
no. 1,
pp. 93—97,
2022.
| DOI: | 10.1007/s10389-021-01655-2 |
M. Kantauskaite and
et al,
"Intensity of mycophenolate mofetil treatment is associated with an impaired immune response to SARS-CoV-2 vaccination in kidney transplant recipients",
American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons,
vol. 22,
pp. 634–639,
2022.
| DOI: | 10.1111/ajt.16851 |
Oorschot and
D. Stahl,
"Interaktive Homepage für Trauernde in Pandemiezeiten",
Schmerz, Nervenarzt, Forum DKG, Urologe, Onkologe,
2022.
P. Dönges,
J. Wagner,
S. Contreras,
E. N. Iftekhar,
S. Bauer,
S. B. Mohr,
J. Dehning,
A. C. Valdez,
M. Kretzschmar,
M. Mäs,
K. Nagel and
V. Priesemann,
"Interplay Between Risk Perception, Behavior, and COVID-19 Spread",
Frontiers in Physics,
vol. 10,
pp. 842180,
2022.
| DOI: | 10.3389/fphy.2022.842180 |
[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.
S. Stillfried,
R. Bülow,
R. Röhrig,
P. Meybohm and
P. Boor,
"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,
pp. 83,
2022.
| DOI: | 10.1186/s13054-022-03945-x |
B. Pauli,
J. Strupp,
K. Schloesser and
D. Stahl,
"It’s like standing in front of a prison fence – Dying during the SARS-CoV2 pandemic: A qualitative study of bereaved relatives’ experiences",
Palliative Medicine,
2022.
| DOI: | 10.1177/02692163221076355 |
[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.
F. P,
K. J,
P. T,
L. S,
M. V,
S. Fischer,
S. H,
D. C,
S. M,
Z. S,
S. M,
M. D,
F. GR and
A. N,
"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.
S. Krishnaratne,
H. Littlecott,
K. Sell,
J. Burns,
J. E. Rabe,
J. M. Stratil,
T. Litwin,
C. Kreutz,
M. Coenen,
K. Geffert,
A. H. Boger,
A. Movsisyan,
S. Kratzer,
C. Klinger,
K. Wabnitz,
B. Strahwald,
B. Verboom,
E. Rehfuess,
R. L. Biallas,
C. Jung-Sievers,
S. Voss and
L. M. Pfadenhauer,
"Measures implemented in the school setting to contain the COVID-19 pandemic: a rapid review",
Cochrane Database of Systematic Reviews,
vol. 2022,
pp. CD015029,
2022.
| DOI: | 10.1002/14651858.CD015029 |
D. Jonigk,
"Microvascular placental alterations in maternal COVID-19",
American Journal of Obstetrics & Gynecology,
vol. 226,
pp. 135-136,
Jan.
2022.
| DOI: | https://doi.org/10.1016/j.ajog.2021.06.098 |
J. Schwartz,
M. C. Reuters,
M. Schallenburger,
S. Meier,
C. Roch,
L. Werner,
B. Oorschot and
M. Neukirchen,
"Modelle guter Praxis: Alleine sterben ist ethisch nicht vertretbar",
Praxis Palliative Care,
vol. 54,
pp. 29-36,
2022.
N. Wanner,
G. Andrieux,
P. Badia-i-Mompel and
et al,
"Molecular consequences of SARS-CoV-2 liver tropism",
Nat Metab,
vol. 4,
pp. 310-319,
2022.
| DOI: | 10.1038/s42255-022-00552-6 |
H. Gruell and
et al,
"mRNA booster immunization elicits potent neutralizing serum activity against the SARS-CoV-2 Omicron variant",
Nature Medicine,
2022.
| DOI: | 10.1038/s41591-021-01676-0 |
Z. Liu and
et al,
"Multi-Omics Integration Reveals Only Minor Long-Term Molecular and Functional Sequelae in Immune Cells of Individuals Recovered From COVID-19",
Frontiers in immunology,
vol. 13,
pp. 838132,
2022.
| DOI: | 10.3389/fimmu.2022.838132 |
T. Illig,
"NAPKON- Eine Erfolgsgeschichte",
Plenarvortrag, Nationales Biobanken Symposium,
2022.
C. Bausewein,
F. Hodiamont,
N. Berges,
A. Ullrich,
C. Gerlach,
K. Oechsle,
B. Pauli,
J. Weber,
S. Stiel,
N. Schneider and
D. Stahl,
"National strategy for palliative care of severely ill and dying people and their relatives in pandemics (PallPan) in Germany - study protocol of a mixed-methods project",
BMC palliative care,
vol. 21,
no. 1,
pp. 10,
2022.
| DOI: | 10.1186/s12904-021-00898-w |
[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.
F. Heinrich,
K. Roedl,
D. Jarczak and
et al,
"New Insights in the Occurrence of Venous Thromboembolism in Critically Ill Patients with COVID-19—A Large Postmortem and Clinical Analysis",
Viruses,
vol. 14,
pp. 811,
2022.
| DOI: | 10.3390/v14040811 |
P. Arora and
et al,
"No evidence for increased cell entry or antibody evasion by Delta sublineage AY.4.2",
Cellular & Molecular Immunology,
2022.
| DOI: | 10.1038/s41423-021-00811-8 |
M. S. Ercanoglu and
et al,
"No substantial preexisting B cell immunity against SARS-CoV-2 in healthy adults",
iScience,
vol. 25,
pp. 103951,
2022.
| DOI: | 10.1016/j.isci.2022.103951 |
S. Zellmer,
E. Bachmann,
A. Muzalyova and
et al,
"One year of the COVID-19 pandemic in dental medical facilities in Germany: A questionnaire-based analysis",
Int J Environ Res Public Health,
vol. 19,
no. 1,
2022.
| DOI: | 10.3390/ijerph19010175 |
[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.
Abstract:
The use of autopsies in medicine has been declining. The COVID-19 pandemic has documented and rejuvenated the importance of autopsies as a tool of modern medicine. In this review, we discuss the various autopsy techniques, the applicability of modern analytical methods to understand the pathophysiology of COVID-19, the major pathological organ findings, limitations or current studies, and open questions. This article summarizes published literature and the consented experience of the nationwide network of clinical, neuro-, and forensic pathologists from 27 German autopsy centers with more than 1200 COVID-19 autopsies. The autopsy tissues revealed that SARS-CoV-2 can be found in virtually all human organs and tissues, and the majority of cells. Autopsies have revealed the organ and tissue tropism of SARS-CoV-2, and the morphological features of COVID-19. This is characterized by diffuse alveolar damage, combined with angiocentric disease, which in turn is characterized by endothelial dysfunction, vascular inflammation, (micro-) thrombosis, vasoconstriction, and intussusceptive angiogenesis. These findings explained the increased pulmonary resistance in COVID-19 and supported the recommendations for antithrombotic treatment in COVID-19. In contrast, in extra-respiratory organs, pathological changes are often nonspecific and unclear to which extent these changes are due to direct infection vs. indirect/secondary mechanisms of organ injury, or a combination thereof. Ongoing research using autopsies aims at answering questions on disease mechanisms, e.g., focusing on variants of concern, and future challenges, such as post-COVID conditions. Autopsies are an invaluable tool in medicine and national and international interdisciplinary collaborative autopsy-based research initiatives are essential.
| DOI: | 10.1007/s00428-022-03319-2 |
Abstract:
The use of autopsies in medicine has been declining. The COVID-19 pandemic has documented and rejuvenated the importance of autopsies as a tool of modern medicine. In this review, we discuss the various autopsy techniques, the applicability of modern analytical methods to understand the pathophysiology of COVID-19, the major pathological organ findings, limitations or current studies, and open questions. This article summarizes published literature and the consented experience of the nationwide network of clinical, neuro-, and forensic pathologists from 27 German autopsy centers with more than 1200 COVID-19 autopsies. The autopsy tissues revealed that SARS-CoV-2 can be found in virtually all human organs and tissues, and the majority of cells. Autopsies have revealed the organ and tissue tropism of SARS-CoV-2, and the morphological features of COVID-19. This is characterized by diffuse alveolar damage, combined with angiocentric disease, which in turn is characterized by endothelial dysfunction, vascular inflammation, (micro-) thrombosis, vasoconstriction, and intussusceptive angiogenesis. These findings explained the increased pulmonary resistance in COVID-19 and supported the recommendations for antithrombotic treatment in COVID-19. In contrast, in extra-respiratory organs, pathological changes are often nonspecific and unclear to which extent these changes are due to direct infection vs. indirect/secondary mechanisms of organ injury, or a combination thereof. Ongoing research using autopsies aims at answering questions on disease mechanisms, e.g., focusing on variants of concern, and future challenges, such as post-COVID conditions. Autopsies are an invaluable tool in medicine and national and international interdisciplinary collaborative autopsy-based research initiatives are essential.
D. Jonigk,
C. Werlein and
et al,
"Organ manifestations of COVID-19: what have we learned so far (not only) from autopsies?",
Virchows Arch,
2022.
| DOI: | 10.1007/s00428-022-03319-2 |
Oorschot and
D. Stahl,
"PallPan Richtig handeln in der Betreuung Schwerkranker und Sterbender in Pandemiezeiten",
Der Ophthalmologe,
2022.
J. Ebler,
P. Ebert,
W. Clarke,
T. Rausch,
P. Audano,
T. Houwaart,
Y. Mao,
J. Korbel,
E. Eichler,
M. Zody,
A. Dilthey and
T. Marschall,
"Pangenome-based genome inference allows efficient and accurate genotyping across a wide spectrum of variant classes",
Nature genetics,
vol. 54,
no. 4,
pp. 518—525,
2022.
| DOI: | 10.1038/s41588-022-01043-w |
J. Ebler,
P. Ebert,
W. E. Clarke,
T. Rausch,
P. A. Audano,
T. Houwaart,
Y. Mao,
J. O. Korbel,
E. E. Eichler,
M. C. Zody,
A. T. Dilthey and
T. Marschall,
"Pangenome-based genome inference allows efficient and accurate genotyping across a wide spectrum of variant classes",
Nature Genetics,
2022.
| DOI: | 10.1038/s41588-022-01043-w |
| Datei: | https://doi.org/10.1038/s41588-022-01043-w |