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.
A. A. Mardiko,
S. Heinemann,
A. Bludau,
H. E. J. Kaba,
A. Leha,
N. Maltzahn,
N. T. Mutters,
R. Leistner,
F. Mattner and
S. Scheithauer,
"COVID-19 vaccination strategy for hospital staff in Germany: a cross-sectional study in March-April 2021",
The Journal of hospital infection,
vol. 126,
pp. 87—92,
2022.
Abstract:
BACKGROUND SARS-CoV-2 vaccination for healthcare workers (HCWs) started in Germany in December 2020. Hospitals had little time to prepare a vaccination strategy. AIM To gather information on the initial vaccination strategy for HCWs from the infection control practitioners in Germany. METHODS A cross-sectional, ethically approved questionnaire was developed, formatted as an online survey and pre-tested. Infection control practitioners responsible for hygiene/infection prevention in 987 randomly selected German hospitals were invited to participate in the survey in March and April 2021. For statistical analysis, the hospitals were categorized into two groups based on bed capacity (\textless500 beds: small; $\geq$500 beds: large). FINDINGS One hundred out of 987 (10%) infection control practitioners completed the survey. In 80% of the participating hospitals, HCW vaccination prioritization was based on recommendations of the German standing committee on vaccination (STIKO). Even so, only 54% prioritized the vaccination of HCWs with contact to vulnerable patients, thus deviating from STIKO recommendations. HCWs with a high personal health risk were prioritized for vaccination in 24% of the hospitals. Transferring unvaccinated HCWs to an area with less infection risk was considered by 2% of large and 12% of small hospitals. CONCLUSION Vaccination prioritization differed across hospitals and deviated from STIKO recommendations. A pandemic preparedness concept should address the potential impact of divergent strategies compared to a common approach. In addition, further studies analysing the reasons why HCWs remain unvaccinated are needed to adopt effective strategies. This is especially important against the background of facility-based compulsory vaccination.
| DOI: | 10.1016/j.jhin.2022.05.012 |
Abstract:
BACKGROUND SARS-CoV-2 vaccination for healthcare workers (HCWs) started in Germany in December 2020. Hospitals had little time to prepare a vaccination strategy. AIM To gather information on the initial vaccination strategy for HCWs from the infection control practitioners in Germany. METHODS A cross-sectional, ethically approved questionnaire was developed, formatted as an online survey and pre-tested. Infection control practitioners responsible for hygiene/infection prevention in 987 randomly selected German hospitals were invited to participate in the survey in March and April 2021. For statistical analysis, the hospitals were categorized into two groups based on bed capacity (\textless500 beds: small; $\geq$500 beds: large). FINDINGS One hundred out of 987 (10%) infection control practitioners completed the survey. In 80% of the participating hospitals, HCW vaccination prioritization was based on recommendations of the German standing committee on vaccination (STIKO). Even so, only 54% prioritized the vaccination of HCWs with contact to vulnerable patients, thus deviating from STIKO recommendations. HCWs with a high personal health risk were prioritized for vaccination in 24% of the hospitals. Transferring unvaccinated HCWs to an area with less infection risk was considered by 2% of large and 12% of small hospitals. CONCLUSION Vaccination prioritization differed across hospitals and deviated from STIKO recommendations. A pandemic preparedness concept should address the potential impact of divergent strategies compared to a common approach. In addition, further studies analysing the reasons why HCWs remain unvaccinated are needed to adopt effective strategies. This is especially important against the background of facility-based compulsory vaccination.
S. Scheithauer,
A. Bludau,
S. Heinemann,
M. Anton and
P. Knolle,
"COVID-19-Impfstrategien für Beschäftigte deutscher Kliniken: Ergebnisse einer Befragung von Leitungen der (Krankenhaus\hbox-)Hygiene im Rahmen des B-FAST-Projektes",
Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz,
vol. 65,
no. 12,
pp. 1299—1306,
2022.
Abstract:
BACKGROUND AND AIM At the beginning of the COVID-19 vaccination campaign in Germany, employees in medical facilities were prioritised for vaccination against SARS-CoV\hbox-2 due to the high risk of exposure and contact with vulnerable groups. Hospitals were therefore encouraged to organise and implement the vaccination of their employees as soon as possible. The aim of the study was to record the practice regarding the vaccination strategy for employees in German hospitals. METHODS In a~self-developed cross-sectional study, infection control practitioners of all German university hospitals as well as non-university hospitals in Lower Saxony and Bavaria were surveyed in March 2021. The data were stratified according to the characteristics of university hospitals and non-university hospitals. RESULTS Of 416 invitations sent out, 100 questionnaires (university hospitals:~33; non-university hospitals:~67) were completed. University hospitals reported greater vaccination capacity than non-university hospitals, but a~limiting factor was uncertain vaccine supply. Vaccination information campaigns were planned or had already been conducted in 89% of clinics. About two-thirds of the respondents (70%) said they did not plan to conduct antibody tests on vaccinated employees. A~follow-up of vaccinated employees to detect possible SARS-CoV\hbox-2 infections by PCR was planned by 41% of the respondents. In case of detection of SARS-CoV\hbox-2 infection, 72% of the respondents had planned further diagnostic procedures. DISCUSSION All hospitals were able to achieve rapid implementation of COVID-19 vaccination of their employees. At the time of the survey, there was also much uncertainty regarding the management of breakthrough infections as well as the need for booster vaccinations. ZUSAMMENFASSUNG HINTERGRUND UND ZIEL: Zu Beginn der COVID-19-Impfkampagne in Deutschland wurden Beschäftigte in medizinischen Einrichtungen aufgrund des hohen Expositionsrisikos und des Kontakts mit vulnerablen Gruppen priorisiert gegen SARS-CoV\hbox-2 geimpft. Die Krankenhäuser waren angehalten die Impfungen ihrer Beschäftigten möglichst schnell zu organisieren und durchzuführen. Ziel der vorliegenden Arbeit war es, die Impfstrategie für die Mitarbeitenden deutscher Kliniken zu erfassen. METHODEN In einer Querschnittstudie mit selbstentwickeltem Fragebogen wurden die Leitungen der (Krankenhaus\hbox-)Hygiene aller deutschen Universitätskliniken sowie der Nicht-Universitätskliniken in Niedersachsen und Bayern im März 2021 befragt. Die Daten wurden nach den beiden Versorgungsstufen stratifiziert. ERGEBNISSE 100 von 416 versendeten Fragebögen wurden vollständig ausgefüllt (Universitätsklinik:~33, Nicht-Universitätsklinik:~67). Universitätskliniken berichteten von einer größeren Impfkapazität als Nicht-Universitätskliniken, ein begrenzender Faktor waren die ungewissen Impfstofflieferungen. 89 % der Kliniken planten Informationskampagnen zum Thema Impfung oder hatten diese bereits durchgeführt. 70 % gaben an, keine Antikörpertests bei geimpften Beschäftigten durchführen zu wollen. Eine Nachverfolgung geimpfter Beschäftigter zur Detektion möglicher SARS-CoV-2-Infektionen mittels Erregernachweis durch PCR wurde von 41 % geplant. Im Falle des Nachweises einer SARS-CoV-2-Infektion bei geimpften Beschäftigten hatten 72 % weitere Diagnostik geplant. DISKUSSION Alle Krankenhäuser konnten eine schnelle Umsetzung der COVID-19-Vakzinierung ihrer Beschäftigten erreichen. Zum Zeitpunkt der Befragung gab es große Unsicherheit bezüglich des Umgangs mit Durchbruchsinfektionen und der Notwendigkeit von Auffrischimpfungen.
| DOI: | 10.1007/s00103-022-03607-x |
Abstract:
BACKGROUND AND AIM At the beginning of the COVID-19 vaccination campaign in Germany, employees in medical facilities were prioritised for vaccination against SARS-CoV\hbox-2 due to the high risk of exposure and contact with vulnerable groups. Hospitals were therefore encouraged to organise and implement the vaccination of their employees as soon as possible. The aim of the study was to record the practice regarding the vaccination strategy for employees in German hospitals. METHODS In a~self-developed cross-sectional study, infection control practitioners of all German university hospitals as well as non-university hospitals in Lower Saxony and Bavaria were surveyed in March 2021. The data were stratified according to the characteristics of university hospitals and non-university hospitals. RESULTS Of 416 invitations sent out, 100 questionnaires (university hospitals:~33; non-university hospitals:~67) were completed. University hospitals reported greater vaccination capacity than non-university hospitals, but a~limiting factor was uncertain vaccine supply. Vaccination information campaigns were planned or had already been conducted in 89% of clinics. About two-thirds of the respondents (70%) said they did not plan to conduct antibody tests on vaccinated employees. A~follow-up of vaccinated employees to detect possible SARS-CoV\hbox-2 infections by PCR was planned by 41% of the respondents. In case of detection of SARS-CoV\hbox-2 infection, 72% of the respondents had planned further diagnostic procedures. DISCUSSION All hospitals were able to achieve rapid implementation of COVID-19 vaccination of their employees. At the time of the survey, there was also much uncertainty regarding the management of breakthrough infections as well as the need for booster vaccinations. ZUSAMMENFASSUNG HINTERGRUND UND ZIEL: Zu Beginn der COVID-19-Impfkampagne in Deutschland wurden Beschäftigte in medizinischen Einrichtungen aufgrund des hohen Expositionsrisikos und des Kontakts mit vulnerablen Gruppen priorisiert gegen SARS-CoV\hbox-2 geimpft. Die Krankenhäuser waren angehalten die Impfungen ihrer Beschäftigten möglichst schnell zu organisieren und durchzuführen. Ziel der vorliegenden Arbeit war es, die Impfstrategie für die Mitarbeitenden deutscher Kliniken zu erfassen. METHODEN In einer Querschnittstudie mit selbstentwickeltem Fragebogen wurden die Leitungen der (Krankenhaus\hbox-)Hygiene aller deutschen Universitätskliniken sowie der Nicht-Universitätskliniken in Niedersachsen und Bayern im März 2021 befragt. Die Daten wurden nach den beiden Versorgungsstufen stratifiziert. ERGEBNISSE 100 von 416 versendeten Fragebögen wurden vollständig ausgefüllt (Universitätsklinik:~33, Nicht-Universitätsklinik:~67). Universitätskliniken berichteten von einer größeren Impfkapazität als Nicht-Universitätskliniken, ein begrenzender Faktor waren die ungewissen Impfstofflieferungen. 89 % der Kliniken planten Informationskampagnen zum Thema Impfung oder hatten diese bereits durchgeführt. 70 % gaben an, keine Antikörpertests bei geimpften Beschäftigten durchführen zu wollen. Eine Nachverfolgung geimpfter Beschäftigter zur Detektion möglicher SARS-CoV-2-Infektionen mittels Erregernachweis durch PCR wurde von 41 % geplant. Im Falle des Nachweises einer SARS-CoV-2-Infektion bei geimpften Beschäftigten hatten 72 % weitere Diagnostik geplant. DISKUSSION Alle Krankenhäuser konnten eine schnelle Umsetzung der COVID-19-Vakzinierung ihrer Beschäftigten erreichen. Zum Zeitpunkt der Befragung gab es große Unsicherheit bezüglich des Umgangs mit Durchbruchsinfektionen und der Notwendigkeit von Auffrischimpfungen.
L. Radbruch and
C. Bausewein,
"Covid-19: Was die Palliativmedizin leisten kann",
Rheinisches Ärzteblatt,
no. 6,
2022.
P. Tober-Lau and
et al,
"Cross-Variant Neutralizing Serum Activity after SARS-CoV-2 Breakthrough Infections",
Emerging infectious diseases,
vol. 28,
2022.
| DOI: | 10.3201/eid2805.220271 |
L. Meyer-Arndt and
et al,
"Cutting Edge: Serum but Not Mucosal Antibody Responses Are Associated with Pre-Existing SARS-CoV-2 Spike Cross-Reactive CD4+ T Cells following BNT162b2 Vaccination in the Elderly",
Journal of immunology,
vol. 208,
pp. 1001–1005,
2022.
| DOI: | 10.4049/jimmunol.2100990 |
H. Chen and
et al,
"Detection and functional resolution of soluble immune complexes by an FcγR reporter cell panel",
EMBO Mol Med,
vol. 14,
pp. e14182,
2022.
| DOI: | 10.15252/emmm.202114182 |
H. Chen,
A. Maul‐Pavicic,
M. Holzer and
et al,
"Detection and functional resolution of soluble immune complexes by an FcγR reporter cell panel",
EMBO Mol Med,
vol. 14,
no. 1,
2022.
| DOI: | 10.15252/emmm.202114182 |
| Datei: | https://doi.org/10.15252/emmm.202114182 |
M. Tauchert,
I. Bernemann,
A. Kühn-Steven,
V. Kopfnagel,
S. Kunze,
T. Illig and
G. Anton,
"Digital knowledge management within the NAPKON study.",
Nationales Biobanken Symposium Abstract 11,
2022.
M. Tauchert,
I. Bernemann,
A. Kühn-Steven,
V. Kopfnagel,
S. Kunze,
T. Illig and
G. Anton,
"Digital knowledge management within the NAPKON study. Abstract. 11. Nationales Biobanken Symposium. 2022",
Not available,
2022.
K. Vanshylla and
et al,
"Durability of omicron-neutralising serum activity after mRNA booster immunisation in older adults",
The Lancet Infectious Diseases,
vol. 22,
pp. 445–446,
2022.
| DOI: | 10.1016/S1473-3099(22)00135-9 |
[en]
F. Heinrich,
C. Romich,
T. Zimmermann,
I. Kniep,
A. Fitzek,
S. Steurer,
M. Glatzel,
D. Nörz,
T. Günther,
M. Czech-Sioli,
N. Fischer,
A. Grundhoff,
M. Lütgehetmann and
B. Ondruschka,
"Dying of VOC-202012/01 — multimodal investigations in a death case of the SARS-CoV-2 variant",
International Journal of Legal Medicine,
vol. 136,
no. 1,
pp. 193—202,
Jan.
2022.
Abstract:
The current pandemic with Severe acute respiratory syndrome-coronavirus-2 has been taking on new dynamics since the emergence of new variants last fall, some of them spreading more rapidly. Many countries currently find themselves in a race to ramp up vaccination strategies that have been initiated and a possible third wave of the pandemic from new variants, such as the Variant of Concern-202012/01 from the B.1.1.7 lineage. Until today, many investigations in death cases of Coronavirus-disease-19 have been conducted, revealing pulmonary damage to be the predominant feature of the disease. Thereby, different degrees of macroscopic and microscopic lung damage have been reported, most of them resembling an Acute Respiratory Distress Syndrome. Far more, systemic complications of the disease such as pulmonary embolisms have been described. However, neither morphologic nor virologic findings of patients dying of the new variants have yet been reported. Here, we report on a comprehensive analysis of radiologic, morphologic, and virologic findings in a fatal case of this variant.
| DOI: | 10.1007/s00414-021-02618-8 |
| Datei: | https://doi.org/10.1007/s00414-021-02618-8 |
Abstract:
The current pandemic with Severe acute respiratory syndrome-coronavirus-2 has been taking on new dynamics since the emergence of new variants last fall, some of them spreading more rapidly. Many countries currently find themselves in a race to ramp up vaccination strategies that have been initiated and a possible third wave of the pandemic from new variants, such as the Variant of Concern-202012/01 from the B.1.1.7 lineage. Until today, many investigations in death cases of Coronavirus-disease-19 have been conducted, revealing pulmonary damage to be the predominant feature of the disease. Thereby, different degrees of macroscopic and microscopic lung damage have been reported, most of them resembling an Acute Respiratory Distress Syndrome. Far more, systemic complications of the disease such as pulmonary embolisms have been described. However, neither morphologic nor virologic findings of patients dying of the new variants have yet been reported. Here, we report on a comprehensive analysis of radiologic, morphologic, and virologic findings in a fatal case of this variant.
N. Koerber,
A. Priller,
S. Yazici and
et al,
"Dynamics of spike-and nucleocapsid specific immunity during long-term follow-up and vaccination of SARS-CoV-2 convalescents",
Nat Commun,
vol. 13,
no. 1,
2022.
| DOI: | 10.1038/s41467-021-27649-y |
B. Akbil and
et al,
"Early and Rapid Identification of COVID-19 Patients with Neutralizing Type I Interferon Auto-antibodies",
Journal of Clinical Immunology,
2022.
| DOI: | 10.1007/s10875-022-01252-2 |
[en]
B. Akbil,
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. N. 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. M. 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.
M. Pietzner,
R. L. Chua,
E. Wheeler,
K. Jechow,
H. Radbruch and
e. a. Trump,
"ELF5 is a respiratory epithelial cell-specific risk gene for severe COVID-19",
medRxiv,
2022.
| DOI: | 10.1101/2022.01.17.22269283 |
S. Hopff,
K. Tilch,
M. Kraus,
L. Lorenz-Depiereux,
G. Anton,
K. Appel,
T. Bahmer,
A. Bartschke,
C. Bellinghausen,
I. Bernemann and
others,
"Ethical and coordinative challenges in setting up a national cohort study exemplified by the German National Pandemic Cohort Network (NAPKON)",
Abstract ECCMID 2022,
2022.
K. Antoniou,
E. Vasarmidi,
A. Russell,
C. Andrejak,
B. Crestani,
M. Delcroix,
A. Dinh-Xuan,
V. Poletti,
N. Sverzellati,
M. Vitacca,
M. Witzenrath,
T. Tonia and
A. Spanevello,
"European Respiratory Society statement on long COVID follow-up",
Eur Respir J,
vol. 60,
no. 2,
pp. 2102174,
2022.
| DOI: | 10.1183/13993003.02174-2021 |
L. Krüger,
J. Klein,
F. Tobian and
others,
"Evaluation of accuracy, exclusivity, limit-of-detection and ease-of-use of LumiraDx™: An antigen-detecting point-of-care device for SARS-CoV-2",
Infection,
vol. 50,
2022.
| DOI: | 10.1007/s15010-021-01681-y |
| Datei: | https://doi.org/10.1007/s15010-021-01681-y |
M. Hoffmann and
et al,
"Evidence for an ACE2-Independent Entry Pathway That Can Protect from Neutralization by an Antibody Used for COVID-19 Therapy",
mBio,
2022.
| DOI: | 10.1128/mbio.00364-22 |
[en]
T. J. Hartung,
C. Neumann,
T. Bahmer,
I. Chaplinskaya-Sobol,
M. Endres,
J. Geritz,
K. G. Haeusler,
P. U. Heuschmann,
H. Hildesheim,
A. Hinz,
S. Hopff,
A. Horn,
M. Krawczak,
L. Krist,
J. Kudelka,
W. Lieb,
C. Maetzler,
A. Mehnert-Theuerkauf,
F. A. Montellano,
C. Morbach,
S. Schmidt,
S. Schreiber,
F. Steigerwald,
S. Störk,
W. Maetzler and
C. Finke,
"Fatigue and cognitive impairment after COVID-19: A prospective multicentre study",
EClinicalMedicine,
vol. 53,
no. 101651,
pp. 101651,
Nov.
2022.
Elsevier BV.
Abstract:
Background: Reliable estimates of frequency, severity and associated factors of both fatigue and cognitive impairment after COVID-19 are needed. Also, it is not clear whether the two are distinct sequelae of COVID-19 or part of the same syndrome." Methods: In this prospective multicentre study, frequency of post-COVID fatigue and cognitive impairment were assessed in n = 969 patients (535 [55%] female) $\geq$6 months after SARS-CoV-2 infection with the FACIT-Fatigue scale (cut-off $łeq$30) and Montreal Cognitive Assessment ($łeq$25 mild, $łeq$17 moderate impairment) between November 15, 2020 and September 29, 2021 at University Medical Center Schleswig-Holstein, Campus Kiel and University Hospital W"urzburg in Germany. 969 matched non-COVID controls were drawn from a pre-pandemic, randomised, Germany-wide population survey which also included the FACIT-Fatigue scale. Associated sociodemographic, comorbid, clinical, psychosocial factors and laboratory markers were identified with univariate and multivariable linear regression models. Findings: On average 9 months after infection, 19% of patients had clinically relevant fatigue, compared to 8% of matched non-COVID controls (p < 0.001). Factors associated with fatigue were female gender, younger age, history of depression and the number of acute COVID symptoms. Among acute COVID symptoms, altered consciousness, dizziness and myalgia were most strongly associated with long-term fatigue. Moreover, 26% of patients had mild and 1% had moderate cognitive impairment. Factors associated with cognitive impairment were older age, male gender, shorter education and a history of neuropsychiatric disease. There was no significant correlation between fatigue and cognitive impairment and only 5% of patients suffered from both conditions. Interpretation: Fatigue and cognitive impairment are two common, but distinct sequelae of COVID-19 with potentially separate pathophysiological pathways. Funding: German Federal Ministry of Education and Research (BMBF).
| DOI: | 10.1016/j.eclinm.2022.101651 |
| Pubmed: | 36133318 |
Abstract:
Background: Reliable estimates of frequency, severity and associated factors of both fatigue and cognitive impairment after COVID-19 are needed. Also, it is not clear whether the two are distinct sequelae of COVID-19 or part of the same syndrome." Methods: In this prospective multicentre study, frequency of post-COVID fatigue and cognitive impairment were assessed in n = 969 patients (535 [55%] female) $\geq$6 months after SARS-CoV-2 infection with the FACIT-Fatigue scale (cut-off $łeq$30) and Montreal Cognitive Assessment ($łeq$25 mild, $łeq$17 moderate impairment) between November 15, 2020 and September 29, 2021 at University Medical Center Schleswig-Holstein, Campus Kiel and University Hospital W"urzburg in Germany. 969 matched non-COVID controls were drawn from a pre-pandemic, randomised, Germany-wide population survey which also included the FACIT-Fatigue scale. Associated sociodemographic, comorbid, clinical, psychosocial factors and laboratory markers were identified with univariate and multivariable linear regression models. Findings: On average 9 months after infection, 19% of patients had clinically relevant fatigue, compared to 8% of matched non-COVID controls (p < 0.001). Factors associated with fatigue were female gender, younger age, history of depression and the number of acute COVID symptoms. Among acute COVID symptoms, altered consciousness, dizziness and myalgia were most strongly associated with long-term fatigue. Moreover, 26% of patients had mild and 1% had moderate cognitive impairment. Factors associated with cognitive impairment were older age, male gender, shorter education and a history of neuropsychiatric disease. There was no significant correlation between fatigue and cognitive impairment and only 5% of patients suffered from both conditions. Interpretation: Fatigue and cognitive impairment are two common, but distinct sequelae of COVID-19 with potentially separate pathophysiological pathways. Funding: German Federal Ministry of Education and Research (BMBF).
R. Ameratunga,
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 |
[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.
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 |
F. Steinbeis,
P. Knape,
M. Mittermaier,
E. Helbig,
P. Tober-Lau,
C. Thibeault,
L. Lippert,
W. Xiang,
M. Müller-Plathe,
S. Steinbrecher and
others,
"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,
P. Ahnert,
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,
P. Ahnert,
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
others,
"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
others,
"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.
S. Bernatz,
S. Afat,
A. E. Othman and
et al,
"Impact of the COVID-19 Pandemic on Radiology in Inpatient and Outpatient Care in Germany: A Nationwide Survey Regarding the First and Second Wave",
Fortschr Röntgenstr,
vol. 194,
pp. 70-82,
2022.
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,
W. Ahrens 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. 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",
The Journal of hospital infection,
vol. 125,
pp. 28—36,
2022.
Abstract:
BACKGROUND Patients are at risk of nosocomial COVID-19 infection. The role of accompanying persons/visitors as potential infection donors is not yet well researched, but the risk will be influenced by prevention measures recommended by infection control practitioners. AIM To collect information about COVID-19 infection control strategies for patients and accompanying persons from infection control practitioners in German hospitals. METHODS A cross-sectional questionnaire was developed, ethically approved, pre-tested and formatted as an online tool. Infection control practitioners in 987 randomly selected German hospitals were invited to participate in March and April 2021. For statistical analysis, the hospitals were categorized as small (0-499 beds) or large ($\geq$500 beds). FINDINGS One hundred surveys were completed (response rate: 10%). A higher proportion of large (71%) than small (49%) hospitals let patients decide freely whether to wear medical or FFP2 masks. Most hospitals reported spatial separation for COVID-19 patients and non-COVID-19 cases (38%) or additionally for suspected COVID-19 cases (53%). A separation of healthcare teams for these areas existed in 54% of the hospitals. Accompaniment bans were more prevalent in large (52%) than in small hospitals (29%), but large hospitals granted more exemptions. CONCLUSION The decision as to whether to separate areas and teams seemed to depend on the hospital's structural conditions, therefore impairing the implementation of recommendations. Accompaniment regulations differ between hospital sizes and may depend on patient numbers, case type/severity and patients' requirements. In the dynamic situation of a pandemic, it can be difficult to stay up to date with findings and recommendations on infection control.
| DOI: | 10.1016/j.jhin.2022.03.014 |
Abstract:
BACKGROUND Patients are at risk of nosocomial COVID-19 infection. The role of accompanying persons/visitors as potential infection donors is not yet well researched, but the risk will be influenced by prevention measures recommended by infection control practitioners. AIM To collect information about COVID-19 infection control strategies for patients and accompanying persons from infection control practitioners in German hospitals. METHODS A cross-sectional questionnaire was developed, ethically approved, pre-tested and formatted as an online tool. Infection control practitioners in 987 randomly selected German hospitals were invited to participate in March and April 2021. For statistical analysis, the hospitals were categorized as small (0-499 beds) or large ($\geq$500 beds). FINDINGS One hundred surveys were completed (response rate: 10%). A higher proportion of large (71%) than small (49%) hospitals let patients decide freely whether to wear medical or FFP2 masks. Most hospitals reported spatial separation for COVID-19 patients and non-COVID-19 cases (38%) or additionally for suspected COVID-19 cases (53%). A separation of healthcare teams for these areas existed in 54% of the hospitals. Accompaniment bans were more prevalent in large (52%) than in small hospitals (29%), but large hospitals granted more exemptions. CONCLUSION The decision as to whether to separate areas and teams seemed to depend on the hospital's structural conditions, therefore impairing the implementation of recommendations. Accompaniment regulations differ between hospital sizes and may depend on patient numbers, case type/severity and patients' requirements. In the dynamic situation of a pandemic, it can be difficult to stay up to date with findings and recommendations on infection control.
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. Dahlen,
J. Nicolai,
M. Stiller,
J. Blum,
C. Lange,
C. Adelmann,
B. Schroer,
U. Osmers,
C. Grice,
P. 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. J. Scholz,
N. Jazmati,
K. Göbels,
R. Zotz,
K. Pfeffer,
J. Timm,
L. Ehlkes,
A. Walker and
A. T. Dilthey,
"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.
Abstract:
BackgroundTracking person-to-person SARS-CoV-2 transmission in the population is important to understand the epidemiology of community transmission and may contribute to the containment of SARS-CoV-2. Neither contact tracing nor genomic surveillance alone, however, are typically sufficient to achieve this objective.AimWe demonstrate the successful application of the integrated genomic surveillance (IGS) system of the German city of Düsseldorf for tracing SARS-CoV-2 transmission chains in the population as well as detecting and investigating travel-associated SARS-CoV-2 infection clusters.MethodsGenomic surveillance, phylogenetic analysis, and structured case interviews were integrated to elucidate two genetically defined clusters of SARS-CoV-2 isolates detected by IGS in Düsseldorf in July 2021.ResultsCluster 1 (n = 67 Düsseldorf cases) and Cluster 2 (n = 36) were detected in a surveillance dataset of 518 high-quality SARS-CoV-2 genomes from Düsseldorf (53% of total cases, sampled mid-June to July 2021). Cluster 1 could be traced back to a complex pattern of transmission in nightlife venues following a putative importation by a SARS-CoV-2-infected return traveller (IP) in late June; 28 SARS-CoV-2 cases could be epidemiologically directly linked to IP. Supported by viral genome data from Spain, Cluster 2 was shown to represent multiple independent introduction events of a viral strain circulating in Catalonia and other European countries, followed by diffuse community transmission in Düsseldorf.ConclusionIGS enabled high-resolution tracing of SARS-CoV-2 transmission in an internationally connected city during community transmission and provided infection chain-level evidence of the downstream propagation of travel-imported SARS-CoV-2 cases.
| DOI: | 10.2807/1560-7917.ES.2022.27.43.2101089 |
Abstract:
BackgroundTracking person-to-person SARS-CoV-2 transmission in the population is important to understand the epidemiology of community transmission and may contribute to the containment of SARS-CoV-2. Neither contact tracing nor genomic surveillance alone, however, are typically sufficient to achieve this objective.AimWe demonstrate the successful application of the integrated genomic surveillance (IGS) system of the German city of Düsseldorf for tracing SARS-CoV-2 transmission chains in the population as well as detecting and investigating travel-associated SARS-CoV-2 infection clusters.MethodsGenomic surveillance, phylogenetic analysis, and structured case interviews were integrated to elucidate two genetically defined clusters of SARS-CoV-2 isolates detected by IGS in Düsseldorf in July 2021.ResultsCluster 1 (n = 67 Düsseldorf cases) and Cluster 2 (n = 36) were detected in a surveillance dataset of 518 high-quality SARS-CoV-2 genomes from Düsseldorf (53% of total cases, sampled mid-June to July 2021). Cluster 1 could be traced back to a complex pattern of transmission in nightlife venues following a putative importation by a SARS-CoV-2-infected return traveller (IP) in late June; 28 SARS-CoV-2 cases could be epidemiologically directly linked to IP. Supported by viral genome data from Spain, Cluster 2 was shown to represent multiple independent introduction events of a viral strain circulating in Catalonia and other European countries, followed by diffuse community transmission in Düsseldorf.ConclusionIGS enabled high-resolution tracing of SARS-CoV-2 transmission in an internationally connected city during community transmission and provided infection chain-level evidence of the downstream propagation of travel-imported SARS-CoV-2 cases.
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
others,
"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
others,
"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,
J. M. Adler,
K. Eschke,
G. Teixeira Alves,
S. Peidli,
F. Pott,
J. Kazmierski,
L. Michalick,
O. Kershaw,
J. Bushe,
S. Andreotti,
P. Pennitz,
A. Abdelgawad,
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.
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. 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",
J Clin Neurosci,
2022.
| DOI: | 10.1016/j.jocn.2022.05.031 |
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 |
M. Ackermann and
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 |