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.
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
others,
"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 |
D. Jonigk,
C. Werlein,
T. Acker 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 |
[eng]
D. Jonigk,
C. Werlein,
T. Acker,
M. Aepfelbacher,
K. U. Amann,
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.
Oorschot and
others,
"PallPan Richtig handeln in der Betreuung Schwerkranker und Sterbender in Pandemiezeiten",
Der Ophthalmologe,
2022.
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,
vol. 54,
no. 4,
pp. 518—525,
2022.
Abstract:
Typical genotyping workflows map reads to a reference genome before identifying genetic variants. Generating such alignments introduces reference biases and comes with substantial computational burden. Furthermore, short-read lengths limit the ability to characterize repetitive genomic regions, which are particularly challenging for fast k-mer-based genotypers. In the present study, we propose a new algorithm, PanGenie, that leverages a haplotype-resolved pangenome reference together with k-mer counts from short-read sequencing data to genotype a wide spectrum of genetic variation-a process we refer to as genome inference. Compared with mapping-based approaches, PanGenie is more than 4 times faster at 30-fold coverage and achieves better genotype concordances for almost all variant types and coverages tested. Improvements are especially pronounced for large insertions ($\geq$50 bp) and variants in repetitive regions, enabling the inclusion of these classes of variants in genome-wide association studies. PanGenie efficiently leverages the increasing amount of haplotype-resolved assemblies to unravel the functional impact of previously inaccessible variants while being faster compared with alignment-based workflows.
| DOI: | 10.1038/s41588-022-01043-w |
Abstract:
Typical genotyping workflows map reads to a reference genome before identifying genetic variants. Generating such alignments introduces reference biases and comes with substantial computational burden. Furthermore, short-read lengths limit the ability to characterize repetitive genomic regions, which are particularly challenging for fast k-mer-based genotypers. In the present study, we propose a new algorithm, PanGenie, that leverages a haplotype-resolved pangenome reference together with k-mer counts from short-read sequencing data to genotype a wide spectrum of genetic variation-a process we refer to as genome inference. Compared with mapping-based approaches, PanGenie is more than 4 times faster at 30-fold coverage and achieves better genotype concordances for almost all variant types and coverages tested. Improvements are especially pronounced for large insertions ($\geq$50 bp) and variants in repetitive regions, enabling the inclusion of these classes of variants in genome-wide association studies. PanGenie efficiently leverages the increasing amount of haplotype-resolved assemblies to unravel the functional impact of previously inaccessible variants while being faster compared with alignment-based workflows.
C. Yüksel,
M. Sähn,
M. Kleines,
J. Brokmann,
C. Kuhl,
D. Truhn,
A. Ritter,
P. Isfort and
M. Schulze-Hagen,
"Possible Alterations of Imaging Patterns in Computed Tomography for Delta-VOC of SARS-CoV-2",
Rofo,
vol. 194,
no. 11,
pp. 1229—1241,
2022.
| DOI: | 10.1055/a-1826-0436 |
C. Lemhöfer,
K. S. Appel,
W. Häuser,
N. Hettich,
M. Kohls and
M. C. Polidori,
"Post-COVID: Alles eine Frage der Definition?",
Dtsch Med Wochenschr,
vol. 147,
no. 21,
pp. 1391—1397,
Okt.
2022.
Georg Thieme Verlag KG.
Abstract:
Die Pr"avalenz des Post-COVID-Syndroms (PCS) ist noch nicht abschließend gekl"art. Die bisherigen Definitionen bilden vorrangig zeitliche Aspekte ab, lassen jedoch funktionelle Defizite sowie die Objektivierung von Symptomen außer Acht. Dies f"uhrt zu diagnostischen sowie therapeutischen Unklarheiten. In Pubmed wurde daher nach systematischen Reviews gesucht, die sich mit den Folgen einer SARS-CoV-2-Infektion befassten. Die zugrunde liegenden Definitionen sowie zeitlichen Einschlusskriterien wurden extrahiert. 16 systematische Reviews wurden eingeschlossen, davon 11 mit einer Definition des PCS. In 58 % der analysierten Einzelstudien wurden Patienten mit einer Symptomatik > 12 Wochen und damit entsprechend der Definition des PCS inkludiert. Fazit: Eine weitere Pr"azisierung der Definition des PCS ist notwendig, um Diagnostik und eine multimodale Behandlung zu erleichtern und die knappen therapeutischen Ressourcen entsprechend zu nutzen.
Abstract:
Die Pr"avalenz des Post-COVID-Syndroms (PCS) ist noch nicht abschließend gekl"art. Die bisherigen Definitionen bilden vorrangig zeitliche Aspekte ab, lassen jedoch funktionelle Defizite sowie die Objektivierung von Symptomen außer Acht. Dies f"uhrt zu diagnostischen sowie therapeutischen Unklarheiten. In Pubmed wurde daher nach systematischen Reviews gesucht, die sich mit den Folgen einer SARS-CoV-2-Infektion befassten. Die zugrunde liegenden Definitionen sowie zeitlichen Einschlusskriterien wurden extrahiert. 16 systematische Reviews wurden eingeschlossen, davon 11 mit einer Definition des PCS. In 58 % der analysierten Einzelstudien wurden Patienten mit einer Symptomatik > 12 Wochen und damit entsprechend der Definition des PCS inkludiert. Fazit: Eine weitere Pr"azisierung der Definition des PCS ist notwendig, um Diagnostik und eine multimodale Behandlung zu erleichtern und die knappen therapeutischen Ressourcen entsprechend zu nutzen.
F. Heinrich,
A. Schröder,
A. Gerberding and
et al,
"Postmortem Antigen-Detecting Rapid Diagnostic Tests to Predict Infectivity of SARS-CoV-2-Associated Deaths",
Emerg Infect Dis,
vol. 28,
pp. 244-247,
2022.
| DOI: | 10.3201/eid2801.211749 |
T. Schwarz and
et al,
"Preserved T cell responses to SARS-CoV-2 in anti-CD20 treated multiple sclerosis",
Multiple Sclerosis Journal,
2022.
| DOI: | 10.1101/2021.10.11.21264694 |
A. Surov,
H. Kardas,
G. Besutti,
M. Pellegrini,
M. Ottone,
M. Onur,
F. Atak,
A. Erdemir,
E. Hocaoglu,
Ö. Yıldız,
E. Inci,
E. Cingöz,
M. Cingöz,
M. Dursun,
İ. Korkmaz,
Ç. Orhan,
A. Strobel,
A. Wienke and
M. Pech,
"Prognostic Role of the Pectoralis Musculature in Patients with COVID-19. A Multicenter Study",
Acad Radiol,
2022.
| DOI: | 10.1016/j.acra.2022.05.003 |
H. Gorji,
N. Stauffer,
I. Lunati and
et al,
"Projection of healthcare demand in Germany and Switzerland urged by omicron wave (January-March 2022)",
MedRxiv,
2022.
| DOI: | 10.1101/2022.01.24.22269676 |
V. Authors,
"RACOON: Das Radiological Cooperative Network zur Beantwortung der großen Fragen in der Radiologie",
RöFo - Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren,
vol. 194,
no. 01,
pp. 95–95,
2022.
| DOI: | 10.1055/a-1544-2240 |
C. Dächert,
M. Muenchhoff,
A. Graf and
et al,
"Rapid and sensitive identification of omicron by variant-specific PCR and nanopore sequencing: paradigm for diagnostics of emerging SARS-CoV-2 variants",
Med Microbiol Immunol,
vol. 211,
no. 1,
2022.
| DOI: | 10.1007/s00430-022-00728-7 |
| Datei: | https://doi.org/10.1007/s00430-022-00728-7 |
M. Zickler,
S. Stanelle-Bertram,
S. Ehret and
et al,
"Replication of SARS-CoV-2 in adipose tissue determines organ and systemic lipid metabolism in hamsters and humans",
Cell Metab,
vol. 34,
pp. 1-2,
2022.
| DOI: | 10.1016/j.cmet.2021.12.002 |
M. Neidhardt,
S. Gerlach,
R. Mieling and
et al,
"Robotic Tissue Sampling for Safe Post-Mortem Biopsy in Infectious Corpses",
IEEE Trans. Med. Robot. Bionics,
vol. 4,
pp. 94-105,
2022.
| DOI: | 10.1109/TMRB.2022.3146440 |
S. I. Hammerschmidt,
C. Thurm,
B. Bošnjak and
et al,
"Robust induction of neutralizing antibodies against the SARS‐CoV‐2 Delta variant after homologous Spikevax or heterologous Vaxzevria‐Spikevax vaccination",
Eur J Immunol,
vol. 52,
no. 2,
2022.
| DOI: | 10.1002/eji.202149645 |
S. Momsen Reincke and
et al,
"SARS-CoV-2 Beta variant infection elicits potent lineage-specific and cross-reactive antibodies",
Science (New York, N.Y.),
2022.
| DOI: | 10.1126/science.abm5835 |
[eng]
J. Jansen,
K. C. Reimer,
J. S. Nagai,
F. S. Varghese,
G. J. Overheul,
M. Beer,
R. Roverts,
D. Daviran,
L. A. S. Fermin,
B. Willemsen,
M. Beukenboom,
S. Djudjaj,
S. Stillfried,
L. E. Eijk,
M. Mastik,
M. Bulthuis,
W. d. Dunnen,
H. Goor,
J. Hillebrands,
S. H. Triana,
T. Alexandrov,
M. Timm,
B. T. Berge,
M. Broek,
Q. Nlandu,
J. Heijnert,
E. M. J. Bindels,
R. M. Hoogenboezem,
F. Mooren,
C. Kuppe,
P. Miesen,
K. Grünberg,
T. Ijzermans,
E. J. Steenbergen,
J. Czogalla,
M. F. Schreuder,
N. Sommerdijk,
A. Akiva,
P. Boor,
V. G. Puelles,
J. Floege,
T. B. Huber,
C. M. consortium,
R. P. Rij,
I. G. Costa,
R. K. Schneider,
B. Smeets and
R. Kramann,
"SARS-CoV-2 infects the human kidney and drives fibrosis in kidney organoids",
Cell Stem Cell,
vol. 29,
no. 2,
pp. 217—231.e8,
Feb.
2022.
Abstract:
Kidney failure is frequently observed during and after COVID-19, but it remains elusive whether this is a direct effect of the virus. Here, we report that SARS-CoV-2 directly infects kidney cells and is associated with increased tubule-interstitial kidney fibrosis in patient autopsy samples. To study direct effects of the virus on the kidney independent of systemic effects of COVID-19, we infected human-induced pluripotent stem-cell-derived kidney organoids with SARS-CoV-2. Single-cell RNA sequencing indicated injury and dedifferentiation of infected cells with activation of profibrotic signaling pathways. Importantly, SARS-CoV-2 infection also led to increased collagen 1 protein expression in organoids. A SARS-CoV-2 protease inhibitor was able to ameliorate the infection of kidney cells by SARS-CoV-2. Our results suggest that SARS-CoV-2 can directly infect kidney cells and induce cell injury with subsequent fibrosis. These data could explain both acute kidney injury in COVID-19 patients and the development of chronic kidney disease in long COVID.
| DOI: | 10.1016/j.stem.2021.12.010 |
Abstract:
Kidney failure is frequently observed during and after COVID-19, but it remains elusive whether this is a direct effect of the virus. Here, we report that SARS-CoV-2 directly infects kidney cells and is associated with increased tubule-interstitial kidney fibrosis in patient autopsy samples. To study direct effects of the virus on the kidney independent of systemic effects of COVID-19, we infected human-induced pluripotent stem-cell-derived kidney organoids with SARS-CoV-2. Single-cell RNA sequencing indicated injury and dedifferentiation of infected cells with activation of profibrotic signaling pathways. Importantly, SARS-CoV-2 infection also led to increased collagen 1 protein expression in organoids. A SARS-CoV-2 protease inhibitor was able to ameliorate the infection of kidney cells by SARS-CoV-2. Our results suggest that SARS-CoV-2 can directly infect kidney cells and induce cell injury with subsequent fibrosis. These data could explain both acute kidney injury in COVID-19 patients and the development of chronic kidney disease in long COVID.
E. Layer,
S. Hoehl,
M. Widera,
D. Bojkova,
T. Westphal,
R. Gottschalk,
B. Boeddinghaus,
J. Schork,
S. Ciesek and
U. Goetsch,
"SARS-CoV-2 screening strategies for returning international travellers: Evaluation of a rapid antigen test approach",
International Journal of Infectious Diseases,
vol. 118,
pp. 126—131,
2022.
| DOI: | 10.1016/j.ijid.2022.02.045 |
I. Backhaus,
D. Hermsen,
J. Timm,
F. Boege,
N. Lübke,
T. Degode,
K. Göbels and
N. Dragano,
"SARS-CoV-2 seroprevalence and determinants of infection in young adults: A population-based seroepidemiological study",
Public Health,
2022.
| DOI: | https://doi.org/10.1016/j.puhe.2022.03.009 |
P. Arora and
et al,
"SARS-CoV-2 variants C.1.2 and B.1.621 (Mu) partially evade neutralization by antibodies elicited upon infection or vaccination",
Cell Reports,
vol. 39,
pp. 110754,
2022.
| DOI: | 10.1016/j.celrep.2022.110754 |
F. Steinbeis,
C. Thibeault,
F. Doellinger,
R. Ring,
M. Mittermaier,
C. Ruwwe-Glösenkamp,
F. Alius,
P. Knape,
H. Meyer,
L. Lippert,
E. Helbig,
B. Temmesfeld,
N. Suttorp,
L. E. Sander,
F. Kurth,
T. Penzkofer,
M. Witzenrath,
T. Zoller and
D. Grund,
"Severity of respiratory failure and computed chest tomography in acute COVID-19 correlates with pulmonary function and respiratory symptoms after infection with SARS-CoV-2: An observational longitudinal study over 12 months.",
Respir Med. 2022;191:106709.,
2022.
[en]
T. Bahmer,
C. Borzikowsky,
W. Lieb,
A. Horn,
L. Krist,
J. Fricke,
C. Scheibenbogen,
K. F. Rabe,
W. Maetzler,
C. Maetzler,
M. Laudien,
D. Frank,
S. Ballhausen,
A. Hermes,
O. Miljukov,
K. G. Haeusler,
N. E. E. Mokhtari,
M. Witzenrath,
J. J. Vehreschild,
D. Krefting,
D. Pape,
F. A. Montellano,
M. Kohls,
C. Morbach,
S. Störk,
J. Reese,
T. Keil,
P. Heuschmann,
M. Krawczak,
S. Schreiber and
N. group,
"Severity, predictors and clinical correlates of Post-COVID syndrome (PCS) in Germany: A prospective, multi-centre, population-based cohort study",
EClinicalMedicine,
vol. 51,
no. 101549,
pp. 101549,
Sep.
2022.
Elsevier BV.
Abstract:
Background: Post-COVID syndrome (PCS) is an important sequela of COVID-19, characterised by symptom persistence for >3 months, post-acute symptom development, and worsening of pre-existing comorbidities. The causes and public health impact of PCS are still unclear, not least for the lack of efficient means to assess the presence and severity of PCS. Methods: COVIDOM is a population-based cohort study of polymerase chain reaction (PCR) confirmed cases of SARS-CoV-2 infection, recruited through public health authorities in three German regions (Kiel, Berlin, W"urzburg) between November 15, 2020 and September 29, 2021. Main inclusion criteria were (i) a PCR confirmed SARS-CoV-2 infection and (ii) a period of at least 6 months between the infection and the visit to the COVIDOM study site. Other inclusion criteria were written informed consent and age $\geq$18 years. Key exclusion criterion was an acute reinfection with SARS-CoV-2. Study site visits included standardised interviews, in-depth examination, and biomaterial procurement. In sub-cohort Kiel-I, a PCS (severity) score was developed based upon 12 long-term symptom complexes. Two validation sub-cohorts (W"urzburg/Berlin, Kiel-II) were used for PCS score replication and identification of clinically meaningful predictors. This study is registered at clinicaltrials.gov (NCT04679584) and at the German Registry for Clinical Studies (DRKS, DRKS00023742). Findings: In Kiel-I (n = 667, 57% women), 90% of participants had received outpatient treatment for acute COVID-19. Neurological ailments (61·5%), fatigue (57·1%), and sleep disturbance (57·0%) were the most frequent persisting symptoms at 6-12 months after infection. Across sub-cohorts (W"urzburg/Berlin, n = 316, 52% women; Kiel-II, n = 459, 56% women), higher PCS scores were associated with lower health-related quality of life (EQ-5D-5L-VAS/-index: r = -0·54/ -0·56, all p < 0·0001). Severe, moderate, and mild/no PCS according to the individual participant's PCS score occurred in 18·8%, 48·2%, and 32·9%, respectively, of the Kiel-I sub-cohort. In both validation sub-cohorts, statistically significant predictors of the PCS score included the intensity of acute phase symptoms and the level of personal resilience. Interpretation: PCS severity can be quantified by an easy-to-use symptom-based score reflecting acute phase disease burden and general psychological predisposition. The PCS score thus holds promise to facilitate the clinical diagnosis of PCS, scientific studies of its natural course, and the development of therapeutic interventions. Funding: The COVIDOM study is funded by the Network University Medicine (NUM) as part of the National Pandemic Cohort Network (NAPKON).
| DOI: | 10.1016/j.eclinm.2022.101549 |
| Pubmed: | 35875815 |
Abstract:
Background: Post-COVID syndrome (PCS) is an important sequela of COVID-19, characterised by symptom persistence for >3 months, post-acute symptom development, and worsening of pre-existing comorbidities. The causes and public health impact of PCS are still unclear, not least for the lack of efficient means to assess the presence and severity of PCS. Methods: COVIDOM is a population-based cohort study of polymerase chain reaction (PCR) confirmed cases of SARS-CoV-2 infection, recruited through public health authorities in three German regions (Kiel, Berlin, W"urzburg) between November 15, 2020 and September 29, 2021. Main inclusion criteria were (i) a PCR confirmed SARS-CoV-2 infection and (ii) a period of at least 6 months between the infection and the visit to the COVIDOM study site. Other inclusion criteria were written informed consent and age $\geq$18 years. Key exclusion criterion was an acute reinfection with SARS-CoV-2. Study site visits included standardised interviews, in-depth examination, and biomaterial procurement. In sub-cohort Kiel-I, a PCS (severity) score was developed based upon 12 long-term symptom complexes. Two validation sub-cohorts (W"urzburg/Berlin, Kiel-II) were used for PCS score replication and identification of clinically meaningful predictors. This study is registered at clinicaltrials.gov (NCT04679584) and at the German Registry for Clinical Studies (DRKS, DRKS00023742). Findings: In Kiel-I (n = 667, 57% women), 90% of participants had received outpatient treatment for acute COVID-19. Neurological ailments (61·5%), fatigue (57·1%), and sleep disturbance (57·0%) were the most frequent persisting symptoms at 6-12 months after infection. Across sub-cohorts (W"urzburg/Berlin, n = 316, 52% women; Kiel-II, n = 459, 56% women), higher PCS scores were associated with lower health-related quality of life (EQ-5D-5L-VAS/-index: r = -0·54/ -0·56, all p < 0·0001). Severe, moderate, and mild/no PCS according to the individual participant's PCS score occurred in 18·8%, 48·2%, and 32·9%, respectively, of the Kiel-I sub-cohort. In both validation sub-cohorts, statistically significant predictors of the PCS score included the intensity of acute phase symptoms and the level of personal resilience. Interpretation: PCS severity can be quantified by an easy-to-use symptom-based score reflecting acute phase disease burden and general psychological predisposition. The PCS score thus holds promise to facilitate the clinical diagnosis of PCS, scientific studies of its natural course, and the development of therapeutic interventions. Funding: The COVIDOM study is funded by the Network University Medicine (NUM) as part of the National Pandemic Cohort Network (NAPKON).
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Abstract:
COVID-19 has challenged the healthcare systems worldwide. To quickly identify successful diagnostic and therapeutic approaches large data sharing approaches are inevitable. Though organizational clinical data are abundant, many of them are available only in isolated silos and largely inaccessible to external researchers. To overcome and tackle this challenge the university medicine network (comprising all 36 German university hospitals) has been founded in April 2020 to coordinate COVID-19 action plans, diagnostic and therapeutic strategies and collaborative research activities. 13 projects were initiated from which the CODEX project, aiming at the development of a Germany-wide Covid-19 Data Exchange Platform, is presented in this publication. We illustrate the conceptual design, the stepwise development and deployment, first results and the current status.
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Abstract:
The German government initiated the Network University Medicine (NUM) in early 2020 to improve national research activities on the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) pandemic. To this end, 36 German Academic Medical Centers started to collaborate on 13 projects, with the largest being the National Pandemic Cohort Network (NAPKON). The NAPKON's goal is creating the most comprehensive Coronavirus Disease 2019 (COVID-19) cohort in Germany. Within NAPKON, adult and pediatric patients are observed in three complementary cohort platforms (Cross-Sectoral, High-Resolution and Population-Based) from the initial infection until up to three years of follow-up. Study procedures comprise comprehensive clinical and imaging diagnostics, quality-of-life assessment, patient-reported outcomes and biosampling. The three cohort platforms build on four infrastructure core units (Interaction, Biosampling, Epidemiology, and Integration) and collaborations with NUM projects. Key components of the data capture, regulatory, and data privacy are based on the German Centre for Cardiovascular Research. By April 01, 2022, 34 university and 40 non-university hospitals have enrolled 5298 patients with local data quality reviews performed on 4727 (89%). 47% were female, the median age was 52 (IQR 36-62-) and 50 pediatric cases were included. 44% of patients were hospitalized, 15% admitted to an intensive care unit, and 12% of patients deceased while enrolled. 8845 visits with biosampling in 4349 patients were conducted by April 03, 2022. In this overview article, we summarize NAPKON's design, relevant milestones including first study population characteristics, and outline the potential of NAPKON for German and international research activities.Trial registration https://clinicaltrials.gov/ct2/show/NCT04768998 . https://clinicaltrials.gov/ct2/show/NCT04747366 . https://clinicaltrials.gov/ct2/show/NCT04679584.
| DOI: | 10.1007/s10654-022-00896-z |
| Pubmed: | 35904671 |
Abstract:
The German government initiated the Network University Medicine (NUM) in early 2020 to improve national research activities on the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) pandemic. To this end, 36 German Academic Medical Centers started to collaborate on 13 projects, with the largest being the National Pandemic Cohort Network (NAPKON). The NAPKON's goal is creating the most comprehensive Coronavirus Disease 2019 (COVID-19) cohort in Germany. Within NAPKON, adult and pediatric patients are observed in three complementary cohort platforms (Cross-Sectoral, High-Resolution and Population-Based) from the initial infection until up to three years of follow-up. Study procedures comprise comprehensive clinical and imaging diagnostics, quality-of-life assessment, patient-reported outcomes and biosampling. The three cohort platforms build on four infrastructure core units (Interaction, Biosampling, Epidemiology, and Integration) and collaborations with NUM projects. Key components of the data capture, regulatory, and data privacy are based on the German Centre for Cardiovascular Research. By April 01, 2022, 34 university and 40 non-university hospitals have enrolled 5298 patients with local data quality reviews performed on 4727 (89%). 47% were female, the median age was 52 (IQR 36-62-) and 50 pediatric cases were included. 44% of patients were hospitalized, 15% admitted to an intensive care unit, and 12% of patients deceased while enrolled. 8845 visits with biosampling in 4349 patients were conducted by April 03, 2022. In this overview article, we summarize NAPKON's design, relevant milestones including first study population characteristics, and outline the potential of NAPKON for German and international research activities.Trial registration https://clinicaltrials.gov/ct2/show/NCT04768998 . https://clinicaltrials.gov/ct2/show/NCT04747366 . https://clinicaltrials.gov/ct2/show/NCT04679584.
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