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Rau AL, Schicht M, Zahn I, Ali MJ, Coroneo MT, Paulsen F. Detection of SARS-CoV-2 binding receptors and miscellaneous targets as well as mucosal surface area of the human lacrimal drainage system. Ocul Surf 2024; 34:S1542-0124(24)00096-X. [PMID: 39218301 DOI: 10.1016/j.jtos.2024.08.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2024] [Revised: 07/23/2024] [Accepted: 08/29/2024] [Indexed: 09/04/2024]
Abstract
PURPOSE Our aim was to evaluate a potential role for the lacrimal drainage system (LDS) as a portal of entry and conduit for SARS-CoV-2 in human infection. We also investigate the mucosal surface area. The relatively long tear contact time in a closed system raises the possibility that this pathway may contribute to the initiation of systemic infection. We looked for expression of ACE2, the main receptor for SARS-CoV-2, as well as cofactors such as TMPRSS2 and other enzymes such as cathepsinB, CD147, elastase1, furin, neuropilin1, neuropilin2, TMPRSS11D and trypsin which also play a role in SARS-CoV-2 infection, in this system. METHODS Human tissue samples of the draining tear ducts from body donors were analyzed by RT-PCR, Western blot and immunohistochemistry. It is not known whether the respective body donors were Sars-Cov-2 positive at any time; they were negative when they entered the institute. Besides, the draining LDS of body donors were measured to determine the mucosal surface in the lacrimal system. RESULTS The expression of the main receptor studied, ACE2, cofactors such as TMPRSS2 and other enzymes such as cathepsinB, CD147, elastase1, furin, neuropilin1, neuropilin2, TMPRSS11D and trypsin were all detected at the gene and protein level. The average mucosal surface area of the lacrimal sac and nasolacrimal duct was calculated to be 110 mm2. CONCLUSION The results show the presence of all analyzed receptors in the efferent LDS. With an average tear passage time of 3 minutes and a relatively large mucosal surface area, the LDS could therefore be considered as a portal of entry and conduit for SARS-CoV-2. In addition, it represents a surface that should be taken into consideration in the administration of topically applied medication to the ocular surface.
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Affiliation(s)
- Anna-Lena Rau
- Functional and Clinical Anatomy, Friedrich Alexander University, Erlangen, Germany.
| | - Martin Schicht
- Functional and Clinical Anatomy, Friedrich Alexander University, Erlangen, Germany
| | - Ingrid Zahn
- Functional and Clinical Anatomy, Friedrich Alexander University, Erlangen, Germany
| | - Mohammad Javed Ali
- Govindram Seksaria Institute of Dacryology, L.V. Prasad Eye Institute, Hyderabad, India
| | - Minas Theodore Coroneo
- Department of Ophthalmology, Prince of Wales Hospital/University of New South Wales, Sydney, Australia; Department of Ophthalmology, Prince of Wales Clinical School, Faculty of Medicine, The University of New South Wales, Sydney, Australia
| | - Friedrich Paulsen
- Functional and Clinical Anatomy, Friedrich Alexander University, Erlangen, Germany.
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Oats A, Phung H, Tudehope L, Sofija E. Demographics, comorbidities and risk factors for severe disease from the early SARS-CoV-2 infection cases in Queensland, Australia. Intern Med J 2024; 54:786-794. [PMID: 37955361 DOI: 10.1111/imj.16276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 09/20/2023] [Indexed: 11/14/2023]
Abstract
BACKGROUND Demographics and comorbidities associated with coronavirus disease 2019 (COVID-19) severity differs between subpopulations and should be determined to aid future pandemic planning and preparedness. AIM To describe the demographics and comorbidities of patients diagnosed with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in Queensland (QLD), Australia, between January 2020 and May 2021. Also, to determine the relationship between these characteristics and disease severity based on the highest level of care. METHODS A retrospective case series analysis was conducted using data obtained from the Notifiable Conditions System. Data on patients confirmed with SARS-CoV-2 infection in QLD were included in this analysis. Descriptive statistics and logistic regression modelling were used to analyse factors that contributed to disease severity. RESULTS One thousand six hundred twenty-five patients with SARS-CoV-2 infection were diagnosed in the study period and analysed. The median age was 41 years and 54.3% (n = 882) were males. A total of 550 patients were hospitalised and 20 patients were admitted to the intensive care unit (ICU). In those admitted to the ICU, 95% (n = 19) were older than 45 years and 95% (n = 19) were male. Comorbidities significantly associated with hospitalisation were chronic cardiac disease (excluding hypertension) and diabetes, and for ICU admission were morbid obesity, chronic respiratory disease and chronic cardiac disease. No demographic factors were shown to be significantly associated with disease severity. CONCLUSIONS Comorbidities associated with the highest level of COVID-19 disease severity were morbid obesity, chronic respiratory disease and cardiac disease. These data can assist with identifying high-risk patients susceptible to severe COVID-19 and can be used to facilitate preparations for future pandemics.
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Affiliation(s)
- Alainah Oats
- School of Medicine and Dentistry, Griffith University, Southport, Queensland, Australia
- Pharmacy Department, Gold Coast University Hospital, Southport, Queensland, Australia
| | - Hai Phung
- School of Medicine and Dentistry, Griffith University, Southport, Queensland, Australia
| | - Lucy Tudehope
- School of Medicine and Dentistry, Griffith University, Southport, Queensland, Australia
| | - Ernesta Sofija
- School of Medicine and Dentistry, Griffith University, Southport, Queensland, Australia
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Karakaş Ö, Erden A, Armağan B, Güven SC, Atalar E, Polat B, Omma A, Küçükşahin O. Evaluation of patients with antiphospholipid syndrome subsequently COVID-19 vaccinations: A retrospective cohort study. Int J Rheum Dis 2023; 26:292-297. [PMID: 36371485 PMCID: PMC9877926 DOI: 10.1111/1756-185x.14490] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 10/16/2022] [Accepted: 10/19/2022] [Indexed: 11/15/2022]
Abstract
The aim of this study is to evaluate development of side effects, thrombotic or obstetric complications in our antiphospholipid syndrome (APS) patient group, after vaccination against coronavirus disease 2019 (COVID-19). A cohort was formed from patients who have previously been followed up with a diagnosis of APS. The patients of the cohort were evaluated retrospectively to find out if they were vaccinated with CoronaVac and/or BNT162b2 vaccines which are being used in our country. To evaluate the side effects seen after the vaccination, the information was collected by the patients in their outpatient appointments or making a phone call. Thirty-five APS patients who had received at least 1 dose of any of the COVID-19 vaccines were included in the study. Median (min-max) number of vaccine doses per patient was 2 (1-3). Eleven patients had a booster dose after primary vaccination. Twenty patients were ever vaccinated with BNT162b2 and 18 with CoronaVac. Among BNT162b2 recipients, 9 (45.0%) and among CoronaVac recipients 15 (42.9%) reported an adverse event after a vaccine administration. The most common adverse events were myalgia and malaise after any dose of both vaccines. No vaccine-related new thrombotic events or APS flares were observed. Our results were comparable with those reported in the literature. Comprehensive large-scale studies are needed for more accurate results on the evaluation of side effects after COVID-19 vaccination in APS patients.
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Affiliation(s)
- Özlem Karakaş
- Clinic of RheumatologyAnkara City HospitalAnkaraTurkey
| | - Abdulsamet Erden
- Division of Rheumatology, Department of Internal MedicineAnkara Yıldırım Beyazıt UniversityAnkaraTurkey
| | | | | | - Ebru Atalar
- Clinic of RheumatologyAnkara City HospitalAnkaraTurkey
| | | | - Ahmet Omma
- Clinic of RheumatologyHealth Sciences University, Ministry of Health Ankara City HospitalAnkaraTurkey
| | - Orhan Küçükşahin
- Division of Rheumatology, Department of Internal MedicineAnkara Yıldırım Beyazıt UniversityAnkaraTurkey
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Jerzynski L, Rotter G, Binting S, Teut M, Tissen-Diabaté T, Jeitler M, Seifert G, Kessler C, Michalsen A, Cramer H, Stöckigt B, Brinkhaus B, Ortiz M. Health-Related Self-Care Strategies and Coping Resources During the COVID-19 Pandemic: An Online-Based Cross-Sectional Study. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2022; 28:799-810. [PMID: 35944275 DOI: 10.1089/jicm.2022.0475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Background: Complementary medicine (CM) is often used as an opportunity for preventive health measures and supportive self-care practices. This study aimed to explore the use of self-care practices and preventive health strategies and the aspects of the experienced emotions during the COVID-19 pandemic in a population with an affinity for CM. Methods: The authors conducted an exploratory cross-sectional study using an anonymous 41-item online survey in the German language. The survey respondents were recruited among adults with an affinity for CM (e.g., as targeted through their memberships in CM associations) from September 2020 to February 2021. A selection of self-care methods, mainly from CM, was presented in the questionnaire. Numerical rating scales (NRSs), ranging from 0 = minimum to 10 = maximum, were used to measure the intensity of different emotions experienced during the pandemic. Statistical analysis was carried out descriptively. Results: A total of 1605 participants (80.6% female; mean age: 55.4 ± 12.6 [SD] years; 43.9% holding a university degree) were included. The use of self-care methods for health promotion during the pandemic was reported by 86.8% of the respondents. Respondents favored staying in nature (85.6%), healthy nutrition (85.6%), and physical activities (83.6%). More than 60% of the respondents made use of vitamin C and/or D, herbal medicines, nutritional supplements, relaxation techniques, breathing exercises, homeopathy, or meditation for health promotion. The analysis of emotional status by NRS (0-10) revealed the lowest mean ± SD (standard deviation) for "feeling lonely" (2.6 ± 2.9) and "feeling anxious" (2.8 ± 2.6), and the highest mean for "feeling connected to others" (6.2 ± 2.5) and "well-being" (5.8 ± 2.4). Conclusions: Participants used a wide variety of self-care methods and prevention strategies to promote their health during the COVID-19 pandemic and showed, overall, a balanced emotional status. Further research should include a control group representative of the general population, to investigate the possible impact of self-care strategies. Clinical Trial Registration Number: "Deutsches Register Klinischer Studien" (German Clinical Trial Register); registration number: DRKS00022909.
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Affiliation(s)
- Lea Jerzynski
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Gabriele Rotter
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Sylvia Binting
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Michael Teut
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Tatjana Tissen-Diabaté
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Michael Jeitler
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- Department of Internal and Integrative Medicine, Immanuel Krankenhaus Berlin, Berlin, Germany
| | - Georg Seifert
- Department of Pediatric Oncology/Hematology, Otto-Heubner Centre for Pediatric and Adolescent Medicine (OHC), Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- Department of Pediatrics, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Christian Kessler
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- Department of Internal and Integrative Medicine, Immanuel Krankenhaus Berlin, Berlin, Germany
| | - Andreas Michalsen
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- Department of Internal and Integrative Medicine, Immanuel Krankenhaus Berlin, Berlin, Germany
| | - Holger Cramer
- Department of Internal and Integrative Medicine, Evang. Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Barbara Stöckigt
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Benno Brinkhaus
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Miriam Ortiz
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
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Profile of Patients with Cardiovascular Diseases during the Pandemic in a Cardiology Clinic of a COVID-19 Support Hospital. Healthcare (Basel) 2022; 10:healthcare10101887. [PMID: 36292334 PMCID: PMC9601427 DOI: 10.3390/healthcare10101887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 09/09/2022] [Accepted: 09/22/2022] [Indexed: 12/02/2022] Open
Abstract
Background: During the pandemic, our hospital became a COVID support hospital and consequently the cardiology clinic had restricted activity; thus, it received only suspect and/or patients confirmed positive with the various COVID-19 strains that were associated with a chronic/flaring cardiovascular pathology. Methods: Two batches of patients admitted during a one-year period were compared in the cardiology clinic over two different periods of time: BATCH I (1 April 2019 to 31 March 2020), in a non-COVID context (BATCH I N-COV) and BATCH II (1 July 2020 to 30 June 2021) comprising patients that presented with respiratory infection of SARS-CoV-2 (BATCH II COV-2), associated with chronic and/or acute cardiovascular condition. To determine the profile of the patients admitted in our clinic, we observed the following parameters: age, type of cardiac condition, and admission mode (for the N-COV group). Results: The data obtained as absolute numbers and as percentages in relation to the total number of admissions were presented in separate tables and graphs for both of the studied groups. Conclusions: The SARS-CoV-2 pandemic, in its almost two years of evolution, has divided the medical world in two main categories: COVID and non-COVID. Admission of the patients with chronic, but non-COVID cardiac conditions, in our case, dropped to almost one-quarter when we compared the two absolute admission numbers: 1382 in the year prior to pandemic compared with only 356 in the pandemic year. We believe that the number of deaths due to SARS-CoV-2 infection was infinitely higher than the reported ones and uncountable, in as much as COVID-19 did not kill only the infected patients, but it has also yielded a very large number of collateral victims among chronic patients who had no contact with the disease, but were unable to be admitted and treated for chronic heart disease.
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Flores Sacoto KM, Sanchez Del Hierro GA, Moreno-Piedrahita Hernández FG, Jarrin Estupiñan JX. Case Fatality Rate of COVID-19 and its Relationship to Sociodemographic Characteristics in Ecuador, 2020. Int J Public Health 2022; 67:1604768. [PMID: 36147885 PMCID: PMC9485263 DOI: 10.3389/ijph.2022.1604768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 07/25/2022] [Indexed: 01/08/2023] Open
Abstract
Objective: To analyze sociodemographic factors’ influence on COVID-19 case fatality rate (CFR) in Ecuador on a subnational level.Methods: Publicly available register-based observational study. A retrospective cohort of COVID-19 infections between epidemiological weeks 8–53 in the Ecuadorian public healthcare system was determined from available records. Statistical analyses were conducted to evaluate CFR trends according to factors such as sex, age, location, and healthcare provider.Results: Overall CFR was 9.4%; by canton, median CFR was 5.2%, with some cantons with much higher rates, like Santa Elena (39.1%). Overall CFR decreased during the period, from 16.6% (week 8) to 2.63% (week 53). Being in a rural area was an independent protective factor. Patients over 65 had a hazard ratio of 11.38 (95% CI [11.05, 11.72]). Sex, ethnicity, and treatment from public facilities were also associated with death risk.Conclusion: CFR is a proxy indicator of COVID-19 impact in Ecuador, and this location-based analysis provides new information on the disease’s specific impact subnationally. Overall COVID-19 CFR during the entire period was high, suggesting the need to improve COVID-19 care in Ecuador.
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Affiliation(s)
- Karla Margarita Flores Sacoto
- CERPOP, UMR 1295, Inserm, Université de Toulouse - Université Paul Sabatier - Toulouse III, Toulouse, France
- Facultad de Medicina Pontificia Universidad Católica del Ecuador, Quito, Ecuador
- *Correspondence: Karla Margarita Flores Sacoto,
| | - Galo Antonio Sanchez Del Hierro
- Facultad de Medicina Pontificia Universidad Católica del Ecuador, Quito, Ecuador
- Centro de Investigación para la Salud en Latino América (CISeAL), Quito, Ecuador
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Goldenbogen B, Adler SO, Bodeit O, Wodke JAH, Escalera‐Fanjul X, Korman A, Krantz M, Bonn L, Morán‐Torres R, Haffner JEL, Karnetzki M, Maintz I, Mallis L, Prawitz H, Segelitz PS, Seeger M, Linding R, Klipp E. Control of COVID-19 Outbreaks under Stochastic Community Dynamics, Bimodality, or Limited Vaccination. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2022; 9:e2200088. [PMID: 35607290 PMCID: PMC9348421 DOI: 10.1002/advs.202200088] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 03/24/2022] [Indexed: 06/15/2023]
Abstract
Reaching population immunity against COVID-19 is proving difficult even in countries with high vaccination levels. Thus, it is critical to identify limits of control and effective measures against future outbreaks. The effects of nonpharmaceutical interventions (NPIs) and vaccination strategies are analyzed with a detailed community-specific agent-based model (ABM). The authors demonstrate that the threshold for population immunity is not a unique number, but depends on the vaccination strategy. Prioritizing highly interactive people diminishes the risk for an infection wave, while prioritizing the elderly minimizes fatalities when vaccinations are low. Control over COVID-19 outbreaks requires adaptive combination of NPIs and targeted vaccination, exemplified for Germany for January-September 2021. Bimodality emerges from the heterogeneity and stochasticity of community-specific human-human interactions and infection networks, which can render the effects of limited NPIs uncertain. The authors' simulation platform can process and analyze dynamic COVID-19 epidemiological situations in diverse communities worldwide to predict pathways to population immunity even with limited vaccination.
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Affiliation(s)
- Björn Goldenbogen
- Theoretical BiophysicsHumboldt‐Universität zu BerlinInvalidenstr. 42Berlin10115Germany
| | - Stephan O. Adler
- Theoretical BiophysicsHumboldt‐Universität zu BerlinInvalidenstr. 42Berlin10115Germany
| | - Oliver Bodeit
- Theoretical BiophysicsHumboldt‐Universität zu BerlinInvalidenstr. 42Berlin10115Germany
- Institute of BiochemistryCharité – Universitätsmedizin BerlinVirchowweg 6Berlin10117Germany
- Institute of Quantitative and Theoretical BiologyHeinrich‐Heine‐UniversitätUniversitätsstraße 1Düsseldorf40225Germany
| | - Judith A. H. Wodke
- Theoretical BiophysicsHumboldt‐Universität zu BerlinInvalidenstr. 42Berlin10115Germany
| | | | - Aviv Korman
- Theoretical BiophysicsHumboldt‐Universität zu BerlinInvalidenstr. 42Berlin10115Germany
| | - Maria Krantz
- Theoretical BiophysicsHumboldt‐Universität zu BerlinInvalidenstr. 42Berlin10115Germany
| | - Lasse Bonn
- Theoretical BiophysicsHumboldt‐Universität zu BerlinInvalidenstr. 42Berlin10115Germany
| | - Rafael Morán‐Torres
- Theoretical BiophysicsHumboldt‐Universität zu BerlinInvalidenstr. 42Berlin10115Germany
| | - Johanna E. L. Haffner
- Theoretical BiophysicsHumboldt‐Universität zu BerlinInvalidenstr. 42Berlin10115Germany
| | - Maxim Karnetzki
- Theoretical BiophysicsHumboldt‐Universität zu BerlinInvalidenstr. 42Berlin10115Germany
| | - Ivo Maintz
- Theoretical BiophysicsHumboldt‐Universität zu BerlinInvalidenstr. 42Berlin10115Germany
| | - Lisa Mallis
- Theoretical BiophysicsHumboldt‐Universität zu BerlinInvalidenstr. 42Berlin10115Germany
| | - Hannah Prawitz
- Theoretical BiophysicsHumboldt‐Universität zu BerlinInvalidenstr. 42Berlin10115Germany
| | - Patrick S. Segelitz
- Theoretical BiophysicsHumboldt‐Universität zu BerlinInvalidenstr. 42Berlin10115Germany
| | - Martin Seeger
- Theoretical BiophysicsHumboldt‐Universität zu BerlinInvalidenstr. 42Berlin10115Germany
- Rewire TxHumboldt‐Universität zu BerlinInvalidenstr. 42Berlin10115Germany
| | - Rune Linding
- Theoretical BiophysicsHumboldt‐Universität zu BerlinInvalidenstr. 42Berlin10115Germany
- Rewire TxHumboldt‐Universität zu BerlinInvalidenstr. 42Berlin10115Germany
| | - Edda Klipp
- Theoretical BiophysicsHumboldt‐Universität zu BerlinInvalidenstr. 42Berlin10115Germany
- Rewire TxHumboldt‐Universität zu BerlinInvalidenstr. 42Berlin10115Germany
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Berger U, Fritz C, Kauermann G. [Mandatory Testing in Schools can Significantly Reduce Underreporting of COVID-19 Infections Among Students with in-Class Teaching Compared to Home Schooling]. DAS GESUNDHEITSWESEN 2022; 84:495-502. [PMID: 35675830 PMCID: PMC11248797 DOI: 10.1055/a-1813-9778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Aim of the study The aim of this was to study investigate the effectiveness of mandatory Covid-19 tests for in-classroom teaching in reopened schools as a containment measure in the pandemic. In Bavaria, mandatory testing at schools was implemented directly after the Easter vacations in 2021. For the first week after the vacations, this resulted in a natural experiment that allowed us to quantify the impact of the new testing strategy on reported Covid-19 cases.Methods We compared changes in the reported 7-day incidence of new infections between districts with in-classroom teaching at school and districts with closed schools. During the calendar week 15, districts with reported incidences below 100 were allowed to reopen schools and have in-classroom teaching if mandatory COVID-19 testing was performed at school with rapid antigen tests. We do not have data on the rapid test results; however, positive test results in the rapid antigen test were verified by a PCR test, and cases of positive PCR test results were reported at the district level by age groups. In the calendar weeks 13 and 14, all schools in Bavaria were closed due to Easter vacations. Taking into account a latency period of about 3-4 days and a reporting period of 1-2 days, this means that any additional increase in reported incidences for districts with in-class teaching and mandatory testing in the week after the vacation cannot be attributed to transmissions at schools, but reflects the reduction of underreporting due to the newly implemented testing strategy.Results Reported incidence increased by a factor of 6.6 for 5-11 year old and by 1.7 for 12-20 year old pupils in districts with in-classroom teaching and mandatory testing at schools. This increase was accompanied by a reduction in underreporting and was significant compared to districts with school closure. Given the situation of a natural experiment, this increase in the reported incidence among school children can be attributed to the testing strategy. For the same time period, no differences in reported incidences were found for the other age groups.Conclusion In-class teaching with mandatory testing in reopened schools changes the role of schools in the pandemic. Our analyses show that reopening schools with a mandatory testing approach is beneficial from an epidemiologic perspective as it can strongly reduce the dark figure of COVID-19 cases among children.
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Affiliation(s)
- Ursula Berger
- IBE – Institute for Medical Information Processing, Biometry
and Epidemiology, Ludwig-Maximilians-Universität München,
Munchen, Germany
| | - Cornelius Fritz
- Statistik, LMU München Fakultät für Mathematik
Informatik und Statistik, Munchen, Germany
| | - Göran Kauermann
- Statistik, LMU München Fakultät für Mathematik
Informatik und Statistik, Munchen, Germany
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Pinky L, Dobrovolny HM. Epidemiological Consequences of Viral Interference: A Mathematical Modeling Study of Two Interacting Viruses. Front Microbiol 2022; 13:830423. [PMID: 35369460 PMCID: PMC8966706 DOI: 10.3389/fmicb.2022.830423] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 02/14/2022] [Indexed: 12/21/2022] Open
Abstract
Some viruses have the ability to block or suppress growth of other viruses when simultaneously present in the same host. This type of viral interference or viral block has been suggested as a potential interaction between some respiratory viruses including SARS-CoV-2 and other co-circulating respiratory viruses. We explore how one virus' ability to block infection with another within a single host affects spread of the viruses within a susceptible population using a compartmental epidemiological model. We find that population-level effect of viral block is a decrease in the number of people infected with the suppressed virus. This effect is most pronounced when the viruses have similar epidemiological parameters. We use the model to simulate co-circulating epidemics of SARS-CoV-2 and influenza, respiratory syncytial virus (RSV), and rhinovirus, finding that co-circulation of SARS-CoV-2 and RSV causes the most suppression of SARS-CoV-2. Paradoxically, co-circulation of SARS-CoV-2 and influenza or rhinovirus results in almost no change in the SARS-CoV-2 epidemic, but causes a shift in the timing of the influenza and rhinovirus epidemics.
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Affiliation(s)
- Lubna Pinky
- School of Health Professions, Eastern Virginia Medical School, Norfolk, VA, United States
| | - Hana M. Dobrovolny
- Department of Physics & Astronomy, Texas Christian University, Fort Worth, TX, United States
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Development of a Model for the Spread of Nosocomial Infection Outbreaks Using COVID-19 Data. Healthcare (Basel) 2022; 10:healthcare10030471. [PMID: 35326949 PMCID: PMC8950425 DOI: 10.3390/healthcare10030471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 02/24/2022] [Accepted: 03/01/2022] [Indexed: 11/23/2022] Open
Abstract
We constructed and validated a mathematical model of infectious diseases to simulate the impact of COVID-19 nosocomial infection outbreaks outside hospitals. The model was constructed with two populations, one inside the hospital and one outside the hospital, and a population diffusion rate k (0 ≤ k ≤ 1) was set as a parameter to simulate the flow of people inside the hospital to outside the hospital. To validate the model, we divided the values of the population diffusion rate k into k = 0–0.25, 0.25–0.50, 0.50–0.75, and 0.75–1.0, and the initial value at the beginning of the simulation was set as day 1. The number of infected people was calculated for a 60-day period. The change in the number of people infected outside the hospital due to the out-break of nosocomial infection was calculated. As a result of the simulation, the number of people infected outside the hospital increased as the population diffusion rate k increased from 0.50 to 0.75, but the number of people infected from 0.75 to 1.0 was almost the same as that from 0 to 0.25, with the peak day being earlier. In future, it will be necessary to examine epidemiological information that has a large impact on the results.
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Fehér Á, Szarvas Z, Lehoczki A, Fekete M, Fazekas-Pongor V. Co-infections in COVID-19 patients and correlation with mortality rate. Minireview. Physiol Int 2022; 109:1-8. [PMID: 35218335 DOI: 10.1556/2060.2022.00015] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 02/01/2022] [Indexed: 12/23/2022]
Abstract
PURPOSE The goal of our review was to gather information on the most important community-acquired and hospital-acquired co-infections among coronavirus disease 2019 (COVID-19) patients, and to examine not only the effect of these co-infections on disease outcomes but also to identify the possible risk factors that predispose COVID-19 patients to co-infections. METHODS Medline (PubMed) and Google Scholar were searched for relevant articles published between January 1st, 2020, and September 31st, 2021, on the topic of co-infections among COVID-19 patients. RESULTS Among community-acquired and hospital-acquired co-infections, bacterial and fungal co-infections are equally frequent, followed by viral co-infections that affected a relatively smaller portion of patients. Overall, co-infections were more frequent in the hospital than at the community level. Risk factors for acquiring co-infections include male gender, longer length of hospital stay, presence of supportive treatment, such as ventilation, the admission to intensive care units, the administration of medications, such as steroids or antibiotics, and certain blood parameters, such as high C-reactive protein or lymphopenia. The presence of co-infections could aggravate the COVID-19 disease severity, prolong the healing time of patients, and lead to worse disease outcomes overall. CONCLUSION Co-infections may increase the mortality of COVID-19 patients, especially in the hospital setting. Paying closer attention to hygiene, adhering to diagnostic and therapeutic protocols, implementing antimicrobial stewardship programs could decrease the occurrence of co-infections and lead to improved outcomes for COVID-19 patients.
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Affiliation(s)
- Ágnes Fehér
- 1 Department of Public Health, Semmelweis University, Faculty of Medicine, Budapest, Hungary
| | - Zsófia Szarvas
- 1 Department of Public Health, Semmelweis University, Faculty of Medicine, Budapest, Hungary
| | - Andrea Lehoczki
- 2 National Institute for Hematology and Infectious Diseases, Department of Hematology and Stem Cell Transplantation, South Pest Central Hospital, Budapest, Hungary
| | - Mónika Fekete
- 1 Department of Public Health, Semmelweis University, Faculty of Medicine, Budapest, Hungary
| | - Vince Fazekas-Pongor
- 1 Department of Public Health, Semmelweis University, Faculty of Medicine, Budapest, Hungary
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12
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The effect of age on ventilation management and clinical outcomes in critically ill COVID-19 patients--insights from the PRoVENT-COVID study. Aging (Albany NY) 2022; 14:1087-1109. [PMID: 35100136 PMCID: PMC8876900 DOI: 10.18632/aging.203863] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 01/12/2022] [Indexed: 11/25/2022]
Abstract
Introduction: We analyzed the association of age with ventilation practice and outcomes in critically ill COVID–19 patients requiring invasive ventilation. Methods: Posthoc analysis of the PRoVENT–COVID study, an observational study performed in 22 ICUs in the first 3 months of the national outbreak in the Netherlands. The coprimary endpoint was a set of ventilator parameters, including tidal volume normalized for predicted bodyweight, positive end–expiratory pressure, driving pressure, and respiratory system compliance in the first 4 days of invasive ventilation. Secondary endpoints were other ventilation parameters, the use of rescue therapies, pulmonary and extrapulmonary complications in the first 28 days in the ICU, hospital– and ICU stay, and mortality. Results: 1122 patients were divided into four groups based on age quartiles. No meaningful differences were found in ventilation parameters and in the use of rescue therapies for refractory hypoxemia in the first 4 days of invasive ventilation. Older patients received more often a tracheostomy, developed more frequently acute kidney injury and myocardial infarction, stayed longer in hospital and ICU, and had a higher mortality. Conclusions: In this cohort of invasively ventilated critically ill COVID–19 patients, age had no effect on ventilator management. Higher age was associated with more complications, longer length of stay in ICU and hospital and a higher mortality.
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13
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Elmir S, Jabi R, Noumairi M, Gartit M, El Bekkaoui M, Skiker I, Housni B, Bouziane M, El Oumri AA. An Exceptional Clinical Presentation associating an occipital stroke, a Superior and Inferior Mesenteric Thrombosis following Covid 19 disease, case report. Ann Med Surg (Lond) 2021; 72:103082. [PMID: 34868574 PMCID: PMC8632876 DOI: 10.1016/j.amsu.2021.103082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Revised: 11/15/2021] [Accepted: 11/16/2021] [Indexed: 11/30/2022] Open
Abstract
Introduction The Covid 19 pandemia since the first reported case in 2019 had a direct socioeconomic impact related to morbi-mortality and indirect in response to protection and isolation strategies. To our knowledge thrombo-embolic complications can be a mode of revelation complicating the management. Case presentation We present an exceptional case of a patient with a history of Covid 19,admitted 21 days later for disturbed consciousness, in whom an ischemic occipital stroke ,intestinal and colonic ishemia had been objectified. Our objective through this presentation is to remind the thrombo-embolic particularity of Covid 19, to take the viral attack as a serious antecedent in the periods following theinfection and to put the point on the primordial place of early rehabilitation in patients with stroke. Discussion and Conclusion We discuss through this report the recommendations of anticoagulation in Covid 19 patients and the place of early rehabilitation in patients with stroke. We also report a new case among the rare cases described in the literature that associates several thrombo-embolic manifestations secondary to Covid 19, in particular the neurological and digestive association. Exceptional Clinical Presentation associating an occipital Stroke, a Superior and Inferior Mesenteric Thrombosis following Covid 19 Disease. We propose take to the viral attack as a serious antecedent. This manuscript can add new perspectives to the management practice of this very rare presentation.
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Affiliation(s)
- Siham Elmir
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine and Pharmacy, Immunohematology/Cellular Therapy Laboratory Adults and Children(LIHTC), University Mohammed First Oujda, Morocco
| | - Rachid Jabi
- Department of General Surgery, Mohammed VI University Hospital, Faculty of Medicine and Pharmacy, Laboratory of Anatomy, Microsurgery and Surgery Experimental and Medical Simulation (LAMCESM),Mohammed Ist University, Oujda, Morocco
| | - Mohammed Noumairi
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine and Pharmacy, Immunohematology/Cellular Therapy Laboratory Adults and Children(LIHTC), University Mohammed First Oujda, Morocco
| | - Mohammed Gartit
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine and Pharmacy, Immunohematology/Cellular Therapy Laboratory Adults and Children(LIHTC), University Mohammed First Oujda, Morocco
| | - Mehdi El Bekkaoui
- Department of Radiolgy, Mohammed VI University Hospital, Faculty of Medicine and Pharmacy, Laboratory of Anatomy, Microsurgery and Surgery Experimental and Medical Simulation (LAMCESM),Mohammed Ist University, Oujda, Morocco
| | - Imane Skiker
- Department of Radiolgy, Mohammed VI University Hospital, Faculty of Medicine and Pharmacy, Laboratory of Anatomy, Microsurgery and Surgery Experimental and Medical Simulation (LAMCESM),Mohammed Ist University, Oujda, Morocco
| | - Brahim Housni
- Department of Anaesthesia and Intensive Care, Mohammed VI University Hospital, Faculty of Medicine and Pharmacy, Laboratory of Anatomy, Microsurgery and Surgery Experimental and Medical Simulation (LAMCESM),Mohammed Ist University, Oujda, Morocco
| | - Mohammed Bouziane
- Department of General Surgery, Mohammed VI University Hospital, Faculty of Medicine and Pharmacy, Laboratory of Anatomy, Microsurgery and Surgery Experimental and Medical Simulation (LAMCESM),Mohammed Ist University, Oujda, Morocco
| | - Ahmed Amine El Oumri
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine and Pharmacy, Immunohematology/Cellular Therapy Laboratory Adults and Children(LIHTC), University Mohammed First Oujda, Morocco
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14
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Wendt R, Lingitz MT, Laggner M, Mildner M, Traxler D, Graf A, Krotka P, Moser B, Hoetzenecker K, Kalbitz S, Lübbert C, Beige J, Ankersmit HJ. Clinical Relevance of Elevated Soluble ST2, HSP27 and 20S Proteasome at Hospital Admission in Patients with COVID-19. BIOLOGY 2021; 10:1186. [PMID: 34827178 PMCID: PMC8615143 DOI: 10.3390/biology10111186] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 11/11/2021] [Accepted: 11/13/2021] [Indexed: 12/12/2022]
Abstract
Although, severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) represents one of the biggest challenges in the world today, the exact immunopathogenic mechanism that leads to severe or critical Coronavirus Disease 2019 (COVID-19) has remained incompletely understood. Several studies have indicated that high systemic plasma levels of inflammatory cytokines result in the so-called "cytokine storm", with subsequent development of microthrombosis, disseminated intravascular coagulation, and multiorgan-failure. Therefore, we reasoned those elevated inflammatory molecules might act as prognostic factors. Here, we analyzed 245 serum samples of patients with COVID-19, collected at hospital admission. We assessed the levels of heat shock protein 27 (HSP27), soluble suppressor of tumorigenicity-2 (sST2) and 20S proteasome at hospital admission and explored their associations with overall-, 30-, 60-, 90-day- and in-hospital mortality. Moreover, we investigated their association with the risk of ventilation. We demonstrated that increased serum sST2 was uni- and multivariably associated with all endpoints. Furthermore, we also identified 20S proteasome as independent prognostic factor for in-hospital mortality (sST2, AUC = 0.73; HSP27, AUC = 0.59; 20S proteasome = 0.67). Elevated sST2, HSP27, and 20S proteasome levels at hospital admission were univariably associated with higher risk of invasive ventilation (OR = 1.8; p < 0.001; OR = 1.1; p = 0.04; OR = 1.03, p = 0.03, respectively). These findings could help to identify high-risk patients early in the course of COVID-19.
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Affiliation(s)
- Ralph Wendt
- Department of Infectious Diseases, Tropical Medicine, Nephrology and Rheumatology, St. Georg Hospital, Delitzscher Str. 141, 04129 Leipzig, Germany; (R.W.); (S.K.); (C.L.); (J.B.)
| | - Marie-Therese Lingitz
- Laboratory for Cardiac and Thoracic Diagnosis, Regeneration and Applied Immunology, Medical University of Vienna, Research Laboratories Vienna General Hospital, Waehringer Guertel 18-20, 1090 Vienna, Austria; (M.-T.L.); (M.L.); (M.M.); (D.T.); (B.M.)
- Department of Anaesthesia, Intensive Care Medicine and Pain Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - Maria Laggner
- Laboratory for Cardiac and Thoracic Diagnosis, Regeneration and Applied Immunology, Medical University of Vienna, Research Laboratories Vienna General Hospital, Waehringer Guertel 18-20, 1090 Vienna, Austria; (M.-T.L.); (M.L.); (M.M.); (D.T.); (B.M.)
| | - Michael Mildner
- Laboratory for Cardiac and Thoracic Diagnosis, Regeneration and Applied Immunology, Medical University of Vienna, Research Laboratories Vienna General Hospital, Waehringer Guertel 18-20, 1090 Vienna, Austria; (M.-T.L.); (M.L.); (M.M.); (D.T.); (B.M.)
- Department of Dermatology, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - Denise Traxler
- Laboratory for Cardiac and Thoracic Diagnosis, Regeneration and Applied Immunology, Medical University of Vienna, Research Laboratories Vienna General Hospital, Waehringer Guertel 18-20, 1090 Vienna, Austria; (M.-T.L.); (M.L.); (M.M.); (D.T.); (B.M.)
- Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - Alexandra Graf
- Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Spitalg. 23, 1090 Vienna, Austria; (A.G.); (P.K.)
| | - Pavla Krotka
- Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Spitalg. 23, 1090 Vienna, Austria; (A.G.); (P.K.)
| | - Bernhard Moser
- Laboratory for Cardiac and Thoracic Diagnosis, Regeneration and Applied Immunology, Medical University of Vienna, Research Laboratories Vienna General Hospital, Waehringer Guertel 18-20, 1090 Vienna, Austria; (M.-T.L.); (M.L.); (M.M.); (D.T.); (B.M.)
- Division of Thoracic Surgery, Department of Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria;
| | - Konrad Hoetzenecker
- Division of Thoracic Surgery, Department of Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria;
| | - Sven Kalbitz
- Department of Infectious Diseases, Tropical Medicine, Nephrology and Rheumatology, St. Georg Hospital, Delitzscher Str. 141, 04129 Leipzig, Germany; (R.W.); (S.K.); (C.L.); (J.B.)
| | - Christoph Lübbert
- Department of Infectious Diseases, Tropical Medicine, Nephrology and Rheumatology, St. Georg Hospital, Delitzscher Str. 141, 04129 Leipzig, Germany; (R.W.); (S.K.); (C.L.); (J.B.)
- Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine II, Leipzig University Medical Center, Liebigstr. 20, 04103 Leipzig, Germany
| | - Joachim Beige
- Department of Infectious Diseases, Tropical Medicine, Nephrology and Rheumatology, St. Georg Hospital, Delitzscher Str. 141, 04129 Leipzig, Germany; (R.W.); (S.K.); (C.L.); (J.B.)
- Department of Internal Medicine II, Martin-Luther-University Halle-Wittenberg, 06108 Halle/Saale, Germany
| | - Hendrik Jan Ankersmit
- Laboratory for Cardiac and Thoracic Diagnosis, Regeneration and Applied Immunology, Medical University of Vienna, Research Laboratories Vienna General Hospital, Waehringer Guertel 18-20, 1090 Vienna, Austria; (M.-T.L.); (M.L.); (M.M.); (D.T.); (B.M.)
- Division of Thoracic Surgery, Department of Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria;
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15
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Sardinha DM, do Socorro Pompeu de Loiola R, Ferreira ALDS, de Sá CAF, Rodrigues YC, Lima KVB, E Guimarães RJDPS, Lima LNGC. Risk factors associated with the severity of COVID-19 in a region of the Brazilian Amazon. Sci Rep 2021; 11:20569. [PMID: 34663823 PMCID: PMC8523658 DOI: 10.1038/s41598-021-00009-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 10/05/2021] [Indexed: 12/12/2022] Open
Abstract
The Brazilian Northern region registered a high incidence of COVID-19 cases, particularly in the state of Pará. The present study investigated the risk factors associated with the severity of COVID-19 in a Brazilian Amazon region of 100,819 cases. An epidemiological, cross-sectional, analytical and demographic study, analyzing data on confirmed cases for COVID-19 available at the Brazilian Ministry of Health's surveillance platform, was conducted. Variables such as, municipalities of residence, age, gender, signs and symptoms, comorbidities were included and associated with COVID-19 cases and outcomes. The spatial distribution was performed using the ArcGIS program. A total of 100,819 cases were evaluated. Overall, patients had the mean age of 42.3 years, were female (51.2%) and with lethality reaching 4.79% of cases. Main symptoms included fever (66.5%), cough (61.9%) and sore throat (39.8%). Regarding comorbidities, most of the patients presented cardiovascular disease (5.1%) and diabetes (4.2%). Neurological disease increased risk of death by nearly 15 times, followed by obesity (5.16 times) and immunodeficiency (5.09 time). The municipalities with the highest incidence rate were Parauapebas, Canaã dos Carajás and Jacareacanga. Similarity between the Lower Amazon, Marajó and Southwest mesoregions of Pará state were observed concerning the highest morbidity rates. The obtained data demonstrated that the majority of cases occurred among young adults, females, with the classic influenza symptoms and chronic diseases. Finally, data suggest that the highest incidences were no longer in the metropolitan region of the state. The higher lethality rate than in Brazil may be associated with the greater impacts of the disease in this Amazonian population, or factors associated with fragile epidemiological surveillance in the notification of cases of cure.
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Affiliation(s)
- Daniele Melo Sardinha
- Programa de Pós-Graduação em Epidemiologia e Vigilância em Saúde, Instituto Evandro Chagas (PPGEVS/IEC), Ananindeua, Pará, Brazil.
| | - Rosane do Socorro Pompeu de Loiola
- Programa de Pós-Graduação em Biologia de Agentes Infecciosos e Parasitários, Universidade Federal do Pará (PPGBAIP/UFPA), Belém, Pará, Brazil
| | - Ana Lúcia da Silva Ferreira
- Programa de Pós-Graduação em Biologia Parasitária na Amazônia, Universidade do Estado do Pará, Instituto Evandro Chagas (PPGBPA/UEPA/IEC), Ananindeua, Pará, Brazil
| | - Carmem Aliandra Freire de Sá
- Programa de Pós-Graduação em Epidemiologia e Vigilância em Saúde, Instituto Evandro Chagas (PPGEVS/IEC), Ananindeua, Pará, Brazil
| | - Yan Corrêa Rodrigues
- Programa de Pós-Graduação em Biologia Parasitária na Amazônia, Universidade do Estado do Pará, Instituto Evandro Chagas (PPGBPA/UEPA/IEC), Ananindeua, Pará, Brazil
| | - Karla Valéria Batista Lima
- Programa de Pós-Graduação em Biologia Parasitária na Amazônia, Universidade do Estado do Pará, Instituto Evandro Chagas (PPGBPA/UEPA/IEC), Ananindeua, Pará, Brazil
| | | | - Luana Nepomuceno Gondim Costa Lima
- Programa de Pós-Graduação em Epidemiologia e Vigilância em Saúde, Instituto Evandro Chagas (PPGEVS/IEC), Ananindeua, Pará, Brazil.,Programa de Pós-Graduação em Biologia Parasitária na Amazônia, Universidade do Estado do Pará, Instituto Evandro Chagas (PPGBPA/UEPA/IEC), Ananindeua, Pará, Brazil
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16
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Kieninger M, Sinning A, Vadász T, Gruber M, Gronwald W, Zeman F, Lunz D, Dienemann T, Schmid S, Graf B, Lubnow M, Müller T, Holzmann T, Salzberger B, Kieninger B. Lower blood pH as a strong prognostic factor for fatal outcomes in critically ill COVID-19 patients at an intensive care unit: A multivariable analysis. PLoS One 2021; 16:e0258018. [PMID: 34587211 PMCID: PMC8480873 DOI: 10.1371/journal.pone.0258018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 09/15/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Data of critically ill COVID-19 patients are being evaluated worldwide, not only to understand the various aspects of the disease and to refine treatment strategies but also to improve clinical decision-making. For clinical decision-making in particular, prognostic factors of a lethal course of the disease would be highly relevant. METHODS In this retrospective cohort study, we analyzed the first 59 adult critically ill Covid-19 patients treated in one of the intensive care units of the University Medical Center Regensburg, Germany. Using uni- and multivariable regression models, we extracted a set of parameters that allowed for prognosing in-hospital mortality. RESULTS Within the cohort, 19 patients died (mortality 32.2%). Blood pH value, mean arterial pressure, base excess, troponin, and procalcitonin were identified as highly significant prognostic factors of in-hospital mortality. However, no significant differences were found for other parameters expected to be relevant prognostic factors, like low arterial partial pressure of oxygen or high lactate levels. In the multivariable logistic regression analysis, the pH value and the mean arterial pressure turned out to be the most influential prognostic factors for a lethal course.
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Affiliation(s)
- Martin Kieninger
- Department of Anesthesiology, University Medical Center Regensburg, Regensburg, Germany
| | - Annemarie Sinning
- Department of Anesthesiology, University Medical Center Regensburg, Regensburg, Germany
| | - Timea Vadász
- Department of Infection Prevention and Infectious Diseases, University Medical Center Regensburg, Regensburg, Germany
| | - Michael Gruber
- Department of Anesthesiology, University Medical Center Regensburg, Regensburg, Germany
| | - Wolfram Gronwald
- Institute of Functional Genomics, University of Regensburg, Regensburg, Germany
| | - Florian Zeman
- Center for Clinical Studies, University Medical Center Regensburg, Regensburg, Germany
| | - Dirk Lunz
- Department of Infection Prevention and Infectious Diseases, University Medical Center Regensburg, Regensburg, Germany
| | - Thomas Dienemann
- Department of Surgery, University Medical Center Regensburg, Regensburg, Germany
| | - Stephan Schmid
- Department of Internal Medicine I, University Medical Center Regensburg, Regensburg, Germany
| | - Bernhard Graf
- Department of Infection Prevention and Infectious Diseases, University Medical Center Regensburg, Regensburg, Germany
| | - Matthias Lubnow
- Department of Internal Medicine II, University Medical Center Regensburg, Regensburg, Germany
| | - Thomas Müller
- Department of Internal Medicine II, University Medical Center Regensburg, Regensburg, Germany
| | - Thomas Holzmann
- Department of Infection Prevention and Infectious Diseases, University Medical Center Regensburg, Regensburg, Germany
| | - Bernd Salzberger
- Department of Infection Prevention and Infectious Diseases, University Medical Center Regensburg, Regensburg, Germany
| | - Bärbel Kieninger
- Department of Infection Prevention and Infectious Diseases, University Medical Center Regensburg, Regensburg, Germany
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Evidence of Long-Lasting Humoral and Cellular Immunity against SARS-CoV-2 Even in Elderly COVID-19 Convalescents Showing a Mild to Moderate Disease Progression. Life (Basel) 2021; 11:life11080805. [PMID: 34440549 PMCID: PMC8401673 DOI: 10.3390/life11080805] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 08/04/2021] [Accepted: 08/07/2021] [Indexed: 12/13/2022] Open
Abstract
We here evaluate the humoral and cellular immune response against SARS-CoV-2 in 41 COVID-19 convalescents. As previous studies mostly included younger individuals, one advantage of our study is the comparatively high mean age of the convalescents included in the cohort considered (54 ± 8.4 years). While anti-SARS-CoV-2 antibodies were still detectable in 95% of convalescents up to 8 months post infection, an antibody-decay over time was generally observed in most donors. Using a multiplex assay, our data additionally reveal that most convalescents exhibit a broad humoral immunity against different viral epitopes. We demonstrate by flow cytometry that convalescent donors show a significantly elevated number of natural killer cells when compared to healthy controls, while no differences were found concerning other leucocyte subpopulations. We detected a specific long-lasting cellular immune response in convalescents by stimulating immune cells with SARS-CoV-2-specific peptides, covering domains of the viral spike, membrane and nucleocapsid protein, and measuring interferon-γ (IFN-γ) release thereafter. We modified a commercially available ELISA assay for IFN-γ determination in whole-blood specimens of COVID-19 convalescents. One advantage of this assay is that it does not require special equipment and can, thus, be performed in any standard laboratory. In conclusion, our study adds knowledge regarding the persistence of immunity of convalescents suffering from mild to moderate COVID-19. Moreover, our study provides a set of simple methods to characterize and confirm experienced COVID-19.
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18
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Can SARS-CoV-2 infect the central nervous system via the olfactory bulb or the blood-brain barrier? Brain Behav Immun 2021; 95:7-14. [PMID: 33412255 PMCID: PMC7836942 DOI: 10.1016/j.bbi.2020.12.031] [Citation(s) in RCA: 60] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 12/23/2020] [Accepted: 12/28/2020] [Indexed: 12/17/2022] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in Wuhan, China in December 2019. On February 11, the World Health Organization (WHO) announced the name for the new illness caused by SARS-CoV-2: COVID-19. By March 11, the outbreak of COVID-19 was declared a pandemic by the WHO. This virus has extensively altered daily life for many across the globe, while claiming hundreds of thousands of lives. While fundamentally a respiratory illness, many infected individuals experience symptoms that involve the central nervous system (CNS). It is likely that many of these symptoms are the result of the virus residing outside of the CNS. However, the current evidence does indicate that the SARS-CoV-2 virus can use olfactory neurons (or other nerve tracts) to travel from the periphery into the CNS, and that the virus may also enter the brain through the blood-brain barrier (BBB). We discuss how the virus may use established infection mechanisms (ACE2, NRP1, TMPRSS2, furin and Cathepsin L), as well mechanisms still under consideration (BASIGIN) to infect and spread throughout the CNS. Confirming the impact of the virus on the CNS will be crucial in dealing with the long-term consequences of the epidemic.
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19
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Talotta R, Robertson ES. Antiphospholipid antibodies and risk of post-COVID-19 vaccination thrombophilia: The straw that breaks the camel's back? Cytokine Growth Factor Rev 2021; 60:52-60. [PMID: 34090785 PMCID: PMC8159713 DOI: 10.1016/j.cytogfr.2021.05.001] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 05/24/2021] [Indexed: 12/12/2022]
Abstract
Antiphospholipid antibodies (aPLs), present in 1–5 % of healthy individuals, are associated with the risk of antiphospholipid syndrome (APS), which is the most common form of acquired thrombophilia. APLs may appear following infections or vaccinations and have been reported in patients with COronaVIrus Disease-2019 (COVID-19). However, their association with COVID-19 vaccination is unclear. Notably, a few cases of thrombocytopenia and thrombotic events resembling APS have been reported to develop in recipients of either adenoviral vector- or mRNA-based COVID-19 vaccines. The aim of this review is therefore to speculate on the plausible role of aPLs in the pathogenesis of these rare adverse events. Adenoviral vector-based vaccines can bind platelets and induce their destruction in the reticuloendothelial organs. Liposomal mRNA-based vaccines may instead favour activation of coagulation factors and confer a pro-thrombotic phenotype to endothelial cells and platelets. Furthermore, both formulations may trigger a type I interferon response associated with the generation of aPLs. In turn, aPLs may lead to aberrant activation of the immune response with participation of innate immune cells, cytokines and the complement cascade. NETosis, monocyte recruitment and cytokine release may further support endothelial dysfunction and promote platelet aggregation. These considerations suggest that aPLs may represent a risk factor for thrombotic events following COVID-19 vaccination, and deserve further investigations.
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Affiliation(s)
- Rossella Talotta
- Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Messina, AOU "Gaetano Martino", via Consolare Valeria 1, 98124, Messina, Italy.
| | - Erle S Robertson
- Department of Otorhinolaryngology-Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, 3610 Hamilton Walk, 201E JP, Philadelphia, PA, 19104, USA.
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20
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Solomay TV, Semenenko TA, Filatov NN, Vedunova SL, Lavrov VF, Smirnova DI, Gracheva AV, Faizuloev EB. [Reactivation of Epstein-Barr virus ( Herpesviridae: Lymphocryptovirus, HHV-4) infection during COVID-19: epidemiological features]. Vopr Virusol 2021; 66:152-161. [PMID: 33993685 DOI: 10.36233/0507-4088-40] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Accepted: 05/15/2021] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Immunodeficiency underlying the development of severe forms of new coronavirus infection may be the result of mixed infection with SARS-CoV-2 and other pathogens, including Epstein-Barr virus (EBV).The aim is to study the prevalence and epidemiological features of co-infection with SARS-CoV-2 and EBV. MATERIAL AND METHODS A cross-sectional randomized study was conducted in Moscow region from March to May 2020. Two groups were examined for EBV-markers: hospital patients (n = 95) treated for SARS-CoV-2 infection and blood donors (n = 92). RESULTS With equal EBV prevalence the detection of active infection markers in donors (10.9%) was noticeably lower than in SARS-CoV-2 patients (80%). Significant differences in this indicator were also found when patients from subgroups with interstitial pneumonia with the presence (96.6%) and absence (97.2%) of SARS-CoV-2 in the nasopharyngeal smear were compared with the subgroup of patients with mild COVID-19 (43.3%). The average IgG VCA and IgG EBNA positivity coefficients in donor group were higher than in patient group (p < 0.05). Patients with active EBV infection markers were significantly more likely to have pneumonia, exceeding the reference values of ALT and the relative number of monocytes (odds ratio - 23.6; 3.5; 9.7, respectively). DISCUSSION The present study examined the incidence and analyzed epidemiological features of active EBV infection in patients with COVID-19. CONCLUSION A significantly higher rate of detection of active EBV infection markers in hospital patients indicates a combined participation SARS-CoV-2 and EBV in the development of interstitial pneumonia. Low levels of specific IgG EBV serve as predictors of EBV reactivation. Exceeding the reference values of ALT and the relative number of monocytes in patients should serve as a reason for examination for active EBV infection markers.
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Affiliation(s)
- T V Solomay
- Interregional Department No. 1 of the Federal Medical and Biological Agency; FSBSI «I.I. Mechnikov Research Institute of Vaccines and Sera»
| | - T A Semenenko
- FSBI «National Research Centre for Epidemiology and Microbiology named after the honorary academician N.F. Gamaleya» of the Ministry of Health of Russia; I.M. Sechenov First Moscow State Medical University (Sechenov University)
| | - N N Filatov
- FSBSI «I.I. Mechnikov Research Institute of Vaccines and Sera»; I.M. Sechenov First Moscow State Medical University (Sechenov University)
| | - S L Vedunova
- FSBSI «I.I. Mechnikov Research Institute of Vaccines and Sera»
| | - V F Lavrov
- FSBSI «I.I. Mechnikov Research Institute of Vaccines and Sera»; FSBEI FPE «Russian Medical Academy of Continuous Professional Education» of the Ministry of Health of Russia
| | - D I Smirnova
- FSBSI «I.I. Mechnikov Research Institute of Vaccines and Sera»
| | - A V Gracheva
- FSBSI «I.I. Mechnikov Research Institute of Vaccines and Sera»
| | - E B Faizuloev
- FSBSI «I.I. Mechnikov Research Institute of Vaccines and Sera»
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21
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Goulart CDL, Silva RN, Oliveira MR, Guizilini S, Rocco IS, Mendez VMF, Bonjorno JC, Caruso FR, Arena R, Borghi-Silva A. Lifestyle and rehabilitation during the COVID-19 pandemic: guidance for health professionals and support for exercise and rehabilitation programs. Expert Rev Anti Infect Ther 2021; 19:1385-1396. [PMID: 33852807 DOI: 10.1080/14787210.2021.1917994] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Introduction: The coronavirus disease-2019 (COVID-19) is a highly contagious respiratory viral disease for both the general population and healthcare professionals caring for infected patients. Of particular concern is the potential for significant respiratory, cardiovascular, physical, and psychological dysfunctions.Areas covered: In this context, the current review will focus on the following areas: 1) staying physically active during the COVID-19 pandemic; 2) highlighting the importance of understanding COVID-19 mechanisms; 3) preventing infections for healthcare workers by using personal protective equipment; 4) highlighting importance of respiratory care and physical therapy during hospitalization in patients with COVID-19; and 5) facilitating referral to a rehabilitation program in patients recovering from COVID-19.Expert opinion: We recommend daily physical exercise, outdoors or at home, as physical exercise increases the synthesis of anti-inflammatory cytokines; Patients with COVID-19 may develop severe acute respiratory syndrome, hypoxemia, diffuse alveolar damage, ACE2 reduction in the cardiovascular system and muscle weakness acquired through a prolonged hospital stay; The role of the physiotherapist in the hospital environment is of fundamental importance-early mobilization is highly recommended in severe cases of COVID-19.
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Affiliation(s)
- Cássia Da Luz Goulart
- Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department, Universidade Federal De Sao Carlos, Sao Carlos, SP, Brazil
| | - Rebeca Nunes Silva
- Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department, Universidade Federal De Sao Carlos, Sao Carlos, SP, Brazil
| | - Murilo Rezende Oliveira
- Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department, Universidade Federal De Sao Carlos, Sao Carlos, SP, Brazil
| | - Solange Guizilini
- Department of the Human Movement Sciences, Universidade Federal De São Paulo - UNIFESP, Santos, SP, Brazil
| | - Isadora Salvador Rocco
- Department of the Human Movement Sciences, Universidade Federal De São Paulo - UNIFESP, Santos, SP, Brazil
| | | | - José Carlos Bonjorno
- Department of Medicine, Universidade Federal De Sao Carlos, Sao Carlos, SP, Brazil
| | - Flavia Rossi Caruso
- Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department, Universidade Federal De Sao Carlos, Sao Carlos, SP, Brazil
| | - Ross Arena
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL., USA.,Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, USA
| | - Audrey Borghi-Silva
- Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department, Universidade Federal De Sao Carlos, Sao Carlos, SP, Brazil.,Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, USA
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22
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Klein A, Langenwalder F, Heinrich F, Meißner K, Schröder AS, Püschel K, Ondruschka B, Lütgehetmann M, Heinemann A. [SARS-CoV‑2 incidental findings among Hamburg deaths: an epidemiological monitoring during the dynamic infection event in spring 2020]. Rechtsmedizin (Berl) 2021; 31:427-433. [PMID: 33897111 PMCID: PMC8056197 DOI: 10.1007/s00194-021-00481-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/05/2021] [Indexed: 01/08/2023]
Abstract
Background In the context of the COVID-19-pandemic, mortality and incidence are key determinants to assess the transmission dynamics and the resulting potential threat. Systematic microbiological monitoring of deaths provides a fundamental basis to particularly assess underrecording of community-acquired mortality. It should be further elucidated whether a death cohort of previously unreported cases may be structurally different from the cohort of officially registered cases. Methods A systematic reverse transcription (RT) qPCR testing for SARS-CoV‑2 infections from nasopharyngeal swab samples was carried out. A representative sample of corpses from crematoria and the Institute of Legal Medicine of the Federal State of Hamburg were included. A comparative analysis of primarily reported and unreported fatalities in an 8‑week period after occurrence of the first pandemic-related deaths in Hamburg was performed. Results A total of 1231 deaths were included, all of which were previously unsuspicious for SARS-CoV‑2 infection. Thereof 29 cases of previously unknown infections were recorded. In the first phase of the pandemic, incidental findings predominantly occurred among younger people from domestic environments with unclear or unnatural manner of death at the Institute of Legal Medicine. Over time, incidental findings investigated at the crematoria increased, mostly related to nursing home residents. The overall cohort showed no significant sociodemographic differences to a comparative collective of known SARS-CoV‑2-associated deaths. Primarily unreported cases showed a significantly lower proportion of COVID-19 as the underlying cause of death. Conclusion A systematic PCR-based monitoring of deaths allows a more targeted detection and classification of SARS-CoV‑2 positive cases. A preventive contribution can be made by disclosing unreported pandemic-related cases of death.
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Affiliation(s)
- Anke Klein
- Institut für Rechtsmedizin, Universitätsklinikum Hamburg-Eppendorf, Butenfeld 34, 22529 Hamburg, Deutschland
| | - Felicia Langenwalder
- Institut für Rechtsmedizin, Universitätsklinikum Hamburg-Eppendorf, Butenfeld 34, 22529 Hamburg, Deutschland
| | - Fabian Heinrich
- Institut für Rechtsmedizin, Universitätsklinikum Hamburg-Eppendorf, Butenfeld 34, 22529 Hamburg, Deutschland
| | - Kira Meißner
- Institut für Rechtsmedizin, Universitätsklinikum Hamburg-Eppendorf, Butenfeld 34, 22529 Hamburg, Deutschland
| | - Ann Sophie Schröder
- Institut für Rechtsmedizin, Universitätsklinikum Hamburg-Eppendorf, Butenfeld 34, 22529 Hamburg, Deutschland
| | - Klaus Püschel
- Institut für Rechtsmedizin, Universitätsklinikum Hamburg-Eppendorf, Butenfeld 34, 22529 Hamburg, Deutschland
| | - Benjamin Ondruschka
- Institut für Rechtsmedizin, Universitätsklinikum Hamburg-Eppendorf, Butenfeld 34, 22529 Hamburg, Deutschland
| | - Marc Lütgehetmann
- Institut für Medizinische Mikrobiologie, Virologie und Hygiene, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Deutschland
| | - Axel Heinemann
- Institut für Rechtsmedizin, Universitätsklinikum Hamburg-Eppendorf, Butenfeld 34, 22529 Hamburg, Deutschland
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23
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Caturano V, Manti B, Carbone F, Lasorsa VA, Colicchio R, Capasso M, Leonardi A, Matarese G, Russo T, Salvatore P. Estimating asymptomatic SARS-CoV-2 infections in a geographic area of low disease incidence. BMC Infect Dis 2021; 21:350. [PMID: 33853532 PMCID: PMC8046491 DOI: 10.1186/s12879-021-06054-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 04/05/2021] [Indexed: 11/25/2022] Open
Abstract
Background The SARS-CoV-2 infection has emerged as a rapidly spreading infection. Today it is relatively easy to isolate Covid-19 symptomatic cases, while remains problematic to control the disease spread by infected but symptom-free individuals. The control of this possible path of contagion requires drastic measures of social distancing, which imply the suspension of most activities and generate economic and social issues. This study is aimed at estimating the percentage of asymptomatic SARS-CoV-2 infection in a geographic area with relatively low incidence of Covid-19. Methods Blood serum samples from 388 healthy volunteers were analyzed for the presence of anti-SARS-CoV-2 IgG by using an ELISA assay based on recombinant viral nucleocapsid protein. Results We found that 7 out of 388 healthy volunteers, who declared no symptoms of Covid-19, like fever, cough, fatigue etc., in the preceding 5 months, have bona fide serum anti-SARS-CoV-2 IgG, that is 1.8% of the asymptomatic population (95% confidence interval: 0.69–2.91%). Conclusions The estimated range of asymptomatic individuals with anti-SARS-CoV-2 IgG should be between 26,565 and 112, 350. In the same geographic area, there are 4665 symptomatic diagnosed cases. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-021-06054-2.
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Affiliation(s)
- Valeria Caturano
- Department of Molecular Medicine and Medical Biotechnology, University of Napoli Federico II, Via S. Pansini 5, 80131, Naples, Italy
| | - Barbara Manti
- Department of Molecular Medicine and Medical Biotechnology, University of Napoli Federico II, Via S. Pansini 5, 80131, Naples, Italy
| | - Fortunata Carbone
- Istituto di Endocrinologia e Oncologia Sperimentale, Consiglio Nazionale Delle Ricerche (IEOS-CNR), Naples, Italy
| | - Vito Alessandro Lasorsa
- Department of Molecular Medicine and Medical Biotechnology, University of Napoli Federico II, Via S. Pansini 5, 80131, Naples, Italy.,CEINGE Biotecnologie Avanzate s.c.ar.l., Naples, Italy
| | - Roberta Colicchio
- Department of Molecular Medicine and Medical Biotechnology, University of Napoli Federico II, Via S. Pansini 5, 80131, Naples, Italy
| | - Mario Capasso
- Department of Molecular Medicine and Medical Biotechnology, University of Napoli Federico II, Via S. Pansini 5, 80131, Naples, Italy.,CEINGE Biotecnologie Avanzate s.c.ar.l., Naples, Italy
| | - Antonio Leonardi
- Department of Molecular Medicine and Medical Biotechnology, University of Napoli Federico II, Via S. Pansini 5, 80131, Naples, Italy
| | - Giuseppe Matarese
- Department of Molecular Medicine and Medical Biotechnology, University of Napoli Federico II, Via S. Pansini 5, 80131, Naples, Italy.,Istituto di Endocrinologia e Oncologia Sperimentale, Consiglio Nazionale Delle Ricerche (IEOS-CNR), Naples, Italy
| | - Tommaso Russo
- Department of Molecular Medicine and Medical Biotechnology, University of Napoli Federico II, Via S. Pansini 5, 80131, Naples, Italy.
| | - Paola Salvatore
- Department of Molecular Medicine and Medical Biotechnology, University of Napoli Federico II, Via S. Pansini 5, 80131, Naples, Italy. .,CEINGE Biotecnologie Avanzate s.c.ar.l., Naples, Italy.
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24
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Wirth R, Becker C, Djukic M, Drebenstedt C, Heppner HJ, Jacobs AH, Meisel M, Michels G, Nau R, Pantel J, Bauer JM. [COVID-19 in old age-The geriatric perspective]. Z Gerontol Geriatr 2021; 54:152-160. [PMID: 33595696 PMCID: PMC7887547 DOI: 10.1007/s00391-021-01864-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Accepted: 02/02/2021] [Indexed: 01/16/2023]
Abstract
Predominantly the older population is affected by a severe course of COVID-19. The mortality of hospitalized patients with COVID-19 above the age of 80 years is up to 54% in international studies. These observations indicate the necessity to highlight the geriatric perspective on this disease. The diagnostics and treatment of COVID-19 do not differ between younger and older patients but atypical symptoms should be expected more frequently in old age. Older subjects show an increased need for rehabilitation after COVID-19. Paradoxically, increasing rehabilitation demands go along with a reduced availability of geriatric rehabilitation options, the latter being a consequence of closure or downsizing of rehabilitation departments during the pandemic. In general, measures of isolation and quarantine should be diligently balanced as the health and emotional consequences of such measures may be severe in older persons. In light of the poor prognosis of older COVID-19 patients, advanced care planning becomes even more relevant. Caregivers and physicians should be encouraged to compose advanced care directives that also reflect the specific circumstances of COVID-19. Fortunately, current data suggest that the effectiveness of the vaccination with the mRNA-vaccines approved in Germany may be equally high in older compared to younger persons.
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Affiliation(s)
- R Wirth
- Deutsche Gesellschaft für Geriatrie (DGG), Berlin, Deutschland.
- Klinik für Altersmedizin und Frührehabilitation, Marien Hospital Herne - Universitätsklinikum der Ruhr-Universität Bochum, Hölkeskampring 40, 44625, Herne, Deutschland.
| | - C Becker
- Deutsche Gesellschaft für Geriatrie (DGG), Berlin, Deutschland
- Klinik für Geriatrie, Robert-Bosch-Krankenhaus Stuttgart, Stuttgart, Deutschland
| | - M Djukic
- Deutsche Gesellschaft für Geriatrie (DGG), Berlin, Deutschland
- Geriatrisches Zentrum, Evangelisches Krankenhaus Göttingen-Weende, Göttingen, Deutschland
- Abteilung für Neuropathologie, Universitätsmedizin Göttingen, Göttingen, Deutschland
| | - C Drebenstedt
- Deutsche Gesellschaft für Geriatrie (DGG), Berlin, Deutschland
- Klinik für Innere Medizin und Geriatrie, St.-Marien-Hospital Friesoythe, Friesoythe, Deutschland
| | - H J Heppner
- Deutsche Gesellschaft für Geriatrie (DGG), Berlin, Deutschland
- Klinik für Geriatrie, Helios Klinikum Schwelm, Lehrstuhl für Geriatrie, Universität Witten-Herdecke, Schwelm, Deutschland
| | - A H Jacobs
- Deutsche Gesellschaft für Geriatrie (DGG), Berlin, Deutschland
- Klinik für Geriatrie mit Neurologie, Johanniter Krankenhaus Bonn, Bonn, Deutschland
- CIO, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn, Deutschland
- EIMI, Westfälische Wilhelms-Universität Münster, Münster, Deutschland
| | - M Meisel
- Deutsche Gesellschaft für Geriatrie (DGG), Berlin, Deutschland
- Klinik für Innere Medizin und Geriatrie, Diakonissenkrankenhaus Dessau, Dessau, Deutschland
| | - G Michels
- Klinik für Akut- und Notfallmedizin, St.-Antonius-Hospital gGmbH Eschweiler, Akademisches Lehrkrankenhaus der RWTH Aachen, Eschweiler, Deutschland
| | - R Nau
- Deutsche Gesellschaft für Geriatrie (DGG), Berlin, Deutschland
- Geriatrisches Zentrum, Evangelisches Krankenhaus Göttingen-Weende, Göttingen, Deutschland
- Abteilung für Neuropathologie, Universitätsmedizin Göttingen, Göttingen, Deutschland
| | - J Pantel
- Deutsche Gesellschaft für Geriatrie (DGG), Berlin, Deutschland
- Institut für Allgemeinmedizin, Johann Wolfgang Goethe-Universität Frankfurt, Frankfurt, Deutschland
| | - J M Bauer
- Deutsche Gesellschaft für Geriatrie (DGG), Berlin, Deutschland
- Geriatrisches Zentrum und Netzwerk Altersmedizin, Agaplesion Bethanien Krankenhaus Heidelberg, Universität Heidelberg, Heidelberg, Deutschland
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25
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Recommendations for the management of COVID-19 pandemic in long-term care facilities. Z Gerontol Geriatr 2021; 54:136-140. [PMID: 33452539 PMCID: PMC7810427 DOI: 10.1007/s00391-021-01847-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Accepted: 01/07/2021] [Indexed: 12/26/2022]
Abstract
Long-term care facilities (LTCF) and their vulnerable residents are particularly affected by the coronavirus disease 2019 (COVID-19) pandemic. Estimates from various countries suggest that 3-66% of all COVID-19 deaths were residents of LTCF, of which 80% died in their facilities. Despite these significant numbers, recommendations for LTCF for the prevention and medical care of residents during the COVID-19 pandemic are still lacking. These recommendations are based on the existing literature and the expertise of the authors who are specialists in geriatric medicine. The recommendations are addressed to LTCF management, their operators, physicians working in LTCFs and also politicians, to provide the necessary framework conditions. We are confident that our recommendations will offer important help and guidance for LTCFs as well as their physicians. Adherence to these recommendations is likely to improve the outcomes and care of residents in long-term facilities during the COVID-19 pandemic.
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26
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Schmidt F, Hauptmann C, Kohlenz W, Gasser P, Hartmann S, Daunderer M, Weiler T, Nowak L. Tackling the Waves of COVID-19: A Planning Model for Intrahospital Resource Allocation. FRONTIERS IN HEALTH SERVICES 2021; 1:718668. [PMID: 36926477 PMCID: PMC10012637 DOI: 10.3389/frhs.2021.718668] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 08/06/2021] [Indexed: 12/23/2022]
Abstract
Background: The current pandemic requires hospitals to ensure care not only for the growing number of COVID-19 patients but also regular patients. Hospital resources must be allocated accordingly. Objective: To provide hospitals with a planning model to optimally allocate resources to intensive care units given a certain incidence of COVID-19 cases. Methods: The analysis included 334 cases from four adjacent counties south-west of Munich. From length of stay and type of ward [general ward (NOR), intensive care unit (ICU)] probabilities of case numbers within a hospital at a certain time point were derived. The epidemiological situation was simulated by the effective reproduction number R, the infection rates in mid-August 2020 in the counties, and the German hospitalization rate. Simulation results are compared with real data from 2nd and 3rd wave (September 2020-May 2021). Results: With R = 2, a hospitalization rate of 17%, mitigation measures implemented on day 9 (i.e., 7-day incidence surpassing 50/100,000), the peak occupancy was reached on day 22 (155.1 beds) for the normal ward and on day 25 (44.9 beds) for the intensive care unit. A higher R led to higher occupancy rates. Simulated number of infections and intensive care unit occupancy was concordant in validation with real data obtained from the 2nd and 3rd waves in Germany. Conclusion: Hospitals could expect a peak occupancy of normal ward and intensive care unit within ~5-11 days after infections reached their peak and critical resources could be allocated accordingly. This delay (in particular for the peak of intensive care unit occupancy) might give options for timely preparation of additional intensive care unit resources.
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Affiliation(s)
| | - Christian Hauptmann
- Führungsgruppe Katastrophenschutz im Rettungsdienstbereich Fürstenfeldbruck, Fürstenfeldbruck, Germany.,Bio-Inspired Information Processing, Department of Electrical Engineering and Computer Engineering, Technical University of Munich, Munich, Germany
| | - Walter Kohlenz
- Führungsgruppe Katastrophenschutz im Rettungsdienstbereich Fürstenfeldbruck, Fürstenfeldbruck, Germany
| | - Philipp Gasser
- Führungsgruppe Katastrophenschutz im Rettungsdienstbereich Fürstenfeldbruck, Fürstenfeldbruck, Germany
| | - Sascha Hartmann
- Führungsgruppe Katastrophenschutz im Rettungsdienstbereich Fürstenfeldbruck, Fürstenfeldbruck, Germany
| | - Michael Daunderer
- Führungsgruppe Katastrophenschutz im Rettungsdienstbereich Fürstenfeldbruck, Fürstenfeldbruck, Germany.,ÄLRD ZRF-FFB, Fürstenfeldbruck, Germany
| | - Thomas Weiler
- Führungsgruppe Katastrophenschutz im Rettungsdienstbereich Fürstenfeldbruck, Fürstenfeldbruck, Germany
| | - Lorenz Nowak
- Asklepios Lung Clinic Munich-Gauting, Gauting, Germany
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27
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Wang J, Zhu X, Sun Y, Zhang X, Zhang W. Efficacy and safety of traditional Chinese medicine combined with routine western medicine for the asymptomatic novel coronavirus disease (COVID-19): A Bayesian network meta-analysis protocol. Medicine (Baltimore) 2020; 99:e21927. [PMID: 32871931 PMCID: PMC7458228 DOI: 10.1097/md.0000000000021927] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND The number of patients infected with novel coronavirus disease (COVID-19) has exceeded 10 million in 2020, and a large proportion of them are asymptomatic. At present, there is still no effective treatment for this disease. Traditional Chinese medicine (TCM) shows a good therapeutic effect on COVID-19, especially for asymptomatic patients. According to the search results, we found that although there are many studies on COVID-19, there are no studies targeting asymptomatic infections. Therefore, we design a network meta-analysis (NMA) to evaluate the therapeutic effect of TCM on asymptomatic COVID-19. METHODS We will search Chinese and English databases to collect all randomized controlled trials (RCTs) of TCM combined with conventional western medicine or using only TCM to treat asymptomatic COVID-19 from December 2019 to July 2020. Then, two investigators will independently filter the articles, extract data, and evaluate the risk of bias. We will conduct a Bayesian NMA to evaluate the effects of different therapies. All data will be processed by Stata 16.0 and WinBUGS. RESULTS This study will evaluate the effectiveness of various treatments for asymptomatic COVID-19. The outcome indicators include the time when the nucleic acid turned negative, the proportion of patients with disease progression, changes in laboratory indicators, and the side effects of drugs. CONCLUSION This analysis will further improve the treatment of asymptomatic COVID-19. INPLASY REGISTRATION NUMBER INPLASY202070022.
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Affiliation(s)
- Jiahao Wang
- First College of Clinical Medicine, Shandong University of Traditional Chinese Medicine
| | - Xue Zhu
- Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan
| | - Yuying Sun
- Agricultural and Rural Bureau of Hedong District, Linyi City, Shandong Province, PR China
| | - Xingcai Zhang
- Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan
| | - Wei Zhang
- Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan
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28
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Salzberger B, Welte T. COVID-19 – eine neue und vielseitige Herausforderung. Internist (Berl) 2020; 61:773-775. [PMID: 32748001 PMCID: PMC7396928 DOI: 10.1007/s00108-020-00851-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- B Salzberger
- Abt. Krankenhaushygiene und Infektiologie, Universitätsklinikum Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Deutschland.
| | - T Welte
- Klinik für Pneumologie und Deutsches Zentrum für Lungenforschung, Medizinische Hochschule Hannover, Hannover, Deutschland
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