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Gietl M, Burkert F, Hofer S, Gostner JM, Sonnweber T, Tancevski I, Pizzini A, Sahanic S, Schroll A, Brigo N, Egger A, Bellmann-Weiler R, Löffler-Ragg J, Weiss G, Kurz K. Laboratory parameters related to disease severity and physical performance after reconvalescence of acute COVID-19 infection. Sci Rep 2024; 14:10388. [PMID: 38710760 DOI: 10.1038/s41598-024-57448-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 03/18/2024] [Indexed: 05/08/2024] Open
Abstract
Research into the molecular basis of disease trajectory and Long-COVID is important to get insights toward underlying pathophysiological processes. The objective of this study was to investigate inflammation-mediated changes of metabolism in patients with acute COVID-19 infection and throughout a one-year follow up period. The study enrolled 34 patients with moderate to severe COVID-19 infection admitted to the University Clinic of Innsbruck in early 2020. The dynamics of multiple laboratory parameters (including inflammatory markers [C-reactive protein (CRP), interleukin-6 (IL-6), neopterin] as well as amino acids [tryptophan (Trp), phenylalanine (Phe) and tyrosine (Tyr)], and parameters of iron and vitamin B metabolism) was related to disease severity and patients' physical performance. Also, symptom load during acute illness and at approximately 60 days (FU1), and one year after symptom onset (FU2) were monitored and related with changes of the investigated laboratory parameters: During acute infection many investigated laboratory parameters were elevated (e.g., inflammatory markers, ferritin, kynurenine, phenylalanine) and enhanced tryptophan catabolism and phenylalanine accumulation were found. At FU2 nearly all laboratory markers had declined back to reference ranges. However, kynurenine/tryptophan ratio (Kyn/Trp) and the phenylalanine/tyrosine ratio (Phe/Tyr) were still exceeding the 95th percentile of healthy controls in about two thirds of our cohort at FU2. Lower tryptophan concentrations were associated with B vitamin availability (during acute infection and at FU1), patients with lower vitamin B12 levels at FU1 had a prolonged and more severe impairment of their physical functioning ability. Patients who had fully recovered (ECOG 0) presented with higher concentrations of iron parameters (ferritin, hepcidin, transferrin) and amino acids (phenylalanine, tyrosine) at FU2 compared to patients with restricted ability to work. Persistent symptoms at FU2 were tendentially associated with IFN-γ related parameters. Women were affected by long-term symptoms more frequently. Conclusively, inflammation-mediated biochemical changes appear to be related to symptoms of patients with acute and Long Covid.
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Affiliation(s)
- Mario Gietl
- Department of Internal Medicine II, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
| | - Francesco Burkert
- Department of Internal Medicine II, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
| | - Stefanie Hofer
- Institute of Medical Biochemistry, Biocenter, Medical University of Innsbruck, Innrain 80, 6020, Innsbruck, Austria
| | - Johanna M Gostner
- Institute of Medical Biochemistry, Biocenter, Medical University of Innsbruck, Innrain 80, 6020, Innsbruck, Austria
| | - Thomas Sonnweber
- Department of Internal Medicine II, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
| | - Ivan Tancevski
- Department of Internal Medicine II, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
| | - Alex Pizzini
- Department of Internal Medicine II, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
| | - Sabina Sahanic
- Department of Internal Medicine II, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
| | - Andrea Schroll
- Department of Internal Medicine II, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
| | - Natascha Brigo
- Department of Internal Medicine II, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
| | - Alexander Egger
- Central Institute for Medical and Chemical Laboratory Diagnostics (ZIMCL), Tirol Kliniken GmbH, Anichstrasse 35, 6020, Innsbruck, Austria
| | - Rosa Bellmann-Weiler
- Department of Internal Medicine II, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
| | - Judith Löffler-Ragg
- Department of Internal Medicine II, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
| | - Günter Weiss
- Department of Internal Medicine II, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria.
| | - Katharina Kurz
- Department of Internal Medicine II, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria.
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Nairz M, Todorovic T, Gehrer CM, Grubwieser P, Burkert F, Zimmermann M, Trattnig K, Klotz W, Theurl I, Bellmann-Weiler R, Weiss G. Single-Center Experience in Detecting Influenza Virus, RSV and SARS-CoV-2 at the Emergency Department. Viruses 2023; 15:v15020470. [PMID: 36851685 PMCID: PMC9958692 DOI: 10.3390/v15020470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 02/02/2023] [Accepted: 02/04/2023] [Indexed: 02/10/2023] Open
Abstract
Reverse transcription polymerase chain reaction (RT-PCR) on respiratory tract swabs has become the gold standard for sensitive and specific detection of influenza virus, respiratory syncytial virus (RSV) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In this retrospective analysis, we report on the successive implementation and routine use of multiplex RT-PCR testing for patients admitted to the Internal Medicine Emergency Department (ED) at a tertiary care center in Western Austria, one of the hotspots in the early coronavirus disease 2019 (COVID-19) pandemic in Europe. Our description focuses on the use of the Cepheid® Xpert® Xpress closed RT-PCR system in point-of-care testing (POCT). Our indications for RT-PCR testing changed during the observation period: From the cold season 2016/2017 until the cold season 2019/2020, we used RT-PCR to diagnose influenza or RSV infection in patients with fever and/or respiratory symptoms. Starting in March 2020, we used the RT-PCR for SARS-CoV-2 and a multiplex version for the combined detection of all these three respiratory viruses to also screen subjects who did not present with symptoms of infection but needed in-hospital medical treatment for other reasons. Expectedly, the switch to a more liberal RT-PCR test strategy resulted in a substantial increase in the number of tests. Nevertheless, we observed an immediate decline in influenza virus and RSV detections in early 2020 that coincided with public SARS-CoV-2 containment measures. In contrast, the extensive use of the combined RT-PCR test enabled us to monitor the re-emergence of influenza and RSV detections, including asymptomatic cases, at the end of 2022 when COVID-19 containment measures were no longer in place. Our analysis of PCR results for respiratory viruses from a real-life setting at an ED provides valuable information on the epidemiology of those infections over several years, their contribution to morbidity and need for hospital admission, the risk for nosocomial introduction of such infection into hospitals from asymptomatic carriers, and guidance as to how general precautions and prophylactic strategies affect the dynamics of those infections.
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3
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Gietl M, Burkert F, Seiwald S, Böhm A, Hofer S, Gostner JM, Piater T, Geisler S, Weiss G, Loeffler-Ragg J, Sonnweber T, Tancevski I, Pizzini A, Sahanic S, Fuchs D, Bellmann-Weiler R, Kurz K. Interferon-gamma Mediated Metabolic Pathways in Hospitalized Patients During Acute and Reconvalescent COVID-19. Int J Tryptophan Res 2023; 16:11786469231154244. [PMID: 37038445 PMCID: PMC10076985 DOI: 10.1177/11786469231154244] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 01/15/2023] [Indexed: 02/15/2023] Open
Abstract
Background: Fatigue, sleep disturbance, and neurological symptoms during and after COVID-19 are common and might be associated with inflammation-induced changes in tryptophan (Trp) and phenylalanine (Phe) metabolism. Aim: This pilot study investigated interferon gamma inducible biochemical pathways (namely Trp catabolism, neopterin, tyrosine [Tyr], and nitrite formation) during acute COVID-19 and reconvalescence. Patients and methods: Thirty one patients with moderate to severe COVID-19 admitted to the University Hospital of Innsbruck in early 2020 (March-May) were followed up. Neurotransmitter precursors Trp, Phe, Tyr as well as kynurenine (Kyn), neopterin, nitrite, and routine laboratory parameters were analyzed during acute infection and at a follow-up (FU) 60 days thereafter. Clinical symptoms of patients (neurological symptoms, fatigue, sleep disturbance) were recorded and associations with concentrations of laboratory parameters investigated. Results and conclusion: Almost half of the patients suffered from neurological symptoms (48.4%), the majority of patients experienced sleep difficulties (56.7%) during acute COVID-19. Fatigue was present in nearly all patients. C-reactive protein (CRP), interleukin-6 (IL-6), neopterin, Kyn, Phe concentrations were significantly increased, and Trp levels depleted during acute COVID-19. Patients with sleep impairment and neurological symptoms during acute illness presented with increased CRP and IL-6 concentrations, Trp levels were lower in patients with sleep disturbance. In general, inflammatory markers declined during reconvalescence. A high percentage of patients suffered from persistent symptoms at FU (neurological symptoms: 17.2%, fatigue: 51.7%, sleeping disturbance: 34.5%) and had higher CRP concentrations. Nitrite and Phe levels were lower in patients with sleeping difficulties at FU and Kyn/Trp ratio, as indicator of IDO activity, was significantly lower in patients with neurological symptoms compared to patients without them at FU. In summary, inflammation induced alterations of amino acid metabolism might be related to acute and persisting symptoms of COVID-19.
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Affiliation(s)
- Mario Gietl
- Department of Internal Medicine II, Medical University Innsbruck, Biocentre, Medical Biochemistry, Innsbruck, Austria
| | - Francesco Burkert
- Department of Internal Medicine II, Medical University Innsbruck, Biocentre, Medical Biochemistry, Innsbruck, Austria
| | - Stefanie Seiwald
- Department of Internal Medicine II, Medical University Innsbruck, Biocentre, Medical Biochemistry, Innsbruck, Austria
| | - Anna Böhm
- Department of Internal Medicine II, Medical University Innsbruck, Biocentre, Medical Biochemistry, Innsbruck, Austria
| | - Stefanie Hofer
- Department of Internal Medicine II, Medical University Innsbruck, Biocentre, Medical Biochemistry, Innsbruck, Austria
| | - Johanna M Gostner
- Department of Internal Medicine II, Medical University Innsbruck, Biocentre, Medical Biochemistry, Innsbruck, Austria
| | - Talia Piater
- Department of Internal Medicine II, Medical University Innsbruck, Biocentre, Medical Biochemistry, Innsbruck, Austria
| | - Simon Geisler
- Department of Internal Medicine II, Medical University Innsbruck, Biocentre, Medical Biochemistry, Innsbruck, Austria
| | - Guenter Weiss
- Department of Internal Medicine II, Medical University Innsbruck, Biocentre, Medical Biochemistry, Innsbruck, Austria
| | - Judith Loeffler-Ragg
- Department of Internal Medicine II, Medical University Innsbruck, Biocentre, Medical Biochemistry, Innsbruck, Austria
| | - Thomas Sonnweber
- Department of Internal Medicine II, Medical University Innsbruck, Biocentre, Medical Biochemistry, Innsbruck, Austria
| | - Ivan Tancevski
- Department of Internal Medicine II, Medical University Innsbruck, Biocentre, Medical Biochemistry, Innsbruck, Austria
| | - Alex Pizzini
- Department of Internal Medicine II, Medical University Innsbruck, Biocentre, Medical Biochemistry, Innsbruck, Austria
| | - Sabina Sahanic
- Department of Internal Medicine II, Medical University Innsbruck, Biocentre, Medical Biochemistry, Innsbruck, Austria
| | - Dietmar Fuchs
- Department of Internal Medicine II, Medical University Innsbruck, Biocentre, Medical Biochemistry, Innsbruck, Austria
| | - Rosa Bellmann-Weiler
- Department of Internal Medicine II, Medical University Innsbruck, Biocentre, Medical Biochemistry, Innsbruck, Austria
| | - Katharina Kurz
- Department of Internal Medicine II, Medical University Innsbruck, Biocentre, Medical Biochemistry, Innsbruck, Austria
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Schneider F, Runer A, Burkert F, Aspang JSU, Reider S, Schneider H, Pocecco E. Digital Workout Versus Team Training: The Impact of the COVID-19 Pandemic on Athletes. Sports Med Int Open 2022; 6:E18-E24. [PMID: 35462685 PMCID: PMC9023314 DOI: 10.1055/a-1734-5457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Accepted: 12/20/2021] [Indexed: 01/08/2023] Open
Abstract
The aim of the study was to assess the effects of the COVID-19 pandemic on sport practice and to identify measures adopted by individuals and sports organizations to allow a safe return to community sports. An electronic survey was launched worldwide in June 2020 in the German and English languages. The questionnaire collected anonymous data on sporting activity before, during, and after pandemic-induced confinement. Participants classified themselves as either recreational, competitive, or professional sports level athletes. A total of 1336 adults (30.5±11.7 years; 54.0% women) participated in the survey; 68.5% were active athletes, 10.1% coaches, 2.1% officials and 4.3% related medical staff, 3.6% had another function, and 11.4% indicated no regular sports activity. Most participants practiced their sport in Europe (93.8%); the majority (61.0%) was amateur athletes. During confinement, 15.7% could perform their main sport unrestricted, 43.5% stated a reduced amount of time spent on sporting activities, 46.4% a reduced intensity level. Most participants (77.5%) were neither aware of screening measures nor of guidelines for dealing with infected athletes (80.0%) or for return to sports after a coronavirus infection (88.6%). Preventive measures mentioned included basic hygiene, measures to reduce personal contacts or virus transmission, or to improve traceability of infections. During confinement, a higher age (p=0.004) and training in a club setting (p<0.001) were associated with reduced sporting activity, while the availability of online training (p=0.030 ) was linked to both increased extent and intensity levels. A lower age (p=0.001) and recreational sports level (p=0.005) were associated with decreased activity after confinement. Although isolation can be necessary to protect public health, it alters the amount and intensity of physical activity.
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Affiliation(s)
- Friedemann Schneider
- University Hospital for Orthopaedics and Traumatology, Medical University Innsbruck, Innsbruck, Austria
| | - Armin Runer
- University Hospital for Orthopaedics and Traumatology, Medical University Innsbruck, Innsbruck, Austria
| | - Francesco Burkert
- Department of Internal Medicine II, Infectious Diseases, Pneumology, Rheumatology, Medical University of Innsbruck, Innsbruck, Austria
| | | | - Simon Reider
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology & Metabolism, Christian Doppler Laboratory for Mucosal Immunology, Medical University of Innsbruck, Innsbruck, Austria
| | - Holm Schneider
- Department of Pediatrics, University Hospital Erlangen, Erlangen, Germany
| | - Elena Pocecco
- Sport Science, University of Innsbruck, Innsbruck, Austria
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5
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Petzer V, Schwendinger S, Haschka D, Vogi V, Tymoszuk P, Burkert F, Sahanic S, Sonnweber T, Bellmann‐Weiler R, Loeffler‐Ragg J, Tancevski I, Zschocke J, Weiss G, Wolf D, Jukic E. Clonal hematopoiesis in patients with Covid-19 is stable and not linked to an aggravated clinical course. Am J Hematol 2021; 96:E331-E333. [PMID: 34028864 PMCID: PMC8212118 DOI: 10.1002/ajh.26251] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 05/18/2021] [Accepted: 05/20/2021] [Indexed: 12/20/2022]
Affiliation(s)
- Verena Petzer
- Department of Internal Medicine V Medical University of Innsbruck Innsbruck Austria
| | - Simon Schwendinger
- Institute of Human Genetics, Medical University of Innsbruck Innsbruck Austria
| | - David Haschka
- Department of Internal Medicine II, Medical University of Innsbruck Innsbruck Austria
| | - Verena Vogi
- Institute of Human Genetics, Medical University of Innsbruck Innsbruck Austria
| | - Piotr Tymoszuk
- Department of Internal Medicine II, Medical University of Innsbruck Innsbruck Austria
| | - Francesco Burkert
- Department of Internal Medicine II, Medical University of Innsbruck Innsbruck Austria
| | - Sabina Sahanic
- Department of Internal Medicine II, Medical University of Innsbruck Innsbruck Austria
| | - Thomas Sonnweber
- Department of Internal Medicine II, Medical University of Innsbruck Innsbruck Austria
| | - Rosa Bellmann‐Weiler
- Department of Internal Medicine II, Medical University of Innsbruck Innsbruck Austria
| | - Judith Loeffler‐Ragg
- Department of Internal Medicine II, Medical University of Innsbruck Innsbruck Austria
| | - Ivan Tancevski
- Department of Internal Medicine II, Medical University of Innsbruck Innsbruck Austria
| | - Johannes Zschocke
- Institute of Human Genetics, Medical University of Innsbruck Innsbruck Austria
| | - Guenter Weiss
- Department of Internal Medicine II, Medical University of Innsbruck Innsbruck Austria
| | - Dominik Wolf
- Department of Internal Medicine V Medical University of Innsbruck Innsbruck Austria
| | - Emina Jukic
- Institute of Human Genetics, Medical University of Innsbruck Innsbruck Austria
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6
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Siegers JY, Novakovic B, Hulme KD, Marshall RJ, Bloxham CJ, Thomas WG, Reichelt ME, Leijten L, van Run P, Knox K, Sokolowski KA, Tse BWC, Chew KY, Christ AN, Howe G, Bruxner TJC, Karolyi M, Pawelka E, Koch RM, Bellmann-Weiler R, Burkert F, Weiss G, Samanta RJ, Openshaw PJM, Bielefeldt-Ohmann H, van Riel D, Short KR. A High-Fat Diet Increases Influenza A Virus-Associated Cardiovascular Damage. J Infect Dis 2021; 222:820-831. [PMID: 32246148 DOI: 10.1093/infdis/jiaa159] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 04/02/2020] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Influenza A virus (IAV) causes a wide range of extrarespiratory complications. However, the role of host factors in these complications of influenza virus infection remains to be defined. METHODS Here, we sought to use transcriptional profiling, virology, histology, and echocardiograms to investigate the role of a high-fat diet in IAV-associated cardiac damage. RESULTS Transcriptional profiling showed that, compared to their low-fat counterparts (LF mice), mice fed a high-fat diet (HF mice) had impairments in inflammatory signaling in the lung and heart after IAV infection. This was associated with increased viral titers in the heart, increased left ventricular mass, and thickening of the left ventricular wall in IAV-infected HF mice compared to both IAV-infected LF mice and uninfected HF mice. Retrospective analysis of clinical data revealed that cardiac complications were more common in patients with excess weight, an association which was significant in 2 out of 4 studies. CONCLUSIONS Together, these data provide the first evidence that a high-fat diet may be a risk factor for the development of IAV-associated cardiovascular damage and emphasizes the need for further clinical research in this area.
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Affiliation(s)
- Jurre Y Siegers
- Department of Viroscience, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Boris Novakovic
- Epigenetics Research, Murdoch Children's Research Institute and Department of Paediatrics, University of Melbourne, Parkville, Australia
| | - Katina D Hulme
- School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Australia
| | - Rebecca J Marshall
- School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Australia
| | - Conor J Bloxham
- School of Biomedical Science, The University of Queensland, Brisbane, Australia
| | - Walter G Thomas
- School of Biomedical Science, The University of Queensland, Brisbane, Australia
| | - Mellissa E Reichelt
- School of Biomedical Science, The University of Queensland, Brisbane, Australia
| | - Lonneke Leijten
- Department of Viroscience, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Peter van Run
- Department of Viroscience, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Karen Knox
- Preclinical Imaging Facility, Translational Research Institute Australia, Brisbane, Australia
| | - Kamil A Sokolowski
- Preclinical Imaging Facility, Translational Research Institute Australia, Brisbane, Australia
| | - Brian W C Tse
- Preclinical Imaging Facility, Translational Research Institute Australia, Brisbane, Australia
| | - Keng Yih Chew
- School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Australia
| | - Angelika N Christ
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, Australia
| | - Greg Howe
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, Australia
| | - Timothy J C Bruxner
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, Australia
| | - Mario Karolyi
- Department for Infectious Diseases, Kaiser Franz Josef Hospital, Vienna, Austria
| | - Erich Pawelka
- Department for Infectious Diseases, Kaiser Franz Josef Hospital, Vienna, Austria
| | - Rebecca M Koch
- Radboud University Medical Center, Department of Intensive Care Medicine, Nijmegen, the Netherlands
| | - Rosa Bellmann-Weiler
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Francesco Burkert
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Günter Weiss
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Romit J Samanta
- Department of Medicine, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
| | - Peter J M Openshaw
- Respiratory Infection Section, National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Helle Bielefeldt-Ohmann
- School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Australia.,Australian Infectious Diseases Research Centre, The University of Queensland, Brisbane, Australia
| | - Debby van Riel
- Department of Viroscience, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Kirsty R Short
- School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Australia.,Australian Infectious Diseases Research Centre, The University of Queensland, Brisbane, Australia
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7
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Bellmann-Weiler R, Lanser L, Burkert F, Seiwald S, Fritsche G, Wildner S, Schroll A, Koppelstätter S, Kurz K, Griesmacher A, Weiss G. Neopterin Predicts Disease Severity in Hospitalized Patients With COVID-19. Open Forum Infect Dis 2020; 8:ofaa521. [PMID: 33442554 PMCID: PMC7665702 DOI: 10.1093/ofid/ofaa521] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 10/21/2020] [Indexed: 01/08/2023] Open
Abstract
This study evaluates the predictive value of circulating inflammatory markers, especially neopterin, in patients with coronavirus disease 2019 (COVID-19). Within this retrospective analysis of 115 hospitalized COVID-19 patients, elevated neopterin levels upon admission were significantly associated with disease severity, risk for intensive care unit admission, need for mechanical ventilation, and death. Therefore, neopterin is a reliable predictive marker in patients with COVID-19 and may help to improve the clinical management of patients.
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Affiliation(s)
- Rosa Bellmann-Weiler
- Department of Internal Medicine II, Innsbruck Medical University, Innsbruck, Austria
| | - Lukas Lanser
- Department of Internal Medicine II, Innsbruck Medical University, Innsbruck, Austria
| | - Francesco Burkert
- Department of Internal Medicine II, Innsbruck Medical University, Innsbruck, Austria
| | - Stefanie Seiwald
- Department of Internal Medicine II, Innsbruck Medical University, Innsbruck, Austria
| | - Gernot Fritsche
- Department of Internal Medicine II, Innsbruck Medical University, Innsbruck, Austria
| | - Sophie Wildner
- Department of Internal Medicine II, Innsbruck Medical University, Innsbruck, Austria
| | - Andrea Schroll
- Department of Internal Medicine II, Innsbruck Medical University, Innsbruck, Austria
| | - Sabine Koppelstätter
- Department of Internal Medicine II, Innsbruck Medical University, Innsbruck, Austria
| | - Katharina Kurz
- Department of Internal Medicine II, Innsbruck Medical University, Innsbruck, Austria
| | - Andrea Griesmacher
- Central Institute for Medical and Chemical Laboratory Diagnosis, Innsbruck University Hospital, Innsbruck, Austria
| | - Günter Weiss
- Department of Internal Medicine II, Innsbruck Medical University, Innsbruck, Austria
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8
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Bellmann-Weiler R, Burkert F, Schwaiger T, Schmidt S, Ludescher C, Oexle H, Wolf D, Weiss G. Janus-faced course of COVID-19 infection in patients with hematological malignancies. Eur J Haematol 2020; 105:502-504. [PMID: 32557918 PMCID: PMC7323382 DOI: 10.1111/ejh.13470] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 06/10/2020] [Accepted: 06/11/2020] [Indexed: 01/08/2023]
Affiliation(s)
- Rosa Bellmann-Weiler
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Francesco Burkert
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Theresa Schwaiger
- Department of Internal Medicine V, Medical University of Innsbruck, Innsbruck, Austria
| | - Stephan Schmidt
- Department of Internal Medicine V, Medical University of Innsbruck, Innsbruck, Austria
| | | | - Horst Oexle
- Department of Internal Medicine, District Hospital Hall, Hall, Austria
| | - Dominik Wolf
- Department of Internal Medicine V, Medical University of Innsbruck, Innsbruck, Austria
| | - Günter Weiss
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
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9
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Pizzini A, Burkert F, Theurl I, Weiss G, Bellmann-Weiler R. Prognostic impact of high sensitive Troponin T in patients with influenza virus infection: A retrospective analysis. Heart Lung 2019; 49:105-109. [PMID: 31146968 DOI: 10.1016/j.hrtlng.2019.05.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 05/07/2019] [Accepted: 05/09/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND Seasonal influenza is an important cause of morbidity and mortality worldwide and cardiac injuries are dangerous complications of influenza infection. Cardiac troponins are established biomarkers of myocardial damage. OBJECTIVE The aim of the study was to assess high sensitive Troponin-T (hsTnT) serum levels as a surrogate parameter of cardiac involvement in influenza patients. METHODS Cross-sectional analysis of 264 patients with laboratory-confirmed influenza virus infection. Routine laboratory parameters, hsTNT, and the history of cardiovascular disease were included in the analysis. Assessed prognostic endpoints were inpatient therapy requirement, death < 30 days after hospitalization and acute cardiac events (ACE) defined as myocardial ischemia, heart failure or new arrhythmia requiring therapy. RESULTS Eighty-four patients (31.8%) had increased hsTnT at the initial presentation and twenty patients (7.6%) experienced ACE. Patients with ACE had higher hsTnT (p < 0.01) and CRP (p = 0.04) serum levels compared to patients who did not experience ACE. A binary logistic regression model to predict ACE revealed hsTnT (p < 0.01) and CRP (p = 0.01) to significantly influence the odds for ACE. A hsTnT cut-off of 46,4 ng/l was identified as having the best discriminative potential to identify patients with ACE (sensitivity = 0.7, specificity = 0.8). CONCLUSION To date, this is the largest available analysis of the specific cardiac marker hsTnT in patients with influenza. A slight elevation of hsTnT is a common feature of patients with influenza, however increased hsTnT also highlights a higher risk for cardiac complications and fatal outcome.
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Affiliation(s)
- Alex Pizzini
- Department of Internal Medicine II, Infectious Diseases, Pneumology, Rheumatology, Medical University of Innsbruck, Innsbruck, Austria
| | - Francesco Burkert
- Department of Internal Medicine II, Infectious Diseases, Pneumology, Rheumatology, Medical University of Innsbruck, Innsbruck, Austria
| | - Igor Theurl
- Department of Internal Medicine II, Infectious Diseases, Pneumology, Rheumatology, Medical University of Innsbruck, Innsbruck, Austria
| | - Günter Weiss
- Department of Internal Medicine II, Infectious Diseases, Pneumology, Rheumatology, Medical University of Innsbruck, Innsbruck, Austria
| | - Rosa Bellmann-Weiler
- Department of Internal Medicine II, Infectious Diseases, Pneumology, Rheumatology, Medical University of Innsbruck, Innsbruck, Austria.
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