Acceptability and feasibility of selforganised blood sample collection for SARS-CoV-2 antibody screening in persons with a high risk for a severe COVID-19 disease progression

Background: The pandemic situation poses new challenges for research. Ethical issues might arise if especially vulnerable individuals expose themselves to a higher risk of infection for study purposes. Research question: How is the feasibility, quality and acceptance of self-organised blood sample collections to measure anti-SARS-CoV-2 Spike IgG antibodies in persons with a high risk for a severe COVID-19 disease progression? Methods: Persons with a high risk for a severe COVID-19 disease progression (immunocompromised, oncology or 80+ years) were recruited between January and September 2021 to send in blood samples (2.6 ml, 7.5 ml or 500 mul EDTA tubes) one month and six months after their second COVID- 19 vaccination. Participants were given the choice of drawing blood themselves (as capillary blood), with the research team, or in local practices or clinics. Participants were surveyed via a computer-assisted telephone interview in December 2021 and January 2022 about their choice of blood sampling methods, experiences, and influence of choice upon study participation. Result(s): Data from 366 participants was collected via telephone follow-up. First, blood samples were collected by the participants themselves (35.8%), local practices or clinics (32.0%) and the research team (22.7%). Second blood samples were mostly collected in local practices or clinics (43.7%) followed by participants themselves (32.5%) and the research team (14.3%). Only 3.3% of blood samples were not sent back or analysable. One-fourth (26%) of participants stated that they would not have participated in the study if it would have been required to travel to the university hospital to give their blood sample. Conclusion(s): Participants were able to self-organise blood collection, using several different blood sample methods. Nearly all blood samples were analyzable when self-collected and sent by post. One-fourth of the participants would not have participated in the study if required to give their blood samples at the study location.

Audiological profile of adult Long COVID patients.

INTRODUCTION: Hearing loss is one of the self-reported symptoms of Long COVID patients, however data from objective and subjective audiological tests demonstrating diminished hearing in Long COVID patients has not been published. MATERIALS AND METHODS: Respondents of a large Long COVID online survey were invited to the ENT-department for an otologic exam. The participants were split into three groups based on their history of SARS-CoV-2 infection and persistence of symptoms. Respondents with a history of a SARS-CoV-2 infection were allocated to the Long COVID group, if they reported persistent symptoms and to the Ex COVID group, if they had regained their previous level of health. Participants without a history of SARS-CoV-2 infection made up the No COVID control group. In total, 295 ears were examined with otoscopy, tympanograms, pure tone audiometry and otoacoustic emissions. Ears with known preexisting hearing loss or status post ear surgery, as well as those with abnormal otoscopic findings, non-type A tympanograms or negative Rinne test were excluded. RESULTS: Compared to the No COVID and Ex COVID groups, we did not find a clinically significant difference in either hearing thresholds or frequency specific TEOAEs. However, at 500 Hz the data from the left ear, but not the right ear showed a significantly better threshold in the Ex COVID group, compared to Long COVID and No COVID groups. Any of the other tested frequencies between 500 Hz and 8 kHz were not significantly different between the different groups. There was a significantly lower frequency-specific signal-to-noise-ratio of the TEOAEs in the Long COVID compared to the No COVID group at 2.8 kHz. At all other frequencies, there were no significant differences between the three groups in the TEOAE signal-to-noise-ratio. CONCLUSION: This study detected no evidence of persistent cochlear damage months after SARS-CoV-2 infection in a large cohort of Long COVID patients, as well as those fully recovered.

COVID-19 vaccination strategy for hospital staff in Germany: a cross-sectional study in March-April 2021.

BACKGROUND: SARS-CoV-2 vaccination for healthcare workers (HCWs) started in Germany in December 2020. Hospitals had little time to prepare a vaccination strategy. AIM: To gather information on the initial vaccination strategy for HCWs from the infection control practitioners in Germany. METHODS: A cross-sectional, ethically approved questionnaire was developed, formatted as an online survey and pre-tested. Infection control practitioners responsible for hygiene/infection prevention in 987 randomly selected German hospitals were invited to participate in the survey in March and April 2021. For statistical analysis, the hospitals were categorized into two groups based on bed capacity (<500 beds: small; ≥500 beds: large). FINDINGS: One hundred out of 987 (10%) infection control practitioners completed the survey. In 80% of the participating hospitals, HCW vaccination prioritization was based on recommendations of the German standing committee on vaccination (STIKO). Even so, only 54% prioritized the vaccination of HCWs with contact to vulnerable patients, thus deviating from STIKO recommendations. HCWs with a high personal health risk were prioritized for vaccination in 24% of the hospitals. Transferring unvaccinated HCWs to an area with less infection risk was considered by 2% of large and 12% of small hospitals. CONCLUSION: Vaccination prioritization differed across hospitals and deviated from STIKO recommendations. A pandemic preparedness concept should address the potential impact of divergent strategies compared to a common approach. In addition, further studies analysing the reasons why HCWs remain unvaccinated are needed to adopt effective strategies. This is especially important against the background of facility-based compulsory vaccination.

Infection control strategies for patients and accompanying persons during the COVID-19 pandemic in German hospitals: a cross-sectional study in March-April 2021.

BACKGROUND: Patients are at risk of nosocomial COVID-19 infection. The role of accompanying persons/visitors as potential infection donors is not yet well researched, but the risk will be influenced by prevention measures recommended by infection control practitioners. AIM: To collect information about COVID-19 infection control strategies for patients and accompanying persons from infection control practitioners in German hospitals. METHODS: A cross-sectional questionnaire was developed, ethically approved, pre-tested and formatted as an online tool. Infection control practitioners in 987 randomly selected German hospitals were invited to participate in March and April 2021. For statistical analysis, the hospitals were categorized as small (0-499 beds) or large (≥500 beds). FINDINGS: One hundred surveys were completed (response rate: 10%). A higher proportion of large (71%) than small (49%) hospitals let patients decide freely whether to wear medical or FFP2 masks. Most hospitals reported spatial separation for COVID-19 patients and non-COVID-19 cases (38%) or additionally for suspected COVID-19 cases (53%). A separation of healthcare teams for these areas existed in 54% of the hospitals. Accompaniment bans were more prevalent in large (52%) than in small hospitals (29%), but large hospitals granted more exemptions. CONCLUSION: The decision as to whether to separate areas and teams seemed to depend on the hospital's structural conditions, therefore impairing the implementation of recommendations. Accompaniment regulations differ between hospital sizes and may depend on patient numbers, case type/severity and patients' requirements. In the dynamic situation of a pandemic, it can be difficult to stay up to date with findings and recommendations on infection control.