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Introduction Vaccination behaviour is influenced by various determinants. Evidence indicates a higher COVID-19 vaccine hesitancy among university students due to their age and a lower risk of complications compared to the general population in Germany. However, little is known about other COVID-19-related determinants for the population of German university students. This study aimed to investigate determinants of vaccination behaviour among German university students. Methods The cross-sectional COVID-19 German Student Well-being Study was conducted at five German universities at the end of 2021 via an online survey (n = 7.267). Multiple logistic regressions were calculated to examine associations of vaccination behaviour (not vaccinated vs. fully vaccinated) and attitudes towards vaccination (5Cs: confidence in the safety of the vaccine, complacency - not perceiving diseases as high risk, constraints - structural and psychological barriers, calculation - engagement in information seeking, collective responsibility - willingness to protect others), health literacy in a pandemic (CHL-P), and additional determinants. Results All 5Cs were associated with the vaccination status ‘fully vaccinated’, except for complacency. Regarding CHL-P, we found that students who felt that the current scientific knowledge about COVID-19 in terms of the policy decisions on pandemic measures was very complex had a higher odds for being vaccinated (OR = 3.02;95% CI: 2.26-4.04). Regarding additional determinants, the analysis revealed that students who had been previously infected had in all regressions a lower odds for being vaccinated compared to students with no previous infection. Conclusions Due to the strong association of the attitudes towards vaccination and vaccination behaviour among university students, we recommend that the different components of the 5Cs should be considered in future COVID-19 vaccination campaigns in the university context. Key messages Attitudes towards vaccinations impact on vaccination behaviour among university students. Perceiving the current scientific knowledge on COVID-19 as very complex increased the odds for vaccination.
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Background Students faced unique challenges during the COVID-19 pandemic that may have affected their financial situation as well as their mental health. This study sought to examine whether changes in financial situation before and during the COVID-19 pandemic were associated with depressive symptoms among German university students. Methods The cross-sectional COVID-19 German Student Well-being Study (C19 GSWS;N = 7,267) was implemented at five German universities between 27.10. and 14.11.2021. Students were asked if they had had sufficient financial resources to cover monthly expenses before the pandemic, as well as during the first and third waves of the pandemic. Depressive symptoms were assessed using the CES-D 8 (score ranges 0-24) and the PHQ-2 (0-6);higher scores indicating more severe depressive symptoms. Linear regression models were used to examine associations between variables. Results A worsened financial situation between the first and the third wave of the pandemic was associated with a one point (0.95) increase on the CES-D 8 scale (95% CI: 0.61, 1.29) and an improved financial situation with a decrease by 0.81 points (95% CI: -1.20, -0.42). A worsened financial situation was associated with a 0.26-point increase in PHQ-2 (95% CI: 0.14, 0.37) and an improved financial situation with a -0.12-point decrease (95% CI: -0.25, 0.01). Similarly, worsened financial situation in the third wave compared to prior to the pandemic, was also associated with an increase in CES-D 8 score and PHQ-2 and an improved financial situation with a decrease in CES-D 8 and PHQ-2. Conclusions Our findings suggest associations between students’ financial situation during the COVID-19 pandemic and their mental health. Due to their instable financial situation, students are a vulnerable group in need of mental and financial support during pandemic crises. Key messages This study revealed associations between students’ financial situation and depressive symptoms. A comprehensive approach in efforts to address mental health, including financial support is required.
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Purpose: Monoclonal antibody (mAB) infusion (bamlanivimab or casirivimab/ imdevimab) for symptomatic, non-hypoxemic, high-risk outpatients with COVID-19 infection, is an available early intervention for COVID-19+ SOT recipients. We aimed to assess efficiency in time from diagnosis to treatment, and outcomes in a retrospective cohort of SOT recipients with COVID-19 who received mAB. Methods: We developed a Nurse Coordinator-led initiative to screen, refer, and facilitate mAB infusion for COVID-19+ SOT recipients within 10 days of symptom onset. SOT recipients received electronic messaging to promptly report potential COVID-19 symptoms to the transplant team. Data were collected on time from symptom onset to diagnosis, mAB infusion, and follow-up > 21 days, and hospital admissions, disease severity, mortality, and rejection. Results: 34 out of 36 referred SOT recipients with symptomatic COVID-19 disease without hypoxia received mAB therapy (3 heart, 8 lung, 16 kidney, 2 Liver-Kidney, 2 Pancreas-Kidney, 3 Kidney-Heart). Median time from symptom onset to diagnosis was 2 days and from date of diagnosis to mAB infusion was 4 days. Of those 34, 88% did not require hospitalization and recovered uneventfully. 12% required hospitalization for COVID disease progression, two on the same day as mAB infusion, and the other 2, more than 26 days post infusion. Of these, 2 patients had mild-moderate hypoxia, and 2 had critical disease. Only 1 patient died from COVID-19 complications and no episodes of rejection or graft loss were observed. Conclusions: The Nurse Coordinator-led initiative efficiently facilitated mAB therapy for COVID-19+ SOT recipients and was associated with excellent outcomes. Compared to prior published COVID-19 outcomes in SOT recipients, patients who received mAB may have reduce hospitalization and low mortality. As mAB therapy may be underutilized in the general population, these results support efforts to educate transplant centers to implement efficient interventions for the screening and referral of COVID+ SOT recipients for mAB therapy.
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OBJECTIVE: Invasively ventilated patients with acute respiratory failure related to coronavirus disease 2019 (COVID-19) potentially benefit from tracheostomy. The aim of this study was to determine the practice of tracheostomy during the first wave of the pandemic in 2020 in the Netherlands, to ascertain whether timing of tracheostomy had an association with outcome, and to identify factors that had an association with timing. METHODS: Secondary analysis of the 'PRactice of VENTilation in COVID-19' (PRoVENT-COVID) study, a multicenter observational study, conducted from March 1, 2020 through June 1, 2020 in 22 Dutch intensive care units (ICU) in the Netherlands. The primary endpoint was the proportion of patients receiving tracheostomy; secondary endpoints were timing of tracheostomy, duration of ventilation, length of stay in ICU and hospital, mortality, and factors associated with timing. RESULTS: Of 1023 patients, 189 patients (18.5%) received a tracheostomy at median 21 [17 to 28] days from start of ventilation. Timing was similar before and after online publication of an amendment to the Dutch national guidelines on tracheostomy focusing on COVID-19 patients (21 [17-28] vs. 21 [17-26] days). Tracheostomy performed ≤ 21 days was independently associated with shorter duration of ventilation (median 26 [21 to 32] vs. 40 [34 to 47] days) and higher mortality in ICU (22.1% vs. 10.2%), hospital (26.1% vs. 11.9%) and at day 90 (27.6% vs. 14.6%). There were no patient demographics or ventilation characteristics that had an association with timing of tracheostomy. CONCLUSIONS: Tracheostomy was performed late in COVID-19 patients during the first wave of the pandemic in the Netherlands and timing of tracheostomy possibly had an association with outcome. However, prospective studies are needed to further explore these associations. It remains unknown which factors influenced timing of tracheostomy in COVID-19 patients.