The Surviral Epidemiological Early Warning System Tyrol Dashboard - System, Functionality and Findings.

BACKGROUND: Dashboards provide a good retrospective view of the development of the disease. Yet, current COVID-related dashboards typically lack the capability to predict future trends. However, this is important for health policy makers and health care providers in order to adopt meaningful containment strategies. OBJECTIVES: The aim of this paper is to present the Surviral dashboard, which allows the effective monitoring of infectious disease dynamics. METHODS: The presented dashboard comprises a wide range of information, including retrospective and prognostic data based on an agent-based simulation framework. It served as the basis for informed decision-making and planning of disease control strategies within the federal state of Tyrol. RESULTS: By visualizing the information in an understandable format, the dashboard provided a comprehensive overview of the COVID-19 situation in Tyrol and allowed for the identification of trends and patterns. CONCLUSION: The presented dashboard is a valuable tool for managing pandemics such as COVID-19. It provides a convenient and efficient way to monitor the spread of a disease and identify potential areas for intervention.

Telemedicine Research from Big Bang to 2022.

The Clinical Information Systems (CIS) section of the IMIA Yearbook of Medical Informatics systematically screens about 2,500 publications from more than 1,000 journals annually to find the best CIS publications. The editors of the CIS section have noticed a trend toward patient-centered care supported by AI and machine learning and increased research in cross-institutional data sharing, particularly in telemedicine. As a result, they adjusted their search query to include the MeSH term "telemedicine." As a preliminary step and to get a sense of the historical development of telemedicine research activity, they performed a bibliometric analysis of all previously published papers in PubMed indexed with the tag "Telemedicine" as MeSH Major Topic. They retrieved 29,289 publications from 1976 to 2022 and used their titles and abstracts to create a bibliometric network that visualizes the most relevant terms, their frequency and relationship to each other, and the chronological sequence of their publication. The development over time also shows a clear move toward patient-centeredness. Interestingly, the term "Covid," which has only recently come into use, takes on a central role in the network.

Persistent somatic symptoms are key to individual illness perception at one year after COVID-19 in a cross-sectional analysis of a prospective cohort study

Objective Subjective illness perception (IP) can differ from physician's clinical assessment results. Herein, we explored patient's IP during coronavirus disease 2019 (COVID-19) recovery. Methods Participants of the prospective observation CovILD study (ClinicalTrials.gov: NCT04416100) with persistent somatic symptoms or cardiopulmonary findings one year after COVID-19 were analyzed (n = 74). Explanatory variables included demographic and comorbidity, COVID-19 course and one-year follow-up data of persistent somatic symptoms, physical performance, lung function testing, chest computed tomography and trans-thoracic echocardiography. Factors affecting IP (Brief Illness Perception Questionnaire) one year after COVID-19 were identified by regularized modeling and unsupervised clustering. Results In modeling, 33% of overall IP variance (R2) was attributed to fatigue intensity, reduced physical performance and persistent somatic symptom count. Overall IP was largely independent of lung and heart findings revealed by imaging and function testing. In clustering, persistent somatic symptom count (Kruskal-Wallis test: η2 = 0.31, p < .001), fatigue (η2 = 0.34, p < .001), diminished physical performance (χ2 test, Cramer V effect size statistic: V = 0.51, p < .001), dyspnea (V = 0.37, p = .006), hair loss (V = 0.57, p < .001) and sleep problems (V = 0.36, p = .008) were strongly associated with the concern, emotional representation, complaints, disease timeline and consequences IP dimensions. Conclusion Persistent somatic symptoms rather than abnormalities in cardiopulmonary testing influence IP one year after COVID-19. Modifying IP represents a promising innovative approach to treatment of post-COVID-19 condition. Besides COVID-19 severity, individual IP should guide rehabilitation and psychological therapy decisions.

Persistent somatic symptoms are key to individual illness perception at one year after COVID-19 in a cross-sectional analysis of a prospective cohort study.

OBJECTIVE: Subjective illness perception (IP) can differ from physician's clinical assessment results. Herein, we explored patient's IP during coronavirus disease 2019 (COVID-19) recovery. METHODS: Participants of the prospective observation CovILD study (ClinicalTrials.gov: NCT04416100) with persistent somatic symptoms or cardiopulmonary findings one year after COVID-19 were analyzed (n = 74). Explanatory variables included demographic and comorbidity, COVID-19 course and one-year follow-up data of persistent somatic symptoms, physical performance, lung function testing, chest computed tomography and trans-thoracic echocardiography. Factors affecting IP (Brief Illness Perception Questionnaire) one year after COVID-19 were identified by regularized modeling and unsupervised clustering. RESULTS: In modeling, 33% of overall IP variance (R2) was attributed to fatigue intensity, reduced physical performance and persistent somatic symptom count. Overall IP was largely independent of lung and heart findings revealed by imaging and function testing. In clustering, persistent somatic symptom count (Kruskal-Wallis test: η2 = 0.31, p < .001), fatigue (η2 = 0.34, p < .001), diminished physical performance (χ2 test, Cramer V effect size statistic: V = 0.51, p < .001), dyspnea (V = 0.37, p = .006), hair loss (V = 0.57, p < .001) and sleep problems (V = 0.36, p = .008) were strongly associated with the concern, emotional representation, complaints, disease timeline and consequences IP dimensions. CONCLUSION: Persistent somatic symptoms rather than abnormalities in cardiopulmonary testing influence IP one year after COVID-19. Modifying IP represents a promising innovative approach to treatment of post-COVID-19 condition. Besides COVID-19 severity, individual IP should guide rehabilitation and psychological therapy decisions.

COVID-19 and its continuing burden after 12†months: a longitudinal observational prospective multicentre trial.

Background: Recovery trajectories from coronavirus disease 2019 (COVID-19) call for longitudinal investigation. We aimed to characterise the kinetics and status of clinical, cardiopulmonary and mental health recovery up to 1 year following COVID-19. Methods: Clinical evaluation, lung function testing (LFT), chest computed tomography (CT) and transthoracic echocardiography were conducted at 2, 3, 6 and 12 months after disease onset. Submaximal exercise capacity, mental health status and quality of life were assessed at 12 months. Recovery kinetics and patterns were investigated by mixed-effect logistic modelling, correlation and clustering analyses. Risk of persistent symptoms and cardiopulmonary abnormalities at the 1-year follow-up were modelled by logistic regression. Findings: Out of 145 CovILD study participants, 108 (74.5%) completed the 1-year follow-up (median age 56.5 years; 59.3% male; 24% intensive care unit patients). Comorbidities were present in 75% (n=81). Key outcome measures plateaued after 180 days. At 12 months, persistent symptoms were found in 65% of participants; 33% suffered from LFT impairment; 51% showed CT abnormalities; and 63% had low-grade diastolic dysfunction. Main risk factors for cardiopulmonary impairment included pro-inflammatory and immunological biomarkers at early visits. In addition, we deciphered three recovery clusters separating almost complete recovery from patients with post-acute inflammatory profile and an enrichment in cardiopulmonary residuals from a female-dominated post-COVID-19 syndrome with reduced mental health status. Conclusion: 1 year after COVID-19, the burden of persistent symptoms, impaired lung function, radiological abnormalities remains high in our study population. Yet, three recovery trajectories are emerging, ranging from almost complete recovery to post-COVID-19 syndrome with impaired mental health.

Seroprevalence of Anti-SARS-CoV-2 IgG Antibodies in Tyrol, Austria: Updated Analysis Involving 22,607 Blood Donors Covering the Period October 2021 to April 2022.

Because a large proportion of the Austrian population has been infected with SARS-CoV-2 during high incidence periods in winter 2021/2022, up-to-date estimates of seroprevalence of anti-SARS-CoV-2 antibodies are required to inform upcoming public health policies. We quantified anti-Spike IgG antibody levels in 22,607 individuals that donated blood between October 2021 and April 2022 across Tyrol, Austria (participation rate: 96.0%). Median age of participants was 45.3 years (IQR: 30.9-55.1); 41.9% were female. From October 2021 to April 2022, seropositivity increased from 84.9% (95% CI: 83.8-86.0%) to 95.8% (94.9-96.4%), and the geometric mean anti-Spike IgG levels among seropositive participants increased from 283 (95% CI: 271-296) to 1437 (1360-1518) BAU/mL. The percentages of participants in categories with undetectable levels and detectable levels at <500, 500-<1000, 1000-<2000, 2000-<3000, and ≥3000 BAU/mL were 15%, 54%, 15%, 10%, 3%, and 3% in October 2021 vs. 4%, 18%, 17%, 18%, 11%, and 32% in April 2022. Of 2711 participants that had repeat measurements taken a median 4.2 months apart, 61.8% moved to a higher, 13.9% to a lower, and 24.4% remained in the same category. Among seropositive participants, antibody levels were 16.8-fold in vaccinated individuals compared to unvaccinated individuals (95% CI: 14.2-19.9; p-value < 0.001). In conclusion, anti-SARS-CoV-2 seroprevalence in terms of seropositivity and average antibody levels has increased markedly during the winter 2021/2022 SARS-CoV-2 waves in Tyrol, Austria.

Wastewater surveillance of SARS-CoV-2 in Austria: development, implementation, and operation of the Tyrolean wastewater monitoring program.

Wastewater-based epidemiology (WBE) is an effective approach for tracking information on spatial distribution and temporal trends of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) at the community level. Herein, the development, implementation, and operation of the wastewater monitoring program serving Tyrol - a federal province of Austria - are described. The development of this program was initiated by Tyrolean health authorities at the end of the first phase of the Coronavirus disease 2019 (COVID-19) pandemic (May 2020). In close co-operation with the water sector and academic institutions, efficient and effective workflows and processes for wastewater surveillance were established. The monitoring program went into operation in November 2020. By the end of July 2021, a total of 5,270 wastewater influent samples collected at 43 sites were analyzed. The monitoring program provided valuable insights into the development of the pandemic situation in Tyrol and fulfilled several tasks that are of importance in different phases of the pandemic. It represented an early-warning system, provided independent confirmation of temporal trends in COVID-19 prevalence, enabled the assessment of the effectiveness of measures, alerted about bursts of disease activity, and provided evidence for the absence of COVID-19. These findings underline the importance of establishing national wastewater monitoring programs as a complementary source of information for efficient and effective pandemic management.

Prevalence of SARS-CoV-2 antibodies in healthy blood donors from the state of Tyrol, Austria, in summer 2020.

BACKGROUND: Seroepidemiological studies provide important insight into the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV­2) in our society. We aimed to determine seropositivity of SARS-CoV­2 antibodies and its cross-sectional correlates in a large cohort of blood donors. METHODS: In this observational cohort study, we tested healthy blood donors residing in Tyrol, Austria, for SARS-CoV­2 antibodies using the Abbott SARS-CoV­2 IgG chemiluminescent microparticle immunoassay. We estimated 95% confidence intervals (95% CI) of seroprevalences using bootstrapping and tested for differences by participant characteristics using logistic regression. FINDINGS: Between 8 June and 4 September 2020, we screened 5345 healthy individuals at local blood donor sessions (mean age 42.7 years, SD 13.5 years, 46.7% female). Overall seroprevalence was 3.1% (95% CI 2.7-3.6%, 165 cases), which is 5.1-fold higher (95% CI 4.5-6.0%) than the case number identified by the health authorities in the state-wide testing program (0.6%; 4536 out of 757,634). Seroprevalence was higher in the district Landeck (16.6%, P < 0.001) and in individuals aged < 25 years (4.7%, P = 0.043), but did not differ by gender, blood types, or medication intake. The odds ratio for seropositivity was 2.51 for participants who had travelled to Ischgl (1.49-4.21, P = 0.001), 1.39 who had travelled to other federal states (1.00-1.93, P = 0.052), and 2.41 who had travelled abroad (1.61-3.63, P < 0.001). Compared to participants who had a suspected/confirmed SARS-CoV­2 infection but were seronegative, seropositive participants more frequently reported loss of smell (odds ratio = 2.49, 1.32-4.68, P = 0.005) and taste (odds ratio = 2.76, 1.54-4.92, P = 0.001). CONCLUSION: In summer 2020, SARS-CoV­2 seroprevalence in Tyrolean blood donors was 3.1%. Our study revealed regional variation and associations with young age, travel history and specific symptoms.

Seroprevalence, Waning and Correlates of Anti-SARS-CoV-2 IgG Antibodies in Tyrol, Austria: Large-Scale Study of 35,193 Blood Donors Conducted between June 2020 and September 2021.

There is uncertainty about the seroprevalence of anti-SARS-CoV-2 antibodies in the general population of Austria and about the waning of antibodies over time. We conducted a seroepidemiological study between June 2020 and September 2021, enrolling blood donors aged 18-70 years across Tyrol, Austria (participation rate: 84.0%). We analyzed serum samples for antibodies against the spike or the nucleocapsid proteins of SARS-CoV-2. We performed a total of 47,363 samples taken from 35,193 individuals (median age, 43.1 years (IQR: 29.3-53.7); 45.3% women; 10.0% with prior SARS-CoV-2 infection). Seroprevalence increased from 3.4% (95% CI: 2.8-4.2%) in June 2020 to 82.7% (95% CI: 81.4-83.8%) in September 2021, largely due to vaccination. Anti-spike IgG seroprevalence was 99.6% (95% CI: 99.4-99.7%) among fully vaccinated individuals, 90.4% (95% CI: 88.8-91.7%) among unvaccinated individuals with prior infection and 11.5% (95% CI: 10.8-12.3%) among unvaccinated individuals without known prior infection. Anti-spike IgG levels were reduced by 44.0% (95% CI: 34.9-51.7%) at 5-6 months compared with 0-3 months after infection. In fully vaccinated individuals, they decreased by 31.7% (95% CI: 29.4-33.9%) per month. In conclusion, seroprevalence in Tyrol increased to 82.7% in September 2021, with the bulk of seropositivity stemming from vaccination. Antibody levels substantially and gradually declined after vaccination or infection.

The Effectiveness of Telemedical Monitoring Program DiabCare Tirol for Patients with Gestational Diabetes Mellitus.

The aim of this paper was to evaluate the effect of telemedical care of gestational diabetes mellitus (GDM) patients with the digital treatment pathway model DiabCare Tirol. METHODS: 27 courses of patients with GDM, who were telemonitored through the integrated care program DiabCare Tirol in a diabetes outpatient clinic in Tyrol, Austria during the COVID-19 pandemic in 2020, were analyzed. In addition, randomized controlled trials (RCTs) on telemedicine interventions for GDM were researched, and their results were used for comparison with this disease management method. The patient outcome analysis was used to examine the effects of the integrated care program involving telemonitoring support and compared them to the results of RCTs in which participants were randomly assigned to one of two groups, either mobile monitored or standard treatment group. RESULTS: The feasibility of the digital treatment pathway model was confirmed in practice, as the trend analysis of the 27 GDM patients involved showed significantly improved glycaemic control. Results of RCT studies tend to support the findings of DiabCare Tirol. CONCLUSION: Benefits of telemonitoring with integrated care to support conventional therapy cannot be dismissed, especially in times of the pandemic. Continuous outcome research with larger patient numbers will be necessary to confirm the effectiveness of telemonitoring in a regular care setting.