Post-COVID-More than chronic fatigue?

After the first COVID-19 survivors were medically treated in Germany from spring 2020 onwards, various courses of the disease emerged that, in addition to the acute infection, led to prolonged symptoms (long COVID), but also to a symptomatic course beyond 12 weeks, which is referred to as "post-COVID syndrome" (PCS). Currently, the incidence of PCS is estimated to be approximately 15% of all symptomatically infected patients, although over- or underestimations may occur due to the soft definition and lack of control groups. The etiology of PCS is currently unknown. The following pathogenetic processes are discussed in particular: an endothelial dysfunction with microcirculatory disturbances and subsequent organ damage, a residual virus or virus particles, and/or an excessive autoimmune process. Due to the large number of organs that may be affected, PCS presents as a very complex clinical picture with up to 200 described symptoms. An evidence-based causal therapy for PCS has not yet been established. The guideline-based inpatient rehabilitation measures adapted to the individual patient resources have proven to be an effective therapy and should therefore be involved in the therapeutic concept at an early stage. Post-COVID syndrome is a multicomplex disease that can have a considerable impact on the quality of life, but also on the professional performance of the affected patients. Thus, it is clearly more than just a chronic fatigue syndrome. In the interest of our patients, treating physicians should take this disease seriously, clarify the differential diagnoses, and provide sensitive therapeutic care.

COVID-19 symptoms are reduced by targeted hydration of the nose, larynx and trachea.

Dehydration of the upper airways increases risks of respiratory diseases from COVID-19 to asthma and COPD. We find in human volunteer studies involving 464 human subjects in Germany, the US, and India that respiratory droplet generation increases by up to 4 orders of magnitude in dehydration-associated states of advanced age (n = 357), elevated BMI-age (n = 148), strenuous exercise (n = 20) and SARS-CoV-2 infection (n = 87), and falls with hydration of the nose, larynx and trachea by calcium-rich hypertonic salts. We also find in a protocol of exercise-induced airway dehydration that hydration of the airways by calcium-rich salts increases oxygenation relative to a non-treatment control (P < 0.05). In a random control study of COVID-19 positive subjects (n = 40), thrice-a-day delivery of the calcium-rich hypertonic salts (active) suppressed respiratory droplet generation by 51% ± 11% and increased oxygen saturation over three days of treatment by 48.08% ± 9.61% (P < 0.001), while no changes were observed in the nasal-saline control group. Self-reported symptoms significantly declined in the active group and did not decline in the control group. Hydration of the upper airways appears promising as a non-drug approach for reducing risks of respiratory diseases such as COVID-19.

Influence of a Heterologous (ChAdOx1-nCoV-19/BNT162b2) or Homologous (BNT162b2/BNT162b2) Vaccination Regimen on the Antibody and T Cell Response to a Third Vaccination with BNT162b2.

Emerging numbers of SARS-CoV-2 infections are currently combated with a third vaccination. Considering the different vaccination regimens used for the first two vaccine doses, we addressed whether the previous vaccination influences the immune response to the booster. Participants for this prospective study were recruited from among healthcare workers. N = 20 participants were previously vaccinated with two doses of BNT162b2, and n = 53 received a priming dose of ChAdOx1-nCoV-19 followed by a BNT162b2 dose. Participants were vaccinated with a third dose of BNT162b2 in December 2021. Antibody concentrations were determined after vaccination, and in a subset of n = 19 participants, T cell responses were evaluated. Anti-S concentrations and IFNγ production increased during the first 21 days. The choice of the first and second vaccineshad no influence on the final outcome of the booster vaccination. Before booster vaccination, antibody concentrations were lower for older participants but increased more strongly over time.

[Oncological Rehabilitation and Development of Strategies in Crisis Situations Using the Example of the Covid 19 Pandemic in 2020 by Using a Patient and Staff Survey Results of Pandemic Care]. / Onkologische Rehabilitation und Entwicklung von Strategien in Krisensituationen am Beispiel der Covid-19-Pandemie im Jahr 2020 unter Berücksichtigung einer Patienten- und Mitarbeiterbefragung.

INTRODUCTION: Cancer is a life-threatening disease often with curative therapy approaches, high risk of relapse and distressing symptoms, which require immediate, quality-assured care throughout the entire therapy process including rehabilitation, even in a pandemie. METHODS: We started to develop a pandemic plan to maintain oncological rehabilitation in February 2020. With the involvement of the whole clinic staff we developed protection scenarios with the aim of achieving Covid-19-free clinics. Schedules were developed and implemented based on the epidemiological bulletins of the RKI (Robert Koch Institute, Germany) of 2017 (influenza infection) and 2020 (Covid-19). The effects of these measures were evaluated by means of a patient and employee survey. RESULTS: The challenges of the pandemic have been successfully implemented. Both the patient and employee surveys showed a high level of acceptance of the measures. For example, 98.5% of patients stated that the continuation of rehabilitation was important for their health, even in the pandemic situation. At the same time, 87% felt safe. 88% of all employees (MA) and 93% of MA in the risk group stated that the protective measures were introduced at the right time. At the same time, 76% of all employees and 84% of the employees in the risk group agreed with the additional burden. In spite of the high risk potential in the clinics (immunocompromised patients, patients from different districts with different levels of exposure), an outbreak of SARS-CoV-2 could be avoided in the clinics. CONCLUSION: The timely roll-out of adapted pandemic rules in rehabilitation clinics enables the continuation of high-quality oncological rehabilitation even in pandemic times and thus contributes to a stabilisation of the supply chain for cancer diseases. A high level of acceptance of the measures among patients and hospital staff was evaluated.