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1.
Dtsch Arztebl Int ; (Forthcoming)2022 May 13.
Article in English | MEDLINE | ID: covidwho-1834320

ABSTRACT

BACKGROUND: One of the purposes of outpatient treatment for COVID-19 patients is to prevent severe disease courses and hospitalization. There is a need for evidence-based recommendations to be applied in primary care and specialized outpatient settings. METHODS: This guideline was developed on the basis of publications that were retrieved by a systematic search for randomized controlled trials in the Cochrane COVID-19 trial registry. The quality of evidence was assessed with GRADE, and structured consensus generation was carried out with MAGICapp. RESULTS: Unvaccinated COVID-19 outpatients with at least one risk factor for a severe disease course may be treated in the early phase of the disease with sotrovimab, remdesivir, or nirmatrelvir/ritonavir. Molnupiravir may also be used for such patients if no other clinically appropriate treatment options are available. Immunosuppressed persons with COVID-19 who are at high risk, and whose response to vaccination is expected to be reduced, ought to be treated with sotrovimab. It should be noted, however, that the clinical efficacy of sotrovimab against infections with the omicron subtype BA.2 is uncertain at the currently used dose, as the drug has displayed reduced activity against this subtype in vitro. COVID-19 patients at risk of a severe course may be offered budesonide inhalation, according to an off-label recommendation of the German College of General Practitioners and Family Physicians (other medical societies do not recommend either for or against this treatment). Thromboembolism prophylaxis with low-molecular-weight heparin may be given to elderly patients or those with a pre-existing illness. No recommendation is made concerning fluvoxamine or colchicine. Acetylsalicylic acid, azithromycin, ivermectin, systemic steroids, and vitamin D should not be used for the outpatient treatment of COVID-19. CONCLUSION: Drug treatment is now available for outpatients with COVID-19 in the early phase. Nearly all of the relevant trials have been conducted in unvaccinated subjects; this needs to be kept in mind in patient selection.

2.
BMC Med Educ ; 22(1): 257, 2022 Apr 08.
Article in English | MEDLINE | ID: covidwho-1785151

ABSTRACT

BACKGROUND: In mid-March 2020, the coronavirus pandemic led to a national lockdown in Germany. Face-to-face teaching was cancelled in universities for the 2020 summer semester. Teaching moved online with no prior IT testing and lecturer training. The study analyses experiences of the suspension of face-to-face teaching and the move to digitalised learning for students and lecturers of dentistry at Kiel. METHODS: In summer 2020, qualitative guided interviews were conducted with students (4th, 6th, 8th, and 10th semesters), and lecturers. Deductive and inductive qualitative content analysis of the results was carried out. RESULTS: Thirty-nine students (69% female) and 19 lecturers (32% female) were interviewed. Reactions to the changes in teaching were observed. Feelings ranged from an essentially positive attitude, through insecurity and uncertainty to a failure to fully appreciate the situation. The loss of social contact was lamented. Digitalisation was associated with technological challenges and additional work. However, it also fostered learning independent of time and place, and encouraged autonomy. Negative aspects of digitalisation included a lack of feedback and loss of interaction. CONCLUSION: The introduction of ad hoc digitalisation challenged both students and lecturers alike. Dealing with lockdown and the changes in teaching and studying required significant flexibility.


Subject(s)
COVID-19 , Students, Dental , COVID-19/epidemiology , Communicable Disease Control , Female , Humans , Learning , Male , Pandemics , Teaching
3.
Int J Environ Res Public Health ; 18(2)2021 01 07.
Article in English | MEDLINE | ID: covidwho-1024574

ABSTRACT

Targeting dementia prevention, first trials addressing multiple modifiable risk factors showed promising results in at-risk populations. In Germany, AgeWell.de is the first large-scale initiative investigating the effectiveness of a multi-component lifestyle intervention against cognitive decline. We aimed to investigate the recruitment process and baseline characteristics of the AgeWell.de participants to gain an understanding of the at-risk population and who engages in the intervention. General practitioners across five study sites recruited participants (aged 60-77 years, Cardiovascular Risk Factors, Aging, and Incidence of Dementia/CAIDE dementia risk score ≥ 9). Structured face-to-face interviews were conducted with eligible participants, including neuropsychological assessments. We analyzed group differences between (1) eligible vs. non-eligible participants, (2) participants vs. non-participants, and (3) between intervention groups. Of 1176 eligible participants, 146 (12.5%) dropped out before baseline; the study population was thus 1030 individuals. Non-participants did not differ from participants in key sociodemographic factors and dementia risk. Study participants were M = 69.0 (SD = 4.9) years old, and 52.1% were women. The average Montreal Cognitive Assessment/MoCA score was 24.5 (SD = 3.1), indicating a rather mildly cognitively impaired study population; however, 39.4% scored ≥ 26, thus being cognitively unimpaired. The bandwidth of cognitive states bears the interesting potential for differential trial outcome analyses. However, trial conduction is impacted by the COVID-19 pandemic, requiring adjustments to the study protocol with yet unclear methodological consequences.


Subject(s)
Cognitive Dysfunction/prevention & control , Life Style , Patient Selection , Aged , Female , Germany , Healthy Aging , Humans , Male , Middle Aged , Neuropsychological Tests
4.
Z. Allg.med. ; 6(96): 257-260, 2020.
Article in German | WHO COVID, ELSEVIER | ID: covidwho-667853

ABSTRACT

Since the United Kingdom has been severly hit by the corona virus pandemic, a renowned epidemiologist, together with 26 colleagues has made a proposal how to lead the way out of the crisis: They suggested to make a weekly PCR-test on the whole British population. This paper was set out to analyse the pro-cedural and economic risks and opportunities of this idea.

5.
Z. Allg.med. ; 5(96): 230-234, 2020.
Article in German | WHO COVID, ELSEVIER | ID: covidwho-360996

ABSTRACT

Assays to test for antibodies against SARS-CoV-2 can display a high proportion of false-positive results if the frequency of the disease in the general population is low. Testing is not suitable for proving or ruling out an acute infection. Judging an individual patient, a positive antibody titer does not necessarily mean that this person is immune. Currently ELISA assays are not appropriate for individual screening purposes but possibly can complement diagnostic procedures. They are suitable for population-based screening in the context of studies.

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