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2.
Open Forum Infect Dis ; 9(7): ofac203, 2022 Jul.
Article in English | MEDLINE | ID: covidwho-1922310

ABSTRACT

Background: Reactogenicity of coronavirus disease 2019 (COVID-19) vaccines can result in inability to work. The object of this study was to evaluate health care workers' sick leave after COVID-19 vaccination and to compare it with sick leave due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and quarantine leave. Methods: A multicenter cross-sectional survey was conducted at Regensburg University Medical Center and 10 teaching hospitals in South-East Germany from July 28 to October 15, 2021. Results: Of 2662 participants, 2309 (91.8%) were fully vaccinated without a history of SARS-CoV-2 infection. Sick leave after first/second vaccination occurred in 239 (10.4%) and 539 (23.3%) participants. In multivariable logistic regression, the adjusted odds ratio for sick leave after first/second vaccination compared with BNT162b2 was 2.26/3.72 for mRNA-1237 (95% CI, 1.28-4.01/1.99-6.96) and 27.82/0.48 for ChAdOx1-S (95% CI, 19.12-40.48/0.24-0.96). The actual median sick leave (interquartile range [IQR]) was 1 (0-2) day after any vaccination. Two hundred fifty-one participants (9.4%) reported a history of SARS-CoV-2 infection (median sick leave [IQR] 14 [10-21] days), 353 (13.3%) were quarantined at least once (median quarantine leave [IQR], 14 [10-14] days). Sick leave due to SARS-CoV-2 infection (4642 days) and quarantine leave (4710 days) accounted for 7.7 times more loss of workforce than actual sick leave after first and second vaccination (1216 days) in all fully vaccinated participants. Conclusions: Sick leave after COVID-19 vaccination is frequent and is associated with the vaccine applied. COVID-19 vaccination should reduce the much higher proportion of loss of workforce due to SARS-CoV-2 infection and quarantine.

3.
Scand J Work Environ Health ; 2022 Jun 07.
Article in English | MEDLINE | ID: covidwho-1879594

ABSTRACT

OBJECTIVE: The aim of this study was to identify the occupational risk for a SARS-CoV-2 infection in a nationwide sample of German workers during the first wave of the COVID-19 pandemic (1 February-31 August 2020). METHODS: We used the data of 108 960 workers who participated in a COVID follow-up survey of the German National Cohort (NAKO). Occupational characteristics were derived from the German Classification of Occupations 2010 (Klassifikation der Berufe 2010). PCR-confirmed SARS-CoV-2 infections were assessed from self-reports. Incidence rates (IR) and incidence rate ratios (IRR) were estimated using robust Poisson regression, adjusted for person-time at risk, age, sex, migration background, study center, working hours, and employment relationship. RESULTS: The IR was 3.7 infections per 1000 workers [95% confidence interval (CI) 3.3-4.1]. IR differed by occupational sector, with the highest rates observed in personal (IR 4.8, 95% CI 4.0-5.6) and business administration (IR 3.4, 95% CI 2.8-3.9) services and the lowest rates in occupations related to the production of goods (IR 2.0, 95% CI 1.5-2.6). Infections were more frequent among essential workers compared with workers in non-essential occupations (IRR 1.95, 95% CI 1.59-2.40) and among highly skilled compared with skilled professions (IRR 1.36, 95% CI 1.07-1.72). CONCLUSIONS: The results emphasize higher infection risks in essential occupations and personal-related services, especially in the healthcare sector. Additionally, we found evidence that infections were more common in higher occupational status positions at the beginning of the pandemic.

4.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-314840

ABSTRACT

Background: COVID-19 is a new syndrome caused by the recently emerged SARS-CoV-2. We collected clinical and epidemiologic data in an almost complete cohort of SARS-CoV-2 positive individuals from Regensburg, Germany, from March 2020 to May 2020. Methods: : Retrospective cohort of consecutive COVID-19 cases recorded between March 7, 2020 and May 24, 2020 as part of an infection control investigation program, with prospective follow-up interviews gathering information on type and duration of symptoms and COVID-19 risk factors until June 26, 2020. Results: : Of 1,089 total cases, 1,084 (99.6%) cases were included. The incidence during the time period was 315.4/100,000, lower than in the superordinate government district Oberpfalz (468,5/100,000) and the overall state of Bavaria (359.7/100,000). The case fatality rate was 2.1%. Among fatal cases, the mean age was 74.4 years and 87% presented with known risk factors, most commonly chronic heart disease, chronic lung disease, kidney disease, and diabetes mellitus. 897 cases (82,7%) showed at least one symptom, most frequently cough (45%) and fever (41%). Further, 18% of cases suffered from odour/taste disorder. 17% of total cases reported no symptoms. The median duration of general illness was 10 days. During follow-up, 8,9% of 419 interviewed cases reported at least one symptom lasting at least 6 weeks, and fatigue was the most frequent persistent symptom. Discussion: We report data on type and duration of symptoms, and clinical severity of nearly all (99,5%) patients with SARS-CoV-2 recorded from March 2020 to May 2020 in Regensburg. A broad range of symptoms and symptom duration was seen, some of them lasting several weeks. The case fatality rate was 2.1%. Asymptomatic cases may be underrepresented due to the nature of the study.

5.
J Infect Dis ; 225(2): 190-198, 2022 01 18.
Article in English | MEDLINE | ID: covidwho-1630684

ABSTRACT

BACKGROUND: From a public health perspective, effective containment strategies for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) should be balanced with individual liberties. METHODS: We collected 79 respiratory samples from 59 patients monitored in an outpatient center or in the intensive care unit of the University Hospital Regensburg. We analyzed viral load by quantitative real-time polymerase chain reaction, viral antigen by point-of-care assay, time since onset of symptoms, and the presence of SARS-CoV-2 immunoglobulin G (IgG) antibodies in the context of virus isolation from respiratory specimens. RESULTS: The odds ratio for virus isolation increased 1.9-fold for each log10 level of SARS-CoV-2 RNA and 7.4-fold with detection of viral antigen, while it decreased 6.3-fold beyond 10 days of symptoms and 20.0-fold with the presence of SARS-CoV-2 antibodies. The latter was confirmed for B.1.1.7 strains. The positive predictive value for virus isolation was 60.0% for viral loads >107 RNA copies/mL and 50.0% for the presence of viral antigen. Symptom onset before 10 days and seroconversion predicted lack of infectivity with negative predictive values of 93.8% and 96.0%. CONCLUSIONS: Our data support quarantining patients with high viral load and detection of viral antigen and lifting restrictive measures with increasing time to symptom onset and seroconversion. Delay of antibody formation may prolong infectivity.


Subject(s)
COVID-19/diagnosis , SARS-CoV-2 , Seroconversion , Viral Load , Adult , Antibodies, Viral , Antigens, Viral , COVID-19/immunology , Female , Humans , Male , Public Health , RNA, Viral , SARS-CoV-2/isolation & purification , SARS-CoV-2/pathogenicity , Severity of Illness Index
6.
Front Pediatr ; 9: 721518, 2021.
Article in English | MEDLINE | ID: covidwho-1518517

ABSTRACT

Background: Opening schools and keeping children safe from SARS-CoV-2 infections at the same time is urgently needed to protect children from direct and indirect consequences of the COVID-19 pandemic. To achieve this goal, a safe, efficient, and cost-effective SARS-CoV-2 testing system for schools in addition to standard hygiene measures is necessary. Methods: We implemented the screening WICOVIR concept for schools in the southeast of Germany, which is based on gargling at home, pooling of samples in schools, and assessment of SARS-CoV-2 by pool rRT-PCR, performed decentralized in numerous participating laboratories. Depooling was performed if pools were positive, and results were transmitted with software specifically developed for the project within a day. Here, we report the results after the first 13 weeks in the project. Findings: We developed and implemented the proof-of-concept test system within a pilot phase of 7 weeks based on almost 17,000 participants. After 6 weeks in the main phase of the project, we performed >100,000 tests in total, analyzed in 7,896 pools, identifying 19 cases in >100 participating schools. On average, positive children showed an individual CT value of 31 when identified in the pools. Up to 30 samples were pooled (mean 13) in general, based on school classes and attached school staff. All three participating laboratories detected positive samples reliably with their previously established rRT-PCR standard protocols. When self-administered antigen tests were performed concomitantly in positive cases, only one of these eight tests was positive, and when antigen tests performed after positive pool rRT-PCR results were already known were included, 3 out of 11 truly positive tests were also identified by antigen testing. After 3 weeks of repetitive WICOVIR testing twice weekly, the detection rate of positive children in that cohort decreased significantly from 0.042 to 0.012 (p = 0.008). Interpretation: Repeated gargle pool rRT-PCR testing can be implemented quickly in schools. It is an effective, valid, and well-received test system for schools, superior to antigen tests in sensitivity, acceptance, and costs.

8.
J Infect Dis ; 225(2): 190-198, 2022 01 18.
Article in English | MEDLINE | ID: covidwho-1370780

ABSTRACT

BACKGROUND: From a public health perspective, effective containment strategies for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) should be balanced with individual liberties. METHODS: We collected 79 respiratory samples from 59 patients monitored in an outpatient center or in the intensive care unit of the University Hospital Regensburg. We analyzed viral load by quantitative real-time polymerase chain reaction, viral antigen by point-of-care assay, time since onset of symptoms, and the presence of SARS-CoV-2 immunoglobulin G (IgG) antibodies in the context of virus isolation from respiratory specimens. RESULTS: The odds ratio for virus isolation increased 1.9-fold for each log10 level of SARS-CoV-2 RNA and 7.4-fold with detection of viral antigen, while it decreased 6.3-fold beyond 10 days of symptoms and 20.0-fold with the presence of SARS-CoV-2 antibodies. The latter was confirmed for B.1.1.7 strains. The positive predictive value for virus isolation was 60.0% for viral loads >107 RNA copies/mL and 50.0% for the presence of viral antigen. Symptom onset before 10 days and seroconversion predicted lack of infectivity with negative predictive values of 93.8% and 96.0%. CONCLUSIONS: Our data support quarantining patients with high viral load and detection of viral antigen and lifting restrictive measures with increasing time to symptom onset and seroconversion. Delay of antibody formation may prolong infectivity.


Subject(s)
COVID-19/diagnosis , SARS-CoV-2 , Seroconversion , Viral Load , Adult , Antibodies, Viral , Antigens, Viral , COVID-19/immunology , Female , Humans , Male , Public Health , RNA, Viral , SARS-CoV-2/isolation & purification , SARS-CoV-2/pathogenicity , Severity of Illness Index
9.
Infection ; 49(4): 661-669, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1118287

ABSTRACT

BACKGROUND: COVID-19 is a syndrome caused by the recently emerged SARS-CoV-2. We collected clinical and epidemiologic data in an almost complete cohort of SARS-CoV-2 positive individuals from Regensburg, Germany, from March 2020 to May 2020. METHODS: Analysis of a retrospectively documented cohort of consecutive COVID-19 cases recorded between March 7, 2020 and May 24, 2020 as part of an infection control investigation program, with prospective follow-up interviews gathering information on type and duration of symptoms and COVID-19 risk factors until June 26, 2020. RESULTS: Of 1089 total cases, 1084 (99.5%) cases were included. The incidence during the time period was 315.4/100,000, lower than in the superordinate government district Oberpfalz (468.5/100,000) and the overall state of Bavaria (359.7/100,000). The case fatality ratio (CFR) was 2.1%. Among fatal cases, the mean age was 74.4 years and 87% presented with known risk factors, most commonly chronic heart disease, chronic lung disease, kidney disease, and diabetes mellitus. 897 cases (82.7%) showed at least one symptom, most frequently cough (45%) and fever (41%). Further, 18% of cases suffered from odour/taste disorder. 17% of total cases reported no symptoms. The median duration of general illness was 10 days. During follow-up, 8.9% of 419 interviewed cases reported at least one symptom lasting at least 6 weeks, and fatigue was the most frequent persistent symptom. DISCUSSION: We report data on type and duration of symptoms, and clinical severity of nearly all (99.5%) patients with SARS-CoV-2 recorded from March 2020 to May 2020 in Regensburg. A broad range of symptoms and symptom duration was seen, some of them lasting several weeks in a considerable number of cases. The case-fatality ratio was 2.1%. Asymptomatic cases may be underrepresented due to the nature of the study.


Subject(s)
COVID-19/epidemiology , Adolescent , Adult , Age Distribution , Aged , Aged, 80 and over , COVID-19/mortality , Child , Child, Preschool , Cohort Studies , Disease Outbreaks , Female , Germany/epidemiology , Hospitalization/statistics & numerical data , Humans , Incidence , Infant , Male , Middle Aged , Retrospective Studies , Sex Distribution , Time Factors , Young Adult
10.
J Infect Public Health ; 13(12): 1862-1867, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-1023650

ABSTRACT

BACKGROUND: During the novel coronavirus disease (COVID-19) pandemic it is crucial for hospitals to implement infection prevention strategies to reduce nosocomial transmission to the lowest possible number. This is all the more important because molecular tests for identifying SARS-CoV-2 infected patients are uncertain, and the resources available for them are limited. In this view, a monocentric, retrospective study with an interventional character was conducted to investigate the extent to which the introduction of a strict hygiene bundle including a general mask requirement and daily screening for suspicious patients has an impact on the SARS-CoV-2 nosocomial rate in the pandemic environment. METHODS: All inpatients from a maximum care hospital in Regensburg (Bavaria) between March 1st and June 10th 2020 were included. Patient with respiratory symptoms were tested for SARS-CoV-2 at admission, patients were managed according to a standard hygiene protocol. At the end of March a strict hygiene bundle was introduced including a general mask obligation and a daily clinical screening of inpatients for respiratory symptoms. Nosocomial infection rate for COVID-19 and the risk for infection transmission estimated by the nosocomial incidence density before and after introduction the hygiene bundle were compared. The infection pressure for the hospital during the entire observational period was characterized by the infection reports in the region in relation to the number of hospitalized COVID-19 patients and the number of infected employees. RESULTS: In fact, after the introduction of a strict hygiene bundle including a general mouth and nose protection obligation and a daily clinical screening of suspicious patients, a significant reduction of the nosocomial rate from 0.28 to 0.06 (p = 0.026) was observed. Furthermore, the risk of spreading hospital-acquired infections also decreased dramatically from 0.0007 to 0.00018 (p = 0.031; rate ratio after/before 0.25 (95%CI 0.06, 1.07) despite a slow decrease of the hospital COVID 19-prevalence and an increase of infected employees. CONCLUSION: The available data underline that a strict hygiene bundle seem to be associated with a decrease of nosocomial SARS-CoV-2 transmission in the pandemic situation.


Subject(s)
COVID-19/prevention & control , Hygiene , SARS-CoV-2 , COVID-19/transmission , Germany , Humans , Infection Control
11.
Nephrologe ; 16(1): 3-9, 2021.
Article in German | MEDLINE | ID: covidwho-986662

ABSTRACT

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has rapidly spread globally since December 2019. A first wave is visible up to the end of June 2020 in many regions. This article presents a review of the current knowledge on the epidemiology and prevention. The SARS-CoV­2 predominantly replicates in the upper and lower respiratory tracts and is particularly transmitted by droplets and aerosols. The estimate for the basic reproduction number (R0) is between 2 and 3 and the median incubation period is 6 days (range 2-14 days). As with the related SARS-CoV and Middle East respiratory syndrome (MERS-CoV), superspreading events play an important role in the dissemination. A high proportion of infections are uncomplicated but moderate or severe courses develop in 5-10% of infected persons. Pneumonia, cardiac involvement and thromboembolisms are the most frequent manifestations leading to hospitalization. Risk factors for a complicated course are high age, hypertension, diabetes mellitus and chronic cardiovascular and pulmonary diseases as well as immunodeficiency. Currently, the estimation for the infection fatality rate (IFR) is between 0.5% and 1% across all age groups. Outbreaks were limited in many regions with bundles of various measures for reduction of social contacts. The incidence for the first wave in Germany can be estimated as 0.4-1.8% and excess mortality could not be observed.

12.
GMS Hyg Infect Control ; 15: Doc27, 2020.
Article in English | MEDLINE | ID: covidwho-937400

ABSTRACT

Background: We analyzed the epidemiology of COVID-19 in Regensburg after the first wave ended in June 2020 and compared it with patients' characteristics and symptoms in late summer/early autumn 2020. Methods: Retrospective analysis of epidemiological data from Regensburg (city/county) on age and initial symptoms as reported during case investigation for containment. Observed periods: March 7, 2020 to June 6, 2020 and August 12, 2020 to October 9, 2020. Results: The proportion of asymptomatic persons who tested positive for SARS-COV-2 in the second period was 55% (286 of 520 cases), whereas during the first wave from March to June 2020 this percentage was 14.4% (169 of 1,170 cases). A comparison of typical symptoms shows that the most common symptoms of COVID-19 in the first wave (cough, fever and generally feeling ill) were less often reported in the second period: cough 14% vs. 42%, fever 17% vs. 38%, general signs of illness 14% vs. 22% in the second vs. first period, respectively overall cases were younger in the second period, the median age of asymptomatic cases was comparable in both periods. The case fatality rate for the first period was 2.1%, in the second it was 0.2%. Discussion: The epidemiological situation in the second period is different from that during the first wave. We observed a considerable proportion of questionable cases in August/September 2020 (asymptomatic cases, high ct values, often only detection of one gene). False positive cases/non-contagious cases have to be taken into account for this period. On-demand or free-of-charge testing for asymptomatic persons will lower the positive predictive value of tests and place a high burden on finite capacities.

13.
Infection ; 49(2): 233-239, 2021 Apr.
Article in English | MEDLINE | ID: covidwho-848552

ABSTRACT

PURPOSE: SARS-CoV-2 is a recently emerged ß-coronavirus. Here we present the current knowledge on its epidemiologic features. METHODS: Non-systematic review. RESULTS: SARS-CoV-2 replicates in the upper and lower respiratory tract. It is mainly transmitted by droplets and aerosols from asymptomatic and symptomatic infected subjects. The consensus estimate for the basis reproduction number (R0) is between 2 and 3, and the median incubation period is 5.7 (range 2-14) days. Similar to SARS and MERS, superspreading events have been reported, the dispersion parameter (kappa) is estimated at 0.1. Most infections are uncomplicated, and 5-10% of patients are hospitalized, mainly due to pneumonia with severe inflammation. Complications are respiratory and multiorgan failure; risk factors for complicated disease are higher age, hypertension, diabetes, chronic cardiovascular, chronic pulmonary disease and immunodeficiency. Nosocomial and infections in medical personnel have been reported. Drastic reductions of social contacts have been implemented in many countries with outbreaks of SARS-CoV-2, leading to rapid reductions. Most interventions have used bundles, but which of the measures have been more or less effective is still unknown. The current estimate for the infection's fatality rate is 0.5-1%. Using current models of age-dependent infection fatality rates, upper and lower limits for the attack rate in Germany can be estimated between 0.4 and 1.6%, lower than in most European countries. CONCLUSIONS: Despite a rapid worldwide spread, attack rates have been low in most regions, demonstrating the efficacy of control measures.


Subject(s)
COVID-19/epidemiology , SARS-CoV-2/pathogenicity , Age Distribution , Basic Reproduction Number , COVID-19/pathology , COVID-19/prevention & control , COVID-19/transmission , Cross Infection/epidemiology , Humans , Incidence , Infectious Disease Incubation Period , Mortality , Risk Factors
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