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1.
Laryngo- Rhino- Otologie ; 101:S243, 2022.
Article in English | EMBASE | ID: covidwho-1967666

ABSTRACT

Aim The project aims to examine chemosensory dysfunction in long-COVID with a focus on olfactory function about 9 months after SARS-CoV-II-infection. Material and Methods In this population-based cross sectional study, PCR-confirmed SARS-CoV-2 outpatients were examined between November and June 2020 at Kiel university hospital. Data on medical history and chemosensory function were collected via questionnaires and a Visual Analogue Scale (VAS), olfactory performance was psychophysically objectified using the Sniffin' Sticks test. Results A total of 376 female and 290 male patients were included with a mean age of 48.2 years ranging from 19 to 87 years. The mean follow-up was 9.09 months (range 1.64-15.18) after initial positive PCR-testing. The prevalence for olfactory dysfunction (OD) during infection was 66,1 %. 33,7 % of the subjects reported persistent OD subjectively at the time of examination (female 28,8 %, male 42,3 %). T-test analysis showed a significant decline of reported olfactory evaluation from before COVID-19 to the time of examination based on VAS (p < 0.001). 34,6 % of the subjects were tested hyposmic or anosmic by Sniffin' Sticks. A significant correlation was shown between a subjective estimation of OD by the patients and an objectively tested OD (p < 0.001). The TDI-score correlated positively with the amount of time (in months) that passed since PCR-testing (p < 0.001). Discussion OD in SARS-CoV-II-infection is frequent and can be persistent long beyond the acute phase of ilness. We demonstrated that anamnestic OD is significantly related to psychophysically tested OD. Therefore one can conclude that a subjective OD is a likely predictor of an actual objective OD. Furthermore, OD shows a tendency to improve over time.

2.
Laryngo- Rhino- Otologie ; 101:S242, 2022.
Article in English | EMBASE | ID: covidwho-1967662

ABSTRACT

Background This study aims to investigate the prevalence and long-term development of gustatory dysfunction (GD) after COVID-19. Methods In the population-based cross-sectional COVIDOM-study, 667 patients above the age of 18 years (mean 48.2) who tested positive for SARSCoV- 2 via PCR-testing on average 9.09 months ago were examined between November 2020 and June 2021. Extensive medical history taking was conducted via questionnaires. Participants were asked to rate their ability to taste before, during and after COVID-19 on a Visual Analogue Scale (VAS) ranging from 0 to 10. Whole mouth gustatory testing with Taste Strips for the qualities sweet, sour, salty, and bitter was performed. Results 60.9 % (406 of 667) participants reported gustatory impairment during their infection. Out of those, 56.9 % perceived this symptom as severe and 13.3 % noticed it as the earliest symptom. At the time of our examination, 36.2 % had a persistent subjective GD, defined as a lower score on the VAS than before COVID-19 (mean difference -0.9 points). This difference was significant (p < 0.001). In the testing, 7.3 % (47 of 667) participants had a GD, defined as the correct identification of less than three out of four Taste Strips. No signifi- cant correlation was found between subjectively persistent and tested GD (p = 0.250). Conclusions SARS-CoV-2 seems to frequently affect the gustatory function in the long term as well, what might have an influence on patients' everyday-life. However, Patients' own perception does not always correspond with psychophysiological testing which might be caused by the common difficulty to differentiate between the chemosensory senses of taste and smell.

3.
Viruses ; 14(2)2022 01 30.
Article in English | MEDLINE | ID: covidwho-1667347

ABSTRACT

Currently, SARS-CoV-2 causing coronavirus disease 2019 (COVID-19) is responsible for one of the most deleterious pandemics of our time. The interaction between the ACE2 receptors at the surface of human cells and the viral Spike (S) protein triggers the infection, making the receptor-binding domain (RBD) of the SARS-CoV-2 S-protein a focal target for the neutralizing antibodies (Abs). Despite the recent progress in the development and deployment of vaccines, the emergence of novel variants of SARS-CoV-2 insensitive to Abs produced in response to the vaccine administration and/or monoclonal ones represent a potential danger. Here, we analyzed the diversity of neutralizing Ab epitopes and assessed the possible effects of single and multiple mutations in the RBD of SARS-CoV-2 S-protein on its binding affinity to various antibodies and the human ACE2 receptor using bioinformatics approaches. The RBD-Ab complexes with experimentally resolved structures were grouped into four clusters with distinct features at sequence and structure level. The performed computational analysis indicates that while single amino acid replacements in RBD may only cause partial impairment of the Abs binding, moreover, limited to specific epitopes, the variants of SARS-CoV-2 with multiple mutations, including some which were already detected in the population, may potentially result in a much broader antigenic escape. Further analysis of the existing RBD variants pointed to the trade-off between ACE2 binding and antigenic escape as a key limiting factor for the emergence of novel SAR-CoV-2 strains, as the naturally occurring mutations in RBD tend to reduce its binding affinity to Abs but not to ACE2. The results provide guidelines for further experimental studies aiming to identify high-risk RBD mutations that allow for an antigenic escape.


Subject(s)
Antibodies, Neutralizing/metabolism , Antibodies, Viral/metabolism , Binding Sites, Antibody/genetics , Computational Biology/methods , Mutation , SARS-CoV-2/genetics , Spike Glycoprotein, Coronavirus/genetics , Antibodies, Neutralizing/immunology , Antibodies, Viral/immunology , Epitopes/metabolism , Host Microbial Interactions/genetics , Humans , Protein Binding , SARS-CoV-2/immunology , Spike Glycoprotein, Coronavirus/immunology
4.
Allergologie ; 44(1):54-80, 2021.
Article in German | Web of Science | ID: covidwho-1572877

ABSTRACT

With the advent of biologicals, more and more therapeutics are available that specifically address specific switch points in the pathomechanism of immunologically dominated diseases. Thus, the focus of diagnostics and therapy (precision medicine) is more on the individual disease characteristics of the individual patient. Regarding the different phenotypes of atopic diseases, severe asthma was the first entity for which biologicals were approved, followed by urticaria, and finally atopic dermatitis and chronic rhinosinusitis with nasal polyps. Experience in the treatment of severe bronchial asthma has shown that the intensity of the response to biological therapy depends on the quality of clinical and immunological phenotyping of the patients. This also applies to different diseases of the atopic form, as patients can suffer from several atopic diseases at the same time, each with different characteristics. Biologics are already emerging that may represent a suitable therapy for allergic bronchial asthma, which often occurs together with severe neurodennatitis. and chronic rhinosinusitis with nasal polyps. In practice, however, the question of possible combinations of biologicals for the therapy of complex clinical pictures of individual patients is increasingly arising. In doing so, the side effect profile must be taken into account, including hypersensitivity reactions, whose diagnostic and logistical management must aim at a safe and efficient therapy of the underlying disease. Increased attention must also be paid to biological therapy in pregnancy and planned (predictable) vaccinations as well as existing infections, such as SARS-CoV-2 infection. Before starting a biological therapy, the immune status should be checked with regard to chronic vi- ral and bacterial infections and, if necessary. the vaccination status should be refreshed or missing vaccinations should be made up for before starting therapy. Currently, reliable data on the effect of biologicals on the immunological situation of SARS-CoV-2 infection and COVID-19 are not available. Therefore, research and development of suitable diagnostic methods for detection of immunologically caused side effects as well as detection of potential therapy responders and non-responders is of great importance.

6.
Science ; 2021 May 20.
Article in English | MEDLINE | ID: covidwho-1388438

ABSTRACT

Airborne transmission by droplets and aerosols is important for the spread of viruses. Face masks are a well-established preventive measure, but their effectiveness for mitigating SARS-CoV-2 transmission is still under debate. We show that variations in mask efficacy can be explained by different regimes of virus abundance and related to population-average infection probability and reproduction number. For SARS-CoV-2, the viral load of infectious individuals can vary by orders of magnitude. We find that most environments and contacts are under conditions of low virus abundance (virus-limited) where surgical masks are effective at preventing virus spread. More advanced masks and other protective equipment are required in potentially virus-rich indoor environments including medical centers and hospitals. Masks are particularly effective in combination with other preventive measures like ventilation and distancing.

7.
Science ; 2021 May 20.
Article in English | MEDLINE | ID: covidwho-1238480

ABSTRACT

Airborne transmission by droplets and aerosols is important for the spread of viruses. Face masks are a well-established preventive measure, but their effectiveness for mitigating SARS-CoV-2 transmission is still under debate. We show that variations in mask efficacy can be explained by different regimes of virus abundance and related to population-average infection probability and reproduction number. For SARS-CoV-2, the viral load of infectious individuals can vary by orders of magnitude. We find that most environments and contacts are under conditions of low virus abundance (virus-limited) where surgical masks are effective at preventing virus spread. More advanced masks and other protective equipment are required in potentially virus-rich indoor environments including medical centers and hospitals. Masks are particularly effective in combination with other preventive measures like ventilation and distancing.

8.
Preprint in English | bioRxiv | ID: ppbiorxiv-435322

ABSTRACT

SARS-CoV-2 causing coronavirus disease 2019 (COVID-19) is responsible for one of the most deleterious pandemics of our time. The interaction between the ACE2 receptors at the surface of human cells and the viral Spike (S) protein triggers the infection making the receptor-binding domain (RBD) of the SARS-CoV-2 S-protein a focal target for the neutralizing antibodies (Abs). Despite the recent progress in the development and deployment of vaccines, the emergence of novel variants of SARS-CoV-2 insensitive to Abs produced in response to the vaccine administration and/or monoclonal ones represents upcoming jeopardy. Here, we assessed the possible effects of single and multiple mutations in the RBD of SARS-CoV-2 S-protein on its binding energy to various antibodies and the human ACE2 receptor. The performed computational analysis indicates that while single amino acid replacements in RBD may only cause partial impairment of the Abs binding, moreover, limited to specific epitopes, some variants of SARS-CoV-2 (with as few as 8 mutations), which are already present in the population, may potentially result in a much broader antigenic escape. We also identified a number of point mutations, which, in contrast to the majority of replacements, reduce RBD affinity to various antibodies without affecting its binding to ACE2. Overall, the results provide guidelines for further experimental studies aiming at the identification of the high-risk RBD mutations allowing for an antigenic escape.

9.
Allergologie ; 44(1):54, 2021.
Article in German | ProQuest Central | ID: covidwho-1068435

ABSTRACT

Mit den Biologika stehen zunehmend mehr Therapeutika zur Verfügung, die zielgerichtet bestimmte Schaltstellen im Pathomechanismus immunologisch dominierter Erkrankungen adressieren. Damit steht mehr die individuelle Krankheitsausprägung des einzelnen Patienten im Fokus der Diagnostik und Therapie (Präzisionsmedizin). Bezüglich der unterschiedlichen Phänotypen atopischer Erkrankungen war das schwere Asthma die erste Entität, für die Biologika zugelassen wurde, gefolgt von Urtikaria, und schließlich der atopischen Dermatitis und der chronischen Rhinosinusitis mit nasalen Polypen. Die Erfahrungen in der Therapie des schweren Asthma bronchiale machten deutlich, dass die Intensität des Ansprechens auf eine Biologikatherapie entscheidend von der Qualität der klinischen und immunologischen Phänotypisierung der Patienten abhängt, wobei diese Unterscheidung z. T. schwierig sein kann und sich verschiedene Phänotypen durchaus überlagern können. Das gilt auch für unterschiedliche Erkrankungen des atopischen Formenkreises, da Patienten in jeweils entsprechend unterschiedlicher Ausprägung unter mehreren atopischen Krankheiten gleichzeitig leiden können. Es bilden sich bereits Biologika heraus, die eine geeignete Therapie für das allergische Asthma bronchiale, das häufig gemeinsam mit einer schweren Neurodermitis auftritt, sowie die chronische Rhinosinusitis mit nasalen Polypen darstellen können. In der Praxis stellt sich dennoch zunehmend die Frage nach möglichen Biologika-Kombinationen zur Therapie komplexer Krankheitsbilder einzelner Patienten. Dabei gilt es, das Nebenwirkungsprofil zu beachten, zu denen auch Hypersensitivitätsreaktionen gehören, deren diagnostisches und logistisches Management eine sichere und effiziente Therapie der Grunderkrankung zum Ziel haben muss. Erhöhte Aufmerksamkeit gilt auch für eine Biologikatherapie bei Schwangerschaften und geplanten (planbaren) Impfungen sowie bestehenden Infektionen, wie zum Beispiel die SARS-CoV-2-Infektion. Vor dem Start einer Biologikatherapie sollten der Immunstatus in Bezug auf chronische Virusund bakterielle Infektionen geprüft und gegebenenfalls vor Therapieeinleitung der Impfstatus aufgefrischt bzw. fehlende Impfungen nachgeholt werden. Derzeit liegen verlässliche Daten zum Effekt von Biologika auf die immunologische Situation der SARS-CoV-2-Infektion und COVID-19 nicht vor. Daher ist die Erforschung und Entwicklung geeigneter Diagnostikverfahren zur Erfassung immunologisch bedingter Nebenwirkungen sowie der Erfassung potenzieller Therapie-Responder und -Non-Responder von großer BedeutungAlternate abstract:With the advent of biologicals, more and more therapeutics are available that specifically address specific switch points in the pathomechanism of immunologically dominated diseases. Thus, the focus of diagnostics and therapy (precision medicine) is more on the individual disease characteristics of the individual patient. Regarding the different phenotypes of atopic diseases, severe asthma was the first entity for which biologicals were approved, followed by urticaria, and finally atopic dermatitis and chronic rhinosinusitis with nasal polyps. Experience in the treatment of severe bronchial asthma has shown that the intensity of the response to biological therapy depends on the quality of clinical and immunological phenotyping of the patients. This also applies to different diseases of the atopic form, as patients can suffer from several atopic diseases at the same time, each with different characteristics. Biologics are already emerging that may represent a suitable therapy for allergic bronchial asthma, which often occurs together with severe neurodermatitis, and chronic rhinosinusitis with nasal polyps. In practice, however, the question of possible combinations of biologicals for the therapy of complex clinical pictures of individual patients is increasingly arising. In doing so, the side effect profile must be taken into account, including hypersensitivity reactions, whose diagnostic and logistical management must aim at a safe and e ficient therapy of the underlying disease. Increased attention must also be paid to biological therapy in pregnancy and planned (predictable) vaccinations as well as existing infections, such as SARS-CoV-2 infection. Before starting a biological therapy, the immune status should be checked with regard to chronic viral and bacterial infections and, if necessary, the vaccination status should be refreshed or missing vaccinations should be made up for before starting therapy. Currently, reliable data on the effect of biologicals on the immunological situation of SARS-CoV-2 infection and COVID-19 are not available. Therefore, research and development of suitable diagnostic methods for detection of immunologically caused side effects as well as detection of potential therapy responders and non-responders is of great importance.

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