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1.
COVID ; 2(10):1435-1448, 2022.
Article in English | MDPI | ID: covidwho-2071259

ABSTRACT

In this study, we describe how to keep a campus safe and 'open';by implementing a proactive, as opposed to reactive, strategy (the Green Zone strategy). The pillars are leadership, clear communication, clean air, vaccination campaigns, and intense efforts in mass testing. Over a period of 12 months, about 277,000 pooled real-time polymerase chain reaction (RT-PCR) samples and lateral flow tests (LFTs) were collected, and 201 people were identified as COVID-19-positive. For the PCRs, we use the Lollipop technique, combined with nose swabs and gargle samples, to minimize sample-collection efforts. Importantly, not only staff, students, and contractors, but also their family members, friends, and partners;daycare centers;and local sports and arts teams, etc., were invited and participated. This outreach made it possible to propagate the tests more widely and monitor a larger network. At times of larger social gatherings-most prominently, on 23 December 2021 before Christmas (during the rise of the Omicron wave)-testing capacities were increased. The results not only demonstrate the great power of mass testing in providing an open-but-safe work environment, even if the surroundings are highly infectious (red zone), but also the strength and resilience of a university. It shows how the unique pillars of science, infrastructure, students, and independency make it possible to maneuver a community, even through unpredictable times.

3.
J Ultrasound Med ; 2022 Jul 30.
Article in English | MEDLINE | ID: covidwho-1966063

ABSTRACT

Lung ultrasound has the potential to enable standardized follow-up without radiation exposure and with lower associated costs in comparison to CT scans. It is a valuable tool to follow up on patients after a COVID-19 infection and evaluate if there is pulmonary fibrosis developing. Echocardiography, including strain imaging, is a proven tool to assess various causes of dyspnea and adds valuable information in the context of long COVID care. Including two-dimensional (2D) strain imaging, a better comprehension of myocardial damage in post-COVID syndrome can be made. Especially 2D strain imaging (left and the right ventricular strain) can provide information about prognosis.

4.
Atmospheric Measurement Techniques Discussions ; : 1-24, 2022.
Article in English | Academic Search Complete | ID: covidwho-1903762

ABSTRACT

Nitrogen dioxide (NO2) air pollution provides valuable information for quantifying NOx emissions and exposures. This study presents a comprehensive method to estimate average tropospheric NO2 emission strengths derived from three-year (April 2018 - March 2021) TROPOMI observations by combining a wind-assigned anomaly approach and a Machine Learning (ML) method, the so-called Gradient Descent. This combined approach is firstly applied to the Saudi Arabian capital city Riyadh, as a test site, and yields a total emission rate of 1.04×1026 molec./s. The ML-trained anomalies fit very well with the wind-assigned anomalies with an R2 value of 1.0 and a slope of 0.99. Hotspots of NO2 emissions are apparent at several sites where the cement plant and power plants are located and over areas along the highways. Using the same approach, an emission rate of 1.80×1025 molec./s is estimated in the Madrid metropolitan area, Spain. Both the estimate and spatial pattern are comparable to the CAMS inventory. Weekly variations of NO2 emission are highly related to anthropogenic activities, such as the transport sector. The NO2 emissions were reduced by 24% at weekends in Riyadh, and high reductions are found near the city center and the areas along the highway. An average weekend reduction estimate of 30% in Madrid is found. The regions with dominant sources are located in the east of Madrid, where the residential areas and the Madrid-Barajas airport are located. Additionally, the NO2 emissions decreased by 21% in March-June 2020 compared to the same period in 2019 induced by the COVID-19 lockdowns in Riyadh. A much higher reduction (60%) is estimated for Madrid where a very strict lockdown policy was implemented. The high emission strengths during lockdown only persist in the residential areas and cover smaller areas during weekdays than at weekends. The spatial patterns of NO2 emission strengths during lockdown are similar to those observed at weekends in both cities. Though our analysis is limited to two cities as testing examples, the method has proved to provide reliable and consistent results. Therefore, it is expected to be suitable for other trace gases and other target regions. [ FROM AUTHOR] Copyright of Atmospheric Measurement Techniques Discussions is the property of Copernicus Gesellschaft mbH and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

5.
The international journal of cardiovascular imaging ; : 1-15, 2022.
Article in English | EuropePMC | ID: covidwho-1842736

ABSTRACT

Cardiac involvement has been described in varying proportions of patients recovered from COVID-19 and proposed as a potential cause of prolonged symptoms, often described as post-COVID or long COVID syndrome. Recently, cardiac complications have been reported from COVID-19 vaccines as well. We aimed to compare CMR-findings in patients with clinical cardiac symptoms after COVID-19 and after vaccination. From May 2020 to May 2021, we included 104 patients with suspected cardiac involvement after COVID-19 who received a clinically indicated cardiac magnetic resonance (CMR) examination at a high-volume center. The mean time from first positive PCR to CMR was 112  ± 76 days. During their COVID-19 disease, 21% of patients required hospitalization, 17% supplemental oxygen and 7% mechanical ventilation. In 34 (32.7%) of patients, CMR provided a clinically relevant diagnosis: Isolated pericarditis in 10 (9.6%), %), acute myocarditis (both LLC) in 7 (6.7%), possible myocarditis (one LLC) in 5 (4.8%), ischemia in 4 (3.8%), recent infarction in 2 (1.9%), old infarction in 4 (3.8%), dilated cardiomyopathy in 3 (2.9%), hypertrophic cardiomyopathy in 2 (1.9%), aortic stenosis, pleural tumor and mitral valve prolapse each in 1 (1.0%). Between May 2021 and August 2021, we examined an additional 27 patients with suspected cardiac disease after COVID-19 vaccination. Of these, CMR provided at least one diagnosis in 22 (81.5%): Isolated pericarditis in 4 (14.8%), acute myocarditis in 9 (33.3%), possible myocarditis (acute or subsided) in 6 (22.2%), ischemia in 3 (37.5% out of 8 patients with stress test), isolated pericardial effusion (> 10 mm) and non-compaction-cardiomyopathy each in 1 (3.7%). The number of myocarditis diagnoses after COVID-19 was highly dependent on the stringency of the myocarditis criteria applied. When including only cases of matching edema and LGE and excluding findings in the right ventricular insertion site, the number of cases dropped from 7 to 2 while the number of cases after COVID-19 vaccination remained unchanged at 9. While myocarditis is an overall rare side effect after COVID-19 vaccination, it is currently the leading cause of myocarditis in our institution due to the large number of vaccinations applied over the last months. Contrary to myocarditis after vaccination, LGE and edema in myocarditis after COVID-19 often did not match or were confined to the RV-insertion site. Whether these cases truly represent myocarditis or a different pathological entity is to be determined in further studies.

6.
J Clin Med ; 11(9)2022 May 02.
Article in English | MEDLINE | ID: covidwho-1820306

ABSTRACT

The aim was to evaluate hospitalization rates for aneurysmal subarachnoid hemorrhage (SAH) within an interdisciplinary multicenter neurovascular network (NVN) during the shutdown for the COVID-19 pandemic along with its modifiable risk factors. In this multicenter study, admission rates for SAH were compared for the period of the shutdown for the COVID-19 pandemic in Germany (calendar weeks (cw) 12 to 16, 2020), the periods before (cw 6-11) and after the shutdown (cw 17-21 and 22-26, 2020), as well as with the corresponding cw in the years 2015-2019. Data on all-cause and pre-hospital mortality within the area of the NVN were retrieved from the Department of Health, and the responsible emergency medical services. Data on known triggers for systemic inflammation, e.g., respiratory viruses and air pollution, were analyzed. Hospitalizations for SAH decreased during the shutdown period to one-tenth within the multicenter NVN. There was a substantial decrease in acute respiratory illness rates, and of air pollution during the shutdown period. The implementation of public health measures, e.g., contact restrictions and increased personal hygiene during the shutdown, might positively influence modifiable risk factors, e.g., systemic inflammation, leading to a decrease in the incidence of SAH.

7.
Front Cardiovasc Med ; 9: 829392, 2022.
Article in English | MEDLINE | ID: covidwho-1809360

ABSTRACT

Serious adverse events associated with new vaccines targeting SARS-CoV-2 are of high interest to the public and to public health as a worldwide mass immunization campaign has been initiated to contain the ongoing COVID-19 pandemic. We describe a series of 4 individuals with signs of a myocarditis/pericarditis according to cardiac MRI results in temporal association with currently in the European Union authorized SARS-CoV-2 vaccines. We found mild abnormal MRI results independent of the type of SARS-CoV-2 vaccine. There is a need of continuing monitoring outcomes of myocarditis cases after COVID-19 vaccination as recently published cases suggest an uncomplicated short-term course whereas the long-term implications are not yet known but taking the available evidence into account the benefits of using COVID-19 vaccines still clearly outweigh the risks.

8.
ACS Infect Dis ; 8(4): 790-799, 2022 04 08.
Article in English | MEDLINE | ID: covidwho-1768765

ABSTRACT

Recent efforts in understanding the course and severity of SARS-CoV-2 infections have highlighted both potentially beneficial and detrimental effects of cross-reactive antibodies derived from memory immunity. Specifically, due to a significant degree of sequence similarity between SARS-CoV-2 and other members of the coronavirus family, memory B-cells that emerged from previous infections with endemic human coronaviruses (HCoVs) could be reactivated upon encountering the newly emerged SARS-CoV-2, thus prompting the production of cross-reactive antibodies. Determining the affinity and concentration of these potentially cross-reactive antibodies to the new SARS-CoV-2 antigens is therefore particularly important when assessing both existing immunity against common HCoVs and adverse effects like antibody-dependent enhancement (ADE) in COVID-19. However, these two fundamental parameters cannot easily be disentangled by surface-based assays like enzyme-linked immunosorbent assays (ELISAs), which are routinely used to assess cross-reactivity. Here, we have used microfluidic antibody affinity profiling (MAAP) to quantitatively evaluate the humoral immune response in COVID-19 convalescent patients by determining both antibody affinity and concentration against spike antigens of SARS-CoV-2 directly in nine convalescent COVID-19 patient and three pre-pandemic sera that were seropositive for common HCoVs. All 12 sera contained low concentrations of high-affinity antibodies against spike antigens of HCoV-NL63 and HCoV-HKU1, indicative of past exposure to these pathogens, while the affinity against the SARS-CoV-2 spike protein was lower. These results suggest that cross-reactivity as a consequence of memory reactivation upon an acute SARS-CoV-2 infection may not be a significant factor in generating immunity against SARS-CoV-2.


Subject(s)
COVID-19 , SARS-CoV-2 , Antibodies, Viral , Antibody Affinity , Humans , Microfluidics , Spike Glycoprotein, Coronavirus
9.
Wien Klin Wochenschr ; 133(23-24): 1298-1309, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1748480

ABSTRACT

Hundreds of millions got infected, and millions have died worldwide and still the number of cases is rising.Chest radiographs and computed tomography (CT) are useful for imaging the lung but their use in infectious diseases is limited due to hygiene and availability.Lung ultrasound has been shown to be useful in the context of the pandemic, providing clinicians with valuable insights and helping identify complications such as pleural effusion in heart failure or bacterial superinfections. Moreover, lung ultrasound is useful for identifying possible complications of procedures, in particular, pneumothorax.Associations between coronavirus disease 2019 (COVID-19) and cardiac complications, such as acute myocardial infarction and myocarditis, have been reported. As such, point of care echocardiography as well as a comprehensive approach in later stages of the disease provide important information for optimally diagnosing and treating complications of COVID-19.In our experience, lung ultrasound in combination with echocardiography, has a great impact on treatment decisions. In the acute state as well as in the follow-up setting after a severe or critical state of COVID-19, ultrasound can be of great impact to monitor the progression and regression of disease.


Subject(s)
COVID-19 , Critical Illness , Echocardiography , Humans , Lung/diagnostic imaging , Point-of-Care Systems , SARS-CoV-2 , Ultrasonography
11.
Life Sci Alliance ; 5(2)2022 02.
Article in English | MEDLINE | ID: covidwho-1547941

ABSTRACT

The clinical outcome of SARS-CoV-2 infections, which can range from asymptomatic to lethal, is crucially shaped by the concentration of antiviral antibodies and by their affinity to their targets. However, the affinity of polyclonal antibody responses in plasma is difficult to measure. Here we used microfluidic antibody affinity profiling (MAAP) to determine the aggregate affinities and concentrations of anti-SARS-CoV-2 antibodies in plasma samples of 42 seropositive individuals, 19 of which were healthy donors, 20 displayed mild symptoms, and 3 were critically ill. We found that dissociation constants, K d, of anti-receptor-binding domain antibodies spanned 2.5 orders of magnitude from sub-nanomolar to 43 nM. Using MAAP we found that antibodies of seropositive individuals induced the dissociation of pre-formed spike-ACE2 receptor complexes, which indicates that MAAP can be adapted as a complementary receptor competition assay. By comparison with cytopathic effect-based neutralisation assays, we show that MAAP can reliably predict the cellular neutralisation ability of sera, which may be an important consideration when selecting the most effective samples for therapeutic plasmapheresis and tracking the success of vaccinations.


Subject(s)
Antibodies, Viral/blood , COVID-19/immunology , Microfluidics/methods , SARS-CoV-2/immunology , Adult , Aged , Angiotensin-Converting Enzyme 2/blood , Angiotensin-Converting Enzyme 2/immunology , Antibodies, Viral/immunology , Antibody Affinity , B-Lymphocytes/immunology , B-Lymphocytes/virology , COVID-19/blood , COVID-19/etiology , Cross Reactions , Female , Humans , Male , Middle Aged , Severity of Illness Index , Spike Glycoprotein, Coronavirus/blood , Spike Glycoprotein, Coronavirus/immunology , Surface Plasmon Resonance
13.
J Neurooncol ; 153(3): 479-485, 2021 Jul.
Article in English | MEDLINE | ID: covidwho-1265544

ABSTRACT

PURPOSE: Neuro-oncology tumor boards (NTBs) hold an established function in cancer care as multidisciplinary tumor boards. However, NTBs predominantly exist at academic and/or specialized centers. In addition to increasing centralization throughout the healthcare system, changes due to the COVID-19 pandemic have arguably resulted in advantages by conducting clinical meetings virtually. We therefore asked about the experience and acceptance of (virtualized) NTBs and their potential benefits. METHODS: A survey questionnaire was developed and distributed via a web-based platform. Specialized neuro-oncological centers in Germany were identified based on the number of brain tumor cases treated in the respective institution per year. Only one representative per center was invited to participate in the survey. Questions targeted the structure/organization of NTBs as well as changes due to the COVID-19 pandemic. RESULTS: A total of 65/97 institutions participated in the survey (response rate 67%). In the context of the COVID-19 pandemic, regular conventions of NTBs were maintained by the respective centers and multi-specialty participation remained high. NTBs were considered valuable by respondents in achieving the most optimal therapy for the affected patient and in maintaining/encouraging interdisciplinary debate/exchange. The settings of NTBs have been adapted during the pandemic with the increased use of virtual technology. Virtual NTBs were found to be beneficial, yet administrative support is lacking in some places. CONCLUSIONS: Virtual implementation of NTBs was feasible and accepted in the centers surveyed. Therefore, successful implementation offers new avenues and may be pursued for networking between centers, thereby increasing coverage of neuro-oncology care.


Subject(s)
COVID-19/epidemiology , Health Plan Implementation , Neoplasms/therapy , Practice Patterns, Physicians'/standards , SARS-CoV-2/isolation & purification , Telemedicine , COVID-19/virology , Cross-Sectional Studies , Delivery of Health Care , Humans , Surveys and Questionnaires
14.
ACS Infect Dis ; 7(8): 2362-2369, 2021 08 13.
Article in English | MEDLINE | ID: covidwho-1193571

ABSTRACT

The humoral immune response plays a key role in suppressing the pathogenesis of SARS-CoV-2. The molecular determinants underlying the neutralization of the virus remain, however, incompletely understood. Here, we show that the ability of antibodies to disrupt the binding of the viral spike protein to the angiotensin-converting enzyme 2 (ACE2) receptor on the cell, the key molecular event initiating SARS-CoV-2 entry into host cells, is controlled by the affinity of these antibodies to the viral antigen. By using microfluidic antibody-affinity profiling, we were able to quantify the serum-antibody mediated inhibition of ACE2-spike binding in two SARS-CoV-2 seropositive individuals. Measurements to determine the affinity, concentration, and neutralization potential of antibodies were performed directly in human serum. Using this approach, we demonstrate that the level of inhibition in both samples can be quantitatively described using the dissociation constants (KD) of the binary interactions between the ACE2 receptor and the spike protein as well as the spike protein and the neutralizing antibody. These experiments represent a new type of in-solution receptor binding competition assay, which has further potential applications, ranging from decisions on donor selection for convalescent plasma therapy, to identification of lead candidates in therapeutic antibody development, and vaccine development.


Subject(s)
COVID-19 , SARS-CoV-2 , Angiotensin-Converting Enzyme 2 , Antibody Affinity , COVID-19/therapy , Humans , Immunization, Passive , Peptidyl-Dipeptidase A/genetics , Spike Glycoprotein, Coronavirus/genetics
15.
Z Rheumatol ; 80(5): 399-407, 2021 Jun.
Article in German | MEDLINE | ID: covidwho-1193139

ABSTRACT

BACKGROUND: In 2020 the COVID-19 pandemic led to the annual meeting of the German Society for Rheumatology (DGRh) being conducted as the virtual German Rheumatology Congress. AIM: How is the virtual German Rheumatology Congress accepted and what are the possibilities of optimization for the future? MATERIAL AND METHOD: The registered participants were asked to take part in an online congress evaluation. RESULTS: Of 2566 congress attendees, 721 participated in the evaluation. The majority (80.2%) were (very) satisfied with the event overall. Compared to the traditional format collegial exchange was perceived as worse using the virtual approach. The technology platform was predominantly described as easy to use and easily accessible. The selected topics of the congress met the expectations of 89% of the participants. The presented contents were estimated to be relevant for their professional activities by 85.2% of the participants. The majority of participants (85.3%) would welcome the congress contents to be permanently available on demand. DISCUSSION: Overall, the participants appreciated the virtual format of the German Rheumatology Congress. Optimization aspects could be shown and these could be considered in the implementation of further (digital) congresses. The results of this work provide suggestions for improvement on how the DGRh can meet and exceed the needs of participants in organizing a virtual or hybrid conference in the future.


Subject(s)
COVID-19 , Rheumatology , Humans , Pandemics , SARS-CoV-2
16.
Geophys Res Lett ; 48(5): e2020GL091987, 2021 Mar 16.
Article in English | MEDLINE | ID: covidwho-1160793

ABSTRACT

Throughout spring and summer 2020, ozone stations in the northern extratropics recorded unusually low ozone in the free troposphere. From April to August, and from 1 to 8 kilometers altitude, ozone was on average 7% (≈4 nmol/mol) below the 2000-2020 climatological mean. Such low ozone, over several months, and at so many stations, has not been observed in any previous year since at least 2000. Atmospheric composition analyses from the Copernicus Atmosphere Monitoring Service and simulations from the NASA GMI model indicate that the large 2020 springtime ozone depletion in the Arctic stratosphere contributed less than one-quarter of the observed tropospheric anomaly. The observed anomaly is consistent with recent chemistry-climate model simulations, which assume emissions reductions similar to those caused by the COVID-19 crisis. COVID-19 related emissions reductions appear to be the major cause for the observed reduced free tropospheric ozone in 2020.

18.
Nat Rev Rheumatol ; 17(3): 177-184, 2021 03.
Article in English | MEDLINE | ID: covidwho-1012684

ABSTRACT

During the COVID-19 pandemic, the need to provide high-level care for a large number of patients with COVID-19 has affected resourcing for, and limited the routine care of, all other conditions. The impact of this health emergency is particularly relevant in the rare connective tissue diseases (rCTDs) communities, as discussed in this Perspective article by the multi-stakeholder European Reference Network on Rare and Complex Connective Tissue and Musculoskeletal Diseases (ERN ReCONNET). The clinical, organizational and health economic challenges faced by health-care providers, institutions, patients and their families during the SARS-CoV-2 outbreak have demonstrated the importance of ensuring continuity of care in the management of rCTDs, including adequate diagnostics and monitoring protocols, and highlighted the need for a structured emergency strategy. The vulnerability of patients with rCTDs needs to be taken into account when planning future health policies, in preparation for not only the post-COVID era, but also any possible new health emergencies.


Subject(s)
COVID-19/epidemiology , Connective Tissue Diseases/epidemiology , Delivery of Health Care/organization & administration , Pandemics , SARS-CoV-2 , Comorbidity , Connective Tissue Diseases/therapy , Humans
19.
Clin Oral Investig ; 25(6): 3853-3860, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1012217

ABSTRACT

OBJECTIVE: The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic has created hitherto unknown challenges for healthcare systems and patient care. This study aimed to analyze its influence on patient care and healthcare management in oral and maxillofacial surgery (OMFS) in Germany. MATERIALS AND METHODS: A nationwide survey of the German Association of Oral and Maxillofacial Surgery was performed. Individual questionnaires containing 10 questions for university as well as non-university hospitals and 15 questions for private practices (PPs) for OMFS were created to collect data for patient numbers and surgical procedures conducted, usage of personal protection equipment (PPE), SARS-CoV-2 tests, and economic aspects. RESULTS: Fifty-four hospitals and 240 PPs participated in the study. The reduction in ward capacities and number of surgical procedures ranged from 17 to 78%. PPE consisted of standard surgical masks (58% hospitals, 64% PPs) and FFP2/N95/KN95 respirators (45% hospitals, 48% PPs). Preoperative SARS-CoV-2 tests were more frequently performed in hospitals (34% vs 2%). At PPs, turnover for medical and dental procedures billed to the public insurance had reduced to 58.81% and 62.43%, respectively, of the corresponding values for 2019, and 58.75% of the PPs had applied for short-time allowances. CONCLUSION: With the exception of some elective procedures, primary patient care in OMFS has been assured during the pandemic. However, the immense economic burden on hospitals and PPs cannot be conclusively assessed at this point. CLINICAL RELEVANCE: For OMFS, the German healthcare system has shown the ability to adapt to emergency situations such as the SARS-CoV-2 pandemic. Adequate surgical capacities in OMFS are necessary even during pandemics.


Subject(s)
COVID-19 , Surgery, Oral , Germany/epidemiology , Hospitals , Humans , Pandemics , Private Practice , SARS-CoV-2 , Surveys and Questionnaires
20.
GMS J Med Educ ; 37(7): Doc102, 2020.
Article in English | MEDLINE | ID: covidwho-970665

ABSTRACT

Introduction: Auscultation skills are among the basic techniques to be learned in medical school. Such skills are achieved through supervised examination of patients often supported by simulator-based learning. The emergence of COVID-19 has disrupted and continues to hinder hands-on on-site medical training on a global scale. Project description: An effective virtual auscultation course was established in times of contact restrictions due to COVID-19 at the Medical Faculty of the Heinrich Heine University Düsseldorf. The interactive case-based webinar was designed to improve listening techniques, description and interpretation of auscultation findings in an off-site context. Clinical cases with pre-recorded auscultation sounds and additional case-based diagnostics were presented. The course focused on common heart murmurs including aortic and mitral valve stenosis and regurgitation as well as congenital heart defects (ventricular septal defect and patent ductus arteriosus). Results: The course was well received by the students and assessed as being useful and instructive. Assessment of learning effects, such as detection of pathological findings before and after training, is ongoing as part of a subsequent trial. Conclusion: Virtual interactive learning using a sound simulation lesson with clinical case presentations via video chat can well be used as a supplement to practical auscultation training. This learning format could also play a useful role in the curriculum of medical studies once contact restrictions are revoked.


Subject(s)
Auscultation/methods , COVID-19/epidemiology , Education, Distance/organization & administration , Education, Medical/organization & administration , Videoconferencing/organization & administration , Humans , Pandemics , SARS-CoV-2 , Students, Medical/psychology
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