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1.
Acta Anaesthesiol Scand ; 2022 Oct 20.
Article in English | MEDLINE | ID: covidwho-2078297

ABSTRACT

BACKGROUND: Gravity-dependent positioning therapy is an established concept in the treatment of severe acute respiratory distress syndrome and improves oxygenation in spontaneously breathing patients with hypoxemic acute respiratory failure. In patients with coronavirus disease 2019, this therapy seems to be less effective. Electrical impedance tomography as a point-of-care functional imaging modality for visualizing regional ventilation can possibly help identify patients who might benefit from positioning therapy and guide those maneuvers in real-time. Therefore, in this prospective observational study, we aimed to discover typical patterns in response to positioning maneuvers. METHODS: Distribution of ventilation in 10 healthy volunteers and in 12 patients with hypoxemic respiratory failure due to coronavirus disease 2019 was measured in supine, left, and right lateral positions using electrical impedance tomography. RESULTS: In this study, patients with coronavirus disease 2019 showed a variety of ventilation patterns, which were not predictable, whereas all but one healthy volunteer showed a typical and expected gravity-dependent distribution of ventilation with the body positions. CONCLUSION: Distribution of ventilation and response to lateral positioning is variable and thus unpredictable in spontaneously breathing patients with coronavirus disease 2019. Electrical impedance tomography might add useful information on the immediate reaction to postural maneuvers and should be elucidated further in clinical studies. Therefore, we suggest a customized individualized positioning therapy guided by electrical impedance tomography.

2.
Laryngo- Rhino- Otologie ; 101:S233, 2022.
Article in English | EMBASE | ID: covidwho-1967661

ABSTRACT

Introduction Reprocessing of medical devices becomes increasingly complex, due to higher hygiene requirements. Former studies revealed satisfactory bactericidal properties of UV-C light disinfection in otorhinolaryngological endoscopes. Especially in the context of the current COVID-19 pandemic, virucidal properties are of high importance. In this study the virucidal efficacy of UV-C light disinfection was analyzed using a bacteriophage model. Materials and methods MS-2 bacteriophages were used as surrogate for stable viruses with high tenacity. The bacteriophage samples were irradiated for up to three cycles of 25 seconds by UV-C light (D25, UV-Smart Technologies B.V.). A dilution series of the irradiated test samples was mixed with 1x108 CFU of Escherichia coli. After incubation plaque formation of Escherichia coli were counted and hence the phage concentration was determined. Results The initial contamination of the test samples was 1.8x1012 plaque forming units (pfu). After 25 seconds of UV-C light irradiation, a non-significant Log reduction of 2.2 was found (p = 0,82). After 50 and 75 seconds of UV-exposure a significant Log reduction of 3.4 e.g. 5.1 (p = 0.05 e.g. p = 0.004) was found. The control sample showed a titer of 1.2 x 1010 pfu. Conclusion The tested UV system seems to provide a significant virucidal effect after a short time of exposure. In combination with the results of the bacteriological testing it appears suitable for clinical use as a substitute for current disinfection methods.

3.
Viruses ; 13(9)2021 09 03.
Article in English | MEDLINE | ID: covidwho-1390792

ABSTRACT

Surveillance of the evolving SARS-CoV-2 genome combined with epidemiological monitoring and emerging vaccination became paramount tasks to control the pandemic which is rapidly changing in time and space. Genomic surveillance must combine generation and sharing sequence data with appropriate bioinformatics monitoring and analysis methods. We applied molecular portrayal using self-organizing maps machine learning (SOM portrayal) to characterize the diversity of the virus genomes, their mutual relatedness and development since the beginning of the pandemic. The genetic landscape obtained visualizes the relevant mutations in a lineage-specific fashion and provides developmental paths in genetic state space from early lineages towards the variants of concern alpha, beta, gamma and delta. The different genes of the virus have specific footprints in the landscape reflecting their biological impact. SOM portrayal provides a novel option for 'bioinformatics surveillance' of the pandemic, with strong odds regarding visualization, intuitive perception and 'personalization' of the mutational patterns of the virus genomes.


Subject(s)
COVID-19/virology , Evolution, Molecular , Genetic Variation , Genome, Viral , SARS-CoV-2/genetics , COVID-19/epidemiology , Computational Biology , Genomics/methods , Humans , Incidence , Mutation , Pandemics , Phylogeny , Polymorphism, Single Nucleotide , SARS-CoV-2/classification
4.
J Clin Monit Comput ; 36(4): 975-985, 2022 Aug.
Article in English | MEDLINE | ID: covidwho-1356022

ABSTRACT

Respiratory failure due to SARS-CoV-2 may progress rapidly. During the course of COVID-19, patients develop an increased respiratory drive, which may induce high mechanical strain a known risk factor for Patient Self-Inflicted Lung Injury (P-SILI). We developed a novel Electrical Impedance Tomography-based approach to visualize the Dynamic Relative Regional Strain (DRRS) in SARS-CoV-2 positive patients and compared these findings with measurements in lung healthy volunteers. DRRS was defined as the ratio of tidal impedance changes and end-expiratory lung impedance within each pixel of the lung region. DRRS values of the ten patients were considerably higher than those of the ten healthy volunteers. On repeated examination, patterns, magnitude and frequency distribution of DRRS were reproducible and in line with the clinical course of the patients. Lung ultrasound scores correlated with the number of pixels showing DRRS values above the derived threshold. Using Electrical Impedance Tomography we were able to generate, for the first time, images of DRRS which might indicate P-SILI in patients suffering from COVID-19.Trial Registration This observational study was registered 06.04.2020 in German Clinical Trials Register (DRKS00021276).


Subject(s)
COVID-19 , Tomography , Electric Impedance , Humans , Lung/diagnostic imaging , Positive-Pressure Respiration/methods , SARS-CoV-2 , Tomography/methods
5.
Journal für Mineralstoffwechsel & Muskuloskelettale Erkrankungen ; 2021.
Article in German | PMC | ID: covidwho-1157051
6.
Dtsch Med Wochenschr ; 146(7): 466-470, 2021 Apr.
Article in German | MEDLINE | ID: covidwho-1155718

ABSTRACT

Only fifteen months after the beginning of the COVID-19 pandemic, several vaccines are already available for clinical use. While the spike protein of SARS-CoV-2 constitutes the main target of all predominant SARS-CoV-2 vaccines, they work by different mechanisms (mRNA-based vaccines vs. vector-based vaccines vs. protein-based vaccines).Though there are slight differences regarding the level of protection against mild COVID-19, all five vaccines that have been through phase 3 trials were nearly 100 % effective in preventing severe or fatal cases of COVID-19. The side effects were of short duration.Patients with chronic kidney disease (or other significant comorbidities) were largely excluded from Phase 3 trials, which makes definite recommendations concerning their vaccination difficult. The vaccine's effectiveness may be reduced in that population due to a uremic immune defect and/or immunosuppressive medication. However, these patients have an increased risk for severe or fatal COVID-19, so that they may particularly benefit from the vaccine.


Subject(s)
COVID-19 Vaccines/standards , COVID-19/complications , COVID-19/prevention & control , Renal Insufficiency, Chronic/complications , COVID-19 Vaccines/adverse effects , COVID-19 Vaccines/immunology , Clinical Trials, Phase III as Topic , Humans , Immunosuppressive Agents/therapeutic use , RNA, Messenger/immunology , Renal Insufficiency, Chronic/immunology , Uremia/complications , Uremia/immunology , Vaccines, Synthetic/adverse effects , Vaccines, Synthetic/immunology , Vaccines, Synthetic/standards
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