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1.
Wien Klin Wochenschr ; 2022 Apr 12.
Article in English | MEDLINE | ID: covidwho-1782809

ABSTRACT

BACKGROUND: The novel strain of severe acute respiratory syndrome coronavirus 2 is highly contagious; therefore, special emphasis must be given to personal protective equipment for healthcare workers. Reusable elastomeric respirators were previously used in intensive care units (ICU). These respirators include full or half masks and devices modified to accommodate a filter. Although the general comfort of masks used in the ICU has been studied, data comparing multiple types of masks during a pandemic are missing. METHODS: A prospective randomized trial was conducted in an ICU. After standardized training, participants were randomized to use one of three mask types (full, half or snorkelling mask), each fitted with a filter equivalent to a class 3 particle-filtering half mask (FFP3) during one shift. The main outcomes were characteristics of using the mask itself (donning/doffing, quality of seal, cleaning), working conditions with the mask (vision, comfort, perceived safety, communication) and a subjective comparison to single-use FFP2/3 masks. RESULTS: A total of 30 participants were included in the trial, randomized to 10 participants per group. The masks were worn 6.4 (4.5) times (mean SD) for a total duration of 132 (66) min per shift. The tested masks were rated 7 (2.6) (mean SD) in comparison to FFP2/3 on a Likert scale (0: worst, 10: best). Significant differences between the masks were found in respect to comfort (7/4/8), donning (8/7/9), overall rating (8/5/8) and comparison to single-use FFP2/3 masks (9/7/9; full-, half, snorkelling mask). CONCLUSION: Using reusable elastomeric masks is feasible in clinical practice. Full face masks were significantly better in terms of comfort, donning, overall rating and in comparison to single-use FFP2/3 masks.

2.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-311834

ABSTRACT

Background: New commercially available point-of-care (POC) immunodiagnostic tests are appearing, which may yield rapid results for anti-SARS-CoV-2 antibodies. The aim of this study was to evaluate the diagnostic accuracy of rapid antibody detection tests compared to a validated laboratory-based enzyme-linked immunosorbent assay (ELISA) and to investigate infections amongst healthcare workers (HCWs) after unprotected close contact to COVID-19 patients. Methods: : Blood serum and whole blood of 130 participants were tested with NADAL® COVID-19 IgG/IgM Rapid Test and mö-screen 2019-NCOV Corona Virus Test against a validated ELISA test. Infection status was evaluated using real-time polymerase-chain-reaction. Results: : Acute COVID-19 infection was detected in 2.4% of exposed HCWs. Antibody tests showed an overall frequency of IgG and IgM in 5.3%, with 1.6% asymptomatic infections. The NADAL® test showed a sensitivity (IgM/ IgG) of 100% (100%/ 100%), a specificity (IgM/ IgG) of 98.8% (97.6%/ 100 %), a PPV of 76.9% (57.1%/ 100%), an NPV of 100% (100%/ 100%), and a diagnostic accuracy of 98.8% (97.7%/ 100%). The mö-screen test had a sensitivity (IgM/IgG) of 90.9% (80%/ 100%), a specificity (IgM/IgG) of 98.8% (97.6%/ 100%), a PPV of 76.9% (57.1%/ 100%), an NPV of 99.6% (99.2%/ 100%), and a diagnostic accuracy of 98.5% (96.9%/ 100%). Conclusions: : The frequency of COVID-19 infections in HCWs after unprotected close contact is higher than in the general population of a low-prevalence country. Both POC tests were useful for detecting IgG, but did not perform well for IgM, mainly due to false positive results.

3.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-307390

ABSTRACT

Background: The identification of SARS-CoV-2 antigen or RNA in a respiratory specimen collected from a person ≥14 days after completing all recommended doses of authorized COVID-19 vaccine series is a rare condition and defined as „breakthrough infection“. Data on mildly symptomatic or asymptomatic SARS-CoV-2 vaccine breakthrough infection cases especially with respect to viral characteristics and temporal relation to vaccination date is scarce. The purpose of the present investigation was to investigate the prevalence of postvaccination infections in hospital employees and to compare between m-RNA and vector based SARS-CoV-2 vaccines.Methods: At the General Hospital of Vienna 8 553 actively employed staff members participated at an voluntary in-house vaccination program, which took place between January and May 2021 and comprised of application of two doses of either COMIRNATY (BNT162b2;Pfizer/BioNTech, Inc.) or VAXZEVRIA (AstraZeneca, Inc.). Findings: By the end of July 2021 a total of 78 postvaccination infection cases after administration of a minimum of one dose of vaccination had been identified (median age: 40·5 years (IQR: 19-60 years);53 women) of whom 53 had been vaccinated with VAXZEVRIA and 25 with COMIRNATY. The majority of infections was related to an insufficient or partial vaccination status;the incidence of postvaccination infection ≥14 days after complete vaccination (i.e. breakthrough infection) was 34·8: 10 000 for COMIRNATY and 8·8: 10 000 for VAXZEVRIA. There was no difference in PCR-CT values between the two vaccine brands (24·67 (SD: 7·41) for VAXZEVRIA vaccinated versus 24·0 (SD: 6·53) for COMIRNATY vaccinated persons). Genotyping of positive PCR specimens revealed 42 variant of concerns: B.1.1.7 (n=34);B.1.351 (n=2), B.1.617.2 (n=6). The prevalence of „real brakthrough infections“ (≥14 days after second vaccination) was higher in COMIRNATY vaccinated subjects than in the VAXZEVRIA vaccinated subjects with a ratio of 14:4 (p<0,01). Interpretation: mRNA and vector vaccines against COVID-19 are both highly effective in protecting against a broad genomic spectrum of SARS-CoV-2 infections, at least with respect to severe illness. In the present investigation VAXZEVRIA was more effective than COMIRNATY with respect to prevent breakthrough infections after full immunization, however, it seems important, that all recommended vaccine doses are applicated. Maintaining distinct precautions and ongoing testing, at least for the immediate period after vaccination, to detect asymptomatic infections is highly recommended.Funding: None to declare. Declaration of Interest: We decline no conflicting interest. Ethical Approval: The study was approved by the ethics committee of the Medical University of Vienna [No.1721/2021] and the medical directorate of the hospital.

4.
Urology ; 2022 Jan 23.
Article in English | MEDLINE | ID: covidwho-1630640

ABSTRACT

Infection with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has been associated with changes in blood coagulation resulting in increased incidence of venous thromboembolic events and coagulopathy. Moreover, single cases of ischemic priapism have been reported in adult patients with SARS-CoV-2 infection. In this report, we describe the case of ischemic priapism in a 12-year-old child with recent SARS- CoV-2 infection.

5.
Clin Microbiol Infect ; 28(4): 596-601, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1616427

ABSTRACT

OBJECTIVES: The identification of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antigen or RNA in respiratory specimens ≥14 days after administration of all recommended doses of authorized coronavirus disease 2019 (COVID-19) vaccines is defined as breakthrough infection. In the present investigation, mRNA and vector-based SARS-CoV-2 vaccines were analysed with respect to postvaccination infections in vaccinated hospital employees. METHODS: A total of 8553 staff members were vaccinated with BNT162b2 (47%) or ChAdOx1-S (53%) between January and May 2021. In a retrospective observational cohort study, incidence of SARS-CoV-2 postvaccination infections was analysed in relation to demographic data, viral load, virus variants, vaccine brand and vaccination status at time of positive PCR test (fully vaccinated: ≥14 days since second dose; partially vaccinated: >21 days since first, but <14 days after second dose; insufficiently vaccinated: <22 days since first dose). RESULTS: Within the follow-up period, ending on 31 July 2021, person-time at risk-adjusted monthly rates for SARS-CoV-2 postvaccination infections were 0.18% (BNT162b2) and 0.57% (ChAdOx1-S) for insufficiently vaccinated, 0.34% (BNT162b2) and 0.32% (ChAdOx1-S) for partially vaccinated and 0.06% (BNT162b2) and 0.04% (ChAdOx1-S) for fully vaccinated participants. The two vaccine types did not differ with respect to hazard ratios for any of the respective postvaccination infection types. No cases of COVID-19-related hospitalizations or deaths were reported. Genotyping of positive PCR specimens revealed 42 variants of concern: B.1.1.7 (Alpha variant; n = 34); B.1.351 (Beta variant; n = 2), B.1.617.2 (Delta variant; n = 6). CONCLUSIONS: BNT162b2 and ChAdOx1-S are both effective in preventing breakthrough infections; however, it seems important, that all recommended vaccine doses are administered.


Subject(s)
COVID-19 , SARS-CoV-2 , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines , Humans , RNA, Messenger , Retrospective Studies , Tertiary Care Centers , Vaccination
6.
Int J Environ Res Public Health ; 18(8)2021 04 15.
Article in English | MEDLINE | ID: covidwho-1186958

ABSTRACT

Personal protective equipment and adherence to disinfection protocols are essential to prevent nosocomial severe acute respiratory syndrome coronavirus (SARS-CoV-2) transmission. Here, we evaluated infection control measures in a prospective longitudinal single-center study at the Vienna General Hospital, the biggest tertiary care center in Austria, with a structurally planned low SARS-CoV-2 exposure. SARS-CoV-2-specific antibodies were assessed by Abbott ARCHITECT chemiluminescent assay (CLIA) in 599 health care workers (HCWs) at the start of the SARS-CoV-2 epidemic in early April and two months later. Neutralization assay confirmed CLIA-positive samples. A structured questionnaire was completed at both visits assessing demographic parameters, family situation, travel history, occupational coronavirus disease 2019 (COVID-19) exposure, and personal protective equipment handling. At the first visit, 6 of 599 participants (1%) tested positive for SARS-CoV-2-specific antibodies. The seroprevalence increased to 1.5% (8/553) at the second visit and did not differ depending on the working environment. Unprotected SARS-CoV-2 exposure (p = 0.003), positively tested family members (p = 0.04), and travel history (p = 0.09) were more frequently reported by positively tested HCWs. Odds for COVID-19 related symptoms were highest for congestion or runny nose (p = 0.002) and altered taste or smell (p < 0.001). In conclusion, prevention strategies proved feasible in reducing the risk of transmission of SARS-CoV-2 from patients and among HCWs in a low incidence hospital, not exceeding the one described in the general population.


Subject(s)
COVID-19 , Austria , Health Personnel , Humans , Incidence , Infection Control , Prospective Studies , SARS-CoV-2 , Seroepidemiologic Studies , Tertiary Care Centers
7.
Wien Klin Wochenschr ; 133(7-8): 412-413, 2021 Apr.
Article in English | MEDLINE | ID: covidwho-963994

ABSTRACT

In this case report we present a rare case of a patient with multiple risk factors for severe coronavirus disease (COVID 19) in whom intensive glucocorticoid treatment due to incipient nephrotic syndrome coincided with SARS-CoV­2 infection. Despite this high baseline risk profile and the use of glucocorticoids the patient developed only mild disease including IgG SARS-CoV­2 seroconversion.


Subject(s)
COVID-19 , Nephrosis, Lipoid , Glucocorticoids , Humans , Immunoglobulin G , SARS-CoV-2 , Seroconversion
8.
GMS Hyg Infect Control ; 15: Doc28, 2020.
Article in English | MEDLINE | ID: covidwho-937401

ABSTRACT

Background: New commercially available point-of-care (POC) immunodiagnostic tests are appearing, which may yield rapid results for anti-SARS-CoV-2 antibodies. The aim of this study was to evaluate the diagnostic accuracy of rapid antibody detection tests compared to a validated laboratory-based enzyme-linked immunosorbent assay (ELISA) and to investigate infections amongst healthcare workers (HCWs) after unprotected close contact to COVID-19 patients. Methods: Blood serum and whole blood of 130 participants were tested with NADAL® COVID-19 IgG/IgM rapid test and mö-screen 2019-NCOV coronavirus test against a validated ELISA test. Infection status was evaluated using real-time polymerase-chain-reaction. Results: Acute COVID-19 infection was detected in 2.4% of exposed HCWs. Antibody tests showed an overall frequency of IgG and IgM in 5.3%, with 1.6% asymptomatic infections. The NADAL® test showed a sensitivity (IgM/IgG) of 100% (100%/100%), a specificity (IgM/IgG) of 98.8% (97.6%/100 %), a PPV of 76.9% (57.1%/100%), an NPV of 100% (100%/100%), and a diagnostic accuracy of 98.8% (97.7%/100%). The mö-screen test had a sensitivity (IgM/IgG) of 90.9% (80%/100%), a specificity (IgM/IgG) of 98.8% (97.6%/100%), a PPV of 76.9% (57.1%/100%), an NPV of 99.6% (99.2%/100%), and a diagnostic accuracy of 98.5% (96.9%/100%). Conclusions: The frequency of COVID-19 infections in HCWs after unprotected close contact is higher than in the general population of a low-prevalence country. Both POC tests were useful for detecting IgG, but did not perform well for IgM, mainly due to false positive results.

10.
Infection ; 49(1): 171-175, 2021 Feb.
Article in English | MEDLINE | ID: covidwho-714361

ABSTRACT

We report of two cases of progressed COVID-19 with negative PCR tests from nasopharyngeal swabs, in whom diagnosis was made by different antibody assays, including a lateral flow rapid test and multiple commercial ELISAs, finally confirmed by comprehensive serological assays. These cases highlight that commercial ELISAs and even rapid tests might significantly aid the diagnosis of COVID-19, particularly, if a combination of serological assays is used with a specific clinical question, in severely ill patients after seroconversion and when comprehensive serological methods are used for confirmation.


Subject(s)
Antibodies, Viral/blood , COVID-19/diagnosis , Enzyme-Linked Immunosorbent Assay/statistics & numerical data , SARS-CoV-2/immunology , Aged , COVID-19/immunology , COVID-19/virology , COVID-19 Testing , Female , Humans , Male , Middle Aged , Nasopharynx/virology , Reverse Transcriptase Polymerase Chain Reaction , SARS-CoV-2/genetics , Sensitivity and Specificity , Severity of Illness Index , Tomography, X-Ray Computed
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