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1.
Viruses ; 13(12)2021 11 30.
Article in English | MEDLINE | ID: covidwho-1591432

ABSTRACT

BACKGROUND: It is a matter of debate whether diabetes alone or its associated comorbidities are responsible for severe COVID-19 outcomes. This study assessed the impact of diabetes on intensive care unit (ICU) admission and in-hospital mortality in hospitalized COVID-19 patients. METHODS: A retrospective analysis was performed on a countrywide cohort of 40,632 COVID-19 patients hospitalized between March 2020 and March 2021. Data were provided by the Austrian data platform. The association of diabetes with outcomes was assessed using unmatched and propensity-score matched (PSM) logistic regression. RESULTS: 12.2% of patients had diabetes, 14.5% were admitted to the ICU, and 16.2% died in the hospital. Unmatched logistic regression analysis showed a significant association of diabetes (odds ratio [OR]: 1.24, 95% confidence interval [CI]: 1.15-1.34, p < 0.001) with in-hospital mortality, whereas PSM analysis showed no significant association of diabetes with in-hospital mortality (OR: 1.08, 95%CI: 0.97-1.19, p = 0.146). Diabetes was associated with higher odds of ICU admissions in both unmatched (OR: 1.36, 95%CI: 1.25-1.47, p < 0.001) and PSM analysis (OR: 1.15, 95%CI: 1.04-1.28, p = 0.009). CONCLUSIONS: People with diabetes were more likely to be admitted to ICU compared to those without diabetes. However, advanced age and comorbidities rather than diabetes itself were associated with increased in-hospital mortality in COVID-19 patients.


Subject(s)
COVID-19/mortality , Comorbidity , Diabetes Mellitus/epidemiology , Hospital Mortality , Public Health , Adult , Aged , Aged, 80 and over , Austria/epidemiology , Cohort Studies , Female , Hospitalization , Humans , Intensive Care Units , Male , Middle Aged , Odds Ratio , Propensity Score , Retrospective Studies , Risk Factors , SARS-CoV-2 , Young Adult
2.
Sci Rep ; 11(1): 24416, 2021 12 24.
Article in English | MEDLINE | ID: covidwho-1585784

ABSTRACT

Since the beginning of the COVID -19 pandemic, many contact sport teams are facing major challenges to safely continue training and competition. We present the design and implementation of a structured monitoring concept for the Austrian national football league. 146 professional players from five clubs of the professional Austrian football league were monitored for a period of 12 weeks. Subjective health parameters, PCR- test results and data obtained from a geo-tracking app were collected. Simulations modelling the consequences of a COVID-19 case with increasing reproduction number were computed. No COVID -19 infection occurred during the observation period in the players. Infections in the nearer surroundings lead to increased perceived risk of infection. Geo tracking was particularly hindered due to technical problems and reluctance of users. Simulation models suggested a hypothetical shut-down of all training and competition activities. A structured monitoring concept can help to continue contact sports safely in times of a pandemic. Cooperation of all involved is essential. Trial registration: ID: DRKS00022166 15/6/2020 https://www.who.int/ictrp/search/en/ .


Subject(s)
COVID-19/diagnosis , Computer Simulation , Algorithms , Austria , COVID-19/virology , Humans , SARS-CoV-2/genetics , SARS-CoV-2/isolation & purification , Soccer
3.
Int J Environ Res Public Health ; 18(24)2021 12 11.
Article in English | MEDLINE | ID: covidwho-1572459

ABSTRACT

The COVID-19 pandemic has dramatically impacted human lifestyles across the world. Lockdowns and home confinement decreased prior opportunities for everyday physical activity. To retrospectively assess how the Austrian population coped with these aspects of the crisis, we conducted a cross-sectional online survey from March to September 2021 using a structured questionnaire in German. In total, 1214 participants (56.9% females, mean age 37.0 years) living across Austria shared self-reported information on sociodemographic characteristics, indoor and outdoor physical activity, reasons for being outdoors, and life satisfaction before and after the emergence of the virus. As a result, overall indoor physical activity significantly decreased in a before-during COVID-19 crisis comparison, although exercising at home with online instructions increased by about 63%. Exercising outdoors increased overall, specifically in periurban forests and rural areas, both by about 9%. Life satisfaction decreased significantly by 19.7% (p < 0.001). Outdoor public places and natural environments gained importance due to restrictions affecting access to sport facilities. Further research is needed to evaluate benefits and therapeutic values of outdoor nature for physical and mental health in times of a global pandemic to maintain resilient societies, as it might impact future active living and life satisfaction.


Subject(s)
COVID-19 , Adult , Austria , Communicable Disease Control , Cross-Sectional Studies , Exercise , Female , Humans , Male , Pandemics , Personal Satisfaction , Retrospective Studies , SARS-CoV-2
4.
Mult Scler ; 27(14): 2209-2218, 2021 12.
Article in English | MEDLINE | ID: covidwho-1523230

ABSTRACT

BACKGROUND: Knowledge on immunity after SARS-CoV-2 infection in patients with multiple sclerosis (pwMS) and the impact of disease-modifying treatment (DMT) is limited. OBJECTIVE: To evaluate degree, duration and potential predictors of specific humoral immune response in pwMS with prior COVID-19. METHODS: Anti-SARS-CoV-2 antibody testing was performed in pwMS with PCR-confirmed diagnosis of symptomatic COVID-19 from a nation-wide registry. Predictors of seropositivity were identified by multivariate regression models. RESULTS: In 125 pwMS (mean age = 42.4 years (SD = 12.3 years), 70% female), anti-SARS-CoV-2 antibodies were detected in 76.0% after a median of 5.2 months from positive PCR. Seropositivity rate was significantly lower in patients on IS-DMT (61.4%, p = 0.001) than without DMT or immunomodulatory DMT (80.6%; 86.0%, respectively). In multivariate analysis, IS-DMT was associated with reduced probability of seropositivity (odds ratio (OR): 0.51; 95% confidence interval (95% CI): 0.17-0.82; p < 0.001). Predefined subgroup analyses showed marked reduction of seropositivity in pwMS on rituximab/ocrelizumab (OR 0.15; 95% CI: 0.05-0.56; p < 0.001). Rate of seropositivity did not change significantly over 6 months. CONCLUSIONS: Humoral immunity is stable after SARS-CoV-2 infection in MS, but is reduced by immunosuppressive DMT, particularly anti-CD20 monoclonal antibodies. This provides important evidence for advising pwMS as well as for planning and prioritizing vaccination.


Subject(s)
COVID-19 , Multiple Sclerosis , Adult , Austria , Female , Humans , Immunity, Humoral , Male , Multiple Sclerosis/drug therapy , SARS-CoV-2
5.
Curr Oncol ; 28(6): 4776-4785, 2021 11 17.
Article in English | MEDLINE | ID: covidwho-1523894

ABSTRACT

The COVID-19 pandemic has an unprecedented impact on cancer treatment worldwide. We aimed to evaluate the effects of the pandemic on the radiation treatment of patients in order to provide data for future management of such crises. We compared the number of performed radiotherapy sessions of the pandemic period from February 2020 until May 2021 with those of 2018 and 2019 for reference. At our department, no referred patients had to be rejected or postponed, nor any significant changes in fractionation schedules implemented. Nevertheless, there was a substantial drop in overall radiotherapy sessions in 2020 following the first incidence wave of up to -25% (in June) in comparison to previous years. For breast cancer, a maximum decline of sessions of -45% (July) was recorded. Only a short drop of prostate cancer sessions (max -35%, May) followed by a rebound (+42%, July) was observed. Over the investigated period, a loss of 4.4% of expected patients never recovered. The severe impact of COVID-19 on cancer treatment, likely caused by retarded diagnosis and delayed interdisciplinary co-treatment, is reflected in a lower count of radiotherapy sessions. Radiation oncology is a crucial cornerstone in upholding both curative treatment options and treatment capacity during a pandemic.


Subject(s)
COVID-19 , Radiation Oncology , Austria , Humans , Pandemics , SARS-CoV-2
6.
PLoS One ; 16(11): e0259580, 2021.
Article in English | MEDLINE | ID: covidwho-1505862

ABSTRACT

A lockdown implies a shift from the public to the private sphere, and from market to non-market production, thereby increasing the volume of unpaid work. Already before the pandemic, unpaid work was disproportionately borne by women. This paper studies the effect of working from home for pay (WFH), due to a lockdown, on the change in the division of housework and childcare within couple households. While previous studies on the effect of WFH on the reconciliation of work and family life and the division of labour within the household suffered from selection bias, we are able to identify this effect by drawing upon the shock of the first COVID-19 lockdown in Austria. The corresponding legal measures left little choice over WFH. In any case, WFH is exogenous, conditional on a small set of individual and household characteristics we control for. We employ data from a survey on the gendered aspects of the lockdown. The dataset includes detailed information on time use during the lockdown and on the quality and experience of WFH. Uniquely, this survey data also includes information on the division, and not only magnitude, of unpaid work within households. Austria is an interesting case in this respect as it is characterized by very conservative gender norms. The results reveal that the probability of men taking on a larger share of housework increases if men are WFH alone or together with their female partner. By contrast, the involvement of men in childcare increased only in the event that the female partner was not able to WFH. Overall, the burden of childcare, and particularly homeschooling, was disproportionately borne by women.


Subject(s)
COVID-19/epidemiology , Child Care , Employment , Quarantine , Teleworking , Austria , Child , Child, Preschool , Family Characteristics , Female , Humans , Infant , Infant, Newborn , Male , Models, Econometric , Social Class , Surveys and Questionnaires
7.
Stud Health Technol Inform ; 285: 205-210, 2021 Oct 27.
Article in English | MEDLINE | ID: covidwho-1502266

ABSTRACT

The aim of this paper was to evaluate the effect of telemedical care of gestational diabetes mellitus (GDM) patients with the digital treatment pathway model DiabCare Tirol. METHODS: 27 courses of patients with GDM, who were telemonitored through the integrated care program DiabCare Tirol in a diabetes outpatient clinic in Tyrol, Austria during the COVID-19 pandemic in 2020, were analyzed. In addition, randomized controlled trials (RCTs) on telemedicine interventions for GDM were researched, and their results were used for comparison with this disease management method. The patient outcome analysis was used to examine the effects of the integrated care program involving telemonitoring support and compared them to the results of RCTs in which participants were randomly assigned to one of two groups, either mobile monitored or standard treatment group. RESULTS: The feasibility of the digital treatment pathway model was confirmed in practice, as the trend analysis of the 27 GDM patients involved showed significantly improved glycaemic control. Results of RCT studies tend to support the findings of DiabCare Tirol. CONCLUSION: Benefits of telemonitoring with integrated care to support conventional therapy cannot be dismissed, especially in times of the pandemic. Continuous outcome research with larger patient numbers will be necessary to confirm the effectiveness of telemonitoring in a regular care setting.


Subject(s)
Diabetes, Gestational , Telemedicine , Austria , COVID-19 , Diabetes, Gestational/therapy , Female , Humans , Monitoring, Physiologic , Pregnancy
9.
Sci Transl Med ; 13(617): eabh1803, 2021 10 27.
Article in English | MEDLINE | ID: covidwho-1494932

ABSTRACT

[Figure: see text].


Subject(s)
COVID-19 , SARS-CoV-2 , Austria , Genomics , Humans , Mutation/genetics
10.
BMC Public Health ; 21(1): 1502, 2021 08 04.
Article in English | MEDLINE | ID: covidwho-1477359

ABSTRACT

BACKGROUND: Introducing national lockdown has been effective in containing Covid-19. However, several studies indicated negative impacts of lockdowns on the well-being and mental health of many people. In Austria, the first Covid-19-related lockdown was introduced on 16 March 2020 with most restrictions being lifted 1 month later. Seven months after that, in November 2020, the second full lockdown was implemented. The aim of this study was to compare the perceptions and experiences of the general population related to the first and second Covid-19 lockdowns in Austria. METHODS: Two waves of an online survey were conducted in May and December 2020 asking respondents about their concerns related to the Covid-19 illness, personal experiences of the lockdowns, perceptions of and compliance with imposed public health measures, and the impact of the Covid-19 pandemic on different aspects of life during the two lockdowns. Descriptive statistics including frequency analysis were used to compare respondents' answers collected in the two waves of the survey. T-test and chi-square tests were used to test differences between the two lockdowns. RESULTS: Five hundred sixty participants were included in the first wave and a sub-sample of 134 participants in the second wave of data collection. During the second lockdown, study respondents were more concerned about their family members contracting Covid-19 when compared with the first lockdown. Compliance with public health measures was overall lower during the second lockdown, although it varied according to the type of the measure. Closure of schools was seen as the least essential restriction during the second lockdown, while wearing masks gained additional approval between the first and the second lockdown. Larger negative impacts of the Covid-19 pandemic on friendships, leisure activities, education and community were reported during the second lockdown. CONCLUSIONS: The study found that the extended duration of the pandemic and recurring lockdowns restricting freedom of movement and social contacts appear to have caused significant disruptions to many areas of life. Furthermore, declining adherence to most public health measures over time raises a question about the effectiveness of future lockdown measures.


Subject(s)
COVID-19 , Pandemics , Austria , Communicable Disease Control , Humans , Perception , Public Health , SARS-CoV-2
11.
BMC Psychiatry ; 21(1): 509, 2021 10 15.
Article in English | MEDLINE | ID: covidwho-1468052

ABSTRACT

BACKGROUND: The first wave of the COVID-19-pandemic hit different countries with varying degrees of severity, so that differences in the type and level of emergency measures were also necessary. It can be assumed that the psychological burden was higher in countries subjected to a more severe course of the pandemic (Italy) than in countries subjected to a less severe one (Germany, Austria). OBJECTIVE: To investigate and contrast the wellbeing of the population in Italy, Austria, and Germany in the early phase of the first lockdown. METHOD: Online survey on N = 4289 individuals. The questionnaire comprised a self-administered section, exploring the dimensions: perceived severity of COVID-19, perceived risk of disease, concerns related to COVID-19, emergency measure acceptance and emotional distress due to emergency measures; and standardized scales to record emotional state and coping: Stress-Coping-Style Questionnaire, Positive and Negative Affect Schedule, State-Trait-Anxiety-Inventory. RESULTS: The three countries displayed significant differences in all investigated dimensions (p < .001). Italian participants assessed the COVID-19 virus as much more dangerous (p < .001), but despite the prevalence of the virus, the subjective risk of disease was perceived to be lower in Italy (p < .001). This could be a positive effect of the restrictive curfews set by the government in Italy. The emergency measures were generally perceived to be very effective in all three countries, but due to the duration and the severity of the measures, the fear and stress-reaction were the strongest among Italian participants (p < .001). CONCLUSION: The stricter measures in Italy prevented an application of many positive stress processing strategies, which, in turn, fostered the perpetuation of stresses and fear.


Subject(s)
COVID-19 , Psychological Distress , Austria , Communicable Disease Control , Germany/epidemiology , Humans , Italy/epidemiology , Pandemics , SARS-CoV-2 , Surveys and Questionnaires
12.
Viruses ; 13(10)2021 10 07.
Article in English | MEDLINE | ID: covidwho-1463836

ABSTRACT

Currently countries across the globe are preparing for the fourth wave of SARS-CoV-2 infections, which is mainly driven by the rapid spread of novel SARS-CoV-2 variants. Austria and, in particular, the capital city of Vienna, witnessed a disproportionally steep rise in SARS-CoV-2 infection rates during the last wave of infections. By the end of January 2021, the government of Vienna launched an innovative, state-wide SARS-CoV-2 screening program based on PCR analysis of self-collected mouthwash samples. More than 400,000 mouthwash samples were collected in Vienna during the third wave of infection from January to March 2021. All preanalytical and analytical steps were carried out in a highly standardized manner at a single certified testing center. SARS-CoV-2 specific PCR analysis revealed in these samples a positivity rate of 0.43%. The relative proportion of N501Y positive virus samples increased continually to 68% of weekly samples. Mutation K417N was detected only in three samples. With this study, we were able to map the temporal occurrence of SARS-CoV-2 variants in a highly unbiased manner. Positivity rates and variant prevalence rates in this study were lower than in other nationwide programs. The results presented in this study indicate that actual virus prevalence tends to be overestimated by surveillance programs such as results of cluster analysis or contact tracing programs.


Subject(s)
COVID-19 Testing/methods , COVID-19/epidemiology , SARS-CoV-2/genetics , Austria/epidemiology , Humans , Mass Screening , Mutation/genetics , Polymerase Chain Reaction , Prevalence , SARS-CoV-2/isolation & purification
13.
Anaesthesist ; 70(8): 655-661, 2021 Aug.
Article in German | MEDLINE | ID: covidwho-1453678

ABSTRACT

BACKGROUND: During the peak of the COVID-19 pandemic in spring 2020, the entire emergency rescue system was confronted with major challenges. Starting on 15 March, all tourists were asked to leave the State of Tyrol, Austria. The main goal of the efforts was to ensure the usual quality of emergency medical care while reducing the physical contact during emergency interventions on site. METHODS: The Austrian Emergency Medical Service is physician-based, meaning that in addition to an ambulance team, an emergency physician (EP) is dispatched to every potential life-threatening emergency call. In Tyrol and starting on 17 March 2020, 413 types of emergency call dispatches, which were addressed with an ambulance crew as well as an EP crew before COVID-19, were now dispatched only with an ambulance crew. This procedure of dispatching differently as well as the general development of emergency calls during this period were analyzed from 15 March to 15 May 2020 and compared to the data from the same time period from 2017 to 2019. RESULTS: Despite the reduction of the population of around 30% because of absent tourists and foreign students staying in Tyrol, emergency calls with the operational keyword "difficulty in breathing/shortness of breath" rose by 18.7% (1533 vs. 1291), while calls due to traffic incidents decreased by 26.4% (2937 vs. 2161). Emergency calls with the dispatch of teams with an EP were reduced by 38.5% (1511 vs. 2456.3), whereby the NACA scores III and IV were the ones with the significant reduction of 40% each. For the reduced dispatchs, the additional dispatch of an EP team by the ambulance team amounted to 14.5%; however, for the keywords "unconscious/fainting" and "convulsions/seizures" the additional dispatch was significantly higher with over 40% each. DISCUSSION: There was an overall reduction of emergency calls. Considering, that the reduced dispatches would have led to an EP team dispatch the overall emergency doctor dispatches would have been higher than in the years before. Our study was not able to find the reasons for this increase. Only considering the additional dispatching of EPs, was this reduction in dispatching EP teams highly accurate, except for the symptoms of "unconscious/fainting" and "convulsions/seizures"; however, the actual diagnoses that the hospitals or GPs made could not be collected for this study. Therefore, it cannot be said for sure that there was equality in the quality of emergency medical care. CONCLUSION: It was possible to achieve the primary goal of reducing the physical contact with patients; however, before keeping these reductions of the dispatching order regarding. EPs for the routine operation, adaptions in these reductions as well as deeper evaluations under consideration of the data from hospitals and GPs would be necessary. Also, different options to reduce physical contact should be evaluated, e.g. building an EMT-led scout team to evaluate the patient's status while the EP team is waiting outside.


Subject(s)
Ambulances , COVID-19 , Emergency Medical Services , Austria , Emergency Medical Services/statistics & numerical data , Humans , Pandemics , Physicians , Triage
14.
Sci Rep ; 11(1): 19245, 2021 09 28.
Article in English | MEDLINE | ID: covidwho-1442808

ABSTRACT

There is a paucity of studies investigating the impact of chronic corticosteroid use for coexisting conditions in patients with Coronavirus Disease 2019 (COVID-19). Additionally, the information regarding the impact of chronic liver disease (CLD) on COVID-19 outcomes is evolving. Our study aims to investigate hospitalization outcomes of patients with COVID-19 on long term corticosteroids for coexisting conditions while also seeking to compare outcomes between such patients with a history of CLD to analyze the impact on mortality. We conducted a retrospective chart review across our 10-hospital network identifying patients on chronic corticosteroids (Prednisone ≥ 5 mg daily dose or equivalent dose of another steroid, for a duration of 30 days or more) who were hospitalized with COVID-19 from March 1, 2020 to June 30, 2020. Of these patients who met inclusion criteria, patients were then divided into groups based upon their history of CLD. Primary outcomes of the study looked to investigate the hospitalization outcomes of patients with a history of CLD and comorbid conditions requiring chronic corticosteroid use. Secondary outcomes sought to further investigate risk factors for mortality in our study sample. 837 charts were reviewed. 139 patients met inclusion criteria of which 34 patients had a history of CLD. Statistical analysis demonstrated no difference in length of hospital stay but increased ICU admission rate in the CLD group (41.2% vs 23.8%). No statistically significant difference was seen in between the CLD and non-CLD groups in term of complication rates and 28-day mortality. However, chronic corticosteroids patients were found to have higher rates of ICU admission and overall 28-day and ICU mortality in comparison to patients who were not on chronic corticosteroids prior to COVID-19 hospitalization. The larger contributor to COVID-19 severity was likely chronic corticosteroid use rather than CLD and thus chronic corticosteroid use should be limited throughout the COVID-19 pandemic especially in patients with additional speculated risk factors for COVID-19 such as CLD.


Subject(s)
Adrenal Cortex Hormones/adverse effects , COVID-19 , End Stage Liver Disease , Adrenal Cortex Hormones/therapeutic use , Aged , Aged, 80 and over , Austria/epidemiology , COVID-19/epidemiology , COVID-19/pathology , Comorbidity , Critical Care Outcomes , End Stage Liver Disease/drug therapy , Female , Humans , Male , Middle Aged , Mortality , Retrospective Studies , Risk Factors
15.
Sci Rep ; 11(1): 19241, 2021 09 28.
Article in English | MEDLINE | ID: covidwho-1442800

ABSTRACT

Behavioral gender differences have been found for a wide range of human activities including the way people communicate, move, provision themselves, or organize leisure activities. Using mobile phone data from 1.2 million devices in Austria (15% of the population) across the first phase of the COVID-19 crisis, we quantify gender-specific patterns of communication intensity, mobility, and circadian rhythms. We show the resilience of behavioral patterns with respect to the shock imposed by a strict nation-wide lock-down that Austria experienced in the beginning of the crisis with severe implications on public and private life. We find drastic differences in gender-specific responses during the different phases of the pandemic. After the lock-down gender differences in mobility and communication patterns increased massively, while circadian rhythms tended to synchronize. In particular, women had fewer but longer phone calls than men during the lock-down. Mobility declined massively for both genders, however, women tended to restrict their movement stronger than men. Women showed a stronger tendency to avoid shopping centers and more men frequented recreational areas. After the lock-down, males returned back to normal quicker than women; young age-cohorts return much quicker. Differences are driven by the young and adolescent population. An age stratification highlights the role of retirement on behavioral differences. We find that the length of a day of men and women is reduced by 1 h. We interpret and discuss these findings as signals for underlying social, biological and psychological gender differences when coping with crisis and taking risks.


Subject(s)
Behavior/physiology , COVID-19 , Sex Factors , Surveys and Questionnaires , Age Factors , Austria , Cell Phone , Circadian Rhythm , Communication , Female , Humans , Leisure Activities , Male , Pandemics
16.
Public Health ; 200: 56-58, 2021 Nov.
Article in English | MEDLINE | ID: covidwho-1433756

ABSTRACT

OBJECTIVE: COVID-19-related social restrictions resulted in more loneliness, but whether this had further effects on mental health remains unclear. This study aimed at examining the longitudinal effects of COVID-19-related loneliness on mental health among older adults (aged ≥60 years) in Austria. STUDY DESIGN: Survey data were gathered from a longitudinal observational study among a random sample of older Austrian adults. The first survey wave was conducted in May 2020 (N1 = 557), and the second wave was conducted in March 2021 (N2 = 463). METHODS: Data collection was based on either computer-assisted web or telephone interviewing. For statistical analysis, we used a cross-lagged panel analysis. RESULTS: The results showed the perceived COVID-19-related social restrictions to predict loneliness, which in turn predicted depressive and anxiety symptoms 10 months later. CONCLUSIONS: COVID-19-related loneliness emerged as a risk factor for subsequent mental distress among older adults in Austria.


Subject(s)
COVID-19 , Loneliness , Aged , Austria , Depression/epidemiology , Humans , Mental Health , SARS-CoV-2
17.
Am J Infect Control ; 49(11): 1350-1353, 2021 11.
Article in English | MEDLINE | ID: covidwho-1432731

ABSTRACT

BACKGROUND: Nursing homes and long-term care facilities (LTCF) caring for elderly and chronically ill residents are at high risk to experience severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) outbreaks. We report an outbreak of coronavirus disease 2019 (COVID-19) in 3 LTCFs of the Geriatric Health Centres of Graz, Austria lasting from March 22 to April 14, 2020. AIM: The objectives of our study were: (1) to elucidate contributing factors and transmission pathways of SARS-CoV-2, (2) to analyze symptoms of COVID-19 in the residents and health care workers. METHODS: We carried out a retrospective outbreak analysis. FINDINGS: Thirty-six of /277 residents of 3 LTCFs were infected with SARS-CoV-2. Only a quarter of COVID-19 cases among residents had fever ≥38.1°C and 19% suffered from cough. Six of 36 residents remained asymptomatic. Hospitalization rate was 58% in residents. Overall, 33% (12/36) residents infected with SARS-CoV-2 died. Nineteen of 214 health care workers were tested positive for SARS-CoV-2. Universal rt-PCR testing for SARS-CoV-2 of all residents and health care workers as well as infection control measures contributed to ending the outbreaks. CONCLUSIONS: Delayed recognition of possible COVID-19 cases due to either mild symptoms or symptoms that were perceived as atypical early in the pandemic contributed to the transmission of SARS-CoV-2 in LTCFs. This emphasizes the importance of low-threshold testing in LTCF residents.


Subject(s)
COVID-19 , Long-Term Care , Aged , Austria/epidemiology , Disease Outbreaks , Humans , Retrospective Studies , SARS-CoV-2
18.
J Infect Dis ; 224(5): 764-770, 2021 09 01.
Article in English | MEDLINE | ID: covidwho-1413436

ABSTRACT

The kinetics of immunoglobulin G (IgG) avidity maturation during severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection obtained from 217 participants of the Ischgl cohort, Austria, was studied 0.5-1.5 months (baseline) and 7-8 months (follow-up) after infection. The IgG avidity assay, using a modified IgG enzyme-linked immunosorbent assay (ELISA) and 5.5 M urea, revealed that old age does not diminish the increase in avidity, detected in all participants positive at both time points, from 18% to 42%. High avidity was associated with a marked residual neutralization capacity in 97.2.% of participants (211/217), which was even higher in the older age group, revealing an important role of avidity assays as easy and cheap surrogate tests for assessing the maturation of the immune system conveying potential protection against further SARS-CoV-2 infections without necessitating expensive and laborious neutralization assays.


Subject(s)
Antibodies, Viral/immunology , COVID-19/immunology , SARS-CoV-2/immunology , Adolescent , Adult , Aged , Antibodies, Neutralizing/immunology , Austria , Cohort Studies , Enzyme-Linked Immunosorbent Assay/methods , Female , Humans , Immunoglobulin G/immunology , Male , Middle Aged , Young Adult
19.
BMC Infect Dis ; 21(1): 915, 2021 Sep 06.
Article in English | MEDLINE | ID: covidwho-1398841

ABSTRACT

BACKGROUND: The aims of this study are to determine (i) SARS-CoV-2 antibody positive employees in Austrian trauma hospitals and rehabilitation facilities, (ii) number of active virus carriers (symptomatic and asymptomatic) during the study, (iii) antibody decline in seropositive subjects over a period of around 6 months, (iv) the usefulness of rapid antibody tests for outpatient screening. METHOD: A total of 3301 employees in 11 Austrian trauma hospitals and rehabilitation facilities of the Austrian Social Insurance for Occupational Risks (AUVA) participated in this open uncontrolled prospective cohort study. Rapid lateral flow tests, detecting a combination of IgM and IgM against SARS-CoV-2), two different types of CLIA (Diasorin, Roche), RT-PCR tests and serum neutralization tests (SNTs) were performed. The tests were conducted twice, with an interval of 42.4 ± 7.7 (Min = 30, Max = 64) days. Positive participants were re-tested with CLIA/SNT at a third time point after 188.0 ± 12.8 days. RESULTS: Only 27 out of 3301 participants (0.82%) had a positive antibody test at any time point during the study confirmed via neutralization test. Among positively tested participants in either test, 50.4% did not report any symptoms consistent with common manifestations of COVID-19 during the study period or within the preceding 6 weeks. In the group who tested positive during or prior to study inclusion the most common symptoms of an acute viral illness were rhinitis (21.9%), and loss of taste and olfactory sense (21.9%). Based on the neutralization test as the true condition, the rapid antibody test performed better on serum than whole blood as 84.6% instead of 65.4% could be detected correctly. Concerning both CLIA tests overall the Roche test detected 24 (sensitivity = 88.9%) and the Diasorin test 22 positive participants (sensitivity = 81.5%). In participants with a positive SNT result, a significant drop in neutralizing antibody titre from 31.8 ± 22.9 (Md = 32.0) at T1 to 26.1 ± 17.6 (Md = 21.3) at T2 to 21.4 ± 13.4 (Md = 16.0) at T3 (χ2 = 23.848, df = 2, p < 0.001) was observed (χ2 = 23.848, df = 2, p < 0.001)-with an average time of 42.4 ± 7.7 days between T1 and T2 and 146.9 ± 13.8 days between T2 and T3. CONCLUSIONS: During the study period (May 11th-August 3rd) only 0.82% were tested positive for antibodies in our study cohort. The antibody concentration decreases significantly over time with 14.8% (4 out of 27) losing detectable antibodies.


Subject(s)
COVID-19 , SARS-CoV-2 , Antibodies, Viral , Asymptomatic Infections , Austria/epidemiology , Humans , Personnel, Hospital , Prospective Studies , Seroepidemiologic Studies
20.
Water Sci Technol ; 84(6): 1324-1339, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1394668

ABSTRACT

In the case of SARS-CoV-2 pandemic management, wastewater-based epidemiology aims to derive information on the infection dynamics by monitoring virus concentrations in the wastewater. However, due to the intrinsic random fluctuations of the viral signal in wastewater caused by several influencing factors that cannot be determined in detail (e.g. dilutions; number of people discharging; variations in virus excretion; water consumption per day; transport and fate processes in sewer system), the subsequent prevalence analysis may result in misleading conclusions. It is thus helpful to apply data filtering techniques to reduce the noise in the signal. In this paper we investigate 13 smoothing algorithms applied to the virus signals monitored in four wastewater treatment plants in Austria. The parameters of the algorithms have been defined by an optimization procedure aiming for performance metrics. The results are further investigated by means of a cluster analysis. While all algorithms are in principle applicable, SPLINE, Generalized Additive Model and Friedman's Super Smoother are recognized as superior methods in this context (with the latter two having a tendency to over-smoothing). A first analysis of the resulting datasets indicates the positive effect of filtering to the correlation of the viral signal to monitored incidence values.


Subject(s)
COVID-19 , SARS-CoV-2 , Austria , Humans , Waste Water
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