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102. Evaluation einer Intervention zur Infektionsprävention bei Patient*innen ohne Milz

Author

Bayrhuber, Marianne, Anka, Natascha, Camp, Johannes, Rieg, Siegbert, Farin-Glattacker, Erik, and Glattacker, Manuela

Subjects
ddc: 610, Medicine and health
Abstract

Hintergrund und Stand der Forschung: Menschen ohne Milz (Asplenie) haben lebenslang ein deutlich erhöhtes Risiko für schwere, invasive bakterielle Infektionen. Die Krankenhaus-Sterblichkeit der Postsplenektomie-Sepsis (auch Overwhelming Post Splenectomy Infection) liegt auch heute noch bei [zum vollständigen Text gelangen Sie über die oben angegebene URL]

Published
2022

104. Short-course versus long-course antibiotic treatment for uncomplicated vancomycin-resistant enterococcal bacteraemia: a retrospective multicentre cohort study

Author

Bahrs, Christina, primary, Rieg, Siegbert, additional, Hennigs, Annette, additional, Hitzenbichler, Florian, additional, Brehm, Thomas T., additional, Rose, Norman, additional, Jacobi, Rebecca J., additional, Heine, Valerie, additional, Hornuss, Daniel, additional, Huppertz, Gunnar, additional, Hagel, Stefan, additional, Hanses, Frank, additional, Rolling, Thierry, additional, Jung, Norma, additional, Bahrs, Christina, additional, and Kaasch, Achim, additional

Published
2022
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105. Hospitalized patients dying with SARS-CoV-2 infection-An analysis of patient characteristics and management in ICU and general ward of the LEOSS registry

Author

Raichle, Claudia, Borgmann, Stefan, Bausewein, Claudia, Rieg, Siegbert, Jakob, Carolin E. M., Simon, Steffen T., Tometten, Lukas, Vehreschild, Jorg Janne, Leisse, Charlotte, Erber, Johanna, Stecher, Melanie, Pauli, Berenike, Ruethrich, Maria Madeleine, Pilgram, Lisa, Hanses, Frank, Isberner, Nora, Hower, Martin, Degenhardt, Christian, Hertenstein, Bernd, Vehreschild, Maria J. G. T., Roemmele, Christoph, Jung, Norma, Raichle, Claudia, Borgmann, Stefan, Bausewein, Claudia, Rieg, Siegbert, Jakob, Carolin E. M., Simon, Steffen T., Tometten, Lukas, Vehreschild, Jorg Janne, Leisse, Charlotte, Erber, Johanna, Stecher, Melanie, Pauli, Berenike, Ruethrich, Maria Madeleine, Pilgram, Lisa, Hanses, Frank, Isberner, Nora, Hower, Martin, Degenhardt, Christian, Hertenstein, Bernd, Vehreschild, Maria J. G. T., Roemmele, Christoph, and Jung, Norma

Abstract

Background COVID-19 is a severe disease with a high need for intensive care treatment and a high mortality rate in hospitalized patients. The objective of this study was to describe and compare the clinical characteristics and the management of patients dying with SARS-CoV-2 infection in the acute medical and intensive care setting. Methods Descriptive analysis of dying patients enrolled in the Lean European Open Survey on SARS-CoV-2 Infected Patients (LEOSS), a non-interventional cohort study, between March 18 and November 18, 2020. Symptoms, comorbidities and management of patients, including palliative care involvement, were compared between general ward and intensive care unit (ICU) by univariate analysis. Results 580/4310 (13%) SARS-CoV-2 infected patients died. Among 580 patients 67% were treated on ICU and 33% on a general ward. The spectrum of comorbidities and symptoms was broad with more comorbidities (>= four comorbidities: 52% versus 25%) and a higher age distribution (>65 years: 98% versus 70%) in patients on the general ward. 69% of patients were in an at least complicated phase at diagnosis of the SARS-CoV-2 infection with a higher proportion of patients in a critical phase or dying the day of diagnosis treated on ICU (36% versus 11%). While most patients admitted to ICU came from home (71%), patients treated on the general ward came likewise from home and nursing home (44% respectively) and were more frequently on palliative care before admission (29% versus 7%). A palliative care team was involved in dying patients in 15%. Personal contacts were limited but more often documented in patients treated on ICU (68% versus 47%). Conclusion Patients dying with SARS-CoV-2 infection suffer from high symptom burden and often deteriorate early with a demand for ICU treatment. Therefor a demand for palliative care expertise with early involvement seems to exist.

Published
2022

106. Development and validation of BLOOMY prediction scores for 14-day and 6-month mortality in hospitalised adults with bloodstream infections: a multicentre, prospective, cohort study

Author

Tacconelli, Evelina, Goepel, Siri, Gladstone, Beryl P., Eisenbeis, Simone, Hoelzl, Florian, Buhl, Michael, Gorska, Anna, Cattaneo, Chiara, Mischnik, Alexander, Rieg, Siegbert, Rohde, Anna M., Kohlmorgen, Britta, Falgenhauer, Jane, Trauth, Janina, Kaeding, Nadja, Kramme, Evelyn, Biehl, Lena M., Walker, Sarah, V, Peter, Silke, Gastmeier, Petra, Chakraborty, Trinad, Vehreschild, Maria J. G. T., Seifert, Harald, Rupp, Jan, Kern, Winfried, V, Tacconelli, Evelina, Goepel, Siri, Gladstone, Beryl P., Eisenbeis, Simone, Hoelzl, Florian, Buhl, Michael, Gorska, Anna, Cattaneo, Chiara, Mischnik, Alexander, Rieg, Siegbert, Rohde, Anna M., Kohlmorgen, Britta, Falgenhauer, Jane, Trauth, Janina, Kaeding, Nadja, Kramme, Evelyn, Biehl, Lena M., Walker, Sarah, V, Peter, Silke, Gastmeier, Petra, Chakraborty, Trinad, Vehreschild, Maria J. G. T., Seifert, Harald, Rupp, Jan, and Kern, Winfried, V

Abstract

Background The burden of bloodstream infections remains high worldwide and cannot be confined to short-term in-hospital mortality. We aimed to develop scores to predict short-term and long-term mortality in patients with bloodstream infections. Methods The Bloodstream Infection due to Multidrug-resistant Organisms: Multicenter Study on Risk Factors and Clinical Outcomes (BLOOMY) study is a prospective, multicentre cohort study at six German tertiary care university hospitals to develop and validate two scores assessing 14-day and 6-month mortality in patients with bloodstream infections. We excluded patients younger than 18 years or who were admitted to an ophthalmology or psychiatry ward. Microbiological, clinical, laboratory, treatment, and survival data were prospectively collected on day 0 and day 3 and then from day 7 onwards, weekly. Participants were followed up for 6 months. All patients in the derivation cohort who were alive on day 3 were included in the analysis. Predictive scores were developed using logistic regression and Cox proportional hazards models with a machine-learning approach. Validation was completed using the C statistic and predictive accuracy was assessed using sensitivity, specificity, and predictive values. Findings Between Feb 1,2017, and Jan 31,2019,2568 (61.5%) of 4179 eligible patients were recruited into the derivation cohort. The in-hospital mortality rate was 23.75% (95% CI 22.15-25.44; 610 of 2568 patients) and the 6-month mortality rate was 41.55% (39.54-43-59; 949 of 2284). The model predictors for 14-day mortality (C statistic 0.873, 95% CI 0.849-0-896) and 6-month mortality (0.807, 0.784-0-831) included age, body-mass index, platelet and leukocyte counts, C-reactive protein concentrations, malignancy (ie, comorbidity), in-hospital acquisition, and pathogen. Additional predictors were, for 14-day mortality, mental status, hypotension, and the need for mechanical ventilation on day 3 and, for 6-month mortality, focus of infect

Published
2022

107. Invasiveness of Ventilation Therapy Is Associated to Prevalence of Secondary Bacterial and Fungal Infections in Critically Ill COVID-19 Patients

Author

de Hesselle, Marie Louise, Borgmann, Stefan, Rieg, Siegbert, Vehreshild, Jorg Janne, Spinner, Christoph D., Koll, Carolin E. M., Hower, Martin, Stecher, Melanie, Ebert, Daniel, Hanses, Frank, Schumann, Julia, de Hesselle, Marie Louise, Borgmann, Stefan, Rieg, Siegbert, Vehreshild, Jorg Janne, Spinner, Christoph D., Koll, Carolin E. M., Hower, Martin, Stecher, Melanie, Ebert, Daniel, Hanses, Frank, and Schumann, Julia

Abstract

Superinfections are a fundamental critical care problem, and their significance in severe COVID-19 cases needs to be determined. This study analyzed data from the Lean European Open Survey on SARS-CoV-2-Infected Patients (LEOSS) cohort focusing on intensive care patients. A retrospective analysis of patient data from 840 cases of COVID-19 with critical courses demonstrated that co-infections were frequently present and were primarily of nosocomial origin. Furthermore, our analysis showed that invasive therapy procedures accompanied an increased risk for healthcare-associated infections. Non-ventilated ICU patients were rarely affected by secondary infections. The risk of infection, however, increased even when non-invasive ventilation was used. A further, significant increase in infection rates was seen with the use of invasive ventilation and even more so with extracorporeal membrane oxygenation (ECMO) therapy. The marked differences among ICU techniques used for the treatment of COVID-19-induced respiratory failure in terms of secondary infection risk profile should be taken into account for the optimal management of critically ill COVID-19 patients, as well as for adequate antimicrobial therapy.

Published
2022

108. COVID-19 Severity and Thrombo-Inflammatory Response Linked to Ethnicity

Author

Heissig, Beate, Salama, Yousef, Iakoubov, Roman, Vehreschild, Joerg Janne, Rios, Ricardo, Nogueira, Tatiane, Vehreschild, Maria J. G. T., Stecher, Melanie, Mori, Hirotake, Lanznaster, Julia, Adachi, Eisuke, Jakob, Carolin, Tabe, Yoko, Ruethrich, Maria, Borgmann, Stefan, Naito, Toshio, Wille, Kai, Valenti, Simon, Hower, Martin, Hattori, Nobutaka, Rieg, Siegbert, Nagaoka, Tetsutaro, Jensen, Bjoern-Erik, Yotsuyanagi, Hiroshi, Hertenstein, Bernd, Ogawa, Hideoki, Wyen, Christoph, Kominami, Eiki, Roemmele, Christoph, Takahashi, Satoshi, Rupp, Jan, Takahashi, Kazuhisa, Hanses, Frank, Hattori, Koichi, Heissig, Beate, Salama, Yousef, Iakoubov, Roman, Vehreschild, Joerg Janne, Rios, Ricardo, Nogueira, Tatiane, Vehreschild, Maria J. G. T., Stecher, Melanie, Mori, Hirotake, Lanznaster, Julia, Adachi, Eisuke, Jakob, Carolin, Tabe, Yoko, Ruethrich, Maria, Borgmann, Stefan, Naito, Toshio, Wille, Kai, Valenti, Simon, Hower, Martin, Hattori, Nobutaka, Rieg, Siegbert, Nagaoka, Tetsutaro, Jensen, Bjoern-Erik, Yotsuyanagi, Hiroshi, Hertenstein, Bernd, Ogawa, Hideoki, Wyen, Christoph, Kominami, Eiki, Roemmele, Christoph, Takahashi, Satoshi, Rupp, Jan, Takahashi, Kazuhisa, Hanses, Frank, and Hattori, Koichi

Abstract

Although there is strong evidence that SARS-CoV-2 infection is associated with adverse outcomes in certain ethnic groups, the association of disease severity and risk factors such as comorbidities and biomarkers with racial disparities remains undefined. This retrospective study between March 2020 and February 2021 explores COVID-19 risk factors as predictors for patients' disease progression through country comparison. Disease severity predictors in Germany and Japan were cardiovascular-associated comorbidities, dementia, and age. We adjusted age, sex, body mass index, and history of cardiovascular disease comorbidity in the country cohorts using a propensity score matching (PSM) technique to reduce the influence of differences in sample size and the surprisingly young, lean Japanese cohort. Analysis of the 170 PSM pairs confirmed that 65.29% of German and 85.29% of Japanese patients were in the uncomplicated phase. More German than Japanese patients were admitted in the complicated and critical phase. Ethnic differences were identified in patients without cardiovascular comorbidities. Japanese patients in the uncomplicated phase presented a suppressed inflammatory response and coagulopathy with hypocoagulation. In contrast, German patients exhibited a hyperactive inflammatory response and coagulopathy with hypercoagulation. These differences were less pronounced in patients in the complicated phase or with cardiovascular diseases. Coagulation/fibrinolysis-associated biomarkers rather than inflammatory-related biomarkers predicted disease severity in patients with cardiovascular comorbidities: platelet counts were associated with severe illness in German patients. In contrast, high D-dimer and fibrinogen levels predicted disease severity in Japanese patients. Our comparative study indicates that ethnicity influences COVID-19-associated biomarker expression linked to the inflammatory and coagulation (thrombo-inflammatory) response. Future studies will be necessary t

Published
2022

109. Prognostic indicators and outcomes of hospitalised COVID-19 patients with neurological disease: An individual patient data meta-analysis

Author

Singh, Bhagteshwar, Lant, Suzannah, Cividini, Sofia, Cattrall, Jonathan W S, Goodwin, Lynsey C, Benjamin, Laura, Michael, Benedict D, Khawaja, Ayaz, Matos, Aline de Moura Brasil, Alkeridy, Walid, Pilotto, Andrea, Lahiri, Durjoy, Rawlinson, Rebecca, Mhlanga, Sithembinkosi, Lopez, Evelyn C, Sargent, Brendan F, Somasundaran, Anushri, Tamborska, Arina, Webb, Glynn, Younas, Komal, Al Sami, Yaqub, Babu, Heavenna, Banks, Tristan, Cavallieri, Francesco, Cohen, Matthew, Davies, Emma, Dhar, Shalley, Fajardo Modol, Anna, Farooq, Hamzah, Harte, Jeffrey, Hey, Samuel, Joseph, Albert, Karthikappallil, Dileep, Kassahun, Daniel, Lipunga, Gareth, Mason, Rachel, Minton, Thoma, Mond, Gabrielle, Poxon, Joseph, Rabas, Sophie, Soothill, Germander, Zedde, Marialuisa, Yenkoyan, Konstantin, Brew, Bruce, Contini, Erika, Cysique, Lucette, Zhang, Xin, Maggi, Pietro, van Pesch, Vincent, Lechien, Jérome, Saussez, Sven, Heyse, Alex, Brito Ferreira, Maria Lúcia, Soares, Cristiane N, Elicer, Isabel, Eugenín-von Bernhardi, Laura, Ñancupil Reyes, Waleng, Yin, Rong, Azab, Mohammed A, Abd-Allah, Foad, Elkady, Ahmed, Escalard, Simon, Corvol, Jean-Christophe, Delorme, Cécile, Tattevin, Pierre, Bigaut, Kévin, Lorenz, Norbert, Hornuss, Daniel, Hosp, Jona, Rieg, Siegbert, Wagner, Dirk, Knier, Benjamin, Lingor, Paul, Winkler, Andrea Sylvia, Sharifi-Razavi, Athena, Moein, Shima T, Seyedalinaghi, Seyedahmad, Jamalimoghadamsiahkali, Saeidreza, Morassi, Mauro, Padovani, Alessandro, Giunta, Marcello, Libri, Ilenia, Beretta, Simone, Ravaglia, Sabrina, Foschi, Matteo, Calabresi, Paolo, Primiano, Guido Alessandro, Servidei, Serenella, Biagio Mercuri, Nicola, Liguori, Claudio, Pierantozzi, Mariangela, Sarmati, Loredana, Boso, Federica, Garazzino, Silvia, Mariotto, Sara, Patrick, Kimani N, Costache, Oana, Pincherle, Alexander, Klok, Frederikus A, Meza, Roger, Cabreira, Verónica, Valdoleiros, Sofia R, Oliveira, Vanessa, Kaimovsky, Igor, Guekht, Alla, Koh, Jasmine, Fernández Díaz, Eva, Barrios-López, José María, Guijarro-Castro, Cristina, Beltrán-Corbellini, Álvaro, Martínez-Poles, Javier, Diezma-Martín, Alba María, Morales-Casado, Maria Isabel, García García, Sergio, Breville, Gautier, Coen, Matteo, Uginet, Marjolaine, Bernard-Valnet, Raphaël, Du Pasquier, Renaud, Kaya, Yildiz, Abdelnour, Loay H, Rice, Claire, Morrison, Hamish, Defres, Sylviane, Huda, Saif, Enright, Noelle, Hassell, Jane, D'Anna, Lucio, Benger, Matthew, Sztriha, Laszlo, Raith, Eamon, Chinthapalli, Krishna, Nortley, Ro, Paterson, Ro, Chandratheva, Arvind, Werring, David J, Dervisevic, Samir, Harkness, Kirsty, Pinto, Ashwin, Jillella, Dinesh, Beach, Scott, Gunasekaran, Kulothungan, Rocha Ferreira Da Silva, Ivan, Nalleballe, Krishna, Santoro, Jonathan, Scullen, Tyler, Kahn, Lora, Kim, Carla Y, Thakur, Kiran T, Jain, Rajan, Umapathi, Thirugnanam, Nicholson, Timothy R, Sejvar, James J, Hodel, Eva Maria, Tudur Smith, Catrin, Solomon, Tom, Calabresi, Paolo (ORCID:0000-0003-0326-5509), Primiano, Guido, Servidei, Serenella (ORCID:0000-0001-8478-2799), Singh, Bhagteshwar, Lant, Suzannah, Cividini, Sofia, Cattrall, Jonathan W S, Goodwin, Lynsey C, Benjamin, Laura, Michael, Benedict D, Khawaja, Ayaz, Matos, Aline de Moura Brasil, Alkeridy, Walid, Pilotto, Andrea, Lahiri, Durjoy, Rawlinson, Rebecca, Mhlanga, Sithembinkosi, Lopez, Evelyn C, Sargent, Brendan F, Somasundaran, Anushri, Tamborska, Arina, Webb, Glynn, Younas, Komal, Al Sami, Yaqub, Babu, Heavenna, Banks, Tristan, Cavallieri, Francesco, Cohen, Matthew, Davies, Emma, Dhar, Shalley, Fajardo Modol, Anna, Farooq, Hamzah, Harte, Jeffrey, Hey, Samuel, Joseph, Albert, Karthikappallil, Dileep, Kassahun, Daniel, Lipunga, Gareth, Mason, Rachel, Minton, Thoma, Mond, Gabrielle, Poxon, Joseph, Rabas, Sophie, Soothill, Germander, Zedde, Marialuisa, Yenkoyan, Konstantin, Brew, Bruce, Contini, Erika, Cysique, Lucette, Zhang, Xin, Maggi, Pietro, van Pesch, Vincent, Lechien, Jérome, Saussez, Sven, Heyse, Alex, Brito Ferreira, Maria Lúcia, Soares, Cristiane N, Elicer, Isabel, Eugenín-von Bernhardi, Laura, Ñancupil Reyes, Waleng, Yin, Rong, Azab, Mohammed A, Abd-Allah, Foad, Elkady, Ahmed, Escalard, Simon, Corvol, Jean-Christophe, Delorme, Cécile, Tattevin, Pierre, Bigaut, Kévin, Lorenz, Norbert, Hornuss, Daniel, Hosp, Jona, Rieg, Siegbert, Wagner, Dirk, Knier, Benjamin, Lingor, Paul, Winkler, Andrea Sylvia, Sharifi-Razavi, Athena, Moein, Shima T, Seyedalinaghi, Seyedahmad, Jamalimoghadamsiahkali, Saeidreza, Morassi, Mauro, Padovani, Alessandro, Giunta, Marcello, Libri, Ilenia, Beretta, Simone, Ravaglia, Sabrina, Foschi, Matteo, Calabresi, Paolo, Primiano, Guido Alessandro, Servidei, Serenella, Biagio Mercuri, Nicola, Liguori, Claudio, Pierantozzi, Mariangela, Sarmati, Loredana, Boso, Federica, Garazzino, Silvia, Mariotto, Sara, Patrick, Kimani N, Costache, Oana, Pincherle, Alexander, Klok, Frederikus A, Meza, Roger, Cabreira, Verónica, Valdoleiros, Sofia R, Oliveira, Vanessa, Kaimovsky, Igor, Guekht, Alla, Koh, Jasmine, Fernández Díaz, Eva, Barrios-López, José María, Guijarro-Castro, Cristina, Beltrán-Corbellini, Álvaro, Martínez-Poles, Javier, Diezma-Martín, Alba María, Morales-Casado, Maria Isabel, García García, Sergio, Breville, Gautier, Coen, Matteo, Uginet, Marjolaine, Bernard-Valnet, Raphaël, Du Pasquier, Renaud, Kaya, Yildiz, Abdelnour, Loay H, Rice, Claire, Morrison, Hamish, Defres, Sylviane, Huda, Saif, Enright, Noelle, Hassell, Jane, D'Anna, Lucio, Benger, Matthew, Sztriha, Laszlo, Raith, Eamon, Chinthapalli, Krishna, Nortley, Ro, Paterson, Ro, Chandratheva, Arvind, Werring, David J, Dervisevic, Samir, Harkness, Kirsty, Pinto, Ashwin, Jillella, Dinesh, Beach, Scott, Gunasekaran, Kulothungan, Rocha Ferreira Da Silva, Ivan, Nalleballe, Krishna, Santoro, Jonathan, Scullen, Tyler, Kahn, Lora, Kim, Carla Y, Thakur, Kiran T, Jain, Rajan, Umapathi, Thirugnanam, Nicholson, Timothy R, Sejvar, James J, Hodel, Eva Maria, Tudur Smith, Catrin, Solomon, Tom, Calabresi, Paolo (ORCID:0000-0003-0326-5509), Primiano, Guido, and Servidei, Serenella (ORCID:0000-0001-8478-2799)

Abstract

BackgroundNeurological COVID-19 disease has been reported widely, but published studies often lack information on neurological outcomes and prognostic risk factors. We aimed to describe the spectrum of neurological disease in hospitalised COVID-19 patients; characterise clinical outcomes; and investigate factors associated with a poor outcome.MethodsWe conducted an individual patient data (IPD) meta-analysis of hospitalised patients with neurological COVID-19 disease, using standard case definitions. We invited authors of studies from the first pandemic wave, plus clinicians in the Global COVID-Neuro Network with unpublished data, to contribute. We analysed features associated with poor outcome (moderate to severe disability or death, 3 to 6 on the modified Rankin Scale) using multivariable models.ResultsWe included 83 studies (31 unpublished) providing IPD for 1979 patients with COVID-19 and acute new-onset neurological disease. Encephalopathy (978 [49%] patients) and cerebrovascular events (506 [26%]) were the most common diagnoses. Respiratory and systemic symptoms preceded neurological features in 93% of patients; one third developed neurological disease after hospital admission. A poor outcome was more common in patients with cerebrovascular events (76% [95% CI 67-82]), than encephalopathy (54% [42-65]). Intensive care use was high (38% [35-41]) overall, and also greater in the cerebrovascular patients. In the cerebrovascular, but not encephalopathic patients, risk factors for poor outcome included breathlessness on admission and elevated D-dimer. Overall, 30-day mortality was 30% [27-32]. The hazard of death was comparatively lower for patients in the WHO European region.InterpretationNeurological COVID-19 disease poses a considerable burden in terms of disease outcomes and use of hospital resources from prolonged intensive care and inpatient admission; preliminary data suggest these may differ according to WHO regions and country income levels. The different

Published
2022

110. Age and Comorbidity Burden of Patients Critically Ill with COVID-19 Affect Both Access to and Outcome of Ventilation Therapy in Intensive Care Units.

Author

de Hesselle, Marie Louise, Borgmann, Stefan, Rieg, Siegbert, Vehreschild, Jörg Janne, Rasch, Sebastian, Koll, Carolin E. M., Hower, Martin, Stecher, Melanie, Ebert, Daniel, Hanses, Frank, and Schumann, Julia

Subjects
INTENSIVE care units, COVID-19 pandemic, VENTILATION, CRITICALLY ill, INTENSIVE care patients
Abstract

During the COVID-19 pandemic, large numbers of elderly, multimorbid people required treatment in intensive care units. This study investigated how the inherent patient factors age and comorbidity burden affected the treatment strategy and the outcome achieved. Retrospective analysis of data from intensive care patients enrolled in the Lean European Open Survey on SARS-CoV2-Infected Patients (LEOSS) cohort found that a patient's age and comorbidity burden in fact influenced their mortality rate and the use of ventilation therapy. Evidence showed that advanced age and multimorbidity were associated with the restrictive use of invasive ventilation therapies, particularly ECMO. Geriatric patients with a high comorbidity burden were clustered in the sub-cohort of non-ventilated ICU patients characterized by a high mortality rate. The risk of death generally increased with older age and accumulating comorbidity burden. Here, the more aggressive an applied procedure, the younger the age in which a majority of patients died. Clearly, geriatric, multimorbid COVID-19 patients benefit less from invasive ventilation therapies. This implies the need for a holistic approach to therapy decisions, taking into account the patient's wishes. [ABSTRACT FROM AUTHOR]

Published
2023
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112. Short-lived booster effect and stable CD8+ T cell memory after 3rd COVID-19 vaccine dose

Author

Reinscheid, Matthias, primary, Luxenburger, Hendrik, additional, Karl, Vivien, additional, Graeser, Anne, additional, Giese, Sebastian, additional, Ciminski, Kevin, additional, Reeg, David, additional, Oberhardt, Valerie, additional, Röhlen, Natascha, additional, Lang-Meli, Julia, additional, Heim, Kathrin, additional, Gross, Nina, additional, Baum, Christina, additional, Rieg, Siegbert, additional, Speer, Claudius, additional, Emmerich, Florian, additional, Breisinger, Susanne, additional, Steinmann, Daniel, additional, Bengsch, Bertram, additional, Boettler, Tobias, additional, Kochs, Georg, additional, Schwemmle, Martin, additional, Thimme, Robert, additional, Neumann-Haefelin, Christoph, additional, and Hofmann, Maike, additional

Published
2022
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113. Development and validation of BLOOMY prediction scores for 14-day and 6-month mortality in hospitalised adults with bloodstream infections: a multicentre, prospective, cohort study

Author

Tacconelli, Evelina, primary, Göpel, Siri, additional, Gladstone, Beryl P, additional, Eisenbeis, Simone, additional, Hölzl, Florian, additional, Buhl, Michael, additional, Górska, Anna, additional, Cattaneo, Chiara, additional, Mischnik, Alexander, additional, Rieg, Siegbert, additional, Rohde, Anna M, additional, Kohlmorgen, Britta, additional, Falgenhauer, Jane, additional, Trauth, Janina, additional, Käding, Nadja, additional, Kramme, Evelyn, additional, Biehl, Lena M, additional, Walker, Sarah V, additional, Peter, Silke, additional, Gastmeier, Petra, additional, Chakraborty, Trinad, additional, Vehreschild, Maria JGT, additional, Seifert, Harald, additional, Rupp, Jan, additional, Kern, Winfried V, additional, Lemke, Elke, additional, Thoma, Norbert, additional, Wolke, Solvy, additional, Imirzalioglu, Can, additional, Herold, Susanne, additional, Tewes, Nicole, additional, Fritzenwanker, Moritz, additional, Vehreschild, Jörg Janne, additional, Classen, Annika Yanina, additional, Tobys, David, additional, Higgins, Paul, additional, Blum, Yannic, additional, Kleipaß, Matthias, additional, Höltig, Lisa, additional, Nagel, Katharina, additional, Schmauder, Kristina, additional, Künstle, Larissa, additional, Stoll, Elisabeth, additional, Dinkelacker, Ariane Gertraud, additional, Peyerl-Hoffmann, Gabriele, additional, Häcker, Georg, additional, Spitznagel, Heike, additional, and Olawumi-Hurter, Sara Christina, additional

Published
2022
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118. Covid‐19 in patients with hematological and solid cancers at a Comprehensive Cancer Center in Germany

Author

Shoumariyeh, Khalid, Biavasco, Francesca, Ihorst, Gabriele, Rieg, Siegbert, Nieters, Alexandra, Kern, Winfried V., Miething, Cornelius, Duyster, Justus, Engelhardt, Monika, and Bertz, Hartmut

Subjects
Male, Cancer Research, Pneumonia, Viral, epidemiology and prevention, lcsh:RC254-282, Betacoronavirus, Risk Factors, Germany, Neoplasms, Oncology Service, Hospital, Humans, Pandemics, Original Research, Aged, Retrospective Studies, Aged, 80 and over, SARS-CoV-2, Clinical Cancer Research, COVID-19, Middle Aged, lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, Prognosis, Hospitalization, Survival Rate, cancer management, Oncology, Radiology Nuclear Medicine and imaging, Hematologic Neoplasms, epidemiology, Female, viral infection, Coronavirus Infections
Abstract

Background Patients with cancer are considered a high‐risk group for viral pneumonia, with an increased probability of fatal outcome. Here, we investigated the clinical characteristics and outcome of patients with solid and hematological cancers and concomitant Covid‐19 at a Comprehensive Cancer Center in a Covid‐19 hotspot area in Germany. Methods We performed a retrospective single center cohort study of 39 patients with hematological and solid cancers who were hospitalized at the University Hospital Freiburg for Covid‐19. Using univariate and multivariate Cox regression models we compared time to severe events and overall survival to an age‐matched control cohort of 39 patients with confirmed Covid‐19 without a cancer diagnosis. Results In the cancer cohort 29 patients had a diagnosis of a solid tumor, and 10 had a hematological malignancy. In total, eight patients (21%) in the cancer and 14 patients (36%) from the noncancer cohort died during the observation period. Presence of a malignancy was not significantly associated with survival or time to occurrence of severe events. Major influences on mortality were high IL‐6 levels at Covid‐19 diagnosis (HR = 6.95, P = .0121) and age ≥ 65 years (HR = 6.22, P = .0156). Conclusions Compared to an age‐matched noncancer cohort, we did not observe an association between a cancer diagnosis and a more severe disease course or higher fatality rate in patients with Covid‐19. Patients with a hematological malignancy showed a trend towards a longer duration until clinical improvement and longer hospitalization time compared to patients with a solid cancer. Cancer per se does not seem to be a confounder for dismal outcome in Covid‐19., In this retrospective single center cohort study at a Comprehensive Cancer Center in Germany we did not observe an association between a cancer diagnosis and a more severe disease course or higher fatality rate in patients with Covid‐19 when compared to an age‐matched control cohort of patients with confirmed Covid‐19 without a cancer diagnosis.

Published
2020

119. Convalescent plasma treatment for SARS-CoV-2 infected high-risk patients: a matched pair analysis to the LEOSS cohort

Author

Freise, Noemi F., Gliga, Smaranda, Fischer, Johannes, Lübke, Nadine, Lutterbeck, Matthias, Schöler, Miriam, Bölke, Edwin, Orth, Hans Martin, Feldt, Torsten, Roemmele, Christoph, Wilke, Dominik, Schneider, Jochen, Wille, Kai, Hohmann, Christian, Strauss, Richard, Hower, Martin, Ruf, Andreas, Schubert, Joerg, Isberner, Nora, Stecher, Melanie, Pilgram, Lisa, Vehreschild, Jörg J., de With, Katja, Spinner, Christoph, Lanznaster, Julia, Beutel, Gernot, Jung, Norma, Göpel, Siri, Westhoff, Timm, Hohenstein, Bernd, Rothfuss, Katja, Rieg, Siegbert, Ruethrich, Maria Madeleine, Rupp, Jan, Hanses, Frank, Luedde, Tom, and Jensen, Björn

Subjects
Multidisciplinary, SARS-CoV-2, Renal Dialysis, Matched-Pair Analysis, Immunization, Passive, Humans, COVID-19, ddc:610, COVID-19 Serotherapy, Retrospective Studies
Abstract

BackgroundEstablishing the optimal treatment for COVID-19 patients remains challenging. Specifically, immunocompromised and pre-diseased patients are at high risk for severe disease course and face limited therapeutic options. Convalescent plasma has been considered as therapeutic approach, but reliable data are lacking, especially for high-risk patients.MethodsWe performed a retrospective analysis of 55 hospitalized COVID-19 patients with high risk for disease progression, primarily due to immunosuppression from cancer, solid organ transplantation, autoimmune disease, dialysis. A matched-pairs analysis (1:4) was performed with 220 patients from the Lean European Open Survey on SARS-CoV-2-infected Patients (LEOSS) who were treated or not treated with convalescent plasma. ResultsBoth cohorts, had high mortality (UKD 41.8%, LEOSS 34.1%). A matched-pairs analysis showed no significant effect on mortality. CP administration before the formation of pulmonary infiltrates showed the lowest mortality in both cohorts (10%), whereas mortality in the complicated phase was 27.8%. CP administration during the critical phase revealed the highest mortality; UKD 60.9%, LEOSS 48.3%. ConclusionIn our cohort of SARS-CoV-2 infected patients with severe comorbidities CP did not significantly reduce mortality in a retrospective matched pairs analysis. However, our data supports the concept that a reduction in mortality is achievable when CP is administered early.

Published
2022

120. SARS-CoV-2 specific T cells induced by both SARS-CoV-2 infection and mRNA vaccination broadly cross-recognize omicron

Author

Lang-Meli, Julia, primary, Luxenburger, Hendrik, additional, Wild, Katharina, additional, Karl, Vivien, additional, Oberhardt, Valerie, additional, Alizei, Elahe Salimi, additional, Graeser, Anne, additional, Reinscheid, Matthias, additional, Roehlen, Natascha, additional, Giese, Sebastian, additional, Ciminski, Kevin, additional, Götz, Veronika, additional, August, Dietrich, additional, Rieg, Siegbert, additional, Waller, Cornelius, additional, Wengenmayer, Tobias, additional, Staudacher, Dawid, additional, Bengsch, Bertram, additional, Kochs, Georg, additional, Schwemmle, Martin, additional, Emmerich, Florian, additional, Boettler, Tobias, additional, Thimme, Robert, additional, Hofmann, Maike, additional, and Neumann-Haefelin, Christoph, additional

Published
2022
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123. Evolving phenotypes of non-hospitalized patients that indicate long COVID

Author

ESTIRI, Hossein, Strasser, Zachary, Brat, Gabriel, Semenov, Yevgeniy, Patel, Chirag, Murphy, Shawn, Aaron, James, Agapito, Giuseppe, Albayrak, Adem, Alessiani, Mario, Amendola, Danilo, Anthony, Li, Aronow, Bruce, Ashraf, Fatima, Atz, Andrew, Avillach, Paul, Balshi, James, Beaulieu-Jones, Brett, Bell, Douglas, Bellasi, Antonio, Bellazzi, Riccardo, Benoit, Vincent, Beraghi, Michele, Sobrino, José Luis Bernal, Bernaux, Mélodie, Bey, Romain, Martínez, Alvar Blanco, Boeker, Martin, Bonzel, Clara-Lea, Booth, John, Bosari, Silvano, Bourgeois, Florence, Bradford, Robert, Bréant, Stéphane, Brown, Nicholas, Bryant, William, Bucalo, Mauro, Burgun, Anita, Cai, Tianxi, Cannataro, Mario, Carmona, Aldo, Caucheteux, Charlotte, Champ, Julien, Chen, Jin, Chen, Krista, Chiovato, Luca, Chiudinelli, Lorenzo, Cho, Kelly, Cimino, James, Colicchio, Tiago, Cormont, Sylvie, COSSIN, Sébastien, Craig, Jean, Bermúdez, Juan Luis Cruz, Rojo, Jaime Cruz, Dagliati, Arianna, Daniar, Mohamad, Daniel, Christel, Davoudi, Anahita, Devkota, Batsal, Dubiel, Julien, Esteve, Loic, Fan, Shirley, Follett, Robert, Gaiolla, Paula, Ganslandt, Thomas, Barrio, Noelia García, Garmire, Lana, Gehlenborg, Nils, GEVA, Alon, Gradinger, Tobias, Gramfort, Alexandre, Griffier, Romain, Griffon, Nicolas, Grisel, Olivier, Gutiérrez-Sacristán, Alba, Hanauer, David, Haverkamp, Christian, He, Bing, Henderson, Darren, Hilka, Martin, Holmes, John, Hong, Chuan, Horki, Petar, Huling, Kenneth, HUTCH, Meghan, Issitt, Richard, Jannot, Anne Sophie, Jouhet, Vianney, Keller, Mark, Kirchoff, Katie, Klann, Jeffrey, Kohane, Isaac, Krantz, Ian, Kraska, Detlef, Krishnamurthy, Ashok, L’Yi, Sehi, Le, Trang, Leblanc, Judith, Leite, Andressa, Lemaitre, Guillaume, Lenert, Leslie, Leprovost, Damien, Liu, Molei, LOH, Ne Hooi Will, Lozano-Zahonero, Sara, Luo, Yuan, Lynch, Kristine, Mahmood, Sadiqa, Maidlow, Sarah, Malovini, Alberto, Mandl, Kenneth, Mao, Chengsheng, Maram, Anupama, Martel, Patricia, Masino, Aaron, Mazzitelli, Maria, Mensch, Arthur, Milano, Marianna, Minicucci, Marcos, Moal, Bertrand, Moore, Jason, Moraleda, Cinta, Morris, Jeffrey, MORRIS, Michele, Moshal, Karyn, Mousavi, Sajad, Mowery, Danielle, Murad, Douglas, Naughton, Thomas, Neuraz, Antoine, Ngiam, Kee Yuan, Norman, James, Obeid, Jihad, Okoshi, Marina, Olson, Karen, Omenn, Gilbert, Orlova, Nina, Ostasiewski, Brian, Palmer, Nathan, Paris, Nicolas, Patel, Lav, Jimenez, Miguel Pedrera, Pfaff, Emily, Pillion, Danielle, Prokosch, Hans, Prudente, Robson, González, Víctor Quirós, Ramoni, Rachel, Raskin, Maryna, RIEG, Siegbert, Domínguez, Gustavo Roig, Rojo, Pablo, Sáez, Carlos, Salamanca, Elisa, Samayamuthu, Malarkodi, Sandrin, Arnaud, Santos, Janaina, Savino, Maria, SCHRIVER, Emily, Schubert, Petra, Schuettler, Juergen, Scudeller, Luigia, Sebire, Neil, Balazote, Pablo Serrano, Serre, Patricia, Serret-Larmande, Arnaud, Shakeri, Zahra, Silvio, Domenick, Sliz, Piotr, SON, Jiyeon, Sonday, Charles, South, Andrew, Spiridou, Anastasia, Tan, Amelia, Tan, Bryce, Tan, Byorn, Tanni, Suzana, Taylor, Deanne, Terriza Torres, Ana, Tibollo, Valentina, Tippmann, Patric, Torti, Carlo, Trecarichi, Enrico, Tseng, Yi-Ju, Vallejos, Andrew, Varoquaux, Gael, Vella, Margaret, Verdy, Guillaume, Vie, Jill-Jênn, Visweswaran, Shyam, Vitacca, Michele, Wagholikar, Kavishwar, Waitman, Lemuel, Wang, Xuan, Wassermann, Demian, Weber, Griffin, XIA, Zongqi, Yehya, Nadir, Yuan, William, Zambelli, Alberto, Zhang, Harrison, Zoeller, Daniel, Zucco, Chiara, Massachusetts General Hospital [Boston], Harvard Medical School [Boston] (HMS), Service d'informatique médicale et biostatistiques [CHU Necker], CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Health data- and model- driven Knowledge Acquisition (HeKA), Inria de Paris, Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-Centre de Recherche des Cordeliers (CRC (UMR_S_1138 / U1138)), École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université de Paris (UP)-École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université de Paris (UP), Université de Paris - UFR Médecine Paris Centre [Santé] (UP Médecine Paris Centre), Université de Paris (UP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPC)-École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPC), Université Paris Cité - UFR Médecine Paris Centre [Santé] (UPC Médecine Paris Centre), Université Paris Cité (UPC), This work was supported by the National Human Genome Research Institute grant 3U01HG008685-05S2 and the National Library of Medicine grant T15LM007092., École Pratique des Hautes Études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPCité)-École Pratique des Hautes Études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPCité), UFR Médecine [Santé] - Université Paris Cité (UFR Médecine UPCité), and Université Paris Cité (UPCité)

Subjects
medicine.medical_specialty, Neurological disorder, Chest pain, MESH: Phenotype, Article, 03 medical and health sciences, 0302 clinical medicine, Post-Acute COVID-19 Syndrome, Diabetes mellitus, Internal medicine, Machine learning, medicine, Chronic fatigue syndrome, Humans, Electronic health records, Post-acute sequelae of SARS-CoV-2, MESH: COVID-19, 030304 developmental biology, Retrospective Studies, 0303 health sciences, MESH: Humans, business.industry, Medical record, Type 2 Diabetes Mellitus, COVID-19, Retrospective cohort study, MESH: Retrospective Studies, General Medicine, medicine.disease, 3. Good health, Dysgeusia, Phenotypes, Phenotype, Medicine, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, medicine.symptom, business, 030217 neurology & neurosurgery, Research Article, Cohort study
Abstract

Background For some SARS-CoV-2 survivors, recovery from the acute phase of the infection has been grueling with lingering effects. Many of the symptoms characterized as the post-acute sequelae of COVID-19 (PASC) could have multiple causes or are similarly seen in non-COVID patients. Accurate identification of PASC phenotypes will be important to guide future research and help the healthcare system focus its efforts and resources on adequately controlled age- and gender-specific sequelae of a COVID-19 infection. Methods In this retrospective electronic health record (EHR) cohort study, we applied a computational framework for knowledge discovery from clinical data, MLHO, to identify phenotypes that positively associate with a past positive reverse transcription-polymerase chain reaction (RT-PCR) test for COVID-19. We evaluated the post-test phenotypes in two temporal windows at 3–6 and 6–9 months after the test and by age and gender. Data from longitudinal diagnosis records stored in EHRs from Mass General Brigham in the Boston Metropolitan Area was used for the analyses. Statistical analyses were performed on data from March 2020 to June 2021. Study participants included over 96 thousand patients who had tested positive or negative for COVID-19 and were not hospitalized. Results We identified 33 phenotypes among different age/gender cohorts or time windows that were positively associated with past SARS-CoV-2 infection. All identified phenotypes were newly recorded in patients’ medical records 2 months or longer after a COVID-19 RT-PCR test in non-hospitalized patients regardless of the test result. Among these phenotypes, a new diagnosis record for anosmia and dysgeusia (OR 2.60, 95% CI [1.94–3.46]), alopecia (OR 3.09, 95% CI [2.53–3.76]), chest pain (OR 1.27, 95% CI [1.09–1.48]), chronic fatigue syndrome (OR 2.60, 95% CI [1.22–2.10]), shortness of breath (OR 1.41, 95% CI [1.22–1.64]), pneumonia (OR 1.66, 95% CI [1.28–2.16]), and type 2 diabetes mellitus (OR 1.41, 95% CI [1.22–1.64]) is one of the most significant indicators of a past COVID-19 infection. Additionally, more new phenotypes were found with increased confidence among the cohorts who were younger than 65. Conclusions The findings of this study confirm many of the post-COVID-19 symptoms and suggest that a variety of new diagnoses, including new diabetes mellitus and neurological disorder diagnoses, are more common among those with a history of COVID-19 than those without the infection. Additionally, more than 63% of PASC phenotypes were observed in patients under 65 years of age, pointing out the importance of vaccination to minimize the risk of debilitating post-acute sequelae of COVID-19 among younger adults.

Published
2021
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124. Closing Sexual Health Service Gaps With a New Service Model in Germany: Performance of an on-Site Integrated, Cross-Sectoral, Low Threshold Sexually Transmitted Infections/HIV Counseling and Treatment Service

Author

Müller, Matthias C., Usadel, Susanne, Zimmermann, Stefan, Fahrhöfer, Andreas, Kern, Winfried V., Hoffmeister, Ulrike, and Rieg, Siegbert

Subjects
Adult, Counseling, Male, Sexual and Gender Minorities, Germany, Public Health, Environmental and Occupational Health, Sexually Transmitted Diseases, Humans, Female, HIV Infections, Pre-Exposure Prophylaxis, Longitudinal Studies, Homosexuality, Male
Abstract

PurposeIn Germany, the incidence of bacterial sexual transmitted infections (STI) is on the rise and still high for HIV infections. The Center for Sexual Health Freiburg (CSHF) was established to offer low threshold access for STI/HIV counseling, testing, HIV pre-exposure prophylaxis (PrEP), and on-site treatment. The objective of this study was to analyze the performance of CSHF.MethodsLongitudinal study that includes all clients presenting between 1 May 2020 and 28 February 2021 at CSHF and willing to sign informed consent.ResultsIn the study period, 536 clients presented at CSHF of whom 417 clients were included in the study resulting in 668 client contacts. Clients' median age was 28.1 years (range: 18.0–73.1), 55.9% were men, 42.0% were women, 0.3% were transman, and 1.7% were not binary. Clients' sexual orientation was heterosexual (56.6%), homosexual men (26.2%), and bisexual (13.6%). STI screening resulted in the detection of any STI in 3.4% (95% confidence interval (CI): 0.7–6.1) of women, in 3.1% (95% CI: 0.0–6.5) of heterosexual men, and in 22.2% (95% CI: 13.0–31.5) of men having sex with men (MSM) not taking PrEP. Eighty-one MSM received PrEP with a total follow-up of 57.3 person-years and 0.44 STIs per person-year.ConclusionThe substantial burden of STI in the study population emphasizes the need for regular and low threshold STI screening services. The concept of CSHF may facilitate access to STI/HIV counseling, testing, and PrEP for a wide spectrum of people and may prove to be an important contribution to the efforts to reduce STI and HIV incidence in Germany.

Published
2021

125. Multinational characterization of neurological phenotypes in patients hospitalized with COVID-19

Author

Le, Trang, Gutiérrez-Sacristán, Alba, Son, Jiyeon, Hong, Chuan, South, Andrew, Beaulieu-Jones, Brett, Loh, Ne Hooi Will, Luo, Yuan, Morris, Michele, Ngiam, Kee Yuan, Patel, Lav, Samayamuthu, Malarkodi, Schriver, Emily, Tan, Amelia, Moore, Jason, Cai, Tianxi, Omenn, Gilbert, Avillach, Paul, Kohane, Isaac, Visweswaran, Shyam, Mowery, Danielle, Xia, Zongqi, Aaron, James, Agapito, Giuseppe, Albayrak, Adem, Alessiani, Mario, Amendola, Danilo, Angoulvant, François, Anthony, Li, Aronow, Bruce, Atz, Andrew, Balshi, James, Bell, Douglas, Bellasi, Antonio, Bellazzi, Riccardo, Benoit, Vincent, Beraghi, Michele, Bernal Sobrino, José Luis, Bernaux, Mélodie, Bey, Romain, Blanco Martínez, Alvar, Boeker, Martin, Bonzel, Clara-Lea, Booth, John, Bosari, Silvano, Bourgeois, Florence, Bradford, Robert, Brat, Gabriel, Bréant, Stéphane, Brown, Nicholas, Bryant, William, Bucalo, Mauro, Burgun, Anita, Cannataro, Mario, Carmona, Aldo, Caucheteux, Charlotte, Champ, Julien, Chen, Krista, Chen, Jin, Chiovato, Luca, Chiudinelli, Lorenzo, Cimino, James, Colicchio, Tiago, Cormont, Sylvie, Cossin, Sébastien, Craig, Jean, Cruz Bermúdez, Juan Luis, Cruz Rojo, Jaime, Dagliati, Arianna, Daniar, Mohamad, Daniel, Christel, Davoudi, Anahita, Devkota, Batsal, Dubiel, Julien, Esteve, Loic, Fan, Shirley, Follett, Robert, Gaiolla, Paula, Ganslandt, Thomas, García Barrio, Noelia, Garmire, Lana, Gehlenborg, Nils, Geva, Alon, Gradinger, Tobias, Gramfort, Alexandre, Griffier, Romain, Griffon, Nicolas, Grisel, Olivier, Hanauer, David, Haverkamp, Christian, He, Bing, Henderson, Darren, Hilka, Martin, Holmes, John, Horki, Petar, Huling, Kenneth, Hutch, Meghan, Issitt, Richard, Jannot, Anne Sophie, Jouhet, Vianney, Kavuluru, Ramakanth, Keller, Mark, Kirchoff, Katie, Klann, Jeffrey, Krantz, Ian, Kraska, Detlef, Krishnamurthy, Ashok, L’yi, Sehi, Leblanc, Judith, Leite, Andressa, Lemaitre, Guillaume, Lenert, Leslie, Leprovost, Damien, Liu, Molei, Lozano-Zahonero, Sarah, Lynch, Kristine, Mahmood, Sadiqa, Maidlow, Sarah, Makoudjou Tchendjou, Adeline, Malovini, Alberto, Mandl, Kenneth, Mao, Chengsheng, Maram, Anupama, Martel, Patricia, Masino, Aaron, Matheny, Michael, Maulhardt, Thomas, Mazzitelli, Maria, Mcduffie, Michael, Mensch, Arthur, Ashraf, Fatima, Milano, Marianna, Minicucci, Marcos, Moal, Bertrand, Moraleda, Cinta, Morris, Jeffrey, Moshal, Karyn, Mousavi, Sajad, Murad, Douglas, Murphy, Shawn, Naughton, Thomas, Neuraz, Antoine, Norman, James, Obeid, Jihad, Okoshi, Marina, Olson, Karen, Orlova, Nina, Ostasiewski, Brian, Palmer, Nathan, Paris, Nicolas, Pedrera Jimenez, Miguel, Pfaff, Emily, Pillion, Danielle, Prokosch, Hans, Prudente, Robson, Quirós González, Víctor, Ramoni, Rachel, Raskin, Maryna, Rieg, Siegbert, Roig Domínguez, Gustavo, Rojo, Pablo, Sáez, Carlos, Salamanca, Elisa, Sandrin, Arnaud, Santos, Janaina, Savino, Maria, Schuettler, Juergen, Scudeller, Luigia, Sebire, Neil, Balazote, Pablo Serrano, Serre, Patricia, Serret-Larmande, Arnaud, Shakeri, Zahra, Silvio, Domenick, Sliz, Piotr, Sonday, Charles, Spiridou, Anastasia, Tan, Bryce, Tan, Byorn, Tanni, Suzana, Taylor, Deanne, Terriza-Torres, Ana, Tibollo, Valentina, Tippmann, Patric, Torti, Carlo, Trecarichi, Enrico, Tseng, Yi-Ju, Vallejos, Andrew, Varoquaux, Gael, Vella, Margaret, Vie, Jill-Jênn, Vitacca, Michele, Wagholikar, Kavishwar, Waitman, Lemuel, Wassermann, Demian, Weber, Griffin, William, Yuan, Yehya, Nadir, Zambelli, Alberto, Zhang, Harrison, Zoeller, Daniela, Zucco, Chiara, Unité d'informatique médicale, CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Health data- and model- driven Knowledge Acquisition (HeKA), Inria de Paris, Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-Centre de Recherche des Cordeliers (CRC (UMR_S_1138 / U1138)), École Pratique des Hautes Études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPCité)-École Pratique des Hautes Études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPCité), UFR Médecine [Santé] - Université Paris Cité (UFR Médecine UPCité), Université Paris Cité (UPCité), AS is funded by National Institutes of Health (NIH) National Heart Lung, and Blood Institute (NHLBI) K23HL148394 and L40HL148910, and NIH-National Center for Advancing Translational Sciences (NCATS) UL1TR001420. JM is funded by NIH-National Institute of Allergy and Infectious Disease (NIAD) AI11679. LP is funded by NCATS Clinical and Translational Science Award (CTSA) Number UL1TR002366. GO is funded by NIH National Institute of Environmental Health Sciences (NIEHS) P30ES017885 and National Cancer Institute (NCI) U24CA210967. SV is funded by NIH-National Library of Medicine (NLM) R01LM012095 and NCATS UL1TR001857. DM is funded by NCATS CTSA Number UL1-TR001878. ZX is funded by NIH National Institute of Neurological Disorders and Stroke (NINDS) R01NS098023., Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), National Cancer Institute, École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université de Paris (UP)-École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université de Paris (UP), Université de Paris - UFR Médecine Paris Centre [Santé] (UP Médecine Paris Centre), Université de Paris (UP), University of Pennsylvania Perelman School of Medicine, Harvard Medical School, University of Pittsburgh, Wake Forest School of Medicine, National University Health Systems, Northwestern University, University of Kansas Medical Center, University of Pennsylvania Health System, University of Michigan, University of Kentucky, University Magna Graecia of Catanzaro, INC., Lombardia Region Health System, Universidade Estadual Paulista (UNESP), Assistance Publique-Hôpitaux de Paris, Tan Tock Seng Hospital, University of Cincinnati, Medical University of South Carolina, St. Luke’s University Health Network, David Geffen School of Medicine at UCLA, ASST Papa Giovanni XXIII, University of Pavia, APHP Greater Paris University Hospital, ASST Pavia, Hospital Universitario, University of Freiburg, Informatics and Virtual Environments (DRIVE), IRCCS Ca’ Granda Ospedale Maggiore Policlinico di Milano, University of North Carolina, BIOMERIS (BIOMedical Research Informatics Solutions), CEA, LIRMM, Boston Children’s Hospital, Istituti Clinici Scientifici Maugeri SpA SB IRCCS, University of Alabama at Birmingham, Bordeaux University Hospital/ERIAS-Inserm U1219 BPH, Children’s Hospital of Philadelphia, Inria Centre de Paris, Heidelberg University, and Pain Medicine Boston Children’s Hospital, University of Michigan Medical School, MSHI Medical University of South Carolina, Massachusetts General Hospital, The Children’s Hospital of Philadelphia, University Hospital, Clevy.io, Harvard T.H. Chan School of Public Health, VA Salt Lake City Health Care System, Veterans Affairs Medical Center, PSL Université Paris, School of Biomedical Informatics, Great Ormond Street Hospital for Children, University of Erlangen-Nürnberg, Office of Research and Development, Universitat Politècnica de València, Nurse Department of FMB-Medicine School of Botucatu, FAU Erlangen-Nürnberg, National University Hospital, Chang Gung University, Medical College of Wisconsin, McGill University, Inria Lille, ICS S Maugeri IRCCS, University of Missouri, Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPC)-École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPC), Université Paris Cité - UFR Médecine Paris Centre [Santé] (UPC Médecine Paris Centre), and Université Paris Cité (UPC)

Subjects
Male, Epidemiology, Cross-sectional study, Disease, Severity of Illness Index, MESH: Aged, 80 and over, 0302 clinical medicine, MESH: Child, Prevalence, MESH: COVID-19, 030212 general & internal medicine, Young adult, Child, Aged, 80 and over, MESH: Aged, MESH: Middle Aged, Multidisciplinary, MESH: Infant, Newborn, Middle Aged, MESH: Infant, 3. Good health, Neurology, MESH: Young Adult, Child, Preschool, Medicine, Female, Encephalitis, Adult, MESH: Pandemics, medicine.medical_specialty, Adolescent, Science, Myelitis, MESH: Nervous System Diseases, Article, Young Adult, 03 medical and health sciences, Medical research, MESH: Cross-Sectional Studies, MESH: Severity of Illness Index, Internal medicine, Severity of illness, medicine, Humans, Pandemics, MESH: Prevalence, Aged, MESH: Adolescent, MESH: Humans, business.industry, MESH: Child, Preschool, Infant, Newborn, COVID-19, Infant, MESH: Adult, medicine.disease, MESH: Male, Confidence interval, Cross-Sectional Studies, Relative risk, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Nervous System Diseases, business, MESH: Female, Neurological disorders, 030217 neurology & neurosurgery
Abstract

Made available in DSpace on 2022-04-29T08:35:59Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-12-01 Division of Intramural Research, National Institute of Allergy and Infectious Diseases Division of Microbiology and Infectious Diseases, National Institute of Allergy and Infectious Diseases National Institute of Allergy and Infectious Diseases National Center for Advancing Translational Sciences National Heart, Lung, and Blood Institute National Institute of Environmental Health Sciences U.S. National Library of Medicine National Institute of Neurological Disorders and Stroke Division of Cancer Prevention, National Cancer Institute Neurological complications worsen outcomes in COVID-19. To define the prevalence of neurological conditions among hospitalized patients with a positive SARS-CoV-2 reverse transcription polymerase chain reaction test in geographically diverse multinational populations during early pandemic, we used electronic health records (EHR) from 338 participating hospitals across 6 countries and 3 continents (January–September 2020) for a cross-sectional analysis. We assessed the frequency of International Classification of Disease code of neurological conditions by countries, healthcare systems, time before and after admission for COVID-19 and COVID-19 severity. Among 35,177 hospitalized patients with SARS-CoV-2 infection, there was an increase in the proportion with disorders of consciousness (5.8%, 95% confidence interval [CI] 3.7–7.8%, pFDR < 0.001) and unspecified disorders of the brain (8.1%, 5.7–10.5%, pFDR < 0.001) when compared to the pre-admission proportion. During hospitalization, the relative risk of disorders of consciousness (22%, 19–25%), cerebrovascular diseases (24%, 13–35%), nontraumatic intracranial hemorrhage (34%, 20–50%), encephalitis and/or myelitis (37%, 17–60%) and myopathy (72%, 67–77%) were higher for patients with severe COVID-19 when compared to those who never experienced severe COVID-19. Leveraging a multinational network to capture standardized EHR data, we highlighted the increased prevalence of central and peripheral neurological phenotypes in patients hospitalized with COVID-19, particularly among those with severe disease. Department of Biostatistics Epidemiology and Informatics University of Pennsylvania Perelman School of Medicine Department of Biomedical Informatics Harvard Medical School Department of Neurology University of Pittsburgh, Biomedical Science Tower 3, Suite 7014, 3501 5th Avenue Department of Pediatrics Wake Forest School of Medicine Department of Critical Care National University Health Systems Department of Preventive Medicine Northwestern University Department of Biomedical Informatics University of Pittsburgh Department of Surgery National University Health Systems Department of Internal Medicine University of Kansas Medical Center Data Analytics Center University of Pennsylvania Health System Department of Computational Medicine and Bioinformatics University of Michigan Department of Biomedical Informatics University of Kentucky Department of Legal Economic and Social Sciences University Magna Graecia of Catanzaro Health Catalyst INC. Department of Surgery ASST Pavia Lombardia Region Health System Clinical Research Unit of Botucatu Medical School São Paulo State University Pediatric Emergency Department Hôpital Necker-Enfants Malades Assistance Publique-Hôpitaux de Paris National Center for Infectious Diseases Tan Tock Seng Hospital Departments of Biomedical Informatics Pediatrics Cincinnati Children’s Hospital Medical Center University of Cincinnati Department of Pediatrics Medical University of South Carolina Department of Surgery St. Luke’s University Health Network Department of Medicine David Geffen School of Medicine at UCLA UOC Ricerca Innovazione e Brand Reputation ASST Papa Giovanni XXIII Department of Electrical Computer and Biomedical Engineering University of Pavia IT Department Innovation & Data APHP Greater Paris University Hospital I.T. Department ASST Pavia Health Informatics Hospital Universitario, 12 de Octubre Strategy and Transformation Department APHP Greater Paris University Hospital Faculty of Medicine and Medical Center University of Freiburg Digital Research Informatics and Virtual Environments (DRIVE), Great Ormond Street Hospital for Children Scientific Direction IRCCS Ca’ Granda Ospedale Maggiore Policlinico di Milano North Carolina Translational and Clinical Sciences (NC TraCS) Institute University of North Carolina BIOMERIS (BIOMedical Research Informatics Solutions) Department of Biomedical Informatics HEGP APHP Greater Paris University Hospital Department of Medical and Surgical Sciences Data Analytics Research Center University Magna Graecia of Catanzaro Department of Anesthesia St. Luke’s University Health Network Université Paris-Saclay Inria CEA INRIA Sophia-Antipolis–ZENITH Team LIRMM Computational Health Informatics Program Boston Children’s Hospital Department of Internal Medicine University of Kentucky Unit of Internal Medicine and Endocrinology Istituti Clinici Scientifici Maugeri SpA SB IRCCS Department of Internal Medicine and Therapeutics University of Pavia Informatics Institute University of Alabama at Birmingham IAM Unit Bordeaux University Hospital/ERIAS-Inserm U1219 BPH Biomedical Informatics Center Medical University of South Carolina Clinical Research Informatics Boston Children’s Hospital Department of Biomedical and Health Informatics Children’s Hospital of Philadelphia SED/SIERRA Inria Centre de Paris Health Information Technology & Services University of Michigan Internal Medicine Department Botucatu Medical School São Paulo State University Heinrich-Lanz-Center for Digital Health University Medicine Mannheim Heidelberg University Department of Anesthesiology Critical Care and Pain Medicine Boston Children’s Hospital Department of Learning Health Sciences University of Michigan Medical School MSHI Medical University of South Carolina Department of Medicine Massachusetts General Hospital Division of Human Genetics Department of Pediatrics The Children’s Hospital of Philadelphia Center for Medical Information and Communication Technology University Hospital Renaissance Computing Institute/Department of Computer Science University of North Carolina Clinical Research Unit Saint Antoine Hospital APHP Greater Paris University Hospital Clevy.io Department of Biostatistics Harvard T.H. Chan School of Public Health VA Informatics and Computing Infrastructure VA Salt Lake City Health Care System MICHR Informatics University of Michigan Laboratory of Informatics and Systems Engineering for Clinical Research Istituti Clinici Scientifici Maugeri SpA SB IRCCS Harvard Catalyst Harvard Medical School Clinical Research Unit Paris Saclay APHP Greater Paris University Hospital Department of Anesthesiology and Critical Care Children’s Hospital of Philadelphia VA Informatics and Computing Infrastructure Tennessee Valley Healthcare System Veterans Affairs Medical Center École Normale Supérieure PSL Université Paris BIG-ARC The University of Texas Health Science Center at Houston School of Biomedical Informatics Pediatric Infectious Disease Department Hospital Universitario, 12 de Octubre Department of Infectious Diseases Great Ormond Street Hospital for Children Department of Neurology Massachusetts General Hospital Internal Medicine Department of Botucatu Medical School São Paulo State University Department of Pediatrics Boston Children’s Hospital Center for Biomedical Informatics Wake Forest School of Medicine Department of Medical Informatics University of Erlangen-Nürnberg Department of Veterans Affairs Office of Research and Development Biomedical Data Science Lab ITACA Institute Universitat Politècnica de València Nurse Department of FMB-Medicine School of Botucatu Management Engineering ASST Pavia Lombardia Region Health System Department of Anesthesiology University Hospital Erlangen FAU Erlangen-Nürnberg Critical Care Medicine Department of Medicine St. Luke’s University Health Network Department of Medicine National University Hospital Department of Information Management Chang Gung University Clinical & Translational Science Institute Medical College of Wisconsin Montréal Neurological Institute McGill University SequeL Inria Lille Respiratory Department ICS S Maugeri IRCCS Department of Health Management and Informatics University of Missouri Department of Oncology ASST Papa Giovanni XXIII Clinical Research Unit of Botucatu Medical School São Paulo State University Internal Medicine Department Botucatu Medical School São Paulo State University Internal Medicine Department of Botucatu Medical School São Paulo State University Division of Intramural Research, National Institute of Allergy and Infectious Diseases: AI11679 Division of Microbiology and Infectious Diseases, National Institute of Allergy and Infectious Diseases: AI11679 National Institute of Allergy and Infectious Diseases: AI11679 National Center for Advancing Translational Sciences: CTSA Award #UL1TR001878 National Center for Advancing Translational Sciences: CTSA Award #UL1TR002366 National Heart, Lung, and Blood Institute: K23HL148394 National Institute of Environmental Health Sciences: P30ES017885 U.S. National Library of Medicine: R01LM012095 National Institute of Neurological Disorders and Stroke: R01NS098023 Division of Cancer Prevention, National Cancer Institute: U24CA210967 National Center for Advancing Translational Sciences: UL1TR001420 National Center for Advancing Translational Sciences: UL1TR001857

Published
2021
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127. Short-course versus long-course antibiotic treatment for uncomplicated vancomycin-resistant enterococcal bacteraemia: a retrospective multicentre cohort study.

Author

Bahrs, Christina, Rieg, Siegbert, Hennigs, Annette, Hitzenbichler, Florian, Brehm, Thomas T., Rose, Norman, Jacobi, Rebecca J., Heine, Valerie, Hornuss, Daniel, Huppertz, Gunnar, Hagel, Stefan, and Hanses, Frank

Subjects
*COHORT analysis, *ANTIBIOTICS, *BACTEREMIA, *HOSPITAL patients, *TREATMENT duration, *UNIVERSITY hospitals
Abstract

The optimal treatment duration for vancomycin-resistant enterococcal (VRE) bacteraemia is still a matter of debate. The aim of the present study was to compare short-course (≤9 days) and long-course (≥10 days) antibiotic treatments in hospitalized adult patients with uncomplicated VRE bacteraemia. This retrospective study was conducted in four university hospitals in Germany. Adult patients with a positive blood culture for a VRE were screened from 1 January 2016 to 31 December 2018. Only patients who received a VRE-active antibiotic for at least 48 hours were included. The exclusion criteria were a survival of <10 days and a deep-seated source of infection requiring prolonged treatment. To compare the outcome of short-course therapy with that of long-course therapy, 30-day and 90-day overall mortality, relapse within 90 days, duration of hospitalization, and potential antibiotic-related adverse events were analysed by inverse probability of treatment weighting using the propensity score and by additional covariate adjustment. Of the 363 patients screened, 219 (60.3%) patients were included in the final analysis. Among them, 48 (21.9%) patients had underlying haematological diseases. Seventy-eight (35.6%) patients received short-course treatment (median, 7 days; interquartile range, 5–8 days) and 141 (64.4%) patients received long-course treatment (median, 15 days; interquartile range, 12–23.5 days). Thirty-day mortality was similar in both groups (19.2% vs. 22.0%; adjusted OR, 1.15; p 0.773). Duration of hospitalization (in total and after onset of bacteraemia) was significantly shorter (p < 0.05) in the short-course treatment group, whereas other secondary outcome parameters did not differ between both groups. Our study suggests that short-course treatment might not be associated with a worse outcome in patients with uncomplicated VRE bacteraemia. [ABSTRACT FROM AUTHOR]

Published
2023
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128. Akzeptanz und Umsetzung einer Intervention zur Infektionsprävention bei Patient*innen ohne Milz (Asplenie) - Ergebnisse einer qualitativen Interviewstudie

Author

Anka, Natascha, Bayrhuber, Marianne, Rieg, Siegbert, Camp, Johannes, Farin-Glattacker, Erik, and Glattacker, Manuela

Subjects
ddc: 610, Medicine and health
Abstract

Hintergrund und Stand der Forschung: Patient*innen ohne Milz(-funktion) haben ein erhöhtes Risiko für potentiell lebensbedrohlich verlaufende Infektionen wie z.B. eine Sepsis, die durch Präventionsmaßnahmen (Impfungen, Stand-by-Antibiotika und Notfallausweis) weitgehend vermeidbar [zum vollständigen Text gelangen Sie über die oben angegebene URL]

Published
2021
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129. Neurological symptoms and complications in predominantly hospitalized COVID-19 patients: Results of the European multinational Lean European Open Survey on SARS-Infected Patients (LEOSS)

Author

Kleineberg, Nina N., Knauss, Samuel, Gülke, Eileen, Pinnschmidt, Hans O., Jakob, Carolin E. M., Lingor, Paul, Hellwig, Kerstin, Berthele, Achim, Höglinger, Günter, Fink, Gereon R., Endres, Matthias, Gerloff, Christian, Klein, Christine, Stecher, Melanie, Classen, Annika Y., Rieg, Siegbert, Borgmann, Stefan, Hanses, Frank, Haselberger, Martina, Merle, Uta, Dolff, Sebastian, Degenhardt, Christian, Jensen, Björn-Erik O., Vehreschild, Maria J. G. T., Erber, Johanna, Franke, Christiana, Warnke, Clemens, Spinner, Christoph, Lanzster, Julia, Jensen, Björn, Vehreschild, Maria, Hower, Martin, Rüthrich, Maria Madeleine, Rothfuss, Katja, Piepel, Christiane, Wyen, Christopf, Römmele, Christoph, Eberwein, Lukas, Käding, Kadja, Wille, Kai, Haake, Hendrik, Voigt, Ingo, Tometten, Lukas, Neufang, Mark, Jung, Norma, Schultheis, Beate, Raichle, Claudia, von Bergwelt-Baildon, Michael, Göpel, Siri, Strauß, Richard, Rauschning, Dominic, Isberner, Nora, Walter, Lorenz, Milovanovic, Mile, D'Hooghe, Marie, Grunwald, Stephan, Akova, Murat, Markart, Philipp, Grüner, Beate, Kielstein, Jan, Guggemos, Wolfgang, Trauth, Janina, Heigener, David, Beutel, Gernot, Gramatniece, Alise, de With, Katja, Bals, Robert, Friedrichs, Anette, Röseler, Stefani, Müller-Jörger, Gabriele, Ritter, Annika, Vehreschild, Jörg Janne, Pilgram, Lisa, Schons, Max, de Miranda, Susana Nunes, Schulze, Nick, Fuhrmann, Sandra, Claßen, Annika, Franke, Bernd, Praßer, Fabian, Lablans, Martin, and LEOSS Study Group

Subjects
medicine.medical_specialty, Nausea, medicine.medical_treatment, Medizin, Disease, SARS‐CoV‐2, COVID‐19, Internal medicine, medicine, Extracorporeal membrane oxygenation, Humans, Clinical significance, ddc:610, Stroke, business.industry, SARS-CoV-2, Headache, COVID-19, Neurodegenerative Diseases, Odds ratio, Original Articles, medicine.disease, Neurology, neurological manifestations, Delirium, Original Article, Neurology (clinical), medicine.symptom, Complication, business
Abstract

Background and purpose During acute coronavirus disease 2019 (COVID‐19) infection, neurological signs, symptoms and complications occur. We aimed to assess their clinical relevance by evaluating real‐world data from a multinational registry. Methods We analyzed COVID‐19 patients from 127 centers, diagnosed between January 2020 and February 2021, and registered in the European multinational LEOSS (Lean European Open Survey on SARS‐Infected Patients) registry. The effects of prior neurological diseases and the effect of neurological symptoms on outcome were studied using multivariate logistic regression. Results A total of 6537 COVID‐19 patients (97.7% PCR‐confirmed) were analyzed, of whom 92.1% were hospitalized and 14.7% died. Commonly, excessive tiredness (28.0%), headache (18.5%), nausea/emesis (16.6%), muscular weakness (17.0%), impaired sense of smell (9.0%) and taste (12.8%), and delirium (6.7%) were reported. In patients with a complicated or critical disease course (53%) the most frequent neurological complications were ischemic stroke (1.0%) and intracerebral bleeding (ICB; 2.2%). ICB peaked in the critical disease phase (5%) and was associated with the administration of anticoagulation and extracorporeal membrane oxygenation (ECMO). Excessive tiredness (odds ratio [OR] 1.42, 95% confidence interval [CI] 1.20–1.68) and prior neurodegenerative diseases (OR 1.32, 95% CI 1.07–1.63) were associated with an increased risk of an unfavorable outcome. Prior cerebrovascular and neuroimmunological diseases were not associated with an unfavorable short‐term outcome of COVID‐19. Conclusion Our data on mostly hospitalized COVID‐19 patients show that excessive tiredness or prior neurodegenerative disease at first presentation increase the risk of an unfavorable short‐term outcome. ICB in critical COVID‐19 was associated with therapeutic interventions, such as anticoagulation and ECMO, and thus may be an indirect complication of a life‐threatening systemic viral infection., We retrospectively analyzed data from 6537 predominantly hospitalized COVID‐19 patients registered in the European multinational Lean European Open Survey on SARS‐Infected Patients (LEOSS) registry between January 2020 and February 2021. Common neurological symptoms were excessive tiredness (28.0%), headache (18.5%), nausea/emesis (16.6%), muscular weakness (17.0%), impaired sense of smell (9.0%) and taste (12.8%), and delirium (6.7%). Most frequent neurological complications were ischemic stroke (1.0%) and intracerebral bleeding (2.2%) in patients with a complicated or critical disease course. Excessive tiredness (odds ratio [OR] 1.42) and prior neurodegenerative disease (OR 1.32) were associated with an increased risk of an unfavorable outcome.

Published
2021
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130. Complement system component dysregulation is a distinctive feature of COVID-19 disease: a prospective and comparative analysis of patients admitted to the emergency department for suspected COVID-19 disease

Author

Gauchel, Nadine, primary, Rieder, Marina, additional, Krauel, Krystin, additional, Goller, Isabella, additional, Jeserich, Maren, additional, Salzer, Ulrich, additional, Venhoff, Ana Cecilia, additional, Baldus, Niklas, additional, Pollmeier, Luisa, additional, Wirth, Luisa, additional, Kern, Winfried, additional, Rieg, Siegbert, additional, Busch, Hans-Jörg, additional, Hofmann, Maike, additional, Bode, Christoph, additional, Duerschmied, Daniel, additional, Lother, Achim, additional, and Heger, Lukas A., additional

Published
2021
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131. Early and rapid identification of COVID-19 patients with neutralizing type I-interferon auto-antibodies by an easily implementable algorithm

Author

Akbil, Bengisu, primary, Meyer, Tim, additional, Stubbemann, Paula, additional, Thibeault, Charlotte, additional, Staudacher, Olga, additional, Niemeyer, Daniela, additional, Jansen, Jenny, additional, Muehlemann, Barbara, additional, Doehn, Jan-Moritz, additional, Tabeling, Christoph, additional, Nusshag, Christian, additional, Hirzel, Cedric, additional, Soekler Sanchez, David, additional, Nieters, Alexandra, additional, Lother, Achim, additional, Duerschmied, Daniel, additional, Schallner, Nils, additional, Lieberum, Jan Nikolaus, additional, August, Dietrich, additional, Rieg, Siegbert, additional, Falcone, Valeria, additional, Hengel, Hartmut, additional, Koelsch, Uwe, additional, Unterwalder, Nadine, additional, Huebner, Ralf-Harto, additional, Jones, Terry C., additional, Suttorp, Norbert, additional, Drosten, Christian, additional, Warnatz, Klaus, additional, Spinetti, Thibaud, additional, Schefold, Joerg C., additional, Doerner, Thomas, additional, Sander, Leif, additional, Corman, Victor M, additional, Merle, Uta, additional, Kurth, Florian, additional, von Bernuth, Horst, additional, Meisel, Christian, additional, and Goffinet, Christine, additional

Published
2021
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132. Neuropsychologic Profiles and Cerebral Glucose Metabolism in Neurocognitive Long COVID Syndrome

Author

Dressing, Andrea, primary, Bormann, Tobias, additional, Blazhenets, Ganna, additional, Schroeter, Nils, additional, Walter, Lea I., additional, Thurow, Johannes, additional, August, Dietrich, additional, Hilger, Hanna, additional, Stete, Katarina, additional, Gerstacker, Kathrin, additional, Arndt, Susan, additional, Rau, Alexander, additional, Urbach, Horst, additional, Rieg, Siegbert, additional, Wagner, Dirk, additional, Weiller, Cornelius, additional, Meyer, Philipp T., additional, and Hosp, Jonas A., additional

Published
2021
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133. S2k-Leitlinie* „Diagnostik und Therapie der Syphilis“ – Kurzfassung S2k guideline* “Diagnosis and therapy of syphilis” —- short version

Author

Schöfer, Helmut, Weberschock, Tobias, Bräuninger, Wolfgang, Bremer, Viviane, Dreher, Andreas, Enders, Martin, Esser, Stefan, Hamouda, Osama, Hagedorn, Hans-Jochen, Handrick, Werner, Krause, Walter, Mayr, Christoph, Münster-mann, Dieter, Nast, Alexander, Ochsendorf, Falk, Petry, Ulrich, Potthoff, Anja, Prange, Hilmar, Rieg, Siegbert, Schneede, Peter, Sing, Andreas, Weber, Jörg, Wichelhaus, Thomas A., and Brockmeyer, Norbert

Published
2015
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134. S2k guideline* “Diagnosis and therapy of syphilis”—short version

Author

Schöfer, Helmut, Weberschock, Tobias, Bräuninger, Wolfgang, Bremer, Viviane, Dreher, Andreas, Enders, Martin, Esser, Stefan, Hamouda, Osama, Hagedorn, Hans- Jochen, Handrick, Werner, Krause, Walter, Mayr, Christoph, Münstermann, Dieter, Nast, Alexander, Ochsendorf, Falk, Petry, Ulrich, Potthoff, Anja, Prange, Hilmar, Rieg, Siegbert, Schneede, Peter, Sing, Andreas, Weber, Jörg, Wichelhaus, Thomas A., and Brockmeyer, Norbert

Published
2015
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136. International Analysis of Electronic Health Records of Children and Youth Hospitalized With COVID-19 Infection in 6 Countries

Author

Bourgeois, Florence, Gutiérrez-Sacristán, Alba, Keller, Mark, Liu, Molei, Hong, Chuan, Bonzel, Clara-Lea, Tan, Amelia, Aronow, Bruce, Boeker, Martin, Booth, John, Cruz Rojo, Jaime, Devkota, Batsal, García Barrio, Noelia, Gehlenborg, Nils, Geva, Alon, Hanauer, David, Hutch, Meghan, Issitt, Richard, Klann, Jeffrey, Luo, Yuan, Mandl, Kenneth, Mao, Chengsheng, Moal, Bertrand, Moshal, Karyn, Murphy, Shawn, Neuraz, Antoine, Ngiam, Kee Yuan, Omenn, Gilbert, Patel, Lav, Jiménez, Miguel Pedrera, Sebire, Neil, Balazote, Pablo Serrano, Serret-Larmande, Arnaud, South, Andrew, Spiridou, Anastasia, Taylor, Deanne, Tippmann, Patric, Visweswaran, Shyam, Weber, Griffin, Kohane, Isaac, Cai, Tianxi, Avillach, Paul, Cruz-Rojo, Jaime, García-Barrio, Noelia, Pedrera-Jiménez, Miguel, Serrano-Balazote, Pablo, Aaron, James, Agapito, Giuseppe, Albayrak, Adem, Alessiani, Mario, Amendola, Danilo, Angoulvant, François, Anthony, Li Llj, Atz, Andrew, Balshi, James, Beaulieu-Jones, Brett, Bell, Douglas, Bellasi, Antonio, Bellazzi, Riccardo, Benoit, Vincent, Beraghi, Michele, Bernal Sobrino, José Luis, Bernaux, Mélodie, Bey, Romain, Blanco Martínez, Alvar, Bosari, Silvano, Bradford, Robert, Brat, Gabriel, Bréant, Stéphane, Brown, Nicholas, Bryant, William, Bucalo, Mauro, Burgun, Anita, Cannataro, Mario, Carmona, Aldo, Caucheteux, Charlotte, Champ, Julien, Chen, Krista, Chen, Jin, Chiovato, Luca, Chiudinelli, Lorenzo, Cimino, James, Colicchio, Tiago, Cormont, Sylvie, Cossin, Sébastien, Craig, Jean, Cruz Bermúdez, Juan Luis, Dagliati, Arianna, Daniar, Mohamad, Daniel, Christel, Davoudi, Anahita, Dubiel, Julien, Duvall, Scott, Esteve, Loic, Fan, Shirley, Follett, Robert, Gaiolla, Paula Sa, Ganslandt, Thomas, Garmire, Lana, Gradinger, Tobias, Gramfort, Alexandre, Griffier, Romain, Griffon, Nicolas, Grisel, Olivier, Haverkamp, Christian, He, Bing, Henderson, Darren, Hilka, Martin, Holmes, John, Horki, Petar, Huling, Kenneth, Jannot, Anne Sophie, Jouhet, Vianney, Kavuluru, Ramakanth, Kirchoff, Katie, Krantz, Ian, Kraska, Detlef, Krishnamurthy, Ashok, L'Yi, Sehi, Le, Trang, Leblanc, Judith, Leite, Andressa Rr, Lemaitre, Guillaume, Lenert, Leslie, Leprovost, Damien, Loh, Ne Hooi Will, Lynch, Kristine, Mahmood, Sadiqa, Maidlow, Sarah, Malovini, Alberto, Maram, Anupama, Martel, Patricia, Masino, Aaron, Matheny, Michael, Maulhardt, Thomas, Mazzitelli, Maria, Mcduffie, Michael, Mensch, Arthur, Milano, Marianna, Minicucci, Marcos, Moore, Jason, Moraleda, Cinta, Morris, Jeffrey, Morris, Michele, Mousavi, Sajad, Mowery, Danielle, Murad, Douglas, Naughton, Thomas, Norman, James, Obeid, Jihad, Okoshi, Marina, Olson, Karen, Orlova, Nina, Ostasiewski, Brian, Palmer, Nathan, Paris, Nicolas, Pfaff, Emily, Pillion, Danielle, Prokosch, Hans, Prudente, Robson, Quirós González, Víctor, Ramoni, Rachel, Raskin, Maryna, Rieg, Siegbert, Roig Domínguez, Gustavo, Rojo, Pablo, Sáez, Carlos, Salamanca, Elisa, Samayamuthu, Malarkodi, Sandrin, Arnaud, Santos, Janaina Cc, Savino, Maria, Schriver, Emily, Schuettler, Juergen, Scudeller, Luigia, Serre, Patricia, Silvio, Domenick, Sliz, Piotr, Son, Jiyeon, Sonday, Charles, Tan, Bryce Wq, Tan, Byorn Wl, Tanni, Suzana, Terriza Torres, Ana, Tibollo, Valentina, Torti, Carlo, Trecarichi, Enrico, Tseng, Yi-Ju, Vallejos, Andrew, Varoquaux, Gael, Vie, Jill-Jênn, Vitacca, Michele, Wagholikar, Kavishwar, Waitman, Lemuel, Wassermann, Demian, William, Yuan, Xia, Zongqi, Yehya, Nadir, Zambelli, Alberto, Zhang, Harrison, Zucco, Chiara, Service d'informatique médicale et biostatistiques [CHU Necker], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Health data- and model- driven Knowledge Acquisition (HeKA), Inria de Paris, Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-Centre de Recherche des Cordeliers (CRC (UMR_S_1138 / U1138)), École Pratique des Hautes Études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPCité)-École Pratique des Hautes Études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPCité), UFR Médecine [Santé] - Université Paris Cité (UFR Médecine UPCité), Université Paris Cité (UPCité), Dr Bourgeois was funded by a grant from the Burroughs Wellcome Fund and supported by the Harvard-MIT Center for Regulatory Science. Mr Keller was funded by grant 5T32HG002295-18 from the National Human Genome Research Institute (NHGRI). Dr Aronow was funded by grant U24 HL148865 from the National Heart, Lung, and Blood Institute (NHLBI). Ms García Barrio was supported by grant PI18/00981 from the Carlos III Health Institute. Dr Gehlenborg was funded by grant T15 LM007092 from the NIH National Library of Medicine. Dr Geva was funded by grant K12 HD047349 from the NIH and Eunice Kennedy Shriver National Institute of Child Health and Human Development. Dr Hanauer was funded by grant UL1TR002240 from the National Center for Advancing Translational Sciences (NCATS). Drs Klann and Murphy were funded by grant 5UL1TR001857-05 from the NCATS and grant 5R01HG009174-04 from the NHGRI. Dr Luo was funded by grant R01LM013337 from the NLM. Mr Patel was funded by grant UL1TR002366 from the NCATS. Dr Gutiérrez-Sacristán was funded by grants K23HL148394 and L40HL148910 from the NIH NHLBI and grant UL1TR001420 from the NIH NCATS. Dr Visweswaran was funded by grant R01LM012095 from the NLM and grant UL1TR001857 from the NCATS. Dr Weber was supported by grants UL1TR002541 and UL1TR000005 from the NIH-NCATS, and grant R01LM013345 from the NLM., CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université de Paris (UP)-École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université de Paris (UP), Université de Paris - UFR Médecine Paris Centre [Santé] (UP Médecine Paris Centre), Université de Paris (UP), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPC)-École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPC), Université Paris Cité - UFR Médecine Paris Centre [Santé] (UPC Médecine Paris Centre), and Université Paris Cité (UPC)

Subjects
medicine.medical_specialty, MESH: Pandemics, education, Health Informatics, MESH: Global Health, MESH: Hospitalization, Procalcitonin, 03 medical and health sciences, 0302 clinical medicine, 030225 pediatrics, Internal medicine, MESH: Child, Epidemiology, medicine, Infection control, MESH: COVID-19, MESH: SARS-CoV-2, 030212 general & internal medicine, health care economics and organizations, MESH: Electronic Health Records, Original Investigation, MESH: Adolescent, Disease surveillance, MESH: Humans, business.industry, Research, MESH: Infant, Newborn, MESH: Child, Preschool, Retrospective cohort study, MESH: Retrospective Studies, General Medicine, medicine.disease, MESH: Infant, MESH: Male, 3. Good health, Online Only, Respiratory failure, Viral pneumonia, Cohort, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, MESH: Female
Abstract

This cohort study aims to describe international hospitalization trends and key epidemiological and clinical features of children and youth with COVID-19., Key Points Question What are international trends in hospitalizations for children and youth with SARS-CoV-2, and what are the epidemiological and clinical features of these patients? Findings This cohort study of 671 children and youth found discrete surges in hospitalizations with variable trends and timing across countries. Common complications included cardiac arrhythmias and viral pneumonia, and laboratory findings included elevations in markers of inflammation and abnormalities of coagulation; few children and youth were treated with medications directed specifically at SARS-CoV-2. Meaning These findings suggest large-scale informatics-based approaches used to incorporate electronic health record data across health care systems can provide an efficient source of information to monitor disease activity and define epidemiological and clinical features of pediatric patients hospitalized with SARS-CoV-2 infections., Importance Additional sources of pediatric epidemiological and clinical data are needed to efficiently study COVID-19 in children and youth and inform infection prevention and clinical treatment of pediatric patients. Objective To describe international hospitalization trends and key epidemiological and clinical features of children and youth with COVID-19. Design, Setting, and Participants This retrospective cohort study included pediatric patients hospitalized between February 2 and October 10, 2020. Patient-level electronic health record (EHR) data were collected across 27 hospitals in France, Germany, Spain, Singapore, the UK, and the US. Patients younger than 21 years who tested positive for COVID-19 and were hospitalized at an institution participating in the Consortium for Clinical Characterization of COVID-19 by EHR were included in the study. Main Outcomes and Measures Patient characteristics, clinical features, and medication use. Results There were 347 males (52%; 95% CI, 48.5-55.3) and 324 females (48%; 95% CI, 44.4-51.3) in this study’s cohort. There was a bimodal age distribution, with the greatest proportion of patients in the 0- to 2-year (199 patients [30%]) and 12- to 17-year (170 patients [25%]) age range. Trends in hospitalizations for 671 children and youth found discrete surges with variable timing across 6 countries. Data from this cohort mirrored national-level pediatric hospitalization trends for most countries with available data, with peaks in hospitalizations during the initial spring surge occurring within 23 days in the national-level and 4CE data. A total of 27 364 laboratory values for 16 laboratory tests were analyzed, with mean values indicating elevations in markers of inflammation (C-reactive protein, 83 mg/L; 95% CI, 53-112 mg/L; ferritin, 417 ng/mL; 95% CI, 228-607 ng/mL; and procalcitonin, 1.45 ng/mL; 95% CI, 0.13-2.77 ng/mL). Abnormalities in coagulation were also evident (D-dimer, 0.78 ug/mL; 95% CI, 0.35-1.21 ug/mL; and fibrinogen, 477 mg/dL; 95% CI, 385-569 mg/dL). Cardiac troponin, when checked (n = 59), was elevated (0.032 ng/mL; 95% CI, 0.000-0.080 ng/mL). Common complications included cardiac arrhythmias (15.0%; 95% CI, 8.1%-21.7%), viral pneumonia (13.3%; 95% CI, 6.5%-20.1%), and respiratory failure (10.5%; 95% CI, 5.8%-15.3%). Few children were treated with COVID-19–directed medications. Conclusions and Relevance This study of EHRs of children and youth hospitalized for COVID-19 in 6 countries demonstrated variability in hospitalization trends across countries and identified common complications and laboratory abnormalities in children and youth with COVID-19 infection. Large-scale informatics-based approaches to integrate and analyze data across health care systems complement methods of disease surveillance and advance understanding of epidemiological and clinical features associated with COVID-19 in children and youth.

Published
2021
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137. Pre-medication with oral anticoagulants is associated with better outcomes in a large multinational COVID-19 cohort with cardiovascular comorbidities

Author

Rieder, Marina, primary, Gauchel, Nadine, additional, Kaier, Klaus, additional, Jakob, Carolin, additional, Borgmann, Stefan, additional, Classen, Annika Y., additional, Schneider, Jochen, additional, Eberwein, Lukas, additional, Lablans, Martin, additional, Rüthrich, Maria, additional, Dolff, Sebastian, additional, Wille, Kai, additional, Haselberger, Martina, additional, Heuzeroth, Hanno, additional, Bode, Christoph, additional, von zur Mühlen, Constantin, additional, Rieg, Siegbert, additional, and Duerschmied, Daniel, additional

Published
2021
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138. Specific Risk Factors for Fatal Outcome in Critically Ill COVID-19 Patients: Results from a European Multicenter Study

Author

Meintrup, David, primary, Borgmann, Stefan, additional, Seidl, Karlheinz, additional, Stecher, Melanie, additional, Jakob, Carolin E. M., additional, Pilgram, Lisa, additional, Spinner, Christoph D., additional, Rieg, Siegbert, additional, Isberner, Nora, additional, Hower, Martin, additional, Vehreschild, Maria, additional, Göpel, Siri, additional, Hanses, Frank, additional, and Nowak-Machen, Martina, additional

Published
2021
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139. Persistierende Beschwerden 6 Monate nach COVID-19 – Erfahrungen aus der COVID-19-Nachsorgeambulanz des Universitätsklinikums Freiburg

Author

August, Dietrich, primary, Stete, Katarina, primary, Kern, Winfried, primary, Rieg, Siegbert, primary, Hilger, Hanna, additional, Götz, Veronika, additional, Biever, Paul, additional, Hosp, Jonas, additional, Wagner, Dirk, additional, Köhler, Thomas Christian, additional, Gerstacker, Kathrin, additional, Seufert, Jochen, additional, and Laubner, Katharina, additional

Published
2021
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141. Additional file 2 of Reducing burden from respiratory infections in refugees and immigrants: a systematic review of interventions in OECD, EU, EEA and EU-applicant countries

Author

Lambert, Jan-Frederic, Stete, Katarina, Balmford, James, Bockey, Annabelle, Kern, Winfried, Rieg, Siegbert, Boeker, Martin, and Lange, Berit

Subjects
InformationSystems_INFORMATIONSYSTEMSAPPLICATIONS, ComputingMilieux_PERSONALCOMPUTING, Data_FILES
Abstract

Additional file 2. Data extraction spreadsheet.

Published
2021
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142. Clinical course and predictive risk factors for fatal outcome of SARS-CoV-2 infection in patients with chronic kidney disease

Author

Wille, Kai, Koehler, Felix C., Stecher, Melanie, Rieg, Siegbert, Kielstein, Jan T., Jakob, Carolin E. M., Rüthrich, Maria, Burst, Volker, Borgmann, Stefan, Müller, Roman-Ulrich, Lanznaster, Julia, Dolff, Sebastian, Tometten, Lukas, Wettstein, Matthias, Isberner, Nora, Spinner, Christoph, Raichle, Claudia, Neufang, Mark, Hanses, Frank, Hohenstein, Bernd, Stieglitz, Sven, Jung, Norma, Bals, Robert, Schubert, Joerg, Worm, Maximilian, Degenhardt, Christian, Brandenburger, Timo, Fuerst, Julia, Vehreschild, Maria, Keller, Ulrich, Hower, Martin, von Bergwelt-Baildon, Michael, Rueddel, Jessica, de With, Katja, Gruener, Beate, Eberwein, Lukas, Schultheis, Beate, Heigener, David, Guggemos, Wolfgang, Peetz, Helga, Walter, Lorenz, Prattes, Juergen, Rothfuss, Katja, Hellwig, Kerstin, Nattermann, Jacob, Merle, Uta, Droehmann, Daniel, Rauschning, Dominic, Mueller-Joerger, Gabriele, Weidemann, Alexander, Piepel, Christiane, Ritter, Annika, Beutel, Gernot, Trauth, Janina, Friedrichs, Anette, Bethge, Wolfgang, Vehreschild, Joerg Janne, Pilgram, Lisa, Schons, Maximilian, Classen, Annika, Fuhrmann, Sandra, Franke, Bernd, Schulze, Nick, Prasser, Fabian, and Lablans, Martin

Subjects
Microbiology (medical), Adult, medicine.medical_specialty, Adolescent, Anemia, medicine.medical_treatment, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Medizin, Disease, Comorbidity, 030204 cardiovascular system & hematology, Logistic regression, LEOSS, Cohort Studies, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Risk Factors, Internal medicine, Chronic kidney disease, Medicine, Humans, 030212 general & internal medicine, Renal replacement therapy, Renal Insufficiency, Chronic, Aged, 80 and over, Original Paper, business.industry, SARS-CoV-2, COVID-19, General Medicine, Odds ratio, Middle Aged, medicine.disease, Infectious Diseases, Logistic Models, Cohort, business, Predictive factor, Kidney disease
Abstract

Purpose The ongoing pandemic caused by the novel severe acute respiratory coronavirus 2 (SARS-CoV-2) has stressed health systems worldwide. Patients with chronic kidney disease (CKD) seem to be more prone to a severe course of coronavirus disease (COVID-19) due to comorbidities and an altered immune system. The study’s aim was to identify factors predicting mortality among SARS-CoV-2-infected patients with CKD. Methods We analyzed 2817 SARS-CoV-2-infected patients enrolled in the Lean European Open Survey on SARS-CoV-2-infected patients and identified 426 patients with pre-existing CKD. Group comparisons were performed via Chi-squared test. Using univariate and multivariable logistic regression, predictive factors for mortality were identified. Results Comparative analyses to patients without CKD revealed a higher mortality (140/426, 32.9% versus 354/2391, 14.8%). Higher age could be confirmed as a demographic predictor for mortality in CKD patients (> 85 years compared to 15–65 years, adjusted odds ratio (aOR) 6.49, 95% CI 1.27–33.20, p = 0.025). We further identified markedly elevated lactate dehydrogenase (> 2 × upper limit of normal, aOR 23.21, 95% CI 3.66–147.11, p p = 0.002), anemia (Hb p = 0.024), and C-reactive protein (≥ 30 mg/l, aOR 3.44, 95% CI 1.13–10.45, p = 0.029) as predictors, while renal replacement therapy was not related to mortality (aOR 1.15, 95% CI 0.68–1.93, p = 0.611). Conclusion The identified predictors include routinely measured and universally available parameters. Their assessment might facilitate risk stratification in this highly vulnerable cohort as early as at initial medical evaluation for SARS-CoV-2.

Published
2021

145. Impact of Immunosuppressive Agents on Clinical Manifestations and Outcome of Staphylococcus aureus Bloodstream Infection: A Propensity Score-Matched Analysis in 2 Large, Prospectively Evaluated Cohorts

Author

Camp, Johannes, Glaubitz, Lina, Filla, Tim, Kaasch, Achim J., Fuchs, Frieder, Scarborough, Matt, Kim, Hong Bin, Tilley, Robert, Liao, Chun-Hsing, Edgeworth, Jonathan, Nsutebu, Emmanuel, Lopez-Cortes, Luis Eduardo, Morata, Laura, Llewelyn, Martin, Fowler, Vance G., Thwaites, Guy, Seifert, Harald, Kern, Winfried, V, Kuss, Oliver, Rieg, Siegbert, Camp, Johannes, Glaubitz, Lina, Filla, Tim, Kaasch, Achim J., Fuchs, Frieder, Scarborough, Matt, Kim, Hong Bin, Tilley, Robert, Liao, Chun-Hsing, Edgeworth, Jonathan, Nsutebu, Emmanuel, Lopez-Cortes, Luis Eduardo, Morata, Laura, Llewelyn, Martin, Fowler, Vance G., Thwaites, Guy, Seifert, Harald, Kern, Winfried, V, Kuss, Oliver, and Rieg, Siegbert

Abstract

Background. Staphylococcus aureus bloodstream infection (SAB) is a common, life-threatening infection. The impact of immunosuppressive agents on the outcome of patients with SAB is incompletely understood. Methods. Data from 2 large prospective, international, multicenter cohort studies (Invasive Staphylococcus aureus Infections Cohort [INSTINCT] and International Staphylococcus aureus Collaboration [ISAC]) between 2006 and 2015 were analyzed. Patients receiving immunosuppressive agents were identified and a 1:1 propensity score-matched analysis was performed to adjust for baseline characteristics of patients. Overall survival and time to SAB-related late complications (SAB relapse, infective endocarditis, osteomyelitis, or other deep-seated manifestations) were analyzed by Cox regression and competing risk analyses, respectively. This approach was then repeated for specific immunosuppressive agents (corticosteroid monotherapy and immunosuppressive agents other than steroids [IMOTS]). Results. Of 3188 analyzed patients, 309 were receiving immunosuppressive treatment according to our definitions and were matched to 309 nonimmunosuppressed patients. After propensity score matching, baseline characteristics were well balanced. In the Cox regression analysis, we observed no significant difference in survival between the 2 groups (death during follow-up: 105/309 [33.9%] immunosuppressed vs 94/309 [30.4%] nonimmunosuppressed; hazard ratio [HR], 1.20 [95% confidence interval {CI}, .84-1.71]). Competing risk analysis showed a cause-specific HR of 1.81 (95% CI,.85-3.87) for SAB-related late complications in patients receiving immunosuppressive agents. The cause-specific HR was higher in patients taking IMOTS (3.69 [95% CI, 1.41-9.68]). Conclusions. Immunosuppressive agents were not associated with an overall higher mortality. The risk for SAB-related late complications in patients receiving specific immunosuppressive agents such as IMOTS warrants further investigations.

Published
2021

146. Outcomes of SARS-CoV-2 Infections in Patients With Neurodegenerative Diseases in the LEOSS Cohort

Author

Huber, Meret K., Raichle, Claudia, Lingor, Paul, Synofzik, Matthis, Borgmann, Stefan, Erber, Johanna, Tometten, Lukas, Rimili, Wolfgang, Dolff, Sebastian, Wille, Kai, Knauss, Samuel, Piepel, Christiane, Lanznaster, Julia, Rieg, Siegbert, Prasser, Fabian, Pilgram, Lisa, Spottke, Annika, Klockgether, Thomas, Klein, Christine, Hopfner, Franziska, Hoeglinger, Guenter U., Huber, Meret K., Raichle, Claudia, Lingor, Paul, Synofzik, Matthis, Borgmann, Stefan, Erber, Johanna, Tometten, Lukas, Rimili, Wolfgang, Dolff, Sebastian, Wille, Kai, Knauss, Samuel, Piepel, Christiane, Lanznaster, Julia, Rieg, Siegbert, Prasser, Fabian, Pilgram, Lisa, Spottke, Annika, Klockgether, Thomas, Klein, Christine, Hopfner, Franziska, and Hoeglinger, Guenter U.

Published
2021

147. Angiotensin II receptor blocker intake associates with reduced markers of inflammatory activation and decreased mortality in patients with cardiovascular comorbidities and COVID-19 disease

Author

Cremer, Sebastian, Pilgram, Lisa, Berkowitsch, Alexander, Stecher, Melanie, Rieg, Siegbert, Shumliakivska, Mariana, Bojkova, Denisa, Wagner, Julian Uwe Gabriel, Aslan, Galip Servet, Spinner, Christoph, Luxan, Guillermo, Hanses, Frank, Dolff, Sebastian, Piepel, Christiane, Ruppert, Clemens, Guenther, Andreas, Ruthrich, Maria Madeleine, Vehreschild, Jorg Janne, Wille, Kai, Haselberger, Martina, Heuzeroth, Hanno, Hansen, Arne, Eschenhagen, Thomas, Cinatl, Jindrich, Ciesek, Sandra, Dimmeler, Stefanie, Borgmann, Stefan, Zeiher, Andreas, Cremer, Sebastian, Pilgram, Lisa, Berkowitsch, Alexander, Stecher, Melanie, Rieg, Siegbert, Shumliakivska, Mariana, Bojkova, Denisa, Wagner, Julian Uwe Gabriel, Aslan, Galip Servet, Spinner, Christoph, Luxan, Guillermo, Hanses, Frank, Dolff, Sebastian, Piepel, Christiane, Ruppert, Clemens, Guenther, Andreas, Ruthrich, Maria Madeleine, Vehreschild, Jorg Janne, Wille, Kai, Haselberger, Martina, Heuzeroth, Hanno, Hansen, Arne, Eschenhagen, Thomas, Cinatl, Jindrich, Ciesek, Sandra, Dimmeler, Stefanie, Borgmann, Stefan, and Zeiher, Andreas

Abstract

Aims Patients with cardiovascular comorbidities have a significantly increased risk for a critical course of COVID-19. As the SARS-CoV2 virus enters cells via the angiotensin-converting enzyme receptor II (ACE2), drugs which interact with the renin angiotensin aldosterone system (RAAS) were suspected to influence disease severity. Methods and results We analyzed 1946 consecutive patients with cardiovascular comorbidities or hypertension enrolled in one of the largest European COVID-19 registries, the Lean European Open Survey on SARS-CoV-2 (LEOSS) registry. Here, we show that angiotensin II receptor blocker intake is associated with decreased mortality in patients with COVID-19 [OR 0.75 (95% CI 0,59-0.96; p = 0.013)]. This effect was mainly driven by patients, who presented in an early phase of COVID-19 at baseline [OR 0,64 (95% CI 0,43-0,96; p = 0.029)]. Kaplan-Meier analysis revealed a significantly lower incidence of death in patients on an angiotensin receptor blocker (ARB) (n = 33/318;10,4%) compared to patients using an angiotensin-converting enzyme inhibitor (ACEi) (n = 60/348;17,2%) or patients who received neither an ACE-inhibitor nor an ARB at baseline in the uncomplicated phase (n = 90/466; 19,3%; p<0.034). Patients taking an ARB were significantly less frequently reaching the mortality predicting threshold for leukocytes (p<0.001), neutrophils (p = 0.002) and the inflammatory markers CRP (p = 0.021), procalcitonin (p = 0.001) and IL-6 (p = 0.049). ACE2 expression levels in human lung samples were not altered in patients taking RAAS modulators. Conclusion These data suggest a beneficial effect of ARBs on disease severity in patients with cardiovascular comorbidities and COVID-19, which is linked to dampened systemic inflammatory activity.

Published
2021

148. Specific Risk Factors for Fatal Outcome in Critically Ill COVID-19 Patients: Results from a European Multicenter Study

Author

Meintrup, David, Borgmann, Stefan, Seidl, Karlheinz, Stecher, Melanie, Jakob, Carolin E. M., Pilgram, Lisa, Spinner, Christoph D., Rieg, Siegbert, Isberner, Nora, Hower, Martin, Vehreschild, Maria, Goepel, Siri, Hanses, Frank, Nowak-Machen, Martina, Meintrup, David, Borgmann, Stefan, Seidl, Karlheinz, Stecher, Melanie, Jakob, Carolin E. M., Pilgram, Lisa, Spinner, Christoph D., Rieg, Siegbert, Isberner, Nora, Hower, Martin, Vehreschild, Maria, Goepel, Siri, Hanses, Frank, and Nowak-Machen, Martina

Abstract

(1) Background: The aim of our study was to identify specific risk factors for fatal outcome in critically ill COVID-19 patients. (2) Methods: Our data set consisted of 840 patients enclosed in the LEOSS registry. Using lasso regression for variable selection, a multifactorial logistic regression model was fitted to the response variable survival. Specific risk factors and their odds ratios were derived. A nomogram was developed as a graphical representation of the model. (3) Results: 14 variables were identified as independent factors contributing to the risk of death for critically ill COVID-19 patients: age (OR 1.08, CI 1.06-1.10), cardiovascular disease (OR 1.64, CI 1.06-2.55), pulmonary disease (OR 1.87, CI 1.16-3.03), baseline Statin treatment (0.54, CI 0.33-0.87), oxygen saturation (unit = 1%, OR 0.94, CI 0.92-0.96), leukocytes (unit 1000/mu L, OR 1.04, CI 1.01-1.07), lymphocytes (unit 100/mu L, OR 0.96, CI 0.94-0.99), platelets (unit 100,000/mu L, OR 0.70, CI 0.62-0.80), procalcitonin (unit ng/mL, OR 1.11, CI 1.05-1.18), kidney failure (OR 1.68, CI 1.05-2.70), congestive heart failure (OR 2.62, CI 1.11-6.21), severe liver failure (OR 4.93, CI 1.94-12.52), and a quick SOFA score of 3 (OR 1.78, CI 1.14-2.78). The nomogram graphically displays the importance of these 14 factors for mortality. (4) Conclusions: There are risk factors that are specific to the subpopulation of critically ill COVID-19 patients.

Published
2021

149. Clinical course and predictive risk factors for fatal outcome of SARS-CoV-2 infection in patients with chronic kidney disease

Author

Pilgram, Lisa, Eberwein, Lukas, Wille, Kai, Koehler, Felix C., Stecher, Melanie, Rieg, Siegbert, Kielstein, Jan T., Jakob, Carolin E. M., Ruthrich, Maria, Burst, Volker, Prasser, Fabian, Borgmann, Stefan, Mueller, Roman-Ulrich, Lanznaster, Julia, Isberner, Nora, Tometten, Lukas, Dolff, Sebastian, Pilgram, Lisa, Eberwein, Lukas, Wille, Kai, Koehler, Felix C., Stecher, Melanie, Rieg, Siegbert, Kielstein, Jan T., Jakob, Carolin E. M., Ruthrich, Maria, Burst, Volker, Prasser, Fabian, Borgmann, Stefan, Mueller, Roman-Ulrich, Lanznaster, Julia, Isberner, Nora, Tometten, Lukas, and Dolff, Sebastian

Abstract

Purpose The ongoing pandemic caused by the novel severe acute respiratory coronavirus 2 (SARS-CoV-2) has stressed health systems worldwide. Patients with chronic kidney disease (CKD) seem to be more prone to a severe course of coronavirus disease (COVID-19) due to comorbidities and an altered immune system. The study's aim was to identify factors predicting mortality among SARS-CoV-2-infected patients with CKD. Methods We analyzed 2817 SARS-CoV-2-infected patients enrolled in the Lean European Open Survey on SARS-CoV-2-infected patients and identified 426 patients with pre-existing CKD. Group comparisons were performed via Chi-squared test. Using univariate and multivariable logistic regression, predictive factors for mortality were identified. Results Comparative analyses to patients without CKD revealed a higher mortality (140/426, 32.9% versus 354/2391, 14.8%). Higher age could be confirmed as a demographic predictor for mortality in CKD patients (> 85 years compared to 15-65 years, adjusted odds ratio (aOR) 6.49, 95% CI 1.27-33.20, p = 0.025). We further identified markedly elevated lactate dehydrogenase (> 2 x upper limit of normal, aOR 23.21, 95% CI 3.66-147.11, p < 0.001), thrombocytopenia (< 120,000/mu l, aOR 11.66, 95% CI 2.49-54.70, p = 0.002), anemia (Hb < 10 g/dl, aOR 3.21, 95% CI 1.17-8.82, p = 0.024), and C-reactive protein (>= 30 mg/l, aOR 3.44, 95% CI 1.13-10.45, p = 0.029) as predictors, while renal replacement therapy was not related to mortality (aOR 1.15, 95% CI 0.68-1.93, p = 0.611). Conclusion The identified predictors include routinely measured and universally available parameters. Their assessment might facilitate risk stratification in this highly vulnerable cohort as early as at initial medical evaluation for SARS-CoV-2.

Published
2021

150. Development and validation of a simplified risk score for the prediction of critical COVID-19 illness in newly diagnosed patients

Author

Werfel, Stanislas, Jakob, Carolin E. M., Borgmann, Stefan, Schneider, Jochen, Spinner, Christoph, Schons, Maximilian, Hower, Martin, Wille, Kai, Haselberger, Martina, Heuzeroth, Hanno, Ruthrich, Maria M., Dolff, Sebastian, Kessel, Johanna, Heemann, Uwe, Vehreschild, Joerg J., Rieg, Siegbert, Schmaderer, Christoph, Werfel, Stanislas, Jakob, Carolin E. M., Borgmann, Stefan, Schneider, Jochen, Spinner, Christoph, Schons, Maximilian, Hower, Martin, Wille, Kai, Haselberger, Martina, Heuzeroth, Hanno, Ruthrich, Maria M., Dolff, Sebastian, Kessel, Johanna, Heemann, Uwe, Vehreschild, Joerg J., Rieg, Siegbert, and Schmaderer, Christoph

Abstract

Scores to identify patients at high risk of progression of coronavirus disease (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), may become instrumental for clinical decision-making and patient management. We used patient data from the multicentre Lean European Open Survey on SARS-CoV-2-Infected Patients (LEOSS) and applied variable selection to develop a simplified scoring system to identify patients at increased risk of critical illness or death. A total of 1946 patients who tested positive for SARS-CoV-2 were included in the initial analysis and assigned to derivation and validation cohorts (n = 1297 and n = 649, respectively). Stability selection from over 100 baseline predictors for the combined endpoint of progression to the critical phase or COVID-19-related death enabled the development of a simplified score consisting of five predictors: C-reactive protein (CRP), age, clinical disease phase (uncomplicated vs. complicated), serum urea, and D-dimer (abbreviated as CAPS-D score). This score yielded an area under the curve (AUC) of 0.81 (95% confidence interval [CI]: 0.77-0.85) in the validation cohort for predicting the combined endpoint within 7 days of diagnosis and 0.81 (95% CI: 0.77-0.85) during full follow-up. We used an additional prospective cohort of 682 patients, diagnosed largely after the first wave of the pandemic to validate the predictive accuracy of the score and observed similar results (AUC for the event within 7 days: 0.83 [95% CI: 0.78-0.87]; for full follow-up: 0.82 [95% CI: 0.78-0.86]). An easily applicable score to calculate the risk of COVID-19 progression to critical illness or death was thus established and validated.

Published
2021

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