COVID-19

Publications and Guidelines

12.01.2021

Pulmonary function and radiological features four months after COVID-19: first results from the national prospective observational Swiss COVID-19 lung study

In this Swiss multi-center study 47 patients after mild/moderate and 66 patients after severe/critical SARS-CoV-2 infection were followed up 4 months after recovery. In the patient group with a severe/critical course there were significantly more patients with a higher BMI, higher age, hypertension, diabetes and renal failure. A severe/critical condition during COVID-19 was associated with decreased pulmonary function as assessed by predicted % diffusion of carbon monoxide (DLCO), reduced distance during a 6 minutes walking test and exercise induced blood oxygen desaturation at 4 months follow up. Mosaic hypoattenuation in chest CT was significantly associated with severe/critical disease progression of COVID-19. Importantly, predicted % DLCO was the strongest and most important correlate for a severe/critical condition during COVID-19 infection, which may explain the reduced walking distance and desaturation during exercise. According to the authors this is the first European prospective longitudinal cohort study to understand the sequelae and different functional trajectories of COVID-19 patients.

Comment Knowledge-Management Taskforce Covid-19

113 COVID-19-Überlebende wurden in der Studie eingeschlossen (leicht/mittelschwer 47, schwer /kritisch 66). Es wurden mehrere Komorbiditäten als Risikofaktoren für einen schweren/kritischen Krankheitsverlauf identifiziert.

#general #publication #infectious diseases #pneumology
07.01.2021

Immunological memory to SARS-CoV-2 assessed for up to 8 months after infection

Analysis of persisting anti-SARS CoV2 humoral, B- and T-cell immunity in 188 patients with mild to moderate COVID-Infection

Comment Knowledge-Mangement Taskforce Covid-19

Humorale, B- und T-Zellimmunität bleibt in der Mehrzahl der Patienten erhalten >6 Monate nach einer COVID-19 Erkrankung.

#general #infectious diseases #immunoresponses
02.01.2021

Efficacy and Safety of the mRNA-1273 SARS-CoV-2 Vaccine

Phase III results for the second COVID-19 mRNA vaccine (Moderna, mRNA-1273) demonstrate a similar performance compared with the Pfizer/Biontech BNT162b2 vaccine. Overall vaccine efficacy over 2 months after dose 2 was 94.1% with no differences according to gender, ethnicity and presence of risk factors. Efficacy > 65 years was somewhat lower (86%). Reactogenicity as to be expected, no severe adverse events reported.

Comment Knowledge-Management Taskforce Covid-19

Die Daten erhärten die hohe Kurzzeit-Immunogenität und Schutzwirkung von COVID-19 mRNA Impfstoffen mit 2 priming Dosen innert 3-4 Wochen bei guter Tolerabilität. Preliminäre Daten suggerieren zusätzlich Potential für Schutz vor asymptomatischer Infektion nach Dosis 1.

#vaccine #prevention #infectious diseases #immunoresponses
18.12.2020

Mortality, Stroke, and Hospitalization Associated With Deferred vs Expedited Aortic Valve Replacement in Patients Referred for Symptomatic Severe Aortic Stenosis During the COVID-19 Pandemic

Postponing the treatment of patients with symptomatic aortic stenosis increases the risk of worse patient outcome.

Comment Knowledge-Management Taskforce Covid-19

Diese Arbeit aus dem Inselspital, Universitätsspital Bern zeigt am Beispiel von Patienten mit Aortenklappenverengung auf, welche Gefahren das Verschieben von nicht-akut lebensbedrohlichen Eingriffen aufgrund der COVID-19 Pandemie mit sich bringen kann.

#imaging #radiology
17.12.2020

A Deep-Learning Diagnostic Support System for the Detection of COVID-19 Using Chest Radiographs A Multireader Validation Study

In this comparison between man and machine, an Artificial Intelligence (AI) algorithm outplayed human radiologists in classifying chest radiographs into “normal”, “COVID-19 pneumonia”, and “other pneumonia”.

Comment Knowledge-Management Taskforce Covid-19

Forschende des Inselspitals und der Universität Bern haben ein auf Künstlicher Intelligenz basierendes System entwickelt, welches  auf Lungenröntgenbildern besser zwischen «Normalbefund», «COVID-19 Pneumonie», und «Andere Pneumonie» unterscheiden konnte als Radiologen.

#imaging #radiology
15.12.2020

Postoperative Onset and Detection of SARS-CoV-2 in Surgically Resected Specimens From Gastrointestinal Cancer Patients With Pre/Asymptomatic COVID-19

Case series with one of the first series of patients with COVID-19 undergoing abdominal surgery. Illustrative is the visualization of SARS-CoV2 in the GI-Tract.

Comment Taskforce Knowledge-Management Covid-19

Mittlerweise fast schon medizinhistorische Serie von chirurgischen Patienten aus Wuhan. Die Relevanz der kleinen Serie liegt in der Visualisierung von Sars-Cov2 in der Mucosa der Resektate. Verminderte Heilung von Anastomosen und eine Infektion von Chirurgen sind mögliche Folgen.

#diagnosis #surgery
11.12.2020

Safety and Efficacy of the BNT162b2 mRNA Covid-19 Vaccine

This is a comprehensive report of the Pfizer/ BioNTech vaccine product tested in a randomized trial (43'448 participants who received the vaccine or placebo injection). Based on 170 laboratory-confirmed infections, vaccine efficacy was 95% (90%–98%) for more than 7 days after a second dose of vaccine. Subgroup analyses for the age group over 65, gender and obesity category show similar vaccine efficacy estimates (all over 90% although with more uncertainty). The safety profile of the vaccine was characterized by short-term, mild-to-moderate pain at the injection site, fatigue, and headache. The incidence of serious adverse events was low and was similar in the vaccine and placebo groups.

Comment Knowledge-Management Taskforce Covid-19

Und nun der zweite ausführliche Bericht über eine SARS-CoV-2 Impfung. Diesmal das Produkt von Pfizer/ BioNTech. Der Bericht enthält auch Resultate zur Wirksamkeit in Untergruppen (Alter, Geschlecht, Studienregion, Übergewicht), welche alle ähnlich gut aussehen. Die kurzfristigen Nebenwirkungen/Beschwerden sind ausführlich beschrieben und deutlich höher als bei der Placebo-Impfung (27% and 12%), was aber nicht erstaunt. Schwere Nebenwirkungen waren in beiden Gruppen selten (0.6% vs 0.5%).

#prevention #infectious diseases #epidemiology
10.12.2020

Safety and Efficacy of the ChAdOx1 nCoV-19 vaccine (AZD1222) against SARS-CoV-2: an interim analysis of four randomised controlled trials in Brazil, South Africa, and the UK

This is an interim analysis based on 11'636 participants (7'548 in the UK, 4088 in Brazil) on the safety and efficacy of the “Oxford & AstraZeneca” vaccine product. Overall vaccine efficacy was 70% (95% CI 55%–81%) for symptomatic COVID-19 cases in seronegative participants more than 14 days after a second dose of vaccine. Adverse events were rare and occurred at similar rate as in the control group where participants received a meningococcal group A, C, W, and Y conjugate vaccine or saline.

Comment Taskforce Knowledge-Management Covid-19

Endlich ein ausführlich beschriebener Bericht über diese Studie, die in UK, Brasilien und Südafrika durchgeführt wurde. Allerdings bleiben immer noch einige Fragen offen, da weniger als 10% der Probanden älter als 70 Jahre alt waren. Zudem wurden hier noch keine separaten Wirksamkeitsanalysen nach Altersgruppen berichtet, sollen aber später folgen, wenn die Resultate für alle 24'000 Probanden vorliegen.

#prevention #epidemiology #infectious diseases
09.12.2020

Assessment of 135'794 Pediatric Patients Tested for Severe Acute Respiratory Syndrome Coronavirus 2 Across the United States

Pediatric risk factors for severe COVID-19 have not been defined. This large study based on a non-selected population of health care insured patients finds that children and adolescents 0-24 years of age with chronic conditions are no more likely to test positive for SARS-CoV-2, but carry a modestly elevated risk of severe disease (i.e., need for hospitalization) compared with previously healthy individuals. Specifically, malignant, endocrine and metabolic disorders are associated with 2-3 fold increased risk, but not respiratory or cardiovascular disease.

Comment Taskforce Knowledge-Management Covid-19

Die Studie bestätigt den klinischen Alltagseindruck, dass Kinder mit Grundkrankheiten bei mit COVID-19 hospitalisierten Patienten übervertreten sind. Die Interpretation ist allerdings dadurch erschwert, dass das Altersspektrum junge Erwachsene bis 24 Jahre einschliesst und letztere quantitativ übervertreten sind. Weitere Studien sind notwendig, um pädiatrische Risikofaktoren für schwere Verläufe zu definieren.

#clinical #prevention #pediatrics #infectious diseases #epidemiology
09.12.2020

Decline in SARS-CoV-2 Antibodies After Mild Infection Among Frontline Health Care Personnel in a Multistate Hospital Network — 12 States, April–August 2020

This study amongst frontline health care workers from 13 hospitals in the US found that 94% of the personell with initially positive antibody test post infectionem showed a decline in the followup testing, 60 days later. Furthermore, it was shown that 28% seroreverted to below the threshold of positivity and that participants with higher initial antibody responses were more likely to have antibodies detected at the follow-up test compared to those who had a lower initial antibody response.

Comment Taskforce Knowledge-Management Covid-19

Ein Rückgang der Antikörper über die Zeit ist häufig und scheint, wie auch Seow et al. bereits in einer kleineren Kohorte berichteten, massgeblich von der Stärke der initialen Immunantwort mitbestimmt. Welchen Einfluss dieser Rückgang auf das Risiko einer Reinfektion hat, ist zum aktuellen Zeitpunkt noch nicht klar. Diese Studie unterstreicht zudem nochmal, dass eine negative Serologie einen vorgängigen Kontakt mit SARS-CoV2 nicht per se ausschliesst.

#clinical #diagnosis #prevention #infectious diseases #immunoresponses