Covid19-Sources

Medical News: American Scientists Reveal the Critical Role of a Tiny Hidden Cut in the SARS-CoV-2 Virus Spike That Supercharges Its Ability to Infect Human Cells A new study led by researchers from Boston Children’s Hospital, Harvard Medical School, the Institute for Protein Innovation, Dexorgen Inc., The Harvard Cryo-EM Center for Structural Biology, and Georgetown University has uncovered...

Background A rise in paediatric cases of acute hepatitis of unknown origin (AHUO) was observed in 2022, some requiring liver transplantation. A link to adeno-associated virus 2 infection and CD4+T-cell mediated disease was reported in cohorts in the UK and USA but does not explain all cases. Objective To determine the intrahepatic immune cell interactions in the inflamed liver and a possible contribution of SARS-CoV-2 infection. Design Patients with acute non-A non-E hepatitis (10/12 AHUO, 2/12 subacute) during February 2022–December 2022 undergoing liver biopsy were recruited in a European patient cohort. Hepatological, virological, histopathological and highly multiplexed spatial and single-cell analyses of liver biopsies were performed. Results Patients were negative for adenoviral and SARS-CoV-2 PCR. Three patients had a positive adenoviral serology and 10/12 patients had a history or serological evidence of SARS-CoV-2 infection. Imaging mass cytometry identified significant intrahepatic immune infiltration with an enrichment of CD8+T-cells. The highest CD8 infiltration and concomitant peripheral immune activation were observed in patients with the most severe hepatitis. CD8+T-cell infiltration was connected to histomorphological interface hepatitis and bridging necrosis. Cellular neighbourhood analysis indicated disease-associated microanatomic interactions between CX3CR1+ endothelial and myeloid cell populations, interacting with effector CD8+T-cells suggesting a pathogenic cellular triad. Of note, we detected intrahepatic SARS-CoV-2 antigens in ACE2-expressing cells in the areas with significant pathology in 11/12 samples using several different detection methods. 10/12 patients were treated with corticosteroid therapy and no liver transplantation was required. Conclusions We identified a possible manifestation of an immune-mediated postacute sequel to COVID-19 associated with a characteristic immune infiltrate in children with AHUO. COVID-19 testing should be considered in paediatric AHUO. Data are available in a public, open access repository. The imaging data and high-resolution versions of the figures illustrating IMC data are available at zenondo.org (reference: 40) 10.5281/zenodo.14097945. The clinical data isare listed in tables in this manuscript.

Background: The COVID-19 pandemic has significantly disrupted healthcare systems, including the management of emergency general surgery. Even though the pandemic ended, the new variants are continuously emerging, making it necessary to standardized the management protocols of emergency general surgery in COVID patients. Objective: This meta-analysis aims to evaluate the outcomes of emergency general surgery in COVID-19 patients compared to non-COVID-19 patients, focusing on mortality, postoperative complications, mechanical ventilation, and ICU admissions. Methods: A systematic search of PubMed, Embase, Cochrane Library, Scopus, and Web of Science databases was conducted, including studies published between December 2019 and the present. Observational studies, cohort studies, case-control studies, and randomized controlled trials reporting outcomes of emergency general surgery in adult patients with and without COVID-19 were included. A random-effects meta-analysis model was employed, and heterogeneity was assessed using the I² statistic. Publication bias was evaluated using funnel plot. Results: The analysis included 10 studies encompassing 7559 patients (3118 COVID19 group, 4441 non-COVID19 group). COVID-19 group patients demonstrated significantly higher mortality having odds ratio (OR) of 3.0036 (95% CI: 2.4263, 3.7184) and risk ratio (RR) of 2.8333 (95% Cl: 2.3127, 3.4712). Conclusion: Emergency general surgery in COVID-19 patients is associated with worse outcomes, including increased mortality, higher complication rates, and increased ICU admissions. These findings highlight the need for tailored perioperative strategies for COVID patients to mitigate risks.

DMZ – FORSCHUNG ¦ Lena Wallner ¦ Psychosomatische Belastung bei Post-COVID stärker als bei Asthma oder COPD – Neue Studie zeigt weitreichende Folgen für Lebensqualität Post-COVID-Patient:innen leiden deutlich stärker unter psychosomatischen Beschwerden als Menschen mit Asthma oder COPD. Eine aktuelle Studie aus einer Rehabilitationsklinik belegt: Die somatische Belastungsstörung (Somatic Symptom Disorder, SSD) wirkt sich bei Post-COVID-Betroffenen gravierender auf den Alltag aus als bei anderen chronischen Atemwegserkrankungen. Die Autor:innen fordern Konsequenzen für Diagnostik und Therapie. In einer Querschnittsstudie, publiziert in der Fachzeitschrift Scientific Reports (April 2025), untersuchte ein Team um den Allgemeinmediziner Prof. Antonius Schneider von der Technischen Universität München die Zusammenhänge zwischen somatischer Belastung, Angst, Depression und Einschränkungen im Alltag bei insgesamt 371 Patient:innen einer pneumologischen Rehabilitationsklinik. 161 der Teilnehmenden litten an einem Post-COVID-Syndrom (PCS), 121 an Asthma, 89 an chronisch-obstruktiver Lungenerkrankung (COPD). Stärkster Einfluss bei Post-COVID durch somatische Belastung Besonders auffällig: Die somatische Belastungsstörung hatte bei den PCS-Patient:innen einen deutlich stärkeren Zusammenhang mit der Alltagsbeeinträchtigung (Odds Ratio 13,8) als bei den Gruppen mit Asthma (8,5) oder COPD (nicht signifikant). Während bei Asthma vor allem Angststörungen (ermittelt mit dem GAD-7-Fragebogen) und bei COPD depressive Symptome (gemessen mit dem PHQ-9) die stärksten Prädiktoren für Einschränkungen waren, stand bei PCS die somatische Belastung im Vordergrund. Auch die typischen PCS-Symptome – Fatigue, kognitive Einschränkungen und Atemnot – waren signifikant mit Einschränkungen des täglichen Lebens (DLI) assoziiert. Doch die Analyse zeigte, dass SSD bei PCS eine noch größere Rolle spielte. Die Befunde lassen den Schluss zu, dass PCS-Betroffene sich intensiver mit ihren körperlichen Symptomen auseinandersetzen – vermutlich auch, weil viele Beschwerden medizinisch bislang nur unzureichend erklärt werden können. Psychosoziale Versorgung bislang unzureichend Das Team um Schneider sieht dringenden Handlungsbedarf: „Die psychosoziale Belastung bei Post-COVID wird noch immer unterschätzt“, heißt es in der Publikation. Insbesondere somatische Belastungsstörungen sollten bei der Rehabilitationsplanung stärker berücksichtigt werden. Denn die Studie zeigt, dass der Einfluss von SSD auf das tägliche Leben bei PCS größer ist als bei etablierten chronischen Erkrankungen wie Asthma oder COPD – obwohl Post-COVID-Patient:innen im Durchschnitt rund zehn Jahre jünger waren. Im Vergleich zu anderen Patientengruppen berichteten die PCS-Betroffenen über die niedrigste Lebensqualität: Der gemessene EQ-5D-5L-Score lag bei 0,64 – deutlich unter dem Durchschnitt vergleichbarer Studien mit Asthma (0,82) und COPD (0,68–0,70). Parallel dazu waren depressive und ängstliche Symptome bei der PCS-Gruppe signifikant häufiger. Lungenfunktion zweitrangig bei PCS Ein weiteres zentrales Ergebnis: Während bei Asthma und COPD die eingeschränkte Diffusionskapazität der Lunge mit der Alltagsbeeinträchtigung korrelierte, spielte dieser Parameter bei PCS keine signifikante Rolle. Die Befunde deuten darauf hin, dass organische Einschränkungen bei PCS in den Hintergrund treten – und psychosomatische Faktoren stärker gewichtet werden müssen. „Unsere Ergebnisse legen nahe, dass sich PCS nicht allein mit klassischen medizinischen Parametern erfassen lässt“, betont Ko-Autor Alexander Hapfelmeier. „Die Einbindung psychosomatischer Diagnostik und Therapieangebote ist entscheidend.“ Interdisziplinäre Therapieansätze gefordert Die Studie empfiehlt eine stärkere Integration psychotherapeutischer Maßnahmen in die Behandlung chronischer Lungenerkrankungen. Dabei sollten die psychischen Belastungsmuster krankheitsspezifisch adressiert werden: etwa ein Fokus auf Angststörungen bei Asthma und auf SSD bei PCS. Die stationäre pneumologische Rehabilitation biete mit ihrem multiprofessionellen Ansatz ideale Voraussetzungen für eine solche ganzheitliche Versorgung. Zwar erlaubt die Querschnittsstudie keine kausalen Aussagen – doch sie verdeutlicht eindrücklich, dass insbesondere bei Post-COVID psychosoziale Faktoren eine Schlüsselrolle für das Erleben und die Bewältigung der Erkrankung spielen. „Eine bessere Versorgung dieser Patientengruppe kann nur gelingen, wenn somatische und psychische Aspekte gemeinsam betrachtet werden“, heißt es im Fazit der Forschenden. Fazit Die Studie liefert ein starkes Argument dafür, psychosomatische Störungen wie SSD bei Post-COVID systematisch zu diagnostizieren und zu behandeln. Während die medizinischen Ursachen vieler Langzeitfolgen von COVID-19 noch ungeklärt sind, zeigt sich klar: Die subjektive Belastung ist hoch, und sie lässt sich nicht allein durch organische Befunde erklären. Eine ganzheitliche Sicht auf die Erkrankung und individualisierte, interdisziplinäre Therapieansätze sind essenziell, um Betroffene wirksam zu unterstützen. > Zur Studie

The majority of COVID-19 neuroimaging literature focuses on the acute period after infection and clinically evident lesions. The chronic effects of CO…

Scientific Reports - Multimodal MRI analysis of COVID-19 effects on pediatric brain

Children who get COVID-19 again are more likely to experience long-term issues.

Test basiert auf Abfrage eines Katalogs von Beschwerden – einfache Anwendung für medizinisches Fachpersonal mittels Web-Applikation geplant

Our results suggest that a positive test for COVID-19 (vs a negative test) was associated with increased rates of diagnosis of various infections in the 12 months following an acute SARS-CoV-2 infection. The putative long-term effects of COVID-19 on the immune system and the propensity for infection with other pathogens should be further evaluated in future studies.

Recently, XEC and KP.3.1.1 have surpassed KP.3 to become the globally dominant lineages of SARS-CoV-2 due to the unique N-terminal domain (NTD) mutations, including Ser31del in KP.3.1.1 and Thr22Asn and Phe59Ser in XEC.1–7 However, several sublineages of JN.1 are increasingly out-competing XEC and KP.3.1.1, exhibiting superior growth advantages; for example, LF.7.2.1, MC.10.1, NP.1, and, most importantly, LP.8.1 (figure A, B). Notably, LF.7.2.1 contains an additional Ala475Val mutation compared with LF.7, which carries the Ser31Pro, Lys182Arg, Arg190Ser, and Lys444Arg mutations on spike, and has rapidly spread from Qatar to the Middle East and Europe.

IMPORTANCE Post-acute sequelae of SARS-CoV-2 infection (PASC) remains a major public health challenge. While previous studies have focused on characterizing PASC and identifying its subphenotypes in children and adolescents following an initial SARS-CoV-2 infection, the risks of PASC with Omicron-variant reinfections remain unclear. Using a real-world data approach, this study investigates the risks of PASC following reinfections during the Omicron phase in the pediatric population. OBJECTIVE To investigate the risks of PASC diagnosis and 24 PASC symptoms and conditions after reinfection of SARS-CoV-2 during Omicron period in the pediatric population. DESIGN, SETTING, AND PARTICIPANTS This retrospective cohort study used data from the RECOVER consortium comprising 40 children's hospitals and health institutions in U.S. between January 2022 and October 2023. EXPOSURES A second SARS-CoV-2 infection, confirmed by a positive polymerase-chain-reaction (PCR) or antigen tests, or a diagnose of COVID-19, occurring at least 60 days after the initial infection, compared to the initial infection. MAIN OUTCOMES AND MEASURES PASC was identified using two approaches: (1) the ICD-10-CM diagnosis code U09.9 and (2) a symptom-based definition including 24 physician-identified symptoms and conditions. Absolute risks of incident PASC were reported, and relative risks (RRs) were calculated by comparing the second infection episode with the first infection episode groups using a modified Poisson regression model, adjusting for demographic, clinical, and healthcare utilization factors through exact matching and propensity scoring matching. RESULTS A total of 465,717 individuals under 21 years old (mean [SD] age 8.17 [6.58] years; 52% male) were included. Compared to the first infection, a second infection was associated with significantly increased risk of an overall PASC diagnosis (RR, 2.08; 95% confidence interval [CI], 1.68-2.59), and with many specific conditions including: myocarditis (RR, 3.60; 95% CI, 1.46-8.86); changes in taste and smell (RR, 2.83; 95% CI, 1.41-5.67); thrombophlebitis and thromboembolism (RR, 2.28; 95% CI, 1.71-3.04); heart disease (RR, 1.96; 95% CI, 1.69 to 2.28); acute kidney injury (RR, 1.90; 95% CI, 1.38 to 2.61); fluid and electrolyte (RR, 1.89; 95% CI, 1.62 to 2.20); generalized pain (RR, 1.70; 95% CI, 1.48 to 1.95); arrhythmias (RR, 1.59; 95% CI, 1.45-1.74); abnormal liver enzyme (RR, 1.56; 95% CI, 1.24 to 1.96); fatigue and malaise (RR, 1.50; 95% CI, 1.38 to 1.64); musculoskeletal pain (RR, 1.45; 95% CI, 1.37 to 1.54); abdominal pain (RR, 1.42; 95% CI, 1.34 to 1.50); postural orthostatic tachycardia syndromes (POTS)/dysautonomia (RR, 1.35; 95% CI, 1.20 to 1.51); cognitive functions (RR, 1.32; 95% CI, 1.15 to 1.50); and respiratory signs and symptoms (RR, 1.29; 95% CI, 1.25 to 1.33). The risks were consistent across various organ systems, including cardiovascular, respiratory, gastrointestinal, neurological, and musculoskeletal systems. CONCLUSIONS AND RELEVANCE Children and adolescents face significantly higher risk of various PASC outcomes after reinfection with SARS-CoV-2. These findings suggest a cumulative risk of PASC and highlight the urgent need for targeted prevention strategies to reduce reinfections, which includes an increased emphasis on initial or re-vaccination of children. ### Competing Interest Statement Dr. Jhaveri is a consultant for AstraZeneca, Seqirus, Gilead, Sanofi; receives an editorial stipend from the Pediatric Infectious Diseases Society; research support from GSK; and royalties from Up To Date/Wolters Kluwer. All other co-authors have no conflicts of interest to report. ### Funding Statement This research was funded by the National Institutes of Health (NIH) Agreement OT2HL161847-01 as part of the Researching COVID to Enhance Recovery (RECOVER) program of research. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Ethnics committee/IRB of University of Pennsylvania waived ethical approval for this work. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes All data produced in the present study are available upon reasonable request.

Nosocomial infections are costly, and airborne transmission is increasingly recognized as important for spread. Air cleaning units (ACUs) may reduce transmission, but little research has focused on their effectiveness on open wards. Aim To assess whether ACUs reduce nosocomial severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), or other, infections on older adult inpatient wards. Methods This was a quasi-experimental before-and-after study on two intervention–control ward pairs in a UK teaching hospital. Infections were identified using routinely collected electronic health record data during 1 year of ACU implementation and the preceding year (‘core study period’). Extended analyses included 6 months of additional data from one ward pair following ACU removal. Hazard ratios (HRs) were estimated through Cox regression controlling for age, sex, ward and background infection risk. The time that the ACUs were switched on was also recorded for Intervention Ward 2. Findings ACUs were initially feasible, but compliance reduced towards the end of the study (average operation in first vs second half of ACU time on Intervention Ward 2: 77% vs 53%). In total, 8171 admissions for 48 h (6112 patients, median age 85 years) were included. Overall, the incidence of ward-acquired SARS-CoV-2 was 3.8%. ACU implementation was associated with a non-significant trend of lower hazard for SARS-CoV-2 infection [HR core study period 0.90, 95% confidence interval (CI) 0.53–1.52; HR extended study period 0.78, 95% CI 0.53–1.14]. Only 1.5% of admissions resulted in other notable ward-acquired infections. Conclusion ACUs may reduce SARS-CoV-2 infection to a clinically meaningfully degree. Larger studies could reduce uncertainty, perhaps using a crossover design, and factors influencing acceptability to staff and patients should be explored further.

Eine retrospektive Analyse von Daten der neurologischen Notfallambulanz des Universitätsklinikums Essen zeigt einen signifikanten Anstieg der Patientenzahlen nach der ersten Medienberichterstattung über Sinusvenenthrombosen als möglicher Folge der COVID-19-Impfung im Jahr 2021. Die Ergebnisse legen nahe, dass ein medieninduzierter Nocebo-Effekte dabei eine bedeutende Rolle spielte.​

There are many reasons to doubt the conclusions of that viral “post-vaccination syndrome” study.

imageimageInnate immune memory enables enhanced responses to antigens through long-lasting epigenetic changes triggered by initial exposure. SARS-CoV-2 mRNA vaccination induces innate immune memory by establishing persistent H3K27ac epigenetic ...

There are limited approaches to monitor virus spread in vivo. Here, the authors report PET/CT-based in vivo imaging to track SARS-CoV-2 biodistribution in a COVID-19 non-human primate model using a radiolabeled human antibody revealing persistent detection in the lung and brain 3 months after infection.

Metabolic activity is the basic life activity of organisms and the fundamental for maintaining body functions. With the improvement of living standards, the incidence of metabolic disorder is also increasing. At present, most of the clinical treatment strategies and meta-analysis for metabolic disorder uncover that combined medicines with berberine ameliorate several metabolic disorders. However, evidence to disclose the therapeutic effect of berberine treatment alone and the possible factors affecting the efficacy is limited. Therefore, we have formulated strict inclusion criteria and selected more reliable data for meta-analysis through more refined screening strategies to provide evidence and guidance for clinical decision-making and understand the effect of berberine treatment alone and the factors affecting its efficacy. Methods and results: Using meta-analysis of “Cochrane Handbook for Systematic Reviews of Interventions” as guidelines, we searched PubMed, GeenMedical, Cochrane library, and china national knowledge infrastructure (CNKI) for trials reporting clinical treatment data of berberine. Another 417 trials were included through other sources to increase confidence in results. Among the 1,660 related documents retrieved from the four databases, 18 eligible documents were selected for analysis. Given the differences in trial design and measurement units, we used the standardized mean difference (SMD) method to eliminate the differences and then summarize the data for analysis. The main factors are triglyceride (TG), total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL), homeostasis model assessment-insulin resistance (HOMA-IR), and fasting plasma glucose (FPG). Random-effect model analysis was performed: TG (SMD: 0.94; 95%CI: 0.49,1.38; p = 0.00), TC (SMD: 1.06; 95%CI: 0.64, 1.48; p = 0.00), LDL (SMD: 1.77; 95%CI: 1.11,2.44; p = 0.00), HDL (SMD: −1.59; 95%CI: −2.32, −0.85; p = 0.00), HOMA-IR (SMD: 1.25; 95%CI: 0.25,2.24; p = 0.01), and FPG (SMD: 0.65; 95%CI: 0.28,1.03; p = 0.00). This study aimed to conduct a systematic review and meta-analysis of the literature to evaluate the therapeutic effect of berberine singly on metabolic diseases. Conclusion: Berberine can improve obesity and hyperlipidemia by reducing TG, TC, and LDL and increasing HDL; reduce insulin resistance to improve type Ⅱ diabetes; and prevent diabetic encephalopathy.

Abstract. SARS-CoV2, severe acute respiratory syndrome coronavirus 2, is frequently associated with neurological manifestations. Despite the presence of mi

epigenetischen Veränderungen führten zu einem verstärkten „Ablesen“ von entzündungsfordernden Genen, was wiederum zur Produktion von Botenstoffen führte, die zahlreiche Immunzellen aktivieren können und somit deren Fähigkeit zur Bekämpfung von Infektionen verstärken. „Da es sich

Head outlines the key themes shaping life and health conversations

Stephenson, Pinto Pereira et al. investigate the proportion of children and young people with Post Covid-19 condition 24-months post-infection. Only 7.2% meet the definition consistently at 3-, 6-, 12- and 24-months post-infection, highlighting the importance of longitudinal studies.

This retrospective cohort study found that patients kidney disease who received nirmatrelvir/ritonavir for COVID-19 were less likely to be hospitalized wit

Cohen et al. report a patient-led case series of 13 individuals with Long COVID who initiated extended courses of Paxlovid outside of, or within the context of, an acute SARS-CoV-2 infection. Long courses of nirmatrelvir/ritonavir have meaningful benefits for some people with Long COVID but not all.

After surviving Coronavirus Disease 2019 (COVID-19), some people develop symptoms known as post-acute sequelae of COVID-19 (PASC). PASC is an emerging phenomenon yet to be fully understood, and identifying risk factors has been challenging. This study investigated the association between the number of COVID-19 episodes and the incidence of PASC among essential workers. Methods We analyzed data from 2511 essential workers, mainly first responders, with confirmed polymerase chain reaction, antibody, or antigen-positive test results for SARS-CoV-2 infection from March 2020 to February 2024. Data were collected through in-person questionnaires and surveys sent via text and email, internal medical records, follow-up calls, and external medical records. Participants who reported continuation or the development of new symptoms three months after the initial SARS-CoV-2 infection, with symptoms lasting for at least two months, were categorized as having PASC, while those without any COVID-19 or whose symptoms resolved were classified as non-PASC. PASC was common in this cohort so we used a Poisson regression model to compute multivariable-adjusted Relative Risk (RR) for the association between risk of PASC and SARS-CoV-2 re-infection, severity, and vaccination status at first infection. Findings A total of 475 (prevalence = 18.9%, [95% confidence interval] = [17.4–20.5]) PASC patients were identified. The mean (standard deviation (SD)) age of participants who experienced PASC (54.8 (7.2) years) was similar to those who did not (54.2 (7.4) years). There were 403 (16.1% [14.6–17.5]) participants who experienced multiple instances of COVID-19. After adjusting for relevant demographic, lifestyle, and clinical variables, we found a significant association between the risk of experiencing PASC and multiple SARS-COV-2 infections (RR = 1.41 [1.14–1.74]), severe COVID-19 (RR = 3.17 [2.41–4.16]), and being unvaccinated at first infection (RR = 3.29 [2.46–4.41]).

Background. Understanding the interference patterns of respiratory viruses could be important for shedding light on potential strategies to combat these human infectious agents. Objective. To investigate the possible interactions between adenovirus type 2 (AdV2), severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and influenza A/H1N1 pandemic (H1N1pdm09) using the A549 cell line. Methods. Single infections, co-infections, and superinfections (at 3 and 24 h after the first virus infection) were performed by varying the multiplicity of infection (MOI). Virus replication kinetics and the mRNA expression of IFN-α, IL-1α and IL-6 were assessed by real-time qPCR. Results. Co-infection experiments showed different growth dynamics, depending on the presence of the specific virus and time. AdV2 replication remained stable or possibly enhanced in the presence of co-infection with each of the two H1N1pdm09 and SARS-CoV-2 viruses used. In contrast, SARS-CoV-2 replication was facilitated by H1N1pdm09 but hindered by AdV2, indicating possible different interactions. Finally, H1N1pdm09 replication exhibited variably effectiveness in the presence of AdV2 and SARS-CoV-2. Superinfection experiments showed that the replication of all viruses was affected by time and MOI. The mRNA expression of IFN-α, IL-1α and IL-6 showed divergent results depending on the virus used and the time of infection. Conclusions. Further investigation of co-infection or superinfection may be helpful in understanding the potential relationship involved in the outcome of viral respiratory infection in the human population.

Mukherjee et al. report that vaccination prior to SARS-CoV-2 infection does not affect the neurological manifestations of Long COVID. Minor symptom differe

DMZ – WISSENSCHAFT ¦ S. Koller ¦ Eine US-amerikanische Studie untersucht erstmals umfassend die Wirksamkeit des COVID-19-Impfstoffs BNT162b2 (Pfizer-BioNTech) bei der Prävention von Long COVID in der pädiatrischen Bevölkerung. Dabei beleuchtet sie sowohl die direkte Schutzwirkung der Impfung als auch deren indirekte Effekte durch die Verhinderung von SARS-CoV-2-Infektionen. Die Ergebnisse liefern wertvolle Einblicke für den öffentlichen Gesundheitssektor. Long COVID bei Kindern und Jugendlichen Long COVID, auch bekannt als Post-Acute Sequelae of SARS-CoV-2 Infection (PASC), umfasst anhaltende oder neu auftretende Symptome nach einer COVID-19-Infektion. Bei Kindern und Jugendlichen zeigt sich Long COVID oft in unterschiedlichen klinischen Merkmalen und mit einer geringeren Häufigkeit im Vergleich zu Erwachsenen. Zu den betroffenen Organsystemen gehören das Herz-Kreislauf-System, das Nervensystem, der Stoffwechsel und die Nieren. Trotz der etablierten Wirksamkeit von COVID-19-Impfstoffen gegen symptomatische und schwere Verläufe bleibt die Frage offen, wie gut eine Impfung vor Long COVID schützt – insbesondere bei jungen Menschen. Die vorliegende Studie schließt diese Wissenslücke und liefert erstmals differenzierte Ergebnisse zu dieser Fragestellung. Methodik der Studie Die Untersuchung nutzte elektronische Gesundheitsdaten (EHR) aus einem nationalen Netzwerk von Kinderkrankenhäusern in den USA. Dabei wurden Daten aus den Perioden der Delta- und Omikron-Varianten analysiert. Die Forscher:innen setzten eine kausale Mediationsanalyse ein, um sowohl die Gesamtwirksamkeit des Impfstoffs auf die Long-COVID-Risiken als auch die direkten und indirekten Effekte der Impfung zu bewerten. Diese Methode ermöglicht es, den Einfluss der Impfung zu quantifizieren, ohne durch mögliche Verzerrungen aufgrund von Infektionsstatus-Bedingungen belastet zu sein. Zudem wurden Computeralgorithmen genutzt, um Long COVID anhand spezifischer Symptome und Krankheitscluster zu definieren. Die Datenbasis umfasste pädiatrische Populationen aus unterschiedlichen Versorgungseinrichtungen, wodurch eine breite repräsentative Stichprobe sichergestellt wurde. Zentrale Ergebnisse Die Studie fand heraus, dass die BNT162b2-Impfung während der Delta-Periode einen hohen Schutz vor Long COVID bot, während die Wirksamkeit in der Omikron-Periode moderater ausfiel. Dieser Rückgang ist auf die höhere Übertragbarkeit und geringere Schwere der Omikron-Varianten sowie die allgemein niedrigere Impfeffektivität zurückzuführen. Die Analyse ergab, dass der Hauptvorteil der Impfung in der Verhinderung von Infektionen liegt. Infektionen nach einer Impfung hatten ein ähnliches Risiko für Long COVID wie Infektionen bei Ungeimpften. Die direkte Schutzwirkung der Impfung gegen die Entwicklung von Long COVID über die Infektionsverhinderung hinaus war dagegen begrenzt. Bedeutung für den öffentlichen Gesundheitssektor Die Ergebnisse unterstreichen die Notwendigkeit, SARS-CoV-2-Infektionen durch Impfprogramme weiterhin zu minimieren. Besonders die pädiatrische Bevölkerung profitiert von einer Impfung nicht nur durch den Schutz vor akuten Infektionen, sondern auch durch die Reduzierung des Risikos für langfristige gesundheitliche Folgen. Zudem liefert die Studie wichtige Erkenntnisse für die weitere Forschung. Sie zeigt, dass bisherige Studien, die den Infektionsstatus als Basis für die Bewertung der Impfwirkung auf Long COVID nutzten, möglicherweise Verzerrungen aufwiesen. Die hier angewandte Mediationsanalyse bietet einen präziseren Ansatz. Fazit Die BNT162b2-Impfung bietet signifikanten Schutz vor Long COVID bei Kindern und Jugendlichen, vor allem durch die Verhinderung von SARS-CoV-2-Infektionen. Diese Ergebnisse betonen die Bedeutung von Impfstrategien als zentrale Maßnahme zur Eindämmung der Pandemie und ihrer Langzeitfolgen. Die Studie stellt einen wichtigen Meilenstein dar, indem sie neue Erkenntnisse für eine gezielte Prävention von Long COVID in der jungen Bevölkerung liefert. Weitere Forschungen sind notwendig, um die Auswirkungen von Impfungen gegen neue Virusvarianten und langfristige Effekte weiterhin zu bewerten. > Zur Studie

ownload PDF Cite Set Alert Get Rights Reprints Previous article Next article Our recent study using data from more than 20 million participants has shown that COVID-19 vaccines consistently prevent long COVID symptoms in adults, with meta-analytic calibrated subdistribution hazard ratio (sHRs) of 0·54 (95% CI 0·44–0·67) in CPRD GOLD, 0·48 (0·34–0·68) in CPRD AURUM, 0·71 (0·55–0·91) in SIDIAP, and 0·59 (0·40–0·87) in CORIVA.1 In addition, when considering post-COVID thromboembolic and cardiovascular complications as outcomes of interest, recently published data have shown that vaccination with any COVID-19 first vaccine dose (ChAdOx1, BNT162b2, and mRNA-1273) is associated with reduced risk of post-acute heart failure (0·45 [0·38–0·53] 0–30 days after SARS-CoV-2 infection; 0·61 [0·51–0·73] 91–180 days after SARS-CoV-2 infection), venous thromboembolism (sHR 0·22 [95% CI 0·17–0·29] 0–30 days after SARS-CoV-2 infection; 0·53 [0·40–0·70] 91–180 days after SARS-CoV-2 infection), and arterial thrombosis (0·53 [0·44–0·63] 0–30 days after SARS-CoV-2 infection; 0·72 [0·58–0·88] 91–180 days after SARS-CoV-2 infection).2 With the use of the Observational Medical Outcomes Partnership (OMOP) common data model (CDM), all our analyses were conducted across three European countries (Estonia, Spain, and the UK) without transferring patient data, using federated analyses similar to those used by the European Medicines Agency-funded Data Analysis and Real World Interrogation Network.

Scientific Reports - Long-COVID in children and adolescents: a systematic review and meta-analyses