Covid19-Sources

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

The psychological trauma following COVID-19 has been lengthy and fraught for some children and their families. The specific problems encountered by ch…

medRxiv - The Preprint Server for Health Sciences

The COVID-19 pandemic has prompted a quest to understand why certain individuals remain uninfected or asymptomatic despite repetitive exposure to SARS-CoV-2. Here, we focused on six exposed females residing with their symptomatic and reinfected SARS-CoV-2 PCR-positive COVID-19 partners. Peripheral blood mononuclear cell samples from couples were analysed for poly (I:C)-induced mRNA expression of type I/III interferons and interferon-stimulated genes (ISGs). Remarkably, we found a significant upregulation of the ISG interferon-inducible protein with tetrapeptide repeats 3 (IFIT3) gene exclusively in exposed uninfected or asymptomatic females, suggesting a potential role in protective immunity against symptomatic COVID-19.

Links between the complement and coagulation systems could lead to Long Covid therapies

Patients with post-COVID condition (PCC) and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) experience symptoms potentially associated with small fiber neuropathy (SFN). Methods A sample of 90 participants, comprising 30 PCC patients, 30 ME/CFS patients, and 30 healthy controls (HC), matched by sex and age, was assessed. Neuropathic, autonomic, and fatigue symptoms were measured with TaskForce Monitor, the Sudoscan, heat and cold evoked potentials, In Vivo Corneal Confocal Microscopy (IVCCM), and specialized questionaries. Results PCC and ME/CFS patients demonstrated significantly higher levels of autonomic symptoms (H = 39.89, p  0.001), neuropathic symptoms (H = 48.94, p  0.001), and fatigue (H = 49.29, p  0.001) compared to HC. Quantitative sensory testing revealed significant differences in heat detection thresholds between PCC patients and HC (F = 4.82; p  0.01). Regarding corneal small fiber tortuosity, there were statistically significant differences between patients and HC (F = 6.80; p  0.01), indicating pathological responses in patients. Small fiber tortuosity in IVCCM was identified as the main discriminator between patients and HC (AUC = 0.720; p  0.01). Conclusion PCC and ME/CFS patients demonstrated sensory SFN, as evidenced by impaired heat detection and increased tortuosity of small fibers in the central corneal subbasal plexus. The findings underscore the importance of a multimodal approach to comprehensively detect and characterize SFN. This study provides valuable scientific insights into the neuropathic manifestations associated with these conditions.

Medical News: Since the emergence of SARS-CoV-2 in late 2019, scientists have been trying to unravel the secrets behind its ability to cause disease. While some people experience only mild symptoms, others suffer from severe complications such as pneumonia, acute respiratory distress syndrome (ARDS), and even death. What makes the virus so dangerous in some cases? A team of researchers, led by Yi ...

Post-COVID-19 syndrome, referred to as “long COVID,” is characterized by persistent symptoms that develop during or after SRAS-CoV-2 infection lasting…

Inflammatory bowel disease (IBD) treatments and pregnancy can independently modulate immune responses, but the combined effects on SARS-CoV-2 vaccine-induced immunity are poorly understood. This study explores the efficacy of SARS-CoV-2 vaccination and placental antibody transfer among pregnant women with IBD on biologic therapies. This observational study included pregnant women with and without IBD from the PIANO and PREVENT-COVID studies and their neonates. We assessed anti-SARS-CoV-2 neutralizing antibody titers (NT50) in maternal and cord blood post-vaccination using a pseudotype neutralization assay and calculated placental transfer ratios. A total of 32 pregnant women participated, and 27 were exposed to a biologic medication during pregnancy. Neutralizing antibody titers were similar between biologic-treated and non-treated groups, and biologic-exposed women demonstrated robust placental transfer of neutralizing antibodies. Corticosteroid use during pregnancy was significantly associated with reduced placental transfer efficiency, although this effect was not significant in a sensitivity analysis excluding patients treated with immunomodulators. Vaccination timing and previous SARS-CoV-2 infection impacted maternal and cord antibody levels, with higher titers observed in those vaccinated before pregnancy or infected during pregnancy. Overall, our findings suggest that pregnant women with IBD on biologic therapies mount effective SARS-CoV-2 neutralizing antibody responses similar to their non-biologic-exposed counterparts, with efficient placental transfer. These findings support the safety and efficacy of SARS-CoV-2 vaccination in this population, although further research with larger cohorts is needed to explore the long-term protective effects of transferred antibodies in neonates. Corticosteroid use, immunomodulator use, and vaccination timing may influence antibody dynamics, underscoring the need for tailored clinical management in this vulnerable population.

A nanoengineered immunosensor uses machine learning to detect multiple biomarkers for rapid prediction of acute thrombosis.

Importance Existing systematic literature reviews (SLRs) on COVID-19 vaccine effectiveness (VE) against post-COVID-19 conditions (PCC) document high heterogeneity across studies, but have not compared VE across design features known to impact PCC burden or VE against other COVID-19 endpoints. Objective This SLR summarizes the evidence across studies among predominately adults that report an adjusted measure of association for the relationship between vaccination and PCC, by timing of vaccination relative to infection or PCC-onset and across different study characteristics. Evidence review A comprehensive search strategy was developed within the OVID platform across EMBASE, MEDLINE® and Evidence-Based Medicine reviews, and supplemented with WHO COVID library and Google Scholar® searches, to collate evidence on vaccination and PCC published or posted as pre-prints between January 1st, 2020 and July 18th, 2023. JBI Critical Appraisal Checklists were used to assess each study’s risk of bias. Findings This review included 97 studies and synthesized results from 56 studies with low risk of bias that reported adjusted measures for the association between vaccination and PCC. Overall, 77% of pre-infection adjusted VE (aVE) estimates (vs. unvaccinated) were statistically significant (range: 7%–95%), 80% of estimates reflecting a mix of those vaccinated before and after infection were statistically significant (range: 62%–73%), one of five estimates reflecting vaccination after PCC onset was statistically significant (aVE=41%), 43% of post-infection vaccination estimates were statistically significant (two were protective [range: 28%–40%] and one was not [aVE=-47%]), and 46% of estimates not specifying vaccination timing were statistically significant (23 were protective [range: 29%–75%] and one was not [aVE=-132%]). Statistically significant pre-infection aVE estimates were slightly higher for mRNA (range: 14%–84%) than non-mRNA vaccines (range: 16%–38%) and aVE ranges during (4 studies; range: 10%–70%) and before Omicron predominance (10 studies; range: 7%–50%) overlapped. Pre-infection vaccination was protective regardless of vaccine type, number of doses received, PCC definition, predominant variant, and severity of acute infections included. Conclusions and Relevance Collectively our findings suggest that COVID-19 vaccination received prior to SARS-CoV-2 infection reduces the subsequent risk of developing PCC regardless of the predominant variant circulating. Question Do measures of COVID-19 vaccine effectiveness against post-COVID-19 conditions (PCC) vary by timing of vaccine relative to SARS-CoV-2 infection or PCC onset, vaccine type and number of doses received, PCC definition, predominant SARS-CoV-2 variant, and disease severity? Findings COVID-19 vaccination before SARS-CoV-2 infection appeared to reduce the risk of PCC (vs. unvaccinated). Compared with other COVID-19 vaccine types, mRNA vaccines seemed to offer greater protection, and a dose response was observed for mRNA vaccines. Meaning Despite heterogeneity across included studies, pre-infection vaccination reduced the risk of ≥1 PCC, regardless of SARS-CoV-2 variant, proportion of sample hospitalized, and PCC definition. ### Competing Interest Statement Nadine Al Akoury, Moe H Kyaw, Abby E Rudolph, Julia Spinardi, and Hammam Haridy are employees of Pfizer Inc. and may hold stock or stock options. Kristen Markus, Isabelle Whittle, and Olivia Wright are employees of Adelphi Values PROVE. Adelphi Values PROVE received funding from the study sponsor for the conduct of the review. This manuscript nor one with substantially similar content has been published or is being considered for publication elsewhere from these authors. ### Funding Statement This study was funded by Pfizer Inc. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes 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 supporting the findings of this study are available within the paper and its Supplementary Information.

Results suggest that vaccines offer less protection against lingering symptoms than expected.

The global spread of Severe Acute Respiratory Syndrome Coronavirus 2. (SARS-CoV-2) and its variant strains, including Alpha, Beta, Gamma, Delta, and now Omicron, pose a significant challenge. With the constant evolution of the virus, Omicron and its subtypes BA.1, BA.2, BA.3, BA.4, and BA.5 have developed the capacity to evade neutralization induced by previous vaccination or infection. This evasion highlights the urgency in discovering new monoclonal antibodies (mAbs) with neutralizing activity, especially broadly neutralizing antibodies (bnAbs), to combat the virus.In the current study, we introduced a fully human neutralizing mAb, CR9, that targets Omicron variants. We demonstrated the mAb’s effectiveness in inhibiting Omicron replication both in vitro and in vivo. Structural analysis using cryo-electron microscopy (cryo-EM) revealed that CR9 binds to an epitope formed by RBD residues, providing a molecular understanding of its neutralization mechanism. Given its potency and specificity, CR9 holds promise as a potential adjunct therapy for treating Omicron infections. Our findings highlight the importance of continuous mAb discovery and characterization in addressing the evolving threat of COVID-19.

Coronavirus disease 2019 (COVID-19) presents a wide spectrum of symptoms, the causes of which remain poorly understood. This study explored the associations between autoantibodies (AABs), particularly those targeting G protein-coupled receptors (GPCRs) and renin‒angiotensin system (RAS) molecules, and the clinical manifestations of COVID-19. Using a cross-sectional analysis of 244 individuals, we applied multivariate analysis of variance, principal component analysis, and multinomial regression to examine the relationships between AAB levels and key symptoms. Significant correlations were identified between specific AABs and symptoms such as fever, muscle aches, anosmia, and dysgeusia. Notably, anti-AGTR1 antibodies, which contribute to endothelial glycocalyx (eGC) degradation, a process reversed by losartan, have emerged as strong predictors of core symptoms. AAB levels increased with symptom accumulation, peaking in patients exhibiting all four key symptoms. These findings highlight the role of AABs, particularly anti-AGTR1 antibodies, in determining symptom severity and suggest their involvement in the pathophysiology of COVID-19, including vascular complications.

We identified seven distinct coronaviruses (CoVs) in bats from Brazil, classified into 229E-related (Alpha-CoV), Nobecovirus, Sarbecovirus, and Merbecovirus (Beta-CoV), including one closely related to MERS-like CoV with 82.8% genome coverage. To accomplish this, we screened 423 oral and rectal swabs from 16 different bat species using molecular assays, RNA sequencing, and evolutionary analysis. Notably, gaps in the spike-encoding gene led us to design new primers and perform Sanger sequencing, which revealed high similarities to MERS-related (MERSr) CoV strains found in humans and camels. Additionally, we identified key residues in the receptor-binding domain (RBD) of the spike protein, suggesting potential interactions with DPP4, the receptor for MERSr-CoV. Our analyses also revealed evidence of recombination involving our laboratory-produced sequences. These findings highlight the extensive genetic diversity of CoVs, the presence of novel viral lineages, and the occurrence of recombination events among bat CoVs circulating in Brazil, underscoring the critical role bats play as reservoirs for emerging viruses and emphasizing the necessity of ongoing surveillance to monitor the public health risks associated with CoV spillover events.

Pulmonary and extrapulmonary manifestations have been reported following infection with SARS-CoV-2, the causative agent of COVID-19. The virus persists in multiple organs due to its tropism for various tissues, including the skeletal system. This study investigates the effects of SARS-CoV-2 infection, including both ancestral and Omicron viral strains, on differentiating mesenchymal stem cells (MSCs), the precursor cells, into osteoblasts. Although both viral strains can productively infect osteoblasts, precursor cell infection remained abortive. Viral exposure during osteoblast differentiation demonstrates that both variants inhibit mineral and organic matrix deposition. This is accompanied by reduced expression of runt-related transcription factor 2 (RUNX2) and increased levels of interleukin-6 (IL-6), a cytokine that negatively regulates osteoblast differentiation. Furthermore, the upregulation of receptor activator of nuclear factor kappa B ligand (RANKL) strongly suggests that the ancestral and Omicron variants may disrupt bone homeostasis by promoting osteoclast differentiation, ultimately leading to the formation of bone-resorbing cells. This process is dependent of spike glycoprotein since its neutralization significantly reduced the effect of infective SARS-CoV-2 and UV-C inactivated virus. This study underscores the capacity of ancestral and Omicron SARS-CoV-2 variants to disrupt osteoblast differentiation, a process essential for preserving the homeostasis and functionality of bone tissue.

Since 2019, SARS-CoV-2 has precipitated an unprecedented global health crisis (1). While many patients infected with the virus exhibit mild to moderate symptoms, including cough, fever, and headache, some progress to severe pneumonia and respiratory failure (1, 2). Severe patients typically experience significant dysfunctional immune responses and cytokine storms, which can progress to acute respiratory distress syndrome (ARDS) (3). The severity of the disease is determined by multiple factors, including individual susceptibility, differences in immunity, and pathogen virulence. As new variants continue to emerge, clinical and experimental results reveal that the pathogenicity of the virus is constantly evolving (4–6). Compared to the wild-type strain, infection with the Alpha and Beta variants results in a higher mortality rate in the K18-hACE2 mouse strain, which is susceptible to SARS-CoV-2 (7). The heightened fusogenicity caused by the P681R mutation in the spike protein of the Delta variant could be a factor contributing to increased severity and unusual symptoms (8). Additionally, the reduced spread of the Omicron variant in lung tissue might be related to its attenuated pathogenicity (9). However, it remains unclear which proteins of SARS-CoV-2 play a decisive role in this process. There is an imperative to understand the internal mechanisms of virus pathogenicity evolution, which is conducive to virus virulence prediction and drug development. Various theories have attempted to explain the pathogenic mechanisms of SARS-CoV-2. Mutations in accessory proteins such as ORF3a and ORF8 can disrupt innate immune signaling, impacting viral pathogenicity (10). The fusogenicity and S1/S2 cleavage efficiency of SARS-CoV-2 may be associated with its pathogenicity (8, 9). Mutations in the Spike protein and NSP6 can reduce replication efficiency in Omicron, thereby weakening its pathogenicity (11). Mutations in the E protein can attenuate its intrinsic toxicity, potentially contributing to reduced pathogenicity (12, 13). Additionally, mutations in NSP4 can inhibit chemokine secretion and reduce host inflammatory responses, thereby attenuating the pathogenicity of the Omicron variant (14). While these studies provide some insights into the pathogenicity changes associated with certain variants, they could not fully explain the evolution of SARS-CoV-2 pathogenicity. For instance, ORF3a is unmutated in both the Alpha and Omicron variants, while the E protein and NSP4 are unmutated in Alpha, Gamma, and Delta variants, suggesting that these proteins do not drive the pathogenicity differences among these variants of concern (VOCs). Mutations in the Spike protein appear closely linked to viral pathogenicity. However, individual Spike protein mutations alone do not replicate the pathogenic profile observed in variant strains (11). Therefore, the pathogenicity of SARS-CoV-2 seems to be the result of multiple virulence factors acting in concert. Systematically understanding the role of SARS-CoV-2 virulence factors and their mutations is essential for elucidating the pathogenic mechanisms. Here, we conduct a thorough review of existing literature to integrate findings from experimental studies, epidemiological data, and clinical research on the subject. We believe that this combined review will allow us to gain deeper insights into the factors driving viral pathogenicity and provide a comprehensive understanding of the mechanisms that differentiate the VOCs in terms of their virulence.

DMZ – FORSCHUNG ¦ Sarah Koller ¦ Seit dem Ausbruch der COVID-19-Pandemie standen Gesundheitssysteme weltweit unter immensem Druck. Das hochansteckende SARS-CoV-2-Virus verbreitete sich schnell und führte zu einer globalen Gesundheitskrise. Während COVID-19 vorwiegend als Atemwegserkrankung bekannt ist, wurde zunehmend klar, dass das Virus auch erhebliche Auswirkungen auf das Herz-Kreislauf-System haben kann. Kardiovaskuläre Risiken bei COVID-19 COVID-19-Patienten haben ein signifikant erhöhtes Risiko, kardiovaskuläre Erkrankungen zu entwickeln. Zu den häufigsten Herzkomplikationen zählen akute Myokardverletzungen, Herzinsuffizienz, Myokarditis, Herzrhythmusstörungen und akute Herzinfarkte. Auch seltenere Krankheitsbilder wie das Takotsubo-Syndrom ("Broken-Heart-Syndrom") und kardiogener Schock wurden im Zusammenhang mit SARS-CoV-2 dokumentiert. Wissenschaftliche Studien haben gezeigt, dass SARS-CoV-2 mehrere Mechanismen nutzt, um das Herz-Kreislauf-System zu schädigen. Das Virus kann akute Koronarsyndrome auslösen, die sowohl mit verengten als auch mit unauffälligen Koronararterien einhergehen. Darüber hinaus wurden Mikrogefäßdysfunktion, Entzündungen der Gefäße (Vaskulitis), endotheliale Schädigungen (Endothelitis) und in-situ-Thrombosen beobachtet. Eine umfassende Meta-Analyse zu kardiovaskulären Komplikationen bei COVID-19 bestätigte diese Befunde. Diagnostik und Therapieansätze Die Diagnostik von kardiovaskulären Komplikationen bei COVID-19 erfordert eine genaue klinische Untersuchung. Symptome wie Brustschmerzen, Atemnot oder Schocksymptome sollten immer auf eine mögliche Herzbeteiligung hin untersucht werden. Wichtige diagnostische Mittel sind Elektrokardiogramme (EKG), Biomarker für Myokardschäden (hsTnT/I, NT-proBNP) und bildgebende Verfahren wie Echokardiografie und CT-Koronarangiografie (CTCA). Diese Methoden sind entscheidend, um zwischen einem Myokardinfarkt und einer Myokarditis zu unterscheiden, insbesondere bei Patienten ohne signifikante Koronarläsionen. Akute Patienten, die mit Symptomen eines Herzinfarkts eingeliefert werden, benötigen häufig eine sofortige interventionelle Therapie. Die primäre perkutane Koronarintervention (PCI) bleibt die Standardbehandlung, auch bei COVID-19-Patienten mit ST-Hebungsinfarkt (STEMI). In Fällen, in denen eine PCI nicht innerhalb von 120 Minuten möglich ist, kann eine Fibrinolyse als Übergangslösung dienen. Allerdings ist dies bei COVID-19-Patienten mit unauffälligen Koronararterien oft nicht indiziert, da keine signifikanten Koronarläsionen vorliegen. Herausforderungen während der Pandemie Die Pandemie führte zu erheblichen Verzögerungen in der Behandlung von Patienten mit akuten Herzerkrankungen. Eine Untersuchung des Journal of the American College of Cardiology zeigte, dass sich sowohl die Zeit bis zum ersten medizinischen Kontakt als auch die Zeit bis zur Durchführung einer PCI während der Pandemie signifikant verlängert haben. Gründe hierfür waren unter anderem die überlasteten Notfallkapazitäten, ein Mangel an Tests und die Sorge des medizinischen Personals vor einer Ansteckung. Diese Verzögerungen hatten schwerwiegende Folgen: In einer Studie, die in JAMA veröffentlicht wurde, konnte gezeigt werden, dass die Mortalität bei STEMI-Patienten während der Pandemie um 27 % höher lag als in der Zeit vor der Pandemie. Langzeitprognose und Forschungsbedarf Patienten mit einer COVID-19-bedingten Myokardverletzung haben ein signifikant höheres Sterblichkeitsrisiko. Besonders ältere Patienten sowie solche mit Vorerkrankungen und starker Entzündungsreaktion sind gefährdet. Darüber hinaus ist die Prognose von Patienten mit Typ-2-Myokardinfarkt, der durch systemische Belastungen wie Sauerstoffmangel und Entzündungen verursacht wird, deutlich schlechter als die von Typ-1-Infarktpatienten. Um die langfristigen Auswirkungen von COVID-19 auf das Herz-Kreislauf-System besser zu verstehen, ist weitere Forschung unerlässlich. Insbesondere die Frage, wie sich die Krankheit langfristig auf die Herzgesundheit auswirkt und welche Präventions- und Behandlungsstrategien optimiert werden können, bedarf intensiver wissenschaftlicher Untersuchung. Mehrere laufende Langzeitstudien in Europa und den USA zielen darauf ab, diese Wissenslücken zu schließen. Fazit COVID-19 hat nicht nur eine Pandemie der Atemwegserkrankungen verursacht, sondern auch die Zahl kardiovaskulärer Komplikationen erheblich gesteigert. Eine differenzierte Diagnostik und Behandlung dieser Komplikationen sind von entscheidender Bedeutung, um die Sterblichkeit zu senken. Die Forschung zu den langfristigen Auswirkungen von COVID-19 auf das Herz-Kreislauf-System muss intensiviert werden, um betroffenen Patienten die bestmögliche Versorgung zu bieten. > Zur Studie

Medical News: SARS-CoV-2 Induces Significant Morphological Changes in the Human Spleen The COVID-19 pandemic, caused by the SARS-CoV-2 virus, has primarily been associated with respiratory complications. However, emerging research indicates that the virus also affects various extrapulmonary organs, including the spleen. Understanding the morphological alterations in the spleen due to SARS-CoV-2 in...

A third of healthcare staff have symptoms consistent with long Covid but only a fraction have a ...

Long COVID is more than just lingering symptoms—it may have a hidden biological basis that standard medical tests fail to detect. A groundbreaking study using advanced MRI technology has uncovered significant lung abnormalities in children and adolescents suffering from long COVID, particularly i

bioRxiv - the preprint server for biology, operated by Cold Spring Harbor Laboratory, a research and educational institution

Environmental surveillance of infectious organisms holds tremendous promise to reduce human-to-human transmission in indoor spaces through early detection. In this study we determined the applicability and limitations of wastewater, indoor high-touch surfaces, in-room air, and rooftop exhaust air sampling methods for detecting SARS-CoV-2 in a real world building occupied by residents recently diagnosed with COVID-19. We concurrently examined the results of three 24-hour environmental surveillance techniques, indoor surface sampling, exhaust air sampling and wastewater surveillance, to the known daily census fluctuations in a COVID-19 isolation dormitory. Additionally, we assessed the ability of aerosol samplers placed in the large volume lobby to detect SARS-CoV-2 multiple times per day. Our research reveals an increase in the number of individuals confirmed positive with COVID-19 as well as their estimated human viral load to be associated with statistically significant increases in viral loads detected in rooftop exhaust aerosol samples (p = 0.0413), wastewater samples (p = 0.0323,), and indoor high-touch surfaces (p < 0.001)). We also report that the viral load detected in lobby aerosol samples was statistically higher in samples collected during presence of occupants whose COVID-19 diagnostic tests were confirmed positive via qPCR compared to periods when the lobby was occupied by either contact-traced (suspected positive) individuals or during unoccupied periods (p = 0.0314 and <2e−16). We conclude that each daily (24h) surveillance method, rooftop exhaust air, indoor high-touch surfaces, and wastewater, provide useful detection signals for building owner/operator(s). Furthermore, we demonstrate that exhaust air sampling can provide spatially resolved signals based upon ventilation exhaust zones. Additionally, we find that indoor lobby air sampling can provide temporally resolved signals useful during short duration sampling periods (e.g., 2-4 hours) even with intermittent occupancy by occupants diagnosed with COVID-19.

Five years on from March 2020, millions of people still face debilitating symptoms, with huge repercussions on public health and productivity. But politicians are starting to pretend the pandemic never happened

Understanding the effects of SARS-CoV-2 infection and COVID-19 vaccination during pregnancy can help inform clinical guidance and tackle vaccine hesitancy. We examined relationships between SARS-CoV-2 infection during pregnancy, COVID-19 vaccination during pregnancy, and early child developmental concerns in children aged 13–15 months in Scotland. Methods We created a large, population-level linked administrative health dataset, combining the COVID-19 in Pregnancy in Scotland (COPS) dataset with age 13–15 month child health review data and other datasets. We included children estimated to have been conceived after May 18, 2020, and born before Sept 30, 2021, and their mothers. We used logistic regression modelling to investigate associations between SARS-CoV-2 infection during pregnancy, COVID-19 vaccination during pregnancy, and developmental concerns (ie, parent or caregiver developmental concerns and health visitor-identified concerns regarding speech–language–communication, problem solving, gross motor, personal–social, and emotional–behavioural development) measured during routine child health reviews at age 13–15 months, including adjustment for confounders and covariates. Findings A total of 24 919 child–mother pairs (12 752 [51·2%] male children; 12 167 [48·8%] female children) were included. 1631 (6·5%) children were prenatally exposed to SARS-CoV-2 and 4943 (19·8%) to COVID-19 vaccination. We found no associations between SARS-CoV-2 infection during pregnancy and developmental concerns. After confounder and covariate adjustment, COVID-19 vaccination during pregnancy was associated with reduced odds of developmental concerns regarding problem solving (odds ratio 0·78 [95% CI 0·64–0·95]), personal–social (0·76 [0·61–0·95]), and emotional–behavioural (0·67 [0·48–0·92]) development, but had no associations with other developmental concerns. Interpretation SARS-CoV-2 infections during pregnancy do not appear to be linked to early childhood developmental concerns, and COVID-19 vaccinations during pregnancy appear to be safe from the perspective of early childhood developmental concerns. As some developmental concerns do not become apparent until children are older than 13–15 months, future research should continue to monitor outcomes as children grow and develop.

Medical News: COVID-19 has been associated with numerous complications, including the deterioration of muscle mass and function, a condition known as sarcopenia. In high-risk patients, the impact of the virus on muscle health can be severe, leading to long-term consequences. A recent clinical study conducted by researchers from Ilam University of Medical Sciences, Tehran University of Medical Scie...

Rund um das Immunsystem gibt es viele Mythen und Missverständnisse. Dieser Text klärt einige häufige Fragen wissenschaftlich fundiert auf.