Browsing by Subject "SARS-CoV-2"

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  • Rusanen, Juuso; Kareinen, Lauri; Levanov, Lev; Mero, Sointu Maarit; Pakkanen, Sari Hannele; Kantele, Anu; Amanat, Fatima; Krammer, Florian; Hedman, Klaus; Vapalahti, Olli; Hepojoki, Jussi (2021)
    Accurate and rapid diagnostic tools are needed for management of the ongoing coronavirus disease 2019 (COVID-19) pandemic. Antibody tests enable detection of individuals past the initial phase of infection and help examine vaccine responses. The major targets of human antibody response in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are the spike glycoprotein (SP) and nucleocapsid protein (NP). We have developed a rapid homogenous approach for antibody detection termed LFRET (protein L-based time-resolved Forster resonance energy transfer immunoassay). In LFRET, fluorophore-labeled protein L and antigen are brought to close proximity by antigen-specific patient immunoglobulins of any isotype, resulting in TR-FRET signal. We set up LFRET assays for antibodies against SP and NP and evaluated their diagnostic performance using a panel of 77 serum/plasma samples from 44 individuals with COVID-19 and 52 negative controls. Moreover, using a previously described SP and a novel NP construct, we set up enzyme linked immunosorbent assays (ELISAs) for antibodies against SARS-CoV-2 SP and NP. We then compared the LFRET assays with these ELISAs and with a SARS-CoV-2 microneutralization test (MNT). We found the LFRET assays to parallel ELISAs in sensitivity (90-95% vs. 90-100%) and specificity (100% vs. 94-100%). In identifying individuals with or without a detectable neutralizing antibody response, LFRET outperformed ELISA in specificity (91-96% vs. 82-87%), while demonstrating an equal sensitivity (98%). In conclusion, this study demonstrates the applicability of LFRET, a 10-min "mix and read" assay, to detection of SARS-CoV-2 antibodies.
  • Jalkanen, Pinja; Pasternack, Arja; Maljanen, Sari; Melen, Krister; Kolehmainen, Pekka; Huttunen, Moona; Lundberg, Rickard; Tripathi, Lav; Khan, Hira; Ritvos, Mikael A.; Naves, Rauno; Haveri, Anu; Österlund, Pamela; Kuivanen, Suvi; Jääskeläinen, Anne J.; Kurkela, Satu; Lappalainen, Maija; Rantasärkkä, Kaisa; Vuorinen, Tytti; Hytönen, Jukka; Waris, Matti; Tauriainen, Sisko; Ritvos, Olli; Kakkola, Laura; Julkunen, Ilkka (2021)
    Background. Primary diagnosis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is based on detection of virus RNA in nasopharyngeal swab samples. In addition, analysis of humoral immunity against SARS-CoV-2 has an important role in viral diagnostics and seroprevalence estimates. Methods. We developed and optimized an enzyme immunoassays (EIA) using SARS-CoV-2 nucleoprotein (N), Si and receptor binding domain (RBD) of the viral spike protein, and N proteins from SARS, Middle East respiratory syndrome (MERS), and 4 low-pathogenic human CoVs. Neutralizing antibody activity was compared with SARS-CoV-2 IgG, IgA, and IgM EIA results. Results. The sensitivity of EIA for detecting immune response in COVID-19 patients (n = 101) was 77% in the acute phase and 100% in the convalescent phase of SARS-CoV-2 infection when N and RBD were used as antigens in IgG and IgA specific EIAs. SARS-CoV-2 infection significantly increased humoral immune responses against the 229E and NL63 N proteins. Si and RBD-based EIA results had a strong correlation with microneutralization test results. Conclusions. The data indicate a combination of SARS-CoV-2 Si or RBD and N proteins and analysis of IgG and IgA immunoglobulin classes in sera provide an excellent basis for specific and sensitive serological diagnostics of COVID-19.
  • ESHRE COVID-19 Working Grp; Vermeulen, Nathalie; Ata, Baris; Gianaroli, Luca; Tapanainen, Juha S.; Veiga, Anna (2020)
    STUDY QUESTION: How did coronavirus disease 2019 (COVID-19) impact on medically assisted reproduction (MAR) services in Europe during the COVID-19 pandemic (March to May 2020)? SUMMARY ANSWER: MAR services, and hence treatments for infertile couples, were stopped in most European countries for a mean of 7 weeks. WHAT IS KNOWN ALREADY: With the outbreak of COVID-19 in Europe, non-urgent medical care was reduced by local authorities to preserve health resources and maintain social distancing. Furthermore, ESHRE and other societies recommended to postpone ART pregnancies as of 14 March 2020. STUDY DESIGN, SIZE, DURATION: A structured questionnaire was distributed in April among the ESHRE Committee of National Representatives, followed by further information collection through email. PARTICIPANTS/MATERIALS, SETTING, METHODS: The information was collected through the questionnaire and afterwards summarised and aligned with data from the European Centre for Disease Control on the number of COVID-19 cases per country. MAIN RESULTS AND THE ROLE OF CHANCE: By aligning the data for each country with respective epidemiological data, we show a large variation in the time and the phase in the epidemic in the curve when MAR/ART treatments were suspended and restarted. Similarly, the duration of interruption varied. Fertility preservation treatments and patient supportive care for patients remained available during the pandemic. LARGE SCALE DATA: N/A LIMITATIONS, REASONS FOR CAUTION: Data collection was prone to misinterpretation of the questions and replies, and required further follow-up to check the accuracy. Some representatives reported that they, themselves, were not always aware of the situation throughout the country or reported difficulties with providing single generalised replies, for instance when there were regional differences within their country. WIDER IMPLICATIONS OF THE FINDINGS: The current article provides a basis for further research of the different strategies developed in response to the COVID-19 crisis. Such conclusions will be invaluable for health authorities and healthcare professionals with respect to future similar situations.
  • Parekh, Utsav; Chariot, Patrick; Dang, Catherine; Stray-Pedersen, Arne; Druid, Henrik; Sajantila, Antti (2020)
    The COVID-19 pandemic has forced forensic practitioners to consider how we perform our normal duties, especially when those duties involve humans. The potential for contracting the virus from working in close contact with living sufferers is high, and we have yet to fully determine the risk of infection from the deceased. In an attempt to support the community, the Journal of Forensic & Legal Medicine has drawn together three articles which underline the importance of continued forensic medical practice during the pandemic and highlight some factors to consider in a Roadmap towards safe practice. Our Roadmap has intentionally taken an international perspective and supports other work we have published in the Journal on our collective response to the COVID-19 crisis.
  • Almeida, Joao Rafael; Pratas, Diogo; Oliveira, Jose Luis (2021)
    Privacy issues limit the analysis and cross-exploration of most distributed and private biobanks, often raised by the multiple dimensionality and sensitivity of the data associated with access restrictions and policies. These characteristics prevent collaboration between entities, constituting a barrier to emergent personalized and public health challenges, namely the discovery of new druggable targets, identification of disease-causing genetic variants, or the study of rare diseases. In this paper, we propose a semi-automatic methodology for the analysis of distributed and private biobanks. The strategies involved in the proposed methodology efficiently enable the creation and execution of unified genomic studies using distributed repositories, without compromising the information present in the datasets. We apply the methodology to a case study in the current Covid-19, ensuring the combination of the diagnostics from multiple entities while maintaining privacy through a completely identical procedure. Moreover, we show that the methodology follows a simple, intuitive, and practical scheme.
  • FinnGen; Kurki, Samu N.; Kantonen, Jonas; Kaivola, Karri; Hokkanen, Laura; Mäyranpää, Mikko I.; Puttonen, Henri; Martola, Juha; Pöyhönen, Minna; Kero, Mia; Tuimala, Jarno; Carpen, Olli; Kantele, Anu; Vapalahti, Olli; Tiainen, Marjaana; Tienari, Pentti J.; Kaila, Kai; Hastbacka, Johanna; Myllykangas, Liisa (2021)
    Apolipoprotein E epsilon 4 allele (APOE4) has been shown to associate with increased susceptibility to SARS-CoV-2 infection and COVID-19 mortality in some previous genetic studies, but information on the role of APOE4 on the underlying pathology and parallel clinical manifestations is scarce. Here we studied the genetic association between APOE and COVID-19 in Finnish biobank, autopsy and prospective clinical cohort datasets. In line with previous work, our data on 2611 cases showed that APOE4 carriership associates with severe COVID-19 in intensive care patients compared with non-infected population controls after matching for age, sex and cardiovascular disease status. Histopathological examination of brain autopsy material of 21 COVID-19 cases provided evidence that perivascular microhaemorrhages are more prevalent in APOE4 carriers. Finally, our analysis of post-COVID fatigue in a prospective clinical cohort of 156 subjects revealed that APOE4 carriership independently associates with higher mental fatigue compared to non-carriers at six months after initial illness. In conclusion, the present data on Finns suggests that APOE4 is a risk factor for severe COVID-19 and post-COVID mental fatigue and provides the first indication that some of this effect could be mediated via increased cerebrovascular damage. Further studies in larger cohorts and animal models are warranted.
  • Bajc, Marika; Hedeer, Fredrik; Lindqvist, Ari; Trägårdh, Elin (2021)
    V/P SPECT from 4 consecutive patients with COVID-19 suggests that ventilation and perfusion images may be applied to diagnose or exclude pulmonary embolism, verify nonsegmental diversion of perfusion from the ventilated areas (dead space ventilation) that may represent inflammation of the pulmonary vasculature, detect the reversed mismatch of poor ventilation and better preserved perfusion (shunt perfusion) in bilateral pulmonary inflammation and indicate redistribution of lung perfusion (antigravitational hyperperfusion) due to cardiac congestion. V/P mismatch and reversed mismatch may be extensive enough to diminish dramatically preserved matching ventilation/perfusion and to induce severe hypoxemia in COVID-19.
  • Holmberg, Ville; Salmi, Heli; Kattainen, Salla; Ollgren, Jukka; Kantele, Anu; Pynnönen, Juulia; Järvinen, Asko; Forsblom, Erik; Silén, Suvi; Kivivuori, Sanna Maria; Meretoja, Atte; Hästbacka, Johanna (2022)
    Objectives: Motivated by reports of increased risk of coronavirus disease 2019 (COVID-19) in ethnic minorities of high-income countries, we explored whether patients with a foreign first language are at an increased risk of COVID-19 infections, more serious presentations, or worse outcomes. Methods: In a retrospective observational population-based quality registry study covering a population of 1.7 million, we studied the incidence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV2), admissions to specialist healthcare and the intensive care unit (ICU), and all-cause case fatality in different language groups between 27th February and 3rd August 2020 in Southern Finland. A first language other than Finnish, Swedish or Sami served as a surrogate marker for a foreign ethnic background. Results: In total, 124 240 individuals were tested, and among the 118 300 (95%) whose first language could be determined, 4005 (3.4%) were COVID-19-positive, 623 (0.5%) were admitted to specialized hospitals, and 147 (0.1%) were admitted to the ICU; 254 (0.2%) died. Those with a foreign first language had lower testing rates (348, 95%CI 340-355 versus 758, 95%CI 753-762 per 10 000, p < 0.0001), higher incidence (36, 95%CI 33-38 versus 22, 95%CI 21-23 per 10 000, p < 0.0001), and higher positivity rates (103, 95%CI 96-109 versus 29, 95%CI 28-30 per 1000, p < 0.0001). There was no significant difference in ICU admissions, disease severity at ICU admission, or ICU outcomes. Case fatality by 90 days was 7.7% in domestic cases and 1.2% in those with a foreign first language, explained by demographics (age-and sex adjusted HR 0.49, 95%CI 0.21-1.15). Conclusions: The population with a foreign first language was at an increased risk for testing positive for SARS-CoV-2, but when hospitalized they had outcomes similar to those in the native, domestic language population. This suggests that special attention should be paid to the prevention and control of infectious diseases among language minorities. (C) 2021 The Authors. Published by Elsevier Ltd on behalf of European Society of Clinical Microbiology and Infectious Diseases.
  • Hemilä, Harri; Chalker, Elizabeth (2021)
    In this individual patient data meta-analysis we examined datasets of two randomized placebo-controlled trials which investigated the effect of nasal carrageenan separately on children and adults. In both trials, iota-carrageenan was administered nasally three times per day for 7 days for patients with the common cold and follow-up lasted for 21 days. We used Cox regression to estimate the effect of carrageenan on recovery rate. We also used quantile regression to calculate the effect of carrageenan on colds of differing lengths. Nasal carrageenan increased the recovery rate from all colds by 54% (95% CI 15%-105%; p = .003). The increase in recovery rate was 139% for coronavirus infections, 119% for influenza A infections, and 70% for rhinovirus infections. The mean duration of all colds in the placebo groups of the first four quintiles were 4.0, 6.8, 8.8, and 13.7 days, respectively. The fifth quintile contained patients with censored data. The 13.7-day colds were shortened by 3.8 days (28% reduction), and 8.8-day colds by 1.3 days (15% reduction). Carrageenan had no meaningful effect on shorter colds. In the placebo group, 21 patients had colds lasting over 20 days, compared with six patients in the carrageenan group, which corresponds to a 71% (p = .003) reduction in the risk of longer colds. Given that carrageenan has an effect on diverse virus groups, and effects at the clinical level on two old coronaviruses, it seems plausible that carrageenan may have an effect on COVID-19. Further research on nasal iota-carrageenan is warranted.
  • Giri, Anil K.; Rana, Divya RSJB (2020)
    The infrastructure needed to detect Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection (COVID-19) that complies completely with WHO guidelines is lacking across many parts of the globe, especially in developing countries, including Nepal. We outline the problems faced by such countries and suggest that the national and international community should collaborate in the development and adoption of novel protocols for the rapid detection of COVID-19 according to locally available infrastructure, in order to fight against the outbreak.
  • Brunotte, Linda; Zheng, Shuyu; Mecate-Zambrano, Angeles; Tang, Jing; Ludwig, Stephan; Rescher, Ursula; Schloer, Sebastian (2021)
    The ongoing SARS-CoV-2 pandemic requires efficient and safe antiviral treatment strategies. Drug repurposing represents a fast and low-cost approach to the development of new medical treatment options. The direct antiviral agent remdesivir has been reported to exert antiviral activity against SARS-CoV-2. Whereas remdesivir only has a very short half-life time and a bioactivation, which relies on pro-drug activating enzymes, its plasma metabolite GS-441524 can be activated through various kinases including the adenosine kinase (ADK) that is moderately expressed in all tissues. The pharmacokinetics of GS-441524 argue for a suitable antiviral drug that can be given to patients with COVID-19. Here, we analyzed the antiviral property of a combined treatment with the remdesivir metabolite GS-441524 and the antidepressant fluoxetine in a polarized Calu-3 cell culture model against SARS-CoV-2. The combined treatment with GS-441524 and fluoxetine were well-tolerated and displayed synergistic antiviral effects against three circulating SARS-CoV-2 variants in vitro in the commonly used reference models for drug interaction. Thus, combinatory treatment with the virus-targeting GS-441524 and the host-directed drug fluoxetine might offer a suitable therapeutic treatment option for SARS-CoV-2 infections.
  • Abdelrehiem, Dina Ahmed Mosselhy; Kareinen, Lauri; Kivistö, Ilkka; Aaltonen, Kirsi; Virtanen, Jenni Maaret Elina; Ge, Yanling; Sironen, Tarja (2021)
    The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remains a severe health threat. The COVID-19 infections occurring in humans and animals render human-animal interfaces hot spots for spreading the pandemic. Lessons from the past point towards the antiviral properties of copper formulations; however, data showing the "contact-time limit" surface inhibitory efficacy of copper formulations to contain SARS-CoV-2 are limited. Here, we show the rapid inhibition of SARS-CoV-2 after only 1 and 5 min on two different surfaces containing copper-silver (Cu-Ag) nanohybrids. We characterized the nanohybrids' powder and surfaces using a series of sophisticated microscopy tools, including transmission and scanning electron microscopes (TEM and SEM) and energy-dispersive X-ray spectroscopy (EDX). We used culturing methods to demonstrate that Cu-Ag nanohybrids with high amounts of Cu (similar to 65 and 78 wt%) and lower amounts of Ag (similar to 7 and 9 wt%) inhibited SARS-CoV-2 efficiently. Collectively, the present work reveals the rapid SARS-CoV-2 surface inhibition and the promising application of such surfaces to break the SARS-CoV-2 transmission chain. For example, such applications could be invaluable within a hospital or live-stock settings, or any public place with surfaces that people frequently touch (i.e., public transportation, shopping malls, elevators, and door handles) after the precise control of different parameters and toxicity evaluations.
  • Pfaar, O; Klimek, L; Jutel, M; Akdis, C A; Bousquet, J; Breiteneder, H; Chinthrajah, S; Diamant, Z; Eiwegger, T; Fokkens, W J; Fritsch, H W; Nadeau, K C; O'Hehir, R E; O'Mahony, L; Rief, W; Sampath, V; Schedlowski, M; Torres, M; Traidl-Hoffmann, C; Wang, D Y; Zhang, L; Bonini, M; Brehler, R; Brough, H A; Chivato, T; Del Giacco, S; Dramburg, S; Gawlik, R; Gelincik, A; Hoffmann-Sommergruber, K; Hox, V; Knol, E; Lauerma, A; Matricardi, P M; Mortz, C G; Ollert, M; Palomares, O; Riggioni, C; Schwarze, J; Skypala, I; Untersmayr, S; Walusiak-Skorupa, J; Ansotegui, I; Bachert, C; Bedbrook, A; Bosnic-Anticevich, S; Brussino, L; Canonica, G W; Cardona, V; Carreiro-Martins, P; Cruz, A A; Czarlewski, W; Fonseca, J A; Gotua, M; Haahtela, T; Ivancevich, J C; Kuna, P; Kvedariene, V; Larenas-Linnemann, D; Latiff, A; Morais-Almeida, M; Mullol, J; Naclerio, R; Ohta, K; Okamoto, Y; Onorato, G L; Papadopoulos, N G; Patella, V; Regateiro, F S; Samolinski, B; Suppli Ulrik, C; Toppila-Salmi, S; Valiulis, A; Ventura, M T; Yorgancioglu, A; Zuberbier, T; Agache, I (2021)
    BackgroundThe coronavirus disease 2019 (COVID-19) has evolved into a pandemic infectious disease transmitted by the severe acute respiratory syndrome coronavirus (SARS-CoV-2). Allergists and other healthcare providers (HCPs) in the field of allergies and associated airway diseases are on the front line, taking care of patients potentially infected with SARS-CoV-2. Hence, strategies and practices to minimize risks of infection for both HCPs and treated patients have to be developed and followed by allergy clinics. MethodThe scientific information on COVID-19 was analysed by a literature search in MEDLINE, PubMed, the National and International Guidelines from the European Academy of Allergy and Clinical Immunology (EAACI), the Cochrane Library, and the internet. ResultsBased on the diagnostic and treatment standards developed by EAACI, on international information regarding COVID-19, on guidelines of the World Health Organization (WHO) and other international organizations, and on previous experience, a panel of experts including clinicians, psychologists, IT experts, and basic scientists along with EAACI and the "Allergic Rhinitis and its Impact on Asthma (ARIA)" initiative have developed recommendations for the optimal management of allergy clinics during the current COVID-19 pandemic. These recommendations are grouped into nine sections on different relevant aspects for the care of patients with allergies. ConclusionsThis international Position Paper provides recommendations on operational plans and procedures to maintain high standards in the daily clinical care of allergic patients while ensuring the necessary safety measures in the current COVID-19 pandemic.
  • Abdelrehiem, Dina Ahmed Mosselhy; Virtanen, Jenni Maaret Elina; Kant, Ravi; He, Wei; Elbahri, Mady; Sironen, Tarja (2021)
    Every day, new information is presented with respect to how to best combat the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This manuscript sheds light on such recent findings, including new co-factors (i.e., neuropilin-1) and routes (i.e., olfactory transmucosal) allowing cell entry of SARS-CoV-2 and induction of neurological symptoms, as well as the new SARS-CoV-2 variants. We highlight the SARS-CoV-2 human-animal interfaces and elaborate containment strategies using the same vaccination (i.e., nanoparticle "NP" formulations of the BNT162b2 and mRNA-1273 vaccines) for humans, minks, raccoon dogs, cats, and zoo animals. We investigate the toxicity issues of anti-CoV NPs (i.e., plasmonic NPs and quantum dots) on different levels. Namely, nano-bio interfaces (i.e., protein corona), in vitro (i.e., lung cells) and in vivo (i.e., zebrafish embryos) assessments, and impacts on humans are discussed in a narrative supported by original figures. Ultimately, we express our skeptical opinion on the comprehensive administration of such antiviral nanotheranostics, even when integrated into facemasks, because of their reported toxicities and the different NP parameters (e.g., size, shape, surface charge, and purity and chemical composition of NPs) that govern their end toxicity. We believe that more toxicity studies should be performed and be presented, clarifying the odds of the safe administration of nanotoxocological solutions and the relief of a worried public.
  • Schloer, Sebastian; Brunotte, Linda; Mecate-Zambrano, Angeles; Zheng, Shuyu; Tang, Jing; Ludwig, Stephan; Rescher, Ursula (2021)
    Background and Purpose The SARS-COV-2 pandemic and the global spread of coronavirus disease 2019 (COVID-19) urgently call for efficient and safe antiviral treatment strategies. A straightforward approach to speed up drug development at lower costs is drug repurposing. Here, we investigated the therapeutic potential of targeting the interface of SARS CoV-2 with the host via repurposing of clinically licensed drugs and evaluated their use in combinatory treatments with virus- and host-directed drugs in vitro. Experimental Approach We tested the antiviral potential of the antifungal itraconazole and the antidepressant fluoxetine on the production of infectious SARS-CoV-2 particles in the polarized Calu-3 cell culture model and evaluated the added benefit of a combinatory use of these host-directed drugs with the direct acting antiviral remdesivir, an inhibitor of viral RNA polymerase. Key Results Drug treatments were well-tolerated and potently impaired viral replication. Importantly, both itraconazole?remdesivir and fluoxetine?remdesivir combinations inhibited the production of infectious SARS-CoV-2 particles?>?90% and displayed synergistic effects, as determined in commonly used reference models for drug interaction. Conclusion and Implications Itraconazole?remdesivir and fluoxetine?remdesivir combinations are promising starting points for therapeutic options to control SARS-CoV-2 infection and severe progression of COVID-19.
  • Resal, Tamas; Bor, Renata; Szanto, Kata; Fabian, Anna; Rutka, Mariann; Sacco, Marco; Ribaldone, Davide Guiseppe; Molander, Pauliina; Nancey, Stephane; Kopytov, Uri; Vavricka, Stephan; Drobne, David; Lukas, Milan; Farkas, Klaudia; Szepes, Zoltan; Molnar, Tamas (2021)
    Introduction: The coronavirus disease 2019 (COVID-19) pandemic poses a challenge to healthcare. Staff and patients are at increased risk during an examination or intervention, so certain restrictions ought to be introduced. Hence, we aimed to measure the effect of the pandemic on endoscopy units in real-life settings. Methods: This was an observational, cross-sectional, questionnaire-based study, carried out between 7 April and 15 June 2020. Responds came from many countries, and the participation was voluntary. The survey contained 40 questions, which evaluated the effect of the COVID-19 pandemic on the endoscopy units and assessed the infection control. Results: A total of 312 questionnaires were filled, 120 from Hungary, and 192 internationally, and 54 questionnaires (17.3%) were sent from high-risk countries; 84.9% of the gastroenterologists declared that they read the European Society of Gastrointestinal Endoscopy (ESGE) statement, while only 32.1% participated in any advanced training at their workplace. Overall, 92.1% of gastroenterologists realized risk stratification, and 72.1% claimed to have enough protective equipment. In 52.6% of the endoscopy units, at least one endoscopist had to discontinue the work due to any risk factor, while 40.6% reported that the reduced staff did not affect the workflow. Gastroenterologists considered that the five most important examinations both in low and high-risk patients are the following: lower/upper gastrointestinal (GI) bleeding with hemodynamic instability, endoscopic retrograde cholangiopancreatography (ERCP) in obstructive jaundice, foreign body in the esophagus, ERCP in acute biliary pancreatitis, and iron deficiency anemia with hemodynamic instability, which correlates well with the ESGE recommendation. Significant correlation was found in the usage of the necessary protective equipment in high-risk patients depending on the countries (p < 0.001). Conclusions: The survey found weak correlation in preliminary training depending on countries; nevertheless, in Hungary during the examined period, endoscopists considered the recommendations more strictly than in other countries. Although many physicians left the endoscopy lab, the workflow was not affected, probably due to the reduced number of examinations.
  • Indolfi, Giuseppe; Stivala, Micol; Lenge, Matteo; Diaz Naderi, Ruben; McIntosh, Jennifer; Llandrich, Ricard Casadevall; Gannon, Joe; McGreevy, Kathleen S.; Trapani, Sandra; Miettinen, Päivi; Lahdenne, Pekka; Desborough, Louisa; Pavare, Jana; van Rossum, Annemarie; Zyska, Dagmara; Resti, Massimo; Zanobini, Alberto (2021)
    The Severe Acute Respiratory Syndrome CoronaVirus type 2 (SARS-CoV-2) pandemic impacted the organization of paediatric hospitals. This study aimed to evaluate the preparedness for the pandemic among a European network of children's hospitals and to explore the strategies to restart health care services. A cross-sectional, web-based survey was distributed in May 2020 to the 13 children's tertiary care hospitals belonging to the European Children's Hospitals Organisation. Responses were obtained from eight hospitals (62%). Significant reductions were observed in accesses to the emergency departments (41.7%), outpatient visits (35.7%), intensive and non-intensive care unit inpatient admissions (16.4 and 13%, respectively) between February 1 and April 30, 2020 as compared with the same period of 2019. Overall, 93 children with SARS CoV-2 infection were admitted to inpatient wards. All the hospitals created SARS-CoV-2 preparedness plans for the diagnosis and management of infected patients. Routine activities were re-scheduled. Four hospitals shared their own staff with adult units, two designated bed spaces for adults and only one admitted adults to inpatient wards. The three main components for the resumption of clinical activities were testing, source control, and reorganization of spaces and flows. Telemedicine and telehealth services were used before the SARS-CoV-2 pandemic by three hospitals and by all the hospitals during it. Conclusion: The present study provides a perspective on preparedness to SARS-CoV-2 pandemic among eight large European children's hospitals, on the impact of the pandemic on the hospital activities and on the strategies adopted to restart clinical activities.
  • De Luca, Giuseppe; Debel, Niels; Cercek, Miha; Jensen, Lisette Okkels; Vavlukis, Marija; Calmac, Lucian; Johnson, Tom; Rourai Ferrer, Gerard; Ganyukov, Vladimir; Wojakowski, Wojtek; Kinnaird, Tim; von Birgelen, Clemens; Cottin, Yves; IJsselmuiden, Alexander; Tuccillo, Bernardo; Versaci, Francesco; Royaards, Kees-Jan; ten Berg, Jurrien; Laine, Mika; Dirksen, Maurits; Siviglia, Massimo; Casella, Gianni; Kala, Petr; Gil, Jose Luis Diez; Banning, Adrian; Becerra, Victor; De Simone, Ciro; Santucci, Andrea; Carrillo, Xavier; Scoccia, Alessandra; Amoroso, Giovanni; van't Hof, Arnoud Wj; Kovarnik, Tomas; Tsigkas, Grigorios; Mehilli, Julinda; Gabrielli, Gabriele; Rios, Xacobe Flores; Bakraceski, Nikola; Levesque, Sebastien; Cirrincione, Giuseppe; Guiducci, Vincenzo; Kidawa, Michal; Spedicato, Leonardo; Marinucci, Lucia; Ludman, Peter; Zilio, Filippo; Galasso, Gennaro; Fabris, Enrico; Menichelli, Maurizio; Garcia-Touchard, Arturo; Manzo, Stephane; Caiazzo, Gianluca; Moreu, Jose; Fores, Juan Sanchis; Donazzan, Luca; Vignali, Luigi; Teles, Rui; Benit, Edouard; Agostoni, Pierfrancesco; Ojeda, Francisco Bosa; Lehtola, Heidi; Camacho-Freiere, Santiago; Kraaijeveld, Adriaan; Antti, Ylitalo; Boccalatte, Marco; Deharo, Pierre; Martinez-Luengas, Inigo Lozano; Scheller, Bruno; Varytimiadi, Efthymia; Moreno, Raul; Uccello, Giuseppe; Faurie, Benjamin; Barrios, Alejandro Gutierrez; Milewski, Marek; Bruwiere, Ewout; Smits, Pieter; Wilbert, Bor; Di Uccio, Fortunato Scotto; Parodi, Guido; Kedhi, Elvin; Verdoia, Monica (2021)
    Background and aims: SARS-Cov-2 predisposes patients to thrombotic complications, due to excessive inflam-mation, endothelial dysfunction, platelet activation, and coagulation/fibrinolysis disturbances. The aim of the present study was to evaluate clinical characteristics and prognostic impact of SARS-CoV-2 positivity among STEMI patients undergoing primary percutaneous coronary intervention (PPCI). Methods: We selected SARS-CoV-2 positive patients included in the ISACS-STEMI COVID-19, a retrospective multicenter European registry including 6609 STEMI patients treated with PPCI from March 1st until April 30th, in 2019 and 2020. As a reference group, we randomly sampled 5 SARS-Cov-2 negative patients per each SARS-CoV-2 positive patient, individually matched for age, sex, and hospital/geographic area. Study endpoints were in-hospital mortality, definite stent thrombosis, heart failure. Results: Our population is represented by 62 positive SARS-CoV-2 positive patients who were compared with a matched population of 310 STEMI patients. No significant difference was observed in baseline characteristics or the modality of access to the PCI center. In the SARS-CoV-2 positive patients, the culprit lesion was more often located in the RCA (p < 0.001). Despite similar pre and postprocedural TIMI flow, we observed a trend in higher use of GP IIb-IIIa inhibitors and a significantly higher use of thrombectomy in the SARS-CoV-2 positive patients. SARS-CoV-2 positivity was associated with a remarkably higher in hospital mortality (29% vs 5.5%, p < 0.001), definite in-stent thrombosis (8.1% vs 1.6%, p symbolscript 0.004) and heart failure (22.6% vs 10.6%, p symbolscript 0.001) that was confirmed after adjustment for confounding factors. Conclusions: Our study showed that among STEMI patients, SARS-CoV-2 positivity is associated with larger thrombus burden, a remarkably higher mortality but also higher rates of in-stent thrombosis and heart failure.
  • Hussein, Tareq; Löndahl, Jakob; Thuresson, Sara; Alsved, Malin; Al-Hunaiti, Afnan; Saksela, Kalle; Aqel, Hazem; Junninen, Heikki; Mahura, Alexander; Kulmala, Markku (2021)
    Transmission of respiratory viruses is a complex process involving emission, deposition in the airways, and infection. Inhalation is often the most relevant transmission mode in indoor environments. For severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the risk of inhalation transmission is not yet fully understood. Here, we used an indoor aerosol model combined with a regional inhaled deposited dose model to examine the indoor transport of aerosols from an infected person with novel coronavirus disease (COVID-19) to a susceptible person and assess the potential inhaled dose rate of particles. Two scenarios with different ventilation rates were compared, as well as adult female versus male recipients. Assuming a source strength of 10 viruses/s, in a tightly closed room with poor ventilation (0.5 h−1), the respiratory tract deposited dose rate was 140–350 and 100–260 inhaled viruses/hour for males and females; respectively. With ventilation at 3 h−1 the dose rate was only 30–90 viruses/hour. Correcting for the half-life of SARS-CoV-2 in air, these numbers are reduced by a factor of 1.2–2.2 for poorly ventilated rooms and 1.1–1.4 for well-ventilated rooms. Combined with future determinations of virus emission rates, the size distribution of aerosols containing the virus, and the infectious dose, these results could play an important role in understanding the full picture of potential inhalation transmission in indoor environments.