Publikationen im NUM
Hier finden Sie eine Liste der Publikationen, die im Zusammenhang mit dem Netzwerk Universitätsmedizin in der ersten und zweiten Förderphase entstanden sind.
[eng]
S. Stillfried,
R. D. Bülow,
R. Röhrig,
P. Meybohm,
P. Boor and
D. C. COVID-19 Autopsies (DeRegCOVID),
"Intracranial hemorrhage in COVID-19 patients during extracorporeal membrane oxygenation for acute respiratory failure: a nationwide register study report",
Critical Care (London, England),
vol. 26,
no. 1,
pp. 83,
Mä.
2022.
Abstract:
BACKGROUND: In severe cases, SARS-CoV-2 infection leads to acute respiratory distress syndrome (ARDS), often treated by extracorporeal membrane oxygenation (ECMO). During ECMO therapy, anticoagulation is crucial to prevent device-associated thrombosis and device failure, however, it is associated with bleeding complications. In COVID-19, additional pathologies, such as endotheliitis, may further increase the risk of bleeding complications. To assess the frequency of bleeding events, we analyzed data from the German COVID-19 autopsy registry (DeRegCOVID). METHODS: The electronic registry uses a web-based electronic case report form. In November 2021, the registry included N = 1129 confirmed COVID-19 autopsy cases, with data on 63 ECMO autopsy cases and 1066 non-ECMO autopsy cases, contributed from 29 German sites. FINDINGS: The registry data showed that ECMO was used in younger male patients and bleeding events occurred much more frequently in ECMO cases compared to non-ECMO cases (56% and 9%, respectively). Similarly, intracranial bleeding (ICB) was documented in 21% of ECMO cases and 3% of non-ECMO cases and was classified as the immediate or underlying cause of death in 78% of ECMO cases and 37% of non-ECMO cases. In ECMO cases, the three most common immediate causes of death were multi-organ failure, ARDS and ICB, and in non-ECMO cases ARDS, multi-organ failure and pulmonary bacterial ± fungal superinfection, ordered by descending frequency. INTERPRETATION: Our study suggests the potential value of autopsies and a joint interdisciplinary multicenter (national) approach in addressing fatal complications in COVID-19.
| DOI: | 10.1186/s13054-022-03945-x |
Abstract:
BACKGROUND: In severe cases, SARS-CoV-2 infection leads to acute respiratory distress syndrome (ARDS), often treated by extracorporeal membrane oxygenation (ECMO). During ECMO therapy, anticoagulation is crucial to prevent device-associated thrombosis and device failure, however, it is associated with bleeding complications. In COVID-19, additional pathologies, such as endotheliitis, may further increase the risk of bleeding complications. To assess the frequency of bleeding events, we analyzed data from the German COVID-19 autopsy registry (DeRegCOVID). METHODS: The electronic registry uses a web-based electronic case report form. In November 2021, the registry included N = 1129 confirmed COVID-19 autopsy cases, with data on 63 ECMO autopsy cases and 1066 non-ECMO autopsy cases, contributed from 29 German sites. FINDINGS: The registry data showed that ECMO was used in younger male patients and bleeding events occurred much more frequently in ECMO cases compared to non-ECMO cases (56% and 9%, respectively). Similarly, intracranial bleeding (ICB) was documented in 21% of ECMO cases and 3% of non-ECMO cases and was classified as the immediate or underlying cause of death in 78% of ECMO cases and 37% of non-ECMO cases. In ECMO cases, the three most common immediate causes of death were multi-organ failure, ARDS and ICB, and in non-ECMO cases ARDS, multi-organ failure and pulmonary bacterial ± fungal superinfection, ordered by descending frequency. INTERPRETATION: Our study suggests the potential value of autopsies and a joint interdisciplinary multicenter (national) approach in addressing fatal complications in COVID-19.
S. Stillfried,
R. Bülow,
R. Röhrig,
P. Meybohm and
P. Boor,
"Intracranial hemorrhage in COVID-19 patients during extracorporeal membrane oxygenation for acute respiratory failure: a nationwide register study report",
Critical care (London, England),
vol. 26,
pp. 83,
2022.
| DOI: | 10.1186/s13054-022-03945-x |
B. Pauli,
J. Strupp,
K. Schloesser and
D. Stahl,
"It’s like standing in front of a prison fence – Dying during the SARS-CoV2 pandemic: A qualitative study of bereaved relatives’ experiences",
Palliative Medicine,
2022.
| DOI: | 10.1177/02692163221076355 |
[en]
E. Wyler,
K. Eschke,
G. Teixeira Alves,
S. Peidli,
F. Pott,
J. Kazmierski,
L. Michalick,
O. Kershaw,
J. Bushe,
P. Pennitz,
D. Postmus,
C. Goffinet,
J. Kreye,
S. M. Reincke,
H. Prüss,
N. Blüthgen,
A. D. Gruber,
W. M. Kuebler,
M. Witzenrath,
M. Landthaler,
G. Nouailles and
J. Trimpert,
"Key benefits of dexamethasone and antibody treatment in COVID-19 hamster models revealed by single-cell transcriptomics",
Mol. Ther.,
vol. 30,
no. 5,
pp. 1952—1965,
Mai
2022.
Elsevier BV.
Abstract:
For coronavirus disease 2019 (COVID-19), effective and well-understood treatment options are still scarce. Since vaccine efficacy is challenged by novel variants, short-lasting immunity, and vaccine hesitancy, understanding and optimizing therapeutic options remains essential. We aimed at better understanding the effects of two standard-of-care drugs, dexamethasone and anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies, on infection and host responses. By using two COVID-19 hamster models, pulmonary immune responses were analyzed to characterize effects of single or combinatorial treatments. Pulmonary viral burden was reduced by anti-SARS-CoV-2 antibody treatment and unaltered or increased by dexamethasone alone. Dexamethasone exhibited strong anti-inflammatory effects and prevented fulminant disease in a severe disease model. Combination therapy showed additive benefits with both anti-viral and anti-inflammatory potency. Bulk and single-cell transcriptomic analyses confirmed dampened inflammatory cell recruitment into lungs upon dexamethasone treatment and identified a specifically responsive subpopulation of neutrophils, thereby indicating a potential mechanism of action. Our analyses confirm the anti-inflammatory properties of dexamethasone and suggest possible mechanisms, validate anti-viral effects of anti-SARS-CoV-2 antibody treatment, and reveal synergistic effects of a combination therapy, thus informing more effective COVID-19 therapies.
| DOI: | 10.1016/j.ymthe.2022.03.014 |
| Pubmed: | 35339689 |
Abstract:
For coronavirus disease 2019 (COVID-19), effective and well-understood treatment options are still scarce. Since vaccine efficacy is challenged by novel variants, short-lasting immunity, and vaccine hesitancy, understanding and optimizing therapeutic options remains essential. We aimed at better understanding the effects of two standard-of-care drugs, dexamethasone and anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies, on infection and host responses. By using two COVID-19 hamster models, pulmonary immune responses were analyzed to characterize effects of single or combinatorial treatments. Pulmonary viral burden was reduced by anti-SARS-CoV-2 antibody treatment and unaltered or increased by dexamethasone alone. Dexamethasone exhibited strong anti-inflammatory effects and prevented fulminant disease in a severe disease model. Combination therapy showed additive benefits with both anti-viral and anti-inflammatory potency. Bulk and single-cell transcriptomic analyses confirmed dampened inflammatory cell recruitment into lungs upon dexamethasone treatment and identified a specifically responsive subpopulation of neutrophils, thereby indicating a potential mechanism of action. Our analyses confirm the anti-inflammatory properties of dexamethasone and suggest possible mechanisms, validate anti-viral effects of anti-SARS-CoV-2 antibody treatment, and reveal synergistic effects of a combination therapy, thus informing more effective COVID-19 therapies.
F. P,
K. J,
P. T,
L. S,
M. V,
S. Fischer,
S. H,
D. C,
S. M,
Z. S,
S. M,
M. D,
F. GR and
A. N,
"Meaningful use of imaging resources to rule out cerebral venous sinus thrombosis after ChAdOx1 COVID-19 vaccination: Evaluation of the AHA diagnostic algorithm with a clinical cohort and a systematic data review.",
Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia,
Aug.
2022.
Abstract:
Vaccin-induzierte immunthrombotische Thrombozytopenie (VITT) mit cerebraler venöser Thrombose (CVST) ist eine unwahrscheinliche (0.0005%), aber möglicherweise tödliche Komplikation nach ChAdOx1 Impfung. Andererseits gehört Kopfschmerzen zu den häufigsten Nebenwirkungen von ChAdOx1 (29,3%). Im September 2021 schlug die American Heart Association (AHA) einen diagnostischen Workflow vor, um die risikoadaptierte Verwendung von bildgebenden Ressourcen für Patienten mit neurologischen Symptomen nach ChAdOx1 zu erleichtern. Wir wollten den AHA-Workflow in einem retrospektiven Patientenkohort bewerten, der nach ChAdOx1 an vier primären Pflegekrankenhäusern in Deutschland präsentiert. Wissenschaftliche Literatur wurde für Fallberichte von VITT mit CVST nach ChAdOx1, veröffentlicht bis 1. September 2021. Einhundertdreizehn aufeinanderfolgende Patienten (77 weiblich, mittleres Alter 38,7 +/- 11,9 Jahre) wurden an unseren Instituten bewertet, darunter ein Fall von VITT mit CVST. Weitere 228 Fallberichte von VITT mit CVST werden in jüngster Literatur veröffentlicht, die Thrombozyten-Thema (225/227 berichtet) und erhöhte d-Dimer-Spiegel (100/101 berichtet) teilen. Der AHA-Workflow hätte alle VITT-Fälle mit CVST (100% Empfindlichkeit) erkannt, die für die Diagnose (NND) benötigte Anzahl betrug 1:113. Die anfängliche Auswertung von Thrombocytopenie oder erhöhten d-Dimer-Spiegeln hätte den NND auf 1:68 reduziert, ohne dass die Empfindlichkeit gekostet wäre. Daher schlagen wir vor, dass bei normalen Thrombozyten- und d-Dimerenspiegeln der Zugang zu weiteren Diagnostiken durch die etablierten klinischen Überlegungen unabhängig von der Impfungsgeschichte begrenzt werden sollte.
| DOI: | 10.1016/j.jocn.2022.05.031 |
Abstract:
Vaccin-induzierte immunthrombotische Thrombozytopenie (VITT) mit cerebraler venöser Thrombose (CVST) ist eine unwahrscheinliche (0.0005%), aber möglicherweise tödliche Komplikation nach ChAdOx1 Impfung. Andererseits gehört Kopfschmerzen zu den häufigsten Nebenwirkungen von ChAdOx1 (29,3%). Im September 2021 schlug die American Heart Association (AHA) einen diagnostischen Workflow vor, um die risikoadaptierte Verwendung von bildgebenden Ressourcen für Patienten mit neurologischen Symptomen nach ChAdOx1 zu erleichtern. Wir wollten den AHA-Workflow in einem retrospektiven Patientenkohort bewerten, der nach ChAdOx1 an vier primären Pflegekrankenhäusern in Deutschland präsentiert. Wissenschaftliche Literatur wurde für Fallberichte von VITT mit CVST nach ChAdOx1, veröffentlicht bis 1. September 2021. Einhundertdreizehn aufeinanderfolgende Patienten (77 weiblich, mittleres Alter 38,7 +/- 11,9 Jahre) wurden an unseren Instituten bewertet, darunter ein Fall von VITT mit CVST. Weitere 228 Fallberichte von VITT mit CVST werden in jüngster Literatur veröffentlicht, die Thrombozyten-Thema (225/227 berichtet) und erhöhte d-Dimer-Spiegel (100/101 berichtet) teilen. Der AHA-Workflow hätte alle VITT-Fälle mit CVST (100% Empfindlichkeit) erkannt, die für die Diagnose (NND) benötigte Anzahl betrug 1:113. Die anfängliche Auswertung von Thrombocytopenie oder erhöhten d-Dimer-Spiegeln hätte den NND auf 1:68 reduziert, ohne dass die Empfindlichkeit gekostet wäre. Daher schlagen wir vor, dass bei normalen Thrombozyten- und d-Dimerenspiegeln der Zugang zu weiteren Diagnostiken durch die etablierten klinischen Überlegungen unabhängig von der Impfungsgeschichte begrenzt werden sollte.
S. Krishnaratne,
H. Littlecott,
K. Sell,
J. Burns,
J. E. Rabe,
J. M. Stratil,
T. Litwin,
C. Kreutz,
M. Coenen,
K. Geffert,
A. H. Boger,
A. Movsisyan,
S. Kratzer,
C. Klinger,
K. Wabnitz,
B. Strahwald,
B. Verboom,
E. Rehfuess,
R. L. Biallas,
C. Jung-Sievers,
S. Voss and
L. M. Pfadenhauer,
"Measures implemented in the school setting to contain the COVID-19 pandemic: a rapid review",
Cochrane Database of Systematic Reviews,
vol. 2022,
pp. CD015029,
2022.
| DOI: | 10.1002/14651858.CD015029 |
[eng]
M. Ackermann and
D. D. Jonigk,
"Microvascular placental alterations in maternal COVID-19",
American Journal of Obstetrics and Gynecology,
vol. 226,
no. 1,
pp. 135—136,
Jan.
2022.
| DOI: | 10.1016/j.ajog.2021.06.098 |
J. Schwartz,
M. C. Reuters,
M. Schallenburger,
S. Meier,
C. Roch,
L. Werner,
B. Oorschot and
M. Neukirchen,
"Modelle guter Praxis: Alleine sterben ist ethisch nicht vertretbar",
Praxis Palliative Care,
vol. 54,
pp. 29-36,
2022.
[eng]
N. Wanner,
G. Andrieux,
P. Badia-I-Mompel,
C. Edler,
S. Pfefferle,
M. T. Lindenmeyer,
C. Schmidt-Lauber,
J. Czogalla,
M. N. Wong,
Y. Okabayashi,
F. Braun,
M. Lütgehetmann,
E. Meister,
S. Lu,
M. L. M. Noriega,
T. Günther,
A. Grundhoff,
N. Fischer,
H. Bräuninger,
D. Lindner,
D. Westermann,
F. Haas,
K. Roedl,
S. Kluge,
M. M. Addo,
S. Huber,
A. W. Lohse,
J. Reiser,
B. Ondruschka,
J. P. Sperhake,
J. Saez-Rodriguez,
M. Boerries,
S. S. Hayek,
M. Aepfelbacher,
P. Scaturro,
V. G. Puelles and
T. B. Huber,
"Molecular consequences of SARS-CoV-2 liver tropism",
Nature Metabolism,
vol. 4,
no. 3,
pp. 310—319,
Mä.
2022.
| DOI: | 10.1038/s42255-022-00552-6 |
N. Wanner,
G. Andrieux,
P. Badia-i-Mompel and
et al,
"Molecular consequences of SARS-CoV-2 liver tropism",
Nat Metab,
vol. 4,
pp. 310-319,
2022.
| DOI: | 10.1038/s42255-022-00552-6 |
H. Gruell and
et al,
"mRNA booster immunization elicits potent neutralizing serum activity against the SARS-CoV-2 Omicron variant",
Nature Medicine,
2022.
| DOI: | 10.1038/s41591-021-01676-0 |
Z. Liu and
et al,
"Multi-Omics Integration Reveals Only Minor Long-Term Molecular and Functional Sequelae in Immune Cells of Individuals Recovered From COVID-19",
Frontiers in immunology,
vol. 13,
pp. 838132,
2022.
| DOI: | 10.3389/fimmu.2022.838132 |
T. Illig,
"NAPKON- Eine Erfolgsgeschichte",
Plenarvortrag, Nationales Biobanken Symposium,
2022.
C. Bausewein,
F. Hodiamont,
N. Berges,
A. Ullrich,
C. Gerlach,
K. Oechsle,
B. Pauli,
J. Weber,
S. Stiel,
N. Schneider and
D. Stahl,
"National strategy for palliative care of severely ill and dying people and their relatives in pandemics (PallPan) in Germany - study protocol of a mixed-methods project",
BMC palliative care,
vol. 21,
no. 1,
pp. 10,
2022.
| DOI: | 10.1186/s12904-021-00898-w |
[eng]
F. Heinrich,
K. Roedl,
D. Jarczak,
H. Goebels,
A. Heinemann,
U. Schäfer,
F. Ludwig,
M. Bachmann,
B. Bein,
C. F. Weber,
K. Sydow,
M. Bota,
H. Paschen,
A. Weerth,
C. Veit,
O. Detsch,
P. Brand,
S. Kluge,
B. Ondruschka and
D. Wichmann,
"New Insights in the Occurrence of Venous Thromboembolism in Critically Ill Patients with COVID-19-A Large Postmortem and Clinical Analysis",
Viruses,
vol. 14,
no. 4,
pp. 811,
Apr.
2022.
Abstract:
Critically ill COVID-19 patients are at high risk for venous thromboembolism (VTE), namely deep vein thrombosis (DVT) and/or pulmonary embolism (PE), and death. The optimal anticoagulation strategy in critically ill patients with COVID-19 remains unknown. This study investigated the ante mortem incidence as well as postmortem prevalence of VTE, the factors predictive of VTE, and the impact of changed anticoagulation practice on patient survival. We conducted a consecutive retrospective analysis of postmortem COVID-19 (n = 64) and non-COVID-19 (n = 67) patients, as well as ante mortem COVID-19 (n = 170) patients admitted to the University Medical Center Hamburg-Eppendorf (Hamburg, Germany). Baseline patient characteristics, parameters related to the intensive care unit (ICU) stay, and the clinical and autoptic presence of VTE were evaluated and statistically compared between groups. The occurrence of VTE in critically ill COVID-19 patients is confirmed in both ante mortem (17%) and postmortem (38%) cohorts. Accordingly, comparing the postmortem prevalence of VTE between age- and sex-matched COVID-19 (43%) and non-COVID-19 (0%) cohorts, we found the statistically significant increased prevalence of VTE in critically ill COVID-19 cohorts (p = 0.001). A change in anticoagulation practice was associated with the statistically significant prolongation of survival time (HR: 2.55, [95% CI 1.41-4.61], p = 0.01) and a reduction in VTE occurrence (54% vs. 25%; p = 0.02). In summary, in the autopsy as well as clinical cohort of critically ill patients with COVID-19, we found that VTE was a frequent finding. A change in anticoagulation practice was associated with a statistically significantly prolonged survival time.
| DOI: | 10.3390/v14040811 |
Abstract:
Critically ill COVID-19 patients are at high risk for venous thromboembolism (VTE), namely deep vein thrombosis (DVT) and/or pulmonary embolism (PE), and death. The optimal anticoagulation strategy in critically ill patients with COVID-19 remains unknown. This study investigated the ante mortem incidence as well as postmortem prevalence of VTE, the factors predictive of VTE, and the impact of changed anticoagulation practice on patient survival. We conducted a consecutive retrospective analysis of postmortem COVID-19 (n = 64) and non-COVID-19 (n = 67) patients, as well as ante mortem COVID-19 (n = 170) patients admitted to the University Medical Center Hamburg-Eppendorf (Hamburg, Germany). Baseline patient characteristics, parameters related to the intensive care unit (ICU) stay, and the clinical and autoptic presence of VTE were evaluated and statistically compared between groups. The occurrence of VTE in critically ill COVID-19 patients is confirmed in both ante mortem (17%) and postmortem (38%) cohorts. Accordingly, comparing the postmortem prevalence of VTE between age- and sex-matched COVID-19 (43%) and non-COVID-19 (0%) cohorts, we found the statistically significant increased prevalence of VTE in critically ill COVID-19 cohorts (p = 0.001). A change in anticoagulation practice was associated with the statistically significant prolongation of survival time (HR: 2.55, [95% CI 1.41-4.61], p = 0.01) and a reduction in VTE occurrence (54% vs. 25%; p = 0.02). In summary, in the autopsy as well as clinical cohort of critically ill patients with COVID-19, we found that VTE was a frequent finding. A change in anticoagulation practice was associated with a statistically significantly prolonged survival time.
F. Heinrich,
K. Roedl,
D. Jarczak and
et al,
"New Insights in the Occurrence of Venous Thromboembolism in Critically Ill Patients with COVID-19—A Large Postmortem and Clinical Analysis",
Viruses,
vol. 14,
pp. 811,
2022.
| DOI: | 10.3390/v14040811 |
P. Arora and
et al,
"No evidence for increased cell entry or antibody evasion by Delta sublineage AY.4.2",
Cellular & Molecular Immunology,
2022.
| DOI: | 10.1038/s41423-021-00811-8 |
M. S. Ercanoglu and
et al,
"No substantial preexisting B cell immunity against SARS-CoV-2 in healthy adults",
iScience,
vol. 25,
pp. 103951,
2022.
| DOI: | 10.1016/j.isci.2022.103951 |
S. Zellmer,
E. Bachmann,
A. Muzalyova and
et al,
"One year of the COVID-19 pandemic in dental medical facilities in Germany: A questionnaire-based analysis",
Int J Environ Res Public Health,
vol. 19,
no. 1,
2022.
| DOI: | 10.3390/ijerph19010175 |
D. Jonigk,
C. Werlein and
et al,
"Organ manifestations of COVID-19: what have we learned so far (not only) from autopsies?",
Virchows Arch,
2022.
| DOI: | 10.1007/s00428-022-03319-2 |
[eng]
D. Jonigk,
C. Werlein,
G. Baretton,
P. Barth,
R. M. Bohle,
A. Büttner,
R. Büttner,
R. Dettmeyer,
P. Eichhorn,
S. Elezkurtaj,
I. Esposito,
K. Evert,
M. Evert,
F. Fend,
N. Gaßler,
S. Gattenlöhner,
M. Glatzel,
H. Göbel,
E. Gradhand,
T. Hansen,
A. Hartmann,
A. Heinemann,
F. L. Heppner,
J. Hilsenbeck,
D. Horst,
J. C. Kamp,
G. Mall,
B. Märkl,
B. Ondruschka,
J. Pablik,
S. Pfefferle,
A. Quaas,
H. Radbruch,
C. Röcken,
A. Rosenwald,
W. Roth,
M. Rudelius,
P. Schirmacher,
J. Slotta-Huspenina,
K. Smith,
L. Sommer,
K. Stock,
P. Ströbel,
S. Strobl,
U. Titze,
G. Weirich,
J. Weis,
M. Werner,
C. Wickenhauser,
T. Wiech,
P. Wild,
T. Welte,
S. Stillfried and
P. Boor,
"Organ manifestations of COVID-19: what have we learned so far (not only) from autopsies?",
Virchows Archiv: An International Journal of Pathology,
vol. 481,
no. 2,
pp. 139—159,
Aug.
2022.
| DOI: | 10.1007/s00428-022-03319-2 |
Oorschot and
D. Stahl,
"PallPan Richtig handeln in der Betreuung Schwerkranker und Sterbender in Pandemiezeiten",
Der Ophthalmologe,
2022.
[de]
K. Gaede,
J. Heidemann,
H. Goebels,
A. Heinemann,
K. Püschel and
B. Ondruschka,
"Pandemic Preparedness bei der Obduktion? Potentiale und Grenzen des IfSG",
Medizinrecht,
vol. 40,
no. 11,
pp. 892—901,
Nov.
2022.
| DOI: | 10.1007/s00350-022-6331-6 |
| Datei: | https://doi.org/10.1007/s00350-022-6331-6 |
J. Ebler,
P. Ebert,
W. E. Clarke,
T. Rausch,
P. A. Audano,
T. Houwaart,
Y. Mao,
J. O. Korbel,
E. E. Eichler,
M. C. Zody,
A. T. Dilthey and
T. Marschall,
"Pangenome-based genome inference allows efficient and accurate genotyping across a wide spectrum of variant classes",
Nature Genetics,
2022.
| DOI: | 10.1038/s41588-022-01043-w |
| Datei: | https://doi.org/10.1038/s41588-022-01043-w |
J. Ebler,
P. Ebert,
W. Clarke,
T. Rausch,
P. Audano,
T. Houwaart,
Y. Mao,
J. Korbel,
E. Eichler,
M. Zody,
A. Dilthey and
T. Marschall,
"Pangenome-based genome inference allows efficient and accurate genotyping across a wide spectrum of variant classes",
Nature genetics,
vol. 54,
no. 4,
pp. 518—525,
2022.
| DOI: | 10.1038/s41588-022-01043-w |
C. Lemhöfer,
K. S. Appel,
W. Häuser,
N. Hettich,
M. Kohls and
M. C. Polidori,
"Post-COVID: Alles eine Frage der Definition?",
Dtsch Med Wochenschr,
vol. 147,
no. 21,
pp. 1391—1397,
Okt.
2022.
Georg Thieme Verlag KG.
Abstract:
Die Pr"avalenz des Post-COVID-Syndroms (PCS) ist noch nicht abschließend gekl"art. Die bisherigen Definitionen bilden vorrangig zeitliche Aspekte ab, lassen jedoch funktionelle Defizite sowie die Objektivierung von Symptomen außer Acht. Dies f"uhrt zu diagnostischen sowie therapeutischen Unklarheiten. In Pubmed wurde daher nach systematischen Reviews gesucht, die sich mit den Folgen einer SARS-CoV-2-Infektion befassten. Die zugrunde liegenden Definitionen sowie zeitlichen Einschlusskriterien wurden extrahiert. 16 systematische Reviews wurden eingeschlossen, davon 11 mit einer Definition des PCS. In 58 % der analysierten Einzelstudien wurden Patienten mit einer Symptomatik > 12 Wochen und damit entsprechend der Definition des PCS inkludiert. Fazit: Eine weitere Pr"azisierung der Definition des PCS ist notwendig, um Diagnostik und eine multimodale Behandlung zu erleichtern und die knappen therapeutischen Ressourcen entsprechend zu nutzen.
Abstract:
Die Pr"avalenz des Post-COVID-Syndroms (PCS) ist noch nicht abschließend gekl"art. Die bisherigen Definitionen bilden vorrangig zeitliche Aspekte ab, lassen jedoch funktionelle Defizite sowie die Objektivierung von Symptomen außer Acht. Dies f"uhrt zu diagnostischen sowie therapeutischen Unklarheiten. In Pubmed wurde daher nach systematischen Reviews gesucht, die sich mit den Folgen einer SARS-CoV-2-Infektion befassten. Die zugrunde liegenden Definitionen sowie zeitlichen Einschlusskriterien wurden extrahiert. 16 systematische Reviews wurden eingeschlossen, davon 11 mit einer Definition des PCS. In 58 % der analysierten Einzelstudien wurden Patienten mit einer Symptomatik > 12 Wochen und damit entsprechend der Definition des PCS inkludiert. Fazit: Eine weitere Pr"azisierung der Definition des PCS ist notwendig, um Diagnostik und eine multimodale Behandlung zu erleichtern und die knappen therapeutischen Ressourcen entsprechend zu nutzen.
F. Heinrich,
A. Schröder,
A. Gerberding and
et al,
"Postmortem Antigen-Detecting Rapid Diagnostic Tests to Predict Infectivity of SARS-CoV-2-Associated Deaths",
Emerg Infect Dis,
vol. 28,
pp. 244-247,
2022.
| DOI: | 10.3201/eid2801.211749 |
[eng]
F. Heinrich,
A. S. Schröder,
A. Gerberding,
M. Gerling,
F. Langenwalder,
P. Lange,
A. Heinemann,
E. Bibiza-Freiwald,
D. S. Nörz,
M. Aepfelbacher,
S. Pfefferle,
B. Ondruschka and
M. Lütgehetmann,
"Postmortem Antigen-Detecting Rapid Diagnostic Tests to Predict Infectivity of SARS-CoV-2-Associated Deaths",
Emerging Infectious Diseases,
vol. 28,
no. 1,
pp. 244—247,
Jan.
2022.
| DOI: | 10.3201/eid2801.211749 |
T. Schwarz and
et al,
"Preserved T cell responses to SARS-CoV-2 in anti-CD20 treated multiple sclerosis",
Multiple Sclerosis Journal,
2022.
| DOI: | 10.1101/2021.10.11.21264694 |
H. Gorji,
N. Stauffer,
I. Lunati and
et al,
"Projection of healthcare demand in Germany and Switzerland urged by omicron wave (January-March 2022)",
MedRxiv,
2022.
| DOI: | 10.1101/2022.01.24.22269676 |
C. Dächert,
M. Muenchhoff,
A. Graf and
et al,
"Rapid and sensitive identification of omicron by variant-specific PCR and nanopore sequencing: paradigm for diagnostics of emerging SARS-CoV-2 variants",
Med Microbiol Immunol,
vol. 211,
no. 1,
2022.
| DOI: | 10.1007/s00430-022-00728-7 |
| Datei: | https://doi.org/10.1007/s00430-022-00728-7 |
M. Zickler,
S. Stanelle-Bertram,
S. Ehret and
et al,
"Replication of SARS-CoV-2 in adipose tissue determines organ and systemic lipid metabolism in hamsters and humans",
Cell Metab,
vol. 34,
pp. 1-2,
2022.
| DOI: | 10.1016/j.cmet.2021.12.002 |
[eng]
M. Zickler,
S. Stanelle-Bertram,
S. Ehret,
F. Heinrich,
P. Lange,
B. Schaumburg,
N. M. Kouassi,
S. Beck,
M. Y. Jaeckstein,
O. Mann,
S. Krasemann,
M. Schroeder,
D. Jarczak,
A. Nierhaus,
S. Kluge,
M. Peschka,
H. Schlüter,
T. Renné,
K. Pueschel,
A. Kloetgen,
L. Scheja,
B. Ondruschka,
J. Heeren and
G. Gabriel,
"Replication of SARS-CoV-2 in adipose tissue determines organ and systemic lipid metabolism in hamsters and humans",
Cell Metabolism,
vol. 34,
no. 1,
pp. 1—2,
Jan.
2022.
Abstract:
Zickler et al. describe SARS-CoV-2 RNA in post-mortem samples of human adipose tissue. In the hamster model, SARS-CoV-2 propagation in adipose tissue leads to specific changes in lipid metabolism, which are reflected in lipidome patterns of hamster and human plasma.
| DOI: | 10.1016/j.cmet.2021.12.002 |
Abstract:
Zickler et al. describe SARS-CoV-2 RNA in post-mortem samples of human adipose tissue. In the hamster model, SARS-CoV-2 propagation in adipose tissue leads to specific changes in lipid metabolism, which are reflected in lipidome patterns of hamster and human plasma.
M. Neidhardt,
S. Gerlach,
R. Mieling,
M. Laves,
T. Weiß,
M. Gromniak,
A. Fitzek,
D. Möbius,
I. Kniep,
A. Ron,
J. Schädler,
A. Heinemann,
K. Püschel,
B. Ondruschka and
A. Schlaefer,
"Robotic Tissue Sampling for Safe Post-Mortem Biopsy in Infectious Corpses",
IEEE Transactions on Medical Robotics and Bionics,
vol. 4,
no. 1,
pp. 94—105,
Feb.
2022.
| DOI: | 10.1109/TMRB.2022.3146440 |
M. Neidhardt,
S. Gerlach,
R. Mieling and
et al,
"Robotic Tissue Sampling for Safe Post-Mortem Biopsy in Infectious Corpses",
IEEE Trans. Med. Robot. Bionics,
vol. 4,
pp. 94-105,
2022.
| DOI: | 10.1109/TMRB.2022.3146440 |
S. Hammerschmidt,
C. Thurm,
B. Bošnjak and
et al,
"Robust induction of neutralizing antibodies against the SARS‐CoV‐2 Delta variant after homologous Spikevax or heterologous Vaxzevria‐Spikevax vaccination",
Eur J Immunol,
vol. 52,
no. 2,
2022.
| DOI: | 10.1002/eji.202149645 |
S. Momsen Reincke and
et al,
"SARS-CoV-2 Beta variant infection elicits potent lineage-specific and cross-reactive antibodies",
Science (New York, N.Y.),
2022.
| DOI: | 10.1126/science.abm5835 |
[eng]
J. Jansen,
K. C. Reimer,
J. S. Nagai,
F. S. Varghese,
G. J. Overheul,
M. Beer,
R. Roverts,
D. Daviran,
L. A. S. Fermin,
B. Willemsen,
M. Beukenboom,
S. Djudjaj,
S. Stillfried,
L. E. Eijk,
M. Mastik,
M. Bulthuis,
W. d. Dunnen,
H. Goor,
J. Hillebrands,
S. H. Triana,
M. Timm,
B. T. Berge,
M. Broek,
Q. Nlandu,
J. Heijnert,
E. M. J. Bindels,
R. M. Hoogenboezem,
F. Mooren,
C. Kuppe,
P. Miesen,
K. Grünberg,
T. Ijzermans,
E. J. Steenbergen,
J. Czogalla,
M. F. Schreuder,
N. Sommerdijk,
P. Boor,
V. G. Puelles,
J. Floege,
T. B. Huber,
C. M. consortium,
R. P. Rij,
I. G. Costa,
R. K. Schneider,
B. Smeets and
R. Kramann,
"SARS-CoV-2 infects the human kidney and drives fibrosis in kidney organoids",
Cell Stem Cell,
vol. 29,
no. 2,
pp. 217—231.e8,
Feb.
2022.
Abstract:
Kidney failure is frequently observed during and after COVID-19, but it remains elusive whether this is a direct effect of the virus. Here, we report that SARS-CoV-2 directly infects kidney cells and is associated with increased tubule-interstitial kidney fibrosis in patient autopsy samples. To study direct effects of the virus on the kidney independent of systemic effects of COVID-19, we infected human-induced pluripotent stem-cell-derived kidney organoids with SARS-CoV-2. Single-cell RNA sequencing indicated injury and dedifferentiation of infected cells with activation of profibrotic signaling pathways. Importantly, SARS-CoV-2 infection also led to increased collagen 1 protein expression in organoids. A SARS-CoV-2 protease inhibitor was able to ameliorate the infection of kidney cells by SARS-CoV-2. Our results suggest that SARS-CoV-2 can directly infect kidney cells and induce cell injury with subsequent fibrosis. These data could explain both acute kidney injury in COVID-19 patients and the development of chronic kidney disease in long COVID.
| DOI: | 10.1016/j.stem.2021.12.010 |
Abstract:
Kidney failure is frequently observed during and after COVID-19, but it remains elusive whether this is a direct effect of the virus. Here, we report that SARS-CoV-2 directly infects kidney cells and is associated with increased tubule-interstitial kidney fibrosis in patient autopsy samples. To study direct effects of the virus on the kidney independent of systemic effects of COVID-19, we infected human-induced pluripotent stem-cell-derived kidney organoids with SARS-CoV-2. Single-cell RNA sequencing indicated injury and dedifferentiation of infected cells with activation of profibrotic signaling pathways. Importantly, SARS-CoV-2 infection also led to increased collagen 1 protein expression in organoids. A SARS-CoV-2 protease inhibitor was able to ameliorate the infection of kidney cells by SARS-CoV-2. Our results suggest that SARS-CoV-2 can directly infect kidney cells and induce cell injury with subsequent fibrosis. These data could explain both acute kidney injury in COVID-19 patients and the development of chronic kidney disease in long COVID.
E. Layer,
S. Hoehl,
M. Widera,
D. Bojkova,
T. Westphal,
R. Gottschalk,
B. Boeddinghaus,
J. Schork,
S. Ciesek and
U. Goetsch,
"SARS-CoV-2 screening strategies for returning international travellers: Evaluation of a rapid antigen test approach",
International Journal of Infectious Diseases,
vol. 118,
pp. 126—131,
2022.
| DOI: | 10.1016/j.ijid.2022.02.045 |
I. Backhaus,
D. Hermsen,
J. Timm,
F. Boege,
N. Lübke,
T. Degode,
K. Göbels and
N. Dragano,
"SARS-CoV-2 seroprevalence and determinants of infection in young adults: A population-based seroepidemiological study",
Public Health,
2022.
| DOI: | https://doi.org/10.1016/j.puhe.2022.03.009 |
P. Arora and
et al,
"SARS-CoV-2 variants C.1.2 and B.1.621 (Mu) partially evade neutralization by antibodies elicited upon infection or vaccination",
Cell Reports,
vol. 39,
pp. 110754,
2022.
| DOI: | 10.1016/j.celrep.2022.110754 |
F. Steinbeis,
C. Thibeault,
F. Doellinger,
R. Ring,
M. Mittermaier,
C. Ruwwe-Glösenkamp,
P. Knape,
H. Meyer,
L. Lippert,
E. Helbig,
B. Temmesfeld,
N. Suttorp,
L. E. Sander,
F. Kurth,
T. Penzkofer,
M. Witzenrath,
T. Zoller and
D. Grund,
"Severity of respiratory failure and computed chest tomography in acute COVID-19 correlates with pulmonary function and respiratory symptoms after infection with SARS-CoV-2: An observational longitudinal study over 12 months.",
Respir Med. 2022;191:106709.,
2022.
S. F,
T. C,
D. F,
R. RM,
M. M,
R. C,
A. F,
K. P,
M. HJ,
L. LJ,
H. ET,
G. D,
T. B,
S. N,
S. LE,
K. F,
P. T,
W. M and
Z. T,
"Severity of respiratory failure and computed chest tomography in acute COVID-19 correlates with pulmonary function and respiratory symptoms after infection with SARS-CoV-2: An observational longitudinal study over 12 months.",
Respiratory medicine,
Jan.
2022.
Abstract:
Prospektive und longitudinale Daten zur Lungenverletzung über ein Jahr nach akuter Coronavirus-Krankheit 2019 (COVID-19) sind spärlich. Die Patienten mit akutem COVID-19 wurden in ein laufendes, prospektives Beobachtungsstudium eingeschrieben und 6 Wochen, 3, 6 und 12 Monate nach Beginn der Symptome von COVID-19 untersucht. Chest CT-Scans, Lungenfunktion und Symptome, die von St. Georges Respiratory Questionnaire bewertet wurden, wurden verwendet, um Atembeschränkungen zu bewerten. Die Patienten wurden nach Schwere der akuten COVID-19 gestreut. Das mittlere Alter aller Patienten betrug 57 Jahre, 37,8% waren weiblich. Höheres Alter, männliches Geschlecht und höheres BMI wurden mit akuter COVID-19 Schwere verbunden (p < 0,0001, 0,001 bzw. 0,004). Auch die Lungenbeschränkung und die verringerte Kohlenmonoxiddiffusionskapazität war mit der Krankheitsschwere verbunden. Bei Patienten mit eingeschränkter und beeinträchtigter Diffusionskapazität verbesserte sich FVC über 12 Monate von 61,32 bis 71,82, DC von 68,92 bis 76,95, D<sub>LCO</sub> von 60,18 bis 68,98 und K<sub>CO</sub> von 81,28 bis 87,80 (prozentige prognostizierte Werte; p = 0,002, 0,045, 0,0002 und 0,0005). Der CT-Score der Lungenbeteiligung in der akuten Phase war mit einer Restriktion und Verringerung der Diffusionskapazität im Anschluss verbunden. Atemwegserkrankungen verbesserten sich bei Patienten in höheren Schweregruppen während der Folge, nicht aber bei Patienten mit zunächst milder Erkrankung. Schwere des Atemversagens während der COVID-19 korreliert mit dem Grad der Lungenfunktion Beeinträchtigung und Atmungsqualität des Lebens im Jahr nach akuter Infektion.
| DOI: | 10.1016/j.rmed.2021.106709 |
Abstract:
Prospektive und longitudinale Daten zur Lungenverletzung über ein Jahr nach akuter Coronavirus-Krankheit 2019 (COVID-19) sind spärlich. Die Patienten mit akutem COVID-19 wurden in ein laufendes, prospektives Beobachtungsstudium eingeschrieben und 6 Wochen, 3, 6 und 12 Monate nach Beginn der Symptome von COVID-19 untersucht. Chest CT-Scans, Lungenfunktion und Symptome, die von St. Georges Respiratory Questionnaire bewertet wurden, wurden verwendet, um Atembeschränkungen zu bewerten. Die Patienten wurden nach Schwere der akuten COVID-19 gestreut. Das mittlere Alter aller Patienten betrug 57 Jahre, 37,8% waren weiblich. Höheres Alter, männliches Geschlecht und höheres BMI wurden mit akuter COVID-19 Schwere verbunden (p < 0,0001, 0,001 bzw. 0,004). Auch die Lungenbeschränkung und die verringerte Kohlenmonoxiddiffusionskapazität war mit der Krankheitsschwere verbunden. Bei Patienten mit eingeschränkter und beeinträchtigter Diffusionskapazität verbesserte sich FVC über 12 Monate von 61,32 bis 71,82, DC von 68,92 bis 76,95, D<sub>LCO</sub> von 60,18 bis 68,98 und K<sub>CO</sub> von 81,28 bis 87,80 (prozentige prognostizierte Werte; p = 0,002, 0,045, 0,0002 und 0,0005). Der CT-Score der Lungenbeteiligung in der akuten Phase war mit einer Restriktion und Verringerung der Diffusionskapazität im Anschluss verbunden. Atemwegserkrankungen verbesserten sich bei Patienten in höheren Schweregruppen während der Folge, nicht aber bei Patienten mit zunächst milder Erkrankung. Schwere des Atemversagens während der COVID-19 korreliert mit dem Grad der Lungenfunktion Beeinträchtigung und Atmungsqualität des Lebens im Jahr nach akuter Infektion.
[en]
T. Bahmer,
C. Borzikowsky,
W. Lieb,
A. Horn,
L. Krist,
J. Fricke,
C. Scheibenbogen,
K. F. Rabe,
W. Maetzler,
C. Maetzler,
M. Laudien,
D. Frank,
S. Ballhausen,
A. Hermes,
O. Miljukov,
K. G. Haeusler,
N. E. E. Mokhtari,
M. Witzenrath,
J. J. Vehreschild,
D. Krefting,
D. Pape,
F. A. Montellano,
M. Kohls,
C. Morbach,
S. Störk,
J. Reese,
T. Keil,
P. Heuschmann,
M. Krawczak,
S. Schreiber and
N. group,
"Severity, predictors and clinical correlates of Post-COVID syndrome (PCS) in Germany: A prospective, multi-centre, population-based cohort study",
EClinicalMedicine,
vol. 51,
no. 101549,
pp. 101549,
Sep.
2022.
Elsevier BV.
Abstract:
Background: Post-COVID syndrome (PCS) is an important sequela of COVID-19, characterised by symptom persistence for >3 months, post-acute symptom development, and worsening of pre-existing comorbidities. The causes and public health impact of PCS are still unclear, not least for the lack of efficient means to assess the presence and severity of PCS. Methods: COVIDOM is a population-based cohort study of polymerase chain reaction (PCR) confirmed cases of SARS-CoV-2 infection, recruited through public health authorities in three German regions (Kiel, Berlin, W"urzburg) between November 15, 2020 and September 29, 2021. Main inclusion criteria were (i) a PCR confirmed SARS-CoV-2 infection and (ii) a period of at least 6 months between the infection and the visit to the COVIDOM study site. Other inclusion criteria were written informed consent and age $\geq$18 years. Key exclusion criterion was an acute reinfection with SARS-CoV-2. Study site visits included standardised interviews, in-depth examination, and biomaterial procurement. In sub-cohort Kiel-I, a PCS (severity) score was developed based upon 12 long-term symptom complexes. Two validation sub-cohorts (W"urzburg/Berlin, Kiel-II) were used for PCS score replication and identification of clinically meaningful predictors. This study is registered at clinicaltrials.gov (NCT04679584) and at the German Registry for Clinical Studies (DRKS, DRKS00023742). Findings: In Kiel-I (n = 667, 57% women), 90% of participants had received outpatient treatment for acute COVID-19. Neurological ailments (61·5%), fatigue (57·1%), and sleep disturbance (57·0%) were the most frequent persisting symptoms at 6-12 months after infection. Across sub-cohorts (W"urzburg/Berlin, n = 316, 52% women; Kiel-II, n = 459, 56% women), higher PCS scores were associated with lower health-related quality of life (EQ-5D-5L-VAS/-index: r = -0·54/ -0·56, all p < 0·0001). Severe, moderate, and mild/no PCS according to the individual participant's PCS score occurred in 18·8%, 48·2%, and 32·9%, respectively, of the Kiel-I sub-cohort. In both validation sub-cohorts, statistically significant predictors of the PCS score included the intensity of acute phase symptoms and the level of personal resilience. Interpretation: PCS severity can be quantified by an easy-to-use symptom-based score reflecting acute phase disease burden and general psychological predisposition. The PCS score thus holds promise to facilitate the clinical diagnosis of PCS, scientific studies of its natural course, and the development of therapeutic interventions. Funding: The COVIDOM study is funded by the Network University Medicine (NUM) as part of the National Pandemic Cohort Network (NAPKON).
| DOI: | 10.1016/j.eclinm.2022.101549 |
| Pubmed: | 35875815 |
Abstract:
Background: Post-COVID syndrome (PCS) is an important sequela of COVID-19, characterised by symptom persistence for >3 months, post-acute symptom development, and worsening of pre-existing comorbidities. The causes and public health impact of PCS are still unclear, not least for the lack of efficient means to assess the presence and severity of PCS. Methods: COVIDOM is a population-based cohort study of polymerase chain reaction (PCR) confirmed cases of SARS-CoV-2 infection, recruited through public health authorities in three German regions (Kiel, Berlin, W"urzburg) between November 15, 2020 and September 29, 2021. Main inclusion criteria were (i) a PCR confirmed SARS-CoV-2 infection and (ii) a period of at least 6 months between the infection and the visit to the COVIDOM study site. Other inclusion criteria were written informed consent and age $\geq$18 years. Key exclusion criterion was an acute reinfection with SARS-CoV-2. Study site visits included standardised interviews, in-depth examination, and biomaterial procurement. In sub-cohort Kiel-I, a PCS (severity) score was developed based upon 12 long-term symptom complexes. Two validation sub-cohorts (W"urzburg/Berlin, Kiel-II) were used for PCS score replication and identification of clinically meaningful predictors. This study is registered at clinicaltrials.gov (NCT04679584) and at the German Registry for Clinical Studies (DRKS, DRKS00023742). Findings: In Kiel-I (n = 667, 57% women), 90% of participants had received outpatient treatment for acute COVID-19. Neurological ailments (61·5%), fatigue (57·1%), and sleep disturbance (57·0%) were the most frequent persisting symptoms at 6-12 months after infection. Across sub-cohorts (W"urzburg/Berlin, n = 316, 52% women; Kiel-II, n = 459, 56% women), higher PCS scores were associated with lower health-related quality of life (EQ-5D-5L-VAS/-index: r = -0·54/ -0·56, all p < 0·0001). Severe, moderate, and mild/no PCS according to the individual participant's PCS score occurred in 18·8%, 48·2%, and 32·9%, respectively, of the Kiel-I sub-cohort. In both validation sub-cohorts, statistically significant predictors of the PCS score included the intensity of acute phase symptoms and the level of personal resilience. Interpretation: PCS severity can be quantified by an easy-to-use symptom-based score reflecting acute phase disease burden and general psychological predisposition. The PCS score thus holds promise to facilitate the clinical diagnosis of PCS, scientific studies of its natural course, and the development of therapeutic interventions. Funding: The COVIDOM study is funded by the Network University Medicine (NUM) as part of the National Pandemic Cohort Network (NAPKON).
D. Medenwald,
T. Brunner,
H. Christiansen and
et al,
"Shift of radiotherapy use during the first wave of the COVID-19 pandemic? An analysis of German inpatient data",
Strahlenther Onkol,
vol. 198,
no. 4,
pp. 334—345,
2022.
| DOI: | 10.1007/s00066-021-01883-1 |
C. Schug,
F. Geiser,
N. Hiebel,
P. Beschoner,
L. Jerg-Bretzke,
K. Weidner,
E. Morawa and
Y. Erim,
"Sick Leave and Intention to Quit the Job among Nursing Staff in German Hospitals during the COVID-19 Pandemic",
International Journal of Environmental Research and Public Health,
vol. 19,
no. 4,
pp. 1947,
Feb.
2022.
| DOI: | 10.3390/ijerph19041947 |
| Datei: |  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8872054/pdf/ijerph-19-01947.pdf |
C. Koll,
S. Hopff,
T. Meurers,
C. Lee,
M. Kohls,
C. Stellbrink,
C. Thibeault,
L. Reinke,
S. Steinbrecher,
S. Schreiber and
D. Stahl,
"Statistical biases due to anonymization evaluated in an open clinical dataset from COVID-19 patients",
Sci Data,
vol. 9,
no. 1,
pp. 776,
2022.
| DOI: | 10.1038/s41597-022-01669-9 |
C. Koll,
S. Hopff and
T. Meurers,
"Statistical biases due to anonymization evaluated in an open clinical dataset from COVID-19 patients.",
Sci Data 9, 776,
2022.
| DOI: | 10.1038/s41597-022-01669-9 |
M. Mayer,
S. Zellmer,
J. Zenk and
et al,
"Status quo after one year of COVID-19 pandemic in otolaryngological hospital-based departments and private practices in Germany",
Eur Arch Otorhinolaryngol,
vol. 279,
no. 2,
2022.
| DOI: | 10.1007/s00405-021-06992-2 |
H. Hoven,
N. Dragano,
P. Angerer,
C. Apfelbacher,
I. Backhaus,
B. Hoffmann,
A. Icks,
S. Wilm,
F. Fangerau and
F. Söhner,
"Striving for health equality: The importance of social determinants of health and ethical considerations in pandemic preparedness planning",
International Journal of Public Health,
vol. 67,
pp. 1604542,
2022.
| DOI: | 10.3389/ijph.2022.1604542 |