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Patients with coronavirus disease 19 (COVID-19) commonly show abnormalities of liver tests (LTs) of undetermined cause. Considering drugs as tentative culprits, the current systematic review searched for published COVID-19 cases with suspected drug-induced liver injury (DILI) and established diagnosis using the diagnostic algorithm of RUCAM (Roussel Uclaf Causality Assessment Method). Data worldwide on DILI cases assessed by RUCAM in COVID-19 patients were sparse. A total of 6/200 reports with initially suspected 996 DILI cases in COVID-19 patients and using all RUCAM-based DILI cases allowed for a clear description of clinical features of RUCAM-based DILI cases among COVID-19 patients: (1) The updated RUCAM published in 2016 was equally often used as the original RUCAM of 1993, with both identifying DILI and other liver diseases as confounders; (2) RUCAM also worked well in patients treated with up to 18 drugs and provided for most DILI cases a probable or highly probable causality level for drugs; (3) DILI was preferentially caused by antiviral drugs given empirically due to their known therapeutic efficacy in other virus infections; (4) hepatocellular injury was more often reported than cholestatic or mixed injury; (5) maximum LT values were found for alanine aminotransferase (ALT) 1.541 U/L and aspartate aminotransferase (AST) 1.076 U/L; (6) the ALT/AST ratio was variable and ranged from 0.4 to 1.4; (7) the mean or median age of the COVID-19 patients with DILI ranged from 54.3 to 56 years; (8) the ratio of males to females was 1.8–3.4:1; (9) outcome was favorable for most patients, likely due to careful selection of the drugs and quick cessation of drug treatment with emerging DILI, but it was fatal in 19 patients; (10) countries reporting RUCAM-based DILI cases in COVID-19 patients included China, India, Japan, Montenegro, and Spain; (11) robust estimation of the percentage contribution of RUCAM-based DILI for the increased LTs in COVID-19 patients is outside of the current scope. In conclusion, RUCAM-based DILI with its clinical characteristics in COVID-19 patients and its classification as a confounding variable is now well defined, requiring a new correct description of COVID-19 features by removing DILI characteristics as confounders.
Background: In March 2020, the COVID-19 outbreak led to the declaration of a pandemic. The accompanying restrictions on public life caused a change in the training routines of athletes worldwide. The present study aimed to investigate the effects of a 13-week supervised home training program on physical performance, sleep quality, and health-related quality of life in professional youth soccer players during the first COVID-19 lockdown in Germany.
Methods: Eight professional soccer players (age range 16–19; height: 1.81 ± 0.07 m; body weight: 72.05 ± 6.96 kg) from a Bundesliga team in Germany participated in this study. During the lockdown, they trained 5–6 days per week with home-based training plans and were monitored via tracking apps and video training. To determine the effects of home training, measurements were taken before (March 2020) and after (June 2020) the home training period. Bioelectrical impedance analysis was used to determine body composition, and an isokinetic strength test and a treadmill step test, including lactate measurements, were used to measure physical performance. Two questionnaires were responded to in order to assess health-related quality of life [Short-Form 36 Health Survey (SF-36)] and sleep quality (Pittsburgh Sleep Quality Index).
Results: When comparing measurements before and after the home training period, we observed significant increases in the following variables: body weight (72.05 ± 6.96 kg vs. 73.50 ± 6.68 kg, p = 0.034), fat mass (11.99 ± 3.13 % vs. 13.98 ± 3.92 %, p = 0.030), body mass index (22.04 ± 0.85 kg/m2 vs. 22.49 ± 0.92 kg/m2, p = 0.049), and mental health component summary score (MCS) of the questionnaire SF-36 (53.95 ± 3.47 vs. 58.33 ± 4.50, p = 0.044). Scores on the general health (77.88 ± 14.56 vs. 89.75 ± 13.76, p = 0.025) and mental health (81.50 ± 9.30 vs. 90.00 ± 11.71, p = 0.018) subscales of the SF-36 also increased significantly.
Conclusion: The COVID-19 lockdown led to an increase in body composition parameters and showed an improvement in the MCS and scores on the general and mental health subscales of the SF-36. Physical performance and sleep quality could be maintained during the home training period. These observations may help trainers for future training planning during longer interruptions in soccer training.
The immune response is known to wane after vaccination with BNT162b2, but the role of age, morbidity and body composition is not well understood. We conducted a cross-sectional study in long-term care facilities (LTCFs) for the elderly. All study participants had completed two-dose vaccination with BNT162b2 five to 7 months before sample collection. In 298 residents (median age 86 years, range 75–101), anti-SARS-CoV-2 rector binding IgG antibody (anti-RBD-IgG) concentrations were low and inversely correlated with age (mean 51.60 BAU/ml). We compared the results to Health Care Workers (HCW) aged 18–70 years (n = 114, median age: 53 years), who had a higher mean anti-RBD-IgG concentration of 156.99 BAU/ml. Neutralization against the Delta variant was low in both groups (9.5% in LTCF residents and 31.6% in HCWs). The Charlson Comorbidity Index was inversely correlated with anti-RBD-IgG, but not the body mass index (BMI). A control group of 14 LTCF residents with known breakthrough infection had significant higher antibody concentrations (mean 3,199.65 BAU/ml), and 85.7% had detectable neutralization against the Delta variant. Our results demonstrate low but recoverable markers of immunity in LTCF residents five to 7 months after vaccination.
The implications of telework are discussed controversially and research on its positive and negative effects has produced contradictory results. We explore voluntariness of employee telework as a boundary condition which may underpin these contradictory findings. Under normal circumstances, individuals who do more telework should perceive fewer disadvantages. However, during the COVID-19 pandemic, employees could no longer voluntarily choose to telecommute, as many organizations were forced to introduce telework by governmental regulations. In two studies, we examine whether the voluntary nature of telework moderates the association between the amount of telework and perceptions of disadvantage. In Study 1, we collected data before and during the COVID-19 pandemic (N = 327). Results show that pre-pandemic participants (who were more likely to voluntarily choose this form of work) reported fewer disadvantages the more telework they did, but this was not the case for employees during the COVID-19 pandemic. To validate these findings, we measured employees’ voluntariness of telework in Study 2 (N = 220). Results support the importance of voluntariness: Individuals who experience a high degree of voluntariness in choosing telework perceive fewer disadvantages the more they telework. However, the amount of telework was not related to reduced perceptions of disadvantages for those who experienced low voluntariness regarding the telecommuting arrangement. Our findings help to understand when telework is related to the perception of disadvantages and they can provide organizations with starting points for practical interventions to reduce the negative effects of telework.
The implications of telework are discussed controversially and research on its positive and negative effects has produced contradictory results. We explore voluntariness of employee telework as a boundary condition which may underpin these contradictory findings. Under normal circumstances, individuals who do more telework should perceive fewer disadvantages. However, during the COVID-19 pandemic, employees could no longer voluntarily choose to telecommute, as many organizations were forced to introduce telework by governmental regulations. In two studies, we examine whether the voluntary nature of telework moderates the association between the amount of telework and perceptions of disadvantage. In Study 1, we collected data before and during the COVID-19 pandemic (N = 327). Results show that pre-pandemic participants (who were more likely to voluntarily choose this form of work) reported fewer disadvantages the more telework they did, but this was not the case for employees during the COVID-19 pandemic. To validate these findings, we measured employees’ voluntariness of telework in Study 2 (N = 220). Results support the importance of voluntariness: Individuals who experience a high degree of voluntariness in choosing telework perceive fewer disadvantages the more they telework. However, the amount of telework was not related to reduced perceptions of disadvantages for those who experienced low voluntariness regarding the telecommuting arrangement. Our findings help to understand when telework is related to the perception of disadvantages and they can provide organizations with starting points for practical interventions to reduce the negative effects of telework.
Vaccination represents one of the fundamentals in the fight against SARS-CoV-2. Myocarditis has been reported as a rare but possible adverse consequence of different vaccines, and its clinical presentation can range from mild symptoms to acute heart failure. We report a case of a 29-year-old man who presented with fever and retrosternal pain after receiving SARS-CoV-2 vaccine. Cardiac magnetic resonance imaging and laboratory data revealed typical findings of acute myocarditis.
Aims: This study aims to: (1) explore the links between past exposure to potentially traumatic events, fear of contracting COVID-19 and perceived stress; (2) investigate how the exposure to traumagenic experiences affects one's locus of control over their health; and (3) examine fear, stress reactions and differences in health locus of control across three different sociocultural contexts.
Methods: A total of 524 adult participants were recruited from Egypt, Germany, and Italy through online channels. Self-reporting instruments were used to assess previous exposure to potentially traumatic events, PTSD symptoms, fear of COVID-19, perceived stress, and health locus of control.
Results: Our findings highlight differences in reaction to COVID-19 in relation to past exposure to potentially traumatic events and country of residence, both of which may inform tailored community-based intervention practices.
Conclusion: The impact of COVID-19 might be particularly disruptive for people who survived potentially traumatic experiences. Nevertheless, the mass mental health impact of the COVID-19 pandemic varies across different sociocultural contexts.
The new variant of concern (VOC) of SARS-CoV-2, Omicron (B.1.1.529), is genetically very different from other VOCs. We compared Omicron with the preceding VOC Delta (B.1.617.2) and the wildtype (wt) strain (B.1) with respect to their interactions with the antiviral interferon (IFN-alpha/beta) response in infected cells. Our data indicate that IFN induction by Omicron is low and comparable to the wt, whereas Delta showed an increased IFN induction. However, Omicron exceeded both the wt and the Delta strain with respect to the ability to withstand the antiviral state imposed by IFN-alpha.
Background: Previous studies reported decreased volumes of acute stroke admissions during the COVID-19 pandemic. We aimed to examine whether aneurysmal subarachnoid hemorrhage (aSAH) volumes demonstrated similar declines in our department. Furthermore, the impact of the pandemic on disease progression should be analyzed.
Methods: We conducted a retrospective study in the neurosurgical department of the university hospital Frankfurt including patients with the diagnosis of aSAH during the first year of the COVID pandemic. One year cumulative volume for aSAH hospitalization procedures was compared to the year before (03/2020 – 02/2021 vs. 03/2019 – 02/2020) and the last 5 pre-COVID-pandemic years (2015-2020). All relevant patient characteristics concerning family history, disease history, clinical condition at admission, active/past COVID-infection, treatment management, complications, and outcome were analyzed.
Results: Compared to the 84 hospital admissions during the pre-pandemic years, the number of aSAH hospitalizations (n = 56) declined during the pandemic without reaching significance. No significant difference in the analyzed patient characteristics including clinical condition at onset, treatment, complications, and outcome, between 56 patients with aSAH admitted during the COVID pandemic and the treated patients in the last 5 years in the pre-COVID period were found. In our multivariable analysis, we detected young age (p < 0.05; OR 4.2) and no existence of early hydrocephalus (p < 0.05; OR 0.13) as important factors for a favorable outcome (mRS ≤ 0–2) after aSAH during the COVID pandemic. A past COVID-infection was detected in young patients suffering from aSAH (Age < 50years, p < 0.05; OR 10.5) with an increased rate of cerebral vasospasm after aSAH onset (p < 0.05; OR 26). Nevertheless, past COVID-infection did not reach significance as a high-risk factor for unfavorable outcomes.
Conclusion: There was a relative decrease in the number of patients with aSAH during the COVID-19 pandemic. Despite the extremely different conditions of hospitalization, there was no impairing significant effect on the treatment and outcome of admitted patients with aSAH. A past COVID infection seemed to be an irrelevant limiting factor concerning favorable outcomes.
Hintergrund: Eine standardisierte Erhebung von COVID-19-Infektionen bei Gesundheitspersonal während der laufenden Pandemie war und ist nicht gegeben. Vor allem der Anteil von arbeitsbedingten Infektionen beim Gesundheitspersonal und die Frage, welche Arbeitnehmer/-innen darunter am meisten gefährdet sind, bleiben unklar.
Ziel: Ziel dieser Studie war es, die gemeldeten COVID-19-Fälle beim Gesundheitspersonal in Frankfurt/Main in den ersten 6 Monaten der Pandemie zu analysieren, die Zahl der arbeitsbedingten Infektionen zu ermitteln und somit eine bessere Interpretation der durch das Robert Koch-Institut veröffentlichten Daten zu ermöglichen.
Methoden: Die Daten des Gesundheitsamts Frankfurt/Main wurden für den Zeitraum vom 01.03. bis zum 31.08.2020 betrachtet und medizinisches Personal für eine Querschnittserhebung im Rahmen einer Umfrage rekrutiert. Drei Subgruppen wurden nach Ort des Infektionskontakts, am Arbeitsplatz, im Privaten und unbekannt, unterteilt und analysiert.
Ergebnisse: Medizinisches Personal machte 11,8 % (319/2700) aller gemeldeten COVID-19-Fälle in Frankfurt/Main im untersuchten Zeitraum aus. In der Umfrage gaben 47,2 % der Befragten an, dass ihre Infektion am Arbeitsplatz erworben wurde. Es zeigte sich eine Assoziation von Kontakt zu COVID-19-Patient/-innen sowie der Beschäftigung auf einer internistischen Station und einer arbeitsbedingten Infektion. Ersichtlich wurde außerdem ein Zusammenhang zwischen mutmaßlichen Infektionen am Arbeitsplatz und folglich gestellten Verdachtsanzeigen auf Berufskrankheit.
Diskussion und Fazit: Gesundheitsämter sind in der Lage, relevante Daten von arbeitsbedingten Transmissionen in Berufen und Arbeitsplätzen im Gesundheitswesen zu erheben, und sollten standardisierte Daten zu infiziertem Gesundheitspersonal generieren. Diese Daten sind notwendig, um gezielte Maßnahmen der Infektionsprävention zu ergreifen, die Gesundheitspersonal und ihre Patient/-innen schützen.