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Article ; Online: Correction: Hospitalizations due to respiratory syncytial virus (RSV) infections in Germany: a nationwide clinical and direct cost data analysis (2010-2019).

Niekler, Patricia / Goettler, David / Liese, Johannes G / Streng, Andrea

2024

Language	English
Publishing date	2024-03-25
Publishing country	Germany
Document type	Published Erratum
ZDB-ID	185104-4
ISSN	1439-0973 ; 0300-8126 ; 0173-2129
ISSN (online)	1439-0973
ISSN	0300-8126 ; 0173-2129
DOI	10.1007/s15010-024-02191-3
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Article ; Online: SARS-CoV-2 Exposition und Seroprävalenz von SARS-CoV-2-Antikörpern bei Medizinstudierenden in der ersten Phase der Pandemie, 2020–2021.

Landmesser, Patricia / Weissbrich, Benedikt / Peter-Kern, Martina / Krone, Manuel / Liese, Johannes G / Streng, Andrea

Gesundheitswesen (Bundesverband der Arzte des Offentlichen Gesundheitsdienstes (Germany))

2024 Volume 86, Issue 4, Page(s) 311–314

Abstract: Background: Due to their clinical training and secondary activities in the hospital, medical students are exposed to contact with SARS-CoV-2 infected people more often than the general population. We determined the seroprevalence of SARS-CoV-2 ... ...

Title translation	SARS-CoV-2 Exposure and Seroprevalence of SARS-CoV-2 Antibodies among Medical Students in the First Phase of the Pandemic 2020-2021.
Abstract	Background: Due to their clinical training and secondary activities in the hospital, medical students are exposed to contact with SARS-CoV-2 infected people more often than the general population. We determined the seroprevalence of SARS-CoV-2 antibodies in medical students in clinical training at different times during the pandemic and asked participants about possible SARS-CoV-2 exposures in both medical and private settings. Methods: From May 2020 to June 2021, medical students each in their 3rd year of training at the University Hospital Würzburg participated in the cross-sectional survey. All SARS-CoV-2 unvaccinated students were offered a determination of their SARS-CoV-2 serostatus. The blood samples were tested by an immunoassay (Elecsys, Roche) for IgG/IgM/IgA antibodies against the SARS-CoV-2 N antigen. Demographic data, SARS-CoV-2 disease and vaccination status, as well as possible SARS-CoV-2 exposures were collected using a questionnaire. Results: Overall, 383 (86.1%) of 445 students took part in the cross-sectional survey (65% female; median age 22 years; IQR 21-24). Serostatus was determined in 223 (58.2% of 383) SARS-CoV-2 unvaccinated participants. In the period between the beginning of the pandemic in Germany (February 2020) and the time of the survey, 332 (86.7% of 383) students stated that they worked in the medical field, mainly in the context of clinical traineeships (76.8%) or secondary activities with patient contact (48.8%); 129 (33.7%) reported previous contact with a COVID-19 patient, of which 78.3% of contacts took place at a medical facility. Antibodies against SARS-CoV-2 were detected in 8 (3.6%) of the 223 unvaccinated participants tested, and in 3 infected persons an association between infection and contact in the course of medical activity seemed likely. Conclusion: Despite frequent patient contact and the associated increased risk of infection, medical students in their 3rd year of training did not show an increased seroprevalence compared to the general population and showed a lower or similar seroprevalence rate than medical students in other European countries in the first 18 months of the pandemic. This indicates sufficient protection of medical students at the beginning of clinical training through the hygiene and infection protection measures implemented at that time during medical activities.
MeSH term(s)	Humans ; Female ; Young Adult ; Adult ; Male ; Students, Medical ; SARS-CoV-2 ; Cross-Sectional Studies ; Pandemics ; Seroepidemiologic Studies ; COVID-19/epidemiology ; Germany/epidemiology ; Hospitals, University
Language	German
Publishing date	2024-01-05
Publishing country	Germany
Document type	English Abstract ; Journal Article
ZDB-ID	1101426-x
ISSN	1439-4421 ; 0941-3790 ; 0949-7013
ISSN (online)	1439-4421
ISSN	0941-3790 ; 0949-7013
DOI	10.1055/a-2183-7279
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Article ; Online: Hospitalizations due to respiratory syncytial virus (RSV) infections in Germany: a nationwide clinical and direct cost data analysis (2010-2019).

Niekler, Patricia / Goettler, David / Liese, Johannes G / Streng, Andrea

Infection

2023

Abstract: Purpose: Clinical and direct medical cost data on RSV-related hospitalizations are relevant for public health decision-making. We analyzed nationwide data on RSV-coded hospitalizations from Germany in different age and risk groups.: Methods: ... ...

Abstract	Purpose: Clinical and direct medical cost data on RSV-related hospitalizations are relevant for public health decision-making. We analyzed nationwide data on RSV-coded hospitalizations from Germany in different age and risk groups. Methods: Assessment of RSV-coded hospitalizations (ICD-10-GM RSV-code J12.1/J20.5/J21.0 as primary discharge diagnosis) from 01/2010 to 12/2019, using remote data retrieval from the Hospital Statistics Database of the German Federal Statistical Office. Results: Overall, 205,352 RSV-coded hospitalizations (198,139 children < 18 years, 1,313 adults, 5,900 seniors > 59 years) were reported (median age < 1 year, IQR 0; 1; 56% males, 32% with RSV pneumonia). Annual median RSV-coded hospitalization incidence was 24.8/100,000 persons (IQR 21.3; 27.5); children reported a median incidence of 145.8 (IQR 130.9; 168.3). Between 2010 and 2019, hospitalization incidence increased 1.7-fold/15.1-fold/103-fold in children/adults/seniors. Adults and seniors reported higher rates of underlying chronic conditions, complications, and intensive care treatment than children; of 612 in-hospital fatalities, 103/51/458 occurred in children/adults/seniors. Per-patient mean costs varied between 3286€ ± 4594 in 1-4-year-olds and 7215€ ± 13,564 among adults. Increased costs were associated with immune disorders (2.55-fold increase compared to those without), nervous system disorders (2.66-fold), sepsis (7.27-fold), ARDS (12.85-fold), intensive care (4.60-fold) and ECMO treatment (16.88-fold). Conclusion: The economic burden of RSV-related hospitalizations in Germany is substantial, even when only considering cases with RSV-coded as the primary discharge diagnosis. Children represented the vast majority of RSV-coded hospitalizations. However, adults and seniors hospitalized for RSV were at a higher risk of severe complications, required more costly treatments, and had higher fatality rates; although their RSV-coded hospitalization incidence showed a clear upward trend since 2017, their true hospitalization incidence is still likely to be underestimated due to lack of routine RSV testing in these age groups. Hence, new treatments and vaccines for RSV ideally should also target adults and seniors in addition to children.
Language	English
Publishing date	2023-11-16
Publishing country	Germany
Document type	Journal Article
ZDB-ID	185104-4
ISSN	1439-0973 ; 0300-8126 ; 0173-2129
ISSN (online)	1439-0973
ISSN	0300-8126 ; 0173-2129
DOI	10.1007/s15010-023-02122-8
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Epidemiology and direct healthcare costs of Influenza-associated hospitalizations - nationwide inpatient data (Germany 2010-2019).

Goettler, David / Niekler, Patricia / Liese, Johannes G / Streng, Andrea

BMC public health

2022 Volume 22, Issue 1, Page(s) 108

Abstract: Introduction: Detailed and up-to-date data on the epidemiology and healthcare costs of Influenza are fundamental for public health decision-making. We analyzed inpatient data on Influenza-associated hospitalizations (IAH), selected complications and ... ...

Abstract	Introduction: Detailed and up-to-date data on the epidemiology and healthcare costs of Influenza are fundamental for public health decision-making. We analyzed inpatient data on Influenza-associated hospitalizations (IAH), selected complications and risk factors, and their related direct costs for Germany during ten consecutive years. Methods: We conducted a retrospective cost-of-illness study on patients with laboratory-confirmed IAH (ICD-10-GM code J09/J10 as primary diagnosis) by ICD-10-GM-based remote data query using the Hospital Statistics database of the German Federal Statistical Office. Clinical data and associated direct costs of hospital treatment are presented stratified by demographic and clinical variables. Results: Between January 2010 to December 2019, 156,097 persons were hospitalized due to laboratory-confirmed Influenza (J09/J10 primary diagnosis). The annual cumulative incidence was low in 2010, 2012 and 2014 (1.3 to 3.1 hospitalizations per 100,000 persons) and high in 2013 and 2015-2019 (12.6 to 60.3). Overall direct per patient hospitalization costs were mean (SD) 3521 EUR (± 8896) and median (IQR) 1805 EUR (1502; 2694), with the highest mean costs in 2010 (mean 8965 EUR ± 26,538) and the lowest costs in 2012 (mean 2588 EUR ± 6153). Mean costs were highest in 60-69 year olds, and in 50-59, 70-79 and 40-49 year olds; they were lowest in 10-19 year olds. Increased costs were associated with conditions such as diabetes (frequency 15.0%; 3.45-fold increase compared to those without diabetes), adiposity (3.3%; 2.09-fold increase) or immune disorders (5.6%; 1.88-fold increase) and with Influenza-associated complications such as Influenza pneumonia (24.3%; 1.95-fold), bacterial pneumonia (6.3%; 3.86-fold), ARDS (1.2%; 10.90-fold increase) or sepsis (2.3%; 8.30-fold). Estimated overall costs reported for the 10-year period were 549.6 Million euros (95% CI 542.7-556.4 million euros). Conclusion: We found that the economic burden of IAH in Germany is substantial, even when considering solely laboratory-confirmed IAH reported as primary diagnosis. The highest costs were found in the elderly, patients with certain underlying risk factors and patients who required advanced life support treatment, and median and mean costs showed considerable variations between single years. Furthermore, there was a relevant burden of disease in middle-aged adults, who are not covered by the current vaccination recommendations in Germany.
MeSH term(s)	Adult ; Aged ; Germany/epidemiology ; Health Care Costs ; Hospitalization ; Humans ; Influenza, Human/epidemiology ; Influenza, Human/therapy ; Inpatients ; Middle Aged ; Retrospective Studies
Language	English
Publishing date	2022-01-15
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2041338-5
ISSN	1471-2458 ; 1471-2458
ISSN (online)	1471-2458
ISSN	1471-2458
DOI	10.1186/s12889-022-12505-5
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Joginder Kumar Anand's support and generosity eased our transition to the NHS.

de la Court, Annette / Hemmen, Bea / Michielsen, Fabienne / Ruting, Ineke / Streng, Isabelle

BMJ (Clinical research ed.)

2023 Volume 380, Page(s) 439

Language	English
Publishing date	2023-02-27
Publishing country	England
Document type	Letter
ZDB-ID	1362901-3
ISSN	1756-1833 ; 0959-8154 ; 0959-8146 ; 0959-8138 ; 0959-535X ; 1759-2151
ISSN (online)	1756-1833
ISSN	0959-8154 ; 0959-8146 ; 0959-8138 ; 0959-535X ; 1759-2151
DOI	10.1136/bmj.p439
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Article: [No title information]

Landmesser, Patricia / Weissbrich, Benedikt / Peter-Kern, Martina / Krone, Manuel / Liese, Johannes G. / Streng, Andrea

Das Gesundheitswesen

2024 Volume 86, Issue 04, Page(s) 311–314

Abstract: Hintergrund: Medizinstudierende sind bedingt durch ihre klinische Ausbildung und bei Nebentätigkeiten in der Klinik häufiger Kontakten zu SARS-CoV-2-Infizierten ausgesetzt als die ... ...

Abstract	Hintergrund: Medizinstudierende sind bedingt durch ihre klinische Ausbildung und bei Nebentätigkeiten in der Klinik häufiger Kontakten zu SARS-CoV-2-Infizierten ausgesetzt als die Allgemeinbevölkerung. Wir bestimmten die Seroprävalenz von SARS-CoV-2-Antikörpern bei Medizinstudierenden in der klinischen Ausbildung zu verschiedenen Zeitpunkten in der Anfangsphase der Pandemie und befragten die Teilnehmenden zu möglichen SARS-CoV-2-Expositionen im medizinischen und im privaten Bereich. Methodik: Im Zeitraum Mai 2020 bis Juni 2021 wurden Medizinstudierende des jeweiligen 3. Studienjahres (6. Fachsemester) am Universitätsklinikum Würzburg befragt und SARS-CoV-2-Ungeimpften eine Bestimmung ihres SARS-CoV-2-Serostatus angeboten. Die Blutproben wurden mittels Immunoassay (Elecsys, Roche) auf IgG/IgM/IgA-Antikörper gegen das SARS-CoV-2 N-Antigen getestet. Demographische Daten, SARS-CoV-2-Erkrankungs- und Impfstatus, sowie mögliche SARS-CoV-2 Expositionen wurden mithilfe eines Fragebogens erfasst. Ergebnisse: 383 (86,1%) von 445 Studierenden beteiligten sich an der Querschnittsbefragung (65% weiblich; Altersmedian 22 Jahre; IQR 21–24). Von 223 (58,2% von 383) ungeimpften Teilnehmenden wurde der Serostatus ermittelt. Im Zeitraum zwischen Pandemiebeginn in Deutschland (Februar 2020) und dem Befragungszeitpunkt gaben 332 (86,7% von 383) an, eine Tätigkeit im medizinischen Bereich auszuüben, vor allem im Rahmen von Famulaturen (76,8%) oder Nebentätigkeiten mit Patientenkontakt (48,8%). 129 (33,7%) gaben einen vorangegangenen Kontakt zu einem COVID-19-Patienten an, davon fanden 78,3% der Kontakte in einer medizinischen Einrichtung statt. Bei 8 (3,6%) der 223 getesteten, ungeimpften Teilnehmenden konnten Antikörper gegen SARS-CoV-2 nachgewiesen werden, dabei ließ sich bei 3 Infizierten ein Zusammenhang zwischen der Infektion und einem Kontakt im Rahmen der medizinischen Tätigkeit vermuten. Schlussfolgerung: Trotz häufigen Patientenkontaktes und des damit möglicherweise einhergehenden erhöhten Infektionsrisikos zeigten Medizinstudierende des 3. Studienjahres in den ersten 18 Monaten der Pandemie gegenüber der Allgemeinbevölkerung keine erhöhte Seroprävalenz und eine niedrigere bzw. ähnliche Seroprävalenzrate wie Medizinstudierende in anderen europäischen Ländern. Dies weist auf einen ausreichenden Schutz von Medizinstudierenden zu Beginn ihrer klinischen Ausbildung durch die damaligen Hygiene- und Infektionsschutzmaßnahmen bei medizinischen Tätigkeiten hin.
Keywords	COVID-19 ; Medizinisches Personal ; Infektionsrisiko ; ungeimpft ; COVID-19 ; health care workers ; risk of infection ; unvaccinated
Language	German
Publishing date	2024-01-05
Publisher	Georg Thieme Verlag KG
Publishing place	Stuttgart ; New York
Document type	Article
ZDB-ID	1101426-x
ISSN	1439-4421 ; 0941-3790 ; 0949-7013
ISSN (online)	1439-4421
ISSN	0941-3790 ; 0949-7013
DOI	10.1055/a-2183-7279
Database	Thieme publisher's database

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Article: Rapid response screening for emerging zoonotic pathogens, barriers and opportunities: A study for enhanced preparedness of the Netherlands.

Streng, Kiki / de Best, Pauline A / Timen, Aura / Koopmans, Marion P G / van der Poel, Wim H M / Sikkema, Reina S

One health (Amsterdam, Netherlands)

2023 Volume 16, Page(s) 100507

Abstract: Background: Outbreaks of zoonotic emerging infectious diseases (EIDs) require rapid identification of potential reservoir hosts and mapping disease spread in these hosts to inform risk assessment and adequate control measures. Animals are often ... ...

Abstract	Background: Outbreaks of zoonotic emerging infectious diseases (EIDs) require rapid identification of potential reservoir hosts and mapping disease spread in these hosts to inform risk assessment and adequate control measures. Animals are often understudied when a novel EID is detected in humans and acquisition of animal samples is hampered by practical, ethical, and legal barriers, of which there is currently no clear overview. Therefore, the three aims of this study are (1) to map potentially available collections of animal samples, (2) to assess possibilities and barriers for reuse of these samples and (3) to assess possibilities and barriers for active animal and environmental sampling in the Netherlands. Methods: A literature search was performed to identify ongoing sampling activities and opportunities for reuse or active sampling. Semi-structured interviews with stakeholder organizations were conducted to gain further insight into the three research questions. Results: Various sample collections of surveillance, diagnostic and research activities exist in the Netherlands. Sample size, coverage, storage methods and type of samples collected differs per animal species which influences reuse suitability. Organizations are more likely to share samples, for reuse in outbreak investigations, when they have a pre-existing relationship with the requesting institute. Identified barriers for sharing were, among others, unfamiliarity with legislation and unsuitable data management systems. Active sampling of animals or the environment is possible through several routes. Related barriers are acquiring approval from animal- or property owners, conflicts with anonymization, and time needed to acquire ethical approval. Conclusion: The animal sample collections identified would be very valuable for use in outbreak investigations. Barriers for sharing may be overcome by increasing familiarity with legislation, building (international) sharing networks and agreements before crises occur and developing systems for sample registration and biobanking. Proactive setting up of ethical approvals will allow for rapid animal sample collection to identify EID hosts and potential spillovers.
Language	English
Publishing date	2023-02-14
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	2834831-X
ISSN	2352-7714
ISSN	2352-7714
DOI	10.1016/j.onehlt.2023.100507
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Measuring Mitochondrial Oxygen Tension during Red Blood Cell Transfusion in Chronic Anemia Patients: A Pilot Study.

Ubbink, Rinse / Streng, Lucia W J M / Raat, Nicolaas J H / Harms, Floor A / Te Boekhorst, Peter A W / Stolker, Robert J / Mik, Egbert G

Biomedicines

2023 Volume 11, Issue 7

Abstract: In light of the associated risks, the question has been raised whether the decision to give a blood transfusion should solely be based on the hemoglobin level. As mitochondria are the final destination of oxygen transport, mitochondrial parameters are ... ...

Abstract	In light of the associated risks, the question has been raised whether the decision to give a blood transfusion should solely be based on the hemoglobin level. As mitochondria are the final destination of oxygen transport, mitochondrial parameters are suggested to be of added value. The aims of this pilot study were to investigate the effect of a red blood cell transfusion on mitochondrial oxygenation as measured by the COMET device in chronic anemia patients and to explore the clinical usability of the COMET monitor in blood transfusion treatments, especially the feasibility of performing measurements in an outpatient setting. To correct the effect of volume load on mitochondrial oxygenation, a red blood cell transfusion and a saline infusion were given in random order. In total, 21 patients were included, and this resulted in 31 observations. If patients participated twice, the order of infusion was reversed. In both the measurements wherein a blood transfusion was given first and wherein 500 mL of 0.9% saline was given first, the median mitochondrial oxygen tension decreased after red blood cell transfusion. The results of this study have strengthened the need for further research into the effect of blood transfusion tissue oxygenation and the potential role of mitochondrial parameters herein.
Language	English
Publishing date	2023-06-30
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2720867-9
ISSN	2227-9059
ISSN	2227-9059
DOI	10.3390/biomedicines11071873
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Article ; Online: Frailty in Non-geriatric Patients With Head and Neck cancer.

Bakas, Ajay T / Polinder-Bos, Harmke A / Streng, Fleur / Mattace-Raso, Francesco U S / Ziere, Gijsbertus / de Jong, Rob J Baatenburg / Sewnaik, Aniel

Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery

2023 Volume 169, Issue 5, Page(s) 1215–1224

Abstract: Objective: Patients with head and neck cancer (HNC) are characterized by a poor lifestyle and comorbidity. The Geriatric 8 (G8) is an established screening tool to identify frail older patients with cancer. However, studies evaluating frailty in younger ...

Abstract	Objective: Patients with head and neck cancer (HNC) are characterized by a poor lifestyle and comorbidity. The Geriatric 8 (G8) is an established screening tool to identify frail older patients with cancer. However, studies evaluating frailty in younger HNC patients are lacking. The aim of this study is to evaluate if the G8 can identify frailty and if it is related to mortality in younger HNC patients. Study design: Case-control study design. Setting: Tertiary cancer center. Methods: We studied patients <70 years with HNC. Patients with G8 ≤ 14 were considered frail. Patients were matched to nonfrail (G8 > 14) control patients. Patients were matched according to sex, age, smoking, tumor location, and period of first consultation. Baseline health characteristics were compared between frail patients and nonfrail controls. Second, the treatment plan and adverse outcomes were compared. Results: Forty-five patients with G8 ≤ 14 were included and matched to 90 nonfrail controls. The median follow-up time was 357 days. Frail patients had a significantly lower body mass index and level of education, a worse World Health Organization performance status, and reported lower experienced overall health. 28.9% of the frail patients died after 1 year versus 10% of the nonfrail control patients (hazard ratio: 3.87 [95% confidence interval: 1.32-11.36], p = 0.014). Conclusion: The G8 is a valid screening tool to identify frail patients in younger HNC patients.
MeSH term(s)	Humans ; Aged ; Frailty/diagnosis ; Frail Elderly ; Case-Control Studies ; Geriatric Assessment ; Head and Neck Neoplasms
Language	English
Publishing date	2023-06-02
Publishing country	England
Document type	Journal Article
ZDB-ID	392085-9
ISSN	1097-6817 ; 0161-6439 ; 0194-5998
ISSN (online)	1097-6817
ISSN	0161-6439 ; 0194-5998
DOI	10.1002/ohn.388
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Article ; Online: Rapid response screening for emerging zoonotic pathogens, barriers and opportunities: A study for enhanced preparedness of the Netherlands

Streng, Kiki / de Best, Pauline A. / Timen, Aura / Koopmans, Marion P.G. / van der Poel, Wim H.M. / Sikkema, Reina S.

One Health. 2023 June, v. 16 p.100507-

2023

Abstract: Outbreaks of zoonotic emerging infectious diseases (EIDs) require rapid identification of potential reservoir hosts and mapping disease spread in these hosts to inform risk assessment and adequate control measures. Animals are often understudied when a ... ...

Abstract	Outbreaks of zoonotic emerging infectious diseases (EIDs) require rapid identification of potential reservoir hosts and mapping disease spread in these hosts to inform risk assessment and adequate control measures. Animals are often understudied when a novel EID is detected in humans and acquisition of animal samples is hampered by practical, ethical, and legal barriers, of which there is currently no clear overview. Therefore, the three aims of this study are (1) to map potentially available collections of animal samples, (2) to assess possibilities and barriers for reuse of these samples and (3) to assess possibilities and barriers for active animal and environmental sampling in the Netherlands. A literature search was performed to identify ongoing sampling activities and opportunities for reuse or active sampling. Semi-structured interviews with stakeholder organizations were conducted to gain further insight into the three research questions. Various sample collections of surveillance, diagnostic and research activities exist in the Netherlands. Sample size, coverage, storage methods and type of samples collected differs per animal species which influences reuse suitability. Organizations are more likely to share samples, for reuse in outbreak investigations, when they have a pre-existing relationship with the requesting institute. Identified barriers for sharing were, among others, unfamiliarity with legislation and unsuitable data management systems. Active sampling of animals or the environment is possible through several routes. Related barriers are acquiring approval from animal- or property owners, conflicts with anonymization, and time needed to acquire ethical approval. The animal sample collections identified would be very valuable for use in outbreak investigations. Barriers for sharing may be overcome by increasing familiarity with legislation, building (international) sharing networks and agreements before crises occur and developing systems for sample registration and biobanking. Proactive setting up of ethical approvals will allow for rapid animal sample collection to identify EID hosts and potential spillovers.
Keywords	animals ; ethics ; information management ; laws and regulations ; monitoring ; risk assessment ; sample size ; stakeholders ; Netherlands ; One health ; Outbreak investigation ; Emerging diseases ; Zoonoses
Language	English
Dates of publication	2023-06
Publishing place	Elsevier B.V.
Document type	Article ; Online
Note	Pre-press version ; Use and reproduction
ZDB-ID	2834831-X
ISSN	2352-7714
ISSN	2352-7714
DOI	10.1016/j.onehlt.2023.100507
Database	NAL-Catalogue (AGRICOLA)

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