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Article ; Online: Diagnostik und Therapie von COVID-19 auf der Intensivstation.

Hoepler, Wolfgang / Traugott, Marianna / Zoufaly, Alexander / Schatzl, Martina / Hind, Julian / Wenisch, Christoph / Neuhold, Stephanie

Medizinische Klinik, Intensivmedizin und Notfallmedizin

2022 Volume 117, Issue 3, Page(s) 177–186

Abstract: Treatment of coronavirus disease 2019 (COVID-19) is particularly challenging due to the rapid scientific advances and the often significant hypoxemia. Use of high-flow oxygen, noninvasive mask ventilation, and the technique of awake proning can sometimes ...

Title translation	Diagnosis and treatment of COVID-19 in intensive care units.
Abstract	Treatment of coronavirus disease 2019 (COVID-19) is particularly challenging due to the rapid scientific advances and the often significant hypoxemia. Use of high-flow oxygen, noninvasive mask ventilation, and the technique of awake proning can sometimes avoid the need for intubation. Mechanical ventilation follows the principles of ventilation for acute respiratory distress syndrome (ARDS; lung protective ventilation) and is generally supplemented by consequent positioning therapy (with at least 16 h in prone position in multiple cycles). Antiviral therapy options such as remdesivir usually come too late for patients with COVID-19 in the ICU, the only exception being the administration of monoclonal antibodies for patients without seroconversion. The value of immunomodulatory therapy such as dexamethasone is undisputed. Interleukin‑6 antagonists, on the other hand, are rather problematic for ICU patients, and for Janus kinase inhibitors, data and experience are still insufficient in this context.
MeSH term(s)	COVID-19 ; Humans ; Intensive Care Units ; Noninvasive Ventilation/methods ; Prone Position ; Respiration, Artificial
Language	German
Publishing date	2022-03-28
Publishing country	Germany
Document type	Journal Article ; Review
ZDB-ID	2636018-4
ISSN	2193-6226 ; 1435-1420 ; 0723-5003 ; 2193-6218 ; 0175-3851
ISSN (online)	2193-6226 ; 1435-1420
ISSN	0723-5003 ; 2193-6218 ; 0175-3851
DOI	10.1007/s00063-022-00909-5
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Article ; Online: The natural killer cell-associated rs9916629-C allele is a novel genetic risk factor for fatal COVID-19.

Vietzen, Hannes / Furlano, Philippe L / Traugott, Marianna / Totschnig, David / Hoepler, Wolfgang / Strassl, Robert / Zoufaly, Alexander / Puchhammer-Stöckl, Elisabeth

Journal of medical virology

2022 Volume 95, Issue 1, Page(s) e28404

Abstract: The severity of COVID-19 is associated with individual genetic host factors. Among these, genetic polymorphisms affecting natural killer (NK) cell responses, as variations in the HLA-E- (HLA-E*0101/0103), FcγRIIIa- (FcγRIIIa-158-F/V), and NKG2C- ( ... ...

Abstract	The severity of COVID-19 is associated with individual genetic host factors. Among these, genetic polymorphisms affecting natural killer (NK) cell responses, as variations in the HLA-E- (HLA-E*0101/0103), FcγRIIIa- (FcγRIIIa-158-F/V), and NKG2C- (KLRC2
MeSH term(s)	Aged ; Humans ; Alleles ; COVID-19/genetics ; Killer Cells, Natural ; NK Cell Lectin-Like Receptor Subfamily C/genetics ; Polymorphism, Genetic ; Risk Factors
Chemical Substances	KLRC2 protein, human ; NK Cell Lectin-Like Receptor Subfamily C
Language	English
Publishing date	2022-12-14
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	752392-0
ISSN	1096-9071 ; 0146-6615
ISSN (online)	1096-9071
ISSN	0146-6615
DOI	10.1002/jmv.28404
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Zs.A 1320: Show issues

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Article ; Online: Monkeypox associated acute arthritis.

Fonti, Mirella / Mader, Theresa / Burmester-Kiang, Jan / Aberle, Stephan W / Horvath-Mechtler, Barbara / Traugott, Marianna / Laferl, Hermann / Zoufaly, Alexander / Wenisch, Christoph / Erlacher, Ludwig / Hoepler, Wolfgang

The Lancet. Rheumatology

2022 Volume 4, Issue 11, Page(s) e804

Language	English
Publishing date	2022-09-12
Publishing country	England
Document type	Journal Article
ISSN	2665-9913
ISSN (online)	2665-9913
DOI	10.1016/S2665-9913(22)00257-0
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Article ; Online: Molecular diagnosis of autochthonous human anaplasmosis in Austria - an infectious diseases case report.

Hoepler, Wolfgang / Markowicz, Mateusz / Schoetta, Anna-Margarita / Zoufaly, Alexander / Stanek, Gerold / Wenisch, Christoph

BMC infectious diseases

2020 Volume 20, Issue 1, Page(s) 288

Abstract: Background: The diagnosis of human anaplasmosis remains elusive and is probably often missed. This case report highlights the efficacy of molecular diagnostic techniques.: Case presentation: We would like to report the case of a 74-year-old man who ... ...

Abstract	Background: The diagnosis of human anaplasmosis remains elusive and is probably often missed. This case report highlights the efficacy of molecular diagnostic techniques. Case presentation: We would like to report the case of a 74-year-old man who was admitted to hospital because of a high fever, marked chills, transient diplopic images and vertigo, 6 weeks after multiple tick bites. The laboratory results showed mild anemia, marked thrombocytopenia and leukopenia and a moderately elevated C-reactive protein. The initial serology seemed to indicate an active infection with Borrelia spp., and Anaplasma phagocytophilum was detected in peripheral blood by polymerase chain reaction (PCR) and subsequent sequencing. The patient received intravenous ceftriaxone for 14 days and oral doxycycline for 4 weeks and made a fast and complete recovery. Conclusions: While human anaplasmosis has been reported very rarely in Austria, it should be considered as a differential diagnosis in febrile patients with low leukocyte and platelet counts with elevated levels of C-reactive protein after exposure to tick bites. Molecular detection of A. phagocytophilum is the technique of choice allowing rapid and reliable diagnosis.
MeSH term(s)	Aged ; Anaplasma phagocytophilum/drug effects ; Anaplasma phagocytophilum/genetics ; Anaplasma phagocytophilum/isolation & purification ; Anaplasmosis/diagnosis ; Anaplasmosis/drug therapy ; Anaplasmosis/etiology ; Anaplasmosis/pathology ; Animals ; Anti-Bacterial Agents/therapeutic use ; Austria ; Borrelia/isolation & purification ; DNA, Bacterial/genetics ; Diagnosis, Differential ; Humans ; Male ; Molecular Diagnostic Techniques ; Tick Bites/complications ; Treatment Outcome
Chemical Substances	Anti-Bacterial Agents ; DNA, Bacterial
Language	English
Publishing date	2020-04-19
Publishing country	England
Document type	Case Reports ; Journal Article
ISSN	1471-2334
ISSN (online)	1471-2334
DOI	10.1186/s12879-020-04993-w
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Article ; Online: Intestinal necrosis as an uncommon complication of Plasmodium falciparum malaria with a parasite count of 50.

Pawelka, Erich / Seitz, Tamara / Hoepler, Wolfgang / Karolyi, Mario / Laferl, Hermann / Neuhold, Stephanie / Petschnak, Sophia / Brandl, Irmgard / Zoufaly, Alexander / Wenisch, Christoph

Journal of travel medicine

2020 Volume 28, Issue 5

MeSH term(s)	Animals ; Humans ; Malaria, Falciparum/complications ; Malaria, Falciparum/drug therapy ; Necrosis ; Parasites ; Plasmodium falciparum
Language	English
Publishing date	2020-10-27
Publishing country	England
Document type	Journal Article
ZDB-ID	1212504-0
ISSN	1708-8305 ; 1195-1982
ISSN (online)	1708-8305
ISSN	1195-1982
DOI	10.1093/jtm/taaa203
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Zs.A 4120: Show issues

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Article ; Online: Heterogeneous SARS-CoV-2-Neutralizing Activities After Infection and Vaccination.

Graninger, Marianne / Camp, Jeremy V / Aberle, Stephan W / Traugott, Marianna T / Hoepler, Wolfgang / Puchhammer-Stöckl, Elisabeth / Weseslindtner, Lukas / Zoufaly, Alexander / Aberle, Judith H / Stiasny, Karin

Frontiers in immunology

2022 Volume 13, Page(s) 888794

Abstract: Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants of concern (VOCs) with different resistance levels to existing immunity have recently emerged. Antibodies that recognize the SARS-CoV-2 spike (S) protein and exhibit ... ...

Abstract	Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants of concern (VOCs) with different resistance levels to existing immunity have recently emerged. Antibodies that recognize the SARS-CoV-2 spike (S) protein and exhibit neutralizing activities are considered the best correlate of protection and an understanding of humoral immunity is crucial for controlling the pandemic. We thus analyzed such antibodies in individuals recovered from infection in 2020 as well as vaccinees after two doses of an mRNA vaccine. Methods: Neutralizing antibody responses against three SARS-CoV-2 variants (D614G, VOCs Beta and Delta) were determined in serum samples from 54 infected individuals (24 non-hospitalized, 30 hospitalized) and 34 vaccinees shortly after symptom onset or second vaccination, respectively, as well as six months later. In addition, the effect of the S sequence of the infecting strain on neutralization was studied. Results: Non-hospitalized patients had the lowest neutralization titers against all variants, while those of hospitalized patients equaled or exceeded those of vaccinees. Neutralizing activity was lower against the two VOCs and declined significantly in all cohorts after six months. This decrease was more pronounced in hospitalized and vaccinated individuals than in non-hospitalized patients. Of note, the specific neutralizing activity (NT titer/ELISA value ratio) was higher in the infected cohorts than in vaccinees and did not differ between non-hospitalized and hospitalized patients. Patients infected with viral strains carrying mutations in the N-terminal domain of the spike protein were impaired in Beta VOC neutralization. Conclusions: Specific neutralizing activities were higher in infected than in vaccinated individuals, and no difference in the quality of these antibodies was observed between hospitalized and non-hospitalized patients, despite significantly lower titers in the latter group. Additionally, antibody responses of infected individuals showed greater heterogeneity than those of vaccinees, which was associated with mutations in the spike protein of the infecting strain. Overall, our findings yielded novel insights into SARS-CoV-2-specific neutralizing antibodies, evolving differently after virus infection and COVID-19 vaccination, which is an important issue to consider in ongoing vaccine strategy improvements.
MeSH term(s)	Antibodies, Viral ; COVID-19/prevention & control ; COVID-19 Vaccines ; Humans ; Membrane Glycoproteins ; Neutralization Tests ; SARS-CoV-2/genetics ; Spike Glycoprotein, Coronavirus/genetics ; Vaccination ; Vaccines, Synthetic ; Viral Envelope Proteins ; mRNA Vaccines
Chemical Substances	Antibodies, Viral ; COVID-19 Vaccines ; Membrane Glycoproteins ; Spike Glycoprotein, Coronavirus ; Vaccines, Synthetic ; Viral Envelope Proteins ; mRNA Vaccines ; spike protein, SARS-CoV-2
Language	English
Publishing date	2022-05-30
Publishing country	Switzerland
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2606827-8
ISSN	1664-3224 ; 1664-3224
ISSN (online)	1664-3224
ISSN	1664-3224
DOI	10.3389/fimmu.2022.888794
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Article ; Online: Correction to: COVID-19 is not "just another flu": a real-life comparison of severe COVID-19 and influenza in hospitalized patients in Vienna, Austria.

Pawelka, Erich / Karolyi, Mario / Mader, Theresa / Omid, Sara / Kelani, Hasan / Baumgartner, Sebastian / Ely, Sarah / Hoepler, Wolfgang / Jilma, Bernd / Koenig, Franz / Laferl, Hermann / Traugott, Marianna / Turner, Michael / Seitz, Tamara / Wenisch, Christoph / Zoufaly, Alexander

Infection

2021 Volume 49, Issue 5, Page(s) 917

Language	English
Publishing date	2021-07-21
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/s15010-021-01654-1
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Zs.A 881: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Clinical and Angiographic Features in Three COVID-19 Patients with Takotsubo Cardiomyopathy. Case Report.

Hoepler, Wolfgang / Traugott, Marianna Theresia / Christ, Guenter / Kitzberger, Reinhard / Pawelka, Erich / Karolyi, Mario / Seitz, Tamara / Baumgartner, Sebastian / Kelani, Hasan / Wenisch, Christoph / Laferl, Hermann / Zoufaly, Alexander / Weseslindtner, Lukas / Neuhold, Stephanie

SN comprehensive clinical medicine

2021 Volume 3, Issue 1, Page(s) 263–268

Abstract: While coronavirus disease 2019 (COVID-19), caused by severe acute respiratory coronavirus 2 (SARS-CoV-2), has often been perceived as a predominantly respiratory condition, it is characterized by complications in multiple organ systems. Especially the ... ...

Abstract	While coronavirus disease 2019 (COVID-19), caused by severe acute respiratory coronavirus 2 (SARS-CoV-2), has often been perceived as a predominantly respiratory condition, it is characterized by complications in multiple organ systems. Especially the involvement of the cardiovascular system, along with the possibly severe pulmonary injury, is crucial for prognosis. We identified three COVID-19 patients with takotsubo (TT) cardiomyopathy at our infectious diseases treatment center and present their clinical, laboratory, echocardiographic, electrocardiographic, and angiographic features. All patients were female (median age, 67 years); disease severity regarding COVID-19 ranged from asymptomatic to ARDS (adult respiratory syndrome) necessitating mechanical ventilation for 22 days. Angiography revealed normal coronary arteries in patient 1, severe three-vessel coronary artery disease (CAD) in patient 2, and insignificant bystander CAD in patient 3. All patients showed classic apical hypokinesia with basal hyperkinesia. In patient 3, TT cardiomyopathy resulted in transient cardiogenic shock. Twenty-eight-day mortality was 0% in this case series. In conclusion, takotsubo cardiomyopathy may be yet another clinical entity associated with SARS-CoV-2 infection.
Language	English
Publishing date	2021-01-06
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2947211-8
ISSN	2523-8973 ; 2523-8973
ISSN (online)	2523-8973
ISSN	2523-8973
DOI	10.1007/s42399-020-00683-5
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Article ; Online: Different Neutralization Profiles After Primary SARS-CoV-2 Omicron BA.1 and BA.2 Infections.

Medits, Iris / Springer, David N / Graninger, Marianne / Camp, Jeremy V / Höltl, Eva / Aberle, Stephan W / Traugott, Marianna T / Hoepler, Wolfgang / Deutsch, Josef / Lammel, Oliver / Borsodi, Christian / Puchhammer-Stöckl, Elisabeth / Zoufaly, Alexander / Weseslindtner, Lukas / Aberle, Judith H / Stiasny, Karin

Frontiers in immunology

2022 Volume 13, Page(s) 946318

Abstract: Background and methods: The SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) Omicron (B.1.1.529) variant is the antigenically most distinct variant to date. As the heavily mutated spike protein enables neutralization escape, we studied serum- ...

Abstract	Background and methods: The SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) Omicron (B.1.1.529) variant is the antigenically most distinct variant to date. As the heavily mutated spike protein enables neutralization escape, we studied serum-neutralizing activities of naïve and vaccinated individuals after Omicron BA.1 or BA.2 sub-lineage infections in live virus neutralization tests with Omicron BA.1, Omicron BA.2, wildtype (WT, B1.1), and Delta (B.1.617.2) strains. Serum samples obtained after WT infections and three-dose mRNA vaccinations with and without prior infection were included as controls. Results: Primary BA.1 infections yielded reduced neutralizing antibody levels against WT, Delta, and Omicron BA.2, while samples from BA.2-infected individuals showed almost no cross-neutralization against the other variants. Serum neutralization of Omicron BA.1 and BA.2 variants was detectable after three-dose mRNA vaccinations, but with reduced titers. Vaccination-breakthrough infections with either Omicron BA.1 or BA.2, however, generated equal cross-neutralizing antibody levels against all SARS-CoV-2 variants tested. Conclusions: Our study demonstrates that although Omicron variants are able to enhance cross-neutralizing antibody levels in pre-immune individuals, primary infections with BA.1 or BA.2 induced mostly variant-specific neutralizing antibodies, emphasizing the differently shaped humoral immunity induced by the two Omicron variants. These data thus contribute substantially to the understanding of antibody responses induced by primary Omicron infections or multiple exposures to different SARS-CoV-2 variants and are of particular importance for developing vaccination strategies in the light of future emerging variants.
MeSH term(s)	Antibodies, Neutralizing ; Antibodies, Viral ; Broadly Neutralizing Antibodies ; COVID-19 ; Humans ; Membrane Glycoproteins ; Neutralization Tests ; RNA, Messenger ; SARS-CoV-2 ; Spike Glycoprotein, Coronavirus/genetics ; Viral Envelope Proteins
Chemical Substances	Antibodies, Neutralizing ; Antibodies, Viral ; Broadly Neutralizing Antibodies ; Membrane Glycoproteins ; RNA, Messenger ; Spike Glycoprotein, Coronavirus ; Viral Envelope Proteins ; spike protein, SARS-CoV-2
Language	English
Publishing date	2022-07-19
Publishing country	Switzerland
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2606827-8
ISSN	1664-3224 ; 1664-3224
ISSN (online)	1664-3224
ISSN	1664-3224
DOI	10.3389/fimmu.2022.946318
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Article ; Online: Early administration of remdesivir may reduce mortality in hospitalized COVID-19 patients : A propensity score matched analysis.

Karolyi, Mario / Kaltenegger, Lukas / Pawelka, Erich / Kuran, Avelino / Platzer, Moritz / Totschnig, David / Koenig, Franz / Hoepler, Wolfgang / Laferl, Hermann / Omid, Sara / Seitz, Tamara / Traugott, Marianna / Arthofer, Sigrun / Erlbeck, Lea / Jaeger, Stefan / Kettenbach, Alina / Assinger, Alice / Wenisch, Christoph / Zoufaly, Alexander

Wiener klinische Wochenschrift

2022

Abstract: Background: Remdesivir is the only antiviral agent approved for the treatment of hospitalized coronavirus disease 2019 (COVID-19) patients requiring supplemental oxygen. Studies show conflicting results regarding its effect on mortality.: Methods: In ...

Abstract	Background: Remdesivir is the only antiviral agent approved for the treatment of hospitalized coronavirus disease 2019 (COVID-19) patients requiring supplemental oxygen. Studies show conflicting results regarding its effect on mortality. Methods: In this single center observational study, we included adult hospitalized COVID-19 patients. Patients who were treated with remdesivir were compared to controls. Remdesivir was administered for 5 days. To adjust for any imbalances in our cohort, a propensity score matched analysis was performed. The aim of our study was to analyze the effect of remdesivir on in-hospital mortality and length of stay (LOS). Results: After propensity score matching, 350 patients (175 remdesivir, 175 controls) were included in our analysis. Overall, in-hospital mortality was not significantly different between groups remdesivir 5.7% [10/175] vs. control 8.6% [15/175], hazard ratio 0.50, 95% confidence interval (CI) 0.22-1.12, p = 0.091. Subgroup analysis showed a significant reduction of in-hospital mortality in patients who were treated with remdesivir ≤ 7 days of symptom onset remdesivir 4.2% [5/121] vs. control 10.4% [13/125], hazard ratio 0.26, 95% CI 0.09 to 0.75, p = 0.012 and in female patients remdesivir 2.9% [2/69] vs. control 12.2% [9/74], hazard ratio 0.18 95%CI 0.04 to 0.85, p = 0.03. Patients in the remdesivir group had a significantly longer LOS (11 days vs. 9 days, p = 0.046). Conclusion: Remdesivir did not reduce in-hospital mortality in our whole propensity score matched cohort, but subgroup analysis showed a significant mortality reduction in female patients and in patients treated within ≤ 7 days of symptom onset. Remdesivir may reduce mortality in patients who are treated in the early stages of illness.
Language	English
Publishing date	2022-10-27
Publishing country	Austria
Document type	Journal Article
ZDB-ID	200462-8
ISSN	1613-7671 ; 0043-5325 ; 0300-5178
ISSN (online)	1613-7671
ISSN	0043-5325 ; 0300-5178
DOI	10.1007/s00508-022-02098-9
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