Wiener klinische Wochenschrift
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Wien. Klin. Wochenschr. · Dec 2022
The impact of COVID-19 on liver transplantation programs in Austria.
Coronavirus disease of 2019 (COVID-19) has affected liver disease management. The impact of the COVID-19 pandemic on the Austrian orthotopic liver transplantation (OLT) programs, however, has not been systematically investigated. ⋯ The number of OLTs in Austria remained unchanged during COVID-19. SARS-CoV‑2 infections were rare but associated with high mortality in patients on the Austrian OLT waiting lists. SARS-CoV‑2 vaccination rates at the end of 2021 were suboptimal, while serological response was better in patients vaccinated pre-OLT vs. post-OLT.
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Wien. Klin. Wochenschr. · Dec 2022
Observational StudyComparison of clinical characteristics among patients infected with alpha vs. delta SARS-CoV-2 variants.
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has undergone different molecular changes, sprouting genetic variants of the original wildtype. Clinical comparisons between patients infected with alpha versus delta are scarce. ⋯ A total of 106 patients infected with alpha and 215 patients infected with delta were included. Patients infected with the delta variant were admitted to hospital earlier after symptom onset (6 vs. 7 days, p < 0.001). Blood levels of C‑reactive protein (43.3 vs. 62.9 mg/l, p = 0.02) and neutrophil count (3.81 vs. 4.53 G/l, p = 0.06) were lower in delta patients. Furthermore, at hospital admission cycle threshold (CT) values were significantly lower in patients infected with the delta variant (22.3 vs. 24.9, p < 0.001). Patients infected with the delta variant needed supplemental oxygen less often during disease course (50% vs. 64%, p = 0.02). Furthermore, there was a statistically non-significant trend towards a lower ICU admission rate among delta patients (16% vs. 24%, p = 0.08) CONCLUSION: Patients diagnosed with the delta variant were admitted to the hospital earlier, had a less severe course of disease and a higher viral replication on admission. This may provide a window of opportunity for antivirals in the hospital setting.
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Wien. Klin. Wochenschr. · Dec 2022
Observational StudyEarly administration of remdesivir may reduce mortality in hospitalized COVID-19 patients : A propensity score matched analysis.
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. ⋯ 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.
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Wien. Klin. Wochenschr. · Dec 2022
Which preventive control measure initiated the "flattening of the curve" : A comparison of Austria and Victoria during the 2nd wave of the COVID-19 pandemic.
When a country introduces different COVID-19 control measures over time, it is important to identify the specific measure that was effective and therefore responsible for "flattening the curve". This information helps policymakers find the right decision and saves the economy by avoiding severe yet ineffective measures. ⋯ Considering that the effect of control measures is expected the earliest one serial interval after their introduction, the control measure responsible for "flattening the curve" was the soft lockdown in Austria and the mask mandate in Victoria. The severe lockdowns in both regions were ineffective.
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Wien. Klin. Wochenschr. · Dec 2022
Observational StudyAssociation of the novel CROW-65 risk score and mortality in hospitalized kidney transplant recipients with COVID-19 : A retrospective observational study.
Kidney transplant recipients (KTR) are a group of patients with heterogeneous risks for adverse outcomes with COVID-19, but risk stratification tools in this patient group are lacking. ⋯ A novel risk score CROW-65 showed significant association with all-cause mortality in KTR yielding important hypothesis-generating findings. Further powered studies should reassess the performance of CROW-65 risk score in this population, including predictability, calibration and discrimination.