Abstract Extracorporeal life support (ECLS) is a means to support patients with acute respiratory failure. Initially, recommendations to treat severe cases of pandemic coronavirus disease 2019 (COVID‐19) with ECLS have been restrained. In the meantime, ECLS has been shown to produce similar outcomes in patients with severe COVID‐19 compared to existing data on ARDS mortality. We performed an international email survey to assess how ECLS providers worldwide have previously used ECLS during the treatment of critically ill patients with COVID‐19. A questionnaire with 45 questions (covering, e.g., indication, technical aspects, benefit, and reasons for treatment discontinuation), mostly multiple choice, was distributed by email to ECLS centers. The survey was approved by the European branch of the Extracorporeal Life Support Organization (ELSO); 276 ECMO professionals from 98 centers in 30 different countries on four continents reported that they employed ECMO for very severe COVID‐19 cases, mostly in veno‐venous configuration (87%). The most common reason to establish ECLS was isolated hypoxemic respiratory failure (50%), followed by a combination of hypoxemia and hypercapnia (39%). Only a small fraction of patients required veno‐arterial cannulation due to heart failure (3%). Time on ECLS varied between less than 2 and more than 4 weeks. The main reason to discontinue ECLS treatment prior to patient’s recovery was lack of clinical improvement (53%), followed by major bleeding, mostly intracranially (13%). Only 4% of respondents reported that triage situations, lack of staff or lack of oxygenators, were responsible for discontinuation of ECLS support. Most ECLS physicians (51%, IQR 30%) agreed that patients with COVID‐19‐induced ARDS (CARDS) benefitted from ECLS. Overall mortality of COVID‐19 patients on ECLS was estimated to be about 55%. ECLS has been utilized successfully during the COVID‐19 pandemic to stabilize CARDS patients in hypoxemic or hypercapnic lung failure. Age and multimorbidity limited the use of ECLS. Triage situations were rarely a concern. ECLS providers stated that patients with severe COVID‐19 benefitted from ECLS. 276 ECMO professionals from 98 centers worldwide participated in this EuroELSO‐associated online survey investigating the use of ECMO for severe COVID‐19. Extracorporeal life support (ECLS) for severe COVID‐19 was used predominantly in veno‐venous configuration (87%) to treat isolated hypoxic respiratory failure (50%). Age and multimorbidity limited the use of ECLS. Overall mortality of COVID‐19 patients on ECLS was estimated to be about 55%.
descriptionPublicationkeyboard_double_arrow_right Article 2020 Netherlands, France, France Wiley
Authors: A. Wollenberg; Carsten Flohr; Dagmar Simon; Michael J. Cork; +29 Authors
A. Wollenberg; Carsten Flohr; Dagmar Simon; Michael J. Cork; Jacob P. Thyssen; Thomas Bieber; M S de Bruin-Weller; S Weidinger; Mette Deleuran; Alain Taieb; Carle Paul; Magdalena Trzeciak; Thomas Werfel; Julien Seneschal; Sébastien Barbarot; Ulf Darsow; Antonio Torrelo; J. F. Stalder; Åke Svensson; DirkJan Hijnen; Carlo Gelmetti; Z. Szalai; U. Gieler; L. De Raeve; B. Kunz; Ph.I. Spuls; L.B. von Kobyletzki; R. Fölster-Holst; Pavel V Chernyshov; Stéphanie Christen-Zaech; Annice Heratizadeh; J. Ring; Christian Vestergaard;
Atopic dermatitis (AD) is a complex disease with elevated risk of respiratory comorbidities.1,2 Severely affected patients are often treated with immune-modulating systemic drugs.3,4 On March 11th 2020, the World Health Organization declared the 2019 novel coronavirus severe acute respiratory syndrome (SARS-Cov-2) epidemic to be a pandemic. The number of cases worldwide is increasing exponentially and poses a major health threat, especially for those who are elderly, immuno-compromised, or have comorbidities. This also applies to AD patients on systemic immune-modulating treatment. In these days of uncertainty, reallocation of medical resources, curfew, hoarding, and shutdown of normal social life, patients, caregivers and doctors ask questions regarding the continuation of systemic immune-modulating treatment of AD patients. The ETFAD decided to address some of these questions here.
Obesity is an important risk factor for major complications, morbidity and mortality related to intubation procedures and ventilation in the intensive care unit (ICU). The fall in functional residual capacity promotes airway closure and atelectasis formation. This narrative review presents the impact of obesity on the respiratory system and the key points to optimize airway management, noninvasive and invasive mechanical ventilation in ICU patients with obesity. Non-invasive strategies should first optimize body position with reverse Trendelenburg position or sitting position. Noninvasive ventilation (NIV) is considered as the first-line therapy in patients with obesity having a postoperative acute respiratory failure. Positive pressure pre-oxygenation before the intubation procedure is the method of reference. The use of videolaryngoscopy has to be considered by adequately trained intensivists, especially in patients with several risk factors. Regarding mechanical ventilation in patients with and without acute respiratory distress syndrome (ARDS), low tidal volume (6 ml/kg of predicted body weight) and moderate to high positive end-expiratory pressure (PEEP), with careful recruitment maneuver in selected patients, are advised. Prone positioning is a therapeutic choice in severe ARDS patients with obesity. Prophylactic NIV should be considered after extubation to prevent re-intubation. If obesity increases mortality and risk of ICU admission in the overall population, the impact of obesity on ICU mortality is less clear and several confounding factors have to be taken into account regarding the “obesity ICU paradox”. Electronic supplementary material The online version of this article (10.1007/s00134-020-06286-x) contains supplementary material, which is available to authorized users.
Ramy Abou Ghayda; Keum Hwa Lee; Young Joo Han; Seohyun Ryu; Sung Hwi Hong; Sojung Yoon; Gwang Hun Jeong; Jinhee Lee; Jun Young Lee; Jae Won Yang; Maria Effenberger; Michael Eisenhut; Andreas Kronbichler; Marco Solmi; Han Li; Louis Jacob; Ai Koyanagi; Joaquim Radua; Jae Il Shin; Lee Smith;
Objective Since the outbreak of the coronavirus disease 2019 (COVID-19) in December of 2019 in China, the estimation of the pandemic’s case fatality rate (CFR) has been the focus and interest of many stakeholders. In this manuscript, we prove that the method of using the cumulative CFR is static and does not reflect the trend according to the daily change per unit of time. Methods A proportion meta-analysis was carried out on CFR in every country reporting COVID-19 cases. Based on the results, we performed a meta-analysis for global COVID-19 CFR. Each analysis was performed on two different calculations of CFR: according to calendar date and according to days since the outbreak of the first confirmed case. We thus explored an innovative and original calculation of CFR concurrently based on the date of the first confirmed case as well as on a daily basis. Results For the first time, we showed that using meta-analyses, according to calendar date and days since the outbreak of the first confirmed case were different. Conclusion We propose that CFR according to days since the outbreak of the first confirmed case might be a better predictor of the current CFR of COVID-19 and its kinetics. Highlights • The estimation of the coronavirus disease 2019 (COVID-19) pandemic’s case fatality rate (CFR) has been the focus and interest of many stakeholders as it plays a key role in understanding this pandemic and guides appropriate responses and efficient mitigation strategies. • The traditional cumulative CFR estimation is static; however, it is rather a dynamic value. Moreover, the estimation of the global CFR of COVID-19 according to the calendar date and days since the outbreak of the first confirmed case is different. • We propose that the estimated kinetics of CFR according to days since the outbreak of the first confirmed case could be a useful predictor to design COVID-19 mitigation strategies.
descriptionPublicationkeyboard_double_arrow_right Article 2021 Netherlands, France Ovid Technologies (Wolters Kluwer Health)
Authors: Valerian L Altersberger; Lotte J. Stolze; Mirjam Rachel Heldner; Hilde Hénon; +34 Authors
Valerian L Altersberger; Lotte J. Stolze; Mirjam Rachel Heldner; Hilde Hénon; Nicolas Martinez-Majander; Christian Hametner; Annika Nordanstig; Andrea Zini; Stefania Nannoni; Bruno Gonçalves; Christian H. Nolte; Philipp Baumgartner; Andreas Kastrup; Panagiotis Papanagiotou; Georg Kägi; Ronen R. Leker; Marialuisa Zedde; Alessandro Padovani; Alessandro Pezzini; Visnja Padjen; Carlo W. Cereda; Georges Ntaios; Leo H. Bonati; Leon A. Rinkel; Urs Fischer; Jan F. Scheitz; Susanne Wegener; Guillaume Turc; Patrik Michel; Mauro Gentile; Alexandros Rentzos; Peter A. Ringleb; Sami Curtze; Charlotte Cordonnier; Marcel Arnold; Paul J. Nederkoorn; Stefan T. Engelter; Henrik Gensicke;
Background and Purpose: Timely reperfusion is an important goal in treatment of eligible patients with acute ischemic stroke. However, during the coronavirus disease 2019 (COVID-19) pandemic, prehospital and in-hospital emergency procedures faced unprecedented challenges, which might have caused a decline in the number of acute reperfusion therapy applied and led to a worsening of key quality measures for this treatment during lockdown. Methods: This prospective multicenter cohort study used data from the TRISP (Thrombolysis in Ischemic Stroke Patients) registry of patients with acute ischemic stroke treated with reperfusion therapies, that is, intravenous thrombolysis or endovascular therapy. We compared prehospital and in-hospital time-based performance measures (stroke-onset-to-admission, admission-to-treatment, admission-to-image, and image-to-treatment time) during the first 6 weeks after announcement of lockdown (lockdown period) with the same period in 2019 (reference period). Secondary outcomes included stroke severity (National Institutes of Health Stroke Scale) after 24 hours and occurrence of symptomatic intracranial hemorrhage (following the ECASS [European-Australasian Acute Stroke Study]-II criteria). Results: Across 20 stroke centers, 540 patients were treated with intravenous thrombolysis/endovascular therapy during lockdown period compared with 578 patients during reference period (−7% [95% CI, 5%–9%]). Performance measures did not change significantly during the lockdown period (2020/2019 minutes median: onset-to-admission 133/145; admission-to-treatment 51/48). Same was true for admission-to-image (20/19) and image-to-treatment (31/30) time in patients with available time of first image (n=871, 77.9%). Median National Institutes of Health Stroke Scale on admission (2020/2019: 11/11) and after 24 hours (2020/2019: 6/5) and percentage of symptomatic intracranial hemorrhage (2020/2019: 6.2/5.7) did not differ significantly between both periods. Conclusions: The COVID-19 pandemic lockdown resulted in a mild decline in the number of patients with stroke treated with acute reperfusion therapies. More importantly, the solid stability of key quality performance measures between the 2020 and 2019 period may indicate resilience of acute stroke care service during the lockdown, at least in well-established European stroke centers. Supplemental Digital Content is available in the text.
descriptionPublicationkeyboard_double_arrow_right Article , Preprint 2020 Turkey, Finland, France, Italy, Brazil, Spain, France, Belgium, Germany, Italy, Netherlands, United Kingdom, United Kingdom, United States Cold Spring Harbor Laboratory
Correction: Chemical Senses, Volume 46, 2021, bjab050, https://doi.org/10.1093/chemse/bjab050 Published: 08 December 2021 Recent anecdotal and scientific reports have provided evidence of a link between COVID-19 and chemosensory impairments, such as anosmia. However, these reports have downplayed or failed to distinguish potential effects on taste, ignored chemesthesis, and generally lacked quantitative measurements. Here, we report the development, implementation, and initial results of a multilingual, international questionnaire to assess self-reported quantity and quality of perception in 3 distinct chemosensory modalities (smell, taste, and chemesthesis) before and during COVID-19. In the first 11 days after questionnaire launch, 4039 participants (2913 women, 1118 men, and 8 others, aged 19-79) reported a COVID-19 diagnosis either via laboratory tests or clinical assessment. Importantly, smell, taste, and chemesthetic function were each significantly reduced compared to their status before the disease. Difference scores (maximum possible change +/- 100) revealed a mean reduction of smell (-79.7 +/- 28.7, mean +/- standard deviation), taste (-69.0 +/- 32.6), and chemesthetic (-37.3 +/- 36.2) function during COVID-19. Qualitative changes in olfactory ability (parosmia and phantosmia) were relatively rare and correlated with smell loss. Importantly, perceived nasal obstruction did not account for smell loss. Furthermore, chemosensory impairments were similar between participants in the laboratory test and clinical assessment groups. These results show that COVID-19-associated chemosensory impairment is not limited to smell but also affects taste and chemesthesis.The multimodal impact of COVID-19 and the lack of perceived nasal obstruction suggest that severe acute respiratory syndrome coronavirus strain 2 (SARS-CoV-2) infection may disrupt sensory-neural mechanisms. Peer reviewed
Abstract In response to the coronavirus disease 2019 (COVID-19) pandemic, countries have implemented various strategies to reduce and slow the spread of the disease in the general population. For countries that have implemented restrictions on its population in a stepwise manner, monitoring of COVID-19 prevalence is of importance to guide the decision on when to impose new, or when to abolish old, restrictions. We are here determining whether measures of odor intensity in a large sample can serve as one such measure. Online measures of how intense common household odors are perceived and symptoms of COVID-19 were collected from 2440 Swedes. Average odor intensity ratings were then compared to predicted COVID-19 population prevalence over time in the Swedish population and were found to closely track each other (r = −0.83). Moreover, we found that there was a large difference in rated intensity between individuals with and without COVID-19 symptoms and the number of symptoms was related to odor intensity ratings. Finally, we found that individuals progressing from reporting no symptoms to subsequently reporting COVID-19 symptoms demonstrated a large drop in olfactory performance. These data suggest that measures of odor intensity, if obtained in a large and representative sample, can be used as an indicator of COVID-19 disease in the general population. Importantly, this simple measure could easily be implemented in countries without widespread access to COVID-19 testing or implemented as a fast early response before widespread testing can be facilitated.
descriptionPublicationkeyboard_double_arrow_right Article , Other literature type 2020 France, Spain, France, France, Italy, Netherlands Springer Science and Business Media LLC
Authors: Per Ljungman; Malgorzata Mikulska; Rafael de la Cámara; Grzegorz W. Basak; +15 Authors
Per Ljungman; Malgorzata Mikulska; Rafael de la Cámara; Grzegorz W. Basak; Christian Chabannon; Selim Corbacioglu; Rafael F. Duarte; Harry Dolstra; Arjan C. Lankester; Mohamad Mohty; Silvia Montoto; John Murray; Régis Peffault de Latour; John A. Snowden; Ibrahim Yakoub-Agha; Bregje Verhoeven; Nicolaus Kröger; Jan Styczyński; Marrow Transplantation;
AbstractThe new coronavirus SARS-CoV-2 has rapidly spread over the world causing the disease by WHO called COVID-19. This pandemic poses unprecedented stress on the health care system including programs performing allogeneic and autologous hematopoietic cell transplantation (HCT) and cellular therapy such as with CAR T cells. Risk factors for severe disease include age and predisposing conditions such as cancer. The true impact on stem cell transplant and CAR T-cell recipients in unknown. The European Society for Blood and Marrow Transplantation (EBMT) has therefore developed recommendations for transplant programs and physicians caring for these patients. These guidelines were developed by experts from the Infectious Diseases Working Party and have been endorsed by EBMT’s scientific council and board. This work intends to provide guidelines for transplant centers, management of transplant candidates and recipients, and donor issues until the COVID-19 pandemic has passed.
descriptionPublicationkeyboard_double_arrow_right Preprint 2020 France Cold Spring Harbor Laboratory EC | PerMedCoE, EC | iPLACENTA, EC | INFORE +1 projects
EC| PerMedCoE ,
EC| iPLACENTA ,
EC| INFORE ,
NIH| Reactome: An Open Knowledgebase of Human Pathways
Authors: Marek Ostaszewski; Anna Niarakis; Alexander Mazein; Inna Kuperstein; +128 Authors
Marek Ostaszewski; Anna Niarakis; Alexander Mazein; Inna Kuperstein; Robert Phair; Aurelio Orta-Resendiz; Vidisha Singh; Sara Sadat Aghamiri; Marcio Luis Acencio; Enrico Glaab; Andreas Ruepp; Gisela Fobo; Corinna Montrone; Barbara Brauner; Goar Frishman; Julia Somers; Matti Hoch; Shailendra K. Gupta; Julia Scheel; Hanna Borlinghaus; Tobias Czauderna; Falk Schreiber; Arnau Montagud; Miguel Ponce de Leon; Akira Funahashi; Yusuke Hiki; Noriko Hiroi; Takahiro G. Yamada; Andreas Dräger; Alina Renz; Muhammad Naveez; Zsolt Bocskei; Daniela Börnigen; Liam Fergusson; Marta Conti; Marius Rameil; Vanessa Nakonecnij; Jakob Vanhoefer; Leonard Schmiester; Muying Wang; Emily E. Ackerman; Jason E. Shoemaker; Jeremy Zucker; Kristie L. Oxford; Jeremy Teuton; Ebru Kocakaya; Gokce Yagmur Summak; Kristina Hanspers; Martina Kutmon; Susan L. Coort; Lars M. T. Eijssen; Friederike Ehrhart; D A B Rex; Denise Slenter; Marvin Martens; Nhung Pham; Robin Haw; Bijay Jassal; Lisa Matthews; M Orlic-Milacic; Andrea Senff-Ribeiro; Karen Rothfels; Veronica Shamovsky; Ralf Stephan; Cristoffer Sevilla; Thawfeek M. Varusai; Jean-Marie Ravel; Vera Ortseifen; Silvia Marchesi; Piotr Gawron; Ewa Smula; Laurent Heirendt; Venkata P. Satagopam; Guanming Wu; Anders Riutta; Martin Golebiewski; Stuart Owen; Carole Goble; Xiaoming Hu; Rupert W. Overall; Dieter Maier; Angela Bauch; Benjamin M. Gyori; John A. Bachman; Carlos Vega; Valentin Grouès; M. Vazquez; Pablo Porras; Luana Licata; Marta Iannuccelli; Francesca Sacco; Dénes Türei; Augustin Luna; Özgün Babur; Sylvain Soliman; Alberto Valdeolivas; Marina Esteban-Medina; Maria Peña-Chilet; Kinza Rian; Tomáš Helikar; Bhanwar Lal Puniya; Anastasia P. Nesterova; Anton Yuryev; Anita de Waard; Dezso Modos; Agatha Treveil; Marton Olbei; Bertrand De Meulder; Aurélien Naldi; Aurelien Dugourd; Laurence Calzone; Chris Sander; Emek Demir; Tamas Korcsmaros; Tom C. Freeman; Franck Augé; Jacques S. Beckmann; Jan Hasenauer; Olaf Wolkenhauer; Egon Willighagen; Alexander R. Pico; Chris T. Evelo; Lincoln Stein; Henning Hermjakob; Julio Saez-Rodriguez; Joaquín Dopazo; Alfonso Valencia; Hiroaki Kitano; Emmanuel Barillot; Charles Auffray; Rudi Balling; Reinhard Schneider;
AbstractWe describe a large-scale community effort to build an open-access, interoperable, and computable repository of COVID-19 molecular mechanisms - the COVID-19 Disease Map. We discuss the tools, platforms, and guidelines necessary for the distributed development of its contents by a multi-faceted community of biocurators, domain experts, bioinformaticians, and computational biologists. We highlight the role of relevant databases and text mining approaches in the enrichment and validation of the curated mechanisms. We describe the contents of the Map and their relevance to the molecular pathophysiology of COVID-19 and the analytical and computational modelling approaches that can be applied for mechanistic data interpretation and predictions. We conclude by demonstrating concrete applications of our work through several use cases and highlight new testable hypotheses.; We describe a large-scale community effort to build an open-access, interoperable, and computable repository of COVID-19 molecular mechanisms - the COVID-19 Disease Map. We discuss the tools, platforms, and guidelines necessary for the distributed development of its contents by a multi-faceted community of biocurators, domain experts, bioinformaticians, and computational biologists. We highlight the role of relevant databases and text mining approaches in the enrichment and validation of the curated mechanisms. We describe the contents of the Map and their relevance to the molecular pathophysiology of COVID-19 and the analytical and computational modelling approaches that can be applied for mechanistic data interpretation and predictions. We conclude by demonstrating concrete applications of our work through several use cases and highlight new testable hypotheses.