TY - JOUR A1 - Meintrup, David A1 - Nowak-Machen, Martina A1 - Borgmann, Stefan T1 - A Comparison of Germany and the United Kingdom Indicates That More SARS-CoV-2 Circulation and Less Restrictions in the Warm Season Might Reduce Overall COVID-19 Burden JF - Life N2 - (1) Background: Between March 2020 and January 2022 severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) caused five infection waves in Europe. The first and the second wave was caused by wildtype SARS-CoV-2, while the following waves were caused by the variants of concern Alpha, Delta, and Omicron respectively. (2) Methods: In the present analysis, the first four waves were compared in Germany and the UK, in order to examine the COVID-19 epidemiology and its modulation by non-pharmaceutical interventions (NPI). (3) Results: The number of COVID-19 patients on intensive care units and the case fatality rate were used to estimate disease burden, the excess mortality to assess the net effect of NPI and other measures on the population. The UK was more severely affected by the first and the third wave while Germany was more affected by the second wave. The UK had a higher excess mortality during the first wave, afterwards the excess mortality in both countries was nearly identical. While most NPI were lifted in the UK in July 2021, the measures were kept and even aggravated in Germany. Nevertheless, in autumn 2021 Germany was much more affected, nearly resulting in a balanced sum of infections and deaths compared to the UK. Within the whole observation period, in Germany the number of COVID-19 patients on ICUs was up to four times higher than in the UK. Our results show that NPI have a limited effect on COVID-19 burden, seasonality plays a crucial role, and a higher virus circulation in a pre-wave situation could be beneficial. (4) Conclusions: Although Germany put much more effort and resources to fight the pandemic, the net balance of both countries was nearly identical, questioning the benefit of excessive ICU treatments and of the implementation of NPI, especially during the warm season. UR - https://doi.org/10.3390/life12070953 KW - COVID-19 KW - SARS-CoV-2 KW - non-pharmaceutical interventions KW - seasonality KW - Germany KW - UK KW - excess mortality Y1 - 2022 UR - https://doi.org/10.3390/life12070953 UR - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:573-26913 SN - 2075-1729 VL - 12 IS - 7 PB - MDPI CY - Basel ER - TY - JOUR A1 - Itzek, Andreas A1 - Weißbach, Victoria A1 - Meintrup, David A1 - Rieß, Beate A1 - van der Linden, Mark A1 - Borgmann, Stefan T1 - Epidemiological and Clinical Features of Streptococcus dysgalactiae ssp. equisimilis stG62647 and Other emm Types in Germany JF - Pathogens N2 - (1) Background: Streptococcus dysgalactiae subspecies equisimilis (SDSE) is an important β-hemolytic pathogen historically described as mainly affecting animals. Studies epidemiologically assessing the pathogenicity in the human population in Germany are rare. (2) Methods: the present study combines national surveillance data from 2010 to 2022 with a single-center clinical study conducted from 2016 to 2022, focusing on emm type, Lancefield antigen, antimicrobial resistance, patient characteristics, disease severity, and clinical infection markers. (3) Results: The nationwide reported invasive SDSE infections suggest an increasing infection burden for the German population. One particular emm type, stG62647, increased over the study period, being the dominant type in both study cohorts, suggesting a mutation-driven outbreak of a virulent clone. The patient data show that men were more affected than women, although in the single-center cohort, this trend was reversed for patients with stG62647 SDSE. Men affected by stG62647 developed predominantly fascial infections, whereas women suffering from superficial and fascial non-stG62647 SDSE infections were significantly younger than other patients. Increasing age was a general risk factor for invasive SDSE infections. (4) Conclusions: further studies are needed to further elucidate the raised questions regarding outbreak origin, underlying molecular mechanisms as well as sex-dependent pathogen adaptation. UR - https://doi.org/10.3390/pathogens12040589 KW - Streptococcus dysgalactiae subspecies equisimilis KW - SDSE KW - Germany KW - stG62647 KW - emm type KW - surveillance KW - clinical study Y1 - 2023 UR - https://doi.org/10.3390/pathogens12040589 UR - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:573-35164 SN - 2076-0817 VL - 12 IS - 4 PB - MDPI CY - Basel ER - TY - JOUR A1 - Meintrup, David A1 - Borgmann, Stefan A1 - Seidl, Karlheinz A1 - Stecher, Melanie A1 - Jakob, Carolin E. M. A1 - Pilgram, Lisa A1 - Spinner, Christoph D. A1 - Rieg, Siegbert A1 - Isberner, Nora A1 - Hower, Martin A1 - Vehreschild, Maria A1 - Göpel, Siri A1 - Hanses, Frank A1 - Nowak-Machen, Martina T1 - Specific Risk Factors for Fatal Outcome in Critically Ill COVID-19 Patients BT - Results from a European Multicenter Study JF - Journal of Clinical Medicine N2 - (1) Background: The aim of our study was to identify specific risk factors for fatal outcome in critically ill COVID-19 patients. (2) Methods: Our data set consisted of 840 patients enclosed in the LEOSS registry. Using lasso regression for variable selection, a multifactorial logistic regression model was fitted to the response variable survival. Specific risk factors and their odds ratios were derived. A nomogram was developed as a graphical representation of the model. (3) Results: 14 variables were identified as independent factors contributing to the risk of death for critically ill COVID-19 patients: age (OR 1.08, CI 1.06–1.10), cardiovascular disease (OR 1.64, CI 1.06–2.55), pulmonary disease (OR 1.87, CI 1.16–3.03), baseline Statin treatment (0.54, CI 0.33–0.87), oxygen saturation (unit = 1%, OR 0.94, CI 0.92–0.96), leukocytes (unit 1000/μL, OR 1.04, CI 1.01–1.07), lymphocytes (unit 100/μL, OR 0.96, CI 0.94–0.99), platelets (unit 100,000/μL, OR 0.70, CI 0.62–0.80), procalcitonin (unit ng/mL, OR 1.11, CI 1.05–1.18), kidney failure (OR 1.68, CI 1.05–2.70), congestive heart failure (OR 2.62, CI 1.11–6.21), severe liver failure (OR 4.93, CI 1.94–12.52), and a quick SOFA score of 3 (OR 1.78, CI 1.14–2.78). The nomogram graphically displays the importance of these 14 factors for mortality. (4) Conclusions: There are risk factors that are specific to the subpopulation of critically ill COVID-19 patients. UR - https://doi.org/10.3390/jcm10173855 KW - COVID-19 KW - SARS-CoV-2 KW - risk factors KW - critically ill patients KW - comorbidities KW - lasso regression KW - nomogram Y1 - 2021 UR - https://doi.org/10.3390/jcm10173855 UR - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:573-10999 SN - 2077-0383 VL - 10 IS - 17 PB - MDPI CY - Basel ER - TY - JOUR A1 - Meintrup, David A1 - Nowak-Machen, Martina A1 - Borgmann, Stefan T1 - Nine months of COVID-19 pandemic in Europe BT - a comparative time series analysis of cases and fatalities in 35 countries JF - International Journal of Environmental Research and Public Health N2 - (1) Background: to describe the dynamic of the pandemic across 35 European countries over a period of 9 months. (2) Methods: a three-phase time series model was fitted for 35 European countries, predicting deaths based on SARS-CoV-2 incidences. Hierarchical clustering resulted in three clusters of countries. A multiple regression model was developed predicting thresholds for COVID-19 incidences, coupled to death numbers. (3) Results: The model showed strongly connected deaths and incidences during the waves in spring and fall. The corrected case-fatality rates ranged from 2% to 20.7% in the first wave, and from 0.5% to 4.2% in the second wave. If the incidences stay below a threshold, predicted by the regression model (R2=85.0%), COVID-19 related deaths and incidences were not necessarily coupled. The clusters represented different regions in Europe, and the corrected case-fatality rates in each cluster flipped from high to low or vice versa. Severely and less severely affected countries flipped between the first and second wave. (4) Conclusions: COVID-19 incidences and related deaths were uncoupled during the summer but coupled during two waves. Once a country-specific threshold of infections is reached, death numbers will start to rise, allowing health care systems and countries to prepare. UR - https://doi.org/10.3390/ijerph18126680 KW - COVID-19 KW - SARS-CoV-2 KW - corrected case fatality rate KW - time series analysis KW - multiple regression KW - flip effect KW - death threshold Y1 - 2021 UR - https://doi.org/10.3390/ijerph18126680 UR - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:573-11001 SN - 1660-4601 VL - 18 IS - 12 PB - MDPI CY - Basel ER - TY - JOUR A1 - Borgmann, Stefan A1 - Rieß, Beate A1 - Meintrup, David A1 - Klare, Ingo A1 - Werner, Guido T1 - Long-Lasting Decrease of the Acquisition of Enterococcus faecium and Gram-Negative Bacteria Producing Extended Spectrum Beta-Lactamase (ESBL) by Transient Application of Probiotics JF - International Journal of Environmental Research and Public Health (IJERPH) N2 - Previously it was shown that application of probiotics stopped the acquisition of vancomycin-resistant Enterococcus faecium (VRE) by patients in an early rehabilitation ward. Once the application of probiotics ended, we examined whether acquisition of VRE reoccurred. Furthermore, we examined whether probiotics altered prevalence of vancomycin-susceptible E. faecium (VSE) and Gram-negative bacteria, which produce extended spectrum beta-lactamase (ESBL). Although probiotic application ceased in April 2018, VRE-colonized patients rarely presented on that ward until 2019. Probiotic treatment also resulted in a decreased number of patients with VSE and ESBL. While decreased incidence of VRE occurred immediately, decreased VSE and ESBL numbers occurred months later. A probiotic-mediated decrease of VSE and ESBL incidence cannot be explained when assuming bacterial transmission exclusively as a linear cause and effect event. The decrease is better understood by considering bacterial transmissions to be stochastic events, which depend on various driving forces similar to an electric current. We hypothesize that VRE, VSE and ESBL uptake by patients and by staff members mutually reinforced each other, leading staff members to form a bacterial reservoir, similar to a condenser that stores electrical energy. Probiotic treatment then inhibited regeneration of that store, resulting in a breakdown of the driving force. UR - https://doi.org/10.3390/ijerph17176100 KW - colonic bacteria KW - Enterococcus faecium KW - vancomycin-resistant Enterococcus faecium KW - vancomycin-susceptible E. faecium KW - Staphylococcus aureus KW - beta-lactamase KW - probiotics KW - health care co-workers KW - electric current KW - transistor KW - condenser KW - electrical current hypothesis of bacterial transmission Y1 - 2020 UR - https://doi.org/10.3390/ijerph17176100 UR - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:573-9425 SN - 1660-4601 VL - 17 IS - 17 PB - MDPI CY - Basel ER - TY - JOUR A1 - Borgmann, Stefan A1 - Meintrup, David A1 - Reimer, Kerstin A1 - Schels, Helmut A1 - Nowak-Machen, Martina T1 - Incidence and Death Rates from COVID-19 Are Not Always Coupled: An Analysis of Temporal Data on Local, Federal, and National Levels JF - Healthcare N2 - SARS-CoV-2 has caused a deadly pandemic worldwide, placing a burden on local health care systems and economies. Infection rates with SARS-CoV-2 and the related mortality of COVID-19 are not equal among countries or even neighboring regions. Based on data from official German health authorities since the beginning of the pandemic, we developed a case-fatality prediction model that correctly predicts COVID-19-related death rates based on local geographical developments of infection rates in Germany, Bavaria, and a local community district city within Upper Bavaria. Our data point towards the proposal that local individual infection thresholds, when reached, could lead to increasing mortality. Restrictive measures to minimize the spread of the virus could be applied locally based on the risk of reaching the individual threshold. Being able to predict the necessity for increasing hospitalization of COVID-19 patients could help local health care authorities to prepare for increasing patient numbers. UR - https://doi.org/10.3390/healthcare9030338 KW - time series analysis KW - COVID-19 incidence KW - case-fatality rate KW - herd immunity KW - Upper Bavaria Y1 - 2021 UR - https://doi.org/10.3390/healthcare9030338 UR - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:573-11023 SN - 2227-9032 VL - 9 IS - 3 PB - MDPI CY - Basel ER -