@article{KruegerLeskienSchulleretal.2021,
  author    = {Kr{\"u}ger, S{\"o}ren and Leskien, Miriam and Schuller, Patricia and Prifert, Christiane and Weißbrich, Benedikt and Vogel, Ulrich and Krone, Manuel},
  title     = {Performance and feasibility of universal PCR admission screening for SARS-CoV-2 in a German tertiary care hospital},
  series = {Journal of Medical Virology},
  volume    = {93},
  journal   = {Journal of Medical Virology},
  number    = {5},
  doi       = {10.1002/jmv.26770},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-238971},
  pages     = {2890 -- 2898},
  year      = {2021},
  abstract  = {Anamnestic screening of symptoms and contact history is applied to identify coronavirus disease 2019 (COVID-19) patients on admission. However, asymptomatic and presymptomatic patients remain undetected although the viral load may be high. In this retrospective cohort study, all hospitalized patients who received polymerase chain reaction (PCR) admission testing from March 26th until May 24th, 2020 were included. Data on COVID-19-specific symptoms and contact history to COVID-19 cases were retrospectively extracted from patient files and from contact tracing notes. The compliance to the universal testing protocol was high with 90\%. Out of 6940 tested patients, 27 new severe acute respiratory syndrome coronavirus-2 infections (0.4\%) were detected. Seven of those COVID-19 cases (26\% of all new cases) were asymptomatic and had no positive contact history, but were identified through a positive PCR test. The number needed to identify an asymptomatic patient was 425 in the first wave of the epidemic, 1218 in the low incidence phase. The specificity of the method was above 99.9\%. Universal PCR testing was highly accepted by staff as demonstrated by high compliance. The costs to detect one asymptomatic case in future studies need to be traded off against the costs and damage caused by potential outbreaks of COVID-19.},
  language  = {en}
}
@article{SchlesingerWeissbrichWedekinketal.2020,
  author    = {Schlesinger, Tobias and Weißbrich, Benedikt and Wedekink, Florian and Notz, Quirin and Herrmann, Johannes and Krone, Manuel and Sitter, Magdalena and Schmid, Benedikt and Kredel, Markus and Stumpner, Jan and D{\"o}lken, Lars and Wischhusen, J{\"o}rg and Kranke, Peter and Meybohm, Patrick and Lotz, Christpher},
  title     = {Biodistribution and serologic response in SARS-CoV-2 induced ARDS: A cohort study},
  series = {PLoS One},
  volume    = {15, 2020},
  journal   = {PLoS One},
  number    = {11},
  doi       = {10.1371/journal.pone.0242917},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-231348},
  year      = {2020},
  abstract  = {Background The viral load and tissue distribution of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remain important questions. The current study investigated SARS-CoV-2 viral load, biodistribution and anti-SARS-CoV-2 antibody formation in patients suffering from severe corona virus disease 2019 (COVID-19) induced acute respiratory distress syndrome (ARDS). Methods This is a retrospective single-center study in 23 patients with COVID-19-induced ARDS. Data were collected within routine intensive care. SARS-CoV-2 viral load was assessed via reverse transcription quantitative polymerase chain reaction (RT-qPCR). Overall, 478 virology samples were taken. Anti-SARS-CoV-2-Spike-receptor binding domain (RBD) antibody detection of blood samples was performed with an enzyme-linked immunosorbent assay. Results Most patients (91\%) suffered from severe ARDS during ICU treatment with a 30-day mortality of 30\%. None of the patients received antiviral treatment. Tracheal aspirates tested positive for SARS-CoV-2 in 100\% of the cases, oropharyngeal swabs only in 77\%. Blood samples were positive in 26\% of the patients. No difference of viral load was found in tracheal or blood samples with regard to 30-day survival or disease severity. SARS-CoV-2 was never found in dialysate. Serologic testing revealed significantly lower concentrations of SARS-CoV-2 neutralizing IgM and IgA antibodies in survivors compared to non-survivors (p = 0.009). Conclusions COVID-19 induced ARDS is accompanied by a high viral load of SARS-CoV-2 in tracheal aspirates, which remained detectable in the majority throughout intensive care treatment. Remarkably, SARS-CoV-2 RNA was never detected in dialysate even in patients with RNAemia. Viral load or the buildup of neutralizing antibodies was not associated with 30-day survival or disease severity.},
  language  = {en}
}
@article{StrengGoettlerHaerleinetal.2019,
  author    = {Streng, Andrea and Goettler, David and Haerlein, Miriam and Lehmann, Lisa and Ulrich, Kristina and Prifert, Christiane and Krempl, Christine and Weißbrich, Benedikt and Liese, Johannes G.},
  title     = {Spread and clinical severity of respiratory syncytial virus A genotype ON1 in Germany, 2011-2017},
  series = {BMC Infectious Diseases},
  volume    = {19},
  journal   = {BMC Infectious Diseases},
  doi       = {10.1186/s12879-019-4266-y},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-201516},
  pages     = {613},
  year      = {2019},
  abstract  = {Background The Respiratory Syncytial Virus (RSV) A genotype ON1, which was first detected in Ontario (Canada) in 2010/11, appeared in Germany in 2011/12. Preliminary observations suggested a higher clinical severity in children infected with this new genotype. We investigated spread and disease severity of RSV-A ON1 in pediatric in- and outpatient settings. Methods During 2010/11 to 2016/17, clinical characteristics and respiratory samples from children with acute respiratory tract infections (RTI) were obtained from ongoing surveillance studies in 33 pediatric practices (PP), one pediatric hospital ward (PW) and 23 pediatric intensive care units (PICU) in Germany. RSV was detected in the respiratory samples by PCR; genotypes were identified by sequencing. Within each setting, clinical severity markers were compared between RSV-A ON1 and RSV-A non-ON1 genotypes. Results A total of 603 children with RSV-RTI were included (132 children in PP, 288 in PW, and 183 in PICU). Of these children, 341 (56.6\%) were infected with RSV-A, 235 (39.0\%) with RSV-B, and one child (0.2\%) with both RSV-A and RSV-B; in 26 (4.3\%) children, the subtype could not be identified. In the 341 RSV-A positive samples, genotype ON1 was detected in 247 (72.4\%), NA1 in 92 (26.9\%), and GA5 in 2 children (0.6\%). RSV-A ON1, rarely observed in 2011/12, was the predominant RSV-A genotype in all settings by 2012/13 and remained predominant until 2016/17. Children in PP or PW infected with RSV-A ON1 did not show a more severe clinical course of disease compared with RSV-A non-ON1 infections. In the PICU group, hospital stay was one day longer (median 8 days, inter-quartile range (IQR) 7-12 vs. 7 days, IQR 5-9; p = 0.02) and duration of oxygen treatment two days longer (median 6 days, IQR 4-9 vs. 4 days, IQR 2-6; p = 0.03) for children infected with RSV-A ON1. Conclusions In children, RSV-A ON1 largely replaced RSV-A non-ON1 genotypes within two seasons and remained the predominant RSV-A genotype in Germany during subsequent seasons. A higher clinical severity of RSV-A ON1 was observed within the group of children receiving PICU treatment, whereas in other settings clinical severity of RSV-A ON1 and non-ON1 genotypes was largely similar.},
  language  = {en}
}