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: 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.
KW  - COVID-19
KW  - SARS-CoV-2
KW  - risk factors
KW  - critically ill patients
KW  - comorbidities
KW  - lasso regression
KW  - nomogram
Y1  - 2021
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-245191
SN  - 2077-0383
VL  - 10
IS  - 17
ER  - 
TY  - JOUR
A1  - Dölken, Lars
A1  - Stich, August
A1  - Spinner, Christoph D.
T1  - Remdesivir for Early COVID-19 Treatment of High-Risk Individuals Prior to or at Early Disease Onset — Lessons Learned
JF  - Viruses
N2  - After more than one year of the COVID-19 pandemic, antiviral treatment options against SARS-CoV-2 are still severely limited. High hopes that had initially been placed on antiviral drugs like remdesivir have so far not been fulfilled. While individual case reports provide striking evidence for the clinical efficacy of remdesivir in the right clinical settings, major trials failed to demonstrate this. Here, we highlight and discuss the key findings of these studies and underlying reasons for their failure. We elaborate on how such shortcomings should be prevented in future clinical trials and pandemics. We suggest in conclusion that any novel antiviral agent that enters human trials should first be tested in a post-exposure setting to provide rapid and solid evidence for its clinical efficacy before initiating further time-consuming and costly clinical trials for more advanced disease. In the COVID-19 pandemic this might have established remdesivir early on as an efficient antiviral agent at a more suitable disease stage which would have saved many lives, in particular in large outbreaks within residential care homes.
KW  - COVID-19
KW  - SARS-CoV-2
KW  - antiviral treatment
KW  - remdesivir
Y1  - 2021
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-239648
SN  - 1999-4915
VL  - 13
IS  - 6
ER  - 
TY  - JOUR
A1  - Lee, Marcel
A1  - Eyer, Florian
A1  - Felgenhauer, Norbert
A1  - Klinker, Hartwig H. F.
A1  - Spinner, Christoph D.
T1  - Overdose of dolutegravir in combination with tenofovir disaproxil fumarate/emtricitabine in suicide attempt in a 21-year old patient
JF  - AIDS Research and Therapy
N2  - A 21 year old MSM patient with newly diagnosed HIV infection was hospitalized in our department after ingestion of an overdose of his antiretroviral therapy (ART) comprising dolutegravir (DTG - Tivicay\(^{®}\)) and tenofovir disaproxil fumarate/emtricitabine (Truvada\(^{®}\)) in suicidal intention. On admission, the patient did not show any clinical signs of intoxication and laboratory findings were unremarkable. After 6 hours of intensive care monitoring, the patient was referred to a psychiatric clinic. 5 days after the day of intoxication, serum creatinine levels increased to high normal values (1.2 mg/dl). However, levels never exceeded the upper threshold. 8 and 12 weeks later, serum creatinine normalized to levels measured prior to the intoxication. No other adverse events occurred, and the patient does not suffer from permanent impairments.
KW  - integrase inhibitor
KW  - HIV
KW  - AIDS
KW  - suicide attempt
KW  - dolutegravir
KW  - tenofovir disaproxil fumarate
KW  - emtricitabine
KW  - overdose
Y1  - 2015
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-151994
VL  - 12
IS  - 18
ER  -