Publications by authors named "Vehreschild J"

Background: Existing risk evaluation tools underperform in predicting intensive care unit (ICU) admission for patients with the Coronavirus Disease 2019 (COVID-19). This study aimed to develop and evaluate an accurate and calculator-free clinical tool for predicting ICU admission at emergency room (ER) presentation.

Methods: Data from patients with COVID-19 in a nationwide German cohort (March 2020-January 2023) were analyzed.

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Unlabelled: In 2022, over 1,000,000 people from Ukraine fled to Germany, mostly women and children. The aim of this study was to determine health status and socio-demographic background of Ukrainian refugee minors in Germany and to compare that to German minors. In this study, Ukrainian refugees of all ages, who voluntarily made contact with the study centres via flyers or refugee shelters, were interviewed with the help of trained interpreters from 09-12/2022.

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With the Network of University Medicine (NUM) and the Medical Informatics Initiative (MII), the BMBF is funding two pioneering, structure-building research measures that are now being merged. The data integration centers (DIZ) of the MII are to be consolidated in the NUM. The aim is to establish a standardized research infrastructure within which the existing data from the clinical routine care of the 36 German university hospitals, from clinical cohorts and clinical-epidemiological studies can be used for various research questions upon request and via coordinated processes.

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  • Patients getting stem cell transplants have a high chance of getting infections, especially right after the procedure, but using regular antibiotics can cause other health issues.
  • A study compared a new antibiotic treatment (IAT) with regular antibiotic use (SAP) and found that while IAT led to fewer days on antibiotics, patients had more bloodstream infections.
  • Overall, both treatments had similar long-term survival rates and health outcomes, suggesting that IAT could be a safe alternative to SAP for these patients.
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In the early phase of the COVID-19 pandemic, many local collections of clinical data on patients infected with SARS-CoV-2 were initiated in Germany. As part of the National Pandemic Cohort Network (NAPKON) of the University Medicine Network, the "Integration Core" was established to design the legal, technical and organisational requirements for the integration of inventory data into ongoing prospective data collections and to test the feasibility of the newly developed solutions using use cases (UCs). Detailed study documents of the data collections were obtained.

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Purpose: This study investigates the care provision and the role of infectious disease (ID) specialists during the coronavirus disease-2019 (COVID-19) pandemic.

Methods: A survey was conducted at German study sites participating in the Lean European Open Survey on SARS-CoV-2 infected patients (LEOSS). Hospitals certified by the German Society of Infectious diseases (DGI) were identified as ID centers.

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Objectives: Efficacy and safety of letermovir as prophylaxis for clinically significant cytomegalovirus infections (csCVMi) was evaluated in randomised controlled trials while most of the real-world studies are single-centre experiences.

Methods: We performed a retrospective, multi-centre case-control study at six German university hospitals to evaluate clinical experiences in patients receiving CMV prophylaxis with letermovir (n = 200) compared to controls without CMV prophylaxis (n = 200) during a 48-week follow-up period after allogeneic hematopoietic cell transplantation (aHCT).

Results: The incidence of csCMVi after aHCT was significantly reduced in the letermovir (34%, n = 68) compared to the control group (56%, n = 112; p < 0.

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  • The study explored the impact of newer antiretroviral drugs (ARVs) on chronic liver enzyme elevation (cLEE) in people with HIV who started ARVs after January 1, 2012.
  • Over the follow-up period, 11.3% of participants experienced cLEE, with higher rates observed in the first year but no cumulative effect from ARV use over time.
  • Notably, the use of non-nucleoside reverse transcriptase inhibitors (NNRTIs) and tenofovir disoproxil fumarate (TDF) increased the risk of cLEE, while darunavir (DRV) appeared to reduce the risk.
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Fair allocation of funding in multi-centre clinical studies is challenging. Models commonly used in Germany - the case fees ("fixed-rate model", FRM) and up-front staffing and consumables ("up-front allocation model", UFAM) lack transparency and fail to suitably accommodate variations in centre performance. We developed a performance-based reimbursement model (PBRM) with automated calculation of conducted activities and applied it to the cohorts of the National Pandemic Cohort Network (NAPKON) within the Network of University Medicine (NUM).

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Tools for predicting COVID-19 outcomes enable personalized healthcare, potentially easing the disease burden. This collaborative study by 15 institutions across Europe aimed to develop a machine learning model for predicting the risk of in-hospital mortality post-SARS-CoV-2 infection. Blood samples and clinical data from 1286 COVID-19 patients collected from 2020 to 2023 across four cohorts in Europe and Canada were analyzed, with 2906 long non-coding RNAs profiled using targeted sequencing.

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  • In cancer treatment, "lines of therapy" (LOT) is a term that means different things to different doctors, and they don't all agree on its definition.
  • A study in Germany found that doctors often have trouble understanding LOT and have had misunderstandings with their colleagues about it.
  • Experts discussed various factors that affect LOT, like types of treatments and therapy breaks, but they mostly agreed on what should matter when deciding about LOT.
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Objective: Interruptions in care of people with HIV (PWH) on antiretroviral therapy (ART) are associated with adverse outcomes, but most studies have relied on composite outcomes. We investigated whether mortality risk following care interruptions differed from mortality risk after first starting ART.

Design: Collaboration of 18 European and North American HIV observational cohort studies of adults with HIV starting ART between 2004 and 2019.

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  • Awareness is crucial for cancer prevention, with U.S. studies showing a strong link between online searches and cancer incidence, whereas the European relationship is less clear.
  • This study focused on Germany, analyzing the relationship between cancer incidence and web searches for various types of cancer between July 2018 and December 2019, using data from Google Ads and national cancer registries.
  • Findings revealed a strong correlation (r = 0.88) between cancer-related web searches and actual cancer rates, with search trends peaking seasonally and differing regionally, potentially aiding in targeted awareness campaigns for cancer prevention.
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  • The study investigates the prevalence and predictors of post-COVID-19 condition (PCC) symptoms in patients infected with SARS-CoV-2 variants delta and omicron.
  • A total of 758 patients were analyzed, revealing that fatigue was the most common PCC symptom, with no significant difference in prevalence between delta and omicron infections at the three-month follow-up.
  • Most patients reported stable health-related quality of life, with over two-thirds experiencing no decline, indicating that PCC is a common issue for both variants in the German population.
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  • Mortality rates among people with HIV significantly dropped after the introduction of combination antiretroviral therapy, particularly between 1999 and 2009, but remained stable from 2010 to 2020.
  • The study analyzed data from over 55,000 participants, revealing that AIDS-related deaths were most common in the earlier period, while deaths from non-AIDS-related malignancies increased in the later years.
  • Despite the decline in overall mortality, the reduction was not entirely attributed to better immune function or the presence of other risk factors, suggesting other contributing elements may be at play.
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Purpose: The objective examination of the Post-COVID syndrome (PCS) remains difficult due to heterogeneous definitions and clinical phenotypes. The aim of the study was to verify the functionality and correlates of a recently developed PCS score.

Methods: The PCS score was applied to the prospective, multi-center cross-sectoral cohort (in- and outpatients with SARS-CoV-2 infection) of the "National Pandemic Cohort Network (NAPKON, Germany)".

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Objectives: To investigate, whether inflammatory rheumatic diseases (IRD) inpatients are at higher risk to develop a severe course of SARS-CoV-2 infections compared to the general population, data from the German COVID-19 registry for IRD patients and data from the Lean European Survey on SARS-CoV-2 (LEOSS) infected patients covering inpatients from the general population with SARS-CoV-2 infections were compared.

Methods: 4310 (LEOSS registry) and 1139 cases (IRD registry) were collected in general. Data were matched for age and gender.

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Purpose: The risk of developing active tuberculosis (TB) is considerably increased in people living with HIV/AIDS (PLWH). However, incidence of HIV/TB coinfection is difficult to assess as surveillance data are lacking in many countries. Here, we aimed to perform a quantitative analysis of HIV/TB coinfections within the Cologne/Bonn HIV cohort and to determine risk factors for active TB.

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Background: Antimicrobial stewardship (AMS) programmes are established across the world to treat infections efficiently, prioritize patient safety, and reduce the emergence of antimicrobial resistance. One of the core elements of AMS programmes is guidance to support and direct physicians in making efficient, safe and optimal decisions when prescribing antibiotics. To optimize and tailor AMS, we need a better understanding of prescribing physicians' experience with AMS guidance.

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Background: Surgical site infections (SSIs), mainly caused by Staphylococcus aureus, pose a significant economic burden in Europe, leading to increased hospitalization duration, mortality, and treatment costs, particularly with drug-resistant strains such as meticillin-resistant S. aureus.

Aim: To conduct a case-control study on the economic impact of S.

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  • The study examined the health of Ukrainian refugees in Germany, focusing on the presence of infectious diseases, immunity levels, and chronic conditions post-arrival in 2022.
  • A total of 1,793 refugees participated, revealing a notable percentage with positive tuberculosis tests and insufficient immunity to diseases like measles, diphtheria, and hepatitis B.
  • The findings highlight the need for improved health screening protocols for migrants and suggest targeted communication strategies to address low vaccine immunity among Ukrainian refugees.
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Background: Depression and fatigue are commonly observed sequelae following viral diseases such as COVID-19. Identifying symptom constellations that differentially classify post-COVID depression and fatigue may be helpful to individualize treatment strategies. Here, we investigated whether self-reported post-COVID depression and post-COVID fatigue are associated with the same or different symptom constellations.

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Introduction: Mortality rates for people living with HIV (PLHIV) on antiretroviral therapy (ART) in high-income countries continue to decline. We compared mortality rates among PLHIV on ART in Europe for 2016-2020 with Spectrum's estimates.

Methods: The AIDS Impact Module in Spectrum is a compartmental HIV epidemic model coupled with a demographic population projection model.

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