Standard SARS-CoV-2 testing protocols using nasopharyngeal/throat (NP/T) swabs are invasive and require trained medical staff for reliable sampling. In addition, it has been shown that PCR is more sensitive as compared to antigen-based tests. Here we describe the analytical and clinical evaluation of our in-house RNA extraction-free saliva-based molecular assay for the detection of SARS-CoV-2. Analytical sensitivity of the test was equal to the sensitivity obtained in other Dutch diagnostic laboratories that process NP/T swabs. In this study, 955 individuals participated and provided NP/T swabs for routine molecular analysis (with RNA extraction) and saliva for comparison. Our RT-qPCR resulted in a sensitivity of 82,86% and a specificity of 98,94% compared to the gold standard. A false-negative ratio of 1,9% was found. The SARS-CoV-2 detection workflow described here enables easy, economical, and reliable saliva processing, useful for repeated testing of individuals.
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The paper explores whether and under what conditions, vaccination against SARS-CoV-2 may become a mandatory requirement for employees. It includes a discussion on EU action on SARS-CoV-2 vaccination and its relevance for national level policy with emphasis on the legal basis and instruments used by the Union to persuade national authorities into action to increase vaccination uptake. The analysis then moves to the national level by focusing on the case of Hungary. Following an overview of the legal and regulatory framework for SARS-CoV-2 vaccines deployment, the analysis zooms into the sphere of employment and explores whether and how the SARS-CoV-2 vaccination may be turned into a mandatory workplace safety requirement. The paper highlights the decision of the Hungarian government to introduce compulsory vaccination for employees in the healthcare sector, and concludes with a discussion of the relevant rules and their potential, broader implications.
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Despite tremendous efforts, the exact structure of SARS-CoV-2 and related betacoronaviruses remains elusive. SARS-CoV-2 envelope is a key structural component of the virion that encapsulates viral RNA. It is composed of three structural proteins, spike, membrane (M), and envelope, which interact with each other and with the lipids acquired from the host membranes. Here, we developed and applied an integrative multi-scale computational approach to model the envelope structure of SARS-CoV-2 with near atomistic detail, focusing on studying the dynamic nature and molecular interactions of its most abundant, but largely understudied, M protein. The molecular dynamics simulations allowed us to test the envelope stability under different configurations and revealed that the M dimers agglomerated into large, filament-like, macromolecular assemblies with distinct molecular patterns. These results are in good agreement with current experimental data, demonstrating a generic and versatile approach to model the structure of a virus de novo.
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Skeletal muscle-related symptoms are common in both acute coronavirus disease (Covid)-19 and post-acute sequelae of Covid-19 (PASC). In this narrative review, we discuss cellular and molecular pathways that are affected and consider these in regard to skeletal muscle involvement in other conditions, such as acute respiratory distress syndrome, critical illness myopathy, and post-viral fatigue syndrome. Patients with severe Covid-19 and PASC suffer from skeletal muscle weakness and exercise intolerance. Histological sections present muscle fibre atrophy, metabolic alterations, and immune cell infiltration. Contributing factors to weakness and fatigue in patients with severe Covid-19 include systemic inflammation, disuse, hypoxaemia, and malnutrition. These factors also contribute to post-intensive care unit (ICU) syndrome and ICU-acquired weakness and likely explain a substantial part of Covid-19-acquired weakness. The skeletal muscle weakness and exercise intolerance associated with PASC are more obscure. Direct severe acute respiratory syndrome coronavirus (SARS-CoV)-2 viral infiltration into skeletal muscle or an aberrant immune system likely contribute. Similarities between skeletal muscle alterations in PASC and chronic fatigue syndrome deserve further study. Both SARS-CoV-2-specific factors and generic consequences of acute disease likely underlie the observed skeletal muscle alterations in both acute Covid-19 and PASC.
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Abstract Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19), has challenged healthcare globally. An acute increase in the number of hospitalized patients has neces‑ sitated a rigorous reorganization of hospital care, thereby creating circumstances that previously have been identifed as facilitating prescribing errors (PEs), e.g. a demanding work environment, a high turnover of doctors, and prescrib‑ ing beyond expertise. Hospitalized COVID-19 patients may be at risk of PEs, potentially resulting in patient harm. We determined the prevalence, severity, and risk factors for PEs in post–COVID-19 patients, hospitalized during the frst wave of COVID-19 in the Netherlands, 3months after discharge. Methods: This prospective observational cohort study recruited patients who visited a post-COVID-19 outpatient clinic of an academic hospital in the Netherlands, 3months after COVID-19 hospitalization, between June 1 and October 1 2020. All patients with appointments were eligible for inclusion. The prevalence and severity of PEs were assessed in a multidisciplinary consensus meeting. Odds ratios (ORs) were calculated by univariate and multivariate analysis to identify independent risk factors for PEs. Results: Ninety-eight patients were included, of whom 92% had ≥1 PE and 8% experienced medication-related harm requiring an immediate change in medication therapy to prevent detoriation. Overall, 68% of all identifed PEs were made during or after the COVID-19 related hospitalization. Multivariate analyses identifed ICU admission (OR 6.08, 95% CI 2.16–17.09) and a medical history of COPD / asthma (OR 5.36, 95% CI 1.34–21.5) as independent risk fac‑ tors for PEs. Conclusions: PEs occurred frequently during the SARS-CoV-2 pandemic. Patients admitted to an ICU during COVID19 hospitalization or who had a medical history of COPD / asthma were at risk of PEs. These risk factors can be used to identify high-risk patients and to implement targeted interventions. Awareness of prescribing safely is crucial to prevent harm in this new patient population.
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Begin 2020 bereikte het coronavirus Nederland. Hoewel we nu een stuk meer weten over het coronavirus SARS-CoV-2, was er in het begin vooral heel veel onbekend. Ouderen werden in één keer als ‘kwetsbaar’ bestempeld.1 De coronamaatregelen waren gericht op het beschermen van ouderen tegen COVID-19 infectie, maar zorgden ook voor minder participatie en meer angst en eenzaamheid bij ouderen.3 4 1 5 Bovendien kwam de autonomie van ouderen onder druk te staan.6 Hoewel ouderenparticipatie aan een opmars bezig is, wordt de mening van ouderen niet altijd meegenomen in beleid over ouderen. Deze periode heeft nog eens benadrukt hoe belangrijk het is om niet alleen te spreken over ouderen, maar om vooral ook in gesprek te blijven met ouderen. Dit is een van de belangrijkste lessen uit ons onderzoek naar welzijn en ondersteuning van ouderen tijdens de coronaperiode. We blikken hier terug op de situatie van twee jaar corona, en kijken ook vooruit naar wat er nodig is in de toekomst.
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The COVID-19 (SARS-CoV-2) pandemic represented a significant break with previous patterns of cultural consumption, effectively halting the growth of “mass cultural tourism” driven by cheap flights and collaborative economy accommodation. Surveys conducted by the ATLAS Cultural Tourism Group in Portugal were used to develop a detailed picture of cultural tourism consumption during the pandemic. In 2020 and early 2021 surveys were conducted at different locations in the country, generating over 500 responses. The research shows that COVID-19 had significant impacts on the profile and activities of cultural tourists in Portugal, with much more domestic tourism at most sites, and fewer visitors staying away from home. Levels of satisfaction and intention to return remained high, as did perceived authenticity. There was a significant drop in touring holidays, with visitors more likely to stay in a single location. Those tourists visiting cultural attractions during the pandemic had a positive experience, despite the challenging conditions. Levels of satisfaction increased compared with previous surveys in Portugal in 2004, but there were also fluctuations in levels of satisfaction during the pandemic period, correlated with levels of COVID-19 infections. Some indications of emerging alternative forms of cultural tourism include an increased proclivity for rural locations and inland areas, away from destinations usually associated with mass (cultural) tourism. The article concludes by considering a number of implications for the development of cultural tourism in Portugal and other destinations in the postpandemic era.
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Wat is er op dit moment (medio augustus 2020) in de wetenschappelijke literatuur bekend over (de effecten van maatregelen tegen) de verspreiding van het coronavirus en wat is de betekenis daarvan voor organisatoren van evenementen?
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Praktische aanbevelingen op basis van bevindingen uit systematisch literatuuronderzoek bij de Covid-19 en vergelijkbare virusuitbraken en interviews met experts en ervaringsdeskundigen.
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