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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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Wat weten we nu eigenlijk van het coronavirus en wat betekent dit voor evenementen?

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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Wat weten we nu eigenlijk van het coronavirus en wat betekent dit voor evenementen?

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What do we know about the coronavirus, up to this point, and what does this mean for events?

What is known in scientific literature at this point in time about the effects of the measures against the transmission of the coronavirus and what is the meaning of this for the organisers of events?

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What do we know about the coronavirus, up to this point, and what does this mean for events?

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Poor nutritional status, risk of sarcopenia and nutrition related complaints are prevalent in COVID-19 patients during and after hospital admission

BACKGROUND AND AIMS: Patients with COVID-19 infection presents with a broad clinical spectrum of symptoms and complications. As a consequence nutritional requirements are not met, resulting in weight- and muscle loss, and malnutrition. The aim of the present study is to delineate nutritional complaints, the (course of the) nutritional status and risk of sarcopenia of COVID-19 patients, during hospitalisation and after discharge.METHODS: In this prospective observational study in 407 hospital admitted COVID-19 patients in four university and peripheral hospitals, data were collected during dietetic consultations. Presence of nutrition related complaints (decreased appetite, loss of smell, changed taste, loss of taste, chewing and swallowing problems, nausea, vomiting, feeling of being full, stool frequency and consistency, gastric retention, need for help with food intake due to weakness and shortness of breath and nutritional status (weight loss, BMI, risk of sarcopenia with SARC-F ≥4 points) before, during hospital stay and after discharge were, where possible, collected.RESULTS: Included patients were most men (69%), median age of 64.8 ± 12.4 years, 60% were admitted to ICU at any time point during hospitalisation with a median LOS of 15 days and an in-hospital mortality rate of 21%. The most commonly reported complaints were: decreased appetite (58%), feeling of being full (49%) and shortness of breath (43%). One in three patients experienced changed taste, loss of taste and/or loss of smell. Prior to hospital admission, 67% of the patients was overweight (BMI >25 kg/m2), 35% of the patients was characterised as malnourished, mainly caused by considerable weight loss. Serious acute weight loss (>5 kg) was showed in 22% of the patents during the hospital stay; most of these patients (85%) were admitted to the ICU at any point in time. A high risk of sarcopenia (SARC-F ≥ 4 points) was scored in 73% of the patients during hospital admission.CONCLUSION: In conclusion, one in five hospital admitted COVID-19 patients suffered from serious acute weight loss and 73% had a high risk of sarcopenia. Moreover, almost all patients had one or more nutritional complaints. Of these complaints, decreased appetite, feeling of being full, shortness of breath and changed taste and loss of taste were the most predominant nutrition related complaints. These symptoms have serious repercussions on nutritional status. Although nutritional complaints persisted a long time after discharge, only a small group of patients received dietetic treatment after hospital discharge in recovery phase. Clinicians should consider the risks of acute malnutrition and sarcopenia in COVID-19 patients and investigate multidisciplinary treatment including dietetics during hospital stay and after discharge.

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Poor nutritional status, risk of sarcopenia and nutrition related complaints are prevalent in COVID-19 patients during and after hospital admission

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PRactice of VENTilation in Patients with Novel Coronavirus Disease (PRoVENT-COVID)

Background: The coronavirus disease 2019 (COVID-19) pandemic is rapidly expanding across the world, with more than 100,000 new cases each day as of end-June 2020. Healthcare workers are struggling to provide the best care for COVID-19 patients. Approaches for invasive ventilation vary widely between and within countries and new insights are acquired rapidly. We aim to investigate invasive ventilation practices and outcome in COVID-19 patients in the Netherlands.Methods: PRoVENT-COVID ('study of PRactice of VENTilation in COVID-19') is an investigator-initiated national, multicenter observational study to be undertaken in intensive care units (ICUs) in The Netherlands. Consecutive COVID-19 patients aged 18 years or older, who are receiving invasive ventilation in the participating ICUs, are to be enrolled during a 10-week period, with a daily follow-up of 7 days. The primary outcome is ventilatory management (including tidal volume expressed as mL/kg predicted body weight and positive end-expiratory pressure expressed as cmH2O) during the first 3 days of ventilation. Secondary outcomes include other ventilatory variables, use of rescue therapies for refractory hypoxemia such as prone positioning and extracorporeal membrane oxygenation, use of sedatives, vasopressors and inotropes; daily cumulative fluid balances; acute kidney injury; ventilator-free days and alive at day 28 (VFD-28), duration of ICU and hospital stay, and ICU, hospital and 90-day mortality.Discussion: PRoVENT-COVID will be the largest observational study to date, with high density ventilatory data and major outcomes. There is urgent need for a better understanding of ventilation practices, and the effects of ventilator settings on outcomes in COVID-19 patients. The results of PRoVENT-COVID will be rapidly disseminated through electronic presentations, such as webinars and electronic conferences, and publications in international peer-reviewed journals. Access to source data will be made available through local, regional and national anonymized datasets on request, and after agreement of the PRoVENT-COVID steering committee.Trial Registration: PRoVENT-COVID is registered at clinicaltrials.gov (identifier NCT04346342).

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PRactice of VENTilation in Patients with Novel Coronavirus Disease (PRoVENT-COVID)

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Cultural tourism during the covid-19 pandemic in Portugal

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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Skeletal muscle alterations in patients with acute Covid-19 and post-acute sequelae of Covid-19

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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Skeletal muscle alterations in patients with acute Covid-19 and post-acute sequelae of Covid-19

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Comprehensive analytical and clinical evaluation of a RNA extraction-free saliva-based molecular assay for SARS-CoV-2

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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SARS-COV-2 vaccination and employment

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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Wat weten we nu eigenlijk van het coronavirus en wat betekent dit voor evenementen?

What do we know about the coronavirus, up to this point, and what does this mean for events?

Poor nutritional status, risk of sarcopenia and nutrition related complaints are prevalent in COVID-19 patients during and after hospital admission

PRactice of VENTilation in Patients with Novel Coronavirus Disease (PRoVENT-COVID)

Cultural tourism during the covid-19 pandemic in Portugal

Skeletal muscle alterations in patients with acute Covid-19 and post-acute sequelae of Covid-19

Comprehensive analytical and clinical evaluation of a RNA extraction-free saliva-based molecular assay for SARS-CoV-2

SARS-COV-2 vaccination and employment

Projects 2

3D scanning voor passende mondkapjes

Nieuwe moleculen voor de diagnose van infectieziekten

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Products 60

Co-fit

Wat weten we nu eigenlijk van het coronavirus en wat betekent dit voor evenementen?

What do we know about the coronavirus, up to this point, and what does this mean for events?

Poor nutritional status, risk of sarcopenia and nutrition related complaints are prevalent in COVID-19 patients during and after hospital admission

PRactice of VENTilation in Patients with Novel Coronavirus Disease (PRoVENT-COVID)

Cultural tourism during the covid-19 pandemic in Portugal

Skeletal muscle alterations in patients with acute Covid-19 and post-acute sequelae of Covid-19

Comprehensive analytical and clinical evaluation of a RNA extraction-free saliva-based molecular assay for SARS-CoV-2

SARS-COV-2 vaccination and employment

Projects 2

3D scanning voor passende mondkapjes

Nieuwe moleculen voor de diagnose van infectieziekten