Background: Healthcare and social workers had an increased occupational risk of contracting SARS-CoV-2 during the pandemic. Some developed long-lasting symptoms known as post-COVID syndrome (PCS). To assess the consequences of COVID-19 for individuals insured by the German Social Accident Insurance, the BG hospitals (Berufsgenossenschaftliche Kliniken: clinics for occupational accident insurance) established an interdisciplinary diagnostic programme. Data collected during routine clinical practice are transmitted to a multicenter post-COVID registry to enhance knowledge of the long-term consequences related to COVID-19 and to optimize diagnostics, treatment, and rehabilitation. The design of the post-COVID registry, along with a description of the study population, is detailed in this paper.
Methods: The registry includes patients with an occupational disease or accident. Depending on the severity and complexity of the symptoms, patients received an outpatient post-COVID examination or an inpatient post-COVID check (PCC). The collected data comprise demographics, occupational and social history, disease progression, pre-existing conditions, utilization of health services, persistent symptoms, and psychosocial and neuropsychological assessments. Further investigations are carried out in response to symptoms and needs, using clinical assessment, instrumental and imaging techniques, as well as questionnaires. In addition, serum and cerebrospinal fluid samples are preserved for biomarker analysis.
Results: By September 2024, 1,957 patients from six BG hospitals were included. An interim analysis of 1,150 cases shows that patients are predominantly female (77%) and the average age is 51 years (standard deviation [SD] 10.5). Around 43% worked in nursing at the time of infection. In 63% of cases, an inpatient post-COVID check was carried out. About 20% were hospitalized during acute COVID-19 infection, with an average stay of 14.6 days (SD 18.4). More than half were still unable to work at the time of examination, with no significant differences between hospitalized and non-hospitalized patients. Common pre-existing conditions included heart disease (48%), allergies (45%), and lung disease (33%). PCS symptoms mainly consisted of reduced physical capacity (95%), concentration difficulties (79%), and shortness of breath (69%). 81% had previously received outpatient and/or inpatient rehabilitation.
Conclusion: The outpatient and the inpatient PCC are essential in managing the recovery process for patients with PCS. Data analysis will provide insights into the need for medical care and rehabilitation. In addition, longitudinal analyses will be used to track the progress of the post-COVID registry over time and monitor the effectiveness of the recommended measures.
In terms of infection control, environmental cleaning is critical in nursing homes, including long term care facilities. According to the statement of the Commission of Hospital Hygiene and Infection Prevention (KRINKO) at the Robert Koch Institute Berlin on the requirements for disinfectants in these areas, procedures should be used that have been certified by the Association for Applied Hygiene (VAH) for the necessary spectrum of efficacy (or are listed accordingly in the disinfectant list of the Robert Koch Institute). Since ozone is a powerfully oxidizing gas with high inhalation toxicity, the conditions of ap-plication and the measures for occupational safety - including ensuring that the limit value in indoor air is not exceeded when handling and using the product -, must be declared by the manufacturer and observed by the staff to exclude toxic long-term hazard.
Background: Postbiotics comprise soluble compounds freed from the structure of destroyed bacteria or created by living bacteria. Such byproducts provide the host with enhanced biological function as well as specific physiological consequences. This research aims to examine the characteristics and possible health advantages of Lacticaseibacillus (L.) casei-derived postbiotics.
Methods: The antibacterial effects of postbiotics derived from L. casei were examined in vitro against various infectious gastrointestinal agents, as well as pasteurized milk and minced beef. Postbiotic activity potential was evaluated using disc-diffusion agar, minimum inhibitory concentration, minimum bactericidal concentration, and well-diffusion agar methods. Postbiotics were tested for antioxidant activity against 2,2-azinobis (3-ethylbenzothiazoline-6-sulfonic acid) (ABTS) free radicals. Additionally, the total phenolic and flavonoid content of the postbiotics was determined. The colorimetric MTT was used to investigate the potential cytotoxicity of postbiotics. The chemical makeup of the postbiotics was also determined using gas chromatography/mass spectrometry.
Results: The antibacterial capacity was mostly related to pyrrolo[1,2-a] pyrazine-1,4-dione, benzoic acid, and laurostearic acid. Gram-positive microbes were more influenced by microbial byproducts in vitro than Gram-negative bacteria (P<0.05). The minimum effective concentrations of postbiotics were found to be much greater in ground beef and milk in the Listeria monocytogenes-inoculated model than with other bacteria (P<0.05). Postbiotics also show high antioxidant activity. Postbiotics generated from L. casei had the greatest concentrations of phenolic (99.46 mg GAE/g) and flavonoid (17.46 mg QE/g) constituents. Postbiotics had no influence on the viability of human foreskin fibroblasts at any dose.
Conclusion: Lactobacillus spp. postbiotics, particularly L. casei, were recommended for use as antioxidants, antimicrobials, and preservatives in both the food and pharmaceuticals sector for their beneficial effects and biological properties.
Background: Vitamin D is a steroid hormone that protects against viral infections by influencing innate and adaptive immune responses. The effectiveness of vitamin D3 supplementation in COVID-19 is unknown. The study's goal was to elucidate the relationship between blood vitamin D levels and COVID-19 clinical outcomes by examining the effect of a single high dose of vitamin D3 on the length of hospital stay in COVID-19 patients.
Methods: The descriptive, retrospective study was performed from March to May 2021 at a referral center for patients with COVID-19, in Bam, Iran. A checklist consisting of demographic variables was used to gather data, and laboratory assessments of serum 25(OH) D were evaluated and documented. The connection between serum vitamin D and patient clinical outcomes was investigated after patients were given a single oral dose of 200,000 IU of vitamin D3.
Results: 71 COVID-19 patients were treated. Radiological results did not change substantially amongst individuals with various levels of 25(OH)D. After a single dosage of vitamin D3, mean blood levels of 25-hydroxyvitamin D increased considerably and the need for intubation and SpO2 decreased, and as did the respiratory rate in patients requiring hospitalization due to COVID-19.
Conclusion: A single administration of 200,000 IU of vitamin D3 significantly reduced the severity of COVID-19.
Introduction: When using disposable medical gloves, the indications for their use are not always clear in practice, so that they are often worn even in cases where this is neither necessary for the protection of the patient nor for self-protection. This can not only lead to neglect of adequate hand hygiene, but is also ecologically critical in terms of glove consumption and the resources used.
Method: German and international recommendations, including WHO guidelines and information, statements and separate publications on indications and non-indications of disposable medical gloves were evaluated as the basis for deriving the indications for wearing disposable medical gloves.
Results: Typical indications for disposable medical gloves for direct and indirect patient contact, laboratory work and other medical activities are summarized in a table. Situations in which the use of disposable medical gloves is not indicated are also shown separately in tabular form.
Discussion: Further situations are discussed in which the wearing of disposable medical gloves is currently recommended from an infection prevention or occupational health and safety perspective, but should be re-evaluated in the future. In addition to other aspects for reducing glove consumption, such as glove disinfection, guidelines for implementing the use of gloves according to indication are also presented, emphasizing the special role-model function of hygiene staff.
Conclusion: By avoiding the use of disposable medical gloves where there is no indication and by selecting suitable glove material where there is an indication, not only can sustainability be increased, but costs can also be saved without jeopardizing patient and occupational safety.
Introduction: Smoking and tuberculosis are the two major, global health problems. Not only active smokers but also passive smokers are at risk of becoming infected with tuberculosis. Through many mechanisms, smoking decreases immunity and predisposes to numerous infections. This has a negative impact on our health system. This knowledge of the association between smoking and tuberculosis can be utilized to develop a program for TB prevention and control.
Method: This is a retrospective observational study carried out over a period of 18 months on 100 diagnosed cases of sputum smear-positive pulmonary tuberculosis patients undergoing treatment at Mumbai Maharashtra India as a part of the Revised National Tuberculosis Control Program (RNTCP).
Results: 1+ sputum positivity was observed in a higher number of nonsmokers (77%) followed by ex-smokers (43%) and smokers (2%), 2+ and 3+ sputum positivity was observed in a higher number of smokers (63% and 35%, respectively) followed by ex-smokers (29%) and nonsmokers (18% and 5%, respectively).
Conclusion: Smokers demonstrated extensive infiltrates as compared to nonsmokers. Additionally, as the severity of smoking increased (smoking index), and the bacterial load also increased (higher grades of sputum positivity). Smokers also had poorer treatment outcomes than did nonsmokers.
Objective: The aim of this study was to determine the prevalence and trajectory of persistent symptoms following COVID-19 and to investigate factors influencing these among employees in the health and welfare services in Germany.
Methods: This exploratory, mixed retro- and prospective cohort study using paper-and-pencil questionnaires was conducted among insured persons of the German Social Accident Insurance Institution for the health and welfare services with a SARS-CoV-2 infection in 2020. The baseline survey in February 2021 was succeeded by two follow-up surveys after 8 and 13 months. Demographic data, information on the acute illness and persistent symptoms were collected. Kaplan-Meier curves were created to visualize the course of recovery. Factors influencing the time to recovery were analyzed using multivariate Cox regressions.
Results: Of the 4,325 people contacted, 2,053 took part in the survey (response rate: 47%). 1,810 people were included in the analysis. The most common persistent symptoms at all three survey time points were fatigue, concentration and memory problems, and dyspnea. After three months, 76.2% (95% CI: 74.2-78.2%) of participants still reported symptoms, after 18 months this dropped to 67.2% (95% CI: 65.0-69.4%). Significant risk factors for persistent symptoms were female sex (HR: 0.72; 95% CI: 0.58-0.88), age over 50 years (HR: 0.63; 95% CI: 0.50-0.78), a higher number of pre-existing illnesses and a higher number of severe acute symptoms. Respiratory and hormone-metabolic pre-existing conditions as well as severe dyspnea, smell or taste disorders, fatigue and memory or concentration problems during the acute COVID-19 illness also reduced the probability of complete recovery. Compared to other professions, working as a doctor had a protective effect (HR: 1.42; 95% CI: 1.11-1.80).
Conclusion: More than a year after a COVID-19 illness, two-thirds of the healthcare staff surveyed reported persistent symptoms. This high number emphasizes the importance of long-term consequences of the COVID-19 pandemic for public health and the need for suitable therapy and rehabilitation concepts, especially for healthcare staff with post-COVID syndrome.
Objective: This study aimed to assess the awareness of and adherence to infection control practices among healthcare workers (HCWs) in three primary healthcare centers (PHCs) near Aurangabad City, Maharashtra, India.
Method: A prospective observational study over six months involved 64 HCWs from three PHCs (A, B, and C). Questionnaires and observation checklists based on guidelines from the WHO and the Systems for Improved Access to Pharmaceuticals and Services (SIAPS) were used to evaluate infection control practices across nine modules. These modules encompass health facility information, employee health, cleaning practices, hand hygiene, waste management, isolation and standard precautions, childbirth/obstetrics, sterilization, and preparation/administration of parenteral medications.
Results: The study revealed varying levels of adherence to infection control practices among the three PHCs. PHC-A demonstrated strong practices with an overall score of 66%, while PHC-B and PHC-C exhibited weaker practices with 40% and 38%, respectively. Hand hygiene practices showed higher compliance at PHC-A (78%), contrasting with lower compliance observed at PHC-B (39%) and PHC-C (33%). The study also noted deficiencies in hand hygiene facilities and inconsistencies in injection administration and waste disposal practices.
Conclusion: This study underscores the importance of ongoing training and targeted interventions to enhance infection control practices among HCWs in PHCs. The findings provide valuable insights for policymakers and administrators seeking to improve infection prevention measures in primary healthcare settings, contributing to better healthcare outcomes and enhanced patient safety.
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