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1.
J Biol Chem ; 299(6): 104732, 2023 06.
Artigo em Inglês | MEDLINE | ID: mdl-37086785

RESUMO

Nicotianamine synthase (NAS) catalyzes the biosynthesis of the low-molecular-mass metal chelator nicotianamine (NA) from the 2-aminobutyrate moieties of three SAM molecules. NA has central roles in metal nutrition and metal homeostasis of flowering plants. The enzymatic function of NAS remains poorly understood. Crystal structures are available for archaeal and bacterial NAS-like proteins that carry out simpler aminobutanoyl transferase reactions. Here, we report amino acids essential for the activity of AtNAS1 based on structural modeling and site-directed mutagenesis. Using a newly developed enzyme-coupled continuous activity assay, we compare differing NAS proteins identified through multiple sequence alignments and phylogenetic analyses. In most NAS of dicotyledonous and monocotyledonous plants (class Ia and Ib), the core-NAS domain is fused to a variable C-terminal domain. Compared to fungal and moss NAS that comprise merely a core-NAS domain (class III), NA biosynthetic activities of the four paralogous Arabidopsis thaliana NAS proteins were far lower. C-terminally trimmed core-AtNAS variants exhibited strongly elevated activities. Of 320 amino acids of AtNAS1, twelve, 287-TRGCMFMPCNCS-298, accounted for the autoinhibitory effect of the C terminus, of which approximately one-third was attributed to N296 within a CNCS motif that is fully conserved in Arabidopsis. No detectable NA biosynthesis was mediated by two representative plant NAS proteins that naturally lack the C-terminal domain, class Ia Arabidopsis halleri NAS5 and Medicago truncatula NAS2 of class II which is found in dicots and diverged early during the evolution of flowering plants. Next, we will address a possible posttranslational release of autoinhibition in class I NAS proteins.


Assuntos
Alquil e Aril Transferases , Proteínas de Arabidopsis , Arabidopsis , Arabidopsis/enzimologia , Arabidopsis/genética , Proteínas de Arabidopsis/química , Proteínas de Arabidopsis/genética , Filogenia , Alquil e Aril Transferases/química , Alquil e Aril Transferases/genética
2.
Proc Natl Acad Sci U S A ; 118(46)2021 11 16.
Artigo em Inglês | MEDLINE | ID: mdl-34750269

RESUMO

Antibiotic resistance is a major threat to global health; this problem can be addressed by the development of new antibacterial agents to keep pace with the evolutionary adaptation of pathogens. Computational approaches are essential tools to this end since their application enables fast and early strategical decisions in the drug development process. We present a rational design approach, in which acylide antibiotics were screened based on computational predictions of solubility, membrane permeability, and binding affinity toward the ribosome. To assess our design strategy, we tested all candidates for in vitro inhibitory activity and then evaluated them in vivo with several antibiotic-resistant strains to determine minimal inhibitory concentrations. The predicted best candidate is synthetically more accessible, exhibits higher solubility and binding affinity to the ribosome, and is up to 56 times more active against resistant pathogens than telithromycin. Notably, the best compounds designed by us show activity, especially when combined with the membrane-weakening drug colistin, against Acinetobacter baumanii, Pseudomonas aeruginosa, and Escherichia coli, which are the three most critical targets from the priority list of pathogens of the World Health Organization.


Assuntos
Antibacterianos/farmacologia , Bactérias/efeitos dos fármacos , Farmacorresistência Bacteriana Múltipla/efeitos dos fármacos , Macrolídeos/farmacologia , Colistina/farmacologia , Testes de Sensibilidade Microbiana/métodos
3.
Nano Lett ; 23(22): 10126-10131, 2023 Nov 22.
Artigo em Inglês | MEDLINE | ID: mdl-37955345

RESUMO

Magnetism in reduced dimensionalities is of great fundamental interest while also providing perspectives for applications of materials with novel functionalities. In particular, spin dynamics in two dimensions (2D) have become a focus of recent research. Here, we report the observation of coherent propagating spin-wave dynamics in a ∼30 nm thick flake of 2D van der Waals ferromagnet Fe5GeTe2 using X-ray microscopy. Both phase and amplitude information were obtained by direct imaging below TC for frequencies from 2.77 to 3.84 GHz, and the corresponding spin-wave wavelengths were measured to be between 1.5 and 0.5 µm. Thus, parts of the magnonic dispersion relation were determined despite a relatively high magnetic damping of the material. Numerically solving an analytic multilayer model allowed us to corroborate the experimental dispersion relation and predict the influence of changes in the saturation magnetization or interlayer coupling, which could be exploited in future applications by temperature control or stacking of 2D-heterostructures.

4.
Nano Lett ; 22(23): 9236-9243, 2022 Dec 14.
Artigo em Inglês | MEDLINE | ID: mdl-36400013

RESUMO

Skyrmions have been well studied in chiral magnets and magnetic thin films due to their potential application in practical devices. Recently, monochiral skyrmions have been observed in two-dimensional van der Waals magnets. Their atomically flat surfaces and capability to be stacked into heterostructures offer new prospects for skyrmion applications. However, the controlled local nucleation of skyrmions within these materials has yet to be realized. Here, we utilize real-space X-ray microscopy to investigate a heterostructure composed of the 2D ferromagnet Fe3GeTe2 (FGT), an insulating hexagonal boron nitride layer, and a graphite top electrode. Upon a stepwise increase of the voltage applied between the graphite and FGT, a vertically conducting pathway can be formed. This nanocontact allows the tunable creation of individual skyrmions via single nanosecond pulses of low current density. Furthermore, time-resolved magnetic imaging highlights the stability of the nanocontact, while our micromagnetic simulations reproduce the observed skyrmion nucleation process.

5.
Chembiochem ; 23(2): e202100584, 2022 01 19.
Artigo em Inglês | MEDLINE | ID: mdl-34729883

RESUMO

The targeted manipulation of polyketide synthases has in recent years led to numerous new-to-nature polyketides. For type I polyketide synthases the response of post-polyketide synthases (PKS) processing enzymes onto the most frequently polyketide backbone manipulations is so far insufficiently studied. In particular, complex processes such as the polyether cyclisation in the biosynthesis of ionophores such as monensin pose interesting objects of research. We present here a study of the substrate promiscuity of the polyether cyclisation cascade enzymes in monensin biosynthesis in the conversion of redox derivatives of the nascent polyketide chain. LC-HRMS/MS2 -based studies revealed a remarkable flexibility of the post-PKS enzymes. They acted on derivatized polyketide backbones based on the three possible polyketide redox states within two different modules and gave rise to an altered polyether structure. One of these monensin derivatives was isolated and characterized by 2D-NMR spectroscopy, crystallography, and bioactivity studies.


Assuntos
Éteres/química , Monensin/química , Mutação Puntual , Policetídeo Sintases/genética , Anti-Infecciosos/farmacologia , Cromatografia Líquida de Alta Pressão/métodos , Cromatografia de Fase Reversa , Cristalografia por Raios X , Ciclização , Testes de Sensibilidade Microbiana , Estrutura Molecular , Monensin/análogos & derivados , Monensin/farmacologia , Ressonância Magnética Nuclear Biomolecular/métodos , Espectrometria de Massas em Tandem
6.
Anaesthesist ; 70(5): 392-397, 2021 05.
Artigo em Alemão | MEDLINE | ID: mdl-33301057

RESUMO

BACKGROUND: Postdural puncture headache (PDPH) occurs in up to 11% of patients after spinal anesthesia and in more than 80% after dural perforation upon epidural anesthesia. It represents a severe anesthesiological complication in obstetric patients. If conservative medication measures do not result in a timely relief of symptoms, the current guidelines recommend the early implementation of an epidural blood patch; however, although performing an epidural blood patch is effective to treat PDPH, potential side effects include neurological complications, spinal hematoma and infections. Assumed to reduce cerebral vasodilatation as a potential pathophysiological driver of PDPH, the transnasal block of the sphenopalatine ganglion with local anesthetics is discussed as an alternative approach. METHODS: In this case study a modification of this technique is reported using a mucosal atomization device (MAD) for off-label nasal administration of lidocaine in two obstetric patients suffering from PDPH. Up to now there is no experience with this modified technique in obstetric anesthesiology. RESULTS: The first patient (25-year-old secundigravida, body mass index [BMI] 54.7 kg/m2) displayed a pronounced PDPH with nausea and vomiting during the first day after a cesarean section under spinal anesthesia (3 attempts). The second patient (32-year-old tertiagravida, BMI 27.3 kg/m2) was readmitted to hospital due to PDPH 4 days after a natural birth under epidural anesthesia. Whereas conservative measures and therapeutic attempts with nonopioid analgesics and caffeine did not result in a sufficient treatment success, intranasal lidocaine administration via a MAD led to an immediate and persisting symptom relief. Both patients could be discharged from hospital after 24 h of surveillance and did not report any relevant side effects of the lidocaine administration. CONCLUSION: The described noninvasive and simple procedure represents a valuable addition to previously known treatment options for PDPH and a potential alternative to an epidural blood patch in obstetric patients with PDPH. Prospective studies are needed to validate the findings.


Assuntos
Anestesiologia , Cefaleia Pós-Punção Dural , Administração Intranasal , Adulto , Placa de Sangue Epidural , Cesárea , Feminino , Humanos , Lidocaína , Cefaleia Pós-Punção Dural/terapia , Gravidez
7.
Chembiochem ; 20(9): 1183-1189, 2019 05 02.
Artigo em Inglês | MEDLINE | ID: mdl-30629783

RESUMO

The incorporation of new-to-nature extender units into polyketide synthesis is an important source for diversity yet is restricted by limited availability of suitably activated building blocks in vivo. We here describe a straightforward workflow for the biogenic activation of commercially available new-to-nature extender units. Firstly, the substrate scope of a highly flexible malonyl co-enzyme A synthetase from Streptomyces cinnamonensis was characterized. The results were matched by in vivo experiments in which the said extender units were accepted by both the polyketide synthase and the accessory enzymes of the monensin biosynthetic pathway. The experiments gave rise to a series of predictable monensin derivatives by the exploitation of the innate substrate promiscuity of an acyltransferase and downstream enzyme functions.


Assuntos
Proteínas de Bactérias/metabolismo , Coenzima A Ligases/metabolismo , Monensin/biossíntese , Policetídeo Sintases/metabolismo , Aciltransferases/química , Aciltransferases/metabolismo , Monensin/análogos & derivados , Domínios Proteicos , Streptomyces/enzimologia , Especificidade por Substrato
8.
Org Biomol Chem ; 17(26): 6374-6385, 2019 07 14.
Artigo em Inglês | MEDLINE | ID: mdl-31090778

RESUMO

The concept of combinatorial biosynthesis promises access to compound libraries based on privileged natural scaffolds. Ever since the elucidation of the biosynthetic pathway towards the antibiotic erythromycin A in 1990, the predictable manipulation of type I polyketide synthase megaenzymes was investigated. However, this goal was rarely reached beyond simplified model systems. In this study, we identify the intermediates in the biosynthesis of the polyether monensin and numerous mutated variants using a targeted metabolomics approach. We investigate the biosynthetic flow of intermediates and use the experimental setup to reveal the presence of selectivity filters in polyketide synthases. These obstruct the processing of non-native intermediates in the enzymatic assembly line. Thereby we question the concept of a truly modular organization of polyketide synthases and highlight obstacles in substrate channeling along the cascade. In the search for the molecular origin of a selectivity filter, we investigate the role of different thioesterases in the monensin gene cluster and the connection between ketosynthase sequence motifs and incoming substrate structures. Furthermore, we demonstrate that the selectivity filters do not apply to new-to-nature side-chains in nascent polyketides, showing that the acceptance of these is not generally limited by downstream modules.


Assuntos
Policetídeo Sintases/metabolismo , Policetídeos/metabolismo , Engenharia de Proteínas , Policetídeos/química , Conformação Proteica
9.
Chembiochem ; 19(20): 2146-2151, 2018 10 18.
Artigo em Inglês | MEDLINE | ID: mdl-30085399

RESUMO

The enzymatic synthesis of terpenes was investigated by using a cascade based on the mevalonic acid pathway. Suitable enzymes from all kingdoms of life were identified and combined to give rise to geosmin and patchoulol as representative compounds. The pathway was studied in three separate segments, which were subsequently combined in a ten-step cascade plus added cofactor regeneration systems. The cascade delivers farnesyl pyrophosphate with >40 % conversion and cyclises it to sesquiterpenes with >90 % conversion.


Assuntos
Ácido Acético/metabolismo , Ácido Mevalônico/metabolismo , Naftóis/metabolismo , Fosfatos de Poli-Isoprenil/biossíntese , Sesquiterpenos/metabolismo , Archaea/metabolismo , Bactérias/metabolismo , Biocatálise , Ciclização , Enzimas/metabolismo , Fungos/metabolismo , Plantas/metabolismo
10.
Chembiochem ; 19(2): 153-158, 2018 01 18.
Artigo em Inglês | MEDLINE | ID: mdl-29139594

RESUMO

3-Hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase was investigated in different organic cosolvents by means of kinetic and calorimetric measurements, molecular dynamics simulations, and small-angle X-ray scattering. The combined experimental and theoretical techniques were essential to complement each other's limitations in the investigation of the complex interaction pattern between the enzyme, different solvent types, and concentrations. In this way, the underlying mechanisms for the loss of enzyme activity in different water-miscible solvents could be elucidated. These include direct inhibitory effects onto the active center and structural distortions.


Assuntos
Acetonitrilas/metabolismo , Acil Coenzima A/metabolismo , Álcoois/metabolismo , Líquidos Iônicos/metabolismo , Acetonitrilas/química , Acil Coenzima A/química , Álcoois/química , Calorimetria , Líquidos Iônicos/química , Cinética , Simulação de Dinâmica Molecular , Espalhamento a Baixo Ângulo , Solventes/química , Solventes/metabolismo , Sulfolobus solfataricus/enzimologia , Difração de Raios X
11.
Chirality ; 29(8): 409-414, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28560831

RESUMO

The absolute configuration (AC) of the common precursor of the fusicoccane family of terpenoids, fusicocca-2,10(14)-diene (FCdiene), had only been deduced by a lengthy total synthesis, or indirectly from crystal structures of fusicoccin A. However, in particular the AC determinations based on downstream products of the terpene synthase intrinsically overlook potential epimerization reactions. In this contribution, we confirm the relative stereochemistry of FCdiene by comparison of experimental and predicted 13 C-NMR chemical shifts, and finally determine the absolute configuration from an analysis of its infrared and vibrational circular dichroism spectra.


Assuntos
Dicroísmo Circular/métodos , Diterpenos/química , Modelos Moleculares , Espectroscopia de Ressonância Magnética , Estereoisomerismo
12.
Chembiochem ; 15(4): 495-7, 2014 Mar 03.
Artigo em Inglês | MEDLINE | ID: mdl-24504732

RESUMO

No longer in-F-able: fluorine building blocks can be used in polyketide biosynthesis. This represents a more flexible approach to organofluorines than the traditional use of fluorinated starter units in multistep organic syntheses, and will hopefully increase the number of compounds available for drug development.


Assuntos
Produtos Biológicos/metabolismo , Flúor/química , Biocatálise , Produtos Biológicos/química , Coenzima A/metabolismo , Halogenação , Malonatos/química , Malonatos/metabolismo , Policetídeo Sintases/metabolismo , Policetídeos/química , Policetídeos/metabolismo
13.
Chembiochem ; 15(13): 1991-7, 2014 Sep 05.
Artigo em Inglês | MEDLINE | ID: mdl-25044264

RESUMO

The polyether ionophore monensin is biosynthesized by a polyketide synthase that delivers a mixture of monensins A and B by the incorporation of ethyl- or methyl-malonyl-CoA at its fifth module. Here we present the first computational model of the fifth acyltransferase domain (AT5mon ) of this polyketide synthase, thus affording an investigation of the basis of the relaxed specificity in AT5mon , insights into the activation for the nucleophilic attack on the substrate, and prediction of the incorporation of synthetic malonic acid building blocks by this enzyme. Our predictions are supported by experimental studies, including the isolation of a predicted derivative of the monensin precursor premonensin. The incorporation of non-native building blocks was found to alter the ratio of premonensins A and B. The bioactivity of the natural product derivatives was investigated and revealed binding to prenyl-binding protein. We thus show the potential of engineered biosynthetic polyketides as a source of ligands for biological macromolecules.


Assuntos
Produtos Biológicos/síntese química , Monensin/análogos & derivados , Monensin/síntese química , Policetídeo Sintases/química , Aciltransferases/química , Biologia Computacional , Escherichia coli/metabolismo , Fermentação , Malonatos/química , Modelos Moleculares , Monensin/farmacologia , Conformação Proteica , Streptomyces/enzimologia , Especificidade por Substrato
14.
ACS Nano ; 18(28): 18246-18256, 2024 Jul 16.
Artigo em Inglês | MEDLINE | ID: mdl-38975730

RESUMO

The realization of above room-temperature ferromagnetism in the two-dimensional (2D) magnet Fe5GeTe2 represents a major advance for the use of van der Waals (vdW) materials in practical spintronic applications. In particular, observations of magnetic skyrmions and related states within exfoliated flakes of this material provide a pathway to the fine-tuning of topological spin textures via 2D material heterostructure engineering. However, there are conflicting reports as to the nature of the magnetic structures in Fe5GeTe2. The matter is further complicated by the study of two types of Fe5GeTe2 crystals with markedly different structural and magnetic properties, distinguished by their specific fabrication procedure: whether they are slowly cooled or rapidly quenched from the growth temperature. In this work, we combine X-ray and electron microscopy to observe the formation of magnetic stripe domains, skyrmion-like type-I, and topologically trivial type-II bubbles, within exfoliated flakes of Fe5GeTe2. The results reveal the influence of the magnetic ordering of the Fe1 sublattice below 150 K, which dramatically alters the magnetocrystalline anisotropy and leads to a complex magnetic phase diagram and a sudden change of the stability of the magnetic textures. In addition, we highlight the significant differences in the magnetic structures intrinsic to slow-cooled and quenched Fe5GeTe2 flakes.

15.
Beilstein J Org Chem ; 9: 664-74, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23616811

RESUMO

Polyketides are biosynthesized through consecutive decarboxylative Claisen condensations between a carboxylic acid and differently substituted malonic acid thioesters, both tethered to the giant polyketide synthase enzymes. Individual malonic acid derivatives are typically required to be activated as coenzyme A-thioesters prior to their enzyme-catalyzed transfer onto the polyketide synthase. Control over the selection of malonic acid building blocks promises great potential for the experimental alteration of polyketide structure and bioactivity. One requirement for this endeavor is the supplementation of the bacterial polyketide fermentation system with tailored synthetic thioester-activated malonates. The membrane permeable N-acetylcysteamine has been proposed as a coenzyme A-mimic for this purpose. Here, the incorporation efficiency into different polyketides of N-acetylcysteamine activated methylmalonate is studied and quantified, showing a surprisingly high and transferable activity of these polyketide synthase substrate analogues in vivo.

16.
Brain Behav ; 13(12): e3323, 2023 12.
Artigo em Inglês | MEDLINE | ID: mdl-37984468

RESUMO

BACKGROUND: The reasons for developing depression are not fully understood. However, it is known that the serotonergic system plays a role in the etiology, but the endocannabinoid system receives attention. METHOD: In this study, 161 patients with a depressive disorder and 161 healthy participants were examined for the distribution of the CNR1 rs4940353, 5-HT2A rs6311, and 5-HT1A rs6295 by high-resolution melting genotyping. The concentration of arachidonoyl ethanolamide (AEA) and 2-arachidonoylglycerol (2-AG) in the blood was measured by liquid chromatography-tandem mass spectrometry. Additionally, depression and anxiety symptoms were evaluated based on self-questionnaires. Fifty-nine patients participated in a second appointment to measure the concentration of AEA, 2-AG, and symptoms of depression and anxiety. RESULTS: We observed higher AEA and decreased 2-AG concentrations in patients with depression compared to healthy participants. During the treatment, the concentrations of AEA and 2-AG did not change significantly. In patients higher symptoms of anxiety correlated with lower concentrations of 2-AG. Gender differences were found concerning increased 2-AG concentration in male patients and increased anxiety symptoms in female patients. Genotypic variations of 5-HT1A rs6295 and 5-HT2A rs6311 are associated with altered serotonergic activity and serotonin content in patients. CONCLUSION: In conclusion, it seems that the endocannabinoid system, especially the endocannabinoids 2-AG and AEA, and genetic variations of the 5-HT1A and 5-HT2A could play a role in patients with depression and may be involved in a depressive disorder.


Assuntos
Endocanabinoides , Alcamidas Poli-Insaturadas , Feminino , Humanos , Masculino , Cromatografia Líquida , Endocanabinoides/análise , Variação Genética , Receptor CB1 de Canabinoide/genética
17.
Adv Mater ; 35(12): e2208930, 2023 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-36637996

RESUMO

Topological charge plays a significant role in a range of physical systems. In particular, observations of real-space topological objects in magnetic materials have been largely limited to skyrmions - states with a unitary topological charge. Recently, more exotic states with varying topology, such as antiskyrmions, merons, or bimerons and 3D states such as skyrmion strings, chiral bobbers, and hopfions, have been experimentally reported. Along these lines, the realization of states with higher-order topology has the potential to open new avenues of research in topological magnetism and its spintronic applications. Here, real-space imaging of such spin textures, including skyrmion, skyrmionium, skyrmion bag, and skyrmion sack states, observed in exfoliated flakes of the van der Waals magnet Fe3-x GeTe2 (FGT) is reported. These composite skyrmions may emerge from seeded, loop-like states condensed into the stripe domain structure, demonstrating the possibility to realize spin textures with arbitrary integer topological charge within exfoliated flakes of 2D magnets. The general nature of the formation mechanism motivates the search for composite skyrmion states in both well-known and new magnetic materials, which may yet reveal an even richer spectrum of higher-order topological objects.

18.
Angew Chem Int Ed Engl ; 51(42): 10664-9, 2012 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-22996590

RESUMO

Not in the public domain: Site-directed mutagenesis of megasynthases was the key to the generation of a library of polyketides in bacteria. Redox derivatizations are used to change the bioactivity profile of the compounds.


Assuntos
Policetídeo Sintases/genética , Policetídeo Sintases/metabolismo , Policetídeos/síntese química , Espectroscopia de Ressonância Magnética , Mutagênese , Oxirredução , Policetídeos/química
19.
Rev Sci Instrum ; 93(3): 034704, 2022 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-35364984

RESUMO

While the frequencies accessible by signal generators steadily rise, the synthesization of complex and arbitrary waveforms with high frequency components remains challenging, especially when restricted by an external reference clock. In this article, we present a comprehensive software package combined with state-of-the-art hardware as a solution for the generation of highly sampled, arbitrary radio frequency waveforms. The software can be used to conduct both synchronous and heterodyne pump-probe experiments due to a variety of different synchronization modules. While both kinds of modules allow for standard waveforms, such as sines, pulses, and bursts, as well as any arbitrary signal, the heterodyne modules additionally are not restricted by the reference clock frequency. Both the output and the synchronization module can be adapted to support additional measurement devices. Due to the modular software structure, individual classes can be exchanged while maintaining all functionalities. The software provides a user friendly graphical interface that allows us to compose, save, and load complex arbitrary waveforms within only a few steps. The frequency selectivity provided by the software-hardware combination allows us to directly target specific excitation states of physical systems. Conducting a heterodyne scanning transmission x-ray microscopy experiment, we are able to demonstrate the capabilities of the software when paired with a high sample rate arbitrary waveform generator. The heterodyne synchronization modules allow for unlimited flexibility leveraging arbitrary waveform generation to their full power. By solving the challenges of synthesizing highly complex electromagnetic waves, the software enables a large variety of experiments to be performed more conveniently.

20.
Anaesthesiologie ; 71(6): 452-461, 2022 06.
Artigo em Alemão | MEDLINE | ID: mdl-34812895

RESUMO

BACKGROUND: In the current pandemic regarding the infection with the SARS-CoV-2-virus and COVID-19 as the disease, concerns about pregnant women, effects on childbirth and the health of the newborn remain high. Initially, due to the early manifestation of the disease in younger patients, high numbers of COVID-19 patients in women needing peripartum care were expected. OBJECTIVE: This article aims to provide a general overview over the beginning of the pandemic as well as the second wave of infections in Germany and Switzerland, regarding SARS-CoV­2 positive pregnant women hospitalized for childbirth. We therefore launched a registry to gain timely information over the dynamic situation during the SARS-CoV­2 pandemic in Germany. MATERIAL AND METHODS: As part of the COVID-19-related Obstetric Anesthesia Longitudinal Assessment (COALA) registry, centers reported weekly birth rates, numbers of suspected SARS-CoV­2 cases, as well as the numbers of confirmed cases between 16 March and 3 May 2020. Data acquisition was continued from 18 October 2020 till 28 February 2021. The data were analyzed regarding distribution of SARS-CoV­2 positive pregnant women hospitalized for childbirth between centers, calendar weeks and birth rates as well as maternal characteristics, course of disease and outcomes of SARS-CoV­2 positive pregnant women. RESULTS: A total of 9 German centers reported 2270 deliveries over 7 weeks during the first wave of infections including 3 SARS-CoV­2 positive cases and 9 suspected cases. During the second survey period, 6 centers from Germany and Switzerland reported 41 positive cases out of 4897 deliveries. One woman presented with a severe and ultimately fatal course of the disease, while another one needed prolonged ECMO treatment. Of the women 28 presented with asymptomatic infections and 6 neonates were admitted to a neonatal intensive care unit for further treatment. There was one case of neonatal SARS-CoV­2 infection. CONCLUSION: The number of pregnant women infected with SARS-CoV­2 was at a very low level at the time of delivery, with only sporadic suspected or confirmed cases. Due to the lack of comprehensive testing in the first survey period, however, a certain number of asymptomatic cases are to be assumed. Of the cases 68% presented as asymptomatic or as mild courses of disease but the data showed that even in young healthy patients without the presence of typical risk factors, serious progression can occur. These outcomes should raise awareness for anesthesiologists, obstetricians, pediatricians and intensive care physicians to identify severe cases of COVID-19 in pregnant women during childbirth and to take the necessary precautions to ensure the best treatment of mother and neonate. The prospective acquisition of data allowed a timely assessment of the highly dynamic situation and gain knowledge regarding this vulnerable group of patients.


Assuntos
Anestesia Obstétrica , COVID-19 , COVID-19/epidemiologia , Feminino , Humanos , Recém-Nascido , Período Periparto , Gravidez , Estudos Prospectivos , SARS-CoV-2
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