The contribution of SARS-CoV-2 to the burden of acute respiratory infections in winter season 2022/2023: results from the DigiHero study.

OBJECTIVES: In winter of 2022/2023 SARS-CoV-2 had developed into one of many seasonal respiratory pathogens, causing an additional burden of acute respiratory infections (ARIs). Although testing was still widely used, many positive tests were not reported for the official statistics. Using data from a population-based cohort, we aimed to investigate the contribution of SARS-CoV-2 to the burden of ARI. METHODS: Over 70,000 participants of the German population-based DigiHero study were invited to a questionnaire about the number and time point of ARI and SARS-CoV-2 test results in winter 2022/2023. We calculated the incidence of non-severe acute respiratory syndrome (SARS) ARI, the additional contribution of SARS-CoV-2, and extrapolated the age-specific estimates to obtain the total burden of SARS-CoV-2 in Germany. RESULTS: For the winter of 2022/2023, 37,708 participants reported 54,813 ARIs, including 9358 SARS-CoV-2 infections. This translated into a cumulative incidence of 145 infections/100 persons for all ARIs, 120 infections/100 persons for non-SARS ARI, and 25 infections/100 persons for SARS ARI (+21%). CONCLUSIONS: Our estimate for ARI related to SARS-CoV-2 is consistent with the difference in all ARI between pre-pandemic years and 2022/2023. This additional burden should be considered, particularly, with respect to the implications for the work force.

Regional Differences in Uptake of Vaccination against COVID-19 and Influenza in Germany: Results from the DigiHero Cohort.

During the COVID-19 pandemic in Germany, vaccination uptake exhibited considerable regional disparities. To assess the factors contributing to this variation, we examined the association of sociodemographic variables with COVID-19, COVID-19 booster, and influenza vaccination status within a cohort of 37,078 participants from 13 German federal states in the digital health cohort study commonly known as DigiHero. Our findings revealed variations in vaccination rates based on sociodemographic factors. However, these factors had limited explanatory power regarding regional differences in vaccine uptake. In contrast, we found substantial correlations between regional support of specific parties during the last local elections and the vaccination uptake at the level of each administrative district. In conclusion, sociodemographic factors alone did not suffice to explain the regional disparities in vaccine uptake. Political stances can play a major role, although the current investigation did not assess individual political orientations but rather used only an ecological approach.

Morphology and Progression in Primary Varicose Vein Disorder Due to 677C>T and 1298A>C Variants of MTHFR.

BACKGROUND: Clinical assessment and prognostic stratification of primary varicose veins have remained controversial and the molecular pathogenesis is unknown. Previous data have suggested a contribution of the MTHFR (methylenetetrahydrofolate reductase) polymorphism c.677C>T. METHODS: We collected blood and vein specimens from 159 consecutive patients undergoing varicose vein surgery, or autologous vein reconstruction for arterial occlusive disease as controls. We compared the frequencies of c.677C>T and another polymorphism of MTHFR, c.1298A>C, with morphology and types of complicated disease. Morphology was recorded as a trunk or perforator type and peripheral congestive complication was defined as chronic venous insufficiency (CEAP C3-6) associated with edema and skin manifestations. FINDINGS: Multivariate analysis of genotypes for c.677C>T and c.1298A>C indicated that c.677C>T was associated significantly with the trunk phenotype (43/53 patients, 81%, p < 0.01), while c.1298A>C was associated significantly with the perforator phenotype (18/24 patients, 75%, p < 0.01) of primary varicose veins. Accordingly, when both c.677C>T and c.1298A>C displayed a heterozygous genotype, the patients were more likely to present with both phenotypes. Additionally, c.1298A>C was found to be strongly linked to the congestive complication (34/51 patients, 67%, p < 0.01). INTERPRETATION: Both polymorphisms of MTHFR may be involved in the morphological specification of primary varicose veins and contribute to the development of complicated disease. FUNDING: None.

Comparison of stab wound probing versus radiological stab wound channel depiction with contrast medium.

BACKGROUND: Instillation of contrast medium into stab wounds has shown promising results regarding visibility and assessment of general stab direction with computed tomography. However, the accuracy of this method--and, incidentally also probing of stab wounds--has to our knowledge not previously been examined. Also the effect of bluntness of different stabbing objects on the examination of stab wounds was not considered before this study. METHODS: Using a pocket-knife, a steak-knife, and a Phillips screwdriver, nine stab wounds each were inflicted to three pork haunches. The depths of the stab wounds were determined by probing and multislice computed tomography (MSCT) after instillation of a contrast medium (CM) and then compared to those observed by dissection, our internal "gold standard". RESULTS: In stab wounds inflicted by knives, MSCT-CM and probing provided results which differed by roughly 10-11% from the dissection results. In screwdriver stabs MSCT-CM showed a deviation of almost 30%, probing over 33%. DISCUSSION: MSCT-CM is a possible alternative to layer-by-layer dissection in autopsy cases of knife stab wounds. Probing, although obsolete in post-mortem examinations, is sufficiently accurate in determining the length of a stab wound of a living person. In cases of stab wounds with blunt objects such as screwdrivers, neither MSCT-CM nor probing proved to be sufficiently accurate. CONCLUSION: MSCT-CM is a possible alternative to layer-by-layer dissection in autopsy cases of knife stab wounds. Probing, although obsolete in post-mortem examinations, is sufficiently accurate in determining the length of a stab wound of a living person. In cases of stab wounds with blunt objects such as screwdrivers, neither MSCT-CM nor probing proved to be sufficiently accurate.