OBJECTIVES: The aim of the study was to evaluate the efficiency of molecular diagnostics of tick-borne encephalitis (TBE) and to correlate viral RNA (vRNA) detection with the clinical and laboratory data. METHODS: Clinical samples from 1125 patients from South Bohemia, Czech Republic, a highly endemic TBE region, were screened for TBE virus (TBEV) RNA by RT-qPCR. Samples included blood, serum, cerebrospinal fluid (CSF), and urine. RESULTS: TBEV RNA was detected in 14 patients with clinically proven TBE. TBEV RNA was most frequently detected in sera during early infection (11/37 patients tested, 29.7%) but decreased with rising IgG antibody response (3/228, 1.3%). Detection in CSF and urine was infrequent (1/30, 3.3% and 1/52, 1.9%, respectively). Additionally, five patients initially not diagnosed with TBE were retrospectively found to have TBEV RNA in serum, indicating possible underdiagnosis, particularly in mild or atypical presentations. The study also highlighted the diagnostic challenge of an immunocompromised patient whose delayed antibody response hindered timely diagnosis. In such cases, RT-qPCR could significantly shorten the diagnostic timeline. CONCLUSIONS: These findings underscore the value of early RNA detection in improving the diagnosis of TBE and may in the future facilitate the early administration of potential treatment, thereby improving patient outcomes.
- MeSH
- diagnostické techniky molekulární metody MeSH
- dítě MeSH
- dospělí MeSH
- imunoglobulin G krev MeSH
- klíšťová encefalitida * diagnóza virologie MeSH
- kvantitativní polymerázová řetězová reakce MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- předškolní dítě MeSH
- protilátky virové krev MeSH
- RNA virová * krev mozkomíšní mok izolace a purifikace MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- viry klíšťové encefalitidy * izolace a purifikace genetika MeSH
- Check Tag
- dítě MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- předškolní dítě MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH
PURPOSE: Convalescent plasma (CP) collected from people who recovered from COVID-19 became a rapidly available treatment modality in numerous countries, including the Czech Republic. The aims of our study were to evaluate the effectiveness and safety of CP in the treatment of COVID-19. METHODS: This retrospective observational study involved six Czech hospitals. This study enrolled patients with and without CP treatment who were hospitalized between April 2020 and April 2021. Propensity score matching and logistic regression analysis were performed to evaluate the influence of CP administration and its timing on the in-hospital survival of COVID-19 patients. RESULTS: A total of 1,498 patients were enrolled in the study; 406 (27%) were administered CP, and 1,092 (73%) were not treated with CP. The propensity score-matched control group consisted of 1,218 subjects. The survival of patients treated with CP was 79%, while that of patients in the matched control group was 62% (P<0.001). Moreover, the chance of survival was significantly greater when CP was administered within three days after the onset of COVID-19 symptoms than when CP was administered after four or more days (87% vs. 76%, P <0.001). In addition, adverse effects related to CP administration were recorded in only 2% of patients and were considered mild in all patients. CONCLUSIONS: Our study demonstrated that the administration of CP was safe and possibly associated with positive effects that were more pronounced if CP was administered within the first three days after the onset of COVID-19 symptoms.
- MeSH
- COVID-19 * terapie mortalita MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- pasivní imunizace * metody MeSH
- protilátky virové krev MeSH
- retrospektivní studie MeSH
- SARS-CoV-2 * imunologie MeSH
- senioři MeSH
- sérologická léčba covidu-19 * MeSH
- výsledek terapie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- pozorovací studie MeSH
- Geografické názvy
- Česká republika MeSH
Introduction: The multiple roles of nurses have been transformed during the COVID-19 pandemic. As nurses work alongside doctors, this close cooperation enables them to obtain medium-distance information on the roles of the nurses. Goal: The study aimed to describe the nurse's role during the COVID-19 pandemic in the Czech Republic. Methods: In this descriptive qualitative study, we collected data using a semi-structured interview (30 questions). The results were coded (pencil and paper method). Due to the variability of responses, we used a contrast method. Results: The research included 15 doctors (12 females), with a mean time in medical practice of 13.6 years (2-38 years). The individual interviews lasted 40-70 minutes. Using open coding, we identified 12 main categories that matched and differed. The roles identified across the groups were a mother, a team member, and a hero. Both covid and non-covid hospital units reported extended competencies, while primary care was specific in virtual communication with patients and the role of developing working relationships with patients. Non-covid hospital units appreciated the stability of employment. The roles specific to covid units were facing the public, communicating with family, and creatively scaling up service. Conclusion: Identifying nurses' leading, often competing roles during the pandemic enables employers, educators, and professional bodies to steer pregraduate and postgraduate education to address these roles better.
Matrix metalloproteinases (MMPs) play an important role in central nervous system infections. We analysed the levels of 8 different MMPs in the cerebrospinal fluid (CSF) of 89 adult patients infected with tick-borne encephalitis (TBE) virus and compared them with the levels in a control group. MMP-9 was the only MMP that showed significantly increased CSF levels in TBE patients. Serum MMP-9 levels were subsequently measured in 101 adult TBE patients at various time points during the neurological phase of TBE and at follow-up. In addition, serum MMP-9 was analysed in 37 paediatric TBE patients. Compared with control levels, both paediatric and adult TBE patients had significantly elevated serum MMP-9 levels. In most adult patients, serum MMP-9 levels peaked at hospital admission, with higher serum MMP-9 levels observed in patients with encephalitis than in patients with meningitis. Elevated serum MMP-9 levels were observed throughout hospitalisation but decreased to normal levels at follow-up. Serum MMP-9 levels correlated with clinical course, especially in patients heterozygous for the single-nucleotide polymorphism rs17576 (A/G; Gln279Arg) in the MMP9 gene. The results highlight the importance of MMP-9 in the pathogenesis of TBE and suggest that serum MMP-9 may serve as a promising bioindicator of TBE in both paediatric and adult TBE patients.
- MeSH
- biologické markery MeSH
- dítě MeSH
- dospělí MeSH
- jednonukleotidový polymorfismus MeSH
- klíšťová encefalitida * diagnóza mozkomíšní mok MeSH
- lidé MeSH
- matrixová metaloproteinasa 9 genetika MeSH
- viry klíšťové encefalitidy * genetika MeSH
- Check Tag
- dítě MeSH
- dospělí MeSH
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
Aim: The study aimed to describe nurses' roles, map their views, knowledge, and experiences, and clarify the factors influencing their work and personal life during the Covid-19 pandemic in the Czech Republic. Design: A descriptive and cross-sectional design was used for the study. Methods: A representative sociological survey was conducted. A non-standardized questionnaire was used to collect data; the primary objective was to survey nurses' views, knowledge, and experiences gained during the Covid-19 pandemic and identify essential issues that must be addressed before the next pandemic. The questionnaire contained a total of 57 questions. The sample was constructed by quota sampling; the criteria for inclusion in the sample were the respondents' gender, age, and region. These characteristics were established as representative. The sample consisted of 1,197 nurses. Results: The most commonly reported factor influencing the work of nurses during the Covid-19 pandemic was fear of transmitting the infection (63.6%). Fear of the unknown (59%) and increased workload (54.7%) were also frequently reported to be strong influencers. The responses of nurses were statistically significantly influenced by the type of medical facility in which they worked (p < 0.05) and where they worked during the Covid-19 pandemic (p < 0.001). Most respondents (89.6%) said Covid-19 represented increased physical and mental burdens. Almost the same proportion of respondents (88.4%) felt Covid-19 affected their social lives, and 76.7% reported that it also affected their personal lives. Conclusion: Healthcare facility management should ensure sufficient personal protective equipment (PPE) is available before pandemics and pay close attention to the needs of staff regarding psychological counselling and crisis intervention during pandemics.
Úvod: Výroba a použití rekonvalescentní plazmy (RP) získané od osob, které prodělaly onemocnění COVID-19, se v době pandemie SARS-CoV-2 stala rychle dostupnou léčebnou metodou v řadě zemí, vč. České republiky. V období od dubna 2020 do dubna 2021 bylo v ČR vyrobeno celkem 19 079 transfuzních jednotek (T.U.) RP, z toho 14 197 T.U. bylo vydáno pro cca 7 100 pacientů v 61 nemocnicích. Z celkového počtu 131 000 hospitalizovaných pacientů s COVID-19 za dané období byla RP podána 5,4 % pacientům. Pro zhodnocení účinnosti a bezpečnosti léčby RP onemocnění COVID-19 byla provedena retrospektivní multicentrická studie RESCOVID-19. Materiál a metodika: Primárním cílem studie, do které se zapojilo 6 nemocnic, bylo zhodnocení klinické účinnosti RP v léčbě COVID-19 oproti shodné standardní terapii bez podání RP. Sekundárním cílem bylo zhodnocení vlivu výše hladiny anti-SARS-CoV-2 protilátek (VNP) v RP na přežití a rychlost zotavení. Dále byl zjištěn výskyt a závažnost nežádoucích reakcí spojených s podáním RP. Výsledky: Do studie bylo zařazeno celkem 1 506 pacientů, z toho 414 (27,3 %) léčených RP a 1 092 (72,7 %) bez této léčby (kontrolní skupina). Výsledky modelu logistické regrese ukázaly odhad střední hodnoty pravděpodobnosti přežití 91,8 % u pacientů skupiny s RP podanou do 3 dnů od počátku příznaků (n = 100), což je podobné jako u kontrolní skupiny s pravděpodobností přežití 91,7 %. Nejhorší výsledky pak byly zjištěny u skupiny pacientů s podanou RP po 3. dnu (n = 313), kdy přežití bylo pouze 82,3 %. Nicméně pacienti s RP aplikovanou do 3. dne se zotavili významně dříve oproti kontrolám i nemocným s RP podanou po 3. dnu. Ve studii nebyl prokázán vliv obsahu anti-SARS-CoV-2 protilátek v RP na přežití (78% přežití při VNP ≤ 320, 78% přežití u VNP ≥ 320). Nežádoucí účinky související s podáním RP byly zaznamenány u 2,17 % pacientů; ve všech případech klinicky málo závažné. Závěr: Výsledky studie prokázaly, že podání RP nemělo příznivý vliv na přežití COVID-19, ale pokud byla podána do 3 dnů od počátku příznaků infekce SARS-CoV-2, alespoň vedla k časnějšímu zotavení. Koncentrace anti-SARS-CoV-2 protilátek v RP neměla vliv na přežití ani na rychlost zotavení z COVID-19.
Introduction: The production and use of convalescent plasma (CP) collected from persons after COVID-19 disease became a rapidly available treatment modality in a number of countries, including the Czech Republic, during the SARS-CoV-2 pandemic. Between April 2020 and April 2021, a total of 19,079 CP units were produced in the Czech Republic, of which 14,197 units were dispensed to approximately 7,100 patients in 61 hospitals. Of the total number of 131,000 hospitalized patients with COVID-19 during the given period, CP was administered to 5.4%. The retrospective multicentre RESCOVID-19 study was conducted to evaluate the eff ectiveness and safety of CP treatment of COVID-19 disease. Material and methods: The primary objective of the study, which involved 6 hospitals, was to evaluate the clinical eff ectiveness of CP in the treatment of COVID-19 compared to standard therapy without the administration of CP. The secondary objective was to evaluate the impact of the level of anti-SARS-CoV-2 antibodies in CP on survival and speed of recovery. The incidence and severity of adverse reactions associated with the administration of CP were also determined. Results: A total of 1,506 patients were enrolled in the study, of which 414 (27.3%) were treated with CP and 1092 (72.7%) were without this treatment (control group). The results of the logistic regression model showed a mean survival probability estimate of 91.8% for patients in the CP group administered within 3 days of symptom onset (N = 100), which is similar to the control group with a survival probability of 91.7%. The worst results were found in the group of patients with CP administered after the 3rd day (N = 313) where survival was only 82.3%. However, patients with CP transfused by the 3rd day recovered signifi cantly earlier compared to controls and patients with CP transfused after the 3rd day. The study did not demonstrate an eff ect of the amount of anti-SARS-CoV-2 antibodies in the CP on survival (78% survival with VNP ≤ 320, 78% survival with VNP ≥ 320). Adverse eff ects related to CP administration were recorded in 2.17% of patients; clinically mild in all cases. Conclusion: The results of the study showed that early application of CP accelerated recovery but had no eff ect on COVID-19 survival. The anti-SARS-CoV-2 antibody concentration in CP had no eff ect on survival and speed of recovery.
- Klíčová slova
- rekonvalescentní plazma, studie RESCOVID-19,
- MeSH
- analýza přežití MeSH
- COVID-19 * krev terapie MeSH
- dospělí MeSH
- komorbidita MeSH
- krevní plazma * MeSH
- lidé středního věku MeSH
- lidé MeSH
- multicentrické studie jako téma MeSH
- protilátky virové analýza krev MeSH
- retrospektivní studie MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
OBJECTIVE: Over 480 000 Ukrainian refugees have arrived in the Czech Republic since the Russian invasion of Ukraine in 2022, including over 500 people with HIV. This study describes the demographics, characteristics, and management of Ukrainian refugees with HIV in the Czech Republic. DESIGN: Retrospective, observational, noninterventional study. METHODS: Ukrainian nationals registering at HIV centers in the Czech Republic with war refugee status were included. Data were collected from medical records between 1 March and 31 July 2022. The study was registered with the Czech State Institute for Drug Control, ID number 2301200000. RESULTS: Four hundred and eighty-two patients were included in the study. Most patients were female (69.5%; n = 335/482) with well-controlled HIV. The median [interquartile range] CD4 + cell count was 597 [397] cells/μl of blood, and 79.3% ( n = 361/455) of patients had HIV RNA <40 copies/ml. Coinfections of hepatitis C virus, hepatitis B virus, and/or tuberculosis were reported for 17.4% ( n = 78/449), 9% ( n = 40/446) and 1.3% ( n = 6/446) of patients, respectively. In Ukraine, 85.7% ( n = 384/448) of patients had been receiving an integrase strand transfer inhibitor-based regimen and most (69.7%; n = 310/445) did not switch therapy upon arrival in the Czech Republic. CONCLUSION: Migration from Ukraine is changing the characteristics of HIV epidemiology in the Czech Republic. Ukrainian refugees with HIV have been provided with a high standard of medical care in the Czech Republic. Improved coordination between medical services within the Czech Republic and between countries in the European Union is necessary to optimize patient care.
- MeSH
- HIV infekce * epidemiologie MeSH
- lidé MeSH
- retrospektivní studie MeSH
- tuberkulóza * MeSH
- uprchlíci * MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Česká republika MeSH
Tick-borne encephalitis virus (TBEV) is a flavivirus commonly found in at least 27 European and Asian countries. It is an emerging public health problem, with steadily increasing case numbers over recent decades. Tick-borne encephalitis virus affects between 10,000 and 15,000 patients annually. Infection occurs through the bite of an infected tick and, much less commonly, through infected milk consumption or aerosols. The TBEV genome comprises a positive-sense single-stranded RNA molecule of ∼11 kilobases. The open reading frame is > 10,000 bases long, flanked by untranslated regions (UTR), and encodes a polyprotein that is co- and post-transcriptionally processed into three structural and seven non-structural proteins. Tick-borne encephalitis virus infection results in encephalitis, often with a characteristic biphasic disease course. After a short incubation time, the viraemic phase is characterised by non-specific influenza-like symptoms. After an asymptomatic period of 2-7 days, more than half of patients show progression to a neurological phase, usually characterised by central and, rarely, peripheral nervous system symptoms. Mortality is low-around 1% of confirmed cases, depending on the viral subtype. After acute tick-borne encephalitis (TBE), a minority of patients experience long-term neurological deficits. Additionally, 40%-50% of patients develop a post-encephalitic syndrome, which significantly impairs daily activities and quality of life. Although TBEV has been described for several decades, no specific treatment exists. Much remains unknown regarding the objective assessment of long-lasting sequelae. Additional research is needed to better understand, prevent, and treat TBE. In this review, we aim to provide a comprehensive overview of the epidemiology, virology, and clinical picture of TBE.
Cíl: Téma očkování zdravotníků proti covid-19 je předmětem diskusí především v případě zdravotních sester. Primární otázkou pro tento literární přehled bylo: “Jaké jsou postoje sester vůči očkování proti covid-19 ve srovnání s ostatními typy zdravotnických profesí?” Druhou otázkou bylo, jaký je podíl sester, které se chystají nechat se očkovat a dále co sestrám v očkování brání, a naopak co jim pomůže při rozhodování nechat se očkovat. Metody: Pro přehledovou práci byl použit formát PRISMA-ScR pro přehledy typu scoping review s ohledem na novou oblast vakcín proti covid-19. V databázích (PubMed/MEDLINE, PROquest and EBSCO) byly vyhledány původní studie ze všech zemí světa, publikované v anglickém jazyce před 20. březnem 2022. Ochota nechat se očkovat byla hodnocena v jedné kategorii společně pro zdravotní sestry a studenty ošetřovatelství, zatímco ve druhé kategorii byli ostatní zdravotničtí pracovníci. Vývoj postojů sester k očkování v čase ve vztahu k postoji ostatních zdravotníků byl vyhodnocen post hoc. Faktory spojené s ochotou nechat se očkovat proti covid-19 byly rozděleny podle kategorií WHO (kontextuální vlivy, individuální/ skupinové vlivy a otázky specifické pro očkování/danou vakcínu) a jsou shrnuty v narativním přehledu. Výsledky: Celkem bylo do přehledu zařazeno 58 studií, které všechny měly průřezové dotazníkové uspořádání, a kterých se zúčastnilo 95 418 zdravotníků (včetně 33 130 sester a 7 391 studentů ošetřovatelství) v 44 zemích Evropy, Ameriky, Afriky a Asie. Hlavní kontextuální faktory, které v hodnocených studiích zvyšovaly ochotu nechat se očkovat, byly důvěra ve vědu, důvěra v lékaře, v odborníky a ve vládní instituce, zatímco altruismus a kolektivní ochrana nebo ochrana ohrožených osob v domácnosti dotazovaných zdravotníků byly zmíněny pouze v malém počtu studií. V počátečních obdobích očkování, tedy před uvedením vakcín do praxe, uváděly sestry nižší ochotu nechat se očkovat než lékaři a ostatní zdravotníci a tento rozdíl mezi zdravotnickými profesemi v čase klesal (p = 0,022). Ochota nechat se očkovat se zvyšovala s rostoucím věkem (n = 25 studií), vyšším stupněm dosaženého vzdělání (n = 7), vyšším počtem let v klinické praxi (n = 4) a byla vyšší u mužů než u žen (n = 23). Pouze v malém poštu studií uváděli zdravotníci jako důvod pro očkování pociťované vysoké osobní riziko těžkého průběhu infekce covid-19 (n = 14) nebo práci na covidových jednotkách (n = 5). Mezi hlavní faktory spojené s vakcinací či vakcínou, které zvyšovaly ochotu nechat se očkovat, patřily důvěra ve vakcínu a v její účinnost a bezpečnost, celkový pozitivní vztah k očkování a především absolvované očkování proti chřipce v předchozích letech (n = 21 studií). Významným faktorem spojeným s vyšší ochotou nechat se očkovat patřila “vakcinační gramotnost”, “pochopení vakcinace”, “znalosti o vakcinaci” případně “pochopení výhod a nevýhod očkování” (n = 17 studií). Závěry: Zdravotní sestry byly zpočátku méně ochotné nechat se očkovat proti covid-19 než ostatní zdravotníci, ale tento rozdíl postupem času vymizel. Podobně váhavý vyčkávací postoj sester k očkování se projevuje i v údajích realizovaného očkování zdravotníků proti covid-19, které registruje Ústav zdravotnických informací a statistiky ČR. Důvěra ve vědecké instituce a výrobce vakcín zvyšuje ochotu nechat se očkovat. Tato ochota také roste s rostoucím věkem, vyšším stupněm vzdělání, delší dobou klinické praxe a také je vyšší u mužů. Mezi nezávislé, zevní intervencí potenciálně ovlivnitelné faktory spojené s vyšší ochotou nechat se očkovat patří vakcinační gramotnost a účast v jiném očkovacím programu, především v případě očkování proti sezonní chřipce.
Aim: There is a discussion about COVID-19 vaccination rates among healthcare workers (HCW), especially nurses. The primary question for this review was: “What are the attitudes of nurses, compared to other HCW, towards COVID-19 vaccination?” The secondary questions included the proportion of nurses with intention to get vaccinated, what prevents the nurses from accepting the vaccine and what enables them to accept the vaccine. Methods: The PRISMA-ScR format for scoping reviews was chosen to respect the novelty of COVID-19 vaccines. Database search (PubMed/MEDLINE, PROquest and EBSCO) was performed for original studies in English language, from all geographies, with most recent search on March 20, 2022. Vaccination acceptance rates were charted for nurses and nursing students in one category, and HCW other than nurses in the other category. The evolution in time of the nurses attitude to vaccine acceptance relative to that of HCW other than nurses was charted post hoc. The factors associated with COVID-19 vaccination intention according to the WHO categories (contextual influences, individual/ group influences, and vaccine/vaccination specific issues) were reviewed as narrative summary. Results: Total 58 eligible studies were selected, all with cross-sectional study design, including 95418 healthcare workers of whom 33130 were nurses and 7391 were nursing students, from 44 countries in Europe, Americas, Africa and Asia. Trust in science, in doctors, in experts and in governments were the main contextual factors increasing vaccination acceptance mentioned in the studies, while altruism and collective protection, or protecting a person at risk at home was mentioned only few times. The nurses were less likely to accept vaccination compared to doctors and other HCWs at the onset, eg. before vaccine rollout, and this difference decreased with time (p = 0.022). Being older (n = 25 studies), being male (n = 23), having higher degree of education (n = 7), and having more years of clinical practice (n = 4) were associated with higher vaccination acceptance. Percieved individual risk of having severe COVID-19 (n = 14) or working in a COVID-19 dedicated units (n = 5) was mentioned in a minority of studies. The main vaccine-releated factors associated with higher vaccination intention were trust in the vaccine and its efficacy and safety, general vaccinatoin acceptance and specifically having had influenza vaccination in previous years (n = 21 studies). A significant factor associated with higher vaccine acceptance was high “vaccine knowledge”, “vaccine literacy”, „understanding the vaccine” or “understanding benefits and barriers of vaccination” (n = 17 studies). Conclusions: Nurses have been more hesitant to accept COVID-19 vaccination than other healthcare professions at the beginning, but with time this difference disappeared. This general nurse attitude of wait-and-see reported in the studies corresponds with real-life data from practicing healthcare workers as reported by the Czech Institute of Health Information and Statistics on vaccination against COVID-19. Trust in scientific structures and vaccine makers increases the vaccine acceptance. The acceptance increases also with higher age, increasing level of education, longer clinical experience, and also with being a male. Vaccine literacy and having participated in previous vaccination programmes, especially influenza vaccine, were identified as independent modifiable factors increasing vaccination acceptance.
