COVID-19 Symposium - Challenges in Patient Care and Research Findings
Participants at a high-profile symposium focused on key findings related to COVID-19.
The Austrian healthcare system and research have faced unprecedented challenges in lieu of the COVID 19 pandemic. The pandemic is testing the resilience of medical facilities around the world and at the same time, those involved in research are creating vaccines and new medical treatments at breakneck speed. Scientists, academics, and professionals are working together closely to deliver new findings and share newfound expertise as quickly as possible
The same applies to medical professionals and researchers at the Kepler University Hospital and at the Johannes Kepler University Linz. As soon as it was understood just how the pandemic would impact medical facilities and society, many realized that university medicine had to be more involved with objectives in clinical and translational research.
Two of the COVID-19 symposium organizers, Univ. Prof. Dr. Clemens Schmitt and Prim. Priv.-Doz. Dr. Bernd Lamprecht, remarked: "This high-profile COVID-19 symposium provides an ideal opportunity to not only present the remarkable scientific findings over the past 20 months of the pandemic, but talk about various findings and research approaches and give interested parties an opportunity to hear first-hand how all this has been possible in lieu of conditions related to the pandemic."
Prof. Dr. Meinhard Lukas, Rector at the Johannes Kepler University Linz, offered: "We are currently experiencing the fourth wave of the coronavirus. While it is a stressful and difficult time for everyone, it is also a time that is showing each and every one of us just how important science is. Ambitious researchers have developed effective vaccines in a very short period of time, and scientists are work relentlessly to conduct research on new treatments. We need to listen to the experts and trust their judgment. On behalf of the entire JKU, I would like to thank Prof. Schmitt and Prim. Lamprecht for their valuable efforts and for making this COVID 19 Symposium a reality."
Franz Harnoncourt, CEO of the Kepler University Hospital Ltd., added: "Along with the JKU Faculty of Medicine, the Kepler University Hospital’s main goal is to conduct research that truly reaches people. Today's symposium features researchers and those involved in patient care providing an overview of accomplishments over past 20 months and talking about their triumphs in the field of base-knowledge research as well as healthcare research. I am grateful that we have these kinds of dedicated experts here, especially those who approach the issue of "Covid" from a wide variety of perspectives but always focus on the patients’ well-being."
Priv. Doz. Dr. Karl-Heinz Stadlbauer, medical director at the Kepler University Hospital, stated: "Since the pandemic began, our explicit goal at the Kepler University Hospital has been provide the best patient care possible. To this end, we have to be able to draw on well-founded, scientific findings. The fact that the JKU Faculty of Medicine is now located in close proximity to the hospital is ideal; we can network and the research opportunities are at hand. I am proud to have employees who are among the best in their field, both in research and healthcare."
Overview of Presentations by Medical Professionals and Researchers:
Bernd Lamprecht, deputy Dean of Academic Affairs at the JKU Faculty of Medicine and head of the Department of Pulmonary Medicine at the Kepler University Hospital.
"COVID-19 Healthcare in Upper Austria - Experiences at the Kepler University Hospital":
The Kepler University Hospital has treated over 2,500 patients for COVID-19 since the spring of 2020 and as a result, has acquired a great deal of expertise in the field. From the start, medical professionals acquired experience in treating COVID-19 by actively taking part in large clinical trials, such as SOLIDARITY and DISCOVERY, as well as sharing information with worldwide partners as part of a WHO initiative. In addition, patients had access to proven treatments as well as findings from an interesting range of drug studies (ranging from the "Penninger preparation" to new approaches as part of the Austrian ACOVACT study).
Helmut Salzer, Senior Physician at the Department of Pulmonary Medicine at the Kepler University Hospital
“COVID-19 Clinical Trials”:
We have continuously provided medical care to COVID-19 patients at our infectious diseases ward since the pandemic began. We have always believed in providing translational access to science and working closely with other departments and institutes. As a teaching hospital, we believe it is important to provide our patients with the best evidence-based medicine, but also play our part to provide a better understanding of this new infectious disease by conducting research and collaborating with others. At the start of the pandemic in particular and as part of complex treatment studies, we were able to provide our COVID-19 patients with a therapeutic advantage.
Rupert Langer, head of the Department of Pathology and Molecular Pathology at the JKU, Professor of Pathology and Molecular Pathology at the JKU.
"COVID-19: What is the Pathological Perspective?"
During the initial phase of the pandemic in particular, pathology contributed significantly to describing and understanding the Covid-19 through patient autopsies. We are seeing severe pulmonary damage in almost all patients which vary at different stages depending on the duration and progression of the disease. In addition, we can create a visualization of complications, such as superinfections or fungal infection in the lungs, as well as explore the way other organs respond and are impacted. Post-mortem examinations revealed a high risk of infection, particularly during the earlier period when a vaccine was unavailable. We were able to reduce this by creating techniques for limited and minimally invasive postmortem procedures. The preserved lung tissue and organ samples are available for additional scientific study, i.e. of a molecular genetic nature. The Institute of Clinical Pathology and Molecular Pathology at the KUK has over 1000 preserved tissue samples from over 100 deceased individuals, some of which have been processed to a great extent and are now being further analyzed as a whole.
Jens Meier, head of the Department of Anesthesiology and Operative Intensive Care Medicine, head of the Department of Neuroanesthesiology and Intensive Care Medicine at the Kepler University Hospital, Professor of Anesthesiology and Operative Intensive Care Medicine at the JKU.
"Challenges in Intensive Care to Treat Critically Ill COVID-19 Patients"
Since the start of the first wave, teams at various ICUs have face major challenges in treating COVID-19 patients. While we knew little at the start of the pandemic in regard to ICU treatment and the required safety protocols, as we experienced more waves, we began to realize that caring for COVID-19 patients is highly complex and protracted. ECMO therapy in particular has pushed ICU medicine to its limits.
Soyoung Lee, Professor of Tumor Biology at the JKU
“Virus-Induced Senescence as a Newly Identified Driver and Treatment of COVID-19”:
Prof. Soyoung Lee’s current study shows how host cells respond to a SARS-CoV-2 infection and determine the progression of COVID-19. Viral infection triggers a stress response in host cells that is also a protective program called cellular senescence. While senescent cells stop proliferating and halt the proliferation of damaged cells, at the same time they create signals (cytokines) that activate inflammatory cascades, damaging the patient's organs. In this regard, targeting senescent cells may reduce the massive release of cytokines ("cytokine storm") and lung damage, thereby giving us a new option to treat COVID-19 patients.
Rainer Hintenberger, Senior Physician at the Department of Internal Medicine - Gastroenterology/Hepatology at the Kepler University Hospital
"B and T Cell Specific Vaccination Response in Recovered and Non-Recovered KUK Employees:
The present study shows that hospital personnel are at high risk of contracting COVID-19. Recovered medical personnel have a good vaccine response on B and T-cell level after receiving one dose of the vaccine compared to those who were not infected with COVID-19.
Clemens Schmitt, head of the Department of Hematology and Internal Oncology at the Kepler University Hospital, Professor of Hematology and Internal Oncology at the JKU
"Humoral and Cellular Immune Response to mRNA-based SARS-CoV-2 Vaccines in Cancer Patients"
A study focused on 87 tumor patients and 44 control subjects in regard to antibody-based and cell-based immune responses after two doses of SARS-CoV-2 mRNA vaccine.
Approximately one-quarter of the tumor patients did not attain a positive antibody response whereas all of the control subjects developed antibodies. In the tumor group, patients with hematologic tumors in particular (such as lymphoma) - and especially after CD20 antibody therapy - contribute to the lack of success in developing antibodies after receiving the vaccine.
Only about 10% of all tumor patients actively receiving drug therapy display a complete lack of antibody-based and T-cell-based immune response; however, about 30% show either a lack of antibody or a lack of T-cell responses. Follow-up studies intend to show how long T-cell immune responses alone last and to what extent they protect against severe COVID-19 progression.
Daniel Kiblböck, Senior Physician at the Department of Cardiology and Internal Intensive Care Medicine at the Kepler University Hospital
"Bioptic Evaluation of Suspected Myocarditis Cases after the mRNA-SARS-CoV-2 Vaccination":
The European Medicines Agency (EMA) has reported an increase of myocarditis after receiving the mRNA-SARS-CoV-2 vaccination. Our study in cooperation with the Cardiopathology Department of the University Hospital Tübingen explored myocardial biopsies in 24 patients suspected of myocarditis after receiving the mRNA-SARS-CoV-2 vaccination. In addition to cases of acute lymphocytic myocarditis, we saw cases of chronic and healing myocarditis as well as cardiac sarcoidosis and cases of non-specific myocardial damage. This seldom seen side effect of the mRNA-SARS-CoV-2 vaccination should not, however, lessen its value as a very important preventive measure to combat the global COVID-19 pandemic.
Sabine Enengl, Senior Physician at the Department of Gynecology, Obstetrics and Gynecological Endocrinology
"COVID-19 and Pregnancy":
Pregnant women are showing an increased risk of a severe course of the SARS-CoV-2 infection compared to the non-pregnant patient population, even if most patients have no, or only mild, symptoms. To date, approximately 170 recovered or ill patients have delivered babies at the Department of Gynecology, Obstetrics, and Gynecologic Endocrinology at the KUK. One patient was critically ill and needed intensive medical care. By analyzing the immunizing antibodies in the umbilical cord blood of affected patients, we can draw conclusions about how to potentially protect newborns from an infection.n.
Wolfram Hötzenecker, head of the Department of Dermatology and Venereology, Professor of Dermatology and Venereology at the JKU
"COVID-19 from a Dermatological Perspective":
Covid-19 is visible on the skin: As part of a study, scientists and physicians at the Department of Dermatology studied skin symptoms in patients infected with COVID-19. Although these "skin rashes" are not diagnostically useful, they occur in about 20% of patients as an accompanying symptom.
Irene Tiemann-Boege, Professor at the JKU Institute of Biophysics
“Optimizing the SARS-CoV-2 PCR Test”:
What is really behind a PCR test for the coronavirus? The media regularly touts PCR testing in its reports and expects everyone to understand, but do they really? The presentation focused on explaining what a PCR test is, its advantages and limitations, and how it compares to the standard rapid antigen test to detect a COVID-19 infection.
David Bernhard, head of the Center for Medical Research at the JKU Faculty of Medicine, Professor at the Institute of Physiology and Pathophysiology / Department of Pathophysiology at the JKU.
"Developing SARS-CoV-2 for Testing at Schools":
Since the start of the pandemic, advances in clinical research have made detecting and treating SARS-CoV2 arguably unique in the history of medicine. The speed and quality to develop new, high-quality tests and testing systems to detect infection and build antibodies to protect against SARS-CoV2 is equally as unique. Our developments in the area of testing and their applications, particularly as part of an Austria-wide study on schools and at Upper Austrian pharmacies, have generated exciting findings.
Tim von Oertzen, head of the Department of Neurology 1 at the Kepler University Hospital, Hhad of the Center for Geriatric Medicine
"Long COVID and Post COVID from a Neurological Perspective"
Symptoms persisting for more than 28 days after having contracted COVID is called Long COVID; symptoms persisting for over three months is referred to as Post-COVID Syndrome. The Neurology Department created a Post COVID Outpatient Clinic. Most of the affected patients had a mild case of COVID-19 and did not require hospitalization. The most common symptom is fatigue (chronic fatigue). We are conducting a prospective exploratory study parallel to the outpatient clinic to identify molecular biomarkers related to inflammation, thrombophilia, neurodegeneration and genetic predisposition in patients who neurologically show long COVID symptoms.