Specific adverse outcomes associated with selective serotonin reuptake inhibitors use in COVID-19 patients might be potentiated by remdesivir use

Background: Due to non-consistent reports in the literature, there are uncertainties about the potential benefits and harms of selective serotonin reuptake inhibitors (SSRIs) in patients with Coronavirus disease 2019 (COVID-19). Aim: To investigate associations of SSRIs with clinical characteristics and unwanted outcomes among real-life severe and critical COVID-19 patients and their relationship with remdesivir (RDV) use. Methods: This retrospective cohort study evaluated a total of 1558 COVID-19 patients of the white race treated in a tertiary center institution, among them 779 patients treated with RDV and 779 1:1 case-matched patients. Results: A total of 78 (5%) patients were exposed to SSRIs during hospitalization, similarly distributed among patients treated with RDV and matched patients (5.1 and 4.9%). No significant associations of SSRI use with age, sex, comorbidity burden, and COVID-19 severity were present in either of the two cohorts (p < 0.05 for all analyses). In multivariate analyses adjusted for clinically meaningful variables, SSRI use was significantly associated with higher mortality among RDV (adjusted odds ratio (aOR) 2.0, p = 0.049) and matched patients (aOR 2.22, p = 0.044) and with higher risk for mechanical-ventilation (aOR 2.57, p = 0.006), venous-thromboembolism (aOR 3.69, p = 0.007), and bacteremia (aOR 2.22, p = 0.049) among RDV treated patients. Conclusions: Adverse outcomes associated with SSRI use in COVID-19 patients might be potentiated by RDV use, and clinically significant interactions between these two drug classes might exist. Although our findings raise important considerations for clinical practice, they are limited by retrospective nature of the study, lack of ethnic diversity, and the potential for unmeasured confounding factors. Future studies exploring underlying biological mechanisms are needed

Neuro-cognitive mechanisms of simultanagnosia in patients with posterior cortical atrophy

Posterior cortical atrophy is dominated by progressive degradation of parieto-occipital grey and white matter, and represents in most cases a variant of Alzheimer's disease. Patients with posterior cortical atrophy are characterized by increasing higher visual and visuo-spatial impairments. In particular, a key symptom of posterior cortical atrophy is simultanagnosia i.e. the inability to perceive multiple visual objects at the same time. Two neuro-cognitive mechanisms have been suggested to underlie simultanagnosia, either reduced visual short-term memory capacity or decreased visual processing speed possibly resulting from white matter impairments over and above damage to cortical brain areas. To test these distinct hypotheses, we investigated a group of 12 patients suffering from posterior cortical atrophy with homogenous lesion sides in parieto-occipital cortices and varying severity of grey and white matter loss. More specifically, we (i) tested whether impaired short-term memory capacity or processing speed underlie symptoms of simultanagnosia; (ii) assessed the link to grey and white matter damage; and (iii) integrated those findings into a neuro-cognitive model of simultanagnosia in patients with posterior cortical atrophy. To this end, simultaneous perception of multiple visual objects was tested in patients with posterior cortical atrophy mostly with positive Alzheimer's disease biomarkers and healthy age-matched controls. Critical outcome measures were identification of overlapping relative to non-overlapping figures and visuo-spatial performance in tests sensitive to simultanagnosia. Using whole report of briefly presented letter arrays based on the mathematically formulated 'Theory of Visual Attention', we furthermore quantified parameters of visual short-term memory capacity and visual processing speed. Grey and white matter atrophy was assessed by voxel-based morphometry analyses of structural magnetic resonance data. All patients showed severe deficits of simultaneous perception. Compared to controls, we observed a specific slowing of visual processing speed, while visual short-term memory capacity was preserved. In a regression analysis, processing speed was identified as the only significant predictor of simultaneous perception deficits that explained a high degree of variance (70-82%) across simultanagnosia tasks. More severe slowing was also indicative for more severe impairments in reading and scene comprehension. Voxel-based morphometry yielded extensive reductions of grey and white matter in parieto-occipital and thalamic brain areas. Importantly, the degree of individual atrophy of white matter in left superior parietal lobe, but not of any grey matter region, was associated with processing speed. Based on these findings, we propose that atrophy of white matter commonly observed in posterior cortical atrophy leads to slowing of visual processing speed, which underlies the overt clinical symptoms of simultanagnosia

Real-life experience with remdesivir for treatment of hospitalized coronavirus disease 2019 patients: matched case-control study from a large tertiary hospital registry

Aim: To evaluate the association of remdesivir use and the survival of hospitalized patients with coronavirus disease 2019 (COVID-19). ----- Methods: We retrospectively reviewed the medical records of 5959 COVID-19 patients admitted to our tertiary-level hospital from March 2020 to June 2021. A total of 876 remdesivir-treated patients were matched with 876 control patients in terms of age, sex, Charlson comorbidity index (CCI), WHO-defined COVID-19 severity on admission, and oxygen requirement at the time of remdesivir use. ----- Results: Among 1752 COVID-19 patients (median age 66 years, 61.8% men), 1405 (80.2%) had severe and 311 (17.8%) had critically severe COVID-19 on admission. Remdesivir was given at a median of one day after hospital admission and at a median of eight days from the onset of symptoms. Overall, 645 (73.6%) patients received remdesivir before high-flow oxygen therapy (HFOT) or mechanical ventilation (MV), 198 (22.6%) after HFOT institution, and 83 (9.5%) after MV institution. Remdesivir use was associated with improved survival in the entire cohort (hazard ratio 0.79, P=0.006). Survival benefit was evident among patients receiving remdesivir during low-flow oxygen requirement (hazard ratio 0.61, P<0.001) but not among patients who received it after starting HFOT (P=0.499) or MV (P=0.380). ----- Conclusion: Remdesivir, if given during low-flow oxygen therapy, might be associated with survival benefit in hospitalized COVID-19 patients

Datenflut und Informationskanäle

Im Digitalzeitalter haben die Produktion, Verbreitung und Speicherung von Daten gigantische Ausmaße angenommen. Pro Minute werden weltweit fast 140 Millionen E-Mails verschickt, 100 Stunden Videomaterial auf YouTube hochgeladen, 350.000 Tweets geschrieben, 970 neue Blogeinträge von Wordpress-Usern veröffentlicht und 240.000 Fotos auf Facebook hochgeladen — Tendenz steigend. Abgesehen von der expliziten Erstellung von Daten sind wir alle selbst als Mediennutzer und Konsumenten Datenquellen. Diese Daten sind bereits zu einem monetär relevanten, maßgeblichen Bestandteil gezielten Marketings geworden. Unter dem Schlagwort „Open Data“ wird auch gegenüber dem Staat gefordert, öffentliche Verwaltungsdaten für alle verfügbar und nutzbar zu machen. Gleichzeitig bieten Enthüllungsplattformen à la WikiLeaks gerade geheimen und vertraulichen Daten eine breite Öffentlichkeit. Und auch immer mehr Unternehmen und politische Parteien wollen aus der Datenflut im Netz Profit schlagen. Mit statistisch-algorithmischen Methoden wird beim sogenannten „data mining“ versucht, Wissenswertes aus dem Datenberg ans Licht zu befördern. „Digital Humanities“ verfolgen das Ziel, neue Fragestellungen und Erkenntnismodelle für die Geisteswissenschaften zu generieren

Medienräume

Die Mehrdeutigkeit des Schlagwortes Raum zieht vielschichtige Interpretationen, Fragestellungen, Theorien und Analysemethoden für die Kategorie des Raumlichen nach sich. Diese Pluralitatder Deutungen und disziplinaren Zugange gilt in ahnlicher Weise für den Untersuchungsgegenstand Medien. Der vorliegende Sammelband biindelt Forschungsansatze aus so unterschiedlichen Disziplinen wie Medien- und Kommunikationswissenschaft, Bildungswissenschaft, Sprachwissenschaft, Ethnologie, Géographie und Architektur. Auf der einen Seite zeigen sich régionale Medienraume eng mit dem globalen Mediensystem verwoben. Auf der anderen Seite kann zwischen materiellen und immateriellen Raumen unterschieden werden. Wahrend einige Beitrage dieses reichhaltige Forschungsgebiet theoretisch abstecken, zeigen einige Beitrage mögliche Anknüpfungspunkte für die Praxis auf

Medienräume

Die Mehrdeutigkeit des Schlagwortes Raum zieht vielschichtige Interpretationen, Fragestellungen, Theorien und Analysemethoden für die Kategorie des Raumlichen nach sich. Diese Pluralitatder Deutungen und disziplinaren Zugange gilt in ahnlicher Weise für den Untersuchungsgegenstand Medien. Der vorliegende Sammelband biindelt Forschungsansatze aus so unterschiedlichen Disziplinen wie Medien- und Kommunikationswissenschaft, Bildungswissenschaft, Sprachwissenschaft, Ethnologie, Géographie und Architektur. Auf der einen Seite zeigen sich régionale Medienraume eng mit dem globalen Mediensystem verwoben. Auf der anderen Seite kann zwischen materiellen und immateriellen Raumen unterschieden werden. Wahrend einige Beitrage dieses reichhaltige Forschungsgebiet theoretisch abstecken, zeigen einige Beitrage mögliche Anknüpfungspunkte für die Praxis auf