nach oben

Die Gastroenterologie

Erschienen in:

11.11.2020 | Computertomografie | Schwerpunkt Zur Zeit gratis

COVID-19-Pneumonie

verfasst von: Prof. Dr. M. Pfeifer, O. W. Hamer

Erschienen in: Die Gastroenterologie | Ausgabe 6/2020

Einloggen, um Zugang zu erhalten

Zusammenfassung

Die Prognose der pandemisch auftretenden Coronavirus Disease 2019 (COVID-19) wird wesentlich durch das Ausmaß der Infektion der unteren Atemwege mit dem „severe acute respiratory syndrome coronavirus 2“ (SARS-CoV-2) bestimmt. Auch wenn die Mehrzahl der Patienten einen milden Verlauf zeigt, ist die Entwicklung einer Pneumonie mit dem Risiko einer schweren respiratorischen Insuffizienz verbunden. Neben der Virusdiagnostik an Material aus den oberen und/oder unteren Atemwegen hat sich die radiologische Diagnostik mittels hochauflösender Computertomographie (HRCT) als wichtige Methode für die Erkennung und das Verlaufsmonitoring der Erkrankung etabliert. In dem Übersichtsartikel wird neben der Darstellung der klinischen Zeichen und der komplexen und besonderen Pathophysiologie dieser Pneumonie detailliert auf die typischen radiologischen Muster eingegangen, deren Erkennen für die Beurteilung der Erkrankung und der möglichen therapeutischen Ansätze von Bedeutung ist. Bisher ist die Therapie im Wesentlichen symptombezogen und wird vor allem durch die intensivmedizinische Stabilisierung der respiratorischen Insuffizienz bestimmt. Aktuell zeigen sich dabei erste Ansätze einer gezielten medikamentöse Therapie mit antiviralen und antiinflammatorischen Substanzen.

Ai T, Yang Z, Hou H, Zhan C, Chen C, Lv W et al (2020) Correlation of chest CT and RT-PCR testing in coronavirus disease 2019 (COVID-19) in China: a report of 1014 cases. Radiology. https://doi.org/10.1148/radiol.2020200642CrossRefPubMedPubMedCentral

Zhu N, Zhang D, Wang W, Li X, Yang B, Song J et al (2020) A novel Coronavirus from patients with pneumonia in China, 2019. N Engl J Med 382(8):727–733CrossRef

Cheung KS, Hung IF, Chan PP, Lung KC, Tso E, Liu R et al (2020) Gastrointestinal manifestations of SARS-coV‑2 infection and virus load in fecal samples from the Hong Kong cohort and systematic review and meta-analysis. Gastroenterology. https://doi.org/10.1053/j.gastro.2020.03.065CrossRefPubMedPubMedCentral

Haider N, Yavlinsky A, Simons D, Osman AY, Ntoumi F, Zumla A et al (2020) Passengers’ destinations from China: low risk of novel Coronavirus (2019-ncoV) transmission into africa and South America. Epidemiol Infect 148:e41CrossRef

Salje H, Kiem TC, Lefrancq N, Courtejoie N, Bosetti P, Paireau J et al (2020) Estimating the burden of SARS-CoV‑2 in France. Science 369(6500):208–211CrossRef

Channappanavar R, Perlman S (2017) Pathogenic human coronavirus infections: causes and consequences of cytokine storm and immunopathology. Semin Immunopathol 39(5):529–539CrossRef

Peiris JS, Chu CM, Cheng VC, Chan KS, Hung IF, Poon LL et al (2003) Clinical progression and viral load in a community outbreak of coronavirus-associated SARS pneumonia: a prospective study. Lancet 361(9371):1767–1772CrossRef

Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J et al (2020) Clinical characteristics of 138 hospitalized patients with 2019 novel Coronavirus-infected pneumonia in Wuhan, China. JAMA. https://doi.org/10.1001/jama.2020.1585CrossRefPubMedPubMedCentral

Ruan Q, Yang K, Wang W, Jiang L, Song J (2020) Clinical predictors of mortality due to COVID-19 based on an analysis of data of 150 patients from Wuhan, China. Intensive Care Med. https://doi.org/10.1007/s00134-020-05991-xCrossRefPubMedPubMedCentral

10.

Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z et al (2020) Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet 395(10229):1054–1062CrossRef

11.

Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y et al (2020) Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 395(10223):497–506CrossRef

12.

Sinha P, Matthay MA, Calfee CS (2020) Is a “cytokine storm” relevant to COVID-19? JAMA Intern Med. https://doi.org/10.1001/jamainternmed.2020.3313CrossRefPubMed

13.

Wichmann D, Sperhake JP, Lutgehetmann M, Steurer S, Edler C, Heinemann A et al (2020) Autopsy findings and venous thromboembolism in patients with COVID-19. Ann Intern Med. https://doi.org/10.7326/m20-2003CrossRefPubMedPubMedCentral

14.

Patel BV, Arachchillage DJ, Ridge CA, Bianchi P, Doyle JF, Garfield B et al (2020) Pulmonary angiopathy in severe COVID-19: physiologic, imaging, and hematologic observations. Am J Respir Crit Care Med 202(5):690–699CrossRef

15.

Ackermann M, Verleden SE, Kuehnel M, Haverich A, Welte T, Laenger F et al (2020) Pulmonary vascular endothelialitis, thrombosis, and angiogenesis in Covid-19. N Engl J Med. https://doi.org/10.1056/nejmoa2015432CrossRefPubMed

16.

Force ADT, Ranieri VM, Rubenfeld GD, Thompson BT, Ferguson ND, Caldwell E et al (2012) Acute respiratory distress syndrome: the Berlin definition. JAMA 307(23):2526–2533

17.

Han R, Huang L, Jiang H, Dong J, Peng H, Zhang D (2020) Early clinical and CT manifestations of Coronavirus disease 2019 (COVID-19) pneumonia. AJR Am J Roentgenol. https://doi.org/10.2214/AJR.20.22961CrossRefPubMed

18.

Zhao W, Zhong Z, Xie X, Yu Q, Liu J (2020) Relation between chest CT findings and clinical conditions of Coronavirus disease (COVID-19) pneumonia: a multicenter study. AJR Am J Roentgenol. https://doi.org/10.2214/AJR.20.22976CrossRefPubMed

19.

Zhang L, Liu Y (2020) Potential interventions for novel Coronavirus in China: a systematic review. J Med Virol. https://doi.org/10.1002/jmv.25707CrossRefPubMedPubMedCentral

20.

Brochard L, Slutsky A, Pesenti A (2017) Mechanical ventilation to minimize progression of lung injury in acute respiratory failure. Am J Respir Crit Care Med 195(4):438–442CrossRef

21.

Barach A, Martin J, Eckman M (1938) Positive pressure respiration and its application to the treatment of acute pulmonary edema. Ann Intern Med 12:754–759CrossRef

22.

Barach AL, Eckman M et al (1946) Studies on positive pressure respiration; general aspects and types of pressure breathing; effects on respiration and circulation at sea level. J Aviat Med 17:290–232PubMed

23.

Mascheroni D, Kolobow T, Fumagalli R, Moretti MP, Chen V, Buckhold D (1988) Acute respiratory failure following pharmacologically induced hyperventilation: an experimental animal study. Intensive Care Med 15(1):8–14CrossRef

24.

Yoshida T, Grieco DL, Brochard L, Fujino Y (2020) Patient self-inflicted lung injury and positive end-expiratory pressure for safe spontaneous breathing. Curr Opin Crit Care 26(1):59–65CrossRef

25.

Gattinoni L et al (2020) COVID-19 pneumonia: different respiratory treatment for different phenotypes? Intensive Care Med. https://doi.org/10.1007/s00134-020-06033-2CrossRefPubMedPubMedCentral

26.

Gattinoni L, Coppola S, Cressoni M, Busana M, Rossi S, Chiumello D (2020) Covid-19 does not lead to a “typical” acute respiratory distress syndrome. Am J Respir Crit Care Med. https://doi.org/10.1164/rccm.202003-0817LECrossRefPubMedPubMedCentral

27.

Xu Z et al (2020e) Pathological findings of COVID-19 associated with acuterespiratory distress syndrome. Lancet Respir Med. https://doi.org/10.1016/S2213-2600(20)30076-XCrossRefPubMedPubMedCentral

28.

Ding Y, Wang H, Shen H, Li Z, Geng J, Han H et al (2003) The clinical pathology of severe acute respiratory syndrome (SARS): a report from China. J Pathol 200(3):282–289CrossRef

29.

Ng DL, Al Hosani F, Keating MK, Gerber SI, Jones TL, Metcalfe MG et al (2016) Clinicopathologic, immunohistochemical, and ultrastructural findings of a fatal case of middle east respiratory syndrome Coronavirus infection in the united Arab emirates, April 2014. Am J Pathol 186(3):652–658CrossRef

30.

Grasselli G, Pesenti A, Cecconi M (2020) Critical care utilization for the COVID-19 outbreak in Lombardy, Italy: early experience and forecast during an emergency response. JAMA. https://doi.org/10.1001/jama.2020.4031CrossRefPubMedPubMedCentral

31.

Wang Y, Dong C, Hu Y, Li C, Ren Q, Zhang X et al (2020) Temporal changes of CT findings in 90 patients with COVID-19 pneumonia: a longitudinal study. Radiology. https://doi.org/10.1148/radiol.2020200843CrossRefPubMedPubMedCentral

32.

Linton NM, Kobayashi T, Yang Y, Hayashi K, Akhmetzhanov AR, Jung SM et al (2020) Incubation period and other epidemiological characteristics of 2019 novel Coronavirus infections with right truncation: a statistical analysis of publicly available case data. J Clin Med. https://doi.org/10.3390/jcm9020538CrossRef

33.

Guo T, Fan Y, Chen M, Wu X, Zhang L, He T et al (2020) Cardiovascular Implications of Fatal Outcomes of Patients With Coronavirus Disease 2019 (COVID-19). JAMA Cardiol. https://doi.org/10.1001/jamacardio.2020.1017CrossRefPubMedPubMedCentral

34.

Cui S, Chen S, Li X, Liu S, Wang F (2020) Prevalence of venous thromboembolism in patients with severe novel coronavirus pneumonia. J Thromb Haemost. https://doi.org/10.1111/jth.14830CrossRefPubMedPubMedCentral

35.

Fox SE, Akmatbekov A, Harbert JL, Li G, Quincy Brown J, Vander Heide RS (2020) Pulmonary and cardiac pathology in African American patients with COVID-19: an autopsy series from New Orleans. Lancet Respir Med. https://doi.org/10.1016/S2213-2600(20)30243-5CrossRefPubMedPubMedCentral

36.

Fan E, Beitler JR, Brochard L, Calfee CS, Ferguson ND, Slutsky AS et al (2020) COVID-19-associated acute respiratory distress syndrome: is a different approach to management warranted? Lancet Respir Med. https://doi.org/10.1016/s2213-2600(20)30304-0CrossRefPubMedPubMedCentral

37.

Dohla M, Boesecke C, Schulte B, Diegmann C, Sib E, Richter E et al (2020) Rapid point-of-care testing for SARS-CoV‑2 in a community screening setting shows low sensitivity. Public Health 182:170–172CrossRef

38.

Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX et al (2020) Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. https://doi.org/10.1101/2020.02.06.20020974CrossRefPubMedPubMedCentral

39.

Cummings MJ, Baldwin MR, Abrams D, Jacobson SD, Meyer BJ, Balough EM et al (2020) Epidemiology, clinical course, and outcomes of critically ill adults with COVID-19 in New York City: a prospective cohort study. Lancet 395(10239):1763–1770CrossRef

40.

Wong HYF, Lam HYS, Fong AH, Leung ST, Chin TW, Lo CSY et al (2019) Frequency and distribution of chest radiographic findings in COVID-19 positive patients. Radiology. https://doi.org/10.1148/radiol.2020201160CrossRefPubMed

41.

Vogel-Claussen J, Ley-Zaporozhan J, Agarwal P, Biederer J, Kauczor HU, Ley S et al (2020) Recommendations of the Thoracic Imaging Section of the German Radiological Society for clinical application of chest imaging and structured CT reporting in the COVID-19 pandemic. Rofo 192(7):633–640CrossRef

42.

Revel MP, Parkar AP, Prosch H, Silva M, Sverzellati N, Gleeson F et al (2020) COVID-19 patients and the radiology department—advice from the European Society of Radiology (ESR) and the European Society of Thoracic Imaging (ESTI). Eur Radiol. https://doi.org/10.1007/s00330-020-06865-yCrossRefPubMedPubMedCentral

43.

Simpson S, Kay FU, Abbara S, Bhalla S, Chung JH, Chung M et al (2020) Radiological society of north America expert consensus statement on reporting chest CT findings related to COVID-19. Endorsed by the society of thoracic radiology, the American college of radiology, and RSNA—secondary publication. J Thorac Imaging 35(4):219–227CrossRef

44.

Kim H, Hong H, Yoon SH (2020) Diagnostic performance of CT and reverse transcriptase-polymerase chain reaction for Coronavirus disease 2019: a meta-analysis. Radiology. https://doi.org/10.1148/radiol.2020201343CrossRefPubMedPubMedCentral

45.

Schaible J, Meiler S, Poschenrieder F, Scharf G, Maintz D, Pregler B et al (2020) Radiology of COVID-19 pneumonia—pictorial essay and structured reporting. Rofo 192(6):513–517CrossRef

46.

Stoecklin BS, Rolland P, Silue Y, Mailles A, Campese C, Simondon A et al (2020) First cases of coronavirus disease 2019 (COVID-19) in France: surveillance, investigations and control measures, January 2020. Euro Surveill. https://doi.org/0.2807/1560-7917.ES.2020.25.6.2000094

47.

Zhou S, Wang Y, Zhu T, Xia L (2020) CT features of Coronavirus disease 2019 (COVID-19) pneumonia in 62 patients in Wuhan, China. AJR Am J Roentgenol 214(6):1287–1294CrossRef

48.

Kanne JP, Little BP, Chung JH, Elicker BM, Ketai LH (2020) Essentials for radiologists on COVID-19: an update-radiology scientific expert panel. Radiology. https://doi.org/10.1148/radiol.2020200527CrossRefPubMedPubMedCentral

49.

Grant MC, Geoghegan L, Arbyn M, Mohammed Z, McGuinness L, Clarke EL et al (2020) The prevalence of symptoms in 24,410 adults infected by the novel coronavirus (SARS-CoV‑2; COVID-19): A systematic review and meta-analysis of 148 studies from 9 countries. PLoS ONE 15(6):e234765CrossRef

50.

Lechien JR, Chiesa-Estomba CM, Hans S, Barillari MR, Jouffe L, Saussez S (2020) Loss of smell and taste in 2013 European patients with mild to moderate COVID-19. Ann Intern Med. https://doi.org/10.7326/M20-2428CrossRefPubMedPubMedCentral

51.

ICNARC (2020) ICNARC report on COVID-19

52.

Karagiannidis C, Mostert C, Hentschker C, Voshaar T, Malzahn J, Schillinger G et al (2020) Case characteristics, resource use, and outcomes of 10021 patients with COVID-19 admitted to 920 German hospitals: an observational study. Lancet Respir Med 8(9):853–862CrossRef

53.

Kluge S, Janssens U, Welte T, Weber-Carstens S, Schälte G, Salzberger B et al (2020) Empfehlungen zur intensivmedizinischen Therapie von Patienten mit COVID-19 (S1-Leitlinie). www.awmf.org

54.

Fichtner F, Moerer O, Laudi S, Weber-Carstens S, Nothacker M, Kaisers U et al (2018) Mechanical ventilation and Extracorporeal membrane oxygena tion in acute respiratory insufficiency. Dtsch Arztebl Int 115(50):840–847PubMedPubMedCentral

55.

Pfeifer M, Ewig S, Voshaar T, Randerath W, Bauer T, Geiseler J et al (2020) Position paper for the state of the art application of respiratory support in patients with COVID-19—German respiratory society. Pneumologie. https://doi.org/10.1159/000509104CrossRefPubMedPubMedCentral

56.

Langer F, Kluge S, Klamroth R, Oldenburg J (2020) Coagulopathy in COVID-19 and its implication for safe and efficacious thromboprophylaxis. Hamostaseologie. https://doi.org/10.1055/a-1178-3551CrossRefPubMedPubMedCentral

57.

Horby PW, Mafham M, Bell JL, Linsell L, Staplin N, Emberson J et al (2020) Lopinavin-ritonavir in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial. Lancet. https://doi.org/10.1016/S0140-6736(20)32013-4CrossRef

58.

Pan F, Ye T, Sun P, Gui S, Liang B, Li L et al (2020) Time course of lung changes on chest CT during recovery from 2019 novel Coronavirus (COVID-19) pneumonia. Radiology. https://doi.org/10.1148/radiol.2020200370CrossRefPubMedPubMedCentral

59.

Beigel JH, Tomashek KM, Dodd LE, Mehta AK, Zingman BS, Kalil AC et al (2020) Remdesivir for the treatment of Covid-19—final report. N Engl J Med. https://doi.org/10.1056/NEJMoa2007764CrossRefPubMedPubMedCentral

60.

Wang Y, Zhang D, Du G, Du R, Zhao J, Jin Y et al (2020) Remdesivir in adults with severe COVID-19: a randomised, double-blind, placebo-controlled, multicentre trial. Lancet 395(10236):1569–1578CrossRef

61.

Cala-Garcia JD, Sierra-Breton JD, Cavelier-Baiz JE, Faccini-Martinez AA, Perez-Diaz CE (2020) Recovery of COVID-19 acute respiratory distress syndrome with tocilizumab: successful outcome in two critically ill patients. Immunotherapy. https://doi.org/10.2217/imt-2020-0154CrossRefPubMedPubMedCentral

62.

Coyle J, Igbinomwanhia E, Sanchez-Nadales A, Danciu S, Chu C, Shah N (2020) A recovered case of COVID-19 Myocarditis and ARDS treated with Corticosteroids, Tocilizumab, and experimental AT-001. J Am Coll Cardiol. https://doi.org/10.1016/j.jaccas.2020.04.025CrossRef

63.

Toniati P, Piva S, Cattalini M, Garrafa E, Regola F, Castelli F et al (2020) Tocilizumab for the treatment of severe COVID-19 pneumonia with hyperinflammatory syndrome and acute respiratory failure: A single center study of 100 patients in Brescia, Italy. Autoimmun Rev. https://doi.org/10.1016/j.autrev.2020.102568CrossRefPubMedPubMedCentral

64.

Cavalli G, De Luca G, Campochiaro C, Della-Torre E, Ripa M, Canetti D et al (2020) Interleukin‑1 blockade with high-dose anakinra in patients with COVID-19, acute respiratory distress syndrome, and hyperinflammation: a retrospective cohort study. Lancet Rheumatol 2(6):e325–e331CrossRef

65.

Fu B, Xu X, Wei H (2020) Why tocilizumab could be an effective treatment for severe COVID-19? J Transl Med 18(1):164CrossRef

66.

Munoz-Jimenez A, Rubio-Romero E, Marenco de la Fuente JL (2020) Proposal for the use of anakinra in acute respiratory distress secondary to COVID-19. Reumatol Clin. https://doi.org/10.1016/j.reuma.2020.04.009CrossRefPubMedPubMedCentral

67.

Villar J, Ferrando C, Martinez D, Ambros A, Munoz T, Soler JA et al (2020) Dexamethasone treatment for the acute respiratory distress syndrome: a multicentre, randomised controlled trial. Lancet Respir Med 8(3):267–276CrossRef

68.

The RECOVERY Collaborative Group. (2020) Dexamethasone in hospitalized patients with Covid-19—preliminary report. N Engl J Med. https://doi.org/10.1056/NEJMoa2021436CrossRefPubMedCentral

69.

Tomazini BM, Maia IS, Cavalcanti AB, Berwanger O, Rosa RG, Veiga VC et al (2020) Effect of dexamethasone on days alive and ventilator-free in patients with moderate or severe acute respiratory distress syndrome and COVID-19: the coDEX randomized clinical trial. JAMA 324(13):1307–1316CrossRef

70.

Investigators TWCftR‑C (2020) Effect of hydrocortisone on mortality and organ support in patients with severe COVID-19: the REMAP-CAP COVID-19 corticosteroid domain randomized clinical trial. JAMA 324(13):1317–1329CrossRef

71.

Group TWREAfC-TW (2020) Association between administration of systemic corticosteroids and mortality among critically ill patients with COVID-19: a meta-analysis. JAMA 324(13):1330–1341CrossRef

72.

Kolditz M, Dellweg D, Geerdes-Fenge H, Lepper PM, Schaberg T, Ewig S et al (2020) Treatment with dexamethasone in patients with COVID-19—a position paper of the German respiratory society (DGP). Pneumologie. https://doi.org/10.1055/a-1216-5739CrossRefPubMedPubMedCentral

73.

Salazar E, Christensen PA, Graviss EA, Nguyen DT, Castillo B, Chen J et al (2020) Treatment of Coronavirus disease 2019 patients with convalescent plasma reveals a signal of significantly decreased mortality. Am J Pathol. https://doi.org/10.1016/j.ajpath.2020.08.001CrossRefPubMedPubMedCentral

74.

Valk SJ, Piechotta V, Chai KL, Doree C, Monsef I, Wood EM et al (2020) Convalescent plasma or hyperimmune immunoglobulin for people with COVID-19: a rapid review. Cochrane Database Syst Rev. https://doi.org/10.1002/14651858.CD013600CrossRefPubMed

75.

Li L, Zhang W, Hu Y, Tong X, Zheng S, Yang J et al (2020) Effect of convalescent plasma therapy on time to clinical improvement in patients with severe and life-threatening COVID-19: a randomized clinical trial. JAMA 324(5):460–470CrossRef

76.

DGI Konsensus-Empfehlungen zur COVID-19 Pharmakotherapie der Deutschen Gesellschaft für Infektiologie. https://www.dgi-net.de/konsensus-empfehlungen-zur-covid-19-pharmakotherapie-der-deutschen-gesellschaft-fuer-infektiologie-dgi/

77.

Beigel JH et al (2020) Remdesivir for the treatment of Covid-19–preliminary report. N Engl J Med. https://doi.org/10.1056/NEJMoa2007764CrossRef

78.

Horby P et al (2020) Dexamethasone in hospitalized patients with Covid-19—preliminary report. N Engl J Med. https://doi.org/10.1056/NEJMoa2021436CrossRefPubMedPubMedCentral

79.

EMA Veklury (remdesivir). An overview of Veklury and why it is authorised in the EU. https://www.ema.europa.eu/documents/overview/veklury-epar-medicine-overview_en.pdf

80.

FDA emergency use authorization. https://www.fda.gov/media/137564/download (Erstellt: 27. Mai 2020)

81.

Wang Y et al (2020) Remdesivir in adults with severe COVID-19: a randomised, double-blind, placebo-controlled, multicentre trial. Lancet 395(10236):1569–1578CrossRef

82.

Williamson BN et al (2020) Clinical benefit of remdesivir in rhesus macaques infected with SARS-CoV‑2. bioRxiv

83.

Olender SA et al (2020) Remdesivir for severe COVID-19 versus a cohort receiving standard of care. Clin Infect Dis. https://doi.org/10.1093/cid/ciaa1041CrossRefPubMedPubMedCentral

84.

Goldman JD et al (2020) Remdesivir for 5 or 10 days in patients with severe Covid-19. N Engl J Med. https://doi.org/10.1056/NEJMoa2015301CrossRefPubMedPubMedCentral

Titel: COVID-19-Pneumonie
verfasst von: Prof. Dr. M. Pfeifer
O. W. Hamer
Publikationsdatum: 11.11.2020
Verlag: Springer Medizin
Schlagwörter: Computertomografie
Polymerase-Kettenreaktion
Pneumonie
Akutes respiratorisches Distress-Syndrom
Coronaviren
COVID-19
SARS-CoV-2
Computertomografie
Erschienen in: Die Gastroenterologie / Ausgabe 6/2020
Print ISSN: 2731-7420
Elektronische ISSN: 2731-7439
DOI: https://doi.org/10.1007/s11377-020-00488-x

Passend zum Thema

IPD-Fallzahlen & Pneumokokken-Impfung bei Kindern in Deutschland

Das Niveau der postpandemischen Fallzahlen für invasive Pneumokokken-Erkrankungen (IPD) ist aus Sicht des Referenz-Zentrums für Streptokokken in Aachen alarmierend [1]. Wie sich die monatlichen IPD-Fallzahlen bei Kindern und Jugendlichen von Juli 2015 bis März 2023 entwickelt haben, lesen Sie hier.

HPV-Impfung: Auch für junge Erwachsene sinnvoll und wichtig

Auch nach dem 18. Lebensjahr kann eine HPV-Impfung sinnvoll und wichtig sein. Viele gesetzliche Krankenkassen übernehmen die Kosten auch zu einem späteren Zeitpunkt noch.

Impfstoffe – Krankheiten vorbeugen, bevor sie entstehen

Seit mehr als 130 Jahren entwickelt und produziert MSD Impfstoffe für alle Altersgruppen. Hier finden Sie nützliche Informationen und Praxismaterialien rund um das Thema Impfen.

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Zusammenfassung

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 6/2020

Erratum zu: Aktuelle Aspekte der Immunsuppression nach Transplantation solider Organe

Die Virologie von SARS-CoV-2

Mitteilungen der Gesellschaft für Gastroenterologie in NRW

Darmkrebsvorsorge zu COVID‑19‑Zeiten: Aufklärung notwendig

Update zur Epidemiologie von SARS-CoV-2

Folgen der SARS-CoV-2-Pandemie für die Gastroenterologie

Passend zum Thema

IPD-Fallzahlen & Pneumokokken-Impfung bei Kindern in Deutschland

HPV-Impfung: Auch für junge Erwachsene sinnvoll und wichtig

Impfstoffe – Krankheiten vorbeugen, bevor sie entstehen