Department / Institute: Forschungs- und Lehreinheit Hebammenwissenschaft

The provision of perinatal healthcare changed significantly during the COVID-19 pandemic. Its impact on the experiences of families who went through pregnancy, childbirth and the postpartum period is very likely, and families who suffered from a stillbirth or neonatal death were burdened even more. This global research project aims to investigate the caring implications of the pandemic as well as the experiences of parents who used perinatal healthcare services in that period.
A cross-sectional study was realised in 15 countries worldwide. The German sub-survey with n=6746 participants was conducted by MHH in collaboration with the German parents organisation Mother Hood e.V. The data collection instrument included validated psychometric scales to assess psychosocial health. Besides descriptive analysis of the data, multivariable analysis will be used to explore explanatory factors for care deficiencies in Germany and worldwide. Findings could help to improve the provision of perinatal healthcare during future crisis situations.
https://www.mhh.de/en/mhh-institutes/midwifery-research-and-education-unit/research

Department / Institute: Psychiatry, Social Psychiatry and Psychotherapy

In a retrospective analysis we investigate the impact of the current COVID-19 pandemic on mental health in individuals with Prader-Willi syndrome.

 

Department / Institute: Division of Clinical Psychology & Sexual Medicine

Preliminary data indicates that the COVID-19 pandemic has a substantial impact on mental health and well-being. We conducted a web-based self-report survey including various aspects of mental health (e.g., PHQ-D, PHQ-4, WHO-5 and comparative questions on a 5-point Likert scale concerning sleep, irritability and interpersonal violence). First wave data (N=3545) were taken during the height of lockdown measures in Germany from 1 April to 15 April 2020. We found increased levels of psychosocial distress, anxiety, depressive symptoms, irritability and interpersonal violence as well as a decrease in overall well-being, sense of coherence, sexual contentment and sleep quality. Our findings suggest that women have more trouble coping with the current situation. Moreover participants reported to find comfort in family, friends, conversation, exercise, and activity.

Department / Institute: Department of Psychiatry, Social Psychiatry and Psychotherapy

This project deals with the question of the actual use of psychotherapy via videoconferencing during the Corona pandemic in a ecological valid sample.

For this purpose psychotherapists were surveyed about their as well as their patients’ experience with the use of online-therapy.

The collected data show that 30% of patients could not be reached by online-therapy. Approximately half of the patients in this group were unable to use the therapy due to a lack of technical equipment. The other half declined online-therapy even though they had access to the technical requirements.

Furthermore, our data showed that the use of online-therapy increases with decreasing age and increasing educational level.
The results show that despite the widespread use of online-therapy, a considerable proportion of patients could not be reached by this alternative. Therefore, special offers for this group should be considered in the instance of a further lockdown situation.

 

Department / Institute: Department of Psychiatry, Social Psychiatry and Psychotherapy

Patient care is facing unprecedented challenges during the coronavirus disease 2019 pandemic. Psychopharmacotherapy is associated with a multitude of adverse drug reactions (ADRs). Since direct contact to patients is reduced, new techniques in diagnosing and treating patients have to be established to promote patient and drug safety. Patients should be informed about relevant ADRs and physicians should actively ask about the development of ADRs. Several psychotropic drugs carry a risk for ADRs, which are particularly unfavorable if they occur simultaneously with an acute infection or may even lead to an increased risk of infection. These include respiratory depression, agranulocytosis, intoxication by inhibition of metabolizing enzymes, and venous thromboembolism, each of which may be associated with potentially fatal consequences. However, physicians should ensure adequate efficacy of treatment, since the ongoing crisis may lead to a worsening of pre-existing mental illness and to a surge in first onset of psychiatric disorders.

Department / Institute: Department of Psychiatry, Social Psychiatry and Psychotherapy

This study aims to present the immediate effects of the pandemic on patients presenting in the psychiatric emergency department (PED) of Hannover Medical School. Patients presenting the same timeframe in 2019 served as a control group. A decrease in PED visits was observed during the pandemic with an increase in repeat visits within one month (30.2% vs. 20.4%, p=.001). Fewer patients with affective disorders utilized the PED (15.2% vs. 22.2%, p=.010). Suicidal ideation was stated more frequently among patients suffering from substance use disorders (47.4% vs. 26.8%, p=.004). Patients with schizophrenia more commonly had persecutory delusions (68.7% vs. 43.5%, p=.023) and visual hallucinations (18.6% vs. 3.3%, p=.011). Presentation rate of patients with neurotic, stress-related and somatoform disorders increased. By understanding how patients react to this situation, we can consider how to improve care for patients in the future and which measures need to be taken to protect these particularly vulnerable patients.

Department / Institute: Institute for Molecular and Translational Therapeutic Strategies

The coronavirus disease 2019 (COVID-19) outbreak has emerged as a global pandemic. Angiotensin-converting enzyme 2 (ACE2) is the main entry receptor of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) regulating host cell infection. ACE2 is known to be abundantly expressed in cardiomyocytes thereby enabling the SARS-CoV-2 to infect cardiomyocytes as well. In this study, we investigated if there are microRNA (miRNA) molecules which target ACE2 and could be further exploited to modulate SARS-CoV-2 entry into cardiomyocytes. We identified a few miRNAs that can target ACE2 based on in-silico analysis. Furthermore, we successfully demonstrated that miR-200c can inhibit both Ace2 mRNA and Ace2 protein levels in rat primary cardiomyocytes. More importantly these findings were also translated into human induced pluripotent stem cell derived cardiomyocytes. We reported the first miRNA candidate that can target ACE2 in cardiomyocytes and may be developed further as a preventive therapeutic strategy against COVID-19 mediated heart failure.

Department / Institute: Institute for Molecular and Translational Therapeutic Strategies

The coronavirus disease 2019 (COVID-19) pandemic has caused serious health concerns worldwide. Moreover, a strong correlation exists between cardiovascular comorbidities and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The binding of the viral spike protein with the angiotensin-converting enzyme 2 (ACE2) plays a crucial role in regulating the entry of the SARS-CoV-2 particles into the host cells. In this project, we aim to investigate the non-coding RNAs which regulate SARS-CoV-2 infection. To this end, we employ the human induced pluripotent stem cell derived cardiomyocytes (hiPSC-CMs) and further validate these findings in living myocardial slices isolated from left ventricular specimens of failing human hearts. Preliminarily, a pseuodovirus expressing fluorescently tagged spike protein is used to test infectivity in both model systems. Eventually, we aim to infect the hiPSC-CMs and live human myocardial slices with the SARS-CoV-2 virus and analyze the transcriptome to identify potential non-coding RNAs involved in this process.

Department / Institute: Institute of Clinical Biochemistry, Hannover Unified Biobank (HUB)

The outcome of an infection with SARS-CoV-2 strongly depends on known risk factors like age or pre-existing illnesses. However, even within a particular age-cohort, severity of infection can vary considerably. An important component of viral-host interaction is the host-specific glycosylation which is depended on genetics but can be strongly affected by age or pathophysiological conditions. The research group of Falk Büttner applies a broad spectrum of analytical techniques to decipher the glycome. We plan to compare glycosylation of people infected by SARS-CoV-2 with the mean population. Thereby we intend to correlate susceptibility towards infection with SARS-CoV-2 as well as severity of the disease progression with the human glycome. With the support of Prof. Illig we will have access to specimens from patients and from the healthy population. We expect to identify glycan-based determinants enabling us to explain susceptibility and severity of infection at a molecular level. These host specific glycosylation might be also used as a prospective marker for the course of infection.

Department / Institute: Clinical Biochemistry

Individuals having a blood group O have a lower risk of infection with SARS-CoV-1 and SARS-CoV-2. Current data suggest that antibodies against A- or B- antigens could reduce binding of the virus spike protein to the host cells. A person of blood group O (~41 % of the German population) would thus be partly protected against infection if the virus carrier is of blood group A (~43 % of the German population), B (~11 % of the German population) or AB (~5 % of the German population). The degree of protection would depend on the antibody titer, which is highly variable between individuals and decreases with aging.
Do anti-blood group antibodies prevent interaction of the SARS-CoV-2 spike protein with the ACE2 receptor? Are the A- or B- blood group determinants co-receptors facilitating entry of the virus? This project concentrates on the importance of glycans (specifically of blood group glycans) in SARS-CoV-2 infections.

Department / Institute: MHH CRC Core Facility, University Eye Hospital, Hannover Unified Biobank (HUB)

Collection of tearfilm probes in participants of clinical trials investigating the safety and efficacy of vaccines against SARS-CoV-2. In cooperation of the MHH partners CRC-Core Facility, University Eye Hospital and Hannover Unified Biobank, we collect and store probes of human tears (Schirmer-Test). All study participants are assessed in a comprehensive ohthalmological examination.
The aim of this project is the identification and characterisation of potential diagnostic and/ or prognostic immuno-biomarkers in human tears to investiagate the immunological response after vaccination.

Department / Institute: Department of Radiotherapy and Special Oncology

The beginning of the pandemic affected all areas of health sector. While disciplines directly managing patients with SARS-CoV2-infection (pneumonology/intensive-care) were hardest hit, the multidisciplinary management of cancer was also affected: The limited availability of intensive-care-unit-capacity led to a call from the “German Ministry of Health” to delay all non-urgent surgery to free up intensive-care-capacity. Whereas cancer treatment is not considered elective, recommendations on interdisciplinary-management under conditions of limited resources were made. One pattern of these recommendations was the consideration to avoid surgery, which would be expected to require postoperative intensive-care, and prefer non-surgical treatments. Therewith, the use of radiotherapy may have been affected by increased demand. An additional potential cause of delayed changes could be postponed cancer diagnosis, resulting e.g. from a lower participation in cancer screening. The current analysis focuses on four disease sites with distinct properties regarding potential effects on radiotherapy.

Department / Institute: Department of Rehabilitation Medicine

COVID-19 is a challenge for acute care as well as long-term rehabilitation. So we have developed the COVID-19 Rehabilitation Needs Survey (C19-RehabNeS) that specifically addresses long-term functional deficits such as e.g. smell disorders, hair loss and the fatigue syndrome. Together with the SF-36 (quality of life), the RehabNeS contains eleven ICF dimensions that evaluate the rehabilitation needs and inquire about satisfaction with treatments and healthcare providers in the context of the infection.
The RehabNeS has been sent to over 1,000 COVID-19 patients in Bavaria by our working group so far. Of these, around 400 responses are included in the analysis. The questionnaire as well as the results on functional impairment and satisfaction are currently being published nationally and internationally. The questionnaire can be used as an essential tool for further COVID-19 studies that deal with the incriminating long-term effects for patients.

Department / Institute: Zentrum für Informationsmanagement

The Enterprise Clinical Research Data Warehouse (ECRDW) of Hannover Medical School (MHH) is available as an interdisciplinary data integration and analysis for research-relevant purposes.

For COVID-19 research, a DataMart was provided that consolidates ICD-10 diagnoses, movement data, laboratory findings, ICU data, and others from the EHR systems (SAP i.s.h.), laboratory and radiology information systems, and the MHH biobank.

The ECRDW-COVID19-DataMart serves as a data source for various COVID19-based registries and research with medical data.

Department / Institute: Clinic for Ophthalmology

In the context of SARS-CoV-2 infections, the development of macro- and microangiopathy is known. In our study we investigate the effects of SARS-CoV-2 infection on retinal vessels. Patients who were hospitalized at MHH with SARS-CoV-2 infection will be included. Patients will receive a complete eye examination including angio-OCT of the retinal center. These images will be evaluated and compared to healthy volunteers.

Registered in DRKS: DRKS00022874.

Department / Institute: MKG-Chirurgie

The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic has created hitherto unknown challenges for healthcare systems and patient care. This study aimed to analyze its influence on patient care and healthcare management in oral and maxillofacial surgery (OMFS) in Germany.
A nationwide survey including fifty-four hospitals and 240 private practices (PPs) was performed. Individual questionnaires containing 10 questions for university as well as non-university hospitals and 15 questions for PPs for OMFS were created to collect data for patient numbers and surgical procedures conducted, usage of personal protection equipment (PPE), SARS-CoV-2 tests, and economic aspects.
With the exception of some elective procedures, primary patient care in OMFS has been assured during the pandemic. However, the immense economic burden on hospitals and PPs cannot be conclusively assessed at this point.