Linus B Grabenhenrich

Robert Koch Institut | RKI

A novel non-invasive asthma prediction tool from the Leicester Cohort, UK, forecasts asthma at age 8 years based on 10 predictors assessed in early childhood, including current respiratory symptoms, eczema, and parental history of asthma. We aimed to externally validate the proposed asthma prediction method in a German birth cohort. The MAS-90 stud...

Objectives: To compare transcutaneous bilirubin (TcB) readings with total serum bilirubin (TSB) after phototherapy, estimating the range of TcB where confirmation through blood sampling can be avoided. Methods: Preterm and term neonates receiving in-hospital phototherapy underwent TcB measurements (device JM-103, TcB) alongside routine TSB befor...

Background Oral challenges are the gold standard in food allergy diagnostic, but time consuming. Aim of the study was to investigate the role of peanut- and hazelnut-component-specific IgE in the diagnostics of peanut and hazelnut allergy and to identify cut-off levels to make some challenges superfluous.Methods In a prospective and multicenter stu...

Background Anaphylaxis is a severe potentially life‐threatening hypersensitivity reaction with an estimated lifetime prevalence of 0.5–2.0%. The prevalence and incidence of anaphylactic reactions in Germany are unknown. We therefore assessed anaphylactic patients seen by emergency physicians in the Berlin area covering 4 million people. MethodsA st...

The lack of longitudinal data analyses from birth to adulthood is hampering long-term asthma prevention strategies. We aimed to determine early-life predictors of asthma incidence up to age 20 years in a birth cohort study by applying time-to-event analysis. In 1990, the Multicenter Allergy Study included 1314 newborns in 5 German cities. Children...

Background The spread of several severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) variants of concern (VOCs) has repeatedly led to increasing numbers of coronavirus disease 2019 (COVID-19) patients in German intensive care units (ICUs), resulting in capacity shortages and even transfers of COVID-19 intensive care patients between f...

BACKGROUND Emergency department (ED) routine data represent a unique opportunity for syndromic surveillance for both communicable and non-communicable diseases. In 2020 the Robert Koch Institute (RKI) established a syndromic surveillance system, using ED data from the AKTIN registry. OBJECTIVE In this context, this study aims to develop and valida...

Background IgE antibodies to cross‐reactive carbohydrate determinants (CCD) are usually clinically irrelevant but they can be a cause of false positive outcomes of allergen‐specific IgE tests in vitro. Their prevalence and levels have been so far cross‐sectionally examined among adult allergic patients and much less is known about their origins and...

Background The spread of several severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) variants of concern (VOC) repeatedly led to increasing numbers of coronavirus disease 2019 (COVID-19) patients in German intensive care units (ICUs), resulting in capacity shortages and even transfers of COVID-19 intensive care patients between federa...

Die Globalisierung, und die damit verbundene transkontinentale Mobilität von Menschen und Gütern, aber auch Klimawandel, fehlender Impfschutz und Migration, begünstigen die Ausbreitung von übertragbaren Krankheiten und schafft eine neue Komplexität von Lagen. Epidemien werden so schneller zu supranationalen Problemlagen. Um bereits frühzeitig die n...

Background: During the COVID-19 pandemic and associated public health and social measures, decreasing patient numbers have been described in various healthcare settings in Germany, including emergency care. This could be explained by changes in disease burden, e.g. due to contact restrictions, but could also be a result of changes in utilisation b...

Background The spread of several SARS-CoV-2 variants of concern (VOC) led to increasing numbers of patients with coronavirus disease 2019 (COVID-19) in German intensive care units (ICU), resulting in capacity shortages and even transfers of COVID-19 ICU patients between federal states in late 2021. Comprehensive evidence on the impact of predominan...

UNSTRUCTURED Artificial intelligence (AI) and data sharing go hand in hand. In order to develop powerful AI models for medical and health applications, data needs to be collected and brought together over multiple centers. However, due to various reasons, including data privacy, not all data can be made publicly available or shared with other parti...

Artificial intelligence (AI) and data sharing go hand in hand. In order to develop powerful AI models for medical and health applications, data need to be collected and brought together over multiple centers. However, due to various reasons, including data privacy, not all data can be made publicly available or shared with other parties. Federated...

Introduction: Studies investigating risk factors for severe COVID-19 often lack information on the representativeness of the study population. Here, we investigate factors associated with severe COVID-19 and compare the representativeness of the dataset to the general population. Methods: We used data from the Lean European Open Survey on SARS-C...

Substantial opportunities for global health intelligence and research arise from the combined and optimised use of secondary data within data ecosystems. Secondary data are information being used for purposes other than those intended when they were collected. These data can be gathered from sources on the verge of widespread use such as the intern...

Background Drugs are a frequent cause of severe anaphylactic reactions. Here, we analyze a large dataset on drug induced anaphylaxis regarding elicitors, risk factors, symptoms, and treatment. Methods Data from the European Anaphylaxis Registry (2007–2019) with 1815 reported cases of drug‐induced anaphylaxis were studied accordingly. Results Drug...

Zusammenfassung Hintergrund Die Pandemie hat zu Veränderungen in der Notfallversorgung mit atypischen Schwankungen der Einsatzzahlen geführt. Dies wurde u. a. mit dem veränderten Verhalten und einem gesteigerten Belastungsempfinden der Bevölkerung erklärt. Bestehende Untersuchungen geben Hinweise auf das gesteigerte Auftreten von psychischen Krank...

Background In vitro immunoglobulin E (IgE) tests can be better standardized if based on molecules rather than extracts. However, singleplex screening tests for respiratory or food allergies are still based on extracts only. Target To validate a novel singleplex IgE screening test for respiratory allergies, based on a mix of major allergenic molecu...

Background The Dermatophagoides pteronyssinus molecule Der p 23 is a major allergen whose clinical relevance has been shown in cross‐sectional studies. We longitudinally analysed the trajectory of Der p 23‐specific IgE antibody (sIgE) levels throughout childhood and youth, their early‐life determinants and their clinical relevance for allergic rhin...

Background The COVID-19 pandemic expanded the need for timely information on acute respiratory illness at population level. Aim We explored the potential of routine emergency department data for syndromic surveillance of acute respiratory illness in Germany. Methods We used routine attendance data from emergency departments, which continuously tr...

The Robert Koch Institute (RKI) monitors the actual number of COVID-19 patients requiring intensive care from aggregated data reported by hospitals in Germany. So far, there is no infrastructure to make use of individual patient-level data from intensive care units for public health surveillance. Adopting concepts and components of the already esta...

Background: During the COVID-19 pandemic and associated public health and social measures, decreasing patient numbers have been described in various healthcare settings in Germany, including emergency care. This could be explained by changes in disease burden, e.g. due to contact restrictions, but could also be a result of changes in utilization be...

The COVID-19 pandemic has led to a high interest in mathematical models describing and predicting the diverse aspects and implications of the virus outbreak. Model results represent an important part of the information base for the decision process on different administrative levels. The Robert-Koch-Institute (RKI) initiated a project whose main go...

Introduction and objective Drugs are a frequent cause of severe anaphylactic reactions. Clinical epidemiology of drug-induced anaphylaxis (DIA) supports the identification of the most frequent eliciting drug groups, risk factors, symptoms and treatment procedures. Our aim was to analyze data to promote better recognition and long-term management of...

Zusammenfassung Hintergrund Zeitdynamische Prognosemodelle spielen eine zentrale Rolle zur Steuerung von intensivmedizinischen COVID-19-Kapazitäten im Pandemiegeschehen. Ein wichtiger Vorhersagewert (Prädiktor) für die zukünftige intensivmedizinische (ITS-)COVID-19-Bettenbelegungen ist die Anzahl der SARS-CoV-2-Neuinfektionen in der Bevölkerung, d...

Zusammenfassung Hintergrund Die Häufigkeit von Suizidversuchen ist ein zentraler Indikator der psychischen Gesundheit der Bevölkerung und daher Gegenstand der Mental Health Surveillance am Robert Koch-Institut. Da bisher keine Datenquellen systematisch zur kontinuierlichen Erfassung von psychiatrischen Notfällen – zu denen Suizidversuche zählen –...

Differentiable programming has recently received much interest as a paradigm that facilitates taking gradients of computer programs. While the corresponding flexible gradient-based optimization approaches so far have been used predominantly for deep learning or enriching the latter with modeling components, we want to demonstrate that they can also...

Introduction: To better assess the epidemiological situation of acute respiratory illness in Germany over time, we used emergency department data for syndromic surveillance before and during the COVID-19 pandemic. Methods: We included routine attendance data from emergency departments who continuously transferred data between week 10-2017 and 10-20...

Here, we report on the increasing frequency of the SARS-CoV-2 lineage A.27 in Germany during the first months of 2021. Genomic surveillance identified 710 A.27 genomes in Germany as of 2 May 2021, with a vast majority identified in laboratories from a single German state (Baden-Wuerttemberg, n = 572; 80.5%). Baden-Wuerttemberg is located near the b...

Epidemiologische und klinische Studien sind standardisiert und gut dokumentiert, jedoch erfüllen Studienprotokolle, eingesetzte Erhebungsinstrumente und erhobene Daten die Anforderungen der FAIR-Prinzipien nicht in ausreichendem Maße. NFDI4Health wird daher eine Struktur schaffen, die eine zentrale Suche nach existierenden, dezentral verwalteten Da...

Zusammenfassung Public-Health-Forschung, epidemiologische und klinische Studien sind erforderlich, um die COVID-19-Pandemie besser zu verstehen und geeignete Maßnahmen zu ergreifen. Daher wurden auch in Deutschland zahlreiche Forschungsprojekte initiiert. Zum heutigen Zeitpunkt ist es ob der Fülle an Informationen jedoch kaum noch möglich, einen Üb...

Zusammenfassung Die Epidemiologie als wissenschaftliche Disziplin ist prädestiniert dafür, Kernfragen der COVID-19-Pandemie zu bearbeiten. Hierzu werden klassische und neue Methoden eingesetzt, es stellen sich jedoch auch neue Herausforderungen. Der Beitrag bezieht sich auf die verschiedenen Phasen des bevölkerungsbezogenen Verlaufs der SARS-CoV-2-...

Background: The COVID-19 pandemic has led to a high interest in mathematical models describing and predicting the diverse aspects and implications of the virus outbreak. Model results represent an important part of the information base for the decision process on different administrative levels. The Robert-Koch-Institute (RKI) initiated a project w...

Background Coexistence of childhood asthma, eczema and allergic rhinitis is higher than can be expected by chance, suggesting a common mechanism. Data on allergic multimorbidity from a pan‐European, population‐based birth cohort study have been lacking. This study compares the prevalence and early‐life risk factors of these diseases in European pri...

Background: Primary hazelnut allergy is a common cause of anaphylaxis in children, as compared to birch-pollen associated hazelnut allergy. Population-based data on hazelnut and concomitant birch-pollen allergy in children are lacking. We aimed to investigate the prevalence of primary and pollen-associated hazelnut allergy and sensitization profil...

Natural disasters can have significant consequences for population mental health. Using a digital spatial epidemiologic approach, this study documents emotional changes over space and time in the context of a large-scale disaster. Our aims were to a) explore the spatial distribution of negative emotional expressions of Twitter users before, during,...

Zusammenfassung Echtzeitdaten aus der medizinischen Versorgung spielen für die Handlungsteuerung in Public Health eine entscheidende Rolle. Dies zeigt die COVID-19-Pandemie besonders deutlich: Viele Public-Health-Akteure sind auf die aktuellen Daten aus dem klinischen und Versorgungsgeschehen angewiesen, um wichtige Entscheidungen treffen und Empfe...

Das Betacoronavirus SARS-CoV-2 gelangte höchstwahrscheinlich als zoonotischer Erreger gegen Ende 2019 in die menschliche Bevölkerung, vermutlich in Form einer einzelnen Transmission (monophyletischer Ursprung) aus einem noch immer unbekannten Tierreservoir (1, 2). Ebenso wie zum Beispiel bei Influenzaviren und HIV handelt es sich bei SARS-CoV-2 um...

Background The COVID-19 pandemic poses the risk of overburdening health care systems, and in particular intensive care units (ICUs). Non-pharmaceutical interventions (NPIs), ranging from wearing masks to (partial) lockdowns have been implemented as mitigation measures around the globe. However, especially severe NPIs are used with great caution due...

Differentiable programming has recently received much interest as a paradigm that facilitates taking gradients of computer programs. While the corresponding flexible gradient-based optimization approaches so far have been used predominantly for deep learning or enriching the latter with modeling components, we want to demonstrate that they can also...

Hintergrund: Infolge des Klimawandels werden häufigere, intensivere und auch längere Hitzewellen erwartet. Besonders betroffen von der Hitze sind ältere Menschen und Menschen mit Vorerkrankungen. Es stellt sich die Frage, inwieweit sich die Auswirkungen von Hitzewellen in Deutschland über die Zeit verändern und Präventivmaßnahmen wirksam werden. Me...

Background Nationwide, unbiased, and unselected data of hospitalised patients with COVID-19 are scarce. Our aim was to provide a detailed account of case characteristics, resource use, and outcomes of hospitalised patients with COVID-19 in Germany, where the health-care system has not been overwhelmed by the pandemic. Methods In this observational...

Background The prevalence of food allergy (FA) among European school children is poorly defined. Estimates have commonly been based on parent‐reported symptoms. We aimed to estimate the frequency of FA and sensitization against food allergens in primary school children in eight European countries. Methods A follow‐up assessment at age 6‐10 years o...

Background: Worldwide, guidelines recommend the use of adrenaline autoinjectors (AAIs) for self-medication in patients who experience severe allergic reaction. The European Medical Agency recommends the prescription of two AAIs, which should be carried by patients at all times. The European Academy of Allergy and Clinical Immunology guidelines pro...

Background: Hen's egg is one of the commonest causes of food allergy but there are little data on its risk factors. Objective: To assess the risk factors, particularly eczema, for hen's egg allergy in the EuroPrevall birth cohort. Methods: In the pan-European EuroPrevall birth cohort, questionnaires were undertaken at 12 and 24 months or when...

Background Patients with a history of anaphylaxis are at risk of future anaphylactic reactions. Thus, secondary prevention measures are recommended for these patients to prevent or attenuate the next reaction. Methods Data from the Anaphylaxis Registry were analyzed to identify secondary prevention measures offered to patients who experienced anap...

Food allergy affects a small but significant number of children and adults. Food allergy is responsible for considerable morbidity and is the commonest cause of anaphylaxis in children. One of the aims of the European Union funded “Integrated Approaches to Food Allergen and Allergy Risk Management” (iFAAM) project was to improve our understanding o...

Background: During the summers of 2003 and 2015, heat was found to be the cause of a substantial number of deaths in Germany. Until now, estimates for the total number of heat-related deaths were only available regionally in Germany. For the summer of 2003, an analysis for Baden-Württemberg was extrapolated to the whole of Germany. Objectives: O...

Objectives: The weekly monitoring of European all-cause excess mortality, the EuroMOMO network, observed a high excess mortality in participating countries during the 2017/18 winter season, especially among elderly; elevated levels of hospitalisations were also observed. This was unexpected as the dominating influenza virus was type B, commonly con...

Background Preschool wheeze is an important problem worldwide. No comparative population-based studies covering different countries have previously been undertaken. Objective To assess the prevalence of early childhood wheeze across Europe and evaluate risk factors focusing on food allergy, breast feeding and smoke exposure. Methods Infants from...

Background Interaction of respiratory multimorbidity and lung function has not been examined in longitudinal population studies. We aimed to assess the association of multimorbidity of asthma and rhinitis with lung function and bronchial hyperresponsiveness in comparison to single and no allergies from early school age to young adulthood. Methods...

The physical environment strongly influences physical activity in urban settings. While walkability is frequently assessed for adults, an approach for mapping the friendliness of urban environments focusing on children's activities is not available. The aim of the presented approach was to identify supporting and limiting factors of activity friend...

Background: Current guidelines recommend intramuscular administration of epinephrine as the first-line drug for the emergency treatment of severe allergic reactions (anaphylaxis), but no randomized trial evidence supports this consensus. Objective: We aimed to assess anaphylaxis treatment practices over 10 years, covering several European region...

Background: Seasonal allergic rhinitis (SAR) is a common disease that has detrimental effects on the quality of life (QoL) of affected individuals. Approximately 18% of patients try to alleviate their symptoms through acupuncture. The ACUSAR (ACUpuncture in Seasonal Allergic Rhinitis) study (ClinicalTrials.gov registration no. NCT00610584) assesse...

Background: High expectations about acupuncture might contribute to larger treatment effects (Prady et al., 2015). However, problems in the assessment are well known: 1) floor or ceiling effects lower variance; 2) expectation measures include general beliefs about complementary medicine; 3) construct validity of expectation measures remains unclear...

Background: Blinded food challenges are considered the current gold standard for the diagnosis of food allergies. We used data from a pan-European multicentre project to assess differences between study centres, aiming to identify the impact of subjective aspects for the interpretation of oral food challenges. Methods: Nine study centres of the...

Recommendations and guidelines on the prevention of food allergy have changed in recent decades. The aim of this review of the current evidence and ongoing studies is to provide a comprehensive and up to date picture of prevention of food allergy for healthcare professionals. The review was undertaken as part of the European Union funded Integrated...

Data S1. Generic forms and SOPs for the assessment of food allergy.

Atopic dermatitis (AD) is the most common inflammatory skin disease in childhood, with an onset usually in early infancy. It imposes a considerable burden on patients and their families and frequently represents the first chronic health problem for many families. The clinical manifestation of AD may vary according to age, with a more general manife...

Allergic rhinitis is an allergen-induced, immunoglobulin E–mediated chronic inflammatory disease of the nasal mucosa. It represents one of the most prevalent manifestations of allergic disorders, usually starting in the first 2 decades of life. It is frequently accompanied by concomitant conjunctivitis. Allergic rhinitis is characterized by nasal i...

Table of contents WORKSHOP 4: Challenging clinical scenarios (CS01–CS06) CS01 Bullous lesions in two children: solitary mastocytoma S. Tolga Yavuz, Ozan Koc, Ali Gungor, Faysal Gok CS02 Multi-System Allergy (MSA) of cystic fibrosis: our institutional experience Jessica Hawley, Christopher O’Brien, Matthew Thomas, Malcolm Brodlie, Louise Michaelis C...

Background The evolution of the IgE response to the numerous allergen molecules of Dermatophagoides pteronyssinus is still unknown. Objectives We sought to characterize the evolutionary patterns of the IgE response to 12 molecules of D pteronyssinus from birth to adulthood and to investigate their determinants and clinical relevance. Methods We i...

Table of contents ORAL ABSTRACTS Symposium 1: Biochemistry, structure and environment of the allergen: what makes a protein an allergen? O1 Two cell-membrane peptidases carrying galactose-alpha-1,3-galactose are implicated in delayed anaphylactic reactions upon pork kidney ingestion in patients with IgE-antibodies to alpha-Gal Christiane Hilger, Ky...

Background: Phenotypes of childhood-onset asthma are characterized by distinct trajectories and functional features. For atopy, definition of phenotypes during childhood is less clear. Objective: To define phenotypes of atopic sensitization over the first 6 years of life by a latent class analysis (LCA) integrating three dimensions of atopy: all...

Background The conduct of oral food challenges as the preferred diagnostic standard for food allergy (FA) was harmonized over the last years. However, documentation and interpretation of challenge results, particularly in research settings, are not sufficiently standardized to allow valid comparisons between studies. Our aim was to develop a diagno...

The interpretation of epidemiological data on food hypersensitivities should clearly separate two issues: the disposition to respond symptomatically to certain foods and the actual reactions occurring, which can be observed only when there is sufficient consumption or targeted exposure/provocation. The exact specification of the case definition is...

Anaphylaxis has been defined as a "severe, life-threatening generalized or systemic hypersensitivity reaction". However, data indicate that the vast majority of food-triggered anaphylactic reactions are not life-threatening. Nonetheless, severe life-threatening reactions do occur, and are unpredictable. We discuss the concepts surrounding perceptio...

Objective To assess universal health coverage for adults aged 50 years or older with chronic illness in China, Ghana, India, Mexico, the Russian Federation and South Africa. Methods We obtained data on 16 631 participants aged 50 years or older who had at least one diagnosed chronic condition from the World Health Organization Study on Global Agei...

Background: Specific IgE measurement predicts the outcome of oral food challenges with considerable uncertainty when evaluating food allergy. Objective: Our aim was to assess whether accounting for the ratio of component- or allergen-specific to total IgE can improve this prediction. Methods: This multicenter study collected blood samples from...