{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,25]],"date-time":"2025-10-25T19:11:41Z","timestamp":1761419501221,"version":"build-2065373602"},"reference-count":38,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2022,1,20]],"date-time":"2022-01-20T00:00:00Z","timestamp":1642636800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100007192","name":"National Institute for Public Health and the Environment","doi-asserted-by":"publisher","award":["NA"],"award-info":[{"award-number":["NA"]}],"id":[{"id":"10.13039\/501100007192","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Jeroen Bosch Hospital, 's Hertogenbosch","award":["NA"],"award-info":[{"award-number":["NA"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: the geographical similarities of the Dutch 2007\u20132010 Q fever outbreak and the start of the 2020 coronavirus disease 19 (COVID-19) outbreak in the Netherlands raised questions and provided a unique opportunity to study an association between Coxiella burnetii infection and the outcome following SARS-CoV-2 infection. Methods: We performed a retrospective cohort study in two Dutch hospitals. We assessed evidence of previous C. burnetii infection in COVID-19 patients diagnosed at the ED during the first COVID-19 wave and compared a combined outcome of in-hospital mortality and intensive care unit (ICU) admission using adjusted odds ratios (OR). Results: In total, 629 patients were included with a mean age of 68.0 years. Evidence of previous C. burnetii infection was found in 117 patients (18.6%). The combined primary outcome occurred in 40.2% and 40.4% of patients with and without evidence of previous C. burnetii infection respectively (adjusted OR of 0.926 (95% CI 0.605\u20131.416)). The adjusted OR of the secondary outcomes in-hospital mortality, ICU-admission and regular ward admission did not show an association either. Conclusion: no influence of previous C. burnetii infection on the risk of ICU admission and\/or mortality for patients with COVID-19 presenting at the ED was observed.<\/jats:p>","DOI":"10.3390\/jcm11030526","type":"journal-article","created":{"date-parts":[[2022,1,20]],"date-time":"2022-01-20T22:51:06Z","timestamp":1642719066000},"page":"526","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["No Influence of Previous Coxiella burnetii Infection on ICU Admission and Mortality in Emergency Department Patients Infected with SARS-CoV-2"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9419-216X","authenticated-orcid":false,"given":"Jesper M.","family":"Weehuizen","sequence":"first","affiliation":[{"name":"Department of Internal Medicine and Infectious Diseases, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rik","family":"van Spronsen","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Infectious Diseases, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andy I. M.","family":"Hoepelman","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Infectious Diseases, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chantal P.","family":"Bleeker-Rovers","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Infectious Diseases, Radboud Expertise Center for Q Fever, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6146-3808","authenticated-orcid":false,"given":"Jan Jelrik","family":"Oosterheert","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Infectious Diseases, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter C.","family":"Wever","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology and Infection Control, Jeroen Bosch Hospital, 5223 GZ \u2018s-Hertogenbosch, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,1,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1128\/CMR.12.4.518","article-title":"Q fever","volume":"12","author":"Maurin","year":"1999","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"847","DOI":"10.1017\/S0950268812001203","article-title":"Screening for Coxiella burnetii seroprevalence in chronic Q fever high-risk groups reveals the magnitude of the Dutch Q fever outbreak","volume":"141","author":"Kampschreur","year":"2013","journal-title":"Epidemiol. Infect."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1111\/j.1574-695X.2011.00876.x","article-title":"The 2007\u20132010 Q fever epidemic in the Netherlands: Characteristics of notified acute Q fever patients and the association with dairy goat farming","volume":"64","author":"Dijkstra","year":"2012","journal-title":"FEMS Immunol. Med. Microbiol."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Morroy, G., Keijmel, S.P., Delsing, C.E., Bleijenberg, G., Langendam, M., Timen, A., and Bleeker-Rovers, C.P. (2016). Fatigue following acute Q-fever: A systematic literature review. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0155884"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1390","DOI":"10.1016\/j.cmi.2018.11.023","article-title":"Chronic Q fever-related complications and mortality: Data from a nationwide cohort","volume":"25","author":"Wever","year":"2019","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_6","first-page":"D4962","article-title":"COVID-19: Patient zero in the Netherlands","volume":"164","author":"Alderweireld","year":"2020","journal-title":"Ned. Tijdschr. Geneeskd."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"6","DOI":"10.2807\/1560-7917.ES.2020.25.12.2000334","article-title":"Rapid assessment of regional SARS-CoV-2 community transmission through a convenience sample of healthcare workers, the Netherlands, March 2020","volume":"25","author":"Reusken","year":"2020","journal-title":"Eurosurveillance"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3389\/fimmu.2020.01548","article-title":"Role of Immune Dysregulation in Increased Mortality Among a Specific Subset of COVID-19 Patients and Immune-Enhancement Strategies for Combatting Through Nutritional Supplements","volume":"11","author":"Rao","year":"2020","journal-title":"Front. Immunol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3389\/fcvm.2020.629933","article-title":"Why Is COVID-19 More Severe in Patients With Diabetes? The Role of Angiotensin-Converting Enzyme 2, Endothelial Dysfunction and the Immunoinflammatory System","volume":"7","author":"Roberts","year":"2021","journal-title":"Front. Cardiovasc. Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1002\/iid3.404","article-title":"Age-related differences in the immune response could contribute to determine the spectrum of severity of COVID-19","volume":"9","author":"Costagliola","year":"2021","journal-title":"Immunity, Inflamm. Dis."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"E105","DOI":"10.1152\/ajpendo.00198.2020","article-title":"Obesity and COVID-19: Immune and metabolic derangement as a possible link to adverse clinical outcomes","volume":"319","author":"Korakas","year":"2020","journal-title":"Am. J. Physiol.-Endocrinol. Metab."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"720","DOI":"10.1111\/liv.14774","article-title":"Clinical characteristics of COVID-19 patients with hepatitis B virus infection\u2014A retrospective study","volume":"41","author":"Liu","year":"2021","journal-title":"Liver Int."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Poloni, C., Szyf, M., Cheishvili, D., and Tsoukas, C.M. (2021). Are the healthy vulnerable? Cytomegalovirus seropositivity in healthy adults is associated with accelerated epigenetic age and immune-dysregulation. J Infect Dis, preprint.","DOI":"10.1093\/infdis\/jiab365"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1015","DOI":"10.1002\/eji.201848012","article-title":"A possible link between recurrent upper respiratory tract infections and lower cytokine production in patients with Q fever fatigue syndrome","volume":"49","author":"Raijmakers","year":"2019","journal-title":"Eur. J. Immunol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1093\/ofid\/ofz296","article-title":"Long-Lasting Transcriptional Changes in Circulating Monocytes of Acute Q Fever Patients","volume":"6","author":"Raijmakers","year":"2019","journal-title":"Open Forum Infect. Dis."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"969","DOI":"10.1016\/j.cell.2020.04.042","article-title":"Trained Immunity: A Tool for Reducing Susceptibility to and the Severity of SARS-CoV-2 Infection","volume":"181","author":"Netea","year":"2020","journal-title":"Cell"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1126\/science.aaf1098","article-title":"Trained immunity: A program of innate immune memory in health and disease","volume":"352","author":"Netea","year":"2016","journal-title":"Science"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"34","DOI":"10.3143\/geriatrics.42.34","article-title":"Prevention of elderly pneumonia by pneumococcal, influenza and BCG vaccinations","volume":"42","author":"Ohrui","year":"2005","journal-title":"Nihon Ronen Igakkai Zasshi"},{"key":"ref_19","first-page":"185","article-title":"The efficacy of Bacillus Calmette-Guerin vaccinations for the prevention of acute upper respiratory tract infection in the elderly","volume":"43","author":"Wardhana","year":"2011","journal-title":"Acta Med. Indones."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1016\/j.cell.2020.08.051","article-title":"Activate: Randomized Clinical Trial of BCG Vaccination against Infection in the Elderly","volume":"183","author":"Tsilika","year":"2020","journal-title":"Cell"},{"key":"ref_21","first-page":"20","article-title":"Two Randomized Controlled Trials of Bacillus Calmette-Gu\u00e9rin Vaccination to reduce absenteeism among health care workers and hospital admission by elderly persons during the COVID-19 pandemic: A structured summary of the study protocols for two randomised","volume":"21","author":"Moorlag","year":"2020","journal-title":"Trials"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1186\/s13063-020-04714-3","article-title":"Using BCG vaccine to enhance non-specific protection of health care workers during the COVID-19 pandemic: A structured summary of a study protocol for a randomised controlled trial in Denmark","volume":"21","author":"Madsen","year":"2020","journal-title":"Trials"},{"key":"ref_23","first-page":"20","article-title":"BCG revaccination of health workers in Brazil to improve innate immune responses against COVID-19: A structured summary of a study protocol for a randomised controlled trial","volume":"21","author":"Borges","year":"2020","journal-title":"Trials"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"676","DOI":"10.1093\/aje\/kwq433","article-title":"Updating and validating the charlson comorbidity index and score for risk adjustment in hospital discharge abstracts using data from 6 countries","volume":"173","author":"Quan","year":"2011","journal-title":"Am. J. Epidemiol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"512","DOI":"10.1093\/qjmed\/94.10.521","article-title":"Validation of a modified Early Warning Score in medical admissions","volume":"94","author":"Subbe","year":"2001","journal-title":"QJM"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1111\/j.1537-2995.2011.03250.x","article-title":"Coxiella burnetii infection among blood donors during the 2009 Q-fever outbreak in The Netherlands","volume":"52","author":"Hogema","year":"2012","journal-title":"Transfusion"},{"key":"ref_27","first-page":"157","article-title":"Doorgemaakte Q-koorts geassocieerd met ernstige ziekte of sterfte van COVID-19-pati\u00ebnten?","volume":"28","author":"Mulder","year":"2020","journal-title":"Ned. Tijdschr. Med. Microbiol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1067","DOI":"10.1093\/qjmed\/hcs119","article-title":"An analysis of Q fever patients 6 years after an outbreak in Newport, Wales, UK","volume":"105","author":"Islam","year":"2012","journal-title":"QJM"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Wielders, C.C.H., Van Loenhout, J.A.F., Morroy, G., Rietveld, A., Notermans, D.W., Wever, P.C., Renders, N.H.M., Leenders, A.C.A.P., Van Der Hoek, W., and Schneeberger, P.M. (2015). Long-term Serological follow-up of acute Q-fever patients after a large epidemic. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0131848"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Morroy, G., Van Der Hoek, W., Albers, J., Coutinho, R.A., Bleeker-Rovers, C.P., and Schneeberger, P.M. (2015). Population screening for chronic Q-fever seven years after a major outbreak. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0131777"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1569","DOI":"10.1007\/s10096-021-04179-5","article-title":"Long-term serological follow-up after primary Coxiella burnetii infection in patients with vascular risk factors for chronic Q fever","volume":"40","author":"Buijs","year":"2021","journal-title":"Eur. J. Clin. Microbiol. Infect. Dis."},{"key":"ref_32","first-page":"e14412","article-title":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)\/Hepatitis B virus (HBV) Co-infected Patients: A case series and review of the literature","volume":"75","author":"Arslan","year":"2021","journal-title":"Int. J. Clin. Pract."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1002\/rmv.2144","article-title":"Why the elderly appear to be more severely affected by COVID-19: The potential role of immunosenescence and CMV","volume":"30","author":"Kadambari","year":"2020","journal-title":"Rev. Med. Virol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1038\/s41598-021-85359-3","article-title":"Epidemiology and outcomes of COVID-19 in HIV-infected individuals: A systematic review and meta-analysis","volume":"11","author":"Ssentongo","year":"2021","journal-title":"Sci. Rep."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Post, P.M., Hogerwerf, L., Huss, A., Petie, R., Boender, G.J., Baliatsas, C., Lebret, E., Heederik, D., Hagenaars, T.J., and IJzermans, C.J. (2019). Risk of pneumonia among residents living near goat and poultry farms during 2014\u20132016. PLoS ONE, 14.","DOI":"10.1371\/journal.pone.0223601"},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Kalkowska, D.A., Boender, G.J., Smit, L.A.M., Baliatsas, C., Yzermans, J., Heederik, D.J.J., and Hagenaars, T.J. (2018). Associations between pneumonia and residential distance to livestock farms over a five-year period in a large population-based study. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0200813"},{"key":"ref_37","first-page":"1","article-title":"Updated systematic review: Associations between proximity to animal feeding operations and health of individuals in nearby communities","volume":"6","author":"Auvermann","year":"2017","journal-title":"Syst. Rev."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Skrajnowska, D., Brumer, M., Kankowska, S., Matysek, M., Miazio, N., and Bobrowska-Korczak, B. (2021). COVID 19: Diet composition and health. Nutrients, 13.","DOI":"10.3390\/nu13092980"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/3\/526\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:04:47Z","timestamp":1760133887000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/3\/526"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1,20]]},"references-count":38,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2022,2]]}},"alternative-id":["jcm11030526"],"URL":"https:\/\/doi.org\/10.3390\/jcm11030526","relation":{},"ISSN":["2077-0383"],"issn-type":[{"type":"electronic","value":"2077-0383"}],"subject":[],"published":{"date-parts":[[2022,1,20]]}}}