After months of restrictive containment efforts to fight the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) epidemic, European countries are planning to reopen. To support the process, we conducted a cross-sectional survey among the Hungarian population to estimate the prevalence of

Objectives: The actual frequency and the risk factors of SARS-CoV-2 reinfection is still a matter of intense scientific discussion. In this case series, we report three elite athletes who underwent COVID-19 reinfection with a short time frame. Case presentations: As a part of contact tracing, three speed skaters (22-, 24-, and 29-year-old males) were found to be SARS-CoV-2 positive by polymerase chain reaction (PCR) tests. Later on, only one of the athletes experienced mild symptoms, such as fatigue, loss of smell and taste and subfebrility, while the other two athletes were asymptomatic. Following the quarantine period, detailed return-to-play examinations, including laboratory testing, ECG, 24-h Holter monitoring, transthoracic echocardiography and cardiac magnetic resonance imaging, revealed no apparent abnormality; therefore, the athletes restarted training. After a median of 74 days, all three athletes presented with typical symptoms of COVID-19, such as fever, marked fatigue and headache. SARS-CoV-2 PCR tests were performed again, showing recurrent positivity. Repeated return-to-play assessments were initiated, finding no relevant abnormality. Athletes were also tested for SARS-CoV-2 anti-nucleoprotein antibody titers, showing only modest increases following the second infection. Conclusions: We report a small cluster of elite athletes who underwent a PCR-proven SARS-CoV-2 reinfection. According to these findings, athletes may be considered as a high-risk group in terms of recurrent COVID-19.

Összefoglaló. A HUNgarian COronaVirus disease-19 Epidemiological Research (H-UNCOVER) vizsgálat egy országos szintű reprezentatív felmérés volt, melyet az Innovációs és Technológiai Minisztérium (ITM) támogatásával végzett el a négy orvostudományi képzést folytató magyar egyetem a Központi Statisztikai Hivatallal (KSH) együttműködve. A vizsgálat célja az volt, hogy egy reprezentatív mintán keresztül felmérje a magyar lakosság SARS-CoV-2 átfertőzöttségét, és támaszul szolgáljon a koronavírus első hulláma kapcsán meghozott restriktív intézkedések utáni lazításra. A világszinten is jelentős méretű vizsgálat alacsony átfertőzöttségi arányt mutatott, így nemcsak a restriktív intézkedések hatékonyságát mutatta meg, de egy biztos járványügyi támaszt jelentett a gazdaság újranyitásának tervezéséhez. Summary. Close to the end of the first wave of the COVID-19 pandemic in Europe, many countries started to consider the possibility of reopening their economy, and lifting some of the containment measures introduced in the previous weeks. Such a decision is utterly complicated, as reopening might easily lead to an increase in active SARS-CoV-2 cases, but a delay puts an almost unbearable burden on the country’s economy. The objective of the HUNgarian COronaVirus disease-19 Epidemiological Research (H-UNCOVER) study was to conduct a cross-sectional survey among the Hungarian population to estimate the total number of infectious cases and the prevalence of prior SARS-CoV-2 exposure, and by using these data help to plan an exit strategy. The H-UNCOVER study was performed by the 4 medical universities in Hungary (Semmelweis University, University of Pécs, University of Debrecen and University of Szeged) with the help of the Central Statistical Office, Hungarian National Ambulance Service, Governmental offices and General Practitioners. The study was initiated 50 days after the Hungarian restrictions and performed between 1-16 May. With the help of the Central Statistical Office, 17,787 people were selected to represent the Hungarian population of 14 years or older living in private households (n=8,283,810). SARS-CoV-2 PCR and blood tests were performed to assess the prevalence of active infection and seropositivity. These tests were accompanied by a questionnaire about symptoms, comorbidities, and COVID-19 contacts. More specifically, questions included topics about home office, going abroad after the 1st of March, or possible contacts with COVID-19 positive, or quarantined individuals, as well as symptoms which might be due to COVID-19 infection. Altogether 67.7% of the selected individuals participated in some form in the study, which is an exceptionally high number compared to such studies. 10,502 individuals had SARS-CoV-2 PCR testing and 10,501 people had a blood test to assess SARS-CoV-2 IgG levels. Of the tested individuals, three had positive PCR and 69 had positive serological tests. Population estimates of the number of SARS-CoV-2 infections and seropositivity were 2,421 and 56,439, respectively, thus the active infection rate (2.9/10,000, 95% confidence interval: 0-6.7/10,000) and the prevalence of prior SARS-CoV-2 exposure (68/10,000, 95% confidence interval: 50-86/10,000) were low. A total of 10,474 individuals completed the questionnaire. Self-reported loss of smell or taste and body aches were significantly more frequent among those with SARS-CoV-2. Our study suggested that the early containment measures initiated by the Government of Hungary were effective in preventing the escalation of the first wave of COVID-19 in Hungary. We also found that the highest prevalence of the disease was in Budapest, and those who attended their workplace on a regular basis, travelled abroad after the 1st of March, or contacted with a COVID-19 positive or quarantined individual had a higher tendency to become infected. In conclusion, the H-UNCOVER study supported the exit strategy after the first wave of COVID-19 in Hungary.

Jelenleg a kereskedelmi forgalomban még nem érhetőek el a szív mechanikai funkciójának támogatására azok az újnak tekintett gyógyszerek, amelyekre, mint kardiális miozin-aktivátorok hivatkoznak. Az omecamtiv mecarbil, mint a csoport egyetlen ismert képviselője előzetes preklinikai vizsgálatokban hatékonynak tűnt. Továbbá bíztató eredmé-nyek láttak napvilágot a már lezárt I. és II. fázis klinikai vizsgálatokban is. A vegyület pontos hatásmechanizmusával és biztonságosságával kapcsolatban azonban még nem rendelkezünk kiterjedt ismeretekkel. Jelen áttekintés célja az, hogy a rendelkezésre álló laboratóriumi és klinikai adatok tükrében értékelje az omecamtiv mecarbil várható klinikai használhatóságát. Inotropic therapy with the myosin activator omecamtiv mecarbilThe novel cardiotonic drugs, called cardiac myosin activators have not been commercialized for clinical administrations yet. Omecamtiv mecarbil, the only known representative of the above class of drugs, appeared to be effective in preclinical investigations. Moreover, promising results have been also reported for phase I and phase II clinical trials as well. Nevertheless, our understanding on the exact mechanism of action and safety of omecamtiv mecarbil is still limited. The aim of the present overview is to summarize the currently available preclinical and clinical data on omecamtiv mecarbil, and thereby to estimate its potential clinical benefi t. BevezetésMelyek az ideális pozitív inotróp vegyület-tel szemben támasztott elvárások? Napjainkra már többszörösen igazolt tény, hogy a szív pumpafunkcióját támogató konvencionális pozitív inotróp hatású gyógyszerek alkalmazása -a kedvező hemodinamikai hatások dacára -nem problémamentes, hiszen alkalmazásuk fokozott mortalitással járhat (1-3).Mivel minden szempontból meggyőző pozitív inotróp hatású szer továbbra sem áll a rendelkezésünkre, az inotrópia a farmakológiai kutatások számára ma is cél-területként szerepel. A kívánatos az lenne, ha olyan kardiotonikus szereket sikerülne kifejleszteni, amelyek úgy javítanák a myocardium teljesítményét, hogy ezzel párhuzamosan nem fokozódna a szív oxigénfogyasztá-sa. Az ideális pozitív inotróp szerekkel szemben továb-myosin activators, omecamtiv mecarbil, positive inotropy, heart failure, Ca 2+ sensitiser positive inotrope agents Kulcsszavak:Keywords:miozin-aktivátorok, omecamtiv-mecarbil, pozitív inotrópia, szívelégtelenség, Ca 2+ -érzékenyítő pozitív inotróp vegyületek

BackgroundOrganization of mass sport events in the COVID-19 era is utterly complicated. Containments measures, required to avoid a virus outbreak, force athletes to compete under circumstances they never experienced before, most likely having a deleterious effect on their performance.PurposeWe aimed to design a so-called athlete-friendly bubble system for the International Swimming League 2020 event, which is strict enough to avoid a COVID-19 outbreak, but still provides a supportive environment for the athletes.MethodsTo avoid the feeling of imprisonment, athletes were permitted to spend a certain amount of time in the parks surrounding the hotels. Such alleviations were possible to apply with strict adherence to the hygienic and social distancing protocols and regular COVID-19 testing. Evaluation of every COVID-19 positive case was key, and if prolonged PCR positivity or false positive PCR result was identified, the unnecessary quarantine was planned to be lifted. Return to play protocol (RTP) was planned, in case of a COVID-19 infection of an athlete inside the bubble. To test, if the athlete-friendly system provided a supportive environment, we evaluated athlete performance.Results11,480 PCR tests were performed for 1,421 individuals. 63 COVID-19 positive cases were detected, of which 5 turned out to be clinically insignificant, either because of prolonged PCR positivity or because of a false positive result. 93.1% of the positive cases were detected in the local crew, while no athlete got infected inside the bubble, as the two infected athletes were tested positive upon arrival. RTP was provided for two athletes. 85% of the athletes showed improvement during the bubble and 8 world records were broken.ConclusionThe applied protocol proved to be effective, as no athlete got infected inside the bubble, moreover, the athlete-friendly system supported the athletes to improve their performance.