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Pallotto C, Tommasi A, Albagini M, Genga G, Svizzeretto E, Gidari A, Tordi S, Francisci D. Chronic antibiotic suppressive therapy with dalbavancin: a case series. J Chemother 2024:1-5. [PMID: 38712995 DOI: 10.1080/1120009x.2024.2349442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 04/24/2024] [Indexed: 05/08/2024]
Abstract
Dalbavancin is a relatively new long-acting anti-Gram positive antimicrobial approved for the treatment of acute bacterial skin and skin structures infections. An increasing number of observational studies and case series were published on its off-label uses. Great interest is emerging about complicated cases where antibiotic treatment cannot be discontinued, and a chronic suppressive therapy is needed. We described a case series of 6 patients treated or ongoing on treatment with dalbavancin as chronic suppressive therapy (CAST) administered with the following regimen: dalbavancin 1500 mg on day 1 and 8 and then every 4 weeks. CAST median duration was 27 weeks. Five out of 6 patients reached a good clinical control of the infection (one of them completely resolved) while in one case we observed a recurrence of the infection. No adverse events were detected. Larger studies are needed to better clarify dalbavancin off-label uses and the most appropriate dose regimen.
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Affiliation(s)
- Carlo Pallotto
- Infectious Diseases Clinic, Santa Maria della Misericordia Hospital, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Andrea Tommasi
- Infectious Diseases Clinic, Santa Maria della Misericordia Hospital, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Margherita Albagini
- Infectious Diseases Clinic, Santa Maria della Misericordia Hospital, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Giovanni Genga
- Infectious Diseases Clinic, Santa Maria della Misericordia Hospital, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Elisabetta Svizzeretto
- Infectious Diseases Clinic, Santa Maria della Misericordia Hospital, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Anna Gidari
- Infectious Diseases Unit, Santa Maria Hospital, Department of Medicine and Surgery, University of Perugia, Terni, Italy
| | - Sara Tordi
- Infectious Diseases Clinic, Santa Maria della Misericordia Hospital, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Daniela Francisci
- Infectious Diseases Clinic, Santa Maria della Misericordia Hospital, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
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De Socio GV, Tordi S, Altobelli D, Gidari A, Zoffoli A, Francisci D. Dolutegravir/Lamivudine versus Tenofovir Alafenamide/Emtricitabine/Bictegravir as a Switch Strategy in a Real-Life Cohort of Virogically Suppressed People Living with HIV. J Clin Med 2023; 12:7759. [PMID: 38137828 PMCID: PMC10743626 DOI: 10.3390/jcm12247759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 12/01/2023] [Accepted: 12/12/2023] [Indexed: 12/24/2023] Open
Abstract
BACKGROUND The aim of the study is to evaluate the effectiveness, safety, and tolerability of a two-drug regimen (2-DR) dolutegravir/lamivudine (DTG/3TC) versus a three-drug regimen (3-DR) tenofovir alafenamide/emtricitabine/bictegravir (TAF/FTC/BIC) in a real-life cohort of HIV-1 virologically suppressed treatment-experienced (TE) people living with HIV (PLWH). METHODS This was a single-center, retrospective, observational study analyzing adult TE PLWH who started the 2-DR or 3-DR between January 2018 and January 2023. All PLWH with a viral load (VL) <50 copies/mL at the time of switching, and a follow-up of more than 6 months or interruption of treatment at any time, were included. RESULTS A total of 324 PLWH were included; of these, 110 (34%) were on the 2-DR and 214 (66%) were on the 3-DR. Most patients remained on therapy in both groups (93.6% 2-DR versus 90.2% 3-DR) and, at the last control, 99.1% achieved VL < 50 copies/mL with the 2-DR versus 97.2% with the 3-DR (p = 0.260). No virological failures occurred in either group. Adverse events occurred in a few cases: four (3.6%) in the 2-DR group and five (2.3%) in the 3-DR group (p = 0.500). The median follow-up-time was 19.6 months for the 2-DR and 27.5 months for the 3-DR. CONCLUSION Our study shows a similar effectiveness and safety profile in virologically suppressed PLWH switching to DTG/3TC or TAF/FTC/BIC.
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Affiliation(s)
| | - Sara Tordi
- Correspondence: (G.V.D.S.); (S.T.); Tel.: +39-0755783262 (S.T.)
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Gidari A, Benedetti S, Tordi S, Zoffoli A, Altobelli D, Schiaroli E, De Socio GV, Francisci D. Bictegravir/Tenofovir Alafenamide/Emtricitabine: A Real-Life Experience in People Living with HIV (PLWH). Infect Dis Rep 2023; 15:766-777. [PMID: 38131882 PMCID: PMC10742537 DOI: 10.3390/idr15060069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 11/27/2023] [Accepted: 12/01/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Bictegravir (BIC), a recently introduced integrase inhibitor, is available in a single tablet regimen with tenofovir alafenamide (TAF) and emtricitabine (FTC) (BIC-STR). This study aimed to describe a real-life experience with BIC-STR. METHODS We retrospectively analyzed the data of people living with HIV (PLWH) on antiretroviral therapy (ART) with BIC-STR followed by the Clinic of Infectious Diseases of Perugia (Perugia, Italy) from September 2019 to February 2023. RESULTS 270 PLWH were enrolled with a median follow-up time on BIC-STR of 2.2 years (IQR 1.2-2.7). In the overall population, in treatment-experienced (N = 242), in treatment-naïve (N = 28), and in population with age > 60 years old (N = 86), we observed that CD4 cell count improved in absolute number, percentage and CD4/CD8 ratio, under BIC-STR. Patients with viremia < 50 cp/mL increased in all groups. In the overall population, previous ART with TAF and nadir CD4 cell count favored immunological recovery. In the ART-experienced group, time in therapy with BIC-STR was associated with HIV-RNA undetectability. In the older group, previous opportunistic infection and advanced age were associated with lower CD4 count. CONCLUSIONS BIC-STR was demonstrated, in real-life, to be a valid option for a switch, such as initial ART.
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Affiliation(s)
- Anna Gidari
- Department of Medicine, Clinic of Infectious Diseases, “Santa Maria della Misericordia” Hospital, University of Perugia, 06132 Perugia, Italy; (S.B.); (S.T.); (A.Z.); (D.A.); (E.S.); (G.V.D.S.); (D.F.)
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4
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Bianconi E, Gidari A, Souma M, Sabbatini S, Grifagni D, Bigiotti C, Schiaroli E, Comez L, Paciaroni A, Cantini F, Francisci D, Macchiarulo A. The hope and hype of ellagic acid and urolithins as ligands of SARS-CoV-2 Nsp5 and inhibitors of viral replication. J Enzyme Inhib Med Chem 2023; 38:2251721. [PMID: 37638806 PMCID: PMC10464554 DOI: 10.1080/14756366.2023.2251721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 08/14/2023] [Accepted: 08/19/2023] [Indexed: 08/29/2023] Open
Abstract
Non-structural protein 5 (Nsp5) is a cysteine protease that plays a key role in SARS-CoV-2 replication, suppressing host protein synthesis and promoting immune evasion. The investigation of natural products as a potential strategy for Nsp5 inhibition is gaining attention as a means of developing antiviral agents. In this work, we have investigated the physicochemical properties and structure-activity relationships of ellagic acid and its gut metabolites, urolithins A-D, as ligands of Nsp5. Results allow us to identify urolithin D as promising ligand of Nsp5, with a dissociation constant in the nanomolar range of potency. Although urolithin D is able to bind to the catalytic cleft of Nsp5, the appraisal of its viral replication inhibition against SARS-CoV-2 in Vero E6 assay highlights a lack of activity. While these results are discussed in the framework of the available literature reporting conflicting data on polyphenol antiviral activity, they provide new clues for natural products as potential viral protease inhibitors.
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Affiliation(s)
- Elisa Bianconi
- Department of Pharmaceutical Sciences, University of Perugia, Perugia, Italy
| | - Anna Gidari
- Department of Medicine and Surgery, Clinic of Infectious Diseases, University of Perugia, Perugia, Italy
| | - Maria Souma
- Department of Pharmaceutical Sciences, University of Perugia, Perugia, Italy
| | - Samuele Sabbatini
- Medical Microbiology Section, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Deborah Grifagni
- Centre for Magnetic Resonance, University of Florence, Sesto Fiorentino, Italy
- Department of Chemistry, University of Florence, Sesto Fiorentino, Italy
| | - Carlo Bigiotti
- Department of Pharmaceutical Sciences, University of Perugia, Perugia, Italy
| | - Elisabetta Schiaroli
- Department of Medicine and Surgery, Clinic of Infectious Diseases, University of Perugia, Perugia, Italy
| | - Lucia Comez
- Istituto Officina dei Materiali-IOM, National Research Council-CNR, Perugia, Italy
| | | | - Francesca Cantini
- Centre for Magnetic Resonance, University of Florence, Sesto Fiorentino, Italy
- Department of Chemistry, University of Florence, Sesto Fiorentino, Italy
| | - Daniela Francisci
- Department of Medicine and Surgery, Clinic of Infectious Diseases, University of Perugia, Perugia, Italy
| | - Antonio Macchiarulo
- Department of Pharmaceutical Sciences, University of Perugia, Perugia, Italy
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Schiaroli E, Gidari A, Brachelente G, Bicchieraro G, Spaccapelo R, Bastianelli S, Pierucci S, Busti C, Pallotto C, Malincarne L, Camilloni B, Falcinelli F, De Socio GV, Villa A, Mencacci A, Francisci D. Impaired neutralizing antibody efficacy of tixagevimab-cilgavimab 150+150 mg as pre-exposure prophylaxis against Omicron BA.5. A real-world experience in booster vaccinated immunocompromised patients. J Clin Virol 2023; 168:105584. [PMID: 37778220 DOI: 10.1016/j.jcv.2023.105584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 09/07/2023] [Accepted: 09/12/2023] [Indexed: 10/03/2023]
Abstract
BACKGROUND Tixagevimab-cilgavimab has been approved as primary pre-exposure prophylaxis in immunocompromised patients as support or replacement for vaccination, even though the Omicron variant of concern (VOC) was spreading at the time. OBJECTIVES The aim of our study was to evaluate the post-injection neutralising activity (NT90-Abs titre) against the Omicron BA.5 variant in fully vaccinated immunocompromised patients. STUDY DESIGN NT90-Abs titres against BA.5 and 20A.EU1 as well as anti-spike and anti-receptor-binding domain IgG were evaluated 0, 14, and 30 d after tixagevimab-cilgavimab administration. The primary end point was NT90-Abs titres ≥ 80 against BA.5 in ≥ 25% of patients, and the secondary end point was NT90-Abs titres ≥ 1280 against 20A.EU1 in >50% of patients on day 14. RESULTS At baseline, 35.2%, 37.02%, and 32.5% of booster vaccinated patients exhibited undetectable levels of anti-S and anti-RBD IgG antibodies such as NT90-Abs titres against A20.EU1. Moreover, 35 patients (61.5%) had undetectable NT90-Abs titres against BA.5. On day 14, IgG anti-S and anti-RBD levels were 3880 BAU/mL and 776.6 AU/mL, respectively. Only 12.5% of patients met a NT90-Abs titres ≥ 80 against BA.5, whereas the median NT90-Abs titre against 20A.EU1 was 1280. NT90-Abs titres against BA.5 were 64-fold lower than those against A20.EU1. Four patients (7.5%) had a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in the 3 months after treatment, all with a time gap between the booster vaccination and injection. CONCLUSIONS To date, tixagevimab-cilgavimab cannot be considered a substitute for vaccination but may be a useful supporting therapy if the recommended dose for pre-exposure prophylaxis is doubled.
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Affiliation(s)
- Elisabetta Schiaroli
- Clinic of Infectious Diseases, Department of Medicine and Surgery, University of Perugia, Perugia, Italy.
| | - Anna Gidari
- Clinic of Infectious Diseases, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Giovanni Brachelente
- Clinical Pathology and Ematology, Santa Maria della Misericordia Hospital, Perugia, Italy
| | - Giulia Bicchieraro
- Genomics and Genetics Section, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Roberta Spaccapelo
- Functional Genomic Center (C.U.R.Ge.F), Department of Medicine and Surgery, Genomics and Genetics section Department of Medicine and Surgery, University of Perugia, Italy
| | - Sabrina Bastianelli
- Clinic of Infectious Diseases, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Sara Pierucci
- Clinic of Infectious Diseases, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Chiara Busti
- Clinic of Infectious Diseases, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Carlo Pallotto
- Clinic of Infectious Diseases, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Lisa Malincarne
- Clinic of Infectious Diseases, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Barbara Camilloni
- Microbiology and Clinical Microbiology, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Flavio Falcinelli
- Hematolgy Clinic, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Giuseppe Vittorio De Socio
- Clinic of Infectious Diseases, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Alfredo Villa
- Clinical Pathology and Ematology, Santa Maria della Misericordia Hospital, Perugia, Italy
| | - Antonella Mencacci
- Microbiology and Clinical Microbiology, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Daniela Francisci
- Clinic of Infectious Diseases, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
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Gidari A, Sabbatini S, Schiaroli E, Bastianelli S, Pierucci S, Busti C, Saraca LM, Capogrossi L, Pasticci MB, Francisci D. Synergistic Activity of Remdesivir-Nirmatrelvir Combination on a SARS-CoV-2 In Vitro Model and a Case Report. Viruses 2023; 15:1577. [PMID: 37515263 PMCID: PMC10385213 DOI: 10.3390/v15071577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 07/10/2023] [Accepted: 07/17/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND This study aims to investigate the activity of the remdesivir-nirmatrelvir combination against Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) and to report a case of Coronavirus Disease 2019 (COVID-19) cured with this combination. METHODS A Vero E6 cell-based infection assay was used to investigate the in vitro activity of the remdesivir-nirmatrelvir combination. The SARS-CoV-2 strains tested were 20A.EU1, BA.1 and BA.5. After incubation, a viability assay was performed. The supernatants were collected and used for viral titration. The Highest Single Agent (HSA) reference model was calculated. An HSA score >10 is considered synergic. RESULTS Remdesivir and nirmatrelvir showed synergistic activity at 48 and 72 h, with an HSA score of 52.8 and 28.6, respectively (p < 0.0001). These data were confirmed by performing supernatant titration and against the omicron variants: the combination reduced the viral titer better than the more active compound alone. An immunocompromised patient with prolonged and critical COVID-19 was successfully treated with remdesivir, nirmatrelvir/ritonavir, tixagevimab/cilgavimab and dexamethasone, with an excellent clinical-radiological response. However, she required further off-label prolonged therapy with nirmatrelvir/ritonavir until she tested negative. CONCLUSIONS Remdesivir-nirmatrelvir combination has synergic activity in vitro. This combination may have a role in immunosuppressed patients with severe COVID-19 and prolonged viral shedding.
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Affiliation(s)
- Anna Gidari
- Department of Medicine and Surgery, Clinic of Infectious Diseases, "Santa Maria della Misericordia" Hospital, University of Perugia, 06123 Perugia, Italy
- Clinic of Infectious Diseases, "Santa Maria" Hospital, Terni, 05100 Terni, Italy
| | - Samuele Sabbatini
- Department of Medicine and Surgery, Medical Microbiology Section, University of Perugia, 06123 Perugia, Italy
| | - Elisabetta Schiaroli
- Department of Medicine and Surgery, Clinic of Infectious Diseases, "Santa Maria della Misericordia" Hospital, University of Perugia, 06123 Perugia, Italy
| | - Sabrina Bastianelli
- Department of Medicine and Surgery, Clinic of Infectious Diseases, "Santa Maria della Misericordia" Hospital, University of Perugia, 06123 Perugia, Italy
| | - Sara Pierucci
- Department of Medicine and Surgery, Clinic of Infectious Diseases, "Santa Maria della Misericordia" Hospital, University of Perugia, 06123 Perugia, Italy
| | - Chiara Busti
- Department of Medicine and Surgery, Clinic of Infectious Diseases, "Santa Maria della Misericordia" Hospital, University of Perugia, 06123 Perugia, Italy
| | - Lavinia Maria Saraca
- Clinic of Infectious Diseases, "Santa Maria" Hospital, Terni, 05100 Terni, Italy
| | - Luca Capogrossi
- Department of Medicine and Surgery, Clinic of Infectious Diseases, "Santa Maria della Misericordia" Hospital, University of Perugia, 06123 Perugia, Italy
| | - Maria Bruna Pasticci
- Department of Medicine and Surgery, Clinic of Infectious Diseases, "Santa Maria della Misericordia" Hospital, University of Perugia, 06123 Perugia, Italy
- Clinic of Infectious Diseases, "Santa Maria" Hospital, Terni, 05100 Terni, Italy
| | - Daniela Francisci
- Department of Medicine and Surgery, Clinic of Infectious Diseases, "Santa Maria della Misericordia" Hospital, University of Perugia, 06123 Perugia, Italy
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Paciaroni A, Libera V, Ripanti F, Orecchini A, Petrillo C, Francisci D, Schiaroli E, Sabbatini S, Gidari A, Bianconi E, Macchiarulo A, Hussain R, Silvestrini L, Moretti P, Belhaj N, Vercelli M, Roque Y, Mariani P, Comez L, Spinozzi F. Stabilization of the Dimeric State of SARS-CoV-2 Main Protease by GC376 and Nirmatrelvir. Int J Mol Sci 2023; 24:ijms24076062. [PMID: 37047038 PMCID: PMC10093836 DOI: 10.3390/ijms24076062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 03/10/2023] [Accepted: 03/21/2023] [Indexed: 04/14/2023] Open
Abstract
The main protease (Mpro or 3CLpro) is an enzyme that is evolutionarily conserved among different genera of coronaviruses. As it is essential for processing and maturing viral polyproteins, Mpro has been identified as a promising target for the development of broad-spectrum drugs against coronaviruses. Like SARS-CoV and MERS-CoV, the mature and active form of SARS-CoV-2 Mpro is a dimer composed of identical subunits, each with a single active site. Individual monomers, however, have very low or no catalytic activity. As such, inhibition of Mpro can be achieved by molecules that target the substrate binding pocket to block catalytic activity or target the dimerization process. In this study, we investigated GC376, a transition-state analog inhibitor of the main protease of feline infectious peritonitis coronavirus, and Nirmatrelvir (NMV), an oral, bioavailable SARS-CoV-2 Mpro inhibitor with pan-human coronavirus antiviral activity. Our results show that both GC376 and NMV are capable of strongly binding to SARS-CoV-2 Mpro and altering the monomer-dimer equilibrium by stabilizing the dimeric state. This behavior is proposed to be related to a structured hydrogen-bond network established at the Mpro active site, where hydrogen bonds between Ser1' and Glu166/Phe140 are formed in addition to those achieved by the latter residues with GC376 or NMV.
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Affiliation(s)
- Alessandro Paciaroni
- Department of Physics and Geology, University of Perugia, Via Alessandro Pascoli, 06123 Perugia, Italy
| | - Valeria Libera
- Department of Physics and Geology, University of Perugia, Via Alessandro Pascoli, 06123 Perugia, Italy
- Istituto Officina dei Materiali-IOM, National Research Council-CNR, Via Alessandro Pascoli, 06123 Perugia, Italy
| | - Francesca Ripanti
- Department of Physics and Geology, University of Perugia, Via Alessandro Pascoli, 06123 Perugia, Italy
| | - Andrea Orecchini
- Department of Physics and Geology, University of Perugia, Via Alessandro Pascoli, 06123 Perugia, Italy
| | - Caterina Petrillo
- Department of Physics and Geology, University of Perugia, Via Alessandro Pascoli, 06123 Perugia, Italy
| | - Daniela Francisci
- Department of Medicine and Surgery, Clinic of Infectious Diseases, University of Perugia, Piazzale Gambuli, 06129 Perugia, Italy
| | - Elisabetta Schiaroli
- Department of Medicine and Surgery, Clinic of Infectious Diseases, University of Perugia, Piazzale Gambuli, 06129 Perugia, Italy
| | - Samuele Sabbatini
- Department of Medicine and Surgery, Medical Microbiology Section, University of Perugia, Piazzale Gambuli, 06129 Perugia, Italy
| | - Anna Gidari
- Department of Medicine and Surgery, Clinic of Infectious Diseases, University of Perugia, Piazzale Gambuli, 06129 Perugia, Italy
| | - Elisa Bianconi
- Department of Pharmaceutical Sciences, University of Perugia, Via del Liceo, 06123 Perugia, Italy
| | - Antonio Macchiarulo
- Department of Pharmaceutical Sciences, University of Perugia, Via del Liceo, 06123 Perugia, Italy
| | - Rohanah Hussain
- Diamond Light Source Ltd., Harwell Science and Innovation Campus, Didcot OX11 0DE, UK
| | - Lucia Silvestrini
- Department of Life and Environmental Sciences, Polytechnic University of Marche, Via Brecce Bianche, 12, 60131 Ancona, Italy
| | - Paolo Moretti
- Department of Life and Environmental Sciences, Polytechnic University of Marche, Via Brecce Bianche, 12, 60131 Ancona, Italy
| | - Norhan Belhaj
- Department of Life and Environmental Sciences, Polytechnic University of Marche, Via Brecce Bianche, 12, 60131 Ancona, Italy
| | - Matteo Vercelli
- Department of Life and Environmental Sciences, Polytechnic University of Marche, Via Brecce Bianche, 12, 60131 Ancona, Italy
| | - Yessica Roque
- Department of Life and Environmental Sciences, Polytechnic University of Marche, Via Brecce Bianche, 12, 60131 Ancona, Italy
| | - Paolo Mariani
- Department of Life and Environmental Sciences, Polytechnic University of Marche, Via Brecce Bianche, 12, 60131 Ancona, Italy
| | - Lucia Comez
- Istituto Officina dei Materiali-IOM, National Research Council-CNR, Via Alessandro Pascoli, 06123 Perugia, Italy
| | - Francesco Spinozzi
- Department of Life and Environmental Sciences, Polytechnic University of Marche, Via Brecce Bianche, 12, 60131 Ancona, Italy
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Gidari A, Schiaroli E, Sabbatini S, Bastianelli S, Pierucci S, Busti C, Francisci D. Impact of SARS-CoV-2 Omicron Variants on Serum Neutralization in a Cohort of Healthcare Workers Vaccinated with BNT162b2. J Infect 2022; 85:e125-e126. [PMID: 36031155 PMCID: PMC9419996 DOI: 10.1016/j.jinf.2022.08.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 08/19/2022] [Indexed: 11/24/2022]
Affiliation(s)
- Anna Gidari
- Department of Medicine and Surgery, Clinic of Infectious Diseases, "Santa Maria della Misericordia" Hospital, University of Perugia, Perugia, Italy.
| | - Elisabetta Schiaroli
- Department of Medicine and Surgery, Clinic of Infectious Diseases, "Santa Maria della Misericordia" Hospital, University of Perugia, Perugia, Italy
| | - Samuele Sabbatini
- Department of Medicine and Surgery, Medical Microbiology Section, University of Perugia, Perugia, Italy
| | - Sabrina Bastianelli
- Department of Medicine and Surgery, Clinic of Infectious Diseases, "Santa Maria della Misericordia" Hospital, University of Perugia, Perugia, Italy
| | - Sara Pierucci
- Department of Medicine and Surgery, Clinic of Infectious Diseases, "Santa Maria della Misericordia" Hospital, University of Perugia, Perugia, Italy
| | - Chiara Busti
- Department of Medicine and Surgery, Clinic of Infectious Diseases, "Santa Maria della Misericordia" Hospital, University of Perugia, Perugia, Italy
| | - Daniela Francisci
- Department of Medicine and Surgery, Clinic of Infectious Diseases, "Santa Maria della Misericordia" Hospital, University of Perugia, Perugia, Italy
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Gidari A, Bastianelli S, Pierucci S, Busti C, Sabbatini S, Schiaroli E, Benedetti S, Gamboni G, Lanzi A, Francisci D. BNT162b2 Elicited an Efficient Humoral Response Against Different Strains of SARS-CoV-2 in People Living with HIV. Curr HIV Res 2022; 20:296-300. [PMID: 35909272 DOI: 10.2174/1570162x20666220729143949] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 04/07/2022] [Accepted: 05/05/2022] [Indexed: 01/27/2023]
Abstract
BACKGROUND Vaccines have had a fundamental impact in containing the ongoing Coronavirus Disease 2019 (COVID-19) pandemic. However, there are few efficacy data relating to frail patients, including the HIV-positive patient. OBJECTIVE This study evaluated the Severe Acute Respiratory Syndrome Coronavirus 2 (SARSCoV- 2) serum neutralization in People Living with HIV (PLWH) compared to a cohort of healthy volunteers both vaccinated with BNT162b2. METHODS A serum sample was then withdrawn 14-21 days after the second dose of the vaccine and a serum neutralization assay was performed on Vero E6 cells. The experiments were performed using two strains of SARS-CoV-2 as 20A.EU1 and B.1.617.2. RESULTS PLWH on Antiretroviral Therapy (ART) showed a vaccine response comparable to the healthy subjects. No correlation between CD4 count or CD4/CD8 and neutralizing antibodies (NTAbs) has been found. No differences in NT-Abs between patients with CD4 nadir above or under 200 cells/μl have been found. In both cohorts, vaccine-elicited serum better neutralized 20A.EU1 than B.1.617.2 strain. CONCLUSION PLWH in ART and with good immuno-virological recovery showed a vaccine response comparable to that of healthy subjects and regardless of their immunological status at HIV infection diagnosis. However, larger studies are needed to confirm our results and to evaluate the vaccine response even in patients with low CD4 counts.
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Affiliation(s)
- Anna Gidari
- Department of Medicine and Surgery, Clinic of Infectious Diseases, "Santa Maria della Misericordia" Hospital, University of Perugia, Perugia, Italy
| | - Sabrina Bastianelli
- Department of Medicine and Surgery, Clinic of Infectious Diseases, "Santa Maria della Misericordia" Hospital, University of Perugia, Perugia, Italy
| | - Sara Pierucci
- Department of Medicine and Surgery, Clinic of Infectious Diseases, "Santa Maria della Misericordia" Hospital, University of Perugia, Perugia, Italy
| | - Chiara Busti
- Department of Medicine and Surgery, Clinic of Infectious Diseases, "Santa Maria della Misericordia" Hospital, University of Perugia, Perugia, Italy
| | - Samuele Sabbatini
- Department of Medicine and Surgery, Medical Microbiology Section, University of Perugia, Perugia, Italy
| | - Elisabetta Schiaroli
- Department of Medicine and Surgery, Clinic of Infectious Diseases, "Santa Maria della Misericordia" Hospital, University of Perugia, Perugia, Italy
| | - Sara Benedetti
- Department of Medicine and Surgery, Clinic of Infectious Diseases, "Santa Maria della Misericordia" Hospital, University of Perugia, Perugia, Italy
| | - Giulia Gamboni
- Department of Medicine and Surgery, Clinic of Infectious Diseases, "Santa Maria della Misericordia" Hospital, University of Perugia, Perugia, Italy
| | - Alessandra Lanzi
- Department of Medicine and Surgery, Clinic of Infectious Diseases, "Santa Maria della Misericordia" Hospital, University of Perugia, Perugia, Italy
| | - Daniela Francisci
- Department of Medicine and Surgery, Clinic of Infectious Diseases, "Santa Maria della Misericordia" Hospital, University of Perugia, Perugia, Italy
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10
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Fiaschi L, Dragoni F, Schiaroli E, Bergna A, Rossetti B, Giammarino F, Biba C, Gidari A, Lai A, Nencioni C, Francisci D, Zazzi M, Vicenti I. Efficacy of Licensed Monoclonal Antibodies and Antiviral Agents against the SARS-CoV-2 Omicron Sublineages BA.1 and BA.2. Viruses 2022; 14:v14071374. [PMID: 35891355 PMCID: PMC9321742 DOI: 10.3390/v14071374] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 06/20/2022] [Accepted: 06/22/2022] [Indexed: 12/10/2022] Open
Abstract
Newly emerging SARS-CoV-2 variants may escape monoclonal antibodies (mAbs) and antiviral drugs. By using live virus assays, we assessed the ex vivo inhibition of the B.1 wild-type (WT), delta and omicron BA.1 and BA.2 lineages by post-infusion sera from 40 individuals treated with bamlanivimab/etesevimab (BAM/ETE), casirivimab/imdevimab (CAS/IMD), and sotrovimab (SOT) as well as the activity of remdesivir, nirmatrelvir and molnupiravir. mAbs and drug activity were defined as the serum dilution (ID50) and drug concentration (IC50), respectively, showing 50% protection of virus-induced cytopathic effect. All pre-infusion sera were negative for SARS-CoV-2 neutralizing activity. BAM/ETE, CAS/IMD, and SOT showed activity against the WT (ID50 6295 (4355–8075) for BAM/ETE; 18,214 (16,248–21,365) for CAS/IMD; and 456 (265–592) for SOT) and the delta (14,780 (ID50 10,905–21,020) for BAM/ETE; 63,937 (47,211–79,971) for CAS/IMD; and 1103 (843–1334) for SOT). Notably, only SOT was active against BA.1 (ID50 200 (37–233)), whereas BA.2 was neutralized by CAS/IMD (ID50 174 (134–209) ID50) and SOT (ID50 20 (9–31) ID50), but not by BAM/ETE. No significant inter-variant IC50 differences were observed for molnupiravir (1.5 ± 0.1/1.5 ± 0.7/1.0 ± 0.5/0.8 ± 0.01 μM for WT/delta/BA.1/BA.2, respectively), nirmatrelvir (0.05 ± 0.02/0.06 ± 0.01/0.04 ± 0.02/0.04 ± 0.01 μM) or remdesivir (0.08 ± 0.04/0.11 ± 0.08/0.05 ± 0.04/0.08 ± 0.01 μM). Continued evolution of SARS-CoV-2 requires updating the mAbs arsenal, although antivirals have so far remained unaffected.
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Affiliation(s)
- Lia Fiaschi
- Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy; (L.F.); (F.D.); (F.G.); (C.B.); (M.Z.)
| | - Filippo Dragoni
- Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy; (L.F.); (F.D.); (F.G.); (C.B.); (M.Z.)
| | - Elisabetta Schiaroli
- Department of Medicine and Surgery, Clinic of Infectious Diseases, University of Perugia, 06129 Perugia, Italy; (E.S.); (A.G.); (D.F.)
| | - Annalisa Bergna
- Department of Biomedical and Clinical Sciences L. Sacco, University of Milan, 20157 Milan, Italy; (A.B.); (A.L.)
| | - Barbara Rossetti
- Infectious Disease Department, USL SUDEST, Toscana, Misericordia Hospital, 58100 Grosseto, Italy; (B.R.); (C.N.)
| | - Federica Giammarino
- Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy; (L.F.); (F.D.); (F.G.); (C.B.); (M.Z.)
| | - Camilla Biba
- Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy; (L.F.); (F.D.); (F.G.); (C.B.); (M.Z.)
| | - Anna Gidari
- Department of Medicine and Surgery, Clinic of Infectious Diseases, University of Perugia, 06129 Perugia, Italy; (E.S.); (A.G.); (D.F.)
| | - Alessia Lai
- Department of Biomedical and Clinical Sciences L. Sacco, University of Milan, 20157 Milan, Italy; (A.B.); (A.L.)
| | - Cesira Nencioni
- Infectious Disease Department, USL SUDEST, Toscana, Misericordia Hospital, 58100 Grosseto, Italy; (B.R.); (C.N.)
| | - Daniela Francisci
- Department of Medicine and Surgery, Clinic of Infectious Diseases, University of Perugia, 06129 Perugia, Italy; (E.S.); (A.G.); (D.F.)
| | - Maurizio Zazzi
- Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy; (L.F.); (F.D.); (F.G.); (C.B.); (M.Z.)
| | - Ilaria Vicenti
- Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy; (L.F.); (F.D.); (F.G.); (C.B.); (M.Z.)
- Correspondence: ; Tel.: +39-057-7233-855
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11
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Mencacci A, Gili A, Gidari A, Schiaroli E, Russo C, Cenci E, Camilloni B, Graziani A, Melelli-Roia A, Francisci D, Stracci F. Role of Nucleocapsid Protein Antigen Detection for Safe End of Isolation of SARS-CoV-2 Infected Patients with Long Persistence of Viral RNA in Respiratory Samples. J Clin Med 2021; 10:jcm10184037. [PMID: 34575147 PMCID: PMC8469917 DOI: 10.3390/jcm10184037] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 08/31/2021] [Accepted: 09/03/2021] [Indexed: 12/23/2022] Open
Abstract
Background. In SARS-CoV-2 infection, viral RNA may persist in respiratory samples for several weeks after the resolution of symptoms. Criteria to assess the end of infectivity are not unequivocally defined. In some countries, time from diagnosis is the unique criterion used, in addition to symptom cessation. This study evaluates the role of the Lumipulse® Antigen Assay (LAA) for the safe end of isolation of patients ≥21 days after the diagnosis of infection. Methods. A total of 671 nasopharyngeal swabs from patients diagnosed with infection at least 21 days before were assessed by RT-PCR and LAA, and the role of LAA in predicting the absence of infectivity was evaluated by virus cell culture. Results. Viable virus was present in 10/138 cultured samples. Eight out of ten infective patients suffered from a concomitant disease, predisposing them to long-term shedding of infective virus. In particular, infectious virus was isolated from 10/20 RT-PCR+/LAA+ cultured samples, whereas no viable virus was found in all 118 RT-PCR+/LAA– cultured swabs. LLA and RT-PCR agreed in 484/671 (72.1%) samples, with 100% and 26.7% concordance in RT-PCR negative and positive samples, respectively. Conclusions. Viable virus can be found ≥21 days after diagnosis in immunocompromised or severely ill patients. LAA better than RT-PCR predicts non-infectivity of patients and can be safely used to end isolation in cases with long persistence of viral RNA in the respiratory tract.
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Affiliation(s)
- Antonella Mencacci
- Department of Medicine and Surgery, Microbiology and Clinical Microbiology, Santa Maria Della Misericordia” Hospital, University of Perugia, 06129 Perugia, Italy; (C.R.); (E.C.); (B.C.); (A.G.); (A.M.-R.)
- Correspondence: (A.M.); (A.G.); Tel.: +39-0755784277 (A.M.); +39-0755858033 (A.G.)
| | - Alessio Gili
- Public Health Section, Department of Medicine and Surgery, University of Perugia, 06129 Perugia, Italy;
- Correspondence: (A.M.); (A.G.); Tel.: +39-0755784277 (A.M.); +39-0755858033 (A.G.)
| | - Anna Gidari
- Department of Medicine and Surgery, Infectious Diseases Clinic, “Santa Maria della Misericordia” Hospital, University of Perugia, 06129 Perugia, Italy; (A.G.); (E.S.); (D.F.)
| | - Elisabetta Schiaroli
- Department of Medicine and Surgery, Infectious Diseases Clinic, “Santa Maria della Misericordia” Hospital, University of Perugia, 06129 Perugia, Italy; (A.G.); (E.S.); (D.F.)
| | - Carla Russo
- Department of Medicine and Surgery, Microbiology and Clinical Microbiology, Santa Maria Della Misericordia” Hospital, University of Perugia, 06129 Perugia, Italy; (C.R.); (E.C.); (B.C.); (A.G.); (A.M.-R.)
| | - Elio Cenci
- Department of Medicine and Surgery, Microbiology and Clinical Microbiology, Santa Maria Della Misericordia” Hospital, University of Perugia, 06129 Perugia, Italy; (C.R.); (E.C.); (B.C.); (A.G.); (A.M.-R.)
| | - Barbara Camilloni
- Department of Medicine and Surgery, Microbiology and Clinical Microbiology, Santa Maria Della Misericordia” Hospital, University of Perugia, 06129 Perugia, Italy; (C.R.); (E.C.); (B.C.); (A.G.); (A.M.-R.)
| | - Alessandro Graziani
- Department of Medicine and Surgery, Microbiology and Clinical Microbiology, Santa Maria Della Misericordia” Hospital, University of Perugia, 06129 Perugia, Italy; (C.R.); (E.C.); (B.C.); (A.G.); (A.M.-R.)
| | - Arduino Melelli-Roia
- Department of Medicine and Surgery, Microbiology and Clinical Microbiology, Santa Maria Della Misericordia” Hospital, University of Perugia, 06129 Perugia, Italy; (C.R.); (E.C.); (B.C.); (A.G.); (A.M.-R.)
| | - Daniela Francisci
- Department of Medicine and Surgery, Infectious Diseases Clinic, “Santa Maria della Misericordia” Hospital, University of Perugia, 06129 Perugia, Italy; (A.G.); (E.S.); (D.F.)
| | - Fabrizio Stracci
- Public Health Section, Department of Medicine and Surgery, University of Perugia, 06129 Perugia, Italy;
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12
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Biagioli M, Marchianò S, Roselli R, Di Giorgio C, Bellini R, Bordoni M, Gidari A, Sabbatini S, Francisci D, Fiorillo B, Catalanotti B, Distrutti E, Carino A, Zampella A, Costantino G, Fiorucci S. Discovery of a AHR pelargonidin agonist that counter-regulates Ace2 expression and attenuates ACE2-SARS-CoV-2 interaction. Biochem Pharmacol 2021; 188:114564. [PMID: 33872570 PMCID: PMC8052506 DOI: 10.1016/j.bcp.2021.114564] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 04/09/2021] [Accepted: 04/12/2021] [Indexed: 02/06/2023]
Abstract
The severe acute respiratory syndrome (SARS)-CoV-2 is the pathogenetic agent of Corona Virus Induced Disease (COVID)19. The virus enters the human cells after binding to the angiotensin converting enzyme (ACE)2 receptor in target tissues. ACE2 expression is induced in response to inflammation. The colon expression of ACE2 is upregulated in patients with inflammatory bowel disease (IBD), highlighting a potential risk of intestinal inflammation in promoting viral entry in the human body. Because mechanisms that regulate ACE2 expression in the intestine are poorly understood and there is a need of anti-SARS-CoV-2 therapies, we have settled to investigate whether natural flavonoids might regulate the expression of Ace2 in intestinal models of inflammation. The results of these studies demonstrated that pelargonidin activates the Aryl hydrocarbon Receptor (AHR) in vitro and reverses intestinal inflammation caused by chronic exposure to high fat diet or to the intestinal braking-barrier agent TNBS in a AhR-dependent manner. In these two models, development of colon inflammation associated with upregulation of Ace2 mRNA expression. Colon levels of Ace2 mRNA were directly correlated with Tnf-α mRNA levels. Molecular docking studies suggested that pelargonidin binds a fatty acid binding pocket on the receptor binding domain of SARS-CoV-2 Spike protein. In vitro studies demonstrated that pelargonidin significantly reduces the binding of SARS-CoV-2 Spike protein to ACE2 and reduces the SARS-CoV-2 replication in a concentration-dependent manner. In summary, we have provided evidence that a natural flavonoid might hold potential in reducing intestinal inflammation and ACE2 induction in the inflamed colon in a AhR-dependent manner.
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Affiliation(s)
- Michele Biagioli
- Dipartimento di Medicina e Chirurgia, Università di Perugia, Perugia, Italy
| | - Silvia Marchianò
- Dipartimento di Medicina e Chirurgia, Università di Perugia, Perugia, Italy
| | - Rosalinda Roselli
- University of Naples Federico II, Department of Pharmacy, Naples, Italy
| | | | - Rachele Bellini
- Dipartimento di Medicina e Chirurgia, Università di Perugia, Perugia, Italy
| | - Martina Bordoni
- Dipartimento di Medicina e Chirurgia, Università di Perugia, Perugia, Italy
| | - Anna Gidari
- Dipartimento di Medicina e Chirurgia, Università di Perugia, Perugia, Italy
| | - Samuele Sabbatini
- Dipartimento di Medicina e Chirurgia, Università di Perugia, Perugia, Italy
| | - Daniela Francisci
- Dipartimento di Medicina e Chirurgia, Università di Perugia, Perugia, Italy
| | - Bianca Fiorillo
- University of Naples Federico II, Department of Pharmacy, Naples, Italy
| | - Bruno Catalanotti
- University of Naples Federico II, Department of Pharmacy, Naples, Italy
| | - Eleonora Distrutti
- SC di Gastroenterologia ed Epatologia, Azienda Ospedaliera di Perugia, Perugia, Italy
| | - Adriana Carino
- Dipartimento di Medicina e Chirurgia, Università di Perugia, Perugia, Italy
| | - Angela Zampella
- University of Naples Federico II, Department of Pharmacy, Naples, Italy
| | | | - Stefano Fiorucci
- Dipartimento di Medicina e Chirurgia, Università di Perugia, Perugia, Italy,Corresponding author
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13
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De Socio GV, Gidari A, Sicari F, Palumbo M, Francisci D. National Early Warning Score 2 (NEWS2) better predicts critical Coronavirus Disease 2019 (COVID-19) illness than COVID-GRAM, a multi-centre study. Infection 2021; 49:1033-1038. [PMID: 33970431 PMCID: PMC8108728 DOI: 10.1007/s15010-021-01620-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Accepted: 04/27/2021] [Indexed: 12/25/2022]
Abstract
Purpose Clinical scores to rapidly assess the severity illness of Coronavirus Disease 2019 (COVID-19) could be considered of help for clinicians. Recently, a specific score (named COVID-GRAM) for severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection, based on a nationwide Chinese cohort, has been proposed. We routinely applied the National Early Warning Score 2 (NEWS2) to predict critical COVID-19. Aim of this study is to compare NEWS2 and COVID-GRAM score. Methods We retrospectively analysed data of 121 COVID-19 patients admitted in two Clinics of Infectious Diseases in the Umbria region, Italy. The primary outcome was critical COVID-19 illness defined as admission to the intensive care unit, invasive ventilation, or death. Accuracy of the scores was evaluated with the area under the receiver-operating characteristic curve (AUROC). Differences between scores were confirmed used Hanley–McNeil test. Results The NEWS2 AUROC curve measured 0.87 (standard error, SE 0.03; 95% CI 0.80–0.93; p < 0.0001). The COVID-GRAM score AUROC curve measured 0.77 (SE 0.04; 95% CI 0.68–0.85; p < 0.0001). Hanley–McNeil test showed that NEWS2 better predicted severe COVID-19 (Z = 2.03). Conclusions The NEWS2 showed superior accuracy to COVID-GRAM score for prediction of critical COVID-19 illness. Supplementary Information The online version contains supplementary material available at 10.1007/s15010-021-01620-x.
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Affiliation(s)
- Giuseppe Vittorio De Socio
- Department of Medicine and Surgery, Clinic of Infectious Diseases, "Santa Maria della Misericordia" Hospital, Università degli Studi di Perugia, Piazzale Lucio Severi 1, 06132, Perugia, Italy
| | - Anna Gidari
- Department of Medicine and Surgery, Clinic of Infectious Diseases, "Santa Maria della Misericordia" Hospital, Università degli Studi di Perugia, Piazzale Lucio Severi 1, 06132, Perugia, Italy.
| | - Francesco Sicari
- Department of Medicine, Clinic of Infectious Diseases, "Santa Maria" Hospital, 05100, Terni, Italy
| | - Michele Palumbo
- Department of Medicine, Clinic of Infectious Diseases, "Santa Maria" Hospital, 05100, Terni, Italy
| | - Daniela Francisci
- Department of Medicine and Surgery, Clinic of Infectious Diseases, "Santa Maria della Misericordia" Hospital, Università degli Studi di Perugia, Piazzale Lucio Severi 1, 06132, Perugia, Italy
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14
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Gidari A, Sabbatini S, Bastianelli S, Pierucci S, Busti C, Bartolini D, Stabile AM, Monari C, Galli F, Rende M, Cruciani G, Francisci D. SARS-CoV-2 Survival on Surfaces and the Effect of UV-C Light. Viruses 2021; 13:v13030408. [PMID: 33807521 PMCID: PMC7998261 DOI: 10.3390/v13030408] [Citation(s) in RCA: 58] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 02/24/2021] [Accepted: 03/02/2021] [Indexed: 12/23/2022] Open
Abstract
The aim of this study was to establish the persistence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on inanimate surfaces such as plastic, stainless steel, and glass during UV-C irradiation which is a physical means commonly utilized in sanitization procedures. The viral inactivation rate, virus half-life, and percentage of titer reduction after UV-C irradiation were assessed. Infectivity was maintained on plastic and glass until 120 h and on stainless steel until 72 h. The virus half-life was 5.3, 4.4, and 4.2 h on plastic, stainless steel, and glass, respectively. In all cases, titer decay was >99% after drop drying. UV-C irradiation efficiently reduced virus titer (99.99%), with doses ranging from 10.25 to 23.71 mJ/cm2. Plastic and stainless steel needed higher doses to achieve target reduction. The total inactivation of SARS-CoV-2 on glass was obtained with the lower dose applied. SARS-CoV-2 survival can be long lasting on inanimate surfaces. It is worth recommending efficient disinfection protocols as a measure of prevention of viral spread. UV-C can provide rapid, efficient and sustainable sanitization procedures of different materials and surfaces. The dosages and mode of irradiation are important parameters to consider in their implementation as an important means to fight the SARS-CoV-2 pandemic.
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Affiliation(s)
- Anna Gidari
- Department of Medicine and Surgery, Clinic of Infectious Diseases, “Santa Maria della Misericordia” Hospital, University of Perugia, 06129 Perugia, Italy; (S.B.); (S.P.); (C.B.); (D.F.)
- Correspondence:
| | - Samuele Sabbatini
- Department of Medicine and Surgery, Medical Microbiology Section, University of Perugia, 06129 Perugia, Italy; (S.S.); (C.M.)
| | - Sabrina Bastianelli
- Department of Medicine and Surgery, Clinic of Infectious Diseases, “Santa Maria della Misericordia” Hospital, University of Perugia, 06129 Perugia, Italy; (S.B.); (S.P.); (C.B.); (D.F.)
| | - Sara Pierucci
- Department of Medicine and Surgery, Clinic of Infectious Diseases, “Santa Maria della Misericordia” Hospital, University of Perugia, 06129 Perugia, Italy; (S.B.); (S.P.); (C.B.); (D.F.)
| | - Chiara Busti
- Department of Medicine and Surgery, Clinic of Infectious Diseases, “Santa Maria della Misericordia” Hospital, University of Perugia, 06129 Perugia, Italy; (S.B.); (S.P.); (C.B.); (D.F.)
| | - Desirée Bartolini
- Department of Pharmaceutical Sciences, Unit of Nutrition and Clinical Biochemistry, University of Perugia, 06122 Perugia, Italy; (D.B.); (F.G.)
| | - Anna Maria Stabile
- Department of Medicine and Surgery, Unit of Human, Clinical and Forensic Anatomy, University of Perugia, 06129 Perugia, Italy; (A.M.S.); (M.R.)
| | - Claudia Monari
- Department of Medicine and Surgery, Medical Microbiology Section, University of Perugia, 06129 Perugia, Italy; (S.S.); (C.M.)
| | - Francesco Galli
- Department of Pharmaceutical Sciences, Unit of Nutrition and Clinical Biochemistry, University of Perugia, 06122 Perugia, Italy; (D.B.); (F.G.)
| | - Mario Rende
- Department of Medicine and Surgery, Unit of Human, Clinical and Forensic Anatomy, University of Perugia, 06129 Perugia, Italy; (A.M.S.); (M.R.)
| | - Gabriele Cruciani
- Department of Chemistry, Biology and Biotechnology, University of Perugia, 06123 Perugia, Italy;
| | - Daniela Francisci
- Department of Medicine and Surgery, Clinic of Infectious Diseases, “Santa Maria della Misericordia” Hospital, University of Perugia, 06129 Perugia, Italy; (S.B.); (S.P.); (C.B.); (D.F.)
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15
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Gidari A, Nofri M, Saccarelli L, Bastianelli S, Sabbatini S, Bozza S, Camilloni B, Fusco-Moffa I, Monari C, De Robertis E, Mencacci A, Francisci D. Is recurrence possible in coronavirus disease 2019 (COVID-19)? Case series and systematic review of literature. Eur J Clin Microbiol Infect Dis 2021; 40:1-12. [PMID: 33037944 PMCID: PMC7547550 DOI: 10.1007/s10096-020-04057-6] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 09/30/2020] [Indexed: 12/20/2022]
Abstract
Can a patient diagnosed with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) be infected again? This question is still unsolved. We tried to analyze local and literature cases with a positive respiratory swab after recovery. We collected data from symptomatic patients diagnosed with SARS-CoV-2 infection in the Italian Umbria Region that, after recovery, were again positive for SARS-CoV-2 in respiratory tract specimens. Samples were also assessed for infectivity in vitro. A systematic review of similar cases reported in the literature was performed. The study population was composed of 9 patients during a 4-month study period. Among the new positive samples, six were inoculated in Vero-E6 cells and showed no growth and negative molecular test in culture supernatants. All patients were positive for IgG against SARS-CoV-2 nucleoprotein and/or S protein. Conducting a review of the literature, 1350 similar cases have been found. The presumptive reactivation occurred in 34.5 days on average (standard deviation, SD, 18.7 days) after COVID-19 onset, when the 5.6% of patients presented fever and the 27.6% symptoms. The outcome was favorable in 96.7% of patients, while the 1.1% of them were still hospitalized at the time of data collection and the 2.1% died. Several hypotheses have been formulated to explain new positive respiratory samples after confirmed negativity. According to this study, the phenomenon seems to be due to the prolonged detection of SARS-CoV-2 RNA traces in respiratory samples of recovered patients. The failure of the virus to replicate in vitro suggests its inability to replicate in vivo.
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Affiliation(s)
- Anna Gidari
- Department of Medicine, Clinic of Infectious Diseases, "Santa Maria della Misericordia" Hospital, University of Perugia, Perugia, Italy.
| | - Marco Nofri
- Department of Medicine, Clinic of Infectious Diseases, "Santa Maria della Misericordia" Hospital, University of Perugia, Perugia, Italy
| | - Luca Saccarelli
- Department of Anesthesiology, Intensive Care and Pain therapy Center, "Santa Maria della Misericordia" Hospital, University of Perugia, Perugia, Italy
| | - Sabrina Bastianelli
- Department of Medicine, Clinic of Infectious Diseases, "Santa Maria della Misericordia" Hospital, University of Perugia, Perugia, Italy
| | - Samuele Sabbatini
- Department of Medicine, Medical Microbiology Section, University of Perugia, Perugia, Italy
| | - Silvia Bozza
- Department of Medicine, Medical Microbiology Section, University of Perugia, Perugia, Italy
| | - Barbara Camilloni
- Department of Medicine, Medical Microbiology Section, University of Perugia, Perugia, Italy
| | - Igino Fusco-Moffa
- Department of Prevention, Local Health Unit Umbria 1, Travel Medicine Unit, Perugia, Italy
| | - Claudia Monari
- Department of Medicine, Medical Microbiology Section, University of Perugia, Perugia, Italy
| | - Edoardo De Robertis
- Department of Anesthesiology, Intensive Care and Pain therapy Center, "Santa Maria della Misericordia" Hospital, University of Perugia, Perugia, Italy
| | - Antonella Mencacci
- Department of Medicine, Medical Microbiology Section, University of Perugia, Perugia, Italy
| | - Daniela Francisci
- Department of Medicine, Clinic of Infectious Diseases, "Santa Maria della Misericordia" Hospital, University of Perugia, Perugia, Italy
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Gidari A, Sabbatini S, Schiaroli E, Perito S, Francisci D, Baldelli F, Monari C. Tedizolid-Rifampicin Combination Prevents Rifampicin-Resistance on in vitro Model of Staphylococcus aureus Mature Biofilm. Front Microbiol 2020; 11:2085. [PMID: 32983061 PMCID: PMC7484889 DOI: 10.3389/fmicb.2020.02085] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 08/07/2020] [Indexed: 12/14/2022] Open
Abstract
Staphylococcus aureus infections associated with implanted medical devices are difficult to treat and require long-lasting antibiotic therapies, especially when device removal is not possible or easy such as in the case of joint prostheses. Biofilm formation is a major cause of treatment failure and infection recurrence. This study aimed to test, for the first time, the in vitro combination of tedizolid plus rifampicin on methicillin-sensitive (MSSA ATCC 6538) and methicillin-resistant (MRSA ATCC 43300) S. aureus mature biofilm. Here, we demonstrated that the combination of tedizolid with rifampicin significantly disaggregated pre-formed biofilm of both strains, reduced their metabolic activity and exerted bactericidal activity at clinically meaningful concentrations. Notably, tedizolid was able to completely prevent the emergence of resistance to rifampicin. Moreover these effects were similar to those obtained with daptomycin plus rifampicin, a well-known and widely used combination. Preliminary results on some MRSA clinical isolates confirmed the efficacy of this combination in reducing biofilm biomass and preventing rifampicin resistance onset. Further in vivo studies are needed to confirm the validity of this promising therapeutic option that can be useful against biofilm-associated S. aureus infections.
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Affiliation(s)
- Anna Gidari
- Department of Medicine, Clinic of Infectious Diseases, University of Perugia, Perugia, Italy
| | - Samuele Sabbatini
- Department of Medicine, Medical Microbiology Section, University of Perugia, Perugia, Italy
| | - Elisabetta Schiaroli
- Department of Medicine, Clinic of Infectious Diseases, University of Perugia, Perugia, Italy
| | - Stefano Perito
- Department of Medicine, Medical Microbiology Section, University of Perugia, Perugia, Italy
| | - Daniela Francisci
- Department of Medicine, Clinic of Infectious Diseases, University of Perugia, Perugia, Italy
| | - Franco Baldelli
- Department of Medicine, Clinic of Infectious Diseases, University of Perugia, Perugia, Italy
| | - Claudia Monari
- Department of Medicine, Medical Microbiology Section, University of Perugia, Perugia, Italy
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17
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Gidari A, De Socio GV, Sabbatini S, Francisci D. Predictive value of National Early Warning Score 2 (NEWS2) for intensive care unit admission in patients with SARS-CoV-2 infection. Infect Dis (Lond) 2020; 52:698-704. [PMID: 32584161 DOI: 10.1080/23744235.2020.1784457] [Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Background: From January 2020, Coronavirus disease 19 (COVID-19) has rapidly spread all over the world. An early assessment of illness severity is important for the stratification of patients. We analysed the predictive value of National Early Warning Score 2 (NEWS2) for intensive care unit admission (ICU) in patients with Severe Acute Respiratory Syndrome- Coronavirus-2 (SARS-CoV-2) infection.Methods: Data of 71 patients with SARS-CoV-2 admitted from 1 March to 20 April 2020, to the Clinic of Infectious Diseases of Perugia Hospital, Italy, were retrospectively reviewed. NEWS2 at hospital admission, demographic, comorbidity and clinical data were collected. Univariate and multivariate analyses were performed to establish the correlation between each variable and ICU admission.Results: Among 68 patients included in the analysis, 27 were admitted to ICU. NEWS2 at hospital admission was a good predictor of ICU admission as shown by an area under the receiver-operating characteristic curve analysis of 0.90 (standard error 0.04; 95% confidence interval 0.82-0.97). In multivariate logistic regression analysis, NEWS2 was significantly related to ICU admission using thresholds of 5 and 7. No other clinical variables included in the model were significantly correlated with ICU admission.A NEWS2 threshold of 5 had higher sensitivity than a threshold of 7 (89% and 63%). Higher specificity, positive likelihood ratio and positive predictive value were found using a threshold of 7 than a threshold of 5.Conclusions: NEWS2 at hospital admission was a good predictor for ICU admission. Patients with severe COVID-19 were correctly and rapidly stratified.
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Affiliation(s)
- Anna Gidari
- Department of Medicine, Clinic of Infectious Diseases, 'Santa Maria della Misericordia' Hospital, University of Perugia, Perugia, Italy
| | - Giuseppe Vittorio De Socio
- Department of Medicine, Clinic of Infectious Diseases, 'Santa Maria della Misericordia' Hospital, University of Perugia, Perugia, Italy
| | - Samuele Sabbatini
- Department of Medicine, Medical Microbiology Section, University of Perugia, Perugia, Italy
| | - Daniela Francisci
- Department of Medicine, Clinic of Infectious Diseases, 'Santa Maria della Misericordia' Hospital, University of Perugia, Perugia, Italy
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