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Bai F, Bono V, Borghi L, Bonazza F, Falcinella C, Vitaletti V, Miraglia F, Trunfio M, Calcagno A, Cusato J, Vegni E, Monforte AD, Marchetti G. Association between tight junction proteins and cognitive performance in untreated Persons living with HIV (PLWH). AIDS 2024:00002030-990000000-00485. [PMID: 38704619 DOI: 10.1097/qad.0000000000003923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2024]
Abstract
BACKGROUND HIV-associated neurocognitive disorders (HAND) still affects persons living with HIV (PLWH) and their pathogenesis isn't completely understood. We aimed to explore the association between plasma and CSF markers of blood-brain barrier (BBB) impairment and HAND in untreated PLWH. DESIGN Cross-sectional study. METHODS We enrolled untreated PLWH, who underwent blood exams and lumbar puncture to measure inflammation (IL-15, TNF-α), BBB damage (zonulin and tight junction proteins, TJs: occludin, claudin-5) and endothelial adhesion molecules (VCAM-1, ICAM-1). A comprehensive neurocognitive battery was used to diagnose HAND (Frascati criteria). RESULTS Twenty-one patients (21/78, 26,9%) patients presented HAND (100% ANI). HAND patients displayed more frequently non-CNS AIDS-defining conditions, lower nadir CD4+ T-cells and increased CD4+ T-cell exhaustion (lower CD4+CD127+ and CD4+CD45RA+ T cells percentages), in comparison to subjects without cognitive impairment. Furthermore, HAND was characterized by higher plasma inflammation (IL-15), but lower CSF levels of biomarkers of BBB impairment (zonulin and occludin). The association between BBB damage with HAND was confirmed by fitting a multivariable logistic regression. CSF/plasma endothelial adhesion molecules weren't associated with HAND, but with a poor performance in different cognitive domains. CONCLUSIONS By showing heightened inflammation and BBB impairment, our study suggests loss of BBB integrity as a possible factor contributing to the development of HAND in untreated PLWH.
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Affiliation(s)
- Francesca Bai
- Clinic of Infectious Diseases, San Paolo Hospital, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, Milan, Italy
| | - Valeria Bono
- Clinic of Infectious Diseases, San Paolo Hospital, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, Milan, Italy
| | - Lidia Borghi
- Unit of Clinical Psychology, San Paolo Hospital, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, Milan, Italy
| | - Federica Bonazza
- Unit of Clinical Psychology, San Paolo Hospital, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, Milan, Italy
| | - Camilla Falcinella
- Clinic of Infectious Diseases, San Paolo Hospital, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, Milan, Italy
| | - Virginia Vitaletti
- Clinic of Infectious Diseases, San Paolo Hospital, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, Milan, Italy
| | - Federica Miraglia
- Clinic of Infectious Diseases, San Paolo Hospital, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, Milan, Italy
| | - Mattia Trunfio
- Clinic of Infectious Diseases, Amedeo di Savoia Hospital, Department of Medical Sciences, University of Turin
| | - Andrea Calcagno
- Clinic of Infectious Diseases, Amedeo di Savoia Hospital, Department of Medical Sciences, University of Turin
| | - Jessica Cusato
- Laboratory of Pharmacology and Pharmacotherapy, Amedeo di Savoia Hospital, Department of Medical Sciences, University of Turin
| | - Elena Vegni
- Unit of Clinical Psychology, San Paolo Hospital, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, Milan, Italy
| | | | - Giulia Marchetti
- Clinic of Infectious Diseases, San Paolo Hospital, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, Milan, Italy
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d'Arminio Monforte A, Tavelli A, Di Biagio A, Sarmati L, Marchetti GC, Bai F, Cingolani A, Quiros Roldan E, Mussini C, Lichtner M, Vergori A, Piconi S, Orofino G, Fusco FM, Bandera A, Nozza S, Castagna A, Antinori A. Long-term outcomes of bictegravir/emtricitabine/tenofovir alafenamide as first-line therapy and as switch strategy in virologically suppressed persons with HIV: data from the ICONA cohort. J Antimicrob Chemother 2024:dkae081. [PMID: 38581349 DOI: 10.1093/jac/dkae081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 03/06/2024] [Indexed: 04/08/2024] Open
Abstract
OBJECTIVES To assess the effectiveness of bictegravir/emtricitabine/tenofovir alafenamide (BIC/FTC/TAF) among people poorly represented in clinical trials and potentially at higher risk of suboptimal response to ART. METHODS Observational cohort study on persons with HIV (PWH) enrolled in ICONA who started BIC/FTC/TAF as initial therapy or as switching regimen while virologically suppressed. Primary endpoint was time to treatment failure (TF): new AIDS/death or virological failure (VF) or discontinuation for toxicity/failure. Secondary endpoints were time to treatment discontinuation for toxicity (TDT) and to VF. Groups of interest were those aged >50 years, female sex, and advanced HIV disease at first ART start. Probability of the events overall and according to groups and adjusted HR for every endpoint were calculated by Kaplan-Meier curves and Cox regression models. RESULTS Nine hundred and thirty-three ART-naive and 1655 ART-experienced PWH initiated BIC/FTC/TAF. Over a median follow-up of 69.8 weeks, 89 (9.6%) PWH at their first regimen experienced TF. PWH aged >50 years had 1.83-fold (95% CI: 1.19-2.83) higher risk of TF; PWH with advanced HIV disease had 2.21-fold (95% CI: 1.53-3.82) higher risk; there were no differences in TF according to sex.Over a median follow-up of 146.3 weeks, 109 (6.6%) out of 1655 switching PWH experienced TF; no differences were found in the risk of TF, TDT and VF according to groups of interest. CONCLUSIONS Overall, BIC/FTC/TAF is well tolerated and virologically effective in the real-world scenario for ART-naive and -experienced PWH. Older ART-naive PWH and those with advanced HIV disease may respond less well as the burden of diseases might compromise treatment efficacy.
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Affiliation(s)
| | | | - Antonio Di Biagio
- Department of Health Sciences IRCCS Ospedale Policlinico San Martino, University of Genova, Genova, Italy
| | - Loredana Sarmati
- Department of Medicine of Systems, University of Rome Tor Vergata, Policlinico Tor Vergata, Rome, Italy
| | - Giulia C Marchetti
- Department of Health Sciences, ASST Santi Paolo e Carlo, Clinic of Infectious Diseases, University of Milan, Milan, Italy
| | - Francesca Bai
- Department of Health Sciences, ASST Santi Paolo e Carlo, Clinic of Infectious Diseases, University of Milan, Milan, Italy
| | - Antonella Cingolani
- Fondazione Policlinico Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Eugenio Quiros Roldan
- Department of Clinical and Experimental Sciences, Unit of Infectious and Tropical Diseases, University of Brescia, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Cristina Mussini
- Clinic of Infectious Diseases, University Hospital of Modena, University of Modena and Reggio Emilia, Modena, Italy
| | - Miriam Lichtner
- Department of Public Health and Infectious Diseases, Sapienza University, Infectious Diseases Unit, Santa Maria Goretti Hospital, Latina, Italy
| | - Alessandra Vergori
- Clinical and Research Infectious Diseases Department, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, Rome, Italy
| | - Stefania Piconi
- Infectious Diseases Unit, Alessandro Manzoni Hospital, ASST Lecco, Lecco, Italy
| | - Giancarlo Orofino
- Unit of Infectious Diseases, Amedeo di Savoia Hospital, Torino, Italy
| | - Francesco Maria Fusco
- UOC Infezioni Sistemiche e dell'Immunodepresso, AORN Ospedali dei Colli, P.O. "D. Cotugno", Naples, Italy
| | - Alessandra Bandera
- Centre for Multidisciplinary Research in Health Science (MACH), University of Milano, Infectious Diseases Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Silvia Nozza
- Clinic of Infectious Diseases, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Antonella Castagna
- Clinic of Infectious Diseases, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Andrea Antinori
- Clinical and Research Infectious Diseases Department, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, Rome, Italy
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Ranzani A, Castelli F, Di Biagio A, d'Arminio Monforte A, D'Avolio A, Soria A, Bai F, Focà E, Taramasso L, Calcagno A, Bresciani E, Torsello A, Bonfanti P, Lapadula G. Influence of efavirenz and 8-hydroxy-efavirenz plasma levels on cognition and central nervous system side effects. HIV Med 2024; 25:491-497. [PMID: 38104964 DOI: 10.1111/hiv.13600] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Accepted: 11/22/2023] [Indexed: 12/19/2023]
Abstract
OBJECTIVES To investigate whether efavirenz (EFV) or 8-hydroxy-EFV (8-OH-EFV) plasma levels are associated with neurocognitive impairment and central nervous system (CNS) side effects. METHODS We conducted a cross-sectional analysis to explore the potential links between EFV/8-OH-EFV levels and cognitive performance or CNS-related side effects in patients screened within a randomized trial involving a switch from EFV to rilpivirine. The Mann-Whitney test was employed to compare drug levels in patients with or without cognitive impairment, depression, anxiety, sleep disorder or CNS symptoms. Additionally, Spearman's test was used to assess correlations between drug levels and test scores. RESULTS Among 104 patients, neither EFV nor 8-OH-EFV levels were linked to cognitive impairment, although trends towards higher EFV levels were observed in those with impaired executive function (p = 0.055) and language performances (p = 0.021). On the other hand, elevated 8-OH-EFV levels, but not EFV levels, were associated with more CNS side effects (222 vs. 151 ng/mL, p = 0.027), depressive symptoms (247 vs. 164 ng/mL, p = 0.067) and sleep impairment (247 vs. 164 ng/mL, p = 0.078). Consistently, a trend towards a correlation between EFV levels and lower z-scores in executive function and motor function was observed, while 8-OH-EFV levels, but not EFV levels, were directly correlated with symptom scores. CONCLUSIONS Higher levels of 8-OH-EFV were associated with CNS side effects, while EFV levels were only marginally associated with cognitive performance, thus suggesting that EFV and its metabolite may act differently in determining detrimental neurological effects.
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Affiliation(s)
- Alice Ranzani
- Fondazione IRCCS "San Gerardo dei Tintori", Monza, Italy
| | | | | | | | | | | | | | | | | | | | | | | | - Paolo Bonfanti
- Fondazione IRCCS "San Gerardo dei Tintori", Monza, Italy
- University of Milano-Bicocca, Milan, Italy
| | - Giuseppe Lapadula
- Fondazione IRCCS "San Gerardo dei Tintori", Monza, Italy
- University of Milano-Bicocca, Milan, Italy
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Cozzi-Lepri A, Borghi V, Rotundo S, Mariani B, Ferrari A, Del Borgo C, Bai F, Colletti P, Miraglia P, Torti C, Cattelan AM, Cenderello G, Berruti M, Tascini C, Parruti G, Coladonato S, Gori A, Marchetti G, Lichtner M, Coppola L, Sorace C, D'Abramo A, Mazzotta V, Guaraldi G, Franceschini E, Meschiari M, Sarmati L, Antinori A, Nicastri E, Mussini C. Development and validation of a prediction score for failure to casirivimab/imdevimab in hospitalized patients with COVID-19 pneumonia. Front Med (Lausanne) 2024; 11:1293431. [PMID: 38529120 PMCID: PMC10961453 DOI: 10.3389/fmed.2024.1293431] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 02/19/2024] [Indexed: 03/27/2024] Open
Abstract
Introduction Casirivimab and imdevimab (CAS/IMV) are two non-competing, high-affinity human IgG1 anti-SARS-CoV-2 monoclonal antibodies, that showed a survival benefit in seronegative hospitalized patients with COVID-19. This study aimed to estimate the day-28 risk of mechanical ventilation (MV) and death in individuals hospitalized for severe COVID-19 pneumonia and receiving CAS/IMV. Additionally, it aimed to identify variables measured at the time of hospital admission that could predict these outcomes and derive a prediction algorithm. Methods This is a retrospective, observational cohort study conducted in 12 hospitals in Italy. Adult patients who were consecutively hospitalized from November 2021 to February 2022 receiving CAS/IMV were included. A multivariable logistic regression model was used to identify predictors of MV or death by day 28 from treatment initiation, and β-coefficients from the model were used to develop a risk score that was derived by means of leave-one-out internal cross-validation (CV), external CV, and calibration. Secondary outcome was mortality. Results A total of 480 hospitalized patients in the training set and 157 patients in the test set were included. By day 28, 36 participants (8%) underwent MV and 28 died (6%) for a total of 58 participants (12%) experiencing the composite primary endpoint. In multivariable analysis, four factors [age, PaO2/FiO2 ratio, lactate dehydrogenase (LDH), and platelets] were independently associated with the risk of MV/death and were used to generate the proposed risk score. The accuracy of the score in the area under the curve (AUC) was 0.80 and 0.77 in internal validation and test for the composite endpoint and 0.87 and 0.86 for death, respectively. The model also appeared to be well calibrated with the raw data. Conclusion The mortality risk reported in our study was lower than that previously reported. Although CAS/IMV is no longer used, our score might help in identifying which patients are not likely to benefit from monoclonal antibodies and may require alternative interventions.
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Affiliation(s)
- Alessandro Cozzi-Lepri
- Centre for Clinical Research, Epidemiology, Modelling and Evaluation (CREME), Institute for Global Health, University College London, London, United Kingdom
| | - Vanni Borghi
- Clinic of Infectious Diseases, Azienda Ospedaliero-Universitaria Policlinico, Modena, Italy
| | - Salvatore Rotundo
- Unit of Infectious and Tropical Diseases, University Magna Græcia, Catanzaro, Italy
| | - Bianca Mariani
- Unità Organizzativa Complessa Malattie Infettive, Fondazione Istituto di Ricovero e Cura a Caratetre Scientifico, Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Anna Ferrari
- Unità Organizzativa Complessa Malattie Infettive, Azienda Ospedale Università, Padova, Italy
| | - Cosmo Del Borgo
- Unità Organizzativa Complessa Malattie Infettive, Ospedale SM Goretti, Latina, Italy
| | - Francesca Bai
- Clinica delle Malattie Infettive, Dipartimento di Scienze della Salute, ASST Santi Paolo e Carlo, University of Milano, Milan, Italy
| | - Pietro Colletti
- Unit of Infectious Diseases, Paolo Borsellino Hospital, ASP Trapani, Trapani, Italy
| | - Piermauro Miraglia
- Unit of Infectious Diseases, Paolo Borsellino Hospital, ASP Trapani, Trapani, Italy
| | - Carlo Torti
- Unit of Infectious and Tropical Diseases, University Magna Græcia, Catanzaro, Italy
| | - Anna Maria Cattelan
- Unità Organizzativa Complessa Malattie Infettive, Azienda Ospedale Università, Padova, Italy
| | | | - Marco Berruti
- SC Malattie Infettive Asl1 Imperiese, Imperia, Italy
| | - Carlo Tascini
- Clinic of Infectious Diseases, University of Udine, Udine, Italy
| | - Giustino Parruti
- Unit of Infectious Diseases, Hospital of Pescara, Pescara, Italy
| | | | - Andrea Gori
- Infectious Disease Unit, Ospedale L. Sacco, University of Milano, Milan, Italy
| | - Giulia Marchetti
- Clinica delle Malattie Infettive, Dipartimento di Scienze della Salute, ASST Santi Paolo e Carlo, University of Milano, Milan, Italy
| | - Miriam Lichtner
- Unità Organizzativa Complessa Malattie Infettive, Ospedale SM Goretti, Latina, Italy
| | - Luigi Coppola
- Clinical Infectious Diseases, Tor Vergata University, Rome, Italy
| | - Chiara Sorace
- Clinical Infectious Diseases, Tor Vergata University, Rome, Italy
| | | | | | - Giovanni Guaraldi
- Department of Surgical, Medical, Dental and Morphological Sciences, University of Modena and Reggio Emilia, Modena, Emilia-Romagna, Italy
| | - Erica Franceschini
- Department of Surgical, Medical, Dental and Morphological Sciences, University of Modena and Reggio Emilia, Modena, Emilia-Romagna, Italy
| | - Marianna Meschiari
- Department of Surgical, Medical, Dental and Morphological Sciences, University of Modena and Reggio Emilia, Modena, Emilia-Romagna, Italy
| | - Loredana Sarmati
- Clinical Infectious Diseases, Tor Vergata University, Rome, Italy
| | - Andrea Antinori
- Istituto Nazionale Malattie Infettive L. Spallanzani, Rome, Italy
| | | | - Cristina Mussini
- Department of Surgical, Medical, Dental and Morphological Sciences, University of Modena and Reggio Emilia, Modena, Emilia-Romagna, Italy
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Huo Y, Wang W, Zhang J, Xu D, Bai F, Gui Y. Maternal androgen excess inhibits fetal cardiomyocytes proliferation through RB-mediated cell cycle arrest and induces cardiac hypertrophy in adulthood. J Endocrinol Invest 2024; 47:603-617. [PMID: 37642904 PMCID: PMC10904501 DOI: 10.1007/s40618-023-02178-1] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 08/16/2023] [Indexed: 08/31/2023]
Abstract
PURPOSE Maternal hyperandrogenism during pregnancy is associated with adverse gestational outcomes and chronic non-communicable diseases in offspring. However, few studies are reported to demonstrate the association between maternal androgen excess and cardiac health in offspring. This study aimed to explore the relation between androgen exposure in utero and cardiac health of offspring in fetal and adult period. Its underlying mechanism is also illustrated in this research. METHODS Pregnant mice were injected with dihydrotestosterone (DHT) from gestational day (GD) 16.5 to GD18.5. On GD18.5, fetal heart tissue was collected for metabolite and morphological analysis. The hearts from adult offspring were also collected for morphological and qPCR analysis. H9c2 cells were treated with 75 μM androsterone. Immunofluorescence, flow cytometry, qPCR, and western blot were performed to observe cell proliferation and explore the underlying mechanism. RESULTS Intrauterine exposure to excessive androgen led to thinner ventricular wall, decreased number of cardiomyocytes in fetal offspring and caused cardiac hypertrophy, compromised cardiac function in adult offspring. The analysis of steroid hormone metabolites in fetal heart tissue by ultra performance liquid chromatography and tandem mass spectrometry showed that the content of androgen metabolite androsterone was significantly increased. Mechanistically, H9c2 cells treated with androsterone led to a significant decrease in phosphorylated retinoblastoma protein (pRB) and cell cycle-related protein including cyclin-dependent kinase 2 (CDK2), cyclin-dependent kinase 4 (CDK4), and cyclin D1 (CCND1) in cardiomyocytes. This resulted in cell cycle arrest at G1-S phase, which in turn inhibited cardiomyocyte proliferation. CONCLUSION Taken together, our results indicate that in utero exposure to DHT, its metabolite androsterone could directly decrease cardiomyocytes proliferation through cell cycle arrest, which has a life-long-lasting effect on cardiac health. Our study highlights the importance of monitoring sex hormones in women during pregnancy and the follow-up of cardiac function in offspring with high risk of intrauterine androgen exposure.
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Affiliation(s)
- Y Huo
- National Children's Medical Center, Children's Hospital of Fudan University, Fudan University, Shanghai, 201102, China
- National Health Commission (NHC) Key Laboratory of Neonatal Diseases, Fudan University, 399 Wanyuan Road, Minhang, Shanghai, 201102, China
| | - W Wang
- Guangzhou Center for Disease Control and Prevention, Guangzhou, 510080, China
| | - J Zhang
- National Children's Medical Center, Children's Hospital of Fudan University, Fudan University, Shanghai, 201102, China
- National Health Commission (NHC) Key Laboratory of Neonatal Diseases, Fudan University, 399 Wanyuan Road, Minhang, Shanghai, 201102, China
- Institute of Pediatrics, Children's Hospital of Fudan University, Shanghai, 201102, China
| | - D Xu
- National Children's Medical Center, Children's Hospital of Fudan University, Fudan University, Shanghai, 201102, China
- National Health Commission (NHC) Key Laboratory of Neonatal Diseases, Fudan University, 399 Wanyuan Road, Minhang, Shanghai, 201102, China
| | - F Bai
- National Children's Medical Center, Children's Hospital of Fudan University, Fudan University, Shanghai, 201102, China
- National Health Commission (NHC) Key Laboratory of Neonatal Diseases, Fudan University, 399 Wanyuan Road, Minhang, Shanghai, 201102, China
| | - Y Gui
- National Children's Medical Center, Children's Hospital of Fudan University, Fudan University, Shanghai, 201102, China.
- National Health Commission (NHC) Key Laboratory of Neonatal Diseases, Fudan University, 399 Wanyuan Road, Minhang, Shanghai, 201102, China.
- Cardiovascular Center, Children's Hospital of Fudan University, Shanghai, 201102, China.
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Hedberg P, Parczewski M, Serwin K, Marchetti G, Bai F, Ole Jensen BE, Pereira JP, Drobniewski F, Reschreiter H, Naumovas D, Ceccherini-Silberstein F, Rubio Quintanares GH, Mwau M, Toscano C, König F, Pfeifer N, Zazzi M, Fanti I, Incardona F, Cozzi-Lepri A, Sönnerborg A, Nauclér P. In-hospital mortality during the wild-type, alpha, delta, and omicron SARS-CoV-2 waves: a multinational cohort study in the EuCARE project. Lancet Reg Health Eur 2024; 38:100855. [PMID: 38476753 PMCID: PMC10928271 DOI: 10.1016/j.lanepe.2024.100855] [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] [Figures] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 01/10/2024] [Accepted: 01/19/2024] [Indexed: 03/14/2024]
Abstract
Background Investigating outcomes of hospitalised COVID-19 patients throughout the pandemic is crucial to understand the impact of different SARS-CoV-2 variants. We compared 28-day in-hospital mortality of Wild-type, Alpha, Delta, and Omicron variant infections. Whether the difference in risk by variant varied by age was also evaluated. Methods We conducted a cohort study including patients ≥18 years, hospitalised between 2020 and 02-01 and 2022-10-15 with a SARS-CoV-2 positive test, from nine countries. Variant was classified based on sequenced viruses or from national public metadata. Mortality was compared using the cumulative incidence function and subdistribution hazard ratios (SHR) adjusted for age, sex, calendar time, and comorbidities. Results were shown age-stratified due to effect measure modification (P < 0.0001 for interaction between age and variant). Findings We included 38,585 participants: 19,763 Wild-type, 6387 Alpha, 3640 Delta, and 8795 Omicron. The cumulative incidence of mortality decreased throughout the study period. Among participants ≥70 years, the adjusted SHR (95% confidence interval) for Delta vs. Omicron was 1.66 (1.29-2.13). This estimate was 1.66 (1.17-2.36) for Alpha vs. Omicron, and 1.34 (0.92-1.95) for Wild-type vs. Omicron. These were 1.21 (0.81-1.82), 1.21 (0.68-2.17), and 0.98 (0.53-1.82) among unvaccinated participants. When comparing Omicron sublineages, the aSHR for BA.1 was 1.92 (1.43-2.58) compared to BA.2 and 1.52 (1.11-2.08) compared to BA.5. Interpretation The herein observed decrease in in-hospital mortality seems to reflect a combined effect of immunity from vaccinations and previous infections, although differences in virulence between SARS-CoV-2 variants may also have contributed. Funding European Union's Horizon Europe Research and Innovation Programme.
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Affiliation(s)
- Pontus Hedberg
- Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - Milosz Parczewski
- Department of Tropical Infectious Diseases and Immune Deficiency, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Karol Serwin
- Department of Tropical Infectious Diseases and Immune Deficiency, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Giulia Marchetti
- Department of Health Sciences, Clinic of Infectious Diseases, ASST Santi Paolo E Carlo, University of Milan, Milan, Italy
| | - Francesca Bai
- Department of Health Sciences, Clinic of Infectious Diseases, ASST Santi Paolo E Carlo, University of Milan, Milan, Italy
| | - Björn-Erik Ole Jensen
- Department of Gastroenterology, Hepatology and Infectious Diseases, Medical Faculty and University Hospital Duesseldorf, Heinrich Heine University, Duesseldorf, Germany
| | - Joana P.V. Pereira
- Department of Gastroenterology, Hepatology and Infectious Diseases, Medical Faculty and University Hospital Duesseldorf, Heinrich Heine University, Duesseldorf, Germany
| | - Francis Drobniewski
- Department of Infectious Disease, Imperial College, London, W12 0NN, UK
- University Hospital Dorset, Poole Hospital, Poole, Dorset, UK
| | | | - Daniel Naumovas
- Vilnius Santaros Klinikos Biobank, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | | | - Gibran Horemheb Rubio Quintanares
- Virus Security Department, Paul Ehrlich Institute, Langen, Germany
- Infectious Diseases Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico
| | - Matilu Mwau
- Center for Infectious and Parasitic Diseases Control Research, Kenya Medical Research Institute, Busia, Kenya
| | - Cristina Toscano
- Microbiology Laboratory, Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal
| | - Florian König
- Institute for Bioinformatics and Medical Informatics and Medical Informatics (IBMI), University of Tübingen, Tübingen, Germany
- Methods in Medical Informatics Department of Computer Science, University of Tübingen, Tübingen, Germany
| | - Nico Pfeifer
- Institute for Bioinformatics and Medical Informatics and Medical Informatics (IBMI), University of Tübingen, Tübingen, Germany
- Methods in Medical Informatics Department of Computer Science, University of Tübingen, Tübingen, Germany
| | - Maurizio Zazzi
- Department of Medical Biotechnologies, University of Siena, Italy
| | - Iuri Fanti
- EuResist Network GEIE, Via Guido Guinizelli, 98/100, 00152, Roma, Italy
| | - Francesca Incardona
- EuResist Network GEIE, Via Guido Guinizelli, 98/100, 00152, Roma, Italy
- InformaPRO s.r.l., Via Guido Guinizelli, 98/100, 00152, Roma, Italy
| | - Alessandro Cozzi-Lepri
- Centre for Clinical Research, Epidemiology, Modelling and Evaluation (CREME) Institute for Global Health UCL, Rowland Hill St, London, NW3 2PF, UK
| | - Anders Sönnerborg
- Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Pontus Nauclér
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
- Division of Infectious Diseases, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden
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Lombardi A, Villa S, Colaneri M, Scaglione G, Bai F, Varisco B, Bono V, Vena A, Dentone C, Russo C, Tettamanti M, Renisi G, Viero G, Azzarà C, Mantero M, Peyvandi F, Bassetti M, Marchetti G, Muscatello A, Nobili A, Gori A, Bandera A. Clinical characteristics and outcomes of vaccinated patients hospitalised with SARS-CoV-2 breakthrough infection: Multi-IPV, a multicentre study in Northern Italy. J Infect Public Health 2024; 17:467-473. [PMID: 38262085 DOI: 10.1016/j.jiph.2023.12.026] [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: 06/06/2023] [Revised: 12/29/2023] [Accepted: 12/31/2023] [Indexed: 01/25/2024] Open
Abstract
BACKGROUND Despite the well-known efficacy of anti-COVID-19 vaccines in preventing morbidity and mortality, several vaccinated individuals are diagnosed with SARS-CoV-2 breakthrough infection, which might require hospitalisation. This multicentre, observational, and retrospective study aimed to investigate the clinical characteristics and outcomes of vaccinated vs. non-vaccinated patients, both hospitalised with SARS-CoV-2 infection in 3 major hospitals in Northern Italy. METHODS Data collection was retrospective, and paper and electronic medical records of adult patients with a diagnosed SARS-CoV-2 infection were pseudo-anonymised and analysed. Vaccinated and non-vaccinated individuals were manually paired, using a predetermined matching criterion (similar age, gender, and date of hospitalisation). Demographic, clinical, treatment, and outcome data were compared between groups differing by vaccination status using Pearson's Chi-square and Mann-Whitney tests. Moreover, multiple logistic regression analyses were performed to assess the impact of vaccination status on ICU admission or intra-hospital mortality. RESULTS Data from 360 patients were collected. Vaccinated patients presented with a higher prevalence of relevant comorbidities, like kidney replacement therapy or haematological malignancy, despite a milder clinical presentation at the first evaluation. Non-vaccinated patients required intensive care more often than their vaccinated counterparts (8.8% vs. 1.7%, p = 0.002). Contrariwise, no difference in intra-hospital mortality was observed between the two groups (19% vs. 20%, p = 0.853). These results were confirmed by multivariable logistic regressions, which showed that vaccination was significantly associated with decreased risk of ICU admission (aOR=0.172, 95%CI: 0.039-0.542, p = 0.007), but not of intra-hospital mortality (aOR=0.996, 95%CI: 0.582-1.703, p = 0.987). CONCLUSIONS This study provides real-world data on vaccinated patients hospitalised with COVID-19 in Northern Italy. Our results suggest that COVID-19 vaccination has a protective role in individuals with higher risk profiles, especially regarding the need for ICU admission. These findings contribute to our understanding of SARS-CoV-2 infection outcomes among vaccinated individuals and emphasise the importance of vaccination in preventing severe disease, particularly in those countries with lower first-booster uptake rates.
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Affiliation(s)
- Andrea Lombardi
- Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Infectious Diseases Unit, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milano, Italy.
| | - Simone Villa
- Department of Pathophysiology and Transplantation, University of Milan, Milano, Italy
| | - Marta Colaneri
- Department of Infectious Diseases, Ospedale Luigi Sacco, Milan, Italy
| | | | - Francesca Bai
- Department of Health Sciences, Clinic of Infectious Diseases, ASST Santi Paolo e Carlo, Milan, Italy
| | - Benedetta Varisco
- Department of Health Sciences, Clinic of Infectious Diseases, ASST Santi Paolo e Carlo, Milan, Italy
| | - Valeria Bono
- Department of Health Sciences, Clinic of Infectious Diseases, ASST Santi Paolo e Carlo, Milan, Italy
| | - Antonio Vena
- Department of Health Sciences, University of Genoa, Genoa, Italy; Infectious Diseases Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Chiara Dentone
- Department of Health Sciences, University of Genoa, Genoa, Italy; Infectious Diseases Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Chiara Russo
- Department of Health Sciences, University of Genoa, Genoa, Italy; Infectious Diseases Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Mauro Tettamanti
- Department of Health Policy, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Giulia Renisi
- Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Infectious Diseases Unit, Milan, Italy
| | - Giulia Viero
- Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Infectious Diseases Unit, Milan, Italy
| | - Cecilia Azzarà
- Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Infectious Diseases Unit, Milan, Italy
| | - Marco Mantero
- Department of Pathophysiology and Transplantation, University of Milan, Milano, Italy; Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Respiratory Unit and Cystic Fibrosis Center, Milan, Italy
| | - Flora Peyvandi
- Department of Pathophysiology and Transplantation, University of Milan, Milano, Italy; Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Milan, Italy
| | - Matteo Bassetti
- Department of Health Sciences, University of Genoa, Genoa, Italy; Infectious Diseases Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Giulia Marchetti
- Department of Health Sciences, Clinic of Infectious Diseases, ASST Santi Paolo e Carlo, Milan, Italy
| | - Antonio Muscatello
- Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Infectious Diseases Unit, Milan, Italy
| | - Alessandro Nobili
- Department of Health Policy, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Andrea Gori
- Department of Pathophysiology and Transplantation, University of Milan, Milano, Italy; Department of Infectious Diseases, Ospedale Luigi Sacco, Milan, Italy
| | - Alessandra Bandera
- Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Infectious Diseases Unit, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milano, Italy
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Vergori A, Tavelli A, Matusali G, Azzini AM, Augello M, Mazzotta V, Pellicanò GF, Costantini A, Cascio A, De Vito A, Marconi L, Righi E, Sartor A, Pinnetti C, Maggi F, Bai F, Lanini S, Piconi S, Levy Hara G, Marchetti G, Giannella M, Tacconelli E, d’Arminio Monforte A, Antinori A, Cozzi-Lepri A. SARS-CoV-2 mRNA Vaccine Response in People Living with HIV According to CD4 Count and CD4/CD8 Ratio. Vaccines (Basel) 2023; 11:1664. [PMID: 38005996 PMCID: PMC10675416 DOI: 10.3390/vaccines11111664] [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: 09/08/2023] [Revised: 10/19/2023] [Accepted: 10/24/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND Our aim was to estimate the rates of not achieving a robust/above-average humoral response to the COVID-19 mRNA vaccine in people living with HIV (PLWH) who received ≥2 doses and to investigate the role of the CD4 and CD4/CD8 ratio in predicting the humoral response. METHODS We evaluated the humoral anti-SARS-CoV-2 response 1-month after the second and third doses of COVID-19 mRNA vaccine as a proportion of not achieving a robust/above-average response using two criteria: (i) a humoral threshold identified as a correlate of protection against SARS-CoV-2 (<90% vaccine efficacy): anti-RBD < 775 BAU/mL or anti-S < 298 BAU/mL, (ii) threshold of binding antibodies equivalent to average neutralization activity from the levels of binding (nAb titer < 1:40): anti-RBD < 870 BAU/mL or anti-S < 1591 BAU/mL. PLWH were stratified according to the CD4 count and CD4/CD8 ratio at first dose. Logistic regression was used to compare the probability of not achieving robust/above-average responses. A mixed linear model was used to estimate the mean anti-RBD titer at various time points across the exposure groups. RESULTS a total of 1176 PLWH were included. The proportions of participants failing to achieve a robust/above-average response were significantly higher in participants with a lower CD4 and CD4/CD8 ratio, specifically, a clearer gradient was observed for the CD4 count. The CD4 count was a better predictor of the humoral response of the primary cycle than ratio. The third dose was pivotal in achieving a robust/above-average humoral response, at least for PLWH with CD4 > 200 cells/mm3 and a ratio > 0.6. CONCLUSIONS A robust humoral response after a booster dose has not been reached by 50% of PLWH with CD4 < 200 cells mm3. In the absence of a validated correlate of protections in the Omicron era, the CD4 count remains the most solid marker to guide vaccination campaigns in PLWH.
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Affiliation(s)
- Alessandra Vergori
- HIV/AIDS Unit, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, Italy; (A.V.); (V.M.); (C.P.); (S.L.); (A.A.)
| | | | - Giulia Matusali
- Laboratory of Virology, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, Italy; (G.M.); (F.M.)
| | - Anna Maria Azzini
- Division of Infectious Diseases, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy; (A.M.A.); (E.R.); (E.T.)
| | - Matteo Augello
- Clinic of Infectious Diseases, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, 20142 Milan, Italy; (M.A.); (F.B.); (G.M.)
| | - Valentina Mazzotta
- HIV/AIDS Unit, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, Italy; (A.V.); (V.M.); (C.P.); (S.L.); (A.A.)
| | - Giovanni Francesco Pellicanò
- Department of Human Pathology of the Adult and the Developmental Age “G. Barresi”, University of Messina, 98121 Messina, Italy;
| | - Andrea Costantini
- Clinical Immunology Unit, Azienda Ospedaliero Universitaria delle Marche, Marche Polytechnic University, 60126 Ancona, Italy;
| | - Antonio Cascio
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties “G. D’Alessandro”, University of Palermo, 90127 Palermo, Italy;
| | - Andrea De Vito
- Unit of Infectious Diseases, Department of Medicine, Surgery, and Pharmacy, University of Sassari, 07100 Sassari, Italy;
| | - Lorenzo Marconi
- Infectious Diseases Unit, IRCCS Azienda Ospedaliero Universitaria di Bologna, Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, 40138 Bologna, Italy; (L.M.); (M.G.)
| | - Elda Righi
- Division of Infectious Diseases, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy; (A.M.A.); (E.R.); (E.T.)
| | - Assunta Sartor
- Microbiology Unit, Udine University Hospital, 33100 Udine, Italy;
| | - Carmela Pinnetti
- HIV/AIDS Unit, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, Italy; (A.V.); (V.M.); (C.P.); (S.L.); (A.A.)
| | - Fabrizio Maggi
- Laboratory of Virology, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, Italy; (G.M.); (F.M.)
| | - Francesca Bai
- Clinic of Infectious Diseases, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, 20142 Milan, Italy; (M.A.); (F.B.); (G.M.)
| | - Simone Lanini
- HIV/AIDS Unit, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, Italy; (A.V.); (V.M.); (C.P.); (S.L.); (A.A.)
| | - Stefania Piconi
- Infectious Diseases Unit, Alessandro Manzoni Hospital, ASST Lecco, 23900 Lecco, Italy;
| | - Gabriel Levy Hara
- Instituto Alberto Taquini de Investigación en Medicina Traslacional, Facultad de Medicina, Universidad de Buenos Aires, Buenos Aires C1122AAJ, Argentina;
| | - Giulia Marchetti
- Clinic of Infectious Diseases, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, 20142 Milan, Italy; (M.A.); (F.B.); (G.M.)
| | - Maddalena Giannella
- Infectious Diseases Unit, IRCCS Azienda Ospedaliero Universitaria di Bologna, Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, 40138 Bologna, Italy; (L.M.); (M.G.)
| | - Evelina Tacconelli
- Division of Infectious Diseases, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy; (A.M.A.); (E.R.); (E.T.)
| | - Antonella d’Arminio Monforte
- Icona Foundation, 20142 Milan, Italy;
- Clinic of Infectious Diseases, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, 20142 Milan, Italy; (M.A.); (F.B.); (G.M.)
| | - Andrea Antinori
- HIV/AIDS Unit, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, Italy; (A.V.); (V.M.); (C.P.); (S.L.); (A.A.)
| | - Alessandro Cozzi-Lepri
- Centre for Clinical Research, Epidemiology, Modelling and Evaluation (CREME), Institute for Global Health, UCL, London NW3 2PF, UK;
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Hedberg P, Varisco B, Bai F, Sönnerborg A, Naucler P, Pfeifer N, Cozzi-Lepri A, Ceccherini-Silberstein F, Naumovas D, Drobniewski F, Jensen BEO, Toscano C, Parczewski M, Quintanares GHR, Mwau M, Pinto JA, Incardona F, Mommo C, Marchetti G. EuCARE-hospitalised study protocol: a cohort study of patients hospitalised with COVID-19 in the EuCARE project. BMC Infect Dis 2023; 23:690. [PMID: 37845624 PMCID: PMC10580565 DOI: 10.1186/s12879-023-08658-2] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 09/29/2023] [Indexed: 10/18/2023] Open
Abstract
BACKGROUND Severe acute respiratory syndrome coronavirus 2 (SARS CoV-2), the virus responsible for coronavirus disease 2019 (COVID-19), can lead to hospitalisation, particularly in elderly, immunocompromised, and non-vaccinated or partially vaccinated individuals. Although vaccination provides protection, the duration of this protection wanes over time. Additional doses can restore immunity, but the influence of viral variants, specific sequences, and vaccine-induced immune responses on disease severity remains unclear. Moreover, the efficacy of therapeutic interventions during hospitalisation requires further investigation. The study aims to analyse the clinical course of COVID-19 in hospitalised patients, taking into account SARS-CoV-2 variants, viral sequences, and the impact of different vaccines. The primary outcome is all-cause in-hospital mortality, while secondary outcomes include admission to intensive care unit and length of stay, duration of hospitalisation, and the level of respiratory support required. METHODS This ongoing multicentre study observes hospitalised adult patients with confirmed SARS-CoV-2 infection, utilising a combination of retrospective and prospective data collection. It aims to gather clinical and laboratory variables from around 35,000 patients, with potential for a larger sample size. Data analysis will involve biostatistical and machine-learning techniques. Selected patients will provide biological material. The study started on October 14, 2021 and is scheduled to end on October 13, 2026. DISCUSSION The analysis of a large sample of retrospective and prospective data about the acute phase of SARS CoV-2 infection in hospitalised patients, viral variants and vaccination in several European and non-European countries will help us to better understand risk factors for disease severity and the interplay between SARS CoV-2 variants, immune responses and vaccine efficacy. The main strengths of this study are the large sample size, the long study duration covering different waves of COVID-19 and the collection of biological samples that allows future research. TRIAL REGISTRATION The trial has been registered on ClinicalTrials.gov. The unique identifier assigned to this trial is NCT05463380.
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Affiliation(s)
- Pontus Hedberg
- Division of Infectious Diseases, Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - Benedetta Varisco
- Department of Health Sciences, University of Milan, Clinic of Infectious Diseases, San Paolo Hospital, ASST Santi Paolo E Carlo, Milan, Italy
| | - Francesca Bai
- Department of Health Sciences, University of Milan, Clinic of Infectious Diseases, San Paolo Hospital, ASST Santi Paolo E Carlo, Milan, Italy
| | - Anders Sönnerborg
- Division of Infectious Diseases, Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Pontus Naucler
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Nico Pfeifer
- Institute for Bioinformatics and Medical Informatics, University of Tübingen, Tübingen, Germany
| | - Alessandro Cozzi-Lepri
- Centre for Clinical Research, Epidemiology, Modelling and Evaluation (CREME), Institute for Global Health, UCL, London, UK
| | | | - Daniel Naumovas
- Vilnius Santaros Klinikos Biobank, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - Francis Drobniewski
- Department of Infectious Disease, Imperial College London, London, UK
- Department of Medical Microbiology, University Hospitals Dorset, Poole, UK
| | - Björn-Erik Ole Jensen
- Department of Gastroenterology, Hepatology and Infectious Diseases, Medical Facultyand, University Hospital Düsseldorf, Heinrich Heine University, Düsseldorf, Germany
| | - Cristina Toscano
- Microbiology Laboratory, Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal
| | - Miłosz Parczewski
- Department of Infectious, Tropical Diseases and Immune Deficiency, Pomeranian Medical Universityin, Szczecin, Szczecin, Poland
| | - Gibran Horemheb Rubio Quintanares
- Infectious Diseases Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
- Paul Ehrlich Institut, Virus Safety, Virology Department, Langen, Germany
| | - Matilu Mwau
- Center for Infectious and Parasitic Diseases Control Research, Kenya Medical Research Institute, Busia, Kenya
| | - Jorge A Pinto
- Department of Pediatrics, Pediatric Immunology Division, School of Medicine, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | | | | | - Giulia Marchetti
- Department of Health Sciences, University of Milan, Clinic of Infectious Diseases, San Paolo Hospital, ASST Santi Paolo E Carlo, Milan, Italy.
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10
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Varisco B, Bai F, De Benedittis S, Tavelli A, Cozzi-Lepri A, Sala M, Miraglia FG, Santoro MM, Ceccherini-Silberstein F, Shimoni Y, Ravid S, Kozlovski T, König F, Pfeifer N, Shamsara E, Parczewski M, Monforte AD, Incardona F, Mommo C, Marchetti G. EuCARE-POSTCOVID Study: a multicentre cohort study on long-term post-COVID-19 manifestations. BMC Infect Dis 2023; 23:684. [PMID: 37833640 PMCID: PMC10576381 DOI: 10.1186/s12879-023-08595-0] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 09/11/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND Post-COVID-19 condition refers to persistent or new onset symptoms occurring three months after acute COVID-19, which are unrelated to alternative diagnoses. Symptoms include fatigue, breathlessness, palpitations, pain, concentration difficulties ("brain fog"), sleep disorders, and anxiety/depression. The prevalence of post-COVID-19 condition ranges widely across studies, affecting 10-20% of patients and reaching 50-60% in certain cohorts, while the associated risk factors remain poorly understood. METHODS This multicentre cohort study, both retrospective and prospective, aims to assess the incidence and risk factors of post-COVID-19 condition in a cohort of recovered patients. Secondary objectives include evaluating the association between circulating SARS-CoV-2 variants and the risk of post-COVID-19 condition, as well as assessing long-term residual organ damage (lung, heart, central nervous system, peripheral nervous system) in relation to patient characteristics and virology (variant and viral load during the acute phase). Participants will include hospitalised and outpatient COVID-19 patients diagnosed between 01/03/2020 and 01/02/2025 from 8 participating centres. A control group will consist of hospitalised patients with respiratory infections other than COVID-19 during the same period. Patients will be followed up at the post-COVID-19 clinic of each centre at 2-3, 6-9, and 12-15 months after clinical recovery. Routine blood exams will be conducted, and patients will complete questionnaires to assess persisting symptoms, fatigue, dyspnoea, quality of life, disability, anxiety and depression, and post-traumatic stress disorders. DISCUSSION This study aims to understand post-COVID-19 syndrome's incidence and predictors by comparing pandemic waves, utilising retrospective and prospective data. Gender association, especially the potential higher prevalence in females, will be investigated. Symptom tracking via questionnaires and scales will monitor duration and evolution. Questionnaires will also collect data on vaccination, reinfections, and new health issues. Biological samples will enable future studies on post-COVID-19 sequelae mechanisms, including inflammation, immune dysregulation, and viral reservoirs. TRIAL REGISTRATION This study has been registered with ClinicalTrials.gov under the identifier NCT05531773.
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Affiliation(s)
- Benedetta Varisco
- Department of Health Sciences, Clinic of Infectious Diseases, University of Milan, ASST Santi Paolo E Carlo, Via A Di Rudinì 8, 20142, Milan, Italy
| | - Francesca Bai
- Department of Health Sciences, Clinic of Infectious Diseases, University of Milan, ASST Santi Paolo E Carlo, Via A Di Rudinì 8, 20142, Milan, Italy
| | | | | | - Alessandro Cozzi-Lepri
- Centre for Clinical Research, Epidemiology, Modelling and Evaluation (CREME), Institute for Global Health, UCL, London, UK
| | - Matteo Sala
- Department of Health Sciences, Clinic of Infectious Diseases, University of Milan, ASST Santi Paolo E Carlo, Via A Di Rudinì 8, 20142, Milan, Italy
| | | | | | | | - Yishai Shimoni
- Healthcare Informatics, IBM Research-Haifa, Mount Carmel Haifa, Israel
| | - Sivan Ravid
- Healthcare Informatics, IBM Research-Haifa, Mount Carmel Haifa, Israel
| | - Tal Kozlovski
- Healthcare Informatics, IBM Research-Haifa, Mount Carmel Haifa, Israel
| | - Florian König
- Institute for Bioinformatics and Medical Informatics, University of Tübingen, Tübingen, Germany
| | - Nico Pfeifer
- Institute for Bioinformatics and Medical Informatics, University of Tübingen, Tübingen, Germany
| | - Elham Shamsara
- Institute for Bioinformatics and Medical Informatics, University of Tübingen, Tübingen, Germany
| | - Milosz Parczewski
- Department of Infectious Tropical Diseases and Immune Deficiency, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | | | | | | | - Giulia Marchetti
- Department of Health Sciences, Clinic of Infectious Diseases, University of Milan, ASST Santi Paolo E Carlo, Via A Di Rudinì 8, 20142, Milan, Italy.
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Hu QX, Yao WX, Xu LL, Bai F. A Comparative Study of Measuring Bladder Volume in Patients with Pelvic Tumor Receiving Radiotherapy Using a Portable Bladder Scanner Made in China and CT Analog Positioning Machine. Int J Radiat Oncol Biol Phys 2023; 117:e673. [PMID: 37785985 DOI: 10.1016/j.ijrobp.2023.06.2122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) The purpose of this study was to investigate whether the bladder volume of patients with pelvic tumor treated with radiotherapy (RT) can be accurately measured using the Meike Palm Bladder Scanner PBSV3.2 manufactured in China and the accuracy of its measurement under different influencing factors. MATERIALS/METHODS One hundred and sixty-five patients with pelvic tumor radiotherapy who were positioned in our department from January 12, 2022, to July 7, 2022, were selected. All patients voided their bowels and urine one hour before positioning, had a gynecological examination, were instructed to drink 500-800 ml of water, urine volume was measured using PBSV3.2 when they felt the urge to urinate, and urine volume reached 150-350 ml given for positioning (20 minutes expected from making the film appliance to the end of positioning), and the data were measured and recorded using a cystometric device immediately after positioning. The CT bladder volume outlined by the treating physician is viewed in the planning system. The accuracy of PBSV3.2 was evaluated by comparing the bladder volume measured by the bladder scanner and CT. To investigate the accuracy of PBSV3.2 in different sex, ages, treatment purpose, and bladder volume. RESULTS There was a significant positive correlation with bladder volume on CT and PBSV (r = 0.874; p<0.001). The mean difference between CT measured values and PBSV was (-0.14±50.17) ml. The results of the different variables showed that the overall mean of PBSV and CT measurements were statistically different in the age ≥65 years, bladder volumes >400ml and ≤400ml groups (p = 0.028, 0.002, 0.001). There was no statistical significance between the remaining variables. The volume difference between PBSV measurement and CT was 12.87ml in male patients, which was larger than that in female patients 3.27ml. Pearson correlation analysis showed that the correlation coefficient was 0.473 for bladder volume greater than 400ml and 0.868 for bladder volume less than 400ml; the correlation coefficient of the other variables ranged from 0.802 to 0.893. CONCLUSION This is the first large-sample study to evaluate the accuracy of PBSV in a pelvic tumor RT population using the convenient bladder scanner PBSV3.2 made in China. PBSV provides an acceptable indicator for monitoring bladder volume in patients with pelvic RT. It is recommended to monitor bladder volume with PBSV when the planned bladder volume is 200-400ml. For male and patients ≥65 years old, at least two repeat measurements are required when using a bladder scanner and the volume should be corrected by using a modified feature to improve bladder volume consistency.
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Affiliation(s)
- Q X Hu
- Department of Radiation Oncology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - W X Yao
- Department of Radiation Oncology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - L L Xu
- Department of Radiation Oncology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - F Bai
- Department of Radiation Oncology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
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Yao WX, Hu QX, Xu LL, Bai F. Optimizing the Imaging Scheme of Small-Dose Contrast Agent in 4D-CT Localization Enhancement Scan for Radiotherapy of Liver Cancer. Int J Radiat Oncol Biol Phys 2023; 117:e740. [PMID: 37786150 DOI: 10.1016/j.ijrobp.2023.06.2273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) The primary liver cancer radiation therapy 4D-CT-enhanced (CE-4DCT) scan can accurately reflect the state of the liver as it moves with respiration, and enables clear visualization of the tumor, providing a precise range for target area outlining. However, the CE-4DCT scan localization time of primary liver cancer is long, and the fixed delay time of diagnostic CT cannot obtain high-quality 4DCT images. To this end, we designed a randomized controlled study to investigate the ideal localization scan delay time parameters for primary liver cancer CE-4DCT. MATERIALS/METHODS Patients with primary hepatocellular carcinoma who presented to our department for radiotherapy CT localization from January to December 2022 participated in this study. All subjects were randomly divided into two groups in a 1:1 ratio. CE-4DCT scans were performed using a high concentration of iodomepril (400 mg/ml) contrast agent with a contrast volume equal to the patient's body weight. The scanning parameters were set according to scheme A (flow rate 2.0 ml/s, delay time 30s) and B (2.0 ml/s, 35s) respectively. Before the CE-4D CT scan, CT plain scan was routinely performed, physicians measured the CT value (HU) of abdominal aorta, portal vein, left hepatic vein, middle hepatic vein, right hepatic vein, liver parenchyma and tumor lesion on CT40 time item and plain scan images respectively. The image quality was subjectively and qualitatively assessed. The image enhancement effect is divided into excellent, good, relatively poor and poor. RESULTS A total of 18 patients were included in this study. Patient characteristics were well-balanced in both groups. There were statistical differences between the two groups (A vs B) in the abdominal aorta (226.66 ± 45.59 vs. 176.66 ± 32.84, p = 0.017), left hepatic vein (142.77 ± 24.41 vs. 164.88 ± 19.02, p = 0.048); in the portal vein, middle hepatic vein, right hepatic vein, liver parenchyma, and tumor lesions CT values were not statistically different. The comparison of all flat-scan images between the two groups was statistically significant. The comparison of all flat-scan images in both groups was statistically significant. The subjective qualitative assessment of the developing effect was excellent in 44.4% (33.3% vs. 11.1%), good in 16.7% (5.6% vs. 11.1%), and poor in 38.9% (16.7% vs. 22.2%) in both groups. image quality was slightly higher in group A than in group B, but did not reach statistical significance (χ2 = 1.088, p = 0.698). In patients with primary hepatocellular carcinoma with portal vein carcinoma thrombosis 83.33% subjectively evaluated poor results. CONCLUSION Qualitatively acceptable enhanced images were obtained for primary hepatocellular carcinoma (CE-4DCT) localization scans with a delay time controlled at 30s when using the least amount of contrast agent and the same flow rate.
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Affiliation(s)
- W X Yao
- Department of Radiation Oncology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Q X Hu
- Department of Radiation Oncology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - L L Xu
- Department of Radiation Oncology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - F Bai
- Department of Radiation Oncology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
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Yang H, Huang D, Bai F, Yao WX, Xu L, Wei L, Zhao LN. Pseudo CT Synthesis Using Cone-Beam CT of Cervical Cancer with GAN-Based Neural Network Model. Int J Radiat Oncol Biol Phys 2023; 117:e556. [PMID: 37785707 DOI: 10.1016/j.ijrobp.2023.06.1868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Cervical cancer (CC) is a tumor disease that threatens the health of women. As an important treatment of CC, radiotherapy has been widely used in clinic. With the rapid development of radiotherapy technology, adaptive radiotherapy has received much attention. Adaptive radiotherapy means more accurate radiation dose and more accurate radiation area, which can effectively protect normal tissue. It is significant to improve the local control rate of tumor and the quality of life of patients. However, the Cone-Beam CT (CBCT) images collected during radiotherapy are of poor quality and cannot provide real-time radiation effect information, resulting in timely and effective adjustment of radiation dose and radiation area in the process of radiotherapy for cervical cancer. To alleviate this issue, this study will establish a model to leverage CC CBCT images to synthetize pseudo computed tomography (CT) images with high quality, so as to achieve the purpose of quality improvement. MATERIALS/METHODS This study included the data of 20 patients with CC in ** hospital. The planning CT and CBCT scan data of each patient before radiotherapy were collected, and the interval between the two kinds of image data was required to be less than one week. After data preprocessing, a total of 1206 pairs of images were trained and tested. The generative adversarial network (GAN) is constructed. In order to ensure the similarity between the input image and the output image, the L1 loss function is leveraged. And the full supervision method is used to train the model to achieve a better effect of image synthesis and improve the quality of CBCT image. Peak signal-to-noise ratio (PSNR) and structural similarity (SSIM) were used as evaluation indexes. RESULTS Using five-fold cross-validation, the values of PSNR between the pseudo-CT (sCT) and the planning CT (pCT) image and between the CBCT and the pCT image are calculated. The results are 26.9 and 22.6, respectively. The sCT obtained from the GAN model increases the peak signal-to-noise ratio by 19% compared with the original CBCT, which means that the proposed model built in this study can improve the useful information of the CBCT image. The SSIM values between sCT and pCT and between CBCT and pCT are also calculated, and the average values of them are 0.89 and 0.63, respectively. Therefore, in this experiment, the structure of the sCT obtained by the proposed model is closer to pCT. And the SSIM increases by 41.2% compared with the original CBCT, which means that the sCT by the proposed model is more similar to the pCT in structure. These results could make a more accurate judgment on the effect of radiotherapy. CONCLUSION In this study, the pseudo-CT synthesis method based on GAN can improve the quality of CC CBCT image. The results show this method makes the structure clearer and could assist doctors to adjust the radiation dose and radiation area in time. This study is able to facilitate the development of adaptive radiotherapy for CC.
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Affiliation(s)
- H Yang
- Department of Radiation Oncology, Xijing Hospital, Air Force Medical University, Xi'an, China
| | - D Huang
- Department of Military Biomedical Engineering, Air Force Medical University, Xi'an, Shaanxi, China
| | - F Bai
- Department of Radiation Oncology, Xi an, China
| | - W X Yao
- Department of Radiation Oncology, Xijing Hospital of the Air Force Medical University, Xi'an, Shaanxi, China
| | - L Xu
- Department of Radiation Oncology, Xijing Hospital, Air Force Medical University( Fourth Military Medical University), Xi'an, China
| | - L Wei
- Department of Radiation Oncology, First Affiliated Hospital of Air Force Medical University, Xi'an, China
| | - L N Zhao
- Department of Radiation Oncology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
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Zixuan L, Fengbin Z, Bo L, Zang J, Bai F. Preheating Thermoplastic Membrane Reduce Setup Error in Patients with Thoracic Cancer Undergoing Radiation Therapy: A Prospective Randomized Controlled Study. Int J Radiat Oncol Biol Phys 2023; 117:e750. [PMID: 37786172 DOI: 10.1016/j.ijrobp.2023.06.2517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Thermoplasticfilm routinely placed in the treatment room always led to uncomfortable feeling in patients receiving thorax radiation therapy because of significant temperature difference between thermoplastic film and body surface. Therefore, it may result in setup error and further affect accuracy of radiation therapy. Here, we designed a randomized controlled study to investigate the efficacy of preheat thermoplastic film to reduce setup error in patients receiving thorax radiotherapy. MATERIALS/METHODS Patients with thoracic cancer receiving radiotherapy once daily with five fraction per week were enrolled in this study from October 2022 to January 2023. All participants were randomly assigned into room-temperature group and preheating group in a 1:1 ratio. For the preheating group, the thermoplastic film was preheated for 10 minutes in a 37°C thermostat before it was used for patients' setup. For controlled group, the thermoplastic film with room-temperature was used for patients' setup. The cone beam computed tomography (CBCT) was used to evaluate setup errors once a week. The setup errors in translational directions X, Y and Z were recorded based on CBCT image. to measure the left-right as well as anterior-posterior diameter of the thorax in cross-section to observe whether there was any difference in thorax size from that at positioning. A modified Likert questionnaire was conducted to investigate the setup comfort level between two groups before radiotherapy and Day 5 of radiotherapy. RESULTS A total of 34 patients were enrolled in this study. Patient characteristics were well balanced in both arms. The setup errors in the X, Y, and Z axes in group A were 1(-1,1) mm, 0(-1,2.75) mm and 0(-1,1) mm, respectively, while those in group B were 0(-2,2) mm, 1(-1.25,3) mm, and -1(-2,1) mm in the X, Y, and Z axes, respectively. Setup error in preheating group was smaller than room-temperature group in the X-axis direction (Z = 2.04, P = 0.042), but no significant differences were detected in Y and Z axes. Comparison of changes in anteroposterior thoracic diameter between the two groups. The preheated group was smaller than the normothermic group (-0.19 ± 0.48 vs -0.38 ± 0.36, P < 0.01). The total comfort scale scores of the two groups were 30.88 ± 3.39 vs 30.59 ± 3.34 (p = 0.42) before treatment and 32.125 ± 4.31 vs 31.06 ± 3.15 (p = 0.80) after treatment. Among the eight sub-items, only the fourth dimension of temperature was statistically different (pre 3.12 ± 0.48 vs 2.88 ± 0.60, P = 0.218; post 4.12 ± 0.78 vs 2.94 ± 0.43, P < 0.01). CONCLUSION Ourcenter proposed the first method of heating the mold for postural fixation during patient radiotherapy. Compared with room-temperature thermoplastic film, our study found preheating thermoplastic film with 37°C could significantly reduce setup error in the X direction with less effect on the anterior-posterior diameter change of the thorax and higher patient temperature comfort satisfaction.
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Affiliation(s)
- L Zixuan
- Department of Radiation Oncology, Xijing Hospital, Fourth Military Medical University, Xi'an, China, Xi'an, Shaanxi Province, China
| | - Z Fengbin
- Department of Radiation Oncology, Xijing Hospital, Fourth Military Medical University, Xi'an, China, Xi'an, Shaanxi Province, China
| | - L Bo
- Department of Radiation Oncology, Xijing Hospital, Fourth Military Medical University, Xi'an, China, Xi'an, Shanxi, China
| | - J Zang
- Department of Radiation Oncology, Xijing Hospital, Air Force Medical University (Fourth Military Medical University), Xi'an, China
| | - F Bai
- Department of Radiation Oncology, Xi an, China
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Trunfio M, Pinnetti C, Arsuffi S, Bai F, Celani L, D'Ettorre G, Vera JH, D'Arminio Monforte A, Focà E, Ghisetti V, Bonora S, Antinori A, Calcagno A. The presence of resistance‐associated mutations in reverse transcriptase gene is associated with cerebrospinal fluid HIV‐1 escape: A multicentric retrospective analysis. J Med Virol 2023; 95:e28704. [PMID: 36967541 DOI: 10.1002/jmv.28704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 02/07/2023] [Accepted: 03/23/2023] [Indexed: 04/05/2023]
Abstract
Higher risk of cerebrospinal fluid escape (CVE) has been associated with the use of specific antiretroviral (ARV) classes, such as protease inhibitors. We assessed whether archived resistance-associated mutations (RAMs) can mediate this relationship by identifying patients treated with incompletely active antiretroviral regimens. A retrospective multicentric study on 282 adult people with HIV on antiretroviral therapy (ART) and available historical plasma genotype resistance testing (HGRT) for reverse transcriptase (RT) and protease genes between 2001 and 2021. The odds ratio for demographic, clinic-, and ART-related variables and CVE was estimated by multivariable modeling. HGRT-adjusted central nervous system effectiveness penetration (CPE) score was computed in modeling the risk. Median age, plasma VL, and CD4 count were 49 years, <50 copies/mL, and 310 cells/μL. CVE was detected in 51 participants (17.0%). No difference in CVE prevalence was observed according to ART type, number of ARVs or ARV classes. Participants with CVE had more frequently plasma (52.9% vs. 32.1%, p = 0.005) and CSF RAMs in RT (n = 63, 57.1% vs. 28.6%, p = 0.029), but not in protease gene. The presence of plasma RAMs in RT associated with increased odds of CVE in adjusted analyses (aOR 3.9, p < 0.001) and in models restricted to plasma viral load ≤50 copies/mL (n = 202; aOR 4.3, p = 0.003). CVE risk decreased by 40% per each point increase in HGRT-adjusted CPE score in multivariable models (p < 0.001). Rather than the type of ARV classes or of ART regimens, functional mono or dual regimens caused by the presence of RAMs affecting ART components may explain the majority of cases of CVE.
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Affiliation(s)
- Mattia Trunfio
- Unit of Infectious Diseases, Amedeo di Savoia Hospital at Department of Medical Sciences University of Turin Turin Italy
| | - Carmela Pinnetti
- Clinical and Research Infectious Diseases Department, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS Rome Italy
| | - Stefania Arsuffi
- Department of Clinical and Experimental Sciences, Division of Infectious and Tropical Diseases, Spedali Civili General Hospital University of Brescia Brescia Italy
| | - Francesca Bai
- Department of Health Sciences, Clinic of Infectious Diseases and Tropical Medicine, S.Paolo Hospital, ASST Santi Paolo e Carlo University of Milan Milan Italy
| | - Luigi Celani
- Department of Public Health and Infectious Diseases Azienda Policlinico Umberto I Rome Italy
| | - Gabriella D'Ettorre
- Department of Public Health and Infectious Diseases Azienda Policlinico Umberto I Rome Italy
| | - Jaime H. Vera
- Department of Global Health and Infection Brighton and Sussex Medical School Brighton UK
| | - Antonella D'Arminio Monforte
- Department of Health Sciences, Clinic of Infectious Diseases and Tropical Medicine, S.Paolo Hospital, ASST Santi Paolo e Carlo University of Milan Milan Italy
| | - Emanuele Focà
- Department of Clinical and Experimental Sciences, Division of Infectious and Tropical Diseases, Spedali Civili General Hospital University of Brescia Brescia Italy
| | - Valeria Ghisetti
- Molecular Biology and Microbiology Unit, Amedeo di Savoia Hospital ASL Città di Torino Turin Italy
| | - Stefano Bonora
- Unit of Infectious Diseases, Amedeo di Savoia Hospital at Department of Medical Sciences University of Turin Turin Italy
| | - Andrea Antinori
- Clinical and Research Infectious Diseases Department, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS Rome Italy
| | - Andrea Calcagno
- Unit of Infectious Diseases, Amedeo di Savoia Hospital at Department of Medical Sciences University of Turin Turin Italy
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16
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Bai F, Mazzitelli M, Silvola S, Raumer F, Restelli U, Croce D, Marchetti G, Cattelan AM. Cost analysis of dalbavancin versus standard of care for the treatment of acute bacterial skin and skin structure infections (ABSSSIs) in two Italian hospitals. JAC Antimicrob Resist 2023; 5:dlad044. [PMID: 37090914 PMCID: PMC10116602 DOI: 10.1093/jacamr/dlad044] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 03/25/2023] [Indexed: 04/25/2023] Open
Abstract
Objectives Thanks to its long half-life, dalbavancin qualifies as an optimal drug for saving costs. We aimed to assess the cost and effectiveness of dalbavancin versus the standard of care (SoC). Patients and methods We conducted a multicentre retrospective study, including all hospitalized or outpatients diagnosed with ABSSSIs at Padua University Hospital, Padua and San Paolo Hospital, Milan (1 January 2016 to 31 July 2020). We compared patients according to antibiotic treatment (dalbavancin versus SoC), the number of lines of dalbavancin treatment, and monotherapy or combination (dalbavancin in association with other antibiotics). Primary endpoints were direct medical costs and length of hospital stay (LOS) associated with ABSSSI management; Student's t-test, chi-squared test and one-way ANOVA were used. Results One hundred and twenty-six of 228 (55.3%) patients received SoC, while 102/228 (44.7%) received dalbavancin. Twenty-seven of the 102 (26.5%) patients received dalbavancin as first-line treatment, 46 (45.1%) as second-line, and 29 (28.4%) as third- or higher-line treatment. Most patients received dalbavancin as monotherapy (62/102; 60.8%). Compared with SoC, dalbavancin was associated with a significant reduction of LOS (5 ± 7.47 days for dalbavancin, 9.2 ± 5.59 days for SoC; P < 0.00001) and with lower mean direct medical costs (3470 ± 2768€ for dalbavancin; 3493 ± 1901€ for SoC; P = 0.9401). LOS was also reduced for first-line dalbavancin, in comparison with second-, third- or higher-line groups, and for dalbavancin monotherapy versus combination therapy. Mean direct medical costs were significantly lower in first-line dalbavancin compared with higher lines, but no cost difference was observed between monotherapy and combination therapy. Conclusions Monotherapy with first-line dalbavancin was confirmed as a promising strategy for ABSSSIs in real-life settings, thanks to its property in reducing LOS and saving direct medical costs.
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Affiliation(s)
| | | | - Sofia Silvola
- Carlo Cattaneo—LIUC University, Castellanza, VA, Italy
- Department of Public Health Medicine, School of Health System & Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | | | - Umberto Restelli
- Carlo Cattaneo—LIUC University, Castellanza, VA, Italy
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Davide Croce
- Carlo Cattaneo—LIUC University, Castellanza, VA, Italy
- Department of Public Health Medicine, School of Health System & Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | | | - Anna Maria Cattelan
- Infectious and Tropical Diseases Unit Department, Padua University Hospital, Padua, Italy
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Mastrorosa I, Gagliardini R, Segala FV, Mondi A, Lorenzini P, Cerva C, Taddei E, Bai F, Vergori A, Marcantonio N, Pinnetti C, Cicalini S, Murri R, Mazzotta V, Camici M, Mosti S, Bini T, Maffongelli G, Beccacece A, Milozzi E, Iannetta M, Lamonica S, Fusto M, Plazzi MM, Ottou S, Lichtner M, Fantoni M, Andreoni M, Sarmati L, Cauda R, Girardi E, Nicastri E, D'Arminio Monforte A, Palmieri F, Cingolani A, Vaia F, Antinori A. Sarilumab plus standard of care vs standard of care for the treatment of severe COVID-19: a phase 3, randomized, open-labeled, multi-center study (ESCAPE study). EClinicalMedicine 2023; 57:101895. [PMID: 36936403 PMCID: PMC9999914 DOI: 10.1016/j.eclinm.2023.101895] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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] [Received: 11/29/2022] [Revised: 02/15/2023] [Accepted: 02/15/2023] [Indexed: 03/12/2023] Open
Abstract
BACKGROUND Among interleukin-6 inhibitors suggested for use in COVID-19, there are few robust evidences for the efficacy of sarilumab. Herein, we evaluated the efficacy and safety of sarilumab in severe COVID-19. METHODS In this phase 3, open-labeled, randomized clinical trial, conducted at 5 Italian hospitals, adults with severe COVID-19 pneumonia (excluding mechanically ventilated) were randomized 2:1 to receive intravenous sarilumab (400 mg, repeatable after 12 h) plus standard of care (SOC) (arm A) or to continue SOC (arm B). Randomization was web-based. As post-hoc analyses, the participants were stratified according to baseline inflammatory parameters. The primary endpoint was analysed on the modified Intention-To-Treat population, including all the randomized patients who received any study treatment (sarilumab or SOC). It was time to clinical improvement of 2 points on a 7-points ordinal scale, from baseline to day 30. We used Kaplan Meier method and log-rank test to compare the primary outcome between two arms, and Cox regression stratified by clinical center and adjusted for severity of illness, to estimate the hazard ratio (HR). The trial was registered with EudraCT (2020-001390-76). FINDINGS Between May 2020 and May 2021, 191 patients were assessed for eligibility, of whom, excluding nine dropouts, 176 were assigned to arm A (121) and B (55). At day 30, no significant differences in the primary endpoint were found (88% [95% CI 81-94] in arm A vs 85% [74-93], HR 1.07 [0.8-1.5] in arm B; log-rank p = 0.50). After stratifying for inflammatory parameters, arm A showed higher probability of improvement than B without statistical significance in the strata with C reactive protein (CRP) < 7 mg/dL (88% [77-96] vs 79% [63-91], HR 1.55 [0.9-2.6]; log-rank p = 0.049) and in the strata with lymphocytes <870/mmc (90% [79-96]) vs (73% [55-89], HR 1.53 [0.9-2.7]; log-rank p = 0.058). Overall, 39/121 (32%) AEs were reported in arm A and 14/55 (23%) in B (p = 0.195), while serious AEs were 22/121 (18%) and 7/55 (11%), respectively (p = 0.244). There were no treatment-related deaths. INTERPRETATION The efficacy of sarilumab in severe COVID-19 was not demonstrated both in the overall and in the stratified for severity analysis population. Exploratory analyses suggested that subsets of patients with lower CRP values or lower lymphocyte counts might have had benefit with sarilumab treatment, but this finding would require replication in other studies. The relatively low rate of concomitant corticosteroid use, could partially explain our results. FUNDING This study was supported by INMI "Lazzaro Spallanzani" Ricerca Corrente Linea 1 on emerging and reemerging infections, funded by Italian Ministry of Health.
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Affiliation(s)
- Ilaria Mastrorosa
- National Institute for Infectious Diseases, Lazzaro Spallanzani IRCCS, Rome, Italy
- Corresponding author. Clinical Department of Infectious Diseases and Research, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, Via Portuense 292, 00149, Roma, Italy.
| | - Roberta Gagliardini
- National Institute for Infectious Diseases, Lazzaro Spallanzani IRCCS, Rome, Italy
| | | | - Annalisa Mondi
- National Institute for Infectious Diseases, Lazzaro Spallanzani IRCCS, Rome, Italy
| | - Patrizia Lorenzini
- National Institute for Infectious Diseases, Lazzaro Spallanzani IRCCS, Rome, Italy
- National Center for Disease Prevention and Health Promotion, National Institute of Health, Rome, Italy
| | - Carlotta Cerva
- National Institute for Infectious Diseases, Lazzaro Spallanzani IRCCS, Rome, Italy
| | - Eleonora Taddei
- Fondazione Policlinico A. Gemelli, Catholic University of the Sacred Heart, Rome, Italy
| | - Francesca Bai
- ASST Santi Paolo e Carlo, University of Milan, Italy
| | - Alessandra Vergori
- National Institute for Infectious Diseases, Lazzaro Spallanzani IRCCS, Rome, Italy
| | - Negri Marcantonio
- Fondazione Policlinico A. Gemelli, Catholic University of the Sacred Heart, Rome, Italy
| | - Carmela Pinnetti
- National Institute for Infectious Diseases, Lazzaro Spallanzani IRCCS, Rome, Italy
| | - Stefania Cicalini
- National Institute for Infectious Diseases, Lazzaro Spallanzani IRCCS, Rome, Italy
| | - Rita Murri
- Fondazione Policlinico A. Gemelli, Catholic University of the Sacred Heart, Rome, Italy
| | - Valentina Mazzotta
- National Institute for Infectious Diseases, Lazzaro Spallanzani IRCCS, Rome, Italy
| | - Marta Camici
- National Institute for Infectious Diseases, Lazzaro Spallanzani IRCCS, Rome, Italy
| | - Silvia Mosti
- National Institute for Infectious Diseases, Lazzaro Spallanzani IRCCS, Rome, Italy
| | - Teresa Bini
- ASST Santi Paolo e Carlo, University of Milan, Italy
| | - Gaetano Maffongelli
- National Institute for Infectious Diseases, Lazzaro Spallanzani IRCCS, Rome, Italy
| | - Alessia Beccacece
- National Institute for Infectious Diseases, Lazzaro Spallanzani IRCCS, Rome, Italy
| | - Eugenia Milozzi
- National Institute for Infectious Diseases, Lazzaro Spallanzani IRCCS, Rome, Italy
| | | | - Silvia Lamonica
- Fondazione Policlinico A. Gemelli, Catholic University of the Sacred Heart, Rome, Italy
| | - Marisa Fusto
- National Institute for Infectious Diseases, Lazzaro Spallanzani IRCCS, Rome, Italy
| | | | - Sandrine Ottou
- National Institute for Infectious Diseases, Lazzaro Spallanzani IRCCS, Rome, Italy
| | | | - Massimo Fantoni
- Fondazione Policlinico A. Gemelli, Catholic University of the Sacred Heart, Rome, Italy
| | | | | | - Roberto Cauda
- Fondazione Policlinico A. Gemelli, Catholic University of the Sacred Heart, Rome, Italy
| | - Enrico Girardi
- National Institute for Infectious Diseases, Lazzaro Spallanzani IRCCS, Rome, Italy
| | - Emanuele Nicastri
- National Institute for Infectious Diseases, Lazzaro Spallanzani IRCCS, Rome, Italy
| | | | - Fabrizio Palmieri
- National Institute for Infectious Diseases, Lazzaro Spallanzani IRCCS, Rome, Italy
| | - Antonella Cingolani
- Fondazione Policlinico A. Gemelli, Catholic University of the Sacred Heart, Rome, Italy
| | - Francesco Vaia
- National Institute for Infectious Diseases, Lazzaro Spallanzani IRCCS, Rome, Italy
| | - Andrea Antinori
- National Institute for Infectious Diseases, Lazzaro Spallanzani IRCCS, Rome, Italy
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Zhou Y, Bai F, Li X, Zhou G, Tian X, Li G, Zhang Y, Zhou X, Xu D, Ding Y. Genetic polymorphisms in MIR1208 and MIR5708 are associated with susceptibility to COPD in the Chinese population. Pulmonology 2023; 29:6-12. [PMID: 36115827 DOI: 10.1016/j.pulmoe.2021.07.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 11/06/2020] [Revised: 05/06/2021] [Accepted: 07/24/2021] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) is a complex disease characterized by limited airflow and is influenced by genetic and environmental factors. The purpose of this study was to investigate the effects of gene polymorphisms in MIR5708 and MIR1208 on COPD risk. METHODS Four single nucleotide polymorphisms (SNPs) in MIR5708 (rs6473227 and rs16907751) and MIR1208 (rs2608029 and rs13280095) were selected and genotyped among 315 COPD patients and 314 healthy controls using the Agena MassARRAY platform. SPSS 18.0 was used for statistical analysis and data processing. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to assess the association between genetic variants of MIR1208 and MIR5708 and COPD risk. RESULTS The results suggested that rs16907751 variants in MIR5708 contributed to an increased susceptibility to COPD in the allelic (P = 0.001), co-dominant (homozygous) (P = 0.001), dominant (P = 0.017), recessive (P = 0.002), and additive (P = 0.002) models. The effects of MIR5708 and MIR1208 gene polymorphisms on the risk of COPD were age-, sex-, smoking status-, and BMI-related. Furthermore, the C-A and G-A haplotypes of rs2608029 and rs13280095 in MIR1208 were identified as risk factors for COPD in the population over 70 years (P = 0.029) and in women (P = 0.049), respectively. Finally, significant associations between rs16907751genotypes with pulse rate and forced expiratory volume in 1 s were found among COPD patients. CONCLUSION Genetic polymorphisms in MIR5708 and MIR1208 are associated with increased risk of COPD in China.
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Affiliation(s)
- Y Zhou
- Center of Appointment Clinic Service, Hainan General Hospital, Hainan affiliated Hospital of Hainan Medical University, Hainan, China
| | - F Bai
- Department of Science and Education Department, Hainan General Hospital, Hainan affiliated Hospital of Hainan Medical University, Hainan, China
| | - X Li
- Department of General Practice, People's Hospital of Wanning, Hainan, China
| | - G Zhou
- Department of Nursing, People's Hospital of Wanning, Hainan, China
| | - X Tian
- Department of Medical, People's Hospital of Wanning, Hainan, China
| | - G Li
- Department of General Practice, People's Hospital of Wanning, Hainan, China
| | - Y Zhang
- Department of General Practice, Hainan General Hospital, Hainan affiliated Hospital of Hainan Medical University, Hainan, China
| | - X Zhou
- Department of General Practice, Hainan General Hospital, Hainan affiliated Hospital of Hainan Medical University, Hainan, China
| | - D Xu
- Department of Emergency, Hainan General Hospital, Hainan affiliated Hospital of Hainan Medical University, Hainan, China.
| | - Y Ding
- Department of General Practice, Hainan General Hospital, Hainan affiliated Hospital of Hainan Medical University, Hainan, China.
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19
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Gao B, Jiao TY, Li YT, Chen H, Lin WP, An Z, Ru LH, Zhang ZC, Tang XD, Wang XY, Zhang NT, Fang X, Xie DH, Fan YH, Ma L, Zhang X, Bai F, Wang P, Fan YX, Liu G, Huang HX, Wu Q, Zhu YB, Chai JL, Li JQ, Sun LT, Wang S, Cai JW, Li YZ, Su J, Zhang H, Li ZH, Li YJ, Li ET, Chen C, Shen YP, Lian G, Guo B, Li XY, Zhang LY, He JJ, Sheng YD, Chen YJ, Wang LH, Zhang L, Cao FQ, Nan W, Nan WK, Li GX, Song N, Cui BQ, Chen LH, Ma RG, Zhang ZC, Yan SQ, Liao JH, Wang YB, Zeng S, Nan D, Fan QW, Qi NC, Sun WL, Guo XY, Zhang P, Chen YH, Zhou Y, Zhou JF, He JR, Shang CS, Li MC, Kubono S, Liu WP, deBoer RJ, Wiescher M, Pignatari M. Deep Underground Laboratory Measurement of ^{13}C(α,n)^{16}O in the Gamow Windows of the s and i Processes. Phys Rev Lett 2022; 129:132701. [PMID: 36206440 DOI: 10.1103/physrevlett.129.132701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 04/01/2022] [Accepted: 06/01/2022] [Indexed: 06/16/2023]
Abstract
The ^{13}C(α,n)^{16}O reaction is the main neutron source for the slow-neutron-capture process in asymptotic giant branch stars and for the intermediate process. Direct measurements at astrophysical energies in above-ground laboratories are hindered by the extremely small cross sections and vast cosmic-ray-induced background. We performed the first consistent direct measurement in the range of E_{c.m.}=0.24 to 1.9 MeV using the accelerators at the China Jinping Underground Laboratory and Sichuan University. Our measurement covers almost the entire intermediate process Gamow window in which the large uncertainty of the previous experiments has been reduced from 60% down to 15%, eliminates the large systematic uncertainty in the extrapolation arising from the inconsistency of existing datasets, and provides a more reliable reaction rate for the studies of the slow-neutron-capture and intermediate processes along with the first direct determination of the alpha strength for the near-threshold state.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - R J deBoer
- Center for Nuclear Study, University of Tokyo, Wako, Saitama 351-0198, Japan
| | - M Wiescher
- Center for Nuclear Study, University of Tokyo, Wako, Saitama 351-0198, Japan
- Wolfson Fellow of Royal Society, School of Physics and Astronomy, University of Edinburgh, King's Buildings, Edinburgh EH9 3FD, United Kingdom
| | - M Pignatari
- Konkoly Observatory, Research Centre for Astronomy and Earth Sciences (CSFK), Eötvös Loránd Research Network (ELKH), Konkoly Thege Miklós út 15-17, H-1121 Budapest, Hungary
- CSFK, MTA Centre of Excellence, Budapest, Konkoly Thege Miklós út 15-17, Budapest H-1121, Hungary
- E. A. Milne Centre for Astrophysics, Department of Physics and Mathematics, University of Hull, Hull, HU6 7RX, United Kingdom
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20
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Xu LP, Bai F, Tao H. [Current clinical application of lacrimal gland injection of botulinum toxin type A in inhibiting lacrimal secretion]. Zhonghua Yan Ke Za Zhi 2022; 58:722-726. [PMID: 36069098 DOI: 10.3760/cma.j.cn112142-20220130-00044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Lacrimal gland injection of botulinum toxin type A inhibits the secretion of tears. As a new method to treat or alleviate the symptom of tears or epiphora, it has the characteristics of simple operation, definite curative effect, repeatable treatment and no irreversible complications. It provides an optional treatment scheme for many patients with refractory tears or epiphora. This article reviews the pharmacological characteristics of botulinum toxin type A, the mechanism of inhibiting tear secretion, the method and dose of lacrimal gland injection, indications and contraindications, clinical efficacy evaluation, complications, existing problems to be solved and prospects for reference.
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Affiliation(s)
- L P Xu
- Department of Ophthalmology, The Affiliated Zhongshan Hospital of Dalian University, Dalian 116001, China
| | - F Bai
- Lacrimal Center, Department of Ophthalmology, Chinese PLA General Hospital, Beijing 100039, China
| | - H Tao
- Lacrimal Center, Department of Ophthalmology, Chinese PLA General Hospital, Beijing 100039, China
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21
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Comelli A, Genovese C, Lombardi A, Bobbio C, Scudeller L, Restelli U, Muscatello A, Antinori S, Bonfanti P, Casari S, Castagna A, Castelli F, Monforte AD, Franzetti F, Grossi P, Lupi M, Morelli P, Piconi S, Puoti M, Pusterla L, Regazzetti A, Rizzi M, Rusconi S, Zuccaro V, Gori A, Bandera A, Giacomelli A, Rossi M, Bruno R, Garilli S, Marco R, Signorini L, Bai F, Pan A, Merli M, Ricaboni D, Molteni C, Benatti SV, Castiglioni B, Rovelli C, Piazza M, Franzetti M. What is the impact of SARS-CoV-2 pandemic on antimicrobial stewardship programs (ASPs)? The results of a survey among a regional network of infectious disease centres. Antimicrob Resist Infect Control 2022; 11:108. [PMID: 36038903 PMCID: PMC9421115 DOI: 10.1186/s13756-022-01152-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 08/22/2022] [Indexed: 11/12/2022] Open
Abstract
Discontinuation of antimicrobial stewardship programs (ASPs) and increased antibiotic use were described during SARS-CoV-2 pandemic. In order to measure COVID-19 impact on ASPs in a setting of high multidrug resistance organisms (MDRO) prevalence, a qualitative survey was designed. In July 2021, eighteen ID Units were asked to answer a questionnaire about their hospital characteristics, ASPs implementation status before the pandemic and impact of SARS-CoV-2 pandemic on ASPs after the 1st and 2nd pandemic waves in Italy. Nine ID centres (50%) reported a reduction of ASPs and in 7 cases (38.9%) these were suspended. After the early pandemic waves, the proportion of centres that restarted their ASPs was higher among the ID centres where antimicrobial stewardship was formally identified as a priority objective (9/11, 82%, vs 2/7, 28%). SARS-CoV-2 pandemic had a severe impact in ASPs in a region highly affected by COVID-19 and antimicrobial resistance but weaknesses related to the pre-existent ASPs might have played a role.
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22
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Li X, Wang P, Hao Q, Cao Z, Zhang H, Guo J, Hu S, Bai F. Esophageal cancer-related gene 4 and solid tumors: a brief literature review. J Physiol Pharmacol 2022; 73. [PMID: 36696238 DOI: 10.26402/jpp.2022.4.01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Received: 07/04/2024] [Accepted: 08/30/2022] [Indexed: 01/26/2023]
Abstract
Esophageal cancer-related gene 4 (ECRG4) plays key roles in various malignancies, including lung cancer, prostate cancer, esophageal cancer, and breast cancer, and has potential applications in the early diagnosis, prevention, treatment, and prognosis of cancer. However, the mechanisms underlying the role of ECRG4 in cancer remain elusive. An association between ECRG4 and proliferation, migration, cell cycle, apoptosis, methylation, and ubiquitination in cancer has been found. Additionally, some studies have investigated the regulatory mechanism of the relationship between ECRG4 and long non-coding RNAs, co-factors, and resistance to chemotherapy. Drugs that demethylate ECRG4 are in clinical use. Thus, further investigation of the mechanisms by which ECRG4 influences tumorigenesis, and its clinical significance, are needed. The present study outlines the current understanding of the functions of ECRG4 in cancer and discusses its potential value in cancer therapy.
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Affiliation(s)
- X Li
- School of Clinical Medicine, Ningxia Medical University, Yinchuan, Ningxia, P.R. China.,Department of Gastroenterology, People's Hospital of Ningxia Hui Autonomous Region, Yinchuan, Ningxia, P.R. China.,Department of Gastroenterology, Northwest Minzu University, Lanzhou, Gansu, P.R. China
| | - P Wang
- Department of Gastroenterology, People's Hospital of Ningxia Hui Autonomous Region, Yinchuan, Ningxia, P.R. China.,Department of Gastroenterology, Northwest Minzu University, Lanzhou, Gansu, P.R. China
| | - Q Hao
- Department of Gastroenterology, People's Hospital of Ningxia Hui Autonomous Region, Yinchuan, Ningxia, P.R. China.,Department of Gastroenterology, Northwest Minzu University, Lanzhou, Gansu, P.R. China
| | - Z Cao
- Department of Gastroenterology, People's Hospital of Ningxia Hui Autonomous Region, Yinchuan, Ningxia, P.R. China.,Department of Gastroenterology, Northwest Minzu University, Lanzhou, Gansu, P.R. China
| | - H Zhang
- Department of Gastroenterology, People's Hospital of Ningxia Hui Autonomous Region, Yinchuan, Ningxia, P.R. China.,Department of Gastroenterology, Northwest Minzu University, Lanzhou, Gansu, P.R. China
| | - J Guo
- Department of Gastroenterology, People's Hospital of Ningxia Hui Autonomous Region, Yinchuan, Ningxia, P.R. China.,Department of Gastroenterology, Northwest Minzu University, Lanzhou, Gansu, P.R. China
| | - S Hu
- Department of Gastroenterology, People's Hospital of Ningxia Hui Autonomous Region, Yinchuan, Ningxia, P.R. China. .,Department of Gastroenterology, Northwest Minzu University, Lanzhou, Gansu, P.R. China
| | - F Bai
- The Gastroenterology Clinical Medical Center of Hainan Province, Haikou, P.R. China.,Department of Gastroenterology, The Second Affiliated Hospital of Hainan Medical University, Haikou, P.R. China.
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23
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Liu X, Jin S, Hu S, Bai F, Wang Y. 118 Single-cell transcriptomics links cellular origins of malignant T cells to the tumor immune landscape in cutaneous T cell lymphoma. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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24
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Yu X, Wang J, Hu Y, Sun Y, Zhao J, Yu Y, Hu C, Yang K, Feng G, Leaw S, Yuan Y, Lin X, Bai F, Lu S. 18P RATIONALE-307: Safety analysis of patients (pts) receiving tislelizumab (TIS) plus chemotherapy (chemo) vs chemo alone in advanced squamous (sq) NSCLC. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.02.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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25
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d’Arminio Monforte A, Tavelli A, De Benedittis S, Bai F, Tincati C, Gazzola L, Viganò O, Allegrini M, Mondatore D, Tesoro D, Barbanotti D, Mulé G, Castoldi R, De Bona A, Bini T, Chiumello D, Centanni S, Passarella S, Orfeo N, Marchetti G, Cozzi-Lepri A. Real World Estimate of Vaccination Protection in Individuals Hospitalized for COVID-19. Vaccines (Basel) 2022; 10:vaccines10040550. [PMID: 35455299 PMCID: PMC9031136 DOI: 10.3390/vaccines10040550] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 03/29/2022] [Accepted: 03/30/2022] [Indexed: 12/17/2022] Open
Abstract
Whether vaccination confers a protective effect against progression after hospital admission for COVID-19 remains to be elucidated. Observational study including all the patients admitted to San Paolo Hospital in Milan for COVID-19 in 2021. Previous vaccination was categorized as: none, one dose, full vaccination (two or three doses >14 days before symptoms onset). Data were collected at hospital admission, including demographic and clinical variables, age-unadjusted Charlson Comorbidity index (CCI). The highest intensity of ventilation during hospitalization was registered. The endpoints were in-hospital death (primary) and mechanical ventilation/death (secondary). Survival analysis was conducted by means of Kaplan-Meier curves and Cox regression models. Effect measure modification by age was formally tested. We included 956 patients: 151 (16%) fully vaccinated (18 also third dose), 62 (7%) one dose vaccinated, 743 (78%) unvaccinated. People fully vaccinated were older and suffering from more comorbidities than unvaccinated. By 28 days, the risk of death was of 35.9% (95%CI: 30.1−41.7) in unvaccinated, 41.5% (24.5−58.5) in one dose and 28.4% (18.2−38.5) in fully vaccinated (p = 0.63). After controlling for age, ethnicity, CCI and month of admission, fully vaccinated participants showed a risk reduction of 50% for both in-hospital death, AHR 0.50 (95%CI: 0.30−0.84) and for mechanical ventilation or death, AHR 0.49 (95%CI: 0.35−0.69) compared to unvaccinated, regardless of age (interaction p > 0.56). Fully vaccinated individuals in whom vaccine failed to keep them out of hospital, appeared to be protected against critical disease or death when compared to non-vaccinated. These data support universal COVID-19 vaccination.
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Affiliation(s)
- Antonella d’Arminio Monforte
- Unit of Infectious Diseases ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, 20142 Milan, Italy; (A.T.); (S.D.B.); (F.B.); (C.T.); (L.G.); (O.V.); (M.A.); (D.M.); (D.T.); (D.B.); (G.M.); (R.C.); (A.D.B.); (T.B.); (G.M.)
- Correspondence:
| | - Alessandro Tavelli
- Unit of Infectious Diseases ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, 20142 Milan, Italy; (A.T.); (S.D.B.); (F.B.); (C.T.); (L.G.); (O.V.); (M.A.); (D.M.); (D.T.); (D.B.); (G.M.); (R.C.); (A.D.B.); (T.B.); (G.M.)
| | - Sara De Benedittis
- Unit of Infectious Diseases ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, 20142 Milan, Italy; (A.T.); (S.D.B.); (F.B.); (C.T.); (L.G.); (O.V.); (M.A.); (D.M.); (D.T.); (D.B.); (G.M.); (R.C.); (A.D.B.); (T.B.); (G.M.)
| | - Francesca Bai
- Unit of Infectious Diseases ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, 20142 Milan, Italy; (A.T.); (S.D.B.); (F.B.); (C.T.); (L.G.); (O.V.); (M.A.); (D.M.); (D.T.); (D.B.); (G.M.); (R.C.); (A.D.B.); (T.B.); (G.M.)
| | - Camilla Tincati
- Unit of Infectious Diseases ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, 20142 Milan, Italy; (A.T.); (S.D.B.); (F.B.); (C.T.); (L.G.); (O.V.); (M.A.); (D.M.); (D.T.); (D.B.); (G.M.); (R.C.); (A.D.B.); (T.B.); (G.M.)
| | - Lidia Gazzola
- Unit of Infectious Diseases ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, 20142 Milan, Italy; (A.T.); (S.D.B.); (F.B.); (C.T.); (L.G.); (O.V.); (M.A.); (D.M.); (D.T.); (D.B.); (G.M.); (R.C.); (A.D.B.); (T.B.); (G.M.)
| | - Ottavia Viganò
- Unit of Infectious Diseases ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, 20142 Milan, Italy; (A.T.); (S.D.B.); (F.B.); (C.T.); (L.G.); (O.V.); (M.A.); (D.M.); (D.T.); (D.B.); (G.M.); (R.C.); (A.D.B.); (T.B.); (G.M.)
| | - Marina Allegrini
- Unit of Infectious Diseases ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, 20142 Milan, Italy; (A.T.); (S.D.B.); (F.B.); (C.T.); (L.G.); (O.V.); (M.A.); (D.M.); (D.T.); (D.B.); (G.M.); (R.C.); (A.D.B.); (T.B.); (G.M.)
| | - Debora Mondatore
- Unit of Infectious Diseases ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, 20142 Milan, Italy; (A.T.); (S.D.B.); (F.B.); (C.T.); (L.G.); (O.V.); (M.A.); (D.M.); (D.T.); (D.B.); (G.M.); (R.C.); (A.D.B.); (T.B.); (G.M.)
| | - Daniele Tesoro
- Unit of Infectious Diseases ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, 20142 Milan, Italy; (A.T.); (S.D.B.); (F.B.); (C.T.); (L.G.); (O.V.); (M.A.); (D.M.); (D.T.); (D.B.); (G.M.); (R.C.); (A.D.B.); (T.B.); (G.M.)
| | - Diletta Barbanotti
- Unit of Infectious Diseases ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, 20142 Milan, Italy; (A.T.); (S.D.B.); (F.B.); (C.T.); (L.G.); (O.V.); (M.A.); (D.M.); (D.T.); (D.B.); (G.M.); (R.C.); (A.D.B.); (T.B.); (G.M.)
| | - Giovanni Mulé
- Unit of Infectious Diseases ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, 20142 Milan, Italy; (A.T.); (S.D.B.); (F.B.); (C.T.); (L.G.); (O.V.); (M.A.); (D.M.); (D.T.); (D.B.); (G.M.); (R.C.); (A.D.B.); (T.B.); (G.M.)
| | - Roberto Castoldi
- Unit of Infectious Diseases ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, 20142 Milan, Italy; (A.T.); (S.D.B.); (F.B.); (C.T.); (L.G.); (O.V.); (M.A.); (D.M.); (D.T.); (D.B.); (G.M.); (R.C.); (A.D.B.); (T.B.); (G.M.)
| | - Anna De Bona
- Unit of Infectious Diseases ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, 20142 Milan, Italy; (A.T.); (S.D.B.); (F.B.); (C.T.); (L.G.); (O.V.); (M.A.); (D.M.); (D.T.); (D.B.); (G.M.); (R.C.); (A.D.B.); (T.B.); (G.M.)
| | - Teresa Bini
- Unit of Infectious Diseases ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, 20142 Milan, Italy; (A.T.); (S.D.B.); (F.B.); (C.T.); (L.G.); (O.V.); (M.A.); (D.M.); (D.T.); (D.B.); (G.M.); (R.C.); (A.D.B.); (T.B.); (G.M.)
| | - Davide Chiumello
- Intensive Care Unit ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, 20142 Milan, Italy;
| | - Stefano Centanni
- Pneumology Unit ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, 20142 Milan, Italy;
| | - Sabrina Passarella
- Medical Direction ASST Santi Paolo e Carlo, 20142 Milan, Italy; (S.P.); (N.O.)
| | - Nicola Orfeo
- Medical Direction ASST Santi Paolo e Carlo, 20142 Milan, Italy; (S.P.); (N.O.)
| | - Giulia Marchetti
- Unit of Infectious Diseases ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, 20142 Milan, Italy; (A.T.); (S.D.B.); (F.B.); (C.T.); (L.G.); (O.V.); (M.A.); (D.M.); (D.T.); (D.B.); (G.M.); (R.C.); (A.D.B.); (T.B.); (G.M.)
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Ferrucci R, Dini M, Rosci C, Capozza A, Groppo E, Reitano MR, Allocco E, Poletti B, Brugnera A, Bai F, Monti A, Ticozzi N, Silani V, Centanni S, D’Arminio Monforte A, Tagliabue L, Priori A. One‐Year Cognitive Follow‐Up of COVID‐19 Hospitalized Patients. Eur J Neurol 2022; 29:2006-2014. [PMID: 35285122 PMCID: PMC9111730 DOI: 10.1111/ene.15324] [Citation(s) in RCA: 40] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 02/12/2022] [Accepted: 03/03/2022] [Indexed: 11/28/2022]
Abstract
Background and purpose Methods Results Conclusion
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Affiliation(s)
- Roberta Ferrucci
- Aldo Ravelli” Research Center for Neurotechnology and Experimental Brain therapeutics Department of Health Sciences University of Milan 20142 Milan Italy
- ASST Santi Paolo e Carlo San Paolo University Hospital 20142 Milan Italy
| | - Michelangelo Dini
- Aldo Ravelli” Research Center for Neurotechnology and Experimental Brain therapeutics Department of Health Sciences University of Milan 20142 Milan Italy
| | - Chiara Rosci
- ASST Santi Paolo e Carlo San Paolo University Hospital 20142 Milan Italy
| | - Antonella Capozza
- ASST Santi Paolo e Carlo San Paolo University Hospital 20142 Milan Italy
| | - Elisabetta Groppo
- ASST Santi Paolo e Carlo San Paolo University Hospital 20142 Milan Italy
| | - Maria R. Reitano
- ASST Santi Paolo e Carlo San Paolo University Hospital 20142 Milan Italy
| | - Elisa Allocco
- ASST Santi Paolo e Carlo San Paolo University Hospital 20142 Milan Italy
| | - Barbara Poletti
- Department of Neurology and Laboratory of Neuroscience IRCCS Istituto Auxologico Italiano 20149 Milan Italy
| | - Agostino Brugnera
- Department of Human and Social sciences University of Bergamo 24129 Bergamo Italy
| | - Francesca Bai
- ASST Santi Paolo e Carlo San Paolo University Hospital 20142 Milan Italy
| | - Alessia Monti
- Department of Neurorehabilitation Sciences Casa di Cura Policlinico 20144 Milan Italy
| | - Nicola Ticozzi
- Department of Neurology and Laboratory of Neuroscience IRCCS Istituto Auxologico Italiano 20149 Milan Italy
- Department of Pathophysiology and Transplantation Dino Ferrari” Center University of Milano 20122 Milan Italy
| | - Vincenzo Silani
- Aldo Ravelli” Research Center for Neurotechnology and Experimental Brain therapeutics Department of Health Sciences University of Milan 20142 Milan Italy
- Department of Neurology and Laboratory of Neuroscience IRCCS Istituto Auxologico Italiano 20149 Milan Italy
- Department of Pathophysiology and Transplantation Dino Ferrari” Center University of Milano 20122 Milan Italy
| | - Stefano Centanni
- ASST Santi Paolo e Carlo San Paolo University Hospital 20142 Milan Italy
- Department of Health Sciences (DISS) University of Milan 20142 Milan Italy
| | - Antonella D’Arminio Monforte
- ASST Santi Paolo e Carlo San Paolo University Hospital 20142 Milan Italy
- Department of Health Sciences (DISS) University of Milan 20142 Milan Italy
| | - Luca Tagliabue
- ASST Santi Paolo e Carlo San Paolo University Hospital 20142 Milan Italy
| | - Alberto Priori
- Aldo Ravelli” Research Center for Neurotechnology and Experimental Brain therapeutics Department of Health Sciences University of Milan 20142 Milan Italy
- ASST Santi Paolo e Carlo San Paolo University Hospital 20142 Milan Italy
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27
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Liu L, Bai F, Song H, Xiao R, Wang Y, Yang H, Ren X, Li S, Gao L, Ma C, Yang X, Liang X. Corrigendum to “Upregulation of TIPE1 in tubular epithelial cell aggravates diabetic nephropathy by disrupting PHB2 mediated mitophagy” [Redox Biol. 50 (2022) 2213–2317/102260]. Redox Biol 2022; 52:102302. [PMID: 35365434 PMCID: PMC9108084 DOI: 10.1016/j.redox.2022.102302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Mondatore D, Bai F, Augello M, Giovenzana M, Pisani Ceretti A, Bono V, Opocher E, d’Arminio Monforte A, Marchetti GC, Tincati C. Persistence of High Peripheral Activated CD8+ T-cells and Not a Low CD4:CD8 Ratio Predict cytologic HPV-Related Dysplasia in cART-Treated, HIV-Positive Subjects. Open Forum Infect Dis 2022; 9:ofac046. [PMID: 35291446 PMCID: PMC8918388 DOI: 10.1093/ofid/ofac046] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Accepted: 01/27/2022] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
People with HIV are at increased risk of HPV-disease progression, given the persistence of immune activation and residual inflammation despite effective cART. Whether a low CD4:CD8 T-cell ratio, known to mirror peripheral immune dysfunction, associates with Squamous Intraepithelial Lesions (SIL) is unknown.
Methods
Retrospective cohort study on cART-treated HIV-positive subjects undergoing screening for HPV-related dysplasia (anal/cervical cytology and HPV genotyping). SIL was defined as the presence of either atypical squamous cells of undetermined significance (ASCUS), Low-grade SIL or High-grade SIL. Demographic and viro-immunological parameters (T-cell count, CD4:CD8 T-cell ratio, CD8+CD38+ T-cells percentage) at the time of screening were analyzed by Chi square, Mann Whitney test and multivariate logistic regression analysis.
Results
419 cART-treated subjects were included. Half of the patients had cervical/anal SIL. Individuals with SIL were more commonly males, MSM, co-infected with Treponema pallidum, treated with Integrase Inhibitors (INSTI)-based cART regimens and with a shorter time since HIV diagnosis and cART initiation than subjects with normal cytology. CD38+CD8+ T-cells percentage, but not the CD4:CD8 T-cell ratio, correlated with SIL. HPV infection, especially with multiple and high-risk genotypes, was confirmed associated with SIL. In multivariate analysis, the only factors independently associated with cervical/anal dysplasia were HPV infection and harbouring higher percentages of peripheral activated CD38+CD8+ T-cells.
Conclusions
HPV infection is the major driver of dysplasia in the setting of HIV infection. CD8+CD38+ T-cells also resulted an independent predictor of dysplasia in cART-treated subjects, while the CD4:CD8 T-cell ratio did not. In the setting of HIV-HPV co-infection, the CD4:CD8 T-cell ratio may not fully capture the alterations of HPV-specific immunity.
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Affiliation(s)
- D Mondatore
- Department of Health Sciences, Clinic of Infectious Diseases, ASST Santi Paolo e Carlo, University of Milan, Italy
| | - F Bai
- Department of Health Sciences, Clinic of Infectious Diseases, ASST Santi Paolo e Carlo, University of Milan, Italy
| | - M Augello
- Department of Health Sciences, Clinic of Infectious Diseases, ASST Santi Paolo e Carlo, University of Milan, Italy
| | - M Giovenzana
- Department of Health Sciences, Hepato-biliopancreatic and Digestive Surgery, ASST Santi Paolo e Carlo, University of Milan, Italy
| | - A Pisani Ceretti
- Department of Health Sciences, Hepato-biliopancreatic and Digestive Surgery, ASST Santi Paolo e Carlo, University of Milan, Italy
| | - V Bono
- Department of Health Sciences, Clinic of Infectious Diseases, ASST Santi Paolo e Carlo, University of Milan, Italy
| | - E Opocher
- Department of Health Sciences, Hepato-biliopancreatic and Digestive Surgery, ASST Santi Paolo e Carlo, University of Milan, Italy
| | - A d’Arminio Monforte
- Department of Health Sciences, Clinic of Infectious Diseases, ASST Santi Paolo e Carlo, University of Milan, Italy
| | - G C Marchetti
- Department of Health Sciences, Clinic of Infectious Diseases, ASST Santi Paolo e Carlo, University of Milan, Italy
| | - C Tincati
- Department of Health Sciences, Clinic of Infectious Diseases, ASST Santi Paolo e Carlo, University of Milan, Italy
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Castoldi R, Bai F, Caberlon S, Ferrari D, Moro A, Podda GM, d'Arminio Monforte A, Marchetti GC. A 20-year-old girl with an unusual febrile illness. Intern Emerg Med 2022; 17:181-186. [PMID: 33400162 PMCID: PMC7782573 DOI: 10.1007/s11739-020-02605-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 12/10/2020] [Indexed: 10/27/2022]
Affiliation(s)
- Roberto Castoldi
- Department of Health Sciences, Clinic of Infectious Diseases, ASST Santi Paolo E Carlo, University of Milan, via A Di Rudinì, 8 20142, Milan, Italy
| | - Francesca Bai
- Department of Health Sciences, Clinic of Infectious Diseases, ASST Santi Paolo E Carlo, University of Milan, via A Di Rudinì, 8 20142, Milan, Italy
| | - Sabrina Caberlon
- Department of Health Sciences, Clinic of Internal Medicine III, ASST Santi Paolo E Carlo, University of Milan, Milan, Italy
| | - Daris Ferrari
- Department of Medical Oncology, ASST Santi Paolo E Carlo, Milan, Italy
| | - Alessia Moro
- Division of Pathology, ASST Santi Paolo E Carlo, Milan, Italy
| | - Gian Marco Podda
- Department of Health Sciences, Clinic of Internal Medicine III, ASST Santi Paolo E Carlo, University of Milan, Milan, Italy
| | - Antonella d'Arminio Monforte
- Department of Health Sciences, Clinic of Infectious Diseases, ASST Santi Paolo E Carlo, University of Milan, via A Di Rudinì, 8 20142, Milan, Italy
| | - Giulia Carla Marchetti
- Department of Health Sciences, Clinic of Infectious Diseases, ASST Santi Paolo E Carlo, University of Milan, via A Di Rudinì, 8 20142, Milan, Italy.
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Bai F, Tomasoni D, Falcinella C, Barbanotti D, Castoldi R, Mulè G, Augello M, Mondatore D, Allegrini M, Cona A, Tesoro D, Tagliaferri G, Viganò O, Suardi E, Tincati C, Beringheli T, Varisco B, Battistini CL, Piscopo K, Vegni E, Tavelli A, Terzoni S, Marchetti G, Monforte AD. Female gender is associated with long COVID syndrome: a prospective cohort study. Clin Microbiol Infect 2021; 28:611.e9-611.e16. [PMID: 34763058 PMCID: PMC8575536 DOI: 10.1016/j.cmi.2021.11.002] [Citation(s) in RCA: 205] [Impact Index Per Article: 68.3] [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: 03/24/2021] [Revised: 10/27/2021] [Accepted: 11/01/2021] [Indexed: 12/11/2022]
Abstract
Objective We explored the association between female gender and long COVID syndrome, defined as persistence of physical and/or psychological symptoms for more than 4 weeks after recovery from acute COVID-19 disease. The secondary aim was to identify predictors of long COVID syndrome by multivariable logistic regression analysis. Methods This was a single-centre prospective cohort study conducted at San Paolo Hospital in Milan, Italy. We enrolled adult patients who were evaluated at the post-COVID outpatient service of our Infectious Diseases Unit between 15 April 2020 and 15 December 2020. Participants were individuals who had clinically recovered from COVID-19 and in whom virological clearance had occurred. Previous infection by SARS-CoV-2 was microbiologically documented by positivity using a reverse-transcriptase polymerase chain reaction (RT-PCR) assay of nasopharyngeal swab. All enrolled patients underwent blood tests and a comprehensive medical examination at follow-up. Individuals were interviewed about resolved and persisting symptoms and were asked to fill in two questionnaires to allow assessment of the Hospital Anxiety and Depression symptoms (HADS) score and of the Impact of Event Scale–Revised (IES-R) score. Results A total of 377 patients were enrolled in the study. The median time from symtpom onset to virological clerance was 44 (37–53) days. A diagnosis of long COVID syndrome was made in 260/377 (69%) patients. The most common reported symptoms were fatigue (149/377, 39.5%), exertional dyspnoea (109/377, 28.9%), musculoskeletal pain (80/377, 21.2%) and “brain fog” (76/377, 20.2%). Anxiety symptoms were ascertained in 71/377 (18.8%) individuals, whereas 40/377 (10.6%) patients presented symptoms of depression. Post-traumatic stress disorder (defined by a pathological IES-R score) was diagnosed in one-third of patients (85/275, 31%). Female gender was independently associated with long COVID syndrome at multivariable analysis (AOR 3.3 vs. males, 95% CI 1.8–6.2, p < 0.0001). Advanced age (adjusted (A)OR 1.03 for 10 years older, 95% CI 1.01–1.05, p 0.01) and active smoking (AOR 0.19 for former smokers vs. active smokers, 95% CI 0.06–0.62, p 0.002) were also associated with a higher risk of long COVID, while no association was found between severity of disease and long COVID (AOR 0.67 for continuous positive airway pressure (CPAP)/non-invasive mechanical ventilation (NIMV)/orotracheal intubation (OTI) vs. no 02 therapy, 95% CI 0.29–1.55, p 0.85). Discussion Factors that were found to be associated with a higher risk of developing “long COVID” syndrome were female gender, older age and active smoking, but not severity of the acute disease. Individuals affected by SARS-CoV-2 infection with the aforementioned features should be early identified and involved in follow-up programmes.
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Affiliation(s)
- Francesca Bai
- Clinic of Infectious Diseases, San Paolo Hospital, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, Italy.
| | - Daniele Tomasoni
- Clinic of Infectious Diseases, San Paolo Hospital, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, Italy
| | - Camilla Falcinella
- Clinic of Infectious Diseases, San Paolo Hospital, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, Italy
| | - Diletta Barbanotti
- Clinic of Infectious Diseases, San Paolo Hospital, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, Italy
| | - Roberto Castoldi
- Clinic of Infectious Diseases, San Paolo Hospital, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, Italy
| | - Giovanni Mulè
- Clinic of Infectious Diseases, San Paolo Hospital, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, Italy
| | - Matteo Augello
- Clinic of Infectious Diseases, San Paolo Hospital, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, Italy
| | - Debora Mondatore
- Clinic of Infectious Diseases, San Paolo Hospital, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, Italy
| | - Marina Allegrini
- Clinic of Infectious Diseases, San Paolo Hospital, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, Italy
| | - Andrea Cona
- Clinic of Infectious Diseases, San Paolo Hospital, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, Italy
| | - Daniele Tesoro
- Clinic of Infectious Diseases, San Paolo Hospital, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, Italy
| | - Gianmarco Tagliaferri
- Clinic of Infectious Diseases, San Paolo Hospital, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, Italy
| | - Ottavia Viganò
- Clinic of Infectious Diseases, San Paolo Hospital, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, Italy
| | - Elisa Suardi
- Clinic of Infectious Diseases, San Paolo Hospital, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, Italy
| | - Camilla Tincati
- Clinic of Infectious Diseases, San Paolo Hospital, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, Italy
| | - Tomaso Beringheli
- Clinic of Infectious Diseases, San Paolo Hospital, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, Italy
| | - Benedetta Varisco
- Clinic of Infectious Diseases, San Paolo Hospital, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, Italy
| | - Chiara Luridiana Battistini
- Unit of Clinical Psychology, San Paolo Hospital, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, Italy
| | - Kyrie Piscopo
- Unit of Clinical Psychology, San Paolo Hospital, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, Italy
| | - Elena Vegni
- Unit of Clinical Psychology, San Paolo Hospital, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, Italy
| | - Alessandro Tavelli
- Clinic of Infectious Diseases, San Paolo Hospital, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, Italy
| | | | - Giulia Marchetti
- Clinic of Infectious Diseases, San Paolo Hospital, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, Italy
| | - Antonella d'Arminio Monforte
- Clinic of Infectious Diseases, San Paolo Hospital, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, Italy
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Tian L, Wang QY, Sun RM, Qi MM, Li YX, Gao X, Zhang LQ, Ma X, Shi H, Yu J, Bai F. [Effects of SGLT2i on 24-hour ambulatory blood pressure in patients with type 2 diabetes complicating hypertension: a meta-analysis]. Zhonghua Xin Xue Guan Bing Za Zhi 2021; 49:1000-1011. [PMID: 34674438 DOI: 10.3760/cma.j.cn112148-20210127-00098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To analyze the effects of different types of sodium-glucose cotransporter 2 inhibitors (SGLT2i) on 24-hour ambulatory blood pressure in patients with type 2 diabetes mellitus and hypertension. Method: In this meta-analysis, we searched for randomized controlled trials on the effect of SGLT2i on 24-hour ambulatory blood pressure in patients with type 2 diabetes and hypertension. Three databases, namely PubMed, Web of Science and Cochrane Library, were searched. The search was organized on the concept of 3 conceptual groups: the first group contained terms used to describe SGLT2i, the second group contained terms related to blood pressure, and the third group contained terms used to describe randomized controlled trials. The search time was from the establishment of the database to December 2020. The inclusion and exclusion criteria were formulated in accordance with the requirements of the Cochrane systematic review. According to whether the heterogeneity of the study was significant or not, a random effect model or a fixed effect model were used to conduct the analysis on the impact of different types of SGLT2i on 24-hour ambulatory blood pressure and day and night blood pressure in patients with type 2 diabetes and hypertension. Further subgroup analysis was performed to define potential factors, which might lead to clinical heterogeneity. Results: Seven clinical trials were finally included. The result of the meta-analysis showed that compared with placebo group, SGLT2i could reduce the 24-hour dynamic systolic blood pressure of patients with type 2 diabetes and hypertension by 4.36 mmHg (1 mmHg=0.133 kPa). Reduction was 4.59, 3.74, 5.06, and 3.64 mmHg by canagliflozin, dapagliflozin, empagliflozin, and ertugliflozin respectively; SGLT2i could reduce the 24-hour dynamic diastolic blood pressure of patients with type 2 diabetes and hypertension by 2.20 mmHg, and the reduction was 2.30, 1.22, 2.00, and 2.69 mmHg by canagliflozin, dapagliflozin, empagliflozin and ertugliflozin respectively. SGLT2i could reduce the daytime systolic blood pressure of patients with type 2 diabetes and hypertension by 5.25 mmHg, and reduction was 5.38, 4.87, 6.00, and 4.37 mmHg by canagliflozin, dapagliflozin, empagliflozin and ertugliflozin, respectively. Simultaneously, SGLT2i could reduce the diastolic blood pressure of patients with type 2 diabetes and hypertension by 2.62 mmHg, and the reduction was 2.56, 2.47, and 2.80 mmHg by canagliflozin, empagliflozin and ertugliflozin, respectively. SGLT2i could reduce the nighttime systolic blood pressure of patients with type 2 diabetes and hypertension by 3.62 mmHg, and the reduction was 2.09, 2.06, 3.92, and 2.45 mmHg by canagliflozin, dapagliflozin, empagliflozin and ertugliflozin, respectively. At the same time, SGLT2i could reduce the nighttime diastolic blood pressure of patients with type 2 diabetes and hypertension by 1.60 and 1.51 mmHg, the reduction was 1.53 and 2.58 mmHg by canagliflozin, empagliflozin and ertugliflozin, respectively. Conclusion: SGLT2i can reduce 24-hour ambulatory blood pressure in patients with type 2 diabetes and hypertension.
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Affiliation(s)
- L Tian
- Department of Cardiology, Lanzhou University Second Hospital, Lanzhou 730030, China
| | - Q Y Wang
- Department of Cardiology, Lanzhou University Second Hospital, Lanzhou 730030, China
| | - R M Sun
- Department of Cardiology, Lanzhou University Second Hospital, Lanzhou 730030, China Cardiovascular Laboratory, Lanzhou University Second Hospital, Lanzhou 730030, China
| | - M M Qi
- Department of Cardiology, Lanzhou University Second Hospital, Lanzhou 730030, China Cardiovascular Laboratory, Lanzhou University Second Hospital, Lanzhou 730030, China
| | - Y X Li
- Second Clinical Medicine College of Lanzhou University, Lanzhou 730030, China
| | - X Gao
- Second Clinical Medicine College of Lanzhou University, Lanzhou 730030, China
| | - L Q Zhang
- Second Clinical Medicine College of Lanzhou University, Lanzhou 730030, China
| | - X Ma
- Medical College of Northwest Minzu University, Lanzhou 730030, China
| | - H Shi
- Medical College of Northwest Minzu University, Lanzhou 730030, China
| | - J Yu
- Department of Cardiology, Lanzhou University Second Hospital, Lanzhou 730030, China Cardiovascular Laboratory, Lanzhou University Second Hospital, Lanzhou 730030, China
| | - F Bai
- Department of Cardiology, Lanzhou University Second Hospital, Lanzhou 730030, China Cardiovascular Laboratory, Lanzhou University Second Hospital, Lanzhou 730030, China
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Wang J, Lu S, Wang Z, Hu C, Sun Y, Yang K, Chen M, Zhao J, Liang L, Huo Y, Zhang Y, Huang R, Wu X, Ma X, Leaw S, Bai F, Shen Z. FP04.02 RATIONALE-307: Updated Biomarker Analysis of Phase 3 Study of Tislelizumab Plus Chemo vs Chemo Alone For 1L Advanced Sq-NSCLC. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.216] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Lu S, Yu X, Wang J, Zhao J, Yu Y, Hu C, Feng G, Ying K, Zhuang W, Zhou J, Wu J, Leaw S, Bai F, Lin X. P17.02 RATIONALE 307: A Subgroup Analysis of Tislelizumab Plus Chemo vs Chemo Alone As 1L Treatment for Stage IIIB Advanced Sq NSCLC. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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D’Arminio Monforte A, Tavelli A, Bai F, Tomasoni D, Falcinella C, Castoldi R, Barbanotti D, Mulè G, Allegrini M, Suardi E, Tesoro D, Tagliaferri G, Mondatore D, Augello M, Cona A, Beringheli T, Gemignani N, Sala M, Varisco B, Molà F, Pettenuzzo S, Biasioli L, Copes A, Gazzola L, Viganò O, Tincati C, De Bona A, Bini T, Marchetti G. Declining Mortality Rate of Hospitalised Patients in the Second Wave of the COVID-19 Epidemics in Italy: Risk Factors and the Age-Specific Patterns. Life (Basel) 2021; 11:979. [PMID: 34575128 PMCID: PMC8464683 DOI: 10.3390/life11090979] [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: 08/06/2021] [Revised: 09/10/2021] [Accepted: 09/13/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Mortality rate from COVID-19 in Italy is among the world's highest. We aimed to ascertain whether there was any reduction of in-hospital mortality in patients hospitalised for COVID-19 in the second-wave period (October 2020-January 2021) compared to the first one (February-May 2020); further, we verified whether there were clusters of hospitalised patients who particularly benefitted from reduced mortality rate. METHODS Data collected related to in-patients' demographics, clinical, laboratory, therapies and outcome. Primary end-point was time to in-hospital death. Factors associated were evaluated by uni- and multivariable analyses. A flow diagram was created to determine the rate of in-hospital death according to individual and disease characteristics. RESULTS A total of 1561 patients were included. The 14-day cumulative incidence of in-hospital death by competing risk regression was of 24.8% (95% CI: 21.3-28.5) and 15.9% (95% CI: 13.7-18.2) in the first and second wave. We observed that the highest relative reduction of death from first to second wave (more than 47%) occurred mainly in the clusters of patients younger than 70 years. CONCLUSIONS Progress in care and supporting therapies did affect population over 70 years to a lesser extent. Preventive and vaccination campaigns should focus on individuals whose risk of death from COVID-19 remains high.
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Affiliation(s)
- Antonella D’Arminio Monforte
- Institute of Infectious Diseases, Department of Health Science, ASST Santi Paolo e Carlo, University of Milan, 20142 Milan, Italy; (A.T.); (F.B.); (D.T.); (C.F.); (R.C.); (D.B.); (G.M.); (M.A.); (E.S.); (D.T.); (G.T.); (D.M.); (M.A.); (A.C.); (T.B.); (N.G.); (M.S.); (B.V.); (F.M.); (S.P.); (L.B.); (A.C.); (L.G.); (O.V.); (C.T.); (A.D.B.); (T.B.); (G.M.)
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Augello M, Bai F, Galassi A, Bono V, Moro A, Carsana L, Tonello C, Tosoni A, Nebuloni M, Monforte AD, Marchetti G. Renal microsporidiosis due to Encephalitozoon cuniculi in an HIV/AIDS patient with persistent fever and kidney injury. Clin Microbiol Infect 2021; 27:1439-1440. [PMID: 34139336 DOI: 10.1016/j.cmi.2021.06.011] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 06/04/2021] [Accepted: 06/07/2021] [Indexed: 11/16/2022]
Affiliation(s)
- Matteo Augello
- Clinic of Infectious Diseases and Tropical Medicine, San Paolo Hospital, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, Milan, Italy.
| | - Francesca Bai
- Clinic of Infectious Diseases and Tropical Medicine, San Paolo Hospital, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, Milan, Italy
| | - Andrea Galassi
- Clinic of Nephrology and Haemodialysis, San Paolo Hospital, ASST Santi Paolo e Carlo, Milan, Italy
| | - Valeria Bono
- Clinic of Infectious Diseases and Tropical Medicine, San Paolo Hospital, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, Milan, Italy
| | - Alessia Moro
- Division of Pathology, San Paolo Hospital, ASST Santi Paolo e Carlo, Milan, Italy
| | - Luca Carsana
- Division of Pathology, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Cristina Tonello
- Division of Pathology, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Antonella Tosoni
- Division of Pathology, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Manuela Nebuloni
- Division of Pathology, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Antonella d'Arminio Monforte
- Clinic of Infectious Diseases and Tropical Medicine, San Paolo Hospital, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, Milan, Italy
| | - Giulia Marchetti
- Clinic of Infectious Diseases and Tropical Medicine, San Paolo Hospital, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, Milan, Italy
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Bai F, Tavelli A, Mulè G, Falcinella C, Mondatore D, Tesoro D, Barbanotti D, Tomasoni D, Castoldi R, Augello M, Allegrini M, Tagliaferri G, Cona A, Cozzi-Lepri A, Marchetti G, d'Arminio Monforte A. A Quantitative Estimate of the Expected Shortening of the Median Isolation Period of Patients With COVID-19 After the Adoption of a Symptom-Based Strategy. Front Public Health 2021; 9:639347. [PMID: 34178914 PMCID: PMC8222664 DOI: 10.3389/fpubh.2021.639347] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 05/14/2021] [Indexed: 11/13/2022] Open
Abstract
A long period of isolation was observed in patients hospitalized for COVID-19 in Milan over March-September 2020 (45; IQR: 37–54 days). A significantly shorter period would have been observed by the application of May-WHO (22, IQR: 17–30 days, P < 0.001) and October-Italian (26, IQR: 21–34 days, P < 0.001) Guidelines. The adoption of the new symptom-based criteria is likely to lead to a significant reduction in the length of the isolation period with potential social, economic and psychological benefits, particularly in the younger population with mild/moderate disease and no comorbidities. In our opinion, the release from isolation after 21 days from symptoms onset, even without a PCR diagnostic test, in most cases seems the most adequate strategy that could balance precautions to prevent SARS CoV-2 transmission and unnecessary prolonged isolation or overuse of diagnostic testing.
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Affiliation(s)
- Francesca Bai
- Department of Health Sciences, Clinic of Infectious Diseases, San Paolo Hospital, ASST Santi Paolo e Carlo, University of Milan, Milan, Italy
| | - Alessandro Tavelli
- Department of Health Sciences, Clinic of Infectious Diseases, San Paolo Hospital, ASST Santi Paolo e Carlo, University of Milan, Milan, Italy
| | - Giovanni Mulè
- Department of Health Sciences, Clinic of Infectious Diseases, San Paolo Hospital, ASST Santi Paolo e Carlo, University of Milan, Milan, Italy
| | - Camilla Falcinella
- Department of Health Sciences, Clinic of Infectious Diseases, San Paolo Hospital, ASST Santi Paolo e Carlo, University of Milan, Milan, Italy
| | - Debora Mondatore
- Department of Health Sciences, Clinic of Infectious Diseases, San Paolo Hospital, ASST Santi Paolo e Carlo, University of Milan, Milan, Italy
| | - Daniele Tesoro
- Department of Health Sciences, Clinic of Infectious Diseases, San Paolo Hospital, ASST Santi Paolo e Carlo, University of Milan, Milan, Italy
| | - Diletta Barbanotti
- Department of Health Sciences, Clinic of Infectious Diseases, San Paolo Hospital, ASST Santi Paolo e Carlo, University of Milan, Milan, Italy
| | - Daniele Tomasoni
- Department of Health Sciences, Clinic of Infectious Diseases, San Paolo Hospital, ASST Santi Paolo e Carlo, University of Milan, Milan, Italy
| | - Roberto Castoldi
- Department of Health Sciences, Clinic of Infectious Diseases, San Paolo Hospital, ASST Santi Paolo e Carlo, University of Milan, Milan, Italy
| | - Matteo Augello
- Department of Health Sciences, Clinic of Infectious Diseases, San Paolo Hospital, ASST Santi Paolo e Carlo, University of Milan, Milan, Italy
| | - Marina Allegrini
- Department of Health Sciences, Clinic of Infectious Diseases, San Paolo Hospital, ASST Santi Paolo e Carlo, University of Milan, Milan, Italy
| | - Gianmarco Tagliaferri
- Department of Health Sciences, Clinic of Infectious Diseases, San Paolo Hospital, ASST Santi Paolo e Carlo, University of Milan, Milan, Italy
| | - Andrea Cona
- Department of Health Sciences, Clinic of Infectious Diseases, San Paolo Hospital, ASST Santi Paolo e Carlo, University of Milan, Milan, Italy
| | - Alessandro Cozzi-Lepri
- Research Department of Infection and Population Health, Institute for Global Health, Centre for Clinical Research, Epidemiology, Modelling and Evaluation, University College London, London, United Kingdom
| | - Giulia Marchetti
- Department of Health Sciences, Clinic of Infectious Diseases, San Paolo Hospital, ASST Santi Paolo e Carlo, University of Milan, Milan, Italy
| | - Antonella d'Arminio Monforte
- Department of Health Sciences, Clinic of Infectious Diseases, San Paolo Hospital, ASST Santi Paolo e Carlo, University of Milan, Milan, Italy
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Bai F, Wang DY, Fan YJ, Qiu J, Wang L, Dai Y, Song L. Assisted reproductive technology service availability, efficacy and safety in mainland China: 2016. Hum Reprod 2021; 35:446-452. [PMID: 32020190 DOI: 10.1093/humrep/dez245] [Citation(s) in RCA: 73] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 09/19/2019] [Indexed: 11/14/2022] Open
Abstract
STUDY QUESTION What is the current status of assisted reproductive technology (ART) service availability, efficacy and safety in mainland China? SUMMARY ANSWER In this first national report on ART status in mainland China, data on treatment numbers, outcomes and complications in 2016 are provided and analyzed, respectively. WHAT IS KNOWN ALREADY National ART Service Provision Surveys are conducted in mainland China regularly. Data were analyzed, and this manuscript was written by team members from the National Center for Women and Children's Health, China CDC and the Department of Women and Children Health, National Health Commission of the People's Republic of China. STUDY DESIGN, SIZE AND DURATION A cross-sectional nationwide survey was completed in 2018, in which data regarding ART treatments, performed from 1st January to 31st December2016 in 445 ART clinics located in 31 provinces of mainland China, were collected. PARTICIPANTS/MATERIALS, SETTING AND METHODS There were in total 451 licensed ART clinics (including artificial insemination clinics) in mainland China in 2016, of which 445 submitted service data. A total of 906 840 cycles were provided by 323 in vitro fertilization (IVF) clinics, involving 375 770 conventional IVF cycles, 154 948 intracytoplasmic sperm injection (ICSI) cycles, 367 146 frozen embryo transfer (FET) thawing cycles and 8976 preimplantation genetic diagnosis (PGD) treatment cycles. A total of 161 376 artificial (i.e. intrauterine) insemination (AI) cycles were reported by 443 clinics, with 126 872 cycles using the husband's semen (AIH) and 34 504 using donor semen (AID). MAIN RESULTS AND THE ROLE OF CHANCE In total, 98.7% of the licensed clinics, contributing to 100% of the ART services (including AID and AIH cycles), were included in this report. (Six clinics provided institutional information only and were excluded.) There were 906 840 in vitro fertilization cycles performed in mainland China with a population of over 1.3 billion inhabitants, with cycles per million inhabitants (C/M) increasing from 360 in 2013 to 657 in 2016, nationwide (range among provinces: 45-3676). After treatment with conventional IVF, the clinical pregnancy rate (PR) per oocyte retrieval cycle was 23.2%, the delivery rate (DR) per oocyte retrieval cycle was 18.7% and the proportion of twin delivery among the total deliveries was 27.9%. For ICSI cycles, the PR, DR and TDR were 20.5%, 16.7% and 27.2%, respectively. For FET per thawing cycles, the PR, DR and TDR were 48.2%, 37.6% and 24.2%. For PGD per diagnosis cycles, the PR, DR and TDR were 38.1%, 29.7% and 4.2%. For AIH cycles, the PR and DR were 13.3% and 10.5%; for AID cycles, the PR and DR were 24.3% and 21.1%, respectively. The total number of live infants born in mainland China in 2016, was 18.46 million, and the number of infants born through ART conducted in 2016 was 311 309, which accounted for 1.69% of the total. The reported rate of birth defects was about 87/10 000. The incidence of moderate to severe ovarian hyper-stimulation syndrome (OHSS) was 11.5 per 1000 oocyte retrieval cycles, and other complications were much more rare. LIMITATIONS AND REASONS FOR CAUTION This report is based on the summary data of ART services provided. The success rates were not calculated by age stratification. A low rate of birth defects was reported, which might be confounded by variations in birth follow-up methods, statistical timing and record taking. WIDER IMPLICATIONS OF THE FINDINGS ART service availability has improved significantly in recent years in mainland China. Because China is a vast country, significant imbalances in ART service provision do exist; however, the main efficacy and safety indicators were close to those of western countries. TRIAL REGISTRATION NUMBER N/A. STUDY FUNDING/COMPETING INTEREST(S) The study was funded by the National Key R&D Program of China (2016YFC1000307-2). There are no competing interests.
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Affiliation(s)
- F Bai
- ART Management Department, National Center for Women and Children's Health, China CDC, No.12 Dahuisi Road, Haidian District, Beijing 100081, China
| | - D Y Wang
- ART Management Department, National Center for Women and Children's Health, China CDC, No.12 Dahuisi Road, Haidian District, Beijing 100081, China
| | - Y J Fan
- ART Management Department, National Center for Women and Children's Health, China CDC, No.12 Dahuisi Road, Haidian District, Beijing 100081, China
| | - J Qiu
- Department of Women and Children Health, National Health Commission of the People's Republic of China, No.14 Zhichun Road, Haidian District, Beijing 100191, China
| | - L Wang
- Department of Women and Children Health, National Health Commission of the People's Republic of China, No.14 Zhichun Road, Haidian District, Beijing 100191, China
| | - Y Dai
- Department of Women and Children Health, National Health Commission of the People's Republic of China, No.14 Zhichun Road, Haidian District, Beijing 100191, China
| | - L Song
- Department of Women and Children Health, National Health Commission of the People's Republic of China, No.14 Zhichun Road, Haidian District, Beijing 100191, China
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Ancona G, Merlini E, Tincati C, Barassi A, Calcagno A, Augello M, Bono V, Bai F, Cannizzo ES, d'Arminio Monforte A, Marchetti G. Long-Term Suppressive cART Is Not Sufficient to Restore Intestinal Permeability and Gut Microbiota Compositional Changes. Front Immunol 2021; 12:639291. [PMID: 33717191 PMCID: PMC7952451 DOI: 10.3389/fimmu.2021.639291] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 02/04/2021] [Indexed: 12/22/2022] Open
Abstract
Background: We explored the long-term effects of cART on markers of gut damage, microbial translocation, and paired gut/blood microbiota composition, with a focus on the role exerted by different drug classes. Methods: We enrolled 41 cART naïve HIV-infected subjects, undergoing blood and fecal sampling prior to cART (T0) and after 12 (T12) and 24 (T24) months of therapy. Fifteen HIV-uninfected individuals were enrolled as controls. We analyzed: (i) T-cell homeostasis (flow cytometry); (ii) microbial translocation (sCD14, EndoCab, 16S rDNA); (iii) intestinal permeability and damage markers (LAC/MAN, I-FABP, fecal calprotectin); (iv) plasma and fecal microbiota composition (alpha- and beta-diversity, relative abundance); (v) functional metagenome predictions (PICRUSt). Results: Twelve and twenty four-month successful cART resulted in a rise in EndoCAb (p = 0.0001) and I-FABP (p = 0.039) vis-à-vis stable 16S rDNA, sCD14, calprotectin and LAC/MAN, along with reduced immune activation in the periphery. Furthermore, cART did not lead to substantial modifications of microbial composition in both plasma and feces and metabolic metagenome predictions. The stratification according to cART regimens revealed a feeble effect on microbiota composition in patients on NNRTI-based or INSTI-based regimens, but not PI-based regimens. Conclusions: We hereby show that 24 months of viro-immunological effective cART, while containing peripheral hyperactivation, exerts only minor effects on the gastrointestinal tract. Persistent alteration of plasma markers indicative of gut structural and functional impairment seemingly parallels enduring fecal dysbiosis, irrespective of drug classes, with no effect on metabolic metagenome predictions.
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Affiliation(s)
- Giuseppe Ancona
- Clinic of Infectious Diseases, Department of Health Sciences, University of Milan, Azienda Socio Sanitaria Territoriale Santi Paolo e Carlo, Milan, Italy
| | - Esther Merlini
- Clinic of Infectious Diseases, Department of Health Sciences, University of Milan, Azienda Socio Sanitaria Territoriale Santi Paolo e Carlo, Milan, Italy
| | - Camilla Tincati
- Clinic of Infectious Diseases, Department of Health Sciences, University of Milan, Azienda Socio Sanitaria Territoriale Santi Paolo e Carlo, Milan, Italy
| | - Alessandra Barassi
- Biochemistry Laboratory, Department of Health Sciences, University of Milan, Azienda Socio Sanitaria Territoriale Santi Paolo e Carlo, Milan, Italy
| | - Andrea Calcagno
- Unit of Infectious Diseases, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Matteo Augello
- Clinic of Infectious Diseases, Department of Health Sciences, University of Milan, Azienda Socio Sanitaria Territoriale Santi Paolo e Carlo, Milan, Italy
| | - Valeria Bono
- Clinic of Infectious Diseases, Department of Health Sciences, University of Milan, Azienda Socio Sanitaria Territoriale Santi Paolo e Carlo, Milan, Italy
| | - Francesca Bai
- Clinic of Infectious Diseases, Department of Health Sciences, University of Milan, Azienda Socio Sanitaria Territoriale Santi Paolo e Carlo, Milan, Italy
| | - Elvira S Cannizzo
- Clinic of Infectious Diseases, Department of Health Sciences, University of Milan, Azienda Socio Sanitaria Territoriale Santi Paolo e Carlo, Milan, Italy
| | - Antonella d'Arminio Monforte
- Clinic of Infectious Diseases, Department of Health Sciences, University of Milan, Azienda Socio Sanitaria Territoriale Santi Paolo e Carlo, Milan, Italy
| | - Giulia Marchetti
- Clinic of Infectious Diseases, Department of Health Sciences, University of Milan, Azienda Socio Sanitaria Territoriale Santi Paolo e Carlo, Milan, Italy
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Ferrucci R, Dini M, Groppo E, Rosci C, Reitano MR, Bai F, Poletti B, Brugnera A, Silani V, D’Arminio Monforte A, Priori A. Long-Lasting Cognitive Abnormalities after COVID-19. Brain Sci 2021; 11:235. [PMID: 33668456 PMCID: PMC7917789 DOI: 10.3390/brainsci11020235] [Citation(s) in RCA: 83] [Impact Index Per Article: 27.7] [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: 12/30/2020] [Revised: 02/03/2021] [Accepted: 02/09/2021] [Indexed: 02/07/2023] Open
Abstract
Considering the mechanisms capable of causing brain alterations in COVID-19, we aimed to study the occurrence of cognitive abnormalities in the months following hospital discharge. We recruited 38 (aged 22-74 years; 27 males) patients hospitalized for complications of SARS-CoV-2 infection in nonintensive COVID units. Participants underwent neuropsychological testing about 5 months after hospital discharge. Of all patients, 42.1% had processing speed deficits, while 26.3% showed delayed verbal recall deficits. Twenty-one percent presented with deficits in both processing speed and verbal memory. Bivariate analysis revealed a positive correlation between the lowest arterial oxygen partial pressure (PaO2) to fractional inspired oxygen (FiO2) (P/F) ratio during hospitalization and verbal memory consolidation performance (SRT-LTS score, r = 0.404, p = 0.027), as well as a positive correlation between SpO2 levels upon hospital arrival and delayed verbal recall performance (SRT-D score, rs = 0.373, p = 0.042). Acute respiratory distress syndrome (ARDS) during hospitalization was associated with worse verbal memory performance (ARDS vs. no ARDS: SRT-LTS mean score = 30.63 ± 13.33 vs. 44.50 ± 13.16, p = 0.007; SRT-D mean score = 5.95 ± 2.56 vs. 8.10 ± 2.62, p = 0.029). Cognitive abnormalities can frequently be found in COVID-19 patients 5 months after hospital discharge. Increased fatigability, deficits of concentration and memory, and overall decreased cognitive speed months after hospital discharge can interfere with work and daily activities.
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Affiliation(s)
- Roberta Ferrucci
- Aldo Ravelli Research Center for Neurotechnology and Experimental Brain Therapeutics, University of Milan, 20142 Milan, Italy; (R.F.); (M.D.); (V.S.)
- ASST-Santi Paolo e Carlo University Hospital, 20142 Milan, Italy; (E.G.); (C.R.); (M.R.R.); (F.B.); (A.D.M.)
- Department of Health Science (DISS), University of Milan, 20142 Milan, Italy
| | - Michelangelo Dini
- Aldo Ravelli Research Center for Neurotechnology and Experimental Brain Therapeutics, University of Milan, 20142 Milan, Italy; (R.F.); (M.D.); (V.S.)
- ASST-Santi Paolo e Carlo University Hospital, 20142 Milan, Italy; (E.G.); (C.R.); (M.R.R.); (F.B.); (A.D.M.)
- Department of Health Science (DISS), University of Milan, 20142 Milan, Italy
| | - Elisabetta Groppo
- ASST-Santi Paolo e Carlo University Hospital, 20142 Milan, Italy; (E.G.); (C.R.); (M.R.R.); (F.B.); (A.D.M.)
| | - Chiara Rosci
- ASST-Santi Paolo e Carlo University Hospital, 20142 Milan, Italy; (E.G.); (C.R.); (M.R.R.); (F.B.); (A.D.M.)
| | - Maria Rita Reitano
- ASST-Santi Paolo e Carlo University Hospital, 20142 Milan, Italy; (E.G.); (C.R.); (M.R.R.); (F.B.); (A.D.M.)
| | - Francesca Bai
- ASST-Santi Paolo e Carlo University Hospital, 20142 Milan, Italy; (E.G.); (C.R.); (M.R.R.); (F.B.); (A.D.M.)
- Department of Health Science (DISS), University of Milan, 20142 Milan, Italy
| | - Barbara Poletti
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italian, 20149 Milan, Italy;
| | - Agostino Brugnera
- Department of Human and Social sciences, University of Bergamo, 24129 Bergamo, Italy;
| | - Vincenzo Silani
- Aldo Ravelli Research Center for Neurotechnology and Experimental Brain Therapeutics, University of Milan, 20142 Milan, Italy; (R.F.); (M.D.); (V.S.)
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italian, 20149 Milan, Italy;
- Department of Pathophysiology and Transplantation, “Dino Ferrari” Center, University of Milano, 20122 Milan, Italy
| | - Antonella D’Arminio Monforte
- ASST-Santi Paolo e Carlo University Hospital, 20142 Milan, Italy; (E.G.); (C.R.); (M.R.R.); (F.B.); (A.D.M.)
- Department of Health Science (DISS), University of Milan, 20142 Milan, Italy
| | - Alberto Priori
- Aldo Ravelli Research Center for Neurotechnology and Experimental Brain Therapeutics, University of Milan, 20142 Milan, Italy; (R.F.); (M.D.); (V.S.)
- ASST-Santi Paolo e Carlo University Hospital, 20142 Milan, Italy; (E.G.); (C.R.); (M.R.R.); (F.B.); (A.D.M.)
- Department of Health Science (DISS), University of Milan, 20142 Milan, Italy
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Clerici B, Muscatello A, Bai F, Pavanello D, Orlandi M, Marchetti GC, Castelli V, Casazza G, Costantino G, Podda GM. Sensitivity of SARS-CoV-2 Detection With Nasopharyngeal Swabs. Front Public Health 2021; 8:593491. [PMID: 33575241 PMCID: PMC7870983 DOI: 10.3389/fpubh.2020.593491] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [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: 08/10/2020] [Accepted: 12/31/2020] [Indexed: 12/28/2022] Open
Abstract
Background: SARS-CoV-2-infected subjects have been proven contagious in the symptomatic, pre-symptomatic and asymptomatic phase. The identification of these patients is crucial in order to prevent virus circulation. No reliable data on the sensitivity of nasopharyngeal swabs (NPS) are available because of the lack of a shared reference standard to identify SARS-CoV-2 infected patients. The aim of our study was to collect data on patients with a known diagnosis of COVID-19 who underwent serial testing to assess NPS sensitivity. Methods: The study was a multi-center, observational, retrospective clinical study with consecutive enrollment. We enrolled patients who met all of the following inclusion criteria: clinical recovery, documented SARS-CoV-2 infection (≥1 positive rRT-PCR result) and ≥1 positive NPS among the first two follow-up swabs. A positive NPS not preceded by a negative nasopharyngeal swab collected 24-48 h earlier was considered a true positive. A negative NPS followed by a positive NPS collected 24-48 h later was regarded as a false negative. The primary outcome was to define sensitivity of SARS-CoV-2 detection with NPS. Results: Three hundred and ninety three NPS were evaluated in 233 patients; the sensitivity was 77% (95% CI, 73 to 81%). Sensitivity of the first follow-up NPS (n = 233) was 79% (95% CI, 73 to 84%) with no significant variations over time. We found no statistically significant differences in the sensitivity of the first follow-up NPS according to time since symptom onset, age, sex, number of comorbidities, and onset symptoms. Conclusions: NPS utility in the diagnostic algorithm of COVID-19 should be reconsidered.
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Affiliation(s)
- Bianca Clerici
- Divisione di Medicina Generale II, ASST Santi Paolo e Carlo, Dipartimento di Scienze della Salute, Università degli Studi di Milano, Milan, Italy
| | - Antonio Muscatello
- Unità Operativa Complessa di Malattie Infettive, IRCCS Fondazione Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Francesca Bai
- Dipartimento di Malattie Infettive, ASST Santi Paolo e Carlo, Università degli Studi di Milano, Milan, Italy
| | - Donatella Pavanello
- U.O.C Pronto Soccorso e Medicina D'Urgenza, IRCCS Fondazione Ca' Granda, Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy
| | - Michela Orlandi
- Divisione di Medicina Generale II, ASST Santi Paolo e Carlo, Dipartimento di Scienze della Salute, Università degli Studi di Milano, Milan, Italy
| | - Giulia C Marchetti
- Dipartimento di Malattie Infettive, ASST Santi Paolo e Carlo, Università degli Studi di Milano, Milan, Italy
| | - Valeria Castelli
- U.O.C Pronto Soccorso e Medicina D'Urgenza, IRCCS Fondazione Ca' Granda, Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy
| | - Giovanni Casazza
- Dipartimento di Scienze Biomediche e Cliniche "L. Sacco", Università degli Studi di Milano, Milan, Italy
| | - Giorgio Costantino
- U.O.C Pronto Soccorso e Medicina D'Urgenza, IRCCS Fondazione Ca' Granda, Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy
| | - Gian Marco Podda
- Divisione di Medicina Generale II, ASST Santi Paolo e Carlo, Dipartimento di Scienze della Salute, Università degli Studi di Milano, Milan, Italy
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Bonazza F, Borghi L, di San Marco EC, Piscopo K, Bai F, Monforte AD, Vegni E. Psychological outcomes after hospitalization for COVID-19: data from a multidisciplinary follow-up screening program for recovered patients. Res Psychother 2020; 23:491. [PMID: 33585298 PMCID: PMC7875065 DOI: 10.4081/ripppo.2020.491] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 11/04/2020] [Indexed: 12/16/2022]
Abstract
Patients who are hospitalized for coronavirus disease 2019 (COVID-19) face an extremely stressful experience that might challenge their mental health. The study aims to describe the psychological condition of recovered patients, focusing on anxiety and depression symptoms, as well as post-traumatic stress. All the recovered COVID-19 patients who accessed to a multidisciplinary follow-up screening program scheduled within two months after their hospital discharge were included. As far as the psychological assessment, patients completed the Hospital Anxiety and Depression Scale and the Impact of Event Scale- Revised for post-traumatic stress. Socio-demographic and clinical data (days of hospitalization, intensity of received care, and number of supportive sessions with the hospital psychologist after the hospitalization) were collected. Descriptive, correlation and regression analyses were conducted. The sample includes 261 patients (68.2% men), aged between 23 and 90 (mean=58.9 st. dev=13.3). High numbers of patients reported anxiety (28%) and depression symptoms (17%), as well as post-traumatic stress (36.4%). Impaired outcomes were associated with female gender, while patient's age was found to be negatively correlated with anxiety symptoms. 13.8% of patients underwent a psychological visit and 6.1% of them were taken in charge for psychological support. Few months after hospital discharge, individuals recovered by COVID-19 reported negative consequences on their mental health. Understanding the impact that COVID-19 and hospitalization have on recovered patients may provide insights about how to develop an effective psychological intervention to help them deal with such psychological distress and prevent further psychopathological effects.
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Affiliation(s)
| | - Lidia Borghi
- Department of Health Science, University of Milan
| | | | - Kyrie Piscopo
- Unit of Clinical Psychology, Santi Paolo and Carlo Hospital, Milan
| | - Francesca Bai
- Clinic of Infectious Diseases and Tropical Medicine, Department of Health Sciences, University of Milan, ASST Santi Paolo e Carlo, Milan, Italy
| | - Antonella d’Arminio Monforte
- Clinic of Infectious Diseases and Tropical Medicine, Department of Health Sciences, University of Milan, ASST Santi Paolo e Carlo, Milan, Italy
| | - Elena Vegni
- Department of Health Science, University of Milan
- Unit of Clinical Psychology, Santi Paolo and Carlo Hospital, Milan
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Li JH, Ma J, Kang W, Wang CF, Bai F, Zhao K, Yao N, Liu Q, Dang BL, Wang BW, Wei QQ, Kang WZ, Sun YT. The histone deacetylase inhibitor chidamide induces intermittent viraemia in HIV-infected patients on suppressive antiretroviral therapy. HIV Med 2020; 21:747-757. [PMID: 33369029 DOI: 10.1111/hiv.13027] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
OBJECTIVES To evaluate the safety and efficacy of chidamide to reverse HIV-1 latency in vivo and to compare the effects of four clinically tested histone deacetylase (HDAC) inhibitors on non-histone proteins in vitro. METHODS Participants received chidamide orally at 10 mg twice weekly for 4 weeks while maintaining baseline antiretroviral therapy. The primary outcome was plasma viral rebound during chidamide dosing and the secondary outcomes were safety, pharmacokinetic and pharmacodynamic profiles, changes in cell-associated HIV-1 RNA and HIV-1 DNA, and immune parameters. Western blotting was used to compare the in vitro effects of the four HDAC inhibitors on HSP90, NF-κB and AP-1. RESULTS Seven aviraemic participants completed eight oral doses of chidamide, and only grade 1 adverse events were observed. Cyclic increases in histone acetylation were also detected. All participants showed robust and repeated plasma viral rebound (peak viraemia 147-3850 copies/mL), as well as increased cell-associated HIV-1 RNA, during chidamide treatment. Furthermore, we identified an enhanced HIV-1-specific cellular immune response and a modest 37.7% (95% CI: 12.7-62.8%, P = 0.028) reduction in cell-associated HIV-1 DNA. Compared with the other three HDAC inhibitors, chidamide had minimal cytotoxicity in vitro at clinically relevant concentrations and showed mechanistically superior effects on non-histone proteins, including HSP90, NF-κB and AP-1. CONCLUSIONS Chidamide safely and vigorously disrupts HIV-1 latency in vivo, which makes it a promising latency-reversing agent.
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Affiliation(s)
- J H Li
- Department of Infectious Diseases, Tangdu Hospital, The Air Force Military Medical University, Xi'an, China
| | - J Ma
- Department of Gastroenterology, Tangdu Hospital, The Air Force Military Medical University, Xi'an, China
| | - W Kang
- Department of Infectious Diseases, Tangdu Hospital, The Air Force Military Medical University, Xi'an, China
| | - C F Wang
- Department of Infectious Diseases, Tangdu Hospital, The Air Force Military Medical University, Xi'an, China
| | - F Bai
- Department of Infectious Diseases, 986 Hospital of Air Force affiliated to Xijing Hospital, The Air Force Military Medical University, Xi'an, China
| | - K Zhao
- Department of Infectious Diseases, 986 Hospital of Air Force affiliated to Xijing Hospital, The Air Force Military Medical University, Xi'an, China
| | - N Yao
- Department of Infectious Diseases, Tangdu Hospital, The Air Force Military Medical University, Xi'an, China
| | - Q Liu
- Department of Infectious Diseases, Tangdu Hospital, The Air Force Military Medical University, Xi'an, China
| | - B L Dang
- Department of Infectious Diseases, Tangdu Hospital, The Air Force Military Medical University, Xi'an, China
| | - B W Wang
- Department of Infectious Diseases, Tangdu Hospital, The Air Force Military Medical University, Xi'an, China
| | - Q Q Wei
- Department of Infectious Diseases, Tangdu Hospital, The Air Force Military Medical University, Xi'an, China
| | - W Z Kang
- Department of Infectious Diseases, Tangdu Hospital, The Air Force Military Medical University, Xi'an, China
| | - Y T Sun
- Department of Infectious Diseases, Tangdu Hospital, The Air Force Military Medical University, Xi'an, China
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Bai F, Ling T. Rapid identification of positive blood culture using MALDI-TOF and gel separation technique with short incubation period. Int J Infect Dis 2020. [DOI: 10.1016/j.ijid.2020.09.524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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44
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Lagi F, Kiros ST, Di Giambenedetto S, Lombardi F, Pecorari M, Borghi V, Lepore L, Monno L, Setti M, Micheli V, Bagnarelli P, Paolini E, Bai F, Bartoloni A, Sterrantino G. Long-term maintenance of virologic suppression in native and migrant HIV-1 naïve patients: an Italian cohort study. AIDS Care 2020; 33:1159-1166. [PMID: 33172289 DOI: 10.1080/09540121.2020.1839011] [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] [Indexed: 10/23/2022]
Abstract
Little is known about long-term maintenance of virologic suppression in HIV migrants in Italy. The study aims to compare virologic failure rates and associated factors among antiretroviral therapy (ART)-naïve migrants and natives enrolled in the ARCA database since 2007 who achieved virologic suppression within 18 months from the beginning of the ART. Kaplan-Meier method assessed the probability of virologic suppression and failure. Cox regression model was used for multivariate analysis. Of 2515 patients, 2020 (80.3%) were Italian, 286 (10.6%) migrants from low-income countries, of whom 201 (75.0%) from Africa, and 227 (9.0%) from high-income-countries. The median follow-up was 4.5 years (IQR 2.5-7). No difference was observed in the time of achievement of virological suppression in the three groups (log-rank: p = 0.5687). Higher probability of virologic failure was observed in Africans compared to Italians, to patients from high-income-countries and from low-income-countries other than Africans (Log-rank = p < 0.001). In the adjusted analysis, a higher virologic failure risk was found in Africans only compared to Italians. [HR 4.01; 95% CI 2.44-6.56, p < 0.001]. In Italy, African migrants are less likely to maintain virologic suppression compared to natives and other migrants. Targeted interventions could be needed for foreigners, especially for Africans.
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Affiliation(s)
- Filippo Lagi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.,Infectious and Tropical Diseases Unit, Careggi University and Hospital, Florence, Italy
| | - Seble Tekle Kiros
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Simona Di Giambenedetto
- Institute of Clinical Infectious Diseases, Catholic University of Sacred Heart, Policlinico Gemelli, Rome, Italy
| | - Francesca Lombardi
- Institute of Clinical Infectious Diseases, Catholic University of Sacred Heart, Policlinico Gemelli, Rome, Italy
| | - Monica Pecorari
- Unit of Virology and Molecular Microbiology, University Hospital, Modena, Italy
| | - Vanni Borghi
- Department of Infectious Diseases, University of Modena, Modena, Italy
| | - Luciana Lepore
- Department of Biomedical Sciences and Human Oncology, Clinic of Infectious Diseases, University of Bari, Italy
| | - Laura Monno
- Department of Biomedical Sciences and Human Oncology, Clinic of Infectious Diseases, University of Bari, Italy
| | - Maurizio Setti
- Clinic of Immunology and Internal Medicine, Ospedale Policlinico San Martino, Genoa, Italy
| | - Valeria Micheli
- Microbiology and Virology Laboratory, L. Sacco Hospital, Milano, Italy
| | - Patrizia Bagnarelli
- Virology Unit, Azienda Ospedaliera Universitaria Ospedali Riuniti di Ancona, Ancona, Italy
| | - Elisabetta Paolini
- Immuno-Ematology and Transfusion Medicine Service, Cremona Hospital, Cremona, Italy
| | - Francesca Bai
- Infectious Diseases, San Paolo Hospital, Milan, Italy
| | - Alessandro Bartoloni
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.,Infectious and Tropical Diseases Unit, Careggi University and Hospital, Florence, Italy
| | - Gaetana Sterrantino
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
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Tomasoni D, Bai F, Castoldi R, Barbanotti D, Falcinella C, Mulè G, Mondatore D, Tavelli A, Vegni E, Marchetti G, d'Arminio Monforte A. Anxiety and depression symptoms after virological clearance of COVID-19: A cross-sectional study in Milan, Italy. J Med Virol 2020; 93:1175-1179. [PMID: 32841387 PMCID: PMC7461061 DOI: 10.1002/jmv.26459] [Citation(s) in RCA: 86] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 08/16/2020] [Accepted: 08/19/2020] [Indexed: 12/31/2022]
Abstract
Prevalence of anxiety or depression was investigated in 105 coronavirus disease 2019 (COVID-19) patients at 1 to 3 months from virological clearance by hospital anxiety and depression scale (HADS-A/D). 30% of patients displayed pathological HADS-A/D, 52.4% showed persistent symptoms. Pathological patients with HADS-A/D more commonly reported symptom persistence, even after adjustment for age, gender, and disease severity. Psychological assessments should be encouraged in COVID-19 patients' follow-up.
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Affiliation(s)
- Daniele Tomasoni
- Department of Health Sciences, ASST Santi Paolo e Carlo, Clinic of Infectious Diseases, San Paolo Hospital, University of Milan, Milan, Italy
| | - Francesca Bai
- Department of Health Sciences, ASST Santi Paolo e Carlo, Clinic of Infectious Diseases, San Paolo Hospital, University of Milan, Milan, Italy
| | - Roberto Castoldi
- Department of Health Sciences, ASST Santi Paolo e Carlo, Clinic of Infectious Diseases, San Paolo Hospital, University of Milan, Milan, Italy
| | - Diletta Barbanotti
- Department of Health Sciences, ASST Santi Paolo e Carlo, Clinic of Infectious Diseases, San Paolo Hospital, University of Milan, Milan, Italy
| | - Camilla Falcinella
- Department of Health Sciences, ASST Santi Paolo e Carlo, Clinic of Infectious Diseases, San Paolo Hospital, University of Milan, Milan, Italy
| | - Giovanni Mulè
- Department of Health Sciences, ASST Santi Paolo e Carlo, Clinic of Infectious Diseases, San Paolo Hospital, University of Milan, Milan, Italy
| | - Debora Mondatore
- Department of Health Sciences, ASST Santi Paolo e Carlo, Clinic of Infectious Diseases, San Paolo Hospital, University of Milan, Milan, Italy
| | - Alessandro Tavelli
- Department of Health Sciences, ASST Santi Paolo e Carlo, Clinic of Infectious Diseases, San Paolo Hospital, University of Milan, Milan, Italy
| | - Elena Vegni
- Unit of Clinical Psychology, Department of Health Sciences, ASST Santi Paolo e Carlo, University of Milan, Milan, Italy
| | - Giulia Marchetti
- Department of Health Sciences, ASST Santi Paolo e Carlo, Clinic of Infectious Diseases, San Paolo Hospital, University of Milan, Milan, Italy
| | - Antonella d'Arminio Monforte
- Department of Health Sciences, ASST Santi Paolo e Carlo, Clinic of Infectious Diseases, San Paolo Hospital, University of Milan, Milan, Italy
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d'Arminio Monforte A, Tavelli A, Bai F, Tomasoni D, Falcinella C, Castoldi R, Barbanotti D, Mulè G, Allegrini M, Tesoro D, Tagliaferri G, Mondatore D, Augello M, Cona A, Ancona G, Gazzola L, Iannotti N, Tincati C, Viganò O, De Bona A, Bini T, Cozzi-Lepri A, Marchetti G. The importance of patients' case-mix for the correct interpretation of the hospital fatality rate in COVID-19 disease. Int J Infect Dis 2020; 100:67-74. [PMID: 32950738 PMCID: PMC7497732 DOI: 10.1016/j.ijid.2020.09.037] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [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: 07/30/2020] [Revised: 08/31/2020] [Accepted: 09/13/2020] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE We aimed to document data on the epidemiology and factors associated with clinical course leading to death of patients hospitalised with COVID-19. METHODS Prospective observational cohort study on patients hospitalised with COVID-19 disease in February-24th/May-17th 2020 in Milan, Italy. Uni-multivariable Cox regression analyses were performed. Death's percentage by two-weeks' intervals according to age and disease severity was analysed. RESULTS A total of 174/539 (32.3%) patients died in hospital over 8228 person-day follow-up; the 14-day Kaplan-Meier probability of death was 29.5% (95%CI: 25.5-34.0). Older age, burden of comorbidities, COVID-19 disease severity, inflammatory markers at admission were independent predictors of increased risk, while several drug-combinations were predictors of reduced risk of in-hospital death. The highest fatality rate, 36.5%, occurred during the 2nd-3rd week of March, when 55.4% of patients presented with severe disease, while a second peak, by the end of April, was related to the admission of older patients (55% ≥80 years) with less severe disease, 30% coming from long-term care facilities. CONCLUSIONS The unusual fatality rate in our setting is likely to be related to age and the clinical conditions of our patients. These findings may be useful to better allocate resources of the national healthcare system, in case of re-intensification of COVID-19 epidemics.
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Affiliation(s)
- Antonella d'Arminio Monforte
- Clinic of Infectious Diseases, Department of Health Science, ASST Santi Paolo e Carlo, University of Milan, Milan, Italy.
| | - Alessandro Tavelli
- Clinic of Infectious Diseases, Department of Health Science, ASST Santi Paolo e Carlo, University of Milan, Milan, Italy
| | - Francesca Bai
- Clinic of Infectious Diseases, Department of Health Science, ASST Santi Paolo e Carlo, University of Milan, Milan, Italy
| | - Daniele Tomasoni
- Clinic of Infectious Diseases, Department of Health Science, ASST Santi Paolo e Carlo, University of Milan, Milan, Italy
| | - Camilla Falcinella
- Clinic of Infectious Diseases, Department of Health Science, ASST Santi Paolo e Carlo, University of Milan, Milan, Italy
| | - Roberto Castoldi
- Clinic of Infectious Diseases, Department of Health Science, ASST Santi Paolo e Carlo, University of Milan, Milan, Italy
| | - Diletta Barbanotti
- Clinic of Infectious Diseases, Department of Health Science, ASST Santi Paolo e Carlo, University of Milan, Milan, Italy
| | - Giovanni Mulè
- Clinic of Infectious Diseases, Department of Health Science, ASST Santi Paolo e Carlo, University of Milan, Milan, Italy
| | - Marina Allegrini
- Clinic of Infectious Diseases, Department of Health Science, ASST Santi Paolo e Carlo, University of Milan, Milan, Italy
| | - Daniele Tesoro
- Clinic of Infectious Diseases, Department of Health Science, ASST Santi Paolo e Carlo, University of Milan, Milan, Italy
| | - Gianmarco Tagliaferri
- Clinic of Infectious Diseases, Department of Health Science, ASST Santi Paolo e Carlo, University of Milan, Milan, Italy
| | - Debora Mondatore
- Clinic of Infectious Diseases, Department of Health Science, ASST Santi Paolo e Carlo, University of Milan, Milan, Italy
| | - Matteo Augello
- Clinic of Infectious Diseases, Department of Health Science, ASST Santi Paolo e Carlo, University of Milan, Milan, Italy
| | - Andrea Cona
- Clinic of Infectious Diseases, Department of Health Science, ASST Santi Paolo e Carlo, University of Milan, Milan, Italy
| | - Giuseppe Ancona
- Clinic of Infectious Diseases, Department of Health Science, ASST Santi Paolo e Carlo, University of Milan, Milan, Italy
| | - Lidia Gazzola
- Clinic of Infectious Diseases, Department of Health Science, ASST Santi Paolo e Carlo, University of Milan, Milan, Italy
| | - Nathalie Iannotti
- Clinic of Infectious Diseases, Department of Health Science, ASST Santi Paolo e Carlo, University of Milan, Milan, Italy
| | - Camilla Tincati
- Clinic of Infectious Diseases, Department of Health Science, ASST Santi Paolo e Carlo, University of Milan, Milan, Italy
| | - Ottavia Viganò
- Clinic of Infectious Diseases, Department of Health Science, ASST Santi Paolo e Carlo, University of Milan, Milan, Italy
| | - Anna De Bona
- Clinic of Infectious Diseases, Department of Health Science, ASST Santi Paolo e Carlo, University of Milan, Milan, Italy
| | - Teresa Bini
- Clinic of Infectious Diseases, Department of Health Science, ASST Santi Paolo e Carlo, University of Milan, Milan, Italy
| | - Alessandro Cozzi-Lepri
- Centre for Clinical Research, Epidemiology, Modelling and Evaluation, Institute for Global Health, University College London, London, UK
| | - Giulia Marchetti
- Clinic of Infectious Diseases, Department of Health Science, ASST Santi Paolo e Carlo, University of Milan, Milan, Italy
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Bai F, Aldieri C, Cattelan A, Raumer F, Di Meco E, Moioli MC, Tordato F, Morelli P, Borghi F, Rizzi M, Van Hauwermeiren E, Castelli F, Migliorino G, Menzaghi B, Rizzardini G, Saracino A, Cascio A, Puoti M, d'Arminio Monforte A, Marchetti G. Efficacy and safety of dalbavancin in the treatment of acute bacterial skin and skin structure infections (ABSSSIs) and other infections in a real-life setting: data from an Italian observational multicentric study (DALBITA study). Expert Rev Anti Infect Ther 2020; 18:1271-1279. [PMID: 32797758 DOI: 10.1080/14787210.2020.1798227] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVES We evaluated the efficacy and safety of dalbavancin in ABSSSI and 'other sites' infections' (OTA). METHODS Observational study involving 11 Italian hospitals including patients that received ≥1 dose of dalbavancin in 2016-2019. The outcome was end-of-treatment efficacy and safety in ABSSSI and OTA in a real-life setting. RESULTS 206 patients enrolled (males 50%, median age 62 [IQR 50-76] years), 60.2% ABSSSI, 39.8% OTA. 69.7% ABSSSI vs 90.7% OTA (p = 0.003) and 46.3% ABSSSI vs 37.2% OTA (p = 0.786) received previous and concomitant antibiotics, respectively. 82.5% reached clinical cure . Eleven (5.4%) patients had non-serious adverse events (AE). OTA patients showed longer hospitalization (13.5 days, 5.5-22 vs 3, 0-11.7; p<0.0001) and received longer previous (18 days, 9-30 vs 11, 7-19; p = 0.007)/concomitant antibiotic treatments (21 days, 14-52 vs 11, 8-14; p < 0.0001), compared to ABSSSI. ABSSSI and OTA showed similar efficacy (85.5% vs 75%, p = 0.459) and safety (no AE: 81.5% vs 64.3%, p = 0.258); efficacy was independent of previous/concomitant therapies. CONCLUSIONS Dalbavancin demonstrated a success rate of >80%, with similar efficacy/safety in ABSSSI and off-label indications. The preferential use of dalbavancin as second-line or combination therapy would seem to suggest the need for in-depth studies focused on its off-label use.
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Affiliation(s)
- Francesca Bai
- Clinic of Infectious Diseases, San Paolo Hospital, ASST Santi Paolo E Carlo, University of Milan , Milan, Italy
| | - Chiara Aldieri
- Clinic of Infectious Diseases, San Paolo Hospital, ASST Santi Paolo E Carlo, University of Milan , Milan, Italy
| | - AnnaMaria Cattelan
- Clinic of Infectious Diseases, Department of Internal Medicine, University Hospital of Padua , Padua, Italy
| | - Francesca Raumer
- Clinic of Infectious Diseases, Department of Internal Medicine, University Hospital of Padua , Padua, Italy
| | - Eugenia Di Meco
- Clinic of Infectious Diseases, Department of Internal Medicine, University Hospital of Padua , Padua, Italy
| | - Maria Cristina Moioli
- Clinic of Infectious Diseases, ASST Grande Ospedale Metropolitano Niguarda , Milan, Italy
| | - Federica Tordato
- Infectious Diseases Unit, Hospital Health Direction, Humanitas Clinical and Research Center , Milan, Italy
| | - Paola Morelli
- Infectious Diseases Unit, Hospital Health Direction, Humanitas Clinical and Research Center , Milan, Italy
| | - Federica Borghi
- Infectious Diseases Unit, ASST Papa Giovanni XXIII, Bergamo Hospital , Bergamo, Italy
| | - Marco Rizzi
- Infectious Diseases Unit, ASST Papa Giovanni XXIII, Bergamo Hospital , Bergamo, Italy
| | - Evelyn Van Hauwermeiren
- Infectious Diseases Unit, Department of Clinical and Epidemiological Science, ASST Spedali Civili, University of Brescia , Brescia, Italy
| | - Francesco Castelli
- Infectious Diseases Unit, Department of Clinical and Epidemiological Science, ASST Spedali Civili, University of Brescia , Brescia, Italy
| | | | - Barbara Menzaghi
- Infectious Diseases Unit, ASST Valle Olona, Busto Arsizio Hospital , Busto Arsizio, Varese, Italy
| | - Giuliano Rizzardini
- Department of Infectious Diseases, ASST Fatebenefratelli, Luigi Sacco Hospital , Milan, Italy
| | - Annalisa Saracino
- University of Bari 'Aldo Moro', Clinic of Infectious Diseases, Department of Biomedical Sciences and Human Oncology, University of Bari , Bari, Italy
| | - Antonio Cascio
- Dipartimento Di Promozione Della Salute, Materno-Infantile, Di Medicina Interna E Specialistica Di Eccellenza "G. D'Alessandro", University of Palermo , Palermo, Italy
| | - Massimo Puoti
- Clinic of Infectious Diseases, ASST Grande Ospedale Metropolitano Niguarda , Milan, Italy
| | | | - Giulia Marchetti
- Clinic of Infectious Diseases, San Paolo Hospital, ASST Santi Paolo E Carlo, University of Milan , Milan, Italy
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Tincati C, Mondatore D, Bai F, d'Arminio Monforte A, Marchetti G. Do Combination Antiretroviral Therapy Regimens for HIV Infection Feature Diverse T-Cell Phenotypes and Inflammatory Profiles? Open Forum Infect Dis 2020; 7:ofaa340. [PMID: 33005694 PMCID: PMC7513927 DOI: 10.1093/ofid/ofaa340] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 08/06/2020] [Indexed: 12/19/2022] Open
Abstract
Immune abnormalities featuring HIV infection persist despite the use of effective combination antiretroviral therapy (cART) and may be linked to the development of noninfectious comorbidities. The aim of the present narrative, nonsystematic literature review is to understand whether cART regimens account for qualitative differences in immune reconstitution. Many studies have reported differences in T-cell homeostasis, inflammation, coagulation, and microbial translocation parameters across cART classes and in the course of triple vs dual regimens, yet such evidence is conflicting and not consistent. Possible reasons for discrepant results in the literature are the paucity of randomized controlled clinical trials, the relatively short follow-up of observational studies, the lack of clinical validation of the numerous inflammatory biomarkers utilized, and the absence of research on the effects of cART in tissues. We are currently thus unable to establish if cART classes and regimens are truly accountable for the differences observed in immune/inflammation parameters in different clinical settings. Questions still remain as to whether an early introduction of cART, specifically in the acute stage of disease, or newer drugs and novel dual drug regimens are able to significantly impact the quality of immune reconstitution and the risk of disease progression in HIV-infected subjects.
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Affiliation(s)
- Camilla Tincati
- Department of Health Sciences, Clinic of Infectious Diseases, San Paolo Hospital, ASST Santi Paolo e Carlo, University of Milan, Milan, Italy
| | - Debora Mondatore
- Department of Health Sciences, Clinic of Infectious Diseases, San Paolo Hospital, ASST Santi Paolo e Carlo, University of Milan, Milan, Italy
| | - Francesca Bai
- Department of Health Sciences, Clinic of Infectious Diseases, San Paolo Hospital, ASST Santi Paolo e Carlo, University of Milan, Milan, Italy
| | - Antonella d'Arminio Monforte
- Department of Health Sciences, Clinic of Infectious Diseases, San Paolo Hospital, ASST Santi Paolo e Carlo, University of Milan, Milan, Italy
| | - Giulia Marchetti
- Department of Health Sciences, Clinic of Infectious Diseases, San Paolo Hospital, ASST Santi Paolo e Carlo, University of Milan, Milan, Italy
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Hu AB, Ling XC, Duan JL, Liao WW, Zhu XF, He XS, Liu FR, Bai F. [Early efficacy of islet transplantation in the treatment of adult advanced diabetes]. Zhonghua Yi Xue Za Zhi 2020; 100:2040-2043. [PMID: 32654450 DOI: 10.3760/cma.j.cn112137-20191012-02204] [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] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To evaluate the safety and efficacy of islet transplantation for patients with advanced diabetes. Methods: Five cases of islet allotransplantation were performed on 4 adult recipients. The same blood type adult brain-dead pancreas donors were selected and the islets were prepared in GMP laboratory. The prepared islet suspension was slowly injected into the liver of the recipients within 30-60 minutes. The immunosuppressive regimen was a combination of basiliximab, tacrolimus and mycophenolate mofetil and TNF-alpha monoclonal antibody was used to reduce the post-transplant inflammatory response. Insulin was temporarily applied to control blood glucose after surgery, and the dosage of insulin was adjusted to decrease according to the blood glucose level until it was discontinued. Results: A total of 5 islet transplants were performed in 4 patients, including 1 patient who received the second islet transplantations. All operations were succeed and the blood glucose and portal pressure were stable during the operation. Exogenous insulin was continued to keep blood glucose level stable (4-12 mmol/L) after surgery. Four cases (including the one who received two islet transplantation) started to stop using insulin at the third to fourth week, and the insulin dosage of the other case was 74% lower than that before the operation, and no hypoglycemic reaction occurred in all patients after islet transplantation. The C-peptide level in 3 patients reached the normal range, and the level in one patient with type I diabetes (without insulin release) remained at 0.45-0.6 μg/L (0.15-0.2 nmol/L). In addition, one patient showed a rise in blood glucose again and continued to use insulin half a year after insulin discontinuation. Then, he was performed the second islet transplantation which showed good effect and stopped taking insulin in 10 days after surgery. There were 3 cases of liver puncture bleeding after opeation, of which 2 cases were treated with ultrasound radiofrequency ablation to stop bleeding, 1 case stopped spontaneously, and no other complications were found. Conclusions: Islet transplantation is effective in the treatment of advanced diabetes patients with small trauma and high safety, which is worthy of more promotion. Long-term efficacy and maintenance therapy still need further investigation.
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Affiliation(s)
- A B Hu
- Organ Transplantation Center, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
| | - X C Ling
- Organ Transplantation Center, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
| | - J L Duan
- Organ Transplantation Center, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
| | - W W Liao
- Organ Transplantation Center, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
| | - X F Zhu
- Organ Transplantation Center, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
| | - X S He
- Organ Transplantation Center, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
| | - F R Liu
- Organ Transplantation Center, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
| | - F Bai
- Organ Transplantation Center, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
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Bai F, Wang DY, Fan YJ, Qiu J, Wang L, Dai Y, Song L. Erratum: Assisted reproductive technology service availability, efficacy and safety in mainland China: 2016. Hum Reprod 2020; 35:1477. [DOI: 10.1093/humrep/deaa076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 09/19/2019] [Indexed: 11/14/2022] Open
Affiliation(s)
- F Bai
- ART Management Department, National Center for Women and Children’s Health, China CDC, No.12 Dahuisi Road, Haidian District, Beijing 100081, China
| | - D Y Wang
- ART Management Department, National Center for Women and Children’s Health, China CDC, No.12 Dahuisi Road, Haidian District, Beijing 100081, China
| | - Y J Fan
- ART Management Department, National Center for Women and Children’s Health, China CDC, No.12 Dahuisi Road, Haidian District, Beijing 100081, China
| | - J Qiu
- Department of Women and Children Health, National Health Commission of the People’s Republic of China, No.14 Zhichun Road, Haidian District, Beijing 100191, China
| | - L Wang
- Department of Women and Children Health, National Health Commission of the People’s Republic of China, No.14 Zhichun Road, Haidian District, Beijing 100191, China
| | - Y Dai
- Department of Women and Children Health, National Health Commission of the People’s Republic of China, No.14 Zhichun Road, Haidian District, Beijing 100191, China
| | - L Song
- Department of Women and Children Health, National Health Commission of the People’s Republic of China, No.14 Zhichun Road, Haidian District, Beijing 100191, China
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