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Aloè T, Novelli F, Puppo G, Pinelli V, Barisione E, Trucco E, Costanzo R, Covesnon MG, Grillo F, Zoccali P, Milanese M, Maniscalco S, Tagliabue E, Piroddi IMG, Venturi S, Serra M, Scordamaglia F, Ferrari M, Serafini A. Prevalence of Long COVID Symptoms Related to SARS-CoV-2 Strains. Life (Basel) 2023; 13:1558. [PMID: 37511933 PMCID: PMC10381360 DOI: 10.3390/life13071558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 07/10/2023] [Accepted: 07/11/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND Few studies have assessed the differences of patterns of Long COVID (L-COVID) with regards to the pathogenetic SARS-CoV-2 strains. OBJECTIVES To investigate the relationship between demographic and clinical characteristics of acute phase of infection and the persistence of L-COVID symptoms and clinical presentation across different SARS-CoV-2 strains. METHODS In this observational-multicenter study we recorded all demographic and clinical characteristics, severity of infection, presence/persistence of symptoms of fatigue, dyspnoea and altered quality of life (QoL) at baseline and after 6 months, in a sample of Italian patients from Liguria between March 2020 and March 2022. RESULTS 308 patients (mean age 63.2 years; 55.5% men) with previous COVID were enrolled. Obese patients were 21.2% with a significant difference in obesity prevalence across the second and third wave (p = 0.012). Treatment strategies differed between waves (p < 0.001): more patients required invasive mechanical ventilation in the first wave, more patients were treated with high-flow nasal cannula/non-invasive ventilation in the in the second and more patients were treated with oxygen-therapy in the fourth wave. At baseline, a high proportion of patients were symptomatic (dyspnoea and fatigue), with impairment in some QoL indicators. A higher prevalence of patients with pain, were seen in the first wave compared to later infections (p = 0.01). At follow-up, we observed improvement of dyspnoea, fatigue and some dimensions of QoL scale evaluation such as mobility, usual activities, pain evaluations; instead there was no improvement in remaining QoL scale indicators (usual care and anxiety-depression). CONCLUSIONS There were no significant differences in the prevalence of the most frequent L-COVID symptoms, except for QoL pain domain that was especially associated with classical variant. Our results show substantial impact on social and professional life and usual care activities. These findings highlight the importance of multidisciplinary post COVID follow-up care including mental health support and rehabilitation program.
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Affiliation(s)
- Teresita Aloè
- Interventional Pulmonology Unit, IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16100 Genoa, Italy
| | | | | | | | - Emanuela Barisione
- Interventional Pulmonology Unit, IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16100 Genoa, Italy
| | - Elisa Trucco
- Pulmonology Unit, Ospedale Civile, 18100 Imperia, Italy
| | - Roberta Costanzo
- Pulmonology Unit, Ospedale Villa Scassi, ASL3 Genovese, 16100 Genoa, Italy
| | | | - Federica Grillo
- Anatomic Pathology Unit, IRCCS Ospedale Policlinico San Martino, 16100 Genoa, Italy
- Anatomic Pathology Unit, Università degli Studi di Genova, 16100 Genoa, Italy
| | | | - Manlio Milanese
- Pulmonology Unit, Ospedale S.Corona, 17027 Pietra Ligure, Italy
| | - Sara Maniscalco
- Pulmonology Unit, Ospedale S.Corona, 17027 Pietra Ligure, Italy
| | - Elena Tagliabue
- Interventional Pulmonology Unit, IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16100 Genoa, Italy
| | - Ines Maria Grazia Piroddi
- Interventional Pulmonology Unit, IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16100 Genoa, Italy
| | - Simonetta Venturi
- Pulmonology Unit, Ospedale Villa Scassi, ASL3 Genovese, 16100 Genoa, Italy
| | - Maria Serra
- Pulmonology Unit, Ospedale Villa Scassi, ASL3 Genovese, 16100 Genoa, Italy
| | | | - Marta Ferrari
- Pulmonology Unit, IRCCS Ospedale Policlinico San Martino, 16100 Genoa, Italy
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Lanfranchi F, Maggio S, Delucchi C, Bertoldi F, Corica F, De Feo MS, Marini C, Aloè T, Frantellizzi V, De Vincentis G, Morbelli S, Sambuceti G, Barisione E, Bauckneht M. The added value of lung perfusion scintigraphy semiquantitative measures in post-COVID patients with persistent dyspnea without pulmonary embolism. Expert Rev Med Devices 2023; 20:1243-1249. [PMID: 37897179 DOI: 10.1080/17434440.2023.2277236] [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: 07/03/2023] [Accepted: 10/04/2023] [Indexed: 10/29/2023]
Abstract
BACKGROUND Persistent dyspnea is frequent in post-COVID patients, even in the absence of pulmonary embolism (PE). In this scenario, the role of lung perfusion scintigraphy is unclear. The present study correlated scintigraphy-based semiquantitative perfusion parameters with chest high-resolution computed tomography (hrCT) volumetric indexes and clinical data in post-COVID patients with persistent dyspnea. RESEARCH DESIGN AND METHODS Sixty patients (30 post-COVID and 30 not previously affected by COVID-19) with persistent dyspnea submitted to lung perfusion scintigraphy and hrCT were retrospectively recruited. Perfusion rates of the pulmonary fields and hrCT-based normalized inflated, emphysematous, infiltrated, collapsed, and vascular lung volumes were calculated. Inflammatory and coagulation biomarkers were collected. PE at imaging was an exclusion criterion. RESULTS Compared to controls, reduced perfusion rates of the lower pulmonary fields and higher perfusion rates of the middle ones were observed in post-COVID patients, while hrCT findings were superimposable between the two groups. Perfusion rates of lower pulmonary fields were significantly associated only with abnormal lung volumes at hrCT. CONCLUSIONS In post-COVID dyspnea without PE, lung perfusion scintigraphy may reveal a pulmonary involvement not detectable by hrCT. Post-COVID patients may show decreased perfusion rates of lower pulmonary fields in the presence of normal vascular density and markers of inflammation/coagulation.
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Affiliation(s)
| | - Sara Maggio
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Carlo Delucchi
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Francesca Bertoldi
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | - Ferdinando Corica
- Department of Radiological, Oncological and Anatomopathological Sciences, Sapienza University of Rome, Rome, Italy
| | - Maria Silvia De Feo
- Department of Radiological, Oncological and Anatomopathological Sciences, Sapienza University of Rome, Rome, Italy
| | - Cecilia Marini
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- CNR Institute of Molecular Bioimaging and Physiology, Milan, Italy
| | - Teresita Aloè
- Interventional Pulmonology Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Viviana Frantellizzi
- Department of Radiological, Oncological and Anatomopathological Sciences, Sapienza University of Rome, Rome, Italy
| | - Giuseppe De Vincentis
- Department of Radiological, Oncological and Anatomopathological Sciences, Sapienza University of Rome, Rome, Italy
| | - Silvia Morbelli
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Gianmario Sambuceti
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Emanuela Barisione
- Interventional Pulmonology Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Matteo Bauckneht
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
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Trimarco V, Izzo R, Zanforlin A, Tursi F, Scarpelli F, Santus P, Pennisi A, Pelaia G, Mussi C, Mininni S, Messina N, Marazzi G, Maniscalco M, Mallardo M, Fazio G, Diana A, Capra Marzani M, Aloè T, Mone P, Trimarco B, Santulli G. Endothelial dysfunction in long-COVID: New insights from the nationwide multicenter LINCOLN Study. Pharmacol Res 2022; 185:106486. [PMID: 36206959 PMCID: PMC9531936 DOI: 10.1016/j.phrs.2022.106486] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 09/30/2022] [Indexed: 11/25/2022]
Affiliation(s)
- Valentina Trimarco
- Department of Neuroscience, Reproductive Sciences and Dentistry, “Federico II” University, Naples, Italy
| | - Raffaele Izzo
- Department of Advanced Biomedical Sciences, “Federico II” University, Naples, Italy,Corresponding author
| | | | | | | | | | | | - Girolamo Pelaia
- Department of Health Science, Magna Graecia University, Catanzaro, Italy
| | - Chiara Mussi
- Department of Biomedical and Metabolic Sciences and Neuroscience, University of Modena and Reggio Emilia, Modena, Italy
| | - Simone Mininni
- Associazione Scientifica Interdisciplinare Aggiornamento Medico (ASIAM), Florence, Italy
| | | | | | | | | | | | | | | | | | - Pasquale Mone
- Department of Medicine, Albert Einstein College of Medicine, New York, NY, USA
| | - Bruno Trimarco
- Department of Neuroscience, Reproductive Sciences and Dentistry, “Federico II” University, Naples, Italy
| | - Gaetano Santulli
- Department of Advanced Biomedical Sciences, “Federico II” University, Naples, Italy,Department of Medicine, Albert Einstein College of Medicine, New York, NY, USA,Department of Molecular Pharmacology, Albert Einstein College of Medicine, New York, NY, USA,Correspondence to: Departments of Medicine and Molecular Phaarmacology, Albert Einstein College of Medicine, New York, NY
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4
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Izzo R, Trimarco V, Mone P, Aloè T, Capra Marzani M, Diana A, Fazio G, Mallardo M, Maniscalco M, Marazzi G, Messina N, Mininni S, Mussi C, Pelaia G, Pennisi A, Santus P, Scarpelli F, Tursi F, Zanforlin A, Santulli G, Trimarco B. Combining L-Arginine with vitamin C improves long-COVID symptoms: The LINCOLN Survey. Pharmacol Res 2022; 183:106360. [PMID: 35868478 PMCID: PMC9295384 DOI: 10.1016/j.phrs.2022.106360] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 07/17/2022] [Accepted: 07/18/2022] [Indexed: 02/08/2023]
Abstract
INTRODUCTION Recent evidence suggests that oxidative stress and endothelial dysfunction play critical roles in the pathophysiology of COVID-19 and Long-COVID. We hypothesized that a supplementation combining L-Arginine (to improve endothelial function) and Vitamin C (to reduce oxidation) could have favorable effects on Long-COVID symptoms. METHODS We designed a survey (LINCOLN: L-Arginine and Vitamin C improves Long-COVID), assessing several symptoms that have been associated with Long-COVID to be administered nationwide to COVID-19 survivors; the survey also included effort perception, measured using the Borg scale. Patients receiving the survey were divided in two groups, with a 2:1 ratio: the first group included patients that received L-Arginine + Vitamin C, whereas the second group received a multivitamin combination (alternative treatment). RESULTS 1390 patients successfully completed the survey. Following a 30-day treatment in both groups, the survey revealed that patients in the L-Arginine + Vitamin C treatment arm had significantly lower scores compared to patients who had received the multivitamin combination. There were no other significant differences between the two groups. When examining effort perception, we observed a significantly lower value (p < 0.0001) in patients receiving L-Arginine + Vitamin C compared to the alternative-treatment arm. CONCLUSIONS Our survey indicates that the supplementation with L-Arginine + Vitamin C has beneficial effects in Long-COVID, in terms of attenuating its typical symptoms and improving effort perception.
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Affiliation(s)
- Raffaele Izzo
- Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy
| | - Valentina Trimarco
- Department of Neuroscience, Reproductive Sciences and Dentistry, Federico II University, Naples, Italy
| | - Pasquale Mone
- Department of Medicine, Albert Einstein College of Medicine, New York, NY, USA
| | | | | | | | | | | | | | | | | | - Simone Mininni
- Associazione Scientifica Interdisciplinare Aggiornamento Medico (ASIAM), Florence, Italy
| | - Chiara Mussi
- Department of Biomedical and Metabolic Sciences and Neuroscience, University of Modena and Reggio Emilia, Modena, Italy
| | - Girolamo Pelaia
- Department of Health Science, Magna Graecia University, Catanzaro, Italy
| | | | | | | | | | | | - Gaetano Santulli
- Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy; Department of Medicine, Albert Einstein College of Medicine, New York, NY, USA.
| | - Bruno Trimarco
- Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy
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5
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Grisanti SG, Garbarino S, Barisione E, Aloè T, Grosso M, Schenone C, Pardini M, Biassoni E, Zaottini F, Picasso R, Morbelli S, Campi C, Pesce G, Massa F, Girtler N, Battaglini D, Cabona C, Bassetti M, Uccelli A, Schenone A, Piana M, Benedetti L. Neurological long-COVID in the outpatient clinic: Two subtypes, two courses. J Neurol Sci 2022; 439:120315. [PMID: 35717880 PMCID: PMC9212262 DOI: 10.1016/j.jns.2022.120315] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 05/05/2022] [Accepted: 05/31/2022] [Indexed: 01/01/2023]
Abstract
INTRODUCTION Symptoms referable to central and peripheral nervous system involvement are often evident both during the acute phase of COVID-19 infection and during long-COVID. In this study, we evaluated a population of patients with prior COVID-19 infection who showed signs and symptoms consistent with neurological long-COVID. METHODS We prospectively collected demographic and acute phase course data from patients with prior COVID-19 infection who showed symptoms related to neurological involvement in the long-COVID phase. Firstly, we performed a multivariate logistic linear regression analysis to investigate the impact of demographic and clinical data, the severity of the acute COVID-19 infection and hospitalization course, on the post-COVID neurological symptoms at three months follow-up. Secondly, we performed an unsupervised clustering analysis to investigate whether there was evidence of different subtypes of neurological long COVID-19. RESULTS One hundred and nine patients referred to the neurological post-COVID outpatient clinic. Clustering analysis on the most common neurological symptoms returned two well-separated and well-balanced clusters: long-COVID type 1 contains the subjects with memory disturbances, psychological impairment, headache, anosmia and ageusia, while long-COVID type 2 contains all the subjects with reported symptoms related to PNS involvement. The analysis of potential risk-factors among the demographic, clinical presentation, COVID 19 severity and hospitalization course variables showed that the number of comorbidities at onset, the BMI, the number of COVID-19 symptoms, the number of non-neurological complications and a more severe course of the acute infection were all, on average, higher for the cluster of subjects with reported symptoms related to PNS involvement. CONCLUSION We analyzed the characteristics of neurological long-COVID and presented a method to identify well-defined patient groups with distinct symptoms and risk factors. The proposed method could potentially enable treatment deployment by identifying the optimal interventions and services for well-defined patient groups, so alleviating long-COVID and easing recovery.
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Affiliation(s)
- Stefano Giuseppe Grisanti
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy
| | - Sara Garbarino
- MIDA, Dipartimento di Matematica Università di Genova, Genova, Italy
| | | | - Teresita Aloè
- IRCCS, Ospedale Policlinico San Martino, Genova, Italy
| | - Marco Grosso
- IRCCS, Ospedale Policlinico San Martino, Genova, Italy
| | - Cristina Schenone
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy
| | - Matteo Pardini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy; IRCCS, Ospedale Policlinico San Martino, Genova, Italy
| | - Erica Biassoni
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy
| | | | | | | | - Cristina Campi
- MIDA, Dipartimento di Matematica Università di Genova, Genova, Italy; LISCOMP, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | | | - Federico Massa
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy
| | - Nicola Girtler
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy; IRCCS, Ospedale Policlinico San Martino, Genova, Italy
| | - Denise Battaglini
- Anesthesia and Intensive Care, IRCCS, Ospedale Policlinico San Martino, Genova, Italy
| | | | | | - Antonio Uccelli
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy; IRCCS, Ospedale Policlinico San Martino, Genova, Italy
| | - Angelo Schenone
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy; IRCCS, Ospedale Policlinico San Martino, Genova, Italy
| | - Michele Piana
- MIDA, Dipartimento di Matematica Università di Genova, Genova, Italy; LISCOMP, IRCCS Ospedale Policlinico San Martino, Genova, Italy
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6
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Salvarani C, Massari M, Costantini M, Franco Merlo D, Lucia Mariani G, Viale P, Nava S, Guaraldi G, Dolci G, Boni L, Savoldi L, Bruzzi P, Turrà C, Catanoso M, Maria Marata A, Barbieri C, Valcavi A, Franzoni F, Cavuto S, Mazzi G, Corsini R, Trapani F, Bartoloni A, Barisione E, Barbieri C, Jole Burastero G, Pan A, Inojosa W, Scala R, Burattini C, Luppi F, Codeluppi M, Eldin Tarek K, Cenderello G, Salio M, Foti G, Dongilli R, Bajocchi G, Alberto Negri E, Ciusa G, Fornaro G, Bassi I, Zammarchi L, Aloè T, Facciolongo N. Intravenous methylprednisolone pulses in hospitalised patients with severe COVID-19 pneumonia, A double-blind, randomised, placebo-controlled trial. Eur Respir J 2022; 60:13993003.00025-2022. [PMID: 35361632 PMCID: PMC8971731 DOI: 10.1183/13993003.00025-2022] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [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: 01/05/2022] [Accepted: 03/08/2022] [Indexed: 12/29/2022]
Abstract
Rationale Pulse glucocorticoid therapy is used in hyperinflammation related to coronavirus disease 2019 (COVID-19). We evaluated the efficacy and safety of pulse intravenous methylprednisolone in addition to standard treatment in COVID-19 pneumonia. Methods In this multicentre, randomised, double-blind, placebo-controlled trial, 304 hospitalised patients with COVID-19 pneumonia were randomised to receive 1 g of methylprednisolone intravenously for three consecutive days or placebo in addition to standard dexamethasone. The primary outcome was the duration of patient hospitalisation, calculated as the time interval between randomisation and hospital discharge without the need for supplementary oxygen. The key secondary outcomes were survival free from invasive ventilation with orotracheal intubation and overall survival. Results Overall, 112 (75.4%) out of 151 patients in the pulse methylprednisolone arm and 111 (75.2%) of 150 in the placebo arm were discharged from hospital without oxygen within 30 days from randomisation. Median time to discharge was similar in both groups (15 days, 95% CI 13.0–17.0 days and 16 days, 95% CI 13.8–18.2 days, respectively; hazard ratio (HR) 0.92, 95% CI 0.71–1.20; p=0.528). No significant differences between pulse methylprednisolone and placebo arms were observed in terms of admission to intensive care unit with orotracheal intubation or death (20.0% versus 16.1%; HR 1.26, 95% CI 0.74–2.16; p=0.176) or overall mortality (10.0% versus 12.2%; HR 0.83, 95% CI 0.42–1.64; p=0.584). Serious adverse events occurred with similar frequency in the two groups. Conclusions Methylprenisolone pulse therapy added to dexamethasone was not of benefit in patients with COVID-19 pneumonia. The quick and strong anti-inflammatory effect of pulse glucocorticoid therapy seems to be of no benefit in COVID-19 pneumoniahttps://bit.ly/3IkUmSn
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Affiliation(s)
- Carlo Salvarani
- SOC Reumatologia, Azienda USL-IRCCS, Reggio Emilia (Italy) .,Unità di Reumatologia, Università degli Studi di Modena e Reggio Emilia, Modena.,Co-first authors: Carlo Salvarani and Marco Massari contributed equally to this article
| | - Marco Massari
- SOC Malattie Infettive, Azienda USL-IRCCS, Reggio Emilia.,Co-first authors: Carlo Salvarani and Marco Massari contributed equally to this article
| | | | | | | | - Pierluigi Viale
- Unità Operativa di Malattie Infettive, IRCCS Policlinico S. Orsola-Malpighi, Dipartimento Scienze Mediche e Chirurgiche, Alma Mater Studiorum Università di Bologna
| | - Stefano Nava
- SOC Pneumologia e Terapia Intensiva Respiratoria, IRCCS Policlinico S. Orsola-Malpighi, Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Alma Mater Studiorum Università di Bologna
| | - Giovanni Guaraldi
- Unità di Malattie Infettive, Dipartimento Chirurgico, Medico, Odontoiatrico e di Scienze Morfologiche, Università di Modena e Reggio Emilia
| | - Giovanni Dolci
- Unità di Malattie Infettive, Dipartimento Chirurgico, Medico, Odontoiatrico e di Scienze Morfologiche, Università di Modena e Reggio Emilia
| | - Luca Boni
- Unità di Epidemiologia Clinica, IRCCS Ospedale Policlinico San Martino, Genova
| | - Luisa Savoldi
- SOC Infrastruttura Ricerca e Statistica, Azienda USL-IRCCS, Reggio Emilia
| | - Paolo Bruzzi
- Unità di Epidemiologia Clinica, IRCCS Ospedale Policlinico San Martino, Genova
| | | | | | | | - Chiara Barbieri
- Unità per il coinvolgimento dei pazienti nei processi di ricerca, Azienda USL-IRCCS, Reggio Emilia
| | | | - Francesca Franzoni
- SOC Infrastruttura Ricerca e Statistica, Azienda USL-IRCCS, Reggio Emilia
| | - Silvio Cavuto
- SOC Infrastruttura Ricerca e Statistica, Azienda USL-IRCCS, Reggio Emilia
| | - Giorgio Mazzi
- Direttore Presidio Ospedaliero, Azienda USL-IRCCS, Reggio Emilia
| | - Romina Corsini
- SOC Malattie Infettive, Azienda USL-IRCCS, Reggio Emilia
| | - Fabio Trapani
- Unità Operativa di Malattie Infettive, IRCCS Policlinico S. Orsola-Malpighi, Dipartimento Scienze Mediche e Chirurgiche, Alma Mater Studiorum Università di Bologna
| | - Alessandro Bartoloni
- SOD Malattie Infettive e Tropicali, AOU Careggi, Firenze.,Dipartimento di Medicina Sperimentale e Clinica, Università degli Studi di Firenze
| | - Emanuela Barisione
- UOC Pneumologia Interventistica, IRCCS Ospedale Policlinico San Martino, Genova
| | | | - Giulia Jole Burastero
- Unità di Malattie Infettive, Dipartimento Chirurgico, Medico, Odontoiatrico e di Scienze Morfologiche, Università di Modena e Reggio Emilia
| | - Angelo Pan
- Unità di Malattie Infettive, Dipartimento Chirurgico, Medico, Odontoiatrico e di Scienze Morfologiche, Università di Modena e Reggio Emilia
| | - Walter Inojosa
- Unità Operativa di Malattie Infettive di Treviso, AULSS2, Treviso
| | | | | | - Fabrizio Luppi
- Clinica Pneumologica, Università di Milano-Bicocca, Ospedale San Gerardo, Monza
| | - Mauro Codeluppi
- UOC Malattie Infettive, Ospedale Guglielmo da Saliceto, Piacenza
| | | | | | - Mario Salio
- SC Malattie dell'Apparato Respiratorio, AO SS Antonio e Biagio e C. Arrigo, Alessandria
| | - Giuseppe Foti
- Università di Milano-Bicocca, Ospedale San Gerardo, Monza
| | - Roberto Dongilli
- Divisione di Pneumologia e Terapia Subintensiva Respiratoria, Ospedale di Bolzano
| | | | | | - Giacomo Ciusa
- SOC Malattie Infettive, Azienda USL-IRCCS, Reggio Emilia.,Unità di Malattie Infettive, Dipartimento Chirurgico, Medico, Odontoiatrico e di Scienze Morfologiche, Università di Modena e Reggio Emilia
| | - Giacomo Fornaro
- Unità Operativa di Malattie Infettive, IRCCS Policlinico S. Orsola-Malpighi, Dipartimento Scienze Mediche e Chirurgiche, Alma Mater Studiorum Università di Bologna
| | - Ilaria Bassi
- SOC Pneumologia e Terapia Intensiva Respiratoria, IRCCS Policlinico S. Orsola-Malpighi, Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Alma Mater Studiorum Università di Bologna
| | - Lorenzo Zammarchi
- SOD Malattie Infettive e Tropicali, AOU Careggi, Firenze.,Dipartimento di Medicina Sperimentale e Clinica, Università degli Studi di Firenze
| | - Teresita Aloè
- UOC Pneumologia Interventistica, IRCCS Ospedale Policlinico San Martino, Genova
| | - Nicola Facciolongo
- SOC Pneumologia e Terapia Intensiva Respiratoria, IRCCS Policlinico S. Orsola-Malpighi, Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Alma Mater Studiorum Università di Bologna
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7
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Sulli A, Gotelli E, Bica PF, Schiavetti I, Pizzorni C, Aloè T, Grosso M, Barisione E, Paolino S, Smith V, Cutolo M. Detailed videocapillaroscopic microvascular changes detectable in adult COVID-19 survivors. Microvasc Res 2022; 142:104361. [PMID: 35339493 PMCID: PMC8942583 DOI: 10.1016/j.mvr.2022.104361] [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: 01/03/2022] [Revised: 03/08/2022] [Accepted: 03/14/2022] [Indexed: 12/12/2022]
Abstract
Objective COVID-19 is a multisystem disease that causes endothelial dysfunction and organ damage. Aim of the study was to evaluate the microvascular status in COVID-19 survivors with past different disease severity, in comparison with age and sex-matched primary Raynaud's phenomenon (PRP) patients and control subjects (CNT), including possible effects of concomitant therapies. Methods Sixty-one COVID-19 survivors (mean age 58 ± 13 years, mean days from disease onset 126 ± 53 and mean days from recovery 104 ± 53), thirty-one PRP patients (mean age 59 ± 15 years, mean disease duration 11 ± 10 years) and thirty CNT (mean age 58 ± 13 years) underwent nailfold videocapillaroscopy (NVC) examination. The following capillaroscopic parameters were searched and scored (0–3): dilated capillaries, giant capillaries, isolated microhemorrhages, capillary ramifications (angiogenesis) and capillary number, including absolute capillary number per linear millimeter at the nailfold bed. Results The mean nailfold capillary number per linear millimeter was significantly lower in COVID-19 survivors when compared with PRP patients and CNT (univariate and multivariate analysis p < 0.001). On the contrary, COVID-19 survivors showed significantly less isolated microhemorrhages than PRP patients and CNT (univariate and multivariate analysis, p = 0.005 and p = 0.012, respectively). No statistically significant difference was observed between COVID-19 survivors and control groups concerning the frequency of dilated capillaries and capillary ramifications. COVID-19 selective therapies showed a promising trend on preserving capillary loss and deserving further investigations. Conclusions SARS-CoV-2 seems to mainly induce a significant loss of capillaries in COVID-19 survivors at detailed NVC analysis in comparison to controls. The presence of a significant reduced score for isolated microhaemorrhages in COVID-19 survivors deserves further analysis.
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Affiliation(s)
- Alberto Sulli
- Laboratory of Experimental Rheumatology and Academic Division of Clinical Rheumatology, Department of Internal Medicine and Specialties, University of Genova, IRCCS San Martino Polyclinic Hospital, Genova, Italy.
| | - Emanuele Gotelli
- Laboratory of Experimental Rheumatology and Academic Division of Clinical Rheumatology, Department of Internal Medicine and Specialties, University of Genova, IRCCS San Martino Polyclinic Hospital, Genova, Italy
| | - Pietro Francesco Bica
- Laboratory of Experimental Rheumatology and Academic Division of Clinical Rheumatology, Department of Internal Medicine and Specialties, University of Genova, IRCCS San Martino Polyclinic Hospital, Genova, Italy
| | - Irene Schiavetti
- Department of Health Sciences, University of Genova, Genova, Italy
| | - Carmen Pizzorni
- Laboratory of Experimental Rheumatology and Academic Division of Clinical Rheumatology, Department of Internal Medicine and Specialties, University of Genova, IRCCS San Martino Polyclinic Hospital, Genova, Italy.
| | - Teresita Aloè
- Interventional Pneumology Unit, IRCCS San Martino Polyclinic Hospital, Genova, Italy
| | - Marco Grosso
- Interventional Pneumology Unit, IRCCS San Martino Polyclinic Hospital, Genova, Italy
| | - Emanuela Barisione
- Interventional Pneumology Unit, IRCCS San Martino Polyclinic Hospital, Genova, Italy
| | - Sabrina Paolino
- Laboratory of Experimental Rheumatology and Academic Division of Clinical Rheumatology, Department of Internal Medicine and Specialties, University of Genova, IRCCS San Martino Polyclinic Hospital, Genova, Italy.
| | - Vanessa Smith
- Department of Rheumatology, Ghent University Hospital, Ghent, Belgium; Department of Internal Medicine, Ghent University Hospital, Ghent, Belgium; Unit for Molecular Immunology and Inflammation, Vlaams Instituut voor Biotechnologie (VIB), Inflammation Research Center (IRC), Ghent, Belgium.
| | - Maurizio Cutolo
- Laboratory of Experimental Rheumatology and Academic Division of Clinical Rheumatology, Department of Internal Medicine and Specialties, University of Genova, IRCCS San Martino Polyclinic Hospital, Genova, Italy.
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Genova C, Tagliabue E, Mora M, Aloè T, Dono M, Salvi S, Zullo L, Barisione E. Potential application of cryobiopsy for histo-molecular characterization of mediastinal lymph nodes in patients with thoracic malignancies: a case presentation series and implications for future developments. BMC Pulm Med 2022; 22:5. [PMID: 34996404 PMCID: PMC8741535 DOI: 10.1186/s12890-021-01814-x] [Citation(s) in RCA: 6] [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: 07/08/2021] [Accepted: 12/20/2021] [Indexed: 12/12/2022] Open
Abstract
Background The management of non-small cell lung cancer (NSCLC) has become increasingly complex due to the evolution of personalized medicine approaches. Such approaches are characterized by the necessity of adequate tumor samples; hence, improved biopsy techniques are needed. Transbronchial lung cryobiopsy is a novel endoscopic procedure designed to collect peripheral pulmonary tissue, and it is currently employed in interstitial lung diseases. The use of this technique in oncology might result in improved mediastinum staging and molecular characterizations; however, available data involving the use of a cryoprobe on mediastinal lymph nodes are still limited. Case presentation Here we present a series of five consecutive patients who underwent endoscopic assessment of mediastinal lymph nodes for oncologic reasons. All patients were subjected both to endobronchial ultrasound-guided transbronchial needle aspiration (EBUS TBNA) and cryobiopsy of mediastinal lymph nodes during the same procedure, and no complications were observed. In three of the reported cases, both cryobiopsy and cell block from EBUS TBNA were positive, while in one case cryobiopsy was not diagnostic and EBUS TBNA was negative; moreover, one case showed discordance between the procedures, as cryobiopsy was negative and cell block obtained from multiple stations was diagnostic for small cell lung cancer. In one case involving a patient treated for lymphoma, cryobiopsy provided more complete histologic characterization, and in another case involving a patient affected by NSCLC cryobiopsy provided more material for molecular analyses. Conclusion This case presentation series suggests that cryobiopsy, which has been generally used on peripheral lung lesions so far, is a feasible and safe approach for diagnosis and staging of mediastinal lymph nodal involvement, especially when station 7 is involved. Compared to EBUS TBNA, cryobiopsy might provide more adequate histological samples, with a possible impact on molecular characterizations and, therefore, therapeutic decisions. However, the learning curve of the procedure has not to be understated and optimal protocols for implementing this technique are needed. In our opinion, further studies designed to integrate the routine use of cryobiopsy in current practice for solid and eventually hematologic tumors with mediastinal lymph node involvement are warranted. Supplementary Information The online version contains supplementary material available at 10.1186/s12890-021-01814-x.
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Affiliation(s)
- Carlo Genova
- UOC Clinica Di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genova, Italy. .,Dipartimento Di Medicina Interna E Specialità Mediche (DiMI), Facoltà Di Medicina E Chirurgia, Università Degli Studi Di Genova, Genova, Italy.
| | - Elena Tagliabue
- UOC Pneumologia Interventistica, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Marco Mora
- UOC Anatomia Patologica, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Teresita Aloè
- UOC Pneumologia Interventistica, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Mariella Dono
- UO Diagnostica Molecolare, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Sandra Salvi
- UO Diagnostica Molecolare, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Lodovica Zullo
- UOC Oncologia Medica 2, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Emanuela Barisione
- UOC Pneumologia Interventistica, IRCCS Ospedale Policlinico San Martino, Genova, Italy
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Bauckneht M, Aloè T, Tagliabue E, Cittadini G, Guadagno A, Morbelli S, Barisione E. Beyond Covid-19 vaccination-associated pitfalls on [ 18F]Fluorodeoxyglucose (FDG) PET: a case of a concomitant sarcoidosis. Eur J Nucl Med Mol Imaging 2021; 48:2661-2662. [PMID: 33876261 PMCID: PMC8055475 DOI: 10.1007/s00259-021-05360-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 04/05/2021] [Indexed: 12/17/2022]
Affiliation(s)
- Matteo Bauckneht
- Nuclear Medicine Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Teresita Aloè
- Interventional Pulmonology Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Elena Tagliabue
- Clinic of Respiratory Disease and Allergology, Department of Internal Medicine and Medical Specialties, University of Genoa, Genoa, Italy
| | | | - Antonio Guadagno
- Anatomic Pathology Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Silvia Morbelli
- Nuclear Medicine Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy. .,Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy.
| | - Emanuela Barisione
- Interventional Pulmonology Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
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Bagnasco D, Aloè T, Sclifò F, Ferrantino MG, Marugo F, Arcadipane F, Manfredi A, Canonica GW, Passalacqua G. When to stop biologicals. Severe asthma exacerbation after mepolizumab discontinuation. Eur Ann Allergy Clin Immunol 2020; 51:135-137. [PMID: 31081606 DOI: 10.23822/eurannaci.1764-1489.88] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- D Bagnasco
- Allergy and Respiratory Diseases, IRCCS Policlinico San Martino, University of Genoa, Genoa, Italy
| | - T Aloè
- Allergy and Respiratory Diseases, IRCCS Policlinico San Martino, University of Genoa, Genoa, Italy
| | - F Sclifò
- Emergency Department, Ospedale Policlinico San Martino, Genoa, Italy
| | - M G Ferrantino
- Respiratory Diseases, Azienda Ospedaliera Nazionale SS. Antonio e Biagio e C. Arrigo, Alessandria, Italy
| | - F Marugo
- Respiratory Diseases, Ospedale La Colletta, Arenzano, Italy
| | - F Arcadipane
- Respiratory Diseases, Azienda Ospedaliera Nazionale SS. Antonio e Biagio e C. Arrigo, Alessandria, Italy
| | - A Manfredi
- Respiratory Diseases, Ospedale La Colletta, Arenzano, Italy
| | - G W Canonica
- Personalized Medicine Clinic Asthma and Allergy, Humanitas Clinical and Research Center, Department of Biomedical Sciences, Humanitas University, Rozzano, Milan, Italy
| | - G Passalacqua
- Allergy and Respiratory Diseases, IRCCS Policlinico San Martino, University of Genoa, Genoa, Italy
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11
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Bagnasco D, Caminati M, Ferrando M, Aloè T, Testino E, Canonica GW, Passalacqua G. Anti-IL-5 and IL-5Ra: Efficacy and Safety of New Therapeutic Strategies in Severe Uncontrolled Asthma. Biomed Res Int 2018; 2018:5698212. [PMID: 30519580 PMCID: PMC6241368 DOI: 10.1155/2018/5698212] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Accepted: 09/25/2018] [Indexed: 12/25/2022]
Abstract
The current developments of the new biological drugs targeting interleukin 5 (IL-5) and IL-5 receptor allowed to expand the treatment options for severe hypereosinophilic asthma. Clinicians will then be able to choose between antibodies targeting either circulating IL-5 or its receptor expressed on eosinophils and basophils. The available clinical trials consistently reported favorable results about the reduction of exacerbations rate, improvement in quality of life, and sparing of the systemic steroid use, with a favorable safety profile. Two of these new drugs are administered subcutaneously, mepolizumab every 4 weeks and benralizumab every 8 weeks, whereas reslizumab is given intravenously monthly on a weigh-based dose. In the future, the research actions will be involved in the identification of a single biomarker or multiple biomarkers for the optimal choice of biological agents to be properly prescribed.
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Affiliation(s)
- Diego Bagnasco
- Allergy & Respiratory Diseases, DIMI Department of Internal Medicine, University of Genoa, IRCCS AOU San Martino-IST, Genoa, Italy
| | - Marco Caminati
- Asthma Center and Allergy Unit, Verona University and General Hospital, Verona, Italy
| | - Matteo Ferrando
- Allergy & Respiratory Diseases, DIMI Department of Internal Medicine, University of Genoa, IRCCS AOU San Martino-IST, Genoa, Italy
| | - Teresita Aloè
- Allergy & Respiratory Diseases, DIMI Department of Internal Medicine, University of Genoa, IRCCS AOU San Martino-IST, Genoa, Italy
| | - Elisa Testino
- Allergy & Respiratory Diseases, DIMI Department of Internal Medicine, University of Genoa, IRCCS AOU San Martino-IST, Genoa, Italy
| | - Giorgio Walter Canonica
- Allergy & Respiratory Diseases, DIMI Department of Internal Medicine, University of Genoa, IRCCS AOU San Martino-IST, Genoa, Italy
- Department of Internal Medicine, Respiratory Disease Clinic, IRCCS, Humanitas Clinical and Research Center, Humanitas University, Rozzano, Milan, Italy
| | - Giovanni Passalacqua
- Allergy & Respiratory Diseases, DIMI Department of Internal Medicine, University of Genoa, IRCCS AOU San Martino-IST, Genoa, Italy
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