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Staffolani S, Iencinella V, Cimatti M, Tavio M. Long COVID-19 syndrome as a fourth phase of SARS-CoV-2 infection. Infez Med 2022; 30:22-29. [PMID: 35350258 DOI: 10.53854/liim-3001-3] [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] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 02/22/2022] [Indexed: 01/13/2023]
Abstract
The SARS-CoV-2 pandemic has affected in the last two years a large number of subjects, with a high cost in terms of morbidity and mortality. The scientific community made progress in understanding risk factors, pathophysiology, clinical manifestations, diagnosis and treatment of acute SARS-CoV-2 infection. In the last months, another condition has become evident and caught the attention of the scientific community: the so-called long COVID syndrome. The pathophysiology of this condition is not known, even if some hypothesis have been made but not demonstrated yet. Long COVID is characterized by a very heterogeneous group of subacute and/or chronic symptoms and signs that follow the acute phase of SARS-CoV-2 infection and have a very variable duration. The presence of this syndrome in an individual is not dependent from the severity of the acute SARS-CoV-2 infection. Because of the extreme clinical heterogeneity, and also due to the lack of a shared and specific definition of the disease, it is very difficult to know the real prevalence and incidence of this condition. Some risk factors for the development of the disease have been identified: advanced age, elevated body mass index, comorbidities, specific symptoms of acute COVID-19 (in particular dyspnea), number of symptoms in the acute phase and female sex. The number of individuals affected by long COVID is high, even if it occurs only in a part of the subjects who had COVID-19. Therefore, long COVID constitutes now a major health issue and has to be managed in order to ensure an adequate access to care for all the people that need it. "Post COVID" clinics have been created in various countries, especially in Europe, for the management of people affected by long COVID syndrome. Guidelines have been written to help clinicians. An important role in the management of long COVID patients is played by the general practitioner, directly or indirectly linked to post COVID hospital clinics. The extreme heterogeneity of clinical presentation needs a patient-tailored, multidisciplinary approach. As NHS guidelines say, the three principal of care for long COVID patients are personalized care, multidisciplinary support and rehabilitation. More studies are needed in order to know better the pathophysiology of the disease. It is also necessary to create standardized and shared definitions of the disease, in order to better understand the epidemiology, the diagnostic criteria and to offer the right treatment to all the individuals who need it, without social or economic diffeences.
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Affiliation(s)
- Silvia Staffolani
- Gastroenterological and Transplant Department, S.O.D. Malattie Infettive Emergenti e degli Immunodepressi, University Hospital "Ospedali Riuniti", Ancona, Italy
| | - Valentina Iencinella
- Gastroenterological and Transplant Department, S.O.D. Malattie Infettive Emergenti e degli Immunodepressi, University Hospital "Ospedali Riuniti", Ancona, Italy
| | - Matteo Cimatti
- Gastroenterological and Transplant Department, S.O.D. Malattie Infettive Emergenti e degli Immunodepressi, University Hospital "Ospedali Riuniti", Ancona, Italy
| | - Marcello Tavio
- Gastroenterological and Transplant Department, S.O.D. Malattie Infettive Emergenti e degli Immunodepressi, University Hospital "Ospedali Riuniti", Ancona, Italy
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Brescini L, Della Martera F, Morroni G, Mazzanti S, Di Pietrantonio M, Mantini P, Candelaresi B, Pallotta F, Olivieri S, Iencinella V, Castelletti S, Cocci E, Polo RG, Veccia S, Cirioni O, Tavio M, Giacometti A. Use of Dalbavancin in Skin, Bone and Joint Infections: A Real-Life Experience in an Italian Center. Antibiotics (Basel) 2021; 10:antibiotics10091129. [PMID: 34572711 PMCID: PMC8468778 DOI: 10.3390/antibiotics10091129] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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: 07/22/2021] [Revised: 08/23/2021] [Accepted: 09/15/2021] [Indexed: 11/16/2022] Open
Abstract
Dalbavancin is a lipoglycopeptide approved for the treatment of acute bacterial skin and skin structure infections (ABSSSI). The aim of the study was to evaluate the efficacy and safety in all patients who received at least one administration of dalbavancin. METHODS We carried out a retrospective study of the use of dalbavancin in 55 patients at the Azienda Ospedaliera Ospedali Riuniti Umberto I (Ancona, Italy) from February 2017 to May 2020 and compared "on label" and "off label" use of dalbavancin in ABSSSI and non-ABSSSI. RESULTS A total of 55 patients were included in the study. The median age was 61 years; 51% had ABSSSI; 24% had prosthetic joint infections, and 14% had osteomyelitis. A total of 53% received a single 1500 mg infusion of dalbavancin, and 18% received a second dose 14 days later; 24% of patients received further doses at 14-day intervals. In 91% of cases, patients achieved clinical objectives with dalbavancin: 96% of patients with ABSSSI and 69% of those with prosthetic joint infections. CONCLUSIONS Dalbavancin was shown to have an excellent tolerability profile and to be a highly successful therapeutic approach even in those cases treated "off-label".
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Affiliation(s)
- Lucia Brescini
- Infectious Diseases Clinic, Ospedali Riuniti Umberto I, Via Conca 71, 60126 Torrette, AN, Italy; (F.D.M.); (S.M.); (M.D.P.); (P.M.); (B.C.); (F.P.); (S.O.); (S.V.); (O.C.); (A.G.)
- Department of Biomedical Sciences and Public Health, Polytechnic University of Marche Medical School, Via Tronto 10/a, 60020 Torrette, AN, Italy; (G.M.); (V.I.)
- Correspondence: ; Tel.: +39-071-596-3502
| | - Filippo Della Martera
- Infectious Diseases Clinic, Ospedali Riuniti Umberto I, Via Conca 71, 60126 Torrette, AN, Italy; (F.D.M.); (S.M.); (M.D.P.); (P.M.); (B.C.); (F.P.); (S.O.); (S.V.); (O.C.); (A.G.)
- Department of Biomedical Sciences and Public Health, Polytechnic University of Marche Medical School, Via Tronto 10/a, 60020 Torrette, AN, Italy; (G.M.); (V.I.)
| | - Gianluca Morroni
- Department of Biomedical Sciences and Public Health, Polytechnic University of Marche Medical School, Via Tronto 10/a, 60020 Torrette, AN, Italy; (G.M.); (V.I.)
| | - Sara Mazzanti
- Infectious Diseases Clinic, Ospedali Riuniti Umberto I, Via Conca 71, 60126 Torrette, AN, Italy; (F.D.M.); (S.M.); (M.D.P.); (P.M.); (B.C.); (F.P.); (S.O.); (S.V.); (O.C.); (A.G.)
- Department of Biomedical Sciences and Public Health, Polytechnic University of Marche Medical School, Via Tronto 10/a, 60020 Torrette, AN, Italy; (G.M.); (V.I.)
| | - Maria Di Pietrantonio
- Infectious Diseases Clinic, Ospedali Riuniti Umberto I, Via Conca 71, 60126 Torrette, AN, Italy; (F.D.M.); (S.M.); (M.D.P.); (P.M.); (B.C.); (F.P.); (S.O.); (S.V.); (O.C.); (A.G.)
- Department of Biomedical Sciences and Public Health, Polytechnic University of Marche Medical School, Via Tronto 10/a, 60020 Torrette, AN, Italy; (G.M.); (V.I.)
| | - Paolo Mantini
- Infectious Diseases Clinic, Ospedali Riuniti Umberto I, Via Conca 71, 60126 Torrette, AN, Italy; (F.D.M.); (S.M.); (M.D.P.); (P.M.); (B.C.); (F.P.); (S.O.); (S.V.); (O.C.); (A.G.)
- Department of Biomedical Sciences and Public Health, Polytechnic University of Marche Medical School, Via Tronto 10/a, 60020 Torrette, AN, Italy; (G.M.); (V.I.)
| | - Bianca Candelaresi
- Infectious Diseases Clinic, Ospedali Riuniti Umberto I, Via Conca 71, 60126 Torrette, AN, Italy; (F.D.M.); (S.M.); (M.D.P.); (P.M.); (B.C.); (F.P.); (S.O.); (S.V.); (O.C.); (A.G.)
- Department of Biomedical Sciences and Public Health, Polytechnic University of Marche Medical School, Via Tronto 10/a, 60020 Torrette, AN, Italy; (G.M.); (V.I.)
| | - Francesco Pallotta
- Infectious Diseases Clinic, Ospedali Riuniti Umberto I, Via Conca 71, 60126 Torrette, AN, Italy; (F.D.M.); (S.M.); (M.D.P.); (P.M.); (B.C.); (F.P.); (S.O.); (S.V.); (O.C.); (A.G.)
- Department of Biomedical Sciences and Public Health, Polytechnic University of Marche Medical School, Via Tronto 10/a, 60020 Torrette, AN, Italy; (G.M.); (V.I.)
| | - Silvia Olivieri
- Infectious Diseases Clinic, Ospedali Riuniti Umberto I, Via Conca 71, 60126 Torrette, AN, Italy; (F.D.M.); (S.M.); (M.D.P.); (P.M.); (B.C.); (F.P.); (S.O.); (S.V.); (O.C.); (A.G.)
- Department of Biomedical Sciences and Public Health, Polytechnic University of Marche Medical School, Via Tronto 10/a, 60020 Torrette, AN, Italy; (G.M.); (V.I.)
| | - Valentina Iencinella
- Department of Biomedical Sciences and Public Health, Polytechnic University of Marche Medical School, Via Tronto 10/a, 60020 Torrette, AN, Italy; (G.M.); (V.I.)
- Infectious Diseases, Ospedali Riuniti Umberto I, ViaConca 71, 60126 Torrette, AN, Italy; (S.C.); (M.T.)
| | - Sefora Castelletti
- Infectious Diseases, Ospedali Riuniti Umberto I, ViaConca 71, 60126 Torrette, AN, Italy; (S.C.); (M.T.)
| | - Emanuele Cocci
- Hospital Pharmacy, Ospedali Riuniti Umberto I, Via Conca 71, 60126 Torrette, AN, Italy; (E.C.); (R.G.P.)
| | - Rosaria G. Polo
- Hospital Pharmacy, Ospedali Riuniti Umberto I, Via Conca 71, 60126 Torrette, AN, Italy; (E.C.); (R.G.P.)
| | - Salvatore Veccia
- Infectious Diseases Clinic, Ospedali Riuniti Umberto I, Via Conca 71, 60126 Torrette, AN, Italy; (F.D.M.); (S.M.); (M.D.P.); (P.M.); (B.C.); (F.P.); (S.O.); (S.V.); (O.C.); (A.G.)
| | - Oscar Cirioni
- Infectious Diseases Clinic, Ospedali Riuniti Umberto I, Via Conca 71, 60126 Torrette, AN, Italy; (F.D.M.); (S.M.); (M.D.P.); (P.M.); (B.C.); (F.P.); (S.O.); (S.V.); (O.C.); (A.G.)
- Department of Biomedical Sciences and Public Health, Polytechnic University of Marche Medical School, Via Tronto 10/a, 60020 Torrette, AN, Italy; (G.M.); (V.I.)
| | - Marcello Tavio
- Infectious Diseases, Ospedali Riuniti Umberto I, ViaConca 71, 60126 Torrette, AN, Italy; (S.C.); (M.T.)
| | - Andrea Giacometti
- Infectious Diseases Clinic, Ospedali Riuniti Umberto I, Via Conca 71, 60126 Torrette, AN, Italy; (F.D.M.); (S.M.); (M.D.P.); (P.M.); (B.C.); (F.P.); (S.O.); (S.V.); (O.C.); (A.G.)
- Department of Biomedical Sciences and Public Health, Polytechnic University of Marche Medical School, Via Tronto 10/a, 60020 Torrette, AN, Italy; (G.M.); (V.I.)
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Pasquini Z, Barocci I, Brescini L, Candelaresi B, Castelletti S, Iencinella V, Mazzanti S, Procaccini G, Orsetti E, Pallotta F, Amadio G, Giacometti A, Tavio M, Barchiesi F. Bloodstream infections in the COVID-19 era: results from an Italian multi-centre study. Int J Infect Dis 2021; 111:31-36. [PMID: 34416402 PMCID: PMC8372445 DOI: 10.1016/j.ijid.2021.07.065] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [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: 04/21/2021] [Revised: 07/21/2021] [Accepted: 07/27/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Correlation between coronavirus disease 2019 (COVID-19) and superinfections has been investigated, but remains to be fully assessed. This multi-centre study reports the impact of the pandemic on bloodstream infections (BSIs). METHODS This study included all patients with BSIs admitted to four Italian hospitals between 1 January and 30 June 2020. Clinical, demographic and microbiologic data were compared with data for patients hospitalized during the same period in 2019. RESULTS Among 26,012 patients admitted between 1 January and 30 June 2020, 1182 had COVID-19. Among the patients with COVID-19, 107 BSIs were observed, with an incidence rate of 8.19 episodes per 1000 patient-days. The incidence of BSI was significantly higher in these patients compared with patients without COVID-19 (2.72/1000 patient-days) and patients admitted in 2019 (2.76/1000 patient-days). In comparison with patients without COVID-19, BSI onset in patients with COVID-19 was delayed during the course of hospitalization (16.0 vs 5 days, respectively). Thirty-day mortality among patients with COVID-19 was 40.2%, which was significantly higher compared with patients without COVID-19 (23.7%). BSIs in patients with COVID-19 were frequently caused by multi-drug-resistant pathogens, which were often centre-dependent. CONCLUSIONS BSIs are a common secondary infection in patients with COVID-19, characterized by increased risk during hospitalization and potentially burdened with high mortality.
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Affiliation(s)
- Zeno Pasquini
- Università Politecnica delle Marche Facoltà di Medicina e Chirurgia, Clinica Malattie Infettive, Dipartimento di Scienze Biomediche e Sanità Pubblica, Macerata, Italy; Azienda Ospedaliera Ospedali Riuniti Marche Nord, Malattie Infettive, Pesaro, Italy.
| | - Iacopo Barocci
- Università Politecnica delle Marche Facoltà di Medicina e Chirurgia, Clinica Malattie Infettive, Dipartimento di Scienze Biomediche e Sanità Pubblica, Macerata, Italy
| | - Lucia Brescini
- Università Politecnica delle Marche Facoltà di Medicina e Chirurgia, Clinica Malattie Infettive, Dipartimento di Scienze Biomediche e Sanità Pubblica, Macerata, Italy
| | - Bianca Candelaresi
- Università Politecnica delle Marche Facoltà di Medicina e Chirurgia, Clinica Malattie Infettive, Dipartimento di Scienze Biomediche e Sanità Pubblica, Macerata, Italy
| | - Sefora Castelletti
- Azienda Ospedaliero Universitaria Ospedali Riuniti di Ancona Umberto I G M Lancisi G Salesi, Divisione Malattie Infettive, Ancona, Italy
| | - Valentina Iencinella
- Università Politecnica delle Marche Facoltà di Medicina e Chirurgia, Clinica Malattie Infettive, Dipartimento di Scienze Biomediche e Sanità Pubblica, Macerata, Italy
| | - Sara Mazzanti
- Università Politecnica delle Marche Facoltà di Medicina e Chirurgia, Clinica Malattie Infettive, Dipartimento di Scienze Biomediche e Sanità Pubblica, Macerata, Italy
| | - Gaia Procaccini
- Università Politecnica delle Marche Facoltà di Medicina e Chirurgia, Clinica Malattie Infettive, Dipartimento di Scienze Biomediche e Sanità Pubblica, Macerata, Italy
| | - Elena Orsetti
- Ospedale Augusto Murri, Malattie Infettive, Fermo, Italy
| | - Francesco Pallotta
- Università Politecnica delle Marche Facoltà di Medicina e Chirurgia, Clinica Malattie Infettive, Dipartimento di Scienze Biomediche e Sanità Pubblica, Macerata, Italy
| | - Giorgio Amadio
- Ospedale Augusto Murri, Malattie Infettive, Fermo, Italy
| | - Andrea Giacometti
- Università Politecnica delle Marche Facoltà di Medicina e Chirurgia, Clinica Malattie Infettive, Dipartimento di Scienze Biomediche e Sanità Pubblica, Macerata, Italy
| | - Marcello Tavio
- Azienda Ospedaliero Universitaria Ospedali Riuniti di Ancona Umberto I G M Lancisi G Salesi, Divisione Malattie Infettive, Ancona, Italy
| | - Francesco Barchiesi
- Università Politecnica delle Marche Facoltà di Medicina e Chirurgia, Clinica Malattie Infettive, Dipartimento di Scienze Biomediche e Sanità Pubblica, Macerata, Italy; Azienda Ospedaliera Ospedali Riuniti Marche Nord, Malattie Infettive, Pesaro, Italy
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