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Background and purpose: The patterns of long-term risk of SARS-CoV-2 infection, hospitalization for COVID-19, and related death are uncertain in people with Parkinson disease (PD) or parkinsonism (PS). The aim of the study was to quantify these risks compared to a control population cohort, during the period March 2020–May 2021, in Bologna, Northern Italy. Methods: ParkLink Bologna cohort (759 PD, 192 PS) and controls (9226) anonymously matched (ratio=1:10) for sex, age, district, and comorbidity were included. Data were analysed in the whole period and in the two different pandemic waves (March–May 2020 and October 2020–May 2021). Results: Adjusted hazard ratio of SARS-CoV-2 infection was 1.3 (95% confidence interval [CI] = 1.04–1.7) in PD and 1.9 (95% CI=1.3–2.8) in PS compared to the controls. The trend was detected in both the pandemic waves. Adjusted hazard ratio of hospitalization for COVID-19 was 1.1 (95% CI=0.8–1.7) in PD and 1.8 (95% CI=0.97–3.1) in PS. A higher risk of hospital admission was detected in PS only in the first wave. The 30-day mortality risk after hospitalization was higher (p= 0.048) in PS (58%) than in PD (19%) and controls (26%). Conclusions: Compared with controls, after adjustment for key covariates, people with PD and PS showed a higher risk of SARS-CoV-2 infection throughout the first 15 months of the pandemic. COVID-19 hospitalization risk was increased only in people with PS and only during the first wave. This group of patients was burdened by a very high risk of death after infection and hospitalization.

Baruzzi A. (Chair), Albani F., Calbucci F., D’Alessandro R., Michelucci R. (IRCCS Institute of Neurological Sciences, Bologna, Italy), Brandes A. (Department of Medical Oncology, Bellaria-Maggiore Hospitals, Bologna, Italy), Eusebi V. (Department of Hematology and Oncological Sciences ‘‘L. & A. Seragnoli’’, Section of Anatomic Pathology at Bellaria Hospital, Bologna, Italy), Ceruti S., Fainardi E., Tamarozzi R. (Neuroradiology Unit, Department of Neurosciences and Rehabilitation, S. Anna Hospital, Ferrara, Italy), Emiliani E. (Istituto Oncologico Romagnolo, Department of Medical Oncology, Santa Maria delle Croci Hospital, Ravenna, Italy), Cavallo M. (Division of Neurosurgery, Department of Neurosciences and Rehabilitation, S. Anna Hospital, Ferrara, Italy).

Diabetes mellitus is fast becoming a world epidemic. About one-third of individuals with diabetes, after 10 yrs, develop diabetic nephropathy, the first cause of end-stage kidney disease. The evolution of diabetic nephropathy can be considered in three stages: glomerular hyperfiltration, microalbuminuria (30-300 mg/24 hr) and proteinuria (300 mg/24 hr). This study was designed to investigate the tubular basis of glomerular hyperfiltration in early diabetes mellitus. Diabetes was inducted in rats with i.p. streptozotocin (65 mg/kg bw) for 6 days. At the end of the treatment, the glomerular filtration rate (GFR), measured by inulin clearance, had substantially increased in diabetic rats compared with controls. Quantitative polymerase chain reaction (PCR) and Western blot analysis reveal that in diabetic rats compared with controls, mRNA and protein abundance was higher for type 3 sodium/hydrogen exchanger (NHE3) in proximal tubule and ascending limbs of Henle's loop, and higher for bumetanide-sensitive sodium-potassium-2 chloride cotransporter (NKCC2) in ascending limbs of Henle's loop. Western blot analysis confirmed the PCR results. Finally, the abundance of á -ENaC protein was unchanged in diabetic rats compared to controls. These results show that the primary sodium reabsorption increase in proximal tubule reduces salt concentrations at the macula densa. This elicits a tubuloglomerular feedback-dependent increase in single nephron GFR.

The growing demand for brain MR scans in recent years has led to long waiting lists and indiscriminate referral with respect to the clinical need for imaging and appropriateness criteria for MR scanning. To overcome this problem, the Bologna Public Health Service in conjunction with S. Orsola-Malpighi Hospital devised an experimental project instituting a radiological assessment prior to booking MR scans, implemented on 1st November 2003. The assessment is carried out by doctors in the Radiology and neuroradiology units to establish whether referral for MR scan is appropriate and to draw up a priority scale for access to MR diagnosis. If MR investigation is deemed inappropriate, the project provides for an alternative procedure or specialist clinical examination. The patient is admitted to the charge of the service and followed throughout the diagnostic work-up, i.e. the doctor undertaking the assessment will prescribe a possible specialist clinical consultation or other radiological procedures, generally CT scans performed by the same Radiology or Neuroradiology unit. We report on neuroradiological assessment of referrals for brain MR scans on behalf of the Public Health Service and carried out at the Neuroradiology Unit in Bellaria Hospital, Bologna. From 1st November to 31st July 2004, 2659 assessments were undertaken. Of these 2163 were approved for MR scanning whereas 496 referrals were modified, mostly into CT scans and some patients were referred for otorhinolaringology, endocrinology or neurology specialist consultation. To assess the impact of this “filter”, we compared a sample period of six months from 1st February 2003 to 31st July 2003 before the radiological assessment project had been implemented with a period of the same length the following year. We found that the number of negative MR scans was halved after the project had been implemented (from 24.49% in 2003 to 12.18% in 2004), showing that in addition to shortening waiting lists for MR scans, there has been a sharp rise in the number of appropriate scans.