Search

Your search keyword '"Borelli, Massimo"' showing total 13 results
Start Over Author "Borelli, Massimo" Topic covid-19
13 results on '"Borelli, Massimo"'

1. Evolution of in-hospital patient characteristics and predictors of death in the COVID-19 pandemic across four waves: are they moving targets with implications for patient care?

Author

Trecarichi EM, Olivadese V, Davoli C, Rotundo S, Serapide F, Lionello R, Tassone B, La Gamba V, Fusco P, Russo A, Borelli M, and Torti C

Subjects
Humans, Aged, Inpatients, Pandemics, Retrospective Studies, SARS-CoV-2, Patient Care, Hospitals, Teaching, COVID-19 epidemiology, Renal Insufficiency, Chronic
Abstract

Objectives: The aim of this work was to study characteristics, outcomes and predictors of all-cause death in inpatients with SARS-CoV-2 infection across the pandemic waves in one large teaching hospital in Italy to optimize disease management., Methods: All patients with SARS-CoV-2 infection admitted to our center from March 2020 to June 2022 were included in this retrospective observational cohort study. Both descriptive and regression tree analyses were applied to identify factors influencing all-cause mortality., Results: 527 patients were included in the study (65.3% with moderate and 34.7% with severe COVID-19). Significant evolutions of patient characteristics were found, and mortality increased in the last wave with respect to the third wave notwithstanding vaccination. Regression tree analysis showed that in-patients with severe COVID-19 had the greatest mortality across all waves, especially the older adults, while prognosis depended on the pandemic waves in patients with moderate COVID-19: during the first wave, dyspnea was the main predictor, while chronic kidney disease emerged as determinant factor afterwards., Conclusion: Patients with severe COVID-19, especially the older adults during all waves, as well as those with moderate COVID-19 and concomitant chronic kidney disease during the most recent waves require more attention for monitoring and care. Therefore, our study drives attention towards the importance of co-morbidities and their clinical impact in patients with COVID-19 admitted to hospital, indicating that the healthcare system should adapt to the evolving features of the epidemic., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Trecarichi, Olivadese, Davoli, Rotundo, Serapide, Lionello, Tassone, La Gamba, Fusco, Russo, Borelli, Torti and the IDTM UMG COVID-19 Group.)

Published
2024
Full Text
View/download PDF

2. Interleukin-6 2 /lymphocyte as a proposed predictive index for COVID-19 patients treated with monoclonal antibodies.

Author

Rotundo S, Borelli M, Scaglione V, Lionello R, Biamonte F, Olivadese V, Quirino A, Morrone HL, Matera G, Costanzo FS, Russo A, Trecarichi EM, and Torti C

Subjects
Humans, Interleukin-6, SARS-CoV-2, Antibodies, Monoclonal therapeutic use, Lymphocytes, Disease Progression, COVID-19
Abstract

In a convenience sample of 93 patients treated with monoclonal antibodies (moAbs) against SARS-CoV-2, the interleukin-6 2 /lymphocyte count ratio (IL-6 2 /LC) was able to predict clinical worsening both in early stages of COVID-19 and in oxygen-requiring patients. Moreover, we analysed 18 most at-risk patients with asymptomatic or mild disease treated with both moAbs and antiviral treatment and found that only 2 had clinical progression, while patients with a similar risk were reported to have an unfavourable outcome in most cases from recent data. In only one of our 18 patients, clinical progression was attributable to COVID-19, and in the other cases, clinical progression was observed despite IL-6 2 /LC being above the risk cut-off. In conclusion, IL-6 2 /LC may be a valuable method to identify patients requiring more aggressive treatments both in earlier and later stages of the disease; however, most at-risk patients can be protected from clinical worsening by combining moAbs and antivirals, even if levels of the IL-6 2 /LC biomarker are lower than the risk cut-off., (© 2023. The Author(s).)

Published
2023
Full Text
View/download PDF

3. The role of outdoor and indoor air quality in the spread of SARS-CoV-2: Overview and recommendations by the research group on COVID-19 and particulate matter (RESCOP commission).

Author

Piscitelli P, Miani A, Setti L, De Gennaro G, Rodo X, Artinano B, Vara E, Rancan L, Arias J, Passarini F, Barbieri P, Pallavicini A, Parente A, D'Oro EC, De Maio C, Saladino F, Borelli M, Colicino E, Gonçalves LMG, Di Tanna G, Colao A, Leonardi GS, Baccarelli A, Dominici F, Ioannidis JPA, and Domingo JL

Subjects
Humans, Pandemics prevention & control, Particulate Matter, RNA, Viral, SARS-CoV-2, Air Pollution, Indoor, COVID-19 epidemiology, COVID-19 prevention & control
Abstract

There are important questions surrounding the potential contribution of outdoor and indoor air quality in the transmission of SARS-CoV-2 and perpetuation of COVID-19 epidemic waves. Environmental health may be a critical component of COVID-19 prevention. The public health community and health agencies should consider the evolving evidence in their recommendations and statements, and work to issue occupational guidelines. Evidence coming from the current epidemiological and experimental research is expected to add knowledge about virus diffusion, COVID-19 severity in most polluted areas, inter-personal distance requirements and need for wearing face masks in indoor or outdoor environments. The COVID-19 pandemic has highlighted the need for maintaining particulate matter concentrations at low levels for multiple health-related reasons, which may also include the spread of SARS-CoV-2. Indoor environments represent even a more crucial challenge to cope with, as it is easier for the SARS-COV2 to spread, remain vital and infect other subjects in closed spaces in the presence of already infected asymptomatic or mildly symptomatic people. The potential merits of preventive measures, such as CO 2 monitoring associated with natural or controlled mechanical ventilation and air purification, for schools, indoor public places (restaurants, offices, hotels, museums, theatres/cinemas etc.) and transportations need to be carefully considered. Hospital settings and nursing/retirement homes as well as emergency rooms, infectious diseases divisions and ambulances represent higher risk indoor environments and may require additional monitoring and specific decontamination strategies based on mechanical ventilation or air purification., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Published
2022
Full Text
View/download PDF

4. Noninvasive Ventilatory Support of Patients with COVID-19 outside the Intensive Care Units (WARd-COVID).

Author

Bellani G, Grasselli G, Cecconi M, Antolini L, Borelli M, De Giacomi F, Bosio G, Latronico N, Filippini M, Gemma M, Giannotti C, Antonini B, Petrucci N, Zerbi SM, Maniglia P, Castelli GP, Marino G, Subert M, Citerio G, Radrizzani D, Mediani TS, Lorini FL, Russo FM, Faletti A, Beindorf A, Covello RD, Greco S, Bizzarri MM, Ristagno G, Mojoli F, Pradella A, Severgnini P, Da Macallè M, Albertin A, Ranieri VM, Rezoagli E, Vitale G, Magliocca A, Cappelleri G, Docci M, Aliberti S, Serra F, Rossi E, Valsecchi MG, Pesenti A, and Foti G

Subjects
Aged, Cannula, Female, Humans, Intensive Care Units, Italy, Male, Middle Aged, Oxygen Inhalation Therapy, Prospective Studies, SARS-CoV-2, Treatment Failure, COVID-19 therapy, Continuous Positive Airway Pressure methods, Hospital Mortality, Hypoxia therapy, Intubation, Intratracheal statistics & numerical data, Noninvasive Ventilation methods, Patients' Rooms, Respiratory Insufficiency therapy
Abstract

Rationale: Treatment with noninvasive ventilation (NIV) in coronavirus disease (COVID-19) is frequent. Shortage of intensive care unit (ICU) beds led clinicians to deliver NIV also outside ICUs. Data about the use of NIV in COVID-19 is limited. Objectives: To describe the prevalence and clinical characteristics of patients with COVID-19 treated with NIV outside the ICUs. To investigate the factors associated with NIV failure (need for intubation or death). Methods: In this prospective, single-day observational study, we enrolled adult patients with COVID-19 who were treated with NIV outside the ICU from 31 hospitals in Lombardy, Italy. Results: We collected data on demographic and clinical characteristics, ventilatory management, and patient outcomes. Of 8,753 patients with COVID-19 present in the hospitals on the study day, 909 (10%) were receiving NIV outside the ICU. A majority of patients (778/909; 85%) patients were treated with continuous positive airway pressure (CPAP), which was delivered by helmet in 617 (68%) patients. NIV failed in 300 patients (37.6%), whereas 498 (62.4%) patients were discharged alive without intubation. Overall mortality was 25%. NIV failure occurred in 152/284 (53%) patients with an arterial oxygen pressure (Pa O 2 )/fraction of inspired oxygen (Fi O 2 ) ratio <150 mm Hg. Higher C-reactive protein and lower Pa O 2 /Fi O 2 and platelet counts were independently associated with increased risk of NIV failure. Conclusions: The use of NIV outside the ICUs was common in COVID-19, with a predominant use of helmet CPAP, with a rate of success >60% and close to 75% in full-treatment patients. C-reactive protein, Pa O 2 /Fi O 2 , and platelet counts were independently associated with increased risk of NIV failure.Clinical trial registered with ClinicalTrials.gov (NCT04382235).

Published
2021
Full Text
View/download PDF

5. Impact of lockdown for SARS-CoV-2 (COVID-19) on surgical site infection rates: a monocentric observational cohort study.

Author

Losurdo P, Paiano L, Samardzic N, Germani P, Bernardi L, Borelli M, Pozzetto B, de Manzini N, and Bortul M

Subjects
Adult, Aged, Female, Humans, Italy epidemiology, Male, Middle Aged, Pandemics, Prevalence, Prognosis, Retrospective Studies, Risk Factors, Surgical Wound Infection epidemiology, COVID-19 prevention & control, Infection Control, Surgery Department, Hospital organization & administration, Surgical Wound Infection prevention & control
Abstract

Surgical site infections are the most common in-hospital acquired infections. The aim of this study and the primary endpoint is to evaluate how the measures to reduce the SARS-CoV-2 spreading affected the superficial and deep SSI rate. A total of 541 patients were included. Of those, 198 from March to April 2018, 220 from March till April 2019 and 123 in the COVID-19 era from March to April 2020. The primary endpoint occurred in 39 over 541 patients. In COVID-19 era, we reported a lower rate of global SSIs (3.3% vs. 8.4%; p 0.035), few patients developed a superficial SSIs (0.8% vs. 3.4%; p 0.018) and none experienced deep SSIs (0% vs. 3.4%; p 0.025). Comparing the previous two "COVID-19-free" years, no significative differences were reported. At multivariate analysis, the measures to reduce the SARS-CoV-2 spread (OR 0.368; p 0.05) were independently associated with the reduction for total, superficial and deep SSIs. Moreover, the presence of drains (OR 4.99; p 0.009) and a Type III-IV of SWC (OR 1.8; p 0.001) demonstrated a worse effect regarding the primary endpoint. Furthermore, the presence of the drain was not associated with an increased risk of superficial and deep SSIs. In this study, we provided important insights into the superficial and deep SSIs risk assessment for patients who underwent surgery. Simple and easily viable precautions such as wearing surgical masks and the restriction of visitors emerged as promising tools for the reduction of SSIs risk.

Published
2020
Full Text
View/download PDF

7. The impact of COVID-19 on myocardial infarctions, strokes and out-of-hospital cardiopulmonary arrests: an observational retrospective study on time-sensitive disorders in the Friuli Venezia Giulia region (Italy)

Author

Pegani, Carlo, Buttignon, Giovanni, Tullio, Annarita, Naccarato, Marcello, Manganotti, Paolo, Rakar, Serena, Fabris, Enrico, Nadalin, Federico, Mione, Vincenzo, Gigli, Gian Luigi, Lorenzut, Simone, Spedicato, Leonardo, Passadore, Paolo, Pavan, Daniela, Lutman, Cristina, Andrian, Manila, Borelli, Massimo, Novello, Stefano, Belfiore, Rita, Daneluzzi, Chiara, Sinagra, Gianfranco, and Peratoner, Alberto

Published
2022
Full Text
View/download PDF

8. Interleukin-62/lymphocyte as a proposed predictive index for COVID-19 patients treated with monoclonal antibodies.

Author

Rotundo, Salvatore, Borelli, Massimo, Scaglione, Vincenzo, Lionello, Rosaria, Biamonte, Flavia, Olivadese, Vincenzo, Quirino, Angela, Morrone, Helen Linda, Matera, Giovanni, Costanzo, Francesco Saverio, Russo, Alessandro, Trecarichi, Enrico Maria, Torti, Carlo, IDTM UMG COVID-19 Group, Serapide, Francesca, Tassone, Bruno, Fusco, Paolo, Davoli, Chiara, La Gamba, Valentina, and Berardelli, Lavinia

Subjects
COVID-19, MONOCLONAL antibodies, CONVENIENCE sampling (Statistics), ASYMPTOMATIC patients, DISEASE progression
Abstract

In a convenience sample of 93 patients treated with monoclonal antibodies (moAbs) against SARS-CoV-2, the interleukin-62/lymphocyte count ratio (IL-62/LC) was able to predict clinical worsening both in early stages of COVID-19 and in oxygen-requiring patients. Moreover, we analysed 18 most at-risk patients with asymptomatic or mild disease treated with both moAbs and antiviral treatment and found that only 2 had clinical progression, while patients with a similar risk were reported to have an unfavourable outcome in most cases from recent data. In only one of our 18 patients, clinical progression was attributable to COVID-19, and in the other cases, clinical progression was observed despite IL-62/LC being above the risk cut-off. In conclusion, IL-62/LC may be a valuable method to identify patients requiring more aggressive treatments both in earlier and later stages of the disease; however, most at-risk patients can be protected from clinical worsening by combining moAbs and antivirals, even if levels of the IL-62/LC biomarker are lower than the risk cut-off. [ABSTRACT FROM AUTHOR]

Published
2023
Full Text
View/download PDF

9. Communication and visiting policies in Italian intensive care units during the first COVID-19 pandemic wave and lockdown: a nationwide survey

Author

Langer, Thomas, Depalo, Francesca Carmela, Forlini, Clarissa, Landini, Silvia, Mezzetti, Andrea, Previtali, Paola, Monti, Gianpaola, de Toma, Carolina, Biscardi, Davide, Giannini, Alberto, Fumagalli, Roberto, Mistraletti, Giovanni, Lissoni, Barbara, De Martini, Andrea, Mareto, Nadia, Rossitto, Concetta, Zummo, Ugo, Taverna, Martina, Machieraldo, Patrizia, Navarra, Mauro, Parlanti Garbero, Massimiliano, Scaletti, Chiara, Perno, Silvia, Amendolia, Luca, Montrucchio, Giuseppe, Veliaj, Deliana, Barbarello, Giuseppe, Alesci, Maria, Bolgiaghi, Luca, Vailati, Davide, Pezzi, Angelo, Boselli, Enrico, Piccoli, Francesca, Greco, Massimiliano, Gemma, Marco, Resta, Marco, Crotti, Stefania, Bottino, Nicola, Abruzzese, Chiara, Savioli, Monica, Migliorino, Giuseppina, Muttini, Stefano, Umbrello, Michele, Borghi, Beatrice, Greco, Stefano, Dizeo, Micaela, Bottiroli, Maurizio, Mondino, Michele Giovanni, Prosepri, Manlio, Casella, Giampaolo, Curto, Francesco, Zaniboni, Matteo, Giudici, Riccardo, Gentile, Carlo, Bombino, Michela, Rona, Roberto, Cortinovis, Barbara, Benini, Annalisa, Avalli, Leonello, Tavola, Mario, Ferrario, Matteo, Preda, Roberta, Primerano, Enzo, Russo, Gianluca, Porta, Virginia, Valdambrini, Federico, Fassini, Paola, Orando, Serena, Beck, Eduardo, Pedeferri, Matteo, Cogliati, Giacomina, Testini, Denise, Moroni, Benedetta, Codeluppi, Vito, Ruggeri, Patrizia, Milanesi, Elisa, Belliato, Mirko, Besozzi, Alessandra, Riccio, Mario, Zerbi, Silvia, Corbella, Davide, Ferri, Francesco, Grazioli, Lorenzo, Bonanomi, Ezio, Giacomini, Matteo, Sacchi, Noemi, Codognola, Cristian, Ambrosini, Alessandra, Guatteri, Luca, Subert, Matteo, Castelli, Gian Paolo, Borelli, Massimo, Venier, Erica, Dittura, Loredana, Buttera, Stefania, Bigai, Roberto, Magnoni, Sandra, Rauch, Simon, Colombo, Angelo, Fullin, Giorgio, Donolato, Caterina, Cattin, Silvia, State, Veronica, Redeghieri, Enrico, Russo, Alessandro, Pastorini, Simonetta, Allena, Sandra, Munari, Marina, Turchet, Federica, Peta, Mario, De Santis, Vincenzo, Scala, Cristina, Facondini, Francesca, Marangoni, Elisabetta, Tassinati, Tania, Zanzani, Chiara, Russo, Emanuele, Marchio, Annamaria, Barbagallo, Maria, Girardis, Massimo, Taffache, Paolo, Mordacci, Marco, Vincenzi, Matteo, Pennica, Michele, Bracciotti, Giovanna, Iori, Paola, Gambi, Davide, Cappellini, Iacopo, Vegnuti, Lara, De Luca, Alessandra, Romagnoli, Stefano, Mosti, Giamila, Carla, Rossella, Roticiani, Valeria, Pelagalli, Lorella, Fuselli, Ennio, D’Avino, Emilio, De Bellis, Massimo, Gianni, Giulia, Leonardis, Francesca, Rossi, Marzia, Lorusso, Rossana, Magnanimi, Eugenia, Martelli, Sabrina, Baisi, Floriana, Balsamo, Davide, Cotticelli, Virginia, Mattei, Alessia, Farinelli, Ivano, Riccini, Teresa, Cola, Luisanna, Jorio, Antonella, Iacobone, Emanuele, Domizi, Roberta, Pizzi, Simone, Nasso, Armando, Graziani, Romano, Monaco, Anna, Manno, Manuela, Ottelio, Carla Maria, Del Rio, Michela, Serra, Antonio, Enna, Barbara, Loddo, Francesco Marco, Galbiati, Rita, Mellea, Serena, Kimberly, Michelle Brozzi, Vissani, Matteo, Romito, Francesco Massimo, Baccari, Laura, Zarrillo, Nadia, Esposito, Clelia, Murino, Patrizia, Notaro, Salvatore, Ausiello, Carmine, Marra, Annachiara, Policastro, Carmela, Cafora, Chiara, De Benedectis, Giuseppe, Di Falco, Vincenzo, Sciddurlo, Maria, Negro, Giancarlo, Vetuschi, Paolo, Recchia, Andrea, Pasquariello, Rita, Squillace, Rosalba, Ciambrone, Antonio, Bencivenga, Carmela, Camiolo, Melania, Agozzino, Cristina, Oliveri, Francesco, Notarrigo, Tiziana, Castiglione, Giacomo, Mo, Antonella, Condorelli, Laura, Favarato, Martina, Langer, T, Depalo, F, Forlini, C, Landini, S, Mezzetti, A, Previtali, P, Monti, G, de Toma, C, Biscardi, D, Giannini, A, Fumagalli, R, Mistraletti, G, Lissoni, B, De Martini, A, Mareto, N, Rossitto, C, Zummo, U, Taverna, M, Machieraldo, P, Navarra, M, Parlanti Garbero, M, Scaletti, C, Perno, S, Amendolia, L, Montrucchio, G, Veliaj, D, Barbarello, G, Alesci, M, Bolgiaghi, L, Vailati, D, Pezzi, A, Boselli, E, Piccoli, F, Greco, M, Gemma, M, Resta, M, Crotti, S, Bottino, N, Abruzzese, C, Savioli, M, Migliorino, G, Muttini, S, Umbrello, M, Borghi, B, Greco, S, Dizeo, M, Bottiroli, M, Mondino, M, Prosepri, M, Casella, G, Curto, F, Zaniboni, M, Giudici, R, Gentile, C, Bombino, M, Rona, R, Cortinovis, B, Benini, A, Avalli, L, Tavola, M, Ferrario, M, Preda, R, Primerano, E, Russo, G, Porta, V, Valdambrini, F, Fassini, P, Orando, S, Beck, E, Pedeferri, M, Cogliati, G, Testini, D, Moroni, B, Codeluppi, V, Ruggeri, P, Milanesi, E, Belliato, M, Besozzi, A, Riccio, M, Zerbi, S, Corbella, D, Ferri, F, Grazioli, L, Bonanomi, E, Giacomini, M, Sacchi, N, Codognola, C, Ambrosini, A, Guatteri, L, Subert, M, Castelli, G, Borelli, M, Venier, E, Dittura, L, Buttera, S, Bigai, R, Magnoni, S, Rauch, S, Colombo, A, Fullin, G, Donolato, C, Cattin, S, State, V, Redeghieri, E, Russo, A, Pastorini, S, Allena, S, Munari, M, Turchet, F, Peta, M, De Santis, V, Scala, C, Facondini, F, Marangoni, E, Tassinati, T, Zanzani, C, Russo, E, Marchio, A, Barbagallo, M, Girardis, M, Taffache, P, Mordacci, M, Vincenzi, M, Pennica, M, Bracciotti, G, Iori, P, Gambi, D, Cappellini, I, Vegnuti, L, De Luca, A, Romagnoli, S, Mosti, G, Carla, R, Roticiani, V, Pelagalli, L, Fuselli, E, D’Avino, E, De Bellis, M, Gianni, G, Leonardis, F, Rossi, M, Lorusso, R, Magnanimi, E, Martelli, S, Baisi, F, Balsamo, D, Cotticelli, V, Mattei, A, Farinelli, I, Riccini, T, Cola, L, Jorio, A, Iacobone, E, Domizi, R, Pizzi, S, Nasso, A, Graziani, R, Monaco, A, Manno, M, Ottelio, C, Del Rio, M, Serra, A, Enna, B, Loddo, F, Galbiati, R, Mellea, S, Kimberly, M, Vissani, M, Romito, F, Baccari, L, Zarrillo, N, Esposito, C, Murino, P, Notaro, S, Ausiello, C, Marra, A, Policastro, C, Cafora, C, De Benedectis, G, Di Falco, V, Sciddurlo, M, Negro, G, Vetuschi, P, Recchia, A, Pasquariello, R, Squillace, R, Ciambrone, A, Bencivenga, C, Camiolo, M, Agozzino, C, Oliveri, F, Notarrigo, T, Castiglione, G, Mo, A, Condorelli, L, and Favarato, M

Subjects
Adult, Pandemic, Patient-centered care, Communication, COVID-19, Professional-family relations, Intensive Care Units, Policy, Anesthesiology and Pain Medicine, Health communication, Professional-family relation, Surveys and Questionnaires, Communicable Disease Control, Intensive care units, Pandemics, Humans, Intensive care unit, Child
Abstract

Background During the first coronavirus disease 2019 (COVID-19) pandemic wave, an unprecedented number of patients with respiratory failure due to a new, highly contagious virus needed hospitalization and intensive care unit (ICU) admission. The aim of the present study was to describe the communication and visiting policies of Italian intensive care units (ICUs) during the first COVID-19 pandemic wave and national lockdown and compare these data with prepandemic conditions. Methods A national web-based survey was conducted among 290 Italian hospitals. Each ICU (active between February 24 and May 31, 2020) was encouraged to complete an individual questionnaire inquiring the hospital/ICU structure/organization, communication/visiting habits and the role of clinical psychology prior to, and during the first COVID-19 pandemic wave. Results Two hundred and nine ICUs from 154 hospitals (53% of the contacted hospitals) completed the survey (202 adult and 7 pediatric ICUs). Among adult ICUs, 60% were dedicated to COVID-19 patients, 21% were dedicated to patients without COVID-19 and 19% were dedicated to both categories (Mixed). A total of 11,102 adult patients were admitted to the participating ICUs during the study period and only approximately 6% of patients received at least one visit. Communication with family members was guaranteed daily through an increased use of electronic devices and was preferentially addressed to the same family member. Compared to the prepandemic period, clinical psychologists supported physicians more often regarding communication with family members. Fewer patients received at least one visit from family members in COVID and mixed-ICUs than in non-COVID ICUs, l (0 [0–6]%, 0 [0–4]% and 11 [2–25]%, respectively, p Conclusions Visiting policies of Italian ICUs dedicated to adult patients were markedly altered during the first COVID-19 wave. Remote communication was widely adopted as a surrogate for family meetings. New strategies to favor a family-centered approach during the current and future pandemics are warranted.

Published
2022
Full Text
View/download PDF

10. Risk Factors Associated With Mortality Among Patients With COVID-19 in Intensive Care Units in Lombardy, Italy

Author

Grasselli, Giacomo, Greco, Massimiliano, Zanella, Alberto, Albano, Giovanni, Antonelli, Massimo, Bellani, Giacomo, Bonanomi, Ezio, Cabrini, Luca, Carlesso, Eleonora, Castelli, Gianpaolo, Cattaneo, Sergio, Cereda, Danilo, Colombo, Sergio, Coluccello, Antonio, Crescini, Giuseppe, Forastieri Molinari, Andrea, Foti, Giuseppe, Fumagalli, Roberto, Iotti, Giorgio Antonio, Langer, Thomas, Latronico, Nicola, Lorini, Ferdinando Luca, Mojoli, Francesco, Natalini, Giuseppe, Pessina, Carla Maria, Ranieri, Vito Marco, Rech, Roberto, Scudeller, Luigia, Rosano, Antonio, Storti, Enrico, Thompson, B. Taylor, Tirani, Marcello, Villani, Pier Giorgio, Pesenti, Antonio, Cecconi, Maurizio, Agosteo, Emiliano, Albertin, Andrea, Alborghetti, Armando, Aldegheri, Giorgio, Antonini, Benvenuto, Barbara, Enrico, Bardelloni, Giulia, Basilico, Sabrina, Belgiorno, Nicolangela, Beretta, Enrico, Berselli, Angela, Bianciardi, Leonardo, Bonazzi, Stefano, Borelli, Massimo, Bottino, Nicola, Bronzini, Nicola, Brusatori, Serena, Capra, Carlo, Carnevale, Livio, Catena, Emanuele, Celotti, Simona, Cerutti, Stefania, Chiumello, Davide, Cirri, Silvia, Citerio, Giuseppe, Coppini, Davide, Corona, Alberto, Cortellazzi, Paolo, Costantini, Elena, Covello, Remo Daniel, De Filippi, Gianluca, Dei Poli, Marco, Dughi, Paolo, Fieni, Fulvia, Florio, Gaetano, Galletti, Marco, Gallioli, Giorgio Antonio, Gay, Hedwige, Gemma, Marco, Gnesin, Paolo, Greco, Stefano, Grosso, Paolo, Guatteri, Luca, Guzzon, Davide, Keim, Roberto, Lombardo, Andrea, Mamprin, Filippo, Marino, Giovanni, Marino, Francesco, Merli, Guido, Micucci, Antonio, Militano, Carmine Rocco, Monti, Giacomo, Muttini, Stefano, Nadalin, Samantha, Perazzo, Paolo, Perego, Giovanni Battista, Perotti, Luciano, Petrucci, Nicola, Pezzi, Angelo, Piva, Simone, Portella, Gina, Protti, Alessandro, Racagni, Milena, Radrizzani, Danilo, Raimondi, Maurizio, Ranucci, Marco, Riccio, Mario, Ruggeri, Patrizia, Sala, Giuseppe, Salvi, Luca, Sebastiano, Pietro, Severgnini, Paolo, Sigurtà, Donato, Stocchetti, Nino, Subert, Matteo, Tavola, Mario, Todaro, Serena, Torriglia, Francesca, Tubiolo, Daniela, Valsecchi, Roberto, Viola, Uberto, Vitale, Giovanni, Zambon, Massimo, Zoia, Elena, Grasselli, G, Greco, M, Zanella, A, Albano, G, Antonelli, M, Bellani, G, Bonanomi, E, Cabrini, L, Carlesso, E, Castelli, G, Cattaneo, S, Cereda, D, Colombo, S, Coluccello, A, Crescini, G, Forastieri Molinari, A, Foti, G, Fumagalli, R, Iotti, G, Langer, T, Latronico, N, Lorini, F, Mojoli, F, Natalini, G, Pessina, C, Ranieri, V, Rech, R, Scudeller, L, Rosano, A, Storti, E, Thompson, B, Tirani, M, Villani, P, Pesenti, A, Cecconi, M, Grasselli G., Greco M., Zanella A., Albano G., Antonelli M., Bellani G., Bonanomi E., Cabrini L., Carlesso E., Castelli G., Cattaneo S., Cereda D., Colombo S., Coluccello A., Crescini G., Forastieri Molinari A., Foti G., Fumagalli R., Iotti G.A., Langer T., Latronico N., Lorini F.L., Mojoli F., Natalini G., Pessina C.M., Ranieri V.M., Rech R., Scudeller L., Rosano A., Storti E., Thompson B.T., Tirani M., Villani P.G., Pesenti A., and Cecconi M.

Subjects
medicine.medical_specialty, COVID19, mechanical ventilation, 01 natural sciences, law.invention, 03 medical and health sciences, 0302 clinical medicine, COVID-19, ICU, critical illness, mechanical ventilation, mortality, Interquartile range, law, Intensive care, Internal medicine, Internal Medicine, critical illness, Medicine, 030212 general & internal medicine, 0101 mathematics, Risk factor, business.industry, Mortality rate, 010102 general mathematics, Hazard ratio, COVID-19, Retrospective cohort study, mortality, Intensive care unit, ICU, na, business, Cohort study
Abstract

Importance Many patients with coronavirus disease 2019 (COVID-19) are critically ill and require care in the intensive care unit (ICU). Objective To evaluate the independent risk factors associated with mortality of patients with COVID-19 requiring treatment in ICUs in the Lombardy region of Italy. Design, Setting, and Participants This retrospective, observational cohort study included 3988 consecutive critically ill patients with laboratory-confirmed COVID-19 referred for ICU admission to the coordinating center (Fondazione IRCCS [Istituto di Ricovero e Cura a Carattere Scientifico] Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy) of the COVID-19 Lombardy ICU Network from February 20 to April 22, 2020. Infection with severe acute respiratory syndrome coronavirus 2 was confirmed by real-time reverse transcriptase–polymerase chain reaction assay of nasopharyngeal swabs. Follow-up was completed on May 30, 2020. Exposures Baseline characteristics, comorbidities, long-term medications, and ventilatory support at ICU admission. Main Outcomes and Measures Time to death in days from ICU admission to hospital discharge. The independent risk factors associated with mortality were evaluated with a multivariable Cox proportional hazards regression. Results Of the 3988 patients included in this cohort study, the median age was 63 (interquartile range [IQR] 56-69) years; 3188 (79.9%; 95% CI, 78.7%-81.1%) were men, and 1998 of 3300 (60.5%; 95% CI, 58.9%-62.2%) had at least 1 comorbidity. At ICU admission, 2929 patients (87.3%; 95% CI, 86.1%-88.4%) required invasive mechanical ventilation (IMV). The median follow-up was 44 (95% CI, 40-47; IQR, 11-69; range, 0-100) days; median time from symptoms onset to ICU admission was 10 (95% CI, 9-10; IQR, 6-14) days; median length of ICU stay was 12 (95% CI, 12-13; IQR, 6-21) days; and median length of IMV was 10 (95% CI, 10-11; IQR, 6-17) days. Cumulative observation time was 164 305 patient-days. Hospital and ICU mortality rates were 12 (95% CI, 11-12) and 27 (95% CI, 26-29) per 1000 patients-days, respectively. In the subgroup of the first 1715 patients, as of May 30, 2020, 865 (50.4%) had been discharged from the ICU, 836 (48.7%) had died in the ICU, and 14 (0.8%) were still in the ICU; overall, 915 patients (53.4%) died in the hospital. Independent risk factors associated with mortality included older age (hazard ratio [HR], 1.75; 95% CI, 1.60-1.92), male sex (HR, 1.57; 95% CI, 1.31-1.88), high fraction of inspired oxygen (Fio2) (HR, 1.14; 95% CI, 1.10-1.19), high positive end-expiratory pressure (HR, 1.04; 95% CI, 1.01-1.06) or low Pao2:Fio2ratio (HR, 0.80; 95% CI, 0.74-0.87) on ICU admission, and history of chronic obstructive pulmonary disease (HR, 1.68; 95% CI, 1.28-2.19), hypercholesterolemia (HR, 1.25; 95% CI, 1.02-1.52), and type 2 diabetes (HR, 1.18; 95% CI, 1.01-1.39). No medication was independently associated with mortality (angiotensin-converting enzyme inhibitors HR, 1.17; 95% CI, 0.97-1.42; angiotensin receptor blockers HR, 1.05; 95% CI, 0.85-1.29). Conclusions and Relevance In this retrospective cohort study of critically ill patients admitted to ICUs in Lombardy, Italy, with laboratory-confirmed COVID-19, most patients required IMV. The mortality rate and absolute mortality were high.

Published
2020
Full Text
View/download PDF

11. Potential of outpatient steroid therapy in elderly patients with early COVID-19

Author

Roberto Luzzati, Marina De Luca, Gianfranco Sanson, Massimo Borelli, Gianni Biolo, Donatella Giacomazzi, Verena Zerbato, Stefano Di Bella, Luzzati, Roberto, De Luca, Marina, Sanson, Gianfranco, Borelli, Massimo, Biolo, Gianni, Giacomazzi, Donatella, Zerbato, Verena, and Di Bella, Stefano

Subjects
Male, Aging, SARS-CoV-2, COVID-19, Outpatient, Pneumonia, All-cause mortality, COVID-19 Drug Treatment, Oxygen, Elderly, Corticosteroids, Adrenal Cortex Hormones, Outpatients, Corticosteroid, Humans, Steroids, Geriatrics and Gerontology, Aged, Retrospective Studies
Abstract

Corticosteroids lower mortality in hospitalized patients with COVID-19 pneumonia requiring oxygen support. In this observational retrospective study (September 2020-June 2021), we explored the association between receiving home corticosteroids without oxygen supply and 30-day mortality in hospitalized patients with COVID-19 pneumonia. Among a total of 794 COVID-19 pneumonia patients, 763 were included into the study (males 68%; mean age 65 +/- 12 years), of whom 197 (26%) received home corticosteroids (mean daily prednisone equivalent-dose 40 mg +/- 12 mg; range 10-50 mg; median 50 mg; IQR 25-50 mg; for 4 days). The overall 30-day mortality of the study population was 12%. The risk of death-adjusted for age, comorbidities, administration of remdesivir and respiratory failure severity-was lower (HR 0.405; p = 0.024) in patients receiving home corticosteroids. After stratifying the study population by age categories, home corticosteroids were associated with an adjusted decrease in mortality risk in patients > 77 years (HR 0.346; p = 0.040). Home corticosteroids may lower the 30-day mortality in elderly COVID-19 patients.

Published
2022

12. Potential role of particulate matter in the spreading of COVID-19 in Northern Italy: first observational study based on initial epidemic diffusion

Author

Maria Grazia Perrone, Annamaria Colao, Fabrizio Passarini, Emanuele Rizzo, Massimo Borelli, Leonardo Setti, Alessandro Miani, Gianluigi de Gennaro, Sabina Licen, Alessia Di Gilio, Jolanda Palmisani, Andrea Piazzalunga, Pierluigi Barbieri, Prisco Piscitelli, Setti, L., Passarini, F., De Gennaro, G., Barbieri, P., Licen, S., Perrone, M. G., Piazzalunga, A., Borelli, M., Palmisani, J., DI Gilio, A., Rizzo, E., Colao, A., Piscitelli, P., Miani, A., Setti, Leonardo, Passarini, Fabrizio, De Gennaro, Gianluigi, Barbieri, Pierluigi, Licen, Sabina, Perrone, Maria Grazia, Piazzalunga, Andrea, Borelli, Massimo, Palmisani, Jolanda, Di Gilio, Alessia, Rizzo, Emanuele, Colao, Annamaria, Piscitelli, Prisco, and Miani, Alessandro

Subjects
Coronavirus disease 2019 (COVID-19), Pneumonia, Viral, Airborne transmission, Risk Assessment, Betacoronavirus, epidemiology, public health, virology, particulate matter, Air Pollution, Outcome Assessment, Health Care, Disease Transmission, Infectious, Medicine, Humans, Correlation of Data, Close contact, Pandemics, business.industry, SARS-CoV-2, Mortality rate, COVID-19, General Medicine, Particulates, Northern italy, Italy, Observational study, Particulate Matter, Public Health, Epidemic model, business, Coronavirus Infections, Demography
Abstract

ObjectivesA number of studies have shown that the airborne transmission route could spread some viruses over a distance of 2 meters from an infected person. An epidemic model based only on respiratory droplets and close contact could not fully explain the regional differences in the spread of COVID-19 in Italy. On March 16th 2020, we presented a position paper proposing a research hypothesis concerning the association between higher mortality rates due to COVID-19 observed in Northern Italy and average concentrations of PM10exceeding a daily limit of 50 µg/m3.MethodsTo monitor the spreading of COVID-19 in Italy from February 24th to March 13th (the date of the Italian lockdown), official daily data for PM10levels were collected from all Italian provinces between February 9th and February 29th, taking into account the maximum lag period (14 days) between the infection and diagnosis. In addition to the number of exceedances of the daily limit value of PM10, we also considered population data and daily travelling information for each province.ResultsExceedance of the daily limit value of PM10appears to be a significant predictor of infection in univariate analyses (p10levels, while 62 out of 66 Southern provinces presented low PM10concentrations (p0>6.0, comparable with the highest values estimated for China.ConclusionA significant association has been found between the geographical distribution of daily PM10exceedances and the initial spreading of COVID-19 in the 110 Italian provinces.

Published
2020

13. SARS-Cov-2RNA found on particulate matter of Bergamo in Northern Italy: First evidence.

Author

Setti, Leonardo, Passarini, Fabrizio, De Gennaro, Gianluigi, Barbieri, Pierluigi, Perrone, Maria Grazia, Borelli, Massimo, Palmisani, Jolanda, Di Gilio, Alessia, Torboli, Valentina, Fontana, Francesco, Clemente, Libera, Pallavicini, Alberto, Ruscio, Maurizio, Piscitelli, Prisco, and Miani, Alessandro

Subjects
*PARTICULATE matter, *COVID-19, *SARS-CoV-2, *AIR sampling apparatus, *EVIDENCE, *AIR pollution
Abstract

The burden of COVID-19 was extremely severe in Northern Italy, an area characterized by high concentrations of particulate matter (PM), which is known to negatively affect human health. Consistently with evidence already available for other viruses, we initially hypothesized the possibility of SARS-CoV-2 presence on PM, and we performed a first experiment specifically aimed at confirming or excluding this research hyphotesys. We have collected 34 PM10 samples in Bergamo area (the epicenter of the Italian COVID-19 epidemic) by using two air samplers over a continuous 3-weeks period. Filters were properly stored and underwent RNA extraction and amplification according to WHO protocols in two parallel blind analyses performed by two different authorized laboratories. Up to three highly specific molecular marker genes (E, N, and RdRP) were used to test the presence of SARS-CoV-2 RNA on particulate matter. The first test showed positive results for gene E in 15 out of 16 samples, simultaneously displaying positivity also for RdRP gene in 4 samples. The second blind test got 5 additional positive results for at least one of the three marker genes. Overall, we tested 34 RNA extractions for the E, N and RdRP genes, reporting 20 positive results for at least one of the three marker genes, with positivity separately confirmed for all the three markers. Control tests to exclude false positivities were successfully accomplished. This is the first evidence that SARS-CoV-2 RNA can be present on PM, thus suggesting a possible use as indicator of epidemic recurrence. • COVID-19 burden seems more severe in areas with high concentrations of PM. • Particulate matter is already known to have negative effects on human health. • This is the first evidence that SARS-CoV-2RNA can be found on particulate matter. [ABSTRACT FROM AUTHOR]

Published
2020
Full Text
View/download PDF

Catalog

Books, media, physical & digital resources
See catalog results