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Introduction: Reliable venous access is essential in providing effective care for many patients. Various vascular access devices (VAD) are available, and are placed by a specialized team using ultrasound guidance in a dedicated room of the hospital; however, during the pandemic covid-19 many not autonomous or bedridden patients were unable to reach the hospital for VAD insertion, because the unavailability of ambulance for the transport. For this reason the specialized team organized a modality for positioning the VAD at bedside at home., Methods: In 2012 a VAD-team was established by the health authority in the oncology-hematology Department at the hospital of Piacenza. This team was dedicated in positioning ultrasound-guided vascular access. During the covid-19 pandemic the VAD-team modified its organization to reach patients at home to position VAD, initially for oncologic people unable to go to the hospital; this procedure was subsequently extended to other bedridden patients with non-oncologic disease. The positioning of the VAD was performed under ultrasound guidance, according to the same modalities used in hospital. The primary endpoin was the suitability of the VAD to allow the planned treatment. The secondary endpoint was complications of the use of VADs., Results: Between March 2020 to December 2020 and January 2021 to December 2021, VAD were positioned in 118 and 134 patients respectively. The VAD utilized were midlines for each patient. The mean age of the patients was 88 years, the majority were female (>60%). The majority of the patients had neurodegenerative disease (>60%) or advanced cancers (>25%). The VAD allowed the planned treatment in 94% of the patients. The complications were infrequent: VAD dislocation (<1%), thrombosis (<2%). No infection was registered., Discussion and Conclusion: During covid-19 pandemic, the VAD-team demonstrated the feasibility of VADs home positioning, for patients that need to be transported by ambulance to the hospital for a venous catheter insertion. This procedure allows saving of economic and human resources both for patients and caregivers, in addiction can leave the ambulance free for other use. Due to this study, this procedure has become routine practice in our health district for patients bedridden or not autonomous.

North Italy emerged as an epicenter of COVID-19 in the Western world. The majority of studies of patients with COVID-19 have focused on hospitalized patients, and data on early outpatient treatment are limited. This research retrospectively examines consecutive symptomatic adults who did not present to a hospital but who experience laboratory confirmed (nasopharyngeal swabs) or probable COVID-19 infection. From March 12 to April 12, 2020, 124 consecutive patients with laboratory-confirmed COVID-19 infection (84%) or with epidemiologically linked exposure to a person with confirmed infection (16%) were managed at home. The diagnosis of pneumonia was made with a portable ultrasound. COVID-19 treatment was based on low-dose hydroxychloroquine with or without darunavir/cobicistat or azithromycin and enoxaparine for bedridden patients. The patients were monitored by telemedicine. The primary endpoints were clinical improvement or hospitalization, and the secondary endpoints were mortality at day 30 and at day 60. Forty-seven (37.9%) patients had mild COVID-19 infection, 44 (35.5%) had moderate COVID-19 infection, and 33 (26.6%) had severe COVID-19 infection. Four patients (3.2%) were hospitalized and there were no deaths at day 30 and at day 60. Only mild side effects were reported. Early home treatment of COVID-19 patients resulted in a low hospitalization rate with no deaths, with the limitations of the small sample size and that it was conducted within a single geographic area. We believe that this model may be easily reproduced in both cities and rural areas around the world to treat COVID-19 infection.

Patients with cancer are presumed a frail group at high risk of contracting coronavirus disease (COVID-19), and vaccination represents a cornerstone in addressing the COVID-19 pandemic. However, data on COVID-19 vaccination in cancer patients are fragmentary and poor. An observational study was conducted to evaluate the seropositivity rate and safety of a two-dose regimen of the BNT162b2 or messenger RNA-1273 vaccine in adult patients with solid cancer undergoing active anticancer treatment or whose treatment had been terminated within 6 months of the start of the study. The control group was composed of healthy volunteers. Serum samples were evaluated for SARS-COV-2 antibodies before vaccinations and 2–6 weeks after the administration of the second vaccine dose. Primary end-point: seropositivity rate. Secondary end-points: safety, factors influencing seroconversion, IgG titers of patients versus healthy volunteers, COVID-19 infection. Between 20th March 2021 and 12th June 2021, 293 consecutive patients with cancer-solid tumours underwent a program of COVID-19 vaccinations; of these, 2 patients refused vaccination, 13 patients did not receive the second dose of the vaccine because of cancer progression, and 21 patients had COVID-19 antibodies at baseline and were excluded. The 257 evaluable patients had a median age of 65 years (range 28–86), 66.15% with metastatic disease. Primary end-point: seropositivity rate in patients was 75.88% versus 100% in the control group. Secondary end-points: no Grade 3–4 side-effects, no COVID-19 infections were reported. Patients median IgG titer was significantly lower than in the control group; male sex and active anticancer therapy influenced negative seroconversion. BNT162b2 or messenger RNA-1273 vaccines were immunogenic in cancer patients, showing good safety profile. • Patients with cancer are at great risk of serious complications and death from coronavirus disease (COVID-19). • 257 patients with cancer vaccinated against COVID-19, 75.88% showed seroconversion. • 219 of the 257 patients (85.21%) were on active anticancer treatment. • No Grade 3–4 side-effects were reported. • Male sex and active anticancer treatment negatively influence serologic response. [ABSTRACT FROM AUTHOR]