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Objectives: The immunologic profile and opportunistic viral DNA increase were monitored in Italian patients with COVID-19 in order to identify markers of disease severity. Methods: A total of 104 patients infected with SARS-CoV-2 were evaluated in the study. Of them, 42/104 (40.4%) were hospitalized in an intensive care unit (ICU) and 62/104(59.6%) in a sub-intensive care unit (SICU). Human cytomegalovirus (HCMV) and Epstein-Barr virus (EBV), Parvovirus B19 and Human Herpesvirus 6 virus reactivations were determined by real-time PCR, and lymphocyte subpopulation counts were determined by flow cytometry. Results: Among opportunistic viruses, only EBV was consistently detected. EBV DNA was observed in 40/42 (95.2%) of the ICU patients and in 51/61 (83.6%) of the SICU patients. Comparing the two groups of patients, the EBV DNA median level among ICU patients was significantly higher than that observed in SICU patients. In parallel, a significant reduction of CD8 T cell and NK count in ICU patients as compared with SICU patients was observed (p

Background: Chronic rhinitis, pharyngitis and sinusitis are common health problems with a significant impact on public health, and are suspected to be influenced by ageing factors. Nasal inhalation with thermal water may be used to reduce symptoms, inflammation and drug intake. A pre-post clinical study was conducted in 183 consecutive adult and elderly patients with chronic rhinitis, pharyngitis or sinusitis, to evaluate whether thermal water nasal inhalations could improve their symptoms, clinical signs and rhinomanometry measurements, and influence inflammatory biomarkers levels in nasal epithelial cells., Results: Participants profile revealed that they were aged on average (mean age and SD 60.6 ± 15.2 years, median 65, range 20-86, 86 aged ≤ 65 years (47%), 96 aged > 65 years (53%)) and extremely concerned about wellbeing. Older age was associated with better compliance to inhalation treatment. Total symptom and clinical evaluation scores were significantly ameliorated after treatment ( p  < 0.001), with no substantial difference according to age, while rhinomanometry results were inconsistent. Persistence of symptom improvement was confirmed at phone follow up 1 year later ( n  = 74). The training set of 48 inflammatory genes (40 patients) revealed a strong increase of CXCR4 gene expression after nasal inhalations, confirmed both in the validation set (143 patients; 1.2 ± 0.68 vs 3.3 ± 1.2; p  < 0.0001) and by evaluation of CXCR4 protein expression (40 patients; 1.0 ± 0.39 vs 2.6 ± 0.66; p  < 0.0001). CXCR4 expression was consistently changed in patients with rhinitis, pharyngitis or sinusitis. The increase was smaller in current smokers compared to non-smokers. Results were substantially unchanged when comparing aged subjects (≥ 65 years) or the eldest quartile (≥ 71 years) to the others. Other genes showed weaker variations (e.g. FLT1 was reduced only in patients with sinusitis)., Conclusions: These results confirm the clinical impact of thermal water nasal inhalations on upper respiratory diseases both in adults and elders, and emphasize the role of genes activating tissue repair and inflammatory pathways. Future studies should evaluate CXCR4 as possible therapeutic target or response predictor in patients with chronic rhinitis, pharyngitis or sinusitis., Trial Registration: Communication to Italian Ministry of Health - ICPOM 000461. Registered 10/11/2014., Competing Interests: Approval has been obtained by the competent Ethics Committees of IRCCS San Raffaele Pisana, Rome, and of the Liguria Region. All eligible patients admitted to the spa received detailed information about the study by the physician in charge of the treatment, and thereafter were asked to sign an informed consent. Only patients who accepted to participate to the study and signed the consent form were requested to donate biological samples and were administered the questionnaire.Not applicable.The authors declare that they have no competing interests.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Background: Consensus human cytomegalovirus (HCMV) DNA cut-off values for preemptive therapy in transplant recipients have not yet been defined, mainly due to the lack of real-time PCR standardization., Objectives: (i) To compare the kinetics of HCMV DNA in transplanted patients using an in-house real-time PCR assay (Pavia assay) and the new Abbott RealTime CMV assay; (ii) to verify assay concordance in the identification of patients eligible for preemptive treatment and (iii) standardize results with international units (IUs) using the WHO International HCMV DNA Standard as a reference., Study Design: The kinetics of HCMV disseminated infection was retrospectively evaluated in 513 stored whole blood samples from 37 transplanted patients enrolled in randomized prospective studies designed for the clinical validation of HCMV DNA cut-off values. Conversion factors of HCMV DNA copy number to WHO international units (IUs) were determined., Results: Among the 513 samples, 352 (68.6%) were concordant positive, 42 (8.1%) concordant negative and 119 (23.1%) discordant. All discordant samples resulted positive by the Abbott RealTime CMV assay and negative by the Pavia assay, showing higher sensitivity for the Abbott RealTime CMV assay. A significant correlation was observed between concordant positive samples (r=0.89). HCMV DNAemia determined by each assay showed overlapping kinetics. Expression of results as IU/ml provided the best results in preemptive treatment simulation., Conclusion: HCMV DNAemia cut-off values determined using our in-house assay and expressed as IU/ml appear valid for use in commercial assays as well as other potential in-house assays., (Copyright © 2012 Elsevier B.V. All rights reserved.)