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1. Management of severe COPD exacerbations: focus on beclomethasone dipropionate/formoterol/glycopyrronium bromide

Author

Mantero M, Radovanovic D, Santus P, and Blasi F

Subjects
Exacerbation, COPD, Triple Therapy, Beclomethasone, Formoterol, Glycopyrronium, Diseases of the respiratory system, RC705-779
Abstract

Marco Mantero,1,2 Dejan Radovanovic,3 Pierachille Santus,3 Francesco Blasi1,2 1Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy; 2Internal Medicine Department, Respiratory Unit and Regional Adult Cystic Fibrosis Center, IRCCS Fondazione Ca’ Granda Ospedale Policlinico, Milan, Italy; 3Department of Biomedical and Clinical Sciences (DIBIC), Pulmonary Unit, University of Milan, Ospedale L. Sacco, ASST Fatebenefratelli-Sacco, Milan, Italy Abstract: The major determinant of the decline in lung function, quality of life, and the increased mortality risk in patients with COPD is represented by severe acute exacerbations of the disease, that is, those requiring patients’ hospitalization, constituting a substantial social and health care burden in terms of morbidity and medical resource utilization. Different long-term therapeutic strategies have been proposed so far in order to prevent and/or reduce the clinical and social impact of these events, the majority of which were extrapolated from trials initially focused on the effect of long-acting muscarinic antagonist and subsequently on the efficacy of long-acting β2-agonists in combination or not with inhaled corticosteroids. The option to employ all three classes of molecules combined, despite the limited amount of evidence in our possession, represents a choice currently proposed by international guidelines; however, current recommendations are often based mainly on observational studies or on the results of secondary outcomes in randomized controlled trials. The present narrative review evaluates the available trials that investigated the efficacy of inhaled therapy to prevent COPD exacerbations and especially severe ones, with a particular focus on beclomethasone dipropionate/formoterol/glycopyrronium bromide fixed dose combination, which is the first treatment that comprises all the three drug classes, specifically tested for the prevention of moderate and severe COPD exacerbations. Keywords: hospitalization, COPD, triple therapy, inhaled corticosteroids, formoterol, glycopyrronium

Published
2018

2. Acute exacerbations of COPD: risk factors for failure and relapse

Author

Mantero M, Rogliani P, Di Pasquale M, Polverino E, Crisafulli E, Guerrero M, Gramegna A, Cazzola M, and Blasi F

Subjects
Infections, prevention, treatment, COPD, exacerbations, Diseases of the respiratory system, RC705-779
Abstract

Marco Mantero,1,2 Paola Rogliani,3 Marta Di Pasquale,1,2 Eva Polverino,4 Ernesto Crisafulli,5 Monica Guerrero,6 Andrea Gramegna,1,2 Mario Cazzola,3 Francesco Blasi1,2 1Department of Pathophysiology and Transplantation, Università degli Studi di Milano, 2Internal Medicine Department, Respiratory Unit and Regional Adult Cystic Fibrosis Center, IRCCS Fondazione Cà Granda Ospedale Maggiore Policlinico, Milan, 3Respiratory Unit, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy; 4Respiratory Disease Department, Servei de Pneumologia, Hospital Universitari Vall d’Hebron (HUVH), Institut de Recerca Vall d’Hebron (VHIR), Barcelona, Spain; 5Department of Medicine and Surgery, Respiratory Disease and Lung Function Unit, University of Parma, Parma, Italy; 6Hospital d’Igualada, Consorci Socisanitari de l’Anoia, Barcelona, Spain Abstract: Acute exacerbations are a leading cause of worsening COPD in terms of lung ­function decline, quality of life, and survival. They also have a relevant economic burden on the health care system. Determining the risk factors for acute exacerbation and early relapse could be a crucial element for a better management of COPD patients. This review analyzes the current knowledge and underlines the main risk factors for recurrent acute exacerbations. Comprehensive evaluation of COPD patients during stable phase and exacerbation could contribute to prevent treatment failure and relapses. Keywords: infections, prevention, treatment, COPD, exacerbations

Published
2017

3. Cefditoren versus levofloxacin in patients with exacerbations of chronic bronchitis: serum inflammatory biomarkers, clinical efficacy, and microbiological eradication

Author

Blasi F, Tarsia P, Mantero M, Morlacchi LC, and Piffer F

Subjects
Therapeutics. Pharmacology, RM1-950
Abstract

Francesco Blasi, Paolo Tarsia, Marco Mantero, Letizia C Morlacchi, Federico PifferDepartment of Pathophysiology and Transplantation, University of Milan, IRCCS Fondazione Cà Granda Ospedale Maggiore Policlinico, Milan, ItalyBackground: The aim of this open-label, randomized, parallel-group pilot study was to evaluate the efficacy of cefditoren pivoxil and levofloxacin in terms of speed of reduction in inflammatory parameters, clinical recovery, and microbiological eradication.Methods: Forty eligible patients with acute exacerbation of chronic bronchitis (AECB) were randomized to receive cefditoren 200 mg twice a day for 5 days (n = 20) or levofloxacin 500 mg once daily for 7 days (n = 20).Results: The inflammatory parameters which were significantly reduced at test-of-cure with respect to visit 1 were Krebs von den Lundgen-6 (KL-6) and interleukin-6. KL-6 decreased both in the overall study population (from 19 ± 11 UI/mL to 6 ± 8 UI/mL, P = 0.000) and in the cefditoren (from 19 ± 13 UI/mL to 8 ± 10 UI/mL, P = 0.006) and levofloxacin (from 19 ± 10 UI/mL to 5 ± 5 UI/mL, P = 0.000) arms. Similarly, interleukin-6 decreased both in the overall study population (from 13.35 ± 16.41 pg/mL to 3 ± 4.7 pg/mL, P = 0.000) and in the cefditoren (from 15.90 ± 19.54 pg/mL to 4.13 ± 6.42 pg/mL, P = 0.015) and levofloxacin (from 10.80 ± 12.55 pg/mL to 1.87 ± 1.16 pg/mL, P = 0.003) arms. At the end of treatment (test-of-cure, 6–9 days after drug initiation), the clinical success rate in the overall study population was 78%; the clinical cure rate was 80% in the cefditoren arm and 75% in the levofloxacin arm. Globally, bacteriological eradication at test-of-cure was obtained in 85% of the overall study population. Both treatments were well tolerated.Conclusion: Cefditoren represents a valid option in the treatment of mild to moderately severe cases of AECB in the outpatient care setting. Moreover, the use of this cephalosporin is associated with a significant reduction of interleukin-6 and KL-6, two key mediators of lung inflammation and epithelial damage.Keywords: cefditoren pivoxil, levofloxacin, serum inflammatory biomarkers, chronic bronchitis, acute exacerbations

Published
2013

4. Clinical characteristics and outcomes of vaccinated patients hospitalised with SARS-CoV-2 breakthrough infection: Multi-IPV, a multicentre study in Northern Italy

Author

Lombardi, A, Villa, S, Colaneri, M, Scaglione, G, Bai, F, Varisco, B, Bono, V, Vena, A, Dentone, C, Russo, C, Tettamanti, M, Renisi, G, Viero, G, Azzarà, C, Mantero, M, Peyvandi, F, Bassetti, M, Marchetti, G, Muscatello, A, Nobili, A, Gori, A, Bandera, A, Bosari, S, Scudeller, L, Fusetti, G, Rusconi, L, Dell’Orto, S, Prati, D, Valenti, L, Giovannelli, S, Manunta, M, Lamorte, G, Ferarri, F, Gori., A, Mangioni, D, Alagna, L, Bozzi, G, Lombardi., A, Ungaro, R, Ancona, G, Mussa, M, Mariani, B, Bolis, M, Iannotti, N, Ludovisi, S, Comelli, A, Biscarini, S, Castelli, V, Palomba, E, Fava, M, Peri, C, Saltini, P, Itri, T, Ferroni, V, Pastore, V, Massafra, R, Liparoti, A, Muheberimana, T, Giommi, A, Bianco, R, Chitani, G, Bobbio, C, De Matteis, I, Bonomi, A, Gualtierotti, R, Ferrari, B, Rossio, R, Boasi, N, Pagliaro, E, Massimo, C, De Caro, M, Giachi, A, Montano, N, Vigone, B, Bellocchi, C, Carandina, A, Fiorelli, E, Melli, V, Tobaldini, E, Blasi, F, Aliberti, S, Spotti, M, Terranova, L, Misuraca, S, D’Adda, A, Della Fiore, S, Di Pasquale, M, Mantero., M, Contarini, M, Ori, M, Morlacchi, L, Rossetti, V, Gramegna, A, Pappalettera, M, Cavallini, M, Buscemi, A, Vicenzi, M, Rota, I, Costantino, G, Solbiati, M, Furlan, L, Mancarella, M, Colombo, G, Fanin, A, Passarella, M, Monzani, V, Canetta, C, Rovellini, A, Barbetta, L, Billi, F, Folli, C, Accordino, S, Maira, D, Hu, C, Motta, I, Scaramellini, N, Fracanzani, A, Lombardi, R, Cespiati, A, Cesari, M, Lucchi, T, Proietti, M, Calcaterra, L, Mandelli, C, Coppola, C, Cerizza, A, Pesenti, A, Grasselli, G, Galazzi, A, Nobili., A, Monti, I, Galbussera, A, Crisafulli, E, Girelli, D, Maroccia, A, Gabbiani, D, Busti, F, Vianello, A, Biondan, M, Sartori, F, Faverio, P, Pesci, A, Zucchetti, S, Bonfanti, P, Rossi, M, Beretta, I, Spolti, A, Harari, S, Elia, D, Cassandro, R, Caminati, A, Cipollone, F, Guagnano, M, D’Ardes, D, Rossi, I, Vezzani, F, Spanevello, A, Cherubino, F, Visca, D, Contoli, M, Papi, A, Morandi, L, Battistini, N, Moreo, G, Iannuzzi, P, Fumagalla, D, Leone, S, Lombardi, Andrea, Villa, Simone, Colaneri, Marta, Scaglione, Giovanni, Bai, Francesca, Varisco, Benedetta, Bono, Valeria, Vena, Antonio, Dentone, Chiara, Russo, Chiara, Tettamanti, Mauro, Renisi, Giulia, Viero, Giulia, Azzarà, Cecilia, Mantero, Marco, Peyvandi, Flora, Bassetti, Matteo, Marchetti, Giulia, Muscatello, Antonio, Nobili, Alessandro, Gori, Andrea, Bandera, Alessandra, Bosari, Silvano, Scudeller, Luigia, Fusetti, Giuliana, Rusconi, Laura, Dell’Orto, Silvia, Prati, Daniele, Valenti, Luca, Giovannelli, Silvia, Manunta, Maria, Lamorte, Giuseppe, Ferarri, Francesca, Gori. , Andrea, Mangioni, Davide, Alagna, Laura, Bozzi, Giorgio, Lombardi. , Andrea, Ungaro, Riccardo, Ancona, Giuseppe, Mussa, Marco, Mariani, Bianca Veronica, Bolis, Matteo, Iannotti, Nathalie, Ludovisi, Serena, Comelli, Agnese, Biscarini, Simona, Castelli, Valeria, Palomba, Emanuele, Fava, Marco, Peri, Carlo Alberto, Saltini, Paola, Itri, Teresa, Ferroni, Valentina, Pastore, Valeria, Massafra, Roberta, Liparoti, Arianna, Muheberimana, Toussaint, Giommi, Alessandro, Bianco, Rosaria, Chitani, Grazia Eliana, Bobbio, Chiara, De Matteis, Irene, Bonomi, Angelo Bianchi, Gualtierotti, Roberta, Ferrari, Barbara, Rossio, Raffaella, Boasi, Nadia, Pagliaro, Erica, Massimo, Costanza, De Caro, Michele, Giachi, Andrea, Montano, Nicola, Vigone, Barbara, Bellocchi, Chiara, Carandina, Angelica, Fiorelli, Elisa, Melli, Valerie, Tobaldini, Eleonora, Blasi, Francesco, Aliberti, Stefano, Spotti, Maura, Terranova, Leonardo, Misuraca, Sofia, D’Adda, Alice, Della Fiore, Silvia, Di Pasquale, Marta, Mantero. , Marco, Contarini, Martina, Ori, Margherita, Morlacchi, Letizia, Rossetti, Valeria, Gramegna, Andrea, Pappalettera, Maria, Cavallini, Mirta, Buscemi, Agata, Vicenzi, Marco, Rota, Irena, Costantino, Giorgio, Solbiati, Monica, Furlan, Ludovico, Mancarella, Marta, Colombo, Giulia, Colombo, Giorgio, Fanin, Alice, Passarella, Mariele, Monzani, Valter, Canetta, Ciro, Rovellini, Angelo, Barbetta, Laura, Billi, Filippo, Folli, Christian, Accordino, Silvia, Maira, Diletta, Hu, Cinzia Maria, Motta, Irene, Scaramellini, Natalia, Fracanzani, Anna Ludovica, Lombardi, Rosa, Cespiati, Annalisa, Cesari, Matteo, Lucchi, Tiziano, Proietti, Marco, Calcaterra, Laura, Mandelli, Clara, Coppola, Carlotta, Cerizza, Arturo, Pesenti, Antonio Maria, Grasselli, Giacomo, Galazzi, Alessandro, Nobili. , Alessandro, Monti, Igor, Galbussera, Alessia Antonella, Crisafulli, Ernesto, Girelli, Domenico, Maroccia, Alessio, Gabbiani, Daniele, Busti, Fabiana, Vianello, Alice, Biondan, Marta, Sartori, Filippo, Faverio, Paola, Pesci, Alberto, Zucchetti, Stefano, Bonfanti, Paolo, Rossi, Marianna, Beretta, Ilaria, Spolti, Anna, Harari, Sergio, Elia, Davide, Cassandro, Roberto, Caminati, Antonella, Cipollone, Francesco, Guagnano, Maria Teresa, D’Ardes, Damiano, Rossi, Ilaria, Vezzani, Francesca, Spanevello, Antonio, Cherubino, Francesca, Visca, Dina, Contoli, Marco, Papi, Alberto, Morandi, Luca, Battistini, Nicholas, Moreo, Guido Luigi, Iannuzzi, Pasqualina, Fumagalla, Daniele, Leone, Sara, Lombardi, A, Villa, S, Colaneri, M, Scaglione, G, Bai, F, Varisco, B, Bono, V, Vena, A, Dentone, C, Russo, C, Tettamanti, M, Renisi, G, Viero, G, Azzarà, C, Mantero, M, Peyvandi, F, Bassetti, M, Marchetti, G, Muscatello, A, Nobili, A, Gori, A, Bandera, A, Bosari, S, Scudeller, L, Fusetti, G, Rusconi, L, Dell’Orto, S, Prati, D, Valenti, L, Giovannelli, S, Manunta, M, Lamorte, G, Ferarri, F, Gori., A, Mangioni, D, Alagna, L, Bozzi, G, Lombardi., A, Ungaro, R, Ancona, G, Mussa, M, Mariani, B, Bolis, M, Iannotti, N, Ludovisi, S, Comelli, A, Biscarini, S, Castelli, V, Palomba, E, Fava, M, Peri, C, Saltini, P, Itri, T, Ferroni, V, Pastore, V, Massafra, R, Liparoti, A, Muheberimana, T, Giommi, A, Bianco, R, Chitani, G, Bobbio, C, De Matteis, I, Bonomi, A, Gualtierotti, R, Ferrari, B, Rossio, R, Boasi, N, Pagliaro, E, Massimo, C, De Caro, M, Giachi, A, Montano, N, Vigone, B, Bellocchi, C, Carandina, A, Fiorelli, E, Melli, V, Tobaldini, E, Blasi, F, Aliberti, S, Spotti, M, Terranova, L, Misuraca, S, D’Adda, A, Della Fiore, S, Di Pasquale, M, Mantero., M, Contarini, M, Ori, M, Morlacchi, L, Rossetti, V, Gramegna, A, Pappalettera, M, Cavallini, M, Buscemi, A, Vicenzi, M, Rota, I, Costantino, G, Solbiati, M, Furlan, L, Mancarella, M, Colombo, G, Fanin, A, Passarella, M, Monzani, V, Canetta, C, Rovellini, A, Barbetta, L, Billi, F, Folli, C, Accordino, S, Maira, D, Hu, C, Motta, I, Scaramellini, N, Fracanzani, A, Lombardi, R, Cespiati, A, Cesari, M, Lucchi, T, Proietti, M, Calcaterra, L, Mandelli, C, Coppola, C, Cerizza, A, Pesenti, A, Grasselli, G, Galazzi, A, Nobili., A, Monti, I, Galbussera, A, Crisafulli, E, Girelli, D, Maroccia, A, Gabbiani, D, Busti, F, Vianello, A, Biondan, M, Sartori, F, Faverio, P, Pesci, A, Zucchetti, S, Bonfanti, P, Rossi, M, Beretta, I, Spolti, A, Harari, S, Elia, D, Cassandro, R, Caminati, A, Cipollone, F, Guagnano, M, D’Ardes, D, Rossi, I, Vezzani, F, Spanevello, A, Cherubino, F, Visca, D, Contoli, M, Papi, A, Morandi, L, Battistini, N, Moreo, G, Iannuzzi, P, Fumagalla, D, Leone, S, Lombardi, Andrea, Villa, Simone, Colaneri, Marta, Scaglione, Giovanni, Bai, Francesca, Varisco, Benedetta, Bono, Valeria, Vena, Antonio, Dentone, Chiara, Russo, Chiara, Tettamanti, Mauro, Renisi, Giulia, Viero, Giulia, Azzarà, Cecilia, Mantero, Marco, Peyvandi, Flora, Bassetti, Matteo, Marchetti, Giulia, Muscatello, Antonio, Nobili, Alessandro, Gori, Andrea, Bandera, Alessandra, Bosari, Silvano, Scudeller, Luigia, Fusetti, Giuliana, Rusconi, Laura, Dell’Orto, Silvia, Prati, Daniele, Valenti, Luca, Giovannelli, Silvia, Manunta, Maria, Lamorte, Giuseppe, Ferarri, Francesca, Gori. , Andrea, Mangioni, Davide, Alagna, Laura, Bozzi, Giorgio, Lombardi. , Andrea, Ungaro, Riccardo, Ancona, Giuseppe, Mussa, Marco, Mariani, Bianca Veronica, Bolis, Matteo, Iannotti, Nathalie, Ludovisi, Serena, Comelli, Agnese, Biscarini, Simona, Castelli, Valeria, Palomba, Emanuele, Fava, Marco, Peri, Carlo Alberto, Saltini, Paola, Itri, Teresa, Ferroni, Valentina, Pastore, Valeria, Massafra, Roberta, Liparoti, Arianna, Muheberimana, Toussaint, Giommi, Alessandro, Bianco, Rosaria, Chitani, Grazia Eliana, Bobbio, Chiara, De Matteis, Irene, Bonomi, Angelo Bianchi, Gualtierotti, Roberta, Ferrari, Barbara, Rossio, Raffaella, Boasi, Nadia, Pagliaro, Erica, Massimo, Costanza, De Caro, Michele, Giachi, Andrea, Montano, Nicola, Vigone, Barbara, Bellocchi, Chiara, Carandina, Angelica, Fiorelli, Elisa, Melli, Valerie, Tobaldini, Eleonora, Blasi, Francesco, Aliberti, Stefano, Spotti, Maura, Terranova, Leonardo, Misuraca, Sofia, D’Adda, Alice, Della Fiore, Silvia, Di Pasquale, Marta, Mantero. , Marco, Contarini, Martina, Ori, Margherita, Morlacchi, Letizia, Rossetti, Valeria, Gramegna, Andrea, Pappalettera, Maria, Cavallini, Mirta, Buscemi, Agata, Vicenzi, Marco, Rota, Irena, Costantino, Giorgio, Solbiati, Monica, Furlan, Ludovico, Mancarella, Marta, Colombo, Giulia, Colombo, Giorgio, Fanin, Alice, Passarella, Mariele, Monzani, Valter, Canetta, Ciro, Rovellini, Angelo, Barbetta, Laura, Billi, Filippo, Folli, Christian, Accordino, Silvia, Maira, Diletta, Hu, Cinzia Maria, Motta, Irene, Scaramellini, Natalia, Fracanzani, Anna Ludovica, Lombardi, Rosa, Cespiati, Annalisa, Cesari, Matteo, Lucchi, Tiziano, Proietti, Marco, Calcaterra, Laura, Mandelli, Clara, Coppola, Carlotta, Cerizza, Arturo, Pesenti, Antonio Maria, Grasselli, Giacomo, Galazzi, Alessandro, Nobili. , Alessandro, Monti, Igor, Galbussera, Alessia Antonella, Crisafulli, Ernesto, Girelli, Domenico, Maroccia, Alessio, Gabbiani, Daniele, Busti, Fabiana, Vianello, Alice, Biondan, Marta, Sartori, Filippo, Faverio, Paola, Pesci, Alberto, Zucchetti, Stefano, Bonfanti, Paolo, Rossi, Marianna, Beretta, Ilaria, Spolti, Anna, Harari, Sergio, Elia, Davide, Cassandro, Roberto, Caminati, Antonella, Cipollone, Francesco, Guagnano, Maria Teresa, D’Ardes, Damiano, Rossi, Ilaria, Vezzani, Francesca, Spanevello, Antonio, Cherubino, Francesca, Visca, Dina, Contoli, Marco, Papi, Alberto, Morandi, Luca, Battistini, Nicholas, Moreo, Guido Luigi, Iannuzzi, Pasqualina, Fumagalla, Daniele, and Leone, Sara

Abstract

Background: Despite the well-known efficacy of anti-COVID-19 vaccines in preventing morbidity and mortality, several vaccinated individuals are diagnosed with SARS-CoV-2 breakthrough infection, which might require hospitalisation. This multicentre, observational, and retrospective study aimed to investigate the clinical characteristics and outcomes of vaccinated vs. non-vaccinated patients, both hospitalised with SARS-CoV-2 infection in 3 major hospitals in Northern Italy. Methods: Data collection was retrospective, and paper and electronic medical records of adult patients with a diagnosed SARS-CoV-2 infection were pseudo-anonymised and analysed. Vaccinated and non-vaccinated individuals were manually paired, using a predetermined matching criterion (similar age, gender, and date of hospitalisation). Demographic, clinical, treatment, and outcome data were compared between groups differing by vaccination status using Pearson's Chi-square and Mann-Whitney tests. Moreover, multiple logistic regression analyses were performed to assess the impact of vaccination status on ICU admission or intra-hospital mortality. Results: Data from 360 patients were collected. Vaccinated patients presented with a higher prevalence of relevant comorbidities, like kidney replacement therapy or haematological malignancy, despite a milder clinical presentation at the first evaluation. Non-vaccinated patients required intensive care more often than their vaccinated counterparts (8.8% vs. 1.7%, p = 0.002). Contrariwise, no difference in intra-hospital mortality was observed between the two groups (19% vs. 20%, p = 0.853). These results were confirmed by multivariable logistic regressions, which showed that vaccination was significantly associated with decreased risk of ICU admission (aOR=0.172, 95%CI: 0.039–0.542, p = 0.007), but not of intra-hospital mortality (aOR=0.996, 95%CI: 0.582–1.703, p = 0.987). Conclusions: This study provides real-world data on vaccinated patients hospitalised wit

Published
2024

7. External validation of risk scores to predict in-hospital mortality in patients hospitalized due to coronavirus disease 2019

Author

Hassan, S, Ramspek, C, Ferrari, B, van Diepen, M, Rossio, R, Knevel, R, la Mura, V, Artoni, A, Martinelli, I, Bandera, A, Nobili, A, Gori, A, Blasi, F, Canetta, C, Montano, N, Rosendaal, F, Peyvandi, F, Bosari, S, Scudeller, L, Fusetti, G, Rusconi, L, Dell'Orto, S, Prati, D, Valenti, L, Giovannelli, S, Manunta, M, Lamorte, G, Ferarri, F, Muscatello, A, Mangioni, D, Alagna, L, Bozzi, G, Lombardi, A, Ungaro, R, Ancona, G, Zuglian, G, Bolis, M, Iannotti, N, Ludovisi, S, Comelli, A, Renisi, G, Biscarini, S, Castelli, V, Palomba, E, Fava, M, Fortina, V, Peri, C, Saltini, P, Viero, G, Itri, T, Ferroni, V, Pastore, V, Massafra, R, Liparoti, A, Muheberimana, T, Giommi, A, Bianco, R, De Azevedo, R, Chitani, G, Gualtierotti, R, Boasi, N, Pagliaro, E, Massimo, C, De Caro, M, Giachi, A, Vigone, B, Bellocchi, C, Carandina, A, Fiorelli, E, Melli, V, Tobaldini, E, Aliberti, S, Spotti, M, Terranova, L, Misuraca, S, D'Adda, A, Fiore, S, Di Pasquale, M, Mantero, M, Contarini, M, Ori, M, Morlacchi, L, Rossetti, V, Gramegna, A, Pappalettera, M, Cavallini, M, Buscemi, A, Vicenzi, M, Rota, I, Costantino, G, Solbiati, M, Furlan, L, Mancarella, M, Colombo, G, Fanin, A, Passarella, M, Monzani, V, Rovellini, A, Barbetta, L, Billi, F, Folli, C, Accordino, S, Maira, D, Hu, C, Motta, I, Scar-Amellini, N, Fracanzani, A, Lombardi, R, Cespiati, A, Cesari, M, Lucchi, T, Proietti, M, Calcaterra, L, Mandelli, C, Coppola, C, Cerizza, A, Maria Pesenti, A, Grasselli, G, Galazzi, A, Tet-Tamanti, M, Monti, I, Galbussera, A, Crisafulli, E, Girelli, D, Maroccia, A, Gabbiani, D, Busti, F, Vianello, A, Biondan, M, Sartori, F, Faverio, P, Pesci, A, Zucchetti, S, Bonfanti, P, Rossi, M, Beretta, I, Spolti, A, Harari, S, Elia, D, Cassandro, R, Caminati, A, Cipollone, F, Guagnano, M, D'Ardes, D, Rossi, I, Vezzani, F, Spanevello, A, Cherubino, F, Visca, D, Contoli, M, Papi, A, Morandi, L, Battistini, N, Luigi Moreo, G, Iannuzzi, P, Fumagalli, D, Leone, S, Oud, J, Baysan, M, Wigb, J, van Heurn, L, ter Haar, S, Toppenberg, A, Heerdink, L, van IJlzinga Veenstra, A, Eikenboom, A, Wubbolts, J, Uzorka, J, Lijferink, W, Meier, R, de Jonge, I, Arbous, S, de Boer, M, van der Bom, J, Dekkers, O, Hassan S., Ramspek C. L., Ferrari B., van Diepen M., Rossio R., Knevel R., la Mura V., Artoni A., Martinelli I., Bandera A., Nobili A., Gori A., Blasi F., Canetta C., Montano N., Rosendaal F. R., Peyvandi F., Bosari S., Scudeller L., Fusetti G., Rusconi L., Dell'Orto S., Prati D., Valenti L., Giovannelli S., Manunta M., Lamorte G., Ferarri F., Muscatello A., Mangioni D., Alagna L., Bozzi G., Lombardi A., Ungaro R., Ancona G., Zuglian G., Bolis M., Iannotti N., Ludovisi S., Comelli A., Renisi G., Biscarini S., Castelli V., Palomba E., Fava M., Fortina V., Peri C. A., Saltini P., Viero G., Itri T., Ferroni V., Pastore V., Massafra R., Liparoti A., Muheberimana T., Giommi A., Bianco R., De Azevedo R. M., Chitani G. E., Gualtierotti R., Boasi N., Pagliaro E., Massimo C., De Caro M., Giachi A., Vigone B., Bellocchi C., Carandina A., Fiorelli E., Melli V., Tobaldini E., Aliberti S., Spotti M., Terranova L., Misuraca S., D'Adda A., Fiore S. D., Di Pasquale M., Mantero M., Contarini M., Ori M., Morlacchi L., Rossetti V., Gramegna A., Pappalettera M., Cavallini M., Buscemi A., Vicenzi M., Rota I., Costantino G., Solbiati M., Furlan L., Mancarella M., Colombo G., Fanin A., Passarella M., Monzani V., Rovellini A., Barbetta L., Billi F., Folli C., Accordino S., Maira D., Hu C. M., Motta I., Scar-Amellini N., Fracanzani A. L., Lombardi R., Cespiati A., Cesari M., Lucchi T., Proietti M., Calcaterra L., Mandelli C., Coppola C., Cerizza A., Maria Pesenti A., Grasselli G., Galazzi A., Tet-Tamanti M., Monti I., Galbussera A. A., Crisafulli E., Girelli D., Maroccia A., Gabbiani D., Busti F., Vianello A., Biondan M., Sartori F., Faverio P., Pesci A., Zucchetti S., Bonfanti P., Rossi M., Beretta I., Spolti A., Harari S., Elia D., Cassandro R., Caminati A., Cipollone F., Guagnano M. T., D'Ardes D., Rossi I., Vezzani F., Spanevello A., Cherubino F., Visca D., Contoli M., Papi A., Morandi L., Battistini N., Luigi Moreo G., Iannuzzi P., Fumagalli D., Leone S., Oud J. A., Baysan M., Wigb J., van Heurn L. J., ter Haar S. B., Toppenberg A. G. L., Heerdink L., van IJlzinga Veenstra A. A., Eikenboom A. M., Wubbolts J., Uzorka J., Lijferink W., Meier R., de Jonge I. -B., Arbous S. M., de Boer M. G. J., van der Bom J. G., Dekkers O. M., Hassan, S, Ramspek, C, Ferrari, B, van Diepen, M, Rossio, R, Knevel, R, la Mura, V, Artoni, A, Martinelli, I, Bandera, A, Nobili, A, Gori, A, Blasi, F, Canetta, C, Montano, N, Rosendaal, F, Peyvandi, F, Bosari, S, Scudeller, L, Fusetti, G, Rusconi, L, Dell'Orto, S, Prati, D, Valenti, L, Giovannelli, S, Manunta, M, Lamorte, G, Ferarri, F, Muscatello, A, Mangioni, D, Alagna, L, Bozzi, G, Lombardi, A, Ungaro, R, Ancona, G, Zuglian, G, Bolis, M, Iannotti, N, Ludovisi, S, Comelli, A, Renisi, G, Biscarini, S, Castelli, V, Palomba, E, Fava, M, Fortina, V, Peri, C, Saltini, P, Viero, G, Itri, T, Ferroni, V, Pastore, V, Massafra, R, Liparoti, A, Muheberimana, T, Giommi, A, Bianco, R, De Azevedo, R, Chitani, G, Gualtierotti, R, Boasi, N, Pagliaro, E, Massimo, C, De Caro, M, Giachi, A, Vigone, B, Bellocchi, C, Carandina, A, Fiorelli, E, Melli, V, Tobaldini, E, Aliberti, S, Spotti, M, Terranova, L, Misuraca, S, D'Adda, A, Fiore, S, Di Pasquale, M, Mantero, M, Contarini, M, Ori, M, Morlacchi, L, Rossetti, V, Gramegna, A, Pappalettera, M, Cavallini, M, Buscemi, A, Vicenzi, M, Rota, I, Costantino, G, Solbiati, M, Furlan, L, Mancarella, M, Colombo, G, Fanin, A, Passarella, M, Monzani, V, Rovellini, A, Barbetta, L, Billi, F, Folli, C, Accordino, S, Maira, D, Hu, C, Motta, I, Scar-Amellini, N, Fracanzani, A, Lombardi, R, Cespiati, A, Cesari, M, Lucchi, T, Proietti, M, Calcaterra, L, Mandelli, C, Coppola, C, Cerizza, A, Maria Pesenti, A, Grasselli, G, Galazzi, A, Tet-Tamanti, M, Monti, I, Galbussera, A, Crisafulli, E, Girelli, D, Maroccia, A, Gabbiani, D, Busti, F, Vianello, A, Biondan, M, Sartori, F, Faverio, P, Pesci, A, Zucchetti, S, Bonfanti, P, Rossi, M, Beretta, I, Spolti, A, Harari, S, Elia, D, Cassandro, R, Caminati, A, Cipollone, F, Guagnano, M, D'Ardes, D, Rossi, I, Vezzani, F, Spanevello, A, Cherubino, F, Visca, D, Contoli, M, Papi, A, Morandi, L, Battistini, N, Luigi Moreo, G, Iannuzzi, P, Fumagalli, D, Leone, S, Oud, J, Baysan, M, Wigb, J, van Heurn, L, ter Haar, S, Toppenberg, A, Heerdink, L, van IJlzinga Veenstra, A, Eikenboom, A, Wubbolts, J, Uzorka, J, Lijferink, W, Meier, R, de Jonge, I, Arbous, S, de Boer, M, van der Bom, J, Dekkers, O, Hassan S., Ramspek C. L., Ferrari B., van Diepen M., Rossio R., Knevel R., la Mura V., Artoni A., Martinelli I., Bandera A., Nobili A., Gori A., Blasi F., Canetta C., Montano N., Rosendaal F. R., Peyvandi F., Bosari S., Scudeller L., Fusetti G., Rusconi L., Dell'Orto S., Prati D., Valenti L., Giovannelli S., Manunta M., Lamorte G., Ferarri F., Muscatello A., Mangioni D., Alagna L., Bozzi G., Lombardi A., Ungaro R., Ancona G., Zuglian G., Bolis M., Iannotti N., Ludovisi S., Comelli A., Renisi G., Biscarini S., Castelli V., Palomba E., Fava M., Fortina V., Peri C. A., Saltini P., Viero G., Itri T., Ferroni V., Pastore V., Massafra R., Liparoti A., Muheberimana T., Giommi A., Bianco R., De Azevedo R. M., Chitani G. E., Gualtierotti R., Boasi N., Pagliaro E., Massimo C., De Caro M., Giachi A., Vigone B., Bellocchi C., Carandina A., Fiorelli E., Melli V., Tobaldini E., Aliberti S., Spotti M., Terranova L., Misuraca S., D'Adda A., Fiore S. D., Di Pasquale M., Mantero M., Contarini M., Ori M., Morlacchi L., Rossetti V., Gramegna A., Pappalettera M., Cavallini M., Buscemi A., Vicenzi M., Rota I., Costantino G., Solbiati M., Furlan L., Mancarella M., Colombo G., Fanin A., Passarella M., Monzani V., Rovellini A., Barbetta L., Billi F., Folli C., Accordino S., Maira D., Hu C. M., Motta I., Scar-Amellini N., Fracanzani A. L., Lombardi R., Cespiati A., Cesari M., Lucchi T., Proietti M., Calcaterra L., Mandelli C., Coppola C., Cerizza A., Maria Pesenti A., Grasselli G., Galazzi A., Tet-Tamanti M., Monti I., Galbussera A. A., Crisafulli E., Girelli D., Maroccia A., Gabbiani D., Busti F., Vianello A., Biondan M., Sartori F., Faverio P., Pesci A., Zucchetti S., Bonfanti P., Rossi M., Beretta I., Spolti A., Harari S., Elia D., Cassandro R., Caminati A., Cipollone F., Guagnano M. T., D'Ardes D., Rossi I., Vezzani F., Spanevello A., Cherubino F., Visca D., Contoli M., Papi A., Morandi L., Battistini N., Luigi Moreo G., Iannuzzi P., Fumagalli D., Leone S., Oud J. A., Baysan M., Wigb J., van Heurn L. J., ter Haar S. B., Toppenberg A. G. L., Heerdink L., van IJlzinga Veenstra A. A., Eikenboom A. M., Wubbolts J., Uzorka J., Lijferink W., Meier R., de Jonge I. -B., Arbous S. M., de Boer M. G. J., van der Bom J. G., and Dekkers O. M.

Abstract

Background: The coronavirus disease 2019 (COVID-19) presents an urgent threat to global health. Prediction models that accurately estimate mortality risk in hospitalized patients could assist medical staff in treatment and allocating limited resources. Aims: To externally validate two promising previously published risk scores that predict in-hospital mortality among hospitalized COVID-19 patients. Methods: Two prospective cohorts were available; a cohort of 1028 patients admitted to one of nine hospitals in Lombardy, Italy (the Lombardy cohort) and a cohort of 432 patients admitted to a hospital in Leiden, the Netherlands (the Leiden cohort). The endpoint was in-hospital mortality. All patients were adult and tested COVID-19 PCR-positive. Model discrimination and calibration were assessed. Results: The C-statistic of the 4C mortality score was good in the Lombardy cohort (0.85, 95CI: 0.82−0.89) and in the Leiden cohort (0.87, 95CI: 0.80−0.94). Model calibration was acceptable in the Lombardy cohort but poor in the Leiden cohort due to the model systematically overpredicting the mortality risk for all patients. The C-statistic of the CURB-65 score was good in the Lombardy cohort (0.80, 95CI: 0.75−0.85) and in the Leiden cohort (0.82, 95CI: 0.76−0.88). The mortality rate in the CURB-65 development cohort was much lower than the mortality rate in the Lombardy cohort. A similar but less pronounced trend was found for patients in the Leiden cohort. Conclusion: Although performances did not differ greatly, the 4C mortality score showed the best performance. However, because of quickly changing circumstances, model recalibration may be necessary before using the 4C mortality score.

Published
2022

8. Clinical risk scores for the early prediction of severe outocomes in patients hospitalized for COVID-19: comment

Author

Rossio, R, Tettamanti, M, Nobili, A, Harari, S, Mannucci, P, Bandera, A, Peyvandi, F, Bosari, S, Scudeller, L, Fusetti, G, Rusconi, L, Dell'Orto, S, Prati, D, Valenti, L, Giovannelli, S, Manunta, M, Lamorte, G, Ferrari, F, Gori, A, Muscatello, A, Mangioni, D, Alagna, L, Bozzi, G, Lombardi, A, Ungaro, R, Ancona, G, Zuglian, G, Bolis, M, Iannotti, N, Ludovisi, S, Comelli, A, Renisi, G, Biscarini, S, Castelli, V, Palomba, E, Fava, M, Fortina, V, Peri, C, Saltini, P, Viero, G, Itri, T, Ferroni, V, Pastore, V, Massafra, R, Liparoti, A, Muheberimana, T, Giommi, A, Bianco, R, De Azevedo, R, Chitani, G, Gualtierotti, R, Ferrari, B, Boasi, N, Pagliaro, E, Massimo, C, De Caro, M, Giachi, A, Montano, N, Vigone, B, Bellocchi, C, Carandina, A, Fiorelli, E, Melli, V, Tobaldini, E, Blasi, F, Aliberti, S, Spotti, M, Terranova, L, Misuraca, S, D'Adda, A, Fiore, S, Di Pasquale, M, Mantero, M, Contarini, M, Ori, M, Morlacchi, L, Rossetti, V, Gramegna, A, Pappalettera, M, Cavallini, M, Buscemi, A, Vicenzi, M, Rota, I, Costantino, G, Solbiati, M, Furlan, L, Mancarella, M, Colombo, G, Fanin, A, Passarella, M, Monzani, V, Canetta, C, Rovellini, A, Barbetta, L, Billi, F, Folli, C, Accordino, S, Maira, D, Hu, C, Motta, I, Scaramellini, N, Fracanzani, A, Lombardi, R, Cespiati, A, Cesari, M, Lucchi, T, Proietti, M, Calcaterra, L, Mandelli, C, Coppola, C, Cerizza, A, Pesenti, A, Grasselli, G, Galazzi, A, Monti, I, Galbussera, A, Crisafulli, E, Girelli, D, Maroccia, A, Gabbiani, D, Busti, F, Vianello, A, Biondan, M, Sartori, F, Faverio, P, Pesci, A, Zucchetti, S, Bonfanti, P, Rossi, M, Beretta, I, Spolti, A, Elia, D, Cassandro, R, Caminati, A, Cipollone, F, Guagnano, M, D'Ardes, D, Rossi, I, Vezzani, F, Spanevello, A, Cherubino, F, Visca, D, Contoli, M, Papi, A, Morandi, L, Battistini, N, Moreo, G, Iannuzzi, P, Fumagalli, D, Leone, S, Rossio R., Tettamanti M., Nobili A., Harari S., Mannucci P. M., Bandera A., Peyvandi F., Bosari S., Scudeller L., Fusetti G., Rusconi L., Dell'Orto S., Prati D., Valenti L., Giovannelli S., Manunta M., Lamorte G., Ferrari F., Gori A., Muscatello A., Mangioni D., Alagna L., Bozzi G., Lombardi A., Ungaro R., Ancona G., Zuglian G., Bolis M., Iannotti N., Ludovisi S., Comelli A., Renisi G., Biscarini S., Castelli V., Palomba E., Fava M., Fortina V., Peri C. A., Saltini P., Viero G., Itri T., Ferroni V., Pastore V., Massafra R., Liparoti A., Muheberimana T., Giommi A., Bianco R., De Azevedo R. M., Chitani G. E., Gualtierotti R., Ferrari B., Boasi N., Pagliaro E., Massimo C., De Caro M., Giachi A., Montano N., Vigone B., Bellocchi C., Carandina A., Fiorelli E., Melli V., Tobaldini E., Blasi F., Aliberti S., Spotti M., Terranova L., Misuraca S., D'Adda A., Fiore S. D., Di Pasquale M., Mantero M., Contarini M., Ori M., Morlacchi L., Rossetti V., Gramegna A., Pappalettera M., Cavallini M., Buscemi A., Vicenzi M., Rota I., Costantino G., Solbiati M., Furlan L., Mancarella M., Colombo G., Fanin A., Passarella M., Monzani V., Canetta C., Rovellini A., Barbetta L., Billi F., Folli C., Accordino S., Maira D., Hu C. M., Motta I., Scaramellini N., Fracanzani A. L., Lombardi R., Cespiati A., Cesari M., Lucchi T., Proietti M., Calcaterra L., Mandelli C., Coppola C., Cerizza A., Pesenti A. M., Grasselli G., Galazzi A., Monti I., Galbussera A. A., Crisafulli E., Girelli D., Maroccia A., Gabbiani D., Busti F., Vianello A., Biondan M., Sartori F., Faverio P., Pesci A., Zucchetti S., Bonfanti P., Rossi M., Beretta I., Spolti A., Elia D., Cassandro R., Caminati A., Cipollone F., Guagnano M. T., D'Ardes D., Rossi I., Vezzani F., Spanevello A., Cherubino F., Visca D., Contoli M., Papi A., Morandi L., Battistini N., Moreo G. L., Iannuzzi P., Fumagalli D., Leone S., Rossio, R, Tettamanti, M, Nobili, A, Harari, S, Mannucci, P, Bandera, A, Peyvandi, F, Bosari, S, Scudeller, L, Fusetti, G, Rusconi, L, Dell'Orto, S, Prati, D, Valenti, L, Giovannelli, S, Manunta, M, Lamorte, G, Ferrari, F, Gori, A, Muscatello, A, Mangioni, D, Alagna, L, Bozzi, G, Lombardi, A, Ungaro, R, Ancona, G, Zuglian, G, Bolis, M, Iannotti, N, Ludovisi, S, Comelli, A, Renisi, G, Biscarini, S, Castelli, V, Palomba, E, Fava, M, Fortina, V, Peri, C, Saltini, P, Viero, G, Itri, T, Ferroni, V, Pastore, V, Massafra, R, Liparoti, A, Muheberimana, T, Giommi, A, Bianco, R, De Azevedo, R, Chitani, G, Gualtierotti, R, Ferrari, B, Boasi, N, Pagliaro, E, Massimo, C, De Caro, M, Giachi, A, Montano, N, Vigone, B, Bellocchi, C, Carandina, A, Fiorelli, E, Melli, V, Tobaldini, E, Blasi, F, Aliberti, S, Spotti, M, Terranova, L, Misuraca, S, D'Adda, A, Fiore, S, Di Pasquale, M, Mantero, M, Contarini, M, Ori, M, Morlacchi, L, Rossetti, V, Gramegna, A, Pappalettera, M, Cavallini, M, Buscemi, A, Vicenzi, M, Rota, I, Costantino, G, Solbiati, M, Furlan, L, Mancarella, M, Colombo, G, Fanin, A, Passarella, M, Monzani, V, Canetta, C, Rovellini, A, Barbetta, L, Billi, F, Folli, C, Accordino, S, Maira, D, Hu, C, Motta, I, Scaramellini, N, Fracanzani, A, Lombardi, R, Cespiati, A, Cesari, M, Lucchi, T, Proietti, M, Calcaterra, L, Mandelli, C, Coppola, C, Cerizza, A, Pesenti, A, Grasselli, G, Galazzi, A, Monti, I, Galbussera, A, Crisafulli, E, Girelli, D, Maroccia, A, Gabbiani, D, Busti, F, Vianello, A, Biondan, M, Sartori, F, Faverio, P, Pesci, A, Zucchetti, S, Bonfanti, P, Rossi, M, Beretta, I, Spolti, A, Elia, D, Cassandro, R, Caminati, A, Cipollone, F, Guagnano, M, D'Ardes, D, Rossi, I, Vezzani, F, Spanevello, A, Cherubino, F, Visca, D, Contoli, M, Papi, A, Morandi, L, Battistini, N, Moreo, G, Iannuzzi, P, Fumagalli, D, Leone, S, Rossio R., Tettamanti M., Nobili A., Harari S., Mannucci P. M., Bandera A., Peyvandi F., Bosari S., Scudeller L., Fusetti G., Rusconi L., Dell'Orto S., Prati D., Valenti L., Giovannelli S., Manunta M., Lamorte G., Ferrari F., Gori A., Muscatello A., Mangioni D., Alagna L., Bozzi G., Lombardi A., Ungaro R., Ancona G., Zuglian G., Bolis M., Iannotti N., Ludovisi S., Comelli A., Renisi G., Biscarini S., Castelli V., Palomba E., Fava M., Fortina V., Peri C. A., Saltini P., Viero G., Itri T., Ferroni V., Pastore V., Massafra R., Liparoti A., Muheberimana T., Giommi A., Bianco R., De Azevedo R. M., Chitani G. E., Gualtierotti R., Ferrari B., Boasi N., Pagliaro E., Massimo C., De Caro M., Giachi A., Montano N., Vigone B., Bellocchi C., Carandina A., Fiorelli E., Melli V., Tobaldini E., Blasi F., Aliberti S., Spotti M., Terranova L., Misuraca S., D'Adda A., Fiore S. D., Di Pasquale M., Mantero M., Contarini M., Ori M., Morlacchi L., Rossetti V., Gramegna A., Pappalettera M., Cavallini M., Buscemi A., Vicenzi M., Rota I., Costantino G., Solbiati M., Furlan L., Mancarella M., Colombo G., Fanin A., Passarella M., Monzani V., Canetta C., Rovellini A., Barbetta L., Billi F., Folli C., Accordino S., Maira D., Hu C. M., Motta I., Scaramellini N., Fracanzani A. L., Lombardi R., Cespiati A., Cesari M., Lucchi T., Proietti M., Calcaterra L., Mandelli C., Coppola C., Cerizza A., Pesenti A. M., Grasselli G., Galazzi A., Monti I., Galbussera A. A., Crisafulli E., Girelli D., Maroccia A., Gabbiani D., Busti F., Vianello A., Biondan M., Sartori F., Faverio P., Pesci A., Zucchetti S., Bonfanti P., Rossi M., Beretta I., Spolti A., Elia D., Cassandro R., Caminati A., Cipollone F., Guagnano M. T., D'Ardes D., Rossi I., Vezzani F., Spanevello A., Cherubino F., Visca D., Contoli M., Papi A., Morandi L., Battistini N., Moreo G. L., Iannuzzi P., Fumagalli D., and Leone S.

Published
2022

10. Patient-Reported Symptoms and Sequelae 12 Months After COVID-19 in Hospitalized Adults: A Multicenter Long-Term Follow-Up Study

Author

Comelli, A, Viero, G, Bettini, G, Nobili, A, Tettamanti, M, Galbussera, A, Muscatello, A, Mantero, M, Canetta, C, Martinelli Boneschi, F, Arighi, A, Brambilla, P, Vecchi, M, Lampertico, P, Bonfanti, P, Contoli, M, Blasi, F, Gori, A, Bandera, A, Comelli, Agnese, Viero, Giulia, Bettini, Greta, Nobili, Alessandro, Tettamanti, Mauro, Galbussera, Alessia Antonella, Muscatello, Antonio, Mantero, Marco, Canetta, Ciro, Martinelli Boneschi, Filippo, Arighi, Andrea, Brambilla, Paolo, Vecchi, Maurizio, Lampertico, Pietro, Bonfanti, Paolo, Contoli, Marco, Blasi, Francesco, Gori, Andrea, Bandera, Alessandra, Comelli, A, Viero, G, Bettini, G, Nobili, A, Tettamanti, M, Galbussera, A, Muscatello, A, Mantero, M, Canetta, C, Martinelli Boneschi, F, Arighi, A, Brambilla, P, Vecchi, M, Lampertico, P, Bonfanti, P, Contoli, M, Blasi, F, Gori, A, Bandera, A, Comelli, Agnese, Viero, Giulia, Bettini, Greta, Nobili, Alessandro, Tettamanti, Mauro, Galbussera, Alessia Antonella, Muscatello, Antonio, Mantero, Marco, Canetta, Ciro, Martinelli Boneschi, Filippo, Arighi, Andrea, Brambilla, Paolo, Vecchi, Maurizio, Lampertico, Pietro, Bonfanti, Paolo, Contoli, Marco, Blasi, Francesco, Gori, Andrea, and Bandera, Alessandra

Abstract

Objective: Our knowledge on the long-term consequences of COVID-19 is still scarce despite the clinical relevance of persisting syndrome. The aim of this study was to analyze patient-reported outcomes, including assessment by specific questionnaires of health impairment and symptoms. Methods: This is a prospective, observational and multicenter cohort study coordinated by Fondazione IRCSS Ca' Granda Ospedale Maggiore Policlinico di Milano and Istituto di Ricerche Farmacologiche Mario Negri IRCCS including eight hospitals located in North and Central Italy. A telephone interview to assess rehospitalization, access to health care resources, general health status subjective evaluation, and symptoms was performed at 12 months after the discharge in patients admitted to hospital because of COVID-19 from February 2020 to the end of May 2020. Results: Among the 776 patients discharged alive, 44 (5.7%) died, 456 subjects (58.8%) completed the questionnaire and 276 (35.6%) were not reachable or refused to join the telephone interview. The mean age of the study population was 59.4 years (SD 14.1), 69.8% of individuals needed oxygen support during hospitalization and 10.4% were admitted to ICU. Overall, 91.7% of participants reported at least one symptom/sequela at 12 months. Exertional dyspnea (71.7%), fatigue (54.6%), and gastrointestinal symptoms (32.8%) were the most reported ones. Health issues after discharge including hospitalization or access to emergency room were described by 19.4% of subjects. Female and presence of comorbidities were independent predictors of whealth impairment and presence of ≥2 symptoms/sequelae after 12 months from hospitalization for COVID-19. Conclusions: Patient-reported symptoms and sequelae, principally dyspnea and fatigue, are found in most individuals even 12 months from COVID-19 hospitalization. Long-term follow-up based on patient-centered outcome can contribute to plan tailored interventions.

Published
2022

11. Efficacy and safety of trabectedin for the treatment of advanced uterine or ovarian carcinosarcoma: Results of a phase II multicenter clinical trial (MITO-26)

Author

Lorusso, Domenica, Pignata, S., Tamberi, S., Mangili, G., Bologna, A., Nicoloso, M. S., Giolitto, S., Salutari, Vanda, Mantero, M., Pisano, C., Bergamini, A., Musacchio, L., Ronzulli, D., Raspagliesi, F., Scambia, Giovanni, Lorusso D., Salutari V., Scambia G. (ORCID:0000-0003-2758-1063), Lorusso, Domenica, Pignata, S., Tamberi, S., Mangili, G., Bologna, A., Nicoloso, M. S., Giolitto, S., Salutari, Vanda, Mantero, M., Pisano, C., Bergamini, A., Musacchio, L., Ronzulli, D., Raspagliesi, F., Scambia, Giovanni, Lorusso D., Salutari V., and Scambia G. (ORCID:0000-0003-2758-1063)

Abstract

Objective: This open-label phase II clinical trial evaluated the antitumor activity and safety of trabectedin in patients with advanced ovarian (OC) or uterine carcinosarcomas (UC). Methods: Eligible patients were adults (≥18 years) with histologically proven recurrent OC/UC not amenable to surgery or radiotherapy who received up to two prior chemotherapy lines. Trabectedin 1.3 mg/m2 was administered as a 3-h infusion every three weeks. The primary endpoint was objective response rate (ORR) as per RECIST v.1.1. If at least 8 of 43 patients (18.6%) achieve an objective response, trabectedin would be declared worthy for further investigations. Results: Forty-five patients with either OC (n = 32) or UC (n = 13) from seven MITO centers across Italy were enrolled. The ORR was 11.9% (90% CI: 6–23) and included two patients with a complete response and three with a partial response. Eight patients (19.0%) had disease stabilization for a disease control rate of 31.0% (90% CI: 20–44). Median progression-free survival was 2.01 months (95% CI: 1.78–2.30) and median overall survival was 4.64 months (95% CI: 3.19–8.29). Neutrophil count decreases (n = 8, 18.2%) and transaminase increases (n = 6, 13.6%) were the most common grade 3–5 adverse events related with trabectedin. Two patients died due to trabectedin-related grade 5 hematological toxicity. Conclusion: Although trabectedin did not meet the prespecified activity criteria, it confers modest but clinically meaningful benefit to patients with advanced OC/UC as being as effective as any other available treatment for this indication. The toxicity profile appears in line with that previously reported for the drug.

Published
2022

15. Clinical risk scores for the early prediction of severe outocomes in patients hospitalized for COVID-19: comment

Author

Rossio R., Tettamanti M., Nobili A., Harari S., Mannucci P. M., Bandera A., Peyvandi F., Bosari S., Scudeller L., Fusetti G., Rusconi L., Dell'Orto S., Prati D., Valenti L., Giovannelli S., Manunta M., Lamorte G., Ferrari F., Gori A., Muscatello A., Mangioni D., Alagna L., Bozzi G., Lombardi A., Ungaro R., Ancona G., Zuglian G., Bolis M., Iannotti N., Ludovisi S., Comelli A., Renisi G., Biscarini S., Castelli V., Palomba E., Fava M., Fortina V., Peri C. A., Saltini P., Viero G., Itri T., Ferroni V., Pastore V., Massafra R., Liparoti A., Muheberimana T., Giommi A., Bianco R., De Azevedo R. M., Chitani G. E., Gualtierotti R., Ferrari B., Boasi N., Pagliaro E., Massimo C., De Caro M., Giachi A., Montano N., Vigone B., Bellocchi C., Carandina A., Fiorelli E., Melli V., Tobaldini E., Blasi F., Aliberti S., Spotti M., Terranova L., Misuraca S., D'Adda A., Fiore S. D., Di Pasquale M., Mantero M., Contarini M., Ori M., Morlacchi L., Rossetti V., Gramegna A., Pappalettera M., Cavallini M., Buscemi A., Vicenzi M., Rota I., Costantino G., Solbiati M., Furlan L., Mancarella M., Colombo G., Fanin A., Passarella M., Monzani V., Canetta C., Rovellini A., Barbetta L., Billi F., Folli C., Accordino S., Maira D., Hu C. M., Motta I., Scaramellini N., Fracanzani A. L., Lombardi R., Cespiati A., Cesari M., Lucchi T., Proietti M., Calcaterra L., Mandelli C., Coppola C., Cerizza A., Pesenti A. M., Grasselli G., Galazzi A., Monti I., Galbussera A. A., Crisafulli E., Girelli D., Maroccia A., Gabbiani D., Busti F., Vianello A., Biondan M., Sartori F., Faverio P., Pesci A., Zucchetti S., Bonfanti P., Rossi M., Beretta I., Spolti A., Elia D., Cassandro R., Caminati A., Cipollone F., Guagnano M. T., D'Ardes D., Rossi I., Vezzani F., Spanevello A., Cherubino F., Visca D., Contoli M., Papi A., Morandi L., Battistini N., Moreo G. L., Iannuzzi P., Fumagalli D., Leone S., Rossio, R, Tettamanti, M, Nobili, A, Harari, S, Mannucci, P, Bandera, A, Peyvandi, F, Bosari, S, Scudeller, L, Fusetti, G, Rusconi, L, Dell'Orto, S, Prati, D, Valenti, L, Giovannelli, S, Manunta, M, Lamorte, G, Ferrari, F, Gori, A, Muscatello, A, Mangioni, D, Alagna, L, Bozzi, G, Lombardi, A, Ungaro, R, Ancona, G, Zuglian, G, Bolis, M, Iannotti, N, Ludovisi, S, Comelli, A, Renisi, G, Biscarini, S, Castelli, V, Palomba, E, Fava, M, Fortina, V, Peri, C, Saltini, P, Viero, G, Itri, T, Ferroni, V, Pastore, V, Massafra, R, Liparoti, A, Muheberimana, T, Giommi, A, Bianco, R, De Azevedo, R, Chitani, G, Gualtierotti, R, Ferrari, B, Boasi, N, Pagliaro, E, Massimo, C, De Caro, M, Giachi, A, Montano, N, Vigone, B, Bellocchi, C, Carandina, A, Fiorelli, E, Melli, V, Tobaldini, E, Blasi, F, Aliberti, S, Spotti, M, Terranova, L, Misuraca, S, D'Adda, A, Fiore, S, Di Pasquale, M, Mantero, M, Contarini, M, Ori, M, Morlacchi, L, Rossetti, V, Gramegna, A, Pappalettera, M, Cavallini, M, Buscemi, A, Vicenzi, M, Rota, I, Costantino, G, Solbiati, M, Furlan, L, Mancarella, M, Colombo, G, Fanin, A, Passarella, M, Monzani, V, Canetta, C, Rovellini, A, Barbetta, L, Billi, F, Folli, C, Accordino, S, Maira, D, Hu, C, Motta, I, Scaramellini, N, Fracanzani, A, Lombardi, R, Cespiati, A, Cesari, M, Lucchi, T, Proietti, M, Calcaterra, L, Mandelli, C, Coppola, C, Cerizza, A, Pesenti, A, Grasselli, G, Galazzi, A, Monti, I, Galbussera, A, Crisafulli, E, Girelli, D, Maroccia, A, Gabbiani, D, Busti, F, Vianello, A, Biondan, M, Sartori, F, Faverio, P, Pesci, A, Zucchetti, S, Bonfanti, P, Rossi, M, Beretta, I, Spolti, A, Elia, D, Cassandro, R, Caminati, A, Cipollone, F, Guagnano, M, D'Ardes, D, Rossi, I, Vezzani, F, Spanevello, A, Cherubino, F, Visca, D, Contoli, M, Papi, A, Morandi, L, Battistini, N, Moreo, G, Iannuzzi, P, Fumagalli, D, and Leone, S

Subjects
Male, Outcome Assessment, Disease, 030204 cardiovascular system & hematology, Respiratory failure, 0302 clinical medicine, Risk Factors, Epidemiology, Early prediction, Outcome Assessment, Health Care, 030212 general & internal medicine, Framingham Risk Score, Respiration, Area under the curve, Middle Aged, Hospitalization, Survival Rate, Italy, Artificial, Emergency Medicine, Female, Clinical risk factor, 2019-20 coronavirus outbreak, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Ce - Letter to the Editor, MEDLINE, Risk Assessment, 03 medical and health sciences, Predictive Value of Tests, Internal medicine, Internal Medicine, medicine, Intubation, Intratracheal, Humans, In patient, Derivation, COVID-19, Risk prediction model, SARS-CoV 2, Selection (genetic algorithm), Aged, Retrospective Studies, SARS-CoV-2, business.industry, Retrospective cohort study, Respiration, Artificial, Im - Original, Health Care, Intratracheal, ROC Curve, Intubation, business
Abstract

Coronavirus disease of 2019 (COVID-19) is associated with severe acute respiratory failure. Early identification of high-risk COVID-19 patients is crucial. We aimed to derive and validate a simple score for the prediction of severe outcomes. A retrospective cohort study of patients hospitalized for COVID-19 was carried out by the Italian Society of Internal Medicine. Epidemiological, clinical, laboratory, and treatment variables were collected at hospital admission at five hospitals. Three algorithm selection models were used to construct a predictive risk score: backward Selection, Least Absolute Shrinkage and Selection Operator (LASSO), and Random Forest. Severe outcome was defined as the composite of need for non-invasive ventilation, need for orotracheal intubation, or death. A total of 610 patients were included in the analysis, 313 had a severe outcome. The subset for the derivation analysis included 335 patients, the subset for the validation analysis 275 patients. The LASSO selection identified 6 variables (age, history of coronary heart disease, CRP, AST, D-dimer, and neutrophil/lymphocyte ratio) and resulted in the best performing score with an area under the curve of 0.79 in the derivation cohort and 0.80 in the validation cohort. Using a cut-off of 7 out of 13 points, sensitivity was 0.93, specificity 0.34, positive predictive value 0.59, and negative predictive value 0.82. The proposed score can identify patients at low risk for severe outcome who can be safely managed in a low-intensity setting after hospital admission for COVID-19.

Published
2021

16. Chronic rhinosinusitis with nasal polyps impact in severe asthma patients: Evidences from the Severe Asthma Network Italy (SANI) registry

Author

Canonica, G. W., Malvezzi, L., Blasi, F., Paggiaro, P., Mantero, M., Senna, G., Heffler, E., Bonavia, M., Caiaffa, P., Calabrese, C., Camiciottoli, G., Caruso, C., Centanni, S., Conte, M. E., Corsico, A. G., Cosmi, L., Costantino, M. T., Crimi, N., D'Alonzo, Silvia, D'Amato, M., Del Giacco, S., Favero, E., Farsi, A., Foschino, B. P. M., Guarnieri, G., Guida, G., Latorre, M., Lombardi, C., Macchia, Gabriella, Menzella, F., Milanese, M., Montuschi, Paolo, Nucera, Eleonora, Parente, R., Passalacqua, G., Patella, V., Pelaia, G., Pini, L., Ricciardolo, F. L. M., Ricciardi, L., Richeldi, Luca, Ridolo, E., Marolla, Giovanna, Santus, P., Scichilone, N., Solidoro, P., Spadaro, G., Spanevello, A., Vianello, A., Yacoub, M. R., Zappa, M. C., D'Alo S., Macchia L., Montuschi P. (ORCID:0000-0001-5589-1750), Nucera E. (ORCID:0000-0002-0565-7680), Richeldi L. (ORCID:0000-0001-8594-1448), Rolla G., Canonica, G. W., Malvezzi, L., Blasi, F., Paggiaro, P., Mantero, M., Senna, G., Heffler, E., Bonavia, M., Caiaffa, P., Calabrese, C., Camiciottoli, G., Caruso, C., Centanni, S., Conte, M. E., Corsico, A. G., Cosmi, L., Costantino, M. T., Crimi, N., D'Alonzo, Silvia, D'Amato, M., Del Giacco, S., Favero, E., Farsi, A., Foschino, B. P. M., Guarnieri, G., Guida, G., Latorre, M., Lombardi, C., Macchia, Gabriella, Menzella, F., Milanese, M., Montuschi, Paolo, Nucera, Eleonora, Parente, R., Passalacqua, G., Patella, V., Pelaia, G., Pini, L., Ricciardolo, F. L. M., Ricciardi, L., Richeldi, Luca, Ridolo, E., Marolla, Giovanna, Santus, P., Scichilone, N., Solidoro, P., Spadaro, G., Spanevello, A., Vianello, A., Yacoub, M. R., Zappa, M. C., D'Alo S., Macchia L., Montuschi P. (ORCID:0000-0001-5589-1750), Nucera E. (ORCID:0000-0002-0565-7680), Richeldi L. (ORCID:0000-0001-8594-1448), and Rolla G.

Abstract

Background: The clinical and laboratory features of patients enrolled in the Severe Asthma Network in Italy (SANI) registry, a web-based observatory collecting demographic, clinical, functional and inflammatory data of patients with severe asthma were evaluated, with a special emphasis to chronic rhinosinusitis with nasal polyposis (CRSwNP). Methods: For each eligible patients the following information has been collected: demographic data, clinical features, asthma control in the previous month according to the GINA (Global INitiative for Asthma) Guidelines and standardized questionnaires, concomitant regular and on demand treatments and inflammatory markers. Results: 695 patients with severe asthma enrolled in 66 SANI centers were analyzed. The prevalence of chronic rhinosinusitis with nasal polyposis was 40.6%. Atopic dermatitis and bronchiectasis was significantly more frequent in patients with CRSwNP than in subjects without nasal polyposis; similarly, FeNO values are significantly higher in subject with CRSwNP than in patients without nasal polyposis. Finally, patients with CRSwNP had a significantly higher number of asthma exacerbations per year, more days on oral corticosteroids and were more likely to be OCS long term users. Conclusion: OCS sparing is needed in patients with severe asthma, mainly in subjects with CRSwNP, adopting adequate strategies such as a better adherence to the treatment with inhaled therapy according to the GINA recommendations, the use of biologic agents and a multidisciplinary approach of the patient.

Published
2020

24. Early recognition of airway obstruction in Fabry disease and correlation with dyspnea: A case series

Author

Faverio, P, Mantero, M, Pieruzzi, F, Torti, G, Di Giacomo, A, Pesci, A, Faverio P, Mantero M, Pieruzzi F, TORTI, GIACOMO, Di Giacomo A, Pesci A., Faverio, P, Mantero, M, Pieruzzi, F, Torti, G, Di Giacomo, A, Pesci, A, Faverio P, Mantero M, Pieruzzi F, TORTI, GIACOMO, Di Giacomo A, and Pesci A.

Abstract

BACKGROUND: Fabry disease (FD) is an X-linked lysosomal storage disease that mainly affects kidney, heart and the nervous system, but a respiratory involvement, in the form of obstructive airway disease, has also been described. METHODS: We performed a complete evaluation of pulmonary functional tests (PFTs) on 18 consecutive adult patients with FD. In our cohort we identified 5 subjects with main airway obstruction, but only 2 had airway obstruction in absence of causes other than FD. RESULTS: We found in the majority of patients early signs of airway obstruction, including small-airway obstruction, mild to moderate lung hyperinflation and mild to moderate increase in specific airway resistance. Lung hyperinflation (expressed as increased residual volume at plethysmography) was positively correlated with the presence of dyspnea (both at rest and after exertion). CONCLUSIONS: Therefore complete PFTs, which can detect early signs of airway obstruction, may be considered as a useful screening tool for patients with FD, particularly for those presenting with dyspnea.

Published
2016

25. The role of immune suppression in COVID-19 hospitalization: clinical and epidemiological trends over three years of SARS-CoV-2 epidemic

Author

Marta Canuti, Maria Cristina Monti, Chiara Bobbio, Antonio Muscatello, Toussaint Muheberimana, Sante Leandro Baldi, Francesco Blasi, Ciro Canetta, Giorgio Costantino, Alessandro Nobili, Flora Peyvandi, Mauro Tettamanti, Simone Villa, Stefano Aliberti, Mario C. Raviglione, Andrea Gori, Alessandra Bandera, COVID-19 Network Study Group, Bosari Silvano, Scudeller Luigia, Fusetti Giuliana, Rusconi Laura, Dell’Orto Silvia, Prati Daniele, Valenti Luca, Giovannelli Silvia, Manunta Maria, Lamorte Giuseppe, Ferarri Francesca, Mangioni Davide, Alagna Laura, Bozzi Giorgio, Lombardi Andrea, Ungaro Riccardo, Ancona Giuseppe, Zuglian Gianluca, Bolis Matteo, Iannotti Nathalie, Ludovisi Serena, Comelli Agnese, Renisi Giulia, Biscarini Simona, Castelli Valeria, Palomba Emanuele, Fava Marco, Fortina Valeria, Liparoti Arianna, Pastena Andrea, Alberto Peri Carlo, Saltini Paola, Viero Giulia, Itri Teresa, Ferroni Valentina, Pastore Valeria, Massafra Roberta, Curri Maria Teresa, Rizzo Alice, Scarpa Stefano, Giommi Alessandro, Bianco Rosaria, Chitani Grazia Eliana, Gualtierotti Roberta, Ferrari Barbara, Rossio Raffaella, Boasi Nadia, Pagliaro Erica, Massimo Costanza, Caro Michele De, Giachi Andrea, Montano Nicola, Vigone Barbara, Bellocchi Chiara, Carandina Angelica, Fiorelli Elisa, Melli Valerie, Tobaldini Eleonora, Spotti Maura, Terranova Leonardo, Misuraca Sofia, D’Adda Alice, Fiore Silvia Della, Pasquale Marta Di, Mantero Marco, Contarini Martina, Ori Margherita, Morlacchi Letizia, Rossetti Valeria, Gramegna Andrea, Pappalettera Maria, Cavallini Mirta, Buscemi Agata, Vicenzi Marco, Rota Irena, Solbiati Monica, Furlan Ludovico, Mancarella Marta, Colombo Giulia, Colombo Giorgio, Fanin Alice, Passarella Mariele, Monzani Valter, Rovellini Angelo, Barbetta Laura, Billi Filippo, Folli Christian, Accordino Silvia, Maira Diletta, Hu Cinzia Maria, Motta Irene, Scaramellini Natalia, Fracanzani Anna Ludovica, Lombardi Rosa, Cespiati Annalisa, Cesari Matteo, Lucchi Tiziano, Proietti Marco, Calcaterra Laura, Mandelli Clara, Coppola Carlotta, Cerizza Arturo, Grasselli Giacomo, Galazzi Alessandro, Monti Igor, and Galbusera Alessia Antonella

Subjects
SARS-CoV-2, COVID-19, disease outcome, hospitalization, COVID-19 vaccination, immune suppression, Medicine (General), R5-920
Abstract

Specific immune suppression types have been associated with a greater risk of severe COVID-19 disease and death. We analyzed data from patients >17 years that were hospitalized for COVID-19 at the “Fondazione IRCCS Ca′ Granda Ospedale Maggiore Policlinico” in Milan (Lombardy, Northern Italy). The study included 1727 SARS-CoV-2-positive patients (1,131 males, median age of 65 years) hospitalized between February 2020 and November 2022. Of these, 321 (18.6%, CI: 16.8–20.4%) had at least one condition defining immune suppression. Immune suppressed subjects were more likely to have other co-morbidities (80.4% vs. 69.8%, p

Published
2023
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26. Interstitial pneumonia with autoimmune features: an additional risk factor for ARDS?

Author

Grasselli, G, Vergnano, B, Pozzi, M, Sala, V, Dâ andrea, G, Scaravilli, V, Mantero, M, Pesci, A, Pesenti, A, GRASSELLI, GIACOMO, VERGNANO, BEATRICE, POZZI, MARIA ROSA, SALA, VITTORIA LUDOVICA, SCARAVILLI, VITTORIO, MANTERO, MARCO, PESCI, ALBERTO, PESENTI, ANTONIO MARIA, D’andrea, G, Grasselli, G, Vergnano, B, Pozzi, M, Sala, V, Dâ andrea, G, Scaravilli, V, Mantero, M, Pesci, A, Pesenti, A, GRASSELLI, GIACOMO, VERGNANO, BEATRICE, POZZI, MARIA ROSA, SALA, VITTORIA LUDOVICA, SCARAVILLI, VITTORIO, MANTERO, MARCO, PESCI, ALBERTO, PESENTI, ANTONIO MARIA, and D’andrea, G

Abstract

Background: Interstitial pneumonia with autoimmune features (IPAF) identifies a recently recognized autoimmune syndrome characterized by interstitial lung disease and autoantibodies positivity, but absence of a specific connective tissue disease diagnosis or alternative etiology. We retrospectively reviewed the clinical presentation, diagnostic workup and management of seven critically ill patients who met diagnostic criteria for IPAF. We compared baseline characteristics and clinical outcome of IPAF patients with those of the population of ARDS patients admitted in the same period. Results: Seven consecutive patients with IPAF admitted to intensive care unit for acute respiratory distress syndrome (ARDS) were compared with 78 patients with ARDS secondary to a known risk factor and with eight ARDS patients without recognized risk factors. Five IPAF patients (71%) survived and were discharged alive from ICU: Their survival rate was equal to that of patients with a known risk factor (71%), while the subgroup of patients without risk factors had a markedly lower survival (38%). According to the Berlin definition criteria, ARDS was severe in four IPAF patients and moderate in the remaining three. All had multiple organ dysfunction at presentation. The most frequent autoantibody detected was anti-SSA/Ro52. All patients required prolonged mechanical ventilation (median duration 49 days, range 10–88); four received extracorporeal membrane oxygenation and one received low-flow extracorporeal CO2 removal. All patients received immunosuppressive therapy. Conclusions: This is the first description of a cohort of critical patients meeting the diagnostic criteria for IPAF presenting with ARDS. This diagnosis should be considered in any critically ill patient with interstitial lung disease of unknown origin. While management is challenging and level of support high, survival appears to be good and comparable to that of patients with ARDS associated with a known clinical insult.

Published
2017

27. Impact of exacerbations in the natural course of COPD

Author

Edited by:Blasi, F, Miravitlles, M, Welte, T, Blasi, F, Aliberti, S, Mantero, M, Blasi F, Mantero M., ALIBERTI, STEFANO, Edited by:Blasi, F, Miravitlles, M, Welte, T, Blasi, F, Aliberti, S, Mantero, M, Blasi F, Mantero M., and ALIBERTI, STEFANO

Abstract

Exacerbations represent an important event in the natural history of patients with chronic obstructive pulmonary disease (COPD). They are associated with considerable physiological deterioration and increased airway inflammatory changes, and may enhance disease progression by accelerating the decline in lung function. Some patients are prone to frequent exacerbations, which are an important cause of hospital admission and readmission, and these frequent episodes may have considerable impact on quality of life, activities of daily living and mortality. Although exacerbations become more frequent and more severe as COPD progresses, the rate at which they occur appears to reflect an independent susceptibility phenotype: the "frequent exacerbator". © ERS 2013.

Published
2013

28. Serum and exhaled breath condensate inflammatory cytokines in community-acquired pneumonia: a prospective cohort study

Author

Aliberti, S, Morlacchi, L, Faverio, P, Fernandez-Botran, R, Cosentini, R, Mantero, M, Peyrani, P, Ramirez, J, Bordon, J, Blasi, F, Aliberti, Stefano, Morlacchi, Letizia Corinna, Faverio, Paola, Fernandez-Botran, Rafael, Cosentini, Roberto, Mantero, Marco, Peyrani, Paula, Ramirez, Julio, Bordon, Jose, Blasi, Francesco, Aliberti, S, Morlacchi, L, Faverio, P, Fernandez-Botran, R, Cosentini, R, Mantero, M, Peyrani, P, Ramirez, J, Bordon, J, Blasi, F, Aliberti, Stefano, Morlacchi, Letizia Corinna, Faverio, Paola, Fernandez-Botran, Rafael, Cosentini, Roberto, Mantero, Marco, Peyrani, Paula, Ramirez, Julio, Bordon, Jose, and Blasi, Francesco

Abstract

The role and relationship between pro- and anti-inflammatory cytokines represents one of the least studied aspects of the pathogenesis of community-acquired pneumonia (CAP). The aim of the present study was to evaluate pro- and anti-inflammatory cytokines at both local (lung) and systemic (blood) levels and their relationship with the severity of the disease on admission and time for a patient to reach clinical stability during hospitalisation.

Published
2016

33. Utilization of a multidisciplinary protocol for postoperative pain treatment

Author

Frascio M, Corrado P, Traverso E, Serra D, Prato Y, Ricci B, Gastaldo P, Palermo S, Mantero M, Camisassi A, Luca Bertolaccini, and Berti Riboli E

Subjects
Patient Care Team, Psychotherapy, Analgesics, Pain, Postoperative, Humans, Prospective Studies, Physical and Rehabilitation Medicine, Case Management, Combined Modality Therapy, Pain Measurement
Published
2003

34. Hiperactividad vesical con incontinencia urinaria: trece años de calvario

Author

Ramos Sánchez, Mª Esperanza, Domínguez Domínguez, Sergio, Asuero Mantero, M. J., Pérez Espejo, María P., De la Corte Sánchez, M., Domínguez Anguiano, M., Ramos Sánchez, Mª Esperanza, Domínguez Domínguez, Sergio, Asuero Mantero, M. J., Pérez Espejo, María P., De la Corte Sánchez, M., and Domínguez Anguiano, M.

Abstract

The International Continent Society defines urinary incontinence (UI) as a situation in that the involuntary loss of urine through the urethra, provable objectively, generates a social and hygienic problem. It represents a complex pathology and of difficult solution. The impact on the quality of life of the UI is superior to other chronic pathologies,as hypertension or the diabetes; it deteriorates the quality of life, reduces self-esteem, having severe psychological and social repercussions. This article presents the clinical case of a patient with vesical hyperactivity and urinary incontinence, who during thirteen years sees her life altered by this pathology.., La International Continent Society define la incontinencia urinaria (IU) como una situación en que la pérdida involuntaria de orina a través de la uretra, demostrable objetivamente, genera un problema social e higiénico. Esta representa una patología compleja y de difícil solución. El impacto sobre la calidad de vida de la IU es superior a otras patologías crónicas, como la hipertensión o la diabetes; deteriora la calidad de vida, reduce la autoestima, teniendo graves repercusiones psicológicas y sociales. Este artículo presenta el caso clínico de una paciente con hiperactividad vesical e incontinencia urinaria, que durante trece años ve alterada su vida por esta patología.

Published
2013

35. Compliance with anti-H1N1 vaccine among healthcare workers and general population

Author

Blasi, F, Aliberti, S, Mantero, M, Centanni, S, ALIBERTI, STEFANO, Centanni, S., Blasi, F, Aliberti, S, Mantero, M, Centanni, S, ALIBERTI, STEFANO, and Centanni, S.

Abstract

Clin Microbiol Infect 2012; 18 (Suppl. 5) 37-41 ABSTRACT: Population protection through vaccination against infectious diseases has been one of the major achievements of public health care. The recent H1N1 influenza virus pandemic reopened the discussion on the strategic arrangements for vaccination in the face of spreading infection. Even though vaccination against a pandemic strain is considered to be one of the most effective countermeasures for protecting individuals, the general acceptance of H1N1 influenza vaccination has been low worldwide. The understanding of the potential health risks of the novel influenza A (H1N1) strain, the distrust of vaccinations and concerns about vaccine safety are the main reasons reported by the public for not undergoing vaccination. Concern about vaccine safety and distrust of health authorities are the commonest reasons given for low compliance with vaccination by healthcare workers. Better communication strategies to improve vaccination acceptance by the general population and by healthcare workers are required

Published
2012

36. Stratifying Risk Factors for Multidrug-Resistant Pathogens in Hospitalized Patients Coming From the Community With Pneumonia

Author

Aliberti, S, Di Pasquale, M, Zanaboni, A, Cosentini, R, Brambilla, A, Seghezzi, S, Tarsia, P, Mantero, M, Blasi, F, ALIBERTI, STEFANO, Zanaboni, AM, Brambilla, AM, Blasi, F., Aliberti, S, Di Pasquale, M, Zanaboni, A, Cosentini, R, Brambilla, A, Seghezzi, S, Tarsia, P, Mantero, M, Blasi, F, ALIBERTI, STEFANO, Zanaboni, AM, Brambilla, AM, and Blasi, F.

Abstract

(See the Editorial Commentary by Kollef, on pages 479-82.)Background. Not all risk factors for acquiring multidrug-resistant (MDR) organisms are equivalent in predicting pneumonia caused by resistant pathogens in the community. We evaluated risk factors for acquiring MDR bacteria in patients coming from the community who were hospitalized with pneumonia. Our evaluation was based on actual infection with a resistant pathogen and clinical outcome during hospitalization. Methods. An observational, prospective study was conducted on consecutive patients coming from the community who were hospitalized with pneumonia. Data on admission and during hospitalization were collected. Logistic regression models were used to evaluate risk factors for acquiring MDR bacteria independently associated with the actual presence of a resistant pathogen and in-hospital mortality.Results.Among the 935 patients enrolled in the study, 473 (51%) had at least 1 risk factor for acquiring MDR bacteria on admission. Of all risk factors, hospitalization in the preceding 90 days (odds ratio [OR], 4.87 95% confidence interval {CI}, 1.90-12.4]; P =. 001) and residency in a nursing home (OR, 3.55 [95% CI, 1.12-11.24]; P =. 031) were independent predictors for an actual infection with a resistant pathogen. A score able to predict pneumonia caused by a resistant pathogen was computed, including comorbidities and risk factors for MDR. Hospitalization in the preceding 90 days and residency in a nursing home were also independent predictors for in-hospital mortality. Conclusions. Risk factors for acquiring MDR bacteria should be weighted differently, and a probabilistic approach to identifying resistant pathogens among patients coming from the community with pneumonia should be embraced. © 2011 The Author.

Published
2012

37. Antibiotics as immunomodulant agents in COPD

Author

Blasi, F, Mantero, M, Aliberti, S, ALIBERTI, STEFANO, Blasi, F, Mantero, M, Aliberti, S, and ALIBERTI, STEFANO

Abstract

It is widely accepted that some antibiotics have activities beyond their direct antibacterial effects. Macrolide is the antibiotic class with more convincing studies and evidence on its immunomodulatory and anti-inflammatory activities. Different clinical studies have shown that macrolide prophylaxis in patients with moderate-severe chronic obstructive pulmonary disease (COPD) can have a significant impact on the exacerbation rate reducing morbidity and, potentially, mortality of the disease. Other antibiotics, such as fluoroquinolones, demonstrate a variety of immunomodulatory effects but only few clinical data are available in COPD. New macrolide derivatives devoid of antibacterial activity have been synthetized. This review analyses the relevance of immunomodulatory and anti-inflammatory effects of antibiotics in the management of COPD.

Published
2012

38. Impact of traffic-related air pollution on pulmonary oxidative stress

Author

Mantero, M, Aliberti, S, Faverio, P, Geroli, L, Novelli, L, Alinovi, R, Pinelli, S, Pesci, A, MANTERO, MARCO, ALIBERTI, STEFANO, FAVERIO, PAOLA, GEROLI, LUCA, NOVELLI, LUCA, PESCI, ALBERTO, Mantero, M, Aliberti, S, Faverio, P, Geroli, L, Novelli, L, Alinovi, R, Pinelli, S, Pesci, A, MANTERO, MARCO, ALIBERTI, STEFANO, FAVERIO, PAOLA, GEROLI, LUCA, NOVELLI, LUCA, and PESCI, ALBERTO

Published
2011

40. Effectiveness and safety of a nonremovable fiberglass off-bearing cast versus a therapeutic shoe in the treatment of neuropathic foot ulcers: a randomized study.

Author

Caravaggi C, Faglia E, De Giglio R, Mantero M, Quarantiello A, Sommariva E, Gino M, Pritelli C, Morabito A, Caravaggi, C, Faglia, E, De Giglio, R, Mantero, M, Quarantiello, A, Sommariva, E, Gino, M, Pritelli, C, and Morabito, A

Abstract

Objective: To evaluate and compare the rate of reduction of the surface area of neuropathic plantar ulcers in diabetic patients treated with nonremovable rigidity-differentiated fiberglass off-bearing casts or a cloth shoe with a rigid sole with unloading alkaform insoles. The secondary aim was to evaluate the side effects and degree of patient acceptance of treatment.Research Design and Methods: Fifty diabetic patients with neuropathic plantar ulcers were consecutively enrolled and randomized to one of two treatment groups. Of the 50 patients, 24 were treated with a specialized cloth shoe with a rigid sole and an unloading alkaform insole (shoe group), and 26 patients were treated with a nonremovable off-bearing fiberglass cast (cast group). All patients in both study groups returned to the clinic for weekly control visits. Their ulcers were treated with a standard dressing. Tracings of the ulcer area using a transparent dressing were performed on the day of entry to the study and after 30 days of treatment. The presence of new ulcerations caused by the use of the pressure-relief apparatus was recorded. Patient acceptance of the treatment was measured using a visual analog scale.Results: At the end of the treatment period, an 8.3% increase of the ulcer area was observed in two patients in the shoe group, whereas in the cast group, no patient presented an increase. The reduction of the ulcer area was statistically more rapid in the cast group (Mann-Whitney test, P = 0.0004). Furthermore, the number of ulcers completely healed at the 30-day time point was 13 (50%) in the cast group and 5 (20.8%) in the shoe group (P = 0.03). In both groups, no side effects were recorded. The average score +/- SD of patient acceptance was 91.15 +/- 9.9 in the shoe group and 88.33 +/- 17.3 (NS) in the cast group.Conclusions: Our study has shown a significant difference in the speed of the reduction of neuropathic plantar ulcers treated with a fiberglass cast compared with a specialized cloth shoe. The use of fiberglass material with variable rigidity has also shown two important results: the elimination of side effects including ulcers caused by the cast, and high patient acceptance. These data show that the use of off-bearing casts made with fiberglass bandages of variable rigidity is the elective treatment of neuropathic plantar ulcers. [ABSTRACT FROM AUTHOR]

Published
2000
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48. Long-term prognosis of diabetic patients with critical limb ischemia: a population-based cohort study.

Author

Faglia E, Clerici G, Clerissi J, Gabrielli L, Losa S, Mantero M, Caminiti M, Curci V, Quarantiello A, Luppattelli T, Morabito A, Faglia, Ezio, Clerici, Giacomo, Clerissi, Jacques, Gabrielli, Livio, Losa, Sergio, Mantero, Manuela, Caminiti, Maurizio, Curci, Vincenzo, and Quarantiello, Antonella

Abstract

Objective: To evaluate the long-term prognosis of critical limb ischemia (CLI) in diabetic patients.Research Design and Methods: A total of 564 consecutive diabetic patients were hospitalized for CLI from January 1999 to December 2003; 554 were followed until December 2007.Results: The mean follow-up was 5.93 +/- 1.28 years. Peripheral angioplasty (PTA) was performed in 420 (74.5%) and bypass graft (BPG) in 117 (20.6%) patients. Neither PTA nor BPG were possible in 27 (4.9%) patients. Major amputations were performed in 74 (13.4%) patients: 34 (8.2%) in PTA, 24 (21.1%) in BPG, and 16 (59.2%) in a group that received no revascularization. Restenosis occurred in 94 patients, bypass failures in 36 patients, and recurrent ulcers in 71 patients. CLI was observed in the contralateral limb of 225 (39.9%) patients; of these, 15 (6.7%) required major amputations (rate in contralateral compared with initial limb, P = 0.007). At total of 276 (49.82%) patients died. The Cox model showed significant hazard ratios (HRs) for mortality with age (1.05 for 1 year [95% CI 1.03-1.07]), unfeasible revascularization (3.06 [1.40-6.70]), dialysis (3.00 [1.63-5.53]), cardiac disease history (1.37 [1.05-1.79]), and impaired ejection fraction (1.08 for 1% point [1.05-1.09]).Conclusions: Diabetic patients with CLI have high risks of amputation and death. In a dedicated diabetic foot center, the major amputation, ulcer recurrence, and major contralateral limb amputation rates were low. Coronary artery disease (CAD) is the leading cause of death, and in patients with CAD history the impaired ejection fraction is the major independent prognostic factor. [ABSTRACT FROM AUTHOR]

Published
2009
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49. Transient 2D FEM-fluid network coupling for thermo-mechanical whole gas turbine engine simulations: modelling features and applications

Author

Giuntini Sabrina, Andreini Antonio, Facchini Bruno, Mantero Marco, Pirotta Marco, and Olmes Sven

Subjects
Environmental sciences, GE1-350
Abstract

In order to control the thermo-mechanical stresses that large heavy-duty power generation turbines have to face nowadays in their frequent operational transients, the analysis of the heat transfer between main flow, secondary air systems and structural components has to consider multi-physics coupled interactions, and has to be carried out with a whole engine modelling approach, simulating the entire machine in the real operating conditions. This is fundamental to guarantee a reliable assessment of life timing consumption and optimize clearances and temperature picks, through an efficient secondary air system design. It is here proposed a comprehensive description of modelling features and assumptions needed for the transient thermo-mechanical characterization of the whole engine through the application of a FEM-fluid network coupling methodology developed in collaboration with Ansaldo Energia and based on the open source code CalculiX®. In the present work the transient thermal modelling capability of the procedure will be verified through its application to a real whole engine geometry under a realistic transient cycle, comparing results with those of a reference FEM code.

Published
2020
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