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1. EBV DNA increase in COVID-19 patients with impaired lymphocyte subpopulation count

Author

Bruno, R, Mondelli, M, Brunetti, E, Di Matteo, A, Seminari, E, Maiocchi, L, Zuccaro, V, Pagnucco, L, Mariani, B, Ludovisi, S, Lissandrin, R, Parisi, A, Sacchi, P, Patruno, SFA, Michelone, G, Gulminetti, R, Zanaboni, D, Novati, S, Maserati, R, Orsolini, P, Vecchia, M, Sciarra, M, Asperges, E, Colaneri, M, Di Filippo, A, Sambo, M, Biscarini, S, Lupi, M, Roda, S, Pieri, TC, Gallazzi, I, Sachs, M, Valsecchi, P, Perlini, S, Alfano, C, Bonzano, M, Briganti, F, Crescenzi, G, Falchi, AG, Guarnone, R, Guglielmana, B, Maggi, E, Martino, I, Pettenazza, P, Pioli di Marco, S, Quaglia, F, Sabena, A, Salinaro, F, Speciale, F, Zunino, I, De Lorenzo, M, Secco, G, Dimitry, L, Cappa, G, Maisak, I, Chiodi, B, Sciarrini, M, Barcella, B, Resta, F, Moroni, L, Vezzoni, G, Scattaglia, L, Boscolo, E, Zattera, C, Tassi, MF, Capozza, V, Vignaroli, D, Bazzini, M, Iotti, G, Mojoli, F, Belliato, M, Perotti, L, Mongodi, S, Tavazzi, G, Marseglia, G, Licari, A, Brambilla, I, Barbarini, D, Bruno, A, Cambieri, P, Campanini, G, Cavanna, C., Comolli, G, Corbella, M, Daturi, R, Furione, M, Marone, P, Monzillo, E, Paolucci, S, Parea, M, Percivalle, E, Piralla, A, Rovida, F, Sarasini, A, Zavattoni, M, Adzasehoun, G, Ardizzone, M, Bellotti, L, Brunco, V, Cabano, E, Casali, G, Capella, L, Devitis, D, Dossena, L, Frisco, G, Garbagnoli, G, Gardellini, F, Girello, A, Guerrizio, A, Landini, V, Lucchelli, C, Maliardi, V, Piemontese, P, Pezzaia, S, Premoli, M, Rebuffa, C, Zanello, C, Bagnarino, J, Bergami, F, Bonetti, A, Caneva, G, Cassaniti, I, Corcione, A, Di Martino, R, Di Napoli, A, Ferrari, A, Ferrari, G, Fiorina, L, Gallone, A, Giardina, F, Girardi, A, Mercato, A, Merla, C, Novazzi, F, Ratano, G, Rossi, B, Saveriaempillai, G, Sciabica, IM, Tallarita, M, Vecchio Nepita, E, Vitali, J, Cerino, A, Varchetta, S, Oliviero, B, Mantovani, S, Mele, D, Calvi, M, Tizzoni, M, Nicora, C, Triarico, A, Petronella, V, Marena, C, Muzzi, A, Lago, P, Cutti, S, Novelli, V, Comandatore, F, BatistiBiffignandi, G, Gaiarsa, S, Rettani, M, Bandi, C, Paolucci, Stefania, Cassaniti, Irene, Novazzi, Federica, Fiorina, Loretta, Piralla, Antonio, Comolli, Giuditta, Bruno, Raffaele, Maserati, Renato, Gulminetti, Roberto, Novati, Stefano, Mojoli, Francesco, and Baldanti, Fausto

Published
2021
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2. Lung ultrasound for the early diagnosis of COVID-19 pneumonia: an international multicenter study

Author

Volpicelli, G., Gargani, L., Perlini, S., Spinelli, S., Barbieri, G., Lanotte, A., Casasola, G. G., Nogue-Bou, R., Lamorte, A., Agricola, E., Villen, T., Deol, P. S., Nazerian, P., Corradi, F., Stefanone, V., Fraga, D. N., Navalesi, P., Ferre, R., Boero, E., Martinelli, G., Cristoni, L., Perani, C., Vetrugno, L., Mcdermott, C., Miralles-Aguiar, F., Secco, G., Zattera, C., Salinaro, F., Grignaschi, A., Boccatonda, A., Giostra, F., Infante, M. N., Covella, M., Ingallina, G., Burkert, J., Frumento, P., Forfori, F., Ghiadoni, L., Fraccalini, T., Vendrame, A., Basile, V., Cipriano, A., Frassi, F., Santini, M., Falcone, M., Menichetti, F., Barcella, B., Delorenzo, M., Resta, F., Vezzoni, G., Bonzano, M., Briganti, D. F., Cappa, G., Zunino, I., Demitry, L., Vignaroli, D., Dipietro, L. S. S., Bazzini, M., Capozza, V., Gonzalez, M. M., Gibal, R. V., Ibarz, R. P., Alfaro, L. M., Alfaro, C. M., Alins, M. G., Brown, A., Dunlop, H., Ralli, M. L., Persona, P., Russel, F. M., Pang, P. S., Rovida, S., Deana, C., Franchini, D., Gargani, Luna, Volpicelli, G., Gargani, L., Perlini, S., Spinelli, S., Barbieri, G., Lanotte, A., Casasola, G. G., Nogue-Bou, R., Lamorte, A., Agricola, E., Villen, T., Deol, P. S., Nazerian, P., Corradi, F., Stefanone, V., Fraga, D. N., Navalesi, P., Ferre, R., Boero, E., Martinelli, G., Cristoni, L., Perani, C., Vetrugno, L., Mcdermott, C., Miralles-Aguiar, F., Secco, G., Zattera, C., Salinaro, F., Grignaschi, A., Boccatonda, A., Giostra, F., Infante, M. N., Covella, M., Ingallina, G., Burkert, J., Frumento, P., Forfori, F., Ghiadoni, L., Fraccalini, T., Vendrame, A., Basile, V., Cipriano, A., Frassi, F., Santini, M., Falcone, M., Menichetti, F., Barcella, B., Delorenzo, M., Resta, F., Vezzoni, G., Bonzano, M., Briganti, D. F., Cappa, G., Zunino, I., Demitry, L., Vignaroli, D., Dipietro, L. S. S., Bazzini, M., Capozza, V., Gonzalez, M. M., Gibal, R. V., Ibarz, R. P., Alfaro, L. M., Alfaro, C. M., Alins, M. G., Brown, A., Dunlop, H., Ralli, M. L., Persona, P., Russel, F. M., Pang, P. S., Rovida, S., Deana, C., and Franchini, D.

Subjects
Adult, medicine.medical_specialty, Multivariate analysis, Letter, Coronavirus disease 2019 (COVID-19), Original, COVID-19, Interstitial pneumonia, Lung ultrasound, SARS-CoV-2, Critical Care and Intensive Care Medicine, 03 medical and health sciences, 0302 clinical medicine, Anesthesiology, Internal medicine, medicine, Humans, Lung, Aged, Ultrasonography, business.industry, 030208 emergency & critical care medicine, Odds ratio, Middle Aged, medicine.disease, Confidence interval, Pneumonia, Early Diagnosis, 030228 respiratory system, Respiratory failure, Observational study, business
Abstract

Purpose To analyze the application of a lung ultrasound (LUS)-based diagnostic approach to patients suspected of COVID-19, combining the LUS likelihood of COVID-19 pneumonia with patient’s symptoms and clinical history. Methods This is an international multicenter observational study in 20 US and European hospitals. Patients suspected of COVID-19 were tested with reverse transcription-polymerase chain reaction (RT-PCR) swab test and had an LUS examination. We identified three clinical phenotypes based on pre-existing chronic diseases (mixed phenotype), and on the presence (severe phenotype) or absence (mild phenotype) of signs and/or symptoms of respiratory failure at presentation. We defined the LUS likelihood of COVID-19 pneumonia according to four different patterns: high (HighLUS), intermediate (IntLUS), alternative (AltLUS), and low (LowLUS) probability. The combination of patterns and phenotypes with RT-PCR results was described and analyzed. Results We studied 1462 patients, classified in mild (n = 400), severe (n = 727), and mixed (n = 335) phenotypes. HighLUS and IntLUS showed an overall sensitivity of 90.2% (95% CI 88.23–91.97%) in identifying patients with positive RT-PCR, with higher values in the mixed (94.7%) and severe phenotype (97.1%), and even higher in those patients with objective respiratory failure (99.3%). The HighLUS showed a specificity of 88.8% (CI 85.55–91.65%) that was higher in the mild phenotype (94.4%; CI 90.0–97.0%). At multivariate analysis, the HighLUS was a strong independent predictor of RT-PCR positivity (odds ratio 4.2, confidence interval 2.6–6.7, p

Published
2021

3. Emergency Department and Out-of-Hospital Emergency System (112—AREU 118) integrated response to Coronavirus Disease 2019 in a Northern Italy centre

Author

Perlini, S., Canevari, F., Cortesi, S., Sgromo, V., Brancaglione, A., Contri, E., Pettenazza, P., Salinaro, F., Speciale, F., Sechi, G., Mare, C., Cutti, S., Novelli, V., Marena, C., Muzzi, A., Bruno, R., Palo, A., Mondelli, M. U., Brunetti, E., Di Matteo, A., Seminari, E., Maiocchi, L., Zuccaro, V., Pagnucco, L., Mariani, B., Ludovisi, S., Lissandrin, R., Parisi, A., Sacchi, P., Patruno, S. F. A., Michelone, G., Gulminetti, R., Zanaboni, D., Novati, S., Maserati, R., Orsolini, P., Vecchia, M., Sciarra, M., Asperges, E., Colaneri, M., Di Filippo, A., Sambo, M., Biscarini, S., Lupi, M., Roda, S., Pieri, T. C., Gallazzi, I., Sachs, M., Valsecchi, P., Alfano, C., Bonzano, M., Briganti, F., Crescenzi, G., Falchi, A. G., Guarnone, R., Guglielmana, B., Maggi, E., Martino, I., di Marco, S. P., Quaglia, F., Sabena, A., Zunino, I., Furlan, N., Savioli, G., De Lorenzo, M., Secco, G., Dimitry, L., Cappa, G., Maisak, I., Chiodi, B., Sciarrini, M., Barcella, B., Resta, F., Moroni, L., Vezzoni, G., Scattaglia, L., Boscolo, E., Zattera, C., Fidel, T. M., Vincenzo, C., Bazzini, M., Lago, E., Bracchi, F., Sturniolo, G., Iotti, G., Mojoli, F., Belliato, M., Perotti, L., Mongodi, S., Tavazzi, G., Marseglia, G., Licari, A., Brambilla, I., Daniela, B., Antonella, B., Patrizia, C., Giulia, C., Giuditta, C., Marta, C., Rossana, D., Milena, F., Bianca, M., Roberta, M., Enza, M., Stefania, P., Maurizio, P., Elena, P., Antonio, P., Francesca, R., Antonella, S., Maurizio, Z., Guy, A., Laura, B., Ermanna, C., Giuliana, C., Luca, D., Gabriella, F., Gabriella, G., Alessia, G., Viviana, L., Claudia, L., Valentina, M., Simona, P., Marta, P., Alice, B., Giacomo, C., Irene, C., Alfonso, C., Raffella, D. M., Annapia, D. N., Alessandro, F., Guglielmo, F., Loretta, F., Federica, G., Alessandra, M., Novazzi, Federica, Giacomo, R., Beatrice, R., Maria, S. I., Monica, T., Edoardo, V. N., Cerino, A., Varchetta, S., Oliviero, B., Mantovani, S., Mele, D., Calvi, M., Tizzoni, M., Nicora, C., Triarico, A., Petronella, V., Lago, P., Rettani, M., Comandatore, F., Bissignandi, G., Gaiarsa, S., Bandi, C., Ferrari, A., and Pasi, F.

Subjects
Emergency Medical Services, Coronavirus disease 2019 (COVID-19), Pneumonia, Viral, Population, Disease, 030204 cardiovascular system & hematology, law.invention, Hospital, 03 medical and health sciences, Patient Admission, 0302 clinical medicine, law, Health care, Pandemic, Internal Medicine, medicine, Covid-19, Emergency department, Emergency medical system, Emergency medical system organization, SARS-CoV-2, COVID-19, Coronavirus Infections, Emergency Service, Hospital, Humans, Intensive Care Units, Italy, Pandemics, Viral, 030212 general & internal medicine, education, Emergency Service, education.field_of_study, business.industry, Outbreak, Pneumonia, medicine.disease, Intensive care unit, Im - Original, Emergency Medicine, Medical emergency, business
Abstract

Since December 2019, the world has been facing the life-threatening disease, named Coronavirus disease-19 (COVID-19), recognized as a pandemic by the World Health Organization. The response of the Emergency Medicine network, integrating "out-of-hospital" and "hospital" activation, is crucial whenever the health system has to face a medical emergency, being caused by natural or human-derived disasters as well as by a rapidly spreading epidemic outbreak. We here report the Pavia Emergency Medicine network response to the COVID-19 outbreak. The "out-of-hospital" response was analysed in terms of calls, rescues and missions, whereas the "hospital" response was detailed as number of admitted patients and subsequent hospitalisation or discharge. The data in the first 5 weeks of the Covid-19 outbreak (February 21-March 26, 2020) were compared with a reference time window referring to the previous 5 weeks (January 17-February 20, 2020) and with the corresponding historical average data from the previous 5 years (February 21-March 26). Since February 21, 2020, a sudden and sustained increase in the calls to the AREU 112 system was noted (+ 440%). After 5 weeks, the number of calls and missions was still higher as compared to both the reference pre-Covid-19 period (+ 48% and + 10%, respectively) and the historical control (+ 53% and + 22%, respectively). Owing to the overflow from the neighbouring hospitals, which rapidly became overwhelmed and had to temporarily close patient access, the population served by the Pavia system more than doubled (from 547.251 to 1.135.977 inhabitants, + 108%). To minimize the possibility of intra-hospital spreading of the infection, a separate "Emergency Department-Infective Disease" was created, which evaluated 1241 patients with suspected infection (38% of total ED admissions). Out of these 1241 patients, 58.0% (n = 720) were admitted in general wards (n = 629) or intensive care unit (n = 91). To allow this massive number of admissions, the hospital reshaped many general ward Units, which became Covid-19 Units (up to 270 beds) and increased the intensive care unit beds from 32 to 60. In the setting of a long-standing continuing emergency like the present Covid-19 outbreak, the integration, interaction and team work of the "out-of-hospital" and "in-hospital" systems have a pivotal role. The present study reports how the rapid and coordinated reorganization of both might help in facing such a disaster. AREU-112 and the Emergency Department should be ready to finely tune their usual cooperation to respond to a sudden and overwhelming increase in the healthcare needs brought about by a pandemia like the current one. This lesson should shape and reinforce the future.

Published
2020
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4. Low risk for SARS-CoV2 symptomatic infection and early complications in paediatric patients during the ongoing CoVID19 epidemics in Lombardy

Author

Bruno, R., Mondelli, M., Brunetti, E., Di Matteo, A., Seminari, E., Maiocchi, L., Zuccaro, V., Pagnucco, L., Mariani, B., Ludovisi, S., Lissandrin, R., Parisi, A., Sacchi, P., Patruno, S.F.A., Michelone, G., Gulminetti, R., Zanaboni, D., Novati, S., Maserati, R., Orsolini, P., Vecchia, M., Sciarra, M., Asperges, E., Colaneri, M., Di Filippo, A., Sambo, M., Biscarini, S., Lupi, M., Roda, S., Pieri, T.C., Gallazzi, I., Sachs, M., Valsecchi, P., Perlini, S., Alfano, C., Bonzano, M., Briganti, F., Crescenzi, G., Falchi, A.G., Guarnone, R., Guglielmana, B., Maggi, E., Martino, I., Pettenazza, P., Pioli di Marco, S., Quaglia, F., Sabena, A., Salinaro, F., Speciale, F., Zunino, I., De Lorenzo, M., Secco, G., Dimitry, L., Cappa, G., Maisak, I., Chiodi, B., Sciarrini, M., Barcella, B., Resta, F., Moroni, L., Vezzoni, G., Scattaglia, L., Boscolo, E., Zattera, C., Tassi, M.F., Capozza, V., Vignaroli, D., Bazzini, M., Iotti, G., Mojoli, F., Belliato, M., Perotti, L., Mongodi, S., Tavazzi, G., Marseglia, G., Licari, A., Brambilla, I., Barbarini, D., Bruno, A., Cambieri, P., Campanini, G., Comolli, G., Corbella, M., Daturi, R., Furione, M., Monzillo, E., Paolucci, S., Parea, M., Percivalle, E., Piralla, A., Rovida, F., Sarasini, A., Zavattoni, M., Adzasehoun, G., Bellotti, L., Cabano, E., Casali, G., Dossena, L., Frisco, G., Garbagnoli, G., Girello, A., Landini, V., Lucchelli, C., Maliardi, V., Pezzaia, S., Premoli, M., Bonetti, A., Caneva, G., Cassaniti, I., Corcione, A., Di Martino, R., Di Napoli, A., Ferrari, A., Ferrari, G., Fiorina, L., Giardina, F., Mercato, A., Novazzi, F., Ratano, G., Rossi, B., Sciabica, I.M., Tallarita, M., Vecchio Nepita, E., Calvi, M., Tizzoni, M., Nicora, C., Triarico, A., Petronella, V., Marena, C., Muzzi, A., Lago, P., Cereda, D., Marseglia, G.L., and Baldanti, F.

Published
2020
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5. Severe acute respiratory syndrome coronavirus 2 RNA contamination of inanimate surfaces and virus viability in a health care emergency unit

Author

Colaneri, M., Seminari, E., Novati, S., Asperges, E., Biscarini, S., Piralla, A., Percivalle, E., Cassaniti, I., Baldanti, F., Bruno, R., Mondelli, M. U., Brunetti, E., Di Matteo, A., Maiocchi, L., Zuccaro, V., Pagnucco, L., Ludovisi, S., Lissandrin, R., Parisi, A., Sacchi, P., Patruno, S. F. A., Michelone, G., Gulminetti, R., Zanaboni, D., Maserati, R., Orsolini, P., Vecchia, M., Di Filippo, A., Sambo, M., Lupi, M., Roda, S., Pieri, T. C., Gallazzi, I., Sachs, M., Valsecchi, P., Perlini, S., Alfano, C., Bonzano, M., Briganti, F., Crescenzi, G., Falchi, A. G., Guarnone, R., Guglielmana, B., Maggi, E., Martino, I., Pettenazza, P., di Marco, S. P., Quaglia, F., Sabena, A., Salinaro, F., Speciale, F., Zunino, I., de Lorenzo, M., Secco, G., Dimitry, L., Cappa, G., Maisak, I., Chiodi, B., Sciarrini, M., Barcella, B., Resta, F., Moroni, L., Vezzoni, G., Scattaglia, L., Boscolo, E., Zattera, C., Fidel, T. M., Vincenzo, C., Vignaroli, D., Bazzini, M., Iotti, G., Mojoli, F., Belliato, M., Perotti, L., Mongodi, S., Tavazzi, G., Marseglia, G., Licari, A., Brambilla, I., Barbarini, D., Bruno, A., Cambieri, P., Campanini, G., Cavanna, C., Comolli, G., Corbella, M., Daturi, R., Furione, M., Mariani, B., Marone, P., Monzillo, V., Paolucci, S., Parea, M., Rovida, F., Sarasini, A., Zavattoni, M., Adzasehoun, G., Ardizzone, M., Bellotti, L., Brunco, V., Cabano, E., Casali, G., Capella, L., Devitis, D., Dossena, L., Frisco, G., Garbagnoli, G., Gardellini, F., Girello, A., Guerrizio, A., Landini, V., Lucchelli, C., Maliardi, V., Piemontese, P., Pezzaia, S., Premoli, M., Rebuffa, C., Bagnarino, J., Bergami, F., Bonetti, A., Caneva, G., Corcione, A., Di Martino, R., Di Napoli, A., Ferrari, A., Ferrari, G., Fiorina, L., Gallone, A., Giardina, F., Girardi, A., Mercato, A., Novazzi, F., Ratano, G., Rossi, B., Saverimpilla, G., Sciabica, I. M., Tallarita, M., Nepita, E. V., Vitali, J., Cerino, A., Varchetta, S., Oliviero, B., Mantovani, S., Mele, D., Calvi, M., Tizzoni, M., Nicola, C., Triarico, A., Petronella, V., Marena, C., Muzzi, A., Lago, P., Comandatore, F., Biffignandi, G. B., Gaiarsa, S., Rettani, M., and Bandi, C.

Subjects
0301 basic medicine, Microbiology (medical), Environmental contamination, medicine.medical_treatment, 030106 microbiology, Microbiology, Coronavirus disease 2019, Severe acute respiratory syndrome coronavirus-2, Surfaces, Vero E6 cells, Animals, Betacoronavirus, Chlorocebus aethiops, Coronavirus Envelope Proteins, Equipment Contamination, Fomites, Humans, Intensive Care Units, Microbial Viability, RNA-Dependent RNA Polymerase, Reverse Transcriptase Polymerase Chain Reaction, SARS-CoV-2, Vero Cells, Viral Envelope Proteins, Viral Proteins, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, RNA polymerase, medicine, 030212 general & internal medicine, Continuous positive airway pressure, Respiratory system, Gene, Cytopathic effect, business.industry, RNA, General Medicine, Infectious Diseases, chemistry, Vero cell, business
Abstract

Objectives To detect possible severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) RNA contamination of inanimate surfaces in areas at high risk of aerosol formation by patients with coronavirus disease 2019 (COVID-19). Methods Sampling was performed in the emergency unit and the sub-intensive care ward. SARS-CoV-2 RNA was extracted from swabbed surfaces and objects and subjected to real-time RT-PCR targeting RNA-dependent RNA polymerase and E genes. Virus isolation from positive samples was attempted in vitro on Vero E6 cells. Results Twenty-six samples were collected and only two were positive for low-level SARS-CoV-2 RNA, both collected on the external surface of continuous positive airway pressure helmets. All transport media were inoculated onto susceptible cells, but none induced a cytopathic effect on day 7 of culture. Conclusions Even though daily contact with inanimate surfaces and patient fomites in contaminated areas may be a medium of infection, our data obtained in real-life conditions suggest that it might be less extensive than hitherto recognized.

Published
2020
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7. EBV DNA increase in COVID-19 patients with impaired lymphocyte subpopulation count

Author

Paolucci, Stefania, primary, Cassaniti, Irene, additional, Novazzi, Federica, additional, Fiorina, Loretta, additional, Piralla, Antonio, additional, Comolli, Giuditta, additional, Bruno, Raffaele, additional, Maserati, Renato, additional, Gulminetti, Roberto, additional, Novati, Stefano, additional, Mojoli, Francesco, additional, Baldanti, Fausto, additional, Bruno, R, additional, Mondelli, M, additional, Brunetti, E, additional, Di Matteo, A, additional, Seminari, E, additional, Maiocchi, L, additional, Zuccaro, V, additional, Pagnucco, L, additional, Mariani, B, additional, Ludovisi, S, additional, Lissandrin, R, additional, Parisi, A, additional, Sacchi, P, additional, Patruno, SFA, additional, Michelone, G, additional, Gulminetti, R, additional, Zanaboni, D, additional, Novati, S, additional, Maserati, R, additional, Orsolini, P, additional, Vecchia, M, additional, Sciarra, M, additional, Asperges, E, additional, Colaneri, M, additional, Di Filippo, A, additional, Sambo, M, additional, Biscarini, S, additional, Lupi, M, additional, Roda, S, additional, Pieri, TC, additional, Gallazzi, I, additional, Sachs, M, additional, Valsecchi, P, additional, Perlini, S, additional, Alfano, C, additional, Bonzano, M, additional, Briganti, F, additional, Crescenzi, G, additional, Falchi, AG, additional, Guarnone, R, additional, Guglielmana, B, additional, Maggi, E, additional, Martino, I, additional, Pettenazza, P, additional, Pioli di Marco, S, additional, Quaglia, F, additional, Sabena, A, additional, Salinaro, F, additional, Speciale, F, additional, Zunino, I, additional, De Lorenzo, M, additional, Secco, G, additional, Dimitry, L, additional, Cappa, G, additional, Maisak, I, additional, Chiodi, B, additional, Sciarrini, M, additional, Barcella, B, additional, Resta, F, additional, Moroni, L, additional, Vezzoni, G, additional, Scattaglia, L, additional, Boscolo, E, additional, Zattera, C, additional, Tassi, MF, additional, Capozza, V, additional, Vignaroli, D, additional, Bazzini, M, additional, Iotti, G, additional, Mojoli, F, additional, Belliato, M, additional, Perotti, L, additional, Mongodi, S, additional, Tavazzi, G, additional, Marseglia, G, additional, Licari, A, additional, Brambilla, I, additional, Barbarini, D, additional, Bruno, A, additional, Cambieri, P, additional, Campanini, G, additional, Cavanna, C., additional, Comolli, G, additional, Corbella, M, additional, Daturi, R, additional, Furione, M, additional, Marone, P, additional, Monzillo, E, additional, Paolucci, S, additional, Parea, M, additional, Percivalle, E, additional, Piralla, A, additional, Rovida, F, additional, Sarasini, A, additional, Zavattoni, M, additional, Adzasehoun, G, additional, Ardizzone, M, additional, Bellotti, L, additional, Brunco, V, additional, Cabano, E, additional, Casali, G, additional, Capella, L, additional, Devitis, D, additional, Dossena, L, additional, Frisco, G, additional, Garbagnoli, G, additional, Gardellini, F, additional, Girello, A, additional, Guerrizio, A, additional, Landini, V, additional, Lucchelli, C, additional, Maliardi, V, additional, Piemontese, P, additional, Pezzaia, S, additional, Premoli, M, additional, Rebuffa, C, additional, Zanello, C, additional, Bagnarino, J, additional, Bergami, F, additional, Bonetti, A, additional, Caneva, G, additional, Cassaniti, I, additional, Corcione, A, additional, Di Martino, R, additional, Di Napoli, A, additional, Ferrari, A, additional, Ferrari, G, additional, Fiorina, L, additional, Gallone, A, additional, Giardina, F, additional, Girardi, A, additional, Mercato, A, additional, Merla, C, additional, Novazzi, F, additional, Ratano, G, additional, Rossi, B, additional, Saveriaempillai, G, additional, Sciabica, IM, additional, Tallarita, M, additional, Vecchio Nepita, E, additional, Vitali, J, additional, Cerino, A, additional, Varchetta, S, additional, Oliviero, B, additional, Mantovani, S, additional, Mele, D, additional, Calvi, M, additional, Tizzoni, M, additional, Nicora, C, additional, Triarico, A, additional, Petronella, V, additional, Marena, C, additional, Muzzi, A, additional, Lago, P, additional, Cutti, S, additional, Novelli, V, additional, Comandatore, F, additional, BatistiBiffignandi, G, additional, Gaiarsa, S, additional, Rettani, M, additional, and Bandi, C, additional

Published
2021
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8. Low risk for SARS-CoV2 symptomatic infection and early complications in paediatric patients during the ongoing CoVID19 epidemics in Lombardy

Author

Rovida, F., primary, Cereda, D., additional, Novati, S., additional, Licari, A., additional, Triarico, A., additional, Marseglia, G.L., additional, Bruno, R., additional, Baldanti, F., additional, Mondelli, M., additional, Brunetti, E., additional, Di Matteo, A., additional, Seminari, E., additional, Maiocchi, L., additional, Zuccaro, V., additional, Pagnucco, L., additional, Mariani, B., additional, Ludovisi, S., additional, Lissandrin, R., additional, Parisi, A., additional, Sacchi, P., additional, Patruno, S.F.A., additional, Michelone, G., additional, Gulminetti, R., additional, Zanaboni, D., additional, Maserati, R., additional, Orsolini, P., additional, Vecchia, M., additional, Sciarra, M., additional, Asperges, E., additional, Colaneri, M., additional, Di Filippo, A., additional, Sambo, M., additional, Biscarini, S., additional, Lupi, M., additional, Roda, S., additional, Pieri, T.C., additional, Gallazzi, I., additional, Sachs, M., additional, Valsecchi, P., additional, Perlini, S., additional, Alfano, C., additional, Bonzano, M., additional, Briganti, F., additional, Crescenzi, G., additional, Falchi, A.G., additional, Guarnone, R., additional, Guglielmana, B., additional, Maggi, E., additional, Martino, I., additional, Pettenazza, P., additional, Pioli di Marco, S., additional, Quaglia, F., additional, Sabena, A., additional, Salinaro, F., additional, Speciale, F., additional, Zunino, I., additional, De Lorenzo, M., additional, Secco, G., additional, Dimitry, L., additional, Cappa, G., additional, Maisak, I., additional, Chiodi, B., additional, Sciarrini, M., additional, Barcella, B., additional, Resta, F., additional, Moroni, L., additional, Vezzoni, G., additional, Scattaglia, L., additional, Boscolo, E., additional, Zattera, C., additional, Tassi, M.F., additional, Capozza, V., additional, Vignaroli, D., additional, Bazzini, M., additional, Iotti, G., additional, Mojoli, F., additional, Belliato, M., additional, Perotti, L., additional, Mongodi, S., additional, Tavazzi, G., additional, Marseglia, G., additional, Brambilla, I., additional, Barbarini, D., additional, Bruno, A., additional, Cambieri, P., additional, Campanini, G., additional, Comolli, G., additional, Corbella, M., additional, Daturi, R., additional, Furione, M., additional, Monzillo, E., additional, Paolucci, S., additional, Parea, M., additional, Percivalle, E., additional, Piralla, A., additional, Rovida, F., additional, Sarasini, A., additional, Zavattoni, M., additional, Adzasehoun, G., additional, Bellotti, L., additional, Cabano, E., additional, Casali, G., additional, Dossena, L., additional, Frisco, G., additional, Garbagnoli, G., additional, Girello, A., additional, Landini, V., additional, Lucchelli, C., additional, Maliardi, V., additional, Pezzaia, S., additional, Premoli, M., additional, Bonetti, A., additional, Caneva, G., additional, Cassaniti, I., additional, Corcione, A., additional, Di Martino, R., additional, Di Napoli, A., additional, Ferrari, A., additional, Ferrari, G., additional, Fiorina, L., additional, Giardina, F., additional, Mercato, A., additional, Novazzi, F., additional, Ratano, G., additional, Rossi, B., additional, Sciabica, I.M., additional, Tallarita, M., additional, Vecchio Nepita, E., additional, Calvi, M., additional, Tizzoni, M., additional, Nicora, C., additional, Petronella, V., additional, Marena, C., additional, Muzzi, A., additional, and Lago, P., additional

Published
2020
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9. Clinical characteristics of coronavirus disease (COVID-19) early findings from a teaching hospital in Pavia, North Italy, 21 to 28 February 2020

Author

Colaneri, M., Sacchi, P., Zuccaro, V., Biscarini, S., Sachs, M., Roda, S., Pieri, T. C., Valsecchi, P., Piralla, A., Seminari, E., Matteo, A. D., Novati, S., Maiocchi, L., Pagnucco, L., Tirani, M., Baldanti, F., Mojoli, F., Perlini, S., Bruno, R., Mondelli, M. U., Brunetti, E., Mariani, B., Ludovisi, S., Lissandrin, R., Parisi, A., Patruno, S. F. A., Michelone, G., Gulminetti, R., Zanaboni, D., Maserati, R., Orsolini, P., Vecchia, M., Asperges, E., Filippo, A. D., Sambo, M., Lupi, M., Gallazzi, I., Alfano, C., Bonzano, M., Briganti, F., Crescenzi, G., Falchi, A. G., Guarnone, R., Guglielmana, B., Maggi, E., Martino, I., Pettenazza, P., di Marco, S. P., Quaglia, F., Sabena, A., Salinaro, F., Speciale, F., Zunino, I., de Lorenzo, M., Secco, G., Dimitry, L., Cappa, G., Maisak, I., Chiodi, B., Sciarrini, M., Barcella, B., Resta, F., Moroni, L., Vezzoni, G., Scattaglia, L., Boscolo, E., Zattera, C., Fidel, T. M., Vincenzo, C., Vignaroli, D., Bazzini, M., Iotti, G., Belliato, M., Perotti, L., Mongodi, S., Tavazzi, G., Marseglia, G., Licari, A., Brambilla, I., Daniela, B., Antonella, B., Patrizia, C., Giulia, C., Giuditta, C., Marta, C., Rossana, D., Milena, F., Bianca, M., Roberta, M., Enza, M., Stefania, P., Maurizio, P., Elena, P., Francesca, R., Antonella, S., Maurizio, Z., Marone, P., Guy, A., Laura, B., Ermanna, C., Giuliana, C., Luca, D., Gabriella, F., Gabriella, G., Alessia, G., Viviana, L., Claudia, L., Valentina, M., Simona, P., Marta, P., Alice, B., Giacomo, C., Irene, C., Alfonso, C., Raffella, D. M., Annapia, D. N., Alessandro, F., Guglielmo, F., Loretta, F., Federica, G., Alessandra, M., Novazzi, Federica, Giacomo, R., Beatrice, R., Maria, S. I., Monica, T., Edoardo, V. N., Calvi, M., Tizzoni, M., Nicora, C., Triarico, A., Petronella, V., Marena, C., Muzzi, A., Cutti, S., Novelli, V., Lago, P., Comandatore, F., Gaiarsa, S., Rettani, M., Bandi, C., and Ferrari, A.

Subjects
medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), LDH, Epidemiology, retrospective study, Severe disease, Disease, 030204 cardiovascular system & hematology, medicine.disease_cause, Teaching hospital, Betacoronavirus, 03 medical and health sciences, 0302 clinical medicine, Virology, Internal medicine, Pandemic, medicine, Humans, Viral, 030212 general & internal medicine, Pandemics, Coronavirus, severe disease, Reverse Transcriptase Polymerase Chain Reaction, business.industry, SARS-CoV-2, Teaching, Public Health, Environmental and Occupational Health, Outbreak, COVID-19, Retrospective cohort study, Pneumonia, Hospitals, Europe, Italy, Coronavirus Infections, Hospitals, Teaching, Pneumonia, Viral, business, Rapid Communication
Abstract

We describe clinical characteristics, treatments and outcomes of 44 Caucasian patients with coronavirus disease (COVID-19) at a single hospital in Pavia, Italy, from 21–28 February 2020, at the beginning of the outbreak in Europe. Seventeen patients developed severe disease, two died. After a median of 6 days, 14 patients were discharged from hospital. Predictors of lower odds of discharge were age > 65 years, antiviral treatment and for severe disease, lactate dehydrogenase > 300 mg/dL.

Published
2020

10. Tocilizumab for treatment of severe covid-19 patients: Preliminary results from smatteo covid19 registry (smacore)

Author

Colaneri, M., Bogliolo, L., Valsecchi, P., Sacchi, P., Zuccaro, V., Brandolino, F., Montecucco, C., Mojoli, F., Giusti, E. M., Bruno, R., Mondelli, M. U., Brunetti, E., Di Matteo, A., Seminari, E., Maiocchi, L., Pagnucco, L., Ludovisi, S., Lissandrin, R., Parisi, A., Patruno, S. F. A., Michelone, G., Gulminetti, R., Zanaboni, D., Novati, S., Maserati, R., Orsolini, P., Vecchia, M., Asperges, E., Di Filippo, A., Sambo, M., Biscarini, S., Lupi, M., Roda, S., Chiara Pieri, T., Gallazzi, I., Sachs, M., Perlini, S., Alfano, C., Bonzano, M., Briganti, F., Crescenzi, G., Giulia Falchi, A., Guarnone, R., Guglielmana, B., Maggi, E., Martino, I., Pettenazza, P., Di Marco, S. P., Quaglia, F., Sabena, A., Salinaro, F., Speciale, F., Zunino, I., De Lorenzo, M., Secco, G., Dimitry, L., Cappa, G., Maisak, I., Chiodi, B., Sciarrini, M., Barcella, B., Resta, F., Moroni, L., Vezzoni, G., Scattaglia, L., Boscolo, E., Zattera, C., Fidel, T. M., Vincenzo, C., Vignaroli, D., Bazzini, M., Iotti, G., Maurelli, M., Mongodi, S., Tavazzi, G., Belliato, M., Perotti, L., Aliberti, A. R., Amatu, A., Anfossi, L., Arisi, E., Baldi, C., Bellini, L., Benzi, A., Bichisao, G., Bolongaro, A., Andrea, B., Federica, B., Giacomo, B., Luca, C., Emanuele, C., Valeria, C., Fabrizio, C., Maria, C., Maria Paola, D., Elisa Lucia, D., Federica, F., Fiorenza, F., Marta, F., Marinella, F., Maddalena Margherita, G., Simonetta, G., Marcella, I., Claudia, L. C., Giuseppe, M., Benedetta, M. M., Simonetta, M., Maria, M. P., Maria, M. A., Federica, M., Larissa, N. T., Silvano, N., Anita, O., Michele, P., Debora, P., Simona, P., Raffaella, P., Silvia, P., Marco, P., Emanuela, P., Roberta, P., Danila Katia, R., Gianluca, R., Filippo, R., Francesca, R., Roberto, R., Giuseppe, R., Emanuela, R., Cristina, R., Giuseppe, S. G., Fabio, S., Debora, S., Giulia, T., Federico, V., Silvia, Z., Alessandro, B., Corrado, B., Chiara, B., Andrea, C., Costanza, C., Julia, N., Valentino, D., Roberto, D., Adelaide, G. M., Filippo, G., Andrea, P., Cecilia, Q., Andrea, S., Francesco, T., Chiara, D., Francesco, E., Bruno, L., Elisa, M., Maria Chiara, R., Barbara, R., Mariangela, S., Monica, T., Federica, V., Roberto, V., Marseglia, G., Licari, A., Brambilla, I., Baldanti, F., Barbarini, D., Bruno, A., Campanini, G., Cavanna, C., Comolli, G., Corbella, M., Daturi, R., Furione, M., Mariani, B., Marone, P., Paolucci, S., Parea, M., Percivalle, E., Piralla, A., Rovida, F., Sarasini, A., Zavattoni, M., Piero, M., Cambieri, P., Monzillo, V., Ardizzone, M., Bellotti, L., Brunco, V., Cabano, E., Casali, G., Capella, L., Devitis, D., Dossena, L., Frisco, G., Garbagnoli, G., Gardellini, F., Girello, A., Guerrizio, A., Landini, V., Lucchelli, C., Maliardi, V., Piemontese, P., Pezzaia, S., Premoli, M., Rebuffa, C., Bagnarino, J., Bergami, F., Bonetti, A., Caneva, G., Cassaniti, I., Corcione, A., Di Martino, R., Di Napoli, A., Ferrari, A., Ferrari, G., Fiorina, L., Gallone, A., Giardina, F., Girardi, A., Mercato, A., Novazzi, F., Ratano, G., Rossi, B., Saverimpilla, G., Sciabica, I. M., Tallarita, M., Nepita, E. V., Vitali, J., Cerino, A., Varchetta, S., Oliviero, B., Mantovani, S., Mele, D., Calvi, M., Tizzoni, M., Nicora, C., Triarico, A., Petronella, V., Marena, C., Muzzi, A., Lago, P., Cutti, S., Novelli, V., Comandatore, F., Biffignandi, G. B., Gaiarsa, S., Rettani, M., and Bandi, C.

Subjects
Microbiology (medical), medicine.medical_specialty, Azithromycin, Off label therapy, Microbiology, Article, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Tocilizumab, Virology, Internal medicine, Propensity score matching, Medicine, 030212 general & internal medicine, COVID-19 pneumonia, Adverse effect, lcsh:QH301-705.5, 030203 arthritis & rheumatology, business.industry, Mortality rate, Hydroxychloroquine, medicine.disease, Pneumonia, chemistry, lcsh:Biology (General), Cohort, ICU, tocilizumab, off label therapy, propensity score matching, mortality rate, business, medicine.drug
Abstract

Objective: This study aimed to assess the role of Tocilizumab therapy (TCZ) in terms of ICU admission and mortality rate of critically ill patients with severe COVID-19 pneumonia. Design: Patients with COVID-19 pneumonia were prospectively enrolled in SMAtteo COvid19 REgistry (SMACORE). A retrospective analysis of patients treated with TCZ matched using propensity score to patients treated with Standard Of Care (SOC) was conducted. Setting: The study was conducted at IRCCS Policlinico San Matteo Hospital, Pavia, Italy, from March 14, 2020 to March 27, 2020. Participants: Patients with a confirmed diagnosis of COVID-19 hospitalized in our institution at the time of TCZ availability. Interventions: TCZ was administered to 21 patients. The first administration was 8 mg/kg (up to a maximum 800 mg per dose) of Tocilizumab intravenously, repeated after 12 h if no side effects were reported after the first dose. Main Outcomes and Measures: ICU admission and 7-day mortality rate. Secondary outcomes included clinical and laboratory data. Results: There were 112 patients evaluated (82 were male and 30 were female, with a median age of 63.55 years). Using propensity scores, the 21 patients who received TCZ were matched to 21 patients who received SOC (a combination of hydroxychloroquine, azithromycin and prophylactic dose of low weight heparin). No adverse event was detected following TCZ administration. This study found that treatment with TCZ did not significantly affect ICU admission (OR 0.11; 95% CI between 0.00 and 3.38; p = 0.22) or 7-day mortality rate (OR 0.78; 95% CI between 0.06 and 9.34; p = 0.84) when compared with SOC. Analysis of laboratory measures showed significant interactions between time and treatment regarding C-Reactive Protein (CRP), alanine aminotransferase (ALT), platelets and international normalized ratio (INR) levels. Variation in lymphocytes count was observed over time, irrespective of treatment. Conclusions: TCZ administration did not reduce ICU admission or mortality rate in a cohort of 21 patients. Additional data are needed to understand the effect(s) of TCZ in treating patients diagnosed with COVID-19.

Published
2020

11. Rapid response to COVID-19 outbreak in Northern Italy: how to convert a classic infectious disease ward into a COVID-19 response centre

Author

Asperges, E., Novati, S., Muzzi, A., Biscarini, S., Sciarra, M., Lupi, M., Sambo, M., Gallazzi, I., Peverini, M., Lago, P., Mojoli, F., Perlini, S., Bruno, R., Mondelli, M.U., Brunetti, E., Di Matteo, A., Seminari, E., Maiocchi, L., Zuccaro, V., Pagnucco, L., Mariani, B., Ludovisi, S., Parisi, R.L.A., Sacchi, P., Patruno, S.F.A., Michelone, G., Gulminetti, R., Zanaboni, D., Maserati, R., Orsolini, P., Vecchia, M., Colaneri, M., Di Filippo, A., Roda, S., Pieri, T.C., Sachs, M., Valsecchi, P., Alfano, C., Bonzano, M., Briganti, F., Crescenzi, G., Falchi, A.G., Guarnone, R., Guglielmana, B., Maggi, E., Martino, I., Pettenazza, P., Pioli di Marco, S., Quaglia, F., Sabena, A., Salinaro, F., Speciale, F., Zunino, I., De Lorenzo, M., Secco, G., Dimitry, L., Cappa, G., Maisak, I., Chiodi, B., Sciarrini, M., Barcella, B., Resta, F., Moroni, L., Vezzoni, G., Scattaglia, L., Boscolo, E., Zattera, C., Fidel, T.M., Vincenzo, C., Vignaroli, D., Bazzini, M., Iotti, G., Belliato, M., Perotti, L., Mongodi, S., Tavazzi, G., Marseglia, G., Licari, A., Brambilla, I., Daniela, B., Antonella, B., Patrizia, C., Giulia, C., Giuditta, C., Marta, C., Rossana, D., Milena, F., Bianca, M., Roberta, M., Enza, M., Stefania, P., Maurizio, P., Elena, P., Antonio, P., Francesca, R., Antonella, S., Maurizio, Z., Guy, A., Laura, B., Ermanna, C., Giuliana, C., Luca, D., Gabriella, F., Gabriella, G., Alessia, G., Viviana, L., Claudia, L., Valentina, M., Simona, P., Marta, P., Alice, B., Giacomo, C., Irene, C., Corcione, A., di Martino, R., di Napoli, A., Alessandro, F., Guglielmo, F., Loretta, F., Federica, G., Alessandra, M., Federica, N., Giacomo, R., Beatrice, R., Maria, S.I., Monica, T., Edoardo, V.N., Calvi, M., Tizzoni, M., Nicora, C., Triarico, A., Petronella, V., and Marena, C.

Subjects
Microbiology (medical), 2019-20 coronavirus outbreak, Coronavirus disease 2019 (COVID-19), business.industry, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Outbreak, General Medicine, Virology, Northern italy, Infectious Diseases, Infectious disease (medical specialty), Medicine, business, Rapid response
Published
2020

12. Detection of the SARS-CoV-2 in different biologic specimens from positive patients with COVID-19, in Northern Italy

Author

Novazzi, Federica, Cassaniti, Irene, Piralla, Antonio, Di Sabatino, Antonio, Bruno, Raffaele, Baldanti, Fausto, Mondelli, M, Brunetti, E, Di Matteo, A, Seminari, E, Maiocchi, L, Zuccaro, V, Pagnucco, L, Mariani, B, Ludovisi, S, Lissandrin, R, Parisi, A, Sacchi, P, Patruno, SFA, Michelone, G, Gulminetti, R, Zanaboni, D, Novati, S, Maserati, R, Orsolini, P, Vecchia, M, Sciarra, M, Asperges, E, Colaneri, M, Di Filippo, A, Sambo, M, Biscarini, S, Lupi, M, Roda, S, Pieri, TC, Gallazzi, I, Sachs, M, Valsecchi, P, Perlini, S, Alfano, C, Bonzano, M, Briganti, F, Crescenzi, G, Falchi, AG, Guarnone, R, Guglielmana, B, Maggi, E, Martino, I, Pettenazza, P, Pioli di Marco, S, Quaglia, F, Sabena, A, Salinaro, F, Speciale, F, Zunino, I, De Lorenzo, M, Secco, G, Dimitry, L, Cappa, G, Maisak, I, Chiodi, B, Sciarrini, M, Barcella, B, Resta, F, Moroni, L, Vezzoni, G, Scattaglia, L, Boscolo, E, Zattera, C, Tassi, MF, Capozza, V, Vignaroli, D, Bazzini, M, Iotti, G, Mojoli, F, Belliato, M, Perotti, L, Mongodi, S, Tavazzi, G, Marseglia, G, Licari, A, Brambilla, I, Barbarini, D, Bruno, A, Cambieri, P, Campanini, G, Cavanna, C, Comolli, G, Corbella, M, Daturi, R, Furione, M, Marone, P, Monzillo, E, Paolucci, S, Parea, M, Percivalle, E, Rovida, F, Sarasini, A, Zavattoni, M, Adzasehoun, G, Ardizzone, M, Bellotti, L, Brunco, V, Cabano, E, Casali, G, Capella, L, Devitis, D, Dossena, L, Frisco, G, Garbagnoli, G, Gardellini, F, Girello, A, Guerrizio, A, Landini, V, Lucchelli, C, Maliardi, V, Piemontese, P, Pezzaia, S, Premoli, M, Rebuffa, C, Zanello, C, Bagnarino, J, Bergami, F, Bonetti, A, Caneva, G, Corcione, A, Di Martino, R, Di Napoli, A, Ferrari, A, Ferrari, G, Fiorina, L, Gallone, A, Giardina, F, Girardi, A, Mercato, A, Ratano, G, Rossi, B, Saveriaempillai, G, Sciabica, IM, Tallarita, M, Vecchio Nepita, E, Vitali, J, Cerino, A, Varchetta, S, Oliviero, B, Mantovani, S, Mele, D, Calvi, M, Tizzoni, M, Nicora, C, Triarico, A, Petronella, V, Marena, C, Muzzi, A, Lago, P, Cutti, S, Novelli, V, Comandatore, F, Batisti Biffignandi, G, Gaiarsa, S, Rettani, M, and Bandi, C

Subjects
medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), education, Immunology, medicine.disease_cause, SARS‐CoV‐2, Covid‐19 in Children and Adolescents, 03 medical and health sciences, 2020 Update from The Italian Society of Pediatric Allergy and Immunology, 0302 clinical medicine, COVID‐19, Internal medicine, Epidemiology, transmission routes, medicine, Immunology and Allergy, 030212 general & internal medicine, Pediatrics, Perinatology, and Child Health, Coronavirus, swabs, specimen types, northern Italy, business.industry, SARS-CoV-2, COVID-19, medicine.disease, epidemiology, Northern italy, Pneumonia, 030228 respiratory system, Respiratory secretion, Nasal Swab, Pediatrics, Perinatology and Child Health, Supplement Article, business
Abstract

Coronavirus disease 2019 (COVID‐19) diagnosis is based on molecular detection of SARS‐CoV‐2 in respiratory samples such as nasal swab (NS) However, the evidence that NS in patients with pneumonia was sometimes negative raises the attention to collect other clinical specimens SARS‐CoV‐2 was shown in 10 3% rectal swabs (RS), 7 7% plasma, 1% urine, and 0% feces from 143 NS‐positive patients Potential infection by fluids different from respiratory secretion is possible but unlikely [ABSTRACT FROM AUTHOR] Copyright of Pediatric Allergy & Immunology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission However, users may print, download, or email articles for individual use This abstract may be abridged No warranty is given about the accuracy of the copy Users should refer to the original published version of the material for the full abstract (Copyright applies to all Abstracts )

Published
2020

18. Assessment of blood perfusion as possible tool in differentiating between human benign skin naevi and malignant melanomas.

Author

Rossi, M., Stefanovska, A., Vezzoni, G., Pesce, M., Loggini, B., Ghiara, F., Rossi, G., Pingitore, F., and Barachini, P.

Subjects
MELANOMA, BLOOD flow measurement, NEVUS
Abstract

Malignant melanomas (MM) are characterized by hypervascularisation which may affect MM blood flow and its oscillatory dynamic. The hypothesis of this study was that the blood flow assessment at the level of skin melanocytic lesions may aid in differentiating between benign skin naevi and MM. Fifty one subjects with clinically and dermatoscopically atypical naevi and 23 subjects with clinically and dermatoscopically typical benign naevi underwent blood flow (BF) measurement at the level of the lesion of interest (central and margin lesion site) and at the level of a clinically healthy skin site, contra lateral to the lesion of interest, using a single point laser-Doppler fluxmetry (LDF). After LDF, atypical naevi were excised and underwent histological examination and immuno-histo-chemistry microvessel count. At the histological examination, MM was demonstrated in 9 lesions, atypical benign naevus in 31 lesions and typical benign naevus in 11 lesions. No significant difference in BF was found between clinically benign naevi, histologically benign naevi and histologically atypical naevi (Wilcoxon test), which were then included in a single control group (CG) of 65 naevi. Compared to CG naevi, MM showed a significantly higher BF (at the level of both central and margin lesion site) and a significantly higher ratio in BF between lesion margin site and contra lateral skin site (LMS/CLS ratio), as well as between central lesion site and contra lateral skin site (Wilcoxon test). A LMS/CLS ratio > 1 was observed in 100% of MM and in 60% of CG naevi, with a sensitivity of 100 (95% C.I.: 65.5- 100), a specificity of 40 (95% C.I.: 28.8-52.9) and a ROC area of 0.70 (95% C.I.: 0.64 - 0.76). The results of this study show that MM have a significantly greater BF compared to benign naevi (both typical and atypical) and suggest that a > 1 LMS/CLS BF ratio could be a suitable cut-off for selecting naevi to be examined by histology in order to exclude MM. This last result should be confirmed in a larger group of MM patients. [ABSTRACT FROM AUTHOR]

Published
2013

19. Lung ultrasound presentation of COVID-19 patients: phenotypes and correlations.

Author

Secco G, Delorenzo M, Salinaro F, Zattera C, Barcella B, Resta F, Sabena A, Vezzoni G, Bonzano M, Briganti F, Cappa G, Zugnoni F, Demitry L, Mojoli F, Baldanti F, Bruno R, and Perlini S

Subjects
Humans, Lung diagnostic imaging, Phenotype, RNA, Viral, SARS-CoV-2, Ultrasonography, COVID-19
Abstract

Bedside lung ultrasound (LUS) can play a role in the setting of the SarsCoV2 pneumonia pandemic. To evaluate the clinical and LUS features of COVID-19 in the ED and their potential prognostic role, a cohort of laboratory-confirmed COVID-19 patients underwent LUS upon admission in the ED. LUS score was derived from 12 fields. A prevalent LUS pattern was assigned depending on the presence of interstitial syndrome only (Interstitial Pattern), or evidence of subpleural consolidations in at least two fields (Consolidation Pattern). The endpoint was 30-day mortality. The relationship between hemogasanalysis parameters and LUS score was also evaluated. Out of 312 patients, only 36 (11.5%) did not present lung involvment, as defined by LUS score < 1. The majority of patients were admitted either in a general ward (53.8%) or in intensive care unit (9.6%), whereas 106 patients (33.9%) were discharged from the ED. In-hospital mortality was 25.3%, and 30-day survival was 67.6%. A LUS score > 13 had a 77.2% sensitivity and a 71.5% specificity (AUC 0.814; p < 0.001) in predicting mortality. LUS alterations were more frequent (64%) in the posterior lower fields. LUS score was related with P/F (R 2 0.68; p < 0.0001) and P/F at FiO 2  = 21% (R 2 0.59; p < 0.0001). The correlation between LUS score and P/F was not influenced by the prevalent ultrasound pattern. LUS represents an effective tool in both defining diagnosis and stratifying prognosis of COVID-19 pneumonia. The correlation between LUS and hemogasanalysis parameters underscores its role in evaluating lung structure and function., (© 2021. The Author(s).)

Published
2021
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20. Can Alveolar-Arterial Difference and Lung Ultrasound Help the Clinical Decision Making in Patients with COVID-19?

Author

Secco G, Salinaro F, Bellazzi C, La Salvia M, Delorenzo M, Zattera C, Barcella B, Resta F, Vezzoni G, Bonzano M, Cappa G, Bruno R, Casagranda I, and Perlini S

Abstract

Background: COVID-19 is an emerging infectious disease, that is heavily challenging health systems worldwide. Admission Arterial Blood Gas (ABG) and Lung Ultrasound (LUS) can be of great help in clinical decision making, especially during the current pandemic and the consequent overcrowding of the Emergency Department (ED). The aim of the study was to demonstrate the capability of alveolar-to-arterial oxygen difference (AaDO 2 ) in predicting the need for subsequent oxygen support and survival in patients with COVID-19 infection, especially in the presence of baseline normal PaO 2 /FiO 2 ratio (P/F) values., Methods: A cohort of 223 swab-confirmed COVID-19 patients underwent clinical evaluation, blood tests, ABG and LUS in the ED. LUS score was derived from 12 ultrasound lung windows. AaDO 2 was derived as AaDO 2 = ((FiO 2 ) (Atmospheric pressure - H 2 O pressure) - (PaCO 2 /R)) - PaO 2 . Endpoints were subsequent oxygen support need and survival., Results: A close relationship between AaDO 2 and P/F and between AaDO 2 and LUS score was observed (R 2 = 0.88 and R 2 = 0.67, respectively; p < 0.001 for both). In the subgroup of patients with P/F between 300 and 400, 94.7% ( n = 107) had high AaDO 2 values, and 51.4% ( n = 55) received oxygen support, with 2 ICU admissions and 10 deaths. According to ROC analysis, AaDO 2 > 39.4 had 83.6% sensitivity and 90.5% specificity (AUC 0.936; p < 0.001) in predicting subsequent oxygen support, whereas a LUS score > 6 showed 89.7% sensitivity and 75.0% specificity (AUC 0.896; p < 0.001). Kaplan-Meier curves showed different mortality in the AaDO 2 subgroups ( p = 0.0025)., Conclusions: LUS and AaDO 2 are easy and effective tools, which allow bedside risk stratification in patients with COVID-19, especially when P/F values, signs, and symptoms are not indicative of severe lung dysfunction.

Published
2021
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21. Dynamic markers based on blood perfusion fluctuations for selecting skin melanocytic lesions for biopsy.

Author

Lancaster G, Stefanovska A, Pesce M, Marco Vezzoni G, Loggini B, Pingitore R, Ghiara F, Barachini P, Cervadoro G, Romanelli M, and Rossi M

Subjects
Biopsy, Blood Flow Velocity, Diagnosis, Differential, Genetic Heterogeneity, Humans, Melanoma genetics, Melanoma pathology, Nevus, Pigmented genetics, Nevus, Pigmented pathology, Prognosis, Skin Neoplasms, Melanoma, Cutaneous Malignant, Biomarkers blood, Melanoma blood, Nevus, Pigmented blood
Abstract

Skin malignant melanoma is a highly angiogenic cancer, necessitating early diagnosis for positive prognosis. The current diagnostic standard of biopsy and histological examination inevitably leads to many unnecessary invasive excisions. Here, we propose a non-invasive method of identification of melanoma based on blood flow dynamics. We consider a wide frequency range from 0.005-2 Hz associated with both local vascular regulation and effects of cardiac pulsation. Combining uniquely the power of oscillations associated with individual physiological processes we obtain a marker which distinguishes between melanoma and atypical nevi with sensitivity of 100% and specificity of 90.9%. The method reveals valuable functional information about the melanoma microenvironment. It also provides the means for simple, accurate, in vivo distinction between malignant melanoma and atypical nevi, and may lead to a substantial reduction in the number of biopsies currently undertaken.

Published
2015
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22. The "phone and mail" system in a teledermatology service for chronic psychiatric patients.

Author

Vezzoni GM, Guazzelli M, and Barachini P

Subjects
Follow-Up Studies, Humans, Mental Disorders complications, Mental Disorders therapy, Reproducibility of Results, Skin Diseases complications, Skin Diseases therapy, Surveys and Questionnaires, Treatment Outcome, Cell Phone, Dermatology, Electronic Mail, Mental Disorders diagnosis, Patient Satisfaction, Skin Diseases diagnosis, Telemedicine methods
Abstract

Aim: We aimed to test a new teledermatologic method that permits to match a high level of diagnostic accuracy, comparable with or higher to that of the "Store and Forward" method, with the highest handiness, comparable to that achievable with a video call, without suffering from the limitations of the two methods., Methods: We used latest-generation cell phones with a HSDPA network broad-band internet access system for video calling and for sending via e-mail high-definition images, chosen by the specialist-at-a-distance during the video call, in times comparable to those achievable with fixed-wired access systems. We tested the diagnostic reliability, the compliance and the efficacy of the method., Results: We found a significant concordance both between direct and via video call description of the objective signs and between direct and on high definition image description. The Spearman Rank showed a higher correlation between direct observation and high definition image observation than between direct and via video call observation: this last finding matched the experimenters' subjective experience. The compliance was positive and the efficacy comparable with the ambulatorial follow-up., Conclusion: In conclusion, the "Phone and Mail" method can be seen as being capable of joining together the necessary diagnostic precision and effectiveness with a high degree of practicality and simplicity, thanks to the ease of use of the cell phone, within the reach of everybody, to the ubiquity of its utilization, to the allowed rapidity of diagnosis, practically in real time, and to the low cost of the system.

Published
2011

23. Skin blood flow pattern in burns outcomes.

Author

Barachini P, Vezzoni GM, Palombo C, Franzoni F, and Bigalli G

Subjects
Adult, Analysis of Variance, Arterioles physiopathology, Burns pathology, Burns surgery, Female, Follow-Up Studies, Hot Temperature, Humans, Laser-Doppler Flowmetry, Male, Microcirculation, Middle Aged, Regional Blood Flow, Skin Transplantation, Vasomotor System physiopathology, Venules physiopathology, Wound Healing, Burns physiopathology, Skin blood supply
Abstract

Functional microcirculatory aspects of burned sites were examined including areas of self-healed burns, and grafted areas. Donor areas were also examined. In 10 patients with burns in the lower limbs, both self-healed and with grafts, the microcirculatory response was evaluated by Laser Doppler flowmetry (LDF) measuring for each site the resting flux at 36 degrees, the postural venular-arteriolar reflex (VAR) and the flux at 41 degrees (heating). The first evaluation was carried out on discharge, and subsequently at approximately 45 day intervals during uniform therapy follow-up (elastocompression). The burn-affected area (self-healed, graft) and those donor areas present should increase resting flux by comparison with control areas. This was particularly so in the self-healed burn, which does however tend to converge in time towards control values. Response to stress tests (VAR and heating) presents percentage variations similar to normal skin in the various areas, with the exception of the grafted areas which present a reduced response in the 1st weeks following engraftment. No significant differences in response to heating were detected. It can be suggested that these differences are due to anatomic variations in revascularization and healing in the different areas as well as to alterations in microvascular innervation and local response to vasoactive substances.

Published
2004
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