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2. Venous thromboembolism and COVID-19: a single center experience from an academic tertiary referral hospital of Northern Italy

Author

Melazzini, Federica, Colaneri, Marta, Fumoso, Federica, Freddi, Giulia, Lenti, Marco Vincenzo, Pieri, Teresa Chiara, Piloni, Davide, Noris, Patrizia, Pieresca, Carla, Preti, Paola Stefania, Russo, Mariaconcetta, Corsico, Angelo, Tavazzi, Guido, Baldanti, Fausto, Triarico, Antonio, Mojoli, Francesco, Bruno, Raffaele, Di Sabatino, Antonio, Aronico, Nicola, Bergamaschi, Gaetano, Bertolino, Giampiera, Codega, Silvia, Costanzo, Filippo, Cresci, Roberto, Delliponti, Angela, Derosa, Giuseppe, Di Stefano, Michele, Falaschi, Francesco, Iadarola, Carmine, Lovati, Elisabetta, Lucotti, Pietro Carlo, Martignoni, Alessandra, Mengoli, Caterina, Miceli, Emanuela, Mugellini, Amedeo, Muggia, Chiara, Pagani, Elisabetta, Palumbo, Ilaria, Pecci, Alessandro, Perrone, Tiziano, Sgarlata, Carmelo, Siciliani, Luisa, Staniscia, Andrea, Vjera, Francesca Torello, Achilli, Giovanna, Agostinelli, Andrea, Antoci, Valentina, Ballesio, Alessia, Banfi, Francesco, Barteselli, Chiara, Benedetti, Irene, de Andreis, Federica Borrelli, Brattoli, Michele, Calabretta, Francesca, Cambiè, Ginevra, Canta, Roberta, Conca, Federico, Coppola, Luigi, Cremonte, Elisa Maria, Croce, Gabriele, Del Rio, Virginia, Di Terlizzi, Francesco, Ferrari, Maria Giovanna, Ferrari, Sara, Fiengo, Anna, Forni, Tommaso, Frigerio, Chiara, Fusco, Alessandra, Gabba, Margherita, Garolfi, Matteo, Gentile, Antonella, Gori, Giulia, Grandi, Giacomo, Grimaldi, Paolo, Lampugnani, Alice, Lapia, Francesco, Lepore, Federica, Lettieri, Gianluca, Mambella, Jacopo, Mercanti, Chiara, Merli, Stefania, Mordà, Francesco, Nardone, Alba, Pace, Luca, Padovini, Lucia, Parodi, Alessandro, Pellegrino, Ivan, Pitotti, Lavinia, Reduzzi, Margherita, Rigano, Giovanni, Romito, Giovanni, Rotola, Giorgio, Sabatini, Umberto, Salvi, Lucia, Santacroce, Giovanni, Savioli, Jessica, Soriano, Simone, Spataro, Carmine, Stefani, Debora, Aliberti, Anna Rita, Amatu, Alessandro, Anfossi, Laura, Arisi, Eric, Baldi, Chiara, Belliato, Mirko, Bellini, Lorenzo, Benzi, Alberto, Bichisao, Germana, Bolongaro, Antonia, Bottazzi, Andrea, Broglia, Federica, Bruschi, Giacomo, Caneva, Luca, Capaccio, Emanuele, Carboni, Valeria, Cavalloro, Fabrizio, Ciceri, Maria, Civardi, Luca, Delmonte, Maria Paola, Domenegati, Elisa Lucia, Ferrari, Federica, Ferrari, Fiorenza, Ferrari, Marta, Fuardo, Marinella, Gerletti, Maddalena Margherita, Gualdana, Simonetta, Ilardi, Marcella, Lo Coco, Claudia, Maggio, Giuseppe, Mascia, Maria Benedetta, Mencherini, Simonetta, Merati, Paola Maria, Mongodi, Silvia, Mori, Anna Maria, Morgante, Federica, Niebel, Thekla Larissa, Noli, Silvano, Orlando, Anita, Pagani, Michele, Passador, Debora, Pellicori, Simona, Perotti, Luciano, Picchioni, Raffaella, Poma, Silvia, Pozzi, Marco, Preti, Emanuela, Puce, Roberta, Radolovich, Danila Katia, Ragni, Gianluca, Repossi, Filippo, Riccardi, Francesca, Rizzardi, Roberto, Rodi, Giuseppe, Roldi, Emanuela, Rossi, Cristina, Sala Gallini, Giuseppe, Sciutti, Fabio, Sportiello, Debora, Ticozzelli, Giulia, Visconti, Federico, Zizzi, Silvia, Bagliani, Alessandro, Belotti, Corrado, Bossi, Chiara, Colombo, Andrea, Colombo, Costanza Natalia Julia, Cremascoli, Luca, Dammassa, Valentino, Discepoli, Roberto, Garlando, Maria Adelaide, Grandini, Filippo, Pellegrini, Andrea, Quaranta, Cecilia, Stella, Andrea, Torresani, Francesco, Mondelli, Mario, Brunetti, Enrico, Di Matteo, Angela, Seminari, Elena, Maiocchi, Laura, Zuccaro, Valentina, Pagnucco, Layla, Mariani, Bianca, Ludovisi, Serena, Lissandrin, Raffaella, Parisi, Aldo, Sacchi, Paolo, Patruno, Savino F. A., Michelone, Giuseppe, Gulminetti, Roberto, Zanaboni, Domenico, Novati, Stefano, Maserati, Renato, Orsolini, Paolo, Vecchia, Marco, Asperges, Erika, Di Filippo, Alessandro, Sambo, Margherita, Biscarini, Simona, Lupi, Matteo, Roda, Silvia, Gallazzi, Ilaria, Sachs, Michele, Valsecchi, Pietro, Ferrari, Alessandra, Bosio, Matteo, Cascina, Alessandro, Conio, Valentina, Di Domenica, Rita, Donnetta, Anna, Fraolini, Elia, Gualtieri, Giuseppe, Mangiarotti, Patrizia, Mariani, Francesca, Meloni, Federica, Oggionni, Tiberio, Pasturenzi, Lidia, Ronzoni, Vanessa, Saracino, Laura, Stella, Giulia, Tomaselli, Stefano, Abbate, Tommaso, Accordino, Giulia, Bertuccio, Francesco, Burattini, Cecilia, Cacciatore, Elisa, Cattaneo, Elena, Chino, Vittorio, Coretti, Manuela, Della Zoppa, Matteo, Infusino, Cristina, Lettieri, Sara, Maccabruni, Valeria, Mancinelli, Silvia, Tirelli, Claudio, and Vertui, Valentina

Subjects
medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), 030204 cardiovascular system & hematology, Single Center, Tertiary referral hospital, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Internal Medicine, Medicine, cardiovascular diseases, Mean platelet volume, biology, SARS-CoV-2, business.industry, Pulmonary embolism, C-reactive protein, Anticoagulants, Thrombosis, equipment and supplies, medicine.disease, Im - Original, 030220 oncology & carcinogenesis, biology.protein, Emergency Medicine, Observational study, business
Abstract

Preliminary evidence supports the notion that COVID-19 patients may have an increased susceptibility to develop venous thromboembolism (VTE). However, the magnitude of this association still needs to be defined. Furthermore, clinical predictors of thrombogenesis, and the relationship with the inflammatory status are currently unknown. On this basis, we conducted a retrospective, observational study on 259 consecutive COVID-19 patients admitted to an academic tertiary referral hospital in Northern Italy between March 19th and April 6th, 2020. Records of COVID-19 patients with a definite VTE event were reviewed for demographic information, co-morbidities, risk factors for VTE, laboratory tests, and anticoagulation treatment. Twenty-five cases among 259 COVID-19 patients developed VTE (9.6%), all of them having a Padua score > 4, although being under standard anticoagulation prophylaxis since hospital admission. In the VTE subcohort, we found a significant positive correlation between platelet count (PLT) and either C reactive protein (CRP) (p p = 0.0013), while a significant inverse correlation was observed between PLT and mean platelet volume (p p p = 0.002 and p = 0.005, respectively). No significant difference was found in d-dimer levels between VTE and non VTE patients, while significantly higher levels of LDH (p = 0.04) and IL-6 (p = 0.04) were observed in VTE patients in comparison to non-VTE patients. In conclusion, our findings showed a quite high prevalence of VTE in COVID-19 patients. Raised inflammatory indexes and increased serum levels of pro-inflammatory cytokines should raise the clinical suspicion of VTE.

Published
2020
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3. Integrating data from multidisciplinary Management of Malignant Pleural Mesothelioma: a cohort study.

Author

Saracino, Laura, Bortolotto, Chandra, Tomaselli, Stefano, Fraolini, Elia, Bosio, Matteo, Accordino, Giulia, Agustoni, Francesco, Abbott, David M., Pozzi, Emma, Eleftheriou, Dimitrios, Morbini, Patrizia, Rinaldi, Pietro, Primiceri, Cristiano, Lancia, Andrea, Comoli, Patrizia, Filippi, Andrea R., and Stella, Giulia M.

Subjects
THERAPEUTICS, OVERALL survival, MESOTHELIOMA, SURVIVAL rate, COHORT analysis
Abstract

Background: Malignant pleural mesothelioma (MPM) is a rare and aggressive malignancy that most commonly affects the pleural layers. MPM has a strong association with asbestos, mainly caused by exposure to its biopersistent fibers in at least 80% of cases. Individuals with a chronic exposure to asbestos might develop disease with a 20-40-year latency with few or no symptoms. Such has been the case in the Italian regions of Piedmont and Lombardy, where industrial production of materials laden with asbestos, mainly cements, has been responsible for the onset of a large epidemic. Since 2018, a multidisciplinary team at San Matteo hospital in Pavia has been collecting data on over 100 patients with MPM. The main goal of this project is to define and describe an integrated profile for each MPM case at diagnosis by using data mining and partition analysis.Methods: Here we bring together exhaustive epidemiologic, histologic and radiologic data of 88 MPM patients that came to our observation and draw correlations with predictive and prognostic significance.Results: The median overall survival (OS) was 15.6 months. Most patients presented with pleural effusion, irrespective of disease stage. Quite unexpectedly, no statistically significant association was demonstrated between OS and TNM disease stage at diagnosis. Although average OS is similar in male and female patients, partition analysis of data underlined a significant differential hierarchy of predictor categories based on patient gender. In females with no smoking history, full chemotherapeutic regimens are associated with better outcomes. Moreover, concerning second line treatments, vinorelbine emerged as the most advantageous choice for female patients, whereas in the male subgroup no statistically significant difference resulted between gemcitabine and vinorelbine.Conclusion: A multidisciplinary approach to MPM is mandatory to define better therapeutic approaches, personalize the management and improve patient outcomes. [ABSTRACT FROM AUTHOR]

Published
2021
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5. Impact of Pneumococcal Urinary Antigen Testing in COVID-19 Patients: Outcomes from the San Matteo COVID-19 Registry (SMACORE).

Author

Valsecchi, Pietro, Colaneri, Marta, Zuccaro, Valentina, Asperges, Erika, Costanzo, Filippo, Mariani, Bianca, Roda, Silvia, Minucci, Rita, Bertuccio, Francesco, Fraolini, Elia, Bosio, Matteo, Tirelli, Claudio, Oggionni, Tiberio, Corsico, Angelo, and Bruno, Raffaele

Subjects
COVID-19, COVID-19 testing, TREATMENT effectiveness, BIOMARKERS, ANTIGENS
Abstract

Despite low rates of bacterial co-infections, most COVID-19 patients receive antibiotic therapy. We hypothesized that patients with positive pneumococcal urinary antigens (PUAs) would benefit from antibiotic therapy in terms of clinical outcomes (death, ICU admission, and length of stay). The San Matteo COVID-19 Registry (SMACORE) prospectively enrolls patients admitted for COVID-19 pneumonia at IRCCS Policlinico San Matteo, Pavia. We retrospectively extracted the data of patients tested for PUA from October to December 2020. Demographic, clinical, and laboratory data were recorded. Of 469 patients, 42 tested positive for PUA (8.95%), while 427 (91.05%) tested negative. A positive PUA result had no significant impact on death (HR 0.53 CI [0.22–1.28] p-value 0.16) or ICU admission (HR 0.8; CI [0.25–2.54] p-value 0.70) in the Cox regression model, nor on length of stay in linear regression (estimate 1.71; SE 2.37; p-value 0.47). After adjusting for age, we found no significant correlation between urinary antigen positivity and variations in the WHO ordinal scale and laboratory markers at admission and after 14 days. We found that a positive PUA result was not frequent and had no impact on clinical outcomes or clinical improvement. Our results did not support the routine use of PUA tests to select COVID-19 patients who will benefit from antibiotic therapy. [ABSTRACT FROM AUTHOR]

Published
2021
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