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2. Clinical characteristics and outcomes of vaccinated patients hospitalised with SARS-CoV-2 breakthrough infection: Multi-IPV, a multicentre study in Northern Italy
- Author
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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
3. Microbiota in ICU, not only a gut problem
- Author
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Alagna, L., Bandera, A., Patruno, A., Muscatello, A., Citerio, G., and Gori, A.
- Subjects
Microbiota (Symbiotic organisms) ,Medical colleges ,Hospital patients ,Health care industry - Abstract
Author(s): L. Alagna [sup.1], A. Bandera [sup.1] [sup.2], A. Patruno [sup.3], A. Muscatello [sup.1], G. Citerio [sup.3] [sup.4], A. Gori [sup.1] [sup.2] Author Affiliations: (1) 0000 0004 1757 8749, grid.414818.0, [...]
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- 2019
- Full Text
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4. External validation of risk scores to predict in-hospital mortality in patients hospitalized due to coronavirus disease 2019
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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
5. Clinical factors associated with death in 3044 COVID-19 patients managed in internal medicine wards in Italy: comment
- Author
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Bandera, A, Nobili, A, Tettamanti, M, Harari, S, Bosari, S, Mannucci, P, 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, Peyvandi, F, Gualtierotti, R, Ferrari, B, Rossio, R, Boasi, N, Pagliaro, E, Massimo, C, De Caro, M, 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, 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, Bandera A., Nobili A., Tettamanti M., Harari S., Bosari S., Mannucci P. M., 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., Peyvandi F., Gualtierotti R., Ferrari B., Rossio R., Boasi N., Pagliaro E., Massimo C., De Caro M., 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., Contarini M. M. 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., Bandera, A, Nobili, A, Tettamanti, M, Harari, S, Bosari, S, Mannucci, P, 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, Peyvandi, F, Gualtierotti, R, Ferrari, B, Rossio, R, Boasi, N, Pagliaro, E, Massimo, C, De Caro, M, 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, 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, Bandera A., Nobili A., Tettamanti M., Harari S., Bosari S., Mannucci P. M., 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., Peyvandi F., Gualtierotti R., Ferrari B., Rossio R., Boasi N., Pagliaro E., Massimo C., De Caro M., 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., Contarini M. M. 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
6. Clinical risk scores for the early prediction of severe outocomes in patients hospitalized for COVID-19: comment
- Author
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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.
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- 2022
7. Comparison of multiple definitions for Ventilator-Associated Pneumonia in patients requiring mechanical ventilation for non-pulmonary conditions: preliminary data from PULMIVAP, an Italian multicentre cohort study
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Alagna, L, Palomba, E, Chatenoud, L, Massafra, R, Magni, F, Mancabelli, L, Donnini, S, Elli, F, Forastieri, A, Gaipa, G, Abbruzzese, C, Fumagalli, R, Munari, M, Panacea, A, Picetti, E, Terranova, L, Turroni, F, Vaschetto, R, Zoerle, T, Citerio, G, Gori, A, Bandera, A, Alagna, Laura, Palomba, Emanuele, Chatenoud, Liliane, Massafra, Roberta, Magni, Federico, Mancabelli, Leonardo, Donnini, Sara, Elli, Francesca, Forastieri, Andrea, Gaipa, Giuseppe, Abbruzzese, Chiara, Fumagalli, Roberto, Munari, Marina, Panacea, Antonino, Picetti, Edoardo, Terranova, Leonardo, Turroni, Francesca, Vaschetto, Rosanna, Zoerle, Tommaso, Citerio, Giuseppe, Gori, Andrea, Bandera, Alessandra, Alagna, L, Palomba, E, Chatenoud, L, Massafra, R, Magni, F, Mancabelli, L, Donnini, S, Elli, F, Forastieri, A, Gaipa, G, Abbruzzese, C, Fumagalli, R, Munari, M, Panacea, A, Picetti, E, Terranova, L, Turroni, F, Vaschetto, R, Zoerle, T, Citerio, G, Gori, A, Bandera, A, Alagna, Laura, Palomba, Emanuele, Chatenoud, Liliane, Massafra, Roberta, Magni, Federico, Mancabelli, Leonardo, Donnini, Sara, Elli, Francesca, Forastieri, Andrea, Gaipa, Giuseppe, Abbruzzese, Chiara, Fumagalli, Roberto, Munari, Marina, Panacea, Antonino, Picetti, Edoardo, Terranova, Leonardo, Turroni, Francesca, Vaschetto, Rosanna, Zoerle, Tommaso, Citerio, Giuseppe, Gori, Andrea, and Bandera, Alessandra
- Abstract
Objectives: To compare intensivist-diagnosed ventilator-associated pneumonia (iVAP) with four established definitions, assessing their agreement in detecting new episodes. Methods: A multi-centric prospective study on pulmonary microbiota was carried out in patients requiring mechanical ventilation (MV). Data collected were used to compare hypothetical VAP onset according to iVAP with the study consensus criteria, the European Centre for Disease Control and Prevention definition, and two versions of the latter adjusted for leukocyte count and fever. Results: In our cohort of 186 adult patients, iVAPs were 36.6% (68/186, 95% confidence interval 30.0–44.0%), with an incidence rate of 4.64/100 patient-MV-days, and median MV-day at diagnosis of 6. Forty-seven percent of patients (87/186) were identified as VAP by at least one criterion, with a median MV-day at diagnosis of 5. Agreement between intensivist judgement (iVAP/no-iVAP) and the criteria was highest for the study consensus criteria (50/87, 57.4%), but still one-third of iVAP were not identified and 9% of patients were identified as VAP contrary to intensivist diagnosis. VAP proportion differed between criteria (25.2–30.1%). Conclusions: Caution is needed when evaluating studies describing VAP incidence. Pre-agreed criteria and definitions that capture VAP's evolving nature provide greater consistency, but new clinically driven definitions are needed to align surveillance and diagnostic criteria with clinical practice.
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- 2023
8. Changes in upper airways microbiota in ventilator-associated pneumonia
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Alagna, L, Mancabelli, L, Magni, F, Chatenoud, L, Bassi, G, Del Bianco, S, Fumagalli, R, Turroni, F, Mangioni, D, Migliorino, G, Milani, C, Muscatello, A, Nattino, G, Picetti, E, Pinciroli, R, Rossi, S, Tonetti, T, Vargiolu, A, Bandera, A, Ventura, M, Citerio, G, Gori, A, Alagna, Laura, Mancabelli, Leonardo, Magni, Federico, Chatenoud, Liliane, Bassi, Gabriele, Del Bianco, Silvia, Fumagalli, Roberto, Turroni, Francesca, Mangioni, Davide, Migliorino, Guglielmo M, Milani, Christian, Muscatello, Antonio, Nattino, Giovanni, Picetti, Edoardo, Pinciroli, Riccardo, Rossi, Sandra, Tonetti, Tommaso, Vargiolu, Alessia, Bandera, Alessandra, Ventura, Marco, Citerio, Giuseppe, Gori, Andrea, Alagna, L, Mancabelli, L, Magni, F, Chatenoud, L, Bassi, G, Del Bianco, S, Fumagalli, R, Turroni, F, Mangioni, D, Migliorino, G, Milani, C, Muscatello, A, Nattino, G, Picetti, E, Pinciroli, R, Rossi, S, Tonetti, T, Vargiolu, A, Bandera, A, Ventura, M, Citerio, G, Gori, A, Alagna, Laura, Mancabelli, Leonardo, Magni, Federico, Chatenoud, Liliane, Bassi, Gabriele, Del Bianco, Silvia, Fumagalli, Roberto, Turroni, Francesca, Mangioni, Davide, Migliorino, Guglielmo M, Milani, Christian, Muscatello, Antonio, Nattino, Giovanni, Picetti, Edoardo, Pinciroli, Riccardo, Rossi, Sandra, Tonetti, Tommaso, Vargiolu, Alessia, Bandera, Alessandra, Ventura, Marco, Citerio, Giuseppe, and Gori, Andrea
- Abstract
Background: The role of upper airways microbiota and its association with ventilator-associated pneumonia (VAP) development in mechanically ventilated (MV) patients is unclear. Taking advantage of data collected in a prospective study aimed to assess the composition and over-time variation of upper airway microbiota in patients MV for non-pulmonary reasons, we describe upper airway microbiota characteristics among VAP and NO-VAP patients. Methods: Exploratory analysis of data collected in a prospective observational study on patients intubated for non-pulmonary conditions. Microbiota analysis (trough 16S-rRNA gene profiling) was performed on endotracheal aspirates (at intubation, T0, and after 72 h, T3) of patients with VAP (cases cohort) and a subgroup of NO-VAP patients (control cohort, matched according to total intubation time). Results: Samples from 13 VAP patients and 22 NO-VAP matched controls were analyzed. At intubation (T0), patients with VAP revealed a significantly lower microbial complexity of the microbiota of the upper airways compared to NO-VAP controls (alpha diversity index of 84 ± 37 and 160 ± 102, in VAP and NO_VAP group, respectively, p-value < 0.012). Furthermore, an overall decrease in microbial diversity was observed in both groups at T3 as compared to T0. At T3, a loss of some genera (Prevotella 7, Fusobacterium, Neisseria, Escherichia–Shigella and Haemophilus) was found in VAP patients. In contrast, eight genera belonging to the Bacteroidetes, Firmicutes and Fusobacteria phyla was predominant in this group. However, it is unclear whether VAP caused dysbiosis or dysbiosis caused VAP. Conclusions: In a small sample size of intubated patients, microbial diversity at intubation was less in patients with VAP compared to patients without VAP.
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- 2023
9. Repeat endocarditis: analysis of risk factors based on the International Collaboration on Endocarditis – Prospective Cohort Study
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Alagna, L., Park, L.P., Nicholson, B.P., Keiger, A.J., Strahilevitz, J., Morris, A., Wray, D., Gordon, D., Delahaye, F., Edathodu, J., Miró, J.M., Fernández-Hidalgo, N., Nacinovich, F.M., Shahid, R., Woods, C.W., Joyce, M.J., Sexton, D.J., and Chu, V.H.
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- 2014
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10. Daily cannabis and reduced risk of steatosis in human immunodeficiency virus and hepatitis C virus‐co‐infected patients (ANRS CO13‐HEPAVIH)
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Nordmann, S., Vilotitch, A., Roux, P., Esterle, L., Spire, B., Marcellin, F., Salmon‐Ceron, D., Dabis, F., Chas, J., Rey, D., Wittkop, L., Sogni, P., Carrieri, P., Salmon, D, Trimoulet, P, Izopet, J, Serfaty, L, Paradis, V, Valantin, M.A., Pialoux, G, Poizot‐Martin, I, Barange, K, Naqvi, A, Rosenthal, E, Bicart‐See, A, Bouchaud, O, Gervais, A, Lascoux‐Combe, C, Goujard, C, Lacombe, K, Duvivier, C, Vittecoq, D, Neau, D, Morlat, P, Bani‐Sadr, F, Meyer, L, Boufassa, F, Dominguez, S, Autran, B, Roque, A.M., Solas, C, Fontaine, H, Costagliola, D, Piroth, L, Simon, A, Zucman, D, Boué, F, Miailhes, P, Billaud, E, Aumaître, H, Couffin‐Cadiergues, S, Marchand, L, Salmon, D, Alagna, L, Sogni, P, Terris, B, Krivine, A, Katlama, C, Valantin, M.A., Stitou, H, Benhamou, Y, Charlotte, F, Fourati, S, Simon, A, Cacoub, P, Nafissa, S, Poizot‐Martin, I, Zaegel, O, Porcher, M, Tamalet, C, Pialoux, G, Chas, J, Slama, L, Callard, P, Bendjaballah, F, Le Pendeven, C, Marchou, B, Alric, L, Barange, K, Metivier, S, Selves, J, Larroquette, F, Rosenthal, E, Haudebourg, J, Saint‐Paul, M.C., Partouche, C, Bouchaud, O, Ziol, M, Baazia, Y, Uzan, M, Bicart‐See, A, Garipuy, D, Ferro‐Collados, M.J, Selves, J, Nicot, F, Gervais, A, Yazdanpanah, Y, Adle‐Biassette, H, Alexandre, G, Lascoux‐Combe, C, Molina, J.M, Bertheau, P, Duclos, J, Palmer, P, Lacombe, K, Campa, P, Girard, P.M, Wendum, D, Cervera, P, Adam, J, Viala, C, Goujard, C, Pallier, C, Vittecoq, D, Lortholary, O, Duvivier, C, Shoai‐Tehrani, M, Mélard, A, Neau, D, Ochoa, A, Blanchard, E, Castet‐Lafarie, S, Cazanave, C, Malvy, D, Dupon, M, Dutronc, H, Dauchy, F, Lacaze‐Buzy, L, Bioulac‐Sage, P, Trimoulet, P, Reigadas, S, Morlat, P, Lacoste, D, Bonnet, F, Bernard, N, Bonarek Hessamfar, M, Roger‐Schmeltz, J, Gellie, P, Thibaut, P, Paccalin, F, Martell, C, Carmen Pertusa, M, Vandenhende, M, Mercier, P, Malvy, D, Pistone, T, Receveur, M.C, Caldato, S, Bioulac‐Sage, P, Trimoulet, P, Reigadas, S, Pellegrin, J.L, Viallard, J.F, Lazzaro, E, Greib, C, Bioulac‐Sage, P, Trimoulet, P, Reigadas, S, Zucman, D, Majerholc, C, Guitard, F, Boué, F, Polo Devoto, J, Kansau, I, Chambrin, V, Pignon, C, Berroukeche, L, Fior, R, Martinez, V, Deback, C, Lévy, Y, Dominguez, S, Lelièvre, J.D, Lascaux, A.S, Melica, G, Billaud, E, Raffi, F, Alavena, C, Rodallec, A, Miailhes, P, Peyramond, D, Chidiac, C, Ader, F, Biron, F, Boibieux, A, Cotte, L, Ferry, T, Perpoint, T, Koffi, J, Zoulim, F, Bailly, F, Lack, P, Maynard, M, Radenne, S, Amiri, M, Le‐Thi, T.T, Piroth, L, Chavanet, P, Duong Van Huyen, M, Buisson, M, Waldner‐Combernoux, A, Mahy, S, Binois, R, Simonet‐Lann, A.L, Croisier‐Bertin, D, Aumaître, H, Bani‐Sadr, F, Lambert, D, Nguen, Y, Rouger, C, Berger, J.L, Partrisiani, M, Gautner, P, Batard, M.L, Beniken, D, Lupin, C, Lions, C, Ritleng, A.‐S, Honoré, P, Payssan, V, Breau, S, Joulie, A, Mole, M, Bolliot, C, Touam, F, André, F, Hue, H, Larmet, L, Brochier, C, Thoirain, V, Raho‐Moussa, M, Ogoudjobi, S, Azar, M, Bornarel, D, Gohier, S, Chesnel, C, Maradan, G, Kurkdji, P, Hadjoudj, S, Malet, M, Kmiec, I, Fischer, P, Palacin, A, Pietri, M.P, Le Baut, V, Guet, P, Le Puil, S, Mebarki, M, Fior, A, Adda‐Lievin, A, Conte, V, Delaune, J, Dequae Merchadou, L, Douiri, N, Gillet, S, Gilbert, C, Jacquet, A, Kherraz, R, Lagorse, P, Mora, M, Protopopescu, C, and Rosellini, S
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- 2018
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11. Clinical factors associated with death in 3044 COVID-19 patients managed in internal medicine wards in Italy: comment
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Bandera, A., Nobili, A., Tettamanti, M., Harari, S., Bosari, S., Mannucci, P. M., 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., Peyvandi, F., Gualtierotti, R., Ferrari, B., Rossio, R., Boasi, N., Pagliaro, E., Massimo, C., De Caro, M., 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., Contarini, M. M. 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., C. M., Hu, 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., Bandera, A, Nobili, A, Tettamanti, M, Harari, S, Bosari, S, Mannucci, P, 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, Peyvandi, F, Gualtierotti, R, Ferrari, B, Rossio, R, Boasi, N, Pagliaro, E, Massimo, C, De Caro, M, 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, 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
Adult ,medicine.medical_specialty ,2019-20 coronavirus outbreak ,Coronavirus disease 2019 (COVID-19) ,Critical Care ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Ce - Letter to the Editor ,MEDLINE ,Cohort Studies ,Hospital ,Internal Medicine ,Medicine ,Humans ,Hospital Mortality ,Intensive care medicine ,Aged ,Aged, 80 and over ,business.industry ,SARS-CoV-2 ,COVID-19 ,Middle Aged ,Respiration, Artificial ,Hospitals ,Hospitalization ,Survival Rate ,Italy ,Emergency Medicine ,business ,Human - Abstract
During the COVID-19 2020 outbreak, a large body of data has been provided on general management and outcomes of hospitalized COVID-19 patients. Yet, relatively little is known on characteristics and outcome of patients managed in Internal Medicine Units (IMU). To address this gap, the Italian Society of Internal Medicine has conducted a nationwide cohort multicentre study on death outcome in adult COVID-19 patients admitted and managed in IMU. This study assessed 3044 COVID-19 patients at 41 referral hospitals across Italy from February 3rd to May 8th 2020. Demographics, comorbidities, organ dysfunction, treatment, and outcomes including death were assessed. During the study period, 697 patients (22.9%) were transferred to intensive care units, and 351 died in IMU (death rate 14.9%). At admission, factors independently associated with in-hospital mortality were age (OR 2.46, p = 0.000), productive cough (OR 2.04, p = 0.000), pre-existing chronic heart failure (OR 1.58, p = 0.017) and chronic obstructive pulmonary disease (OR 1.17, p = 0.048), the number of comorbidities (OR 1.34, p = 0.000) and polypharmacy (OR 1.20, p = 0.000). Of note, up to 40% of elderly patients did not report fever at admission. Decreasing PaO
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- 2022
12. Clinical risk scores for the early prediction of severe outocomes in patients hospitalized for COVID-19: comment
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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
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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.
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- 2021
13. Development of a Risk Prediction Model for Carbapenem-resistant Enterobacteriaceae Infection after Liver Transplantation: A Multinational Cohort Study
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Giannella, M., Freire, M., Rinaldi, M., Abdala, E., Rubin, A., Mularoni, A., Gruttadauria, S., Grossi, P., Shbaklo, N., Tandoi, F., Ferrarese, A., Burra, P., Fernandes, R., Aranha Camargo, L. F., Asensio, A., Alagna, L., Bandera, A., Simkins, J., Abbo, L., Halpern, M., Santana Girao, E., Valerio, M., Munoz, P., Fernandez Yunquera, A., Statlender, L., Yahav, D., Franceschini, E., Graziano, E., Morelli, M. C., Cescon, M., Viale, P., Lewis, R., Bartoletti, M., Pascale, R., Campoli, C., Coladonato, S., Cristini, F., Tumietto, F., Siniscalchi, A., Laici, C., Ambretti, S., Romagnoli, R., De Rosa, F. G., Muscatello, A., Mangioni, D., Gori, A., Antonelli, B., Dondossola, D., Rossi, G., Invernizzi, F., Peghin, M., Cillo, U., Mussini, C., Benedetto, F. D., Terrabuio, D. R. B., Bittante, C. D., Toniolo, A. D. R., Balbi, E., Garcia, J. H. P., Morras, I., Ramos, A., Cruz, A. F., Salcedo, M., Giannella M., Freire M., Rinaldi M., Abdala E., Rubin A., Mularoni A., Gruttadauria S., Grossi P., Shbaklo N., Tandoi F., Ferrarese A., Burra P., Fernandes R., Aranha Camargo L.F., Asensio A., Alagna L., Bandera A., Simkins J., Abbo L., Halpern M., Santana Girao E., Valerio M., Munoz P., Fernandez Yunquera A., Statlender L., Yahav D., Franceschini E., Graziano E., Morelli M.C., Cescon M., Viale P., Lewis R., Bartoletti M., Pascale R., Campoli C., Coladonato S., Cristini F., Tumietto F., Siniscalchi A., Laici C., Ambretti S., Romagnoli R., De Rosa F.G., Muscatello A., Mangioni D., Gori A., Antonelli B., Dondossola D., Rossi G., Invernizzi F., Peghin M., Cillo U., Mussini C., Benedetto F.D., Terrabuio D.R.B., Bittante C.D., Toniolo A.D.R., Balbi E., Garcia J.H.P., Morras I., Ramos A., Cruz A.F., and Salcedo M.
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Microbiology (medical) ,Adult ,medicine.medical_specialty ,medicine.medical_treatment ,Carbapenem-resistant enterobacteriaceae ,Liver transplantation ,CRE carriage ,CRE infection ,SOT ,liver transplantation ,Anti-Bacterial Agents ,Carbapenems ,Cohort Studies ,Humans ,Risk Factors ,Carbapenem-Resistant Enterobacteriaceae ,Enterobacteriaceae Infections ,Liver Transplantation ,03 medical and health sciences ,0302 clinical medicine ,Interquartile range ,Internal medicine ,Anti-Bacterial Agent ,Medicine ,030212 general & internal medicine ,Carbapenem ,Univariate analysis ,business.industry ,Risk Factor ,Area under the curve ,Nomogram ,Enterobacteriaceae Infection ,Transplantation ,Infectious Diseases ,030211 gastroenterology & hepatology ,Cohort Studie ,business ,Human ,Cohort study - Abstract
BackgroundPatients colonized with carbapenem-resistant Enterobacteriaceae (CRE) are at higher risk of developing CRE infection after liver transplantation (LT), with associated high morbidity and mortality. Prediction model for CRE infection after LT among carriers could be useful to target preventive strategies.MethodsMultinational multicenter cohort study of consecutive adult patients underwent LT and colonized with CRE before or after LT, from January 2010 to December 2017. Risk factors for CRE infection were analyzed by univariate analysis and by Fine-Gray subdistribution hazard model, with death as competing event. A nomogram to predict 30- and 60-day CRE infection risk was created.ResultsA total of 840 LT recipients found to be colonized with CRE before (n = 203) or after (n = 637) LT were enrolled. CRE infection was diagnosed in 250 (29.7%) patients within 19 (interquartile range [IQR], 9–42) days after LT. Pre- and post-LT colonization, multisite post-LT colonization, prolonged mechanical ventilation, acute renal injury, and surgical reintervention were retained in the prediction model. Median 30- and 60-day predicted risk was 15% (IQR, 11–24) and 21% (IQR, 15–33), respectively. Discrimination and prediction accuracy for CRE infection was acceptable on derivation (area under the curve [AUC], 74.6; Brier index, 16.3) and bootstrapped validation dataset (AUC, 73.9; Brier index, 16.6). Decision-curve analysis suggested net benefit of model-directed intervention over default strategies (treat all, treat none) when CRE infection probability exceeded 10%. The risk prediction model is freely available as mobile application at https://idbologna.shinyapps.io/CREPostOLTPredictionModel/.ConclusionsOur clinical prediction tool could enable better targeting interventions for CRE infection after transplant.
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- 2021
14. COVID-19 Network: the response of an Italian Reference Institute to research challenges about a new pandemia
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Bosari, S., Scudeller, L., Fusetti, G., Rusconi, L., Dell Orto, S., Prati, D., Valenti, L., Lamorte, G., Manunta, M., Baselli, G., Santoro, L., Gori, A., Bandera, A., Muscatello, A., Mangioni, D., Alagna, L., Bozzi, G., Lombardi, A., Ungaro, R., Itri, T., Ferroni, V., Pastore, V., Massafra, R., Rondolini, I., Peyvandi, F., Gualtierotti, R., Ferrari, B., Rossio, R., Corona, E., Rampi, N., Massimo, C., Montano, N., Vigone, B., Bellocchi, C., Fiorelli, E., Melli, V., Tobaldini, E., Blasi, F., Aliberti, S., Spotti, M., Simonetta, E., Terranova, L., Amati, F., Miele, C., Misuraca, S., D'Adda, A., Della Fiore, S., Di Pasquale, M., Contarini, M.M.M., Ori, M., Morlacchi, L., Rossetti, V., Gramegna, A., Pappalettera, M., Cavallini, M., Vigni, A., Vicenzi, M., Rota, I., Costantino, G., Solbiati, M., Furlan, L., Mancarella, M., Colombo, G., Fanin, A., Monzani, V., Rovellini, A., Barbetta, L., Billi, F., Folli, C., Baldini, M., Motta, I., Scaramellini, N., Fracanzani, A.L., Lombardi, R., Iuculano, F., Cesari, M., Proietti, M., Calcaterra, L., Nobili, A., Tettamanti, M., Monti, I., and Pesenti, A.
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- 2020
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15. Combination antifungal therapy for invasive mold infections among pediatric patients with hematological malignancies: Data from a real-life case-series
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Peri, A, Verna, M, Biffi, S, Alagna, L, Longhi, B, Migliorino, G, Foresti, S, Bandera, A, Rovelli, A, Rizzari, C, Gori, A, Colombini, A, Peri A. M., Verna M., Biffi S., Alagna L., Longhi B., Migliorino G. M., Foresti S., Bandera A., Rovelli A., Rizzari C., Gori A., Colombini A., Peri, A, Verna, M, Biffi, S, Alagna, L, Longhi, B, Migliorino, G, Foresti, S, Bandera, A, Rovelli, A, Rizzari, C, Gori, A, Colombini, A, Peri A. M., Verna M., Biffi S., Alagna L., Longhi B., Migliorino G. M., Foresti S., Bandera A., Rovelli A., Rizzari C., Gori A., and Colombini A.
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Background: Invasive mold infections in children with hematological malignancies are associated with high mortality rates. The use of combination antifungal therapy in cases with a severe clinical course is increasing, although information on the efficacy and safety of this approach is limited. Methods: We present a case series of 13 children affected by hemato-oncological disorders who received combination antifungal therapy for invasive mold infections at our center (Pediatric Hematology, San Gerardo Hospital, Monza, Italy) from 2011 to 2016, with the aim of describing their clinical characteristics, types of infections, treatment regimens, clinical outcomes, and treatment safety. Medical records were retrospectively reviewed in order to describe patients’ charac-teristics. Results: Combination antifungal therapy included liposomal amphotericin associated with caspofungin (5/13, 38.4%), voriconazole (5/13, 38.4%), or posaconazole (3/13, 23.1%). The 12-week treatment response rate was 69.2% (6/13 patients showed complete response, 3/13 partial re-sponse). The crude mortality was 30.7% (4/13): half was related to invasive mold infections (2/13, 15.38%) and half to disease progression (2/13, 15.38%). Overall, treatment was well tolerated, and we did not observe any permanent discontinuation of antifungals due to related side effects. Conclusions: In our experience, combination antifungal therapy seems to be a safe option in im-munocompromised children with invasive mold infections. Well-designed studies are needed to confirm the safety of this approach and to better understand its efficacy in the pediatric setting.
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- 2019
16. Effect of anakinra on mortality in patients with COVID-19: a systematic review and patient-level meta-analysis
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Kyriazopoulou, E. Huet, T. Cavalli, G. Gori, A. Kyprianou, M. Pickkers, P. Eugen-Olsen, J. Clerici, M. Veas, F. Chatellier, G. Kaplanski, G. Netea, M.G. Pontali, E. Gattorno, M. Cauchois, R. Kooistra, E. Kox, M. Bandera, A. Beaussier, H. Mangioni, D. Dagna, L. van der Meer, J.W.M. Giamarellos-Bourboulis, E.J. Hayem, G. Netea, M.G. van der Meer, J.W.M. Giamarellos-Bourboulis, E.J. Volpi, S. Sormani, M.P. Signori, A. Bozzi, G. Minoia, F. Aliberti, S. Grasselli, G. Alagna, L. Lombardi, A. Ungaro, R. Agostoni, C. Blasi, F. Costantino, G. Fracanzani, A.L. Montano, N. Peyvandi, F. Sottocorno, M. Muscatello, A. Filocamo, G. Papadopoulos, A. Mouktaroudi, M. Karakike, E. Saridaki, M. Gkavogianni, T. Katrini, K. Vechlidis, N. Avgoustou, C. Chalvatzis, S. Marantos, T. Damoulari, C. Damoraki, G. Ktena, S. Tsilika, M. Koufargyris, P. Karageorgos, A. Droggiti, D.-I. Koliakou, A. Poulakou, G. Tsiakos, K. Myrodia, D.-M. Gravvani, A. Trontzas, I.P. Syrigos, K. Kalomenidis, I. Kranidioti, E. Panagopoulos, P. Petrakis, V. Metallidis, S. Loli, G. Tsachouridou, O. Dalekos, G.N. Gatselis, N. Stefos, A. Georgiadou, S. Lygoura, V. Milionis, H. Kosmidou, M. Papanikolaou, I.C. Akinosoglou, K. Giannitsioti, E. Chrysos, G. Mavroudis, P. Sidiropoulou, C. Adamis, G. Fragkou, A. Rapti, A. Alexiou, Z. Symbardi, S. Masgala, A. Kostaki, K. Kostis, E. Samarkos, M. Bakakos, P. Tzavara, V. Dimakou, K. Tzatzagou, G. Chini, M. Kotsis, V. Tsoukalas, G. Bliziotis, I. Doumas, M. Argyraki, A. Kainis, I. Fantoni, M. Cingolani, A. Angheben, A. Cardellino, C.S. Castelli, F. Serino, F.S. Nicastri, E. Ippolito, G. Bassetti, M. Selmi, C. International Collaborative Group for Anakinra in COVID-19
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Background: Anakinra might improve the prognosis of patients with moderate to severe COVID-19 (ie, patients requiring oxygen supplementation but not yet receiving organ support). We aimed to assess the effect of anakinra treatment on mortality in patients admitted to hospital with COVID-19. Methods: For this systematic review and individual patient-level meta-analysis, a systematic literature search was done on Dec 28, 2020, in Medline (PubMed), Cochrane, medRxiv, bioRxiv, and the ClinicalTrials.gov databases for randomised trials, comparative studies, and observational studies of patients admitted to hospital with COVID-19, comparing administration of anakinra with standard of care, or placebo, or both. The search was repeated on Jan 22, 2021. Individual patient-level data were requested from investigators and corresponding authors of eligible studies; if individual patient-level data were not available, published data were extracted from the original reports. The primary endpoint was mortality after 28 days and the secondary endpoint was safety (eg, the risk of secondary infections). This study is registered on PROSPERO (CRD42020221491). Findings: 209 articles were identified, of which 178 full-text articles fulfilled screening criteria and were assessed. Aggregate data on 1185 patients from nine studies were analysed, and individual patient-level data on 895 patients were provided from six of these studies. Eight studies were observational and one was a randomised controlled trial. Most studies used historical controls. In the individual patient-level meta-analysis, after adjusting for age, comorbidities, baseline ratio of the arterial partial oxygen pressure divided by the fraction of inspired oxygen (PaO2/FiO2), C-reactive protein (CRP) concentrations, and lymphopenia, mortality was significantly lower in patients treated with anakinra (38 [11%] of 342) than in those receiving standard of care with or without placebo (137 [25%] of 553; adjusted odds ratio [OR] 0·32 [95% CI 0·20–0·51]). The mortality benefit was similar across subgroups regardless of comorbidities (ie, diabetes), ferritin concentrations, or the baseline PaO2/FiO2. In a subgroup analysis, anakinra was more effective in lowering mortality in patients with CRP concentrations higher than 100 mg/L (OR 0·28 [95% CI 0·17–0·47]). Anakinra showed a significant survival benefit when given without dexamethasone (OR 0·23 [95% CI 0·12–0·43]), but not with dexamethasone co-administration (0·72 [95% CI 0·37–1·41]). Anakinra was not associated with a significantly increased risk of secondary infections when compared with standard of care (OR 1·35 [95% CI 0·59–3·10]). Interpretation: Anakinra could be a safe, anti-inflammatory treatment option to reduce the mortality risk in patients admitted to hospital with moderate to severe COVID-19 pneumonia, especially in the presence of signs of hyperinflammation such as CRP concentrations higher than 100 mg/L. Funding: Sobi. © 2021 Elsevier Ltd
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- 2021
17. Higher levels of IgA and IgG at sepsis onset are associated with higher mortality: results from the Albumin Italian Outcome Sepsis (ALBIOS) trial
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Alagna, L, Meessen, J, Bellani, G, Albiero, D, Caironi, P, Principale, I, Vivona, L, Grasselli, G, Motta, F, Agnelli, N, Parrini, V, Romagnoli, S, Keim, R, Di Marzo Capozzi, F, Taccone, F, Taccone, W, Bottazzi, B, Bandera, A, Cortegiani, A, Latini, R, Alagna, Laura, Meessen, Jennifer M T A, Bellani, Giacomo, Albiero, Daniela, Caironi, Pietro, Principale, Irene, Vivona, Luigi, Grasselli, Giacomo, Motta, Francesca, Agnelli, Nicolò M, Parrini, Vieri, Romagnoli, Stefano, Keim, Roberto, Di Marzo Capozzi, Francesca, Taccone, Fabio S, Taccone, Walter, Bottazzi, Barbara, Bandera, Alessandra, Cortegiani, Andrea, Latini, Roberto, Alagna, L, Meessen, J, Bellani, G, Albiero, D, Caironi, P, Principale, I, Vivona, L, Grasselli, G, Motta, F, Agnelli, N, Parrini, V, Romagnoli, S, Keim, R, Di Marzo Capozzi, F, Taccone, F, Taccone, W, Bottazzi, B, Bandera, A, Cortegiani, A, Latini, R, Alagna, Laura, Meessen, Jennifer M T A, Bellani, Giacomo, Albiero, Daniela, Caironi, Pietro, Principale, Irene, Vivona, Luigi, Grasselli, Giacomo, Motta, Francesca, Agnelli, Nicolò M, Parrini, Vieri, Romagnoli, Stefano, Keim, Roberto, Di Marzo Capozzi, Francesca, Taccone, Fabio S, Taccone, Walter, Bottazzi, Barbara, Bandera, Alessandra, Cortegiani, Andrea, and Latini, Roberto
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Background: The role of intravenous immunoglobulins (IVIG) during sepsis is controversial, as different trials on IVIG have observed inconsistent survival benefits. We aimed to elucidate the possible association and clinical significance between circulating levels of immunoglobulins. Methods: In a subset of 956 patients with severe sepsis and septic shock of the multicentre, open-label RCT ALBIOS, venous blood samples were serially collected 1, 2, and 7 days after enrolment (or at ICU discharge, whichever came first). IgA, IgG and IgM concentrations were assayed in all patients on day 1 and in a subgroup of 150 patients on days 2 and 7. Ig concentrations were measured employing a turbidimetric assay, OSR61171 system. Results: IgA on day 1 had a significant predictive value for both 28-day and 90-day mortality (28-day mortality, HR: 1.50 (95% CI 1.18–1.92); 90-day mortality, HR: 1.54 (95% CI 1.25–1.91)). IgG, but not IgM, on day 1 showed similar results for 28-day (HR 1.83 (95% CI 1.33–2.51) and 90-day mortality HR: 1.66 (95% CI 1.23–2.25)). In addition, lower levels of IgG but not of IgA and IgM, at day 1 were associated with significantly higher risk of secondary infections (533 [406–772] vs 600 [452–842] mg/dL, median [Q1–Q3], p = 0.007). Conclusions: In the largest cohort study of patients with severe sepsis or septic shock, we found that high levels of IgA and IgG on the first day of diagnosis were associated with a decreased 90-day survival. No association was found between IgM levels and survival. As such, the assessment of endogenous immunoglobulins could be a useful tool to identify septic patients at high risk of mortality. Trial registration #NCT00707122, Clinicaltrial.gov, registered 30 June 2008.
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- 2021
18. Hospital-Acquired Infections in Critically Ill Patients With COVID-19
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Grasselli, G, Scaravilli, V, Mangioni, D, Scudeller, L, Alagna, L, Bartoletti, M, Bellani, G, Biagioni, E, Bonfanti, P, Bottino, N, Coloretti, I, Cutuli, S, De Pascale, G, Ferlicca, D, Fior, G, Forastieri, A, Franzetti, M, Greco, M, Guzzardella, A, Linguadoca, S, Meschiari, M, Messina, A, Monti, G, Morelli, P, Muscatello, A, Redaelli, S, Stefanini, F, Tonetti, T, Antonelli, M, Cecconi, M, Foti, G, Fumagalli, R, Girardis, M, Ranieri, M, Viale, P, Raviglione, M, Pesenti, A, Gori, A, Bandera, A, Grasselli, Giacomo, Scaravilli, Vittorio, Mangioni, Davide, Scudeller, Luigia, Alagna, Laura, Bartoletti, Michele, Bellani, Giacomo, Biagioni, Emanuela, Bonfanti, Paolo, Bottino, Nicola, Coloretti, Irene, Cutuli, Salvatore Lucio, De Pascale, Gennaro, Ferlicca, Daniela, Fior, Gabriele, Forastieri, Andrea, Franzetti, Marco, Greco, Massimiliano, Guzzardella, Amedeo, Linguadoca, Sara, Meschiari, Marianna, Messina, Antonio, Monti, Gianpaola, Morelli, Paola, Muscatello, Antonio, Redaelli, Simone, Stefanini, Flavia, Tonetti, Tommaso, Antonelli, Massimo, Cecconi, Maurizio, Foti, Giuseppe, Fumagalli, Roberto, Girardis, Massimo, Ranieri, Marco, Viale, Pierluigi, Raviglione, Mario, Pesenti, Antonio, Gori, Andrea, Bandera, Alessandra, Grasselli, G, Scaravilli, V, Mangioni, D, Scudeller, L, Alagna, L, Bartoletti, M, Bellani, G, Biagioni, E, Bonfanti, P, Bottino, N, Coloretti, I, Cutuli, S, De Pascale, G, Ferlicca, D, Fior, G, Forastieri, A, Franzetti, M, Greco, M, Guzzardella, A, Linguadoca, S, Meschiari, M, Messina, A, Monti, G, Morelli, P, Muscatello, A, Redaelli, S, Stefanini, F, Tonetti, T, Antonelli, M, Cecconi, M, Foti, G, Fumagalli, R, Girardis, M, Ranieri, M, Viale, P, Raviglione, M, Pesenti, A, Gori, A, Bandera, A, Grasselli, Giacomo, Scaravilli, Vittorio, Mangioni, Davide, Scudeller, Luigia, Alagna, Laura, Bartoletti, Michele, Bellani, Giacomo, Biagioni, Emanuela, Bonfanti, Paolo, Bottino, Nicola, Coloretti, Irene, Cutuli, Salvatore Lucio, De Pascale, Gennaro, Ferlicca, Daniela, Fior, Gabriele, Forastieri, Andrea, Franzetti, Marco, Greco, Massimiliano, Guzzardella, Amedeo, Linguadoca, Sara, Meschiari, Marianna, Messina, Antonio, Monti, Gianpaola, Morelli, Paola, Muscatello, Antonio, Redaelli, Simone, Stefanini, Flavia, Tonetti, Tommaso, Antonelli, Massimo, Cecconi, Maurizio, Foti, Giuseppe, Fumagalli, Roberto, Girardis, Massimo, Ranieri, Marco, Viale, Pierluigi, Raviglione, Mario, Pesenti, Antonio, Gori, Andrea, and Bandera, Alessandra
- Abstract
Background: Few small studies have described hospital-acquired infections (HAIs) occurring in patients with COVID-19. Research Question: What characteristics in critically ill patients with COVID-19 are associated with HAIs and how are HAIs associated with outcomes in these patients? Study Design and Methods: Multicenter retrospective analysis of prospectively collected data including adult patients with severe COVID-19 admitted to eight Italian hub hospitals from February 20, 2020, through May 20, 2020. Descriptive statistics and univariate and multivariate Weibull regression models were used to assess incidence, microbial cause, resistance patterns, risk factors (ie, demographics, comorbidities, exposure to medication), and impact on outcomes (ie, ICU discharge, length of ICU and hospital stays, and duration of mechanical ventilation) of microbiologically confirmed HAIs. Results: Of the 774 included patients, 359 patients (46%) demonstrated 759 HAIs (44.7 infections/1,000 ICU patient-days; 35% multidrug-resistant [MDR] bacteria). Ventilator-associated pneumonia (VAP; n = 389 [50%]), bloodstream infections (BSIs; n = 183 [34%]), and catheter-related BSIs (n = 74 [10%]) were the most frequent HAIs, with 26.0 (95% CI, 23.6-28.8) VAPs per 1,000 intubation-days, 11.7 (95% CI, 10.1-13.5) BSIs per 1,000 ICU patient-days, and 4.7 (95% CI, 3.8-5.9) catheter-related BSIs per 1,000 ICU patient-days. Gram-negative bacteria (especially Enterobacterales) and Staphylococcus aureus caused 64% and 28% of cases of VAP, respectively. Variables independently associated with infection were age, positive end expiratory pressure, and treatment with broad-spectrum antibiotics at admission. Two hundred thirty-four patients (30%) died in the ICU (15.3 deaths/1,000 ICU patient-days). Patients with HAIs complicated by septic shock showed an almost doubled mortality rate (52% vs 29%), whereas noncomplicated infections did not affect mortality. HAIs prolonged mechanical ventilation (median, 24
- Published
- 2021
19. Repeat endocarditis - a consequence of medical progress? Analysis of risk factors based on International Collaboration on Endocarditis - Prospective Cohort Study (ICE-PCS): O168
- Author
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Alagna, L., Park, L., Nicholson, B., Keiger, A., Baloch, K., Woods, C. W., Joyce, M., and Chu, V. H.
- Published
- 2012
20. COVID-19 Network: the response of an Italian Reference Institute to research challenges about a new pandemia
- Author
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Bandera, A., primary, Aliberti, S., additional, Gualtierotti, R., additional, Baldini, M., additional, Blasi, F., additional, Cesari, M., additional, Costantino, G., additional, Fracanzani, A.L., additional, Gori, A., additional, Montano, N., additional, Monzani, V., additional, Nobili, A., additional, Peyvandi, F., additional, Pesenti, A., additional, Prati, D., additional, Valenti, L., additional, Fusetti, G., additional, Scudeller, L., additional, Bosari, S., additional, Rusconi, L., additional, Dell Orto, S., additional, Lamorte, G., additional, Manunta, M., additional, Baselli, G., additional, Santoro, L., additional, Bandera, A., additional, Muscatello, A., additional, Mangioni, D., additional, Alagna, L., additional, Bozzi, G., additional, Lombardi, A., additional, Ungaro, R., additional, Itri, T., additional, Ferroni, V., additional, Pastore, V., additional, Massafra, R., additional, Rondolini, I., additional, Ferrari, B., additional, Rossio, R., additional, Corona, E., additional, Rampi, N., additional, Massimo, C., additional, Vigone, B., additional, Bellocchi, C., additional, Fiorelli, E., additional, Melli, V., additional, Tobaldini, E., additional, Spotti, M., additional, Simonetta, E., additional, Terranova, L., additional, Amati, F., additional, Miele, C., additional, Misuraca, S., additional, D'Adda, A., additional, Della Fiore, S., additional, Di Pasquale, M., additional, Contarini, M.M.M., additional, Ori, M., additional, Morlacchi, L., additional, Rossetti, V., additional, Gramegna, A., additional, Pappalettera, M., additional, Cavallini, M., additional, Vigni, A., additional, Vicenzi, M., additional, Rota, I., additional, Solbiati, M., additional, Furlan, L., additional, Mancarella, M., additional, Colombo, G., additional, Fanin, A., additional, Rovellini, A., additional, Barbetta, L., additional, Billi, F., additional, Folli, C., additional, Motta, I., additional, Scaramellini, N., additional, Lombardi, R., additional, Iuculano, F., additional, Proietti, M., additional, Calcaterra, L., additional, Tettamanti, M., additional, and Monti, I., additional
- Published
- 2020
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21. Duration of quarantine in hospitalized patients with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection: a question needing an answer
- Author
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Lombardi, A., primary, Alagna, L., additional, Bozzi, G., additional, Mangioni, D., additional, Muscatello, A., additional, Peri, A.M., additional, Taramasso, L., additional, Ungaro, R., additional, Bandera, A., additional, and Gori, A., additional
- Published
- 2020
- Full Text
- View/download PDF
22. X-ray absorption spectroscopy studies of ruthenoxane phthalocyanine derivative HO-((Pc)RuO)(sub n)-H
- Author
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Alagna, L., Capobianchi, A., Marovino, P., Paoletti, A.M., Pennesi, G., Prosperi, T., and Rossi, G.
- Subjects
Phthalocyanins -- Research ,Ruthenium -- Research ,Coordination compounds -- Research ,Chemistry - Abstract
A comprehensive study of ruthenoxane phthalocyanine and its chemical precursors ruthenium phthalocyanine dimer and ruthenium bis-pyridine phthalocyanine was conducted using X-ray absorption spectroscopy. Data analysis was used to obtain the distances around the ruthenium atom which confirmed the structural models proposed for the first two compounds. Results and all structural information for the metal site are compared with information previously derived on the same systems and with related species.
- Published
- 1999
23. X-ray diffraction study on the correlation between ordered domains size and ordering degree in InGaP/GaAs alloy layers
- Author
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Francesio, L., Alagna, L., Capelle, B., Ferrari, C., Franzosi, P., and Sauvage, M.
- Published
- 1997
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- View/download PDF
24. Diffraction anomalous near-edge structure in ordered GalnP
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Alagna, L., Prosperi, T., Turchini, S., Ferrari, C., Francesio, L., and Franzosi, P.
- Subjects
Diffraction patterns -- Research ,Gallium -- Isotopes ,Physics - Abstract
Exploiting the site selectivity of x-ray absorption fine structure and the spatial selectivity of x-ray diffraction makes it possible to discriminate the structure around the gallium atom in the bulk, in the epi-layer and in the superstructure of GaxIn1-xP/GaAs. Diffraction anomalous fine structure spectra, originating from the 004 reflections of the substrate and the epi-layer and that from the 'forbidden' -5/2 -5/2 reflection of the superstructure, have been identified at the Ga K edge. It is clear that the spatial and site selectivity for the same element can be used to distinguish between a situation caused by an arrangement in domains and one involving long range ordering.
- Published
- 1998
25. Impact of orotracheal intubation and mechanical ventilation on the microbiota of the lung in the development of Ventilator- Associated Pneumonia
- Author
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Calabretta, D, Piazzai, D, Pinciroli, R, Vargiolu, A, Adriana, P, Alagna, L, Bandera, A, Migliorino4, G, Minardi5, F, Rossi, S, 5, Picetti5, E, Ventura6, M, Gori, A, Citerio, G, D. Calabretta, D. Piazzai, R. Pinciroli, A. Vargiolu, P. Adriana, L. Alagna, A. Bandera, GM. Migliorino4, F. Minardi5, S. Rossi, E. Picetti5, M. Ventura6, A. Gori, G. Citerio, Calabretta, D, Piazzai, D, Pinciroli, R, Vargiolu, A, Adriana, P, Alagna, L, Bandera, A, Migliorino4, G, Minardi5, F, Rossi, S, 5, Picetti5, E, Ventura6, M, Gori, A, Citerio, G, D. Calabretta, D. Piazzai, R. Pinciroli, A. Vargiolu, P. Adriana, L. Alagna, A. Bandera, GM. Migliorino4, F. Minardi5, S. Rossi, E. Picetti5, M. Ventura6, A. Gori, and G. Citerio
- Published
- 2019
26. Microbiota in ICU, not only a gut problem
- Author
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Alagna, L, Bandera, A, Patruno, A, Muscatello, A, Citerio, G, Gori, A, Alagna, L, Bandera, A, Patruno, A, Muscatello, A, Citerio, G, and Gori, A
- Published
- 2019
27. EXAFS and XANES Studies of Calcium Polysaccharides
- Author
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Alagna, L., Prosperi, T., Tomlinson, A. A. G., Rizzo, R., Bayley, P. M., editor, Bianconi, Antonio, editor, and Congiu Castellano, Agostina, editor
- Published
- 1987
- Full Text
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28. The role of immune suppression in COVID-19 hospitalization: clinical and epidemiological trends over three years of SARS-CoV-2 epidemic
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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
- Full Text
- View/download PDF
29. Mutations in the natural strains of NS3 protease domain of HCV in HIV/HCV coinfected patients under antiretroviral therapy including or not HIV protease inhibitors
- Author
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Morsica G, Bagaglio S, Alagna L, Lodrini C, Gallotta G, Galli L, Dispinseri S, Lazzarin A, UBERTI FOPPA , CATERINA, Morsica, G, Bagaglio, S, Alagna, L, Lodrini, C, Gallotta, G, Galli, L, Dispinseri, S, Lazzarin, A, and UBERTI FOPPA, Caterina
- Published
- 2006
30. EXAFS and XANES Studies of Calcium Polysaccharides
- Author
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Alagna, L., primary, Prosperi, T., additional, Tomlinson, A. A. G., additional, and Rizzo, R., additional
- Published
- 1987
- Full Text
- View/download PDF
31. [570] MUTATIONS IN THE NATURAL STRAINS OF NS3 PROTEASE DOMAIN THAT CONFER RESISTANCE TO ANTI-HCV PROTEASE INHIBITORS IN HIV/HCV COINFECTED PATIENTS
- Author
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Bagaglio, S., primary, Uberti-Foppa, C., additional, Alagna, L., additional, Lodrini, C., additional, Gallotta, G., additional, Galli, L., additional, Dispinseri, S., additional, Lazzarin, A., additional, and Morsica, G., additional
- Published
- 2007
- Full Text
- View/download PDF
32. Natural Circular Dichroism at the Nd L3Edge in Single Crystals of Na3Nd(C4H4O5)32NaBF46H2O
- Author
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Alagna, L., primary, Goulon, J., additional, Goulon-Gìnet, C., additional, Peacock, R. D., additional, Prosperi, T., additional, Rogalev, A., additional, Stewart, B., additional, and Turchini, S., additional
- Published
- 1997
- Full Text
- View/download PDF
33. XAS of Ruthenium Phthalocyanine Dimer : Structural Properties of Bulk and Film Form
- Author
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Alagna, L., primary, Capobianchi, A., additional, Pennesi, G., additional, Prosperi, T., additional, and Rossi, G., additional
- Published
- 1997
- Full Text
- View/download PDF
34. Random phase approximation calculations of K-edge rotational strengths of chiral molecules: propylene oxide
- Author
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Alagna, L., primary, Di Fonzo, S., additional, Prosperi, T., additional, Turchini, S., additional, Lazzeretti, P., additional, Malagoli, M., additional, Zanasi, R., additional, Natoli, C.R., additional, and Stephens, P.J., additional
- Published
- 1994
- Full Text
- View/download PDF
35. Microscopic investigation of the strain distribution in InGaAs/GaAs quantum well structures grown by molecular beam epitaxy
- Author
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Proietti, M.G., primary, Martelli, F., additional, Turchini, S., additional, Alagna, L., additional, Bruni, M.R., additional, Prosperi, T., additional, Simeone, M.G., additional, and Garcia, J., additional
- Published
- 1993
- Full Text
- View/download PDF
36. An understanding of the x-ray absorption near-edge structure of copper(II) imidazole complexes
- Author
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Strange, R. W., primary, Alagna, L., additional, Durham, P., additional, and Hasnain, S. S., additional
- Published
- 1990
- Full Text
- View/download PDF
37. X-ray absorption spectroscopy studies of ruthenoxane phthalocyanine derivative HO-[(Pc)RuO]n-H.
- Author
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Alagna, L. and Capobianchi, A.
- Subjects
- *
PHTHALOCYANINES , *X-ray spectroscopy - Abstract
Examines the structure of ruthenoxane phthalocyanine and its precursors by X-ray absorption spectroscopy. Function of ruthenium phthalocyanine dimer and ruthenium bis-pyridine phthalocyanine; Indication of the pyridines in the central metal of the adduct; Structure of the ruthane derivatives; Dimeric structures of the complex.
- Published
- 1999
- Full Text
- View/download PDF
38. extended X-ray absorption fine structure investigation of solid and gel forms of calcium poly(alfa-D-galacturonate)
- Author
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Alagna, L., Prosperi, T., Tomlinson, A. A. G., Rizzo, Roberto, Alagna, L., Prosperi, T., Tomlinson, A. A. G., and Rizzo, Roberto
- Subjects
EXAFS ,polygalacturonate ,calcium interaction ,structure - Published
- 1986
39. The nickel ion environment in jack bean urease
- Author
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Alagna, L, Hasnain, S S, Piggott, B, and Williams, D J
- Abstract
Preliminary results of an extended X-ray absorption fine structure (e.x.a.f.s.) and X-ray absorption near edge structure study of jack bean urease have recently been reported [Hasnain & Piggott (1983) Biochem. Biophys. Res. Commun. 112, 279]. These results indicate that the environment of the nickel ion in the enzyme is similar to that in the model compounds Ni(L)2(L')1(ClO4)1 (where L is 1-n-propyl-2-alpha-hydroxybenzylbenzimidazole and L' is the deprotonated form) and Ni(HMB)3(Br)2 (where HMB is 2-hydroxymethylbenzimidazole), the closest similarity being with Ni(L)2-(L')1(ClO4)1. A detailed e.x.a.f.s. analysis has now been carried out and the crystal structures of the two model compounds solved. These results are reported here.
- Published
- 1984
- Full Text
- View/download PDF
40. Rate of cirrhosis progression reduced in HIV/HCV co-infected non-responders to anti-HCV therapy
- Author
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De Bona A, Galli L, Gallotta G, Guzzo A, Alagna L, Lazzarin A, Caterina Uberti-Foppa, De Bona, A, Galli, L, Gallotta, G, Guzzo, A, Alagna, L, Lazzarin, Adriano, and UBERTI FOPPA, Caterina
- Abstract
This is a retrospective longitudinal follow-up study of 25 HIV/HCV positive cirrhotic patients not responding to peg-IFN plus ribavirin, and 25 untreated controls matched for age ( 5 years), gender and Child-Pugh score. The primary endpoint of the study was the incidence of cirrhosis progression (CP) defined as the occurrence of at least one of the following events: death, ascites, jaundice, encephalopathy, gastrointestinal bleeding and hepatocellular carcinoma (HCC). During the median follow-up of 54 months (34-89), four treated (16%) and 13 untreated patients (52%) experienced CP (p=0.02). Poisson's regression model showed that the independent predictors of CP were Peg-IFN therapy (p=0.016), positive HIV-RNA (p=0.024), and altered ALP values (p=0.012). Peg-IFN therapy seems to slow down the rate of cirrhosis progression also in HIV/HCV co-infected patients nonresponders to anti-HCV therapy, in comparison with untreated patients.
41. GLANCING ANGLE EXAFS INVESTIGATION OF INGAAS/GAAS STRAINED-LAYER MULTIPLE-QUANTUM WELLS - STRAIN AND BOND DISTANCES
- Author
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Turchini, S., Proietti, Mg, Martelli, F., Alagna, L., BRUNI, MR, Prosperi, T., Simeone, Mg, and Joaquin Garcia
42. The first high specific surface area, pillared, layered phosphate with a narrow pore size distribution
- Author
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Olivera-Pastor, P., primary, Jimenez-Lopez, A., additional, Maireles-Torres, P., additional, Rodriguez-Castellon, E., additional, Tomlinson, A. A. G., additional, and Alagna, L., additional
- Published
- 1989
- Full Text
- View/download PDF
43. EXAFS AND XANES OF SUPEROXIDE DISMUTASE : A COPPER PROTEIN
- Author
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HASNAIN, S. S., primary, ALAGNA, L., additional, BLACKBURN, N. J., additional, and STRANGE, R. W., additional
- Published
- 1986
- Full Text
- View/download PDF
44. ChemInform Abstract: ZIRCONIUM PHOSPHATES PARTIALLY EXCHANGED WITH TRANSITION METAL IONS: CHARACTERIZATION AND STEREOCHEMICAL CHANGES INDUCED BY HEAT TREATMENT
- Author
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ALAGNA, L., primary, TOMLINSON, A. A. G., additional, FERRAGINA, C., additional, and LA GINESTRA, A., additional
- Published
- 1982
- Full Text
- View/download PDF
45. ChemInform Abstract: AN EXTENDED X-RAY ABSORPTION FINE STRUCTURE STUDY OF PENTAAMMINECOPPER(II) BIS(TETRAFLUOROBORATE): EVIDENCE FOR FIVE EQUAL BOND LENGTHS
- Author
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ALAGNA, L., primary, PROSPERI, T., additional, TOMLINSON, A. A. G., additional, and VLAIC, G., additional
- Published
- 1983
- Full Text
- View/download PDF
46. EXAFS STUDIES OF METAL-SUPPORT INTERACTIONS VS CLUSTER FORMATION IN IRON PARTICLES DISPERSED IN AMORPHOUS ALUMINA
- Author
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ALAGNA, L., primary, FIORANI, D., additional, PROSPERI, T., additional, and DORMANN, J. L., additional
- Published
- 1986
- Full Text
- View/download PDF
47. Hospital-Acquired Infections in Critically Ill Patients With COVID-19
- Author
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Antonio Muscatello, Giacomo Bellani, Paolo Bonfanti, Gabriele Fior, Sara Linguadoca, Antonio Pesenti, Alessandra Bandera, Massimiliano Greco, Michele Bartoletti, Massimo Girardis, Irene Coloretti, Paola Morelli, N Bottino, Mario Carlo Raviglione, Gennaro De Pascale, Marianna Meschiari, Marco Ranieri, Giacomo Grasselli, Roberto Fumagalli, Luigia Scudeller, Giuseppe Foti, Daniela Ferlicca, Andrea Forastieri, Antonio Messina, Emanuela Biagioni, Flavia Stefanini, Pierluigi Viale, Marco Franzetti, Maurizio Cecconi, Tommaso Tonetti, Andrea Gori, Massimo Antonelli, Laura Alagna, Vittorio Scaravilli, Amedeo Guzzardella, SL Cutuli, Simone Redaelli, Davide Mangioni, Gianpaola Monti, Grasselli G., Scaravilli V., Mangioni D., Scudeller L., Alagna L., Bartoletti M., Bellani G., Biagioni E., Bonfanti P., Bottino N., Coloretti I., Cutuli S.L., De Pascale G., Ferlicca D., Fior G., Forastieri A., Franzetti M., Greco M., Guzzardella A., Linguadoca S., Meschiari M., Messina A., Monti G., Morelli P., Muscatello A., Redaelli S., Stefanini F., Tonetti T., Antonelli M., Cecconi M., Foti G., Fumagalli R., Girardis M., Ranieri M., Viale P., Raviglione M., Pesenti A., Gori A., Bandera A., Grasselli, G, Scaravilli, V, Mangioni, D, Scudeller, L, Alagna, L, Bartoletti, M, Bellani, G, Biagioni, E, Bonfanti, P, Bottino, N, Coloretti, I, Cutuli, S, De Pascale, G, Ferlicca, D, Fior, G, Forastieri, A, Franzetti, M, Greco, M, Guzzardella, A, Linguadoca, S, Meschiari, M, Messina, A, Monti, G, Morelli, P, Muscatello, A, Redaelli, S, Stefanini, F, Tonetti, T, Antonelli, M, Cecconi, M, Foti, G, Fumagalli, R, Girardis, M, Ranieri, M, Viale, P, Raviglione, M, Pesenti, A, Gori, A, and Bandera, A
- Subjects
Pulmonary and Respiratory Medicine ,Male ,medicine.medical_specialty ,COVID-19 ,SARS-CoV-2 ,critical care ,hospital-acquired infections ,medicine.medical_treatment ,Critical Illness ,Critical Care and Intensive Care Medicine ,Aged ,Cross Infection ,Female ,Humans ,Middle Aged ,Pneumonia, Ventilator-Associated ,Retrospective Studies ,Sepsis ,Interquartile range ,Internal medicine ,Settore MED/41 - ANESTESIOLOGIA ,Hospital-acquired infection ,Correspondence ,medicine ,Mechanical ventilation ,hospital-acquired infection ,Septic shock ,business.industry ,Incidence (epidemiology) ,Mortality rate ,Ventilator-associated pneumonia ,Pneumonia ,medicine.disease ,Ventilator-Associated ,Cardiology and Cardiovascular Medicine ,business - Abstract
Background: Few small studies have described hospital-acquired infections (HAIs) occurring in patients with COVID-19. Research Question: What characteristics in critically ill patients with COVID-19 are associated with HAIs and how are HAIs associated with outcomes in these patients? Study Design and Methods: Multicenter retrospective analysis of prospectively collected data including adult patients with severe COVID-19 admitted to eight Italian hub hospitals from February 20, 2020, through May 20, 2020. Descriptive statistics and univariate and multivariate Weibull regression models were used to assess incidence, microbial cause, resistance patterns, risk factors (ie, demographics, comorbidities, exposure to medication), and impact on outcomes (ie, ICU discharge, length of ICU and hospital stays, and duration of mechanical ventilation) of microbiologically confirmed HAIs. Results: Of the 774 included patients, 359 patients (46%) demonstrated 759 HAIs (44.7 infections/1,000 ICU patient-days; 35% multidrug-resistant [MDR] bacteria). Ventilator-associated pneumonia (VAP; n = 389 [50%]), bloodstream infections (BSIs; n = 183 [34%]), and catheter-related BSIs (n = 74 [10%]) were the most frequent HAIs, with 26.0 (95% CI, 23.6-28.8) VAPs per 1,000 intubation-days, 11.7 (95% CI, 10.1-13.5) BSIs per 1,000 ICU patient-days, and 4.7 (95% CI, 3.8-5.9) catheter-related BSIs per 1,000 ICU patient-days. Gram-negative bacteria (especially Enterobacterales) and Staphylococcus aureus caused 64% and 28% of cases of VAP, respectively. Variables independently associated with infection were age, positive end expiratory pressure, and treatment with broad-spectrum antibiotics at admission. Two hundred thirty-four patients (30%) died in the ICU (15.3 deaths/1,000 ICU patient-days). Patients with HAIs complicated by septic shock showed an almost doubled mortality rate (52% vs 29%), whereas noncomplicated infections did not affect mortality. HAIs prolonged mechanical ventilation (median, 24 days [interquartile range (IQR), 14-39 days] vs 9 days [IQR, 5-13 days]; P < .001), ICU stay (24 days [IQR, 16-41 days] vs 9 days [IQR, 6-14 days]; P = .003), and hospital stay (42 days [IQR, 25-59 days] vs 23 days [IQR, 13-34 days]; P < .001). Interpretation: Critically ill patients with COVID-19 are at high risk for HAIs, especially VAPs and BSIs resulting from MDR organisms. HAIs prolong mechanical ventilation and hospitalization, and HAIs complicated by septic shock almost double mortality. Trial Registry: ClinicalTrials.gov; No.: NCT04388670; URL: www.clinicaltrials.gov
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- 2020
48. Changes in upper airways microbiota in ventilator-associated pneumonia
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Laura Alagna, Leonardo Mancabelli, Federico Magni, Liliane Chatenoud, Gabriele Bassi, Silvia Del Bianco, Roberto Fumagalli, Francesca Turroni, Davide Mangioni, Guglielmo M. Migliorino, Christian Milani, Antonio Muscatello, Giovanni Nattino, Edoardo Picetti, Riccardo Pinciroli, Sandra Rossi, Tommaso Tonetti, Alessia Vargiolu, Alessandra Bandera, Marco Ventura, Giuseppe Citerio, Andrea Gori, Alagna, L, Mancabelli, L, Magni, F, Chatenoud, L, Bassi, G, Del Bianco, S, Fumagalli, R, Turroni, F, Mangioni, D, Migliorino, G, Milani, C, Muscatello, A, Nattino, G, Picetti, E, Pinciroli, R, Rossi, S, Tonetti, T, Vargiolu, A, Bandera, A, Ventura, M, Citerio, G, Gori, A, Alagna, Laura, Mancabelli, Leonardo, Magni, Federico, Chatenoud, Liliane, Bassi, Gabriele, Del Bianco, Silvia, Fumagalli, Roberto, Turroni, Francesca, Mangioni, Davide, Migliorino, Guglielmo M, Milani, Christian, Muscatello, Antonio, Nattino, Giovanni, Picetti, Edoardo, Pinciroli, Riccardo, Rossi, Sandra, Tonetti, Tommaso, Vargiolu, Alessia, Bandera, Alessandra, Ventura, Marco, Citerio, Giuseppe, and Gori, Andrea
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Mechanical ventilation ,VAP ,Ventilator-associated pneumonia ,16S-rRNA microbial profiling ,Critical Care and Intensive Care Medicine ,Cohort study ,Upper airways microbiota - Abstract
Background The role of upper airways microbiota and its association with ventilator-associated pneumonia (VAP) development in mechanically ventilated (MV) patients is unclear. Taking advantage of data collected in a prospective study aimed to assess the composition and over-time variation of upper airway microbiota in patients MV for non-pulmonary reasons, we describe upper airway microbiota characteristics among VAP and NO-VAP patients. Methods Exploratory analysis of data collected in a prospective observational study on patients intubated for non-pulmonary conditions. Microbiota analysis (trough 16S-rRNA gene profiling) was performed on endotracheal aspirates (at intubation, T0, and after 72 h, T3) of patients with VAP (cases cohort) and a subgroup of NO-VAP patients (control cohort, matched according to total intubation time). Results Samples from 13 VAP patients and 22 NO-VAP matched controls were analyzed. At intubation (T0), patients with VAP revealed a significantly lower microbial complexity of the microbiota of the upper airways compared to NO-VAP controls (alpha diversity index of 84 ± 37 and 160 ± 102, in VAP and NO_VAP group, respectively, p-value Prevotella 7, Fusobacterium, Neisseria, Escherichia–Shigella and Haemophilus) was found in VAP patients. In contrast, eight genera belonging to the Bacteroidetes, Firmicutes and Fusobacteria phyla was predominant in this group. However, it is unclear whether VAP caused dysbiosis or dysbiosis caused VAP. Conclusions In a small sample size of intubated patients, microbial diversity at intubation was less in patients with VAP compared to patients without VAP.
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- 2023
49. Validation of the INCREMENT‐SOT‐CPE score in a large cohort of liver transplant recipients with carbapenem‐resistant Enterobacterales infection
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Rinaldi, Matteo, Bonazzetti, Cecilia, Gallo, Mena, Ferraro, Giuseppe, Freire, Maristela, Terrabuio, Débora Raquel Benedita, Tandoi, Francesco, Romagnoli, Renato, De Rosa, Francesco Giuseppe, Mularoni, Alessandra, Ferrarese, Alberto, Burra, Patrizia, Halpern, Marcia, Balbi, Elizabeth, Simkins, Jacques, Abbo, Lilian, Morrás, Ignacio, Cantero, Mireia, Alagna, Laura, Bandera, Alessandra, Clemente, Wanessa Trinidade, Valerio, Maricela, Fernández, Ainhoa, Muñoz, Patricia, Statlender, Liran, Yahav, Dafna, Camargo, Luis Fernando Aranha, Girão, Evelyne Santana, Grossi, Paolo, Viale, Pierluigi, Curti, Stefania, Giannella, Maddalena, Rinaldi M., Bonazzetti C., Gallo M., Ferraro G., Freire M., Terrabuio D.R.B., Tandoi F., Romagnoli R., De Rosa F.G., Mularoni A., Ferrarese A., Burra P., Halpern M., Balbi E., Simkins J., Abbo L., Morrás I., Cantero M., Alagna L., Bandera A., Clemente W.T., Valerio M., Fernández A., Muñoz P., Statlender L., Yahav D., Camargo L.F.A., Girão E.S., Grossi P., Viale P., Curti S., and Giannella M.
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INCREMENT-SOT-CPE score ,Transplantation ,Infectious Diseases ,CRE infection ,liver transplantation ,SOT - Abstract
Background: Management of infections due to carbapenemase-resistant Enterobacterales (CRE) in solid organ transplant (SOT) recipients remains a difficult challenge. The INCREMENT-SOT-CPE score has been specifically developed from SOT recipients to stratify mortality risk, but an external validation is lacking.Methods: Multicenter retrospective cohort study of liver transplant (LT) recipients colonized with CRE infection who developed infection after transplant over 7-year period. Primary endpoint was all-cause 30-day mortality from infection onset. A comparison between INCREMENT-SOT-CPE and other selected scores was performed. A two-level mixed effects logistic regression model with random effects for the center was fitted. Performance characteristics at optimal cut-point were calculated. Multivariable Cox regression analysis of risk factors for all-cause 30-day mortality was carried out.Results: Overall, 250 CRE carriers developed infection after LT and were analyzed. The median age was 55 years (interquartile range [IQR]: 46-62) and 157 were males (62.8%). All-cause 30-day mortality was 35.6%. A sequential organ failure assessment (SOFA) score >= 11 showed a sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of 69.7%, 76.4%, 62.0%, 82.0%, and 74.0%, respectively. An INCREMENT-SOT-CPE >= 11 reported a sensitivity, specificity, PPV, NPV, and accuracy of 73.0%, 62.1%, 51.6%, 80.6% and 66.0%, respectively. At multivariable analysis acute renal failure, prolonged mechanical ventilation, INCREMENT-SOT-CPE score >= 11 and SOFA score >= 11 were independently associated with all-cause 30-day mortality, while a tigecycline-based targeted regimen was found to be protective.Conclusions: Both INCREMENT-SOT-CPE >= 11 and SOFA >= 11 were identified as strong predictors of all-cause 30-day mortality in a large cohort of CRE carriers developing infection after LT.
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- 2023
50. Effect of anakinra on mortality in patients with COVID-19: a systematic review and patient-level meta-analysis
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Evdoxia Kyriazopoulou, Thomas Huet, Giulio Cavalli, Andrea Gori, Miltiades Kyprianou, Peter Pickkers, Jesper Eugen-Olsen, Mario Clerici, Francisco Veas, Gilles Chatellier, Gilles Kaplanski, Mihai G Netea, Emanuele Pontali, Marco Gattorno, Raphael Cauchois, Emma Kooistra, Matthijs Kox, Alessandra Bandera, Hélène Beaussier, Davide Mangioni, Lorenzo Dagna, Jos W M van der Meer, Evangelos J Giamarellos-Bourboulis, Gilles Hayem, Mihai G. Netea, Jos W.M. van der Meer, Evangelos J. Giamarellos-Bourboulis, Stefano Volpi, Maria Pia Sormani, Alessio Signori, Giorgio Bozzi, Francesca Minoia, Stefano Aliberti, Giacomo Grasselli, Laura Alagna, Andrea Lombardi, Riccardo Ungaro, Carlo Agostoni, Francesco Blasi, Giorgio Costantino, Anna Ludovica Fracanzani, Nicola Montano, Flora Peyvandi, Marcello Sottocorno, Antonio Muscatello, Giovanni Filocamo, Antonios Papadopoulos, Maria Mouktaroudi, Eleni Karakike, Maria Saridaki, Theologia Gkavogianni, Konstantina Katrini, Nikolaos Vechlidis, Christina Avgoustou, Stamatios Chalvatzis, Theodoros Marantos, Christina Damoulari, Georgia Damoraki, Sofia Ktena, Maria Tsilika, Panagiotis Koufargyris, Athanasios Karageorgos, Dionysia-Irene Droggiti, Aikaterini Koliakou, Garyfallia Poulakou, Konstantinos Tsiakos, Dimitra-Melia Myrodia, Areti Gravvani, Ioannis P. Trontzas, Konstantinos Syrigos, Ioannis Kalomenidis, Eleftheria Kranidioti, Periklis Panagopoulos, Vasileios Petrakis, Simeon Metallidis, Georgia Loli, Olga Tsachouridou, George N. Dalekos, Nikolaos Gatselis, Aggelos Stefos, Sarah Georgiadou, Vassiliki Lygoura, Haralampos Milionis, Maria Kosmidou, Ilias C. Papanikolaou, Karolina Akinosoglou, Efthymia Giannitsioti, Georgios Chrysos, Panagiotis Mavroudis, Chrysanthi Sidiropoulou, Georgios Adamis, Archontoula Fragkou, Aggeliki Rapti, Zoi Alexiou, Styliani Symbardi, Aikaterini Masgala, Konstantina Kostaki, Evangelos Kostis, Michael Samarkos, Petros Bakakos, Vassiliki Tzavara, Katerina Dimakou, Glykeria Tzatzagou, Maria Chini, Vasileios Kotsis, George Tsoukalas, Ioannis Bliziotis, Michael Doumas, Aikaterini Argyraki, Ilias Kainis, Massimo Fantoni, Antonella Cingolani, Andrea Angheben, Chiara Simona Cardellino, Francesco Castelli, Francesco Saverio Serino, Emanuele Nicastri, Giuseppe Ippolito, Matteo Bassetti, Carlo Selmi, Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Kyriazopoulou, E., Huet, T., Cavalli, Giulio., Gori, A., Kyprianou, M., Pickkers, P., Eugen-Olsen, J., Clerici, M., Veas, F., Chatellier, G., Kaplanski, G., Netea, M. G., Pontali, E., Gattorno, M., Cauchois, R., Kooistra, E., Kox, M., Bandera, A., Beaussier, H., Mangioni, D., Dagna, L., van der Meer, J. W. M., Giamarellos-Bourboulis, E. J., Hayem, G., Volpi, S., Sormani, M. P., Signori, A., Bozzi, G., Minoia, F., Aliberti, S., Grasselli, G., Alagna, L., Lombardi, A., Ungaro, R., Agostoni, C., Blasi, F., Costantino, G., Fracanzani, A. L., Montano, N., Peyvandi, F., Sottocorno, M., Muscatello, A., Filocamo, G., Papadopoulos, A., Mouktaroudi, M., Karakike, E., Saridaki, M., Gkavogianni, T., Katrini, K., Vechlidis, N., Avgoustou, C., Chalvatzis, S., Marantos, T., Damoulari, C., Damoraki, G., Ktena, S., Tsilika, M., Koufargyris, P., Karageorgos, A., Droggiti, D. -I., Koliakou, A., Poulakou, G., Tsiakos, K., Myrodia, D. -M., Gravvani, A., Trontzas, I. P., Syrigos, K., Kalomenidis, I., Kranidioti, E., Panagopoulos, P., Petrakis, V., Metallidis, S., Loli, G., Tsachouridou, O., Dalekos, G. N., Gatselis, N., Stefos, A., Georgiadou, S., Lygoura, V., Milionis, H., Kosmidou, M., Papanikolaou, I. C., Akinosoglou, K., Giannitsioti, E., Chrysos, G., Mavroudis, P., Sidiropoulou, C., Adamis, G., Fragkou, A., Rapti, A., Alexiou, Z., Symbardi, S., Masgala, A., Kostaki, K., Kostis, E., Samarkos, M., Bakakos, P., Tzavara, V., Dimakou, K., Tzatzagou, G., Chini, M., Kotsis, V., Tsoukalas, G., Bliziotis, I., Doumas, M., Argyraki, A., Kainis, I., Fantoni, M., Cingolani, A., Angheben, A., Cardellino, C. S., Castelli, F., Serino, F. S., Nicastri, E., Ippolito, G., Bassetti, M., and Selmi, C.
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medicine.medical_specialty ,Anakinra ,business.industry ,Secondary infection ,[SDV]Life Sciences [q-bio] ,Immunology ,lnfectious Diseases and Global Health Radboud Institute for Molecular Life Sciences [Radboudumc 4] ,Odds ratio ,Articles ,Placebo ,law.invention ,Rheumatology ,Randomized controlled trial ,law ,Meta-analysis ,Fraction of inspired oxygen ,Internal medicine ,Clinical endpoint ,Immunology and Allergy ,Medicine ,business ,ComputingMilieux_MISCELLANEOUS ,medicine.drug - Abstract
Contains fulltext : 237989.pdf (Publisher’s version ) (Closed access) BACKGROUND: Anakinra might improve the prognosis of patients with moderate to severe COVID-19 (ie, patients requiring oxygen supplementation but not yet receiving organ support). We aimed to assess the effect of anakinra treatment on mortality in patients admitted to hospital with COVID-19. METHODS: For this systematic review and individual patient-level meta-analysis, a systematic literature search was done on Dec 28, 2020, in Medline (PubMed), Cochrane, medRxiv, bioRxiv, and the ClinicalTrials.gov databases for randomised trials, comparative studies, and observational studies of patients admitted to hospital with COVID-19, comparing administration of anakinra with standard of care, or placebo, or both. The search was repeated on Jan 22, 2021. Individual patient-level data were requested from investigators and corresponding authors of eligible studies; if individual patient-level data were not available, published data were extracted from the original reports. The primary endpoint was mortality after 28 days and the secondary endpoint was safety (eg, the risk of secondary infections). This study is registered on PROSPERO (CRD42020221491). FINDINGS: 209 articles were identified, of which 178 full-text articles fulfilled screening criteria and were assessed. Aggregate data on 1185 patients from nine studies were analysed, and individual patient-level data on 895 patients were provided from six of these studies. Eight studies were observational and one was a randomised controlled trial. Most studies used historical controls. In the individual patient-level meta-analysis, after adjusting for age, comorbidities, baseline ratio of the arterial partial oxygen pressure divided by the fraction of inspired oxygen (PaO(2)/FiO(2)), C-reactive protein (CRP) concentrations, and lymphopenia, mortality was significantly lower in patients treated with anakinra (38 [11%] of 342) than in those receiving standard of care with or without placebo (137 [25%] of 553; adjusted odds ratio [OR] 0·32 [95% CI 0·20-0·51]). The mortality benefit was similar across subgroups regardless of comorbidities (ie, diabetes), ferritin concentrations, or the baseline PaO(2)/FiO(2). In a subgroup analysis, anakinra was more effective in lowering mortality in patients with CRP concentrations higher than 100 mg/L (OR 0·28 [95% CI 0·17-0·47]). Anakinra showed a significant survival benefit when given without dexamethasone (OR 0·23 [95% CI 0·12-0·43]), but not with dexamethasone co-administration (0·72 [95% CI 0·37-1·41]). Anakinra was not associated with a significantly increased risk of secondary infections when compared with standard of care (OR 1·35 [95% CI 0·59-3·10]). INTERPRETATION: Anakinra could be a safe, anti-inflammatory treatment option to reduce the mortality risk in patients admitted to hospital with moderate to severe COVID-19 pneumonia, especially in the presence of signs of hyperinflammation such as CRP concentrations higher than 100 mg/L. FUNDING: Sobi.
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- 2021
- Full Text
- View/download PDF
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