Author: "Cauda, R (ORCID:0000-0002-1498-4229)" - Searchworks@Jio Institute Digital Library Search Results

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64 results on '"Cauda, R (ORCID:0000-0002-1498-4229)"'

1. Peculiar Variations of the Electrostatic Potential of Spike Protein N-terminal Domain Associated with the Emergence of Successive SARS-CoV-2 Omicron Lineages

Author: Pascarella, S., Ciccozzi, M., Benvenuto, D., Borsetti, A., Cauda, Roberto, Cassone, A., Cauda R. (ORCID:0000-0002-1498-4229), Pascarella, S., Ciccozzi, M., Benvenuto, D., Borsetti, A., Cauda, Roberto, Cassone, A., and Cauda R. (ORCID:0000-0002-1498-4229)
Abstract: not available
Published: 2023

2. Fatigue in Covid-19 survivors: The potential impact of a nutritional supplement on muscle strength and function

Author: Galluzzo, Vincenzo, Zazzara, Maria Beatrice, Ciciarello, Francesca, Savera, Giulia, Pais, C., Calvani, Riccardo, Picca, A., Marzetti, Emanuele, Landi, Francesco, Tosato, Matteo, Steering, Committee, Gremese, Elisa, Coordination, Bernabei, Roberto, Fantoni, Massimo, Gasbarrini, Antonio, Field, Investigator, Gastroenterology, Team, Porcari, Serena, Settanni, Carlo Romano, Geriatric, Team, Benvenuto, F., Bramato, Giulia, Brandi, Vincenzo, Carfi, A., Fabrizi, Sofia, Lo Monaco, Maria Rita, Martone, Anna Maria, Napolitano, C., Pagano, Francesco Cosimo, Rocchi, Sara, Rota, E., Salerno, Andrea Maria, Tritto, M., Catalano, Lucio, Damiano, Francesco Paolo, Rocconi, Alessandra, Galliani, Alessandro, Spaziani, G., Tupputi, Salvatore, Cocchi, Camilla, Pirone, Flavia, D'Ignazio, F., Cacciatore, Stefano, Infectious disease, Team, Cauda, Roberto, Tamburrini, Enrica, Borghetti, Alberto, Di Gianbenedetto, S., Murri, Rita, Cingolani, Antonella, Ventura, Giulio, Taddei, E., Moschese, D., Ciccullo, A., Dusina, A., Internal Medicine, Team, Stella, L., Addolorato, Giovanni, Franceschi, Francesco, Mingrone, Geltrude, Zocco, Maria Assunta, Microbiology, Team, Sanguinetti, Maurizio, Cattani Franchi, Paola, Marchetti, Simona, Posteraro, Brunella, Sali, M., Neurology, Team, Bizzarro, Alessandra, Lauria, Alessandra, Ophthalmology, Team, Rizzo, Stanislao, Savastano, Maria Cristina, Gambini, Gloria, Cozzupoli, G. M., Culiersi, Carola, Otolaryngology, Team, Passali, Giulio Cesare, Paludetti, Gaetano, Galli, Jacopo, Crudo, F., Di Cintio, G., Longobardi, Ylenia, Tricarico, Laura, Santantonio, M., Pediatric, Team, Buonsenso, Danilo, Valentini, Piero, Pata, D., Sinatti, Dario, De Rose, Cristina, Pneumology, Team, Richeldi, Luca, Lombardi, F., Calabrese, Anna Chiara, Leone, Paolo Maria, Calvello, M. R., Intini, Enrica, Montemurro, G., Psychiatric, Team, Sani, Gabriele, Janiri, Delfina, Simonetti, Alessio, Giuseppin, G., Molinaro, M., Odica, M., Radiology, Team, Natale, Luigi, Larici, Anna Rita, Marano, Riccardo, Rheumatology, Team, Paglionico, A., Petricca, Luca, Gigante, Lavinia, Natalello, G., Fedele, Anna Laura, Lizzio, Marco Maria, Tolusso, Barbara, Di Mario, Clara, Alivernini, Stefano, Vascular, Team, Santoliquido, Angelo, Santoro, L., Di Giorgio, A., Nesci, A., Popolla, Valentina, Galluzzo V., Zazzara M. B., Ciciarello F., Savera G., Calvani R. (ORCID:0000-0001-5472-2365), Marzetti E. (ORCID:0000-0001-9567-6983), Landi F. (ORCID:0000-0002-3472-1389), Tosato M., Gremese E. (ORCID:0000-0002-2248-1058), Bernabei R. (ORCID:0000-0002-9197-004X), Fantoni M. (ORCID:0000-0001-6913-8460), Gasbarrini A. (ORCID:0000-0002-7278-4823), Porcari S., Settanni C. R., Bramato G., Brandi V., Fabrizi S., Lo Monaco M. R. (ORCID:0000-0002-1457-7981), Martone A. M., Pagano F. C., Rocchi S., Salerno A., Catalano L., Damiano F. P., Rocconi A., Galliani A., Tupputi S., Cocchi C., Pirone F., Cacciatore S., Cauda R. (ORCID:0000-0002-1498-4229), Tamburrini E. (ORCID:0000-0003-4930-426X), Borghetti A., Murri R. (ORCID:0000-0003-4263-7854), Cingolani A. (ORCID:0000-0002-3793-2755), Ventura G. (ORCID:0000-0002-0304-7264), Addolorato G. (ORCID:0000-0002-1522-9946), Franceschi F. (ORCID:0000-0001-6266-445X), Mingrone G. (ORCID:0000-0003-2021-528X), Zocco M. A. (ORCID:0000-0002-0814-9542), Sanguinetti M. (ORCID:0000-0002-9780-7059), Cattani P. (ORCID:0000-0003-4678-4763), Marchetti S., Posteraro B. (ORCID:0000-0002-1663-7546), Bizzarro A., Lauria A., Rizzo S. (ORCID:0000-0001-6302-063X), Savastano M. C. (ORCID:0000-0003-1397-4333), Gambini G., Culiersi C., Passali G. C. (ORCID:0000-0002-8176-0962), Paludetti G. (ORCID:0000-0003-2480-1243), Galli J. (ORCID:0000-0001-6353-6249), Longobardi Y., Tricarico L., Buonsenso D., Valentini P. (ORCID:0000-0001-6095-9510), Sinatti D., De Rose C., Richeldi L. (ORCID:0000-0001-8594-1448), Calabrese A., Leone P. M., Intini E., Sani G. (ORCID:0000-0002-9767-8752), Janiri D., Simonetti A., Natale L. (ORCID:0000-0002-7949-5119), Larici A. R. (ORCID:0000-0002-1882-6244), Marano R. (ORCID:0000-0003-2710-2093), Petricca L., Gigante L., Fedele A. L., Lizzio M. M., Tolusso B. (ORCID:0000-0002-9108-6609), Di Mario C., Alivernini S. (ORCID:0000-0002-7383-4212), Santoliquido A. (ORCID:0000-0003-1539-4017), Popolla V., Galluzzo, Vincenzo, Zazzara, Maria Beatrice, Ciciarello, Francesca, Savera, Giulia, Pais, C., Calvani, Riccardo, Picca, A., Marzetti, Emanuele, Landi, Francesco, Tosato, Matteo, Steering, Committee, Gremese, Elisa, Coordination, Bernabei, Roberto, Fantoni, Massimo, Gasbarrini, Antonio, Field, Investigator, Gastroenterology, Team, Porcari, Serena, Settanni, Carlo Romano, Geriatric, Team, Benvenuto, F., Bramato, Giulia, Brandi, Vincenzo, Carfi, A., Fabrizi, Sofia, Lo Monaco, Maria Rita, Martone, Anna Maria, Napolitano, C., Pagano, Francesco Cosimo, Rocchi, Sara, Rota, E., Salerno, Andrea Maria, Tritto, M., Catalano, Lucio, Damiano, Francesco Paolo, Rocconi, Alessandra, Galliani, Alessandro, Spaziani, G., Tupputi, Salvatore, Cocchi, Camilla, Pirone, Flavia, D'Ignazio, F., Cacciatore, Stefano, Infectious disease, Team, Cauda, Roberto, Tamburrini, Enrica, Borghetti, Alberto, Di Gianbenedetto, S., Murri, Rita, Cingolani, Antonella, Ventura, Giulio, Taddei, E., Moschese, D., Ciccullo, A., Dusina, A., Internal Medicine, Team, Stella, L., Addolorato, Giovanni, Franceschi, Francesco, Mingrone, Geltrude, Zocco, Maria Assunta, Microbiology, Team, Sanguinetti, Maurizio, Cattani Franchi, Paola, Marchetti, Simona, Posteraro, Brunella, Sali, M., Neurology, Team, Bizzarro, Alessandra, Lauria, Alessandra, Ophthalmology, Team, Rizzo, Stanislao, Savastano, Maria Cristina, Gambini, Gloria, Cozzupoli, G. M., Culiersi, Carola, Otolaryngology, Team, Passali, Giulio Cesare, Paludetti, Gaetano, Galli, Jacopo, Crudo, F., Di Cintio, G., Longobardi, Ylenia, Tricarico, Laura, Santantonio, M., Pediatric, Team, Buonsenso, Danilo, Valentini, Piero, Pata, D., Sinatti, Dario, De Rose, Cristina, Pneumology, Team, Richeldi, Luca, Lombardi, F., Calabrese, Anna Chiara, Leone, Paolo Maria, Calvello, M. R., Intini, Enrica, Montemurro, G., Psychiatric, Team, Sani, Gabriele, Janiri, Delfina, Simonetti, Alessio, Giuseppin, G., Molinaro, M., Odica, M., Radiology, Team, Natale, Luigi, Larici, Anna Rita, Marano, Riccardo, Rheumatology, Team, Paglionico, A., Petricca, Luca, Gigante, Lavinia, Natalello, G., Fedele, Anna Laura, Lizzio, Marco Maria, Tolusso, Barbara, Di Mario, Clara, Alivernini, Stefano, Vascular, Team, Santoliquido, Angelo, Santoro, L., Di Giorgio, A., Nesci, A., Popolla, Valentina, Galluzzo V., Zazzara M. B., Ciciarello F., Savera G., Calvani R. (ORCID:0000-0001-5472-2365), Marzetti E. (ORCID:0000-0001-9567-6983), Landi F. (ORCID:0000-0002-3472-1389), Tosato M., Gremese E. (ORCID:0000-0002-2248-1058), Bernabei R. (ORCID:0000-0002-9197-004X), Fantoni M. (ORCID:0000-0001-6913-8460), Gasbarrini A. (ORCID:0000-0002-7278-4823), Porcari S., Settanni C. R., Bramato G., Brandi V., Fabrizi S., Lo Monaco M. R. (ORCID:0000-0002-1457-7981), Martone A. M., Pagano F. C., Rocchi S., Salerno A., Catalano L., Damiano F. P., Rocconi A., Galliani A., Tupputi S., Cocchi C., Pirone F., Cacciatore S., Cauda R. (ORCID:0000-0002-1498-4229), Tamburrini E. (ORCID:0000-0003-4930-426X), Borghetti A., Murri R. (ORCID:0000-0003-4263-7854), Cingolani A. (ORCID:0000-0002-3793-2755), Ventura G. (ORCID:0000-0002-0304-7264), Addolorato G. (ORCID:0000-0002-1522-9946), Franceschi F. (ORCID:0000-0001-6266-445X), Mingrone G. (ORCID:0000-0003-2021-528X), Zocco M. A. (ORCID:0000-0002-0814-9542), Sanguinetti M. (ORCID:0000-0002-9780-7059), Cattani P. (ORCID:0000-0003-4678-4763), Marchetti S., Posteraro B. (ORCID:0000-0002-1663-7546), Bizzarro A., Lauria A., Rizzo S. (ORCID:0000-0001-6302-063X), Savastano M. C. (ORCID:0000-0003-1397-4333), Gambini G., Culiersi C., Passali G. C. (ORCID:0000-0002-8176-0962), Paludetti G. (ORCID:0000-0003-2480-1243), Galli J. (ORCID:0000-0001-6353-6249), Longobardi Y., Tricarico L., Buonsenso D., Valentini P. (ORCID:0000-0001-6095-9510), Sinatti D., De Rose C., Richeldi L. (ORCID:0000-0001-8594-1448), Calabrese A., Leone P. M., Intini E., Sani G. (ORCID:0000-0002-9767-8752), Janiri D., Simonetti A., Natale L. (ORCID:0000-0002-7949-5119), Larici A. R. (ORCID:0000-0002-1882-6244), Marano R. (ORCID:0000-0003-2710-2093), Petricca L., Gigante L., Fedele A. L., Lizzio M. M., Tolusso B. (ORCID:0000-0002-9108-6609), Di Mario C., Alivernini S. (ORCID:0000-0002-7383-4212), Santoliquido A. (ORCID:0000-0003-1539-4017), and Popolla V.
Abstract: Background: Fatigue with reduced tolerance to exercise is a common persistent long-lasting feature amongst COVID-19 survivors. The assessment of muscle function in this category of patients is often neglected.Aim.: To evaluate the potential impact of a daily supplementation based on amino acids, minerals, vi-tamins, and plant extracts (Apportal (R)) on muscle function, body composition, laboratory parameters and self-rated health in a small group of COVID-19 survivors affected by fatigue.Methods: Thirty participants were enrolled among patients affected by physical fatigue during or after acute COVID-19 and admitted to the post-COVID-19 outpatient service at Fondazione Policlinico Gemelli in Rome between 1st March 2021 and 30th April 2021. All participants were evaluated at first visit (t0) and at control visit (t1), after taking a daily sachet of Apportal (R) for 28 days. Muscle function was analyzed using hand grip strength test, exhaustion strength time and the number of repetitions at one -minute chair stand test. Body composition was assessed with bioelectrical impedance analysis (BIA). Laboratory parameters, including standard blood biochemistry and ferritin levels, were evaluated at the first visit and during the control visit. A quick evaluation of self-rated health, before COVID-19, at t0 and t1, was obtained through a visual analogue scale (VAS). Results: Participants aged 60 years and older were 13 (43%). Females represented the 70% of the study sample. Participants hospitalized for COVID-19 with low -flow oxygen supplementation represented the 43.3% of the study sample while 3.3% received noninvasive ventilation (NIV) or invasive ventilation. Hand grip strength improved from 26.3 Kg to 28.9 Kg (p < 0.05) at t1 as compared to t0. The mean time of strength exhaustion increased from 31.7 s (sec) at t0 to 47.5 s at t1 (p < 0.05). Participants performed a higher number of repetitions (28.3 vs. 22.0; p < 0.05) during the one-minute chair stand test at
Published: 2022

3. The Biological Properties of the SARS-CoV-2 Cameroon Variant Spike: An Intermediate between the Alpha and Delta Variants

Author: Pascarella, S., Bianchi, M., Giovanetti, M., Benvenuto, D., Borsetti, A., Cauda, Roberto, Cassone, A., Ciccozzi, M., Cauda R. (ORCID:0000-0002-1498-4229), Pascarella, S., Bianchi, M., Giovanetti, M., Benvenuto, D., Borsetti, A., Cauda, Roberto, Cassone, A., Ciccozzi, M., and Cauda R. (ORCID:0000-0002-1498-4229)
Abstract: An analysis of the structural effect of the mutations of the B.1.640.2 (IHU) Spike Receptor Binding Domain (RBD) and N-terminal Domain (NTD) is reported along with a comparison with the sister lineage B.1.640.1. and a selection of variants of concern. The effect of the mutations on the RBD–ACE2 interaction was also assessed. The structural analysis applied computational methods that are able to carry out in silico mutagenesis to calculate energy minimization and the folding energy variation consequent to residue mutations. Tools for electrostatic calculation were applied to quantify and display the protein surface electrostatic potential. Interactions at the RBD–ACE2 interface were scrutinized using computational tools that identify the interactions and predict the contribution of each interface residue to the stability of the complex. The comparison among the RBDs shows that the most evident differences between the variants is in the distribution of the surface electrostatic potential: that of B.1.640.1 is as that of the Alpha RBD, while B.1.640.2 appears to have an intermediate surface potential pattern with characteristics between those of the Alpha and Delta variants. Moreover, the B.1.640.2 Spike includes the mutation E484K that in other variants has been suggested to be involved in immune evasion. These properties may hint at the possibility that B.1.640.2 emerged with a potentially increased infectivity with respect to the sister B.1.640.1 variant, but significantly lower than that of the Delta and Omicron variants. However, the analysis of their NTD domains highlights deletions, destabilizing mutations and charge alterations that can limit the ability of the B.1.640.1 and B.1.640.2 variants to interact with cellular components, such as cell surface receptors.
Published: 2022

4. Genetic and Structural Data on the SARS-CoV-2 Omicron BQ.1 Variant Reveal Its Low Potential for Epidemiological Expansion

Author: Scarpa, F., Sanna, D., Benvenuto, D., Borsetti, A., Azzena, I., Casu, M., Fiori, P. L., Giovanetti, M., Maruotti, A., Ceccarelli, G., Caruso, A., Caccuri, F., Cauda, Roberto, Cassone, A., Pascarella, S., Ciccozzi, M., Cauda R. (ORCID:0000-0002-1498-4229), Scarpa, F., Sanna, D., Benvenuto, D., Borsetti, A., Azzena, I., Casu, M., Fiori, P. L., Giovanetti, M., Maruotti, A., Ceccarelli, G., Caruso, A., Caccuri, F., Cauda, Roberto, Cassone, A., Pascarella, S., Ciccozzi, M., and Cauda R. (ORCID:0000-0002-1498-4229)
Abstract: The BQ.1 SARS-CoV-2 variant, also known as Cerberus, is one of the most recent Omicron descendant lineages. Compared to its direct progenitor BA.5, BQ.1 has some additional spike mutations in some key antigenic sites, which confer further immune escape ability over other circulating lineages. In such a context, here, we perform a genome-based survey aimed at obtaining a complete-as-possible nuance of this rapidly evolving Omicron subvariant. Genetic data suggest that BQ.1 represents an evolutionary blind background, lacking the rapid diversification that is typical of a dangerous lineage. Indeed, the evolutionary rate of BQ.1 is very similar to that of BA.5 (7.6 × 10−4 and 7 × 10−4 subs/site/year, respectively), which has been circulating for several months. The Bayesian Skyline Plot reconstruction indicates a low level of genetic variability, suggesting that the peak was reached around 3 September 2022. Concerning the affinity for ACE2, structure analyses (also performed by comparing the properties of BQ.1 and BA.5 RBD) indicate that the impact of the BQ.1 mutations may be modest. Likewise, immunoinformatic analyses showed moderate differences between the BQ.1 and BA5 potential B-cell epitopes. In conclusion, genetic and structural analyses on SARS-CoV-2 BQ.1 suggest no evidence of a particularly dangerous or high expansion capability. Genome-based monitoring must continue uninterrupted for a better understanding of its descendants and all other lineages.
Published: 2022

5. Fatigue in Covid-19 survivors: The potential impact of a nutritional supplement on muscle strength and function

Author: Galluzzo, Vincenzo, Zazzara, M. B., Ciciarello, Francesca, Savera, Giulia, Pais, C., Calvani, Riccardo, Picca, A., Marzetti, Emanuele, Landi, Francesco, Tosato, Matteo, Steering, Committee, Gremese, Elisa, Coordination, Bernabei, Roberto, Fantoni, Massimo, Gasbarrini, Antonio, Field, Investigator, Gastroenterology, Team, Porcari, Serena, Settanni, Carlo Romano, Geriatric, Team, Benvenuto, F., Bramato, Giulia, Brandi, Vincenzo, Carfi, A., Fabrizi, Sofia, Lo Monaco, Maria Rita, Martone, Anna Maria, Napolitano, C., Pagano, Francesco Cosimo, Rocchi, Sara, Rota, E., Salerno, Andrea Maria, Tritto, M., Catalano, Lucio, Damiano, Francesco Paolo, Rocconi, Alessandra, Galliani, Alessandro, Spaziani, Giovanni, Tupputi, Salvatore, Cocchi, Camilla, Pirone, Flavia, D'Ignazio, Federica, Cacciatore, Stefano, Infectious disease, Team, Cauda, Roberto, Tamburrini, Enrica, Borghetti, Alberto, Di Gianbenedetto, S., Murri, Rita, Cingolani, Antonella, Ventura, Giulio, Taddei, E., Moschese, D., Ciccullo, A., Dusina, A., Internal Medicine, Team, Stella, Leonardo, Addolorato, Giovanni, Franceschi, Francesco, Mingrone, Geltrude, Zocco, Maria Assunta, Microbiology, Team, Sanguinetti, Maurizio, Cattani Franchi, Paola, Marchetti, Simona, Posteraro, Brunella, Sali, Michela, Neurology, Team, Bizzarro, Alessandra, Lauria, Alessandra, Ophthalmology, Team, Rizzo, Stanislao, Savastano, Maria Cristina, Gambini, Gloria, Cozzupoli, G. M., Culiersi, Carola, Otolaryngology, Team, Passali, Giulio Cesare, Paludetti, Gaetano, Galli, Jacopo, Crudo, F., Di Cintio, G., Longobardi, Ylenia, Tricarico, Laura, Santantonio, M., Pediatric, Team, Buonsenso, Danilo, Valentini, Piero, Pata, D., Sinatti, Dario, De Rose, Cristina, Pneumology, Team, Richeldi, Luca, Lombardi, Francesco, Calabrese, Anna Chiara, Leone, Paolo Maria, Calvello, M. R., Intini, Enrica, Montemurro, G., Psychiatric, Team, Sani, Gabriele, Janiri, Delfina, Simonetti, Alessio, Giuseppin, G., Molinaro, M., Odica, M., Radiology, Team, Natale, Luigi, Larici, Anna Rita, Marano, Riccardo, Rheumatology, Team, Paglionico, A., Petricca, Luca, Gigante, Lavinia, Natalello, G., Fedele, Anna Laura, Lizzio, Marco Maria, Tolusso, Barbara, Di Mario, Clara, Alivernini, Stefano, Vascular, Team, Santoliquido, Angelo, Santoro, Luca, Di Giorgio, Angela, Nesci, Antonio, Popolla, Valentina, Galluzzo V., Ciciarello F., Savera G., Calvani R. (ORCID:0000-0001-5472-2365), Marzetti E. (ORCID:0000-0001-9567-6983), Landi F. (ORCID:0000-0002-3472-1389), Tosato M., Gremese E. (ORCID:0000-0002-2248-1058), Bernabei R. (ORCID:0000-0002-9197-004X), Fantoni M. (ORCID:0000-0001-6913-8460), Gasbarrini A. (ORCID:0000-0002-7278-4823), Porcari S., Settanni C. R., Bramato G., Brandi V., Fabrizi S., Lo Monaco M. R. (ORCID:0000-0002-1457-7981), Martone A. M., Pagano F. C., Rocchi S., Salerno A., Catalano L., Damiano F. P., Rocconi A., Galliani A., Spaziani G., Tupputi S., Cocchi C., Pirone F., D'Ignazio F., Cacciatore S., Cauda R. (ORCID:0000-0002-1498-4229), Tamburrini E. (ORCID:0000-0003-4930-426X), Borghetti A., Murri R. (ORCID:0000-0003-4263-7854), Cingolani A. (ORCID:0000-0002-3793-2755), Ventura G. (ORCID:0000-0002-0304-7264), Stella L., Addolorato G. (ORCID:0000-0002-1522-9946), Franceschi F. (ORCID:0000-0001-6266-445X), Mingrone G. (ORCID:0000-0003-2021-528X), Zocco M. A. (ORCID:0000-0002-0814-9542), Sanguinetti M. (ORCID:0000-0002-9780-7059), Cattani P. (ORCID:0000-0003-4678-4763), Marchetti S., Posteraro B. (ORCID:0000-0002-1663-7546), Sali M. (ORCID:0000-0003-3609-2990), Bizzarro A., Lauria A., Rizzo S. (ORCID:0000-0001-6302-063X), Savastano M. C. (ORCID:0000-0003-1397-4333), Gambini G., Culiersi C., Passali G. C. (ORCID:0000-0002-8176-0962), Paludetti G. (ORCID:0000-0003-2480-1243), Galli J. (ORCID:0000-0001-6353-6249), Longobardi Y., Tricarico L., Buonsenso D., Valentini P. (ORCID:0000-0001-6095-9510), Sinatti D., De Rose C., Richeldi L. (ORCID:0000-0001-8594-1448), Lombardi F., Calabrese A., Leone P. M., Intini E., Sani G. (ORCID:0000-0002-9767-8752), Janiri D., Simonetti A., Natale L. (ORCID:0000-0002-7949-5119), Larici A. R. (ORCID:0000-0002-1882-6244), Marano R. (ORCID:0000-0003-2710-2093), Petricca L., Gigante L., Fedele A. L., Lizzio M. M., Tolusso B. (ORCID:0000-0002-9108-6609), Di Mario C., Alivernini S. (ORCID:0000-0002-7383-4212), Santoliquido A. (ORCID:0000-0003-1539-4017), Santoro L., Di Giorgio A., Nesci A., Popolla V., Galluzzo, Vincenzo, Zazzara, M. B., Ciciarello, Francesca, Savera, Giulia, Pais, C., Calvani, Riccardo, Picca, A., Marzetti, Emanuele, Landi, Francesco, Tosato, Matteo, Steering, Committee, Gremese, Elisa, Coordination, Bernabei, Roberto, Fantoni, Massimo, Gasbarrini, Antonio, Field, Investigator, Gastroenterology, Team, Porcari, Serena, Settanni, Carlo Romano, Geriatric, Team, Benvenuto, F., Bramato, Giulia, Brandi, Vincenzo, Carfi, A., Fabrizi, Sofia, Lo Monaco, Maria Rita, Martone, Anna Maria, Napolitano, C., Pagano, Francesco Cosimo, Rocchi, Sara, Rota, E., Salerno, Andrea Maria, Tritto, M., Catalano, Lucio, Damiano, Francesco Paolo, Rocconi, Alessandra, Galliani, Alessandro, Spaziani, Giovanni, Tupputi, Salvatore, Cocchi, Camilla, Pirone, Flavia, D'Ignazio, Federica, Cacciatore, Stefano, Infectious disease, Team, Cauda, Roberto, Tamburrini, Enrica, Borghetti, Alberto, Di Gianbenedetto, S., Murri, Rita, Cingolani, Antonella, Ventura, Giulio, Taddei, E., Moschese, D., Ciccullo, A., Dusina, A., Internal Medicine, Team, Stella, Leonardo, Addolorato, Giovanni, Franceschi, Francesco, Mingrone, Geltrude, Zocco, Maria Assunta, Microbiology, Team, Sanguinetti, Maurizio, Cattani Franchi, Paola, Marchetti, Simona, Posteraro, Brunella, Sali, Michela, Neurology, Team, Bizzarro, Alessandra, Lauria, Alessandra, Ophthalmology, Team, Rizzo, Stanislao, Savastano, Maria Cristina, Gambini, Gloria, Cozzupoli, G. M., Culiersi, Carola, Otolaryngology, Team, Passali, Giulio Cesare, Paludetti, Gaetano, Galli, Jacopo, Crudo, F., Di Cintio, G., Longobardi, Ylenia, Tricarico, Laura, Santantonio, M., Pediatric, Team, Buonsenso, Danilo, Valentini, Piero, Pata, D., Sinatti, Dario, De Rose, Cristina, Pneumology, Team, Richeldi, Luca, Lombardi, Francesco, Calabrese, Anna Chiara, Leone, Paolo Maria, Calvello, M. R., Intini, Enrica, Montemurro, G., Psychiatric, Team, Sani, Gabriele, Janiri, Delfina, Simonetti, Alessio, Giuseppin, G., Molinaro, M., Odica, M., Radiology, Team, Natale, Luigi, Larici, Anna Rita, Marano, Riccardo, Rheumatology, Team, Paglionico, A., Petricca, Luca, Gigante, Lavinia, Natalello, G., Fedele, Anna Laura, Lizzio, Marco Maria, Tolusso, Barbara, Di Mario, Clara, Alivernini, Stefano, Vascular, Team, Santoliquido, Angelo, Santoro, Luca, Di Giorgio, Angela, Nesci, Antonio, Popolla, Valentina, Galluzzo V., Ciciarello F., Savera G., Calvani R. (ORCID:0000-0001-5472-2365), Marzetti E. (ORCID:0000-0001-9567-6983), Landi F. (ORCID:0000-0002-3472-1389), Tosato M., Gremese E. (ORCID:0000-0002-2248-1058), Bernabei R. (ORCID:0000-0002-9197-004X), Fantoni M. (ORCID:0000-0001-6913-8460), Gasbarrini A. (ORCID:0000-0002-7278-4823), Porcari S., Settanni C. R., Bramato G., Brandi V., Fabrizi S., Lo Monaco M. R. (ORCID:0000-0002-1457-7981), Martone A. M., Pagano F. C., Rocchi S., Salerno A., Catalano L., Damiano F. P., Rocconi A., Galliani A., Spaziani G., Tupputi S., Cocchi C., Pirone F., D'Ignazio F., Cacciatore S., Cauda R. (ORCID:0000-0002-1498-4229), Tamburrini E. (ORCID:0000-0003-4930-426X), Borghetti A., Murri R. (ORCID:0000-0003-4263-7854), Cingolani A. (ORCID:0000-0002-3793-2755), Ventura G. (ORCID:0000-0002-0304-7264), Stella L., Addolorato G. (ORCID:0000-0002-1522-9946), Franceschi F. (ORCID:0000-0001-6266-445X), Mingrone G. (ORCID:0000-0003-2021-528X), Zocco M. A. (ORCID:0000-0002-0814-9542), Sanguinetti M. (ORCID:0000-0002-9780-7059), Cattani P. (ORCID:0000-0003-4678-4763), Marchetti S., Posteraro B. (ORCID:0000-0002-1663-7546), Sali M. (ORCID:0000-0003-3609-2990), Bizzarro A., Lauria A., Rizzo S. (ORCID:0000-0001-6302-063X), Savastano M. C. (ORCID:0000-0003-1397-4333), Gambini G., Culiersi C., Passali G. C. (ORCID:0000-0002-8176-0962), Paludetti G. (ORCID:0000-0003-2480-1243), Galli J. (ORCID:0000-0001-6353-6249), Longobardi Y., Tricarico L., Buonsenso D., Valentini P. (ORCID:0000-0001-6095-9510), Sinatti D., De Rose C., Richeldi L. (ORCID:0000-0001-8594-1448), Lombardi F., Calabrese A., Leone P. M., Intini E., Sani G. (ORCID:0000-0002-9767-8752), Janiri D., Simonetti A., Natale L. (ORCID:0000-0002-7949-5119), Larici A. R. (ORCID:0000-0002-1882-6244), Marano R. (ORCID:0000-0003-2710-2093), Petricca L., Gigante L., Fedele A. L., Lizzio M. M., Tolusso B. (ORCID:0000-0002-9108-6609), Di Mario C., Alivernini S. (ORCID:0000-0002-7383-4212), Santoliquido A. (ORCID:0000-0003-1539-4017), Santoro L., Di Giorgio A., Nesci A., and Popolla V.
Abstract: Background: Fatigue with reduced tolerance to exercise is a common persistent long-lasting feature amongst COVID-19 survivors. The assessment of muscle function in this category of patients is often neglected. Aim.: To evaluate the potential impact of a daily supplementation based on amino acids, minerals, vi- tamins, and plant extracts (Apportal®) on muscle function, body composition, laboratory parameters and self-rated health in a small group of COVID-19 survivors affected by fatigue. Methods: Thirty participants were enrolled among patients affected by physical fatigue during or after acute COVID-19 and admitted to the post-COVID-19 outpatient service at Fondazione Policlinico Gemelli in Rome between 1st March 2021 and 30th April 2021. All participants were evaluated at first visit (t0) and at control visit (t1), after taking a daily sachet of Apportal® for 28 days. Muscle function was analyzed using hand grip strength test, exhaustion strength time and the number of repetitions at one- minute chair stand test. Body composition was assessed with bioelectrical impedance analysis (BIA). Laboratory parameters, including standard blood biochemistry and ferritin levels, were evaluated at the first visit and during the control visit. A quick evaluation of self-rated health, before COVID-19, at t0 and t1, was obtained through a visual analogue scale (VAS). Results: Participants aged 60 years and older were 13 (43%). Females represented the 70% of the study sample. Participants hospitalized for COVID-19 with low-flow oxygen supplementation represented the 43.3% of the study sample while 3.3% received noninvasive ventilation (NIV) or invasive ventilation. Hand grip strength improved from 26.3 Kg to 28.9 Kg (p < 0.05) at t1 as compared to t0. The mean time of strength exhaustion increased from 31.7 s (sec) at t0 to 47.5 s at t1 (p < 0.05). Participants performed a higher number of repetitions (28.3 vs. 22.0; p < 0.05) during the one-minute chair stand test at t1
Published: 2022

6. A real-time integrated framework to support clinical decision making for covid-19 patients

Author: Murri, Rita, Masciocchi, Carlotta, Lenkowicz, Jacopo, Fantoni, Massimo, Damiani, Andrea, Marchetti, A., Sergi, P. D. A., Arcuri, Giovanni, Cesario, Alfredo, Patarnello, S., Antonelli, Massimo, Bellantone, Rocco Domenico Alfonso, Bernabei, Roberto, Boccia, Stefania, Calabresi, Paolo, Cambieri, Andrea, Cauda, Roberto, Colosimo, Cesare, Crea, Filippo, De Maria Marchiano, Ruggero, De Stefano, Valerio, Franceschi, Francesco, Gasbarrini, Antonio, Landolfi, Raffaele, Parolini, Ornella, Richeldi, Luca, Sanguinetti, Maurizio, Urbani, Andrea, Zega, Maurizio, Scambia, Giovanni, Valentini, Vincenzo, Murri R. (ORCID:0000-0003-4263-7854), Masciocchi C., Lenkowicz J., Fantoni M. (ORCID:0000-0001-6913-8460), Damiani A., Arcuri G., Cesario A. (ORCID:0000-0003-4687-0709), Antonelli M. (ORCID:0000-0003-3007-1670), Bellantone R. (ORCID:0000-0002-0844-3469), Bernabei R. (ORCID:0000-0002-9197-004X), Boccia S. (ORCID:0000-0002-1864-749X), Calabresi P. (ORCID:0000-0003-0326-5509), Cambieri A., Cauda R. (ORCID:0000-0002-1498-4229), Colosimo C. (ORCID:0000-0003-3800-3648), Crea F. (ORCID:0000-0001-9404-8846), De Maria R. (ORCID:0000-0003-2255-0583), De Stefano V. (ORCID:0000-0002-5178-5827), Franceschi F. (ORCID:0000-0001-6266-445X), Gasbarrini A. (ORCID:0000-0002-7278-4823), Landolfi R. (ORCID:0000-0002-7913-8576), Parolini O. (ORCID:0000-0002-5211-6430), Richeldi L. (ORCID:0000-0001-8594-1448), Sanguinetti M. (ORCID:0000-0002-9780-7059), Urbani A. (ORCID:0000-0001-9168-3174), Zega M. (ORCID:0000-0002-7821-2615), Scambia G. (ORCID:0000-0003-2758-1063), Valentini V. (ORCID:0000-0003-4637-6487), Murri, Rita, Masciocchi, Carlotta, Lenkowicz, Jacopo, Fantoni, Massimo, Damiani, Andrea, Marchetti, A., Sergi, P. D. A., Arcuri, Giovanni, Cesario, Alfredo, Patarnello, S., Antonelli, Massimo, Bellantone, Rocco Domenico Alfonso, Bernabei, Roberto, Boccia, Stefania, Calabresi, Paolo, Cambieri, Andrea, Cauda, Roberto, Colosimo, Cesare, Crea, Filippo, De Maria Marchiano, Ruggero, De Stefano, Valerio, Franceschi, Francesco, Gasbarrini, Antonio, Landolfi, Raffaele, Parolini, Ornella, Richeldi, Luca, Sanguinetti, Maurizio, Urbani, Andrea, Zega, Maurizio, Scambia, Giovanni, Valentini, Vincenzo, Murri R. (ORCID:0000-0003-4263-7854), Masciocchi C., Lenkowicz J., Fantoni M. (ORCID:0000-0001-6913-8460), Damiani A., Arcuri G., Cesario A. (ORCID:0000-0003-4687-0709), Antonelli M. (ORCID:0000-0003-3007-1670), Bellantone R. (ORCID:0000-0002-0844-3469), Bernabei R. (ORCID:0000-0002-9197-004X), Boccia S. (ORCID:0000-0002-1864-749X), Calabresi P. (ORCID:0000-0003-0326-5509), Cambieri A., Cauda R. (ORCID:0000-0002-1498-4229), Colosimo C. (ORCID:0000-0003-3800-3648), Crea F. (ORCID:0000-0001-9404-8846), De Maria R. (ORCID:0000-0003-2255-0583), De Stefano V. (ORCID:0000-0002-5178-5827), Franceschi F. (ORCID:0000-0001-6266-445X), Gasbarrini A. (ORCID:0000-0002-7278-4823), Landolfi R. (ORCID:0000-0002-7913-8576), Parolini O. (ORCID:0000-0002-5211-6430), Richeldi L. (ORCID:0000-0001-8594-1448), Sanguinetti M. (ORCID:0000-0002-9780-7059), Urbani A. (ORCID:0000-0001-9168-3174), Zega M. (ORCID:0000-0002-7821-2615), Scambia G. (ORCID:0000-0003-2758-1063), and Valentini V. (ORCID:0000-0003-4637-6487)
Abstract: Background: The COVID-19 pandemic affected healthcare systems worldwide. Predictive models developed by Artificial Intelligence (AI) and based on timely, centralized and standardized real world patient data could improve management of COVID-19 to achieve better clinical outcomes. The objectives of this manuscript are to describe the structure and technologies used to construct a COVID-19 Data Mart architecture and to present how a large hospital has tackled the challenge of supporting daily management of COVID-19 pandemic emergency, by creating a strong retrospective knowledge base, a real time environment and integrated information dashboard for daily practice and early identification of critical condition at patient level. This framework is also used as an informative, continuously enriched data lake, which is a base for several on-going predictive studies. Methods: The information technology framework for clinical practice and research was described. It was developed using SAS Institute software analytics tool and SAS® Vyia® environment and Open-Source environment R ® and Python ® for fast prototyping and modeling. The included variables and the source extraction procedures were presented. Results: The Data Mart covers a retrospective cohort of 5528 patients with SARS-CoV-2 infection. People who died were older, had more comorbidities, reported more frequently dyspnea at onset, had higher D-dimer, C-reactive protein and urea nitrogen. The dashboard was developed to support the management of COVID-19 patients at three levels: hospital, single ward and individual care level. Interpretation: The COVID-19 Data Mart based on integration of a large collection of clinical data and an AI-based integrated framework has been developed, based on a set of automated procedures for data mining and retrieval, transformation and integration, and has been embedded in the clinical practice to help managing daily care. Benefits from the availability of a Data Mart include the oppor
Published: 2022

7. The SARS-CoV-2 Mu variant should not be left aside: It warrants attention for its immuno-escaping ability

Author: Pascarella, S., Bianchi, M., Giovanetti, M., Narzi, D., Cauda, Roberto, Cassone, A., Ciccozzi, M., Cauda R. (ORCID:0000-0002-1498-4229), Pascarella, S., Bianchi, M., Giovanetti, M., Narzi, D., Cauda, Roberto, Cassone, A., Ciccozzi, M., and Cauda R. (ORCID:0000-0002-1498-4229)
Abstract: The COVID-19 pandemic continues to have a threatening impact on a global scale, largely due to the emergence of newly SARS-CoV-2 variants. The Mu (PANGO lineage B.1.621), was first identified in Colombia in January 2021 and was classified as a variant of interest (VOI) in August 2021, due to a constellation of mutations that likely-mediate an unexpectedly enhanced immune resistance to inactivated vaccine-elicited antibodies. Despite recent studies suggesting that the Mu variant appears to have less infectivity than the Delta variant, here we examined the structural effect of the Mu spike protein mutations and predicted the potential impact on infectivity of the Mu variant compared with the Delta and Delta plus spike protein.
Published: 2022

8. Health-related quality of life (HRQoL) from HIV patients’ perspective: comparison of patient-reported outcome (PRO) measures among people living with hiv (PLWH) and other chronic clinical conditions

Author: Seguiti, C., Salvo, P. F., Di Stasio, E., Lamonica, S., Fedele, A. L., Manfrida, S., Ciccarelli, N., Corvari, B., De Luca, C., Tartaglione, L., Pitocco, D., Cauda, R., Cingolani, A., Seguiti C., Salvo P. F., Di Stasio E. (ORCID:0000-0003-1047-4261), Fedele A. L., Manfrida S., Ciccarelli N. (ORCID:0000-0002-7582-9142), De Luca C., Tartaglione L., Pitocco D. (ORCID:0000-0002-6220-686X), Cauda R. (ORCID:0000-0002-1498-4229), Cingolani A. (ORCID:0000-0002-3793-2755), Seguiti, C., Salvo, P. F., Di Stasio, E., Lamonica, S., Fedele, A. L., Manfrida, S., Ciccarelli, N., Corvari, B., De Luca, C., Tartaglione, L., Pitocco, D., Cauda, R., Cingolani, A., Seguiti C., Salvo P. F., Di Stasio E. (ORCID:0000-0003-1047-4261), Fedele A. L., Manfrida S., Ciccarelli N. (ORCID:0000-0002-7582-9142), De Luca C., Tartaglione L., Pitocco D. (ORCID:0000-0002-6220-686X), Cauda R. (ORCID:0000-0002-1498-4229), and Cingolani A. (ORCID:0000-0002-3793-2755)
Abstract: Background: People living with HIV (PLWH) are generally known to suffer from a lower quality of life compared to the one of general population, but still very few is known about the self-perception of quality of life when comparing HIV to non-communicable diseases. We performed a comprehensive assessment of patient’s reported outcomes measures (PROMs) among PLWH and patients affected by other chronic conditions (OC) such as diabetes mellitus type 1, rheumatoid arthritis, breast cancer in hormonal therapy, in order to investigate differences in PROMs outcomes between PLWH and other pathologies. Methods: A cross-sectional observational study was performed by using questionnaires investigating health-related quality of life (Medical Outcomes Study Short Form 36-item Health Survey), work productivity (WPI), and global health status (EQ-5D-3L). They were administered to patients affected by chronic diseases consecutively observed at a single University Hospital during a 10 months period, with comparable disease related aspects. Logistic regression analysis was used to analyze the association between disease group (HIV vs OC) and PROMs. Results: 230 patients were enrolled (89 PLWH, 143 OC). Mean age: 49 years (SD 10), mean time of disease 12 years (10), 96% were Caucasian, 35% assumed polypharmacy, 42% of male were PLWH versus 16% OC (p < 0.001), 19% PLWH versus 6% OC had clinical complications (p < 0.001). HIV infection was independently associated to a better health-related quality of life in several domains compared with the other conditions, except in mental health, whereas a worst health-related quality of life in most domains was reported by older patients and those experiencing polypharmacy. Conclusions: In this cohort of patients with chronic conditions followed within the same health setting, PLWH showed better self-reported health outcomes compared to other chronic conditions with comparable characteristics of chronicity. The potential detrimental rol
Published: 2022

9. The electrostatic potential of the Omicron variant spike is higher than in Delta and Delta-plus variants: A hint to higher transmissibility?

Author: Pascarella, S., Ciccozzi, M., Bianchi, M., Benvenuto, D., Cauda, R., Cassone, A., Cauda R. (ORCID:0000-0002-1498-4229), Pascarella, S., Ciccozzi, M., Bianchi, M., Benvenuto, D., Cauda, R., Cassone, A., and Cauda R. (ORCID:0000-0002-1498-4229)
Abstract: not available
Published: 2022

10. The need to continue testing for HIV, even during the coronavirus disease 2019 (COVID-19) pandemic

Author: Ciccullo, A, Borghetti, Alberto, Dusina, A, Segala, F V, Visconti, Elena, Tamburrini, Enrica, Cauda, Roberto, Di Giambenedetto, Simona, Borghetti, A, Visconti, E, Tamburrini, E (ORCID:0000-0003-4930-426X), Cauda, R (ORCID:0000-0002-1498-4229), Di Giambenedetto, S (ORCID:0000-0001-6990-5076), Ciccullo, A, Borghetti, Alberto, Dusina, A, Segala, F V, Visconti, Elena, Tamburrini, Enrica, Cauda, Roberto, Di Giambenedetto, Simona, Borghetti, A, Visconti, E, Tamburrini, E (ORCID:0000-0003-4930-426X), Cauda, R (ORCID:0000-0002-1498-4229), and Di Giambenedetto, S (ORCID:0000-0001-6990-5076)
Abstract: inglese
Published: 2021

11. Hydroxychloroquine and mortality in COVID-19 patients: a systematic review and a meta-analysis of observational studies and randomized controlled trials

Author: Di Castelnuovo, A., Costanzo, S., Cassone, A., Cauda, Roberto, De Gaetano, G., Iacoviello, L., Cauda R. (ORCID:0000-0002-1498-4229), Di Castelnuovo, A., Costanzo, S., Cassone, A., Cauda, Roberto, De Gaetano, G., Iacoviello, L., and Cauda R. (ORCID:0000-0002-1498-4229)
Abstract: Background: Hydroxychloroquine (HCQ) was proposed as potential treatment for COVID-19, but its association with mortality is unclear. We reviewed published literature for evidence of an association between HCQ (with or without azithromycin (AZM)) and total mortality in COVID-19 patients. Methods: Articles were retrieved until April 29th, 2021 by searching in seven databases. Data were combined using the general-variance-based method. Results: A total of 25 cohort studies (N=41,339 patients) and 11 randomized clinical trials (RCTs; N=8,709) were found. The use of HCQ was not associated with mortality in meta-analysis of RCTs (pooled risk ratio (PRR): 1.08, 95%CI: 0.97-1.20; I2=0%), but it was associated with 20% lower mortality risk (PRR=0.80, 95%CI: 0.69-0.93; I2=80%) in pooling of cohort studies. The negative association with mortality was mainly apparent by pooling cohort studies that used lower doses of HCQ (≤400 mg/day; PRR=0.69, 95%CI: 0.57-0.87). Use of HCQ+AZM (11 studies) was associated with 25% non-statistically significant lower mortality risk (PPR=0.75; 0.51-1.10; P=0.15). Use of HCQ was not associated with severe adverse events (PRR=1.12, 95%CI: 0.88-1.44; I2=0%). Conclusions: HCQ use was not associated with mortality in COVID-19 patients in pooling results from RCTs (high level of certainty of evidence), but it was associated with 20% mortality reduction when findings from observational studies were combined (low level of certainty of evidence). The reduction of mortality was mainly apparent in observational studies where lower doses of HCQ were used. These findings might help disentangling the debate on HCQ use in COVID-19.
Published: 2021

12. Missed linkage to care for patients who screened positive for Hepatitis C in a tertiary care centre: Results of the Telepass project

Author: Ponziani, Francesca Romana, Santopaolo, Francesco, Siciliano, Massimo, De Belvis, A. G., Tortora, Annalisa, Mora, Vincenzina, Fanali, Chiara, Morsella, Alisha, Balducci, Federica, Vetrugno, Giuseppe, D'Alfonso, Maria Elena, Cambieri, Andrea, Cauda, Roberto, Bellantone, Rocco Domenico Alfonso, Sanguinetti, Maurizio, Pompili, Maurizio, Gasbarrini, Antonio, Ponziani F. R. (ORCID:0000-0002-5924-6238), Santopaolo F., Siciliano M., Tortora A., Mora V., Fanali C., Morsella A., Balducci F., Vetrugno G. (ORCID:0000-0003-0181-2855), D'Alfonso M. E., Cambieri A., Cauda R. (ORCID:0000-0002-1498-4229), Bellantone R. (ORCID:0000-0002-0844-3469), Sanguinetti M. (ORCID:0000-0002-9780-7059), Pompili M. (ORCID:0000-0001-6699-7980), Gasbarrini A. (ORCID:0000-0002-7278-4823), Ponziani, Francesca Romana, Santopaolo, Francesco, Siciliano, Massimo, De Belvis, A. G., Tortora, Annalisa, Mora, Vincenzina, Fanali, Chiara, Morsella, Alisha, Balducci, Federica, Vetrugno, Giuseppe, D'Alfonso, Maria Elena, Cambieri, Andrea, Cauda, Roberto, Bellantone, Rocco Domenico Alfonso, Sanguinetti, Maurizio, Pompili, Maurizio, Gasbarrini, Antonio, Ponziani F. R. (ORCID:0000-0002-5924-6238), Santopaolo F., Siciliano M., Tortora A., Mora V., Fanali C., Morsella A., Balducci F., Vetrugno G. (ORCID:0000-0003-0181-2855), D'Alfonso M. E., Cambieri A., Cauda R. (ORCID:0000-0002-1498-4229), Bellantone R. (ORCID:0000-0002-0844-3469), Sanguinetti M. (ORCID:0000-0002-9780-7059), Pompili M. (ORCID:0000-0001-6699-7980), and Gasbarrini A. (ORCID:0000-0002-7278-4823)
Abstract: Italy is one of the countries on track with the WHO’s agenda to eliminate hepatitis C virus (HCV) by 2030. Healthcare facilities play a crucial role in seeking patients who are infected but have not yet been treated. We assessed the effectiveness of a recall strategy, named ‘Telepass’ project, for patients exposed to HCV infection who have not yet been linked to care in a large tertiary care centre. The ‘Telepass’ project was structured in two phases: (a) a retrospective analysis first identified all anti–HCV-positive subjects among patients who underwent pre-operative assessment in the facility in the course of one year; (b) a following prospective phase, aimed to recall patients in need either of further diagnostic tests (ie HCV-RNA) or treatment. A total of 12246 records of patients tested for HCV antibodies were reviewed. The overall prevalence of anti–HCV-positive subjects was 1.83% (224/12246) with a male/female ratio of 2.07. Out of the 224 anti–HCV-positive patients, 123 (54.91%) did not have documented HCV-RNA tests and were therefore selected for recall. Of these, 123 were reachable and 26 (21.13%) were successfully linked to care. Ten patients (38.46%) tested HCV-RNA positive and initiated treatment with direct-acting antivirals (DAAs). The Telepass study highlights that a recall strategy starting from internal hospital databases can help identify patients with chronic HCV infection who have not yet been linked to care, and provides an epidemiological insight into the prevalence of HCV infection in Italy in the late DAAs era.
Published: 2021

13. SARS-CoV-2 shifting transmission dynamics and hidden reservoirs potentially limit efficacy of public health interventions in Italy

Author: Giovanetti, M., Cella, E., Benedetti, F., Rife Magalis, B., Fonseca, V., Fabris, S., Campisi, G., Ciccozzi, A., Angeletti, S., Borsetti, A., Tambone, V., Sagnelli, C., Pascarella, S., Riva, A., Ceccarelli, G., Marcello, A., Azarian, T., Wilkinson, E., de Oliveira, T., Alcantara, L. C. J., Cauda, Roberto, Caruso, A., Dean, N. E., Browne, C., Lourenco, J., Salemi, M., Zella, D., Ciccozzi, M., Cauda R. (ORCID:0000-0002-1498-4229), Giovanetti, M., Cella, E., Benedetti, F., Rife Magalis, B., Fonseca, V., Fabris, S., Campisi, G., Ciccozzi, A., Angeletti, S., Borsetti, A., Tambone, V., Sagnelli, C., Pascarella, S., Riva, A., Ceccarelli, G., Marcello, A., Azarian, T., Wilkinson, E., de Oliveira, T., Alcantara, L. C. J., Cauda, Roberto, Caruso, A., Dean, N. E., Browne, C., Lourenco, J., Salemi, M., Zella, D., Ciccozzi, M., and Cauda R. (ORCID:0000-0002-1498-4229)
Abstract: We investigated SARS-CoV-2 transmission dynamics in Italy, one of the countries hit hardest by the pandemic, using phylodynamic analysis of viral genetic and epidemiological data. We observed the co-circulation of multiple SARS-CoV-2 lineages over time, which were linked to multiple importations and characterized by large transmission clusters concomitant with a high number of infections. Subsequent implementation of a three-phase nationwide lockdown strategy greatly reduced infection numbers and hospitalizations. Yet we present evidence of sustained viral spread among sporadic clusters acting as “hidden reservoirs” during summer 2020. Mathematical modelling shows that increased mobility among residents eventually catalyzed the coalescence of such clusters, thus driving up the number of infections and initiating a new epidemic wave. Our results suggest that the efficacy of public health interventions is, ultimately, limited by the size and structure of epidemic reservoirs, which may warrant prioritization during vaccine deployment.
Published: 2021

14. Shortening epitopes to survive: The case of sars-cov-2 lambda variant

Author: Pascarella, S., Ciccozzi, M., Bianchi, M., Benvenuto, D., Giovanetti, M., Cauda, Roberto, Cassone, A., Cauda R. (ORCID:0000-0002-1498-4229), Pascarella, S., Ciccozzi, M., Bianchi, M., Benvenuto, D., Giovanetti, M., Cauda, Roberto, Cassone, A., and Cauda R. (ORCID:0000-0002-1498-4229)
Abstract: Among the more recently identified SARS-CoV-2 Variants of Interest (VOI) is the Lambda variant, which emerged in Peru and has rapidly spread to South American regions and the US. This variant remains poorly investigated, particularly regarding the effects of mutations on the thermodynamic parameters affecting the stability of the Spike protein and its Receptor Binding Domain. We report here an in silico study on the potential impact of the Spike protein mutations on the immuno-escape ability of the Lambda variant. Bioinformatics analysis suggests that a combination of shortening the immunogenic epitope loops and the generation of potential N-glycosylation sites may be a viable adaptation strategy, potentially allowing this emerging viral variant to escape from host immunity.
Published: 2021

15. Multicomponent vaccines to fight SARS-CoV-2 variants of concern

Author: Cassone, A., Cauda, R., Cauda R. (ORCID:0000-0002-1498-4229), Cassone, A., Cauda, R., and Cauda R. (ORCID:0000-0002-1498-4229)
Abstract: not available
Published: 2021

16. A machine-learning parsimonious multivariable predictive model of mortality risk in patients with Covid-19

Author: Murri, Rita, Lenkowicz, Jacopo, Masciocchi, Carlotta, Iacomini, C., Fantoni, Massimo, Damiani, Andrea, Marchetti, A., Sergi, P. D. A., Arcuri, G., Cesario, Alfredo, Patarnello, S., Antonelli, Massimo, Bellantone, Rocco Domenico Alfonso, Bernabei, Roberto, Boccia, Stefania, Calabresi, Paolo, Cambieri, Andrea, Cauda, Roberto, Colosimo, Cesare, Crea, Filippo, De Maria Marchiano, Ruggero, De Stefano, Valerio, Franceschi, Francesco, Gasbarrini, Antonio, Parolini, Ornella, Richeldi, Luca, Sanguinetti, Maurizio, Urbani, Andrea, Zega, Maurizio, Scambia, Giovanni, Valentini, Vincenzo, Armuzzi, Alessandro, Barba, Marta, Baroni, Silvia, Bellesi, Silvia, Bentivoglio, Anna Rita, Biasucci, Luigi Marzio, Biscetti, Federico, Candelli, Marcello, Capalbo, Gennaro, Cattani Franchi, Paola, Chiusolo, Patrizia, Cingolani, Antonella, Corbo, Giuseppe Maria, Covino, Marcello, Cozzolino, A. M., D'Alfonso, Maria Elena, De Angelis, Giulia, De Pascale, Gennaro, Frisullo, Giovanni, Gabrielli, M., Gambassi, Giovanni, Garcovich, M., Gremese, Elisa, Grieco, D. L., Iaconelli, A., Iorio, Raffaele, Landi, Francesco, Larici, Anna Rita, Liuzzo, Giovanna, Maviglia, Riccardo, Miele, Luca, Montalto, Massimo, Natale, Luigi, Nicolotti, Nicola, Ojetti, Veronica, Pompili, Maurizio, Posteraro, Brunella, Rapaccini, Gian Ludovico, Rinaldi, R., Rossi, Elena, Santoliquido, Angelo, Sica, Simona, Tamburrini, Enrica, Teofili, Luciana, Testa, Antonia Carla, Tosoni, A., Trani, Carlo, Varone, Francesco, Verme, L. Z. D., Murri R. (ORCID:0000-0003-4263-7854), Lenkowicz J., Masciocchi C., Fantoni M. (ORCID:0000-0001-6913-8460), Damiani A., Cesario A. (ORCID:0000-0003-4687-0709), Antonelli M. (ORCID:0000-0003-3007-1670), Bellantone R. (ORCID:0000-0002-0844-3469), Bernabei R. (ORCID:0000-0002-9197-004X), Boccia S. (ORCID:0000-0002-1864-749X), Calabresi P. (ORCID:0000-0003-0326-5509), Cambieri A., Cauda R. (ORCID:0000-0002-1498-4229), Colosimo C. (ORCID:0000-0003-3800-3648), Crea F. (ORCID:0000-0001-9404-8846), De Maria R. (ORCID:0000-0003-2255-0583), De Stefano V. (ORCID:0000-0002-5178-5827), Franceschi F. (ORCID:0000-0001-6266-445X), Gasbarrini A. (ORCID:0000-0002-7278-4823), Parolini O. (ORCID:0000-0002-5211-6430), Richeldi L. (ORCID:0000-0001-8594-1448), Sanguinetti M. (ORCID:0000-0002-9780-7059), Urbani A. (ORCID:0000-0001-9168-3174), Zega M. (ORCID:0000-0002-7821-2615), Scambia G. (ORCID:0000-0003-2758-1063), Valentini V. (ORCID:0000-0003-4637-6487), Armuzzi A. (ORCID:0000-0003-1572-0118), Barba M. (ORCID:0000-0001-6084-7666), Baroni S. (ORCID:0000-0002-3410-2617), Bellesi S., Bentivoglio A. (ORCID:0000-0002-9663-095X), Biasucci L. M. (ORCID:0000-0002-6921-6497), Biscetti F. (ORCID:0000-0001-7449-657X), Candelli M. (ORCID:0000-0001-8443-7880), Capalbo G., Cattani P. (ORCID:0000-0003-4678-4763), Chiusolo P. (ORCID:0000-0002-1355-1587), Cingolani A. (ORCID:0000-0002-3793-2755), Corbo G. (ORCID:0000-0002-8104-4659), Covino M. (ORCID:0000-0002-6709-2531), D'Alfonso M., De Angelis G. (ORCID:0000-0002-7087-7399), De Pascale G. (ORCID:0000-0002-8255-0676), Frisullo G., Gambassi G. (ORCID:0000-0002-7030-9359), Gremese E. (ORCID:0000-0002-2248-1058), Iorio R. (ORCID:0000-0002-6270-0956), Landi F. (ORCID:0000-0002-3472-1389), Larici A. (ORCID:0000-0002-1882-6244), Liuzzo G. (ORCID:0000-0002-5714-0907), Maviglia R., Miele L. (ORCID:0000-0003-3464-0068), Montalto M. (ORCID:0000-0001-8819-3684), Natale L. (ORCID:0000-0002-7949-5119), Nicolotti N., Ojetti V. (ORCID:0000-0002-8953-0707), Pompili M. (ORCID:0000-0001-6699-7980), Posteraro B. (ORCID:0000-0002-1663-7546), Rapaccini G. (ORCID:0000-0002-6467-857X), Rossi E. (ORCID:0000-0002-7572-9379), Santoliquido A. (ORCID:0000-0003-1539-4017), Sica S. (ORCID:0000-0003-2426-3465), Tamburrini E. (ORCID:0000-0003-4930-426X), Teofili L. (ORCID:0000-0002-7214-1561), Testa A. (ORCID:0000-0003-2217-8726), Trani C. (ORCID:0000-0001-9777-013X), Varone F., Murri, Rita, Lenkowicz, Jacopo, Masciocchi, Carlotta, Iacomini, C., Fantoni, Massimo, Damiani, Andrea, Marchetti, A., Sergi, P. D. A., Arcuri, G., Cesario, Alfredo, Patarnello, S., Antonelli, Massimo, Bellantone, Rocco Domenico Alfonso, Bernabei, Roberto, Boccia, Stefania, Calabresi, Paolo, Cambieri, Andrea, Cauda, Roberto, Colosimo, Cesare, Crea, Filippo, De Maria Marchiano, Ruggero, De Stefano, Valerio, Franceschi, Francesco, Gasbarrini, Antonio, Parolini, Ornella, Richeldi, Luca, Sanguinetti, Maurizio, Urbani, Andrea, Zega, Maurizio, Scambia, Giovanni, Valentini, Vincenzo, Armuzzi, Alessandro, Barba, Marta, Baroni, Silvia, Bellesi, Silvia, Bentivoglio, Anna Rita, Biasucci, Luigi Marzio, Biscetti, Federico, Candelli, Marcello, Capalbo, Gennaro, Cattani Franchi, Paola, Chiusolo, Patrizia, Cingolani, Antonella, Corbo, Giuseppe Maria, Covino, Marcello, Cozzolino, A. M., D'Alfonso, Maria Elena, De Angelis, Giulia, De Pascale, Gennaro, Frisullo, Giovanni, Gabrielli, M., Gambassi, Giovanni, Garcovich, M., Gremese, Elisa, Grieco, D. L., Iaconelli, A., Iorio, Raffaele, Landi, Francesco, Larici, Anna Rita, Liuzzo, Giovanna, Maviglia, Riccardo, Miele, Luca, Montalto, Massimo, Natale, Luigi, Nicolotti, Nicola, Ojetti, Veronica, Pompili, Maurizio, Posteraro, Brunella, Rapaccini, Gian Ludovico, Rinaldi, R., Rossi, Elena, Santoliquido, Angelo, Sica, Simona, Tamburrini, Enrica, Teofili, Luciana, Testa, Antonia Carla, Tosoni, A., Trani, Carlo, Varone, Francesco, Verme, L. Z. D., Murri R. (ORCID:0000-0003-4263-7854), Lenkowicz J., Masciocchi C., Fantoni M. (ORCID:0000-0001-6913-8460), Damiani A., Cesario A. (ORCID:0000-0003-4687-0709), Antonelli M. (ORCID:0000-0003-3007-1670), Bellantone R. (ORCID:0000-0002-0844-3469), Bernabei R. (ORCID:0000-0002-9197-004X), Boccia S. (ORCID:0000-0002-1864-749X), Calabresi P. (ORCID:0000-0003-0326-5509), Cambieri A., Cauda R. (ORCID:0000-0002-1498-4229), Colosimo C. (ORCID:0000-0003-3800-3648), Crea F. (ORCID:0000-0001-9404-8846), De Maria R. (ORCID:0000-0003-2255-0583), De Stefano V. (ORCID:0000-0002-5178-5827), Franceschi F. (ORCID:0000-0001-6266-445X), Gasbarrini A. (ORCID:0000-0002-7278-4823), Parolini O. (ORCID:0000-0002-5211-6430), Richeldi L. (ORCID:0000-0001-8594-1448), Sanguinetti M. (ORCID:0000-0002-9780-7059), Urbani A. (ORCID:0000-0001-9168-3174), Zega M. (ORCID:0000-0002-7821-2615), Scambia G. (ORCID:0000-0003-2758-1063), Valentini V. (ORCID:0000-0003-4637-6487), Armuzzi A. (ORCID:0000-0003-1572-0118), Barba M. (ORCID:0000-0001-6084-7666), Baroni S. (ORCID:0000-0002-3410-2617), Bellesi S., Bentivoglio A. (ORCID:0000-0002-9663-095X), Biasucci L. M. (ORCID:0000-0002-6921-6497), Biscetti F. (ORCID:0000-0001-7449-657X), Candelli M. (ORCID:0000-0001-8443-7880), Capalbo G., Cattani P. (ORCID:0000-0003-4678-4763), Chiusolo P. (ORCID:0000-0002-1355-1587), Cingolani A. (ORCID:0000-0002-3793-2755), Corbo G. (ORCID:0000-0002-8104-4659), Covino M. (ORCID:0000-0002-6709-2531), D'Alfonso M., De Angelis G. (ORCID:0000-0002-7087-7399), De Pascale G. (ORCID:0000-0002-8255-0676), Frisullo G., Gambassi G. (ORCID:0000-0002-7030-9359), Gremese E. (ORCID:0000-0002-2248-1058), Iorio R. (ORCID:0000-0002-6270-0956), Landi F. (ORCID:0000-0002-3472-1389), Larici A. (ORCID:0000-0002-1882-6244), Liuzzo G. (ORCID:0000-0002-5714-0907), Maviglia R., Miele L. (ORCID:0000-0003-3464-0068), Montalto M. (ORCID:0000-0001-8819-3684), Natale L. (ORCID:0000-0002-7949-5119), Nicolotti N., Ojetti V. (ORCID:0000-0002-8953-0707), Pompili M. (ORCID:0000-0001-6699-7980), Posteraro B. (ORCID:0000-0002-1663-7546), Rapaccini G. (ORCID:0000-0002-6467-857X), Rossi E. (ORCID:0000-0002-7572-9379), Santoliquido A. (ORCID:0000-0003-1539-4017), Sica S. (ORCID:0000-0003-2426-3465), Tamburrini E. (ORCID:0000-0003-4930-426X), Teofili L. (ORCID:0000-0002-7214-1561), Testa A. (ORCID:0000-0003-2217-8726), Trani C. (ORCID:0000-0001-9777-013X), and Varone F.
Abstract: The COVID-19 pandemic is impressively challenging the healthcare system. Several prognostic models have been validated but few of them are implemented in daily practice. The objective of the study was to validate a machine-learning risk prediction model using easy-to-obtain parameters to help to identify patients with COVID-19 who are at higher risk of death. The training cohort included all patients admitted to Fondazione Policlinico Gemelli with COVID-19 from March 5, 2020, to November 5, 2020. Afterward, the model was tested on all patients admitted to the same hospital with COVID-19 from November 6, 2020, to February 5, 2021. The primary outcome was in-hospital case-fatality risk. The out-of-sample performance of the model was estimated from the training set in terms of Area under the Receiving Operator Curve (AUROC) and classification matrix statistics by averaging the results of fivefold cross validation repeated 3-times and comparing the results with those obtained on the test set. An explanation analysis of the model, based on the SHapley Additive exPlanations (SHAP), is also presented. To assess the subsequent time evolution, the change in paO2/FiO2 (P/F) at 48 h after the baseline measurement was plotted against its baseline value. Among the 921 patients included in the training cohort, 120 died (13%). Variables selected for the model were age, platelet count, SpO2, blood urea nitrogen (BUN), hemoglobin, C-reactive protein, neutrophil count, and sodium. The results of the fivefold cross-validation repeated 3-times gave AUROC of 0.87, and statistics of the classification matrix to the Youden index as follows: sensitivity 0.840, specificity 0.774, negative predictive value 0.971. Then, the model was tested on a new population (n = 1463) in which the case-fatality rate was 22.6%. The test model showed AUROC 0.818, sensitivity 0.813, specificity 0.650, negative predictive value 0.922. Considering the first quartile of the predicted risk score (low-risk sc
Published: 2021

17. The need to continue testing for HIV, even during the coronavirus disease 2019 (COVID-19) pandemic

Author: Ciccullo, A., Borghetti, Alberto, Dusina, Alex, Segala, Francesco Vladimiro, Visconti, Elena, Tamburrini, Enrica, Cauda, Roberto, Di Giambenedetto, Simona, Borghetti A., Dusina A., Segala F. V., Visconti E., Tamburrini E. (ORCID:0000-0003-4930-426X), Cauda R. (ORCID:0000-0002-1498-4229), Di Giambenedetto S. (ORCID:0000-0001-6990-5076), Ciccullo, A., Borghetti, Alberto, Dusina, Alex, Segala, Francesco Vladimiro, Visconti, Elena, Tamburrini, Enrica, Cauda, Roberto, Di Giambenedetto, Simona, Borghetti A., Dusina A., Segala F. V., Visconti E., Tamburrini E. (ORCID:0000-0003-4930-426X), Cauda R. (ORCID:0000-0002-1498-4229), and Di Giambenedetto S. (ORCID:0000-0001-6990-5076)
Abstract: N/A Not Available
Published: 2021

18. Has COVID-19 changed the approach to HIV diagnosis?: A multicentric Italian experience

Author: Mazzitelli, M., Ciccullo, A., Baldin, G., Cauda, Roberto, Rusconi, S., Giacomelli, A., Oreni, L., Borghi, V., Mussini, C., Guaraldi, G., Sterrantino, G., Lagi, F., Candelaresi, B., Cirioni, O., De Vito, Antonio, Rossetti, Barbara, Torti, Carlo, Di Giambenedetto, Simona, Cauda R. (ORCID:0000-0002-1498-4229), De Vito A., Rossetti B., Torti C., Di Giambenedetto S. (ORCID:0000-0001-6990-5076), Mazzitelli, M., Ciccullo, A., Baldin, G., Cauda, Roberto, Rusconi, S., Giacomelli, A., Oreni, L., Borghi, V., Mussini, C., Guaraldi, G., Sterrantino, G., Lagi, F., Candelaresi, B., Cirioni, O., De Vito, Antonio, Rossetti, Barbara, Torti, Carlo, Di Giambenedetto, Simona, Cauda R. (ORCID:0000-0002-1498-4229), De Vito A., Rossetti B., Torti C., and Di Giambenedetto S. (ORCID:0000-0001-6990-5076)
Abstract: The occurrence of COVID-19 pandemic had a significant negative effect on health care systems over the last year. Health care providers were forced to focus mainly on COVID-19 patients, neglecting in many cases equally important diseases, both acute and chronic. Therefore, also screening and diagnostic strategies for HIV could have been significantly impaired.This retrospective, multicenter, observational study aimed at assessing the number and characteristics of new HIV/AIDS diagnoses during COVID-19 pandemic in Italy and compared characteristics of people living with HIV at diagnosis between pre- and post-COVID-19 era (2019 vs 2020).Our results showed a significant reduction of HIV diagnoses during pandemic. By contrast, people living with HIV during pandemic were older and were diagnosed in earlier stage of disease (considering CD4+ T cell count) compared to those who were diagnosed the year before. Moreover, there was a significant decrease of new HIV diagnoses among men who have sex with men, probably for the impact of social distancing and restriction applied by the Italian Government. Late presentation incidence, if numbers in 2020 were lower than those in 2019, is still an issue.Routinely performing HIV testing in patients with suspected SARS-CoV-2 infection is identifying and linking to care underdiagnosed people living with HIV earlier. Thus, combined tests (HIV and SARS-CoV-2) should be implemented in patients with SARS-CoV-2 symptoms overlapping HIV's ones. Lastly, our results lastly showed how urgent implementation of a national policy for HIV screening is necessary.
Published: 2021

19. Psychological distress during the initial stage of the COVID-19 pandemic in an italian population living with HIV: An online survey

Author: Donne, V. D., Ciccarelli, Nicoletta, Massaroni, V., Lombardi, Francesca, Lamonica, S., Borghetti, Alberto, Fabbiani, M., Cauda, Roberto, Di Giambenedetto, Simona, Ciccarelli N. (ORCID:0000-0002-7582-9142), Lombardi F. (ORCID:0000-0001-5757-8346), Borghetti A., Cauda R. (ORCID:0000-0002-1498-4229), Di Giambenedetto S. (ORCID:0000-0001-6990-5076), Donne, V. D., Ciccarelli, Nicoletta, Massaroni, V., Lombardi, Francesca, Lamonica, S., Borghetti, Alberto, Fabbiani, M., Cauda, Roberto, Di Giambenedetto, Simona, Ciccarelli N. (ORCID:0000-0002-7582-9142), Lombardi F. (ORCID:0000-0001-5757-8346), Borghetti A., Cauda R. (ORCID:0000-0002-1498-4229), and Di Giambenedetto S. (ORCID:0000-0001-6990-5076)
Abstract: The aim of this study was to explore the psychological impact of the initial stage of the 2019 coronavirus (CO-VID-19) pandemic on people living with HIV (PLWH), a population at increased risk of psychological distress. PLWH participated in an online survey exploring demographic and clinical data, physical symptoms, con-tact history, knowledge and concerns, precautionary measures and additional information about COVID-19 during the first phase of the pandemic in Italy. The Impact of Event Scale-Revised (IES-R) (identifying the COVID-19 pandemic as a specific traumatic life event) and the Depression, Anxiety and Stress Scale (DASS-21) also formed part of the survey. Out of 98 participants, 45% revealed from mild to severe psychological impact from COVID-19 according to IES-R. A lower percentage, instead, complained of significant levels of depression (14%), anxiety (11%) or stress (6%) according to DASS-21. Higher education, being unemployed, number of perceived COVID-19 physical symptoms, concerns about risk of contracting COVID-19 and the pandemic situation in Italy, and needing additional information to prevent COVID-19 infection were positively associated to a higher risk of negative psychological impact. More-over, among the participants, female gender, age, fewer years from HIV diagnosis and not being aware of their own viremia were associated to a higher risk of negative psychological outcomes. Almost half of our PLWH sample experienced significant levels of distress related to the COVID-19 pandemic. Women, elderly patients and those with recent HIV diagnosis appear to be the more psychologically fragile subgroups. Our findings could help identify patients most in need of psychological interventions to improve the wellbeing of PLWH.
Published: 2021

20. Predictors of mortality among adult, old and the oldest old patients with bloodstream infections: An age comparison

Author: Giovannenze, F., Murri, Rita, Palazzolo, C., Taccari, F., Camici, M., Spanu, Teresa, Posteraro, Brunella, Sanguinetti, Maurizio, Cauda, Roberto, Onder, Graziano, Fantoni, Massimo, Murri R. (ORCID:0000-0003-4263-7854), Spanu T. (ORCID:0000-0003-1864-5184), Posteraro B. (ORCID:0000-0002-1663-7546), Sanguinetti M. (ORCID:0000-0002-9780-7059), Cauda R. (ORCID:0000-0002-1498-4229), Onder G. (ORCID:0000-0003-3400-4491), Fantoni M. (ORCID:0000-0001-6913-8460), Giovannenze, F., Murri, Rita, Palazzolo, C., Taccari, F., Camici, M., Spanu, Teresa, Posteraro, Brunella, Sanguinetti, Maurizio, Cauda, Roberto, Onder, Graziano, Fantoni, Massimo, Murri R. (ORCID:0000-0003-4263-7854), Spanu T. (ORCID:0000-0003-1864-5184), Posteraro B. (ORCID:0000-0002-1663-7546), Sanguinetti M. (ORCID:0000-0002-9780-7059), Cauda R. (ORCID:0000-0002-1498-4229), Onder G. (ORCID:0000-0003-3400-4491), and Fantoni M. (ORCID:0000-0001-6913-8460)
Abstract: Background: Bloodstream infections (BSIs) are a major cause of mortality in elderly. Objective of the study is to identify factors predictive of mortality in old and oldest old patients. Methods: This is a single centre retrospective observational study, including all patients admitted to Fondazione Policlinico A. Gemelli university hospital and diagnosed with BSI. Patients were stratified into three groups according to age: adult (A), younger than 65; old (O), aged between 65 and 80; oldest old (OO), older than 80. Primary outcome was 30-day in-hospital mortality. Secondary outcomes were duration of antimicrobial therapy (DOT) and length of hospital stay (LOS). Results: Of the 1034 patients included in the study, 346 were in group A, 447 in group O and 241 in group OO. The rate of 30-day mortality raised from 6.9% (24/346) in group A to 10.8% (84/447) in group O and 33.2% (80/241) in group OO (p<0.01), while DOT and LOS significantly decreased moving from adults to oldest old (p<0.01). Methicillin-resistant Staphylococcus aureus (MRSA) and Enterococcus spp were both independently correlated to an increased 30-day mortality risk selectively in patients older than 80 (MRSA: HR 2.37, p=0.03; Enterococcus spp: HR 2.44, p=0.01). Conclusions: BSIs have a high impact on survival in old and oldest old patients. BSIs by gram-positive pathogens, in particular MRSA and Enterococcus spp, should be a wake-up call for physicians, who should focus efforts on adequate and prompt antibiotic and support treatment.
Published: 2021

21. Psychopathological profile in COVID-19 patients including healthcare workers: the implications

Author: Chieffo, Daniela Pia Rosaria, Delle Donne, Valentina, Massaroni, V, Mastrilli, L, Belella, D, Monti, L, Silveri, Maria Caterina, Cauda, Roberto, Chieffo, D P R, Delle Donne, V, Silveri, M C (ORCID:0000-0001-5012-0682), Cauda, R (ORCID:0000-0002-1498-4229), Chieffo, Daniela Pia Rosaria, Delle Donne, Valentina, Massaroni, V, Mastrilli, L, Belella, D, Monti, L, Silveri, Maria Caterina, Cauda, Roberto, Chieffo, D P R, Delle Donne, V, Silveri, M C (ORCID:0000-0001-5012-0682), and Cauda, R (ORCID:0000-0002-1498-4229)
Abstract: OBJECTIVE: The effects of COVID-19 seem to extend beyond the physical pain and is showing psychiatric implications as well. Moreover, psychopathological implications seem to last also after patients' discharge. Our goal is to investigate the psychological impact and psychopathological outcome of patients affected by COVID-19.PATIENTS AND METHODS: We have engaged 34 patients with COVID-19 conditions [eight of them were healthcare workers patients (HCW)] hospitalized at "Policlinico Gemelli Foundation" of Rome, Italy. All patients were evaluated through the Impact of Event Scale-Revised (IES-R) and the Symptom Checklist 90-R (SCL-90-R) first, during their hospitalization (baseline), and then, after 4 months from hospital discharge (follow-up), through phone interviews.RESULTS: At baseline, 82% of patients revealed from mild to severe psychological impact of COVID-19, according to the IES-R. At follow-up, the mean IES-R total score was significantly decreased (p<0.001) even if almost half (46.6%) of our cohort still showed it. HCW patients showed a significantly higher score than other patients at IES-R scale, both at baseline (p=0.005) and at follow-up (p<0.001). Moreover, at 4 months from discharge, they showed a significantly higher percentage of moderate and severe distress (p=0.015). In addition to this. at follow-up, our cohort of patients showed an increase of anxiety symptoms, even if not significant compared to baseline (46.7% vs. 35.3% respectively; p=1.000). and HCW patients suffered more sleep disorders (p=0.019) and anxiety symptoms (p=0.019) compared to other patients.CONCLUSIONS: We indicate the importance of assessing psychopathology of COVID-19 survivors, monitoring their changes over time, and providing psychological support to improve their psychological well-being.
Published: 2020

22. Ethical criteria for the admission and management of patients in the icu under conditions of limited medical resources: A shared international proposal in view of the covid-19 pandemic

Author: Tambone, V., Boudreau, D., Ciccozzi, M., Sanders, K., Campanozzi, L. L., Wathuta, J., Violante, L., Cauda, R., Petrini, C., Abbate, A., Alloni, R., Argemi, J., Renom, J. A., Benedictis, A. D., Galerneau, F., Garcia-Sanchez, E., Ghilardi, G., Hafler, J. P., Linden, M., Marcos, A., Muda, A. O., Pandolfi, M., Pelaccia, T., Picozzi, M., Revello, R. O., Ricci, G., Rohrbaugh, R., Rossi, P., Sirignano, A., Spagnolo, A. G., Stammers, T., Velazquez, L., Agazzi, E., Mercurio, M., Cauda R. (ORCID:0000-0002-1498-4229), Spagnolo A. G. (ORCID:0000-0002-5762-2164), Tambone, V., Boudreau, D., Ciccozzi, M., Sanders, K., Campanozzi, L. L., Wathuta, J., Violante, L., Cauda, R., Petrini, C., Abbate, A., Alloni, R., Argemi, J., Renom, J. A., Benedictis, A. D., Galerneau, F., Garcia-Sanchez, E., Ghilardi, G., Hafler, J. P., Linden, M., Marcos, A., Muda, A. O., Pandolfi, M., Pelaccia, T., Picozzi, M., Revello, R. O., Ricci, G., Rohrbaugh, R., Rossi, P., Sirignano, A., Spagnolo, A. G., Stammers, T., Velazquez, L., Agazzi, E., Mercurio, M., Cauda R. (ORCID:0000-0002-1498-4229), and Spagnolo A. G. (ORCID:0000-0002-5762-2164)
Abstract: N/A
Published: 2020

23. Antibiotic appropriateness and adherence to local guidelines in perioperative prophylaxis: results from an antimicrobial stewardship intervention

Author: Segala, Francesco Vladimiro, Murri, Rita, Taddei, Eleonora, Giovannenze, F., Del Vecchio, Pierluigi, Birocchi, E., Taccari, F., Cauda, Roberto, Fantoni, Massimo, Segala F. V., Murri R. (ORCID:0000-0003-4263-7854), Taddei E., Del Vecchio P., Cauda R. (ORCID:0000-0002-1498-4229), Fantoni M. (ORCID:0000-0001-6913-8460), Segala, Francesco Vladimiro, Murri, Rita, Taddei, Eleonora, Giovannenze, F., Del Vecchio, Pierluigi, Birocchi, E., Taccari, F., Cauda, Roberto, Fantoni, Massimo, Segala F. V., Murri R. (ORCID:0000-0003-4263-7854), Taddei E., Del Vecchio P., Cauda R. (ORCID:0000-0002-1498-4229), and Fantoni M. (ORCID:0000-0001-6913-8460)
Abstract: Objectives: Surgical antibiotic prophylaxis (SAP) represents a major indication of antibiotic consumption worldwide. The present study aims to report the results of an enabling, long-term AMS intervention conducted between 2013 and 2019 on an Italian University Hospital performing more than 40.000 surgical interventions per year. Methods: SAP inappropriateness was defined according to the ASHP guidelines and divided in four main categories: indication, selection and dosing, duration, timing. Between 2013 and 2019, we conducted a continuative AMS intervention over 14 surgical departments that included enablement, review of selected clinical records and feedback. Results: We collected a total of 789 SAP prescribed to 735 patients (mean age 56.7 ± 17.8y). Overall, guideline adherence improved from 36.6% (n = 149) at baseline to 57.9% (n = 221) post-intervention (P < 0.0001). A significant improvement (P < 0.001) was also detected for each category: indication (from 58.5 to 93.2%), selection and dosing (from 58.5 to 80.6%), timing (from 92.4 to 97.6%), duration (from 71 to 80.1%). Conclusions: Though results cannot be generalized to all hospital populations, enabling AMS interventions may be effective in establishing a sustained improvement in SAP appropriateness rates. Once identified the main causes of SAP inappropriateness, tailored AMS interventions for each department may be beneficial. Further studies are needed to evaluate specific outcomes as incidence of surgical site infections and antimicrobial resistance.
Published: 2020

24. Psychopathological profile in COVID-19 patients including healthcare workers: The implications

Author: Chieffo, D. P. R., Delle Donne, Valentina, Massaroni, V., Mastrilli, L., Belella, D., Monti, Lidia, Silveri, Maria Caterina, Cauda, Roberto, Delle Donne V., Monti L., Silveri M. C. (ORCID:0000-0001-5012-0682), Cauda R. (ORCID:0000-0002-1498-4229), Chieffo, D. P. R., Delle Donne, Valentina, Massaroni, V., Mastrilli, L., Belella, D., Monti, Lidia, Silveri, Maria Caterina, Cauda, Roberto, Delle Donne V., Monti L., Silveri M. C. (ORCID:0000-0001-5012-0682), and Cauda R. (ORCID:0000-0002-1498-4229)
Abstract: OBJECTIVE: The effects of COVID-19 seem to extend beyond the physical pain and is showing psychiatric implications as well. Moreover, psychopathological implications seem to last also after patients’ discharge. Our goal is to investigate the psychological impact and psychopathological outcome of patients affected by COVID-19. PATIENTS AND METHODS: We have engaged 34 patients with COVID-19 conditions [eight of them were healthcare workers patients (HCW)] hospitalized at “Policlinico Gemelli Foundation” of Rome, Italy. All patients were evaluated through the Impact of Event Scale-Revised (IES-R) and the Symptom Checklist 90-R (SCL-90-R) first, during their hospitalization (baseline), and then, after 4 months from hospital discharge (follow-up), through phone interviews. RESULTS: At baseline, 82% of patients revealed from mild to severe psychological impact of COVID-19, according to the IES-R. At follow-up, the mean IES-R total score was significantly decreased (p<0.001) even if almost half (46.6%) of our cohort still showed it. HCW patients showed a significantly higher score than other patients at IES-R scale, both at baseline (p=0.005) and at follow-up (p<0.001). Moreover, at 4 months from discharge, they showed a significantly higher percentage of moderate and severe distress (p=0.015). In addition to this, at follow-up, our cohort of patients showed an increase of anxiety symptoms, even if not significant compared to baseline (46.7% vs. 35.3% respectively; p=1.000), and HCW patients suffered more sleep disorders (p=0.019) and anxiety symptoms (p=0.019) compared to other patients. CONCLUSIONS: We indicate the importance of assessing psychopathology of COVID-19 survivors, monitoring their changes over time, and providing psychological support to improve their psychological well-being.
Published: 2020

25. Ethical criteria for the admission and management of patients in the icu under conditions of limited medical resources: A shared international proposal in view of the covid-19 pandemic

Author: Tambone, V., Boudreau, D., Ciccozzi, M., Sanders, K., Campanozzi, L. L., Wathuta, J., Violante, L., Cauda, Roberto, Petrini, C., Abbate, A., Alloni, R., Argemi, J., Renom, J. A., Benedictis, A. D., Galerneau, F., Garcia-Sanchez, E., Ghilardi, G., Hafler, J. P., Linden, M., Marcos, A., Muda, A. O., Pandolfi, M., Pelaccia, T., Picozzi, M., Revello, R. O., Ricci, G., Rohrbaugh, R., Rossi, P., Sirignano, A., Spagnolo, Antonio Gioacchino, Stammers, T., Velazquez, L., Agazzi, E., Mercurio, M., Cauda R. (ORCID:0000-0002-1498-4229), Spagnolo A. G. (ORCID:0000-0002-5762-2164), Tambone, V., Boudreau, D., Ciccozzi, M., Sanders, K., Campanozzi, L. L., Wathuta, J., Violante, L., Cauda, Roberto, Petrini, C., Abbate, A., Alloni, R., Argemi, J., Renom, J. A., Benedictis, A. D., Galerneau, F., Garcia-Sanchez, E., Ghilardi, G., Hafler, J. P., Linden, M., Marcos, A., Muda, A. O., Pandolfi, M., Pelaccia, T., Picozzi, M., Revello, R. O., Ricci, G., Rohrbaugh, R., Rossi, P., Sirignano, A., Spagnolo, Antonio Gioacchino, Stammers, T., Velazquez, L., Agazzi, E., Mercurio, M., Cauda R. (ORCID:0000-0002-1498-4229), and Spagnolo A. G. (ORCID:0000-0002-5762-2164)
Abstract: Not available
Published: 2020

26. Sarilumab use in severe SARS-CoV-2 pneumonia

Author: Gremese, Elisa, Cingolani, Antonella, Bosello, Silvia Laura, Alivernini, Stefano, Tolusso, Barbara, Perniola, S., Landi, Francesco, Pompili, Maurizio, Murri, Rita, Santoliquido, Angelo, Garcovich, M., Sali, Michela, De Pascale, Gennaro, Gabrielli, Maurizio, Biscetti, Federico, Montalto, Massimo, Tosoni, Alessio, Gambassi, Giovanni, Rapaccini, Gian Ludovico, Iaconelli, Amerigo, Zileri Del Verme, L., Petricca, L., Fedele, A. L., Lizzio, Marco Maria, Tamburrini, Enrica, Natalello, Gerlando, Gigante, Laura, Bruno, D., Verardi, Lucrezia, Taddei, Eleonora, Calabrese, Anna Chiara, Lombardi, Francesca, Bernabei, Roberto, Cauda, Roberto, Franceschi, Francesco, Landolfi, Raffaele, Richeldi, Luca, Sanguinetti, Maurizio, Fantoni, Massimo, Antonelli, Massimo, Gasbarrini, Antonio, Gremese E. (ORCID:0000-0002-2248-1058), Cingolani A. (ORCID:0000-0002-3793-2755), Bosello S. L. (ORCID:0000-0002-4837-447X), Alivernini S. (ORCID:0000-0002-7383-4212), Tolusso B. (ORCID:0000-0002-9108-6609), Landi F. (ORCID:0000-0002-3472-1389), Pompili M. (ORCID:0000-0001-6699-7980), Murri R. (ORCID:0000-0003-4263-7854), Santoliquido A. (ORCID:0000-0003-1539-4017), Sali M. (ORCID:0000-0003-3609-2990), De Pascale G. (ORCID:0000-0002-8255-0676), Gabrielli M., Biscetti F. (ORCID:0000-0001-7449-657X), Montalto M. (ORCID:0000-0001-8819-3684), Tosoni A., Gambassi G. (ORCID:0000-0002-7030-9359), Rapaccini G. L. (ORCID:0000-0002-6467-857X), Iaconelli A., Lizzio M. M., Tamburrini E. (ORCID:0000-0003-4930-426X), Natalello G., Gigante L., Verardi L., Taddei E., Calabrese A., Lombardi F. (ORCID:0000-0001-5757-8346), Bernabei R. (ORCID:0000-0002-9197-004X), Cauda R. (ORCID:0000-0002-1498-4229), Franceschi F. (ORCID:0000-0001-6266-445X), Landolfi R. (ORCID:0000-0002-7913-8576), Richeldi L. (ORCID:0000-0001-8594-1448), Sanguinetti M. (ORCID:0000-0002-9780-7059), Fantoni M. (ORCID:0000-0001-6913-8460), Antonelli M. (ORCID:0000-0003-3007-1670), Gasbarrini A. (ORCID:0000-0002-7278-4823), Gremese, Elisa, Cingolani, Antonella, Bosello, Silvia Laura, Alivernini, Stefano, Tolusso, Barbara, Perniola, S., Landi, Francesco, Pompili, Maurizio, Murri, Rita, Santoliquido, Angelo, Garcovich, M., Sali, Michela, De Pascale, Gennaro, Gabrielli, Maurizio, Biscetti, Federico, Montalto, Massimo, Tosoni, Alessio, Gambassi, Giovanni, Rapaccini, Gian Ludovico, Iaconelli, Amerigo, Zileri Del Verme, L., Petricca, L., Fedele, A. L., Lizzio, Marco Maria, Tamburrini, Enrica, Natalello, Gerlando, Gigante, Laura, Bruno, D., Verardi, Lucrezia, Taddei, Eleonora, Calabrese, Anna Chiara, Lombardi, Francesca, Bernabei, Roberto, Cauda, Roberto, Franceschi, Francesco, Landolfi, Raffaele, Richeldi, Luca, Sanguinetti, Maurizio, Fantoni, Massimo, Antonelli, Massimo, Gasbarrini, Antonio, Gremese E. (ORCID:0000-0002-2248-1058), Cingolani A. (ORCID:0000-0002-3793-2755), Bosello S. L. (ORCID:0000-0002-4837-447X), Alivernini S. (ORCID:0000-0002-7383-4212), Tolusso B. (ORCID:0000-0002-9108-6609), Landi F. (ORCID:0000-0002-3472-1389), Pompili M. (ORCID:0000-0001-6699-7980), Murri R. (ORCID:0000-0003-4263-7854), Santoliquido A. (ORCID:0000-0003-1539-4017), Sali M. (ORCID:0000-0003-3609-2990), De Pascale G. (ORCID:0000-0002-8255-0676), Gabrielli M., Biscetti F. (ORCID:0000-0001-7449-657X), Montalto M. (ORCID:0000-0001-8819-3684), Tosoni A., Gambassi G. (ORCID:0000-0002-7030-9359), Rapaccini G. L. (ORCID:0000-0002-6467-857X), Iaconelli A., Lizzio M. M., Tamburrini E. (ORCID:0000-0003-4930-426X), Natalello G., Gigante L., Verardi L., Taddei E., Calabrese A., Lombardi F. (ORCID:0000-0001-5757-8346), Bernabei R. (ORCID:0000-0002-9197-004X), Cauda R. (ORCID:0000-0002-1498-4229), Franceschi F. (ORCID:0000-0001-6266-445X), Landolfi R. (ORCID:0000-0002-7913-8576), Richeldi L. (ORCID:0000-0001-8594-1448), Sanguinetti M. (ORCID:0000-0002-9780-7059), Fantoni M. (ORCID:0000-0001-6913-8460), Antonelli M. (ORCID:0000-0003-3007-1670), and Gasbarrini A. (ORCID:0000-0002-7278-4823)
Abstract: Background: Interleukin-6 signal blockade showed preliminary beneficial effects in treating inflammatory response against SARS-CoV-2 leading to severe respiratory distress. Herein we describe the outcomes of off-label intravenous use of Sarilumab in severe SARS-CoV-2-related pneumonia. Methods: 53 patients with SARS-CoV-2 severe pneumonia received intravenous Sarilumab; pulmonary function improvement or Intensive Care Unit (ICU) admission rate in medical wards, live discharge rate in ICU treated patients and safety profile were recorded. Sarilumab 400 mg was administered intravenously on day 1, with eventual additional infusion based on clinical judgement, and patients were followed for at least 14 days, unless previously discharged or dead. Findings: Of the 53 SARS-CoV-2pos patients receiving Sarilumab, 39(73·6%) were treated in medical wards [66·7% with a single infusion; median PaO2/FiO2:146(IQR:120–212)] while 14(26·4%) in ICU [92·6% with a second infusion; median PaO2/FiO2: 112(IQR:100–141.5)]. Within the medical wards, 7(17·9%) required ICU admission, 4 of whom were re-admitted to the ward within 5–8 days. At 19 days median follow-up, 89·7% of medical inpatients significantly improved (46·1% after 24 h, 61·5% after 3 days), 70·6% were discharged from the hospital and 85·7% no longer needed oxygen therapy. Within patients receiving Sarilumab in ICU, 64·2% were discharged from ICU to the ward and 35·8% were still alive at the last follow-up. Overall mortality rate was 5·7%. Interpretation: IL-6R inhibition appears to be a potential treatment strategy for severe SARS-CoV-2 pneumonia and intravenous Sarilumab seems a promising treatment approach showing, in the short term, an important clinical outcome and good safety.
Published: 2020

27. A call to research: the relationship between SARS-2-CoV, ACE 2 and antihypertensives

Author: Cassone, A., Gucciardo, D., Cauda, Roberto, Cauda R. (ORCID:0000-0002-1498-4229), Cassone, A., Gucciardo, D., Cauda, Roberto, and Cauda R. (ORCID:0000-0002-1498-4229)
Abstract: Not available
Published: 2020

28. Common cardiovascular risk factors and in-hospital mortality in 3,894 patients with COVID-19: survival analysis and machine learning-based findings from the multicentre Italian CORIST Study

Author: Di Castelnuovo, A., Bonaccio, M., Costanzo, S., Gialluisi, A., Antinori, A., Berselli, N., Blandi, L., Bruno, Rosa Anna, Cauda, Roberto, Guaraldi, G., My, I., Menicanti, L., Parruti, G., Patti, G., Perlini, S., Santilli, F., Signorelli, C., Stefanini, G. G., Vergori, A., Abdeddaim, A., Ageno, W., Agodi, A., Agostoni, P., Aiello, L., Al Moghazi, S., Aucella, F., Barbieri, G., Bartoloni, A., Bologna, C., Bonfanti, P., Brancati, S., Cacciatore, F., Caiano, L., Cannata, F., Carrozzi, L., Cascio, A., Cingolani, Antonella, Cipollone, F., Colomba, C., Crisetti, A., Crosta, F., Danzi, G. B., D'Ardes, D., De Gaetano Donati, Katleen, Di Gennaro, F., Di Palma, G., Di Tano, G., Fantoni, Massimo, Filippini, T., Fioretto, P., Fusco, F. M., Gentile, I., Grisafi, L., Guarnieri, G., Landi, Francesco, Larizza, G., Leone, A., Maccagni, G., Maccarella, S., Mapelli, M., Maragna, R., Marcucci, R., Maresca, G., Marotta, C., Marra, L., Mastroianni, F., Mengozzi, A., Menichetti, F., Milic, J., Murri, Rita, Montineri, A., Mussinelli, R., Mussini, C., Musso, M., Odone, A., Olivieri, M., Pasi, E., Petri, F., Pinchera, B., Pivato, C. A., Pizzi, R., Poletti, V., Raffaelli, Francesca, Ravaglia, C., Righetti, G., Rognoni, A., Rossato, M., Rossi, M., Sabena, A., Salinaro, F., Sangiovanni, V., Sanrocco, C., Scarafino, A., Scorzolini, L., Sgariglia, R., Simeone, P. G., Spinoni, E., Torti, C., Trecarichi, Enrico Maria, Vezzani, F., Veronesi, G., Vettor, R., Vianello, A., Vinceti, M., De Caterina, R., Iacoviello, L., Bruno R., Cauda R. (ORCID:0000-0002-1498-4229), Cingolani A. (ORCID:0000-0002-3793-2755), de Gaetano Donati K., Fantoni M. (ORCID:0000-0001-6913-8460), Landi F. (ORCID:0000-0002-3472-1389), Murri R. (ORCID:0000-0003-4263-7854), Raffaelli F., Trecarichi E. M., Di Castelnuovo, A., Bonaccio, M., Costanzo, S., Gialluisi, A., Antinori, A., Berselli, N., Blandi, L., Bruno, Rosa Anna, Cauda, Roberto, Guaraldi, G., My, I., Menicanti, L., Parruti, G., Patti, G., Perlini, S., Santilli, F., Signorelli, C., Stefanini, G. G., Vergori, A., Abdeddaim, A., Ageno, W., Agodi, A., Agostoni, P., Aiello, L., Al Moghazi, S., Aucella, F., Barbieri, G., Bartoloni, A., Bologna, C., Bonfanti, P., Brancati, S., Cacciatore, F., Caiano, L., Cannata, F., Carrozzi, L., Cascio, A., Cingolani, Antonella, Cipollone, F., Colomba, C., Crisetti, A., Crosta, F., Danzi, G. B., D'Ardes, D., De Gaetano Donati, Katleen, Di Gennaro, F., Di Palma, G., Di Tano, G., Fantoni, Massimo, Filippini, T., Fioretto, P., Fusco, F. M., Gentile, I., Grisafi, L., Guarnieri, G., Landi, Francesco, Larizza, G., Leone, A., Maccagni, G., Maccarella, S., Mapelli, M., Maragna, R., Marcucci, R., Maresca, G., Marotta, C., Marra, L., Mastroianni, F., Mengozzi, A., Menichetti, F., Milic, J., Murri, Rita, Montineri, A., Mussinelli, R., Mussini, C., Musso, M., Odone, A., Olivieri, M., Pasi, E., Petri, F., Pinchera, B., Pivato, C. A., Pizzi, R., Poletti, V., Raffaelli, Francesca, Ravaglia, C., Righetti, G., Rognoni, A., Rossato, M., Rossi, M., Sabena, A., Salinaro, F., Sangiovanni, V., Sanrocco, C., Scarafino, A., Scorzolini, L., Sgariglia, R., Simeone, P. G., Spinoni, E., Torti, C., Trecarichi, Enrico Maria, Vezzani, F., Veronesi, G., Vettor, R., Vianello, A., Vinceti, M., De Caterina, R., Iacoviello, L., Bruno R., Cauda R. (ORCID:0000-0002-1498-4229), Cingolani A. (ORCID:0000-0002-3793-2755), de Gaetano Donati K., Fantoni M. (ORCID:0000-0001-6913-8460), Landi F. (ORCID:0000-0002-3472-1389), Murri R. (ORCID:0000-0003-4263-7854), Raffaelli F., and Trecarichi E. M.
Abstract: Background and aims: There is poor knowledge on characteristics, comorbidities and laboratory measures associated with risk for adverse outcomes and in-hospital mortality in European Countries. We aimed at identifying baseline characteristics predisposing COVID-19 patients to in-hospital death. Methods and results: Retrospective observational study on 3894 patients with SARS-CoV-2 infection hospitalized from February 19th to May 23rd, 2020 and recruited in 30 clinical centres distributed throughout Italy. Machine learning (random forest)-based and Cox survival analysis. 61.7% of participants were men (median age 67 years), followed up for a median of 13 days. In-hospital mortality exhibited a geographical gradient, Northern Italian regions featuring more than twofold higher death rates as compared to Central/Southern areas (15.6% vs 6.4%, respectively). Machine learning analysis revealed that the most important features in death classification were impaired renal function, elevated C reactive protein and advanced age. These findings were confirmed by multivariable Cox survival analysis (hazard ratio (HR): 8.2; 95% confidence interval (CI) 4.6–14.7 for age ≥85 vs 18–44 y); HR = 4.7; 2.9–7.7 for estimated glomerular filtration rate levels <15 vs ≥ 90 mL/min/1.73 m2; HR = 2.3; 1.5–3.6 for C-reactive protein levels ≥10 vs ≤ 3 mg/L). No relation was found with obesity, tobacco use, cardiovascular disease and related-comorbidities. The associations between these variables and mortality were substantially homogenous across all sub-groups analyses. Conclusions: Impaired renal function, elevated C-reactive protein and advanced age were major predictors of in-hospital death in a large cohort of unselected patients with COVID-19, admitted to 30 different clinical centres all over Italy.
Published: 2020

29. Off-label use of tocilizumab in patients with SARS-CoV-2 infection

Author: Di Giambenedetto, Simona, Ciccullo, A., Borghetti, Alberto, Gambassi, Giovanni, Landi, Francesco, Visconti, Elena, Zileri Dal Verme, Lorenzo, Bernabei, Roberto, Tamburrini, Enrica, Cauda, Roberto, Gasbarrini, Antonio, Di Giambenedetto S. (ORCID:0000-0001-6990-5076), Borghetti A., Gambassi G. (ORCID:0000-0002-7030-9359), Landi F. (ORCID:0000-0002-3472-1389), Visconti E., Zileri Dal Verme L., Bernabei R. (ORCID:0000-0002-9197-004X), Tamburrini E. (ORCID:0000-0003-4930-426X), Cauda R. (ORCID:0000-0002-1498-4229), Gasbarrini A. (ORCID:0000-0002-7278-4823), Di Giambenedetto, Simona, Ciccullo, A., Borghetti, Alberto, Gambassi, Giovanni, Landi, Francesco, Visconti, Elena, Zileri Dal Verme, Lorenzo, Bernabei, Roberto, Tamburrini, Enrica, Cauda, Roberto, Gasbarrini, Antonio, Di Giambenedetto S. (ORCID:0000-0001-6990-5076), Borghetti A., Gambassi G. (ORCID:0000-0002-7030-9359), Landi F. (ORCID:0000-0002-3472-1389), Visconti E., Zileri Dal Verme L., Bernabei R. (ORCID:0000-0002-9197-004X), Tamburrini E. (ORCID:0000-0003-4930-426X), Cauda R. (ORCID:0000-0002-1498-4229), and Gasbarrini A. (ORCID:0000-0002-7278-4823)
Abstract: Not available
Published: 2020

30. Derivation and validation of a scoring system to assess pre-test probability of being COVID-19 positive

Author: Borghetti, Alberto, Ciccullo, A, Paratore, Mattia, Rovedi, Fabiana, Stella, Leonardo, Marchetti, Antonio, Cattani Franchi, Paola, Zileri Dal Verme, Lorenzo, Cauda, Roberto, Gasbarrini, Antonio, Di Giambenedetto, Simona, Borghetti, A, Paratore, M, Rovedi, F, Stella, L, Cattani, P (ORCID:0000-0003-4678-4763), Zileri Dal Verme, L, Cauda, R (ORCID:0000-0002-1498-4229), Gasbarrini, A (ORCID:0000-0002-7278-4823), Di Giambenedetto, S (ORCID:0000-0001-6990-5076), Borghetti, Alberto, Ciccullo, A, Paratore, Mattia, Rovedi, Fabiana, Stella, Leonardo, Marchetti, Antonio, Cattani Franchi, Paola, Zileri Dal Verme, Lorenzo, Cauda, Roberto, Gasbarrini, Antonio, Di Giambenedetto, Simona, Borghetti, A, Paratore, M, Rovedi, F, Stella, L, Cattani, P (ORCID:0000-0003-4678-4763), Zileri Dal Verme, L, Cauda, R (ORCID:0000-0002-1498-4229), Gasbarrini, A (ORCID:0000-0002-7278-4823), and Di Giambenedetto, S (ORCID:0000-0001-6990-5076)
Abstract: Not availble
Published: 2020

31. Day 10 post-prescription audit optimizes antibiotic therapy in patients with bloodstream infections

Author: Murri, Rita, Palazzolo, C., Giovannenze, F., Taccari, F., Camici, M., Spanu, Teresa, Posteraro, Brunella, Sanguinetti, Maurizio, Cauda, Roberto, Fantoni, Massimo, Murri R. (ORCID:0000-0003-4263-7854), Spanu T. (ORCID:0000-0003-1864-5184), Posteraro B. (ORCID:0000-0002-1663-7546), Sanguinetti M. (ORCID:0000-0002-9780-7059), Cauda R. (ORCID:0000-0002-1498-4229), Fantoni M. (ORCID:0000-0001-6913-8460), Murri, Rita, Palazzolo, C., Giovannenze, F., Taccari, F., Camici, M., Spanu, Teresa, Posteraro, Brunella, Sanguinetti, Maurizio, Cauda, Roberto, Fantoni, Massimo, Murri R. (ORCID:0000-0003-4263-7854), Spanu T. (ORCID:0000-0003-1864-5184), Posteraro B. (ORCID:0000-0002-1663-7546), Sanguinetti M. (ORCID:0000-0002-9780-7059), Cauda R. (ORCID:0000-0002-1498-4229), and Fantoni M. (ORCID:0000-0001-6913-8460)
Abstract: This study aimed to investigate the clinical and organizational impact of an active re-evaluation (on day 10) of patients on antibiotic treatment diagnosed with bloodstream infections (BSIs). A prospective, single center, pre-post quasi-experimental study was performed. Patients were enrolled at the time of microbial BSI confirmation. In the pre-intervention phase (August 2014–August 2015), clinical status and antibiotic regimen were re-evaluated at day 3. In the intervention phase (January 2016–January 2017), clinical status and antibiotic regimen were re-evaluated at day 3 and day 10. Primary outcomes were rate of optimal therapy, duration of antibiotic therapy, length of hospitalization, and 30-day mortality. A total of 632 patients were enrolled (pre-intervention period, n = 303; intervention period, n = 329). Average duration of therapy reduced from 18.1 days (standard deviation (SD), 11.4) in the pre-intervention period to 16.8 days (SD, 12.7) in the intervention period (p < 0.001). Similarly, average length of hospitalization decreased from 24.1 days (SD, 20.8) to 20.6 days (SD, 17.7) (p = 0.001). No inter-group difference was found for the rate of 30-day mortality. In patients with BSI, re-evaluation of clinical status and antibiotic regimen at day 3 and 10 after microbiological diagnosis was correlated with a reduction in the duration of antibiotic therapy and hospital stay. The intervention is simple and has a low impact on overall costs.
Published: 2020

32. Challenges in COVID-19: is pulmonary thromboembolism related to overall severity?

Author: Bellieni, Agnese, Intini, Enrica, Taddei, Eleonora, Baldi, Fabiana, Larosa, Luigi, Murri, Rita, Richeldi, Luca, Bernabei, Roberto, Cauda, Roberto, Landi, Francesco, Corbo, Giuseppe Maria, Fantoni, Massimo, Bellieni A., Intini E., Taddei E., Baldi F., Larosa L., Murri R. (ORCID:0000-0003-4263-7854), Richeldi L. (ORCID:0000-0001-8594-1448), Bernabei R. (ORCID:0000-0002-9197-004X), Cauda R. (ORCID:0000-0002-1498-4229), Landi F. (ORCID:0000-0002-3472-1389), Corbo G. M. (ORCID:0000-0002-8104-4659), Fantoni M. (ORCID:0000-0001-6913-8460), Bellieni, Agnese, Intini, Enrica, Taddei, Eleonora, Baldi, Fabiana, Larosa, Luigi, Murri, Rita, Richeldi, Luca, Bernabei, Roberto, Cauda, Roberto, Landi, Francesco, Corbo, Giuseppe Maria, Fantoni, Massimo, Bellieni A., Intini E., Taddei E., Baldi F., Larosa L., Murri R. (ORCID:0000-0003-4263-7854), Richeldi L. (ORCID:0000-0001-8594-1448), Bernabei R. (ORCID:0000-0002-9197-004X), Cauda R. (ORCID:0000-0002-1498-4229), Landi F. (ORCID:0000-0002-3472-1389), Corbo G. M. (ORCID:0000-0002-8104-4659), and Fantoni M. (ORCID:0000-0001-6913-8460)
Abstract: Not available
Published: 2020

33. Liability of Health Care Professionals and Institutions During COVID-19 Pandemic in Italy: Symposium Proceedings and Position Statement

Author: Oliva, Antonio, Caputo, Matteo, Grassi, Simone, Vetrugno, Giuseppe, Marazza, Marco, Ponzanelli, Giulio, Cauda, Roberto, Scambia, Giovanni, Forti, Gabrio, Bellantone, Rocco Domenico Alfonso, Pascali, Vincenzo Lorenzo, Oliva A. (ORCID:0000-0001-7120-616X), Caputo M. (ORCID:0000-0001-6792-9349), Grassi S., Vetrugno G. (ORCID:0000-0003-0181-2855), Marazza M. (ORCID:0000-0002-0765-4774), Ponzanelli G. (ORCID:0000-0002-9970-4301), Cauda R. (ORCID:0000-0002-1498-4229), Scambia G. (ORCID:0000-0003-2758-1063), Forti G. (ORCID:0000-0002-5438-4404), Bellantone R. (ORCID:0000-0002-0844-3469), Pascali V. L. (ORCID:0000-0001-6520-5224), Oliva, Antonio, Caputo, Matteo, Grassi, Simone, Vetrugno, Giuseppe, Marazza, Marco, Ponzanelli, Giulio, Cauda, Roberto, Scambia, Giovanni, Forti, Gabrio, Bellantone, Rocco Domenico Alfonso, Pascali, Vincenzo Lorenzo, Oliva A. (ORCID:0000-0001-7120-616X), Caputo M. (ORCID:0000-0001-6792-9349), Grassi S., Vetrugno G. (ORCID:0000-0003-0181-2855), Marazza M. (ORCID:0000-0002-0765-4774), Ponzanelli G. (ORCID:0000-0002-9970-4301), Cauda R. (ORCID:0000-0002-1498-4229), Scambia G. (ORCID:0000-0003-2758-1063), Forti G. (ORCID:0000-0002-5438-4404), Bellantone R. (ORCID:0000-0002-0844-3469), and Pascali V. L. (ORCID:0000-0001-6520-5224)
Abstract: BACKGROUND: On May 12, 2020, a symposium titled "Liability of healthcare professionals and institutions during COVID-19 pandemic" was held in Italy with the participation of national experts in malpractice law, hospital management, legal medicine, and clinical risk management. The symposium's rationale was the highly likely inflation of criminal and civil proceedings concerning alleged errors committed by health care professionals and decision makers during the COVID-19 pandemic. Its aim was to identify and discuss the main issues of legal and medicolegal interest and thus to find solid solutions in the spirit of preparedness planning. METHODS: There were 5 main points of discussion: (A) how to judge errors committed during the pandemic because of the application of protocols and therapies based on no or weak evidence of efficacy, (B) whether hospital managers can be considered liable for infected health care professionals who were not given adequate personal protective equipment, (C) whether health care professionals and institutions can be considered liable for cases of infected inpatients who claim that the infection was transmitted in a hospital setting, (D) whether health care institutions and hospital managers can be considered liable for the hotspots in long-term care facilities/care homes, and (E) whether health care institutions and hospital managers can be considered liable for the worsening of chronic diseases. RESULTS AND CONCLUSION: Limitation of the liability to the cases of gross negligence (with an explicit definition of this term), a no-fault system with statal indemnities for infected cases, and a rigorous methodology for the expert witnesses were proposed as key interventions for successfully facing future proceedings.
Published: 2020

34. Evidence for mutations in SARS-CoV-2 Italian isolates potentially affecting virus transmission

Author: Benvenuto, D., Demir, A. B., Giovanetti, M., Bianchi, M., Angeletti, S., Pascarella, S., Cauda, Roberto, Ciccozzi, M., Cassone, A., Cauda R. (ORCID:0000-0002-1498-4229), Benvenuto, D., Demir, A. B., Giovanetti, M., Bianchi, M., Angeletti, S., Pascarella, S., Cauda, Roberto, Ciccozzi, M., Cassone, A., and Cauda R. (ORCID:0000-0002-1498-4229)
Abstract: Italy is the first western country suffering heavy severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission and disease impact after coronavirus disease-2019 pandemia started in China. Even though the presence of mutations on spike glycoprotein and nucleocapsid in Italian isolates has been reported, the potential impact of these mutations on viral transmission has not been evaluated. We have compared SARS-CoV-2 genome sequences from Italian patients with virus sequences from Chinese patients. We focussed upon three nonsynonymous mutations of genes coding for S(one) and N (two) viral proteins present in Italian isolates and absent in Chinese ones, using various bioinformatics tools. Amino acid analysis and changes in three-dimensional protein structure suggests the mutations reduce protein stability and, particularly for S1 mutation, the enhanced torsional ability of the molecule could favor virus binding to cell receptor(s). This theoretical interpretation awaits experimental and clinical confirmation.
Published: 2020

35. Neutrophil-to-lymphocyte ratio and clinical outcome in COVID-19: a report from the Italian front line

Author: Ciccullo, A., Borghetti, Alberto, Zileri Dal Verme, Lorenzo, Tosoni, Alessio, Lombardi, Francesca, Garcovich, M., Biscetti, Federico, Montalto, Massimo, Cauda, Roberto, Di Giambenedetto, Simona, Borghetti A., Zileri Dal Verme L., Tosoni A., Lombardi F. (ORCID:0000-0001-5757-8346), Biscetti F. (ORCID:0000-0001-7449-657X), Montalto M. (ORCID:0000-0001-8819-3684), Cauda R. (ORCID:0000-0002-1498-4229), Di Giambenedetto S. (ORCID:0000-0001-6990-5076), Ciccullo, A., Borghetti, Alberto, Zileri Dal Verme, Lorenzo, Tosoni, Alessio, Lombardi, Francesca, Garcovich, M., Biscetti, Federico, Montalto, Massimo, Cauda, Roberto, Di Giambenedetto, Simona, Borghetti A., Zileri Dal Verme L., Tosoni A., Lombardi F. (ORCID:0000-0001-5757-8346), Biscetti F. (ORCID:0000-0001-7449-657X), Montalto M. (ORCID:0000-0001-8819-3684), Cauda R. (ORCID:0000-0002-1498-4229), and Di Giambenedetto S. (ORCID:0000-0001-6990-5076)
Abstract: Not available
Published: 2020

36. White Paper: Bridging the gap between surveillance data and antimicrobial stewardship in the outpatient sector-practical guidance from the JPIAMR ARCH and COMBACTE-MAGNET EPI-Net networks

Author: Arieti, F., Gopel, S., Sibani, M., Carrara, E., Pezzani, M. D., Murri, R., Mutters, N. T., Lopez-Cerero, L., Voss, A., Cauda, R., Tacconelli, E., Murri R. (ORCID:0000-0003-4263-7854), Cauda R. (ORCID:0000-0002-1498-4229), Tacconelli E. (ORCID:0000-0001-8722-5824), Arieti, F., Gopel, S., Sibani, M., Carrara, E., Pezzani, M. D., Murri, R., Mutters, N. T., Lopez-Cerero, L., Voss, A., Cauda, R., Tacconelli, E., Murri R. (ORCID:0000-0003-4263-7854), Cauda R. (ORCID:0000-0002-1498-4229), and Tacconelli E. (ORCID:0000-0001-8722-5824)
Abstract: BACKGROUND: The outpatient setting is a key scenario for the implementation of antimicrobial stewardship (AMS) activities, considering that overconsumption of antibiotics occurs mainly outside hospitals. This publication is the result of a joint initiative by the JPIAMR ARCH and COMBACTE-MAGNET EPI-Net networks, which is aimed at formulating a set of target actions for linking surveillance data with AMS activities in the outpatient setting. METHODS: A scoping review of the literature was carried out in three research areas: AMS leadership and accountability; antimicrobial usage and AMS; antimicrobial resistance and AMS. Consensus on the actions was reached through a RAND-modified Delphi process involving over 40 experts in infectious diseases, clinical microbiology, AMS, veterinary medicine or public health, from 18 low-, middle- and high-income countries. RESULTS: Evidence was retrieved from 38 documents, and an initial 25 target actions were proposed, differentiating between essential or desirable targets according to clinical relevance, feasibility and applicability to settings and resources. In the first consultation round, preliminary agreement was reached for all targets. Further to a second review, 6 statements were re-considered and 3 were deleted, leading to a final list of 22 target actions in the form of a practical checklist. CONCLUSIONS: This White Paper is a pragmatic and flexible tool to guide the development of calibrated surveillance-based AMS interventions specific to the outpatient setting, which is characterized by substantial inter- and intra-country variability in the organization of healthcare structures, maintaining a global perspective and taking into account the feasibility of the target actions in low-resource settings.
Published: 2020

37. Challenges in COVID-19: is pulmonary thromboembolism related to overall severity?

Author: Bellieni, Agnese, Intini, Enrica, Taddei, Eleonora, Baldi, Fabiana, Larosa, Luigi, Murri, Rita, Richeldi, Luca, Bernabei, Roberto, Cauda, Roberto, Landi, Francesco, Corbo, Giuseppe Maria, Fantoni, Massimo, Bellieni A., Intini E., Taddei E., Baldi F., Larosa L., Murri R. (ORCID:0000-0003-4263-7854), Richeldi L. (ORCID:0000-0001-8594-1448), Bernabei R. (ORCID:0000-0002-9197-004X), Cauda R. (ORCID:0000-0002-1498-4229), Landi F. (ORCID:0000-0002-3472-1389), Corbo G. M. (ORCID:0000-0002-8104-4659), Fantoni M. (ORCID:0000-0001-6913-8460), Bellieni, Agnese, Intini, Enrica, Taddei, Eleonora, Baldi, Fabiana, Larosa, Luigi, Murri, Rita, Richeldi, Luca, Bernabei, Roberto, Cauda, Roberto, Landi, Francesco, Corbo, Giuseppe Maria, Fantoni, Massimo, Bellieni A., Intini E., Taddei E., Baldi F., Larosa L., Murri R. (ORCID:0000-0003-4263-7854), Richeldi L. (ORCID:0000-0001-8594-1448), Bernabei R. (ORCID:0000-0002-9197-004X), Cauda R. (ORCID:0000-0002-1498-4229), Landi F. (ORCID:0000-0002-3472-1389), Corbo G. M. (ORCID:0000-0002-8104-4659), and Fantoni M. (ORCID:0000-0001-6913-8460)
Published: 2020

38. Virological response and retention in care according to time of starting ART in Italy: Data from the Icona Foundation Study cohort

Author: D'Arminio Monforte, A., Tavelli, A., Cozzi-Lepri, A., Castagna, A., Passerini, S., Francisci, D., Saracino, A., Maggiolo, F., Lapadula, G., Girardi, E., Perno, C. F., Antinori, A., Andreoni, M., Castelli, F., Cauda, Roberto, Di Perri, G., Galli, M., Iardino, R., Ippolito, G., Lazzarin, A., Marchetti, G. C., Rezza, G., Von Schloesser, F., Viale, P., Ceccherini-Silberstein, F., Lo Caputo, S., Mussini, C., Puoti, M., Bai, F., Balotta, C., Bandera, A., Bonora, S., Borderi, M., Calcagno, A., Capetti, A., Capobianchi, M. R., Cicalini, S., Cingolani, Antonella, Cinque, P., De Luca, A., Di Biagio, A., Gianotti, N., Gori, A., Guaraldi, G., Lichtner, M., Madeddu, G., Marchetti, G., Monno, L., Nozza, S., Pinnetti, C., Quiros Roldan, E., Rossotti, R., Rusconi, S., Santoro, M. M., Sarmati, L., Fanti, I., Galli, L., Lorenzini, P., Rodano, A., Macchia, M., Carletti, F., Carrara, S., Di Caro, A., Graziano, S., Petroni, F., Prota, G., Truffa, S., Giacometti, A., Costantini, A., Barocci, V., Angarano, G., Milano, E., Suardi, C., Donati, V., Verucchi, G., Castelnuovo, F., Minardi, C., Menzaghi, B., Abeli, C., Cacopardo, B., Celesia, B., Vecchiet, J., Falasca, K., Pan, A., Lorenzotti, S., Sighinolfi, L., Segala, Francesco Vladimiro, Blanc, P., Vichi, F., Cassola, G., Viscoli, C., Alessandrini, A., Bobbio, N., Mazzarello, G., Fondaco, L., Bonfanti, P., Molteni, C., Chiodera, A., Milini, P., Nunnari, G., Pellicano, G., Rizzardini, G., Cannizzo, E. S., Moioli, M. C., Piolini, R., Bernacchia, D., Salpietro, S., Tincati, C., Puzzolante, C., Migliorino, C., Sangiovanni, V., Borgia, G., Esposito, V., Di Flumeri, G., Gentile, I., Rizzo, V., Cattelan, A. M., Marinello, S., Cascio, A., Trizzino, M., Schiaroli, E., Parruti, G., Sozio, F., Magnani, G., Ursitti, M. A., Cristaudo, A., Vullo, V., Acinapura, R., Moschese, Davide, Capozzi, M., Mondi, A., Rivano Capparuccia, M., Iaiani, G., Latini, A., Gagliardini, R., Plazzi, M. M., De Girolamo, G., Vergori, A., Cecchetto, M., Viviani, F., De Vito, A., Rossetti, B., Montagnani, F., Franco, A., Fontana Del Vecchio, R., Di Giuli, C., Caramello, P., Orofino, G. C., Sciandra, M., Bassetti, M., Londero, A., Manfrin, V., Battagin, G., Starnini, G., Ialungo, A., Cauda R. (ORCID:0000-0002-1498-4229), Cingolani A. (ORCID:0000-0002-3793-2755), Segala D., Moschese D., D'Arminio Monforte, A., Tavelli, A., Cozzi-Lepri, A., Castagna, A., Passerini, S., Francisci, D., Saracino, A., Maggiolo, F., Lapadula, G., Girardi, E., Perno, C. F., Antinori, A., Andreoni, M., Castelli, F., Cauda, Roberto, Di Perri, G., Galli, M., Iardino, R., Ippolito, G., Lazzarin, A., Marchetti, G. C., Rezza, G., Von Schloesser, F., Viale, P., Ceccherini-Silberstein, F., Lo Caputo, S., Mussini, C., Puoti, M., Bai, F., Balotta, C., Bandera, A., Bonora, S., Borderi, M., Calcagno, A., Capetti, A., Capobianchi, M. R., Cicalini, S., Cingolani, Antonella, Cinque, P., De Luca, A., Di Biagio, A., Gianotti, N., Gori, A., Guaraldi, G., Lichtner, M., Madeddu, G., Marchetti, G., Monno, L., Nozza, S., Pinnetti, C., Quiros Roldan, E., Rossotti, R., Rusconi, S., Santoro, M. M., Sarmati, L., Fanti, I., Galli, L., Lorenzini, P., Rodano, A., Macchia, M., Carletti, F., Carrara, S., Di Caro, A., Graziano, S., Petroni, F., Prota, G., Truffa, S., Giacometti, A., Costantini, A., Barocci, V., Angarano, G., Milano, E., Suardi, C., Donati, V., Verucchi, G., Castelnuovo, F., Minardi, C., Menzaghi, B., Abeli, C., Cacopardo, B., Celesia, B., Vecchiet, J., Falasca, K., Pan, A., Lorenzotti, S., Sighinolfi, L., Segala, Francesco Vladimiro, Blanc, P., Vichi, F., Cassola, G., Viscoli, C., Alessandrini, A., Bobbio, N., Mazzarello, G., Fondaco, L., Bonfanti, P., Molteni, C., Chiodera, A., Milini, P., Nunnari, G., Pellicano, G., Rizzardini, G., Cannizzo, E. S., Moioli, M. C., Piolini, R., Bernacchia, D., Salpietro, S., Tincati, C., Puzzolante, C., Migliorino, C., Sangiovanni, V., Borgia, G., Esposito, V., Di Flumeri, G., Gentile, I., Rizzo, V., Cattelan, A. M., Marinello, S., Cascio, A., Trizzino, M., Schiaroli, E., Parruti, G., Sozio, F., Magnani, G., Ursitti, M. A., Cristaudo, A., Vullo, V., Acinapura, R., Moschese, Davide, Capozzi, M., Mondi, A., Rivano Capparuccia, M., Iaiani, G., Latini, A., Gagliardini, R., Plazzi, M. M., De Girolamo, G., Vergori, A., Cecchetto, M., Viviani, F., De Vito, A., Rossetti, B., Montagnani, F., Franco, A., Fontana Del Vecchio, R., Di Giuli, C., Caramello, P., Orofino, G. C., Sciandra, M., Bassetti, M., Londero, A., Manfrin, V., Battagin, G., Starnini, G., Ialungo, A., Cauda R. (ORCID:0000-0002-1498-4229), Cingolani A. (ORCID:0000-0002-3793-2755), Segala D., and Moschese D.
Abstract: Objectives: To describe: (i) factors associated with rapid and delayed ART initiation; (ii) rates of 12 week virological response; and (iii) virologically controlled retention in care by 1 year from ART initiation according to timing of start in a real-life setting. Methods: All individuals in the Icona cohort diagnosed with HIV in 2016-17 who initiated ART were grouped according to the time between HIV diagnosis and ART initiation: Group 1, ≤7 days; Group 2, 8-14 days; Group 3, 15-30 days; Group 4, 31-120 days; and Group 5, >120 days. Multivariable logistic regression models were used to identify factors associated with: (i) the probability of rapid (Group 1) and very delayed (Group 5) ART initiation; (ii) the 12 week virological response (by a modified snapshot algorithm); and (iii) the probability of retention in care at 1 year (on ART with HIV-RNA <50 copies/mL). Results: A total of 1247 individuals were included [82 (6.6%) in Group 1, 115 (9.2%) in Group 2, 267 (21.4%) in Group 3, 641 (51.4%) in Group 4 and 142 (11.4%) in Group 5]. Main predictors of rapid ART start (Group 1) were low CD4 cell count and high HIV-RNA at first contact with the infectious diseases centre. There was no association between probability of virological response and timing of ART initiation. Overall, 90% of individuals remained on ART after 1 year, 91% with undetectable HIV-RNA. Participants of Italian nationality, those with higher CD4 cell count and lower HIV-RNA at ART initiation were more likely to be retained in care after 1 year. Conclusions: In our high-income observational setting, we did not observe differences in the 1 year rate of virological response and retention in care according to timing of ART initiation.
Published: 2020

39. Evolutionary analysis of SARS-CoV-2: how mutation of Non-Structural Protein 6 (NSP6) could affect viral autophagy

Author: Benvenuto, D., Angeletti, S., Giovanetti, M., Bianchi, M., Pascarella, S., Cauda, Roberto, Ciccozzi, M., Cassone, A., Cauda R. (ORCID:0000-0002-1498-4229), Benvenuto, D., Angeletti, S., Giovanetti, M., Bianchi, M., Pascarella, S., Cauda, Roberto, Ciccozzi, M., Cassone, A., and Cauda R. (ORCID:0000-0002-1498-4229)
Abstract: Background: SARS-CoV-2 is a new coronavirus that has spread globally, infecting more than 150000 people, and being declared pandemic by the WHO. We provide here bio-informatic, evolutionary analysis of 351 available sequences of its genome with the aim of mapping genome structural variations and the patterns of selection. Methods: A Maximum likelihood tree has been built and selective pressure has been investigated in order to find any mutation developed during the SARS-CoV-2 epidemic that could potentially affect clinical evolution of the infection. Finding: We have found in more recent isolates the presence of two mutations affecting the Non-Structural Protein 6 (NSP6) and the Open Reding Frame10 (ORF 10) adjacent regions. Amino acidic change stability analysis suggests both mutations could confer lower stability of the protein structures. Interpretation: One of the two mutations, likely developed within the genome during virus spread, could affect virus intracellular survival. Genome follow-up of SARS-CoV-2 spread is urgently needed in order to identify mutations that could significantly modify virus pathogenicity.
Published: 2020

40. Effectiveness of dolutegravir-based regimens as either first-line or switch antiretroviral therapy: data from the Icona cohort

Author: Mondi, A., Cozzi-Lepri, A., Tavelli, A., Rusconi, S., Vichi, F., Ceccherini-Silberstein, F., Calcagno, A., De Luca, A., Maggiolo, F., Marchetti, G., Antinori, A., d'Arminio Monforte, A., Andreoni, M., Castagna, A., Castelli, F., Cauda, Roberto, Di Perri, G., Galli, M., Iardino, R., Ippolito, Giuseppe, Azzarin, A., Rezza, Giovanni, von Schloesser, F., Viale, P., Girardi, E., Lo Caputo, S., Mussini, C., Puoti, M., Perno, C. F., Balotta, C., Bandera, A., Bonora, S., Borderi, M., Capetti, A., Capobianchi, M. R., Cicalini, S., Cingolani, Antonella, Cinque, P., Di Biagio, Anna, Gianotti, N., Gori, A., Guaraldi, G., Lapadula, G., Lichtner, M., Madeddu, G., Monno, L., Nozza, S., Quiros Roldan, E., Rossotti, R., Santoro, M. M., Aracino, A., Sarmati, L., Fanti, I., Lorenzini, P., Rodano', A., Macchia, M., Carletti, F., Carrara, S., Di Caro, A., Graziano, S., Petrone, F., Prota, G., Quartu, S., Truffa, S., Giacometti, I. A., Costantini, A., Barocci, V., Angarano, G., Fabrizio, C., Suardi, C., I, V., Verucchi, G., Castelnuovo, F., Minardi, C., Menzaghi, B., Abeli, C., Cacopardo, Beatrice Marina, Celesia, B., Vecchiet, J., Falasca, K., Pan, A., Lorenzotti, S., Sighinolfi, L., Segala, D., Blanc, P., Cassola, G., Viscoli, C., Lessandrini, A., Bobbio, N., Mazzarello, G., Pozzetto, I., Bonfanti, P., Molteni, C., Chiodera, A., Milini, P., Nunnari, G., Pellicano, G., Rizzardini, G., Bai, F., Moioli, M. C., Piolini, R., Ridolfo, A. L., Salpietro, S., Tincati, C., Puzzolante, C., Migliorino, C., Sangiovanni, V., Borgia, G., Esposito, V., Di Martino, F., Gentile, I., Maddaloni, L., Cattelan, A. M., Marinello, S., Cascio, A., Colomba, C., Baldelli, F., Schiaroli, E., Parruti, G., Sozio, F., Magnani, G., Ursitti, M. A., Cristaudo, A., Vullo, V., Acinapura, R., Baldin, G., Capozzi, M., Rivano Capparucia, M., Iaiani, G., Atini, A., Mastrorosa, I., Plazzi, M. M., Savinelli, S., Vergori, A., Cecchetto, M., Viviani, F., Bagella, P., Rossetti, Barbara, Fontana Del Vecchio, R., Francisci, D., Di Giuli, C., Caramello, P., Orofino, G. C., Sciandra, M., Bassetti, M., Ondero, A., Pellizzer, G., Manfrin, V., Starnini, G., Alungo, A., Cauda R. (ORCID:0000-0002-1498-4229), Ippolito G., Rezza G., Cingolani A. (ORCID:0000-0002-3793-2755), Di Biagio A., Cacopardo B., Rossetti B., Mondi, A., Cozzi-Lepri, A., Tavelli, A., Rusconi, S., Vichi, F., Ceccherini-Silberstein, F., Calcagno, A., De Luca, A., Maggiolo, F., Marchetti, G., Antinori, A., d'Arminio Monforte, A., Andreoni, M., Castagna, A., Castelli, F., Cauda, Roberto, Di Perri, G., Galli, M., Iardino, R., Ippolito, Giuseppe, Azzarin, A., Rezza, Giovanni, von Schloesser, F., Viale, P., Girardi, E., Lo Caputo, S., Mussini, C., Puoti, M., Perno, C. F., Balotta, C., Bandera, A., Bonora, S., Borderi, M., Capetti, A., Capobianchi, M. R., Cicalini, S., Cingolani, Antonella, Cinque, P., Di Biagio, Anna, Gianotti, N., Gori, A., Guaraldi, G., Lapadula, G., Lichtner, M., Madeddu, G., Monno, L., Nozza, S., Quiros Roldan, E., Rossotti, R., Santoro, M. M., Aracino, A., Sarmati, L., Fanti, I., Lorenzini, P., Rodano', A., Macchia, M., Carletti, F., Carrara, S., Di Caro, A., Graziano, S., Petrone, F., Prota, G., Quartu, S., Truffa, S., Giacometti, I. A., Costantini, A., Barocci, V., Angarano, G., Fabrizio, C., Suardi, C., I, V., Verucchi, G., Castelnuovo, F., Minardi, C., Menzaghi, B., Abeli, C., Cacopardo, Beatrice Marina, Celesia, B., Vecchiet, J., Falasca, K., Pan, A., Lorenzotti, S., Sighinolfi, L., Segala, D., Blanc, P., Cassola, G., Viscoli, C., Lessandrini, A., Bobbio, N., Mazzarello, G., Pozzetto, I., Bonfanti, P., Molteni, C., Chiodera, A., Milini, P., Nunnari, G., Pellicano, G., Rizzardini, G., Bai, F., Moioli, M. C., Piolini, R., Ridolfo, A. L., Salpietro, S., Tincati, C., Puzzolante, C., Migliorino, C., Sangiovanni, V., Borgia, G., Esposito, V., Di Martino, F., Gentile, I., Maddaloni, L., Cattelan, A. M., Marinello, S., Cascio, A., Colomba, C., Baldelli, F., Schiaroli, E., Parruti, G., Sozio, F., Magnani, G., Ursitti, M. A., Cristaudo, A., Vullo, V., Acinapura, R., Baldin, G., Capozzi, M., Rivano Capparucia, M., Iaiani, G., Atini, A., Mastrorosa, I., Plazzi, M. M., Savinelli, S., Vergori, A., Cecchetto, M., Viviani, F., Bagella, P., Rossetti, Barbara, Fontana Del Vecchio, R., Francisci, D., Di Giuli, C., Caramello, P., Orofino, G. C., Sciandra, M., Bassetti, M., Ondero, A., Pellizzer, G., Manfrin, V., Starnini, G., Alungo, A., Cauda R. (ORCID:0000-0002-1498-4229), Ippolito G., Rezza G., Cingolani A. (ORCID:0000-0002-3793-2755), Di Biagio A., Cacopardo B., and Rossetti B.
Abstract: Introduction: Concerns about dolutegravir (DTG) tolerability in the real-life setting have recently arisen. We aimed to estimate the risk of treatment discontinuation and virological failure of DTG-based regimens from a large cohort of HIV-infected individuals. Methods: We performed a multicentre, observational study including all antiretroviral therapy (ART)-naïve and virologically suppressed treatment-experienced (TE) patients from the Icona (Italian Cohort Naïve Antiretrovirals) cohort who started, for the first time, a DTG-based regimen from January 2015 to December 2017. We estimated the cumulative risk of DTG discontinuation regardless of the reason and for toxicity, and of virological failure using Kaplan–Meier curves. We used Cox regression model to investigate predictors of DTG discontinuation. Results: About 1679 individuals (932 ART-naïve, 747 TE) were included. The one- and two-year probabilities (95% CI) of DTG discontinuation were 6.7% (4.9 to 8.4) and 11.5% (8.7 to 14.3) for ART-naïve and 6.6% (4.6 to 8.6) and 7.6% (5.4 to 9.8) for TE subjects. In both ART-naïve and TE patients, discontinuations of DTG were mainly driven by toxicity with an estimated risk (95% CI) of 4.0% (2.6 to 5.4) and 2.5% (1.3 to 3.6) by one year and 5.6% (3.8 to 7.5) and 4.0% (2.4 to 5.6) by two years respectively. Neuropsychiatric events were the main reason for stopping DTG in both ART-naïve (2.1%) and TE (1.7%) patients. In ART-naïve, a concomitant AIDS diagnosis predicted the risk of discontinuing DTG for any reason (adjusted relative hazard (aRH) = 3.38, p = 0.001), whereas starting DTG in combination with abacavir (ABC) was associated with a higher risk of discontinuing because of toxicity (aRH = 3.30, p = 0.009). TE patients starting a DTG-based dual therapy compared to a triple therapy had a lower risk of discontinuation for any reason (adjusted hazard ratio (aHR) = 2.50, p = 0.037 for ABC-based triple-th
Published: 2019

41. Durability of different initial regimens in HIV-infected patients starting antiretroviral therapy with CD4+ counts <200 cells/mm3 and HIV-RNA >5 log10 copies/mL

Author: Gianotti, N., Lorenzini, P., Cozzi-Lepri, A., De Luca, Andrea, Madeddu, G., Sighinolfi, L., Pinnetti, C., Santoro, C., Meraviglia, P., Mussini, C., Antinori, A., D'Arminio Monforte, A., Andreoni, M., Angarano, G., Castelli, F., Cauda, Roberto, Di Perri, G., Galli, M., Iardino, R., Ippolito, G., Lazzarin, A., Perno, C. F., Von Schloesser, F., Viale, P., Castagna, A., Ceccherini-Silberstein, F., Girardi, E., Lo Caputo, S., Puoti, M., Ammassari, A., Balotta, C., Bandera, A., Bonfanti, P., Bonora, S., Borderi, M., Calcagno, A., Calza, L., Capobianchi, M. R., Cingolani, Antonella, Cinque, P., Di Biagio, A., Gori, A., Guaraldi, G., Lapadula, G., Lichtner, M., Maggiolo, F., Marchetti, G., Marcotullio, S., Monno, L., Nozza, S., Quiros Roldan, E., Rossotti, R., Rusconi, S., Saracino, A., Zaccarelli, M., Fanti, I., Rodano, A., Shanyinde, M., Tavelli, A., Carletti, F., Carrara, S., Di Caro, A., Graziano, S., Petrone, F., Prota, G., Quartu, S., Truffa, S., Giacometti, A., Costantini, A., Valeriani, C., Suardi, C., Donati, V., Verucchi, G., Quiros, E., Minardi, C., Quirino, T., Abeli, C., Manconi, P. E., Piano, P., Cacopardo, B., Celesia, B., Vecchiet, J., Falasca, K., Segala, D., Mazzotta, F., Vichi, F., Cassola, G., Viscoli, C., Alessandrini, A., Bobbio, N., Mazzarello, G., Mastroianni, C., Belvisi, V., Caramma, I., Chiodera, A., Rizzardini, G., Ridolfo, A. L., Piolini, R., Carenzi, L., Moioli, M. C., Tincati, C., Puzzolante, C., Abrescia, N., Chirianni, A., Borgia, G., Di Martino, F., Maddaloni, L., Gentile, I., Orlando, R., Baldelli, F., Francisci, D., Parruti, G., Ursini, T., Magnani, G., Ursitti, M. A., Vullo, V., Cristaudo, A., Baldin, G., Cicalini, S., Gallo, L., Nicastri, E., Acinapura, R., Capozzi, M., Libertone, R., Savinelli, S., Latini, A., Cecchetto, M., Viviani, F., Mura, M. S., Rossetti, Barbara, Caramello, P., C Orofino, G., Sciandra, M., Bassetti, M., Londero, A., Pellizzer, G., Manfrin, V., De Luca A. (ORCID:0000-0002-8311-6935), Cauda R. (ORCID:0000-0002-1498-4229), Cingolani A. (ORCID:0000-0002-3793-2755), Rossetti B., Gianotti, N., Lorenzini, P., Cozzi-Lepri, A., De Luca, Andrea, Madeddu, G., Sighinolfi, L., Pinnetti, C., Santoro, C., Meraviglia, P., Mussini, C., Antinori, A., D'Arminio Monforte, A., Andreoni, M., Angarano, G., Castelli, F., Cauda, Roberto, Di Perri, G., Galli, M., Iardino, R., Ippolito, G., Lazzarin, A., Perno, C. F., Von Schloesser, F., Viale, P., Castagna, A., Ceccherini-Silberstein, F., Girardi, E., Lo Caputo, S., Puoti, M., Ammassari, A., Balotta, C., Bandera, A., Bonfanti, P., Bonora, S., Borderi, M., Calcagno, A., Calza, L., Capobianchi, M. R., Cingolani, Antonella, Cinque, P., Di Biagio, A., Gori, A., Guaraldi, G., Lapadula, G., Lichtner, M., Maggiolo, F., Marchetti, G., Marcotullio, S., Monno, L., Nozza, S., Quiros Roldan, E., Rossotti, R., Rusconi, S., Saracino, A., Zaccarelli, M., Fanti, I., Rodano, A., Shanyinde, M., Tavelli, A., Carletti, F., Carrara, S., Di Caro, A., Graziano, S., Petrone, F., Prota, G., Quartu, S., Truffa, S., Giacometti, A., Costantini, A., Valeriani, C., Suardi, C., Donati, V., Verucchi, G., Quiros, E., Minardi, C., Quirino, T., Abeli, C., Manconi, P. E., Piano, P., Cacopardo, B., Celesia, B., Vecchiet, J., Falasca, K., Segala, D., Mazzotta, F., Vichi, F., Cassola, G., Viscoli, C., Alessandrini, A., Bobbio, N., Mazzarello, G., Mastroianni, C., Belvisi, V., Caramma, I., Chiodera, A., Rizzardini, G., Ridolfo, A. L., Piolini, R., Carenzi, L., Moioli, M. C., Tincati, C., Puzzolante, C., Abrescia, N., Chirianni, A., Borgia, G., Di Martino, F., Maddaloni, L., Gentile, I., Orlando, R., Baldelli, F., Francisci, D., Parruti, G., Ursini, T., Magnani, G., Ursitti, M. A., Vullo, V., Cristaudo, A., Baldin, G., Cicalini, S., Gallo, L., Nicastri, E., Acinapura, R., Capozzi, M., Libertone, R., Savinelli, S., Latini, A., Cecchetto, M., Viviani, F., Mura, M. S., Rossetti, Barbara, Caramello, P., C Orofino, G., Sciandra, M., Bassetti, M., Londero, A., Pellizzer, G., Manfrin, V., De Luca A. (ORCID:0000-0002-8311-6935), Cauda R. (ORCID:0000-0002-1498-4229), Cingolani A. (ORCID:0000-0002-3793-2755), and Rossetti B.
Abstract: Objectives: Our aim was to investigate the durability of different initial regimens in patients starting ART with CD4+ counts <200 cells/mm3 and HIV-RNA >5 log10 copies/mL. Methods: This was a retrospective study of HIV-infected patients prospectively followed in the ICONA cohort. Those who started ART with boosted protease inhibitors (bPIs), NNRTIs or integrase strand transfer inhibitors (InSTIs), with CD4+ <200 cells/mm3 and HIV-RNA >5 log10 copies/mL, were included. The primary endpoint was treatment failure (TF), a composite endpoint defined as virological failure (VF, first of two consecutive HIV-RNA >50 copies/mL after 6 months of treatment), discontinuation of class of the anchor drug or death. Independent associations were investigated by Poisson regression analysis in a model including age, gender, mode of HIV transmission, CDC stage, HCV and HBV co-infection, pre-treatment HIV-RNA, CD4+ count and CD4+/CD8+ ratio, ongoing opportunistic disease, fibrosis FIB-4 index, estimated glomerular filtration rate, haemoglobin, platelets, neutrophils, calendar year of ART initiation, anchor drug class (treatment group) and nucleos(t)ide backbone. Results: A total of 1195 patients fulfilled the inclusion criteria: 696 started ART with a bPI, 315 with an InSTI and 184 with an NNRTI. During 2759 person-years of follow up, 642 patients experienced TF. Starting ART with bPIs [adjusted incidence rate ratio (aIRR) (95% CI) 1.62 (1.29-2.03) versus starting with NNRTIs; P<0.001] and starting ART with InSTIs [aIRR (95% CI) 0.68 (0.48-0.96) versus starting with NNRTIs; P=0.03] were independently associated with TF. Conclusions: In patients starting ART with <200 CD4+ cells/mm3 and >5 log10 HIV-RNA copies/mL, the durability of regimens based on InSTIs was longer than that of NNRTI- and bPI-based regimens.
Published: 2019

42. Trends of hospitalisations rates in a cohort of HIV-infected persons followed in an Italian hospital from 1998 to 2016

Author: Bellino, S., Borghetti, A., Lombardi, Francesca, Camoni, L., Ciccullo, Arturo, Baldin, Gianmaria, Belmonti, S., Moschese, Davide, Lamonica, S., Cauda, Roberto, Pezzotti, P., Di Giambenedetto, Simona, Lombardi F. (ORCID:0000-0001-5757-8346), Ciccullo A., Baldin G., Moschese D., Cauda R. (ORCID:0000-0002-1498-4229), Di Giambenedetto S. (ORCID:0000-0001-6990-5076), Bellino, S., Borghetti, A., Lombardi, Francesca, Camoni, L., Ciccullo, Arturo, Baldin, Gianmaria, Belmonti, S., Moschese, Davide, Lamonica, S., Cauda, Roberto, Pezzotti, P., Di Giambenedetto, Simona, Lombardi F. (ORCID:0000-0001-5757-8346), Ciccullo A., Baldin G., Moschese D., Cauda R. (ORCID:0000-0002-1498-4229), and Di Giambenedetto S. (ORCID:0000-0001-6990-5076)
Abstract: Here we evaluated hospitalisation rates and associated risk factors of human immunodeficiency virus (HIV)-infected individuals who were followed up in an Italian reference hospital from 1998 to 2016. Incidence rates (IR) of hospitalisations were calculated for five study periods from 1998 to 2016. The random-effects Poisson regression model was used to assess risk factors for hospitalisation including demographic and clinical characteristics. To consider that more events may occur for the same subject, multiple failure-time data analysis was also performed for selected causes using the Cox proportional hazards model. We evaluated 2031 patients. During 13 173 person-years (py) of follow-up, 3356 hospital admissions were carried out for 756 patients (IR: 255 per 1000 py). IR decreased significantly over the study period, from 634 in 1998-2000 to 126 per 1000 py in 2013-2016. Major declines were detected for AIDS-defining events, non-HIV/AIDS-related infections and neurological diseases. Older age, female sex, longer HIV duration and HCV coinfection were associated with a higher hospitalisation risk, whereas higher CD4 nadir and antiretroviral therapy were associated with a reduced risk. Influence of advanced HIV disease markers declined over time. Hospitalisation rates decreased during the study period in most causes. The relative weight of hospitalisations for non-AIDS-related tumours, cardiovascular, respiratory and kidney diseases increased during the study period, whereas those for AIDS-defining events declined.
Published: 2019

43. Use of procalcitonin as a tool for antibiotic stewardship

Author: Murri, Rita, Taddei, Eleonora, Cauda, Roberto, Fantoni, Massimo, Murri R. (ORCID:0000-0003-4263-7854), Taddei E., Cauda R. (ORCID:0000-0002-1498-4229), Fantoni M. (ORCID:0000-0001-6913-8460), Murri, Rita, Taddei, Eleonora, Cauda, Roberto, Fantoni, Massimo, Murri R. (ORCID:0000-0003-4263-7854), Taddei E., Cauda R. (ORCID:0000-0002-1498-4229), and Fantoni M. (ORCID:0000-0001-6913-8460)
Abstract: NOT AVAILABLE
Published: 2019

44. The role of procalcitonin outside of the Intensive Care Unit (ICU): A multidisciplinary approach

Author: Fantoni, Massimo, Taddei, Eleonora, Cauda, Roberto, Antonelli Incalzi, R., Capone, A., Cortese, Francesco, Sanguinetti, Maurizio, Spandonaro, F., Urbani, Andrea, Murri, Rita, Fantoni M. (ORCID:0000-0001-6913-8460), Cauda R. (ORCID:0000-0002-1498-4229), Cortese F., Sanguinetti M. (ORCID:0000-0002-9780-7059), Urbani A. (ORCID:0000-0001-9168-3174), Murri R. (ORCID:0000-0003-4263-7854), Fantoni, Massimo, Taddei, Eleonora, Cauda, Roberto, Antonelli Incalzi, R., Capone, A., Cortese, Francesco, Sanguinetti, Maurizio, Spandonaro, F., Urbani, Andrea, Murri, Rita, Fantoni M. (ORCID:0000-0001-6913-8460), Cauda R. (ORCID:0000-0002-1498-4229), Cortese F., Sanguinetti M. (ORCID:0000-0002-9780-7059), Urbani A. (ORCID:0000-0001-9168-3174), and Murri R. (ORCID:0000-0003-4263-7854)
Abstract: not available
Published: 2019

45. Economic Consequences of Investing in Anti-HCV Antiviral Treatment from the Italian NHS Perspective: A Real-World-Based Analysis of PITER Data

Author: Marcellusi, Andrea, Viti, Raffaella, Kondili, Loreta A., Rosato, Stefano, Vella, Stefano, Mennini, Francesco Saverio, Kondili, L. A., Vella, S., Quaranta, M. G., Rosato, S., Tosti, M. E., Weimer, L. E., Ferrigno, L., D’Angelo, F., Falzano, L., Benedetti, A., Schiadà, L., Cucco, M., Giacometti, A., Brescini, L., Castelletti, S., Drenaggi, D., Mazzaro, C., Angarano, G., Milella, M., Di&nbsp, Leo, A., Rendina, M., Contaldo, A., Iannone, A., La Fortezza, F., Rizzi, M., Cologni, G., Bolondi, L., Benevento, F., Serio, I., Andreone, P., Caraceni, P., Guarneri, V., Margotti, M., Simonetti, G., Mazzella, G., Verucchi, G., Donati, V., Mian, Peter, Rimenti, G., Rossini, A., Contessi, G. B., Castelli, Fulvio, Zaltron, S., Spinetti, A., Odolini, S., Leandro, G., Cozzolongo, R., Zappimbulso, M., Russello, M., Benigno, R., Coco, C., Torti, C., Costa, C., Greco, G., Mazzitelli, M., Pisani, V., Cosco, Lucia, Quintieri, F., De Siena, Martina, Giancotti, F., Vecchiet, J., Falasca, K., Mastroianni, A., Apuzzo, G., Chidichimo, L., Foschi, F. G., Dall’Aglio, A. C., Libanore, M., Segala, D., Sighinolfi, L., Bartolozzi, D., Salomoni, E., Blanc, P., Baragli, F., Del&nbsp, Pin, B., Mariabelli, E., Mazzotta, F., Poggi, A., Zignego, A. L., Monti, M., Madia, Francesca, Xheka, A., Cela, E. M., Santantonio, T. A., Bruno, S. R., Viscoli, C., Alessandrini, A. I., Curti, C., Biagio, A., Nicolini, L. A., Balletto, E., Mastroianni, Chiara, Blerta, K., Prati, D., Raffaele, L., Andreoletti, M., Perboni, G., Costa, P., Manzini, L., Raimondo, G., Filomia, R., Lazzarin, A., Morsica, G., Salpietro, S., Puoti, M., Baiguera, C., Vassalli, S., Rumi, M. G., Labanca, S., Zuin, M., Giorgini, A., Orellana, D., D’Arminio&nbsp, Monforte, A., Debona, A., Solaro, S., Fargion, S., Valenti, L., Periti, G., Pelusi, S., Galli, M., Calvi, E., Milazzo, L., Peri, A., Lampertico, P., Borghi, Margherita, D’Ambrosio, R., Degasperi, E., Vinci, Maria Rosaria, Villa, E., Bernabucci, V., Bristot, Luca, Pereira, F., Chessa, L., Pasetto, M. C., Loi, M., Gori, A., Beretta, I., Pastore, V., Soria, A., Strazzabosco, M., Ciaccio, A., Gemma, M., Borgia, G., Foggia, A., Zappulo, E., Gentile, I., Buonomo, A. R., Abrescia, N., Maddaloni, A., Caporaso, N., Morisco, F., Camera, S., Donnarumma, L., Coppola, C., Amoruso, D. C., Staiano, L., Saturnino, M. R., Coppola, N., Martini, S., Monari, C., Federico, Alex, Dallio, M., Loguercio, C., Gaeta, G. B., Brancaccio, G., Nardone, G., Sgamato, C., D’Adamo, G., Alberti, A., Gonzo, M., Piovesan, S., Chemello, L., Buggio, A., Cavalletto, L., Barbaro, F., Castelli, Enrico, Floreani, A., Cazzagon, N., Franceschet, I., Russo, F. P., Zanetto, A., Franceschet, E., Madonia, S., Cannizzaro, Maria Chiara, Montalto, G., Licata, A., Capitano, A. R., Craxì, A., Petta, S., Calvaruso, V., Rini, F., Ferrari, C., Negri, E., Orlandini, A., Pesci, M., Bruno, R., Lombardi, A., Zuccaro, V., Gulminetti, R., Asti, A., Villaraggia, M., Mondelli, M., Ludovisi, S., Baldelli, F., Di Candilo, F., Parruti, G., Di Stefano, Paolo, Sozio, F., Gizzi, M. C., Brunetto, M. R., Colombatto, P., Coco, B., Surace, L., Foti, G., Pellicano, S., Fornaciari, G., Schianchi, S., Vignoli, P., Massari, M., Corsini, R., Garlassi, E., Ballardini, G., Andreoni, M., Cerva, C., Angelico, M., Gasbarrini, Antonio, Siciliano, M., Nosotti, L., Taliani, G., Biliotti, E., Santori, M., Spaziante, M., Tamburini, F., Vullo, V., D’Ettorre, G., Cavallari, E. N., Gebremeskel, T. S., Pavone, P., Cauda, Roberto, Cingolani, Antonella, Lamonica, S., D’Offizi, G., Lionetti, R., Visco Comandini, U., Grieco, Antonio, D’Aversa, F., Picardi, A., De Vincentis, A., Galati, G., Gallo, Patrizia, Dell’Unto, C., Aghemo, A., Gatti Comini, A., Persico, M., Masarone, M., Anselmo, M., De Leo, P., Marturano, Monia, Brunelli, E., Ridolfi, F., Schimizzi, A. M., Ayoubi Khajekini, M., Framarin, L., Di Perri, G., Cariti, G., Boglione, L., Cardellino, C., Marinaro, L., Saracco, G. M., Ciancio, A., Toniutto, P., Alterini, G., Capra, F., Ieluzzi, D., De Siena, M., Madia, F., Mastroianni, C., Vinci, M., Federico, A., Gasbarrini, A. (ORCID:0000-0002-7278-4823), Cauda, R. (ORCID:0000-0002-1498-4229), Cingolani, A. (ORCID:0000-0002-3793-2755), Grieco, A. (ORCID:0000-0002-0544-8993), Marturano, M., Marcellusi, Andrea, Viti, Raffaella, Kondili, Loreta A., Rosato, Stefano, Vella, Stefano, Mennini, Francesco Saverio, Kondili, L. A., Vella, S., Quaranta, M. G., Rosato, S., Tosti, M. E., Weimer, L. E., Ferrigno, L., D’Angelo, F., Falzano, L., Benedetti, A., Schiadà, L., Cucco, M., Giacometti, A., Brescini, L., Castelletti, S., Drenaggi, D., Mazzaro, C., Angarano, G., Milella, M., Di&nbsp, Leo, A., Rendina, M., Contaldo, A., Iannone, A., La Fortezza, F., Rizzi, M., Cologni, G., Bolondi, L., Benevento, F., Serio, I., Andreone, P., Caraceni, P., Guarneri, V., Margotti, M., Simonetti, G., Mazzella, G., Verucchi, G., Donati, V., Mian, Peter, Rimenti, G., Rossini, A., Contessi, G. B., Castelli, Fulvio, Zaltron, S., Spinetti, A., Odolini, S., Leandro, G., Cozzolongo, R., Zappimbulso, M., Russello, M., Benigno, R., Coco, C., Torti, C., Costa, C., Greco, G., Mazzitelli, M., Pisani, V., Cosco, Lucia, Quintieri, F., De Siena, Martina, Giancotti, F., Vecchiet, J., Falasca, K., Mastroianni, A., Apuzzo, G., Chidichimo, L., Foschi, F. G., Dall’Aglio, A. C., Libanore, M., Segala, D., Sighinolfi, L., Bartolozzi, D., Salomoni, E., Blanc, P., Baragli, F., Del&nbsp, Pin, B., Mariabelli, E., Mazzotta, F., Poggi, A., Zignego, A. L., Monti, M., Madia, Francesca, Xheka, A., Cela, E. M., Santantonio, T. A., Bruno, S. R., Viscoli, C., Alessandrini, A. I., Curti, C., Biagio, A., Nicolini, L. A., Balletto, E., Mastroianni, Chiara, Blerta, K., Prati, D., Raffaele, L., Andreoletti, M., Perboni, G., Costa, P., Manzini, L., Raimondo, G., Filomia, R., Lazzarin, A., Morsica, G., Salpietro, S., Puoti, M., Baiguera, C., Vassalli, S., Rumi, M. G., Labanca, S., Zuin, M., Giorgini, A., Orellana, D., D’Arminio&nbsp, Monforte, A., Debona, A., Solaro, S., Fargion, S., Valenti, L., Periti, G., Pelusi, S., Galli, M., Calvi, E., Milazzo, L., Peri, A., Lampertico, P., Borghi, Margherita, D’Ambrosio, R., Degasperi, E., Vinci, Maria Rosaria, Villa, E., Bernabucci, V., Bristot, Luca, Pereira, F., Chessa, L., Pasetto, M. C., Loi, M., Gori, A., Beretta, I., Pastore, V., Soria, A., Strazzabosco, M., Ciaccio, A., Gemma, M., Borgia, G., Foggia, A., Zappulo, E., Gentile, I., Buonomo, A. R., Abrescia, N., Maddaloni, A., Caporaso, N., Morisco, F., Camera, S., Donnarumma, L., Coppola, C., Amoruso, D. C., Staiano, L., Saturnino, M. R., Coppola, N., Martini, S., Monari, C., Federico, Alex, Dallio, M., Loguercio, C., Gaeta, G. B., Brancaccio, G., Nardone, G., Sgamato, C., D’Adamo, G., Alberti, A., Gonzo, M., Piovesan, S., Chemello, L., Buggio, A., Cavalletto, L., Barbaro, F., Castelli, Enrico, Floreani, A., Cazzagon, N., Franceschet, I., Russo, F. P., Zanetto, A., Franceschet, E., Madonia, S., Cannizzaro, Maria Chiara, Montalto, G., Licata, A., Capitano, A. R., Craxì, A., Petta, S., Calvaruso, V., Rini, F., Ferrari, C., Negri, E., Orlandini, A., Pesci, M., Bruno, R., Lombardi, A., Zuccaro, V., Gulminetti, R., Asti, A., Villaraggia, M., Mondelli, M., Ludovisi, S., Baldelli, F., Di Candilo, F., Parruti, G., Di Stefano, Paolo, Sozio, F., Gizzi, M. C., Brunetto, M. R., Colombatto, P., Coco, B., Surace, L., Foti, G., Pellicano, S., Fornaciari, G., Schianchi, S., Vignoli, P., Massari, M., Corsini, R., Garlassi, E., Ballardini, G., Andreoni, M., Cerva, C., Angelico, M., Gasbarrini, Antonio, Siciliano, M., Nosotti, L., Taliani, G., Biliotti, E., Santori, M., Spaziante, M., Tamburini, F., Vullo, V., D’Ettorre, G., Cavallari, E. N., Gebremeskel, T. S., Pavone, P., Cauda, Roberto, Cingolani, Antonella, Lamonica, S., D’Offizi, G., Lionetti, R., Visco Comandini, U., Grieco, Antonio, D’Aversa, F., Picardi, A., De Vincentis, A., Galati, G., Gallo, Patrizia, Dell’Unto, C., Aghemo, A., Gatti Comini, A., Persico, M., Masarone, M., Anselmo, M., De Leo, P., Marturano, Monia, Brunelli, E., Ridolfi, F., Schimizzi, A. M., Ayoubi Khajekini, M., Framarin, L., Di Perri, G., Cariti, G., Boglione, L., Cardellino, C., Marinaro, L., Saracco, G. M., Ciancio, A., Toniutto, P., Alterini, G., Capra, F., Ieluzzi, D., De Siena, M., Madia, F., Mastroianni, C., Vinci, M., Federico, A., Gasbarrini, A. (ORCID:0000-0002-7278-4823), Cauda, R. (ORCID:0000-0002-1498-4229), Cingolani, A. (ORCID:0000-0002-3793-2755), Grieco, A. (ORCID:0000-0002-0544-8993), and Marturano, M.
Abstract: Objective: We estimated the cost consequence of Italian National Health System (NHS) investment in direct-acting antiviral (DAA) therapy according to hepatitis C virus (HCV) treatment access policies in Italy. Methods: A multistate, 20-year time horizon Markov model of HCV liver disease progression was developed. Fibrosis stage, age and genotype distributions were derived from the Italian Platform for the Study of Viral Hepatitis Therapies (PITER) cohort. The treatment efficacy, disease progression probabilities and direct costs in each health state were obtained from the literature. The break-even point in time (BPT) was defined as the period of time required for the cumulative costs saved to recover the Italian NHS investment in DAA treatment. Three different PITER enrolment periods, which covered the full DAA access evolution in Italy, were considered. Results: The disease stages of 2657 patients who consecutively underwent DAA therapy from January 2015 to December 2017 at 30 PITER clinical centres were standardized for 1000 patients. The investment in DAAs was considered to equal €25 million, €15 million, and €9 million in 2015, 2016, and 2017, respectively. For patients treated in 2015, the BPT was not achieved, because of the disease severity of the treated patients and high DAA prices. For 2016 and 2017, the estimated BPTs were 6.6 and 6.2 years, respectively. The total cost savings after 20 years were €50.13 and €55.50 million for 1000 patients treated in 2016 and 2017, respectively. Conclusions: This study may be a useful tool for public decision makers to understand how HCV clinical and epidemiological profiles influence the economic burden of HCV.
Published: 2019

46. Biochemical and inflammatory modifications after switching to dual antiretroviral therapy in HIV-infected patients in Italy: A multicenter retrospective cohort study from 2007 to 2015

Author: Quiros-Roldan, E., Magro, P., Raffetti, E., Izzo, I., Borghetti, A., Lombardi, F., Saracino, A., Maggiolo, F., Castelli, F., Carosi, G., Paraninfo, G. E., Torti, C., Cauda, R., Di Giambenedetto, S., Fabbiani, M., Colafigli, M., Scalzini, A., Castelnuovo, F., El Hamad, I., Mazzotta, F., Locaputo, S., Marino, N., Pierotti, P., Di Pietro, M., Ble, C., Vichi, F., Sighinolfi, L., Angarano, G., Ladisa, N., Monno, L., Maggi, P., Pan, A., Costarelli, S., Gori, A., Lapadula, G., Puoti, M., Viale, P., Colangeli, V., Borderi, M., Borghetti A., Lombardi F. (ORCID:0000-0001-5757-8346), Carosi G., Torti C., Cauda R. (ORCID:0000-0002-1498-4229), Di Giambenedetto S. (ORCID:0000-0001-6990-5076), Colafigli M., Di Pietro M. (ORCID:0000-0002-3893-8788), Quiros-Roldan, E., Magro, P., Raffetti, E., Izzo, I., Borghetti, A., Lombardi, F., Saracino, A., Maggiolo, F., Castelli, F., Carosi, G., Paraninfo, G. E., Torti, C., Cauda, R., Di Giambenedetto, S., Fabbiani, M., Colafigli, M., Scalzini, A., Castelnuovo, F., El Hamad, I., Mazzotta, F., Locaputo, S., Marino, N., Pierotti, P., Di Pietro, M., Ble, C., Vichi, F., Sighinolfi, L., Angarano, G., Ladisa, N., Monno, L., Maggi, P., Pan, A., Costarelli, S., Gori, A., Lapadula, G., Puoti, M., Viale, P., Colangeli, V., Borderi, M., Borghetti A., Lombardi F. (ORCID:0000-0001-5757-8346), Carosi G., Torti C., Cauda R. (ORCID:0000-0002-1498-4229), Di Giambenedetto S. (ORCID:0000-0001-6990-5076), Colafigli M., and Di Pietro M. (ORCID:0000-0002-3893-8788)
Abstract: Background: Triple-drug regimens are the gold standard for HIV therapy. Nucleos(t)ide reverse transcriptase inhibitors (NRTIs) reducing regimens are used to decrease drugs toxicity, exposure and costs. Aim of our study was to evaluate trends of biochemical and inflammatory indices in patients switching to dual therapy (DT). Methods: We included patients that a) switched to a DT from 2007 to 2015 from a tenofovir/abacavir-based triple regimen b) previously maintained a triple and c) subsequently a dual regimen for 12 months with virological suppression. We retrieved data measured at 5 points (at the switch, 6 and 12 months before and after switch). We used platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR) and CD4/CD8 ratio as inflammatory indices. We assessed temporal trends of viro-immunological, biochemical and inflammatory parameters. Results: Overall, 364 and 65 patients switched from a tenofovir- and an abacavir-triple regimen, respectively. In the tenofovir-reducing group, creatinine clearance and lipids raised after the switch. There was a significant increase in both CD4+ cells and CD4/CD8. CD8+ cells rose after the switch, while opposite trend was found for PLR. In the abacavir-reducing group total lipids showed a decrease during the first 6 months after the switch and then stabilized. An increase of CD4+ and a decrease of CD8+ cells was observed during the study period, although not statistically significant. While CD4/CD8 remained stable after simplification, PLR decreased significantly after 6 months, then returning to baseline. CD8+ cells increased in the tenofovir-reducing group despite a viro-immunological response. Intriguingly, PLR decreased, maintaining this trend for 12 and 6 months after tenofovir and abacavir interruption respectively. Conclusions: Increased PLR has been linked to hypercholesterolemia and metabolic-syndrome, while high CD8+ cells count to increased risk of non-AIDS-related events regardless of CD4 T-cell re
Published: 2018

47. Switching to dual/monotherapy determines an increase in CD8+ in HIV-infected individuals: An observational cohort study

Author: Mussini, C., Lorenzini, P., Cozzi-Lepri, A., Marchetti, G., Rusconi, S., Gori, A., Nozza, S., Lichtner, M., Antinori, A., Cossarizza, A., d'Arminio Monforte, A., Castagna, A., Castelli, F., Cauda, R., Di Perri, G., Galli, M., Iardino, R., Ippolito, G., Lazzarin, A., Marchetti, G. C., Perno, C. F., Rezza, G., von Schloesser, F., Viale, P., Ceccherini-Silberstein, F., Girardi, E., Lo Caputo, S., Puoti, M., Andreoni, M., Ammassari, A., Balotta, C., Bandera, A., Bonfanti, P., Bonora, S., Borderi, M., Calcagno, A., Calza, L., Capobianchi, M. R., Cingolani, A., Cinque, P., De Luca, A., Di Biagio, A., Gianotti, N., Guaraldi, G., Lapadula, G., Madeddu, G., Maggiolo, F., Marcotullio, S., Monno, L., Quiros Roldan, E., Rossotti, R., Santoro, M. M., Saracino, A., Zaccarelli, M., Fanti, I., Galli, L., Rodano, A., Shanyinde, M., Tavelli, A., Carletti, F., Carrara, S., Di Caro, A., Graziano, S., Petrone, F., Prota, G., Quartu, S., Truffa, S., Giacometti, A., Costantini, A., Barocci, V., Angarano, G., Santoro, C., Suardi, C., Donati, V., Verucchi, G., Minardi, C., Quirino, T., Abeli, C., Manconi, P. E., Piano, P., Cacopardo, B., Celesia, B., Vecchiet, J., Falasca, K., Sighinolfi, L., Segala, D., Blanc, P., Vichi, F., Cassola, G., Viscoli, C., Alessandrini, A., Bobbio, N., Mazzarello, G., Mastroianni, C., Pozzetto, I., Caramma, I., Chiodera, A., Milini, P., Rizzardini, G., Moioli, M. C., Piolini, R., Ridolfo, A. L., Salpietro, S., Tincati, C., Puzzolante, C., Abrescia, N., Chirianni, A., Borgia, G., Orlando, R., Bonadies, G., Di Martino, F., Gentile, I., Maddaloni, L., Cattelan, A. M., Marinello, S., Cascio, A., Colomba, C., Baldelli, F., Schiaroli, E., Parruti, G., Sozio, F., Magnani, G., Ursitti, M. A., Cristaudo, A., Vullo, V., Acinapura, R., Baldin, G., Capozzi, M., Cicalini, S., Fontanelli Sulekova, L., Iaiani, G., Latini, A., Mastrorosa, I., Plazzi, M. M., Savinelli, S., Vergori, A., Cecchetto, M., Viviani, F., Bagella, P., Rossetti, B., Franco, A., Fontana Del Vecchio, R., Francisci, D., Di Giuli, C., Caramello, P., Orofino, G. C., Sciandra, M., Bassetti, M., Londero, A., Pellizzer, G., Manfrin, V., Starnini, G., Ialungo, A., Cauda R. (ORCID:0000-0002-1498-4229), Cingolani A. (ORCID:0000-0002-3793-2755), De Luca A. (ORCID:0000-0002-8311-6935), Segala D., Rossetti B., Mussini, C., Lorenzini, P., Cozzi-Lepri, A., Marchetti, G., Rusconi, S., Gori, A., Nozza, S., Lichtner, M., Antinori, A., Cossarizza, A., d'Arminio Monforte, A., Castagna, A., Castelli, F., Cauda, R., Di Perri, G., Galli, M., Iardino, R., Ippolito, G., Lazzarin, A., Marchetti, G. C., Perno, C. F., Rezza, G., von Schloesser, F., Viale, P., Ceccherini-Silberstein, F., Girardi, E., Lo Caputo, S., Puoti, M., Andreoni, M., Ammassari, A., Balotta, C., Bandera, A., Bonfanti, P., Bonora, S., Borderi, M., Calcagno, A., Calza, L., Capobianchi, M. R., Cingolani, A., Cinque, P., De Luca, A., Di Biagio, A., Gianotti, N., Guaraldi, G., Lapadula, G., Madeddu, G., Maggiolo, F., Marcotullio, S., Monno, L., Quiros Roldan, E., Rossotti, R., Santoro, M. M., Saracino, A., Zaccarelli, M., Fanti, I., Galli, L., Rodano, A., Shanyinde, M., Tavelli, A., Carletti, F., Carrara, S., Di Caro, A., Graziano, S., Petrone, F., Prota, G., Quartu, S., Truffa, S., Giacometti, A., Costantini, A., Barocci, V., Angarano, G., Santoro, C., Suardi, C., Donati, V., Verucchi, G., Minardi, C., Quirino, T., Abeli, C., Manconi, P. E., Piano, P., Cacopardo, B., Celesia, B., Vecchiet, J., Falasca, K., Sighinolfi, L., Segala, D., Blanc, P., Vichi, F., Cassola, G., Viscoli, C., Alessandrini, A., Bobbio, N., Mazzarello, G., Mastroianni, C., Pozzetto, I., Caramma, I., Chiodera, A., Milini, P., Rizzardini, G., Moioli, M. C., Piolini, R., Ridolfo, A. L., Salpietro, S., Tincati, C., Puzzolante, C., Abrescia, N., Chirianni, A., Borgia, G., Orlando, R., Bonadies, G., Di Martino, F., Gentile, I., Maddaloni, L., Cattelan, A. M., Marinello, S., Cascio, A., Colomba, C., Baldelli, F., Schiaroli, E., Parruti, G., Sozio, F., Magnani, G., Ursitti, M. A., Cristaudo, A., Vullo, V., Acinapura, R., Baldin, G., Capozzi, M., Cicalini, S., Fontanelli Sulekova, L., Iaiani, G., Latini, A., Mastrorosa, I., Plazzi, M. M., Savinelli, S., Vergori, A., Cecchetto, M., Viviani, F., Bagella, P., Rossetti, B., Franco, A., Fontana Del Vecchio, R., Francisci, D., Di Giuli, C., Caramello, P., Orofino, G. C., Sciandra, M., Bassetti, M., Londero, A., Pellizzer, G., Manfrin, V., Starnini, G., Ialungo, A., Cauda R. (ORCID:0000-0002-1498-4229), Cingolani A. (ORCID:0000-0002-3793-2755), De Luca A. (ORCID:0000-0002-8311-6935), Segala D., and Rossetti B.
Abstract: Background: The CD4/CD8 ratio has been associated with the risk of AIDS and non-AIDS events. We describe trends in immunological parameters in people who underwent a switch to monotherapy or dual therapy, compared to a control group remaining on triple antiretroviral therapy (ART). Methods: We included patients in Icona who started a three-drug combination ART regimen from an ART-naïve status and achieved a viral load ≤ 50 copies/mL; they were subsequently switched to another triple or to a mono or double regimen. Standard linear regression at fixed points in time (12-24 months after the switch) and linear mixed model analysis with random intercepts and slopes were used to compare CD4 and CD8 counts and their ratio over time according to regimen types (triple vs. dual and vs. mono). Results: A total of 1241 patients were included; 1073 switched to triple regimens, 104 to dual (72 with 1 nucleoside reverse transcriptase inhibitor (NRTI), 32 NRTI-sparing), and 64 to monotherapy. At 12 months after the switch, for the multivariable linear regression the mean change in the log10 CD4/CD8 ratio for patients on dual therapy was -0.03 (95% confidence interval (CI) -0.05, -0.0002), and the mean change in CD8 count was +99 (95% CI +12.1, +186.3), taking those on triple therapy as reference. In contrast, there was no evidence for a difference in CD4 count change. When using all counts, there was evidence for a significant difference in the slope of the ratio and CD8 count between people who were switched to triple (points/year change ratio = +0.056, CD8 = -25.7) and those to dual regimen (ratio = -0.029, CD8 = +110.4). Conclusions: We found an increase in CD8 lymphocytes in people who were switched to dual regimens compared to those who were switched to triple. Patients on monotherapy did not show significant differences. The long-term implications of this difference should be ascertained.
Published: 2018

48. Pre-ART HIV-1 DNA in CD4+ T cells correlates with baseline VIRO-immunological status and outcome in patients under first-line ART

Author: Ceccherini-Silberstein, F., Cozzi Lepri, A., Alteri, C., Merlini, E., Surdo, M., Marchetti, G., Capobianchi, M. R., De Luca, Andrea, Gianotti, N., Viale, P., Andreoni, M., Antinori, A., Perno, C. F., D'Arminio Monforte, A., Castagna, A., Castelli, F., Cauda, Roberto, Di Perri, G., Galli, M., Iardino, R., Ippolito, G., Lazzarin, A., Marchetti, G. C., Rezza, G., Von Schloesser, F., Cozzi-Lepri, A., Girardi, E., Lo Caputo, S., Mussini, C., Puoti, M., Ammassari, A., Balotta, C., Bandera, A., Bonfanti, P., Bonora, S., Borderi, M., Calcagno, A., Calza, L., Cingolani, Antonella, Cinque, P., Di Biagio, A., Gori, A., Guaraldi, G., Lapadula, G., Lichtner, M., Madeddu, G., Maggiolo, F., Marcotullio, S., Monno, L., Nozza, S., Quiros Roldan, E., Rossotti, R., Rusconi, S., Santoro, M. M., Saracino, A., Zaccarelli, M., Fanti, I., Galli, L., Lorenzini, P., Rodano, A., Shanyinde, M., Tavelli, A., Carletti, F., Carrara, S., Di Caro, A., Graziano, S., Petrone, F., Prota, G., Quartu, S., Truffa, S., Giacometti, A., Costantini, A., Barocci, V., Angarano, G., Santoro, C., Suardi, C., Donati, V., Verucchi, G., Minardi, C., Quirino, T., Abeli, C., Manconi, P. E., Piano, P., Cacopardo, B., Celesia, B., Vecchiet, J., Falasca, K., Sighinolfi, L., Segala, D., Blanc, P., Vichi, F., Cassola, G., Viscoli, C., Alessandrini, A., Bobbio, N., Mazzarello, G., Mastroianni, C., Pozzetto, I., Molteni, C., Chiodera, A., Milini, P., Nunnari, G., Pellicano, G., Rizzardini, G., Moioli, M. C., Piolini, R., Ridolfo, A. L., Salpietro, S., Tincati, C., Puzzolante, C., Chirianni, A., Borgia, G., Esposito, V., Orlando, R., Bonadies, G., Di Martino, F., Gentile, I., Maddaloni, L., Cattelan, A. M., Marinello, S., Cascio, A., Colomba, C., Baldelli, F., Schiaroli, E., Parruti, G., Sozio, F., Magnani, G., Ursitti, M. A., Acinapura, R., Baldin, G., Capozzi, M., Cicalini, S., Cristaudo, A., Fontanelli Sulekova, L., Iaiani, G., Latini, A., Mastrorosa, I., Plazzi, M. M., Savinelli, S., Vergori, A., Vullo, V., Cecchetto, M., Viviani, F., Bagella, P., Rossetti, Barbara, Franco, A., Fontana Del Vecchio, R., Francisci, D., Di Giuli, C., Caramello, P., Orofino, G. C., Sciandra, M., Bassetti, M., Londero, A., Pellizzer, G., Manfrin, V., Starnini, G., Ialungo, A., De Luca A. (ORCID:0000-0002-8311-6935), Cauda R. (ORCID:0000-0002-1498-4229), Cingolani A. (ORCID:0000-0002-3793-2755), Rossetti B., Ceccherini-Silberstein, F., Cozzi Lepri, A., Alteri, C., Merlini, E., Surdo, M., Marchetti, G., Capobianchi, M. R., De Luca, Andrea, Gianotti, N., Viale, P., Andreoni, M., Antinori, A., Perno, C. F., D'Arminio Monforte, A., Castagna, A., Castelli, F., Cauda, Roberto, Di Perri, G., Galli, M., Iardino, R., Ippolito, G., Lazzarin, A., Marchetti, G. C., Rezza, G., Von Schloesser, F., Cozzi-Lepri, A., Girardi, E., Lo Caputo, S., Mussini, C., Puoti, M., Ammassari, A., Balotta, C., Bandera, A., Bonfanti, P., Bonora, S., Borderi, M., Calcagno, A., Calza, L., Cingolani, Antonella, Cinque, P., Di Biagio, A., Gori, A., Guaraldi, G., Lapadula, G., Lichtner, M., Madeddu, G., Maggiolo, F., Marcotullio, S., Monno, L., Nozza, S., Quiros Roldan, E., Rossotti, R., Rusconi, S., Santoro, M. M., Saracino, A., Zaccarelli, M., Fanti, I., Galli, L., Lorenzini, P., Rodano, A., Shanyinde, M., Tavelli, A., Carletti, F., Carrara, S., Di Caro, A., Graziano, S., Petrone, F., Prota, G., Quartu, S., Truffa, S., Giacometti, A., Costantini, A., Barocci, V., Angarano, G., Santoro, C., Suardi, C., Donati, V., Verucchi, G., Minardi, C., Quirino, T., Abeli, C., Manconi, P. E., Piano, P., Cacopardo, B., Celesia, B., Vecchiet, J., Falasca, K., Sighinolfi, L., Segala, D., Blanc, P., Vichi, F., Cassola, G., Viscoli, C., Alessandrini, A., Bobbio, N., Mazzarello, G., Mastroianni, C., Pozzetto, I., Molteni, C., Chiodera, A., Milini, P., Nunnari, G., Pellicano, G., Rizzardini, G., Moioli, M. C., Piolini, R., Ridolfo, A. L., Salpietro, S., Tincati, C., Puzzolante, C., Chirianni, A., Borgia, G., Esposito, V., Orlando, R., Bonadies, G., Di Martino, F., Gentile, I., Maddaloni, L., Cattelan, A. M., Marinello, S., Cascio, A., Colomba, C., Baldelli, F., Schiaroli, E., Parruti, G., Sozio, F., Magnani, G., Ursitti, M. A., Acinapura, R., Baldin, G., Capozzi, M., Cicalini, S., Cristaudo, A., Fontanelli Sulekova, L., Iaiani, G., Latini, A., Mastrorosa, I., Plazzi, M. M., Savinelli, S., Vergori, A., Vullo, V., Cecchetto, M., Viviani, F., Bagella, P., Rossetti, Barbara, Franco, A., Fontana Del Vecchio, R., Francisci, D., Di Giuli, C., Caramello, P., Orofino, G. C., Sciandra, M., Bassetti, M., Londero, A., Pellizzer, G., Manfrin, V., Starnini, G., Ialungo, A., De Luca A. (ORCID:0000-0002-8311-6935), Cauda R. (ORCID:0000-0002-1498-4229), Cingolani A. (ORCID:0000-0002-3793-2755), and Rossetti B.
Abstract: Objectives We evaluated the association between pre-ART HIV DNA and HIV-infected participant characteristics at baseline as well as with their response to first-line ART. Methods Four hundred and thirty-three patients from the ICONA cohort, starting first-line ART after the year 2000, were analysed. Pre-ART HIV DNA was quantified with the modified COBAS TaqMan HIV-1 Test and normalized by CD4+ T cells. Linear correlation between pre-ART HIV DNA and other continuous markers (HIV RNA, CD4 count, markers of inflammation and coagulation) at baseline was evaluated by means of Pearson correlation coefficient and a linear regression model. Survival analyses and Cox regression models were used to study the association between pre-ART HIV DNA and time to VIRO-immunoclinical events. Results Pre-ART HIV DNA [median (IQR): 10 € 702 (3397-36 € 632) copies/10 6 CD4+ T cells] was correlated with pre-ART HIV RNA [R 2 = +0.44, (P < 0.0001)], CD4+ T cells [R 2 = '0.58, (P < 0.0001)] and CD4/CD8 ratio [R 2 = '0.48, (P < 0.0001)], while weaker correlations were observed with CD8+ T cells (R 2 = '0.20, P = 0.01), IL-6 (R 2 = +0.16, P = 0.002) and soluble CD14 (R 2 = +0.09, P = 0.05). Patients with higher pre-ART HIV DNA showed lower rate and delayed VIROlogical response (defined as HIV RNA ≤50 copies/mL), compared with those having lower HIV DNA (67.2% for >10 € 000, 81.1% for 1000-10 € 000 and 86.4% for 10-1000 copies/10 6 CD4+ T cells; P = 0.0004). Higher pre-ART HIV DNA was also correlated with increased risk of VIROlogical rebound (defined as HIV RNA >50 copies/mL) by 24 months (17.2% for >10 € 000, 7.4% for 1000-10 € 000 and 4.3% for 10-1000 copies/10 6 CD4+ T cells; P = 0.0048). Adjusted HRs of all VIROlogical rebound definitions confirmed these findings (P ≤ 0.02). Conclusions Pre-ART HIV DNA, along with HIV RNA and CD4+ T cell count, should be considered as a new staging marker to better identify people at lower (or higher) risk of viral rebound following achie
Published: 2018

49. Multidisciplinary management of pyogenic spondylodiscitis: epidemiological and clinical features, prognostic factors and long-term outcomes in 207 patients

Author: Pola, Enrico, Taccari, Francesco, Autore, G., Giovannenze, Francesca, Pambianco, V., Cauda, Roberto, Maccauro, Giulio, Fantoni, Massimo, Pola, Enrico (ORCID:0000-0001-5350-3910), Taccari, F., Giovannenze, F., Cauda, R. (ORCID:0000-0002-1498-4229), Maccauro, G. (ORCID:0000-0002-7359-268X), Fantoni, M. (ORCID:0000-0001-6913-8460), Pola, Enrico, Taccari, Francesco, Autore, G., Giovannenze, Francesca, Pambianco, V., Cauda, Roberto, Maccauro, Giulio, Fantoni, Massimo, Pola, Enrico (ORCID:0000-0001-5350-3910), Taccari, F., Giovannenze, F., Cauda, R. (ORCID:0000-0002-1498-4229), Maccauro, G. (ORCID:0000-0002-7359-268X), and Fantoni, M. (ORCID:0000-0001-6913-8460)
Abstract: Purpose: Pyogenic spondylodiscitis (PS) is a potentially life-threatening infection burdened by high morbidity rates. Despite the rising incidence, the proper management of PS is still controversial. Aim of this study was to describe the clinical features of PS and to evaluate the prognostic factors and the long-term outcomes of a large population of patients. Methods: 207 cases of PS treated from 2008 to 2016 with a 2-year follow-up were enrolled. Clinical data from each patient were recorded. The primary outcome was the rate of healing without residual disability. Secondary outcomes included length of stay, healing from infection, death, relapse, and residual disability. Binomial logistic regression and multivariate analysis were used to evaluate prognostic factors. Results: Median diagnostic delay was 30 days and the rate of onset neurological impairment was 23.6%. Microbiological diagnosis was established in 155 patients (74.3%) and the median duration of total antibiotic therapy was 148 days. Orthopedic treatment was conservative for 124 patients and surgical in 47 cases. Complete healing without disability was achieved in 142 patients (77.6%). Statistically confirmed negative prognostic factors were: negative microbiological culture, neurologic impairment at diagnosis and underlying endocarditis (p ≤ 0.05). Healing from infection rate was 90.9%, while residual disabilities occurred in 23.5%. Observed mortality rate was 7.8%. Conclusion: The microbiological diagnosis is the main predictive factor for successful treatment. Early diagnosis and multidisciplinary management are also needed to identify underlying aggressive conditions and to avoid neurological complications associated with poorer long-term outcomes. Despite high healing rates, PS may lead to major disabilities still representing a difficult challenge. Graphical abstract: These slides can be retrieved under Electronic Supplementary material. [Figure not available: see fulltext.]
Published: 2018

50. Answer to the Letter to the Editor of S. Huang et al. concerning “New classification for the treatment of pyogenic spondylodiscitis: validation study on a population of 250 patients with a follow-up of 2 years” by Enrico Pola et al. Eur Spine J (2017) doi:10.1007/s00586-017-5043-5

Author: Pola, Enrico, Autore, G., Formica, V. M., Pambianco, V., Colangelo, Debora, Cauda, Roberto, Fantoni, Massimo, Pola, Enrico (ORCID:0000-0001-5350-3910), Colangelo, D., Cauda, R. (ORCID:0000-0002-1498-4229), Fantoni, M. (ORCID:0000-0001-6913-8460), Pola, Enrico, Autore, G., Formica, V. M., Pambianco, V., Colangelo, Debora, Cauda, Roberto, Fantoni, Massimo, Pola, Enrico (ORCID:0000-0001-5350-3910), Colangelo, D., Cauda, R. (ORCID:0000-0002-1498-4229), and Fantoni, M. (ORCID:0000-0001-6913-8460)
Abstract: Not available
Published: 2017

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