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2. Diagnostic role of internal mammary lymph node involvement in tuberculous pleurisy: a multicenter study

Author

Levi, G., Rocchetti, C., Mei, F., Stella, G.M., Lettieri, S., Lococo, F., Taccari, F., Seguiti, C., Fantoni, M., Natali, F., Candoli, P., Bortolotto, C., Pinelli, V., Mondoni, M., Carlucci, P., Fabbri, A., Trezzi, M, Vannucchi, L., Bonifazi, M., Porcarelli, F., Gasparini, S., Sica, G., Valente, T., Biondini, D., Damin, M., Liani, V., Tamburrini, M., Sorino, C., Mezzasalma, F., Scaramozzino, M.U., Pini, L., Bezzi, M., and Marchetti, G.P.

Published
2024
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6. Treatment with COLchicine in hospitalized patients affected by COVID-19: The COLVID-19 trial

Author

Perricone, C, Scarsi, M, Brucato, A, Pisano, P, Pigatto, E, Becattini, C, Cingolani, A, Tiso, F, Prota, R, Tomasoni, L, Cutolo, M, Tardella, M, Rozza, D, Zerbino, C, Andreoni, M, Poletti, V, Bartoloni, E, Gerli, R, Cafaro, G, Mendeni, M, Colombo, E, Medico, M, Cabras, P, Schiesaro, M, Franco, L, Fantoni, M, Friso, L, Gallo, V, Franceschini, F, Paolino, S, Salaffi, F, Scire, C, Zanetti, A, Diana, C, Passaro, A, Foti, R, Serino, F, Cassol, M, Bucaneve, G, Rocchi, R, Perricone C., Scarsi M., Brucato A., Pisano P., Pigatto E., Becattini C., Cingolani A., Tiso F., Prota R., Tomasoni L. R., Cutolo M., Tardella M., Rozza D., Zerbino C., Andreoni M., Poletti V., Bartoloni E., Gerli R., Cafaro G., Mendeni M., Colombo E., Medico M. D., Cabras P., Schiesaro M. G., Franco L., Fantoni M., Friso L., Gallo V., Franceschini F., Paolino S., Salaffi F., Scire C. A., Zanetti A., Diana C., Passaro A., Foti R., Serino F. S., Cassol M., Bucaneve G., Rocchi R. E., Perricone, C, Scarsi, M, Brucato, A, Pisano, P, Pigatto, E, Becattini, C, Cingolani, A, Tiso, F, Prota, R, Tomasoni, L, Cutolo, M, Tardella, M, Rozza, D, Zerbino, C, Andreoni, M, Poletti, V, Bartoloni, E, Gerli, R, Cafaro, G, Mendeni, M, Colombo, E, Medico, M, Cabras, P, Schiesaro, M, Franco, L, Fantoni, M, Friso, L, Gallo, V, Franceschini, F, Paolino, S, Salaffi, F, Scire, C, Zanetti, A, Diana, C, Passaro, A, Foti, R, Serino, F, Cassol, M, Bucaneve, G, Rocchi, R, Perricone C., Scarsi M., Brucato A., Pisano P., Pigatto E., Becattini C., Cingolani A., Tiso F., Prota R., Tomasoni L. R., Cutolo M., Tardella M., Rozza D., Zerbino C., Andreoni M., Poletti V., Bartoloni E., Gerli R., Cafaro G., Mendeni M., Colombo E., Medico M. D., Cabras P., Schiesaro M. G., Franco L., Fantoni M., Friso L., Gallo V., Franceschini F., Paolino S., Salaffi F., Scire C. A., Zanetti A., Diana C., Passaro A., Foti R., Serino F. S., Cassol M., Bucaneve G., and Rocchi R. E.

Abstract

Objective: To evaluate whether the addition of colchicine to standard of care (SOC) results in better outcomes in hospitalized patients with COVID-19. Design: This interventional, multicenter, randomized, phase 2 study, evaluated colchicine 1.5 mg/day added to SOC in hospitalized COVID-19 patients (COLVID-19 trial) and 227 patients were recruited. The primary outcome was the rate of critical disease in 30 days defined as need of mechanical ventilation, intensive care unit (ICU), or death. Results: 152 non-anti-SARS-CoV-2-vaccinated patients (colchicine vs controls: 77vs75, mean age 69.1±13.1 vs 67.9±15 years, 39% vs 33.3% females, respectively) were analyzed. There was no difference in co-primary end-points between patients treated with colchicine compared to controls (mechanical ventilation 5.2% vs 4%, ICU 1.3% vs 5.3%, death 9.1% vs 6.7%, overall 11 (14.3%) vs 10 (13.3%) patients, P=ns, respectively). Mean time to discharge was similar (colchicine vs controls 14.1±10.4 vs 14.7±8.1 days). Older age (>60 years, P=0.025), P/F<275 mmHg (P=0.005), AST>40 U/L (P<0.001), pre-existent heart (P=0.02), lung (P=0.003), upper-gastrointestinal (P=0.014), lower-gastrointestinal diseases (P=0.009) and cancer (P=0.008) were predictive of achieving the primary outcome. Diarrhoea (9.1% vs 0%, p=0.0031) and increased levels of AST at 6 days (76.9±91.8 vs 33.5±20.7 U/l, P=0.016) were more frequent in the colchicine group. Conclusion: Colchicine did not reduce the rate and the time to the critical stage. Colchicine was relatively safe although adverse hepatic effects require caution. We confirm that older (>60 years) patients with comorbidities are characterized by worse outcome.

Published
2023

7. Direct use of eazyplex® SuperBug CRE assay from positive blood cultures in conjunction with inpatient infectious disease consulting for timely appropriate antimicrobial therapy in Escherichia coli and Klebsiella pneumoniae bloodstream infections

Author

Fiori B, D'Inzeo T, Posteraro B, Menchinelli G, Liotti FM, De Angelis G, De Maio F, Fantoni M, Murri R, Scoppettuolo G, Ventura G, Tumbarello M, Pennestrì F, Taccari F, Sanguinetti M, and Spanu T

Subjects
Escherichia coli, Klebsiella pneumoniae, bloodstream infection, drug resistance, targeted therapy, infectious disease consultation, Infectious and parasitic diseases, RC109-216
Abstract

Barbara Fiori,1–3,* Tiziana D’Inzeo,2,3,* Brunella Posteraro,4,5 Giulia Menchinelli,3 Flora Marzia Liotti,3 Giulia De Angelis,2,3 Flavio De Maio,3 Massimo Fantoni,6,7 Rita Murri,6,7 Giancarlo Scoppettuolo,6 Giulio Ventura,6 Mario Tumbarello,6,7 Francesco Pennestrì,4 Francesco Taccari,7 Maurizio Sanguinetti,2,3 Teresa Spanu2,31Scuola Provinciale Superiore di Sanità Claudiana, Bolzano, Italy; 2Fondazione Policlinico Universitario A. Gemelli IRCCS, Dipartimento di Scienze di Laboratorio e Infettivologiche, Rome, Italy; 3Università Cattolica del Sacro Cuore, Istituto di Microbiologia, Rome, Italy; 4Fondazione Policlinico Universitario A. Gemelli IRCCS, Dipartimento di Scienze Gastroenterologiche, Endocrino-Metaboliche e Nefro-Urologiche, Rome, Italy; 5Università Cattolica del Sacro Cuore Rome, Istituto di Patologia e Semeiotica Medica, Rome, Italy; 6Fondazione Policlinico Universitario A. Gemelli IRCCS, UOC Malattie Infettive, Rome, Italy; 7Istituto di Malattie Infettive, Università Cattolica del Sacro Cuore, Rome, Italy*These authors contributed equally to this workObjectives: To describe a rapid workflow based on the direct detection of Escherichia coli (Ec) and Klebsiella pneumoniae (Kp) producing CTX-M extended-spectrum β-lactamase (ESBL) and/or carbapenemases (eg, KPC, VIM) from blood cultures (BCs) and the infectious disease (ID) consulting for timely appropriate antimicrobial therapy.Methods: This observational, retrospective study included adult patients with a first episode of Ec or Kp bloodstream infection (BSI) in a large Italian university hospital, where an inpatient ID consultation team (IDCT) has been operational. Results from the BCs tested for detecting blaCTX-M, blaKPC, blaNDM, blaOXA-48-like, and blaVIM genes by the eazyplex®, SuperBug CRE assay in Ec and Kp organisms had been notified for antimicrobial therapy consulting.Results: In 321 BSI episodes studied, we found that 151 (47.0%) of Ec or Kp organisms harbored blaCTX-M and/or blaKPC and/or blaVIM (meantime from BC collection: 18.5 h). Empirical antimicrobial treatment was appropriate in 21.8% (33/151) of BSIs, namely 5.9% (3/51) of BSIs caused by KPC/VIM producers and 30.0% (30/100) of BSIs caused by CTX-M producers. After notification of results, the IDCT modified antimicrobial therapy (mean time from BC collection: 20 h) such that the proportion of appropriate treatments increased to 84.8% (128/151) of BSIs, namely 70.6% (36/51) of BSIs caused by KPC/VIM producers and 92.0% (92/100) of BSIs caused by CTX-M producers.Conclusion: Our study shows that a rapid diagnostic-driven clinical strategy allowed for early prescription of potentially effective antimicrobial therapy in BSIs caused by CTX-M ESBL- and/or KPC/VIM carbapenemase-producing Ec and Kp organisms.Keywords: Escherichia coli, Klebsiella pneumoniae, bloodstream infection, drug resistance, targeted therapy, infectious disease consultation

Published
2019

8. Performance evaluation of the (1,3)-β-D-glucan detection assay in non-intensive care unit adult patients

Author

Murri R, Camici M, Posteraro B, Giovannenze F, Taccari F, Ventura G, Scoppettuolo G, Sanguinetti M, Cauda R, and Fantoni M

Subjects
beta-glucan, candidemia, Candida, bloodstream infections, antimicrobial stewardship, diagnostic biomarkers, Infectious and parasitic diseases, RC109-216
Abstract

Rita Murri,1 Marta Camici,1 Brunella Posteraro,2 Francesca Giovannenze,1 Francesco Taccari,1 Giulio Ventura,1 Giancarlo Scoppettuolo,1 Maurizio Sanguinetti,3 Roberto Cauda,1 Massimo Fantoni1 1Institute of Infectious Diseases, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy; 2Institute of Medical Pathology and Semeiotics, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy; 3Institute of Microbiology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy Objectives: To assess the performance of the (1,3)-β-D-glucan (BDG) detection assay in a large cohort of patients with suspected candidemia who were admitted to non-intensive care unit hospital wards. Methods: This observational, retrospective cohort study was conducted in a 1,100-bed university hospital in Rome, where an infectious disease consultation team has been operational. Two groups of patients were included in the analysis: Group 1, patients with Candida bloodstream infection (BSI) who had at least one BDG test performed ±48 hours from the first positive blood culture (Candida BSI Group) and Group 2, patients with risk factors for candidemia who had at least one BDG test but had negative blood cultures (Control Group). Both Group 1 and Group 2 did not receive prior antifungal therapy. Different BDG cutoff values were considered: 80, 200, 300, 400, and ≥500 pg/mL. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under the receiver operating characteristic curve were calculated. Results: A total of 1,296 patients were studied. Of them, 100 patients (candidemic) were in Group 1 and the remaining 1,196 patients (controls) were in Group 2. There were no differences in demographic characteristics between patients of the two groups. According to the above cutoff values, sensitivity (%) and specificity (%) of the BDG assay ranged from 91 to 60.7 and 87.7 to 97.8, respectively, whereas the PPV (%) and NPV (%) ranged from 38.2 to 68.3 and 99.1 to 97.0, respectively. Conclusion: Serum BDG has a very high NPV in a population with~10% prevalence of candidemia. This NPV may support decisions to discontinue antifungal therapy in those patients who were empirically treated because of the suspect of candidemia. Keywords: β-glucan, candidemia, Candida, bloodstream infections, antimicrobial stewardship, diagnostic biomarkers

Published
2018

11. Vehicular Visible Light Communication for Intersection Management

Author

Fantoni, M. A. Vieira, M. Vieira, P. Louro, and P. Vieira

Subjects
vehicular communication, split intersection, vehicle pose connectivity, vehicular visible light communication (V-VLC), white LEDs, SiC photodetectors, OOK modulation scheme, traffic control
Abstract

An innovative treatment for congested urban road networks is the split intersection. Here, a congested two-way–two-way traffic light-controlled intersection is transformed into two lighter intersections. By reducing conflict points and improving travel time, it facilitates smoother flow with less driver delay. We propose a visible light communication system based on Vehicle-to-Vehicle (V2V), Vehicle-to-Infrastructure (V2I) and Infrastructure-to-Vehicle (I2V) communications able to safely manage vehicles crossing through an intersection, leveraging Edge of Things (EoT) facilities. Headlights, street lamps, and traffic signals are used by connected vehicles to communicate with one another and with infrastructure. Through internally installed Driver Agents, an Intersection Manager coordinates traffic flow and interacts with vehicles. For the safe passage of vehicles across intersections, request/response mechanisms and time and space relative pose concepts are used. A virtual scenario is proposed, and a “mesh/cellular” hybrid architecture used. Light signals are emitted by transmitters by encoding, modulating, and converting data. Optical sensors with light-filtering properties are used as receivers and decoders. The VLC request/response concept uplink and downlink communication between the infrastructure and the vehicles is tested. Based on the results, the short-range mesh network provides a secure communication path between street lamp controllers and edge computers through neighbor traffic light controllers that have active cellular connections, as well as peer-to-peer communication, allowing V-VLC ready cars to exchange information.

Published
2023
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13. Two years later: Is the SARS-CoV-2 pandemic still having an impact on emergency surgery? An international cross-sectional survey among WSES members

Author

Reichert, M, Sartelli, M, Weigand, M, Hecker, M, Oppelt, P, Noll, J, Askevold, I, Liese, J, Padberg, W, Coccolini, F, Catena, F, Hecker, A, Peckham-Cooper, A, Camacho-Ortiz, A, Mastoraki, A, Landaluce-Olavarria, A, Pal, A, Kuriyama, A, Chichom-Mefire, A, Porcu, A, Martinez-Perez, A, Karamarkovic, A, Osipov, A, Coppola, A, Cucchetti, A, Spolini, A, Giordano, A, Reinisch-Liese, A, Kavalakat, A, Vasilescu, A, Alamin, A, Gupta, A, Dascalu, A, Musina, A, Bakopoulos, A, Zakaria, A, Vereczkei, A, Balla, A, Bottari, A, Baumann, A, Fette, A, Litvin, A, Reichert, A, Guariniello, A, Paspala, A, Schneck, A, Brillantino, A, Pesce, A, Isik, A, Leppaniemi, A, Papadopoulos, A, Kechagias, A, Mohamed, A, Mitul, A, Marinis, A, Syllaios, A, Mantoglu, B, De Simone, B, Weiss, B, Posentrup, B, Picardi, B, Zampogna, B, Sakakushev, B, Atanasov, B, Nardo, B, Calik, B, Cremonini, C, Ordonez, C, Seretis, C, Cascone, C, Chouliaras, C, Bendinelli, C, Lopes, C, Guerci, C, Weber, C, Nastos, C, Mesina, C, Caputo, D, Massalou, D, Cavaliere, D, Mcnamara, D, Demetriades, D, Pantalone, D, Coletta, D, Sasia, D, Visconti, D, Weber, D, Corallino, D, Chatzipetris, D, Manatakis, D, Ntourakis, D, Papaconstantinou, D, Schizas, D, Chrysikos, D, Adamovich, D, Elkafrawy, D, Seban, D, Garcia, E, Baldini, E, Picetti, E, Tan, E, Baili, E, Lostoridis, E, Toma, E, Colak, E, Cerutti, E, Steyn, E, Hsabo, E, Kapetanakis, E, Kaouras, E, Schneck, E, Akin, E, Gonullu, E, Celik, E, Cicuttin, E, Pinotti, E, Johnsson, E, Moore, E, Agastra, E, Dimitrov, E, Griffiths, E, D'Acapito, F, Saraceno, F, Alconchel, F, Zeppernick, F, Rodriguez, F, Abu-Zidan, F, Pecchini, F, Favi, F, Ferrara, F, Fleres, F, Pata, F, Roscio, F, Mulita, F, Dor, F, Linder, F, Dimofte, G, Rodrigues, G, Nita, G, Sganga, G, Martines, G, Mazzarella, G, Perrone, G, Velmahos, G, Lianos, G, Tomadze, G, Baiocchi, G, D'Ambrosio, G, Pellino, G, Pattacini, G, Giraudo, G, Lisi, G, Tebala, G, Pirozzolo, G, Montori, G, Argenio, G, Brisinda, G, Curro, G, Giuliani, G, Palomba, G, Roscitano, G, Avsar, G, Augustin, G, Clarizia, G, Vega, G, Fraga, G, Sethi, H, Eltyeb, H, Lohse, H, Bayhan, H, Hamid, H, Kryvoruchko, I, Iannone, I, Wani, I, Lazaridis, I, Katsaros, I, Nikolopoulos, I, Negoi, I, Reccia, I, Di Carlo, I, Olaoye, I, Czepiel, J, Kim, J, Meyer, J, Terrazas, J, Tochie, J, Galante, J, Davies, J, Sugand, K, Gonfa, K, Rasa, K, Kok, K, Apostolou, K, Lasithiotakis, K, Tsekouras, K, Angamuthu, K, Akhmeteli, L, Sydorchuk, L, Fortuna, L, Siragusa, L, Pagani, L, Solaini, L, Miller, L, Bains, L, Ansaloni, L, Ferrario, L, Bonavina, L, Conti, L, Buonomo, L, Tallon-Aguilar, L, Tomczyk, L, Widmer, L, Waledziak, M, Gachabayov, M, Bulanauca, M, Malbrain, M, Maegele, M, Catarci, M, Ceresoli, M, Ranucci, M, Antonopoulou, M, Papadoliopoulou, M, Valenti, M, Sotiropoulou, M, D'Oria, M, Martin, M, Hirschburger, M, Veroux, M, Fantoni, M, Nardi, M, Tolonen, M, Montuori, M, Podda, M, Scheiterle, M, Frountzas, M, Sarikaya, M, Yildirim, M, Bender, M, Vailas, M, Teuben, M, Campanelli, M, Ammendola, M, Malerba, M, Pisano, M, Pertea, M, Slavchev, M, Ukkonen, M, Bala, M, Chirica, M, Barone, M, Shaat, M, Mohammed, M, Abuelgasim, M, Gureh, M, Ouadii, M, Balkan, M, Mohamed, M, Hakseven, M, Velenciuc, N, Cillara, N, De'Angelis, N, Tamini, N, Zavras, N, Machairas, N, Michalopoulos, N, Koliakos, N, Pararas, N, Donlon, N, Medappil, N, Ben-Ishay, O, Stefano, O, Islam, O, Tammo, O, Ioannidis, O, Aparicio, O, Baraket, O, Kumar, P, Cianci, P, Ortenwall, P, Uchikov, P, de Reuver, P, Stahel, P, Barie, P, Piccoli, M, Major, P, Navsaria, P, Sasmal, P, Coimbra, R, Rahim, R, Capoglu, R, Koshy, R, Gonsaga, R, Pertile, R, Mohamed, R, Deryol, R, Sawyer, R, Angelico, R, Ragozzino, R, Bini, R, Cammarata, R, Scaramuzzo, R, Gioco, R, Sydorchuk, R, Ahmed, S, Di Saverio, S, Emile, S, Delibegovic, S, Marwah, S, Symeonidis, S, Thomas, S, Demir, S, Awad, S, Atici, S, Chooklin, S, Meric, S, Sarikaya, S, Chowdhury, S, Mirghani, S, Wren, S, Gargarella, S, Del Monte, S, Esposito, S, Xenaki, S, Mohamed, S, Beka, S, Lunca, S, Delis, S, Dritsas, S, Morarasu, S, Magnone, S, Rossi, S, Bitsianis, S, Kykalos, S, Baral, S, Jain, S, Ali, S, Pintar, T, Triantafyllou, T, Delko, T, Perra, T, Sidiropoulos, T, Scalea, T, Vilz, T, Hardcastle, T, Wannatoop, T, Herzog, T, Mishra, T, Boggi, U, Calu, V, Tomajer, V, Agnoletti, V, Lohsiriwat, V, Kong, V, Munoz-Cruzado, V, Shelat, V, Khokha, V, Ghannam, W, Biffl, W, Zuidema, W, Kara, Y, Kobe, Y, Demetrashvili, Z, Memish, Z, Madrazo, Z, Balogh, Z, Bayhan, Z, Reichert M., Sartelli M., Weigand M. A., Hecker M., Oppelt P. U., Noll J., Askevold I. H., Liese J., Padberg W., Coccolini F., Catena F., Hecker A., Peckham-Cooper A., Camacho-Ortiz A., Mastoraki A. T., Landaluce-Olavarria A., Pal A. K., Kuriyama A., Chichom-Mefire A., Porcu A., Martinez-Perez A., Karamarkovic A. R., Osipov A. V., Coppola A., Cucchetti A., Spolini A., Giordano A., Reinisch-Liese A., Kavalakat A. J., Vasilescu A., Alamin A., Gupta A., Dascalu A. M., Musina A. -M., Bakopoulos A., Zakaria A. D., Vereczkei A., Balla A., Bottari A., Baumann A., Fette A., Litvin A., Reichert A. K., Guariniello A., Paspala A., Schneck A. -S., Brillantino A., Pesce A., Isik A., Leppaniemi A. K., Papadopoulos A., Kechagias A., Mohamed A. Y. A., Mitul A. R., Marinis A., Syllaios A., Mantoglu B., De Simone B., Weiss B. S., Posentrup B., Picardi B., Zampogna B., Sakakushev B. E., Atanasov B. C., Nardo B., Calik B., Cremonini C., Ordonez C. A., Seretis C., Cascone C., Chouliaras C., Bendinelli C., Lopes C., Guerci C., Weber C., Nastos C., Mesina C., Caputo D., Massalou D., Cavaliere D., McNamara D. A., Demetriades D., Pantalone D., Coletta D., Sasia D., Visconti D., Weber D. G., Corallino D., Chatzipetris D., Manatakis D. K., Ntourakis D., Papaconstantinou D., Schizas D., Chrysikos D., Adamovich D. M., Elkafrawy D., Seban D., Garcia E. F. H., Baldini E., Picetti E., Tan E. C. T. H., Baili E., Lostoridis E., Toma E. A., Colak E., Cerutti E., Steyn E., Hsabo E. A., Kapetanakis E. I., Kaouras E., Schneck E., Akin E., Gonullu E., celik E., Cicuttin E., Pinotti E., Johnsson E., Moore E. E., Agastra E., Dimitrov E. N., Griffiths E. A., D'Acapito F., Saraceno F., Alconchel F., Zeppernick F. A., Rodriguez F. M., Abu-Zidan F., Pecchini F., Favi F., Ferrara F., Fleres F., Pata F., Roscio F. P. M., Mulita F., Dor F. J. M. F., Linder F., Dimofte G., Rodrigues G., Nita G., Sganga G., Martines G., Mazzarella G., Perrone G., Velmahos G., Lianos G. D., Tomadze G., Baiocchi G. L., D'Ambrosio G., Pellino G., Pattacini G. C., Giraudo G., Lisi G., Tebala G. D., Pirozzolo G., Montori G., Argenio G., Brisinda G., Curro G., Giuliani G., Palomba G., Roscitano G., Avsar G., Augustin G., Clarizia G., Vega G. M. M., Fraga G. P., Sethi H., Eltyeb H. A., Lohse H. A. S., Lohse H. R. S., Bayhan H., Hamid H. K. S., Kryvoruchko I. A., Iannone I., Wani I., Lazaridis I. I., Katsaros I., Nikolopoulos I., Negoi I., Reccia I., Di Carlo I., Olaoye I. O., Czepiel J., Kim J. I., Meyer J., Terrazas J. M. S., Tochie J. N., Galante J. M., Davies J., Sugand K., Gonfa K. B., Rasa K., Kok K. Y. Y., Apostolou K. G., Lasithiotakis K., Tsekouras K., Angamuthu K., Akhmeteli L., Sydorchuk L., Fortuna L., Siragusa L., Pagani L., Solaini L., Miller L. A., Bains L., Ansaloni L., Ferrario L., Bonavina L., Conti L., Buonomo L. A., Tallon-Aguilar L., Tomczyk L., Widmer L. W., Waledziak M., Gachabayov M., Bulanauca M. M., Malbrain M. L. N. G., Maegele M., Catarci M., Ceresoli M., Ranucci M. C., Antonopoulou M. I., Papadoliopoulou M., Valenti M. R., Sotiropoulou M., D'Oria M., Martin M. S., Hirschburger M., Veroux M., Fantoni M., Nardi M., Tolonen M., Montuori M., Podda M., Scheiterle M., Frountzas M., Sarikaya M., Yildirim M., Bender M., Vailas M., Teuben M., Campanelli M., Ammendola M., Malerba M., Pisano M., Pertea M., Slavchev M., Ukkonen M., Bala M., Chirica M., Barone M., Shaat M. M., Mohammed M. J. S., Abuelgasim M. A. A., Gureh M., Ouadii M., Balkan M., Mohamed M., Hakseven M., Velenciuc N., Cillara N., de'Angelis N., Tamini N., Zavras N. J., Machairas N., Michalopoulos N., Koliakos N. N., Pararas N., Donlon N. E., Medappil N., Ben-Ishay O., Stefano O., Islam O., Tammo O., Ioannidis O., Aparicio O., Baraket O., Kumar P., Cianci P., Ortenwall P., Uchikov P. A., de Reuver P., Stahel P. F., Barie P. S., Piccoli M., Major P., Navsaria P. H., Sasmal P. K., Coimbra R., Rahim R., Capoglu R., Koshy R. M., Gonsaga R. A. T., Pertile R., Mohamed R. R. M., Deryol R., Sawyer R. G., Angelico R., Ragozzino R., Bini R., Cammarata R., Scaramuzzo R., Gioco R., Sydorchuk R., Ahmed S., Di Saverio S., Emile S. H., Delibegovic S., Marwah S., Symeonidis S., Thomas S. G., Demir S., Awad S. S., Atici S. D., Chooklin S., Meric S., Sarikaya S., Chowdhury S., Mirghani S. F., Wren S. M., Gargarella S., Del Monte S. R., Esposito S., Xenaki S., Mohamed S. F. G., Beka S. G., Lunca S., Delis S. G., Dritsas S., Morarasu S., Magnone S., Rossi S., Bitsianis S., Kykalos S., Baral S., Jain S. A., Ali S. M., Pintar T., Triantafyllou T., Delko T., Perra T., Sidiropoulos T. A., Scalea T. M., Vilz T. O., Hardcastle T. C., Wannatoop T., Herzog T., Mishra T. S., Boggi U., Calu V., Tomajer V., Agnoletti V., Lohsiriwat V., Kong V., Munoz-Cruzado V. D., Shelat V. G., Khokha V., Ghannam W. M., Biffl W. L., Zuidema W., Kara Y., Kobe Y., Demetrashvili Z., Memish Z. A., Madrazo Z., Balogh Z. J., Bayhan Z., Reichert, M, Sartelli, M, Weigand, M, Hecker, M, Oppelt, P, Noll, J, Askevold, I, Liese, J, Padberg, W, Coccolini, F, Catena, F, Hecker, A, Peckham-Cooper, A, Camacho-Ortiz, A, Mastoraki, A, Landaluce-Olavarria, A, Pal, A, Kuriyama, A, Chichom-Mefire, A, Porcu, A, Martinez-Perez, A, Karamarkovic, A, Osipov, A, Coppola, A, Cucchetti, A, Spolini, A, Giordano, A, Reinisch-Liese, A, Kavalakat, A, Vasilescu, A, Alamin, A, Gupta, A, Dascalu, A, Musina, A, Bakopoulos, A, Zakaria, A, Vereczkei, A, Balla, A, Bottari, A, Baumann, A, Fette, A, Litvin, A, Reichert, A, Guariniello, A, Paspala, A, Schneck, A, Brillantino, A, Pesce, A, Isik, A, Leppaniemi, A, Papadopoulos, A, Kechagias, A, Mohamed, A, Mitul, A, Marinis, A, Syllaios, A, Mantoglu, B, De Simone, B, Weiss, B, Posentrup, B, Picardi, B, Zampogna, B, Sakakushev, B, Atanasov, B, Nardo, B, Calik, B, Cremonini, C, Ordonez, C, Seretis, C, Cascone, C, Chouliaras, C, Bendinelli, C, Lopes, C, Guerci, C, Weber, C, Nastos, C, Mesina, C, Caputo, D, Massalou, D, Cavaliere, D, Mcnamara, D, Demetriades, D, Pantalone, D, Coletta, D, Sasia, D, Visconti, D, Weber, D, Corallino, D, Chatzipetris, D, Manatakis, D, Ntourakis, D, Papaconstantinou, D, Schizas, D, Chrysikos, D, Adamovich, D, Elkafrawy, D, Seban, D, Garcia, E, Baldini, E, Picetti, E, Tan, E, Baili, E, Lostoridis, E, Toma, E, Colak, E, Cerutti, E, Steyn, E, Hsabo, E, Kapetanakis, E, Kaouras, E, Schneck, E, Akin, E, Gonullu, E, Celik, E, Cicuttin, E, Pinotti, E, Johnsson, E, Moore, E, Agastra, E, Dimitrov, E, Griffiths, E, D'Acapito, F, Saraceno, F, Alconchel, F, Zeppernick, F, Rodriguez, F, Abu-Zidan, F, Pecchini, F, Favi, F, Ferrara, F, Fleres, F, Pata, F, Roscio, F, Mulita, F, Dor, F, Linder, F, Dimofte, G, Rodrigues, G, Nita, G, Sganga, G, Martines, G, Mazzarella, G, Perrone, G, Velmahos, G, Lianos, G, Tomadze, G, Baiocchi, G, D'Ambrosio, G, Pellino, G, Pattacini, G, Giraudo, G, Lisi, G, Tebala, G, Pirozzolo, G, Montori, G, Argenio, G, Brisinda, G, Curro, G, Giuliani, G, Palomba, G, Roscitano, G, Avsar, G, Augustin, G, Clarizia, G, Vega, G, Fraga, G, Sethi, H, Eltyeb, H, Lohse, H, Bayhan, H, Hamid, H, Kryvoruchko, I, Iannone, I, Wani, I, Lazaridis, I, Katsaros, I, Nikolopoulos, I, Negoi, I, Reccia, I, Di Carlo, I, Olaoye, I, Czepiel, J, Kim, J, Meyer, J, Terrazas, J, Tochie, J, Galante, J, Davies, J, Sugand, K, Gonfa, K, Rasa, K, Kok, K, Apostolou, K, Lasithiotakis, K, Tsekouras, K, Angamuthu, K, Akhmeteli, L, Sydorchuk, L, Fortuna, L, Siragusa, L, Pagani, L, Solaini, L, Miller, L, Bains, L, Ansaloni, L, Ferrario, L, Bonavina, L, Conti, L, Buonomo, L, Tallon-Aguilar, L, Tomczyk, L, Widmer, L, Waledziak, M, Gachabayov, M, Bulanauca, M, Malbrain, M, Maegele, M, Catarci, M, Ceresoli, M, Ranucci, M, Antonopoulou, M, Papadoliopoulou, M, Valenti, M, Sotiropoulou, M, D'Oria, M, Martin, M, Hirschburger, M, Veroux, M, Fantoni, M, Nardi, M, Tolonen, M, Montuori, M, Podda, M, Scheiterle, M, Frountzas, M, Sarikaya, M, Yildirim, M, Bender, M, Vailas, M, Teuben, M, Campanelli, M, Ammendola, M, Malerba, M, Pisano, M, Pertea, M, Slavchev, M, Ukkonen, M, Bala, M, Chirica, M, Barone, M, Shaat, M, Mohammed, M, Abuelgasim, M, Gureh, M, Ouadii, M, Balkan, M, Mohamed, M, Hakseven, M, Velenciuc, N, Cillara, N, De'Angelis, N, Tamini, N, Zavras, N, Machairas, N, Michalopoulos, N, Koliakos, N, Pararas, N, Donlon, N, Medappil, N, Ben-Ishay, O, Stefano, O, Islam, O, Tammo, O, Ioannidis, O, Aparicio, O, Baraket, O, Kumar, P, Cianci, P, Ortenwall, P, Uchikov, P, de Reuver, P, Stahel, P, Barie, P, Piccoli, M, Major, P, Navsaria, P, Sasmal, P, Coimbra, R, Rahim, R, Capoglu, R, Koshy, R, Gonsaga, R, Pertile, R, Mohamed, R, Deryol, R, Sawyer, R, Angelico, R, Ragozzino, R, Bini, R, Cammarata, R, Scaramuzzo, R, Gioco, R, Sydorchuk, R, Ahmed, S, Di Saverio, S, Emile, S, Delibegovic, S, Marwah, S, Symeonidis, S, Thomas, S, Demir, S, Awad, S, Atici, S, Chooklin, S, Meric, S, Sarikaya, S, Chowdhury, S, Mirghani, S, Wren, S, Gargarella, S, Del Monte, S, Esposito, S, Xenaki, S, Mohamed, S, Beka, S, Lunca, S, Delis, S, Dritsas, S, Morarasu, S, Magnone, S, Rossi, S, Bitsianis, S, Kykalos, S, Baral, S, Jain, S, Ali, S, Pintar, T, Triantafyllou, T, Delko, T, Perra, T, Sidiropoulos, T, Scalea, T, Vilz, T, Hardcastle, T, Wannatoop, T, Herzog, T, Mishra, T, Boggi, U, Calu, V, Tomajer, V, Agnoletti, V, Lohsiriwat, V, Kong, V, Munoz-Cruzado, V, Shelat, V, Khokha, V, Ghannam, W, Biffl, W, Zuidema, W, Kara, Y, Kobe, Y, Demetrashvili, Z, Memish, Z, Madrazo, Z, Balogh, Z, Bayhan, Z, Reichert M., Sartelli M., Weigand M. A., Hecker M., Oppelt P. U., Noll J., Askevold I. H., Liese J., Padberg W., Coccolini F., Catena F., Hecker A., Peckham-Cooper A., Camacho-Ortiz A., Mastoraki A. T., Landaluce-Olavarria A., Pal A. K., Kuriyama A., Chichom-Mefire A., Porcu A., Martinez-Perez A., Karamarkovic A. R., Osipov A. V., Coppola A., Cucchetti A., Spolini A., Giordano A., Reinisch-Liese A., Kavalakat A. J., Vasilescu A., Alamin A., Gupta A., Dascalu A. M., Musina A. -M., Bakopoulos A., Zakaria A. D., Vereczkei A., Balla A., Bottari A., Baumann A., Fette A., Litvin A., Reichert A. K., Guariniello A., Paspala A., Schneck A. -S., Brillantino A., Pesce A., Isik A., Leppaniemi A. K., Papadopoulos A., Kechagias A., Mohamed A. Y. A., Mitul A. R., Marinis A., Syllaios A., Mantoglu B., De Simone B., Weiss B. S., Posentrup B., Picardi B., Zampogna B., Sakakushev B. E., Atanasov B. C., Nardo B., Calik B., Cremonini C., Ordonez C. A., Seretis C., Cascone C., Chouliaras C., Bendinelli C., Lopes C., Guerci C., Weber C., Nastos C., Mesina C., Caputo D., Massalou D., Cavaliere D., McNamara D. A., Demetriades D., Pantalone D., Coletta D., Sasia D., Visconti D., Weber D. G., Corallino D., Chatzipetris D., Manatakis D. K., Ntourakis D., Papaconstantinou D., Schizas D., Chrysikos D., Adamovich D. M., Elkafrawy D., Seban D., Garcia E. F. H., Baldini E., Picetti E., Tan E. C. T. H., Baili E., Lostoridis E., Toma E. A., Colak E., Cerutti E., Steyn E., Hsabo E. A., Kapetanakis E. I., Kaouras E., Schneck E., Akin E., Gonullu E., celik E., Cicuttin E., Pinotti E., Johnsson E., Moore E. E., Agastra E., Dimitrov E. N., Griffiths E. A., D'Acapito F., Saraceno F., Alconchel F., Zeppernick F. A., Rodriguez F. M., Abu-Zidan F., Pecchini F., Favi F., Ferrara F., Fleres F., Pata F., Roscio F. P. M., Mulita F., Dor F. J. M. F., Linder F., Dimofte G., Rodrigues G., Nita G., Sganga G., Martines G., Mazzarella G., Perrone G., Velmahos G., Lianos G. D., Tomadze G., Baiocchi G. L., D'Ambrosio G., Pellino G., Pattacini G. C., Giraudo G., Lisi G., Tebala G. D., Pirozzolo G., Montori G., Argenio G., Brisinda G., Curro G., Giuliani G., Palomba G., Roscitano G., Avsar G., Augustin G., Clarizia G., Vega G. M. M., Fraga G. P., Sethi H., Eltyeb H. A., Lohse H. A. S., Lohse H. R. S., Bayhan H., Hamid H. K. S., Kryvoruchko I. A., Iannone I., Wani I., Lazaridis I. I., Katsaros I., Nikolopoulos I., Negoi I., Reccia I., Di Carlo I., Olaoye I. O., Czepiel J., Kim J. I., Meyer J., Terrazas J. M. S., Tochie J. N., Galante J. M., Davies J., Sugand K., Gonfa K. B., Rasa K., Kok K. Y. Y., Apostolou K. G., Lasithiotakis K., Tsekouras K., Angamuthu K., Akhmeteli L., Sydorchuk L., Fortuna L., Siragusa L., Pagani L., Solaini L., Miller L. A., Bains L., Ansaloni L., Ferrario L., Bonavina L., Conti L., Buonomo L. A., Tallon-Aguilar L., Tomczyk L., Widmer L. W., Waledziak M., Gachabayov M., Bulanauca M. M., Malbrain M. L. N. G., Maegele M., Catarci M., Ceresoli M., Ranucci M. C., Antonopoulou M. I., Papadoliopoulou M., Valenti M. R., Sotiropoulou M., D'Oria M., Martin M. S., Hirschburger M., Veroux M., Fantoni M., Nardi M., Tolonen M., Montuori M., Podda M., Scheiterle M., Frountzas M., Sarikaya M., Yildirim M., Bender M., Vailas M., Teuben M., Campanelli M., Ammendola M., Malerba M., Pisano M., Pertea M., Slavchev M., Ukkonen M., Bala M., Chirica M., Barone M., Shaat M. M., Mohammed M. J. S., Abuelgasim M. A. A., Gureh M., Ouadii M., Balkan M., Mohamed M., Hakseven M., Velenciuc N., Cillara N., de'Angelis N., Tamini N., Zavras N. J., Machairas N., Michalopoulos N., Koliakos N. N., Pararas N., Donlon N. E., Medappil N., Ben-Ishay O., Stefano O., Islam O., Tammo O., Ioannidis O., Aparicio O., Baraket O., Kumar P., Cianci P., Ortenwall P., Uchikov P. A., de Reuver P., Stahel P. F., Barie P. S., Piccoli M., Major P., Navsaria P. H., Sasmal P. K., Coimbra R., Rahim R., Capoglu R., Koshy R. M., Gonsaga R. A. T., Pertile R., Mohamed R. R. M., Deryol R., Sawyer R. G., Angelico R., Ragozzino R., Bini R., Cammarata R., Scaramuzzo R., Gioco R., Sydorchuk R., Ahmed S., Di Saverio S., Emile S. H., Delibegovic S., Marwah S., Symeonidis S., Thomas S. G., Demir S., Awad S. S., Atici S. D., Chooklin S., Meric S., Sarikaya S., Chowdhury S., Mirghani S. F., Wren S. M., Gargarella S., Del Monte S. R., Esposito S., Xenaki S., Mohamed S. F. G., Beka S. G., Lunca S., Delis S. G., Dritsas S., Morarasu S., Magnone S., Rossi S., Bitsianis S., Kykalos S., Baral S., Jain S. A., Ali S. M., Pintar T., Triantafyllou T., Delko T., Perra T., Sidiropoulos T. A., Scalea T. M., Vilz T. O., Hardcastle T. C., Wannatoop T., Herzog T., Mishra T. S., Boggi U., Calu V., Tomajer V., Agnoletti V., Lohsiriwat V., Kong V., Munoz-Cruzado V. D., Shelat V. G., Khokha V., Ghannam W. M., Biffl W. L., Zuidema W., Kara Y., Kobe Y., Demetrashvili Z., Memish Z. A., Madrazo Z., Balogh Z. J., and Bayhan Z.

Abstract

Background: The SARS-CoV-2 pandemic is still ongoing and a major challenge for health care services worldwide. In the first WSES COVID-19 emergency surgery survey, a strong negative impact on emergency surgery (ES) had been described already early in the pandemic situation. However, the knowledge is limited about current effects of the pandemic on patient flow through emergency rooms, daily routine and decision making in ES as well as their changes over time during the last two pandemic years. This second WSES COVID-19 emergency surgery survey investigates the impact of the SARS-CoV-2 pandemic on ES during the course of the pandemic. Methods: A web survey had been distributed to medical specialists in ES during a four-week period from January 2022, investigating the impact of the pandemic on patients and septic diseases both requiring ES, structural problems due to the pandemic and time-to-intervention in ES routine. Results: 367 collaborators from 59 countries responded to the survey. The majority indicated that the pandemic still significantly impacts on treatment and outcome of surgical emergency patients (83.1% and 78.5%, respectively). As reasons, the collaborators reported decreased case load in ES (44.7%), but patients presenting with more prolonged and severe diseases, especially concerning perforated appendicitis (62.1%) and diverticulitis (57.5%). Otherwise, approximately 50% of the participants still observe a delay in time-to-intervention in ES compared with the situation before the pandemic. Relevant causes leading to enlarged time-to-intervention in ES during the pandemic are persistent problems with in-hospital logistics, lacks in medical staff as well as operating room and intensive care capacities during the pandemic. This leads not only to the need for triage or transferring of ES patients to other hospitals, reported by 64.0% and 48.8% of the collaborators, respectively, but also to paradigm shifts in treatment modalities to non-operative approach

Published
2022

14. It is time to define an organizational model for the prevention and management of infections along the surgical pathway: a worldwide cross-sectional survey

Author

Sartelli, M, Labricciosa, F, Coccolini, F, Coimbra, R, Abu-Zidan, F, Ansaloni, L, Al-Hasan, M, Ansari, S, Barie, P, Cainzos, M, Ceresoli, M, Chiarugi, M, Claridge, J, Cicuttin, E, Dellinger, E, Fry, D, Guirao, X, Hardcastle, T, Hecker, A, Leppaniemi, A, Litvin, A, Marwah, S, Maseda, E, Mazuski, J, Memish, Z, Kirkpatrick, A, Pagani, L, Podda, M, Rasa, H, Sakakushev, B, Sawyer, R, Tumietto, F, Xiao, Y, Aboubreeg, W, Adamou, H, Akhmeteli, L, Akin, E, Alberio, M, Alconchel, F, Magagi, I, Arauz, A, Argenio, G, Atanasov, B, Atici, S, Awad, S, Baili, E, Bains, L, Bala, M, Baraket, O, Baral, S, Belskii, V, Benboubker, M, Ben-Ishay, O, Bordoni, P, Boumediene, A, Brisinda, G, Cavazzuti, L, Chandy, S, Chiarello, M, Cillara, N, Clarizia, G, Cocuz, M, Cocuz, I, Conti, L, Coppola, R, Cui, Y, Czepiel, J, D'Acapito, F, Damaskos, D, Das, K, De Simone, B, Delibegovic, S, Demetrashvili, Z, Detanac, D, Dhingra, S, Di Bella, S, Dimitrov, E, Dogjani, A, D'Oria, M, Dumitru, I, Elmangory, M, Enciu, O, Fantoni, M, Filipescu, D, Fleres, F, Foghetti, D, Fransvea, P, Gachabayov, M, Galeiras, R, Gattuso, G, Ghannam, W, Ghisetti, V, Giraudo, G, Gonfa, K, Gonullu, E, Hamad, Y, Hecker, M, Isik, A, Ismail, N, Ismail, A, Jain, S, Kanj, S, Kapoor, G, Karaiskos, I, Kavalakat, A, Kenig, J, Khamis, F, Khokha, V, Kiguba, R, Kim, J, Kobe, Y, Kok, K, Kovacevic, B, Kryvoruchko, I, Kuriyama, A, Landaluce-Olavarria, A, Lasithiotakis, K, Lohsiriwat, V, Lostoridis, E, Luppi, D, Vega, G, Maegele, M, Marinis, A, Martines, G, Martinez-Perez, A, Massalou, D, Mesina, C, Metan, G, Miranda-Novales, M, Mishra, S, Mohamed, M, Mohamedahmed, A, Mora-Guzman, I, Mulita, F, Musina, A, Navsaria, P, Negoi, I, Nita, G, O'Connor, D, Ordonez, C, Pantalone, D, Panyko, A, Papadopoulos, A, Pararas, N, Pata, F, Patel, T, Pellino, G, Perra, T, Perrone, G, Pesce, A, Pintar, T, Popivanov, G, Porcu, A, Quiodettis, M, Rahim, R, Mitul, A, Reichert, M, Rems, M, Campbell, G, Rocha-Pereira, N, Rodrigues, G, Villamil, G, Rossi, S, Sall, I, Kafil, H, Sasia, D, Seni, J, Seretis, C, Serradilla-Martin, M, Shelat, V, Siribumrungwong, B, Slavchev, M, Solaini, L, Tan, B, Tarasconi, A, Tartaglia, D, Toma, E, Tomadze, G, Toro, A, Tovani-Palone, M, van Goor, H, Vasilescu, A, Vereczkei, A, Veroux, M, Weckmann, S, Widmer, L, Yahya, A, Zachariah, S, Zakaria, A, Zubareva, N, Zuidema, W, Di Carlo, I, Cortese, F, Baiocchi, G, Maier, R, Catena, F, Sartelli M., Labricciosa F. M., Coccolini F., Coimbra R., Abu-Zidan F. M., Ansaloni L., Al-Hasan M. N., Ansari S., Barie P. S., Cainzos M. A., Ceresoli M., Chiarugi M., Claridge J. A., Cicuttin E., Dellinger E. P., Fry D. E., Guirao X., Hardcastle T. C., Hecker A., Leppaniemi A. K., Litvin A., Marwah S., Maseda E., Mazuski J. E., Memish Z. A., Kirkpatrick A. W., Pagani L., Podda M., Rasa H. K., Sakakushev B. E., Sawyer R. G., Tumietto F., Xiao Y., Aboubreeg W. F., Adamou H., Akhmeteli L., Akin E., Alberio M. G., Alconchel F., Magagi I. A., Arauz A. B., Argenio G., Atanasov B. C., Atici S. D., Awad S. S., Baili E., Bains L., Bala M., Baraket O., Baral S., Belskii V. A., Benboubker M., Ben-Ishay O., Bordoni P., Boumediene A., Brisinda G., Cavazzuti L., Chandy S. J., Chiarello M. M., Cillara N., Clarizia G., Cocuz M. -E., Cocuz I. G., Conti L., Coppola R., Cui Y., Czepiel J., D'Acapito F., Damaskos D., Das K., De Simone B., Delibegovic S., Demetrashvili Z., Detanac D. S., Dhingra S., Di Bella S., Dimitrov E. N., Dogjani A., D'Oria M., Dumitru I. M., Elmangory M. M., Enciu O., Fantoni M., Filipescu D., Fleres F., Foghetti D., Fransvea P., Gachabayov M., Galeiras R., Gattuso G., Ghannam W. M., Ghisetti V., Giraudo G., Gonfa K. B., Gonullu E., Hamad Y. T. E. Y., Hecker M., Isik A., Ismail N., Ismail A., Jain S. A., Kanj S. S., Kapoor G., Karaiskos I., Kavalakat A. J., Kenig J., Khamis F., Khokha V., Kiguba R., Kim J. I., Kobe Y., Kok K. Y. Y., Kovacevic B. M., Kryvoruchko I. A., Kuriyama A., Landaluce-Olavarria A., Lasithiotakis K., Lohsiriwat V., Lostoridis E., Luppi D., Vega G. M. M., Maegele M., Marinis A., Martines G., Martinez-Perez A., Massalou D., Mesina C., Metan G., Miranda-Novales M. G., Mishra S. K., Mohamed M. I. H., Mohamedahmed A. Y. Y., Mora-Guzman I., Mulita F., Musina A. -M., Navsaria P. H., Negoi I., Nita G. E., O'Connor D. B., Ordonez C. A., Pantalone D., Panyko A., Papadopoulos A., Pararas N., Pata F., Patel T., Pellino G., Perra T., Perrone G., Pesce A., Pintar T., Popivanov G. I., Porcu A., Quiodettis M. A., Rahim R., Mitul A. R., Reichert M., Rems M., Campbell G. Y. R., Rocha-Pereira N., Rodrigues G., Villamil G. E. R., Rossi S., Sall I., Kafil H. S., Sasia D., Seni J., Seretis C., Serradilla-Martin M., Shelat V. G., Siribumrungwong B., Slavchev M., Solaini L., Tan B. K., Tarasconi A., Tartaglia D., Toma E. A., Tomadze G., Toro A., Tovani-Palone M. R., van Goor H., Vasilescu A., Vereczkei A., Veroux M., Weckmann S. A., Widmer L. W., Yahya A. I., Zachariah S. K., Zakaria A. D., Zubareva N., Zuidema W. P., Di Carlo I., Cortese F., Baiocchi G. L., Maier R. V., Catena F., Sartelli, M, Labricciosa, F, Coccolini, F, Coimbra, R, Abu-Zidan, F, Ansaloni, L, Al-Hasan, M, Ansari, S, Barie, P, Cainzos, M, Ceresoli, M, Chiarugi, M, Claridge, J, Cicuttin, E, Dellinger, E, Fry, D, Guirao, X, Hardcastle, T, Hecker, A, Leppaniemi, A, Litvin, A, Marwah, S, Maseda, E, Mazuski, J, Memish, Z, Kirkpatrick, A, Pagani, L, Podda, M, Rasa, H, Sakakushev, B, Sawyer, R, Tumietto, F, Xiao, Y, Aboubreeg, W, Adamou, H, Akhmeteli, L, Akin, E, Alberio, M, Alconchel, F, Magagi, I, Arauz, A, Argenio, G, Atanasov, B, Atici, S, Awad, S, Baili, E, Bains, L, Bala, M, Baraket, O, Baral, S, Belskii, V, Benboubker, M, Ben-Ishay, O, Bordoni, P, Boumediene, A, Brisinda, G, Cavazzuti, L, Chandy, S, Chiarello, M, Cillara, N, Clarizia, G, Cocuz, M, Cocuz, I, Conti, L, Coppola, R, Cui, Y, Czepiel, J, D'Acapito, F, Damaskos, D, Das, K, De Simone, B, Delibegovic, S, Demetrashvili, Z, Detanac, D, Dhingra, S, Di Bella, S, Dimitrov, E, Dogjani, A, D'Oria, M, Dumitru, I, Elmangory, M, Enciu, O, Fantoni, M, Filipescu, D, Fleres, F, Foghetti, D, Fransvea, P, Gachabayov, M, Galeiras, R, Gattuso, G, Ghannam, W, Ghisetti, V, Giraudo, G, Gonfa, K, Gonullu, E, Hamad, Y, Hecker, M, Isik, A, Ismail, N, Ismail, A, Jain, S, Kanj, S, Kapoor, G, Karaiskos, I, Kavalakat, A, Kenig, J, Khamis, F, Khokha, V, Kiguba, R, Kim, J, Kobe, Y, Kok, K, Kovacevic, B, Kryvoruchko, I, Kuriyama, A, Landaluce-Olavarria, A, Lasithiotakis, K, Lohsiriwat, V, Lostoridis, E, Luppi, D, Vega, G, Maegele, M, Marinis, A, Martines, G, Martinez-Perez, A, Massalou, D, Mesina, C, Metan, G, Miranda-Novales, M, Mishra, S, Mohamed, M, Mohamedahmed, A, Mora-Guzman, I, Mulita, F, Musina, A, Navsaria, P, Negoi, I, Nita, G, O'Connor, D, Ordonez, C, Pantalone, D, Panyko, A, Papadopoulos, A, Pararas, N, Pata, F, Patel, T, Pellino, G, Perra, T, Perrone, G, Pesce, A, Pintar, T, Popivanov, G, Porcu, A, Quiodettis, M, Rahim, R, Mitul, A, Reichert, M, Rems, M, Campbell, G, Rocha-Pereira, N, Rodrigues, G, Villamil, G, Rossi, S, Sall, I, Kafil, H, Sasia, D, Seni, J, Seretis, C, Serradilla-Martin, M, Shelat, V, Siribumrungwong, B, Slavchev, M, Solaini, L, Tan, B, Tarasconi, A, Tartaglia, D, Toma, E, Tomadze, G, Toro, A, Tovani-Palone, M, van Goor, H, Vasilescu, A, Vereczkei, A, Veroux, M, Weckmann, S, Widmer, L, Yahya, A, Zachariah, S, Zakaria, A, Zubareva, N, Zuidema, W, Di Carlo, I, Cortese, F, Baiocchi, G, Maier, R, Catena, F, Sartelli M., Labricciosa F. M., Coccolini F., Coimbra R., Abu-Zidan F. M., Ansaloni L., Al-Hasan M. N., Ansari S., Barie P. S., Cainzos M. A., Ceresoli M., Chiarugi M., Claridge J. A., Cicuttin E., Dellinger E. P., Fry D. E., Guirao X., Hardcastle T. C., Hecker A., Leppaniemi A. K., Litvin A., Marwah S., Maseda E., Mazuski J. E., Memish Z. A., Kirkpatrick A. W., Pagani L., Podda M., Rasa H. K., Sakakushev B. E., Sawyer R. G., Tumietto F., Xiao Y., Aboubreeg W. F., Adamou H., Akhmeteli L., Akin E., Alberio M. G., Alconchel F., Magagi I. A., Arauz A. B., Argenio G., Atanasov B. C., Atici S. D., Awad S. S., Baili E., Bains L., Bala M., Baraket O., Baral S., Belskii V. A., Benboubker M., Ben-Ishay O., Bordoni P., Boumediene A., Brisinda G., Cavazzuti L., Chandy S. J., Chiarello M. M., Cillara N., Clarizia G., Cocuz M. -E., Cocuz I. G., Conti L., Coppola R., Cui Y., Czepiel J., D'Acapito F., Damaskos D., Das K., De Simone B., Delibegovic S., Demetrashvili Z., Detanac D. S., Dhingra S., Di Bella S., Dimitrov E. N., Dogjani A., D'Oria M., Dumitru I. M., Elmangory M. M., Enciu O., Fantoni M., Filipescu D., Fleres F., Foghetti D., Fransvea P., Gachabayov M., Galeiras R., Gattuso G., Ghannam W. M., Ghisetti V., Giraudo G., Gonfa K. B., Gonullu E., Hamad Y. T. E. Y., Hecker M., Isik A., Ismail N., Ismail A., Jain S. A., Kanj S. S., Kapoor G., Karaiskos I., Kavalakat A. J., Kenig J., Khamis F., Khokha V., Kiguba R., Kim J. I., Kobe Y., Kok K. Y. Y., Kovacevic B. M., Kryvoruchko I. A., Kuriyama A., Landaluce-Olavarria A., Lasithiotakis K., Lohsiriwat V., Lostoridis E., Luppi D., Vega G. M. M., Maegele M., Marinis A., Martines G., Martinez-Perez A., Massalou D., Mesina C., Metan G., Miranda-Novales M. G., Mishra S. K., Mohamed M. I. H., Mohamedahmed A. Y. Y., Mora-Guzman I., Mulita F., Musina A. -M., Navsaria P. H., Negoi I., Nita G. E., O'Connor D. B., Ordonez C. A., Pantalone D., Panyko A., Papadopoulos A., Pararas N., Pata F., Patel T., Pellino G., Perra T., Perrone G., Pesce A., Pintar T., Popivanov G. I., Porcu A., Quiodettis M. A., Rahim R., Mitul A. R., Reichert M., Rems M., Campbell G. Y. R., Rocha-Pereira N., Rodrigues G., Villamil G. E. R., Rossi S., Sall I., Kafil H. S., Sasia D., Seni J., Seretis C., Serradilla-Martin M., Shelat V. G., Siribumrungwong B., Slavchev M., Solaini L., Tan B. K., Tarasconi A., Tartaglia D., Toma E. A., Tomadze G., Toro A., Tovani-Palone M. R., van Goor H., Vasilescu A., Vereczkei A., Veroux M., Weckmann S. A., Widmer L. W., Yahya A. I., Zachariah S. K., Zakaria A. D., Zubareva N., Zuidema W. P., Di Carlo I., Cortese F., Baiocchi G. L., Maier R. V., and Catena F.

Abstract

Background: The objectives of the study were to investigate the organizational characteristics of acute care facilities worldwide in preventing and managing infections in surgery; assess participants’ perception regarding infection prevention and control (IPC) measures, antibiotic prescribing practices, and source control; describe awareness about the global burden of antimicrobial resistance (AMR) and IPC measures; and determine the role of the Coronavirus Disease 2019 pandemic on said awareness. Methods: A cross-sectional web-based survey was conducted contacting 1432 health care workers (HCWs) belonging to a mailing list provided by the Global Alliance for Infections in Surgery. The self-administered questionnaire was developed by a multidisciplinary team. The survey was open from May 22, 2021, and June 22, 2021. Three reminders were sent, after 7, 14, and 21 days. Results: Three hundred four respondents from 72 countries returned a questionnaire, with an overall response rate of 21.2%. Respectively, 90.4% and 68.8% of participants stated their hospital had a multidisciplinary IPC team or a multidisciplinary antimicrobial stewardship team. Local protocols for antimicrobial therapy of surgical infections and protocols for surgical antibiotic prophylaxis were present in 76.6% and 90.8% of hospitals, respectively. In 23.4% and 24.0% of hospitals no surveillance systems for surgical site infections and no monitoring systems of used antimicrobials were implemented. Patient and family involvement in IPC management was considered to be slightly or not important in their hospital by the majority of respondents (65.1%). Awareness of the global burden of AMR among HCWs was considered very important or important by 54.6% of participants. The COVID-19 pandemic was considered by 80.3% of respondents as a very important or important factor in raising HCWs awareness of the IPC programs in their hospital. Based on the survey results, the authors developed 15 statements for

Published
2022

15. The efficacy of suppressive antibiotic treatment in patients managed non-operatively for periprosthetic joint infection and a draining sinus

Author

Lensen K. -J. D. F., Escudero-Sanchez R., Cobo J., Trebse R., Gubavu C., Tedeschi S., Lomas J. M., Arvieux C., Rodriguez-Pardo D., Fantoni M., Pais M. J. G., Jover F., Salles M. J. C., Sancho I., Sampedro M. F., Soriano A., Wouthuyzen-Bakker M., Roskar S., Praena J., Ribeiro T. C., Taccari T., Meheut A., Achermann Y., Andronic O., Asensi V., Moran-Castan C., Jover-Saenz A., Institut Català de la Salut, [Lensen KDF] Department of Medical Microbiology and Infection Prevention, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands. [Escudero-Sanchez R, Cobo J] Department of Infectious Diseases, Hospital Ramón y Cajal, IRYCIS, Madrid, Spain. [Trebše R] Service for Bone Infections, Valdoltra Orthopaedic Hospital, Ankaran, Slovenia. [Gubavu C] Department of Infectious and Tropical Diseases, CHR Orléans, Orléans, France. [Tedeschi S] Infectious Diseases Unit, Department of Medical and Surgical Sciences, University of Bologna Policlinico di Sant Orsola, Bologna, Italy. [Rodriguez-Pardo D] Servei de Malalties Infeccioses, Vall d'Hebron Hospital Universitari, Barcelona, Spain, Vall d'Hebron Barcelona Hospital Campus, Lensen K.-J.D.F., Escudero-Sanchez R., Cobo J., Trebse R., Gubavu C., Tedeschi S., Lomas J.M., Arvieux C., Rodriguez-Pardo D., Fantoni M., Pais M.J.G., Jover F., Salles M.J.C., Sancho I., Sampedro M.F., Soriano A., Wouthuyzen-Bakker M., Roskar S., Praena J., Ribeiro T.C., Taccari T., Meheut A., Achermann Y., Andronic O., Asensi V., Moran-Castan C., and Jover-Saenz A.

Subjects
prothetic joint infections, suppressive antibiotic therapy, draining sinus tract, medicine.medical_specialty, medicine.drug_class, Original Full-Length Article, Antibiotics, Periprosthetic, Otros calificadores::Otros calificadores::/farmacoterapia [Otros calificadores], Other subheadings::Other subheadings::/drug therapy [Other subheadings], medicine, Bacterial Infections and Mycoses::Infection::Prosthesis-Related Infections [DISEASES], Orthopedics and Sports Medicine, In patient, Prospective cohort study, Sinus (anatomy), Orthopedic surgery, business.industry, infecciones bacterianas y micosis::infección::infecciones relacionadas con prótesis [ENFERMEDADES], diagnóstico::pronóstico::resultado del tratamiento [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS], Articulacions artificials, medicine.disease, Diagnosis::Prognosis::Treatment Outcome [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT], Surgery, Infectious Diseases, medicine.anatomical_structure, Bacteremia, Avaluació de resultats (Assistència sanitària), Infecció, Implant, business, RD701-811, Cohort study
Abstract

Objectives: Patients with prosthetic joint infections (PJIs) not suitable for curative surgery may benefit from suppressive antibiotic therapy (SAT). However, the usefulness of SAT in cases with a draining sinus has never been investigated. Methods: A multicentre, retrospective observational cohort study was performed in which patients with a PJI and a sinus tract were eligible for inclusion if managed conservatively and if sufficient follow-up data were available (i.e. at least 2 years). SAT was defined as a period of > 6 months of oral antibiotic therapy. Results: SAT was initiated in 63 of 72 (87.5 %) included patients. Implant retention during follow-up was the same in patients receiving SAT vs. no SAT (79.4 % vs. 88.9 %; p=0.68). In total, 27 % of patients using SAT experienced side effects. In addition, the occurrence of prosthetic loosening in initially fixed implants, the need for surgical debridement, or the occurrence of bacteremia during follow-up could not be fully prevented with the use of SAT, which still occurred in 42 %, 6.3 %, and 3.2 % of cases, respectively. However, the sinus tract tended to close more often (42 % vs. 13 %; p=0.14), and a higher resolution of pain was observed (35 % vs. 14 %; p=0.22) in patients receiving SAT. Conclusions: SAT is not able to fully prevent complications in patients with a draining sinus. However, it may be beneficial in a subset of patients, particularly in those with pain or the hindrance of a draining sinus. A future prospective study, including a higher number of patients not receiving SAT, is needed.

Published
2021

19. A pandemic recap: lessons we have learned

Author

Coccolini, F, Cicuttin, E, Cremonini, C, Tartaglia, D, Viaggi, B, Kuriyama, A, Picetti, E, Ball, C, Abu-Zidan, F, Ceresoli, M, Turri, B, Jain, S, Palombo, C, Guirao, X, Rodrigues, G, Gachabayov, M, Machado, F, Eftychios, L, Kanj, S, Di Carlo, I, Di Saverio, S, Khokha, V, Kirkpatrick, A, Massalou, D, Forfori, F, Corradi, F, Delibegovic, S, Machain Vega, G, Fantoni, M, Demetriades, D, Kapoor, G, Kluger, Y, Ansari, S, Maier, R, Leppaniemi, A, Hardcastle, T, Vereczkei, A, Karamagioli, E, Pikoulis, E, Pistello, M, Sakakushev, B, Navsaria, P, Galeiras, R, Yahya, A, Osipov, A, Dimitrov, E, Doklestic, K, Pisano, M, Malacarne, P, Carcoforo, P, Sibilla, M, Kryvoruchko, I, Bonavina, L, Kim, J, Shelat, V, Czepiel, J, Maseda, E, Marwah, S, Chirica, M, Biancofiore, G, Podda, M, Cobianchi, L, Ansaloni, L, Fugazzola, P, Seretis, C, Gomez, C, Tumietto, F, Malbrain, M, Reichert, M, Augustin, G, Amato, B, Puzziello, A, Hecker, A, Gemignani, A, Isik, A, Cucchetti, A, Nacoti, M, Kopelman, D, Mesina, C, Ghannam, W, Ben-Ishay, O, Dhingra, S, Coimbra, R, Moore, E, Cui, Y, Quiodettis, M, Bala, M, Testini, M, Diaz, J, Girardis, M, Biffl, W, Hecker, M, Sall, I, Boggi, U, Materazzi, G, Ghiadoni, L, Matsumoto, J, Zuidema, W, Ivatury, R, Enani, M, Litvin, A, Al-Hasan, M, Demetrashvili, Z, Baraket, O, Ordonez, C, Negoi, I, Kiguba, R, Memish, Z, Elmangory, M, Tolonen, M, Das, K, Ribeiro, J, O'Connor, D, Tan, B, Van Goor, H, Baral, S, De Simone, B, Corbella, D, Brambillasca, P, Scaglione, M, Basolo, F, De'Angelis, N, Bendinelli, C, Weber, D, Pagani, L, Monti, C, Baiocchi, G, Chiarugi, M, Catena, F, Sartelli, M, Coccolini F., Cicuttin E., Cremonini C., Tartaglia D., Viaggi B., Kuriyama A., Picetti E., Ball C., Abu-Zidan F., Ceresoli M., Turri B., Jain S., Palombo C., Guirao X., Rodrigues G., Gachabayov M., Machado F., Eftychios L., Kanj S. S., Di Carlo I., Di Saverio S., Khokha V., Kirkpatrick A., Massalou D., Forfori F., Corradi F., Delibegovic S., Machain Vega G. M., Fantoni M., Demetriades D., Kapoor G., Kluger Y., Ansari S., Maier R., Leppaniemi A., Hardcastle T., Vereczkei A., Karamagioli E., Pikoulis E., Pistello M., Sakakushev B. E., Navsaria P. H., Galeiras R., Yahya A. I., Osipov A. V., Dimitrov E., Doklestic K., Pisano M., Malacarne P., Carcoforo P., Sibilla M. G., Kryvoruchko I. A., Bonavina L., Kim J. I., Shelat V. G., Czepiel J., Maseda E., Marwah S., Chirica M., Biancofiore G., Podda M., Cobianchi L., Ansaloni L., Fugazzola P., Seretis C., Gomez C. A., Tumietto F., Malbrain M., Reichert M., Augustin G., Amato B., Puzziello A., Hecker A., Gemignani A., Isik A., Cucchetti A., Nacoti M., Kopelman D., Mesina C., Ghannam W., Ben-Ishay O., Dhingra S., Coimbra R., Moore E. E., Cui Y., Quiodettis M. A., Bala M., Testini M., Diaz J., Girardis M., Biffl W. L., Hecker M., Sall I., Boggi U., Materazzi G., Ghiadoni L., Matsumoto J., Zuidema W. P., Ivatury R., Enani M. A., Litvin A., Al-Hasan M. N., Demetrashvili Z., Baraket O., Ordonez C. A., Negoi I., Kiguba R., Memish Z. A., Elmangory M. M., Tolonen M., Das K., Ribeiro J., O'Connor D. B., Tan B. K., Van Goor H., Baral S., De Simone B., Corbella D., Brambillasca P., Scaglione M., Basolo F., De'Angelis N., Bendinelli C., Weber D., Pagani L., Monti C., Baiocchi G., Chiarugi M., Catena F., Sartelli M., Coccolini, F, Cicuttin, E, Cremonini, C, Tartaglia, D, Viaggi, B, Kuriyama, A, Picetti, E, Ball, C, Abu-Zidan, F, Ceresoli, M, Turri, B, Jain, S, Palombo, C, Guirao, X, Rodrigues, G, Gachabayov, M, Machado, F, Eftychios, L, Kanj, S, Di Carlo, I, Di Saverio, S, Khokha, V, Kirkpatrick, A, Massalou, D, Forfori, F, Corradi, F, Delibegovic, S, Machain Vega, G, Fantoni, M, Demetriades, D, Kapoor, G, Kluger, Y, Ansari, S, Maier, R, Leppaniemi, A, Hardcastle, T, Vereczkei, A, Karamagioli, E, Pikoulis, E, Pistello, M, Sakakushev, B, Navsaria, P, Galeiras, R, Yahya, A, Osipov, A, Dimitrov, E, Doklestic, K, Pisano, M, Malacarne, P, Carcoforo, P, Sibilla, M, Kryvoruchko, I, Bonavina, L, Kim, J, Shelat, V, Czepiel, J, Maseda, E, Marwah, S, Chirica, M, Biancofiore, G, Podda, M, Cobianchi, L, Ansaloni, L, Fugazzola, P, Seretis, C, Gomez, C, Tumietto, F, Malbrain, M, Reichert, M, Augustin, G, Amato, B, Puzziello, A, Hecker, A, Gemignani, A, Isik, A, Cucchetti, A, Nacoti, M, Kopelman, D, Mesina, C, Ghannam, W, Ben-Ishay, O, Dhingra, S, Coimbra, R, Moore, E, Cui, Y, Quiodettis, M, Bala, M, Testini, M, Diaz, J, Girardis, M, Biffl, W, Hecker, M, Sall, I, Boggi, U, Materazzi, G, Ghiadoni, L, Matsumoto, J, Zuidema, W, Ivatury, R, Enani, M, Litvin, A, Al-Hasan, M, Demetrashvili, Z, Baraket, O, Ordonez, C, Negoi, I, Kiguba, R, Memish, Z, Elmangory, M, Tolonen, M, Das, K, Ribeiro, J, O'Connor, D, Tan, B, Van Goor, H, Baral, S, De Simone, B, Corbella, D, Brambillasca, P, Scaglione, M, Basolo, F, De'Angelis, N, Bendinelli, C, Weber, D, Pagani, L, Monti, C, Baiocchi, G, Chiarugi, M, Catena, F, Sartelli, M, Coccolini F., Cicuttin E., Cremonini C., Tartaglia D., Viaggi B., Kuriyama A., Picetti E., Ball C., Abu-Zidan F., Ceresoli M., Turri B., Jain S., Palombo C., Guirao X., Rodrigues G., Gachabayov M., Machado F., Eftychios L., Kanj S. S., Di Carlo I., Di Saverio S., Khokha V., Kirkpatrick A., Massalou D., Forfori F., Corradi F., Delibegovic S., Machain Vega G. M., Fantoni M., Demetriades D., Kapoor G., Kluger Y., Ansari S., Maier R., Leppaniemi A., Hardcastle T., Vereczkei A., Karamagioli E., Pikoulis E., Pistello M., Sakakushev B. E., Navsaria P. H., Galeiras R., Yahya A. I., Osipov A. V., Dimitrov E., Doklestic K., Pisano M., Malacarne P., Carcoforo P., Sibilla M. G., Kryvoruchko I. A., Bonavina L., Kim J. I., Shelat V. G., Czepiel J., Maseda E., Marwah S., Chirica M., Biancofiore G., Podda M., Cobianchi L., Ansaloni L., Fugazzola P., Seretis C., Gomez C. A., Tumietto F., Malbrain M., Reichert M., Augustin G., Amato B., Puzziello A., Hecker A., Gemignani A., Isik A., Cucchetti A., Nacoti M., Kopelman D., Mesina C., Ghannam W., Ben-Ishay O., Dhingra S., Coimbra R., Moore E. E., Cui Y., Quiodettis M. A., Bala M., Testini M., Diaz J., Girardis M., Biffl W. L., Hecker M., Sall I., Boggi U., Materazzi G., Ghiadoni L., Matsumoto J., Zuidema W. P., Ivatury R., Enani M. A., Litvin A., Al-Hasan M. N., Demetrashvili Z., Baraket O., Ordonez C. A., Negoi I., Kiguba R., Memish Z. A., Elmangory M. M., Tolonen M., Das K., Ribeiro J., O'Connor D. B., Tan B. K., Van Goor H., Baral S., De Simone B., Corbella D., Brambillasca P., Scaglione M., Basolo F., De'Angelis N., Bendinelli C., Weber D., Pagani L., Monti C., Baiocchi G., Chiarugi M., Catena F., and Sartelli M.

Abstract

On January 2020, the WHO Director General declared that the outbreak constitutes a Public Health Emergency of International Concern. The world has faced a worldwide spread crisis and is still dealing with it. The present paper represents a white paper concerning the tough lessons we have learned from the COVID-19 pandemic. Thus, an international and heterogenous multidisciplinary panel of very differentiated people would like to share global experiences and lessons with all interested and especially those responsible for future healthcare decision making. With the present paper, international and heterogenous multidisciplinary panel of very differentiated people would like to share global experiences and lessons with all interested and especially those responsible for future healthcare decision making.

Published
2021

21. It is time to define an organizational model for the prevention and management of infections along the surgical pathway: a worldwide cross-sectional survey

Author

Sartelli, M., Labricciosa, F.M., Coccolini, F., Coimbra, R., Abu-Zidan, F.M., Ansaloni, L., Al-Hasan, M.N., Ansari, S., Barie, P.S., Caínzos, M.A., Ceresoli, M., Chiarugi, M., Claridge, J.A., Cicuttin, E., Dellinger, E.P., Fry, D.E., Guirao, X., Hardcastle, T.C., Hecker, A., Leppäniemi, A.K., Litvin, A., Marwah, S., Maseda, E., Mazuski, J.E., Memish, Z.A., Kirkpatrick, A.W., Pagani, L., Podda, M., Rasa, H.K., Sakakushev, B.E., Sawyer, R.G., Tumietto, F., Xiao, Y., Aboubreeg, W.F., Adamou, H., Akhmeteli, L., Akin, E., Alberio, M.G., Alconchel, F., Magagi, I.A., Araúz, A.B., Argenio, G., Atanasov, B.C., Atici, S.D., Awad, S.S., Baili, E., Bains, L., Bala, M., Baraket, O., Baral, S., Belskii, V.A., Benboubker, M., Ben-Ishay, O., Bordoni, P., Boumédiène, A., Brisinda, G., Cavazzuti, L., Chandy, S.J., Chiarello, M.M., Cillara, N., Clarizia, G., Cocuz, M.E., Cocuz, I.G., Conti, L., Coppola, R., Cui, Y., Czepiel, J., D'Acapito, F., Damaskos, D., Das, K., Simone, B. De, Delibegovic, S., Demetrashvili, Z., Detanac, D.S., Dhingra, S., Bella, S. Di, Dimitrov, E.N., Dogjani, A., D'Oria, M., Dumitru, I.M., Elmangory, M.M., Enciu, O., Fantoni, M., Filipescu, D., Fleres, F., Foghetti, D., Fransvea, P., Gachabayov, M., Galeiras, R., Gattuso, G., Ghannam, W.M., Ghisetti, V., Giraudo, G., Gonfa, K.B., Gonullu, E., Hamad, Y., Hecker, M., Isik, A., Ismail, N., Ismail, A., Goor, H. van, Maier, R.V., Catena, F., Sartelli, M., Labricciosa, F.M., Coccolini, F., Coimbra, R., Abu-Zidan, F.M., Ansaloni, L., Al-Hasan, M.N., Ansari, S., Barie, P.S., Caínzos, M.A., Ceresoli, M., Chiarugi, M., Claridge, J.A., Cicuttin, E., Dellinger, E.P., Fry, D.E., Guirao, X., Hardcastle, T.C., Hecker, A., Leppäniemi, A.K., Litvin, A., Marwah, S., Maseda, E., Mazuski, J.E., Memish, Z.A., Kirkpatrick, A.W., Pagani, L., Podda, M., Rasa, H.K., Sakakushev, B.E., Sawyer, R.G., Tumietto, F., Xiao, Y., Aboubreeg, W.F., Adamou, H., Akhmeteli, L., Akin, E., Alberio, M.G., Alconchel, F., Magagi, I.A., Araúz, A.B., Argenio, G., Atanasov, B.C., Atici, S.D., Awad, S.S., Baili, E., Bains, L., Bala, M., Baraket, O., Baral, S., Belskii, V.A., Benboubker, M., Ben-Ishay, O., Bordoni, P., Boumédiène, A., Brisinda, G., Cavazzuti, L., Chandy, S.J., Chiarello, M.M., Cillara, N., Clarizia, G., Cocuz, M.E., Cocuz, I.G., Conti, L., Coppola, R., Cui, Y., Czepiel, J., D'Acapito, F., Damaskos, D., Das, K., Simone, B. De, Delibegovic, S., Demetrashvili, Z., Detanac, D.S., Dhingra, S., Bella, S. Di, Dimitrov, E.N., Dogjani, A., D'Oria, M., Dumitru, I.M., Elmangory, M.M., Enciu, O., Fantoni, M., Filipescu, D., Fleres, F., Foghetti, D., Fransvea, P., Gachabayov, M., Galeiras, R., Gattuso, G., Ghannam, W.M., Ghisetti, V., Giraudo, G., Gonfa, K.B., Gonullu, E., Hamad, Y., Hecker, M., Isik, A., Ismail, N., Ismail, A., Goor, H. van, Maier, R.V., and Catena, F.

Abstract

Item does not contain fulltext, BACKGROUND: The objectives of the study were to investigate the organizational characteristics of acute care facilities worldwide in preventing and managing infections in surgery; assess participants' perception regarding infection prevention and control (IPC) measures, antibiotic prescribing practices, and source control; describe awareness about the global burden of antimicrobial resistance (AMR) and IPC measures; and determine the role of the Coronavirus Disease 2019 pandemic on said awareness. METHODS: A cross-sectional web-based survey was conducted contacting 1432 health care workers (HCWs) belonging to a mailing list provided by the Global Alliance for Infections in Surgery. The self-administered questionnaire was developed by a multidisciplinary team. The survey was open from May 22, 2021, and June 22, 2021. Three reminders were sent, after 7, 14, and 21 days. RESULTS: Three hundred four respondents from 72 countries returned a questionnaire, with an overall response rate of 21.2%. Respectively, 90.4% and 68.8% of participants stated their hospital had a multidisciplinary IPC team or a multidisciplinary antimicrobial stewardship team. Local protocols for antimicrobial therapy of surgical infections and protocols for surgical antibiotic prophylaxis were present in 76.6% and 90.8% of hospitals, respectively. In 23.4% and 24.0% of hospitals no surveillance systems for surgical site infections and no monitoring systems of used antimicrobials were implemented. Patient and family involvement in IPC management was considered to be slightly or not important in their hospital by the majority of respondents (65.1%). Awareness of the global burden of AMR among HCWs was considered very important or important by 54.6% of participants. The COVID-19 pandemic was considered by 80.3% of respondents as a very important or important factor in raising HCWs awareness of the IPC programs in their hospital. Based on the survey results, the authors developed 15 statements for sever

Published
2022

22. Cefiderocol for severe carbapenem-resistant a. Baumannii pneumonia: Towards the comprehension of its place in therapy

Author

Rando, Emanuele, Segala, F. V., Vargas, J., Seguiti, C., De Pascale, Gennaro, Murri, Rita, Fantoni, Massimo, Rando E., De Pascale G. (ORCID:0000-0002-8255-0676), Murri R. (ORCID:0000-0003-4263-7854), Fantoni M. (ORCID:0000-0001-6913-8460), Rando, Emanuele, Segala, F. V., Vargas, J., Seguiti, C., De Pascale, Gennaro, Murri, Rita, Fantoni, Massimo, Rando E., De Pascale G. (ORCID:0000-0002-8255-0676), Murri R. (ORCID:0000-0003-4263-7854), and Fantoni M. (ORCID:0000-0001-6913-8460)

Abstract

Cefiderocol use in A. baumannii pneumonia still represents an important matter of debate. The aim of this study is to describe 13 cases of carbapenem-resistant A. baumannii (CRAB) pneumonia treated with cefiderocol in real-life practice. We retrospectively included patients with CRAB pneumonia hospitalized at Fondazione Policlinico Universitario Agostino Gemelli Hospital treated with cefiderocol either in the general ward or the intensive care unit. A total of 11 patients out of 13 had ventilator-associated pneumonia caused by CRAB, and 12/13 patients had polymicrobial infection. We found a 30-day success rate of 54%. Cefiderocol may have a role when facing severe XDR A. baumannii pneumonia. Future studies are warranted to better define its place in therapy in CRAB infections.

Published
2022

23. 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

24. 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

25. Characteristic of IgA and IgG antibody response to SARS-CoV-2 infection in an Italian referral COVID-19 Hospital

Author

Carnicelli, A., Fiori, B., Ricci, Rosalba, Piano, A., Bonadia, N., Taddei, Eleonora, Fantoni, Massimo, Murri, Rita, Cingolani, Antonella, Barillaro, Christian, Cutuli, S. L., Marchesini, Debora, Della Polla, D. A., Forte, E., Fuorlo, M., Di Maurizio, L., Amorini, Paola, Cattani, P., Franceschi, Francesco, Sanguinetti, Maurizio, Ricci R., Taddei E., Fantoni M. (ORCID:0000-0001-6913-8460), Murri R. (ORCID:0000-0003-4263-7854), Cingolani A. (ORCID:0000-0002-3793-2755), Barillaro C., Marchesini D., Amorini P., Franceschi F. (ORCID:0000-0001-6266-445X), Sanguinetti M. (ORCID:0000-0002-9780-7059), Carnicelli, A., Fiori, B., Ricci, Rosalba, Piano, A., Bonadia, N., Taddei, Eleonora, Fantoni, Massimo, Murri, Rita, Cingolani, Antonella, Barillaro, Christian, Cutuli, S. L., Marchesini, Debora, Della Polla, D. A., Forte, E., Fuorlo, M., Di Maurizio, L., Amorini, Paola, Cattani, P., Franceschi, Francesco, Sanguinetti, Maurizio, Ricci R., Taddei E., Fantoni M. (ORCID:0000-0001-6913-8460), Murri R. (ORCID:0000-0003-4263-7854), Cingolani A. (ORCID:0000-0002-3793-2755), Barillaro C., Marchesini D., Amorini P., Franceschi F. (ORCID:0000-0001-6266-445X), and Sanguinetti M. (ORCID:0000-0002-9780-7059)

Abstract

Introduction: Antibody response plays a fundamental role in the natural history of infectious disease. A better understanding of the immune response in patients with SARS-CoV-2 infection could be important for identifying patients at greater risk of developing a more severe form of disease and with a worse prognosis. Methods: We performed a cross-sectional analysis to determine the presence and the levels of both anti-SARS-CoV-2 IgG and IgA in a cohort of hospitalized patients with confirmed infection at different times in the natural history of the disease. Patients enrolled when admitted at the emergency department were prospectively followed up during hospital stay. Results: Overall, 131 patients were considered with a total of 237 samples processed. Cross-sectional analysis showed that seroconversion for IgA seems to occur between days 6 and 15, while IgG response seems to occur slightly later, peaking at day 20 after symptoms onset. Both IgA and IgG were maintained beyond 2 months. Severe patients showed a higher IgA response compared with mild patients when analyzing optical density (8.3 versus 5.6, p < 0.001). Prospective analysis conducted on 55 patients confirmed that IgA appear slightly earlier than IgG. After stratifying for the severity of disease, both the IgA and IgG responses were more vigorous in severe cases. Moreover, while IgG tended to stabilize, there was a relevant decline after the first month of IgA levels in mild cases. Conclusion: IgA and IgG antibody response is closely related, although seroconversion for IgA occurs earlier. Both IgA and IgG are maintained beyond 2 months. Severe patients showed a more vigorous IgA and IgG response. IgA levels seem to decline after 1 month since the onset of symptoms in mild cases. Our results should be interpreted with cautions due to several limitations in our study, mainly the small number of cases, lack of data on viral load and clinical setting.

Published
2022

26. Diagnostic role of internal mammary lymph node involvement in tuberculous pleurisy: a multicenter study

Author

Levi, G., primary, Rocchetti, C., additional, Mei, F., additional, Stella, G.M., additional, Lettieri, S., additional, Lococo, F., additional, Taccari, F., additional, Seguiti, C., additional, Fantoni, M., additional, Natali, F., additional, Candoli, P., additional, Bortolotto, C., additional, Pinelli, V., additional, Mondoni, M., additional, Carlucci, P., additional, Fabbri, A., additional, Trezzi, M, additional, Vannucchi, L., additional, Bonifazi, M., additional, Porcarelli, F., additional, Gasparini, S., additional, Sica, G., additional, Valente, T., additional, Biondini, D., additional, Damin, M., additional, Liani, V., additional, Tamburrini, M., additional, Sorino, C., additional, Mezzasalma, F., additional, Scaramozzino, M.U., additional, Pini, L., additional, Bezzi, M., additional, and Marchetti, G.P., additional

Published
2022
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28. The burden of clostridioides difficile infection during the COVID-19 pandemic: A retrospective case-control study in Italian hospitals (CloVid)

Author

Granata, G, Bartoloni, A, Codeluppi, M, Contadini, I, Cristini, F, Fantoni, M, Ferraresi, A, Fornabaio, C, Grasselli, S, Lagi, F, Masucci, L, Puoti, M, Raimondi, A, Taddei, E, Trapani, F, Viale, P, Johnson, S, Petrosillo, N, Granata G., Bartoloni A., Codeluppi M., Contadini I., Cristini F., Fantoni M., Ferraresi A., Fornabaio C., Grasselli S., Lagi F., Masucci L., Puoti M., Raimondi A., Taddei E., Trapani F. F., Viale P., Johnson S., Petrosillo N., Granata, G, Bartoloni, A, Codeluppi, M, Contadini, I, Cristini, F, Fantoni, M, Ferraresi, A, Fornabaio, C, Grasselli, S, Lagi, F, Masucci, L, Puoti, M, Raimondi, A, Taddei, E, Trapani, F, Viale, P, Johnson, S, Petrosillo, N, Granata G., Bartoloni A., Codeluppi M., Contadini I., Cristini F., Fantoni M., Ferraresi A., Fornabaio C., Grasselli S., Lagi F., Masucci L., Puoti M., Raimondi A., Taddei E., Trapani F. F., Viale P., Johnson S., and Petrosillo N.

Abstract

Data on the burden of Clostridioides difficile infection (CDI) in Coronavirus Disease 2019 (COVID-19) patients are scant. We conducted an observational, retrospective, multicenter, 1:3 case (COVID-19 patients with CDI)-control (COVID-19 patients without CDI) study in Italy to assess incidence and outcomes, and to identify risk factors for CDI in COVID-19 patients. From February through July 2020, 8402 COVID-19 patients were admitted to eight Italian hospitals; 38 CDI cases were identified, including 32 hospital-onset-CDI (HO-CDI) and 6 community-onset, healthcare-associated-CDI (CO-HCA-CDI). HO-CDI incidence was 4.4 × 10,000 patient-days. The percentage of cases recovering without complications at discharge (i.e., pressure ulcers, chronic heart decompensation) was lower than among controls (p = 0.01); in-hospital stays was longer among cases, 35.0 versus 19.4 days (p = 0.0007). The presence of a previous hospitalisation (p = 0.001), previous steroid administration (p = 0.008) and the administration of antibiotics during the stay (p = 0.004) were risk factors associated with CDI. In conclusions, CDI complicates COVID-19, mainly in patients with co-morbidities and previous healthcare exposures. Its association with antibiotic usage and hospital acquired bacterial infections should lead to strengthen antimicrobial stewardship programmes and infection prevention and control activities.

Published
2020

29. Post-COVID-19 global health strategies: the need for an interdisciplinary approach

Author

Landi, F., Gremese, E., Bernabei, R., Fantoni, M., Gasbarrini, A., Settanni, C. R., Benvenuto, F., Bramato, G., Carfi, A., Ciciarello, F., LoMonaco, M. R., Martone, A. M., Marzetti, E., Napolitano, C., Pagano, F., Rocchi, S., Rota, E., Salerno, A., Tosato, M., Tritto, M., Calvani, R., Catalano, L., Picca, A., Savera, G., Tamburrini, E., Borghetti, A., Di Gianbenedetto, S., Murri, R., Cingolani, A., Ventura, G., Taddei, E., Moschese, D., Ciccullo, A., Stella, L., Addolorato, G., Franceschi, F., Mingrone, G., Zocco, M. A., Sanguinetti, M., Cattani, P., Marchetti, S., Bizzarro, A., Lauria, A., Rizzo, S., Savastano, M. C., Gambini, G., Cozzupoli, G. M., Culiersi, C., Passali, G. C., Paludetti, G., Galli, J., Crudo, F., Di Cintio, G., Longobardi, Y., Tricarico, L., Santantonio, M., Buonsenso, D., Valentini, P., Pata, D., Sinatti, D., De Rose, C., Richeldi, L., Lombardi, F., Calabrese, A., Sani, G., Janiri, D., Giuseppin, G., Molinaro, M., Modica, M., Natale, L., Larici, A. R., Marano, R., Paglionico, A., Petricca, L., Gigante, L., Natalello, G., Fedele, A. L., Lizzio, M. M., Santoliquido, A., Santoro, L., Nesci, A., Popolla, V., Landi F. (ORCID:0000-0002-3472-1389), 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), Settanni C. R., Benvenuto F., Bramato G., Ciciarello F., Martone A. M., Marzetti E. (ORCID:0000-0001-9567-6983), Pagano F., Rocchi S., Rota E., Salerno A., Tosato M., Tritto M., Calvani R. (ORCID:0000-0001-5472-2365), Savera G., 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), Taddei E., 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., Bizzarro A., Lauria A., Rizzo S. (ORCID:0000-0001-6302-063X), Savastano M. C. (ORCID:0000-0003-1397-4333), Culiersi C., Passali G. C. (ORCID:0000-0002-8176-0962), Paludetti G. (ORCID:0000-0003-2480-1243), Galli J. (ORCID:0000-0001-6353-6249), Crudo F., Longobardi Y., Tricarico L., Santantonio M., Buonsenso D., Valentini P. (ORCID:0000-0001-6095-9510), Pata D., Sinatti D., De Rose C., Richeldi L. (ORCID:0000-0001-8594-1448), Lombardi F., Calabrese A., Sani G. (ORCID:0000-0002-9767-8752), Giuseppin G., Molinaro M., Modica M., Natale L. (ORCID:0000-0002-7949-5119), Larici A. R. (ORCID:0000-0002-1882-6244), Marano R. (ORCID:0000-0003-2710-2093), Gigante L., Natalello G., Lizzio M. M., Santoliquido A. (ORCID:0000-0003-1539-4017), Santoro L., Nesci A. (ORCID:0000-0001-9466-1755), Popolla V., Landi, F., Gremese, E., Bernabei, R., Fantoni, M., Gasbarrini, A., Settanni, C. R., Benvenuto, F., Bramato, G., Carfi, A., Ciciarello, F., LoMonaco, M. R., Martone, A. M., Marzetti, E., Napolitano, C., Pagano, F., Rocchi, S., Rota, E., Salerno, A., Tosato, M., Tritto, M., Calvani, R., Catalano, L., Picca, A., Savera, G., Tamburrini, E., Borghetti, A., Di Gianbenedetto, S., Murri, R., Cingolani, A., Ventura, G., Taddei, E., Moschese, D., Ciccullo, A., Stella, L., Addolorato, G., Franceschi, F., Mingrone, G., Zocco, M. A., Sanguinetti, M., Cattani, P., Marchetti, S., Bizzarro, A., Lauria, A., Rizzo, S., Savastano, M. C., Gambini, G., Cozzupoli, G. M., Culiersi, C., Passali, G. C., Paludetti, G., Galli, J., Crudo, F., Di Cintio, G., Longobardi, Y., Tricarico, L., Santantonio, M., Buonsenso, D., Valentini, P., Pata, D., Sinatti, D., De Rose, C., Richeldi, L., Lombardi, F., Calabrese, A., Sani, G., Janiri, D., Giuseppin, G., Molinaro, M., Modica, M., Natale, L., Larici, A. R., Marano, R., Paglionico, A., Petricca, L., Gigante, L., Natalello, G., Fedele, A. L., Lizzio, M. M., Santoliquido, A., Santoro, L., Nesci, A., Popolla, V., Landi F. (ORCID:0000-0002-3472-1389), 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), Settanni C. R., Benvenuto F., Bramato G., Ciciarello F., Martone A. M., Marzetti E. (ORCID:0000-0001-9567-6983), Pagano F., Rocchi S., Rota E., Salerno A., Tosato M., Tritto M., Calvani R. (ORCID:0000-0001-5472-2365), Savera G., 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), Taddei E., 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., Bizzarro A., Lauria A., Rizzo S. (ORCID:0000-0001-6302-063X), Savastano M. C. (ORCID:0000-0003-1397-4333), Culiersi C., Passali G. C. (ORCID:0000-0002-8176-0962), Paludetti G. (ORCID:0000-0003-2480-1243), Galli J. (ORCID:0000-0001-6353-6249), Crudo F., Longobardi Y., Tricarico L., Santantonio M., Buonsenso D., Valentini P. (ORCID:0000-0001-6095-9510), Pata D., Sinatti D., De Rose C., Richeldi L. (ORCID:0000-0001-8594-1448), Lombardi F., Calabrese A., Sani G. (ORCID:0000-0002-9767-8752), Giuseppin G., Molinaro M., Modica M., Natale L. (ORCID:0000-0002-7949-5119), Larici A. R. (ORCID:0000-0002-1882-6244), Marano R. (ORCID:0000-0003-2710-2093), Gigante L., Natalello G., Lizzio M. M., Santoliquido A. (ORCID:0000-0003-1539-4017), Santoro L., Nesci A. (ORCID:0000-0001-9466-1755), and Popolla V.

Abstract

For survivors of severe COVID-19 disease, having defeated the virus is just the beginning of an uncharted recovery path. What follows after the acute phase of SARS-CoV-2 infection depends on the extension and severity of viral attacks in different cell types and organs. Despite the ridiculously large number of papers that have flooded scientific journals and preprint-hosting websites, a clear clinical picture of COVID-19 aftermath is vague at best. Without larger prospective observational studies that are only now being started, clinicians can retrieve information just from case reports and or small studies. This is the time to understand how COVID-19 goes forward and what consequences survivors may expect to experience. To this aim, a multidisciplinary post-acute care service involving several specialists has been established at the Fondazione Policlinico Universitario A. Gemelli IRCSS (Rome, Italy). Although COVID-19 is an infectious disease primarily affecting the lung, its multi-organ involvement requires an interdisciplinary approach encompassing virtually all branches of internal medicine and geriatrics. In particular, during the post-acute phase, the geriatrician may serve as the case manager of a multidisciplinary team. The aim of this article is to describe the importance of the interdisciplinary approach––coordinated by geriatrician––to cope the potential post-acute care needs of recovered COVID-19 patients.

Published
2020

34. Seroprevalence of anti‐SARS‐CoV‐2 IgG antibodies in children with household exposure to adults with COVID‐19: Preliminary findings

Author

Buonsenso, Danilo, Valentini, Piero, De Rose, Cristina, Pata, Davide, Sinatti, Dario, Speziale, Domenico, Ricci, R., Carfi, A., Landi, Francesco, Ferrari, V., De Maio, Flavio, Palucci, Ivana, Sanguinetti, Maurizio, Sali, Michela, Landi, F., Gremese, E., Bernabei, R., Fantoni, M., Gasbarrini, A., Settanni, C. R., Benvenuto, F., Bramato, G., Ciciarello, F., Lo Monaco, M. R., Martone, A. M., Marzetti, Emanuele, Napolitano, C., Pagano, F., Rocchi, S., Rota, E., Salerno, A., Tosato, M., Tritto, M., Calvani, Riccardo, Catalano, L., Picca, A., Savera, G., Cauda, R., Tamburrini, E., Borghetti, A., Di Gianbenedetto, S., Murri, R., Cingolani, A., Ventura, G., Taddei, E., Moschese, D., Ciccullo, A., Stella, L., Addolorato, G., Franceschi, F., Mingrone, G., Zocco, Maria Assunta, Sanguinetti, M., Cattani Franchi, Paola, Marchetti, S., Posteraro, Brunella, Sali, M., Bizzarro, A., Lauria, A., Rizzo, S., Savastano, Maria Cristina, Gambini, G., Cozzupoli, G. M., Culiersi, C., Passali, G. C., Paludetti, G., Galli, J., Crudo, F., Di Cintio, G., Longobardi, Y., Tricarico, L., Santantonio, M., Buonsenso, D., Valentini, P., Pata, D., Sinatti, D., De Rose, C., Richeldi, Luca, Lombardi, F., Calabrese, A., Sani, G., Janiri, D., Giuseppin, G., Molinaro, M., Modica, M., Natale, Luigi, Larici, A. R., Marano, R., Paglionico, A., Petricca, L., Gigante, L., Natalello, G., Fedele, A. L., Lizzio, M. M., Tolusso, B., Alivernini, S., Santoliquido, A., Santoro, L., Nesci, A., and Popolla, V.

Subjects
Adult, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Adolescent, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Antibodies, Viral, Settore MED/07 - MICROBIOLOGIA E MICROBIOLOGIA CLINICA, Immunoglobulin G, SARS‐CoV‐2, 03 medical and health sciences, 0302 clinical medicine, children, COVID‐19, Seroepidemiologic Studies, 030225 pediatrics, Internal medicine, medicine, Seroprevalence, Humans, Pediatrics, Perinatology, and Child Health, Child, Index case, biology, seroprevalence, business.industry, SARS-CoV-2, Public health, Infant, Newborn, COVID-19, Infant, Environmental Exposure, Middle Aged, household, 030228 respiratory system, Child, Preschool, Pediatrics, Perinatology and Child Health, biology.protein, Commentary, Antibody, business, Pediatric population
Abstract

Weather and the susceptibility of children to severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection is still a debated question and currently a hot topic, particularly in view of important decisions regarding opening schools. Therefore, we performed this prospective analysis of anti‐SARS‐CoV‐2 immunoglobulin G (IgG) antibodies in children with known household exposure to SARS‐CoV‐2 and compared their IgG status with the other adults exposed to the index case in the same household. A total of 30 families with a documented COVID‐19 index case were included. A total of 44 out of 80 household contacts (55%) of index patients had anti SARS‐CoV‐2 IgG antibodies. In particular, 16/27 (59,3%) adult partners had IgG antibodies compared with 28/53 (52,3%) of pediatric contacts (p > .05). Among the pediatric population, children ≥5 years of age had a similar probability of having SARS‐CoV‐2 IgG antibodies (21/39, 53.8%) compared to those less than 5 years old (7/14, 50%) (p > .05). Adult partners and children also had a similar probability of having SARS‐CoV‐2 IgG antibodies. Interestingly, 10/28 (35.7%) of children and 5/27 (18.5%) of adults with SARS‐CoV‐2 IgG antibodies were previously diagnosed as COVID‐19 cases. Our study shows evidence of a high rate of IgG antibodies in children exposed to SARS‐CoV‐2. This report has public health implications, highlighting the need to establish appropriate guidelines for school openings and other social activities related to childhood.

Published
2021
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35. Effect of anakinra on mortality in patients with COVID-19: a systematic review and patient-level meta-analysis

Author

Kyriazopoulou, E. Huet, T. Cavalli, G. Gori, A. Kyprianou, M. Pickkers, P. Eugen-Olsen, J. Clerici, M. Veas, F. Chatellier, G. Kaplanski, G. Netea, M.G. Pontali, E. Gattorno, M. Cauchois, R. Kooistra, E. Kox, M. Bandera, A. Beaussier, H. Mangioni, D. Dagna, L. van der Meer, J.W.M. Giamarellos-Bourboulis, E.J. Hayem, G. Netea, M.G. van der Meer, J.W.M. Giamarellos-Bourboulis, E.J. Volpi, S. Sormani, M.P. Signori, A. Bozzi, G. Minoia, F. Aliberti, S. Grasselli, G. Alagna, L. Lombardi, A. Ungaro, R. Agostoni, C. Blasi, F. Costantino, G. Fracanzani, A.L. Montano, N. Peyvandi, F. Sottocorno, M. Muscatello, A. Filocamo, G. Papadopoulos, A. Mouktaroudi, M. Karakike, E. Saridaki, M. Gkavogianni, T. Katrini, K. Vechlidis, N. Avgoustou, C. Chalvatzis, S. Marantos, T. Damoulari, C. Damoraki, G. Ktena, S. Tsilika, M. Koufargyris, P. Karageorgos, A. Droggiti, D.-I. Koliakou, A. Poulakou, G. Tsiakos, K. Myrodia, D.-M. Gravvani, A. Trontzas, I.P. Syrigos, K. Kalomenidis, I. Kranidioti, E. Panagopoulos, P. Petrakis, V. Metallidis, S. Loli, G. Tsachouridou, O. Dalekos, G.N. Gatselis, N. Stefos, A. Georgiadou, S. Lygoura, V. Milionis, H. Kosmidou, M. Papanikolaou, I.C. Akinosoglou, K. Giannitsioti, E. Chrysos, G. Mavroudis, P. Sidiropoulou, C. Adamis, G. Fragkou, A. Rapti, A. Alexiou, Z. Symbardi, S. Masgala, A. Kostaki, K. Kostis, E. Samarkos, M. Bakakos, P. Tzavara, V. Dimakou, K. Tzatzagou, G. Chini, M. Kotsis, V. Tsoukalas, G. Bliziotis, I. Doumas, M. Argyraki, A. Kainis, I. Fantoni, M. Cingolani, A. Angheben, A. Cardellino, C.S. Castelli, F. Serino, F.S. Nicastri, E. Ippolito, G. Bassetti, M. Selmi, C. International Collaborative Group for Anakinra in COVID-19

Abstract

Background: Anakinra might improve the prognosis of patients with moderate to severe COVID-19 (ie, patients requiring oxygen supplementation but not yet receiving organ support). We aimed to assess the effect of anakinra treatment on mortality in patients admitted to hospital with COVID-19. Methods: For this systematic review and individual patient-level meta-analysis, a systematic literature search was done on Dec 28, 2020, in Medline (PubMed), Cochrane, medRxiv, bioRxiv, and the ClinicalTrials.gov databases for randomised trials, comparative studies, and observational studies of patients admitted to hospital with COVID-19, comparing administration of anakinra with standard of care, or placebo, or both. The search was repeated on Jan 22, 2021. Individual patient-level data were requested from investigators and corresponding authors of eligible studies; if individual patient-level data were not available, published data were extracted from the original reports. The primary endpoint was mortality after 28 days and the secondary endpoint was safety (eg, the risk of secondary infections). This study is registered on PROSPERO (CRD42020221491). Findings: 209 articles were identified, of which 178 full-text articles fulfilled screening criteria and were assessed. Aggregate data on 1185 patients from nine studies were analysed, and individual patient-level data on 895 patients were provided from six of these studies. Eight studies were observational and one was a randomised controlled trial. Most studies used historical controls. In the individual patient-level meta-analysis, after adjusting for age, comorbidities, baseline ratio of the arterial partial oxygen pressure divided by the fraction of inspired oxygen (PaO2/FiO2), C-reactive protein (CRP) concentrations, and lymphopenia, mortality was significantly lower in patients treated with anakinra (38 [11%] of 342) than in those receiving standard of care with or without placebo (137 [25%] of 553; adjusted odds ratio [OR] 0·32 [95% CI 0·20–0·51]). The mortality benefit was similar across subgroups regardless of comorbidities (ie, diabetes), ferritin concentrations, or the baseline PaO2/FiO2. In a subgroup analysis, anakinra was more effective in lowering mortality in patients with CRP concentrations higher than 100 mg/L (OR 0·28 [95% CI 0·17–0·47]). Anakinra showed a significant survival benefit when given without dexamethasone (OR 0·23 [95% CI 0·12–0·43]), but not with dexamethasone co-administration (0·72 [95% CI 0·37–1·41]). Anakinra was not associated with a significantly increased risk of secondary infections when compared with standard of care (OR 1·35 [95% CI 0·59–3·10]). Interpretation: Anakinra could be a safe, anti-inflammatory treatment option to reduce the mortality risk in patients admitted to hospital with moderate to severe COVID-19 pneumonia, especially in the presence of signs of hyperinflammation such as CRP concentrations higher than 100 mg/L. Funding: Sobi. © 2021 Elsevier Ltd

Published
2021

36. Determinants of SARS-COV-2 seroconversion in a cohort of recovered patients

Author

Ciccullo, A., Matteo Tosato, Borghetti, A., Moschese, D., Fantoni, M., Di Giambenedetto, S., and Landi, F.

Subjects
Male, SARS-CoV-2, COVID-19, Middle Aged, Settore MED/17 - MALATTIE INFETTIVE, Cohort Studies, Seroconversion, Immunoglobulin G, Humans, Female, Viral, Antigens, Antigens, Viral, Aged
Abstract

Not available.

Published
2021

37. Author Correction: Early treatment of COVID-19 with anakinra guided by soluble urokinase plasminogen receptor plasma levels: a double-blind, randomized controlled phase 3 trial (Nature Medicine, (2021), 27, 10, (1752-1760), 10.1038/s41591-021-01499-z)

Author

Kyriazopoulou, E. Poulakou, G. Milionis, H. Metallidis, S. Adamis, G. Tsiakos, K. Fragkou, A. Rapti, A. Damoulari, C. Fantoni, M. Kalomenidis, I. Chrysos, G. Angheben, A. Kainis, I. Alexiou, Z. Castelli, F. Serino, F.S. Tsilika, M. Bakakos, P. Nicastri, E. Tzavara, V. Kostis, E. Dagna, L. Koufargyris, P. Dimakou, K. Savvanis, S. Tzatzagou, G. Chini, M. Cavalli, G. Bassetti, M. Katrini, K. Kotsis, V. Tsoukalas, G. Selmi, C. Bliziotis, I. Samarkos, M. Doumas, M. Ktena, S. Masgala, A. Papanikolaou, I. Kosmidou, M. Myrodia, D.-M. Argyraki, A. Cardellino, C.S. Koliakou, K. Katsigianni, E.-I. Rapti, V. Giannitsioti, E. Cingolani, A. Micha, S. Akinosoglou, K. Liatsis-Douvitsas, O. Symbardi, S. Gatselis, N. Mouktaroudi, M. Ippolito, G. Florou, E. Kotsaki, A. Netea, M.G. Eugen-Olsen, J. Kyprianou, M. Panagopoulos, P. Dalekos, G.N. Giamarellos-Bourboulis, E.J.

Abstract

In the version of this Article initially published, there was an error in the author affiliations. Specifically, affiliation 27, corresponding to author Carlo Selmi, has been corrected from “Humanitas Research Hospital, Milan, Italy” to read: “Department of Biomedical Sciences, Humanitas University, Milan, Italy & IRCCS Humanitas Research Hospital, Milan, Italy.” The change has been made to the online version of the Article. © The Author(s) 2021.

Published
2021

38. Baricitinib as rescue therapy in a patient with COVID-19 with no complete response to sarilumab

Author

Cingolani, A., Tummolo, A. M., Montemurro, G., Gremese, E., Larosa, L., Cipriani, M. C., Pasciuto, G., Liperoti, R., Murri, R., Pirronti, T., Cauda, R., Fantoni, M., Bellieni, A., Brandi, V., Calabrese, A., Calvello, M. R., Ciccullo, A., Corbo, G., Falsiroli, C., Intini, E., Landi, G., Leone, P. M., Macagno, F., Martis, I., Pais, C., Potenza, A., Salini, S., Simonetti, J., Taddei, E., Tosato, M., Varone, F., Ventura, G., and Siciliano, M.

Subjects
0301 basic medicine, Male, Baricitinib, medicine.medical_treatment, Azithromycin, Lopinavir, 0302 clinical medicine, Respiratory function, 030212 general & internal medicine, Sulfonamides, Brief Report, General Medicine, Drug Combinations, Infectious Diseases, Treatment Outcome, Radiological weapon, Anesthesia, Acute Disease, Immunotherapy, Coronavirus Infections, Respiratory Insufficiency, medicine.drug, Hydroxychloroquine, Microbiology (medical), Coronavirus disease 2019 (COVID-19), 030106 microbiology, Pneumonia, Viral, Antibodies, Monoclonal, Humanized, Antiviral Agents, 03 medical and health sciences, Betacoronavirus, medicine, Humans, Pandemics, Aged, Ritonavir, business.industry, SARS-CoV-2, Sarilumab, Drug Repositioning, COVID-19, Respiratory failure, Purines, Azetidines, Pyrazoles, business
Abstract

A patient with COVID-19-related severe respiratory failure, with insufficient response to an antiretroviral therapy, hydroxychloroquine and Interleukin-6 (IL-6) antagonist therapy, presented a prompt resolution of the respiratory function and improvement in the radiological picture after baricitinib at an oral dose of 4 mg per day for 2 weeks.

Published
2020

39. A pandemic recap: lessons we have learned

Author

Coccolini, F., Cicuttin, E., Cremonini, C., Tartaglia, D., Viaggi, B., Kuriyama, A., Picetti, E., Ball, C., Abu-Zidan, F., Ceresoli, M., Turri, B., Jain, S., Palombo, C., Guirao, X., Rodrigues, G., Gachabayov, M., Machado, F., Eftychios, L., Kanj, S.S., Carlo, I. Di, Saverio, S. Di, Khokha, V., Kirkpatrick, A., Massalou, D., Forfori, F., Corradi, F., Delibegovic, S., Vega, G.M. Machain, Fantoni, M., Demetriades, D., Kapoor, G., Kluger, Y., Ansari, S., Maier, R., Leppaniemi, A., Hardcastle, T., Vereczkei, A., Karamagioli, E., Pikoulis, E., Pistello, M., Sakakushev, B.E., Navsaria, P.H., Galeiras, R., Yahya, A.I., Osipov, A.V., Dimitrov, E., Doklestić, K., Pisano, M., Malacarne, P., Carcoforo, P., Sibilla, M.G., Kryvoruchko, I.A., Bonavina, L., Kim, J.I., Shelat, V.G., Czepiel, J., Maseda, E., Marwah, S., Chirica, M., Biancofiore, G., Podda, M., Cobianchi, L., Ansaloni, L., Fugazzola, P., Seretis, C., Gomez, C.A., Tumietto, F., Malbrain, M., Reichert, M., Augustin, G., Amato, B., Puzziello, A., Hecker, A., Gemignani, A., Isik, A., Cucchetti, A., Nacoti, M., Kopelman, D., Mesina, C., Ghannam, W., Ben-Ishay, O., Dhingra, S., Coimbra, R., Moore, E.E., Cui, Y., Quiodettis, M.A., Bala, M., Testini, M., Diaz, J., Girardis, M., Biffl, W.L., Hecker, M., Sall, I., Boggi, U., Materazzi, G., Ghiadoni, L., Matsumoto, J., Zuidema, W.P., Ivatury, R., Enani, M.A., Goor, H. van, Catena, Fausto, Sartelli, M., Coccolini, F., Cicuttin, E., Cremonini, C., Tartaglia, D., Viaggi, B., Kuriyama, A., Picetti, E., Ball, C., Abu-Zidan, F., Ceresoli, M., Turri, B., Jain, S., Palombo, C., Guirao, X., Rodrigues, G., Gachabayov, M., Machado, F., Eftychios, L., Kanj, S.S., Carlo, I. Di, Saverio, S. Di, Khokha, V., Kirkpatrick, A., Massalou, D., Forfori, F., Corradi, F., Delibegovic, S., Vega, G.M. Machain, Fantoni, M., Demetriades, D., Kapoor, G., Kluger, Y., Ansari, S., Maier, R., Leppaniemi, A., Hardcastle, T., Vereczkei, A., Karamagioli, E., Pikoulis, E., Pistello, M., Sakakushev, B.E., Navsaria, P.H., Galeiras, R., Yahya, A.I., Osipov, A.V., Dimitrov, E., Doklestić, K., Pisano, M., Malacarne, P., Carcoforo, P., Sibilla, M.G., Kryvoruchko, I.A., Bonavina, L., Kim, J.I., Shelat, V.G., Czepiel, J., Maseda, E., Marwah, S., Chirica, M., Biancofiore, G., Podda, M., Cobianchi, L., Ansaloni, L., Fugazzola, P., Seretis, C., Gomez, C.A., Tumietto, F., Malbrain, M., Reichert, M., Augustin, G., Amato, B., Puzziello, A., Hecker, A., Gemignani, A., Isik, A., Cucchetti, A., Nacoti, M., Kopelman, D., Mesina, C., Ghannam, W., Ben-Ishay, O., Dhingra, S., Coimbra, R., Moore, E.E., Cui, Y., Quiodettis, M.A., Bala, M., Testini, M., Diaz, J., Girardis, M., Biffl, W.L., Hecker, M., Sall, I., Boggi, U., Materazzi, G., Ghiadoni, L., Matsumoto, J., Zuidema, W.P., Ivatury, R., Enani, M.A., Goor, H. van, Catena, Fausto, and Sartelli, M.

Abstract

Contains fulltext : 238976.pdf (Publisher’s version ) (Open Access), On January 2020, the WHO Director General declared that the outbreak constitutes a Public Health Emergency of International Concern. The world has faced a worldwide spread crisis and is still dealing with it. The present paper represents a white paper concerning the tough lessons we have learned from the COVID-19 pandemic. Thus, an international and heterogenous multidisciplinary panel of very differentiated people would like to share global experiences and lessons with all interested and especially those responsible for future healthcare decision making. With the present paper, international and heterogenous multidisciplinary panel of very differentiated people would like to share global experiences and lessons with all interested and especially those responsible for future healthcare decision making.

Published
2021

40. COVID-19 and RA share an SPP1 myeloid pathway that drives PD-L1+ neutrophils and CD14+ monocytes

Author

MacDonald, L., Alivernini, S. (ORCID:0000-0002-7383-4212), Tolusso, B., Elmesmari, A., Somma, D., Perniola, S., Paglionico, A., Petricca, L., Bosello, S. L. (ORCID:0000-0002-4837-447X), Carfi, A., Sali, M., Stigliano, E., Cingolani, A. (ORCID:0000-0002-3793-2755), Murri, R. (ORCID:0000-0003-4263-7854), Arena, V. (ORCID:0000-0002-7562-223X), Fantoni, M., Antonelli, M. (ORCID:0000-0003-3007-1670), Landi, F. (ORCID:0000-0002-3472-1389), Franceschi, F., Sanguinetti, M. (ORCID:0000-0002-9780-7059), McInnes, I. B., McSharry, C., Gasbarrini, A. (ORCID:0000-0002-7278-4823), Otto, T. D., Kurowska-Stolarska, M., Gremese, E. (ORCID:0000-0002-2248-1058), MacDonald, L., Alivernini, S. (ORCID:0000-0002-7383-4212), Tolusso, B., Elmesmari, A., Somma, D., Perniola, S., Paglionico, A., Petricca, L., Bosello, S. L. (ORCID:0000-0002-4837-447X), Carfi, A., Sali, M., Stigliano, E., Cingolani, A. (ORCID:0000-0002-3793-2755), Murri, R. (ORCID:0000-0003-4263-7854), Arena, V. (ORCID:0000-0002-7562-223X), Fantoni, M., Antonelli, M. (ORCID:0000-0003-3007-1670), Landi, F. (ORCID:0000-0002-3472-1389), Franceschi, F., Sanguinetti, M. (ORCID:0000-0002-9780-7059), McInnes, I. B., McSharry, C., Gasbarrini, A. (ORCID:0000-0002-7278-4823), Otto, T. D., Kurowska-Stolarska, M., and Gremese, E. (ORCID:0000-0002-2248-1058)

Abstract

We explored the potential link between chronic inflammatory arthritis and COVID-19 pathogenic and resolving macrophage pathways and their role in COVID-19 pathogenesis. We found that bronchoalveolar lavage fluid (BALF) macrophage clusters FCN1+ and FCN1+SPP1+ predominant in severe COVID-19 were transcriptionally related to synovial tissue macrophage (STM) clusters CD48hiS100A12+ and CD48+SPP1+ that drive rheumatoid arthritis (RA) synovitis. BALF macrophage cluster FABP4+ predominant in healthy lung was transcriptionally related to STM cluster TREM2+ that governs resolution of synovitis in RA remission. Plasma concentrations of SPP1 and S100A12 (key products of macrophage clusters shared with active RA) were high in severe COVID-19 and predicted the need for Intensive Care Unit transfer, and they remained high in the post–COVID-19 stage. High plasma levels of SPP1 were unique to severe COVID-19 when compared with other causes of severe pneumonia, and IHC localized SPP1+ macrophages in the alveoli of COVID-19 lung. Investigation into SPP1 mechanisms of action revealed that it drives proinflammatory activation of CD14+ monocytes and development of PD-L1+ neutrophils, both hallmarks of severe COVID-19. In summary, COVID-19 pneumonitis appears driven by similar pathogenic myeloid cell pathways as those in RA, and their mediators such as SPP1 might be an upstream activator of the aberrant innate response in severe COVID-19 and predictive of disease trajectory including post–COVID-19 pathology.

Published
2021

41. Heparin in COVID-19 Patients Is Associated with Reduced In-Hospital Mortality: the Multicenter Italian CORIST Study

Author

Di Castelnuovo, A, Costanzo, S, Antinori, A, Berselli, N, Blandi, L, Bonaccio, M, Cauda, R, Guaraldi, G, Menicanti, L, Mennuni, M, Parruti, G, Patti, G, Santilli, F, Signorelli, C, Vergori, A, Abete, P, Ageno, W, Agodi, A, Agostoni, P, Aiello, L, Al Moghazi, S, Arboretti, R, Astuto, M, Aucella, F, Barbieri, G, Bartoloni, A, Bonfanti, P, Cacciatore, F, Caiano, L, Carrozzi, L, Cascio, A, Ciccullo, A, Cingolani, A, Cipollone, F, Colomba, C, Colombo, C, Crosta, F, Danzi, G, D'Ardes, D, de Gaetano Donati, K, Di Gennaro, F, Di Tano, G, D'Offizi, G, Fantoni, M, Fusco, F, Gentile, I, Gianfagna, F, Grandone, E, Graziani, E, Grisafi, L, Guarnieri, G, Larizza, G, Leone, A, Maccagni, G, Madaro, F, Maitan, S, Mancarella, S, Mapelli, M, Maragna, R, Marcucci, R, Maresca, G, Marongiu, S, Marotta, C, Marra, L, Mastroianni, F, Mazzitelli, M, Mengozzi, A, Menichetti, F, Meschiari, M, Milic, J, Minutolo, F, Molena, B, Montineri, A, Mussini, C, Musso, M, Niola, D, Odone, A, Olivieri, M, Palimodde, A, Parisi, R, Pasi, E, Pesavento, R, Petri, F, Pinchera, B, Poletti, V, Ravaglia, C, Rognoni, A, Rossato, M, Rossi, M, Sangiovanni, V, Sanrocco, C, Scorzolini, L, Sgariglia, R, Simeone, P, Taddei, E, Torti, C, Vettor, R, Vianello, A, Vinceti, M, Virano, A, Vocciante, L, De Caterina, R, Iacoviello, L, Di Castelnuovo, Augusto, Costanzo, Simona, Antinori, Andrea, Berselli, Nausicaa, Blandi, Lorenzo, Bonaccio, Marialaura, Cauda, Roberto, Guaraldi, Giovanni, Menicanti, Lorenzo, Mennuni, Marco, Parruti, Giustino, Patti, Giuseppe, Santilli, Francesca, Signorelli, Carlo, Vergori, Alessandra, Abete, Pasquale, Ageno, Walter, Agodi, Antonella, Agostoni, Piergiuseppe, Aiello, Luca, Al Moghazi, Samir, Arboretti, Rosa, Astuto, Marinella, Aucella, Filippo, Barbieri, Greta, Bartoloni, Alessandro, Bonfanti, Paolo, Cacciatore, Francesco, Caiano, Lucia, Carrozzi, Laura, Cascio, Antonio, Ciccullo, Arturo, Cingolani, Antonella, Cipollone, Francesco, Colomba, Claudia, Colombo, Crizia, Crosta, Francesca, Danzi, Gian Battista, D'Ardes, Damiano, de Gaetano Donati, Katleen, Di Gennaro, Francesco, Di Tano, Giuseppe, D'Offizi, Gianpiero, Fantoni, Massimo, Fusco, Francesco Maria, Gentile, Ivan, Gianfagna, Francesco, Grandone, Elvira, Graziani, Emauele, Grisafi, Leonardo, Guarnieri, Gabriella, Larizza, Giovanni, Leone, Armando, Maccagni, Gloria, Madaro, Ferruccio, Maitan, Stefano, Mancarella, Sandro, Mapelli, Massimo, Maragna, Riccardo, Marcucci, Rossella, Maresca, Giulio, Marongiu, Silvia, Marotta, Claudia, Marra, Lorenzo, Mastroianni, Franco, Mazzitelli, Maria, Mengozzi, Alessandro, Menichetti, Francesco, Meschiari, Marianna, Milic, Jovana, Minutolo, Filippo, Molena, Beatrice, Montineri, Arturo, Mussini, Cristina, Musso, Maria, Niola, Daniela, Odone, Anna, Olivieri, Marco, Palimodde, Antonella, Parisi, Roberta, Pasi, Emanuela, Pesavento, Raffaele, Petri, Francesco, Pinchera, Biagio, Poletti, Venerino, Ravaglia, Claudia, Rognoni, Andrea, Rossato, Marco, Rossi, Marianna, Sangiovanni, Vincenzo, Sanrocco, Carlo, Scorzolini, Laura, Sgariglia, Raffaella, Simeone, Paola Giustina, Taddei, Eleonora, Torti, Carlo, Vettor, Roberto, Vianello, Andrea, Vinceti, Marco, Virano, Alexandra, Vocciante, Laura, De Caterina, Raffaele, Iacoviello, Licia, Di Castelnuovo, A, Costanzo, S, Antinori, A, Berselli, N, Blandi, L, Bonaccio, M, Cauda, R, Guaraldi, G, Menicanti, L, Mennuni, M, Parruti, G, Patti, G, Santilli, F, Signorelli, C, Vergori, A, Abete, P, Ageno, W, Agodi, A, Agostoni, P, Aiello, L, Al Moghazi, S, Arboretti, R, Astuto, M, Aucella, F, Barbieri, G, Bartoloni, A, Bonfanti, P, Cacciatore, F, Caiano, L, Carrozzi, L, Cascio, A, Ciccullo, A, Cingolani, A, Cipollone, F, Colomba, C, Colombo, C, Crosta, F, Danzi, G, D'Ardes, D, de Gaetano Donati, K, Di Gennaro, F, Di Tano, G, D'Offizi, G, Fantoni, M, Fusco, F, Gentile, I, Gianfagna, F, Grandone, E, Graziani, E, Grisafi, L, Guarnieri, G, Larizza, G, Leone, A, Maccagni, G, Madaro, F, Maitan, S, Mancarella, S, Mapelli, M, Maragna, R, Marcucci, R, Maresca, G, Marongiu, S, Marotta, C, Marra, L, Mastroianni, F, Mazzitelli, M, Mengozzi, A, Menichetti, F, Meschiari, M, Milic, J, Minutolo, F, Molena, B, Montineri, A, Mussini, C, Musso, M, Niola, D, Odone, A, Olivieri, M, Palimodde, A, Parisi, R, Pasi, E, Pesavento, R, Petri, F, Pinchera, B, Poletti, V, Ravaglia, C, Rognoni, A, Rossato, M, Rossi, M, Sangiovanni, V, Sanrocco, C, Scorzolini, L, Sgariglia, R, Simeone, P, Taddei, E, Torti, C, Vettor, R, Vianello, A, Vinceti, M, Virano, A, Vocciante, L, De Caterina, R, Iacoviello, L, Di Castelnuovo, Augusto, Costanzo, Simona, Antinori, Andrea, Berselli, Nausicaa, Blandi, Lorenzo, Bonaccio, Marialaura, Cauda, Roberto, Guaraldi, Giovanni, Menicanti, Lorenzo, Mennuni, Marco, Parruti, Giustino, Patti, Giuseppe, Santilli, Francesca, Signorelli, Carlo, Vergori, Alessandra, Abete, Pasquale, Ageno, Walter, Agodi, Antonella, Agostoni, Piergiuseppe, Aiello, Luca, Al Moghazi, Samir, Arboretti, Rosa, Astuto, Marinella, Aucella, Filippo, Barbieri, Greta, Bartoloni, Alessandro, Bonfanti, Paolo, Cacciatore, Francesco, Caiano, Lucia, Carrozzi, Laura, Cascio, Antonio, Ciccullo, Arturo, Cingolani, Antonella, Cipollone, Francesco, Colomba, Claudia, Colombo, Crizia, Crosta, Francesca, Danzi, Gian Battista, D'Ardes, Damiano, de Gaetano Donati, Katleen, Di Gennaro, Francesco, Di Tano, Giuseppe, D'Offizi, Gianpiero, Fantoni, Massimo, Fusco, Francesco Maria, Gentile, Ivan, Gianfagna, Francesco, Grandone, Elvira, Graziani, Emauele, Grisafi, Leonardo, Guarnieri, Gabriella, Larizza, Giovanni, Leone, Armando, Maccagni, Gloria, Madaro, Ferruccio, Maitan, Stefano, Mancarella, Sandro, Mapelli, Massimo, Maragna, Riccardo, Marcucci, Rossella, Maresca, Giulio, Marongiu, Silvia, Marotta, Claudia, Marra, Lorenzo, Mastroianni, Franco, Mazzitelli, Maria, Mengozzi, Alessandro, Menichetti, Francesco, Meschiari, Marianna, Milic, Jovana, Minutolo, Filippo, Molena, Beatrice, Montineri, Arturo, Mussini, Cristina, Musso, Maria, Niola, Daniela, Odone, Anna, Olivieri, Marco, Palimodde, Antonella, Parisi, Roberta, Pasi, Emanuela, Pesavento, Raffaele, Petri, Francesco, Pinchera, Biagio, Poletti, Venerino, Ravaglia, Claudia, Rognoni, Andrea, Rossato, Marco, Rossi, Marianna, Sangiovanni, Vincenzo, Sanrocco, Carlo, Scorzolini, Laura, Sgariglia, Raffaella, Simeone, Paola Giustina, Taddei, Eleonora, Torti, Carlo, Vettor, Roberto, Vianello, Andrea, Vinceti, Marco, Virano, Alexandra, Vocciante, Laura, De Caterina, Raffaele, and Iacoviello, Licia

Abstract

INTRODUCTION: A hypercoagulable condition was described in patients with coronavirus disease 2019 (COVID-19) and proposed as a possible pathogenic mechanism contributing to disease progression and lethality.AIM: We evaluated if in-hospital administration of heparin improved survival in a large cohort of Italian COVID-19 patients.METHODS: In a retrospective observational study, 2,574 unselected patients hospitalized in 30 clinical centers in Italy from February 19, 2020 to June 5, 2020 with laboratory-confirmed severe acute respiratory syndrome coronavirus-2 infection were analyzed. The primary endpoint in a time-to event analysis was in-hospital death, comparing patients who received heparin (low-molecular-weight heparin [LMWH] or unfractionated heparin [UFH]) with patients who did not. We used multivariable Cox proportional-hazards regression models with inverse probability for treatment weighting by propensity scores.RESULTS: Out of 2,574 COVID-19 patients, 70.1% received heparin. LMWH was largely the most used formulation (99.5%). Death rates for patients receiving heparin or not were 7.4 and 14.0 per 1,000 person-days, respectively. After adjustment for propensity scores, we found a 40% lower risk of death in patients receiving heparin (hazard ratio=0.60; 95% confidence interval: 0.49-0.74; E-value=2.04). This association was particularly evident in patients with a higher severity of disease or strong coagulation activation.CONCLUSION: In-hospital heparin treatment was associated with a lower mortality, particularly in severely ill COVID-19 patients and in those with strong coagulation activation. The results from randomized clinical trials are eagerly awaited to provide clear-cut recommendations.

Published
2021

42. Residual respiratory impairment after COVID-19 pneumonia

Author

Lombardi, F., Calabrese, Anna Chiara, Iovene, Bruno, Pierandrei, C., Lerede, M., Varone, Francesco, Richeldi, Luca, Sgalla, Giacomo, Landi, Francesco, Gremese, Elisa, Bernabei, Roberto, Fantoni, Massimo, Gasbarrini, Antonio, Romano Settanni, C., Benvenuto, F., Bramato, Giulia, Carfi, A., Ciciarello, Francesca, Lo Monaco, Maria Rita, Maria Martone, A., Marzetti, Emanuele, Napolitano, C., Pagano, Francesco Cosimo, Rocchi, Sara, Rota, E., Salerno, Andrea Maria, Tosato, Matteo, Tritto, M., Calvani, Riccardo, Catalano, Lucio, Picca, A., Savera, Giulia, Tamburrini, Enrica, Borghetti, Alberto, Di Gianbenedetto, S., Murri, Rita, Cingolani, Antonella, Ventura, Giulio, Taddei, E., Moschese, D., Ciccullo, A., Stella, L., Addolorato, Giovanni, Franceschi, Francesco, Mingrone, Geltrude, Assunta Zocco, M., Sanguinetti, Maurizio, Cattani Franchi, Paola, Marchetti, Simona, Bizzarro, Alessandra, Lauria, Alessandra, Rizzo, Stanislao, Cristina Savastano, M., Gambini, Gloria, Grazia Cozzupoli, M., Culiersi, Carola, Passali, Giulio Cesare, Paludetti, Gaetano, Galli, Jacopo, Crudo, F., Di Cintio, G., Longobardi, Ylenia, Tricarico, Laura, Santantonio, M., Buonsenso, Danilo, Valentini, Piero, Pata, D., Sinatti, Dario, De Rose, Cristina, Sani, Gabriele, Janiri, Delfina, Giuseppin, G., Molinaro, M., Modica, Marco, Natale, Luigi, Rita Larici, A., Marano, Riccardo, Paglionico, A., Petricca, Luca, Gigante, Lavinia, Natalello, G., Laur, a. Fedele A., Maria Lizzio, M., Santoliquido, Angelo, Santoro, L., Nesci, A., Popolla, Valentina, Calabrese A., Iovene B., Varone F., Richeldi L. (ORCID:0000-0001-8594-1448), Sgalla G. (ORCID:0000-0003-3130-9388), Landi F. (ORCID:0000-0002-3472-1389), 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), Bramato G., Ciciarello F., Lo Monaco M. R. (ORCID:0000-0002-1457-7981), Marzetti E. (ORCID:0000-0001-9567-6983), Pagano F., Rocchi S., Salerno A., Tosato M., Calvani R. (ORCID:0000-0001-5472-2365), Catalano L., Savera G., 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), Sanguinetti M. (ORCID:0000-0002-9780-7059), Cattani P. (ORCID:0000-0003-4678-4763), Marchetti S., Bizzarro A., Lauria A., Rizzo S. (ORCID:0000-0001-6302-063X), Gambini G., Culiersi C., Cesare Passali G. (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., Sani G. (ORCID:0000-0002-9767-8752), Janiri D., Modica M., Natale L. (ORCID:0000-0002-7949-5119), Marano R. (ORCID:0000-0003-2710-2093), Petricca L., Gigante L., Santoliquido A. (ORCID:0000-0003-1539-4017), Popolla V., Lombardi, F., Calabrese, Anna Chiara, Iovene, Bruno, Pierandrei, C., Lerede, M., Varone, Francesco, Richeldi, Luca, Sgalla, Giacomo, Landi, Francesco, Gremese, Elisa, Bernabei, Roberto, Fantoni, Massimo, Gasbarrini, Antonio, Romano Settanni, C., Benvenuto, F., Bramato, Giulia, Carfi, A., Ciciarello, Francesca, Lo Monaco, Maria Rita, Maria Martone, A., Marzetti, Emanuele, Napolitano, C., Pagano, Francesco Cosimo, Rocchi, Sara, Rota, E., Salerno, Andrea Maria, Tosato, Matteo, Tritto, M., Calvani, Riccardo, Catalano, Lucio, Picca, A., Savera, Giulia, Tamburrini, Enrica, Borghetti, Alberto, Di Gianbenedetto, S., Murri, Rita, Cingolani, Antonella, Ventura, Giulio, Taddei, E., Moschese, D., Ciccullo, A., Stella, L., Addolorato, Giovanni, Franceschi, Francesco, Mingrone, Geltrude, Assunta Zocco, M., Sanguinetti, Maurizio, Cattani Franchi, Paola, Marchetti, Simona, Bizzarro, Alessandra, Lauria, Alessandra, Rizzo, Stanislao, Cristina Savastano, M., Gambini, Gloria, Grazia Cozzupoli, M., Culiersi, Carola, Passali, Giulio Cesare, Paludetti, Gaetano, Galli, Jacopo, Crudo, F., Di Cintio, G., Longobardi, Ylenia, Tricarico, Laura, Santantonio, M., Buonsenso, Danilo, Valentini, Piero, Pata, D., Sinatti, Dario, De Rose, Cristina, Sani, Gabriele, Janiri, Delfina, Giuseppin, G., Molinaro, M., Modica, Marco, Natale, Luigi, Rita Larici, A., Marano, Riccardo, Paglionico, A., Petricca, Luca, Gigante, Lavinia, Natalello, G., Laur, a. Fedele A., Maria Lizzio, M., Santoliquido, Angelo, Santoro, L., Nesci, A., Popolla, Valentina, Calabrese A., Iovene B., Varone F., Richeldi L. (ORCID:0000-0001-8594-1448), Sgalla G. (ORCID:0000-0003-3130-9388), Landi F. (ORCID:0000-0002-3472-1389), 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), Bramato G., Ciciarello F., Lo Monaco M. R. (ORCID:0000-0002-1457-7981), Marzetti E. (ORCID:0000-0001-9567-6983), Pagano F., Rocchi S., Salerno A., Tosato M., Calvani R. (ORCID:0000-0001-5472-2365), Catalano L., Savera G., 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), Sanguinetti M. (ORCID:0000-0002-9780-7059), Cattani P. (ORCID:0000-0003-4678-4763), Marchetti S., Bizzarro A., Lauria A., Rizzo S. (ORCID:0000-0001-6302-063X), Gambini G., Culiersi C., Cesare Passali G. (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., Sani G. (ORCID:0000-0002-9767-8752), Janiri D., Modica M., Natale L. (ORCID:0000-0002-7949-5119), Marano R. (ORCID:0000-0003-2710-2093), Petricca L., Gigante L., Santoliquido A. (ORCID:0000-0003-1539-4017), and Popolla V.

Abstract

Introduction: The novel coronavirus SARS-Cov-2 can infect the respiratory tract causing a spectrum of disease varying from mild to fatal pneumonia, and known as COVID-19. Ongoing clinical research is assessing the potential for long-term respiratory sequelae in these patients. We assessed the respiratory function in a cohort of patients after recovering from SARS-Cov-2 infection, stratified according to PaO2/FiO2 (p/F) values. Method: Approximately one month after hospital discharge, 86 COVID-19 patients underwent physical examination, arterial blood gas (ABG) analysis, pulmonary function tests (PFTs), and six-minute walk test (6MWT). Patients were also asked to quantify the severity of dyspnoea and cough before, during, and after hospitalization using a visual analogic scale (VAS). Seventy-six subjects with ABG during hospitalization were stratified in three groups according to their worst p/F values: above 300 (n = 38), between 200 and 300 (n = 30) and below 200 (n = 20). Results: On PFTs, lung volumes were overall preserved yet, mean percent predicted residual volume was slightly reduced (74.8 ± 18.1%). Percent predicted diffusing capacity for carbon monoxide (DLCO) was also mildly reduced (77.2 ± 16.5%). Patients reported residual breathlessness at the time of the visit (VAS 19.8, p < 0.001). Patients with p/F below 200 during hospitalization had lower percent predicted forced vital capacity (p = 0.005), lower percent predicted total lung capacity (p = 0.012), lower DLCO (p < 0.001) and shorter 6MWT distance (p = 0.004) than patients with higher p/F. Conclusion: Approximately one month after hospital discharge, patients with COVID-19 can have residual respiratory impairment, including lower exercise tolerance. The extent of this impairment seems to correlate with the severity of respiratory failure during hospitalization.

Published
2021

43. Covid-19 seroprevalence among healthcare workers of a large covid-19 hospital in rome reveals strengths and limits of two different serological tests

Author

Vetrugno, Giuseppe, La Milia, Daniele Ignazio, D'Ambrosio, Floriana, Di Pumpo, Marcello, Pastorino, Roberta, Boccia, Stefania, Ricci, Rosalba, De-Giorgio, F., Cicconi, M., Foti, F., Pascucci, Domenico, Castrini, Francesco, Carini, Elettra, Cambieri, Andrea, D'Alfonso, Maria Elena, Capalbo, Gennaro, Fantoni, Massimo, Moscato, Umberto, Staiti, Domenico, De Simone, F. M., Berloco, Filippo, Damiani, Gianfranco, Zega, Maurizio, Cattani, P., Posteraro, Brunella, Sanguinetti, Maurizio, Laurenti, Patrizia, Vetrugno G. (ORCID:0000-0003-0181-2855), La Milia D. I., D'ambrosio F., Di Pumpo M., Pastorino R. (ORCID:0000-0001-5013-0733), Boccia S. (ORCID:0000-0002-1864-749X), Ricci R., Pascucci D. (ORCID:0000-0002-5804-2284), Castrini F., Carini E., Cambieri A., D'alfonso M. E., Capalbo G., Fantoni M. (ORCID:0000-0001-6913-8460), Moscato U. (ORCID:0000-0002-2568-3966), Staiti D. (ORCID:0000-0001-5179-9690), Berloco F., Damiani G. (ORCID:0000-0003-3028-6188), Zega M. (ORCID:0000-0002-7821-2615), Posteraro B. (ORCID:0000-0002-1663-7546), Sanguinetti M. (ORCID:0000-0002-9780-7059), Laurenti P. (ORCID:0000-0002-8532-0593), Vetrugno, Giuseppe, La Milia, Daniele Ignazio, D'Ambrosio, Floriana, Di Pumpo, Marcello, Pastorino, Roberta, Boccia, Stefania, Ricci, Rosalba, De-Giorgio, F., Cicconi, M., Foti, F., Pascucci, Domenico, Castrini, Francesco, Carini, Elettra, Cambieri, Andrea, D'Alfonso, Maria Elena, Capalbo, Gennaro, Fantoni, Massimo, Moscato, Umberto, Staiti, Domenico, De Simone, F. M., Berloco, Filippo, Damiani, Gianfranco, Zega, Maurizio, Cattani, P., Posteraro, Brunella, Sanguinetti, Maurizio, Laurenti, Patrizia, Vetrugno G. (ORCID:0000-0003-0181-2855), La Milia D. I., D'ambrosio F., Di Pumpo M., Pastorino R. (ORCID:0000-0001-5013-0733), Boccia S. (ORCID:0000-0002-1864-749X), Ricci R., Pascucci D. (ORCID:0000-0002-5804-2284), Castrini F., Carini E., Cambieri A., D'alfonso M. E., Capalbo G., Fantoni M. (ORCID:0000-0001-6913-8460), Moscato U. (ORCID:0000-0002-2568-3966), Staiti D. (ORCID:0000-0001-5179-9690), Berloco F., Damiani G. (ORCID:0000-0003-3028-6188), Zega M. (ORCID:0000-0002-7821-2615), Posteraro B. (ORCID:0000-0002-1663-7546), Sanguinetti M. (ORCID:0000-0002-9780-7059), and Laurenti P. (ORCID:0000-0002-8532-0593)

Abstract

Healthcare workers are at the forefront against COVID-19, worldwide. Since Fondazione Policlinico Universitario A. Gemelli (FPG) IRCCS was enlisted as a COVID-19 hospital, the healthcare workers deployed to COVID-19 wards were separated from those with limited/no exposure, whereas the administrative staff were designated to work from home. Between 4 June and 3 July 2020, an investigation was conducted to evaluate the seroprevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) immunoglobulin (IgG) antibodies among the employees of the FPG using point-of-care (POC) and venous blood tests. Sensitivity, specificity, and predictive values were determined with reverse-transcription polymerase chain reaction on nasal/oropharyngeal swabs as the diagnostic gold standard. The participants enrolled amounted to 4777. Seroprevalence was 3.66% using the POC test and 1.19% using the venous blood test, with a significant difference (p < 0.05). The POC test sensitivity and specificity were, respectively, 63.64% (95% confidence interval (CI): 62.20% to 65.04%) and 96.64% (95% CI: 96.05% to 97.13%), while those of the venous blood test were, respectively, 78.79% (95% CI: 77.58% to 79.94%) and 99.36% (95% CI: 99.07% to 99.55%). Among the low-risk populations, the POC test’s predictive values were 58.33% (positive) and 98.23% (negative), whereas those of the venous blood test were 92.86% (positive) and 98.53% (negative). According to our study, these serological tests cannot be a valid alternative to diagnose COVID-19 infection in progress.

Published
2021

44. Post-prescription audit plus beta-d-glucan assessment decrease echinocandin use in people with suspected invasive candidiasis

Author

Murri, Rita, Lardo, S., De Luca, Alessio, Posteraro, Brunella, Torelli, Riccardo, De Angelis, Giulia, Giovannenze, Francesca, Taccari, Francesco, Pavan, L., Parroni, L., Sanguinetti, Maurizio, Fantoni, Massimo, Murri R. (ORCID:0000-0003-4263-7854), De Luca A., Posteraro B. (ORCID:0000-0002-1663-7546), Torelli R., De Angelis G. (ORCID:0000-0002-7087-7399), Giovannenze F., Taccari F., Sanguinetti M. (ORCID:0000-0002-9780-7059), Fantoni M. (ORCID:0000-0001-6913-8460), Murri, Rita, Lardo, S., De Luca, Alessio, Posteraro, Brunella, Torelli, Riccardo, De Angelis, Giulia, Giovannenze, Francesca, Taccari, Francesco, Pavan, L., Parroni, L., Sanguinetti, Maurizio, Fantoni, Massimo, Murri R. (ORCID:0000-0003-4263-7854), De Luca A., Posteraro B. (ORCID:0000-0002-1663-7546), Torelli R., De Angelis G. (ORCID:0000-0002-7087-7399), Giovannenze F., Taccari F., Sanguinetti M. (ORCID:0000-0002-9780-7059), and Fantoni M. (ORCID:0000-0001-6913-8460)

Abstract

Background and Objectives: Overtreatment with antifungal drugs is often observed. Antifungal stewardship (AFS) focuses on optimizing the treatment for invasive fungal diseases. The objective of the present study was to evaluate the utility of a post-prescription audit plus beta-D-glucan (BDG) assessment on reducing echinocandin use in persons with suspected invasive candidiasis. Materials and Methods: This is a prospective, pre-post quasi-experimental study of people starting echinocandins for suspected invasive candidiasis. The intervention of the study included review of each echinocandin prescription and discontinuation of treatment if a very low probability of fungal disease or a negative BDG value were found. Pre-intervention data were compared with the intervention phase. The primary outcome of the study was the duration of echinocandin therapy. Secondary outcomes were length of hospital stay and mortality. Results: Ninety-two echinocan-din prescriptions were reviewed, 49 (53.3%) in the pre-intervention phase and 43 (46.7%) in the intervention phase. Discontinuation of antifungal therapy was possible in 21 of the 43 patients in the intervention phase (48.8%). The duration of echinocandin therapy was 7.4 (SD 4.7) in the pre-intervention phase, 4.1 days (SD 2.9) in persons undergoing the intervention, and 8.6 (SD 7.3) in persons in whom the intervention was not feasible (p at ANOVA = 0.016). Length of stay and mortality did not differ between pre-intervention and intervention phases. Conclusions: An intervention based on pre-prescription restriction and post-prescription audit when combined with BDG measurement is effective in optimizing antifungal therapy by significantly reducing excessive treatment duration.

Published
2021

45. 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

46. Ceftazidime-avibactam use for KPC-Kp infections: a retrospective observational multicenter study

Author

Tumbarello, M, Raffaelli, F, Giannella, M, Mantengoli, E, Mularoni, A, Venditti, M, De Rosa, F, Sarmati, L, Bassetti, M, Brindicci, G, Rossi, M, Luzzati, R, Grossi, P, Corona, A, Capone, A, Falcone, M, Mussini, C, Trecarichi, E, Cascio, A, Guffanti, E, Russo, A, De Pascale, G, Tascini, C, Gentile, I, Losito, A, Bussini, L, Conti, G, Ceccarelli, G, Corcione, S, Compagno, M, Giacobbe, D, Saracino, A, Fantoni, M, Antinori, S, Peghin, M, Bonfanti, P, Oliva, A, De Gasperi, A, Tiseo, G, Rovelli, C, Meschiari, M, Shbaklo, N, Spanu, T, Cauda, R, Viale, P, Tumbarello, Mario, Raffaelli, Francesca, Giannella, Maddalena, Mantengoli, Elisabetta, Mularoni, Alessandra, Venditti, Mario, De Rosa, Francesco Giuseppe, Sarmati, Loredana, Bassetti, Matteo, Brindicci, Gaetano, Rossi, Marianna, Luzzati, Roberto, Grossi, Paolo Antonio, Corona, Alberto, Capone, Alessandro, Falcone, Marco, Mussini, Cristina, Trecarichi, Enrico Maria, Cascio, Antonio, Guffanti, Elena, Russo, Alessandro, De Pascale, Gennaro, Tascini, Carlo, Gentile, Ivan, Losito, Angela Raffaella, Bussini, Linda, Conti, Giampaolo, Ceccarelli, Giancarlo, Corcione, Silvia, Compagno, Mirko, Giacobbe, Daniele Roberto, Saracino, Annalisa, Fantoni, Massimo, Antinori, Spinello, Peghin, Maddalena, Bonfanti, Paolo, Oliva, Alessandra, De Gasperi, Andrea, Tiseo, Giusy, Rovelli, Cristina, Meschiari, Marianna, Shbaklo, Nour, Spanu, Teresa, Cauda, Roberto, Viale, Pierluigi, Tumbarello, M, Raffaelli, F, Giannella, M, Mantengoli, E, Mularoni, A, Venditti, M, De Rosa, F, Sarmati, L, Bassetti, M, Brindicci, G, Rossi, M, Luzzati, R, Grossi, P, Corona, A, Capone, A, Falcone, M, Mussini, C, Trecarichi, E, Cascio, A, Guffanti, E, Russo, A, De Pascale, G, Tascini, C, Gentile, I, Losito, A, Bussini, L, Conti, G, Ceccarelli, G, Corcione, S, Compagno, M, Giacobbe, D, Saracino, A, Fantoni, M, Antinori, S, Peghin, M, Bonfanti, P, Oliva, A, De Gasperi, A, Tiseo, G, Rovelli, C, Meschiari, M, Shbaklo, N, Spanu, T, Cauda, R, Viale, P, Tumbarello, Mario, Raffaelli, Francesca, Giannella, Maddalena, Mantengoli, Elisabetta, Mularoni, Alessandra, Venditti, Mario, De Rosa, Francesco Giuseppe, Sarmati, Loredana, Bassetti, Matteo, Brindicci, Gaetano, Rossi, Marianna, Luzzati, Roberto, Grossi, Paolo Antonio, Corona, Alberto, Capone, Alessandro, Falcone, Marco, Mussini, Cristina, Trecarichi, Enrico Maria, Cascio, Antonio, Guffanti, Elena, Russo, Alessandro, De Pascale, Gennaro, Tascini, Carlo, Gentile, Ivan, Losito, Angela Raffaella, Bussini, Linda, Conti, Giampaolo, Ceccarelli, Giancarlo, Corcione, Silvia, Compagno, Mirko, Giacobbe, Daniele Roberto, Saracino, Annalisa, Fantoni, Massimo, Antinori, Spinello, Peghin, Maddalena, Bonfanti, Paolo, Oliva, Alessandra, De Gasperi, Andrea, Tiseo, Giusy, Rovelli, Cristina, Meschiari, Marianna, Shbaklo, Nour, Spanu, Teresa, Cauda, Roberto, and Viale, Pierluigi

Abstract

Background: A growing body of observational evidence supports the value of ceftazidime-avibactam (CAZ-AVI) in managing infections caused by carbapenem-resistant Enterobacteriaceae. Methods: We retrospectively analyzed observational data on use and outcomes of CAZ-AVI therapy for infections caused by Klebsiella pneumoniae carbapenemase-producing K. pneumoniae (KPC-Kp) strains. Multivariate regression analysis was used to identify variables independently associated with 30-day mortality. Results were adjusted for propensity score for receipt of CAZ-AVI combination regimens versus CAZ-AVI monotherapy. Results: The cohort comprised 577 adults with bloodstream infections (n = 391) or nonbacteremic infections involving mainly the urinary tract, lower respiratory tract, and intra-abdominal structures. All received treatment with CAZ-AVI alone (n = 165) or with ≥1 other active antimicrobials (n = 412). The all-cause mortality rate 30 days after infection onset was 25% (146/577). There was no significant difference in mortality between patients managed with CAZ-AVI alone and those treated with combination regimens (26.1% vs 25.0%, P =. 79). In multivariate analysis, mortality was positively associated with presence at infection onset of septic shock (P =. 002), neutropenia (P <. 001), or an INCREMENT score ≥8 (P =. 01); with lower respiratory tract infection (LRTI) (P =. 04); and with CAZ-AVI dose adjustment for renal function (P =. 01). Mortality was negatively associated with CAZ-AVI administration by prolonged infusion (P =. 006). All associations remained significant after propensity score adjustment. Conclusions: CAZ-AVI is an important option for treating serious KPC-Kp infections, even when used alone. Further study is needed to explore the drug's seemingly more limited efficacy in LRTIs and potential survival benefits of prolonging CAZ-AVI infusions to ≥3 hours.

Published
2021

47. 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

49. Postmortem Swabs in the Severe Acute Respiratory Syndrome Coronavirus 2 Pandemic

Author

Dell'Aquila, Marco, Cattani Franchi, Paola, Fantoni, M., Marchetti, Simona, Aquila, I., Stigliano, Egidio, Carbone, Arnaldo, Oliva, Antonio, and Arena, Vincenzo

Subjects
Aged, 80 and over, Male, SARS-CoV-2, Pneumonia, Viral, COVID-19, Middle Aged, Settore MED/43 - MEDICINA LEGALE, Specimen Handling, Betacoronavirus, Nasopharynx, Humans, Female, Autopsy, Coronavirus Infections, Lung, Pandemics, Aged
Published
2020

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