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

Author

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

Published
2021
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2. Discordant liver fibrosis predictors in virologically suppressed people living with hiv without hepatitis virus infection

Author

Rossetti, B, Borgo, V, Emiliozzi, A, Colaneri, M, Zanelli, G, D'Alessandro, M, Motta, D, Maiocchi, L, Montagnani, F, Moioli, M, Baiguera, C, Sambo, M, Pieri, T, Valsecchi, P, Bruno, R, Puoti, M, Fabbiani, M, Rossetti B., Borgo V., Emiliozzi A., Colaneri M., Zanelli G., D'alessandro M., Motta D., Maiocchi L., Montagnani F., Moioli M. C., Baiguera C., Sambo M., Pieri T. C., Valsecchi P., Bruno R., Puoti M., Fabbiani M., Rossetti, B, Borgo, V, Emiliozzi, A, Colaneri, M, Zanelli, G, D'Alessandro, M, Motta, D, Maiocchi, L, Montagnani, F, Moioli, M, Baiguera, C, Sambo, M, Pieri, T, Valsecchi, P, Bruno, R, Puoti, M, Fabbiani, M, Rossetti B., Borgo V., Emiliozzi A., Colaneri M., Zanelli G., D'alessandro M., Motta D., Maiocchi L., Montagnani F., Moioli M. C., Baiguera C., Sambo M., Pieri T. C., Valsecchi P., Bruno R., Puoti M., and Fabbiani M.

Abstract

Severe liver fibrosis (LF) is associated with poor long-term liver-related outcomes in people living with HIV (PLWH). The study aimed to explore the prevalence and predictors of LF and the concordance between different non-invasive methods for the estimation of LF in HIV-infected individuals without hepatitis virus infection. We enrolled PLWH with HIV-1-RNA <50 copies/mL for >12 months, excluding individuals with viral hepatitis. LF was assessed by transient elastography (TE) (significant >6.65 kPa), fibrosis-4 (FIB-4) (significant >2.67), and AST-to-platelet ratio index (APRI) (significant >1.5). We included 234 individuals (67% males, median age 49 years, median time from HIV diagnosis 11 years, 38% treated with integrase strand transfer inhibitors). In terms of the TE, 13% had ≥F2 stage; FIB-4 score was >1.5 in 7%; and APRI > 0.5 in 4%. Higher body mass index, diabetes mellitus, detectable baseline HIV-1 RNA and longer atazanavir exposure were associated with higher liver stiffness as per TE. Predictors of higher APRI score were CDC C stage and longer exposure to tenofovir alafenamide, while HBcAb positivity and longer exposure to tenofovir alafenamide were associated to higher FIB-4 scores. Qualitative agreement was poor between FIB-4/TE and between APRI/TE by non-parametric Spearman correlation and kappa statistic. In our study, in the group of PLWH without viral hepatitis, different non-invasive methods were discordant in predicting liver fibrosis.

Published
2022

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

Author

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

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

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

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

Author

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

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

Author

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

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

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

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

Author

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

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

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

Published
2020

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

Author

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

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

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

Published
2020

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

Author

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

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

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

Author

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

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

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

Published
2020

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

Author

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

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

Author

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

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

Author

Bruno, R., Mondelli, M.U., Brunetti, E., Di Matteo, A., Seminari, E., Maiocchi, L., Zuccaro, V., Pagnucco, L., Ludovisi, S., Lissandrin, R., Parisi, A., Sacchi, P., Patruno, S.F.A., Michelone, G., Gulminetti, R., Zanaboni, D., Novati, S., Maserati, R., Orsolini, P., Vecchia, M., Colaneri, M., Asperges, E., Biscarini, S., Piralla, A., Percivalle, E., Cassaniti, I., and Baldanti, F.

Published
2020
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19. Comparison of peginterferon pharmacokinetic and pharmacodynamic profiles

Author

Bruno, R, Sacchi, P, Cima, S, Maiocchi, L, Novati, S, Filice, G, Fagiuoli, S, Bruno R, Sacchi P, Cima S, Maiocchi L, Novati S, Filice G, Fagiuoli S, Bruno, R, Sacchi, P, Cima, S, Maiocchi, L, Novati, S, Filice, G, Fagiuoli, S, Bruno R, Sacchi P, Cima S, Maiocchi L, Novati S, Filice G, and Fagiuoli S

Abstract

The pharmacokinetics and in dosing regimens of the currently available pegylated interferon (peginterferon) alfa molecules differ greatly, depending on the size and nature of their polyethylene glycol (PEG) moiety. Peginterferon alfa-2a has a branched 40 kDa PEG chain covalently attached to lysine residues and circulates as an intact molecule. On the other hand, peginterferon alfa-2b has a linear 12 kDa PEG chain covalently attached to interferon-a-2b via an unstable urethane bond that is hydrolysed after injection, releasing native interferon alfa-2b. The difference in pegylation between the two peginterferons has a significant impact on their pharmacokinetic properties. Data from comparative and non-comparative studies indicate that peginterferon alfa-2b has a shorter half-life in serum than peginterferon alfa-2a, and a significant proportion of patients receiving peginterferon alfa-2b may have trough concentrations below the limit of detection during the latter part of the 7-day dosing schedule. However, the pharmacodynamic parameters of the two drugs appear to be similar.

Published
2012

21. Noninvasive Assessment of Liver Fibrosis and Steatosis in HIV-Monoinfected Subjects

Author

Ferraioli, G., primary, Maiocchi, L., additional, Lissandrin, R., additional, Tinelli, C., additional, Filice, C., additional, Above, E., additional, Chieffo, G., additional, Cima, S., additional, Columpsi, P., additional, Contardi, G., additional, Dellafiore, C., additional, Di Gregorio, M., additional, Gulminetti, R., additional, Maserati, R., additional, Novati, S., additional, Poma, G., additional, Sacchi, P., additional, and Zanaboni, D., additional

Published
2016
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29. Costo efficacia di peginterferone a-2a + ribavirina verso peginterferone a-2b + ribavirina nel trattamento dell’epatite cronica di tipo C in pazienti non pretrattati

Author

Ravasio, Roberto, Sacchi, P., Maiocchi, L., Patruno, S., Bruno, R., and Filice, G.

Abstract

The objective of this study was to evaluate the cost-effectiveness of peginterferon a-2a plus ribavirin versus peginterferon a-2b plus ribavirin as initial therapy for patients with Chronic Hepatitis C (CHC).We used a pre-existent Markov model of disease progression in which two cohorts of patients received peginterferon a-2a plus ribavirin or peginterferon a-2b plus ribavirin for 48 weeks and were followed for their expected lifetimes. The reference patient was a 45-year-old male with CHC without cirrhosis. The sustained virological responses (SVR) with peginterferon a-2a plus ribavirin and peginterferon a-2b plus ribavirin, were taken from two different publications. Utilities and costs for each health state were based on literature estimates and on Italian treatment patterns. Costs in 2005 euros and benefits were discounted at 3%. Sensitivity analyses on key clinical and economic parameters were performed. The analysis was conducted from the perspective of the Italian National Health Service.For the two cohorts expected life-years with peginterferon a-2a plus ribavirin versus peginterferon a-2a plus ribavirin were respectively 30.85 and 30.15 years. Quality-adjusted life years for peginterferon a-2a plus ribavirina were 17.69, and for peginterferon a-2b plus ribavirin were 17.08. The expected cost was €18,272 with peginterferon a-2a plus ribavirin and €18,549 with peginterferon a-2b plus ribavirin.This economic evaluation suggests that peginterferon a-2a plus ribavirin is a dominant strategy versus peginterferon a-2b plus ribavirin for treatment of adults with CHC, under some assumptions regarding treatment effectiveness and model structure.

Published
2005
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33. Accuracy of the ElastPQ® technique for the assessment of liver fibrosis in patients with chronic hepatitis C: A 'real life' single center study

Author

Ferraioli, G., Maiocchi, L., Lissandrin, R., Tinelli, C., Silvestri, A., Filice, C., Above, E., Barbarini, G., Raffaele Bruno, Corona, S., Dellafior, C., Di Gregorio, M., Gulminetti, R., Lanzarini, P., Ludovisi, S., Malfitano, A., Maserati, R., Michelone, G., Minoli, L., Mondelli, M., Novati, S., Patruno, S. F. A., Poma, G., Sacchi, P., and Zanaboni, D.

39. Discordant Liver Fibrosis Predictors in Virologically Suppressed People Living with HIV without Hepatitis Virus Infection

Author

Barbara Rossetti, Valentina Borgo, Arianna Emiliozzi, Marta Colaneri, Giacomo Zanelli, Miriana d’Alessandro, Davide Motta, Laura Maiocchi, Francesca Montagnani, Maria Cristina Moioli, Chiara Baiguera, Margherita Sambo, Teresa Chiara Pieri, Pietro Valsecchi, Raffaele Bruno, Massimo Puoti, Massimiliano Fabbiani, Rossetti, B, Borgo, V, Emiliozzi, A, Colaneri, M, Zanelli, G, D'Alessandro, M, Motta, D, Maiocchi, L, Montagnani, F, Moioli, M, Baiguera, C, Sambo, M, Pieri, T, Valsecchi, P, Bruno, R, Puoti, M, and Fabbiani, M

Subjects
Medicine (General), R5-920, Clinical Biochemistry, Liver fibrosis, HIV, Liver fibrosi, ART, Article, liver fibrosis
Abstract

Severe liver fibrosis (LF) is associated with poor long-term liver-related outcomes in people living with HIV (PLWH). The study aimed to explore the prevalence and predictors of LF and the concordance between different non-invasive methods for the estimation of LF in HIV-infected individuals without hepatitis virus infection. We enrolled PLWH with HIV-1-RNA 12 months, excluding individuals with viral hepatitis. LF was assessed by transient elastography (TE) (significant >6.65 kPa), fibrosis-4 (FIB-4) (significant >2.67), and AST-to-platelet ratio index (APRI) (significant >1.5). We included 234 individuals (67% males, median age 49 years, median time from HIV diagnosis 11 years, 38% treated with integrase strand transfer inhibitors). In terms of the TE, 13% had ≥F2 stage; FIB-4 score was >1.5 in 7%; and APRI > 0.5 in 4%. Higher body mass index, diabetes mellitus, detectable baseline HIV-1 RNA and longer atazanavir exposure were associated with higher liver stiffness as per TE. Predictors of higher APRI score were CDC C stage and longer exposure to tenofovir alafenamide, while HBcAb positivity and longer exposure to tenofovir alafenamide were associated to higher FIB-4 scores. Qualitative agreement was poor between FIB-4/TE and between APRI/TE by non-parametric Spearman correlation and kappa statistic. In our study, in the group of PLWH without viral hepatitis, different non-invasive methods were discordant in predicting liver fibrosis.

Published
2021
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40. Competing-risk analysis of coronavirus disease 2019 in-hospital mortality in a Northern Italian centre from SMAtteo COvid19 REgistry (SMACORE)

Author

Salvatore Battaglia, Matteo Lupi, Laura Maiocchi, Alessandro Di Filippo, Paolo Sacchi, Ilaria Gallazzi, Pietro Valsecchi, Massimo Attanasio, Marco Enea, Simona Biscarini, Stefano Novati, Elena Seminari, Marta Colaneri, Raffaele Bruno, Ciro Celsa, Margherita Sambo, Valentina Zuccaro, Calogero Cammà, Silvia Roda, Erika Asperges, Angela Di Matteo, Michele Sachs, Teresa Chiara Pieri, Zuccaro V., Celsa C., Sambo M., Battaglia S., Sacchi P., Biscarini S., Valsecchi P., Pieri T.C., Gallazzi I., Colaneri M., Sachs M., Roda S., Asperges E., Lupi M., Di Filippo A., Seminari E., Di Matteo A., Novati S., Maiocchi L., Enea M., Attanasio M., Cammà Calogero., and Bruno R.

Subjects
Male, Pediatrics, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Science, Diseases, 030204 cardiovascular system & hematology, Competing risks, Risk Assessment, Article, 03 medical and health sciences, 0302 clinical medicine, medicine, Humans, Cumulative incidence, 030212 general & internal medicine, Hospital Mortality, Registries, Aged, Aged, 80 and over, Multidisciplinary, In hospital mortality, business.industry, COVID-19, Lower intensity, Middle Aged, Italy, Viral infection, Hospital admission, Cohort, Medicine, Infectious diseases, Female, Risk assessment, business, Human
Abstract

An accurate prediction of the clinical outcomes of European patients requiring hospitalisation for Coronavirus Disease 2019 (COVID-19) is lacking. The aim of the study is to identify predictors of in-hospital mortality and discharge in a cohort of Lombardy patients with COVID-19. All consecutive hospitalised patients from February 21st to March 30th, 2020, with confirmed COVID-19 from the IRCCS Policlinico San Matteo, Pavia, Lombardy, Italy, were included. In-hospital mortality and discharge were evaluated by competing risk analysis. The Fine and Gray model was fitted in order to estimate the effect of covariates on the cumulative incidence functions (CIFs) for in-hospital mortality and discharge. 426 adult patients [median age 68 (IQR 56 to 77 years)] were admitted with confirmed COVID-19 over a 5-week period; 292 (69%) were male. By 21 April 2020, 141 (33%) of these patients had died, 239 (56%) patients had been discharged and 46 (11%) were still hospitalised. Among these 46 patients, updated as of 30 May, 2020, 5 (10.9%) had died, 8 (17.4%) were still in ICU, 12 (26.1%) were transferred to lower intensity care units and 21 (45.7%) were discharged. Regression on the CIFs for in-hospital mortality showed that older age, male sex, number of comorbidities and hospital admission after March 4th were independent risk factors associated with in-hospital mortality. Older age, male sex and number of comorbidities definitively predicted in-hospital mortality in hospitalised patients with COVID-19.

Published
2020

41. Assessing Quality of Ultrasound Attenuation Coefficient Results for Liver Fat Quantification.

Author

Ferraioli G, Maiocchi L, Barr RG, and Roccarina D

Abstract

Background/objectives: Algorithms for quantifying liver fat content based on the ultrasound attenuation coefficient (AC) are currently available; however, little is known about whether their accuracy increases by applying quality criteria such as the interquartile range-to-median ratio (IQR/M) or whether the median or average AC value should be used., Methods: AC measurements were performed with the Aplio i800 ultrasound system using the attenuation imaging (ATI) algorithm (Canon Medical Systems, Otawara, Tochigi, Japan). Magnetic resonance imaging proton density fat fraction (MRI-PDFF) was the reference standard. The diagnostic performance of the AC median value of 5 measurements (AC-M) was compared to that of AC average value (AC-A) of 5 or 3 acquisitions and different levels of IQR/M for median values or standard deviation/average (SD/A) for average values were also analyzed. Concordance between AC-5M, AC-5A, and AC3A was evaluated with concordance correlation coefficient (CCC)., Results: A total of 182 individuals (94 females; mean age, 51.2y [SD: 15]) were evaluated. A total of 77 (42.3%) individuals had S0 steatosis (MRI-PDFF < 6%), 75 (41.2%) S1 (MRI-PDFF 6-17%), 10 (5.5%) S2 (MRI-PDFF 17.1-22%), and 20 (11%) S3 (MRI-PDFF ≥ 22.1%). Concordance of AC-5A and AC-3A with AC-5M was excellent (CCC: 0.99 and 0.96, respectively). The correlation with MRI-PDFF was almost perfect. Diagnostic accuracy of AC-5M, AC-5A, and AC3A was not significantly affected by different levels of IQR/M or SD/A., Conclusions: The accuracy of AC in quantifying liver fat content was not affected by reducing the number of acquisitions (from five to three), by using the mean instead of the median, or by reducing the IQR/M or SD/A to ≤5%.

Published
2024
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42. Production of recombinant cytokines and polyclonal antibodies for analysis of cellular immune response in golden Syrian hamster.

Author

Pedra ACK, de Oliveira NR, Maia MAC, Santos FDS, Bunde TT, Souza PHFC, de V Maiocchi L, Dellagostin OA, and Bohn TLO

Subjects
Animals, Cricetinae, Rats, Antibodies immunology, Escherichia coli genetics, Escherichia coli metabolism, Cytokines metabolism, Recombinant Proteins immunology, Recombinant Proteins genetics, Mesocricetus, Immunity, Cellular
Abstract

Background: The development of therapies and vaccines for various diseases often necessitates the analysis of cellular immunity. However, unlike other rodents, the limited availability of reagents for Syrian hamsters restricts immunological analysis, particularly in the determination of serum effector molecules such as cytokines. In this study, we aim to produce and characterize the cytokines IFN-γ, TGF-β, IL-6, IL-10, and TNF-α from Syrian hamsters in recombinant form and to generate polyclonal antibodies against them in rats., Methods and Results: Cytokine transcript sequences were cloned into expression vectors in E. coli. Recombinant proteins were produced, purified through affinity chromatography, and characterized by Western blot using an anti-6xHis monoclonal antibody. Rats were immunized with the recombinant proteins to generate polyclonal antibodies (pAbs). These pAbs were characterized by Western blot and titrated by indirect ELISA. The recombinant cytokines rTNF-α, rIL-10, rIFN-γ, rTGF-β, and rIL-6 were produced and specifically recognized at their expected molecular weights of 22.3 kDa, 19.8 kDa, 18.9 kDa, 11.8 kDa, and 22.9 kDa. pAbs were produced and demonstrated the ability to specifically recognize their target proteins with titers of 409,600 (rIL-10), 204,800 (rTNF-α), 102,400 (rIL-10), 51,200 (rTGF-β), and 25,600 (rIFN-ɣ)., Conclusions: The reagents produced represent a starting point for developing immunoassays to detect hamster cytokines, facilitating the analysis of cellular immunity in this biomodel., (© 2024. The Author(s), under exclusive licence to Springer Nature B.V.)

Published
2024
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43. Understanding confounding factors allows for accurate interpretation of liver stiffness measurements by ElastQ, a novel 2D shear wave elastography technique.

Author

Bauer DJ, De Silvestri A, Maiocchi L, Raimondi A, Mare R, Mandorfer M, Sporea I, Müllner-Bucsics T, Ferraioli G, and Reiberger T

Abstract

Purpose: Liver stiffness measurement (LSM) using vibration-controlled transient elastography (VCTE) or two-dimensional shear wave elastography (2D-SWE) is recommended to assess the risk of liver fibrosis and advanced chronic liver disease. Even though both techniques measure liver stiffness, their numerical results often diverge. Confounders and reliability criteria for 2D-SWE have not been systematically investigated., Materials and Methods: We prospectively recruited participants with paired LSM by VCTE and the novel 2D-SWE technique ElastQ (Philips) in three European tertiary centers. The following parameters were recorded: sex, age, body mass index (BMI), etiology, laboratory markers of liver damage and function, as well as cholestasis, LSM by VCTE and controlled attenuation parameter (CAP), interquartile range (IQR)/median for VCTE-LSM and ElastQ-LSM, and the skin-to-liver capsule distance., Results: We included 840 participants: 447 (53.2%) males; median age 57.0 [IQR:19.0] years; median BMI 25.4 [6.0] kg/m 2 ; median VCTE-LSM 7.25 [9.2] kPa; median ElastQ-LSM 6.7 [5.4] kPa. On uni- and multivariable modeling (adjusted for LSM), we found that the discrepancy increased with liver stiffness and markers of disease severity. Skin-to-liver capsule distance and BMI affected VCTE-LSM more compared to ElastQ-LSM and significantly increased the discordance between the two measurements., Conclusion: The discrepancy of ElastQ-LSM to VCTE-LSM increases with liver stiffness and disease severity. BMI and skin-to-liver capsule distance increase the discrepancy between VCTE- and ElastQ-LSM but affect ElastQ-LSM less. The quality criterion IQR/median ≤ 30% indicates reliable ElastQ-LSM., Competing Interests: DB served as a speaker and/or consultant and/or advisory board member for AbbVie and Siemens, received travel support from AbbVie and Gilead, and received grant support from Gilead and Siemens. ADS, LM, AR, RM: nothing to declare. MM served as a speaker and/or consultant and/or advisory board member for AbbVie, Bristol-Myers Squibb, Gilead, Collective Acumen, and W. L. Gore & Associates and received travel support from AbbVie, Bristol-Myers Squibb, and Gilead. IS served as speaker for AbbVie, BMS, Gilead, Janssen, Echosens, and Philips; and received advisory board fees from AbbVie, Merck; Siemens, Canon; and received research support from Philips. GF served as a speaker for Canon Medical Systems, Fujifilm Medical Systems, Mindray Medical Systems, Philips Medical Systems, and Siemens Healthineers; served as advisory board member for Philips Medical Systems, and her institution received grant/research support from Canon Medical Systems, Esaote S.p.A., Fujifilm Medical Systems, Mindray Medical Systems, Siemens Healthineers. She receives royalties from Elsevier Publisher. TR served as a speaker and/or consultant and/or advisory board member for AbbVie, Bayer, Boehringer Ingelheim, Gilead, Intercept, MSD, Siemens, and W. L. Gore & Associates and received grants/research support from AbbVie, Boehringer Ingelheim, Gilead, MSD, Philips, and W. L. Gore & Associates as well as travel support from Boehringer Ingelheim and Gilead., (The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).)

Published
2024
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44. Ultrasound-based steatosis grading system using 2D-attenuation imaging: An individual patient data meta-analysis with external validation.

Author

Hobeika C, Ronot M, Guiu B, Ferraioli G, Iijima H, Tada T, Lee DH, Kuroda H, Lee YH, Lee JM, Kim SY, Cassinotto C, Maiocchi L, Raimondi A, Nishimura T, Kumada T, Kwon EY, Jang JK, Correas JM, Valla D, Vilgrain V, and Dioguardi Burgio M

Abstract

Background and Aims: Noninvasive tools assessing steatosis, such as ultrasonography-based 2D-attenuation imaging (ATI), are needed to tackle the worldwide burden of steatotic liver disease. This one-stage individual patient data (IPD) meta-analysis aimed to create an ATI-based steatosis grading system., Approach and Results: A systematic review (EMBASE + MEDLINE, 2018-2022) identified studies, including patients with histologically or magnetic resonance imaging proton-density fat fraction (MRI-PDFF)-verified ATI for grading steatosis (S0 to S3). One-stage IPD meta-analyses were conducted using generalized mixed models with a random study-specific intercept. Created ATI-based steatosis grading system (aS0 to aS3) was externally validated on a prospective cohort of patients with type 2 diabetes and metabolic dysfunction-associated steatotic liver disease (n=174, histologically and MRI-PDFF-verified steatosis). Eleven enrolled studies included 1374 patients, classified into S0, S1, S2, and S3 in 45.4%, 35.0%, 9.3%, and 10.3% of the cases. ATI was correlated with histological steatosis ( r = 0.60; 95% CI: 0.52, 0.67; p < 0.001) and MRI-PDFF ( r = 0.70; 95% CI: 0.66, 0.73; p < 0.001) but not with liver stiffness ( r = 0.03; 95% CI: -0.04, 0.11, p = 0.343). Steatosis grade was an independent factor associated with ATI (coefficient: 0.24; 95% CI: [0.22, 0.26]; p < 0.001). ATI marginal means within S0, S1, S2, and S3 subpopulations were 0.59 (95% CI: [0.58, 0.61]), 0.69 (95% CI [0.67, 0.71]), 0.78 (95% CI: [0.76, 0.81]), and 0.85 (95% CI: [0.83, 0.88]) dB/cm/MHz; all contrasts between grades were significant ( p < 0.0001). Three ATI thresholds were calibrated to create a new ATI-based steatosis grading system (aS0 to aS3, cutoffs: 0.66, 0.73, and 0.81 dB/cm/MHz). Its external validation showed Obuchowski measures of 0.84 ± 0.02 and 0.82 ± 0.02 with histologically based and MRI-PDFF-based references., Conclusions: ATI is a reliable, noninvasive marker of steatosis. This validated ATI-based steatosis grading system could be valuable in assessing patients with metabolic dysfunction-associated steatotic liver disease., (Copyright © 2024 American Association for the Study of Liver Diseases.)

Published
2024
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45. Liver Fat Quantification With Ultrasound: Depth Dependence of Attenuation Coefficient.

Author

Ferraioli G, Raimondi A, Maiocchi L, De Silvestri A, Poma G, Kumar V, and Barr RG

Subjects
Female, Humans, Adult, Middle Aged, Aged, Retrospective Studies, Reproducibility of Results, Ultrasonography methods, Liver diagnostic imaging, Algorithms
Abstract

Objectives: The primary aim was to estimate the influence of various depths on ultrasound attenuation coefficient (AC) of multiple vendors in the liver. The secondary aim was to evaluate the impact of region of interest (ROI) size on AC measurements in a subset of participants., Methods: This Institutional Review Board (IRB)-approved Health Insurance Portability and Accountability Act (HIPAA)-compliant retrospective study was carried out in two centers using AC-Canon and AC-Philips algorithms and extracting AC-Siemens values from ultrasound-derived fat fraction algorithm. Measurements were performed positioning ROI upper edge (3 cm size) at 2, 3, 4, 5 cm from the liver capsule with AC-Canon and AC-Philips and at 1.5, 2, 3 cm with Siemens algorithm. In a subset of participants, measurements were obtained with 1 and 3 cm ROI size. Univariate and multivariate linear regression models and Lin's concordance correlation coefficient (CCC) were used for statistical analysis as appropriate., Results: Three different cohorts were studied. Sixty-three participants (34 females; mean age: 51 ± 14 years) were studied with AC-Canon, 60 (46 females; mean age: 57 ± 11 years) with AC-Philips, and 50 (25 females; 61 ± 13 years) with AC-Siemens. There was a decrease in AC values per 1 cm increase in depth in all. In multivariable analysis, the coefficient was -0.049 (-0.060; -0.038 P < .001) with AC-Canon, -0.058 (-0.066; -0.049 P < .001) with AC-Philips and -0.081 (-0.112; -0.050 P < .001) with AC-Siemens. AC values with 1 cm ROI were significantly higher than those obtained with 3 cm ROI at all depths (P < .001) but the agreement between AC values obtained with different ROI size was excellent (CCC 0.82 [0.77-0.88])., Conclusions: There is depth dependence in AC measurement that affects results. A standardized protocol with fixed ROI's depth and size is needed., (© 2023 The Authors. Journal of Ultrasound in Medicine published by Wiley Periodicals LLC on behalf of American Institute of Ultrasound in Medicine.)

Published
2023
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46. Two-dimensional shear wave elastography (ElastQ) accurately rules out liver fibrosis and rules in advanced chronic liver disease across liver disease etiologies: a prospective multicenter study.

Author

Bauer DJM, SilvestriI A, Mare R, Maiocchi L, Raimondi A, Semmler G, Mandorfer M, Sporea I, Ferraioli G, and Reiberger T

Abstract

Purpose: This study evaluated ElastQ, a two-dimensional shear wave elastography (2D-SWE) technique, for the non-invasive assessment of liver fibrosis risk using liver stiffness measurement (LSM). The aim was to determine its diagnostic accuracy and establish LSM cutoffs for clinical risk stratification., Methods: A prospective multicenter study was conducted, employing vibration-controlled transient elastography (VCTE) as a reference standard. The statistical analysis utilized Pearson correlations and Lin concordance correlation coefficients, diagnostic areas under the curve (AUCs), and 90%-specific rule-in and 90%-sensitive rule-out ElastQ cutoffs., Results: The study included 875 patients at risk for liver disease, of whom 816 (376 women, 46.1%; median age, 57.0 years [interquartile range, 19.0]) had successful and reliable VCTE- and ElastQ-LSMs. The median LSM was 13.0 kPa (range, 2.0 to 75.0 kPa) for VCTE and 6.6 kPa (range, 2.9 to 26.5 kPa) for ElastQ. The correlation between VCTE-LSM and ElastQ-LSM was adequate for VCTE-LSM <15 kPa (Pearson r=0.63) but lower for VCTE-LSM ≥15.0 kPa (Pearson r=0.27). VCTE-LSM indicated no fibrosis risk (<5.0 kPa) in 178 cases (21.8%), gray zone (5.0-9.9 kPa) in 347 cases (42.5%), and advanced chronic liver disease (ACLD; ≥10.0 kPa) in 291 cases (35.7%). The diagnostic AUC for ElastQ-LSM was 0.82 for fibrosis risk and 0.90 for ACLD. The clinically relevant ElastQ cutoffs for ruling out fibrosis risk and ruling in compensated ACLD (cACLD) were <5.0 kPa and ≥9.0 kPa, respectively., Conclusion: ElastQ 2D-SWE enables accurate, non-invasive assessments of liver fibrosis and cACLD risk. In clinical practice, ElastQ-LSM <5.0 kPa rules out fibrosis, while ElastQ-LSM ≥9.0 kPa rules in cACLD.

Published
2023
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47. Dynamic NLR and PLR in Predicting COVID-19 Severity: A Retrospective Cohort Study.

Author

Asperges E, Albi G, Zuccaro V, Sambo M, Pieri TC, Calia M, Colaneri M, Maiocchi L, Melazzini F, Lasagna A, Peri A, Mojoli F, Sacchi P, and Bruno R

Abstract

Introduction: The hyperinflammation phase of severe SARS-CoV-2 is characterised by complete blood count alterations. In this context, the neutrophil-to-lymphocyte ratio (NLR) and the platelet-to-lymphocyte ratio (PLR) can be used as prognostic factors. We studied NLR and PLR trends at different timepoints and computed optimal cutoffs to predict four outcomes: use of continuous positive airways pressure (CPAP), intensive care unit (ICU) admission, invasive ventilation and death., Methods: We retrospectively included all adult patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia admitted from 23 January 2020 to 18 May 2021. Analyses included non-parametric tests to study the ability of NLR and PLR to distinguish the patients' outcomes at each timepoint. Receiver operating characteristic (ROC) curves were built for NLR and PLR at each timepoint (minus discharge) to identify cutoffs to distinguish severe and non-severe disease. Their statistical significance was assessed with the chi-square test. Collection of data under the SMACORE database was approved with protocol number 20200046877., Results: We included 2169 patients. NLR and PLR were higher in severe coronavirus disease 2019 (COVID-19). Both ratios were able to distinguish the outcomes at each timepoint. For NLR, the areas under the receiver operating characteristic curve (AUROC) ranged between 0.59 and 0.81, and for PLR between 0.53 and 0.67. From each ROC curve we computed an optimal cutoff value., Conclusion: NLR and PLR cutoffs are able to distinguish severity grades and mortality at different timepoints during the course of disease, and, as such, they allow a tailored approach. Future prospects include validating our cutoffs in a prospective cohort and comparing their performance against other COVID-19 scores., (© 2023. The Author(s).)

Published
2023
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48. Point Shear Wave Elastography by ElastPQ for Fibrosis Screening in Patients with NAFLD: A Prospective, Multicenter Comparison to Vibration-Controlled Elastography.

Author

Bauer DJ, Matic V, Mare R, Maiocchi L, Chromy D, Müllner-Bucsics T, Mandorfer M, Mustapic S, Sporea I, Ferraioli G, Grgurevic I, and Reiberger T

Subjects
Humans, Female, Middle Aged, Male, Prospective Studies, Vibration, Reproducibility of Results, Liver Cirrhosis diagnostic imaging, Fibrosis, Liver diagnostic imaging, Non-alcoholic Fatty Liver Disease diagnostic imaging, Elasticity Imaging Techniques methods
Abstract

Background: Since nonalcoholic fatty liver disease (NAFLD) has become the leading cause of liver disease in the Western world, clinicians need reliable noninvasive tools for the identification of NAFLD-associated fibrosis. Limited evidence on the performance of the novel shear wave elastography technique Elast-PQ (EPQ) in NAFLD is available., Method: In this prospective, European multinational study we assessed the diagnostic accuracy of EPQ using vibration-controlled transient elastography (VCTE) as a reference standard., Results: Among 353 NAFLD patients, 332 (94.1%) fulfilled reliability criteria of VCTE and EPQ (defined by IQR/median ≤0.3; 41.3% female, mean age: 59 [IQR: 16.5], mean BMI: 29.0 (7.1)). 4/353 (1.1%) and 17/353 (4.8%) had unreliable VCTE and EPQ measurements, respectively. VCTE-based NAFLD fibrosis stages were F0/F1: 222(66.9%), F2: 41 (12.3%), F3: 30 (9.1%), F4: 39 (11.7%). We found a strong correlation (Pearson R=0.87; p<0.0001) and concordance (Lin's concordance correlation coefficient =0.792) of EPQ with VCTE. EPQ was able to identify NAFLD-fibrosis risk with the following EPQ cutoffs: ≥6.5 kPa for significant fibrosis (≥F2) (≥1.47 m/s; sensitivity: 78%; specificity: 95%; AUROC: 0.94), ≥6.9 kPa for advanced fibrosis (≥F3) (≥1.52 m/s; sens.: 88%, spec.: 89%; AUROC: 0.949), and ≥10.4 kPa for cirrhosis (F4) (≥1.86 m/s; sens.: 87%; spec.: 94%; AUROC: 0.949)., Conclusion: The point shear wave elastography technique EPQ shows excellent correlation to and concordance with VCTE. EPQ can reliably exclude NAFLD fibrosis <6.0 kPa (<1.41 m/s) and indicate a high risk of advanced fibrosis ≥10.4 kPa (≥1.86 m/s)., Competing Interests: DB served as a speaker and/or consultant and/or advisory board member for AbbVie and received travel support from AbbVie and Gilead. VM, RM, LM, SM: nothing to declare. DC served as a speaker and/or consultant and/or advisory board member for AbbVie, Gilead, and MSD, and received travel support from AbbVie, MSD, ViiV Healthcare, and Gilead. TB has received travel support from BMS, Gilead, and AbbVie. MM served as a speaker and/or consultant and/or advisory board member for AbbVie, Bristol-Myers Squibb, Gilead, Collective Acumen, and W. L. Gore & Associates and received travel support from AbbVie, Bristol-Myers Squibb, and Gilead. IS served as speaker for AbbVie, BMS, Gilead, Janssen, Echosens, Philips; and received advisory board fees by AbbVie, Merck; Siemens, Canon,Toshiba; and received research support by Philips. GF served as speaker for Canon Medical Systems, Hitachi Ltd., Mindray Medical Systems, and Philips. IG served as speaker for Echosens and Philips. TR served as a speaker and/or consultant and/or advisory board member for AbbVie, Bayer, Boehringer Ingelheim, Gilead, Intercept, MSD, Siemens, and W. L. Gore & Associates and received grants/research support from AbbVie, Boehringer Ingelheim, Gilead, MSD, Philips, and W. L. Gore & Associates as well as travel support from Boehringer Ingelheim and Gilead., (The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).)

Published
2023
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49. Is a radiological score needed to define the severity of Nontuberculous mycobacteria lung disease?

Author

Colaneri M, Valsecchi P, Vancheri SG, Valentini A, Marchetti F, Tarantino F, Sambo M, Fabbiani M, Calliada F, Monzillo V, Di Matteo A, Maiocchi L, Lombardi A, Klersy C, Preda L, and Bruno R

Subjects
Humans, Nontuberculous Mycobacteria, Retrospective Studies, Tomography, X-Ray Computed, Mycobacterium Infections, Nontuberculous diagnostic imaging, Lung Diseases diagnostic imaging, Lung Diseases complications
Abstract

High-resolution CT-scan (HRCT) plays a major role in the diagnosis of Nontuberculous mycobacteria lung disease (NTM-LD), but its role in follow-up is controversial. Our aim was first to conceive a radiological score able to quantify the severity of pulmonary involvement by NTM infection and, second, to check its association with the NTM-LD clinical burden. We also intended, if possible, to verify the potential influence of NTM specific treatment on the radiological score. We retrospectively collected the clinical, microbiological and radiological data of all patients who were admitted to our hospital from 1 January 2012 to 1 January 2020 with a confirmed diagnosis of NTM-LD. A radiological score was applied to evaluate lung involvement on HRCT at diagnosis and at 6-18 months follow-up. Twenty-eight patients with NTM-LD performed follow-up HRCT. No association was found between radiological and clinical score (Spearman R -0.05, 95%CI -0.41 to 0.33). Repeated measures analysis showed a significant increase in radiological score over time (change 1.11, 95%CI 0.10 to 2.11; p-value 0.032), while Mann-Whitney test did not show any difference between treated and untreated patients (p value 0.922). Further studies are needed to assess the usefulness of routine radiological follow-up in patients with NTM-LD.

Published
2022

50. Quantification of Liver Fat Content with the iATT Algorithm: Correlation with Controlled Attenuation Parameter.

Author

Ferraioli G, Raimondi A, Maiocchi L, De Silvestri A, and Filice C

Abstract

Background: The primary aim of our study was to assess the correlation between an improved version of the attenuation coefficient available on the Arietta 850 ultrasound system (iATT, Fujifilm Healthcare, Tokyo, Japan) and controlled attenuation parameter (CAP). The secondary aim was to assess whether focusing only on iATT acquisition without following the strict protocol for liver stiffness measurements would affect iATT measurement. Methods: Consecutive individuals were enrolled. Pearson’s r was used to test the correlation between ATT and CAP values. The concordance between iATT and CAP was tested using Lin’s concordance correlation coefficient (CCC). Results: 354 individuals (203 males, 151 females) were studied. The overall Pearson correlation between CAP and iATT values obtained following or not following the liver stiffness measurement protocol, respectively, were r = 0.73 and r = 0.71. The correlation was affected by the interquartile range/median (IQR/M) of the 10 measurements: it was r = 0.75 for IQR/M ≤ 15% and r = 0.60 for IQR/M > 15%. CCC showed that there was a moderate to good concordance between iATT and CAP values. Conclusion: iATT shows a strong correlation with CAP that does not decrease when the protocol for liver stiffness acquisition is not followed. The correlation between iATT and CAP values is higher when the IQR/M ≤ 15%.

Published
2022
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