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1. ECG/echo indexes in the diagnostic approach to amyloid cardiomyopathy: A head-to-head comparison from the AC-TIVE study

Author

Pagura, L, Porcari, A, Cameli, M, Biagini, E, Canepa, M, Crotti, L, Imazio, M, Forleo, C, Pavasini, R, Limongelli, G, Perlini, S, Metra, M, Boriani, G, Emdin, M, Sinagra, G, Merlo, M, Longo, F, Rossi, M, Varrà, G, Saro, R, Dore, F, Girardi, F, Vergaro, G, Musumeci, B, Autore, C, Cappelli, F, Perfetto, F, Olivotto, I, Favale, S, Carella, M, Guaricci, A, Ciccone, M, Di Bella, G, Tomasoni, D, Rella, V, Branzi, G, Badano, L, Parati, G, Palmiero, G, Caiazza, M, Caponetti, A, Saturi, G, Labate, M, Andreis, A, Paneva, E, De Ferrari, G, Di Ienno, L, De Carli, G, Giacomin, E, Arzilli, C, Pagura L., Porcari A., Cameli M., Biagini E., Canepa M., Crotti L., Imazio M., Forleo C., Pavasini R., Limongelli G., Perlini S., Metra M., Boriani G., Emdin M., Sinagra G., Merlo M., Longo F., Rossi M., Varrà G. G., Saro R., Dore F., Girardi F., Vergaro G., Musumeci B., Autore C., Cappelli F., Perfetto F., Olivotto I., Favale S., Carella M. C., Guaricci A. I., Ciccone M. M., Di Bella G., Tomasoni D., Rella V., Branzi G., Badano L., Parati G., Palmiero G., Caiazza M., Caponetti A. G., Saturi G., Labate M. E., Andreis A., Paneva E., De Ferrari G. M., Di Ienno L., De Carli G., Giacomin E., Arzilli C., Pagura, L, Porcari, A, Cameli, M, Biagini, E, Canepa, M, Crotti, L, Imazio, M, Forleo, C, Pavasini, R, Limongelli, G, Perlini, S, Metra, M, Boriani, G, Emdin, M, Sinagra, G, Merlo, M, Longo, F, Rossi, M, Varrà, G, Saro, R, Dore, F, Girardi, F, Vergaro, G, Musumeci, B, Autore, C, Cappelli, F, Perfetto, F, Olivotto, I, Favale, S, Carella, M, Guaricci, A, Ciccone, M, Di Bella, G, Tomasoni, D, Rella, V, Branzi, G, Badano, L, Parati, G, Palmiero, G, Caiazza, M, Caponetti, A, Saturi, G, Labate, M, Andreis, A, Paneva, E, De Ferrari, G, Di Ienno, L, De Carli, G, Giacomin, E, Arzilli, C, Pagura L., Porcari A., Cameli M., Biagini E., Canepa M., Crotti L., Imazio M., Forleo C., Pavasini R., Limongelli G., Perlini S., Metra M., Boriani G., Emdin M., Sinagra G., Merlo M., Longo F., Rossi M., Varrà G. G., Saro R., Dore F., Girardi F., Vergaro G., Musumeci B., Autore C., Cappelli F., Perfetto F., Olivotto I., Favale S., Carella M. C., Guaricci A. I., Ciccone M. M., Di Bella G., Tomasoni D., Rella V., Branzi G., Badano L., Parati G., Palmiero G., Caiazza M., Caponetti A. G., Saturi G., Labate M. E., Andreis A., Paneva E., De Ferrari G. M., Di Ienno L., De Carli G., Giacomin E., and Arzilli C.

Abstract

Background and aims: The discordance between QRS voltages on electrocardiogram (ECG) and left ventricle (LV) wall thickness (LVWT) on echocardiogram (echo) is a recognized red flag (RF) of amyloid cardiomyopathy (AC) and can be measured by specific indexes. No head-to-head comparison of different ECG/echo indexes among subjects with echocardiographic suspicion of AC has yet been undertaken. The study aimed at evaluating the performance and the incremental diagnostic value of different ECG/echo indexes in this subset of patients. Methods: Electrocardiograms of subjects with LV hypertrophy, preserved ejection fraction and ≥ 1 echocardiographic RF of AC participating in the AC-TIVE study, an Italian prospective multicenter study, were independently analyzed by two cardiologists. Low QRS voltages and 8 different ECG/echo indexes were evaluated. Cohort specific cut-offs were computed. Results: Among 170 patients, 55 (32 %) were diagnosed with AC. Combination of low QRS voltages with interventricular septum ≥ 1,6 cm was the most specific (specificity 100 %, positive predictive value 100 %) ECG/echo index, while the ratio between the sum of all QRS voltages and LVWT <7,8 was the most sensitive and accurate (sensitivity 94 %, negative predictive value 97 %, accuracy 82 %). When the latter index was added to a model using easily-accessible clinical variables, the diagnostic accuracy for AC greatly increased (AUC from 0,84 to 0,95; p = 0,007). Conclusions: Among patients with non-dilated hypertrophic ventricles with normal ejection fraction and echocardiographic RF of AC, easily-measurable ECG/echo indexes, mainly when added to few clinical variables, can help the physician orient second level investigations. External validation of the results is warranted.

Published
2024

2. Phenotyping congestion in patients with acutely decompensated heart failure with preserved and reduced ejection fraction: The Decongestion duRing therapY for acute decOmpensated heart failure in HFpEF vs HFrEF- DRY-OFF study

Author

Cogliati, C, Ceriani, E, Gambassi, G, De Matteis, G, Perlini, S, Perrone, T, Muiesan, ML, Salvetti, M, Leidi, F, Ferrara, F, Sabbà, C, Suppressa, P, Fracanzani, A, Montano, N, Fiorelli, E, Tripepi, G, Gori, M, Pitino, A, and Pietrangelo, A

Published
2022
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3. 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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6. Diagnostic pathways to wild-type transthyretin amyloid cardiomyopathy: a multicentre network study

Author

Tini, G, Milani, P, Zampieri, M, Caponetti, A, Fabris, F, Foli, A, Argiro, A, Mazzoni, C, Gagliardi, C, Longhi, S, Saturi, G, Vergaro, G, Aimo, A, Russo, D, Varra, G, Serenelli, M, Fabbri, G, De Michieli, L, Palmiero, G, Ciliberti, G, Carigi, S, Sessarego, E, Mandoli, G, Ricci Lucchi, G, Rella, V, Monti, E, Gardini, E, Bartolotti, M, Crotti, L, Merli, E, Mussinelli, R, Vianello, P, Cameli, M, Marzo, F, Guerra, F, Limongelli, G, Cipriani, A, Perlini, S, Obici, L, Perfetto, F, Autore, C, Porto, I, Rapezzi, C, Sinagra, G, Merlo, M, Musumeci, B, Emdin, M, Biagini, E, Cappelli, F, Palladini, G, Canepa, M, Tini G., Milani P., Zampieri M., Caponetti A. G., Fabris F., Foli A., Argiro A., Mazzoni C., Gagliardi C., Longhi S., Saturi G., Vergaro G., Aimo A., Russo D., Varra G. G., Serenelli M., Fabbri G., De Michieli L., Palmiero G., Ciliberti G., Carigi S., Sessarego E., Mandoli G. E., Ricci Lucchi G., Rella V., Monti E., Gardini E., Bartolotti M., Crotti L., Merli E., Mussinelli R., Vianello P. F., Cameli M., Marzo F., Guerra F., Limongelli G., Cipriani A., Perlini S., Obici L., Perfetto F., Autore C., Porto I., Rapezzi C., Sinagra G., Merlo M., Musumeci B., Emdin M., Biagini E., Cappelli F., Palladini G., Canepa M., Tini, G, Milani, P, Zampieri, M, Caponetti, A, Fabris, F, Foli, A, Argiro, A, Mazzoni, C, Gagliardi, C, Longhi, S, Saturi, G, Vergaro, G, Aimo, A, Russo, D, Varra, G, Serenelli, M, Fabbri, G, De Michieli, L, Palmiero, G, Ciliberti, G, Carigi, S, Sessarego, E, Mandoli, G, Ricci Lucchi, G, Rella, V, Monti, E, Gardini, E, Bartolotti, M, Crotti, L, Merli, E, Mussinelli, R, Vianello, P, Cameli, M, Marzo, F, Guerra, F, Limongelli, G, Cipriani, A, Perlini, S, Obici, L, Perfetto, F, Autore, C, Porto, I, Rapezzi, C, Sinagra, G, Merlo, M, Musumeci, B, Emdin, M, Biagini, E, Cappelli, F, Palladini, G, Canepa, M, Tini G., Milani P., Zampieri M., Caponetti A. G., Fabris F., Foli A., Argiro A., Mazzoni C., Gagliardi C., Longhi S., Saturi G., Vergaro G., Aimo A., Russo D., Varra G. G., Serenelli M., Fabbri G., De Michieli L., Palmiero G., Ciliberti G., Carigi S., Sessarego E., Mandoli G. E., Ricci Lucchi G., Rella V., Monti E., Gardini E., Bartolotti M., Crotti L., Merli E., Mussinelli R., Vianello P. F., Cameli M., Marzo F., Guerra F., Limongelli G., Cipriani A., Perlini S., Obici L., Perfetto F., Autore C., Porto I., Rapezzi C., Sinagra G., Merlo M., Musumeci B., Emdin M., Biagini E., Cappelli F., Palladini G., and Canepa M.

Abstract

Aim: Epidemiology of wild-type transthyretin cardiac amyloidosis (ATTRwt-CA) remains poorly defined. A better characterization of pathways leading to ATTRwt-CA diagnosis is of key importance, and potentially informative of disease course and prognosis. The aim of this study was to describe the characteristics of contemporary pathways leading to ATTRwt-CA diagnosis, and their potential association with survival. Methods and results: This was a retrospective study of patients diagnosed with ATTRwt-CA at 17 Italian referral centres for CA. Patients were categorized into different ‘pathways’ according to the medical reason that triggered the diagnosis of ATTRwt-CA (hypertrophic cardiomyopathy [HCM] pathway, heart failure [HF] pathway, incidental imaging or incidental clinical pathway). Prognosis was investigated with all-cause mortality as endpoint. Overall, 1281 ATTRwt-CA patients were included in the study. The diagnostic pathway leading to ATTRwt-CA diagnosis was HCM in 7% of patients, HF in 51%, incidental imaging in 23%, incidental clinical in 19%. Patients in the HF pathway, as compared to the others, were older and had a greater prevalence of New York Heart Association (NYHA) class III–IV and chronic kidney disease. Survival was significantly worse in the HF versus other pathways, but similar among the three others. In multivariate model, older age at diagnosis, NYHA class III–IV and some comorbidities but not the HF pathway were independently associated with worse survival. Conclusions: Half of contemporary ATTRwt-CA diagnoses occur in a HF setting. These patients had worse clinical profile and outcome than those diagnosed either due to suspected HCM or incidentally, although prognosis remained primarily related to age, NYHA functional class and comorbidities rather than the diagnostic pathway itself.

Published
2023

7. Razionale e valore fondamentale della Rete Italiana integrata dell’Amiloidosi Cardiaca [Rationale and significance of the Italian Network for Cardiac Amyloidosis]

Author

Sinagra, G, Emdin, M, Merlo, M, Vergaro, G, Aimo, A, Biagini, E, Imazio, M, Porcari, A, Limongelli, G, Cipriani, A, Canepa, M, Musumeci, B, Cameli, M, Crotti, L, Di Bella, G, Di Lenarda, A, Cappelli, F, Chimenti, C, Obici, L, Iacoviello, M, Perlini, S, Pieroni, M, Metra, M, Oliva, F, Perrone Filardi, P, Colivicchi, F, Indolfi, C, Sinagra G., Emdin M., Merlo M., Vergaro G., Aimo A., Biagini E., Imazio M., Porcari A., Limongelli G., Cipriani A., Canepa M., Musumeci B., Cameli M., Crotti L., Di Bella G., Di Lenarda A., Cappelli F., Chimenti C., Obici L., Iacoviello M., Perlini S., Pieroni M., Metra M., Oliva F., Perrone Filardi P., Colivicchi F., Indolfi C., Sinagra, G, Emdin, M, Merlo, M, Vergaro, G, Aimo, A, Biagini, E, Imazio, M, Porcari, A, Limongelli, G, Cipriani, A, Canepa, M, Musumeci, B, Cameli, M, Crotti, L, Di Bella, G, Di Lenarda, A, Cappelli, F, Chimenti, C, Obici, L, Iacoviello, M, Perlini, S, Pieroni, M, Metra, M, Oliva, F, Perrone Filardi, P, Colivicchi, F, Indolfi, C, Sinagra G., Emdin M., Merlo M., Vergaro G., Aimo A., Biagini E., Imazio M., Porcari A., Limongelli G., Cipriani A., Canepa M., Musumeci B., Cameli M., Crotti L., Di Bella G., Di Lenarda A., Cappelli F., Chimenti C., Obici L., Iacoviello M., Perlini S., Pieroni M., Metra M., Oliva F., Perrone Filardi P., Colivicchi F., and Indolfi C.

Abstract

The perspective on amyloidosis has changed deeply over the last 10 years following major advances in diagnosis and treatment options, especially in cardiac amyloidosis. This intrinsically heterogeneous disease exposes to the risk of fragmentation of knowledge and requires the interaction among experts of different specialties and subspecialties. Suspicion of disease, timely recognition and confirmation of final diagnosis, prognostic stratification, clinical management and therapeutic strategies represent essential steps to be taken. Missing or delaying the diagnosis may have dramatic impact on patient outcome, as in the case of chemotherapy in unrecognized light-chain amyloidosis. Therefore, there is an urgent need for the foundation of an Italian Amyloidosis Network to deal with the challenges of this condition and orient clinical management at national and local levels. The present consensus document aims to provide the rationale and scopes of the Italian Amyloidosis Network, which has been conceived as an organizational framework for professionals managing patients with amyloidosis.

Published
2023

10. Razionale e valore fondamentale della Rete Italiana integrata dell’Amiloidosi Cardiaca [Rationale and significance of the Italian Network for Cardiac Amyloidosis]

Author

Sinagra G., Emdin M., Merlo M., Vergaro G., Aimo A., Biagini E., Imazio M., Porcari A., Limongelli G., Cipriani A., Canepa M., Musumeci B., Cameli M., Crotti L., Di Bella G., Di Lenarda A., Cappelli F., Chimenti C., Obici L., Iacoviello M., Perlini S., Pieroni M., Metra M., Oliva F., Perrone Filardi P., Colivicchi F., Indolfi C., Sinagra, G, Emdin, M, Merlo, M, Vergaro, G, Aimo, A, Biagini, E, Imazio, M, Porcari, A, Limongelli, G, Cipriani, A, Canepa, M, Musumeci, B, Cameli, M, Crotti, L, Di Bella, G, Di Lenarda, A, Cappelli, F, Chimenti, C, Obici, L, Iacoviello, M, Perlini, S, Pieroni, M, Metra, M, Oliva, F, Perrone Filardi, P, Colivicchi, F, and Indolfi, C

Subjects
Treatment, Clinical management, Cardiac amyloidosi, Differential diagnosi, Perspective
Abstract

The perspective on amyloidosis has changed deeply over the last 10 years following major advances in diagnosis and treatment options, especially in cardiac amyloidosis. This intrinsically heterogeneous disease exposes to the risk of fragmentation of knowledge and requires the interaction among experts of different specialties and subspecialties. Suspicion of disease, timely recognition and confirmation of final diagnosis, prognostic stratification, clinical management and therapeutic strategies represent essential steps to be taken. Missing or delaying the diagnosis may have dramatic impact on patient outcome, as in the case of chemotherapy in unrecognized light-chain amyloidosis. Therefore, there is an urgent need for the foundation of an Italian Amyloidosis Network to deal with the challenges of this condition and orient clinical management at national and local levels. The present consensus document aims to provide the rationale and scopes of the Italian Amyloidosis Network, which has been conceived as an organizational framework for professionals managing patients with amyloidosis.

Published
2023

12. Unmasking the prevalence of amyloid cardiomyopathy in the real world: results from Phase 2 of the AC-TIVE study, an Italian nationwide survey

Author

Merlo, M, Pagura, L, Porcari, A, Cameli, M, Vergaro, G, Musumeci, B, Biagini, E, Canepa, M, Crotti, L, Imazio, M, Forleo, C, Cappelli, F, Perfetto, F, Favale, S, Di Bella, G, Dore, F, Girardi, F, Tomasoni, D, Pavasini, R, Rella, V, Palmiero, G, Caiazza, M, Carella, M, Igoren Guaricci, A, Branzi, G, Caponetti, A, Saturi, G, La Malfa, G, Merlo, A, Andreis, A, Bruno, F, Longo, F, Rossi, M, Varra, G, Saro, R, Di Ienno, L, De Carli, G, Giacomin, E, Arzilli, C, Limongelli, G, Autore, C, Olivotto, I, Badano, L, Parati, G, Perlini, S, Metra, M, Emdin, M, Rapezzi, C, Sinagra, G, Merlo M., Pagura L., Porcari A., Cameli M., Vergaro G., Musumeci B., Biagini E., Canepa M., Crotti L., Imazio M., Forleo C., Cappelli F., Perfetto F., Favale S., Di Bella G., Dore F., Girardi F., Tomasoni D., Pavasini R., Rella V., Palmiero G., Caiazza M., Carella M. C., Igoren Guaricci A., Branzi G., Caponetti A. G., Saturi G., La Malfa G., Merlo A. C., Andreis A., Bruno F., Longo F., Rossi M., Varra G. G., Saro R., Di Ienno L., De Carli G., Giacomin E., Arzilli C., Limongelli G., Autore C., Olivotto I., Badano L., Parati G., Perlini S., Metra M., Emdin M., Rapezzi C., Sinagra G., Merlo, M, Pagura, L, Porcari, A, Cameli, M, Vergaro, G, Musumeci, B, Biagini, E, Canepa, M, Crotti, L, Imazio, M, Forleo, C, Cappelli, F, Perfetto, F, Favale, S, Di Bella, G, Dore, F, Girardi, F, Tomasoni, D, Pavasini, R, Rella, V, Palmiero, G, Caiazza, M, Carella, M, Igoren Guaricci, A, Branzi, G, Caponetti, A, Saturi, G, La Malfa, G, Merlo, A, Andreis, A, Bruno, F, Longo, F, Rossi, M, Varra, G, Saro, R, Di Ienno, L, De Carli, G, Giacomin, E, Arzilli, C, Limongelli, G, Autore, C, Olivotto, I, Badano, L, Parati, G, Perlini, S, Metra, M, Emdin, M, Rapezzi, C, Sinagra, G, Merlo M., Pagura L., Porcari A., Cameli M., Vergaro G., Musumeci B., Biagini E., Canepa M., Crotti L., Imazio M., Forleo C., Cappelli F., Perfetto F., Favale S., Di Bella G., Dore F., Girardi F., Tomasoni D., Pavasini R., Rella V., Palmiero G., Caiazza M., Carella M. C., Igoren Guaricci A., Branzi G., Caponetti A. G., Saturi G., La Malfa G., Merlo A. C., Andreis A., Bruno F., Longo F., Rossi M., Varra G. G., Saro R., Di Ienno L., De Carli G., Giacomin E., Arzilli C., Limongelli G., Autore C., Olivotto I., Badano L., Parati G., Perlini S., Metra M., Emdin M., Rapezzi C., and Sinagra G.

Abstract

Aim: To investigate the prevalence of amyloid cardiomyopathy (AC) and the diagnostic accuracy of echocardiographic red flags of AC among consecutive adult patients undergoing transthoracic echocardiogram for reason other than AC in 13 Italian institutions. Methods and results: This is an Italian prospective multicentre study, involving a clinical and instrumental work-up to assess AC prevalence among patients ≥55 years old with an echocardiogram suggestive of AC (i.e. at least one echocardiographic red flag of AC in hypertrophic, non-dilated left ventricles with preserved ejection fraction). The study was registered at ClinicalTrials.gov (NCT04738266). Overall, 381 patients with an echocardiogram suggestive of AC were identified among a cohort of 5315 screened subjects, and 217 patients completed the investigations. A final diagnosis of AC was made in 62 patients with an estimated prevalence of 29% (95% confidence interval 23%–35%). Transthyretin-related AC (ATTR-AC) was diagnosed in 51 and light chain-related AC (AL-AC) in 11 patients. Either apical sparing or a combination of ≥2 other echocardiographic red flags, excluding interatrial septum thickness, provided a diagnostic accuracy >70%. Conclusion: In a cohort of consecutive adults with echocardiographic findings suggestive of AC and preserved left ventricular ejection fraction, the prevalence of AC (either ATTR or AL) was 29%. Easily available echocardiographic red flags, when combined together, demonstrated good diagnostic accuracy.

Published
2022

13. Erratum: Gender differences in predictors of intensive care units admission among COVID-19 patients: The results of the SARS-RAS study of the Italian Society of Hypertension (PLoS ONE (2020) 15:10 (e0237297) DOI: 10.1371/journal.pone.0237297)

Author

Iaccarino G., Iaccarino, G, Grassi, G, Borghi, C, Carugo, S, Fallo, F, Ferri, C, Giannattasio, C, Grassi, D, Letizia, C, Mancusi, C, Minuz, P, Perlini, S, Pucci, G, Rizzoni, D, Salvetti, M, Sarzani, R, Sechi, L, Veglio, F, Volpe, M, Iaccarino G., Grassi G., Borghi C., Carugo S., Fallo F., Ferri C., Giannattasio C., Grassi D., Letizia C., Mancusi C., Minuz P., Perlini S., Pucci G., Rizzoni D., Salvetti M., Sarzani R., Sechi L., Veglio F., Volpe M., Iaccarino G., Iaccarino, G, Grassi, G, Borghi, C, Carugo, S, Fallo, F, Ferri, C, Giannattasio, C, Grassi, D, Letizia, C, Mancusi, C, Minuz, P, Perlini, S, Pucci, G, Rizzoni, D, Salvetti, M, Sarzani, R, Sechi, L, Veglio, F, Volpe, M, Iaccarino G., Grassi G., Borghi C., Carugo S., Fallo F., Ferri C., Giannattasio C., Grassi D., Letizia C., Mancusi C., Minuz P., Perlini S., Pucci G., Rizzoni D., Salvetti M., Sarzani R., Sechi L., Veglio F., and Volpe M.

Abstract

There is an error in the third sentence of the second paragraph of the Introduction section of this article [1]. Prior to the publication of this article [1], reference 6 was retracted by The New England Journal of Medicine and should not have been cited [2]. The correct reference is: WHO. Gender and COVID-19: Advocacy brief [Internet]. 2020 [cited 2021 Jun 10]. Available from: https://www.who.int/publications/i/item/WHO-2019-nCoV-Advocacy_brief-Gender2020.1 As a result of this correction to the references, the following text in the second paragraph of the discussion is removed: “[odds ratio 0.79 (CI 0.65–0.95)] in an extensive observational database collecting patients from Asia, Europe, and the United States.” The authors provide the following additional clarifications: As stated in the article’s Discussion, the study design does not allow conclusions to be drawn about causal relationships. As such, the authors provide revised wording for the first sentence of the Conclusions section of the Abstract, and the first sentence of the Conclusions section of the Discussion. The correct sentences are, respectively, “Our study demonstrates that gender may be the primary determinant of the disease’s severity among COVID-19” and “Our study demonstrates a possible gender effect for women in COVID-19 that are protected from more severe clinical presentations of the disease.” In the study registry [3], the registered timeframe for the secondary outcome “Number and type of anthropometric and clinical parameters that associate with COVID19 and COVID-19 severity” was 3 months. The article reports a shorter observation period between March 9th and April 29th 2020. The authors wish to clarify that the study design included a steering committee that performed an interim analysis. The number of required patients was collected more quickly than expected.

Published
2022

14. Lung ultrasound for the early diagnosis of COVID-19 pneumonia: an international multicenter study

Author

Volpicelli, G., Gargani, L., Perlini, S., Spinelli, S., Barbieri, G., Lanotte, A., Casasola, G. G., Nogue-Bou, R., Lamorte, A., Agricola, E., Villen, T., Deol, P. S., Nazerian, P., Corradi, F., Stefanone, V., Fraga, D. N., Navalesi, P., Ferre, R., Boero, E., Martinelli, G., Cristoni, L., Perani, C., Vetrugno, L., Mcdermott, C., Miralles-Aguiar, F., Secco, G., Zattera, C., Salinaro, F., Grignaschi, A., Boccatonda, A., Giostra, F., Infante, M. N., Covella, M., Ingallina, G., Burkert, J., Frumento, P., Forfori, F., Ghiadoni, L., Fraccalini, T., Vendrame, A., Basile, V., Cipriano, A., Frassi, F., Santini, M., Falcone, M., Menichetti, F., Barcella, B., Delorenzo, M., Resta, F., Vezzoni, G., Bonzano, M., Briganti, D. F., Cappa, G., Zunino, I., Demitry, L., Vignaroli, D., Dipietro, L. S. S., Bazzini, M., Capozza, V., Gonzalez, M. M., Gibal, R. V., Ibarz, R. P., Alfaro, L. M., Alfaro, C. M., Alins, M. G., Brown, A., Dunlop, H., Ralli, M. L., Persona, P., Russel, F. M., Pang, P. S., Rovida, S., Deana, C., Franchini, D., Gargani, Luna, Volpicelli, G., Gargani, L., Perlini, S., Spinelli, S., Barbieri, G., Lanotte, A., Casasola, G. G., Nogue-Bou, R., Lamorte, A., Agricola, E., Villen, T., Deol, P. S., Nazerian, P., Corradi, F., Stefanone, V., Fraga, D. N., Navalesi, P., Ferre, R., Boero, E., Martinelli, G., Cristoni, L., Perani, C., Vetrugno, L., Mcdermott, C., Miralles-Aguiar, F., Secco, G., Zattera, C., Salinaro, F., Grignaschi, A., Boccatonda, A., Giostra, F., Infante, M. N., Covella, M., Ingallina, G., Burkert, J., Frumento, P., Forfori, F., Ghiadoni, L., Fraccalini, T., Vendrame, A., Basile, V., Cipriano, A., Frassi, F., Santini, M., Falcone, M., Menichetti, F., Barcella, B., Delorenzo, M., Resta, F., Vezzoni, G., Bonzano, M., Briganti, D. F., Cappa, G., Zunino, I., Demitry, L., Vignaroli, D., Dipietro, L. S. S., Bazzini, M., Capozza, V., Gonzalez, M. M., Gibal, R. V., Ibarz, R. P., Alfaro, L. M., Alfaro, C. M., Alins, M. G., Brown, A., Dunlop, H., Ralli, M. L., Persona, P., Russel, F. M., Pang, P. S., Rovida, S., Deana, C., and Franchini, D.

Subjects
Adult, medicine.medical_specialty, Multivariate analysis, Letter, Coronavirus disease 2019 (COVID-19), Original, COVID-19, Interstitial pneumonia, Lung ultrasound, SARS-CoV-2, Critical Care and Intensive Care Medicine, 03 medical and health sciences, 0302 clinical medicine, Anesthesiology, Internal medicine, medicine, Humans, Lung, Aged, Ultrasonography, business.industry, 030208 emergency & critical care medicine, Odds ratio, Middle Aged, medicine.disease, Confidence interval, Pneumonia, Early Diagnosis, 030228 respiratory system, Respiratory failure, Observational study, business
Abstract

Purpose To analyze the application of a lung ultrasound (LUS)-based diagnostic approach to patients suspected of COVID-19, combining the LUS likelihood of COVID-19 pneumonia with patient’s symptoms and clinical history. Methods This is an international multicenter observational study in 20 US and European hospitals. Patients suspected of COVID-19 were tested with reverse transcription-polymerase chain reaction (RT-PCR) swab test and had an LUS examination. We identified three clinical phenotypes based on pre-existing chronic diseases (mixed phenotype), and on the presence (severe phenotype) or absence (mild phenotype) of signs and/or symptoms of respiratory failure at presentation. We defined the LUS likelihood of COVID-19 pneumonia according to four different patterns: high (HighLUS), intermediate (IntLUS), alternative (AltLUS), and low (LowLUS) probability. The combination of patterns and phenotypes with RT-PCR results was described and analyzed. Results We studied 1462 patients, classified in mild (n = 400), severe (n = 727), and mixed (n = 335) phenotypes. HighLUS and IntLUS showed an overall sensitivity of 90.2% (95% CI 88.23–91.97%) in identifying patients with positive RT-PCR, with higher values in the mixed (94.7%) and severe phenotype (97.1%), and even higher in those patients with objective respiratory failure (99.3%). The HighLUS showed a specificity of 88.8% (CI 85.55–91.65%) that was higher in the mild phenotype (94.4%; CI 90.0–97.0%). At multivariate analysis, the HighLUS was a strong independent predictor of RT-PCR positivity (odds ratio 4.2, confidence interval 2.6–6.7, p

Published
2021

16. The UrgeRe (Urgenze Ipertensive: Un Progetto Educazionale Fondato Sulla Vita Reale, Hypertensive Urgencies: A Project in the Real World) Project

Author

Muiesan, M, Rosei, E, Borghi, C, De Luca, N, Ghiadoni, L, Grassi, G, Perlini, S, Pucci, G, Salvetti, M, Volpe, M, Ferri, C, Muiesan M. L., Rosei E. A., Borghi C., De Luca N., Ghiadoni L., Grassi G., Perlini S., Pucci G., Salvetti M., Volpe M., Ferri C., Muiesan, M, Rosei, E, Borghi, C, De Luca, N, Ghiadoni, L, Grassi, G, Perlini, S, Pucci, G, Salvetti, M, Volpe, M, Ferri, C, Muiesan M. L., Rosei E. A., Borghi C., De Luca N., Ghiadoni L., Grassi G., Perlini S., Pucci G., Salvetti M., Volpe M., and Ferri C.

Abstract

The approach to hypertensive emergiencies (HE) and urgencies (HU) may be different according to local clinical practice, despite recent guidelines and position papers recommendations. The Italian Society of Hypertension (Società Italiana della Ipertensione Arteriosa, SIIA) developed an online survey, in order to explore the awareness, management and treatment of HU in Italy, sending by e mail a 12 items questionnaire to the members of the SIIA. The results show that the definition of HU was correctly identified by 62% of the responders. Most physicians identified the role of pharmacological therapy or legal/illegal substances abuse as possible cause of BP elevation; the use of a benzodiazepine drugs was considered worthwhile by 65% of responders. The prescription of diagnostic test and drug administration significantly differed from guidelines recommendations and only 57% of the physicians reported to treat HU with oral drug administration. Sub-lingual nifedipine was prescribed by 13% or responders. This survey shows the need to further spread the updated scientific information on the management and treatment of HE and HU, along with the improvement of the interrelationship with the general practitioner health system in Italy.

Published
2021

19. Monitoring effectiveness and safety of Tafamidis in transthyretin amyloidosis in Italy: a longitudinal multicenter study in a non-endemic area

Author

Cortese, A., Vita, G., Luigetti, M., Russo, M., Bisogni, G., Sabatelli, M., Manganelli, F., Santoro, L., Cavallaro, T., Fabrizi, G. M., Schenone, A., Grandis, M., Gemelli, C., Mauro, A., Pradotto, L. G., Gentile, L., Stancanelli, C., Lozza, A., Perlini, S., Piscosquito, G., Calabrese, D., Mazzeo, A., Obici, L., and Pareyson, D.

Published
2016
Full Text
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20. Clinical factors associated with death in 3044 COVID-19 patients managed in internal medicine wards in Italy: results from the SIMI-COVID-19 study of the Italian Society of Internal Medicine (SIMI)

Author

Corradini E., Ventura P., Ageno W., Cogliati C. B., Muiesan M. L., Girelli D., Pirisi M., Gasbarrini A., Angeli P., Querini P. R., Bosi E., Tresoldi M., Vettor R., Cattaneo M., Piscaglia F., Brucato A. L., Perlini S., Martelletti P., Pontremoli R., Porta M., Minuz P., Olivieri O., Sesti G., Biolo G., Rizzoni D., Serviddio G., Cipollone F., Grassi D., Manfredini R., Moreo G. L., Pietrangelo A., Teatini T., Salvetti M., Crisafulli E., Sainaghi P. P., Zileri Dal Verme L., Piano S., De Lorenzo R., Arcidiacono G., Podda M., Muratori L., Gabiati C., Salinaro F., Luciani M., Barnini C., Morra di Cella S., Dalbeni A., Friso S., Mearelli F., Malerba P., Cavallone F., D'Ardes D., Notargiacomo S., De Giorgi A., Mansi M., Buzzetti E., Ricci A., Martelli F., Corradini E., Ventura P., Ageno W., Cogliati C.B., Muiesan M.L., Girelli D., Pirisi M., Gasbarrini A., Angeli P., Querini P.R., Bosi E., Tresoldi M., Vettor R., Cattaneo M., Piscaglia F., Brucato A.L., Perlini S., Martelletti P., Pontremoli R., Porta M., Minuz P., Olivieri O., Sesti G., Biolo G., Rizzoni D., Serviddio G., Cipollone F., Grassi D., Manfredini R., Moreo G.L., Pietrangelo A., Teatini T., Salvetti M., Crisafulli E., Sainaghi P.P., Zileri Dal Verme L., Piano S., De Lorenzo R., Arcidiacono G., Podda M., Muratori L., Gabiati C., Salinaro F., Luciani M., Barnini C., Morra di Cella S., Dalbeni A., Friso S., Mearelli F., Malerba P., Cavallone F., D'Ardes D., Notargiacomo S., De Giorgi A., Mansi M., Buzzetti E., Ricci A., Martelli F., Corradini, E., Ventura, P., Ageno, W., Cogliati, C. B., Muiesan, M. L., Girelli, D., Pirisi, M., Gasbarrini, A., Angeli, P., Rovere-Querini, P., Bosi, E., Tresoldi, M., Vettor, R., Cattaneo, M., Piscaglia, F., Brucato, A. L., Perlini, S., Martelletti, P., Pontremoli, R., Porta, M., Minuz, P., Olivieri, O., Sesti, G., Biolo, G., Rizzoni, D., Serviddio, G., Cipollone, F., Grassi, D., Manfredini, R., Moreo, G. L., Pietrangelo, A., Teatini, T., Salvetti, M., Crisafulli, E., Sainaghi, P. P., Zileri Dal Verme, L., Piano, S., De Lorenzo, R., Arcidiacono, G., Podda, M., Muratori, L., Gabiati, C., Salinaro, F., Luciani, M., Barnini, C., Morra di Cella, S., Dalbeni, A., Friso, S., Mearelli, F., Malerba, P., Cavallone, F., D'Ardes, D., Notargiacomo, S., De Giorgi, A., Mansi, M., Buzzetti, E., Ricci, A., and Martelli, F.

Subjects
Mortality from COVID-19, Comorbidity, 030204 cardiovascular system & hematology, Cohort Studies, 0302 clinical medicine, 80 and over, Medicine, 030212 general & internal medicine, Hospital Mortality, Internal medicine, Comorbidity, Internal medicine, Mortality from COVID-19, Polypharmacy, SARS-CoV-2, Aged, 80 and over, LS7_9, Mortality rate, Respiration, Middle Aged, Hospitals, Survival Rate, Hospitalization, Italy, Polypharmacy, SARS-CoV-2, Cohort, Artificial, Emergency Medicine, Adult, Aged, COVID-19, Critical Care, Humans, Respiration, Artificial, Internal Medicine, medicine.symptom, Cohort study, medicine.medical_specialty, Settore MED/12 - GASTROENTEROLOGIA, Socio-culturale, 03 medical and health sciences, Intensive care, Survival rate, business.industry, Organ dysfunction, Settore MED/09 - MEDICINA INTERNA, medicine.disease, Im - Original, business
Abstract

During the COVID-19 2020 outbreak, a large body of data has been provided on general management and outcomes of hospitalized COVID-19 patients. Yet, relatively little is known on characteristics and outcome of patients managedin Internal Medicine Units (IMU). To address this gap, the Italian Society of Internal Medicine has conducted a nationwide cohort multicentre study on death outcome in adult COVID-19 patients admitted and managed in IMU. This study assessed 3044 COVID-19 patients at 41 referral hospitals across Italy from February 3rd to May 8th 2020. Demographics, comorbidities, organ dysfunction, treatment, and outcomes including death were assessed. During the study period, 697 patients (22.9%) were transferred to intensive care units, and 351 died in IMU (death rate 14.9%). At admission, factors independently associated with in-hospital mortality were age (OR 2.46, p = 0.000), productive cough (OR 2.04, p = 0.000), pre-existing chronic heart failure (OR 1.58, p = 0.017) and chronic obstructive pulmonary disease (OR 1.17, p = 0.048), the number of comorbidities (OR 1.34, p = 0.000) and polypharmacy (OR 1.20, p = 0.000). Of note, up to 40% of elderly patients did not report fever at admission. Decreasing PaO2/FiO2 ratio at admission was strongly inversely associated with survival. The use of conventional oxygen supplementation increased with the number of pre-existing comorbidities, but it did not associate with better survival in patients with PaO2/FiO2 ratio

Published
2021

21. The UrgeRe (Urgenze Ipertensive: Un Progetto Educazionale Fondato Sulla Vita Reale, Hypertensive Urgencies: A Project in the Real World) Project

Author

Muiesan ML, Rosei EA, Borghi C, De Luca N, Ghiadoni L, Grassi G, Perlini S, Pucci G, Salvetti M, Volpe M, Ferri C, Italian Society of Hypertension., Muiesan, M, Rosei, E, Borghi, C, De Luca, N, Ghiadoni, L, Grassi, G, Perlini, S, Pucci, G, Salvetti, M, Volpe, M, Ferri, C, Muiesan ML, Rosei EA, Borghi C, De Luca N, Ghiadoni L, Grassi G, Perlini S, Pucci G, Salvetti M, Volpe M, Ferri C, and Italian Society of Hypertension.

Subjects
0301 basic medicine, Adult, Male, medicine.medical_specialty, Pharmacological therapy, Adolescent, General Practice, Blood Pressure, Practice Patterns, Hypertension, Hypertensive urgencies, 03 medical and health sciences, Aged, Antihypertensive Agents, Drug Utilization, Emergencies, Female, Guideline Adherence, Health Care Surveys, Humans, Hypertension, Italy, Middle Aged, Practice Guidelines as Topic, Practice Patterns, Physicians', Risk Factors, Treatment Outcome, Young Adult, 0302 clinical medicine, Pharmacotherapy, adolescent, adult, aged, antihypertensive agents, blood pressure, drug utilization, emergencies, female, general practice, guideline adherence, health care surveys, humans, hypertension, italy, male, middle aged, practice guidelines as topic, practice patterns, physicians', risk factors, treatment outcome, young adult, Guidelines recommendations, Internal Medicine, medicine, Medical prescription, Physicians', business.industry, Hypertensive emergiencies, urgencies, Diagnostic test, Drug administration, Clinical Practice, 030104 developmental biology, Family medicine, Original Article, Cardiology and Cardiovascular Medicine, business, 030217 neurology & neurosurgery, Oral retinoid
Abstract

The approach to hypertensive emergiencies (HE) and urgencies (HU) may be different according to local clinical practice, despite recent guidelines and position papers recommendations. The Italian Society of Hypertension (Società Italiana della Ipertensione Arteriosa, SIIA) developed an online survey, in order to explore the awareness, management and treatment of HU in Italy, sending by e mail a 12 items questionnaire to the members of the SIIA. The results show that the definition of HU was correctly identified by 62% of the responders. Most physicians identified the role of pharmacological therapy or legal/illegal substances abuse as possible cause of BP elevation; the use of a benzodiazepine drugs was considered worthwhile by 65% of responders. The prescription of diagnostic test and drug administration significantly differed from guidelines recommendations and only 57% of the physicians reported to treat HU with oral drug administration. Sub-lingual nifedipine was prescribed by 13% or responders. This survey shows the need to further spread the updated scientific information on the management and treatment of HE and HU, along with the improvement of the interrelationship with the general practitioner health system in Italy. Supplementary Information The online version contains supplementary material available at 10.1007/s40292-021-00433-1.

Published
2021

22. Use of hydroxychloroquine in hospitalised COVID-19 patients is associated with reduced mortality: Findings from the observational multicentre Italian CORIST study

Author

Castelnuovo, A, Costanzo, S, Antinori, A, Berselli, N, Blandi, L, Bruno, R, Cauda, R, Guaraldi, G, Menicanti, L, My, I, Parruti, G, Patti, G, Perlini, S, Santilli, F, Signorelli, C, Spinoni, E, Stefanini, G, Vergori, A, Ageno, W, Agodi, A, Aiello, L, Agostoni, P, Moghazi, S, Astuto, M, Aucella, F, Barbieri, G, Bartoloni, A, Bonaccio, M, Bonfanti, P, Cacciatore, F, Caiano, L, Cannata, F, Carrozzi, L, Cascio, A, Ciccullo, A, Cingolani, A, Cipollone, F, Colomba, C, Crosta, F, Pra, C, Danzi, G, D'Ardes, D, Donati, K, Giacomo, P, Gennaro, F, Tano, G, D'Offizi, G, Filippini, T, Fusco, F, Gentile, I, Gialluisi, A, Gini, G, Grandone, E, Grisafi, L, Guarnieri, G, Lamonica, S, Landi, F, Leone, A, Maccagni, G, Maccarella, S, Madaro, A, Mapelli, M, Maragna, R, Marra, L, Maresca, G, Marotta, C, Mastroianni, F, Mazzitelli, M, Mengozzi, A, Menichetti, F, Meschiari, M, Minutolo, F, Montineri, A, Mussinelli, R, Mussini, C, Musso, M, Odone, A, Olivieri, M, Pasi, E, Petri, F, Pinchera, B, Pivato, C, Poletti, V, Ravaglia, C, Rinaldi, M, Rognoni, A, Rossato, M, Rossi, I, Rossi, M, Sabena, A, Salinaro, F, Sangiovanni, V, Sanrocco, C, Scorzolini, L, Sgariglia, R, Simeone, P, Spinicci, M, Trecarichi, E, Venezia, A, Veronesi, G, Vettor, R, Vianello, A, Vinceti, M, Vocciante, L, De Caterina, R, Iacoviello, L, Castelnuovo A. D., Costanzo S., Antinori A., Berselli N., Blandi L., Bruno R., Cauda R., Guaraldi G., Menicanti L., My I., Parruti G., Patti G., Perlini S., Santilli F., Signorelli C., Spinoni E., Stefanini G. G., Vergori A., Ageno W., Agodi A., Aiello L., Agostoni P., Moghazi S. A., Astuto M., Aucella F., Barbieri G., Bartoloni A., Bonaccio M., Bonfanti P., Cacciatore F., Caiano L., Cannata F., Carrozzi L., Cascio A., Ciccullo A., Cingolani A., Cipollone F., Colomba C., Crosta F., Pra C. D., Danzi G. B., D'Ardes D., Donati K. D. G., Giacomo P. D., Gennaro F. D., Tano G. D., D'Offizi G., Filippini T., Fusco F. M., Gentile I., Gialluisi A., Gini G., Grandone E., Grisafi L., Guarnieri G., Lamonica S., Landi F., Leone A., Maccagni G., Maccarella S., Madaro A., Mapelli M., Maragna R., Marra L., Maresca G., Marotta C., Mastroianni F., Mazzitelli M., Mengozzi A., Menichetti F., Meschiari M., Minutolo F., Montineri A., Mussinelli R., Mussini C., Musso M., Odone A., Olivieri M., Pasi E., Petri F., Pinchera B., Pivato C. A., Poletti V., Ravaglia C., Rinaldi M., Rognoni A., Rossato M., Rossi I., Rossi M., Sabena A., Salinaro F., Sangiovanni V., Sanrocco C., Scorzolini L., Sgariglia R., Simeone P. G., Spinicci M., Trecarichi E. M., Venezia A., Veronesi G., Vettor R., Vianello A., Vinceti M., Vocciante L., De Caterina R., Iacoviello L., Castelnuovo, A, Costanzo, S, Antinori, A, Berselli, N, Blandi, L, Bruno, R, Cauda, R, Guaraldi, G, Menicanti, L, My, I, Parruti, G, Patti, G, Perlini, S, Santilli, F, Signorelli, C, Spinoni, E, Stefanini, G, Vergori, A, Ageno, W, Agodi, A, Aiello, L, Agostoni, P, Moghazi, S, Astuto, M, Aucella, F, Barbieri, G, Bartoloni, A, Bonaccio, M, Bonfanti, P, Cacciatore, F, Caiano, L, Cannata, F, Carrozzi, L, Cascio, A, Ciccullo, A, Cingolani, A, Cipollone, F, Colomba, C, Crosta, F, Pra, C, Danzi, G, D'Ardes, D, Donati, K, Giacomo, P, Gennaro, F, Tano, G, D'Offizi, G, Filippini, T, Fusco, F, Gentile, I, Gialluisi, A, Gini, G, Grandone, E, Grisafi, L, Guarnieri, G, Lamonica, S, Landi, F, Leone, A, Maccagni, G, Maccarella, S, Madaro, A, Mapelli, M, Maragna, R, Marra, L, Maresca, G, Marotta, C, Mastroianni, F, Mazzitelli, M, Mengozzi, A, Menichetti, F, Meschiari, M, Minutolo, F, Montineri, A, Mussinelli, R, Mussini, C, Musso, M, Odone, A, Olivieri, M, Pasi, E, Petri, F, Pinchera, B, Pivato, C, Poletti, V, Ravaglia, C, Rinaldi, M, Rognoni, A, Rossato, M, Rossi, I, Rossi, M, Sabena, A, Salinaro, F, Sangiovanni, V, Sanrocco, C, Scorzolini, L, Sgariglia, R, Simeone, P, Spinicci, M, Trecarichi, E, Venezia, A, Veronesi, G, Vettor, R, Vianello, A, Vinceti, M, Vocciante, L, De Caterina, R, Iacoviello, L, Castelnuovo A. D., Costanzo S., Antinori A., Berselli N., Blandi L., Bruno R., Cauda R., Guaraldi G., Menicanti L., My I., Parruti G., Patti G., Perlini S., Santilli F., Signorelli C., Spinoni E., Stefanini G. G., Vergori A., Ageno W., Agodi A., Aiello L., Agostoni P., Moghazi S. A., Astuto M., Aucella F., Barbieri G., Bartoloni A., Bonaccio M., Bonfanti P., Cacciatore F., Caiano L., Cannata F., Carrozzi L., Cascio A., Ciccullo A., Cingolani A., Cipollone F., Colomba C., Crosta F., Pra C. D., Danzi G. B., D'Ardes D., Donati K. D. G., Giacomo P. D., Gennaro F. D., Tano G. D., D'Offizi G., Filippini T., Fusco F. M., Gentile I., Gialluisi A., Gini G., Grandone E., Grisafi L., Guarnieri G., Lamonica S., Landi F., Leone A., Maccagni G., Maccarella S., Madaro A., Mapelli M., Maragna R., Marra L., Maresca G., Marotta C., Mastroianni F., Mazzitelli M., Mengozzi A., Menichetti F., Meschiari M., Minutolo F., Montineri A., Mussinelli R., Mussini C., Musso M., Odone A., Olivieri M., Pasi E., Petri F., Pinchera B., Pivato C. A., Poletti V., Ravaglia C., Rinaldi M., Rognoni A., Rossato M., Rossi I., Rossi M., Sabena A., Salinaro F., Sangiovanni V., Sanrocco C., Scorzolini L., Sgariglia R., Simeone P. G., Spinicci M., Trecarichi E. M., Venezia A., Veronesi G., Vettor R., Vianello A., Vinceti M., Vocciante L., De Caterina R., and Iacoviello L.

Abstract

Background: Hydroxychloroquine (HCQ) was proposed as potential treatment for COVID-19. Objective: We set-up a multicenter Italian collaboration to investigate the relationship between HCQ therapy and COVID-19 in-hospital mortality. Methods: In a retrospective observational study, 3,451 unselected patients hospitalized in 33 clinical centers in Italy, from February 19, 2020 to May 23, 2020, with laboratory-confirmed SARS-CoV-2 infection, were analyzed. The primary end-point in a time-to event analysis was in-hospital death, comparing patients who received HCQ with patients who did not. We used multivariable Cox proportional-hazards regression models with inverse probability for treatment weighting by propensity scores, with the addition of subgroup analyses. Results: Out of 3,451 COVID-19 patients, 76.3% received HCQ. Death rates (per 1,000 person-days) for patients receiving or not HCQ were 8.9 and 15.7, respectively. After adjustment for propensity scores, we found 30% lower risk of death in patients receiving HCQ (HR=0.70; 95%CI: 0.59 to 0.84; E-value=1.67). Secondary analyses yielded similar results. The inverse association of HCQ with inpatient mortality was particularly evident in patients having elevated C-reactive protein at entry. Conclusions: HCQ use was associated with a 30% lower risk of death in COVID-19 hospitalized patients. Within the limits of an observational study and awaiting results from randomized controlled trials, these data do not discourage the use of HCQ in inpatients with COVID-19.

Published
2020

23. Gender differences in predictors of intensive care units admission among COVID-19 patients: The results of the SARS-RAS study of the Italian Society of Hypertension

Author

Iaccarino G, Grassi G, Borghi C, Carugo S, Fallo F, Ferri C, Giannattasio C, Grassi D, Letizia C, Mancusi C, Minuz P, Perlini S, Pucci G, Rizzoni D, Salvetti M, Sarzani R, Sechi L, Veglio F, Volpe M, Muiesan ML, SARS-RAS Investigators, Iaccarino G, Grassi G, Borghi C, Carugo S, Fallo F, Ferri C, Giannattasio C, Grassi D, Letizia C, Mancusi C, Minuz P, Perlini S, Pucci G, Rizzoni D, Salvetti M, Sarzani R, Sechi L, Veglio F, Volpe M, Muiesan ML, SARS-RAS Investigators, Iaccarino, G, Grassi, G, Borghi, C, Carugo, S, Fallo, F, Ferri, C, Giannattasio, C, Grassi, D, Letizia, C, Mancusi, C, Minuz, P, Perlini, S, Pucci, G, Rizzoni, D, Salvetti, M, Sarzani, R, Sechi, L, Veglio, F, Volpe, M, Muiesan, M, Iaccarino, G., Borghi, C., Carugo, S., Fallo, F., Ferri, C., Giannattasio, C., Grassi, D., Letizia, C., Mancusi, C., Minuz, P., Perlini, S., Pucci, G., Rizzoni, D., Salvetti, M., Sarzani, R., Sechi, L., Veglio, F., Volpe, M., Muiesan, M. L., and SARS-RAS Investigator

Subjects
COVID-19, gender, obesity, Male, Pulmonology, Cross-sectional study, Disease, Cardiovascular Medicine, covid , gender, Vascular Medicine, Severity of Illness Index, Covid, law.invention, Adolescent, Adult, Aged, Aged, 80 and over, Betacoronavirus, Coronavirus Infections, Cross-Sectional Studies, Female, Heart Failure, Humans, Hypertension, Italy, Middle Aged, Obesity, Pandemics, Pneumonia, Viral, Renal Insufficiency, Chronic, Risk Factors, Sex Factors, Young Adult, Intensive Care Units, Patient Admission, 0302 clinical medicine, Medical Conditions, Endocrinology, Health care, 80 and over, Medicine, Chronic, Nephrology, Cardiovascular Diseases, Human, medicine.medical_specialty, Endocrine Disorders, Science, Intensive Care Unit, COVID-19, SARS-CoV-2, 03 medical and health sciences, Intensive care, Severity of illness, Renal Diseases, Diabetes Mellitus, Cross-Sectional Studie, Betacoronaviru, Biology and Life Sciences, Correction, Covid 19, Pneumonia, Clinical trial, Health Care, Health Care Facilities, Observational study, SARS_CoV-2, Viral Diseases, Physiology, Sex Factor, 030204 cardiovascular system & hematology, law, Chronic Kidney Disease, Medicine and Health Sciences, Coronary Heart Disease, 030212 general & internal medicine, Viral, Renal Insufficiency, intensive care, Multidisciplinary, SARS_CoV-2, Gender, intensive care, prediction, Intensive care unit, Hospitals, Infectious Diseases, Physiological Parameters, Research Article, Chronic Obstructive Pulmonary Disease, Cardiology, Pandemic, business.industry, Coronavirus Infection, Risk Factor, Body Weight, Gender, prediction, Hyperyension, Metabolic Disorders, Emergency medicine, business
Abstract

BackgroundThe global rate of intensive care unit (ICU) admission during the COVID-19 pandemic varies within countries and is among the main challenges for health care systems worldwide. Conflicting results have been reported about the response to coronavirus infection and COVID-19 outcomes in men and women. Understanding predictors of intensive care unit admission might be of help for future planning and management of the disease.Methods and findingsWe designed a cross-sectional observational multicenter nationwide survey in Italy to understand gender-related clinical predictors of ICU admission in patients with COVID-19. We analyzed information from 2378 charts of Italian patients certified for COVID-19 admitted in 26 hospitals. Three hundred ninety-five patients (16.6%) required ICU admission due to COVID19 infection, more frequently men (74%), with a higher prevalence of comorbidities (1,78±0,06 vs 1,54±0,03 pConclusionsOur study demonstrates that gender is the primary determinant of the disease's severity among COVID-19. Obesity is the condition more often observed among those admitted to ICU within both genders.Trial registrationClinicaltrials.gov: NCT04331574.

Published
2020

24. A national survey on prevalence of possible echocardiographic red flags of amyloid cardiomyopathy in consecutive patients undergoing routine echocardiography: study design and patients characterization-the first insight from the AC-TIVE Study

Author

Merlo, M, Porcari, A, Pagura, L, Cameli, M, Vergaro, G, Musumeci, B, Biagini, E, Canepa, M, Crotti, L, Imazio, M, Forleo, C, Cappelli, F, Favale, S, Di Bella, G, Dore, F, Lombardi, C, Pavasini, R, Rella, V, Palmiero, G, Caiazza, M, Albanese, M, Guaricci, A, Branzi, G, Caponetti, A, Saturi, G, La Malfa, G, Merlo, A, Andreis, A, Bruno, F, Longo, F, Sfriso, E, Di Ienno, L, De Carli, G, Giacomin, E, Spini, V, Milidoni, A, Limongelli, G, Autore, C, Olivotto, I, Badano, L, Parati, G, Perlini, S, Metra, M, Emdin, M, Rapezzi, C, Sinagra, G, Merlo, Marco, Porcari, Aldostefano, Pagura, Linda, Cameli, Matteo, Vergaro, Giuseppe, Musumeci, Beatrice, Biagini, Elena, Canepa, Marco, Crotti, Lia, Imazio, Massimo, Forleo, Cinzia, Cappelli, Francesco, Favale, Stefano, Di Bella, Gianluca, Dore, Franca, Lombardi, Carlo Mario, Pavasini, Rita, Rella, Valeria, Palmiero, Giuseppe, Caiazza, Martina, Albanese, Miriam, Guaricci, Andrea Igoren, Branzi, Giovanna, Caponetti, Angelo Giuseppe, Saturi, Giulia, La Malfa, Giovanni, Merlo, Andrea Carlo, Andreis, Alessandro, Bruno, Francesco, Longo, Francesca, Sfriso, Enrico, Di Ienno, Luca, De Carli, Giuseppe, Giacomin, Elisa, Spini, Valentina, Milidoni, Antonino, Limongelli, Giuseppe, Autore, Camillo, Olivotto, Iacopo, Badano, Luigi, Parati, Gianfranco, Perlini, Stefano, Metra, Marco, Emdin, Michele, Rapezzi, Claudio, Sinagra, Gianfranco, Merlo, M, Porcari, A, Pagura, L, Cameli, M, Vergaro, G, Musumeci, B, Biagini, E, Canepa, M, Crotti, L, Imazio, M, Forleo, C, Cappelli, F, Favale, S, Di Bella, G, Dore, F, Lombardi, C, Pavasini, R, Rella, V, Palmiero, G, Caiazza, M, Albanese, M, Guaricci, A, Branzi, G, Caponetti, A, Saturi, G, La Malfa, G, Merlo, A, Andreis, A, Bruno, F, Longo, F, Sfriso, E, Di Ienno, L, De Carli, G, Giacomin, E, Spini, V, Milidoni, A, Limongelli, G, Autore, C, Olivotto, I, Badano, L, Parati, G, Perlini, S, Metra, M, Emdin, M, Rapezzi, C, Sinagra, G, Merlo, Marco, Porcari, Aldostefano, Pagura, Linda, Cameli, Matteo, Vergaro, Giuseppe, Musumeci, Beatrice, Biagini, Elena, Canepa, Marco, Crotti, Lia, Imazio, Massimo, Forleo, Cinzia, Cappelli, Francesco, Favale, Stefano, Di Bella, Gianluca, Dore, Franca, Lombardi, Carlo Mario, Pavasini, Rita, Rella, Valeria, Palmiero, Giuseppe, Caiazza, Martina, Albanese, Miriam, Guaricci, Andrea Igoren, Branzi, Giovanna, Caponetti, Angelo Giuseppe, Saturi, Giulia, La Malfa, Giovanni, Merlo, Andrea Carlo, Andreis, Alessandro, Bruno, Francesco, Longo, Francesca, Sfriso, Enrico, Di Ienno, Luca, De Carli, Giuseppe, Giacomin, Elisa, Spini, Valentina, Milidoni, Antonino, Limongelli, Giuseppe, Autore, Camillo, Olivotto, Iacopo, Badano, Luigi, Parati, Gianfranco, Perlini, Stefano, Metra, Marco, Emdin, Michele, Rapezzi, Claudio, and Sinagra, Gianfranco

Published
2022

26. C64 UNMASKING THE PREVALENCE OF AMYLOID CARDIOMYOPATHY IN THE REAL WORLD: RESULTS FROM PHASE 2 OF AC–TIVE STUDY, AN ITALIAN NATIONWIDE SURVEY

Author

Merlo, M, primary, Pagura, L, additional, Porcari, A, additional, Cameli, M, additional, Vergaro, G, additional, Musumeci, B, additional, Biagini, E, additional, Canepa, M, additional, Crotti, L, additional, Imazio, M, additional, Forleo, C, additional, Cappelli, F, additional, Favale, S, additional, Di Bella, G, additional, Dore, F, additional, Girardi, F, additional, Tomasoni, D, additional, Pavasini, R, additional, Rella, V, additional, Palmiero, G, additional, Caiazza, M, additional, Albanese, M, additional, Igoren Guarrucci, A, additional, Branzi, G, additional, Caponetti, A, additional, Saturi, G, additional, La Malfa, G, additional, Merlo, A, additional, Andreis, A, additional, Bruno, F, additional, Longo, F, additional, Rossi, M, additional, Varra‘, G, additional, Saro, R, additional, Di Ienno, L, additional, De Carli, G, additional, Giacomin, E, additional, Spini, V, additional, Limongelli, G, additional, Autore, C, additional, Olivotto, I, additional, Badano, L, additional, Parati, G, additional, Perlini, S, additional, Metra, M, additional, Emdin, M, additional, Rapezzi, C, additional, and Sinagra, G, additional

Published
2022
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28. 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

32. Erratum: Gender differences in predictors of intensive care units admission among COVID-19 patients: The results of the SARSRAS study of the Italian Society of Hypertension (PLoS ONE (2020) 15:10 (e0237297) DOI: 10.1371/journal.pone.0237297)

Author

Iaccarino, G., Grassi, G., Borghi, C., Carugo, S., Fallo, F., Ferri, C., Giannattasio, C., Grassi, D., Letizia, C., Mancusi, C., Minuz, P., Perlini, S., Pucci, G., Rizzoni, D., Salvetti, M., Sarzani, R., Sechi, L., Veglio, F., Volpe, M., and Muiesan, M. L.

Published
2021

33. Determinants of healing among patients with COVID-19: The results of the SARS-RAS study of the Italian Society of Hypertension

Author

Mancusi, C., Grassi, G., Borghi, C., Carugo, S., Fallo, F., Ferri, C., Giannattasio, C., Grassi, D., Letizia, C., Minuz, P., Muiesan, M. L., Perlini, S., Pucci, G., Rizzoni, D., Salvetti, M., Sarzani, R., Sechi, L., Veglio, F., Volpe, M., and Iaccarino, G.

Subjects
Adult, Male, Chronic conditions, Adolescent, Angiotensin-Converting Enzyme Inhibitors, Outcomes, Comorbidity, Renin-Angiotensin System, Angiotensin Receptor Antagonists, Young Adult, Coronavirus disease 2019, Multimorbidity, Recovery, Age Factors, Aged, Aged, 80 and over, Analysis of Variance, Antihypertensive Agents, COVID-19, Chronic Disease, Cross-Sectional Studies, Female, Heart Failure, Hospitalization, Humans, Hypertension, Italy, Middle Aged, Renal Insufficiency, Chronic, SARS-CoV-2, Surveys and Questionnaires, 80 and over, Renal Insufficiency, Chronic
Published
2021

34. Disentangling the Association of Hydroxychloroquine Treatment with Mortality in Covid-19 Hospitalized Patients through Hierarchical Clustering

Author

Di Castelnuovo, A, Gialluisi, A, Antinori, A, Berselli, N, Blandi, L, Bonaccio, M, Bruno, R, Cauda, R, Costanzo, S, Guaraldi, G, Menicanti, L, Mennuni, M, My, I, Parruti, G, Patti, G, Perlini, S, Santilli, F, Signorelli, C, Stefanini, G, Vergori, A, Ageno, W, Agodi, A, Agostoni, P, Aiello, L, Al Moghazi, S, Arboretti, R, Aucella, F, Barbieri, G, Barchitta, M, Bonfanti, P, Cacciatore, F, Caiano, L, Cannata, F, Carrozzi, L, Cascio, A, Castiglione, G, Cicullo, A, Cingolani, A, Cipollone, F, Colomba, C, Colombo, C, Crisetti, A, Crosta, F, Danzi, G, D'Ardes, D, de Gaetano Donati, K, Di Gennaro, F, Di Tano, G, D'Offizi, G, Fusco, F, Gaudiosi, C, Gentile, I, Gianfagna1, F, Giuliano, G, Graziani, E, Guarnieri, G, Langella, V, Larizza, G, Leone, A, Maccagni, G, Magni, F, Maitan, S, Mancarella, S, Manuele, R, Mapelli, M, Maragna, R, Marcucci, R, Maresca, G, Marongiu, S, Marotta, C, Marra, L, Mastroianni, F, Mengozzi, A, Meschiari, M, Milic, J, Minutolo, F, Mussinelli, R, Mussini, C, Musso, M, Odone, A, Olivieri, M, Palimodde, A, Pasi, E, Pesavento, R, Petri, F, Pivato, C, Poletti, V, Ravaglia, C, Righetti, G, Rognoni, A, Rossato, M, Rossi, I, Rossi, M, Sabena, A, Salinaro, F, Sangiovanni, V, Sanrocco, C, Schiano Moriello, N, Scorzolini, L, Sgariglia, R, Simeone, P, Spinicci, M, Tamburrini, E, Torti, C, Trecarichi, E, Vettor, R, Vianello, A, Vinceti, M, Virdis, A, De Caterina, R, Iacoviello, L, Di Castelnuovo, Augusto, Gialluisi, Alessandro, Antinori, Andrea, Berselli, Nausicaa, Blandi, Lorenzo, Bonaccio, Marialaura, Bruno, Raffaele, Cauda, Roberto, Costanzo, Simona, Guaraldi, Giovanni, Menicanti, Lorenzo, Mennuni, Marco, My, Ilaria, Parruti, Giustino, Patti, Giuseppe, Perlini, Stefano, Santilli, Francesca, Signorelli, Carlo, Stefanini, Giulio, Vergori, Alessandra, Ageno, Walter, Agodi, Antonella, Agostoni, Piergiuseppe, Aiello, Luca, Al Moghazi, Samir, Arboretti, Rosa, Aucella, Filippo, Barbieri, Greta, Barchitta, Martina, Bonfanti, Paolo, Cacciatore, Francesco, Caiano, Lucia, Cannata, Francesco, Carrozzi, Laura, Cascio, Antonio, Castiglione, Giacomo, Cicullo, Arturo, Cingolani, Antonella, Cipollone, Francesco, Colomba, Claudia, Colombo, Crizia, Crisetti, Annalisa, Crosta, Francesca, Danzi, Gian Battista, D'Ardes, Damiano, de Gaetano Donati, Katleen, Di Gennaro, Francesco, Di Tano, Giuseppe, D'Offizi, Gianpiero, Fusco, Francesco Maria, Gaudiosi, Carlo, Gentile, Ivan, Gianfagna1, Francesco, Giuliano, Gabriele, Graziani, Emauele, Guarnieri, Gabriella, Langella, Valerio, Larizza, Giovanni, Leone, Armando, Maccagni, Gloria, Magni, Federica, Maitan, Stefano, Mancarella, Sandro, Manuele, Rosa, Mapelli, Massimo, Maragna, Riccardo, Marcucci, Rossella, Maresca, Giulio, Marongiu, Silvia, Marotta, Claudia, Marra, Lorenzo, Mastroianni, Franco, Mengozzi, Alessandro, Meschiari, Marianna, Milic, Jovana, Minutolo, Filippo, Mussinelli, Roberta, Mussini, Cristina, Musso, Maria, Odone, Anna, Olivieri, Marco, Palimodde, Antonella, Pasi, Emanuela, Pesavento, Raffaele, Petri, Francesco, Pivato, Carlo A, Poletti, Venerino, Ravaglia, Claudia, Righetti, Giulia, Rognoni, Andrea, Rossato, Marco, Rossi, Ilaria, Rossi, Marianna, Sabena, Anna, Salinaro, Francesco, Sangiovanni, Vincenzo, Sanrocco, Carlo, Schiano Moriello, Nicola, Scorzolini, Laura, Sgariglia, Raffaella, Simeone, Paola Giustina, Spinicci, Michele, Tamburrini, Enrica, Torti, Carlo, Trecarichi, Enrico Maria, Vettor, Roberto, Vianello, Andrea, Vinceti, Marco, Virdis, Agostino, De Caterina, Raffaele, Iacoviello, Licia, Di Castelnuovo, A, Gialluisi, A, Antinori, A, Berselli, N, Blandi, L, Bonaccio, M, Bruno, R, Cauda, R, Costanzo, S, Guaraldi, G, Menicanti, L, Mennuni, M, My, I, Parruti, G, Patti, G, Perlini, S, Santilli, F, Signorelli, C, Stefanini, G, Vergori, A, Ageno, W, Agodi, A, Agostoni, P, Aiello, L, Al Moghazi, S, Arboretti, R, Aucella, F, Barbieri, G, Barchitta, M, Bonfanti, P, Cacciatore, F, Caiano, L, Cannata, F, Carrozzi, L, Cascio, A, Castiglione, G, Cicullo, A, Cingolani, A, Cipollone, F, Colomba, C, Colombo, C, Crisetti, A, Crosta, F, Danzi, G, D'Ardes, D, de Gaetano Donati, K, Di Gennaro, F, Di Tano, G, D'Offizi, G, Fusco, F, Gaudiosi, C, Gentile, I, Gianfagna1, F, Giuliano, G, Graziani, E, Guarnieri, G, Langella, V, Larizza, G, Leone, A, Maccagni, G, Magni, F, Maitan, S, Mancarella, S, Manuele, R, Mapelli, M, Maragna, R, Marcucci, R, Maresca, G, Marongiu, S, Marotta, C, Marra, L, Mastroianni, F, Mengozzi, A, Meschiari, M, Milic, J, Minutolo, F, Mussinelli, R, Mussini, C, Musso, M, Odone, A, Olivieri, M, Palimodde, A, Pasi, E, Pesavento, R, Petri, F, Pivato, C, Poletti, V, Ravaglia, C, Righetti, G, Rognoni, A, Rossato, M, Rossi, I, Rossi, M, Sabena, A, Salinaro, F, Sangiovanni, V, Sanrocco, C, Schiano Moriello, N, Scorzolini, L, Sgariglia, R, Simeone, P, Spinicci, M, Tamburrini, E, Torti, C, Trecarichi, E, Vettor, R, Vianello, A, Vinceti, M, Virdis, A, De Caterina, R, Iacoviello, L, Di Castelnuovo, Augusto, Gialluisi, Alessandro, Antinori, Andrea, Berselli, Nausicaa, Blandi, Lorenzo, Bonaccio, Marialaura, Bruno, Raffaele, Cauda, Roberto, Costanzo, Simona, Guaraldi, Giovanni, Menicanti, Lorenzo, Mennuni, Marco, My, Ilaria, Parruti, Giustino, Patti, Giuseppe, Perlini, Stefano, Santilli, Francesca, Signorelli, Carlo, Stefanini, Giulio, Vergori, Alessandra, Ageno, Walter, Agodi, Antonella, Agostoni, Piergiuseppe, Aiello, Luca, Al Moghazi, Samir, Arboretti, Rosa, Aucella, Filippo, Barbieri, Greta, Barchitta, Martina, Bonfanti, Paolo, Cacciatore, Francesco, Caiano, Lucia, Cannata, Francesco, Carrozzi, Laura, Cascio, Antonio, Castiglione, Giacomo, Cicullo, Arturo, Cingolani, Antonella, Cipollone, Francesco, Colomba, Claudia, Colombo, Crizia, Crisetti, Annalisa, Crosta, Francesca, Danzi, Gian Battista, D'Ardes, Damiano, de Gaetano Donati, Katleen, Di Gennaro, Francesco, Di Tano, Giuseppe, D'Offizi, Gianpiero, Fusco, Francesco Maria, Gaudiosi, Carlo, Gentile, Ivan, Gianfagna1, Francesco, Giuliano, Gabriele, Graziani, Emauele, Guarnieri, Gabriella, Langella, Valerio, Larizza, Giovanni, Leone, Armando, Maccagni, Gloria, Magni, Federica, Maitan, Stefano, Mancarella, Sandro, Manuele, Rosa, Mapelli, Massimo, Maragna, Riccardo, Marcucci, Rossella, Maresca, Giulio, Marongiu, Silvia, Marotta, Claudia, Marra, Lorenzo, Mastroianni, Franco, Mengozzi, Alessandro, Meschiari, Marianna, Milic, Jovana, Minutolo, Filippo, Mussinelli, Roberta, Mussini, Cristina, Musso, Maria, Odone, Anna, Olivieri, Marco, Palimodde, Antonella, Pasi, Emanuela, Pesavento, Raffaele, Petri, Francesco, Pivato, Carlo A, Poletti, Venerino, Ravaglia, Claudia, Righetti, Giulia, Rognoni, Andrea, Rossato, Marco, Rossi, Ilaria, Rossi, Marianna, Sabena, Anna, Salinaro, Francesco, Sangiovanni, Vincenzo, Sanrocco, Carlo, Schiano Moriello, Nicola, Scorzolini, Laura, Sgariglia, Raffaella, Simeone, Paola Giustina, Spinicci, Michele, Tamburrini, Enrica, Torti, Carlo, Trecarichi, Enrico Maria, Vettor, Roberto, Vianello, Andrea, Vinceti, Marco, Virdis, Agostino, De Caterina, Raffaele, and Iacoviello, Licia

Abstract

The efficacy of hydroxychloroquine (HCQ) in treating SARS-CoV-2 infection is harshly debated, with observational and experimental studies reporting contrasting results. To clarify the role of HCQ in Covid-19 patients, we carried out a retrospective observational study of 4,396 unselected patients hospitalized for Covid-19 in Italy (February–May 2020). Patients’ characteristics were collected at entry, including age, sex, obesity, smoking status, blood parameters, history of diabetes, cancer, cardiovascular and chronic pulmonary diseases, and medications in use. These were used to identify subtypes of patients with similar characteristics through hierarchical clustering based on Gower distance. Using multivariable Cox regressions, these clusters were then tested for association with mortality and modification of effect by treatment with HCQ. We identified two clusters, one of 3,913 younger patients with lower circulating inflammation levels and better renal function, and one of 483 generally older and more comorbid subjects, more prevalently men and smokers. The latter group was at increased death risk adjusted by HCQ (HR[CI95%] = 3.80[3.08-4.67]), while HCQ showed an independent inverse association (0.51[0.43-0.61]), as well as a significant influence of cluster∗HCQ interaction (). This was driven by a differential association of HCQ with mortality between the high (0.89[0.65-1.22]) and the low risk cluster (0.46[0.39-0.54]). These effects survived adjustments for additional medications in use and were concordant with associations with disease severity and outcome. These findings suggest a particularly beneficial effect of HCQ within low risk Covid-19 patients and may contribute to clarifying the current controversy on HCQ efficacy in Covid-19 treatment.

Published
2021

35. Lopinavir/Ritonavir and Darunavir/Cobicistat in Hospitalized COVID-19 Patients: Findings From the Multicenter Italian CORIST Study

Author

Di Castelnuovo, A, Costanzo, S, Antinori, A, Berselli, N, Blandi, L, Bonaccio, M, Bruno, R, Cauda, R, Gialluisi, A, Guaraldi, G, Menicanti, L, Mennuni, M, My, I, Parruti, A, Patti, G, Perlini, S, Santilli, F, Signorelli, C, Stefanini, G, Vergori, A, Ageno, W, Aiello, L, Agostoni, P, Al Moghazi, S, Arboretti, R, Aucella, F, Barbieri, G, Barchitta, M, Bartoloni, A, Bologna, C, Bonfanti, P, Caiano, L, Carrozzi, L, Cascio, A, Castiglione, G, Chiarito, M, Ciccullo, A, Cingolani, A, Cipollone, F, Colomba, C, Colombo, C, Crosta, F, Dalena, G, Dal Pra, C, Danzi, G, D'Ardes, D, de Gaetano Donati, K, Di Gennaro, F, Di Tano, G, D'Offizi, G, Filippini, T, Maria Fusco, F, Gaudiosi, C, Gentile, I, Gini, G, Grandone, E, Guarnieri, G, Lamanna, G, Larizza, G, Leone, A, Lio, V, Losito, A, Maccagni, G, Maitan, S, Mancarella, S, Manuele, R, Mapelli, M, Maragna, R, Marra, L, Maresca, G, Marotta, C, Mastroianni, F, Mazzitelli, M, Mengozzi, A, Menichetti, F, Milic, J, Minutolo, F, Molena, B, Mussinelli, R, Mussini, C, Musso, M, Odone, A, Olivieri, M, Pasi, E, Perroni, A, Petri, F, Pinchera, B, Pivato, C, Poletti, V, Ravaglia, C, Rossato, M, Rossi, M, Sabena, A, Salinaro, F, Sangiovanni, V, Sanrocco, C, Scorzolini, L, Sgariglia, R, Simeone, P, Spinicci, M, Trecarichi, E, Veronesi, G, Vettor, R, Vianello, A, Vinceti, M, Visconti, E, Vocciante, L, De Caterina, R, Iacoviello, L, Di Castelnuovo, Augusto, Costanzo, Simona, Antinori, Andrea, Berselli, Nausicaa, Blandi, Lorenzo, Bonaccio, Marialaura, Bruno, Raffaele, Cauda, Roberto, Gialluisi, Alessandro, Guaraldi, Giovanni, Menicanti, Lorenzo, Mennuni, Marco, My, Ilaria, Parruti, Agostino, Patti, Giuseppe, Perlini, Stefano, Santilli, Francesca, Signorelli, Carlo, Stefanini, Giulio G, Vergori, Alessandra, Ageno, Walter, Aiello, Luca, Agostoni, Piergiuseppe, Al Moghazi, Samir, Arboretti, Rosa, Aucella, Filippo, Barbieri, Greta, Barchitta, Martina, Bartoloni, Alessandro, Bologna, Carolina, Bonfanti, Paolo, Caiano, Lucia, Carrozzi, Laura, Cascio, Antonio, Castiglione, Giacomo, Chiarito, Mauro, Ciccullo, Arturo, Cingolani, Antonella, Cipollone, Francesco, Colomba, Claudia, Colombo, Crizia, Crosta, Francesco, Dalena, Giovanni, Dal Pra, Chiara, Danzi, Gian Battista, D'Ardes, Damiano, de Gaetano Donati, Katleen, Di Gennaro, Francesco, Di Tano, Giuseppe, D'Offizi, Gianpiero, Filippini, Tommaso, Maria Fusco, Francesco, Gaudiosi, Carlo, Gentile, Ivan, Gini, Giancarlo, Grandone, Elvira, Guarnieri, Gabriella, Lamanna, Gennaro L F, Larizza, Giovanni, Leone, Armando, Lio, Veronica, Losito, Angela Raffaella, Maccagni, Gloria, Maitan, Stefano, Mancarella, Sandro, Manuele, Rosa, Mapelli, Massimo, Maragna, Riccardo, Marra, Lorenzo, Maresca, Giulio, Marotta, Claudia, Mastroianni, Franco, Mazzitelli, Maria, Mengozzi, Alessandro, Menichetti, Francesco, Milic, Jovana, Minutolo, Filippo, Molena, Beatrice, Mussini, Cristina, Musso, Maria, Odone, Anna, Olivieri, Marco, Pasi, Emanuela, Perroni, Annalisa, Petri, Francesco, Pinchera, Biagio, Pivato, Carlo A, Poletti, Venerino, Ravaglia, Claudia, Rossato, Marco, Rossi, Marianna, Sabena, Anna, Salinaro, Francesco, Sangiovanni, Vincenzo, Sanrocco, Carlo, Scorzolini, Laura, Sgariglia, Raffaella, Simeone, Paola Giustina, Spinicci, Michele, Trecarichi, Enrico Maria, Veronesi, Giovanni, Vettor, Roberto, Vianello, Andrea, Vinceti, Marco, Visconti, Elena, Vocciante, Laura, De Caterina, Raffaele, Iacoviello, Licia, Di Castelnuovo, A, Costanzo, S, Antinori, A, Berselli, N, Blandi, L, Bonaccio, M, Bruno, R, Cauda, R, Gialluisi, A, Guaraldi, G, Menicanti, L, Mennuni, M, My, I, Parruti, A, Patti, G, Perlini, S, Santilli, F, Signorelli, C, Stefanini, G, Vergori, A, Ageno, W, Aiello, L, Agostoni, P, Al Moghazi, S, Arboretti, R, Aucella, F, Barbieri, G, Barchitta, M, Bartoloni, A, Bologna, C, Bonfanti, P, Caiano, L, Carrozzi, L, Cascio, A, Castiglione, G, Chiarito, M, Ciccullo, A, Cingolani, A, Cipollone, F, Colomba, C, Colombo, C, Crosta, F, Dalena, G, Dal Pra, C, Danzi, G, D'Ardes, D, de Gaetano Donati, K, Di Gennaro, F, Di Tano, G, D'Offizi, G, Filippini, T, Maria Fusco, F, Gaudiosi, C, Gentile, I, Gini, G, Grandone, E, Guarnieri, G, Lamanna, G, Larizza, G, Leone, A, Lio, V, Losito, A, Maccagni, G, Maitan, S, Mancarella, S, Manuele, R, Mapelli, M, Maragna, R, Marra, L, Maresca, G, Marotta, C, Mastroianni, F, Mazzitelli, M, Mengozzi, A, Menichetti, F, Milic, J, Minutolo, F, Molena, B, Mussinelli, R, Mussini, C, Musso, M, Odone, A, Olivieri, M, Pasi, E, Perroni, A, Petri, F, Pinchera, B, Pivato, C, Poletti, V, Ravaglia, C, Rossato, M, Rossi, M, Sabena, A, Salinaro, F, Sangiovanni, V, Sanrocco, C, Scorzolini, L, Sgariglia, R, Simeone, P, Spinicci, M, Trecarichi, E, Veronesi, G, Vettor, R, Vianello, A, Vinceti, M, Visconti, E, Vocciante, L, De Caterina, R, Iacoviello, L, Di Castelnuovo, Augusto, Costanzo, Simona, Antinori, Andrea, Berselli, Nausicaa, Blandi, Lorenzo, Bonaccio, Marialaura, Bruno, Raffaele, Cauda, Roberto, Gialluisi, Alessandro, Guaraldi, Giovanni, Menicanti, Lorenzo, Mennuni, Marco, My, Ilaria, Parruti, Agostino, Patti, Giuseppe, Perlini, Stefano, Santilli, Francesca, Signorelli, Carlo, Stefanini, Giulio G, Vergori, Alessandra, Ageno, Walter, Aiello, Luca, Agostoni, Piergiuseppe, Al Moghazi, Samir, Arboretti, Rosa, Aucella, Filippo, Barbieri, Greta, Barchitta, Martina, Bartoloni, Alessandro, Bologna, Carolina, Bonfanti, Paolo, Caiano, Lucia, Carrozzi, Laura, Cascio, Antonio, Castiglione, Giacomo, Chiarito, Mauro, Ciccullo, Arturo, Cingolani, Antonella, Cipollone, Francesco, Colomba, Claudia, Colombo, Crizia, Crosta, Francesco, Dalena, Giovanni, Dal Pra, Chiara, Danzi, Gian Battista, D'Ardes, Damiano, de Gaetano Donati, Katleen, Di Gennaro, Francesco, Di Tano, Giuseppe, D'Offizi, Gianpiero, Filippini, Tommaso, Maria Fusco, Francesco, Gaudiosi, Carlo, Gentile, Ivan, Gini, Giancarlo, Grandone, Elvira, Guarnieri, Gabriella, Lamanna, Gennaro L F, Larizza, Giovanni, Leone, Armando, Lio, Veronica, Losito, Angela Raffaella, Maccagni, Gloria, Maitan, Stefano, Mancarella, Sandro, Manuele, Rosa, Mapelli, Massimo, Maragna, Riccardo, Marra, Lorenzo, Maresca, Giulio, Marotta, Claudia, Mastroianni, Franco, Mazzitelli, Maria, Mengozzi, Alessandro, Menichetti, Francesco, Milic, Jovana, Minutolo, Filippo, Molena, Beatrice, Mussini, Cristina, Musso, Maria, Odone, Anna, Olivieri, Marco, Pasi, Emanuela, Perroni, Annalisa, Petri, Francesco, Pinchera, Biagio, Pivato, Carlo A, Poletti, Venerino, Ravaglia, Claudia, Rossato, Marco, Rossi, Marianna, Sabena, Anna, Salinaro, Francesco, Sangiovanni, Vincenzo, Sanrocco, Carlo, Scorzolini, Laura, Sgariglia, Raffaella, Simeone, Paola Giustina, Spinicci, Michele, Trecarichi, Enrico Maria, Veronesi, Giovanni, Vettor, Roberto, Vianello, Andrea, Vinceti, Marco, Visconti, Elena, Vocciante, Laura, De Caterina, Raffaele, and Iacoviello, Licia

Abstract

Background: Protease inhibitors have been considered as possible therapeutic agents for COVID-19 patients. Objectives: To describe the association between lopinavir/ritonavir (LPV/r) or darunavir/cobicistat (DRV/c) use and in-hospital mortality in COVID-19 patients. Study Design: Multicenter observational study of COVID-19 patients admitted in 33 Italian hospitals. Medications, preexisting conditions, clinical measures, and outcomes were extracted from medical records. Patients were retrospectively divided in three groups, according to use of LPV/r, DRV/c or none of them. Primary outcome in a time-to event analysis was death. We used Cox proportional-hazards models with inverse probability of treatment weighting by multinomial propensity scores. Results: Out of 3,451 patients, 33.3% LPV/r and 13.9% received DRV/c. Patients receiving LPV/r or DRV/c were more likely younger, men, had higher C-reactive protein levels while less likely had hypertension, cardiovascular, pulmonary or kidney disease. After adjustment for propensity scores, LPV/r use was not associated with mortality (HR = 0.94, 95% CI 0.78 to 1.13), whereas treatment with DRV/c was associated with a higher death risk (HR = 1.89, 1.53 to 2.34, E-value = 2.43). This increased risk was more marked in women, in elderly, in patients with higher severity of COVID-19 and in patients receiving other COVID-19 drugs. Conclusions: In a large cohort of Italian patients hospitalized for COVID-19 in a real-life setting, the use of LPV/r treatment did not change death rate, while DRV/c was associated with increased mortality. Within the limits of an observational study, these data do not support the use of LPV/r or DRV/c in COVID-19 patients.

Published
2021

36. Correction: Gender differences in predictors of intensive care units admission among COVID-19 patients: The results of the SARS-RAS study of the Italian Society of Hypertension

Author

Iaccarino, G, Grassi, G, Borghi, C, Carugo, S, Fallo, F, Ferri, C, Giannattasio, C, Grassi, D, Letizia, C, Mancusi, C, Minuz, P, Perlini, S, Pucci, G, Rizzoni, D, Salvetti, M, Sarzani, R, Sechi, L, Veglio, F, Volpe, M, Muiesan, M, Iaccarino, Guido, Grassi, Guido, Borghi, Claudio, Carugo, Stefano, Fallo, Francesco, Ferri, Claudio, Giannattasio, Cristina, Grassi, Davide, Letizia, Claudio, Mancusi, Costantino, Minuz, Pietro, Perlini, Stefano, Pucci, Giacomo, Rizzoni, Damiano, Salvetti, Massimo, Sarzani, Riccardo, Sechi, Leonardo, Veglio, Franco, Volpe, Massimo, Muiesan, Maria Lorenza, Iaccarino, G, Grassi, G, Borghi, C, Carugo, S, Fallo, F, Ferri, C, Giannattasio, C, Grassi, D, Letizia, C, Mancusi, C, Minuz, P, Perlini, S, Pucci, G, Rizzoni, D, Salvetti, M, Sarzani, R, Sechi, L, Veglio, F, Volpe, M, Muiesan, M, Iaccarino, Guido, Grassi, Guido, Borghi, Claudio, Carugo, Stefano, Fallo, Francesco, Ferri, Claudio, Giannattasio, Cristina, Grassi, Davide, Letizia, Claudio, Mancusi, Costantino, Minuz, Pietro, Perlini, Stefano, Pucci, Giacomo, Rizzoni, Damiano, Salvetti, Massimo, Sarzani, Riccardo, Sechi, Leonardo, Veglio, Franco, Volpe, Massimo, and Muiesan, Maria Lorenza

Abstract

[This corrects the article DOI: 10.1371/journal.pone.0237297.].

Published
2021

37. Erratum: Gender differences in predictors of intensive care units admission among COVID-19 patients: The results of the SARSRAS study of the Italian Society of Hypertension (PLoS ONE (2020) 15:10 (e0237297) DOI: 10.1371/journal.pone.0237297)

Author

Iaccarino, Guido, Iaccarino, G, Grassi, G, Borghi, C, Carugo, S, Fallo, F, Ferri, C, Giannattasio, C, Grassi, D, Letizia, C, Mancusi, C, Minuz, P, Perlini, S, Pucci, G, Rizzoni, D, Salvetti, M, Sarzani, R, Sechi, L, Veglio, F, Volpe, M, Muiesan, M, Iaccarino, Guido, Grassi, Guido, Borghi, Claudio, Carugo, Stefano, Fallo, Francesco, Ferri, Claudio, Giannattasio, Cristina, Grassi, Davide, Letizia, Claudio, Mancusi, Costantino, Minuz, Pietro, Perlini, Stefano, Pucci, Giacomo, Rizzoni, Damiano, Salvetti, Massimo, Sarzani, Riccardo, Sechi, Leonardo, Veglio, Franco, Volpe, Massimo, Muiesan, Maria Lorenza, Iaccarino, Guido, Iaccarino, G, Grassi, G, Borghi, C, Carugo, S, Fallo, F, Ferri, C, Giannattasio, C, Grassi, D, Letizia, C, Mancusi, C, Minuz, P, Perlini, S, Pucci, G, Rizzoni, D, Salvetti, M, Sarzani, R, Sechi, L, Veglio, F, Volpe, M, Muiesan, M, Iaccarino, Guido, Grassi, Guido, Borghi, Claudio, Carugo, Stefano, Fallo, Francesco, Ferri, Claudio, Giannattasio, Cristina, Grassi, Davide, Letizia, Claudio, Mancusi, Costantino, Minuz, Pietro, Perlini, Stefano, Pucci, Giacomo, Rizzoni, Damiano, Salvetti, Massimo, Sarzani, Riccardo, Sechi, Leonardo, Veglio, Franco, Volpe, Massimo, and Muiesan, Maria Lorenza

Published
2021

38. Clinical factors associated with death in 3044 COVID-19 patients managed in internal medicine wards in Italy: results from the SIMI-COVID-19 study of the Italian Society of Internal Medicine (SIMI)

Author

Corradini, E., Ventura, P., Ageno, W., Cogliati, C. B., Muiesan, M. L., Girelli, Davide Nicola, Pirisi, M., Gasbarrini, Antonio, Angeli, P., Querini, P. R., Bosi, E., Tresoldi, M., Vettor, R., Cattaneo, M., Piscaglia, F., Brucato, A. L., Perlini, S., Martelletti, P., Pontremoli, R., Porta, M., Minuz, P., Olivieri, O., Sesti, G., Biolo, G., Rizzoni, D., Serviddio, G., Cipollone, F., Grassi, D., Manfredini, R., Moreo, G. L., Pietrangelo, A., Teatini, T., Salvetti, Maria Cristina, Crisafulli, E., Sainaghi, Pier Paolo, Zileri Dal Verme, Lorenzo, Piano, S., De Lorenzo, R., Arcidiacono, G., Podda, Maria Vittoria, Muratori, L., Gabiati, C., Salinaro, F., Luciani, Massimiliano, Barnini, C., Morra di Cella, S., Dalbeni, A., Friso, S., Mearelli, F., Malerba, P., Cavallone, F., D'Ardes, D., Notargiacomo, S., De Giorgi, A., Mansi, M., Buzzetti, E., Ricci, A., Martelli, Franco, Girelli D., Gasbarrini A. (ORCID:0000-0002-7278-4823), Salvetti M., Sainaghi P. P., Zileri Dal Verme L., Podda M. (ORCID:0000-0002-2779-8417), Luciani M., Martelli F., Corradini, E., Ventura, P., Ageno, W., Cogliati, C. B., Muiesan, M. L., Girelli, Davide Nicola, Pirisi, M., Gasbarrini, Antonio, Angeli, P., Querini, P. R., Bosi, E., Tresoldi, M., Vettor, R., Cattaneo, M., Piscaglia, F., Brucato, A. L., Perlini, S., Martelletti, P., Pontremoli, R., Porta, M., Minuz, P., Olivieri, O., Sesti, G., Biolo, G., Rizzoni, D., Serviddio, G., Cipollone, F., Grassi, D., Manfredini, R., Moreo, G. L., Pietrangelo, A., Teatini, T., Salvetti, Maria Cristina, Crisafulli, E., Sainaghi, Pier Paolo, Zileri Dal Verme, Lorenzo, Piano, S., De Lorenzo, R., Arcidiacono, G., Podda, Maria Vittoria, Muratori, L., Gabiati, C., Salinaro, F., Luciani, Massimiliano, Barnini, C., Morra di Cella, S., Dalbeni, A., Friso, S., Mearelli, F., Malerba, P., Cavallone, F., D'Ardes, D., Notargiacomo, S., De Giorgi, A., Mansi, M., Buzzetti, E., Ricci, A., Martelli, Franco, Girelli D., Gasbarrini A. (ORCID:0000-0002-7278-4823), Salvetti M., Sainaghi P. P., Zileri Dal Verme L., Podda M. (ORCID:0000-0002-2779-8417), Luciani M., and Martelli F.

Abstract

During the COVID-19 2020 outbreak, a large body of data has been provided on general management and outcomes of hospitalized COVID-19 patients. Yet, relatively little is known on characteristics and outcome of patients managed in Internal Medicine Units (IMU). To address this gap, the Italian Society of Internal Medicine has conducted a nationwide cohort multicentre study on death outcome in adult COVID-19 patients admitted and managed in IMU. This study assessed 3044 COVID-19 patients at 41 referral hospitals across Italy from February 3rd to May 8th 2020. Demographics, comorbidities, organ dysfunction, treatment, and outcomes including death were assessed. During the study period, 697 patients (22.9%) were transferred to intensive care units, and 351 died in IMU (death rate 14.9%). At admission, factors independently associated with in-hospital mortality were age (OR 2.46, p = 0.000), productive cough (OR 2.04, p = 0.000), pre-existing chronic heart failure (OR 1.58, p = 0.017) and chronic obstructive pulmonary disease (OR 1.17, p = 0.048), the number of comorbidities (OR 1.34, p = 0.000) and polypharmacy (OR 1.20, p = 0.000). Of note, up to 40% of elderly patients did not report fever at admission. Decreasing PaO2/FiO2 ratio at admission was strongly inversely associated with survival. The use of conventional oxygen supplementation increased with the number of pre-existing comorbidities, but it did not associate with better survival in patients with PaO2/FiO2 ratio < 100. The latter, significantly benefited by the early use of non-invasive mechanical ventilation. Our study identified PaO2/FiO2 ratio at admission and comorbidity as the main alert signs to inform clinical decisions and resource allocation in non-critically ill COVID-19 patients admitted to IMU.

Published
2021

39. Determinants of healing among patients with coronavirus disease 2019: the results of the SARS-RAS study of the Italian Society of Hypertension

Author

Mancusi, C, Grassi, G, Borghi, C, Carugo, S, Fallo, F, Ferri, C, Giannattasio, C, Grassi, D, Letizia, C, Minuz, P, Muiesan, M, Perlini, S, Pucci, G, Rizzoni, D, Salvetti, M, Sarzani, R, Sechi, L, Veglio, F, Volpe, M, Iaccarino, G, Mancusi, Costantino, Grassi, Guido, Borghi, Claudio, Carugo, Stefano, Fallo, Francesco, Ferri, Claudio, Giannattasio, Cristina, Grassi, Davide, Letizia, Claudio, Minuz, Pietro, Muiesan, Maria Lorenza, Perlini, Stefano, Pucci, Giacomo, Rizzoni, Damiano, Salvetti, Massimo, Sarzani, Riccardo, Sechi, Leonardo, Veglio, Franco, Volpe, Massimo, Iaccarino, Guido, Mancusi, C, Grassi, G, Borghi, C, Carugo, S, Fallo, F, Ferri, C, Giannattasio, C, Grassi, D, Letizia, C, Minuz, P, Muiesan, M, Perlini, S, Pucci, G, Rizzoni, D, Salvetti, M, Sarzani, R, Sechi, L, Veglio, F, Volpe, M, Iaccarino, G, Mancusi, Costantino, Grassi, Guido, Borghi, Claudio, Carugo, Stefano, Fallo, Francesco, Ferri, Claudio, Giannattasio, Cristina, Grassi, Davide, Letizia, Claudio, Minuz, Pietro, Muiesan, Maria Lorenza, Perlini, Stefano, Pucci, Giacomo, Rizzoni, Damiano, Salvetti, Massimo, Sarzani, Riccardo, Sechi, Leonardo, Veglio, Franco, Volpe, Massimo, and Iaccarino, Guido

Abstract

OBJECTIVE: The burst of COVID-19 epidemics in Italy prompted the Italian Society of Hypertension to start an observational study to explore the characteristics of the hospitalized victims of the disease. The current analysis aimed to investigate the predictors of healing among Italian COVID-19 patients. We also assessed the effect of angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers on the outcome. METHODS: We designed a cross-sectional, observational, multicenter, nationwide survey in Italy to explore the demographic and clinical characteristics of patients with confirmed COVID-19 infection. We analyzed information from 2446 charts of Italian patients admitted for certified COVID-19 in 27 hospitals. Healing from COVID-19 infection, defined as two consecutive negative swabs, was reported in 544 patients (22.2%), 95% of them were hospitalized. RESULTS: Age and Charlson Comorbidity Index were significantly lower in healing compared with nonhealing patients (63 ± 15 vs. 69 ± 15 and 2 ± 2 vs. 3 ± 2, both P < 0.05). In multivariable regression model, predictors of healing were younger age (OR: 0.99; 95% CI 0.98-0.99, P = 0.0001), absence of chronic kidney disease (OR: 0.35; 95% CI 0.17-0.70, P = 0.003) or heart failure (OR: 0.44; 95% CI, 0.28-0.70, P = 0.001). In the subgroup of patients suffering from hypertension and/or heart failure (n = 1498), no differences were observed in the use of ACE inhibitors and angiotensin receptor blockers. CONCLUSION: Our study demonstrated that younger age and absence of comorbidities play a major role in determining healing in patients with COVID-19. No effects of ACE inhibitors and angiotensin receptor blockers on the outcome was reported.

Published
2021

40. 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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42. 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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43. Beneficial effects of adaptive servo-ventilation on natriuretic peptides and diastolic function in acute heart failure patients with preserved ejection fraction and sleep-disordered breathing

Author

D'Elia, E, Ferrero, P, Vittori, C, Iacovoni, A, Grosu, A, Gori, M, Duino, V, Perlini, S, Senni, M, D'Elia E, Ferrero P, Vittori C, Iacovoni A, Grosu A, Gori M, Duino V, Perlini S, Senni M, D'Elia, E, Ferrero, P, Vittori, C, Iacovoni, A, Grosu, A, Gori, M, Duino, V, Perlini, S, Senni, M, D'Elia E, Ferrero P, Vittori C, Iacovoni A, Grosu A, Gori M, Duino V, Perlini S, and Senni M

Abstract

Purpose: Adaptive servo-ventilation (ASV) is a ventilator algorithm able to correct breathing through anticyclic support of breathing in patients with central sleep apnea (CSA). So far, very few data exist regarding the role of ASV on acute heart failure with preserved ejection fraction (HFpEF). Methods: We performed a single-center prospective, randomized, case-control study in consecutive acute HFpEF (left ventricle ejection fraction, LVEF ≥ 45%) patients with sleep-disordered breathing (SDB, apnea–hypopnea index, AHI > 15/h) and prevalence of CSA. Results: We included ten consecutive patients randomized for ASV on top of standard therapy for acute heart failure (group 1) versus standard care alone (group 2). ASV therapy significantly reduced AHI and CSA. An improvement in cardiac diastolic function was seen in group 1 compared to group 2 (E/E’ 17.5 to 9.6, p < 0.02 vs 18.5 to 14.5, p = 0.4). Brain natriuretic peptide (BNP) markedly decreased in cases, but not in controls (298 to 84 pg/ml, p < 0.02 vs 280 to 120 pg/ml, p = 0.06). Right ventricle (RV) function significantly improved in group 1, differently from group 2. Conclusions: An acute use of ASV seems effective in reducing BNP and improving diastolic and RV function in acute HFpEF patients with SDB and CSA, compared to standard treatment.

Published
2018

44. 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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45. 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

46. 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

47. 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

48. 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

49. Gender differences in predictors of intensive care units admission among COVID-19 patients: The results of the SARS-RAS study of the italian society of hypertension

Author

Iaccarino, G, Grassi, G, Borghi, C, Carugo, S, Fallo, F, Ferri, C, Giannattasio, C, Grassi, D, Letizia, C, Mancusi, C, Minuz, P, Perlini, S, Pucci, G, Rizzoni, D, Salvetti, M, Sarzani, R, Sechi, L, Veglio, F, Volpe, M, Muiesan, M, Muiesan, ML, Iaccarino, G, Grassi, G, Borghi, C, Carugo, S, Fallo, F, Ferri, C, Giannattasio, C, Grassi, D, Letizia, C, Mancusi, C, Minuz, P, Perlini, S, Pucci, G, Rizzoni, D, Salvetti, M, Sarzani, R, Sechi, L, Veglio, F, Volpe, M, Muiesan, M, and Muiesan, ML

Abstract

The global rate of intensive care unit (ICU) admission during the COVID-19 pandemic varies within countries and is among the main challenges for health care systems worldwide. Conflicting results have been reported about the response to coronavirus infection and COVID-19 outcomes in men and women. Understanding predictors of intensive care unit admission might be of help for future planning and management of the disease. Methods and findings We designed a cross-sectional observational multicenter nationwide survey in Italy to understand gender-related clinical predictors of ICU admission in patients with COVID-19. We analyzed information from 2378 charts of Italian patients certified for COVID-19 admitted in 26 hospitals. Three hundred ninety-five patients (16.6%) required ICU admission due to COVID19 infection, more frequently men (74%), with a higher prevalence of comorbidities (1,78±0,06 vs 1,54±0,03 p<0.05). In multivariable regression model main predictors of admission to ICU are male gender (OR 1,74 95% CI 1,36–2,22 p<0.0001) and presence of obesity (OR 2,88 95% CI 2,03–4,07 p<0.0001), chronic kidney disease (OR: 1,588; 95%, 1,036–2,434 p<0,05) and hypertension (OR: 1,314; 95% 1,039–1,662; p<0,05). In gender specific analysis, obesity, chronic kidney disease and hypertension are associated with higher rate of admission to ICU among men, whereas in women, obesity (OR: 2,564; 95% CI 1,336–4.920 p<0.0001) and heart failure (OR: 1,775 95% CI: 1,030–3,057) are associated with higher rate of ICU admission. Conclusions Our study demonstrates that gender is the primary determinant of the disease’s severity among COVID-19. Obesity is the condition more often observed among those admitted to ICU within both genders.

Published
2020

50. RAAS inhibitors are not associated with mortality in COVID-19 patients: findings from an observational multicenter study in Italy and a meta-analysis of 19 studies

Author

Di Castelnuovo, A, Costanzo, S, Antinori, A, Berselli, N, Blandi, L, Bonaccio, M, Cauda, R, Gialluisi, A, Guaraldi, G, Menicanti, L, Mennuni, M, Mussinelli, R, My, I, Parruti, G, Patti, G, Perlini, S, Santilli, F, Signorelli, C, Stefanini, G, Vergori, A, Abete, P, Ageno, W, Agostoni, P, Aiello, L, Al Moghazi, S, Arboretti, R, Aucella, F, Barbieri, G, Barchitta, M, Bartoloni, A, Bonfanti, P, Cacciatore, F, Caiano, L, Carrozzi, L, Cascio, A, Castiglione, G, Cianfrone, S, Ciccullo, A, Cingolani, A, Cipollone, F, Colomba, C, Colombo, C, Cozzi, O, Crisetti, A, Crosta, F, Danzi, G, D'Ardes, D, de Gaetano Donati, K, Di Gennaro, F, Di Tano, G, D'Offizi, G, Fusco, F, Gentile, I, Graziani, E, Guarnieri, G, Larizza, G, Leone, A, Lio, V, Lucia, M, Maccagni, G, Madaro, F, Maitan, S, Mancarella, S, Manuele, R, 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, Mussini, C, Musso, M, Odone, A, Olivieri, M, Palimodde, A, Pasi, E, Pesavento, R, Petri, F, Pinchera, B, Pivato, C, Poletti, V, Ravaglia, C, Rossato, M, Rossi, M, Sabena, A, Salinaro, F, Sangiovanni, V, Sanrocco, C, Scoppettuolo, G, Scorzolini, L, Sgariglia, R, Simeone, P, Trecarichi, E, Vettor, R, Vianello, A, Vinceti, M, Virano, A, Vocciante, L, Iacoviello, L, De Caterina, R, Di Castelnuovo, Augusto, Costanzo, Simona, Antinori, Andrea, Berselli, Nausicaa, Blandi, Lorenzo, Bonaccio, Marialaura, Cauda, Roberto, Gialluisi, Alessandro, Guaraldi, Giovanni, Menicanti, Lorenzo, Mennuni, Marco, Mussinelli, Roberta, My, Ilaria, Parruti, Giustino, Patti, Giuseppe, Perlini, Stefano, Santilli, Francesca, Signorelli, Carlo, Stefanini, Giulio G, Vergori, Alessandra, Abete, Paolo, Ageno, Walter, Agostoni, Piergiuseppe, Aiello, Luca, Al Moghazi, Samir, Arboretti, Rosa, Aucella, Filippo, Barbieri, Greta, Barchitta, Martina, Bartoloni, Alessandro, Bonfanti, Paolo, Cacciatore, Francesco, Caiano, Lucia, Carrozzi, Laura, Cascio, Antonio, Castiglione, Giacomo, Cianfrone, Stefania, Ciccullo, Arturo, Cingolani, Antonella, Cipollone, Francesco, Colomba, Claudia, Colombo, Crizia, Cozzi, Ottavia, Crisetti, Annalisa, Crosta, Francesca, Danzi, Gian Battista, D'Ardes, Damiano, de Gaetano Donati, Katleen, Di Gennaro, Francesco, Di Tano, Giuseppe, D'Offizi, Gianpiero, Fusco, Francesco Maria, Gentile, Ivan, Graziani, Emauele, Guarnieri, Gabriella, Larizza, Giovanni, Leone, Armando, Lio, Veronica, Lucia, Mothanje Barbara, Maccagni, Gloria, Madaro, Ferruccio, Maitan, Stefano, Mancarella, Sandro, Manuele, Rosa, 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, Mussini, Cristina, Musso, Maria, Odone, Anna, Olivieri, Marco, Palimodde, Antonella, Pasi, Emanuela, Pesavento, Raffaele, Petri, Francesco, Pinchera, Biagio, Pivato, Carlo A, Poletti, Venerino, Ravaglia, Claudia, Rossato, Marco, Rossi, Marianna, Sabena, Anna, Salinaro, Francesco, Sangiovanni, Vincenzo, Sanrocco, Carlo, Scoppettuolo, Giancarlo, Scorzolini, Laura, Sgariglia, Raffaella, Simeone, Paola Giustina, Trecarichi, Enrico Maria, Vettor, Roberto, Vianello, Andrea, Vinceti, Marco, Virano, Alexandra, Vocciante, Laura, Iacoviello, Licia, De Caterina, Raffaele, Di Castelnuovo, A, Costanzo, S, Antinori, A, Berselli, N, Blandi, L, Bonaccio, M, Cauda, R, Gialluisi, A, Guaraldi, G, Menicanti, L, Mennuni, M, Mussinelli, R, My, I, Parruti, G, Patti, G, Perlini, S, Santilli, F, Signorelli, C, Stefanini, G, Vergori, A, Abete, P, Ageno, W, Agostoni, P, Aiello, L, Al Moghazi, S, Arboretti, R, Aucella, F, Barbieri, G, Barchitta, M, Bartoloni, A, Bonfanti, P, Cacciatore, F, Caiano, L, Carrozzi, L, Cascio, A, Castiglione, G, Cianfrone, S, Ciccullo, A, Cingolani, A, Cipollone, F, Colomba, C, Colombo, C, Cozzi, O, Crisetti, A, Crosta, F, Danzi, G, D'Ardes, D, de Gaetano Donati, K, Di Gennaro, F, Di Tano, G, D'Offizi, G, Fusco, F, Gentile, I, Graziani, E, Guarnieri, G, Larizza, G, Leone, A, Lio, V, Lucia, M, Maccagni, G, Madaro, F, Maitan, S, Mancarella, S, Manuele, R, 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, Mussini, C, Musso, M, Odone, A, Olivieri, M, Palimodde, A, Pasi, E, Pesavento, R, Petri, F, Pinchera, B, Pivato, C, Poletti, V, Ravaglia, C, Rossato, M, Rossi, M, Sabena, A, Salinaro, F, Sangiovanni, V, Sanrocco, C, Scoppettuolo, G, Scorzolini, L, Sgariglia, R, Simeone, P, Trecarichi, E, Vettor, R, Vianello, A, Vinceti, M, Virano, A, Vocciante, L, Iacoviello, L, De Caterina, R, Di Castelnuovo, Augusto, Costanzo, Simona, Antinori, Andrea, Berselli, Nausicaa, Blandi, Lorenzo, Bonaccio, Marialaura, Cauda, Roberto, Gialluisi, Alessandro, Guaraldi, Giovanni, Menicanti, Lorenzo, Mennuni, Marco, Mussinelli, Roberta, My, Ilaria, Parruti, Giustino, Patti, Giuseppe, Perlini, Stefano, Santilli, Francesca, Signorelli, Carlo, Stefanini, Giulio G, Vergori, Alessandra, Abete, Paolo, Ageno, Walter, Agostoni, Piergiuseppe, Aiello, Luca, Al Moghazi, Samir, Arboretti, Rosa, Aucella, Filippo, Barbieri, Greta, Barchitta, Martina, Bartoloni, Alessandro, Bonfanti, Paolo, Cacciatore, Francesco, Caiano, Lucia, Carrozzi, Laura, Cascio, Antonio, Castiglione, Giacomo, Cianfrone, Stefania, Ciccullo, Arturo, Cingolani, Antonella, Cipollone, Francesco, Colomba, Claudia, Colombo, Crizia, Cozzi, Ottavia, Crisetti, Annalisa, Crosta, Francesca, Danzi, Gian Battista, D'Ardes, Damiano, de Gaetano Donati, Katleen, Di Gennaro, Francesco, Di Tano, Giuseppe, D'Offizi, Gianpiero, Fusco, Francesco Maria, Gentile, Ivan, Graziani, Emauele, Guarnieri, Gabriella, Larizza, Giovanni, Leone, Armando, Lio, Veronica, Lucia, Mothanje Barbara, Maccagni, Gloria, Madaro, Ferruccio, Maitan, Stefano, Mancarella, Sandro, Manuele, Rosa, 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, Mussini, Cristina, Musso, Maria, Odone, Anna, Olivieri, Marco, Palimodde, Antonella, Pasi, Emanuela, Pesavento, Raffaele, Petri, Francesco, Pinchera, Biagio, Pivato, Carlo A, Poletti, Venerino, Ravaglia, Claudia, Rossato, Marco, Rossi, Marianna, Sabena, Anna, Salinaro, Francesco, Sangiovanni, Vincenzo, Sanrocco, Carlo, Scoppettuolo, Giancarlo, Scorzolini, Laura, Sgariglia, Raffaella, Simeone, Paola Giustina, Trecarichi, Enrico Maria, Vettor, Roberto, Vianello, Andrea, Vinceti, Marco, Virano, Alexandra, Vocciante, Laura, Iacoviello, Licia, and De Caterina, Raffaele

Abstract

Objective: The hypothesis that been set forward that use of Renin Angiotensin Aldosterone System (RAAS) inhibitors is associated with COVID-19 severity. We set-up a multicenter Italian collaboration (CORIST Project, ClinicalTrials.gov ID: NCT04318418) to retrospectively investigate the relationship between RAAS inhibitors and COVID-19 in-hospital mortality. We also carried out an updated meta-analysis on the relevant studies. Methods: We analyzed 4,069 unselected patients with laboratory-confirmed SARS-CoV-2 infection and hospitalized in 34 clinical centers in Italy from February 19, 2020 to May 23, 2020. The primary end-point in a time-to event analysis was in-hospital death, comparing patients who received angiotensin-converting-enzyme inhibitors (ACE-I) or angiotensin-receptor blockers (ARB) with patients who did not. Articles for the meta-analysis were retrieved until July 13th, 2020 by searching in web-based libraries, and data were combined using the general variance-based method. Results: Out of 4,069 COVID-19 patients, 13.5% and 13.3% received ACE-I or ARB, respectively. Use of neither ACE-I nor ARB was associated with mortality (multivariable hazard ratio (HR) adjusted also for COVID-19 treatments: 0.96, 95% confidence interval 0.77-1.20 and HR=0.89, 0.67-1.19 for ACE-I and ARB, respectively). Findings were similar restricting the analysis to hypertensive (N=2,057) patients (HR=1.00, 0.78-1.26 and HR=0.88, 0.65-1.20) or when ACE-I or ARB were considered as a single group. Results from the meta-analysis (19 studies, 29,057 COVID-19 adult patients, 9,700 with hypertension) confirmed the absence of association. Conclusions: In this observational study and meta-analysis of the literature, ACE-I or ARB use was not associated with severity or in-hospital mortality in COVID-19 patients.

Published
2020

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