Author: "Richeldi, L (ORCID:0000-0001-8594-1448)" - Searchworks@Jio Institute Digital Library Search Results

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104 results on '"Richeldi, L (ORCID:0000-0001-8594-1448)"'

1. Challenges in the diagnosis of idiopathic pulmonary fibrosis: the importance of a multidisciplinary approach

Author: Comes, Alessia, Sgalla, Giacomo, Ielo, Simone, Magrì, Tonia, Richeldi, Luca, Richeldi, L (ORCID:0000-0001-8594-1448), Comes, Alessia, Sgalla, Giacomo, Ielo, Simone, Magrì, Tonia, Richeldi, Luca, and Richeldi, L (ORCID:0000-0001-8594-1448)
Abstract: Introduction: The diagnosis of Idiopathic pulmonary fibrosis (IPF) requires the careful exclusion of secondary causes of interstitial lung disease (ILD), and the collaboration among different specialists is considered paramount to establish a diagnosis with high diagnostic confidence. The multidisciplinary discussion (MDD) has assumed an increasing importance over the years in the different phases of the IPF diagnostic work-up. Areas covered: The role of MDD in the diagnosis and management of IPF will be described. Practical insights will be provided into how and when to perform MDD based on the available scientific evidence. Current limitations and future perspectives will be discussed. Expert opinion: In the absence of high diagnostic confidence, agreement between different specialists during MDD is recognized as a surrogate indicator of diagnostic accuracy. Often, despite a lengthy evaluation, the diagnosis remains unclassifiable in a significant percentage of patients. MDD therefore appears to be pivotal in attaining an accurate diagnosis of ILDs. The discussion among different specialists can also include other specialists, such as rheumatologists and thoracic surgeons, in addition to the core group of pulmonologists, radiologists, and pathologists. Such discussions can allow greater diagnostic accuracy and have important effects on management, pharmacologic therapies, and prognosis.
Published: 2023

2. Ziritaxestat, a Novel Autotaxin Inhibitor, and Lung Function in Idiopathic Pulmonary Fibrosis: The ISABELA 1 and 2 Randomized Clinical Trials

Author: Maher, Toby M, Ford, Paul, Brown, Kevin K, Costabel, Ulrich, Cottin, Vincent, Danoff, Sonye K, Groenveld, Irene, Helmer, Eric, Jenkins, R Gisli, Milner, Julie, Molenberghs, Geert, Penninckx, Bjorn, Randall, Matthew J, Van Den Blink, Bernt, Fieuw, Ann, Vandenrijn, Charlotte, Rocak, Sanda, Seghers, Ineke, Shao, Lixin, Taneja, Amit, Jentsch, Garrit, Watkins, Timothy R, Wuyts, Wim A, Kreuter, Michael, Verbruggen, Nadia, Prasad, Niyati, Wijsenbeek, Marlies, S, Richeldi, Luca, Richeldi L. (ORCID:0000-0001-8594-1448), Maher, Toby M, Ford, Paul, Brown, Kevin K, Costabel, Ulrich, Cottin, Vincent, Danoff, Sonye K, Groenveld, Irene, Helmer, Eric, Jenkins, R Gisli, Milner, Julie, Molenberghs, Geert, Penninckx, Bjorn, Randall, Matthew J, Van Den Blink, Bernt, Fieuw, Ann, Vandenrijn, Charlotte, Rocak, Sanda, Seghers, Ineke, Shao, Lixin, Taneja, Amit, Jentsch, Garrit, Watkins, Timothy R, Wuyts, Wim A, Kreuter, Michael, Verbruggen, Nadia, Prasad, Niyati, Wijsenbeek, Marlies, S, Richeldi, Luca, and Richeldi L. (ORCID:0000-0001-8594-1448)
Abstract: Importance: There is a major need for effective, well-tolerated treatments for idiopathic pulmonary fibrosis (IPF). Objective: To assess the efficacy and safety of the autotaxin inhibitor ziritaxestat in patients with IPF. Design, setting, and participants: The 2 identically designed, phase 3, randomized clinical trials, ISABELA 1 and ISABELA 2, were conducted in Africa, Asia-Pacific region, Europe, Latin America, the Middle East, and North America (26 countries). A total of 1306 patients with IPF were randomized (525 patients at 106 sites in ISABELA 1 and 781 patients at 121 sites in ISABELA 2). Enrollment began in November 2018 in both trials and follow-up was completed early due to study termination on April 12, 2021, for ISABELA 1 and on March 30, 2021, for ISABELA 2. Interventions: Patients were randomized 1:1:1 to receive 600 mg of oral ziritaxestat, 200 mg of ziritaxestat, or placebo once daily in addition to local standard of care (pirfenidone, nintedanib, or neither) for at least 52 weeks. Main outcomes and measures: The primary outcome was the annual rate of decline for forced vital capacity (FVC) at week 52. The key secondary outcomes were disease progression, time to first respiratory-related hospitalization, and change from baseline in St George's Respiratory Questionnaire total score (range, 0 to 100; higher scores indicate poorer health-related quality of life). Results: At the time of study termination, 525 patients were randomized in ISABELA 1 and 781 patients in ISABELA 2 (mean age: 70.0 [SD, 7.2] years in ISABELA 1 and 69.8 [SD, 7.1] years in ISABELA 2; male: 82.4% and 81.2%, respectively). The trials were terminated early after an independent data and safety monitoring committee concluded that the benefit to risk profile of ziritaxestat no longer supported their continuation. Ziritaxestat did not improve the annual rate of FVC decline vs placebo in either study. In ISABELA 1, the least-squares mean annual rate of FVC decline was -124.6 mL (95% CI
Published: 2023

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

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

4. Ultrasound-guided needle aspiration biopsy of isolated anterior mediastinal masses

Author: Viscuso, Marta, Livi, Vanina, Cancellieri, Alessandra, Paioli, Daniela, Magnini, Daniele, Leoncini, F, Richeldi, Luca, Trisolini, Rocco, Viscuso, M, Livi, V, Cancellieri, A, Paioli, D, Magnini, D, Richeldi, L (ORCID:0000-0001-8594-1448), Trisolini, R, Viscuso, Marta, Livi, Vanina, Cancellieri, Alessandra, Paioli, Daniela, Magnini, Daniele, Leoncini, F, Richeldi, Luca, Trisolini, Rocco, Viscuso, M, Livi, V, Cancellieri, A, Paioli, D, Magnini, D, Richeldi, L (ORCID:0000-0001-8594-1448), and Trisolini, R
Published: 2022

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

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

6. Drug-induced interstitial lung disease during cancer therapies: expert opinion on diagnosis and treatment

Author: Conte, P, Ascierto, P A, Patelli, G, Danesi, R, Vanzulli, A, Sandomenico, F, Tarsia, P, Cattelan, A, Comes, Alessia, De Laurentiis, M, Falcone, A, Regge, D, Richeldi, Luca, Siena, S, Comes, A, Richeldi, L (ORCID:0000-0001-8594-1448), Conte, P, Ascierto, P A, Patelli, G, Danesi, R, Vanzulli, A, Sandomenico, F, Tarsia, P, Cattelan, A, Comes, Alessia, De Laurentiis, M, Falcone, A, Regge, D, Richeldi, Luca, Siena, S, Comes, A, and Richeldi, L (ORCID:0000-0001-8594-1448)
Abstract: Background: Drug-induced interstitial lung disease (DIILD) is a form of interstitial lung disease resulting from exposure to drugs causing inflammation and possibly interstitial fibrosis. Antineoplastic drugs are the primary cause of DIILD, accounting for 23%-51% of cases, with bleomycin, everolimus, erlotinib, trastuzumab-deruxtecan and immune checkpoint inhibitors being the most common causative agents. DIILD can be difficult to identify and manage, and there are currently no specific guidelines on the diagnosis and treatment of DIILD caused by anticancer drugs.Objective: To develop recommendations for the diagnosis and management of DIILD in cancer patients.Methods: Based on the published literature and their clinical expertise, a multidisciplinary group of experts in Italy developed recommendations stratified by DIILD severity, based on the Common Terminology Criteria for Adverse Events.Results: The recommendations highlight the importance of multidisciplinary interaction in the diagnosis and management of DIILD. Important components of the diagnostic process are physical examination and careful patient history-taking, measurement of vital signs (particularly respiratory rate and arterial oxygen saturation), relevant laboratory tests, respiratory function testing with spirometry and diffusing capacity of the lung for carbon monoxide and computed tomography/imaging. Because the clinical and radiological signs of DIILD are often similar to those of pneumonias or interstitial lung diseases, differential diagnosis is important, including microbial and serological testing to exclude or confirm infectious causes. In most cases, management of DIILD requires the discontinuation of the antineoplastic agent and the administration of short-term steroids. Steroid tapering must be undertaken slowly to prevent reactivation of DIILD. Patients with severe and very severe (grade 3 and 4) DIILD will require hospitalisation and often need oxygen and non-invasive ventilation. Decis
Published: 2022

7. Detection and Early Referral of Patients With Interstitial Lung Abnormalities: An Expert Survey Initiative

Author: Hunninghake, Gary M, Goldin, Jonathan G, Kadoch, Michael A, Kropski, Jonathan A, Rosas, Ivan O, Wells, Athol U, Yadav, Ruchi, Lazarus, Howard M, Abtin, Fereidoun G, Corte, Tamera J, de Andrade, Joao A, Johannson, Kerri A, Kolb, Martin R, Lynch, David A, Oldham, Justin M, Spagnolo, Paolo, Strek, Mary E, Tomassetti, Sara, Washko, George R, White, Eric S, Richeldi, Luca, Richeldi, L (ORCID:0000-0001-8594-1448), Hunninghake, Gary M, Goldin, Jonathan G, Kadoch, Michael A, Kropski, Jonathan A, Rosas, Ivan O, Wells, Athol U, Yadav, Ruchi, Lazarus, Howard M, Abtin, Fereidoun G, Corte, Tamera J, de Andrade, Joao A, Johannson, Kerri A, Kolb, Martin R, Lynch, David A, Oldham, Justin M, Spagnolo, Paolo, Strek, Mary E, Tomassetti, Sara, Washko, George R, White, Eric S, Richeldi, Luca, and Richeldi, L (ORCID:0000-0001-8594-1448)
Abstract: BACKGROUND: Interstitial lung abnormalities (ILA) may represent undiagnosed early-stage or subclinical interstitial lung disease (ILD). ILA are often observed incidentally in patients who subsequently develop clinically overt ILD. There is limited information on consensus definitions for, and the appropriate evaluation of, ILA. Early recognition of patients with ILD remains challenging, yet critically important. Expert consensus could inform early recognition and referral. RESEARCH QUESTION: Can consensus-based expert recommendations be identified to guide clinicians in the recognition, referral, and follow-up of patients with or at risk of developing STUDY DESIGN AND METHODS: Pulmonologists and radiologists with expertise in ILD participated in two iterative rounds of surveys. The surveys aimed to establish consensus regarding ILA reporting, identification of patients with ILA, and identification of populations that might benefit from screening for ILD. Recommended referral criteria and follow-up processes were also addressed. Threshold for consensus was defined a priori as $ 75% agreement or disagreement. RESULTS: Fifty-five experts were invited and 44 participated; consensus was reached on 39 of 85 questions. The following clinically important statements achieved consensus: honeycombing and traction bronchiectasis or bronchiolectasis indicate potentially progressive ILD; honeycombing detected during lung cancer screening should be reported as potentially significant (eg, with the Lung CT Screening Reporting and Data System "S-modifier" [Lung-RADS; which indicates clinically significant or potentially significant noncancer findings]), recommending referral to a pulmonologist in the radiology report; high-resolution CT imaging and full pulmonary function tests should be ordered if nondependent subpleural reticulation, traction bronchiectasis, honeycombing, centrilobular ground-glass nodules, or patchy ground-glass opacity are observed on CT imaging; patients with h
Published: 2022

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

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

9. CC-90001, a c-Jun N-Terminal kinase (JNK) inhibitor, in patients with pulmonary fibrosis: Design of a phase 2, randomised, placebo-controlled trial

Author: Popmihajlov, Z., Sutherland, D. J., Horan, G. S., Ghosh, A., Lynch, D. A., Noble, P. W., Richeldi, Luca, Reiss, T. F., Greenberg, S., Richeldi L. (ORCID:0000-0001-8594-1448), Popmihajlov, Z., Sutherland, D. J., Horan, G. S., Ghosh, A., Lynch, D. A., Noble, P. W., Richeldi, Luca, Reiss, T. F., Greenberg, S., and Richeldi L. (ORCID:0000-0001-8594-1448)
Abstract: Introduction Idiopathic pulmonary fibrosis (IPF) is a progressive and often fatal interstitial lung disease (ILD); other ILDs have a progressive, fibrotic phenotype (PF-ILD). Antifibrotic agents can slow but not stop disease progression in patients with IPF or PF-ILD. c-Jun N-Terminal kinases (JNKs) are stress-Activated protein kinases implicated in the underlying mechanisms of fibrosis, including epithelial cell death, inflammation and polarisation of profibrotic macrophages, fibroblast activation and collagen production. CC-90001, an orally administered (PO), one time per day, JNK inhibitor, is being evaluated in IPF and PF-ILD. Methods and analysis This is a phase 2, randomised, double-blind, placebo-controlled study evaluating efficacy and safety of CC-90001 in patients with IPF (main study) and patients with PF-ILD (substudy). Both include an 8-week screening period, a 24-week treatment period, up to an 80-week active-Treatment extension and a 4-week post-Treatment follow-up. Patients with IPF (n=165) will be randomised 1:1:1 to receive 200 mg or 400 mg CC-90001 or placebo administered PO one time per day; up to 25 patients/arm will be permitted concomitant pirfenidone use. Forty-five patients in the PF-ILD substudy will be randomised 2:1 to receive 400 mg CC-90001 or placebo. The primary endpoint is change in per cent predicted forced vital capacity from baseline to Week 24 in patients with IPF. Ethics and dissemination This study will be conducted in accordance with Good Clinical Practice guidelines, Declaration of Helsinki principles and local ethical and legal requirements. Results will be reported in a peer-reviewed publication. Trial registration number NCT03142191.
Published: 2022

10. Advances with pharmacotherapy for the treatment of interstitial lung disease

Author: Comes, Alessia, Sgalla, Giacomo, Perrotta, Alessandro, Richeldi, Luca, Comes A., Sgalla G. (ORCID:0000-0003-3130-9388), Perrotta A., Richeldi L. (ORCID:0000-0001-8594-1448), Comes, Alessia, Sgalla, Giacomo, Perrotta, Alessandro, Richeldi, Luca, Comes A., Sgalla G. (ORCID:0000-0003-3130-9388), Perrotta A., and Richeldi L. (ORCID:0000-0001-8594-1448)
Abstract: Introduction: In recent decades, the primary focus of pharmaceutical research in interstitial lung diseases (ILD) has been on idiopathic pulmonary fibrosis (IPF). Recently, pharmaceutical development has also focused on other forms of ILDs, including connective tissue diseases associated ILD, fibrotic hypersensitivity pneumonitis, and sarcoidosis. Areas Covered: The authors summarize the advances in pharmacotherapy for the treatment of ILD. Specifically, the authors review the most recent studies and discuss the most recent research findings and future prospects. Expert opinion: Data collected over the past years have confirmed the efficacy of antifibrotic drugs on slowing disease progression in IPF. The usual strategy for CTD-ILD management is represented by the combined use of corticosteroids and immunosuppressive agents. There is an urgent need for new target therapies. The concept of progressive fibrosing ILD has emerged in the ILD community in recent years, which has led to grouping several diseases with a common disease behavior to find an effective treatment. At present, selecting the best therapy in ILDs should be reasonably performed on a case-by-case basis through a multidisciplinary team discussion in tertiary ILD centers, taking into consideration patients’ symptoms, lung functional trends, and radiological changes.
Published: 2022

11. Acute Respiratory Distress Syndrome and Lung Fibrosis Complicating Surgery in a Patient with Crohn's Disease

Author: Sofia, Carmelo, Adiletta, Veronica, Iovene, Bruno, Sgalla, Giacomo, Richeldi, Luca, Sofia C., Adiletta V., Iovene B., Sgalla G. (ORCID:0000-0003-3130-9388), Richeldi L. (ORCID:0000-0001-8594-1448), Sofia, Carmelo, Adiletta, Veronica, Iovene, Bruno, Sgalla, Giacomo, Richeldi, Luca, Sofia C., Adiletta V., Iovene B., Sgalla G. (ORCID:0000-0003-3130-9388), and Richeldi L. (ORCID:0000-0001-8594-1448)
Published: 2022

12. Temporal progression of mediastinal lymphadenopathy in idiopathic pulmonary fibrosis

Author: Wallis, T. J. M., Gudmundsson, E., Pontoppidan, K., Mogulkoc, N., Savas, R., Unat, Os., Vedwan, K., Battison, S., Thompson, F. J., Brereton, C. J., Marshall, B. G., Fletcher, S. V., Richeldi, Luca, Jacob, J., Jones, M. G., Richeldi L. (ORCID:0000-0001-8594-1448), Wallis, T. J. M., Gudmundsson, E., Pontoppidan, K., Mogulkoc, N., Savas, R., Unat, Os., Vedwan, K., Battison, S., Thompson, F. J., Brereton, C. J., Marshall, B. G., Fletcher, S. V., Richeldi, Luca, Jacob, J., Jones, M. G., and Richeldi L. (ORCID:0000-0001-8594-1448)
Published: 2022

13. The Shorter, the Better: Can We Improve Efficiency of Idiopathic Pulmonary Fibrosis Trials?

Author: Sgalla, Giacomo, Wijsenbeek, M. S., Richeldi, Luca, Sgalla G. (ORCID:0000-0003-3130-9388), Richeldi L. (ORCID:0000-0001-8594-1448), Sgalla, Giacomo, Wijsenbeek, M. S., Richeldi, Luca, Sgalla G. (ORCID:0000-0003-3130-9388), and Richeldi L. (ORCID:0000-0001-8594-1448)
Published: 2022

14. Residual respiratory impairment after COVID-19 pneumonia

Author: Lombardi, F., Calabrese, Anna Chiara, Iovene, Bruno, Pierandrei, C., Lerede, M., Varone, Francesco, Richeldi, Luca, Sgalla, Giacomo, Landi, Francesco, Gremese, Elisa, Bernabei, Roberto, Fantoni, Massimo, Gasbarrini, Antonio, Romano Settanni, C., Benvenuto, F., Bramato, Giulia, Carfi, A., Ciciarello, Francesca, Lo Monaco, Maria Rita, Maria Martone, A., Marzetti, Emanuele, Napolitano, C., Pagano, Francesco Cosimo, Rocchi, Sara, Rota, E., Salerno, Andrea Maria, Tosato, Matteo, Tritto, M., Calvani, Riccardo, Catalano, Lucio, Picca, A., Savera, Giulia, Tamburrini, Enrica, Borghetti, Alberto, Di Gianbenedetto, S., Murri, Rita, Cingolani, Antonella, Ventura, Giulio, Taddei, E., Moschese, D., Ciccullo, A., Stella, L., Addolorato, Giovanni, Franceschi, Francesco, Mingrone, Geltrude, Assunta Zocco, M., Sanguinetti, Maurizio, Cattani Franchi, Paola, Marchetti, Simona, Bizzarro, Alessandra, Lauria, Alessandra, Rizzo, Stanislao, Cristina Savastano, M., Gambini, Gloria, Grazia Cozzupoli, M., Culiersi, Carola, Passali, Giulio Cesare, Paludetti, Gaetano, Galli, Jacopo, Crudo, F., Di Cintio, G., Longobardi, Ylenia, Tricarico, Laura, Santantonio, M., Buonsenso, Danilo, Valentini, Piero, Pata, D., Sinatti, Dario, De Rose, Cristina, Sani, Gabriele, Janiri, Delfina, Giuseppin, G., Molinaro, M., Modica, Marco, Natale, Luigi, Rita Larici, A., Marano, Riccardo, Paglionico, A., Petricca, Luca, Gigante, Lavinia, Natalello, G., Laur, a. Fedele A., Maria Lizzio, M., Santoliquido, Angelo, Santoro, L., Nesci, A., Popolla, Valentina, Calabrese A., Iovene B., Varone F., Richeldi L. (ORCID:0000-0001-8594-1448), Sgalla G. (ORCID:0000-0003-3130-9388), Landi F. (ORCID:0000-0002-3472-1389), Gremese E. (ORCID:0000-0002-2248-1058), Bernabei R. (ORCID:0000-0002-9197-004X), Fantoni M. (ORCID:0000-0001-6913-8460), Gasbarrini A. (ORCID:0000-0002-7278-4823), Bramato G., Ciciarello F., Lo Monaco M. R. (ORCID:0000-0002-1457-7981), Marzetti E. (ORCID:0000-0001-9567-6983), Pagano F., Rocchi S., Salerno A., Tosato M., Calvani R. (ORCID:0000-0001-5472-2365), Catalano L., Savera G., Tamburrini E. (ORCID:0000-0003-4930-426X), Borghetti A., Murri R. (ORCID:0000-0003-4263-7854), Cingolani A. (ORCID:0000-0002-3793-2755), Ventura G. (ORCID:0000-0002-0304-7264), Addolorato G. (ORCID:0000-0002-1522-9946), Franceschi F. (ORCID:0000-0001-6266-445X), Mingrone G. (ORCID:0000-0003-2021-528X), Sanguinetti M. (ORCID:0000-0002-9780-7059), Cattani P. (ORCID:0000-0003-4678-4763), Marchetti S., Bizzarro A., Lauria A., Rizzo S. (ORCID:0000-0001-6302-063X), Gambini G., Culiersi C., Cesare Passali G. (ORCID:0000-0002-8176-0962), Paludetti G. (ORCID:0000-0003-2480-1243), Galli J. (ORCID:0000-0001-6353-6249), Longobardi Y., Tricarico L., Buonsenso D., Valentini P. (ORCID:0000-0001-6095-9510), Sinatti D., De Rose C., Sani G. (ORCID:0000-0002-9767-8752), Janiri D., Modica M., Natale L. (ORCID:0000-0002-7949-5119), Marano R. (ORCID:0000-0003-2710-2093), Petricca L., Gigante L., Santoliquido A. (ORCID:0000-0003-1539-4017), Popolla V., Lombardi, F., Calabrese, Anna Chiara, Iovene, Bruno, Pierandrei, C., Lerede, M., Varone, Francesco, Richeldi, Luca, Sgalla, Giacomo, Landi, Francesco, Gremese, Elisa, Bernabei, Roberto, Fantoni, Massimo, Gasbarrini, Antonio, Romano Settanni, C., Benvenuto, F., Bramato, Giulia, Carfi, A., Ciciarello, Francesca, Lo Monaco, Maria Rita, Maria Martone, A., Marzetti, Emanuele, Napolitano, C., Pagano, Francesco Cosimo, Rocchi, Sara, Rota, E., Salerno, Andrea Maria, Tosato, Matteo, Tritto, M., Calvani, Riccardo, Catalano, Lucio, Picca, A., Savera, Giulia, Tamburrini, Enrica, Borghetti, Alberto, Di Gianbenedetto, S., Murri, Rita, Cingolani, Antonella, Ventura, Giulio, Taddei, E., Moschese, D., Ciccullo, A., Stella, L., Addolorato, Giovanni, Franceschi, Francesco, Mingrone, Geltrude, Assunta Zocco, M., Sanguinetti, Maurizio, Cattani Franchi, Paola, Marchetti, Simona, Bizzarro, Alessandra, Lauria, Alessandra, Rizzo, Stanislao, Cristina Savastano, M., Gambini, Gloria, Grazia Cozzupoli, M., Culiersi, Carola, Passali, Giulio Cesare, Paludetti, Gaetano, Galli, Jacopo, Crudo, F., Di Cintio, G., Longobardi, Ylenia, Tricarico, Laura, Santantonio, M., Buonsenso, Danilo, Valentini, Piero, Pata, D., Sinatti, Dario, De Rose, Cristina, Sani, Gabriele, Janiri, Delfina, Giuseppin, G., Molinaro, M., Modica, Marco, Natale, Luigi, Rita Larici, A., Marano, Riccardo, Paglionico, A., Petricca, Luca, Gigante, Lavinia, Natalello, G., Laur, a. Fedele A., Maria Lizzio, M., Santoliquido, Angelo, Santoro, L., Nesci, A., Popolla, Valentina, Calabrese A., Iovene B., Varone F., Richeldi L. (ORCID:0000-0001-8594-1448), Sgalla G. (ORCID:0000-0003-3130-9388), Landi F. (ORCID:0000-0002-3472-1389), Gremese E. (ORCID:0000-0002-2248-1058), Bernabei R. (ORCID:0000-0002-9197-004X), Fantoni M. (ORCID:0000-0001-6913-8460), Gasbarrini A. (ORCID:0000-0002-7278-4823), Bramato G., Ciciarello F., Lo Monaco M. R. (ORCID:0000-0002-1457-7981), Marzetti E. (ORCID:0000-0001-9567-6983), Pagano F., Rocchi S., Salerno A., Tosato M., Calvani R. (ORCID:0000-0001-5472-2365), Catalano L., Savera G., Tamburrini E. (ORCID:0000-0003-4930-426X), Borghetti A., Murri R. (ORCID:0000-0003-4263-7854), Cingolani A. (ORCID:0000-0002-3793-2755), Ventura G. (ORCID:0000-0002-0304-7264), Addolorato G. (ORCID:0000-0002-1522-9946), Franceschi F. (ORCID:0000-0001-6266-445X), Mingrone G. (ORCID:0000-0003-2021-528X), Sanguinetti M. (ORCID:0000-0002-9780-7059), Cattani P. (ORCID:0000-0003-4678-4763), Marchetti S., Bizzarro A., Lauria A., Rizzo S. (ORCID:0000-0001-6302-063X), Gambini G., Culiersi C., Cesare Passali G. (ORCID:0000-0002-8176-0962), Paludetti G. (ORCID:0000-0003-2480-1243), Galli J. (ORCID:0000-0001-6353-6249), Longobardi Y., Tricarico L., Buonsenso D., Valentini P. (ORCID:0000-0001-6095-9510), Sinatti D., De Rose C., Sani G. (ORCID:0000-0002-9767-8752), Janiri D., Modica M., Natale L. (ORCID:0000-0002-7949-5119), Marano R. (ORCID:0000-0003-2710-2093), Petricca L., Gigante L., Santoliquido A. (ORCID:0000-0003-1539-4017), and Popolla V.
Abstract: Introduction: The novel coronavirus SARS-Cov-2 can infect the respiratory tract causing a spectrum of disease varying from mild to fatal pneumonia, and known as COVID-19. Ongoing clinical research is assessing the potential for long-term respiratory sequelae in these patients. We assessed the respiratory function in a cohort of patients after recovering from SARS-Cov-2 infection, stratified according to PaO2/FiO2 (p/F) values. Method: Approximately one month after hospital discharge, 86 COVID-19 patients underwent physical examination, arterial blood gas (ABG) analysis, pulmonary function tests (PFTs), and six-minute walk test (6MWT). Patients were also asked to quantify the severity of dyspnoea and cough before, during, and after hospitalization using a visual analogic scale (VAS). Seventy-six subjects with ABG during hospitalization were stratified in three groups according to their worst p/F values: above 300 (n = 38), between 200 and 300 (n = 30) and below 200 (n = 20). Results: On PFTs, lung volumes were overall preserved yet, mean percent predicted residual volume was slightly reduced (74.8 ± 18.1%). Percent predicted diffusing capacity for carbon monoxide (DLCO) was also mildly reduced (77.2 ± 16.5%). Patients reported residual breathlessness at the time of the visit (VAS 19.8, p < 0.001). Patients with p/F below 200 during hospitalization had lower percent predicted forced vital capacity (p = 0.005), lower percent predicted total lung capacity (p = 0.012), lower DLCO (p < 0.001) and shorter 6MWT distance (p = 0.004) than patients with higher p/F. Conclusion: Approximately one month after hospital discharge, patients with COVID-19 can have residual respiratory impairment, including lower exercise tolerance. The extent of this impairment seems to correlate with the severity of respiratory failure during hospitalization.
Published: 2021

15. Severe asthma: One disease and multiple definitions

Author: Bagnasco, D., Paggiaro, P., Latorre, M., Folli, C., Testino, E., Bassi, A., Milanese, M., Heffler, E., Manfredi, A., Riccio, A. M., De Ferrari, L., Blasi, F., Canevari, R. F., Canonica, G. W., Passalacqua, G., Guarnieri, G., Patella, V., Maria Pia, F. B., Carpagnano, G. E., Colle, A. D., Scioscia, G., Gerolamo, P., Puggioni, F., Racca, F., Favero, E., Iannacone, S., Savi, E., Montagni, M., Camiciottoli, G., Allegrini, C., Lombardi, Celestino Pio, Spadaro, G., Detoraki, C., Menzella, F., Galeone, C., Ruggiero, P., Yacoub, M. R., Berti, Andrea, Scichilone, N., Durante, C., Costantino, M. T., Roncallo, C., Braschi, M., D'Adda, A., Ridolo, E., Triggiani, M., Parente, R., Maria, D. A., Verrillo, M. V., Rolla, G., Brussino, L., Frazzetto, A. V., Cristina, Z. M., Lilli, M., Crimi, N., Bonavia, M., Corsico, A. G., Grosso, A., Del Giacco, S., Deidda, M., Ricciardi, L., Isola, S., Cicero, F., Amato, G., Vita, F., Spanevello, A., Pignatti, P., Cherubino, F., Visca, D., Massimo Ricciardolo, F. L., Anna Carriero, V. M., Bertolini, Francesca, Santus, P., Barlassina, R., Airoldi, A., Guida, Maria Grazia, Nucera, Eleonora, Aruanno, A., Rizzi, Angela, Caruso, Cristiano, Colantuono, S., Senna, G., Caminati, M., Arcolaci, A., Vianello, A., Bianchi, F. C., Marchi, M. R., Centanni, S., Luraschi, S., Ruggeri, S., Rinaldo, R., Parazzini, E., Calabrese, Anna Chiara, Flora, M., Cosmi, L., Di Pietro, L., Maggi, E., Pini, L., Macchia, L., Di Bona, D., Richeldi, Luca, Condoluci, Carola, Fuso, Leonello, Bonini, Matteo, Farsi, A., Carli, G., Montuschi, Paolo, Santini, G., Conte, M. E., Turchet, E., Barbetta, C., Mazza, F., D'Alo, S., Pucci, S., Caiaffa, M. F., Minenna, E., D'Elia, L., Pasculli, C., Viviano, V., Tarsia, P., Rolo, J., Di Proietto, M., Lo Cicero, Stefano, Lombardi C. (ORCID:0000-0001-8910-6693), Berti A., Bertolini F., Guida G., Eleonora Nucera. (ORCID:0000-0002-0565-7680), Rizzi A. (ORCID:0000-0002-6795-746X), Caruso C., Calabrese C., Richeldi L. (ORCID:0000-0001-8594-1448), Condoluci C., Fuso L. (ORCID:0000-0002-1198-6712), Bonini M. (ORCID:0000-0002-3042-0765), Montuschi P. (ORCID:0000-0001-5589-1750), Lo Cicero S., Bagnasco, D., Paggiaro, P., Latorre, M., Folli, C., Testino, E., Bassi, A., Milanese, M., Heffler, E., Manfredi, A., Riccio, A. M., De Ferrari, L., Blasi, F., Canevari, R. F., Canonica, G. W., Passalacqua, G., Guarnieri, G., Patella, V., Maria Pia, F. B., Carpagnano, G. E., Colle, A. D., Scioscia, G., Gerolamo, P., Puggioni, F., Racca, F., Favero, E., Iannacone, S., Savi, E., Montagni, M., Camiciottoli, G., Allegrini, C., Lombardi, Celestino Pio, Spadaro, G., Detoraki, C., Menzella, F., Galeone, C., Ruggiero, P., Yacoub, M. R., Berti, Andrea, Scichilone, N., Durante, C., Costantino, M. T., Roncallo, C., Braschi, M., D'Adda, A., Ridolo, E., Triggiani, M., Parente, R., Maria, D. A., Verrillo, M. V., Rolla, G., Brussino, L., Frazzetto, A. V., Cristina, Z. M., Lilli, M., Crimi, N., Bonavia, M., Corsico, A. G., Grosso, A., Del Giacco, S., Deidda, M., Ricciardi, L., Isola, S., Cicero, F., Amato, G., Vita, F., Spanevello, A., Pignatti, P., Cherubino, F., Visca, D., Massimo Ricciardolo, F. L., Anna Carriero, V. M., Bertolini, Francesca, Santus, P., Barlassina, R., Airoldi, A., Guida, Maria Grazia, Nucera, Eleonora, Aruanno, A., Rizzi, Angela, Caruso, Cristiano, Colantuono, S., Senna, G., Caminati, M., Arcolaci, A., Vianello, A., Bianchi, F. C., Marchi, M. R., Centanni, S., Luraschi, S., Ruggeri, S., Rinaldo, R., Parazzini, E., Calabrese, Anna Chiara, Flora, M., Cosmi, L., Di Pietro, L., Maggi, E., Pini, L., Macchia, L., Di Bona, D., Richeldi, Luca, Condoluci, Carola, Fuso, Leonello, Bonini, Matteo, Farsi, A., Carli, G., Montuschi, Paolo, Santini, G., Conte, M. E., Turchet, E., Barbetta, C., Mazza, F., D'Alo, S., Pucci, S., Caiaffa, M. F., Minenna, E., D'Elia, L., Pasculli, C., Viviano, V., Tarsia, P., Rolo, J., Di Proietto, M., Lo Cicero, Stefano, Lombardi C. (ORCID:0000-0001-8910-6693), Berti A., Bertolini F., Guida G., Eleonora Nucera. (ORCID:0000-0002-0565-7680), Rizzi A. (ORCID:0000-0002-6795-746X), Caruso C., Calabrese C., Richeldi L. (ORCID:0000-0001-8594-1448), Condoluci C., Fuso L. (ORCID:0000-0002-1198-6712), Bonini M. (ORCID:0000-0002-3042-0765), Montuschi P. (ORCID:0000-0001-5589-1750), and Lo Cicero S.
Abstract: Introduction: There is, so far, no universal definition of severe asthma. This definition usually relies on: number of exacerbations, inhaled therapy, need for oral corticosteroids, and respiratory function. The use of such parameters varies in the different definitions used. Thus, according to the parameters chosen, each patient may result in having severe asthma or not. The aim of this study was to evaluate how the choice of a specific definition of severe asthma can change the allocation of patients. Methods: Data collected from the Severe Asthma Network Italy (SANI) registry were analyzed. All the patients included were then reclassified according to the definitions of U-BIOPRED, NICE, WHO, ATS/ERS, GINA, ENFUMOSA, and TENOR. Results: 540 patients, were extracted from the SANI database. We observed that 462 (86%) met the ATS/ERS criteria as well as the GINA criteria, 259 (48%) the U-Biopred, 222 (41%) the NICE, 125 (23%) the WHO, 313 (58%) the Enfumosa, and 251 (46%) the TENOR criteria. The mean eosinophil value were similar in the ATS/ERS, U-Biopred, and Enfumosa (528, 532 and 516 cells/mcl), higher in WHO and Tenor (567 and 570 cells/mcl) and much higher in the NICE classification (624 cells/mcl). Lung function tests resulted similarly in all groups, with WHO (67%) and ATS/ERS-GINA (73%), respectively, showing the lower and upper mean FEV1 values. Conclusions: The present observations clearly evidence the heterogeneity in the distribution of patients when different definitions of severe asthma are used. However, the recent definition of severe asthma, provided by the GINA document, is similar to that indicated in 2014 by ATS/ERS, allowing mirror reclassification of the patients examined. This lack of homogeneity could complicate the access to biological therapies. The definition provided by the GINA document, which reflects what suggested by ATS/ERS, could partially overcome the problem.
Published: 2021

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

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

17. Mesenchymal Stromal Cell Secretome for Post-COVID-19 Pulmonary Fibrosis: A New Therapy to Treat the Long-Term Lung Sequelae?

Author: Bari, E., Ferrarotti, I., Saracino, L., Perteghella, S., Torre, M. L., Richeldi, Luca, Corsico, A. G., Richeldi L. (ORCID:0000-0001-8594-1448), Bari, E., Ferrarotti, I., Saracino, L., Perteghella, S., Torre, M. L., Richeldi, Luca, Corsico, A. G., and Richeldi L. (ORCID:0000-0001-8594-1448)
Abstract: To date, more than 100 million people worldwide have recovered from COVID-19. Unfortunately, although the virus is eradicated in such patients, fibrotic irreversible interstitial lung disease (pulmonary fibrosis, PF) is clinically evident. Given the vast numbers of individuals affected, it is urgent to design a strategy to prevent a second wave of late mortality associated with COVID-19 PF as a long-term consequence of such a devastating pandemic. Available antifibrotic therapies, namely nintedanib and pirfenidone, might have a role in attenuating profibrotic pathways in SARS-CoV-2 infection but are not economically sustainable by national health systems and have critical adverse effects. It is our opinion that the mesenchymal stem cell secretome could offer a new therapeutic approach in treating COVID-19 fibrotic lungs through its anti-inflammatory and antifibrotic factors.
Published: 2021

18. Looking Ahead: Interstitial Lung Disease Diagnosis and Management in 2030

Author: Johannson, K. A., Collard, H. R., Richeldi, Luca, Richeldi L. (ORCID:0000-0001-8594-1448), Johannson, K. A., Collard, H. R., Richeldi, Luca, and Richeldi L. (ORCID:0000-0001-8594-1448)
Published: 2021

19. Progress and Innovation in Interstitial Lung Disease

Author: Johannson, K. A., Collard, H. R., Richeldi, Luca, Richeldi L. (ORCID:0000-0001-8594-1448), Johannson, K. A., Collard, H. R., Richeldi, Luca, and Richeldi L. (ORCID:0000-0001-8594-1448)
Published: 2021

20. The impact of fixed triple therapy with beclometasone/formoterol/glycopyrronium on health status and adherence in chronic obstructive pulmonary disease (COPD) in an italian context of real life: The TRITRIAL study protocol

Author: Richeldi, L., Piraino, A., Macagno, F., Micarelli, G., Ingrassia, E., Richeldi L. (ORCID:0000-0001-8594-1448), Macagno F., Richeldi, L., Piraino, A., Macagno, F., Micarelli, G., Ingrassia, E., Richeldi L. (ORCID:0000-0001-8594-1448), and Macagno F.
Abstract: Background: The fixed triple combination Beclometasone dipropionate/Formoterol fuma- rate/Glycopyrronium (BDP/FF/G, Trimbow®), an extrafine formulation in a unique pressur- ized metered dose inhaler, is indicated for the maintenance treatment in adult patients with moderate to severe COPD, not adequately treated by ICS/LABA or LABA/LAMA. Besides the evidence from three randomized controlled trials, the impact of fixed triple therapy has not been extensively evaluated in a real-world population of COPD patients. TRITRIAL (TRIple Therapy in Real life: Impact on Adherence and HeaLth status) is a non- interventional study to assess the effect of BDP/FF/G in a real world setting in Italy. Design: TRITRIAL is a 12-month, multicenter, cohort, prospective, longitudinal observational study. Two follow-up visits will be performed at 6 and 12 months, respectively. The study includes the collection of anamnestic clinical and functional data before the start of BDP/FF/G. The study is built for digital conduction, from signature of the informed consent on a dedicated web platform, to the collection of questionnaires and clinical data on the eCRF. Population: A total of 800 patients with COPD ranging from Global Initiative for Obstructive Lung Disease (GOLD) stages 2 to 4, receiving therapy with BDP/FF/G accord- ing to the Summary of Product Characteristics and local clinical practice, will be recruited. All concomitant therapies will be permitted for the duration of the study. Evaluations: The primary endpoint is the change of CAT score at 12 months versus baseline. Secondary endpoints are adherence, health-related quality of life, sleep quality, disease-related outcomes (lung function and COPD exacerbations), device usability, eco- nomic resources consumption, and safety. Conclusion: TRITRIAL study is expected to give relevant information about effectiveness of BDP/FF/G fixed triple therapy in a real-life setting of patients with COPD, where adherence, usability of inhalers and
Published: 2021

21. Phase three clinical trials in idiopathic pulmonary fibrosis

Author: Sgalla, Giacomo, Lerede, Marialessia, Richeldi, Luca, Sgalla G. (ORCID:0000-0003-3130-9388), Lerede M., Richeldi L. (ORCID:0000-0001-8594-1448), Sgalla, Giacomo, Lerede, Marialessia, Richeldi, Luca, Sgalla G. (ORCID:0000-0003-3130-9388), Lerede M., and Richeldi L. (ORCID:0000-0001-8594-1448)
Abstract: Introduction: The last two decades witnessed an increasing number of well-designed late phase trials in patients with Idiopathic Pulmonary Fibrosis (IPF), leading to the approval of the first effective therapies for these patients, pirfenidone and nintedanib. Currently, novel putative agents for the treatment of IPF are being tested in phase III trials, possibly marking a new breakthrough in IPF management. Areas covered: In this review, the available evidence on completed phase III trials in IPF is summarized, from the past failures of immunosuppressive and anti-inflammatory agents, anticoagulants and endothelin-receptor antagonists to the positive results of the antifibrotic treatments that revolutionized IPF therapeutic landscape. Literature search was performed using Medline and Clinicaltrials.org databases (1999–2020). Expert opinion: In the relatively young history of pharmaceutical research in IPF, most phase III trials provided disappointing results, however the lessons learned helped paving the way to the success of the first therapies capable of modifying the natural history of this deadly disease. To date, the conduction of robustly designed phase III trials on novel drugs remains crucial to pursue the goal of halting disease progression in these patients, using a therapeutic approach that should become more and more tailored to the individual.
Published: 2021

22. Economic impact of mepolizumab in uncontrolled severe eosinophilic asthma, in real life

Author: Bagnasco, D., Povero, M., Pradelli, L., Brussino, L., Rolla, G., Caminati, M., Menzella, F., Heffler, E., Canonica, G. W., Paggiaro, P., Senna, G., Milanese, M., Lombardi, C., Bucca, C., Manfredi, A., Canevari, R. F., Passalacqua, G., Guarnieri, G., Patella, V., Maria Pia, F. B., Carpagnano, E., Colle, A. D., Scioscia, G., Gerolamo, P., Latorre, M., Puggioni, F., Racca, F., Favero, E., Iannacone, S., Savi, E., Montagni, M., Camiciottoli, G., Allegrini, C., Spadaro, G., Detoraki, C., Galeone, C., Ruggiero, P., Yacoub, M. R., Berti, Andrea, Colombo, G., Scichilone, N., Durante, C., Costantino, M. T., Roncallo, C., Braschi, M., Blasi, F., D'Adda, A., Ridolo, E., Triggiani, M., Parente, R., Maria, D. A., Verrillo, M. V., Cristina, Z. M., Lilli, M., Crimi, N., Bonavia, M., Corsico, A. G., Grosso, A., Del Giacco, S., Deidda, M., Ricciardi, L., Isola, S., Cicero, F., Amato, G., Vita, F., Spanevello, A., Pignatti, P., Cherubino, F., Visca, D., Aletti, E., Massimo Ricciardolo, F. L., Anna Carriero, V. M., Bertolini, Francesca, Santus, P., Barlassina, R., Airoldi, A., Guida, Maria Grazia, Nucera, Eleonora, Aruanno, A., Rizzi, Angela, Caruso, C., Colantuono, S., Arcolaci, A., Vianello, A., Bianchi, F. C., Marchi, M. R., Centanni, S., Luraschi, S., Ruggeri, S., Rinaldo, R., Parazzini, E., Calabrese, Anna Chiara, Flora, M., Cosmi, L., Di Pietro, L., Maggi, E., Pini, L., Macchia, L., Di Bona, D., Richeldi, Luca, Condoluci, Carola, Fuso, Leonello, Bonini, Matteo, Farsi, A., Carli, G., Montuschi, Paolo, Santini, G., Conte, M. E., Turchet, E., Barbetta, C., Mazza, F., D'Alo, S., Pucci, S., Caiaffa, M. F., Minenna, E., D'Elia, L., Pasculli, C., Viviano, V., Tarsia, P., Rolo, J., Di Proietto, M., Lo Cicero, Stefano, Berti A., Bertolini F., Guida G., Eleonora N. (ORCID:0000-0002-0565-7680), Rizzi A. (ORCID:0000-0002-6795-746X), Calabrese C., Richeldi L. (ORCID:0000-0001-8594-1448), Condoluci C., Fuso L. (ORCID:0000-0002-1198-6712), Bonini M. (ORCID:0000-0002-3042-0765), Montuschi P. (ORCID:0000-0001-5589-1750), Lo Cicero S., Bagnasco, D., Povero, M., Pradelli, L., Brussino, L., Rolla, G., Caminati, M., Menzella, F., Heffler, E., Canonica, G. W., Paggiaro, P., Senna, G., Milanese, M., Lombardi, C., Bucca, C., Manfredi, A., Canevari, R. F., Passalacqua, G., Guarnieri, G., Patella, V., Maria Pia, F. B., Carpagnano, E., Colle, A. D., Scioscia, G., Gerolamo, P., Latorre, M., Puggioni, F., Racca, F., Favero, E., Iannacone, S., Savi, E., Montagni, M., Camiciottoli, G., Allegrini, C., Spadaro, G., Detoraki, C., Galeone, C., Ruggiero, P., Yacoub, M. R., Berti, Andrea, Colombo, G., Scichilone, N., Durante, C., Costantino, M. T., Roncallo, C., Braschi, M., Blasi, F., D'Adda, A., Ridolo, E., Triggiani, M., Parente, R., Maria, D. A., Verrillo, M. V., Cristina, Z. M., Lilli, M., Crimi, N., Bonavia, M., Corsico, A. G., Grosso, A., Del Giacco, S., Deidda, M., Ricciardi, L., Isola, S., Cicero, F., Amato, G., Vita, F., Spanevello, A., Pignatti, P., Cherubino, F., Visca, D., Aletti, E., Massimo Ricciardolo, F. L., Anna Carriero, V. M., Bertolini, Francesca, Santus, P., Barlassina, R., Airoldi, A., Guida, Maria Grazia, Nucera, Eleonora, Aruanno, A., Rizzi, Angela, Caruso, C., Colantuono, S., Arcolaci, A., Vianello, A., Bianchi, F. C., Marchi, M. R., Centanni, S., Luraschi, S., Ruggeri, S., Rinaldo, R., Parazzini, E., Calabrese, Anna Chiara, Flora, M., Cosmi, L., Di Pietro, L., Maggi, E., Pini, L., Macchia, L., Di Bona, D., Richeldi, Luca, Condoluci, Carola, Fuso, Leonello, Bonini, Matteo, Farsi, A., Carli, G., Montuschi, Paolo, Santini, G., Conte, M. E., Turchet, E., Barbetta, C., Mazza, F., D'Alo, S., Pucci, S., Caiaffa, M. F., Minenna, E., D'Elia, L., Pasculli, C., Viviano, V., Tarsia, P., Rolo, J., Di Proietto, M., Lo Cicero, Stefano, Berti A., Bertolini F., Guida G., Eleonora N. (ORCID:0000-0002-0565-7680), Rizzi A. (ORCID:0000-0002-6795-746X), Calabrese C., Richeldi L. (ORCID:0000-0001-8594-1448), Condoluci C., Fuso L. (ORCID:0000-0002-1198-6712), Bonini M. (ORCID:0000-0002-3042-0765), Montuschi P. (ORCID:0000-0001-5589-1750), and Lo Cicero S.
Abstract: Background and aims: Severe asthma is burdened by frequent exacerbations and use of oral corticosteroids (OCS) which worsen patients’ health and increase healthcare spending. Aim of this study was to assess the clinical and economic effect of adding mepolizumab (MEP) for the treatment of these patients. Methods: Patients >18 years old, referred to 8 asthma clinics, starting MEP between May 2017 and December 2018, were enrolled and followed-up for 12 months. Information in the 12 months before mepolizumab were collected retrospectively. The evaluation parameters included: OCS use, number of exacerbations/hospitalizations, concomitant therapies, comorbidity, and annual number of working days lost due to the disease. The primary objective was to compare the annual total cost per patient pre- and post-MEP. Secondary outcomes included rates of exacerbations and number of OCS-dependent patients. Results: 106 patients were enrolled in the study: 46 male, median age 58 years. Mean annual cost pre- and post-MEP (cost of biologic excluded) was €3996 and €1,527, respectively. Total savings due to MEP resulted in €2469 (95%CI 1945–2993), 62% due to exacerbations reduction and 33% due to productivity increase. Such savings could fund about 22% of the total cost of MEP for one year. The introduction of MEP induced a clinical benefit by reducing both OCS-dependent patients (OR = 0.12, 95%CI 0.06–0.23) and exacerbation rate (RR = 0.19, 95%CI 0.15–0.24). Conclusions: Patients with severe eosinophilic asthma experienced a clinical benefit in asthma control adding MEP to standard therapy. Biologic therapy can be, partially, funded by the savings produced by patients’ improvement.
Published: 2021

23. Estimation of the Prevalence of Progressive Fibrosing Interstitial Lung Diseases: Systematic Literature Review and Data from a Physician Survey

Author: Olson, A., Hartmann, N., Patnaik, P., Wallace, L., Schlenker-Herceg, R., Nasser, M., Richeldi, L., Hoffmann-Vold, A. -M., Cottin, V., Richeldi L. (ORCID:0000-0001-8594-1448), Olson, A., Hartmann, N., Patnaik, P., Wallace, L., Schlenker-Herceg, R., Nasser, M., Richeldi, L., Hoffmann-Vold, A. -M., Cottin, V., and Richeldi L. (ORCID:0000-0001-8594-1448)
Abstract: Some patients with interstitial lung diseases (ILDs) other than idiopathic pulmonary fibrosis exhibit a progressive clinical phenotype. These chronic progressive fibrosing ILDs have a variety of underlying diseases, and their prevalence is currently unknown. Here we carry out the first systematic review of literature on the prevalence of fibrosing ILDs and progressive fibrosing ILDs using data from physician surveys to estimate frequency of progression among different ILDs. We searched MEDLINE and Embase for studies assessing prevalence of ILD, individual ILDs associated with fibrosis and progressive fibrosing ILDs. These were combined with data from previously published physician surveys to obtain prevalence estimates of each chronic fibrosing ILD with a progressive phenotype and of progressive fibrosing ILDs overall. We identified 16 publications, including five reporting overall ILD prevalence, estimated at 6.3–76.0 per 100,000 people in Europe (four studies) and 74.3 per 100,000 in the USA (one study). In total, 13–40% of ILDs were estimated to develop a progressive fibrosing phenotype, with overall prevalence estimates for progressive fibrosing ILDs of 2.2–20.0 per 100,000 in Europe and 28.0 per 100,000 in the USA. Prevalence estimates for individual progressive fibrosing ILDs varied up to 16.7 per 100,000 people. These conditions represent a sizeable fraction of chronic respiratory disorders and have a high unmet need.
Published: 2021

24. Suggestions for lung function testing in the context of COVID-19

Author: Milanese, M., Corsico, A. G., Bellofiore, S., Carrozzi, L., Di Marco, F., Iovene, Bruno, Richeldi, Luca, Sanna, A., Santus, P., Schisano, M., Scichilone, N., Vancheri, C., Cerveri, I., Iovene B., Richeldi L. (ORCID:0000-0001-8594-1448), Milanese, M., Corsico, A. G., Bellofiore, S., Carrozzi, L., Di Marco, F., Iovene, Bruno, Richeldi, Luca, Sanna, A., Santus, P., Schisano, M., Scichilone, N., Vancheri, C., Cerveri, I., Iovene B., and Richeldi L. (ORCID:0000-0001-8594-1448)
Abstract: The 2019 coronavirus disease (COVID-19) pandemic is currently a challenge worldwide. Due to the characteristics of lung function tests, the risk of cross infection may be high between health care workers and patients. The role of lung function testing is well defined for the diagnosis of various diseases and conditions. Lung function tests are also indispensable in evaluating the response to medical treatment, in monitoring patient respiratory and systemic pathologies, and in evaluating preoperative risk in cardiothoracic and major abdominal surgeries. However, lung function testing represents a potential route for COVID-19 transmission, due to the aerosol generated during the procedures and the concentration of patients with pulmonary diseases in lung function laboratories. Currently, the opportunities for COVID-19 transmission remain partially unknown, and data are continuously evolving. This review provides useful information on the risks and recommendations for lung function testing, which have varied according to the phase of the pandemic. This information may support national and regional boards and the health authorities to which they belong. There is a need for rapid re-opening of lung function laboratories, but maximum safety is required in the COVID-19 era.
Published: 2021

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

Author: Buonsenso, Danilo, Valentini, Piero, De Rose, Cristina, Pata, Davide, Sinatti, Dario, Speziale, Domenico, Ricci, R., Carfi, A., Landi, Francesco, Ferrari, V., De Maio, Flavio, Palucci, Ivana, Sanguinetti, Maurizio, Sali, Michela, Landi, F., Gremese, E., Bernabei, R., Fantoni, M., Gasbarrini, A., Settanni, C. R., Benvenuto, F., Bramato, G., Ciciarello, F., Lo Monaco, M. R., Martone, A. M., Marzetti, Emanuele, Napolitano, C., Pagano, F., Rocchi, S., Rota, E., Salerno, A., Tosato, M., Tritto, M., Calvani, Riccardo, Catalano, L., Picca, A., Savera, G., Cauda, R., Tamburrini, E., Borghetti, A., Di Gianbenedetto, S., Murri, R., Cingolani, A., Ventura, G., Taddei, E., Moschese, D., Ciccullo, A., Stella, L., Addolorato, G., Franceschi, F., Mingrone, G., Zocco, Maria Assunta, Sanguinetti, M., Cattani Franchi, Paola, Marchetti, S., Posteraro, Brunella, Sali, M., Bizzarro, A., Lauria, A., Rizzo, S., Savastano, Maria Cristina, Gambini, G., Cozzupoli, G. M., Culiersi, C., Passali, G. C., Paludetti, G., Galli, J., Crudo, F., Di Cintio, G., Longobardi, Y., Tricarico, L., Santantonio, M., Buonsenso, D., Valentini, P., Pata, D., Sinatti, D., De Rose, C., Richeldi, Luca, Lombardi, F., Calabrese, A., Sani, G., Janiri, D., Giuseppin, G., Molinaro, M., Modica, M., Natale, Luigi, Larici, A. R., Marano, R., Paglionico, A., Petricca, L., Gigante, L., Natalello, G., Fedele, A. L., Lizzio, M. M., Tolusso, B., Alivernini, S., Santoliquido, A., Santoro, L., Nesci, A., Popolla, V., Buonsenso D., Valentini P. (ORCID:0000-0001-6095-9510), De Rose C., Pata D., Sinatti D., Speziale D., Landi F. (ORCID:0000-0002-3472-1389), De Maio F., Palucci I., Sanguinetti M. (ORCID:0000-0002-9780-7059), Sali M. (ORCID:0000-0003-3609-2990), Marzetti E. (ORCID:0000-0001-9567-6983), Calvani R. (ORCID:0000-0001-5472-2365), Zocco M. A. (ORCID:0000-0002-0814-9542), Cattani P. (ORCID:0000-0003-4678-4763), Posteraro B. (ORCID:0000-0002-1663-7546), Savastano M. C. (ORCID:0000-0003-1397-4333), Richeldi L. (ORCID:0000-0001-8594-1448), Natale L. (ORCID:0000-0002-7949-5119), Buonsenso, Danilo, Valentini, Piero, De Rose, Cristina, Pata, Davide, Sinatti, Dario, Speziale, Domenico, Ricci, R., Carfi, A., Landi, Francesco, Ferrari, V., De Maio, Flavio, Palucci, Ivana, Sanguinetti, Maurizio, Sali, Michela, Landi, F., Gremese, E., Bernabei, R., Fantoni, M., Gasbarrini, A., Settanni, C. R., Benvenuto, F., Bramato, G., Ciciarello, F., Lo Monaco, M. R., Martone, A. M., Marzetti, Emanuele, Napolitano, C., Pagano, F., Rocchi, S., Rota, E., Salerno, A., Tosato, M., Tritto, M., Calvani, Riccardo, Catalano, L., Picca, A., Savera, G., Cauda, R., Tamburrini, E., Borghetti, A., Di Gianbenedetto, S., Murri, R., Cingolani, A., Ventura, G., Taddei, E., Moschese, D., Ciccullo, A., Stella, L., Addolorato, G., Franceschi, F., Mingrone, G., Zocco, Maria Assunta, Sanguinetti, M., Cattani Franchi, Paola, Marchetti, S., Posteraro, Brunella, Sali, M., Bizzarro, A., Lauria, A., Rizzo, S., Savastano, Maria Cristina, Gambini, G., Cozzupoli, G. M., Culiersi, C., Passali, G. C., Paludetti, G., Galli, J., Crudo, F., Di Cintio, G., Longobardi, Y., Tricarico, L., Santantonio, M., Buonsenso, D., Valentini, P., Pata, D., Sinatti, D., De Rose, C., Richeldi, Luca, Lombardi, F., Calabrese, A., Sani, G., Janiri, D., Giuseppin, G., Molinaro, M., Modica, M., Natale, Luigi, Larici, A. R., Marano, R., Paglionico, A., Petricca, L., Gigante, L., Natalello, G., Fedele, A. L., Lizzio, M. M., Tolusso, B., Alivernini, S., Santoliquido, A., Santoro, L., Nesci, A., Popolla, V., Buonsenso D., Valentini P. (ORCID:0000-0001-6095-9510), De Rose C., Pata D., Sinatti D., Speziale D., Landi F. (ORCID:0000-0002-3472-1389), De Maio F., Palucci I., Sanguinetti M. (ORCID:0000-0002-9780-7059), Sali M. (ORCID:0000-0003-3609-2990), Marzetti E. (ORCID:0000-0001-9567-6983), Calvani R. (ORCID:0000-0001-5472-2365), Zocco M. A. (ORCID:0000-0002-0814-9542), Cattani P. (ORCID:0000-0003-4678-4763), Posteraro B. (ORCID:0000-0002-1663-7546), Savastano M. C. (ORCID:0000-0003-1397-4333), Richeldi L. (ORCID:0000-0001-8594-1448), and Natale L. (ORCID:0000-0002-7949-5119)
Abstract: Weather and the susceptibility of children to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is still a debated question and currently a hot topic, particularly in view of important decisions regarding opening schools. Therefore, we performed this prospective analysis of anti-SARS-CoV-2 immunoglobulin G (IgG) antibodies in children with known household exposure to SARS-CoV-2 and compared their IgG status with the other adults exposed to the index case in the same household. A total of 30 families with a documented COVID-19 index case were included. A total of 44 out of 80 household contacts (55%) of index patients had anti SARS-CoV-2 IgG antibodies. In particular, 16/27 (59,3%) adult partners had IgG antibodies compared with 28/53 (52,3%) of pediatric contacts (p >.05). Among the pediatric population, children ≥5 years of age had a similar probability of having SARS-CoV-2 IgG antibodies (21/39, 53.8%) compared to those less than 5 years old (7/14, 50%) (p >.05). Adult partners and children also had a similar probability of having SARS-CoV-2 IgG antibodies. Interestingly, 10/28 (35.7%) of children and 5/27 (18.5%) of adults with SARS-CoV-2 IgG antibodies were previously diagnosed as COVID-19 cases. Our study shows evidence of a high rate of IgG antibodies in children exposed to SARS-CoV-2. This report has public health implications, highlighting the need to establish appropriate guidelines for school openings and other social activities related to childhood.
Published: 2020

26. Pamrevlumab for the treatment of idiopathic pulmonary fibrosis

Author: Sgalla, Giacomo, Franciosa, Claudia, Simonetti, Jacopo, Richeldi, Luca, Sgalla G. (ORCID:0000-0003-3130-9388), Franciosa C., Simonetti J., Richeldi L. (ORCID:0000-0001-8594-1448), Sgalla, Giacomo, Franciosa, Claudia, Simonetti, Jacopo, Richeldi, Luca, Sgalla G. (ORCID:0000-0003-3130-9388), Franciosa C., Simonetti J., and Richeldi L. (ORCID:0000-0001-8594-1448)
Abstract: Introduction: The two available therapies for idiopathic pulmonary fibrosis (IPF), pirfenidone and nintedanib, slow down but do not halt IPF progression. As such, in the last few years several agents with specific molecular targets have been investigated to find a cure forIPF. Pamrevlumab, a recombinant human antibody that binds to connective tissue growth factor (CTGF) has emerged as a potential therapy for IPF and has advanced to phase 3 clinical trials. Areas covered: The authors offer a backdrop to the current IPF treatment market and describe the chemistry, pharmacokinetics and pharmacodynamics of pamrevlumab. They summarize the preclinical and early clinical evidence on pamrevlumab and propose ways of progressing this agent further as a potential IPF treatment. Expert opinion: Pamrevlumab was effective and safe in patients in a placebo-controlled phase 2 trial, demonstrating its potential to become an alternative therapeutic option for IPF; however, the feasibility of intravenous administration in clinical practice may be a hurdle to its use as a first-line treatment. Further studies are necessary to assess its effects when administered with pirfenidone or nintedanib and this could open up a new era of combined therapeutic approaches for IPF.
Published: 2020

27. Early diagnosis of idiopathic pulmonary fibrosis: Closer to the goal?

Author: Comes, Alessia, Sgalla, Giacomo, Richeldi, Luca, Comes A., Sgalla G. (ORCID:0000-0003-3130-9388), Richeldi L. (ORCID:0000-0001-8594-1448), Comes, Alessia, Sgalla, Giacomo, Richeldi, Luca, Comes A., Sgalla G. (ORCID:0000-0003-3130-9388), and Richeldi L. (ORCID:0000-0001-8594-1448)
Abstract: Early diagnosis of idiopathic pulmonary fibrosis (IPF) is definitely a challenge. Several studies have been investigating how to achieve this goal. IPF is the most common type of idiopathic interstitial pneumonia, the median age at diagnosis is approximately 65 years and it's more common in smokers and males [ 1 ]. To date, there are only two therapeutic options available (pirfenidone and nintedanib) that have shown to be effectively slowing disease progression in terms of forced vital capacity (FVC) [ 2 ] with a further decrease in the risk of acute exacerbations for nintedanib [ 3 ]. Regardless of the disease severity, the delay between first respiratory symptoms and referral to a tertiary care centre could be years and this ‘waiting’ leads to an increase in mortality [ 4 ]. Furthermore, the absence of accurate short-term indicators of therapeutic response leaves clinicians with uncertainty regarding management. Reduced survival time has been associated with various factors such as advanced age, severe physiological impairment, low body-mass index, radiological extent and severity of fibrosis determined by chest high-resolution computed tomography (HRCT), presence of comorbidities including pulmonary hypertension (PH), emphysema and bronchogenic cancer. Several risk prediction models have been developed in order to improve clinicians’ ability to predict prognosis in IPF and to modify the natural course of the disease, however accurate prognostication in patients with IPF is challenging due to the highly variable natural course of the disease [ 5 ]. Formulating a diagnosis of IPF at an early stage and increasing prognostic accuracy are fundamental strategies to optimize clinical management and allow timely referral for lung transplantations.
Published: 2020

28. Treatment strategies for asthma: Reshaping the concept of asthma management

Author: Papi, A., Blasi, F., Canonica, G. W., Morandi, L., Richeldi, L., Rossi, A., Richeldi L. (ORCID:0000-0001-8594-1448), Papi, A., Blasi, F., Canonica, G. W., Morandi, L., Richeldi, L., Rossi, A., and Richeldi L. (ORCID:0000-0001-8594-1448)
Abstract: Asthma is a common chronic disease characterized by episodic or persistent respiratory symptoms and airflow limitation. Asthma treatment is based on a stepwise and control-based approach that involves an iterative cycle of assessment, adjustment of the treatment and review of the response aimed to minimize symptom burden and risk of exacerbations. Anti-inflammatory treatment is the mainstay of asthma management. In this review we will discuss the rationale and barriers to the treatment of asthma that may result in poor outcomes. The benefits of currently available treatments and the possible strategies to overcome the barriers that limit the achievement of asthma control in real-life conditions and how these led to the GINA 2019 guidelines for asthma treatment and prevention will also be discussed.
Published: 2020

29. Mediastinal lymph node enlargement in idiopathic pulmonary fibrosis: Relationships with disease progression and pulmonary function trends

Author: Sgalla, Giacomo, Larici, Anna Rita, Golfi, N., Calvello, M., Farchione, Alessandra, Del Ciello, Annemilia, Varone, Francesco, Iovene, Bruno, Manfredi, Riccardo, Richeldi, Luca, Sgalla G. (ORCID:0000-0003-3130-9388), Larici A. R. (ORCID:0000-0002-1882-6244), Farchione A., Del Ciello A., Varone F., Iovene B., Manfredi R. (ORCID:0000-0002-4972-9500), Richeldi L. (ORCID:0000-0001-8594-1448), Sgalla, Giacomo, Larici, Anna Rita, Golfi, N., Calvello, M., Farchione, Alessandra, Del Ciello, Annemilia, Varone, Francesco, Iovene, Bruno, Manfredi, Riccardo, Richeldi, Luca, Sgalla G. (ORCID:0000-0003-3130-9388), Larici A. R. (ORCID:0000-0002-1882-6244), Farchione A., Del Ciello A., Varone F., Iovene B., Manfredi R. (ORCID:0000-0002-4972-9500), and Richeldi L. (ORCID:0000-0001-8594-1448)
Abstract: Background and objectives: Evidence of mediastinal Lymph Node Enlargement (LNE) on CT scan is a common finding in idiopathic pulmonary fibrosis (IPF). We sought to investigate whether the involvement of mediastinal lymph nodes is associated with accelerated disease progression, and explored the changes occurring in mediastinal lymph nodes during the radiological follow up of these patients. Methods: This retrospective study included IPF patients referred to a single ILD centre in Italy. A consensus-based assessment of mediastinal LNE on chest CT scan was performed by two thoracic radiologists. Kaplan-Meier curves and multivariate Cox proportional hazards regression were used to assess hazard ratios for mortality and disease progression (defined as categorical FVC decline ≥10%). The annualized rates of change in functional parameters for each patient were calculated using mixed linear models. Results: The study population consisted of 152 IPF patients, of whom 135 (89%) received antifibrotic treatment for IPF during the study follow up. Patients having evidence of 3 or more enlarged mediastinal lymph nodes on baseline CT scan showed increased rates of mortality (HR 5.03, 95% CI 1.86-13.62, p ≤ 0.001) and significant disease progression (HR 2.99, 95% CI 1.22-7.33, p = 0.17) as compared to patients without LNE, after adjusting for GAP stage. Among 62 patients with LNE who underwent a follow up CT scan of the chest and received antifibrotic treatment, 57 (92%) maintained evidence mediastinal LNE over time. Conclusions: Diffuse mediastinal lymph node involvement predicts clinically meaningful functional deterioration in patients with IPF.
Published: 2020

30. New era of management concept on pulmonary fibrosis with revisiting framework of interstitial lung diseases

Author: Azuma, A., Richeldi, Luca, Richeldi L. (ORCID:0000-0001-8594-1448), Azuma, A., Richeldi, Luca, and Richeldi L. (ORCID:0000-0001-8594-1448)
Abstract: The disease concept of interstitial lung disease with idiopathic pulmonary fibrosis at its core has been relied on for many years depending on morphological classification. The separation of non-specific interstitial pneumonia with a relatively good prognosis from usual interstitial pneumonia is also based on the perception that morphology enables predict the prognosis. Beginning with dust-exposed lungs, initially, interstitial pneumonia is classified by anatomical pathology. Diagnostic imaging has dramatically improved the diagnostic technology for surviving patients through the introduction of high-resolution computed tomography scan. And now, with the introduction of therapeutics, the direction of diagnosis is turning. It can be broadly classified into to make known the importance of early diagnosis, and to understand the importance of predicting the speed of progression/deterioration of pathological conditions. For this reason, the insight of “early lesions” has been discussed. There are reports that the presence or absence of interstitial lung abnormalities affects the prognosis. Searching for a biomarker is another prognostic indicator search. However, as is the case with many chronic diseases, pathological conditions that progress linearly are extremely rare. Rather, it progresses while changing in response to environmental factors. In interstitial lung disease, deterioration of respiratory functions most closely reflect prognosis. Treatment is determined by combining dynamic indicators as faithful indicators of restrictive impairments. Reconsidering the history being classified under the disease concept, the need to reorganize treatment targets based on common pathological phenotype is under discussed. What is the disease concept? That aspect changes with the discussion of improving prognosis.
Published: 2020

31. Telemedicine-enabled accelerated discharge of patients hospitalized with COVID-19 to isolation in repurposed hotel rooms

Author: Bruni, T., Lalvani, A., Richeldi, Luca, Richeldi L. (ORCID:0000-0001-8594-1448), Bruni, T., Lalvani, A., Richeldi, Luca, and Richeldi L. (ORCID:0000-0001-8594-1448)
Abstract: No abstract available
Published: 2020

32. Safety of Nintedanib in Patients with Idiopathic Pulmonary Fibrosis: Global Pharmacovigilance Data

Author: Lasky, J. A., Criner, G. J., Lazarus, H. M., Kohlbrenner, V., Bender, S., Richeldi, Luca, Richeldi L. (ORCID:0000-0001-8594-1448), Lasky, J. A., Criner, G. J., Lazarus, H. M., Kohlbrenner, V., Bender, S., Richeldi, Luca, and Richeldi L. (ORCID:0000-0001-8594-1448)
Abstract: Introduction: The safety and tolerability of nintedanib in patients with idiopathic pulmonary fibrosis (IPF) have been characterized using data from clinical trials. Methods: We further characterized the safety and tolerability of nintedanib in patients with IPF in clinical practice using the global pharmacovigilance database. The database included spontaneously reported adverse events and data collected via solicited reporting in patients treated with nintedanib from 15 October 2014 to 15 October 2018. Adverse events were coded using the Medical Dictionary for Regulatory Activities. Cumulative exposure to nintedanib was estimated on the basis of sales data. Results: Cumulative exposure to nintedanib was estimated as 60,107 patient-years. Diarrhea was the most frequent event (301.6 events per 1000 patient-years). Most (97.0%) diarrhea events were non-serious. The median (25th, 75th percentile) time to onset of the first diarrhea event was 60 (11, 182) days. Elevated liver enzyme or bilirubin levels were reported at a rate of 31.5 events per 1000 patient-years. Bleeding was reported at a rate of 36.8 events per 1000 patient-years; 81.0% of events were non-serious. Major cardiovascular adverse events were reported at a rate of 13.4 events per 1000 patient-years and myocardial infarction at a rate of 4.3 events per 1000 patient-years. Gastrointestinal perforation was reported at a rate of 1.0 event per 1000 patient-years. Conclusions: On the basis of pharmacovigilance data collected over 4 years, the safety profile of nintedanib in patients with IPF was consistent with that observed in clinical trials and described in the product label, with no new safety concerns observed. Graphical Abstract: [Figure not available: see fulltext.]
Published: 2020

33. Interstitial lung abnormalities detected incidentally on CT: a Position Paper from the Fleischner Society

Author: Hatabu, H., Hunninghake, G. M., Richeldi, Luca, Brown, K. K., Wells, A. U., Remy-Jardin, M., Verschakelen, J., Nicholson, A. G., Beasley, M. B., Christiani, D. C., San Jose Estepar, R., Seo, J. B., Johkoh, T., Sverzellati, N., Ryerson, C. J., Graham Barr, R., Goo, J. M., Austin, J. H. M., Powell, C. A., Lee, K. S., Inoue, Y., Lynch, D. A., Richeldi L. (ORCID:0000-0001-8594-1448), Hatabu, H., Hunninghake, G. M., Richeldi, Luca, Brown, K. K., Wells, A. U., Remy-Jardin, M., Verschakelen, J., Nicholson, A. G., Beasley, M. B., Christiani, D. C., San Jose Estepar, R., Seo, J. B., Johkoh, T., Sverzellati, N., Ryerson, C. J., Graham Barr, R., Goo, J. M., Austin, J. H. M., Powell, C. A., Lee, K. S., Inoue, Y., Lynch, D. A., and Richeldi L. (ORCID:0000-0001-8594-1448)
Abstract: The term interstitial lung abnormalities refers to specific CT findings that are potentially compatible with interstitial lung disease in patients without clinical suspicion of the disease. Interstitial lung abnormalities are increasingly recognised as a common feature on CT of the lung in older individuals, occurring in 4–9% of smokers and 2–7% of non-smokers. Identification of interstitial lung abnormalities will increase with implementation of lung cancer screening, along with increased use of CT for other diagnostic purposes. These abnormalities are associated with radiological progression, increased mortality, and the risk of complications from medical interventions, such as chemotherapy and surgery. Management requires distinguishing interstitial lung abnormalities that represent clinically significant interstitial lung disease from those that are subclinical. In particular, it is important to identify the subpleural fibrotic subtype, which is more likely to progress and to be associated with mortality. This multidisciplinary Position Paper by the Fleischner Society addresses important issues regarding interstitial lung abnormalities, including standardisation of the definition and terminology; predisposing risk factors; clinical outcomes; options for initial evaluation, monitoring, and management; the role of quantitative evaluation; and future research needs.
Published: 2020

34. Paracrine SPARC signaling dysregulates alveolar epithelial barrier integrity and function in lung fibrosis

Author: Conforti, F., Ridley, R., Brereton, C., Alzetani, A., Johnson, B., Marshall, B. G., Fletcher, S. V., Ottensmeier, C. H., Richeldi, Luca, Skipp, P., Wang, Y., Jones, M. G., Davies, D. E., Richeldi L. (ORCID:0000-0001-8594-1448), Conforti, F., Ridley, R., Brereton, C., Alzetani, A., Johnson, B., Marshall, B. G., Fletcher, S. V., Ottensmeier, C. H., Richeldi, Luca, Skipp, P., Wang, Y., Jones, M. G., Davies, D. E., and Richeldi L. (ORCID:0000-0001-8594-1448)
Abstract: Idiopathic pulmonary fibrosis (IPF) is a chronic scarring disease in which aging, environmental exposure(s) and genetic susceptibility have been implicated in disease pathogenesis, however, the causes and mechanisms of the progressive fibrotic cascade are still poorly understood. As epithelial–mesenchymal interactions are essential for normal wound healing, through human 2D and 3D in vitro studies, we tested the hypothesis that IPF fibroblasts (IPFFs) dysregulate alveolar epithelial homeostasis. Conditioned media from IPFFs exaggerated the wound-healing response of primary human Type II alveolar epithelial cells (AECs). Furthermore, AECs co-cultured with IPFFs exhibited irregular epithelialization compared with those co-cultured with control fibroblasts (NHLFs) or AECs alone, suggesting that epithelial homeostasis is dysregulated in IPF as a consequence of the abnormal secretory phenotype of IPFFs. Secretome analysis of IPFF conditioned media and functional studies identified the matricellular protein, SPARC, as a key mediator in the epithelial–mesenchymal paracrine signaling, with increased secretion of SPARC by IPFFs promoting persistent activation of alveolar epithelium via an integrin/focal adhesion/cellular-junction axis resulting in disruption of epithelial barrier integrity and increased macromolecular permeability. These findings suggest that in IPF fibroblast paracrine signaling promotes persistent alveolar epithelial activation, so preventing normal epithelial repair responses and restoration of tissue homeostasis. Furthermore, they identify SPARC-mediated paracrine signaling as a potential therapeutic target to promote the restoration of lung epithelial homoestasis in IPF patients.
Published: 2020

35. Fibrotic Hypersensitivity Pneumonitis: Diagnosis and Management

Author: Varone, Francesco, Iovene, Bruno, Sgalla, Giacomo, Calvello, M., Calabrese, Anna Chiara, Larici, Anna Rita, Richeldi, Luca, Varone F., Iovene B., Sgalla G. (ORCID:0000-0003-3130-9388), Calabrese A., Larici A. R. (ORCID:0000-0002-1882-6244), Richeldi L. (ORCID:0000-0001-8594-1448), Varone, Francesco, Iovene, Bruno, Sgalla, Giacomo, Calvello, M., Calabrese, Anna Chiara, Larici, Anna Rita, Richeldi, Luca, Varone F., Iovene B., Sgalla G. (ORCID:0000-0003-3130-9388), Calabrese A., Larici A. R. (ORCID:0000-0002-1882-6244), and Richeldi L. (ORCID:0000-0001-8594-1448)
Abstract: Fibrotic hypersensitivity pneumonitis is a complex interstitial lung disease that is not entirely understood. In its chronic and fibrotic form, hypersensitivity pneumonitis is one of the main mimickers of idiopathic pulmonary fibrosis (IPF). Distinguishing between these two conditions is challenging but is of particular clinical relevance. Two approved therapies are available for IPF, and a considerable number of clinical trials are now exploring newer pharmacological options. This impressive research effort is a consequence of new pathogenetic understanding, updated diagnostic criteria and a long history of pharmacological trials. Conversely, current knowledge gaps on pathogenesis of chronic hypersensitivity pneumonitis, coupled with lack of validated diagnostic criteria, make the management of this disease an unsolved clinical challenge. This also reflects the paucity of therapeutic clinical trials in this field. In this review, we describe the current evidence and the possible future options to approach this complex disease.
Published: 2020

36. Progressive fibrosing interstitial lung disease: clinical uncertainties, consensus recommendations, and research priorities

Author: George, P. M., Spagnolo, P., Kreuter, M., Altinisik, G., Bonifazi, M., Martinez, F. J., Molyneaux, P. L., Renzoni, E. A., Richeldi, Luca, Tomassetti, S., Valenzuela, C., Vancheri, C., Varone, Francesco, Cottin, V., Costabel, U., Richeldi L. (ORCID:0000-0001-8594-1448), Varone F., George, P. M., Spagnolo, P., Kreuter, M., Altinisik, G., Bonifazi, M., Martinez, F. J., Molyneaux, P. L., Renzoni, E. A., Richeldi, Luca, Tomassetti, S., Valenzuela, C., Vancheri, C., Varone, Francesco, Cottin, V., Costabel, U., Richeldi L. (ORCID:0000-0001-8594-1448), and Varone F.
Abstract: Within the spectrum of fibrosing interstitial lung diseases (ILDs) is a subset of patients who have inexorable progression of pulmonary fibrosis despite treatment, which is known as the progressive fibrotic phenotype. Although the concept of progressive fibrosing ILD has been applied largely to patients with idiopathic pulmonary fibrosis (IPF), there is now an increasing focus on irreversible progressive fibrosis in a proportion of patients with a range of underlying ILD diagnoses. Evidence has emerged to support a possible role for antifibrotic therapy in these patients. In this Position Paper, we discuss the importance of retaining diagnostic scrutiny within the multidisciplinary team and suggest a multidomain definition for progressive fibrosis. We consider the potential role of antifibrotic drugs as second-line therapy in the treatment algorithm for patients with progressive non-IPF ILD. We highlight risk factors that might predispose individuals to developing progressive fibrosis. Finally, we discuss key uncertainties and future directions for research and clinical practice.
Published: 2020

37. Balancing evidence and frontline experience in the early phases of the COVID-19 pandemic: current position of the Italian Society of Anti-infective Therapy (SITA) and the Italian Society of Pulmonology (SIP)

Author: Bassetti, M., Giacobbe, D. R., Aliberti, S., Barisione, E., Centanni, S., De Rosa, F. G., Di Marco, F., Gori, A., Granata, Giuseppe, Mikulska, M., Petrosillo, Nicola, Richeldi, Luca, Santus, P., Tascini, Carlo, Vena, A., Viale, P., Blasi, F., Granata G., Petrosillo N., Richeldi L. (ORCID:0000-0001-8594-1448), Tascini C., Bassetti, M., Giacobbe, D. R., Aliberti, S., Barisione, E., Centanni, S., De Rosa, F. G., Di Marco, F., Gori, A., Granata, Giuseppe, Mikulska, M., Petrosillo, Nicola, Richeldi, Luca, Santus, P., Tascini, Carlo, Vena, A., Viale, P., Blasi, F., Granata G., Petrosillo N., Richeldi L. (ORCID:0000-0001-8594-1448), and Tascini C.
Abstract: Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the causative agent of coronavirus disease 2019 (COVID-19), which has rapidly become epidemic in Italy and other European countries. The disease spectrum ranges from asymptomatic/mildly symptomatic presentations to acute respiratory failure. At the present time the absolute number of severe cases requiring ventilator support is reaching or even surpassing the intensive care unit bed capacity in the most affected regions and countries. Objectives: To narratively summarize the available literature on the management of COVID-19 in order to combine current evidence and frontline opinions and to provide balanced answers to pressing clinical questions. Sources: Inductive PubMed search for publications relevant to the topic. Content: The available literature and the authors' frontline-based opinion are summarized in brief narrative answers to selected clinical questions, with a conclusive statement provided for each answer. Implications: Many off-label antiviral and anti-inflammatory drugs are currently being administered to patients with COVID-19. Physicians must be aware that, as they are not supported by high-level evidence, these treatments may often be ethically justifiable only in those worsening patients unlikely to improve only with supportive care, and who cannot be enrolled onto randomized clinical trials. Access to well-designed randomized controlled trials should be expanded as much as possible because it is the most secure way to change for the better our approach to COVID-19 patients.
Published: 2020

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

Author: Landi, Francesco, Gremese, Elisa, Bernabei, Roberto, Fantoni, Massimo, Gasbarrini, Antonio, Settanni, Carlo Romano, Benvenuto, Francesca, Bramato, Giulia, Carfi, A., Ciciarello, Francesca, Lomonaco, M. R., Martone, Anna Maria, Marzetti, Emanuele, Napolitano, C., Pagano, Francesco Cosimo, Rocchi, Sara, Rota, Elisabetta, Salerno, A., Tosato, Matteo, Tritto, Marcello, Calvani, Riccardo, Catalano, Lucio, Picca, A., Savera, Giulia, Tamburrini, Enrica, Borghetti, Alberto, Di Gianbenedetto, S., Murri, Rita, Cingolani, Antonella, Ventura, Giulio, Taddei, Eleonora, Moschese, D., Ciccullo, A., Stella, L., Addolorato, Giovanni, Franceschi, Francesco, Mingrone, Geltrude, Zocco, Maria Assunta, Sanguinetti, Maurizio, Cattani Franchi, Paola, Marchetti, Simona, Bizzarro, Alessandra, Lauria, Alessandra, Rizzo, Stanislao, Savastano, Maria Cristina, Gambini, Gloria, Cozzupoli, G. M., Culiersi, Carola, Passali, Giulio Cesare, Paludetti, Gaetano, Galli, Jacopo, Crudo, Fabrizio, Di Cintio, G., Longobardi, Ylenia, Tricarico, Laura, Santantonio, Mariaconsiglia, Buonsenso, Danilo, Valentini, Piero, Pata, Davide, Sinatti, Dario, De Rose, Cristina, Richeldi, Luca, Lombardi, F., Calabrese, Anna Chiara, Sani, Gabriele, Janiri, D., Giuseppin, Giulia, Molinaro, Marzia, Modica, Marco, Natale, Luigi, Larici, Anna Rita, Marano, Riccardo, Paglionico, A., Petricca, L., Gigante, Laura, Natalello, Gerlando, Fedele, A. L., Lizzio, Marco Maria, Santoliquido, Angelo, Santoro, Luca, Nesci, Domenico Arturo, Popolla, Valentina, Landi F. (ORCID:0000-0002-3472-1389), Gremese E. (ORCID:0000-0002-2248-1058), Bernabei R. (ORCID:0000-0002-9197-004X), Fantoni M. (ORCID:0000-0001-6913-8460), Gasbarrini A. (ORCID:0000-0002-7278-4823), Settanni C. R., Benvenuto F., Bramato G., Ciciarello F., Martone A. M., Marzetti E. (ORCID:0000-0001-9567-6983), Pagano F., Rocchi S., Rota E., Tosato M., Tritto M., Calvani R. (ORCID:0000-0001-5472-2365), Catalano L., Savera G., Tamburrini E. (ORCID:0000-0003-4930-426X), Borghetti A., Murri R. (ORCID:0000-0003-4263-7854), Cingolani A. (ORCID:0000-0002-3793-2755), Ventura G. (ORCID:0000-0002-0304-7264), Taddei E., Addolorato G. (ORCID:0000-0002-1522-9946), Franceschi F. (ORCID:0000-0001-6266-445X), Mingrone G. (ORCID:0000-0003-2021-528X), Zocco M. A. (ORCID:0000-0002-0814-9542), Sanguinetti M. (ORCID:0000-0002-9780-7059), Cattani P. (ORCID:0000-0003-4678-4763), Marchetti S., Bizzarro A., Lauria A., Rizzo S. (ORCID:0000-0001-6302-063X), Savastano M. C. (ORCID:0000-0003-1397-4333), Gambini G., Culiersi C., Passali G. C. (ORCID:0000-0002-8176-0962), Paludetti G. (ORCID:0000-0003-2480-1243), Galli J. (ORCID:0000-0001-6353-6249), Crudo F., Longobardi Y., Tricarico L., Santantonio M., Buonsenso D., Valentini P. (ORCID:0000-0001-6095-9510), Pata D., Sinatti D., De Rose C., Richeldi L. (ORCID:0000-0001-8594-1448), Calabrese A., Sani G. (ORCID:0000-0002-9767-8752), Giuseppin G., Molinaro M., Modica M., Natale L. (ORCID:0000-0002-7949-5119), Larici A. R. (ORCID:0000-0002-1882-6244), Marano R. (ORCID:0000-0003-2710-2093), Gigante L., Natalello G., Lizzio M. M., Santoliquido A. (ORCID:0000-0003-1539-4017), Santoro L., Nesci A. (ORCID:0000-0001-9466-1755), Popolla V., Landi, Francesco, Gremese, Elisa, Bernabei, Roberto, Fantoni, Massimo, Gasbarrini, Antonio, Settanni, Carlo Romano, Benvenuto, Francesca, Bramato, Giulia, Carfi, A., Ciciarello, Francesca, Lomonaco, M. R., Martone, Anna Maria, Marzetti, Emanuele, Napolitano, C., Pagano, Francesco Cosimo, Rocchi, Sara, Rota, Elisabetta, Salerno, A., Tosato, Matteo, Tritto, Marcello, Calvani, Riccardo, Catalano, Lucio, Picca, A., Savera, Giulia, Tamburrini, Enrica, Borghetti, Alberto, Di Gianbenedetto, S., Murri, Rita, Cingolani, Antonella, Ventura, Giulio, Taddei, Eleonora, Moschese, D., Ciccullo, A., Stella, L., Addolorato, Giovanni, Franceschi, Francesco, Mingrone, Geltrude, Zocco, Maria Assunta, Sanguinetti, Maurizio, Cattani Franchi, Paola, Marchetti, Simona, Bizzarro, Alessandra, Lauria, Alessandra, Rizzo, Stanislao, Savastano, Maria Cristina, Gambini, Gloria, Cozzupoli, G. M., Culiersi, Carola, Passali, Giulio Cesare, Paludetti, Gaetano, Galli, Jacopo, Crudo, Fabrizio, Di Cintio, G., Longobardi, Ylenia, Tricarico, Laura, Santantonio, Mariaconsiglia, Buonsenso, Danilo, Valentini, Piero, Pata, Davide, Sinatti, Dario, De Rose, Cristina, Richeldi, Luca, Lombardi, F., Calabrese, Anna Chiara, Sani, Gabriele, Janiri, D., Giuseppin, Giulia, Molinaro, Marzia, Modica, Marco, Natale, Luigi, Larici, Anna Rita, Marano, Riccardo, Paglionico, A., Petricca, L., Gigante, Laura, Natalello, Gerlando, Fedele, A. L., Lizzio, Marco Maria, Santoliquido, Angelo, Santoro, Luca, Nesci, Domenico Arturo, Popolla, Valentina, Landi F. (ORCID:0000-0002-3472-1389), Gremese E. (ORCID:0000-0002-2248-1058), Bernabei R. (ORCID:0000-0002-9197-004X), Fantoni M. (ORCID:0000-0001-6913-8460), Gasbarrini A. (ORCID:0000-0002-7278-4823), Settanni C. R., Benvenuto F., Bramato G., Ciciarello F., Martone A. M., Marzetti E. (ORCID:0000-0001-9567-6983), Pagano F., Rocchi S., Rota E., Tosato M., Tritto M., Calvani R. (ORCID:0000-0001-5472-2365), Catalano L., Savera G., Tamburrini E. (ORCID:0000-0003-4930-426X), Borghetti A., Murri R. (ORCID:0000-0003-4263-7854), Cingolani A. (ORCID:0000-0002-3793-2755), Ventura G. (ORCID:0000-0002-0304-7264), Taddei E., Addolorato G. (ORCID:0000-0002-1522-9946), Franceschi F. (ORCID:0000-0001-6266-445X), Mingrone G. (ORCID:0000-0003-2021-528X), Zocco M. A. (ORCID:0000-0002-0814-9542), Sanguinetti M. (ORCID:0000-0002-9780-7059), Cattani P. (ORCID:0000-0003-4678-4763), Marchetti S., Bizzarro A., Lauria A., Rizzo S. (ORCID:0000-0001-6302-063X), Savastano M. C. (ORCID:0000-0003-1397-4333), Gambini G., Culiersi C., Passali G. C. (ORCID:0000-0002-8176-0962), Paludetti G. (ORCID:0000-0003-2480-1243), Galli J. (ORCID:0000-0001-6353-6249), Crudo F., Longobardi Y., Tricarico L., Santantonio M., Buonsenso D., Valentini P. (ORCID:0000-0001-6095-9510), Pata D., Sinatti D., De Rose C., Richeldi L. (ORCID:0000-0001-8594-1448), Calabrese A., Sani G. (ORCID:0000-0002-9767-8752), Giuseppin G., Molinaro M., Modica M., Natale L. (ORCID:0000-0002-7949-5119), Larici A. R. (ORCID:0000-0002-1882-6244), Marano R. (ORCID:0000-0003-2710-2093), Gigante L., Natalello G., Lizzio M. M., Santoliquido A. (ORCID:0000-0003-1539-4017), Santoro L., Nesci A. (ORCID:0000-0001-9466-1755), and Popolla V.
Abstract: For survivors of severe COVID-19 disease, having defeated the virus is just the beginning of an uncharted recovery path. What follows after the acute phase of SARS-CoV-2 infection depends on the extension and severity of viral attacks in different cell types and organs. Despite the ridiculously large number of papers that have flooded scientific journals and preprint-hosting websites, a clear clinical picture of COVID-19 aftermath is vague at best. Without larger prospective observational studies that are only now being started, clinicians can retrieve information just from case reports and or small studies. This is the time to understand how COVID-19 goes forward and what consequences survivors may expect to experience. To this aim, a multidisciplinary post-acute care service involving several specialists has been established at the Fondazione Policlinico Universitario A. Gemelli IRCSS (Rome, Italy). Although COVID-19 is an infectious disease primarily affecting the lung, its multi-organ involvement requires an interdisciplinary approach encompassing virtually all branches of internal medicine and geriatrics. In particular, during the post-acute phase, the geriatrician may serve as the case manager of a multidisciplinary team. The aim of this article is to describe the importance of the interdisciplinary approach––coordinated by geriatrician––to cope the potential post-acute care needs of recovered COVID-19 patients.
Published: 2020

39. Progressive Fibrosing Interstitial Lung Disease A Proposed Integrated Algorithm for Management

Author: Varone, Francesco, Sgalla, Giacomo, Iovene, Bruno, Richeldi, Luca, Varone F., Sgalla G. (ORCID:0000-0003-3130-9388), Iovene B., Richeldi L. (ORCID:0000-0001-8594-1448), Varone, Francesco, Sgalla, Giacomo, Iovene, Bruno, Richeldi, Luca, Varone F., Sgalla G. (ORCID:0000-0003-3130-9388), Iovene B., and Richeldi L. (ORCID:0000-0001-8594-1448)
Abstract: No abstract available
Published: 2020

40. Progressive fibrosing interstitial lung disease: clinical uncertainties, consensus recommendations, and research priorities

Author: George, P. M., Spagnolo, P., Kreuter, M., Altinisik, G., Bonifazi, M., Martinez, F. J., Molyneaux, P. L., Renzoni, E. A., Richeldi, L., Tomassetti, S., Valenzuela, C., Vancheri, C., Varone, F., Cottin, V., Costabel, U., Richeldi L. (ORCID:0000-0001-8594-1448), Varone F., George, P. M., Spagnolo, P., Kreuter, M., Altinisik, G., Bonifazi, M., Martinez, F. J., Molyneaux, P. L., Renzoni, E. A., Richeldi, L., Tomassetti, S., Valenzuela, C., Vancheri, C., Varone, F., Cottin, V., Costabel, U., Richeldi L. (ORCID:0000-0001-8594-1448), and Varone F.
Abstract: Within the spectrum of fibrosing interstitial lung diseases (ILDs) is a subset of patients who have inexorable progression of pulmonary fibrosis despite treatment, which is known as the progressive fibrotic phenotype. Although the concept of progressive fibrosing ILD has been applied largely to patients with idiopathic pulmonary fibrosis (IPF), there is now an increasing focus on irreversible progressive fibrosis in a proportion of patients with a range of underlying ILD diagnoses. Evidence has emerged to support a possible role for antifibrotic therapy in these patients. In this Position Paper, we discuss the importance of retaining diagnostic scrutiny within the multidisciplinary team and suggest a multidomain definition for progressive fibrosis. We consider the potential role of antifibrotic drugs as second-line therapy in the treatment algorithm for patients with progressive non-IPF ILD. We highlight risk factors that might predispose individuals to developing progressive fibrosis. Finally, we discuss key uncertainties and future directions for research and clinical practice.
Published: 2020

41. Subclinical liver fibrosis in patients with idiopathic pulmonary fibrosis

Author: Cocconcelli, E., Tonelli, R., Abbati, G., Marchioni, A., Castaniere, I., Pelizzaro, F., Russo, F. P., Vegetti, A., Balestro, E., Pietrangelo, A., Richeldi, Luca, Luppi, F., Spagnolo, P., Clini, E., Cerri, S., Richeldi L. (ORCID:0000-0001-8594-1448), Cocconcelli, E., Tonelli, R., Abbati, G., Marchioni, A., Castaniere, I., Pelizzaro, F., Russo, F. P., Vegetti, A., Balestro, E., Pietrangelo, A., Richeldi, Luca, Luppi, F., Spagnolo, P., Clini, E., Cerri, S., and Richeldi L. (ORCID:0000-0001-8594-1448)
Abstract: Data on the presence of subclinical fibrosis across multiple organs in patients with idiopathic lung fibrosis (IPF) are lacking. Our study aimed at investigating through hepatic transient elastography (HTE) the prevalence and clinical impact of subclinical liver fibrosis in a cohort of patients with IPF. Patients referred to the Centre for Rare Lung Disease of the University Hospital of Modena (Italy) from March 2012 to February 2013 with established diagnosis of IPF and without a documented history of liver diseases were consecutively enrolled and underwent HTE. Based on hepatic stiffness status as assessed through METAVIR score patients were categorized as “with liver fibrosis” (corresponding to a METAVIR score of F1–F4) and “without liver fibrosis” (METAVIR F0). Potential predictors of liver fibrosis were investigated through logistic regression model among clinical and serological variables. The overall survival (OS) was assessed according to liver fibrosis and multivariate Cox regression analysis was used to identify independent predictors. In 13 out of 37 patients (35%) with IPF, a certain degree of liver fibrosis was documented. No correlation was found between liver stiffness and clinical–functional parameters. OS was lower in patients ‘with liver fibrosis’ than in patients ‘without liver fibrosis’ (median months 33 [23–55] vs. 63 [26–94], p = 0.038). Patients ‘with liver fibrosis’ presented a higher risk of death at seven years as compared to patients ‘without liver fibrosis’ (HR = 2.6, 95% CI [1.003–6.7], p = 0.049). Higher level of AST to platelet ratio index (APRI) was an independent predictor of survival (HR = 4.52 95% CI [1.3–15.6], p = 0.02). In our cohort, more than one-third of IPF patients had concomitant subclinical liver fibrosis that negatively affected OS. These preliminary claims further investigation aimed at clarifying the mechanisms beyond multiorgan fibrosis and its clinical implication in patients with IPF.
Published: 2020

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

Author: Landi, F., Gremese, E., Bernabei, R., Fantoni, M., Gasbarrini, A., Settanni, C. R., Benvenuto, F., Bramato, G., Carfi, A., Ciciarello, F., LoMonaco, M. R., Martone, A. M., Marzetti, E., Napolitano, C., Pagano, F., Rocchi, S., Rota, E., Salerno, A., Tosato, M., Tritto, M., Calvani, R., Catalano, L., Picca, A., Savera, G., Tamburrini, E., Borghetti, A., Di Gianbenedetto, S., Murri, R., Cingolani, A., Ventura, G., Taddei, E., Moschese, D., Ciccullo, A., Stella, L., Addolorato, G., Franceschi, F., Mingrone, G., Zocco, M. A., Sanguinetti, M., Cattani, P., Marchetti, S., Bizzarro, A., Lauria, A., Rizzo, S., Savastano, M. C., Gambini, G., Cozzupoli, G. M., Culiersi, C., Passali, G. C., Paludetti, G., Galli, J., Crudo, F., Di Cintio, G., Longobardi, Y., Tricarico, L., Santantonio, M., Buonsenso, D., Valentini, P., Pata, D., Sinatti, D., De Rose, C., Richeldi, L., Lombardi, F., Calabrese, A., Sani, G., Janiri, D., Giuseppin, G., Molinaro, M., Modica, M., Natale, L., Larici, A. R., Marano, R., Paglionico, A., Petricca, L., Gigante, L., Natalello, G., Fedele, A. L., Lizzio, M. M., Santoliquido, A., Santoro, L., Nesci, A., Popolla, V., Landi F. (ORCID:0000-0002-3472-1389), Gremese E. (ORCID:0000-0002-2248-1058), Bernabei R. (ORCID:0000-0002-9197-004X), Fantoni M. (ORCID:0000-0001-6913-8460), Gasbarrini A. (ORCID:0000-0002-7278-4823), Settanni C. R., Benvenuto F., Bramato G., Ciciarello F., Martone A. M., Marzetti E. (ORCID:0000-0001-9567-6983), Pagano F., Rocchi S., Rota E., Salerno A., Tosato M., Tritto M., Calvani R. (ORCID:0000-0001-5472-2365), Savera G., Tamburrini E. (ORCID:0000-0003-4930-426X), Borghetti A., Murri R. (ORCID:0000-0003-4263-7854), Cingolani A. (ORCID:0000-0002-3793-2755), Ventura G. (ORCID:0000-0002-0304-7264), Taddei E., Stella L., Addolorato G. (ORCID:0000-0002-1522-9946), Franceschi F. (ORCID:0000-0001-6266-445X), Mingrone G. (ORCID:0000-0003-2021-528X), Zocco M. A. (ORCID:0000-0002-0814-9542), Sanguinetti M. (ORCID:0000-0002-9780-7059), Cattani P. (ORCID:0000-0003-4678-4763), Marchetti S., Bizzarro A., Lauria A., Rizzo S. (ORCID:0000-0001-6302-063X), Savastano M. C. (ORCID:0000-0003-1397-4333), Culiersi C., Passali G. C. (ORCID:0000-0002-8176-0962), Paludetti G. (ORCID:0000-0003-2480-1243), Galli J. (ORCID:0000-0001-6353-6249), Crudo F., Longobardi Y., Tricarico L., Santantonio M., Buonsenso D., Valentini P. (ORCID:0000-0001-6095-9510), Pata D., Sinatti D., De Rose C., Richeldi L. (ORCID:0000-0001-8594-1448), Lombardi F., Calabrese A., Sani G. (ORCID:0000-0002-9767-8752), Giuseppin G., Molinaro M., Modica M., Natale L. (ORCID:0000-0002-7949-5119), Larici A. R. (ORCID:0000-0002-1882-6244), Marano R. (ORCID:0000-0003-2710-2093), Gigante L., Natalello G., Lizzio M. M., Santoliquido A. (ORCID:0000-0003-1539-4017), Santoro L., Nesci A. (ORCID:0000-0001-9466-1755), Popolla V., Landi, F., Gremese, E., Bernabei, R., Fantoni, M., Gasbarrini, A., Settanni, C. R., Benvenuto, F., Bramato, G., Carfi, A., Ciciarello, F., LoMonaco, M. R., Martone, A. M., Marzetti, E., Napolitano, C., Pagano, F., Rocchi, S., Rota, E., Salerno, A., Tosato, M., Tritto, M., Calvani, R., Catalano, L., Picca, A., Savera, G., Tamburrini, E., Borghetti, A., Di Gianbenedetto, S., Murri, R., Cingolani, A., Ventura, G., Taddei, E., Moschese, D., Ciccullo, A., Stella, L., Addolorato, G., Franceschi, F., Mingrone, G., Zocco, M. A., Sanguinetti, M., Cattani, P., Marchetti, S., Bizzarro, A., Lauria, A., Rizzo, S., Savastano, M. C., Gambini, G., Cozzupoli, G. M., Culiersi, C., Passali, G. C., Paludetti, G., Galli, J., Crudo, F., Di Cintio, G., Longobardi, Y., Tricarico, L., Santantonio, M., Buonsenso, D., Valentini, P., Pata, D., Sinatti, D., De Rose, C., Richeldi, L., Lombardi, F., Calabrese, A., Sani, G., Janiri, D., Giuseppin, G., Molinaro, M., Modica, M., Natale, L., Larici, A. R., Marano, R., Paglionico, A., Petricca, L., Gigante, L., Natalello, G., Fedele, A. L., Lizzio, M. M., Santoliquido, A., Santoro, L., Nesci, A., Popolla, V., Landi F. (ORCID:0000-0002-3472-1389), Gremese E. (ORCID:0000-0002-2248-1058), Bernabei R. (ORCID:0000-0002-9197-004X), Fantoni M. (ORCID:0000-0001-6913-8460), Gasbarrini A. (ORCID:0000-0002-7278-4823), Settanni C. R., Benvenuto F., Bramato G., Ciciarello F., Martone A. M., Marzetti E. (ORCID:0000-0001-9567-6983), Pagano F., Rocchi S., Rota E., Salerno A., Tosato M., Tritto M., Calvani R. (ORCID:0000-0001-5472-2365), Savera G., Tamburrini E. (ORCID:0000-0003-4930-426X), Borghetti A., Murri R. (ORCID:0000-0003-4263-7854), Cingolani A. (ORCID:0000-0002-3793-2755), Ventura G. (ORCID:0000-0002-0304-7264), Taddei E., Stella L., Addolorato G. (ORCID:0000-0002-1522-9946), Franceschi F. (ORCID:0000-0001-6266-445X), Mingrone G. (ORCID:0000-0003-2021-528X), Zocco M. A. (ORCID:0000-0002-0814-9542), Sanguinetti M. (ORCID:0000-0002-9780-7059), Cattani P. (ORCID:0000-0003-4678-4763), Marchetti S., Bizzarro A., Lauria A., Rizzo S. (ORCID:0000-0001-6302-063X), Savastano M. C. (ORCID:0000-0003-1397-4333), Culiersi C., Passali G. C. (ORCID:0000-0002-8176-0962), Paludetti G. (ORCID:0000-0003-2480-1243), Galli J. (ORCID:0000-0001-6353-6249), Crudo F., Longobardi Y., Tricarico L., Santantonio M., Buonsenso D., Valentini P. (ORCID:0000-0001-6095-9510), Pata D., Sinatti D., De Rose C., Richeldi L. (ORCID:0000-0001-8594-1448), Lombardi F., Calabrese A., Sani G. (ORCID:0000-0002-9767-8752), Giuseppin G., Molinaro M., Modica M., Natale L. (ORCID:0000-0002-7949-5119), Larici A. R. (ORCID:0000-0002-1882-6244), Marano R. (ORCID:0000-0003-2710-2093), Gigante L., Natalello G., Lizzio M. M., Santoliquido A. (ORCID:0000-0003-1539-4017), Santoro L., Nesci A. (ORCID:0000-0001-9466-1755), and Popolla V.
Abstract: For survivors of severe COVID-19 disease, having defeated the virus is just the beginning of an uncharted recovery path. What follows after the acute phase of SARS-CoV-2 infection depends on the extension and severity of viral attacks in different cell types and organs. Despite the ridiculously large number of papers that have flooded scientific journals and preprint-hosting websites, a clear clinical picture of COVID-19 aftermath is vague at best. Without larger prospective observational studies that are only now being started, clinicians can retrieve information just from case reports and or small studies. This is the time to understand how COVID-19 goes forward and what consequences survivors may expect to experience. To this aim, a multidisciplinary post-acute care service involving several specialists has been established at the Fondazione Policlinico Universitario A. Gemelli IRCSS (Rome, Italy). Although COVID-19 is an infectious disease primarily affecting the lung, its multi-organ involvement requires an interdisciplinary approach encompassing virtually all branches of internal medicine and geriatrics. In particular, during the post-acute phase, the geriatrician may serve as the case manager of a multidisciplinary team. The aim of this article is to describe the importance of the interdisciplinary approach––coordinated by geriatrician––to cope the potential post-acute care needs of recovered COVID-19 patients.
Published: 2020

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

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

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

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

45. Oral CorticoSteroid sparing with biologics in severe asthma: A remark of the Severe Asthma Network in Italy (SANI)

Author: Canonica, G. W., Blasi, F., Paggiaro, P., Senna, G., Passalacqua, G., Spanevello, A., Aliberti, S., Bagnasco, D., Bonavia, M., Bonini, Matteo, Brussino, L., Bucca, C., Caiaffa, M. F., Calabrese, Anna Chiara, Camiciottoli, G., Caminati, M., Carpagnano, G. E., Caruso, Corrado Maria Roberto, Centanni, S., Conte, M. E., Corsico, A. G., Cosmi, L., Costantino, M. T., Crimi, N., D'Alo, S., D'Amato, M., Del Giacco, S., Farsi, A., Favero, E., Foschino Barbaro, M. P., Guarnieri, G., Guida, Maria Grazia, Latorre, M., Lo Cicero, Stefano, Lombardi, Celestino Pio, Macchia, L., Mazza, F., Menzella, F., Milanese, M., Montagni, M., Montuschi, Paolo, Nucera, Eleonora, Parente, R., Patella, V., Pelaia, G., Pini, L., Puggioni, F., Ricciardi, L., Ricciardolo, F. L. M., Richeldi, Luca, Ridolo, E., Rolla, G., Santus, P., Scichilone, N., Spadaro, G., Vianello, A., Viviano, V., Yacoub, M. R., Zappa, M. C., Heffler, E., Bonini M. (ORCID:0000-0002-3042-0765), Calabrese C., Caruso C., Guida G., Lo Cicero S., Lombardi C. (ORCID:0000-0001-8910-6693), Montuschi P. (ORCID:0000-0001-5589-1750), Nucera E. (ORCID:0000-0002-0565-7680), Richeldi L. (ORCID:0000-0001-8594-1448), Canonica, G. W., Blasi, F., Paggiaro, P., Senna, G., Passalacqua, G., Spanevello, A., Aliberti, S., Bagnasco, D., Bonavia, M., Bonini, Matteo, Brussino, L., Bucca, C., Caiaffa, M. F., Calabrese, Anna Chiara, Camiciottoli, G., Caminati, M., Carpagnano, G. E., Caruso, Corrado Maria Roberto, Centanni, S., Conte, M. E., Corsico, A. G., Cosmi, L., Costantino, M. T., Crimi, N., D'Alo, S., D'Amato, M., Del Giacco, S., Farsi, A., Favero, E., Foschino Barbaro, M. P., Guarnieri, G., Guida, Maria Grazia, Latorre, M., Lo Cicero, Stefano, Lombardi, Celestino Pio, Macchia, L., Mazza, F., Menzella, F., Milanese, M., Montagni, M., Montuschi, Paolo, Nucera, Eleonora, Parente, R., Patella, V., Pelaia, G., Pini, L., Puggioni, F., Ricciardi, L., Ricciardolo, F. L. M., Richeldi, Luca, Ridolo, E., Rolla, G., Santus, P., Scichilone, N., Spadaro, G., Vianello, A., Viviano, V., Yacoub, M. R., Zappa, M. C., Heffler, E., Bonini M. (ORCID:0000-0002-3042-0765), Calabrese C., Caruso C., Guida G., Lo Cicero S., Lombardi C. (ORCID:0000-0001-8910-6693), Montuschi P. (ORCID:0000-0001-5589-1750), Nucera E. (ORCID:0000-0002-0565-7680), and Richeldi L. (ORCID:0000-0001-8594-1448)
Abstract: According to the data derived from several national and international registries, including SANI (Severe Asthma Network Italy), and considering the strong impact that frequent or regular use of oral corticosteroid has on quality of life (QoL) of severe asthmatics, as well as on the costs for managing corticosteroid-related diseases, oral corticosteroid sparing up to withdrawal should be considered a primary outcome in the management of severe asthma. New biologics have clearly demonstrated that this effect is possible, with concomitant reduction in the rate of exacerbations and in symptom control. Then, there is no reason for using so frequently oral corticosteroid before having explored all alternatives currently available for a large part of severe asthmatics.
Published: 2020

46. Assessment of neurological manifestations in hospitalized patients with COVID-19

Author: Luigetti, Marco, Iorio, Raffaele, Bentivoglio, Anna Rita, Tricoli, Luca, Riso, Vittorio, Marotta, Jessica, Piano, Carla, Primiano, Guido Alessandro, Zileri Del Verme, L., Lo Monaco, Maria Rita, Calabresi, Paolo, Abbate, V., Acampora, N., Addolorato, G., Agostini, F., Ainora, M. E., Akacha, K., Amato, E., Andreani, F., Andriollo, G., Annetta, Maria Giuseppina, Annicchiarico, B. E., Antonelli, Massimo, Antonucci, G., Anzellotti, G. M., Armuzzi, A., Baldi, F., Barattucci, I., Barillaro, C., Barone, F., Bellantone, R. D. A., Bellieni, A., Bello, G., Benicchi, A., Benvenuto, F., Berardini, L., Berloco, F., Bernabei, R., Bianchi, A., Biasucci, D. G., Biasucci, L. M., Bibbo, S., Bini, A., Bisanti, A., Biscetti, F., Bocci, M. G., Bonadia, N., Bongiovanni, F., Borghetti, A., Bosco, G., Bosello, Silvia Laura, Bove, V., Bramato, G., Brandi, V., Bruni, T., Bruno, C., Bruno, D., Bungaro, M. C., Buonomo, A., Burzo, L., Calabrese, A., Calvello, M. R., Cambieri, A., Cambise, C., Camma, G., Candelli, M., Canistro, G., Cantanale, A., Capalbo, G., Capaldi, L., Capone, E., Capristo, E., Carbone, L., Cardone, S., Carelli, S., Carfi, A., Carnicelli, A., Caruso, C., Casciaro, F. A., Catalano, L., Cauda, R., Cecchini, A. L., Cerrito, L., Cesarano, M., Chiarito, A., Cianci, Rossella, Cicchinelli, S., Ciccullo, A., Cicetti, M., Ciciarello, F., Cingolani, A., Cipriani, M. C., Consalvo, M. L., Coppola, G., Corbo, G. M., Corsello, A., Costante, F., Costanzi, M., Covino, M., Crupi, D., Cutuli, S. L., D'Addio, S., D'Alessandro, A., D'Alfonso, M. E., D'Angelo, E., D'Aversa, F., Damiano, F., De Berardinis, G. M., De Cunzo, T., De Gaetano, D. K., De Luca, G., De Matteis, G., De Pascale, G., De Santis, P., De Siena, M., De Vito, F., Del Gatto, V., Del Giacomo, P., Del Zompo, F., Dell'Anna, A. M., Della, P. D., Di Gialleonardo, L., Di Giambenedetto, S., Di Luca, R., Di Maurizio, L., Di Muro, M., Dusina, A., Eleuteri, D., Esperide, A., Fachechi, D., Faliero, D., Falsiroli, C., Fantoni, M., Fedele, A., Feliciani, D., Ferrante, C., Ferrone, G., Festa, R., Fiore, M. C., Flex, A., Forte, E., Franceschi, Francesco, Francesconi, A., Franza, L., Funaro, B., Fuorlo, M., Fusco, D., Gabrielli, M., Gaetani, E., Galletta, C., Gallo, A., Gambassi, G., Garcovich, M., Gasbarrini, A., Gasparrini, I., Gelli, S., Giampietro, A., Gigante, L., Giuliano, G., Giupponi, B., Gremese, E., Grieco, Domenico Luca, Guerrera, M., Guglielmi, V., Guidone, C., Gulli, A., Iaconelli, A., Iafrati, A., Ianiro, Gianluca, Iaquinta, A., Impagnatiello, M., Inchingolo, R., Intini, E., Iorio, R., Izzi, I. M., Jovanovic, T., Kadhim, C., La Macchia, R., La Milia, D. I., Landi, F., Landi, G., Landi, R., Landolfi, R., Leo, M., Leone, P. M., Levantesi, L., Liguori, A., Liperoti, R., Lizzio, M. M., Lo Monaco Maria, R., Locantore, P., Lombardi, F., Lombardi, G., Lopetuso, L., Loria, V., Losito, A. R., Lucia, M. B. P., Macagno, F., Macerola, N., Maggi, G., Maiuro, G., Mancarella, F., Mangiola, F., Manno, A., Marchesini, D., Maresca, G. M., Marrone, G., Martis, I., Martone, A. M., Marzetti, Emanuele, Mattana, C., Matteo, M. V., Maviglia, R., Mazzarella, A., Memoli, C., Miele, Luca, Migneco, A., Mignini, I., Milani, A., Milardi, D., Montalto, M., Montemurro, G., Monti, F., Montini, Luca, Morena, T. C., Morra, V., Morretta, C., Moschese, D., Murace, C. A., Murdolo, M., Murri, Rita, Napoli, M., Nardella, E., Natalello, G., Natalini, D., Navarra, S. M., Nesci, A., Nicoletti, A., Nicoletti, R., Nicoletti, T. F., Nicolo, R., Nicolotti, N., Nista, E. C., Nuzzo, E., Oggiano, M., Ojetti, V., Pagano, F. C., Paiano, G., Pais, C., Pallavicini, F., Palombo, A., Paolillo, F., Papa, Alfredo, Papanice, D., Papparella, L. G., Paratore, M., Parrinello, G., Pasciuto, G., Pasculli, P., Pecorini, G., Perniola, S., Pero, E., Petricca, L., Petrucci, M., Picarelli, C., Piccioni, A., Piccolo, A., Piervincenzi, E., Pignataro, G., Pignataro, R., Pintaudi, G., Pisapia, L., Pizzoferrato, M., Pizzolante, F., Pola, R., Policola, C., Pompili, M., Pontecorvi, F., Pontecorvi, V., Ponziani, F., Popolla, V., Porceddu, E., Porfidia, A., Porro, L. M., Potenza, A., Pozzana, F., Privitera, G., Pugliese, D., Pulcini, G., Racco, S., Raffaelli, F., Ramunno, V., Rapaccini, G. L., Richeldi, Luca, Rinninella, Emanuele, Rocchi, S., Romano, B., Romano, S., Rosa, F., Rossi, L., Rossi, R., Rossini, E., Rota, E., Rovedi, F., Rubino, C., Rumi, G., Russo, A., Sabia, L., Salerno, A., Salini, S., Salvatore, L., Samori, D., Sandroni, Claudio, Sanguinetti, M., Santarelli, L., Santini, P., Santolamazza, D., Santoliquido, A., Santopaolo, F., Santoro, M. C., Sardeo, F., Sarnari, C., Saviano, A., Saviano, L., Scaldaferri, Franco, Scarascia, R., Schepis, T., Schiavello, F., Scoppettuolo, G., Sedda, D., Sessa, F., Sestito, L., Settanni, C., Siciliano, M., Siciliano, V., Sicuranza, R., Simeoni, B., Simonetti, J., Smargiassi, A., Soave, P. M., Sonnino, C., Staiti, D., Stella, C., Stella, L., Stival, E., Taddei, E., Talerico, R., Tamburello, E., Tamburrini, E., Tanzarella, E. S., Tarascio, E., Tarli, C., Tersali, A., Tilli, P., Timpano, J., Torelli, E., Torrini, F., Tosato, M., Tosoni, A., Tricoli, L., Tritto, M., Tumbarello, M., Tummolo, A. M., Vallecoccia, M. S., Valletta, F., Varone, F., Vassalli, F., Ventura, G., Verardi, L., Vetrone, L., Vetrugno, G., Visconti, E., Visconti, F., Viviani, A., Zaccaria, R., Zaccone, C., Zelano, L., Zileri Dal Verme, L., Zuccala, G., Luigetti M. (ORCID:0000-0001-7539-505X), Iorio R. (ORCID:0000-0002-6270-0956), Bentivoglio A. R. (ORCID:0000-0002-9663-095X), Tricoli L., Riso V., Marotta J., Piano C., Primiano G., Lo Monaco M. R. (ORCID:0000-0002-1457-7981), Calabresi P. (ORCID:0000-0003-0326-5509), Annetta M. G. (ORCID:0000-0001-7574-1311), Antonelli M. (ORCID:0000-0003-3007-1670), Bosello S. (ORCID:0000-0002-4837-447X), Cianci R. (ORCID:0000-0001-5378-8442), Franceschi F. (ORCID:0000-0001-6266-445X), Grieco D. L. (ORCID:0000-0002-4557-6308), Ianiro G. (ORCID:0000-0002-8318-0515), Marzetti E. (ORCID:0000-0001-9567-6983), Miele L. (ORCID:0000-0003-3464-0068), Montini L. (ORCID:0000-0003-4602-5134), Murri R. (ORCID:0000-0003-4263-7854), Papa A. (ORCID:0000-0002-4186-7298), Richeldi L. (ORCID:0000-0001-8594-1448), Rinninella E. (ORCID:0000-0002-9165-2367), Sandroni C. (ORCID:0000-0002-8878-2611), Scaldaferri F. (ORCID:0000-0001-8334-7541), Luigetti, Marco, Iorio, Raffaele, Bentivoglio, Anna Rita, Tricoli, Luca, Riso, Vittorio, Marotta, Jessica, Piano, Carla, Primiano, Guido Alessandro, Zileri Del Verme, L., Lo Monaco, Maria Rita, Calabresi, Paolo, Abbate, V., Acampora, N., Addolorato, G., Agostini, F., Ainora, M. E., Akacha, K., Amato, E., Andreani, F., Andriollo, G., Annetta, Maria Giuseppina, Annicchiarico, B. E., Antonelli, Massimo, Antonucci, G., Anzellotti, G. M., Armuzzi, A., Baldi, F., Barattucci, I., Barillaro, C., Barone, F., Bellantone, R. D. A., Bellieni, A., Bello, G., Benicchi, A., Benvenuto, F., Berardini, L., Berloco, F., Bernabei, R., Bianchi, A., Biasucci, D. G., Biasucci, L. M., Bibbo, S., Bini, A., Bisanti, A., Biscetti, F., Bocci, M. G., Bonadia, N., Bongiovanni, F., Borghetti, A., Bosco, G., Bosello, Silvia Laura, Bove, V., Bramato, G., Brandi, V., Bruni, T., Bruno, C., Bruno, D., Bungaro, M. C., Buonomo, A., Burzo, L., Calabrese, A., Calvello, M. R., Cambieri, A., Cambise, C., Camma, G., Candelli, M., Canistro, G., Cantanale, A., Capalbo, G., Capaldi, L., Capone, E., Capristo, E., Carbone, L., Cardone, S., Carelli, S., Carfi, A., Carnicelli, A., Caruso, C., Casciaro, F. A., Catalano, L., Cauda, R., Cecchini, A. L., Cerrito, L., Cesarano, M., Chiarito, A., Cianci, Rossella, Cicchinelli, S., Ciccullo, A., Cicetti, M., Ciciarello, F., Cingolani, A., Cipriani, M. C., Consalvo, M. L., Coppola, G., Corbo, G. M., Corsello, A., Costante, F., Costanzi, M., Covino, M., Crupi, D., Cutuli, S. L., D'Addio, S., D'Alessandro, A., D'Alfonso, M. E., D'Angelo, E., D'Aversa, F., Damiano, F., De Berardinis, G. M., De Cunzo, T., De Gaetano, D. K., De Luca, G., De Matteis, G., De Pascale, G., De Santis, P., De Siena, M., De Vito, F., Del Gatto, V., Del Giacomo, P., Del Zompo, F., Dell'Anna, A. M., Della, P. D., Di Gialleonardo, L., Di Giambenedetto, S., Di Luca, R., Di Maurizio, L., Di Muro, M., Dusina, A., Eleuteri, D., Esperide, A., Fachechi, D., Faliero, D., Falsiroli, C., Fantoni, M., Fedele, A., Feliciani, D., Ferrante, C., Ferrone, G., Festa, R., Fiore, M. C., Flex, A., Forte, E., Franceschi, Francesco, Francesconi, A., Franza, L., Funaro, B., Fuorlo, M., Fusco, D., Gabrielli, M., Gaetani, E., Galletta, C., Gallo, A., Gambassi, G., Garcovich, M., Gasbarrini, A., Gasparrini, I., Gelli, S., Giampietro, A., Gigante, L., Giuliano, G., Giupponi, B., Gremese, E., Grieco, Domenico Luca, Guerrera, M., Guglielmi, V., Guidone, C., Gulli, A., Iaconelli, A., Iafrati, A., Ianiro, Gianluca, Iaquinta, A., Impagnatiello, M., Inchingolo, R., Intini, E., Iorio, R., Izzi, I. M., Jovanovic, T., Kadhim, C., La Macchia, R., La Milia, D. I., Landi, F., Landi, G., Landi, R., Landolfi, R., Leo, M., Leone, P. M., Levantesi, L., Liguori, A., Liperoti, R., Lizzio, M. M., Lo Monaco Maria, R., Locantore, P., Lombardi, F., Lombardi, G., Lopetuso, L., Loria, V., Losito, A. R., Lucia, M. B. P., Macagno, F., Macerola, N., Maggi, G., Maiuro, G., Mancarella, F., Mangiola, F., Manno, A., Marchesini, D., Maresca, G. M., Marrone, G., Martis, I., Martone, A. M., Marzetti, Emanuele, Mattana, C., Matteo, M. V., Maviglia, R., Mazzarella, A., Memoli, C., Miele, Luca, Migneco, A., Mignini, I., Milani, A., Milardi, D., Montalto, M., Montemurro, G., Monti, F., Montini, Luca, Morena, T. C., Morra, V., Morretta, C., Moschese, D., Murace, C. A., Murdolo, M., Murri, Rita, Napoli, M., Nardella, E., Natalello, G., Natalini, D., Navarra, S. M., Nesci, A., Nicoletti, A., Nicoletti, R., Nicoletti, T. F., Nicolo, R., Nicolotti, N., Nista, E. C., Nuzzo, E., Oggiano, M., Ojetti, V., Pagano, F. C., Paiano, G., Pais, C., Pallavicini, F., Palombo, A., Paolillo, F., Papa, Alfredo, Papanice, D., Papparella, L. G., Paratore, M., Parrinello, G., Pasciuto, G., Pasculli, P., Pecorini, G., Perniola, S., Pero, E., Petricca, L., Petrucci, M., Picarelli, C., Piccioni, A., Piccolo, A., Piervincenzi, E., Pignataro, G., Pignataro, R., Pintaudi, G., Pisapia, L., Pizzoferrato, M., Pizzolante, F., Pola, R., Policola, C., Pompili, M., Pontecorvi, F., Pontecorvi, V., Ponziani, F., Popolla, V., Porceddu, E., Porfidia, A., Porro, L. M., Potenza, A., Pozzana, F., Privitera, G., Pugliese, D., Pulcini, G., Racco, S., Raffaelli, F., Ramunno, V., Rapaccini, G. L., Richeldi, Luca, Rinninella, Emanuele, Rocchi, S., Romano, B., Romano, S., Rosa, F., Rossi, L., Rossi, R., Rossini, E., Rota, E., Rovedi, F., Rubino, C., Rumi, G., Russo, A., Sabia, L., Salerno, A., Salini, S., Salvatore, L., Samori, D., Sandroni, Claudio, Sanguinetti, M., Santarelli, L., Santini, P., Santolamazza, D., Santoliquido, A., Santopaolo, F., Santoro, M. C., Sardeo, F., Sarnari, C., Saviano, A., Saviano, L., Scaldaferri, Franco, Scarascia, R., Schepis, T., Schiavello, F., Scoppettuolo, G., Sedda, D., Sessa, F., Sestito, L., Settanni, C., Siciliano, M., Siciliano, V., Sicuranza, R., Simeoni, B., Simonetti, J., Smargiassi, A., Soave, P. M., Sonnino, C., Staiti, D., Stella, C., Stella, L., Stival, E., Taddei, E., Talerico, R., Tamburello, E., Tamburrini, E., Tanzarella, E. S., Tarascio, E., Tarli, C., Tersali, A., Tilli, P., Timpano, J., Torelli, E., Torrini, F., Tosato, M., Tosoni, A., Tricoli, L., Tritto, M., Tumbarello, M., Tummolo, A. M., Vallecoccia, M. S., Valletta, F., Varone, F., Vassalli, F., Ventura, G., Verardi, L., Vetrone, L., Vetrugno, G., Visconti, E., Visconti, F., Viviani, A., Zaccaria, R., Zaccone, C., Zelano, L., Zileri Dal Verme, L., Zuccala, G., Luigetti M. (ORCID:0000-0001-7539-505X), Iorio R. (ORCID:0000-0002-6270-0956), Bentivoglio A. R. (ORCID:0000-0002-9663-095X), Tricoli L., Riso V., Marotta J., Piano C., Primiano G., Lo Monaco M. R. (ORCID:0000-0002-1457-7981), Calabresi P. (ORCID:0000-0003-0326-5509), Annetta M. G. (ORCID:0000-0001-7574-1311), Antonelli M. (ORCID:0000-0003-3007-1670), Bosello S. (ORCID:0000-0002-4837-447X), Cianci R. (ORCID:0000-0001-5378-8442), Franceschi F. (ORCID:0000-0001-6266-445X), Grieco D. L. (ORCID:0000-0002-4557-6308), Ianiro G. (ORCID:0000-0002-8318-0515), Marzetti E. (ORCID:0000-0001-9567-6983), Miele L. (ORCID:0000-0003-3464-0068), Montini L. (ORCID:0000-0003-4602-5134), Murri R. (ORCID:0000-0003-4263-7854), Papa A. (ORCID:0000-0002-4186-7298), Richeldi L. (ORCID:0000-0001-8594-1448), Rinninella E. (ORCID:0000-0002-9165-2367), Sandroni C. (ORCID:0000-0002-8878-2611), and Scaldaferri F. (ORCID:0000-0001-8334-7541)
Abstract: Background and purpose: The objective of this study was to assess the neurological manifestations in a series of consecutive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-positive patients, comparing their frequency with a population hospitalized in the same period for flu/respiratory symptoms, finally not related to SARS-CoV-2. Methods: Patients with flu/respiratory symptoms admitted to Fondazione Policlinico Gemelli hospital from 14 March 2020 to 20 April 2020 were retrospectively enrolled. The frequency of neurological manifestations of patients with SARS-CoV-2 infection was compared with a control group. Results: In all, 213 patients were found to be positive for SARS-CoV-2, after reverse transcriptase polymerase chain reaction on nasal or throat swabs, whilst 218 patients were found to be negative and were used as a control group. Regarding central nervous system manifestations, in SARS-CoV-2-positive patients a higher frequency of headache, hyposmia and encephalopathy always related to systemic conditions (fever or hypoxia) was observed. Furthermore, muscular involvement was more frequent in SARS-CoV-2 infection. Conclusions: Patients with COVID-19 commonly have neurological manifestations but only hyposmia and muscle involvement seem more frequent compared with other flu diseases.
Published: 2020

47. Reply to Fenton et al

Author: Bruni, T., Lalvani, A., Richeldi, Luca, Richeldi L. (ORCID:0000-0001-8594-1448), Bruni, T., Lalvani, A., Richeldi, Luca, and Richeldi L. (ORCID:0000-0001-8594-1448)
Published: 2020

48. COVID-19 and interstitial lung disease: Keep them separate

Author: Podolanczuk, A. J., Richeldi, Luca, Richeldi L. (ORCID:0000-0001-8594-1448), Podolanczuk, A. J., Richeldi, Luca, and Richeldi L. (ORCID:0000-0001-8594-1448)
Published: 2020

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

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

50. Pharmacological treatment of idiopathic pulmonary fibrosis: Time to step out of the comfort zone?

Author: Sgalla, Giacomo, Richeldi, Luca, Sgalla G. (ORCID:0000-0003-3130-9388), Richeldi L. (ORCID:0000-0001-8594-1448), Sgalla, Giacomo, Richeldi, Luca, Sgalla G. (ORCID:0000-0003-3130-9388), and Richeldi L. (ORCID:0000-0001-8594-1448)
Published: 2020

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