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Introduction: Calprotectin plays an important role in the inflammatory response and its levels were significantly increased in patients with various inflammatory and autoimmune conditions. Calprotectin is located in the cytosol of neutrophils and is released after their activation. The aim of the study was to evaluate the prognostic role of serum circulating calprotectin in COVID-19 patients. Patients and Methods: We retrospectively analyzed data about 195 COVID-19 adult patients, 10 of which resulting in a fatal outcome. Circulating calprotectin and C-reactive protein (CRP) levels were measured with the ACHITECT i2000R System (Abbott Laboratories, Wiesbaden, Germany). Complete blood count was obtained by a standard method on ADVIA 2120 Hematology System (Siemens Healthcare). Result(s): Calprotectin levels and neutrophil counts were higher in patients with a fatal outcome respect to surviving patients: 4.26 (2.01-9.84) vs 1.28 (0.54-3.60) with p=0.006 and 20.26 (8.29-30.26) vs 6.57 (4.74-9.38) with p=0.002.Calprotectin levels correlated with levels CRP (Spearman coefficient 0.354, p<0.001) and neutrophil count (Spearman coefficient 0.350, p<0.001). Both high calprotectin levels and high neutrophil counts were associated with death at multivariate analysis.Multivariate analysis revealed the association with death of both calprotectin levels and neutrophil count, with an odds ratio (OR) higher for calprotectin levels 1.843 (1.292-2.630)p=0.001. ROC curve analysis of calprotectin levels revealed a good discriminating power toward survival with an AUC=0.759 (p=0.0004). The best cut-off value for calprotectin was 1.66 mg/L with a sensitivity of 90% and specificity of 58.9%. To test the prognostic value of this cut-off of calprotectin levels toward the exitus, a Kaplan-Meier analysis was performed. Log-rank test revealed a statistical difference in terms of survival between the two groups (p< 0.0005). Conclusion(s): Calprotectin levels higher than 1.66 mg/L are a predictor of mortality and can be used as a prognostic marker in patients with COVID-19. Calprotectin levels were more efficient in the outcome evaluation than other inflammatory markers, probably because it represents a marker of neutrophil activation.
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Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination is the standard of care for the prevention of COVID-19 disease, with a positive impact in countries in which vaccination has been promoted. Since the emergence of variants of concern (VOCs) European Medicines Agency (EMA) recommended an extra dose of the COVID-19 vaccines Comirnaty (BioNTech/Pfizer) and Spikevax (Moderna) for patients with severely weakened immune system and booster doses for subjects with normal immune system to ensure a lasting response. Although Vaccination triggers both humoral and cellular immune response, COVID-19 vaccination efficacy is evaluated by measuring antibodies only, whereas adaptative cellular immunity is unexplored. Our aim is to test this new kit QuantiFERON SARS-CoV-2 to evaluate the immune response after three doses of BNT162b vaccine in healthy donors compared to two cohort of fragile patients: Common Variable Immunodeficiency (CVID) patients and Kidney Transplant Recipients (KTR) patients. Method(s): Blood samples were collected from eight health care workers in our department, fourteen CVID patients and eight KTR patients. All the individuals recruited were naive to SARS-COV2 and immunized by three doses of BNT162b vaccine. We examined humoral responses to vaccinations using the LIAISON DIASORIN SARSCOV-2 S1/S2 IgG. Next blood from all participants was subjected to the novel Interferon gamma (INF-gamma) Release Assay (IGRA) from Qiagen, measuring INF-gamma release induced by two proprietary SARS-CoV-2 peptide pools (Ag1 and Ag2) encompassing the spike protein and designed to stimulate CD4+ and CD8+ T cells and induce the releases of INF-gamma. Result(s): Using LIAISON SARS-COV-2 S1/S2 IgG assay from DIASORIN we confirm that in healthy subjects BNT162b third dose had successfully mounted humoral immune response with a S1/S2 IgG mean of 17100 BAU/ml. Conversely, the CVID group and KTR group shown a statistically significant reduction of IGg levels with a mean of 978 BAU/ml and 1029 respectively. Notably seven patients (five CVID and two KTR) presented IGg levels below the cut-off (33,8 BAU/ml). Next, we evaluated the INF-gamma response to SARS-CoV-2 Ag1 and Ag2 founding seven non-reactive subjects (three CVID and four KTR). Surprisingly three of non-reactive patients shown a good humoral response, whereas three patients with a negative humoral immune response shown reactiveness to IGRA assay. Conclusion(s): Assessing cellular immunity for SARSCOV-2 in addition to humoral immunity is important taking into account that cellular immunity plays a pivotal role against the virus and likely its variants. Some patients with weakened immune response have no correlation between humoral and cellular immunity, suggesting that the evaluation of T cell responses could be a more sensitive clinical marker of immunization. In this scenario the evaluation of cellular immunity might be informative for clinicians to identify patients more susceptible to a severe COVID-19 disease.
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Background Coronavirus (COVID-19) pandemic control measures actively involved people who were called to adopt new and unusual lifestyles. In this context, children had to stay home from school for weeks, had to adapt to new teaching methods and give up socializing. In many countries, not much attention was paid to the educational sector, and, ultimately, to children's physical and psychological well-being. Objectives In this context, we developed an innovative health education audio-visual model to teach children about public health, empower them to adopt preventive behaviours and limit the risk of infection transmission in schools and in the community. Results We designed and produced the animated cartoon series “Leo&Giulia” to convey solid scientific content and key public health messages related to the ongoing COVID-19 pandemic to primary school-aged children. Contents and dialogues were validated by a scientific committee composed of experts in the fields of public health, paediatrics, infectious diseases, and neuroscience, as well as communication experts. The first episode of Leo&Giulia focused on COVID-19 and explained to children what SARS-CoV2 was, its transmission and why schools were closed. Endorsed by the European Commission, it was broadcasted by national public and private television channels and went viral on social media. The second episode of Leo&Giulia, funded by the Italian Ministry of Research, was launched in April 2022 and focused on vaccines and immunization explaining to children how vaccines work and why herd immunity is important for collective health. Conclusions Leo&Giulia is an innovative health education project to help children to better understand how to cope with COVID-19 as a public health challenge. More broadly, the series aims to increase youth engagement by promoting public health values and healthy behaviours. Key messages • Health promotion targeting children is important and contributes to societal health and wellbeing. • Cartoon series are an innovative digital health education tool that effectively increase youth engagement on public health values.
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Background The COVID-19 pandemic led to an ‘infodemic', as defined by the WHO, which made it difficult to be accurately informed on public health topics. For this purpose, many people use social media as a source of information, mainly YouTube. Given the great resonance of this platform, our study aims at assessing quality and reliability of its content regarding the COVID-19 vaccination. Methods During March 2022, six searches were performed on the Italian YouTube platform using the following terms: “Covid vaccination”, “Covid vaccine”, “Coronavirus vaccination”, “Coronavirus vaccine”, “Sars-Cov-2 vaccination” and “Sars-Cov-2 vaccine”. A total of 329 videos were analysed, after removing 271 duplicated videos, and classified in seven types of channel. The reliability of the content was evaluated through the HoNCode score, while quality was tested using the validated DISCERN tool. Results The most frequent category was ‘Internet Media’ (33%), while the less frequent one was ‘Educational Medical’ (7%). The content reliability (i.e. HoNCode score) resulted higher for videos produced by medical healthcare workers than non-medical ones. Concerning the quality, the DISCERN score resulted significantly higher for the Educational channels (median 46.0 for medical and 41.3 non-medical ones) as compared to Internet Media (26.5) and New Agencies (24.3). Conclusions Although YouTube has implemented a policy against misinformation related to the COVID-19 vaccination, the study highlights that there is extreme heterogeneity in reliability and quality of videos. Content produced by non-medical users, especially “Internet Media” and “News Agencies” categories should be evaluated with attention by users, as their quality is not appropriate to the importance of the topic. Key messages • Because of to the heterogeneity of its content, YouTube should be evaluated carefully when used as a source of information for Covid-19 vaccination. • Content produced by non-medical users, is generally of poor quality, not appropriate to the importance of the topic.
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Introduction: 2019-nCov is a severe acute respiratory syndrome caused by coronavirus 2 (Sars-CoV-2) infection that emerged in Seafood Wholesale Market in Wuhan, China in December 2019 (2) and it spred all over the world, causing death and economic disruption. In January 2020 SARS-CoV-2 was added to the priority World Health Organization (WHO) list of Respiratory Tract Infections (RTIs) with tuberculosis. Covid-19 pandemic has had an impact on socio-economic, phycological, and routine health service, but an important goal for all governments should be to ensure continuity of essential health services, such as Tuberculosis (TB) national program. The aim of this study was to evaluate the impact of Covid-19 pandemic on TB cases in Tor Vergata University Hospital, Rome, with a focus on health care workers. Materials and methods: It was investigated age, gender, clinical diagnosis, nationality, and it was evaluated time between hospitalization and notification date. We examined 192 TB cases notified during the period from January 2018 to December 2020, and confirmed by microbiology laboratory analysis. Results: Totally, we collected data on 192 subjects (135 male and 58 females;70,31 vs 29,7 % respectively). Those TB cases were admitted in the study period as follow: 94 cases (48,9%) in 2018s, 77 subjects (40,1%) in 2019s and 21 cases (10,5%) in 2020s. Discussion: In this study showed how during the Covid-19 pandemic was significantly reduced TB cases notified in PTV according to the use of masks, individual protection devices (IPD), and social distancing. Probably this was influenced by the reduction of hospital accesses and the priority screening for Covid-19 in patients with respiratory symptoms for protect public health, but delayed the TB diagnosis. © 2021 A. CARBONE Editore. All rights reserved.
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The ongoing pandemic of COVID-19 has underlined the importance of adopting effective infection prevention and control (IPC) measures in hospital and community settings. Ultraviolet (UV)-based technologies represent promising IPC tools: their effective application for sanitation has been extensively evaluated in the past but scant, heterogeneous and inconclusive evidence is available on their effect on SARS-CoV-2 transmission. With the aim of pooling the available evidence on the efficacy of UV technologies against coronaviruses, we conducted a systematic review following PRISMA guidelines, searching Medline, Embase and the Cochrane Library, and the main clinical trials' registries (WHO ICTRP, ClinicalTrials.gov, Cochrane and EU Clinical Trial Register). Quantitative data on studies' interventions were summarized in tables, pooled by different coronavirus species and strain, UV source, characteristics of UV light exposure and outcomes. Eighteen papers met our inclusion criteria, published between 1972 and 2020. Six focused on SARS-CoV-2, four on SARS-CoV-1, one on MERS-CoV, three on seasonal coronaviruses, and four on animal coronaviruses. All were experimental studies. Overall, despite wide heterogenicity within included studies, complete inactivation of coronaviruses on surfaces or aerosolized, including SARS-CoV-2, was reported to take a maximum exposure time of 15 min and to need a maximum distance from the UV emitter of up to 1 m. Advances in UV-based technologies in the field of sanitation and their proved high virucidal potential against SARS-CoV-2 support their use for IPC in hospital and community settings and their contribution towards ending the COVID-19 pandemic. National and international guidelines are to be updated and parameters and conditions of use need to be identified to ensure both efficacy and safety of UV technology application for effective infection prevention and control in both healthcare and non-healthcare settings.
Subject(s)
COVID-19 , Coronavirus/radiation effects , SARS-CoV-2/radiation effects , Ultraviolet Rays , Animals , COVID-19/prevention & control , Humans , Pandemics , TechnologyABSTRACT
COVID-19 is a novel infectious disease which has rapidly spread around the globe, disrupting several aspects of public life over the past year. After numerous infection clusters emerged among travelers hosted in ski resorts in early 2020, several European countries closed ski areas. These measures were mostly upheld throughout the 2020 and 2021 winter season, generating significant economic loss for mountain communities. The aim of this rapid systematic review was to explore the association between recreational skiing and the spread of COVID-19. This review was conducted according to the WHO practical guidelines on rapid reviews and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed, Scopus, MedRxiv and Promed-mail were screened to identify relevant scientific and grey literature published since the emergence of COVID-19. Among the 11 articles included, seven focused on cases recorded during the first epidemic wave, when COVID-19 containment measures were not yet mandatory. Most infection clusters could be directly linked to public gatherings which took place without the enforcement of restrictions. There is currently no evidence to suggest an association between COVID-19 spread and recreational skiing. It may be reasonable to consider the reopening of ski areas in compliance with strict rules and preventive measures.