ABSTRACT
Introduction and Purpose of the study: The sensitivity of genomic tests to identify SARS-CoV2 is around 65-75%. It is very common to find clinical and radiological pictures suggestive of infection but with a negative nasopharyngeal swab. The aim of our study was to use BAL fibrobronchoscopy in subjects with negative swab but with clinical and radiological signs suggesting SARS-CoV2 infection. Materials and Methods: 52 subjects admitted to the observation area (gray area) Covid of the F. Miulli Hospital in 2020 were examined. All had negative nasopharyngeal swab (even in several determinations), also performed on sputum, but a clinical and radiological picture (Ground Glass Opacity with or without consolidations) suggestive of infection. In all subjects a fibrobronchoscopy with BAL was performed with the microbiological research also of bacteria and other viruses (pneumo plus film array). The examination was performed about 10 days after the onset of symptoms. Results: The BAL allowed microbiological diagnosis (Covid and non-Covid) in 30.8% of cases, while the positivity rate for SARSCoV 2 was 11.5%. Conclusions: Our data shows that the negativity of BAL in the search for the SARS-CoV 2 virus agrees with the outcome of the nasopharyngeal and sputum swab (89.5%), highlighting 11.5% of positive subjects. However, BAL negativity does not exclude SARS-CoV2 etiology, especially in typical radiological cases. The time interval between the onset of infection and BAL may have allowed the clearance of the virus.
ABSTRACT
Introduction: In our country, the percentage of subjects infected with HCV is about 2% of the general population, with a gradient that increases from the North to the South and the islands. The decline in hepatitis C treatments is sensationally evident. The WHO had set the goal of its elimination by 2030, a result made achievable thanks to the new direct-acting antiviral drugs (DAA), which allow the virus to be eradicated in definitively, quickly and without side effects. The pandemic has slowed both screening and treatment. Purpose of the study: Evaluate the prevalence of subjects positive for hepatitis C antigen (HCV +) in all hospitalized for Covid-19. Materials and Methods: 839 subjects admitted to the Covid Unit of the F. Miulli Hospital in Acquaviva delle Fonti were retrospectively assessed. Results: The prevalence of HCV+subjects was 4.7%. No statistically significant differences were found when comparing the main laboratory tests. No difference emerged regarding the outcomes (length of hospitalization and death) which are similar in the two groups. Conclusions: The prevalence of HCV+subjects in the Covid-19 population is double that of the general population. A project is underway in our hospital which provides for the screening of all over 50 year olds hospitalized in order to bring out HCV+subjects and direct them to an outpatient diagnostic confirmation path and any specific eradicating therapy.
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Background and Aim of the study: CoViD-19 pandemic required to the physicians the necessity to gain effective treatments against this infectious disease;one of the tried drugs is remdesivir. The aim of our study is to analyze clinical and laboratory features of a cohort of CoViD-19 patients treated with remdesivir. Materials and Methods:We evaluated retrospectively data of 22 patients (18 men and 4 women), considering two main items: the trend of inflammation markers (erythrocyte sedimentation rate, Creactive protein, interleukin-6, D-dimers, lymphocyte count, ferritin) and the severity of respiratory failure, comparing data between admission and discharge. Results: At admission, 85,7% of patients showed signs of acute respiratory failure (P/F ratio <300) and needed oxygen therapy but only 9,1% of them had this condition at discharge. Moreover, ESR, CRP and IL-6 levels were high at admission but showed a significant reduction at discharge;lymphocyte count was instead reduced at the beginning of the disease and increased after treatment;no significative variations were observed for D-dimer and ferritin levels. Finally average hospital stay was 4 days lower than the one of the cohort of patients non treated with remdesivir. Conclusions: Our results indicate that patients treated with remdesivir showed a good outcome in terms of respiratory function and reduction of inflammation state. However, a larger cohort of patients and the comparison with control patients are necessary to better investigate potential benefits of remdesivir.
ABSTRACT
Background and Aim of the study: The sensitivity of genomic testsfor the diagnosis of SARS CoV2, (RT-PCR) can be estimated ataround 60%, therefore it is inevitable to find negative subjects. Alot of patients, in the absence of a clear virological diagnosis, during an epidemic, were hospitalized in a 'gray area' to defined thereal negativity. A retrospective observational cohort study was conducted to analyze the clinical and laboratory characteristics of agroup of patients hospitalized in the gray area of F. Miulli Hospital(Acquaviva delle Fonti, BA)Materials and Methods: A cohort of 42 (23 M, 19 F, average age78.6 years) patients was studied retrospectively with respect toclinical and instrumental findings.Results: All patients had fever and in 14 of them also acute hypoxemic respiratory failure. The most represented comorbiditieswere: hypertension 14, ischemic heart disease 2, diabetes 4, ar rhythmias 4, renal failure 4,. The radiological pictures observedwere of: radiological alterations with areas of 'ground glass' in 14subjects;outbreak bronchopneumonia in 26;bronchiolitis ('treein bud') in 1 patient. Only one patient tested positive for SARSCoV2 virus infection detected by the third swab.Conclusions: Subjects hospitalized in 'gray area' were characterized by nonspecific elements, negative RT-PCR genomic test andradiological findings correlated with an intermediate probabilityfor SARS CoV2 virus infection (radiological pictures indeterminatebut suggestive). Most of the clinical and radiological pictures weretherefore related to other infections.