Early Outpatient Treatment of COVID-19: A Retrospective Analysis of 392 Cases in Italy.

COVID-19 was declared a pandemic in March 2020. The knowledge of COVID-19 pathophysiology soon provided a strong rationale for the early use of both anti-inflammatory and antithrombotic drugs; however, its evidence was slowly and partially incorporated into institutional guidelines. The unmet needs of COVID-19 outpatients were taken care of by networks of physicians and researchers. We analyse the characteristics, management and outcomes in COVID-19 outpatients who were taken care of by physicians within the IppocrateOrg Association. In this observational retrospective study, volunteering doctors provided data on 392 COVID-19 patients. The mean age of patients was 48.5 years (range: 0.5-97), and patients were taken care of in COVID-19 stage 0 (15.6%), stage 1 (50.0%), stage 2a (28.8%) and stage 2b (5.6%). Many patients were overweight (26%) or obese (11.5%), with chronic comorbidities (34.9%), mainly cardiovascular (23%) and metabolic (13.3%). The most frequently prescribed drugs included: vitamins and supplements (98.7%), aspirin (66.1%), antibiotics (62%), glucocorticoids (41.8%), hydroxychloroquine (29.6%), enoxaparin (28.6%), colchicine (8.9%), oxygen therapy (6.9%), and ivermectin (2.8%). Hospitalization occurred in 5.8% of cases, mainly in stage 2b (27.3%). A total of 390 patients (99.6%) recovered; one patient was lost at follow up, and one patient died after hospitalization. This is the first real-world study describing the behaviours of physicians caring for COVID-19 outpatients, and the outcomes of COVID-19 early treatment. The lethality in this cohort was 0.2%, while overall, and over the same period, the COVID-19 lethality in Italy was over 3%. The drug use described in this study appears effective and safe. The present evidence should be carefully considered by physicians and political decision makers.

The role of school physical education on adolescents' fitness levels during the pandemic period from COVID-19: An observational study of the Italian scientific high school-section sport and physical activity.

Objectives: In Italy, in 2013, a new school curriculum with a sport character was established in high schools, called Sports High School (SHS). The aims of this study were: (1) to assess the fitness levels of SHS students who, respecting all the safety rules to limit the spread of COVID-19, practiced physical education (PE) at school with continuity for almost all of 2021, and to compare them with Traditional High School (THS) students; (2) to evaluate as the SHS may have influenced the fitness levels in adolescents. Methods: This is a case-control study in which thirty participants were enrolled (SHS: n = 15; THS: n = 15). To assess the fitness levels, the following tests were administered: the Static Baropodometric and Stabilometric Analyses, the Counter Movement Jump (CMJ), and the Handgrip test. All these tests were administered when the non-pharmaceutical interventions (NPIs) for COVID-19 allowed the resumption of PE lessons (T0) and 2 months after their resumption (T1). Results: Unpaired t-test between SHS (T0) vs. THS (T0) showed significant differences between: Handgrip test Dx and Handgrip test Sx (both p < 0.001), Surface Sx foot and Surface Dx foot (both p < 0.05), and CMJ (p < 0.001). These results were also confirmed in T1. The performance analysis between T0 and T1 of both SHS and THS showed improvements in SHS: Handgrip test Dx (p < 0.05; d = 0.57), Handgrip test Sx (p < 0.01; d = 0.87), and CMJ (p < 0.05; d = 0.59). Pearson's analysis of the results of the tests showed significant strong correlations between: Handgrip test Dx and Handgrip test Sx (R = 0.959; p < 0.001), Handgrip test Dx and CMJ (R = 0.881; p < 0.001), Handgrip test Sx and CMJ (R = 0.893; p < 0.001). The same analysis showed significant but moderate correlations between: Surface foot Sx and CMJ (R = 0.489; p < 0.01), Surface foot Sx and y-mean (R = 0.485; p < 0.01), Surface foot Dx and CMJ (R = 0.444; p < 0.05). Conclusions: This study is in agreement with the literature showing that the quarantine period and the NPIs for COVID-19 caused a decrease in fitness levels in adolescents. Our results showed that students of SHS recorded higher strength performance both in the Handgrip test and in the CMJ.

Antibody response to BNT162b2 SARS-CoV-2 mRNA vaccine is not influenced by AB0 blood group in subjects with transfusion-dependent thalassemia.

Not applicable.

Physical Activity and Sports Practice in Children and Adolescents at the Time of the COVID-19 Pandemic: Hypothetical Future Scenarios and Preventive Practical Applications

As a logical and direct consequence of the closure of schools and sports facilities, an expected reduction in the practice of physical activity (PA) and sports has been detected in both children and adolescents all over the world. Hence, we analysed the short-term and long-term consequences of the lack/low level of PA and sports activity in this population, which we referred to as primary and secondary risks, respectively, the latter of which have to be considered in hypothetical future scenarios.

Flower lose, a cell fitness marker, predicts COVID-19 prognosis.

Risk stratification of COVID-19 patients is essential for pandemic management. Changes in the cell fitness marker, hFwe-Lose, can precede the host immune response to infection, potentially making such a biomarker an earlier triage tool. Here, we evaluate whether hFwe-Lose gene expression can outperform conventional methods in predicting outcomes (e.g., death and hospitalization) in COVID-19 patients. We performed a post-mortem examination of infected lung tissue in deceased COVID-19 patients to determine hFwe-Lose's biological role in acute lung injury. We then performed an observational study (n = 283) to evaluate whether hFwe-Lose expression (in nasopharyngeal samples) could accurately predict hospitalization or death in COVID-19 patients. In COVID-19 patients with acute lung injury, hFwe-Lose is highly expressed in the lower respiratory tract and is co-localized to areas of cell death. In patients presenting in the early phase of COVID-19 illness, hFwe-Lose expression accurately predicts subsequent hospitalization or death with positive predictive values of 87.8-100% and a negative predictive value of 64.1-93.2%. hFwe-Lose outperforms conventional inflammatory biomarkers and patient age and comorbidities, with an area under the receiver operating characteristic curve (AUROC) 0.93-0.97 in predicting hospitalization/death. Specifically, this is significantly higher than the prognostic value of combining biomarkers (serum ferritin, D-dimer, C-reactive protein, and neutrophil-lymphocyte ratio), patient age and comorbidities (AUROC of 0.67-0.92). The cell fitness marker, hFwe-Lose, accurately predicts outcomes in COVID-19 patients. This finding demonstrates how tissue fitness pathways dictate the response to infection and disease and their utility in managing the current COVID-19 pandemic.

Physical Activity Levels and Related Energy Expenditure during COVID-19 Quarantine among the Sicilian Active Population: A Cross-Sectional Online Survey Study

Background: During the coronavirus disease 2019 (COVID-19) pandemic, the Italian government has adopted containment measures to control the virus’s spread, including limitations to the practice of physical activity (PA). The aim of this study was to estimate the levels of PA, expressed as energy expenditure (MET–minute/week), among the physically active Sicilian population before and during the last seven days of the COVID-19 quarantine. Furthermore, the relation between this parameter and specific demographic and anthropometric variables was analyzed. Methods: 802 Sicilian physically active participants (mean age: 32.27 ± 12.81 years;BMI: 23.44 ± 3.33 kg/m2) were included in the study and grouped based on gender, age and BMI. An adapted version of the International Physical Activity Questionnaire—short form (IPAQ-SF) was administered to the participants through an online survey. The Wilcoxon signed-rank test and the Kruskal-Wallis rank-sum test were used for statistical analyses. Results: As expected, we observed a significant decrease of the total weekly energy expenditure during the COVID-19 quarantine (p < 0.001). A significant variation in the MET–min/wk in the before quarantine condition (p = 0.046) and in the difference between before and during quarantine (p = 0.009) was found for males and females. The male group decreased the PA level more than the female one. Moreover, a significant difference in the MET–min/wk was found among groups distributions of BMI (p < 0.001, during quarantine) and of age (p < 0.001, both before and during quarantine). In particular, the highest and the lowest levels of PA were reported by the young and the elderly, respectively, both before and during quarantine. Finally, the overweight group showed the lowest level of PA during quarantine. Conclusion: Based on our outcomes, we can determine that the current quarantine has negatively affected the practice of PA, with greater impacts among males and overweight subjects. In regards to different age groups, the young, young adults and adults were more affected than senior adults and the elderly.

One Year of COVID-19 Pandemic in Italy: Effect of Sedentary Behavior on Physical Activity Levels and Musculoskeletal Pain among University Students.

The COVID-19 outbreak forced Italian students to reduce their daily activities, inducing a seden-tary attitude that was worsened by distanced learning. This study aimed to survey the physical activity levels that were maintained before and during the social restrictions following the pan-demic, their correlation to musculoskeletal pain, as well as analyzing the impact of these COVID-19 restrictions on pain and fatigue that affects daily life activities. A total of 2044 students completed the online questionnaire, of which the results of 1654 participants were eligible. Before the pandemic, the levels of physical activity were distributed as: 19.9% no activity, 30.1% light ac-tivity, 21.5% moderate activity, and 28.5% high activity. After one year of the pandemic, 30.6% of the participants were inactive, 48.1%, 10.9%, and 10.5% stated as maintaining, respectively, light, moderate and high levels of physical activity. Furthermore, 43.5% reported neck pain and 33.5% stated to experience low back pain. Physical activity levels lower than 150 min/week may have predisposed students to suffer from neck pain (1.95 OR at 95% CI, 1.44-2.64) and low back pain (1.79 OR at 95% CI, 1.29-2.49). A positive correlation between physical activity levels, Verbal Descriptive Scale (VDS), and pain frequency have been observed for neck and low back pain (p-value < 0.05). Finally, low physical activity levels were associated with musculoskeletal pain onset and pain worsening.

An Interaction Path of Mothers' and Preschoolers' Food- and Physical Activity-Related Aspects in Disadvantaged Sicilian Urban Areas.

Background: The relationship between mothers and their children's lifestyle is still unclear, especially in disadvantaged areas. Consequently, the study aims to identify a path explaining the extent to which maternal eating habits and physical activity (PA) level predict food-related aspects, PA practice and Quotient of Gross Motor Development (QGMD) in preschoolers from disadvantaged urban areas. Methods: In this cross-sectional study, a total of 79 dyads of mothers and children were recruited from kindergartens. Information related to family socio-demographic aspects, mothers' and children's dietary intake frequencies and PA/sedentariness, mothers' weight and height, mothers' perception on children's food intake, and children's food literacy (FL) was collected with a questionnaire and the Food Literacy Assessment Tool (preschool-FLAT), while gross-motor skills were measured with the Test of Gross Motor Development (TGMD); weight and height of children were directly collected. Results: Associations were found between mothers' and children's food habits; mothers' and children's fruit/vegetables consumption, and intake of the other items; mothers' education or PA level and children's FL; mothers' PA or sedentariness and children's QGMD; mothers' BMI and food habits and children's BMI; education and food habits. Conclusions: These findings can be useful to plan effective interventions targeted both to preschoolers and their mothers of disadvantaged urban areas for promoting healthy lifestyles, which have become increasingly difficult to achieve during COVID-19 pandemic.

The Effect of COVID-19 Lockdown Measures on Physical Activity Levels and Sedentary Behaviour in a Relatively Young Population Living in Kosovo.

To abate the spread of the COVID-19 virus, different restriction measures were imperative, limiting the possibility to be engaged in physical activity. Therefore, this study aimed to evaluate the effect of COVID-19 lockdown on physical activity (PA) levels expressed as energy expenditure (MET-min/week) and sedentary behaviour in Kosovo. The possible association between PA levels and other factors was analyzed. 1633 participants (age range: 13 to 63 years; mean: 24.70 ± 9.33 years; body height: 172 ± 10.57 cm; body mass: 69.10 ± 13.80 kg; BMI: 23.09 ± 3.63 kg/m2) participated in the study, categorized by age, gender, BMI, and living area. An online survey, including an adapted version of the IPAQ-SF, was administered once during lockdown to assess PA levels and sedentary behaviour both before and during COVID-19 lockdown. The Wilcoxon signed-rank, Mann-Whitney U and Kruskal-Wallis rank of sum tests were used for statistical analysis. COVID-19 restrictions had a negative impact on the types of and overall PA levels MET-min/week (p < 0.001). Sedentary behaviour significantly increased during COVID-19 restrictions (p < 0.001). Higher decreases in MET-min/week during lockdown were observed among males, young and young adults, overweight, and urban-living participants. Finally, COVID-19 restrictions decreased the PA levels and MET-min/week, and increased sedentary behaviour also in a relatively young cohort. Such differences were dependent on several factors.

Significant reduction of physical activity in patients with neuromuscular disease during COVID-19 pandemic: the long-term consequences of quarantine.

BACKGROUND: Quarantine was the measure taken by governments to control the rapid spread of COVID-19. This restriction resulted in a sudden change in people's lifestyle, leading to an increase in sedentary behavior and a related decrease in the practice of physical activity (PA). However, in neuromuscular diseases patients need to perform regular PA to counteract the negative consequences of the disease. Hence, the aim of this study was to estimate the levels of PA, measured as energy expenditure (MET-minute/week), among patients with neuromuscular disease (NMD) before and during the last week of quarantine. METHODS: A total of 268 Italian subjects, living in Sicily, completed an adapted version of the IPAQ-SF. Participants comprised 149 NMD, enrolled at the Neuromuscular Clinic of Palermo and 119 healthy subjects (control group). The SF-12 questionnaire was also administered to NMD. The Mann-Whitney U and the Kruskal-Wallis rank-sum tests were used for statistical analyses. RESULTS: We observed a significant decrease of the total weekly PA level during COVID-19 quarantine in both patients and controls. Moreover, a significant difference in the total weekly PA level was found depending on the presence of neuromuscular disease, impaired walking, gender and BMI. Finally, we found a correlation between SF-12 scores and the entity of the reduction of PA level during quarantine, thus confirming a relevant association with the quality of life in NMD. CONCLUSION: Our study confirmed that COVID-19 quarantine has affected the practice of PA among both NMD and healthy controls.

The impact of physical activity on psychological health during Covid-19 pandemic in Italy.

The worldwide spread of COVID-19 has upset the normality of Italian daily life, forcing population to social distancing and self-isolation. Since the containment precautions also concern sport-related activities, home workout remained the only possibility to play sports and stay active during the pandemic. The present study aimed to examine changes in the physical activity levels during self-quarantine in Italy, and the impact of exercise on psychological health. A total of 2974 Italian subjects has completed an online survey, but only 2524 subjects resulted eligible for this study. The questionnaire measured the total weekly physical activity energy expenditure before and during quarantine (i.e. the sum of walking, moderate-intensity physical activities, and vigorous-intensity physical activities) in Metabolic Equivalent Task minutes per week (MET-min/wk) using an adapted version of International Physical Activity Questionnaire and their psychological well-being using the Psychological General Well Being Index. Of the 2524 Italian subjects included in the study, 1426 were females (56.4%) and 1098 males (43.6%). Total physical activity significantly decreased between before and during COVID-19 pandemic (Mean: 2429 vs. 1577 MET-min/wk, ∗∗∗∗p < 0.0001), in all age groups and especially in men (Female, mean: 1994 vs. 1443 MET-min/wk, ∗∗∗∗p < 0.0001; Male, mean: 2998 vs. 1754 MET-min/wk, ∗∗∗∗p < 0.0001). Furthermore, a significant positive correlation was found between the variation of physical activity and mental well-being (r = 0.07541, ∗∗∗p = 0.0002), suggesting that the reduction of total physical activity had a profoundly negative impact on psychological health and well-being of population. Based on this scientific evidence, maintaining a regular exercise routine is a key strategy for physical and mental health during a forced rest period like the current coronavirus emergency.