Balanced lifestyle and restart post-COVID-19

I lockdown del periodo COVID-19 e i cambiamenti nelle abitudini della popolazione come l'inattività fisica esacerbata durante il confinamento, l'aumento del consumo di snack e cibi zuccherini, insieme allo stress psicofisico, hanno prodotto conseguenze importanti sulla salute specialmente nei pazienti con Diabete Mellito di tipo 2 (T2DM). Scarsa salute metabolica e stili di vita scorretti sono fattori associati a rischio di covid-19 e maggior severità mentre la dieta vegetariana è stata associata a minor rischi particolarmente vero nelle aree socio economicamente povere. Anche l'obesità determinando disfunzione metabolica, infiammazione cronica, risposta immunitaria compromessa e disordini multipli aumentanti la vulnerabilità del soggetto, è stata fortemente e indipendentemente associata con un aumento del rischio di severità e morte per covid19. L'attività motoria, se associata a una corretta e sana alimentazione ricca di micronutrienti riduce infiammazione e stress ossidativo e rafforza il sistema immunitario, proteggendo meglio l'individuo dall'infezione. Inoltre queste azioni riducono il sovrappeso, la pressione sanguigna, la glicemia e i livelli di grassi nel sangue e, consente al nostro corpo di invecchiare serenamente. Nella ripartenza post-Covid-19 perciò serve rinnovare l'attenzione per uno stile di vita equilibrato come strumento fondamentale di difesa dalle epidemie, in cui l'individuo sappia coniugare una sana e corretta alimentazione, all'attività motoria, all'eliminazione dei fattori di rischio, ai principi della profilasi e cura medica. La medicina orale, emergente disciplina medica, ha evidenziato come anche la salute orale compreso un corretto funzionamento delle ghiandole salivari sia uno dei pilastri della salute generale dell'individuo insieme allo stile di vita. Anche la salute orale pertanto merita una particolare attenzione con azioni di monitoraggio, prevenzione e cure adeguate che prevedano prescrizioni terapeutiche idonee ed efficaci per il suo mantenimento. (Italian) [ FROM AUTHOR]

Ostomy closure rate during COVID-19 pandemic: an Italian multicentre observational study.

During the corona virus disease 2019 (COVID-19) pandemic, most of the surgical procedures were performed for emergencies or oncologic reasons to the detriment of the remaining elective procedures for benign conditions. Ileostomy or colostomy creation are sequelae of oncologic or emergency colorectal surgery, but their closure does not fall within the definition of oncologic or emergency surgery. The aim of this retrospective multicentre observational study is to report the impact of COVID-19 pandemic on the ostomy closure rate in Italy. Data regarding ileostomy and colostomy creation and closure from 24 Italian centres, during the study period (March 2020-February 2021) and during the control period (March 2019-February 2020) were collected. Three hospitals (12.5%) were COVID free. The number of colostomies and ileostomies created and closed in the same period was lower ( -18.8% and -30%, respectively) in the study period in comparison to the control period (p = 0.1915 and p = 0.0001, respectively), such as the ostomies closed in the analysed periods but created before (colostomy -36.2% and ileostomy -7.4%, p = 0.2211 and p = 0.1319, respectively). Overall, a 19.5% reduction in ostomies closed occurred in the study period. Based on the present study, a reduction in ostomy closure rate occurred in Italy between March 2020 and February 2021. During the pandemic, the need to change the clinical practice probably prolonged deterioration of quality of life in patients with ostomies, increasing number of stomas that will never be closed, and related management costs, even if these issues have not been investigated in this study.

Strategies to evaluate outcomes in long-COVID-19 and post-COVID survivors.

SARS-CoV-2 infection can impact the physical, cognitive, mental health of patients, especially in those recovered in intensive care units. Moreover, it was proved that the effects of the virus may persist for weeks or months. The term long-COVID or post-COVID syndrome is commonly used for indicating a variety of physical and psychological symptoms that continue after the resolution of the acute phase. This narrative review is aimed at providing an updated overview of the impact of physical, cognitive, and psychological health disorders in COVID-19 survivors, by summarizing the data already published in literature in the last year. Studies cited were found through PubMed searches. We also presented an overview of the post-COVID-19 health consequences on three important aspects: nutritional status, neurological disorders, and physical health. Moreover, to activate a correct health planning policy, a multidisciplinary approach for addressing the post- COVID-19 issue, has been proposed. Finally, the involvement of health professionals is necessary even after the pandemic, to reduce expected post-pandemic psychosocial responses and mental health disorders.

HLA-B*44 and C*01 Prevalence Correlates with Covid19 Spreading across Italy.

The spread of COVID-19 is showing huge, unexplained, differences between northern and southern Italy. We hypothesized that the regional prevalence of specific class I human leukocyte antigen (HLA) alleles, which shape the anti-viral immune response, might partly underlie these differences. Through an ecological approach, we analyzed whether a set of HLA alleles (A, B, C), known to be involved in the immune response against infections, correlates with COVID-19 incidence. COVID-19 data were provided by the National Civil Protection Department, whereas HLA allele prevalence was retrieved through the Italian Bone-Marrow Donors Registry. Among all the alleles, HLA-A*25, B*08, B*44, B*15:01, B*51, C*01, and C*03 showed a positive log-linear correlation with COVID-19 incidence rate fixed on 9 April 2020 in proximity of the national outbreak peak (Pearson's coefficients between 0.50 and 0.70, p-value < 0.0001), whereas HLA-B*14, B*18, and B*49 showed an inverse log-linear correlation (Pearson's coefficients between -0.47 and -0.59, p-value < 0.0001). When alleles were examined simultaneously using a multiple regression model to control for confounding factors, HLA-B*44 and C*01 were still positively and independently associated with COVID-19: a growth rate of 16% (95%CI: 0.1-35%) per 1% point increase in B*44 prevalence; and of 19% (95%CI: 1-41%) per 1% point increase in C*01 prevalence. Our epidemiologic analysis, despite the limits of the ecological approach, is strongly suggestive of a permissive role of HLA-C*01 and B*44 towards SARS-CoV-2 infection, which warrants further investigation in case-control studies. This study opens a new potential avenue for the identification of sub-populations at risk, which could provide Health Services with a tool to define more targeted clinical management strategies and priorities in vaccination campaigns.