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Introduction: The sudden changes in daily routine due to the containment measures adopted for facing the COVID-19 pandemic have had an impact on the mental health of the general population. In particular, young adults are exposed to a higher risk compared to the general population to suffer from the consequences of the pandemic, in terms of anger and irritability, depressive symptoms and somatic complaints, insomnia, lack of motivation and loneliness. In particular, loneliness can be particularly pronounced during young adulthood. Objective(s): This study aimed to describe the levels of loneliness in a sample of Italian young people during the national lockdown in 2020, evaluating clinical and socio-demographic differences and the role of coping strategies and levels of resilience. Method(s): A sub-analysis of a sample of adults aged 18-34 years has been drawn on a larger cross-sectional observational national trial (COMET, 2020) in which, among other psychopathological dimensions, the levels of loneliness have been assessed by the UCLA scale short version. Result(s): Levels of lonelinesswere particularly severe in a third of cases (risk factors: unemployment, low income and vulnerability inmental health), in association with depression, anxiety, stress, OCD symptoms, higher rates of suicidal ideation, sleep disturbance and excessive use of Internet. Levels of loneliness tended to increase over time. Conclusion(s): Overall, during the Italian COVID-19 lockdown young people have experienced quite high levels of loneliness: this dimension could represent a useful domain to assess in routine clinical practice.
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Introduction: The COVID-19 pandemic represents a new form of trauma, which is impacting on the mental health of the general population. However, the effects of this new trauma are variable, being mediated by individual factors such as the levels of resilience and the coping strategies. Objective(s): The aims of the present study are: 1) describe the levels of resilience and the type of coping strategies adopted by the Italian general adult population during the first wave of the pandemic;2) evaluate the protective role of coping strategies and resilience on the levels of depressive, anxiety and stress symptoms. Method(s): An online survey has been developed, which includes several validated self-reported questionnaires for the evaluation of participants' mental health condition, coping strategies and levels of resilience. The main outcome measure is the Depression Anxiety and Stress Scale-21 (DASS-21). Result(s): The finale sample consists of 20,720 participants, more than half reported low levels of resilience, which were not associated with age or gender. The levels of resilience did not differ among the general population, patients with pre-existing mental disorders and those infected by COVID-19. People with low levels of resilience rarely used adaptive coping strategies. The levels of resilience did not have any influence on stress, depressive or anxiety symptoms. Conclusion(s): The presence of low levels of resilience in the general population may be the missing link between the pandemic and increasing concerns on mental health problems. This could be important for the development of ad-hoc supportive and preventive psychosocial interventions.
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COVID-19 has impacted several sectors, designing news way of collaboration and interaction with customers and partners. The performing arts sector is one of the most affected;activities have been stopped for months and months but, at the same time, the sector has embarked on a systemic transition where old, unsustainable practices have been replaced with more sustainable and technology-based alternatives. Through a narrative literature review, the paper discusses needs, current studies based on immersive technologies, strengths and weakness to be managed, opportunities to be leveraged and threats to be overcome, in order to improve competitiveness and plan future actions. Academics and practitioners can benefit from the results to address their current research and activities. © 2022, Springer Nature Switzerland AG.
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COVID-19 vaccination campagnies with several vaccines types are currently undeway. Recently, the ASTRA ZENECA vaccine has raised public alarm with concerns regarding the development of thrombotic events known as vaccine-induced thrombotic thrombocytopenia (VITT). Early and limited studies have implicated an antibody-mediated platelet activation as the mechanism of the clotting events. Aim of this study was to investigate the platelet and coagulation activation using specialized tests. In this study we enrolled 60 patients (40 men, 20 women;mean age 55±10 years) without cardiovascular risk factors or a history of thrombosis who reported having poplitea deep vein thrombosis (35/60) and pulmonary embolism (25/60) revealed with lower-limb ultrasonography and computed tomography (CT) angiography, respectively, 7 days after vaccination with ASTRA ZENECA. All patients were evaluated for initial testing such as platelet count, prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (Fib) and D-dimer (DD). Platelets were measured by automated analyzer, PT and APTT by coagulometric test, Fib using Clauss method, and DD using ELISA. Complete blood hemostasis was studied by platelet function assay (PFA-100) on Collagen/ADP (CT-ADP) and Collagen/Epinephrine (CT-EPI) cartridges and Thromboelastometry method on Clotting Time (CT), Clotting Formation Time (CFT), Maximum Clot Firmness (MCF), and clot lysis at 30 minutes (LY-30). All patients had thrombocytopenia (60±5x109/L), longer PT (28±10 s) and PTT (50±10 s), lower Fib (80±20 mg/dl), higher DD ((550±100 mg/l). All patients had shorter C/ADP and C/EPI (C/ADP, n.v. 68-121 s (42±10 s) and C/EPI n.v. 84-160 s (38±5 s) and shorter CT (CT, unit: s. n.v. 100-240 s) (INTEM 30±20 s, EXTEM 18±10 s), shorter CFT (CFT, unit: s, n.v. 30-160 s (INTEM 11±10 s, EXTEM 19±10 s), longer MCF (MCF, unit: mm, n.v. 50-72 mm (INTEM 128±10 mm, EXTEM 110±10 mm), and lower LY-30 (LY-30, %: v.n. 15% (INTEM 0.8%, EXTEM 0.7%). These interesting findings may be the novelty in the diagnostic work-up of the VITT. If these tests may aid in the diagnosis of VITT deserve to be confirmed and need reproducing in other studies.
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Background : Coagulopathy has been reported in severe coronavirus disease 2019 (COVID-19) but its pathogenesis remains elusive. Aims : We assessed the inflammation, endothelial and haemostatic markers including IL-6 and Tumor Necrosis Factor-a (TNFa), Tissue Factor (TF), von Willebrand Factor (VWF), and Tissue Factor Pathway Inhibitor (TFPI) as a natural anticoagulant known to attenuate inflammation and vascular thrombosis, and DD, thrombin antithrombin complex (TAT), Fibrinogen (Fib), and Platelet Factor 4 (PF4) and b-Thromboglobulin (b-TG). Methods : We prospectively enrolled 100 severe (60 men, 40 women;mean age 51 years, 32-60) and 60 mild/asymptomatic (40 men, 20 women;mean age 50 years, 31-59) patients COVID-19 reverse transcription polymerase chain reaction (RT-PCR)-confirmed cases. Severe COVID-19 patients had fever, respiratory symptoms and viral pneumonia on computed tomography scan (CT) receiving mechanical ventilation. Our management protocol included antithrombotic prophylaxis with 40 to 60 mg of enoxaparin per day and empirical antimicrobial treatment and antiviral therapy and corticosteroid during the course of hospitalization. IL-6 and TNF-a were measured using multiplex bead array, TF, VWF and TFPI and PF4 and β-TG by ELISA. Results : Severe COVID-19 had elevated IL-6 and TNF-a, and TF, VWF and TFPI (50 ± 10 pg/ml and 40 ± 5 pg/ml and 2000 ± 400 pg/ml, 390 ± 50% and 176 ± 60 ng/ml) compared with mild/asymptomatic COVID-19 (4 ± 1 pg/ml and 8 ± 2 pg/ml and 19 ± 2 pg/ml, 51 ± 8% and 74 ± 10 ng/ml) as well as DD, TAT and Fib (540 ± 100 mg/l, 72 ± 10 mg/l and 610 ± 20 mg/dl) compared with mild/asymptomatic COVID-19 (59 ± 5 mg/l, 2 ± 1 mg/l and 175 ± 10 mg/l) and PF4 and b-TG (160 ± 63 IU/ml and 250 ± 16 IU/ml) compared with mild/asymptomatic COVID-19 (3 ± 2 UI/ml and 9 ± 5 IU/ml). A positive correlation there was between studied parameters ( P < .05). Conclusions : These findings demonstrate that severe COVID-19 has profound inflammation associated to severe endotheliopathy leading increased uncontrolled TFPI haemostatic activity.
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Background: Myeloproliferative Neoplasms (MPNs) - polycythemia vera (PV), essential thrombocythemia (ET), and primary myelofibrosis (PMF) - are marked by thrombosis. COVID-19 infection is marked by thrombosis as reported in China and confirmed in autopsies of patients experiencing sudden death. The thrombosis in MPNs is related to inflammation and endotheliopathy. The thrombosis in COVID-19 may be related to devastating enhancement of inflammation ("cytokine storm") and profound endotheliopathy, known as COVID-19-associated coagulopathy (CAC). It is showed that patients with hematological malignancies and COVID-19 had worse outcomes. It is unclear if COVID-19 exerts additive or synergistic thrombotic effects. Aims: Therefore, we evaluated Interleukin-6 (IL-6) and Tissue Factor (TF), as inflammatory and endothelial mediators, D-dimer (DD), thrombin antithrombin complex (TAT) and Fibrinogen (Fib), as coagulation activation mediators, platelet factor 4 (PF4), as platelet activation mediator, and whole blood viscoelastic analysis, as indicator of whole hemostatic activation. Methods: The cohort study included 120 WHO-defined MPNs patients with COVID-19 ascertained by positive RT-PCR on nasopharyngeal swab (n= 40 PV, n= 40 ET, n= 40 PMF) (60 men, 60 women;mean age 51 years, range 32-60) and 90 WHO-defined MPNs patients without COVID-19 (n= 30 PV, n= 30 ET, n= 30 PMF) (45 men, 45 women, mean age 50 years, range 30-60). All patients gave written informed consent for study enrollment. The mean duration of disease was 12 years. All patients were on ASA 100 mg once daily. Concerning presentation and therapy, our MPNs patients with COVID-19 and without COVID-19 had not comorbidities and drug treatment was consistent with therapeutic standards (hydroxyurea, interferon, anagrelide, ruxolitinib). All patients were on ASA 100 mg once daily. IL-6 was measured by multiplex bead array (Millipore Sigma), TF and DD, and TAT by ELISA and Fib by Clauss method. PF4 was determined by ELISA. Whole blood viscoelastic analysis including clotting time (CT), and clot formation time (CFT) were measured by thomboelastometry method. Results: MPNs with COVID-19 had high IL-6 and TF (50±12pg/ml and 1950±500 pg/ml) compared with MPNs without COVID-19 (3±2pg/ml and 19±2 pg/ml), as well as DD, TAT and Fib (549±100 □g/l, 69±10 □g/l and 590±20mg/dl) compared with MPNs without COVID-19 (59±5□g/l, 2±1□g/l and 149±10 mg/l). PF4 was elevated (150.1□62.7 IU/ml) in MPNs with COVID-19 compared with MPNs without COVID-19 (2□1 UI/ml). A positive correlation was found between inflammatory, endothelial and coagulation mediators. A p-value of <.05 was considered statistically significant. Shortened CT (CT, unit: s. n.v. 100-240 s) (40±20 s) and shortened CFT (CFT, unit: s, n.v. 30-160 s (14±10 s) there were in MPNs with COVID-19 compared with MPNs without COVID-19 (CT 99±10 s and CFT 39±5 s). Summary/Conclusion: These data suggest that COVID-19 infection in MPNs patients may increase the thrombotic risk and get worse prognosis. In our opinion, this study can serve as a baseline study of COVID-19 thrombotic risk in MPNs and it is worthy of dissemination amongst patients and clinician communities.