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1.
Clin Infect Dis ; 74(5): 893-896, 2022 03 09.
Article in English | MEDLINE | ID: covidwho-1703879

ABSTRACT

We analyzed 221 coronavirus disease 2019 cases identified between June 2020 and January 2021 in 6074 individuals screened for immunoglobulin G antibodies in May 2020, representing 77% of residents of 5 Italian municipalities. The relative risk of developing symptomatic infection in seropositive participants was 0.055 (95% confidence interval, .014-.220).


Subject(s)
COVID-19 , SARS-CoV-2 , Antibodies, Viral , Humans , Immunoglobulin G , Reinfection
2.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-308560

ABSTRACT

BACKGROUND: The aim of this retrospective comparative study was to assess the impact of the COVID-19 related disease on emergency surgery, comparing clinical main outcomes in the period March –May 2019 (Group 1) with the same period in Covid-19 Italian lockdown (March-May 2020, Group 2). METHODS: A comparison (Group 1 versus 2) was performed between the demographic, anamnestic, surgical, clinical and management features. RESULTS: 246 patients were included, 137 in Group 1 and 109 in Group 2 (p=0.03). No significant differences in peri-operative characteristics were registered. A declared delay in access to hospital and SARS-CoV-2 preoperatively infection rates were 15.5% and 5.8% respectively in Group 2. The overall morbidity (OR=2.22, 95%CI=1.08-4.55, p=0.03) and 30-day mortality (OR=1.34, 95%CI=0.33-5.50, =0.68) increased significantly in Group 2. Delayed access cohort demonstrated a close correlation with increased morbidity (OR=3.19, 95%CI=0.89-11.44, p=0.07), blood transfusion (OR=5.13, 95%CI=1.05-25.15, p=0.04) and a 30-day mortality risk (OR=8.00, 95%CI=1.01-63.23, p=0.05). Positive SARS-CoV-2 patients had higher risk of blood transfusion (20% vs 7.8%, p= 0.37), ICU admissions (20% vs 2.6%, p= 0.17) and median LOS (9 days vs 4 days, p= 0.11). CONCLUSIONS: This article provides enhanced understanding of the effects of the COVID-19 pandemic on patients access to emergency surgical care. Our findings suggest that COVID-19 changed the quality of surgical care with poorer prognosis and higher morbidity rates. A delayed Emergency Department access and a “filter effect” induced by a COVID-fear in the population resulted in only the most severe cases reaching the Emergency Department in time.

3.
Ann Ist Super Sanita ; 57(4): 265-271, 2021.
Article in English | MEDLINE | ID: covidwho-1614145

ABSTRACT

INTRODUCTION: To evaluate the decline of antibodies induced by SARS-CoV-2 infection, the individuals resident in 5 municipalities of the Autonomous Province of Trento, Northern Italy, who resulted IgG positive for anti-SARS-CoV-2 nucleocapsid (NC) in May 2020, were tested four months later. METHODS: Anti-SARS-CoV-2 NC antibodies were detected using the Abbott SARS-CoV-2 IgG assay. Samples that gave a negative result were re-tested using the Liaison SARS-CoV-2 IgG assay to assess anti-spike (S) S1/S2 antibodies. The fifty-percent tissue culture infective dose (TCID50) neutralizing assay was performed on a subgroup of formerly positive sera. Statistical analysis was performed by STATA version 16.1 (STATA Corp., College Station, Texas, USA). RESULTS: Overall, 480 out of 1159 participants became seronegative for anti-NC IgG antibodies. Age above 70 years and cough were associated with persistent anti-NC IgG levels. Most anti-NC IgG negative sera were positive for anti-S IgG (77.9%). The neutralization assay showed high concordance with anti-S antibodies positivity. CONCLUSION: In conclusion, a decline of anti-NC IgG values was recorded four months after the first evaluation. A high proportion of anti-NC seronegative individuals were positive for anti-spike IgG antibodies, which appear to persist longer and to better correlate with neutralization activity.


Subject(s)
Antibodies, Neutralizing , COVID-19 , Aged , Antibodies, Viral , COVID-19 Serological Testing , Humans , SARS-CoV-2
5.
Int J Environ Res Public Health ; 18(16)2021 08 10.
Article in English | MEDLINE | ID: covidwho-1348641

ABSTRACT

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic had a devastating impact on nursing homes/long-term care facilities. This study examined the relationship between geography, size, design, organizational characteristics, and implementation of infection prevention and control (IPC) measures and the extent of COVID-19 outbreaks in nursing homes in the Autonomous Province of Trento (Italy) during the time frame of March-May 2020. METHODS: The analysis included 57 nursing homes (5145 beds). The association between median cumulative incidence of COVID-19 cases among residents and characteristics of nursing homes was assessed by Mann-Whitney U test, Kruskal-Wallis test or Spearman rho. To evaluate the potential confounding of geographical area, a 2-level random intercept logistic model was fitted, with level 1 units (patients in nursing homes) nested into level 2 units (nursing homes), and "being a COVID-19 case" as the dependent variable. RESULTS: Median cumulative incidence was not significantly associated with any of the variables, except for geographical region (p = 0.002). COVID-19 cases clustered in the part of the province bordering the Italian region most affected by the pandemic (Lombardy) (45.2% median cumulative incidence). CONCLUSIONS: Structural/organizational factors and standard IPC measures may not predict the epidemiology of COVID-19 outbreaks and be sufficient alone to protect nursing homes against them.


Subject(s)
COVID-19 , Disease Outbreaks , Humans , Nursing Homes , Retrospective Studies , Risk Factors , SARS-CoV-2
6.
World J Emerg Surg ; 16(1): 37, 2021 07 13.
Article in English | MEDLINE | ID: covidwho-1309917

ABSTRACT

BACKGROUND: The aim of this retrospective comparative study was to assess the impact of COVID-19 and delayed emergency department access on emergency surgery outcomes, by comparing the main clinical outcomes in the period March-May 2019 (group 1) with the same period during the national COVID-19 lockdown in Italy (March-May 2020, group 2). METHODS: A comparison (groups 1 versus 2) and subgroup analysis were performed between patients' demographic, medical history, surgical, clinical and management characteristics. RESULTS: Two-hundred forty-six patients were included, 137 in group 1 and 109 in group 2 (p = 0.03). No significant differences were observed in the peri-operative characteristics of the two groups. A declared delay in access to hospital and preoperative SARS-CoV-2 infection rates were 15.5% and 5.8%, respectively in group 2. The overall morbidity (OR = 2.22, 95% CI 1.08-4.55, p = 0.03) and 30-day mortality (OR = 1.34, 95% CI 0.33-5.50, =0.68) were significantly higher in group 2. The delayed access cohort showed a close correlation with increased morbidity (OR = 3.19, 95% CI 0.89-11.44, p = 0.07), blood transfusion (OR = 5.13, 95% CI 1.05-25.15, p = 0.04) and 30-day mortality risk (OR = 8.00, 95% CI 1.01-63.23, p = 0.05). SARS-CoV-2-positive patients had higher risk of blood transfusion (20% vs 7.8%, p = 0.37) and ICU admissions (20% vs 2.6%, p = 0.17) and a longer median LOS (9 days vs 4 days, p = 0.11). CONCLUSIONS: This article provides enhanced understanding of the effects of the COVID-19 pandemic on patient access to emergency surgical care. Our findings suggest that COVID-19 changed the quality of surgical care with poorer prognosis and higher morbidity rates. Delayed emergency department access and a "filter effect" induced by a fear of COVID-19 infection in the population resulted in only the most severe cases reaching the emergency department in time.


Subject(s)
COVID-19/epidemiology , Emergencies , Emergency Service, Hospital/statistics & numerical data , Pandemics , Surgical Procedures, Operative/statistics & numerical data , Time-to-Treatment/statistics & numerical data , Adult , Aged , Communicable Disease Control/methods , Comorbidity , Female , Follow-Up Studies , Hospitalization/trends , Humans , Italy/epidemiology , Male , Middle Aged , Retrospective Studies
7.
Clin Infect Dis ; 74(5): 893-896, 2022 03 09.
Article in English | MEDLINE | ID: covidwho-1270734

ABSTRACT

We analyzed 221 coronavirus disease 2019 cases identified between June 2020 and January 2021 in 6074 individuals screened for immunoglobulin G antibodies in May 2020, representing 77% of residents of 5 Italian municipalities. The relative risk of developing symptomatic infection in seropositive participants was 0.055 (95% confidence interval, .014-.220).


Subject(s)
COVID-19 , SARS-CoV-2 , Antibodies, Viral , Humans , Immunoglobulin G , Reinfection
8.
Z Gesundh Wiss ; 30(1): 77-92, 2022.
Article in English | MEDLINE | ID: covidwho-1270517

ABSTRACT

AIM: In response to the SARS-CoV-2 emergency, the Competence Centre on digital health 'TrentinoSalute4.0' has developed TreC_Televisita, a tele visit solution that meets the needs of the Trentino healthcare system and maintains high-quality patient-doctor interactions while respecting social distancing. This paper highlights how 'TreC_Televisita' was integrated into the Trentino healthcare system and its potential to become a structural and durable solution for the future local healthcare service provisioning. SUBJECT AND METHODS: This paper presents the multifactorial context that TreC_Televisita has faced for its implementation and the strategies adopted for its structural integration into the healthcare system. The analysis focuses on the main issues faced for the integration of the tele visits (e.g. privacy, payments) and how the context of TrentinoSalute4.0 permitted responding quickly to its implementation during the pandemic. It also describes how TreC_Televisita fits into the healthcare continuum from the organisational and technological standpoint, the end-user perspective and the barriers that could hamper the solution scalability. RESULTS: TreC_Televisita has demonstrated to be a technological solution that can be contextualised for different clinical domains beyond SARS-CoV-2. Moreover, it has shown its potential to scale up the solution beyond the COVID-19 emergency to the whole healthcare provisioning system in the long term. CONCLUSION: Being a positive experience in the first months of its implementation, the long-term goal is to transform TreC_Televisita into a structural pillar of the Trentino healthcare system, setting the bases for a sustainable, win-win situation for all the stakeholders involved in healthcare service provisioning.

9.
Clin Microbiol Infect ; 27(4): 633.e1-633.e7, 2021 Apr.
Article in English | MEDLINE | ID: covidwho-987373

ABSTRACT

OBJECTIVES: A seroprevalence study of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was conducted in a high-incidence area located in northeastern Italy. METHODS: All citizens above 10 years of age resident in five municipalities of the Autonomous Province of Trento, with the highest incidence of coronavirus disease 2019 (COVID-19) cases, were invited to participate in the study. Among 6098 participants, 6075 sera and a standardized questionnaire administered face-to-face were collected between 5 May and 15 May 2020 and examined. Symptomatic individuals and their family contacts were tested by RT-PCR. Anti-SARS-CoV-2 antibodies were detected using an Abbott SARS-CoV-2 IgG assay, which was performed on the Abbott Architect i2000SR automated analyser. Seroprevalence was calculated as the proportion of positive results among the total number tested. A multivariable logistic regression model was performed to assess the relationship between seropositive versus seronegative individuals for a set of explanatory variables. RESULTS: A total of 1402 participants were positive for IgG antibodies against SARS-CoV-2, with a prevalence of 23.1% (1402/6075). The highest prevalence was found in the age class 40-49 years. Overall, 34.4% (2096/6098) of the participants reported at least one symptom. The ratio between reported cases identified by molecular test and those with seropositive results was 1:3, with a maximum ratio of about 1:7 in the age group <20 years and a minimum around 1:1 in those >70 years old. The infection fatality rate was 2.5% (35/1402). Among the symptoms, anosmia and ageusia were strongly associated with seropositivity. CONCLUSIONS: The estimated seroprevalence of 23% was three-fold higher than the number of cases reported in the COVID-19 Integrated Surveillance data in the study area. This may be explained in part by a relatively high number of individuals presenting mild or no illness, especially those of younger age, and people who did not seek medical care or testing, but who may contribute to virus transmission in the community.


Subject(s)
Antibodies, Viral/blood , COVID-19 Serological Testing , COVID-19/epidemiology , Immunoglobulin G/blood , SARS-CoV-2/immunology , Adolescent , Adult , Aged , COVID-19/immunology , COVID-19 Nucleic Acid Testing , Female , Humans , Incidence , Italy/epidemiology , Male , Middle Aged , Seroepidemiologic Studies , Young Adult
10.
Int J Cardiol Heart Vasc ; 30: 100625, 2020 Oct.
Article in English | MEDLINE | ID: covidwho-739833

ABSTRACT

INTRODUCTION: During the recent COVID-19 outbreak, Italian health authorities mandated to replace in-person outpatient evaluations with remote evaluations. METHODS: From March 16th 2020 to April 22th 2020, all outpatients scheduled for in-person cardiac evaluations were instead evaluated by phone. We aimed to report the short-term follow-up of 345 patients evaluated remotely and to compare it with a cohort of patients evaluated in-person during the same period in 2019. RESULTS: During a mean follow-up of 54 ± 11 days, a significantly higher proportion of patients evaluated in-person in 2019 visited the emergency department or died for any cause (39/391, 10% versus 13/345 3.7%, p = 0.001) and visited the emergency department for cardiovascular causes (19/391, 4.9% versus 7/345, 2.0%, p = 0.04) compared to 2020. No cardiovascular death was recorded in the two periods. To an evaluation with a satisfaction questionnaire 49% of patients would like to continue using remote controls in addition to traditional ones. CONCLUSION: These findings may have important implications for the management of patients during the current COVID-19 pandemic because they suggest that remote cardiovascular evaluations may replace in-hospital visits for a limited period.

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