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1.
Eur Heart J ; 43(Suppl 2), 2022.
Article in English | PubMed Central | ID: covidwho-2107416

ABSTRACT

Background: Clinical manifestations of children's coronavirus disease-2019 (COVID-19) were initially considered less severe compared with adult patients. However, there is now increasing evidence of a “long-tail” of COVID-19 related symptoms lasting for several months after recovery from the acute infection. Long COVID-19-related symptoms and mechanisms are poorly characterized and understood, with several phenotypes reported, often driven by long-term tissue damage (such as lung, heart and brain) and pathological inflammation due to viral persistence and/or immune deregulation. Purpose: The objective of this study was to evaluate atrio-ventricular mechanics, by means of two-dimensional speckle-tracking echocardiography, in previously healthy children recovered from asymptomatic or mildly symptomatic severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection in a long-term follow-up. Methods: We analysed a cohort of 157 paediatric patients, mean age 7±4 years, who had a confirmed diagnosis of SARS-CoV-2 infection and were asymptomatic or mildly symptomatic for COVID-19. Patients underwent standard transthoracic echocardiogram and speckle tracking echocardiographic study 148±68 days after diagnosis. One hundred seven age, sex, and body surface area comparable healthy subjects were used as control group. Results: Left ventricular ejection fraction was within normal limits in postCOVID-19 cases and CTRL with no significant differences between the two groups (postCOVID-19: 65.6±4% vs CTRL: 65.0±5%, p=0.182).Left ventricular (LV) global longitudinal strain (postCOVID-19: −20.5±2.9%;CTRL: −21.8±1.7%;p<0.001) was significantly reduced in cases compared with CTRLs. An amount of 11 (7%) postCOVID-19 cases showed impaired GLS values < −17% and 95 subjects (60%) presented with a strain lower than −16% in more than 2 segments. These subjects did not show any difference regarding symptoms or serological findings. Moreover, GLS was significantly reduced in children with disease's onset during the second wave of COVID-19 pandemic, compared with those during the first wave (second wave: −20.2±2.6%;first wave: −21.2±3.4%;p=0.048). Finally, peak left atrial systolic strain was within the normal range in the postCOVID-19 group with no significant differences compared to CTRL (postCOVID-19: 49.1±12%;CTRL: 49.5±18%). Conclusions: SARS-CoV-2 infection may affect left ventricular deformation in children despite an asymptomatic or only mildly symptomatic acute illness. Our data show an amount of 60% of children, recovering from asymptomatic or mildly symptomatic COVID-19, with still mild subclinical systolic cardiac impairment in the mid- and long-term follow-up after the infection. This subtle impairment was seen to be worse in children recovering from the second wave of COVID-19 compared to the first one.A follow-up is needed to verify the reversibility of these alterations and their impact on long-term outcomes. Funding Acknowledgement: Type of funding sources: None.

2.
Acs Es&T Water ; : 11, 2022.
Article in English | Web of Science | ID: covidwho-1927041

ABSTRACT

Wastewater-based epidemiology is now widely used as an indirect tool to monitor the spread of SARS-CoV-2. In this study, five different sample matrices representing diverse phases of the wastewater treatment process were collected during the second wave of SARS-CoV-2 from two wastewater treatment plants (WWTPs) serving the Civil Hospital and Sacca Fisola island in Venice, Italy. Positive SARS-CoV-2 detections occurred at both WWTPs, and data on viral genome detection rate and quantification suggest that the pellet (i.e., the particulate resulting from the influent) is a sensitive matrix that permits reliable assessment of infection prevalence while reducing time to results. On the contrary, analysis of post-treatment matrices provides evidence of the decontamination efficacy of both WWTPs. Finally, direct sequencing of wastewater samples enabled us to identify B.1.177 and B.1.160 as the prevalent SARS-CoV-2 lineages circulating in Venice at the time of sampling. This study confirmed the suitability of wastewater testing for studying SARS-CoV-2 circulation and established a simplified workflow for the prompt detection and characterization of the virus.

3.
Italian Journal of Medicine ; 16(SUPPL 1):21, 2022.
Article in English | EMBASE | ID: covidwho-1913295

ABSTRACT

Background: COVID-19 is a worldwide emergency;hospitals are subjected to intense workloads, reduced compared to the previous waves, for advent of vaccination and use of immunomodulators Aim: to evaluate the clinical outcome of patients during the last wave in a Spoke hospital and compare the results with those of the end of 2020. Methods: In the period Dec. 21-Jan. 22 we treated 105 patients (62 men, average age 68.4 y, range 30-99, 51 polipathological), 56 of them with complete vaccination cycle ;the mean age of the vaccinated was lower (65.2+-15.1 vs 71.8+-15.7);in addition to therapy with EBPM and dexamethasone if indicated, 23 with risk factors were treated with casirivimab and indevimab 1200+1200 mg, 33 with remdesivir and 9 baricitinib;6 patients with combination therapies. The mean hospital stay was 7.9 days, range 3-24. Results: 10 patients died (5 unvaccinated) and 13 needed UTI (10 NIV support, 6 unvaccinated, and 3 IOT, 2 unvaccinated) but with a favorable evolution in over 2/3 of the cases;the other patients were discharged at home. Considering then other 75 hospitalized patients between Dec 20-Jan21, 53 men, average age 69.5 y, range 36-91, treated only with standard therapy (EBPM and steroid), the average stay had been 12.6 days and the previous outcome was 23 transferred UTI (8 intubated) and total of 17 deaths. Conclusions: With advent of vaccines, monoclonal antibodies, antivirals and immunomodulators, hospitalization times, the need for intensive care (13 vs 23) and deaths (10 vs 17) have been approximately halved.

4.
Italian Journal of Medicine ; 16(SUPPL 1):53-54, 2022.
Article in English | EMBASE | ID: covidwho-1913294

ABSTRACT

Background: Remdesivir (REM) is authorized to cure COVID-19 pneumonia with low oxygen supplementation. We evaluated the effect of combination of REM and usual treatment with enoxaparin and dexamethasone on clinical outcome. Methods: A prospective open study with REM (200 mg first day and then 100 mg /day for four days) was performed in a medical unit with critical sector in the period of half november 2021 and half January 2022 . All COVID-19 patients requiring supplemental low O2 therapy were treated with enoxaparin (4000 unit/day for almost patients) and dexamethasone (6 mg);three patients were treated even with baricitinib for rapid pulmonary deterioration. The primary endpoint was the final outcome with discharge from Hospital. Results: 33 COVID-19 patients were enrolled, 20 men, mean age 66 y (range 41-87);14 patients with a complete vaccinal schedule;therapy was started 1-2 days after entering the hospital. The lenght of hospitalization was 7.5 days with a range of 7-25;mortality in two patients (one not vaccinated), need of intensive care in 10 patients with favorouble evolution (3 with oral intubation and seven with non invasive ventilation support);at the end, 31 patients were discharged or at home or at sub acute unit. We did not observe major side effects, cough, headache, moderate increase of transaminases Conclusions: REM treatment, associated with heparin, dexamethasone and oxigen supplement, especially if started early, is safety and associated with reduced length of hospitalization and reduction mortality.

5.
Italian Journal of Medicine ; 15(3):10, 2021.
Article in English | EMBASE | ID: covidwho-1567790

ABSTRACT

Background: Many CoViD-19-infected patients may die due to an over-response of the immune system (IS) characterized by the abnormal release of circulating cytokines. The SARS-CoV-2 virus binds to alveolar cells, activating the IS, with the release of numerous cytokines, including interleukin 6 (IL-6), which is responsible for the increase of the reactive C protein (PCR). PCR is useful for assessing the trend of acute inflammation in patients with CoViD-19 pneumonia, while the dosage of IL-6 is not routine. Materials and Methods: In 35 consecutive patients coming from the Emergency Room and then admitted to our division, we dosed IL-6 and PCR at the entrance (T0) and after 5 days (T5), to understand if the combination of the 2 values could be more predictive of the course of the disease. The degree of clinical stability was assessed using the Modified Early Warning Score (Mews). Results: At T0 the subjects with MEWS score 0 were 9, score 1 were 11, score 2 were 12, 1 score 3, 1 score 4. The average value of IL-6 of the subjects to T0 was 52.6 (range 16-150), with higher values in subjects with higher MEWS, from score 0 to 3 respectively: 16.9, 46.8, 76.4, 150.0. Values of IL-6 at T5 remain increasing as the MEWS score increases, with average values=24.3 for MEWS 0-2 and 138.7 for MEWS 3-5 (p=0.07). Similar trends presented PCR values: with average values of 41.0 for MEWS 0-2 and 144.4 for MEWS 3-5 (p<0.05). Conclusions: Preliminary data from our study, limited by the small sample, suggest that high values of IL-6 and PCR are present in patients with more severe clinical scores, and should be confirmed by larger-scale studies.

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