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1.
PubMed; 2020.
Preprint in English | PubMed | ID: ppcovidwho-333540

ABSTRACT

BACKGROUND: A 2017 meta-analysis of data from 25 randomised controlled trials of vitamin D supplementation for the prevention of acute respiratory infections revealed a protective effect of the intervention. Since then, 20 new RCTs have been completed. METHODS: Systematic review and meta-analysis of data from randomised controlled trials (RCTs) of vitamin D for ARI prevention using a random effects model. Pre-specified sub-group analyses were done to determine whether effects of vitamin D on risk of ARI varied according to baseline 25-hydroxyvitamin D (25[OH]D) concentration or dosing regimen. We searched MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science and the ClinicalTrials.gov registry from inception to 1st May 2020. Double-blind RCTs of supplementation with vitamin D or calcidiol, of any duration, were eligible if they were approved by a Research Ethics Committee and if ARI incidence was collected prospectively and pre-specified as an efficacy outcome. Aggregate data, stratified by baseline 25(OH)D concentration, were obtained from study authors. The study was registered with PROSPERO (no. CRD42020190633). FINDINGS: We identified 45 eligible RCTs (total 73,384 participants). Data were obtained for 46,331 (98.0%) of 47,262 participants in 42 studies, aged 0 to 95 years. For the primary comparison of vitamin D supplementation vs. placebo, the intervention reduced risk of ARI overall (Odds Ratio [OR] 0.91, 95% CI 0.84 to 0.99;P for heterogeneity 0.01). No statistically significant effect of vitamin D was seen for any of the sub-groups defined by baseline 25(OH)D concentration. However, protective effects were seen for trials in which vitamin D was given using a daily dosing regimen (OR 0.75, 95% CI 0.61 to 0.93);at daily dose equivalents of 400-1000 IU (OR 0.70, 95% CI 0.55 to 0.89);and for a duration of <=12 months (OR 0.82, 95% CI 0.72 to 0.93). No significant interaction was seen between allocation to vitamin D vs. placebo and dose frequency, dose size, or study duration. Vitamin D did not influence the proportion of participants experiencing at least one serious adverse event (OR 0.97, 95% CI 0.86 to 1.09). Risk of bias within individual studies was assessed as being low for all but three trials. A funnel plot showed left-sided asymmetry (P=0.008, Egger's test). INTERPRETATION: Vitamin D supplementation was safe and reduced risk of ARI, despite evidence of significant heterogeneity across trials. Protection was associated with administration of daily doses of 400-1000 IU vitamin D for up to 12 months. The relevance of these findings to COVID-19 is not known and requires investigation. FUNDING: None.

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Notiziario dell'Istituto Superiore di Sanit ; 35(1):15-18, 2022.
Article in Italian | GIM | ID: covidwho-1756101

ABSTRACT

The National Transplant Centre, in order to follow the changes in communication tools and languages occurred during COVID-19 outbreak, has launched a new campaign about organ, tissue and cell donations. The methods of accessing and using information sources have also changed, focusing mainly on new digital and social platforms. On this basis, the National Transplant Centre launched an in-depth scenario research activity aiming at achieving a new strategy for the promotion of what discussed above. A new campaign was born, supported by the Ministry of Health, with the aim to give a new impulse to communication on the subject and to inform citizens on how to become donors.

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Reviews in Medical Microbiology ; 33(1):E148-E160, 2022.
Article in English | Web of Science | ID: covidwho-1583950

ABSTRACT

Coronavirus disease 2019 (COVID-19) was declared as a pandemic by the WHO on 2020 a novel disease with no confirmed and precise therapeutic agent. Lopinavir/ ritonavir has shown no benefit in 199 COVID-19 hospitalized adult patients compared with standard care alone. Remdesivir has shown promising results in the first case of COVID-19 in the USA, but recent reports were disappointing and still are under more investigation in clinical trials. The arbidol (Umifenovir) and Favipiravir act well in postexposure prophylaxis and viral clearance. Interferons in combination with other antiviral agents, if administered in the early stages of the disease, can cause advantageous effects. Ribavirin is no more recommended in new guidelines. Tocilizumab (Actemra) is an effective treatment in severe patients of COVID-19 and a new therapeutic strategy. Systemic corticosteroids seem to have a great impact in reducing mortality rate in mechanically ventilated patients. There are also some supplementary agents such as vitamin C, A, D, selenium, and zinc that have been reported to be effective in the prevention and treatment of viral infections. Recent findings indicate human recombinant soluble angiotensin-converting enzyme 2, niclosamide, and ivermectin had strong in-vitro results which can lead to fast in-vivo trials and help us to control infection. Copyright (C) 2021 Wolters Kluwer Health, Inc. All rights reserved.

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Public Health Nutrition ; 24(12):3905-3915, 2021.
Article in English | CAB Abstracts | ID: covidwho-1410769

ABSTRACT

Objective: To evaluate changes in ultra-processed food (UPF) intake and its major correlates during the first Italian lockdown (9 March-3 May 2020). Design: Retrospective observational study. Setting: Italy. Participants: We analysed 2992 subjects (mean age 57.9 +or- 15.3 years, 40.4% men). Individual participant data were pooled from two retrospective cohorts: (1) The Moli-LOCK cohort consists of 1501 adults, a portion of the larger Moli-sani study (n 24 325;2005-2010) who were administered a phone-based questionnaire to assess lifestyles and psychological factors during confinement and (2) the Analysis of Long Term Risk of Covid-19 Emergency is a web-based survey of 1491 individuals distributed throughout Italy who self-responded to the same questionnaire by using Google forms. UPF was defined according to NOVA classification based on degree of food processing. An UPF score was created by assigning 1 point to increased consumption, -1 to decreased and 0 point for unchanged intakes of nineteen food items, with higher values indicating an increase in UPF during confinement.

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Transplant International ; 34:199-199, 2021.
Article in English | Web of Science | ID: covidwho-1396069
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International Journal of Environmental Research & Public Health [Electronic Resource] ; 18(8):08, 2021.
Article in English | MEDLINE | ID: covidwho-1208753

ABSTRACT

Since December 2019, coronavirus disease (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has rapidly spread, becoming the first pandemic of the 21st century by number of deaths (over 2,000,000 worldwide). Many aspects of SARS-CoV-2 infection in children and adolescents remain unclear, and optimal treatment has not yet been defined. Therefore, our goal was to develop a consensus document, practically synthesizing the accumulated data and clinical experience of our expert group. Literature research was carried out using the keywords "COVID-19" or "SARS-CoV-2" and "children" or "pediatrics" and "prevention" or "diagnosis" or "MIS-C" or "treatment" in electronic databases (MEDLINE, PUBMED), existing guidelines and gray literature. The fact that the majority of the problems posed by SARS-CoV-2 infection in pediatric age do not need hospital care and that, therefore, infected children and adolescents can be managed at home highlights the need for a strengthening of territorial pediatric structures. The sharing of hospitalization and therapeutic management criteria for severe cases between professionals is essential to ensure a fair approach based on the best available knowledge. Moreover, the activity of social and health professionals must also include the description, management and limitation of psychophysical-relational damage resulting from the SARS-CoV-2 pandemic on the health of children and adolescents, whether or not affected by COVID-19. Due to the characteristics of COVID-19 pathology in pediatric age, the importance of strengthening the network between hospital and territorial pediatrics, school, educational, social and family personnel both for strictly clinical management and for the reduction in discomfort, with priority in children of more frail families, represents a priority.

14.
European Journal of Hospital Pharmacy. Science and Practice ; 28(Suppl 1):A108, 2021.
Article in English | ProQuest Central | ID: covidwho-1136093

ABSTRACT

Background and importanceIn the constantly evolving new regulations for clinical trials, the hospital pharmacist is more and more involved in clinical trials.1 In the current context of a deep economic crisis, clinical trials represent an important aspect of healthcare, especially for access to the latest generation therapies.Aim and objectivesThe aims of the study were to provide an overview of the governance of clinical trials and to estimate the cost savings generated by unused resources, attributable to the provision of drugs used in phase IV trials and for ‘compassionate use’.Material and methodsA retrospective study was conducted on clinical trials started between 1 July 2016 and 30 June 2020 in hospital settings. Characteristics analysed were phase and type of study, drug (according to anatomical chemical therapeutic classification (ATC)), method of storage and route of administration. The first arrival of supplies was considered as the index date. The savings were calculated by monetising supplies for phase IV and ‘compassionate use’. Costs estimated considered the ex-factory cost (excluding VAT), net of temporary legal reductions, where applicable.ResultsDuring the study period, 129 clinical trials were evaluated (phase I (1.2%), phase II (16.7%) phase III (54.9%), phase IV (10.9%) and ‘compassionate use’ (16.3%)): 44.44% were international multicentre trials and 92.6% were randomised blinded trials (double blind=22.4%). 188 different drugs were involved (70.5% stored at 2–8°C);solid oral formulations (11.78%). Phase IV trials involved eight drugs (ATC: A10A;B01A;J05A;L01C;L01X;N02C;N07X);‘compassionate use’ involved 12 drugs (ATC: L01XC=93%;L01XE=5%;other=2%). The overall savings was 1 046 341.79€ (compassionate use=85.61%). In the first semester of 2020, savings were 309 736.00€. In particular, savings were related to use of ATC:L01X (93.81%) and ATC:N02C (6.19%). In the first semester of 2020, with the pandemic in progress, 2.48% of trials in the digestive pathophysiology area (29/129) saw at least one referral to the patient‘s home.Conclusion and relevanceClinical research generates not only economic value for the health system, but also clinical benefits related to the availability of innovative therapies. This study showed that the care system for clinical trials worked even during an unprecedented health emergency. Thanks to the collaboration of all the health professionals involved, no ‘lockdown effect’ resulted in detriment to the patients enrolled in clinical trials.References and/or acknowledgementsDe Fina, et al. IJMSBR 2020;07:01–08.Conflict of interestNo conflict of interest

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