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Italian Journal of Medicine ; 15(3):60-61, 2021.
Article in English | EMBASE | ID: covidwho-1567680


Background and Aim:We currently do not have a specific therapy for SARS-CoV-2 infection;experimental therapies have been improved with various drugs such as lopinavir/ritonavir, hydroxychloroquine, tocilizumab with controversial data about efficacy. The aim of the study is to highlight any gender differences in the response to the aforementioned therapies. Materials and Methods: Retrospective analysis of 234 patients, 96 F and 138 M, referring to our CoViD UNIT from March 2020 to April 2021, divided into groups based on the administered drug. Results: Lopinavir/ritonavir: in the overall cohort (M+F) the drug reduces the risk of death/ICU admission (p=0.01);this impact on the outcome is not significant in the individual groups M and F when analyzed separately. On the other hand, considering mortality alone, in the collective group this was lower in treated patients, an efficacy figure that does not differ in the two sexes after stratification by gender. Hydroxychloroquine: considering the whole cohort there is a reduced mortality in the treated (p <0.001). The impact of the drug on the risk of death/intensive care admission is comparable in the two sexes. Tocilizumab: the drug does not change the risk of death/ICU admission in the overall group;the subgroup analysis is lacking due to the small number of samples. Conclusions: The gender difference does not show a significant impact on the efficacy of the drugs considered. New studies, on larger cohorts, are needed to confirm or refute these preliminary data.

Italian Journal of Medicine ; 15(3):6, 2021.
Article in English | EMBASE | ID: covidwho-1567594


Background and Aim: Vaccination against SARS-CoV-2 started in Italy in January 2021. First, healthcare personnel were vaccinated. Immunization of subjects should lead to a reduction in the clinical manifestations of the disease. Aim of the study was to evaluate the antibody response after the administration of two doses of the BNT162b2 SARS-CoV-2 mRNA vaccine. Materials and Methods: We determined antibody levels at baseline (before second dose of vaccine) and 3 weeks after the second dose of the BNT162b2 SARS-CoV-2 mRNA vaccine in 92 (middle age 44±12 ) health care workers (35 male 38%, and 57 female). Written informed consent was obtained for all study participants. Results: Antibody responses was of 452 U/mL±2744 (median 36, interquartile range 9-99) vs 3154±4389 (median 1957, interquartile range 1242-3238) p<0.001 (average increase of 2702±2554). Excluding 3 cases with baseline value>1000 the response was 63±92 (median 35, interquartile range 8-78) vs 2693±2410 (median 1912, interquartile range 1241-3136) p<0.001 (average increase of 2630±2369). According to multivariate regression analysis: baseline is inversely associated with age (p <0.001) but not with sex (p=0.393);post sampling is inversely associated with age (p=0.003) but not with sex (p=0.653). Conclusions: Our data demonstrate that the antibody response after the administration of two doses of the BNT162b2 SARS-CoV-2 mRNA vaccine was obtained in 100% of the subjects studied. In particular, there is a relationship with age: younger subjects show a more robust response. Gender does not influence extent of response.

Italian Journal of Medicine ; 15(3):34, 2021.
Article in English | EMBASE | ID: covidwho-1567458


Background and Aim of the study: CoViD-19 pandemic required to the physicians the necessity to gain effective treatments against this infectious disease;one of the tried drugs is remdesivir. The aim of our study is to analyze clinical and laboratory features of a cohort of CoViD-19 patients treated with remdesivir. Materials and Methods:We evaluated retrospectively data of 22 patients (18 men and 4 women), considering two main items: the trend of inflammation markers (erythrocyte sedimentation rate, Creactive protein, interleukin-6, D-dimers, lymphocyte count, ferritin) and the severity of respiratory failure, comparing data between admission and discharge. Results: At admission, 85,7% of patients showed signs of acute respiratory failure (P/F ratio <300) and needed oxygen therapy but only 9,1% of them had this condition at discharge. Moreover, ESR, CRP and IL-6 levels were high at admission but showed a significant reduction at discharge;lymphocyte count was instead reduced at the beginning of the disease and increased after treatment;no significative variations were observed for D-dimer and ferritin levels. Finally average hospital stay was 4 days lower than the one of the cohort of patients non treated with remdesivir. Conclusions: Our results indicate that patients treated with remdesivir showed a good outcome in terms of respiratory function and reduction of inflammation state. However, a larger cohort of patients and the comparison with control patients are necessary to better investigate potential benefits of remdesivir.