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Italian Journal of Medicine ; 16(SUPPL 1):6, 2022.
Article in English | EMBASE | ID: covidwho-1913112


Background: Little is known about the long-term re-hospitalization of patients with confirmed infection by SARS CoV 2 discharged from hospital. Aim: The aim of our retrospective cohort study was to identify death and re-hospitalization outcomes in a 16-month follow-up in a population of subjects already hospitalized for Covid-19. Materials and Methods: The study was conducted in the metropolitan area of Bari (population: 472,385 inhabitants) by examining the patients hospitalized from 17/03/2020 to 28/05/2021 at the Covid Unit of the F. Miulli hospital in Acquaviva delle Fonti. Results: 1238 patients (754 males, 60.9%, median 70 years) were hospitalized in Covid Unit: 1060 (85.6%) (M 60.1% median 71 years) were hospitalized in non-intensive wards, while 178 (14.4%) (M 65.7%, median 69 aa), passed through the IT. At follow-up, 922 subjects were still alive;66 deceased (7.2% of the total, 37.8% males, median 80 years). Analyzing only the data of patients residing in the metropolitan area, where the hospital is the reference, 780 patients discharged alive were examined. Of these, 11.2% were rehospitalized at least once, 30 died (4.3%). Mortality on re-admission to hospital was 17.2%. A third of the re-admissions were unrelated to Covid. Infections, pneumonia and cardiovascular disease were the most represented reason for hospitalization. Conclusions: Data show that at a follow-up of 16 months 92.8% of the subjects were still alive, while 7.2% had died, mainly elderly women. 11.2% of those discharged from the Covid ward have been re-admitted to the hospital at least once.

Italian Journal of Medicine ; 16(SUPPL 1):21, 2022.
Article in English | EMBASE | ID: covidwho-1912998


Introduction and Purpose of the study: SARS-CoV2 infection is characterized by massive involvement of the respiratory system. During the various waves, the patients admitted to the Covid wards presented different degrees of pulmonary involvement and numerous comorbidities. Administration of oxygen therapy was the prevalent measure in almost all subjects. The aim of our study was to verify the level of severity and ventilation procedures in a group of subjects hospitalized for SARS-CoV2 infection. Materials and Methods: 388 subjects admitted to the semi-intensive Covid Unit of the F. Miulli Hospital in 2020 were retrospectively analyzed, by examining the SDOs. The main diagnoses and procedures performed were identified. A severity cluster was identified characterized by death, ventilation and hospitalization in the semi-intensive area (cut off at 14 days). Results: 82 were the deceased (21.1%). The main diagnoses most represented were: 84.2% respiratory failure, 3.3% heart failure, 2.5% pulmonary embolism and 1.5% septicemia. Regarding the procedures, 31.9% underwent C-PAP ventilation, while 0.7% underwent non-invasive mechanical ventilation. 64% of the subjects had a severe degree of disease evidenced by the composite cluster of deaths, ventilation and at least 14 nights in semi-intensive care. Conclusions: Our data shows that in the face of almost all patients with respiratory failure, about one third underwent ventilation procedures (C-PAP and NIV). More than half of the subjects had a severe degree of disease.

Italian Journal of Medicine ; 16(SUPPL 1):58, 2022.
Article in English | EMBASE | ID: covidwho-1912954


Introduction: In our country, the percentage of subjects infected with HCV is about 2% of the general population, with a gradient that increases from the North to the South and the islands. The decline in hepatitis C treatments is sensationally evident. The WHO had set the goal of its elimination by 2030, a result made achievable thanks to the new direct-acting antiviral drugs (DAA), which allow the virus to be eradicated in definitively, quickly and without side effects. The pandemic has slowed both screening and treatment. Purpose of the study: Evaluate the prevalence of subjects positive for hepatitis C antigen (HCV +) in all hospitalized for Covid-19. Materials and Methods: 839 subjects admitted to the Covid Unit of the F. Miulli Hospital in Acquaviva delle Fonti were retrospectively assessed. Results: The prevalence of HCV+subjects was 4.7%. No statistically significant differences were found when comparing the main laboratory tests. No difference emerged regarding the outcomes (length of hospitalization and death) which are similar in the two groups. Conclusions: The prevalence of HCV+subjects in the Covid-19 population is double that of the general population. A project is underway in our hospital which provides for the screening of all over 50 year olds hospitalized in order to bring out HCV+subjects and direct them to an outpatient diagnostic confirmation path and any specific eradicating therapy.

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.

Italian Journal of Medicine ; 15(3):32, 2021.
Article in English | EMBASE | ID: covidwho-1567423


Background and Aim: The CoViD-19 pandemic experienced two main waves: February-June 2020 and October 2020-February 2021 respectively. The F. Miulli Hospital has activated intensive and semi-intensive care, pulmonology and infectious disease departments, for a total of 240 beds. Aim of the study was to evaluate differences between the two waves, in relation to the length of hospitalization and mortality. Materials and Methods: We collected data from 1005 subjects (619 men). Age, gender, length of hospital stay, and deaths were analyzed. Results: In the second wave we found a higher percentage of deaths (25.8 vs 19.4%;p=0.043) and among these a higher prevalence of males (66 vs 44.7%;p=0.007);furthermore, in the subjects hospitalized during the second wave, we observed a lower average age of the deceased (78±13 vs 82±8 years;p=0.019) and a shorter duration of hospitalization (18±13 vs 21±14 days;p=0.004). No significant difference was observed in the prevalence of males, however most affected (62.4% second wave vs 59.1% first wave), and in mean age (69±15 seconds vs 68±18 first wave). Conclusions: The second wave showed greater lethality especially for males and younger subjects. Despite this, the duration of hospitalization was shorter, a condition probably linked to the experience acquired by the health professionals involved in the assistance and to a wider network of local structures capable of welcoming CoViD patients. The impact of the variants on the severity of the disease remains to be assessed.