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Vaccines (Basel) ; 9(11)2021 Oct 20.
Article in English | MEDLINE | ID: covidwho-1538556


(1) Background: Children with chronic medical conditions may be at increased risk for severe complications related to vaccine-preventable infections. Therefore, additional booster doses or supplementary vaccines are recommended, over and above the routine immunization schedule for healthy children. The aim of this study was to investigate attitude, knowledge, and practices toward additional vaccinations for children affected by chronic conditions among pediatricians and parents. (2) Methods: This study is based on two surveys: (i) a national cross-sectional survey, targeting pediatrician working in hospitals or in the primary health sector; (ii) a local cross-sectional survey, targeting parents of children with a previous diagnosis of chronic disease. (3) Results: Despite the fact that most of the health professionals and parents interviewed had an overall positive vaccine attitude, most pediatricians did not show an adequate knowledge of additional vaccinations for children affected by chronic diseases. Moreover, the coverage of additional recommended vaccinations in chronic pediatric patients was low. (4) Conclusions: This research highlighted important existing challenges hampering optimal vaccination coverage among pediatric chronic patients, including knowledge gaps on tailored vaccination schedules among pediatricians and organizational issues. The ongoing review of the Italian national immunization plan is a not-to-be-missed-opportunity to include evidence-based, detailed, and comprehensive recommendations on vaccinations for children affected by chronic conditions.

BMJ Open ; 11(10): e051506, 2021 10 07.
Article in English | MEDLINE | ID: covidwho-1462964


OBJECTIVES: The present study aimed to explore differences in COVID-19 outcomes between male and female cases in the Apulian District of Foggia, Italy. DESIGN AND SETTING: We performed a retrospective epidemiological study among all COVID-19 confirmed cases that occurred in the Apulian District of Foggia from 29 February to 30 June 2020. The surveillance data from a regional registry (GIAVA-COVID) were used. MAIN OUTCOMES: The main outcome measures were the proportion of hospitalisations, virus clearance and the case fatality rate. RESULTS: A total of 1175 cases (50.7% female; median age: 55 years) were identified among 55 131 tests performed. The proportion of hospitalisation with COVID-19 diagnosis was 45.4% in men versus 37.9% in women (p<0.01), while the average length of stay in hospitals was 31.3±14.6 days in women versus 26.8±14.4 days in men (p<0.01). The proportion of cases who achieved virus clearance was higher in women (84.2%; days to clearance: 28.0±12.1) than in men (79.3%; days to clearance: 29.4±12.9; p<0.05). Men were associated with a significantly higher risk of dying from COVID-19 than women (case fatality rate 16.1% vs 10.4%; p<0.01). The mean time, from diagnosis to death, was 14.5±14.4 days in women compared with 10.6±10.7 days in men (p<0.01). The male sex, age ≥55 years and presence of at least one underlying comorbidity significantly raised the risk of hospitalisation, persistent infection and death (p<0.05). CONCLUSIONS: This study suggests that more attention should be paid to sex as a variable for the interpretation of COVID-19 data. Sex-disaggregated data will help clinicians to make appropriate patient-tailored medical decisions.

COVID-19 , COVID-19 Testing , Female , Humans , Italy/epidemiology , Male , Middle Aged , Retrospective Studies , SARS-CoV-2 , Sex Factors
Environ Res ; 195: 110793, 2021 04.
Article in English | MEDLINE | ID: covidwho-1051629


BACKGROUND: Healthcare workers (HCWs) are highly exposed to SARS-CoV-2 infection given their specific tasks. The IgG-IgM serological assay has demonstrated good accuracy in early detection in symptomatic patients, but its role in the diagnosis of asymptomatic patients is uncertain. The aim of our study was to assess IgM and IgG prevalence in sera in a large cohort of HCWs previously subjected to Nasopharyngeal swab test (NST) after accurate risk assessment due to positive COVID-19 patient exposure during an observation period of 90 days. METHODS: 2407 asymptomatic HCWs that had close contact with COVID-19 patients in the period between April 8th and June 7th were screened with NST based on the RT-PCR method. In parallel, they underwent large-scale chemiluminescence immunoassays involving IgM-IgG serological screening to determine actual viral spread in the same cohort. RESULTS: During the 90-day observation period, 18 workers (0.75%) resulted positive for SARS-CoV-2 infection at the NST, whereas the positivity rates for IgM and IgG were 11.51% and 2.37%, respectively (277 workers). Despite high specificity, serological tests were inadequate for detecting SARS-CoV-2 infection in patients with previous positive NST results (IgM and IgG sensitivities of 27.78% and 50.00%, respectively). CONCLUSIONS: These findings indicate a widespread low viral load of SARS-CoV-2 among hospital workers. However, serological screening showed very low sensitivity with respect to NST in identifying infected workers, and negative IgG and IgM results should not exclude the diagnosis of COVID-19. IgG-IgM chemiluminescence immunoassays could increase the diagnosis of COVID-19 only in association with NST, and this association is considered helpful for decision-making regarding returning to work.

COVID-19 , SARS-CoV-2 , Antibodies, Viral , Health Personnel , Hospitals , Humans , Immunoglobulin G , Immunoglobulin M , Italy/epidemiology , Prevalence , Public Health , Sensitivity and Specificity