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1.
Viruses ; 14(5)2022 05 17.
Article in English | MEDLINE | ID: covidwho-1875808

ABSTRACT

Despite the existence of an effective live-attenuated vaccine, measles can appear in vaccinated individuals. We investigated breakthrough measles cases identified during our surveillance activities within the measles/rubella surveillance network (MoRoNet) in Milan and surrounding areas (Northern Italy). Between 2017 and 2021, we confirmed measles virus (genotypes B3 or D8) infections in 653 patients and 51 of these (7.8%) were vaccinees. Among vaccinated individuals whose serum was available, a secondary failure was evidenced in 69.4% (25/36) of cases while 11 patients (30.6%) were non-responders. Non-responders were more frequently hospitalized and had significantly lower Ct values in both respiratory and urine samples. Median age and time since the last immunization were similar in the two groups. Importantly, we identified onward transmissions from vaccine failure cases. Vaccinees were involved in 20 outbreaks, in 10 of them they were able to transmit the virus, and in 8 of them, they were the index case. Comparing viral hemagglutinin sequences from vaccinated and non-vaccinated subjects did not show a specific mutation pattern. These results suggest that vaccination failure was likely due to the poor immune response of single individuals and highlights the importance of identifying breakthrough cases and characterizing their clinical and virologic profiles.


Subject(s)
Measles , Disease Outbreaks/prevention & control , Humans , Italy/epidemiology , Measles/epidemiology , Measles/prevention & control , Measles Vaccine , Measles virus/genetics , Vaccines, Attenuated
2.
Cells ; 11(7)2022 04 06.
Article in English | MEDLINE | ID: covidwho-1776141

ABSTRACT

COVID-19, a recently emerged disease caused by SARS-CoV-2 infection, can present with different degrees of severity and a large variety of signs and symptoms. The oral manifestations of COVID-19 often involve the tongue, with loss of taste being one of the most common symptoms of the disease. This study aimed to detect SARS-CoV-2 RNA and assess possible morphological and immunopathological alterations in the lingual tissue of patients who died with a history of SARS-CoV-2 infection. Sixteen cadavers from 8 SARS-CoV-2 positive (COVID-19+) and 8 negative (COVID-19-) subjects provided 16 tongues, that were biopsied. Samples underwent molecular analysis through Real-Time RT-PCR for the detection of SARS-CoV-2 RNA. Lingual papillae were harvested and processed for histological analysis and for immunohistochemical evaluation for ACE2, IFN-γ and factor VIII. Real-Time RT-PCR revealed the presence of SARS-CoV-2 RNA in filiform, foliate, and circumvallate papillae in 6 out of 8 COVID-19+ subjects while all COVID-19- samples resulted negative. Histology showed a severe inflammation of COVID-19+ papillae with destruction of the taste buds. ACE2 and IFN-γ resulted downregulated in COVID-19+ and no differences were evidenced for factor VIII between the two groups. The virus was detectable in most COVID-19+ tongues. An inflammatory damage to the lingual papillae, putatively mediated by ACE2 and IFN-γ in tongues from COVID-19+ cadavers, was observed. Further investigations are needed to confirm these findings and deepen the association between taste disorders and inflammation in SARS-CoV-2 infection.


Subject(s)
COVID-19 , Tongue , Angiotensin-Converting Enzyme 2 , COVID-19/immunology , COVID-19/pathology , Cadaver , Factor VIII , Humans , Inflammation , RNA, Viral , SARS-CoV-2 , Tongue/pathology , Tongue/virology
3.
BMJ Glob Health ; 7(3)2022 03.
Article in English | MEDLINE | ID: covidwho-1745703

ABSTRACT

Two years after the start of the COVID-19 pandemic, key questions about the emergence of its aetiological agent (SARS-CoV-2) remain a matter of considerable debate. Identifying when SARS-CoV-2 began spreading among people is one of those questions. Although the current canonically accepted timeline hypothesises viral emergence in Wuhan, China, in November or December 2019, a growing body of diverse studies provides evidence that the virus may have been spreading worldwide weeks, or even months, prior to that time. However, the hypothesis of earlier SARS-CoV-2 circulation is often dismissed with prejudicial scepticism and experimental studies pointing to early origins are frequently and speculatively attributed to false-positive tests. In this paper, we critically review current evidence that SARS-CoV-2 had been circulating prior to December of 2019, and emphasise how, despite some scientific limitations, this hypothesis should no longer be ignored and considered sufficient to warrant further larger-scale studies to determine its veracity.


Subject(s)
COVID-19 , SARS-CoV-2 , China/epidemiology , Humans , Pandemics
4.
Cells ; 10(11)2021 11 16.
Article in English | MEDLINE | ID: covidwho-1523883

ABSTRACT

While the risk of SARS-CoV-2 infection and/or COVID-19 disease progression in the general population has been largely assessed, its impact on HIV-positive individuals remains unclear. We present clinical and immunological data collected in a cohort of HIV-infected young individuals during the first wave of COVID-19 pandemic. SARS-CoV-2 RNA, virus-specific antibodies, as well as the expression of factors involved in the anti-viral immune response were analyzed. Moreover, we set up an in vitro coinfection assay to study the mechanisms correlated to the coinfection process. Our results did not show any increased risk of severe COVID-19 in HIV-positive young individuals. In those subjects who contracted SARS-CoV-2 infection, an increase in IL-10 expression and production was observed. Furthermore, in the in vitro coinfection assay, we revealed a reduction in SARS-CoV-2 replication associated to an upregulation of IL-10. We speculate that IL-10 could play a crucial role in the course of SARS-CoV-2 infection in HIV-positive individuals. These results might help defining clinical management of HIV/SARS-CoV-2 co-infected young individuals, or putative indications for vaccination schedules in this population.


Subject(s)
COVID-19/immunology , Coinfection/immunology , HIV Infections/immunology , Adolescent , Adult , COVID-19/virology , Child , Child, Preschool , Coinfection/virology , HIV Infections/virology , Humans , Infant , Inflammation , Interleukin-10/blood , Interleukin-10/genetics , Male , RNA, Messenger/blood , SARS-CoV-2/immunology , Young Adult
5.
Epidemiol Prev ; 45(6): 598-601, 2021.
Article in Italian | MEDLINE | ID: covidwho-1524741

ABSTRACT

Il "progetto Michelangelo" è nato dall'esigenza di rallentare la diffusione dei contagi da SARS-CoV-2 e alleggerire il carico a livello ospedaliero. Inizialmente, la maggior parte degli ospiti dell'hotel Michelangelo di Milano erano pazienti dimessi dagli ospedali con test molecolare ancora positivo che non avevano la possibilità di restare in isolamento domiciliare. Ben presto, però, il progetto è stato esteso e circa un ospite su quattro era un adulto/nucleo familiare in condizioni di grave disagio economico o sociale o una persona senza fissa dimora. Inoltre, la maggior parte degli ospiti era di nazionalità non italiana: persone che, a causa di barriere linguistiche, legali, culturali e sociali, hanno trovato maggiore difficoltà ad avere un rapido accesso ai servizi sanitari. Il "progetto Michelangelo" non ha solo contribuito a ridurre il sovraffollamento degli ospedali, ma è stato di supporto ai servizi rivolti al contrasto della grave marginalità.


Subject(s)
COVID-19 , Humans , Italy/epidemiology , SARS-CoV-2
6.
PLoS One ; 16(9): e0257046, 2021.
Article in English | MEDLINE | ID: covidwho-1486676

ABSTRACT

The benefits of schools' closure, used as a containment strategy by many European countries, must be carefully considered against the adverse effects of child wellbeing. In this study, we assessed SARS-CoV-2 seroprevalence, which better estimates the real extent of the infection unraveling asymptomatic cases, among schoolchildren aged 3 to 18 in Milan, using dried blood spot, a safe and extremely viable methods for children, and then compared it between September 2020 and January 2021. Secondly, we evaluated the seroconversion rate and compared it between students attending schools in presence and those switched to distance-learning, using a logistic regression model, both as univariate and multivariate, adjusting for age and biological-sex. Among 1109 pupils, we found a seroprevalence of 2.8% in September before school reopening, while in January 2021, the seropositive rate was 12.5%, reflecting the general growth rate of infections during the second pandemic wave. The overall seroconversion rate was 10%, with no differences based on biological-sex and age groups; we observed no seroreversion. When considered age groups, the seroconversion rate was 10.5% (95%Confidence Interval, 2.9-24.8) among children attending preschools, 10.6% (95%Confidence Interval, 8.2-13.4) for primary schools, 9.9% (95%Confidence Interval, 6.8-13.8) for secondary schools, and 7.8% (95%Confidence Interval, 4-13.2) among high-school students. Interestingly, no differences in seroconversion rate were found between students who attended school compared to those who started remote learning in the first days of November. Furthermore, most patients (61%) reported that the contact occurred within the household. We reported a low seroconversion rate among school children in Milan, with no differences between those who attended from September 2020 to January 2021 compared to those who switched to remote learning in the first days of November. Our data suggest that schools do not amplify SARS-CoV-2 transmission, but rather reflect the level of the transmission in the community.


Subject(s)
COVID-19/diagnosis , SARS-CoV-2/isolation & purification , Schools , Students/statistics & numerical data , Adolescent , COVID-19/epidemiology , COVID-19/virology , Child , Child, Preschool , Female , Humans , Italy/epidemiology , Logistic Models , Male , Multivariate Analysis , Pandemics/prevention & control , Prospective Studies , SARS-CoV-2/physiology , Seroepidemiologic Studies
7.
PLoS One ; 16(9): e0257046, 2021.
Article in English | MEDLINE | ID: covidwho-1388956

ABSTRACT

The benefits of schools' closure, used as a containment strategy by many European countries, must be carefully considered against the adverse effects of child wellbeing. In this study, we assessed SARS-CoV-2 seroprevalence, which better estimates the real extent of the infection unraveling asymptomatic cases, among schoolchildren aged 3 to 18 in Milan, using dried blood spot, a safe and extremely viable methods for children, and then compared it between September 2020 and January 2021. Secondly, we evaluated the seroconversion rate and compared it between students attending schools in presence and those switched to distance-learning, using a logistic regression model, both as univariate and multivariate, adjusting for age and biological-sex. Among 1109 pupils, we found a seroprevalence of 2.8% in September before school reopening, while in January 2021, the seropositive rate was 12.5%, reflecting the general growth rate of infections during the second pandemic wave. The overall seroconversion rate was 10%, with no differences based on biological-sex and age groups; we observed no seroreversion. When considered age groups, the seroconversion rate was 10.5% (95%Confidence Interval, 2.9-24.8) among children attending preschools, 10.6% (95%Confidence Interval, 8.2-13.4) for primary schools, 9.9% (95%Confidence Interval, 6.8-13.8) for secondary schools, and 7.8% (95%Confidence Interval, 4-13.2) among high-school students. Interestingly, no differences in seroconversion rate were found between students who attended school compared to those who started remote learning in the first days of November. Furthermore, most patients (61%) reported that the contact occurred within the household. We reported a low seroconversion rate among school children in Milan, with no differences between those who attended from September 2020 to January 2021 compared to those who switched to remote learning in the first days of November. Our data suggest that schools do not amplify SARS-CoV-2 transmission, but rather reflect the level of the transmission in the community.


Subject(s)
COVID-19/diagnosis , SARS-CoV-2/isolation & purification , Schools , Students/statistics & numerical data , Adolescent , COVID-19/epidemiology , COVID-19/virology , Child , Child, Preschool , Female , Humans , Italy/epidemiology , Logistic Models , Male , Multivariate Analysis , Pandemics/prevention & control , Prospective Studies , SARS-CoV-2/physiology , Seroepidemiologic Studies
11.
Emerg Infect Dis ; 27(2): 648-650, 2021 02.
Article in English | MEDLINE | ID: covidwho-965245

ABSTRACT

We identified severe acute respiratory syndrome coronavirus 2 RNA in an oropharyngeal swab specimen collected from a child with suspected measles in early December 2019, ≈3 months before the first identified coronavirus disease case in Italy. This finding expands our knowledge on timing and mapping of novel coronavirus transmission pathways.


Subject(s)
COVID-19 Nucleic Acid Testing , COVID-19/diagnosis , RNA, Viral/analysis , SARS-CoV-2/genetics , Skin Diseases, Infectious/diagnosis , COVID-19/virology , Child, Preschool , Humans , Italy , Male , Oropharynx/virology , Skin Diseases, Infectious/virology
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