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Plast Reconstr Surg Glob Open ; 11(1): e4808, 2023 Jan.
Article in English | MEDLINE | ID: covidwho-2229031


The presence of a high number of positive SARS-CoV-2 patients is found daily in the emergency room database, finding evidence of infection also in trauma and burns. Surgical debridement remains the gold standard for eschar removal, but it does not come without complications such as bleeding and high heat loss. In recent years, there has been an increase in the use of enzymatic debridement techniques, replacing surgical escharotomy. Early eschar removal is proven to be important; it has been proved that an early and effective burn treatment in COVID-19 patients can reduce other infection. Five clinical cases of patients arrived at our COVID-19 Major Burns Intensive Care Unit. On admission, burns extension and depth were assessed by an expert burn surgeon. We evaluated eschar removal modality, adverse events, and potential side effects. Enzymatic debridement was efficient in all patients treated with complete eschar removal, and no serious adverse events. All patients were treated within 24 hours of arrival at our facility with Nexobrid by specialized personnel in deep sedation and with O2 support using a face mask or nasal goggles. The use of enzymatic debridement in COVID-19-positive burn patients within dedicated pathways through nonsurgical treatment optimizes the treatment time. We believe that the use of enzymatic debridement could be a valid therapeutic option in burn patients, even with SARS-CoV-2 infection, and its use, when indicated, is safe and effective for the patient and optimizes the use of instrumental and human resources in a pandemic emergency.

J Clin Med ; 10(18)2021 Sep 08.
Article in English | MEDLINE | ID: covidwho-1403845


We hypothesized that the spread of SARS-CoV-2 in urine during a severe COVID-19 infection may be the expression of the worsening disease evolution. Therefore, the aim of this study was to verify if the COVID-19 disease severity is related to the viral presence in urine samples. We evaluated the clinical evolution in acute COVID-19 patients admitted in the sub-intensive care and intensive care units between 28 of December 2020 and 15th of February 2021 and being positive for SARS-CoV-2 RNA in the respiratory tract, including repeated endotracheal aspirates (ETA), sputum, nasopharyngeal swabs (NPS) and urine. We found that those subjects with SARS-COV-2 in the urine at admittance (8 out of 60 eligible patients) had a more severe disease than those with negative SARS-CoV-2 in urine. Further, they showed an increase in fibrinogen and (C-reactive Protein) CRP serum levels, requiring mechanic ventilation. Of those with positive SARS-CoV-2 in the urine, 50% died. According to our preliminary results, it seems that the presence of SARS-CoV-2 in the urine characterizes patients with a more severe disease and is also related to a higher death rate.

iScience ; 24(4): 102322, 2021 Apr 23.
Article in English | MEDLINE | ID: covidwho-1144743


The established risk factors of coronavirus disease 2019 (COVID-19) are advanced age, male sex, and comorbidities, but they do not fully explain the wide spectrum of disease manifestations. Genetic factors implicated in the host antiviral response provide for novel insights into its pathogenesis. We performed an in-depth genetic analysis of chromosome 21 exploiting the genome-wide association study data, including 6,406 individuals hospitalized for COVID-19 and 902,088 controls with European genetic ancestry from the COVID-19 Host Genetics Initiative. We found that five single nucleotide polymorphisms within TMPRSS2 and near MX1 gene show associations with severe COVID-19. The minor alleles of the five single nucleotide polymorphisms (SNPs) correlated with a reduced risk of developing severe COVID-19 and high level of MX1 expression in blood. Our findings demonstrate that host genetic factors can influence the different clinical presentations of COVID-19 and that MX1 could be a potential therapeutic target.