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Front Immunol ; 12: 656362, 2021.
Article in English | MEDLINE | ID: covidwho-1211814


Since March 2020, the outbreak of Sars-CoV-2 pandemic has changed medical practice and daily routine around the world. Huge efforts from pharmacological industries have led to the development of COVID-19 vaccines. In particular two mRNA vaccines, namely the BNT162b2 (Pfizer-BioNTech) and the mRNA-1273 (Moderna), and a viral-vectored vaccine, i.e. ChAdOx1 nCoV-19 (AstraZeneca), have recently been approved in Europe. Clinical trials on these vaccines have been published on the general population showing a high efficacy with minor adverse events. However, specific data about the efficacy and safety of these vaccines in patients with immune-mediated inflammatory diseases (IMIDs) are still lacking. Moreover, the limited availability of these vaccines requires prioritizing some vulnerable categories of patients compared to others. In this position paper, we propose the point of view about the management of COVID-19 vaccination from Italian experts on IMIDs and the identification of high-risk groups according to the different diseases and their chronic therapy.

COVID-19 Vaccines/immunology , COVID-19/complications , COVID-19/prevention & control , Immune System Diseases/virology , Vaccination/methods , Diabetes Mellitus/immunology , Diabetes Mellitus/virology , Europe , Expert Testimony , Glomerulonephritis/complications , Glomerulonephritis/immunology , Glomerulonephritis/virology , Humans , Inflammation/immunology , Inflammation/virology , Inflammatory Bowel Diseases/complications , Inflammatory Bowel Diseases/immunology , Inflammatory Bowel Diseases/virology , Lung Diseases/complications , Lung Diseases/immunology , Lung Diseases/virology , Pandemics/prevention & control , Rheumatic Diseases/complications , Rheumatic Diseases/immunology , Rheumatic Diseases/virology , Skin Diseases/complications , Skin Diseases/immunology , Skin Diseases/virology , Uveitis/complications , Uveitis/immunology , Uveitis/virology
Nutrition ; 82: 111047, 2021 02.
Article in English | MEDLINE | ID: covidwho-960019


Preliminary studies indicate that a robust immune response across different cell types is crucial in recovery from coronavirus disease 2019 (COVID-19). An enormous number of investigations point to the vital importance of various micronutrients in the interactions between the host immune system and viruses, including COVID-19. There are complex and multifaceted links among micronutrient status, the host immune response, and the virulence of pathogenic viruses. Micronutrients play a critical role in the coordinated recruitment of innate and adaptive immune responses to viral infections, particularly in the regulation of pro- and anti-inflammatory host responses. Furthermore, inadequate amounts of micronutrients not only weaken the immune system in combating viral infections, but also contribute to the emergence of more virulent strains via alterations of the genetic makeup of the viral genome. The aim of this study was to evaluate the evidence that suggests the contribution of micronutrients in the spread as well as the morbidity and mortality of COVID-19. Both the presence of micronutrient deficiencies among infected individuals and the effect of micronutrient supplementation on the immune responses and overall outcome of the disease could be of great interest when weighing the use of micronutrients in the prevention and treatment of COVID-19 infection. These investigations could be of great value in dealing with future viral epidemics.

COVID-19/immunology , Immune System Diseases/virology , Micronutrients/deficiency , Nutritional Status/immunology , SARS-CoV-2/immunology , COVID-19/virology , Humans , Immune System Diseases/immunology , Immunity/drug effects , Micronutrients/immunology
BMC Anesthesiol ; 20(1): 177, 2020 07 20.
Article in English | MEDLINE | ID: covidwho-656789


The management of Acute Respiratory Distress Syndrome (ARDS) secondary to the novel Coronavirus Disease 2019 (COVID-19) proves to be challenging and controversial. Multiple studies have suggested the likelihood of an atypical pathophysiology to explain the spectrum of pulmonary and systemic manifestations caused by the virus. The principal paradox of COVID-19 pneumonia is the presence of severe hypoxemia with preserved pulmonary mechanics. Data derived from the experience of multiple centers around the world have demonstrated that initial clinical efforts should be focused into avoid intubation and mechanical ventilation in hypoxemic COVID-19 patients. On the other hand, COVID-19 patients progressing or presenting into frank ARDS with typical decreased pulmonary compliance, represents another clinical enigma to many clinicians, since routine therapeutic interventions for ARDS are still a subject of debate.

Betacoronavirus , Coronavirus Infections/therapy , Critical Care/methods , Pneumonia, Viral/therapy , Respiratory Distress Syndrome/therapy , Adrenal Cortex Hormones/therapeutic use , Biomarkers/metabolism , COVID-19 , COVID-19 Testing , Clinical Laboratory Techniques/methods , Coronavirus Infections/diagnosis , Coronavirus Infections/drug therapy , Coronavirus Infections/transmission , Cross Infection/transmission , Cytokines/metabolism , Diagnostic Imaging , Extracorporeal Membrane Oxygenation/methods , Humans , Hypoxia/virology , Immune System Diseases/virology , Intubation, Intratracheal , Neuromuscular Blockade/methods , Pandemics , Patient Positioning/methods , Pneumonia, Viral/diagnosis , Pneumonia, Viral/transmission , Pneumonia, Viral/virology , Prone Position/physiology , Respiration, Artificial/methods , Respiratory Distress Syndrome/virology , SARS-CoV-2 , Thrombophilia/virology , Vasodilator Agents/therapeutic use