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1.
J Med Virol ; 93(2): 886-891, 2021 02.
Article in English | MEDLINE | ID: covidwho-1898895

ABSTRACT

Italy was one of the most affected nations by coronavirus disease 2019 outside China. The infections, initially limited to Northern Italy, spread to all other Italian regions. This study aims to provide a snapshot of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) epidemiology based on a single-center laboratory experience in Rome. The study retrospectively included 6565 subjects tested for SARS-CoV-2 at the Laboratory of Virology of Sapienza University Hospital in Rome from 6 March to 4 May. A total of 9995 clinical specimens were analyzed, including nasopharyngeal swabs, bronchoalveolar lavage fluids, gargle lavages, stools, pleural fluids, and cerebrospinal fluids. Positivity to SARS-CoV-2 was detected in 8% (527/6565) of individuals, increased with age, and was higher in male patients (P < .001). The number of new confirmed cases reached a peak on 18 March and then decreased. The virus was detected in respiratory samples, in stool and in pleural fluids, while none of gargle lavage or cerebrospinal fluid samples gave a positive result. This analysis allowed to gather comprehensive information on SARS-CoV-2 epidemiology in our area, highlighting positivity variations over time and in different sex and age group and the need for a continuous surveillance of the infection, mostly because the pandemic evolution remains unknown.


Subject(s)
COVID-19 , Pandemics , SARS-CoV-2/pathogenicity , Adolescent , Adult , Aged , Aged, 80 and over , Bronchoalveolar Lavage Fluid/virology , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19 Testing , Child , Child, Preschool , Feces/virology , Female , Hospitals, University , Humans , Infant , Infant, Newborn , Laboratories , Male , Middle Aged , Nasopharynx/virology , Pleural Effusion/virology , Retrospective Studies , Reverse Transcriptase Polymerase Chain Reaction , Rome/epidemiology , SARS-CoV-2/genetics , Severity of Illness Index
2.
Epidemiol Prev ; 46(1-2): 59-67, 2022.
Article in Italian | MEDLINE | ID: covidwho-1856463

ABSTRACT

OBJECTIVES: to estimate the impact of the COVID-19 epidemic on total and cause-specific mortality in people residing and dead in the Municipality of Rome (Italy) in 2020, and to describe the causes of death of subjects with SARS-CoV-2 infection confirmed by molecular test. DESIGN: descriptive analysis of total and cause-specific mortality in 2020 in Rome and comparison with a reference period (2015-2018 for total mortality and 2018 for cause-specific mortality); descriptive analysis of cause-specific mortality in the cohort of SARS-CoV-2 infected subjects. SETTING AND PARTICIPANTS: 27,471 deaths registered in the Lazio mortality-cause Registry, relating to people residing and died in the municipality of Rome in 2020, 2,374 of which died from COVID-19.MAIN OUCOME MEASURES: all-cause mortality by month, gender, age group and place of death, cause-specific mortality (ICD-10 codes). RESULTS: in the municipality of Rome in 2020, an excess of mortality from all causes equal to +10% was observed, with a greater increase in the months of October-December (+27%, +56%, and +26%, respectively) in people aged 50+, with the greatest contribution from the oldest age groups (80+) who died in the nursing homes or at home. Lower mortality was observed in the age groups 0-29 years (-30%) and 40-49 years (-13%). In 2020, COVID-19 represents the fourth cause of death in Rome after malignant tumours, diseases of the circulatory system, and respiratory diseases. Excess mortality was observed from stroke and pneumonia (both in men and women), from respiratory diseases (in men), from diabetes, mental disorders, dementia and Parkinson's disease (in women). On the contrary, mortality is lower for all cancers, for diseases of the blood and haematopoietic organs and for the causes of the circulatory system. The follow-up analysis of SARS-CoV-2 positive subjects residing in Rome shows that a share of deaths (about 20%) reports other causes of death such as cardiovascular diseases, malignant tumours, and diseases of the respiratory system on the certificate collected by the Italian National Statistics Institute. CONCLUSIONS: the 2020 mortality study highlighted excesses for acute and chronic pathologies, indicative of possible delays in the diagnosis or treatment of conditions indirectly caused by the pandemic, but also a share of misclassification of the cause of death that is recognized as COVID-19 death.


Subject(s)
COVID-19 , Adolescent , Adult , Cause of Death , Child , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Italy/epidemiology , Male , Middle Aged , Rome/epidemiology , SARS-CoV-2 , Young Adult
3.
Eur Rev Med Pharmacol Sci ; 26(7): 2631-2638, 2022 04.
Article in English | MEDLINE | ID: covidwho-1811985

ABSTRACT

OBJECTIVE: Temporary COVID-19 hotels have been established in Italy to assist the homeless people that test positive for SARS-CoV-2 and require isolation. This observational study aimed to investigate the characteristics of the subjects who were isolated at the Casa tra Noi COVID-19 hotel in Rome between October 2020 and May 2021 and to estimate the duration of SARS-CoV-2 positivity according to their main socio-demographic, behavioural and clinical features. SUBJECTS AND METHODS: Socio-demographic data, clinical history, and anamnestic data of guests were collected by the clinicians reviewing the medical documentation and face-to-face interviewing. Nasopharyngeal swabs were performed every 7 days and the presence of SARS-CoV-2 was assessed by RT-PCR. Median duration of SARS-CoV-2 positivity according to socio-demographic, behavioral factors and clinical condition was calculated. RESULTS: The 196 guests (161 males, 82.1%) had a median age of 41 years (IQR: 30-53), and were mostly African (87, 44.4%). Only asymptomatic/paucisymptomatic infections were observed. Almost half of the individuals (84, 42.9%) were affected by at least one co-morbidity, the frequency of which was higher among women (57.1% vs. 39.8%, p=0.06). The date of the negative SARS-CoV-2 molecular test was known for 144 guests (73.5%). Among these, the median duration of positivity was 21 days (IQR: 14-26) and did not significantly vary with age, country of origin, smoking status, alcohol or drug abuse. Among the co-morbidities, only infectious diseases significantly modified the duration of positivity, which increased from 21 to 34 days (p=0.013). CONCLUSIONS: Hotel guests were frequently affected by physical/mental co-morbidities. Duration of SARS-CoV-2 positivity was significantly prolonged only in individuals affected by an infectious disease.


Subject(s)
COVID-19 , Adult , Asymptomatic Infections , COVID-19/epidemiology , Female , Humans , Italy/epidemiology , Male , Middle Aged , Rome/epidemiology , SARS-CoV-2
4.
Int J Environ Res Public Health ; 19(8)2022 04 09.
Article in English | MEDLINE | ID: covidwho-1785687

ABSTRACT

BACKGROUND: on the 9 March 2020, the Italian government declared a state of lockdown on the entire national territory aimed at reducing the spread of SARS-CoV-2, causing strong repercussions for people's lifestyles. The aim of the study was to analyze the impact of the lockdown on the nutritional status and lipid profile of employees of an Italian teaching hospital. METHODS: an observational retrospective cohort study was carried out at the Department of Occupational Medicine of the Umberto I General Hospital of Rome, including all employees who underwent two consecutive occupational medical examinations before and after the first lockdown (9 March 2020-18 May 2020). Employee medical records were used as a data source. RESULTS: 1014 employees were involved in the study (50.6% nurses, 31% physicians, 14.8% technical staff, 3.6% administrative staff). Post lockdown BMI, total cholesterol and LDL values increased statistically significantly compared to pre lockdown ones. Nurses showed a significant association with increased BMI (p < 0.001), while workers with heart disease were inversely associated with total cholesterol (p < 0.001) and LDL (p < 0.001). CONCLUSION: this study showed that lockdown had a significant impact on employees' lifestyles. Further studies are needed to understand changes in health-related behaviors, such as diet and physical activity, of specific categories of workers over time under lockdown conditions.


Subject(s)
COVID-19 , COVID-19/epidemiology , Cholesterol , Communicable Disease Control , Hospitals, Teaching , Humans , Lipids , Nutritional Status , Quarantine , Retrospective Studies , Rome , SARS-CoV-2
5.
Clin Ter ; 173(1): 64-66, 2022 Feb 07.
Article in English | MEDLINE | ID: covidwho-1687409

ABSTRACT

ABSTRACT: COVID-19 has dramatically affected working forces. We aim to report our occupational medicine service's experience in managing suspected COVID-19 cases during the pandemic through a retrospec-tive observational study. We compared the number of days employees were absent from work due to flu-like symptoms from March 2020 to February 2021 to the same period the previous year (2019-2020). Two hundred thirty-four patients (+47.2% compared to the previous year) who tested negative for SARS-CoV-2 reported flu-like symp-toms; the number of days of absence from work was 2812 (+190.2% compared to the previous year). On average, employees with flu-like symptoms lost 12.07 working days compared to 6.12 in the previous year (p<0.0001). In conclusion, in our sample COVID-19 has increased the number of working day loss. However, our approach proved to be important, especially during the first months of the pandemic, to limit SARS-CoV-2 spread in workplaces.


Subject(s)
COVID-19 , Pandemics , Humans , Italy/epidemiology , Rome/epidemiology , SARS-CoV-2
6.
Int J Risk Saf Med ; 33(2): 117-124, 2022.
Article in English | MEDLINE | ID: covidwho-1686423

ABSTRACT

BACKGROUND: The COVID-19 pandemic represented a global earthquake that made the review of health policies aimed at strengthening common governance necessary. OBJECTIVE: The paper analyses the reasons for which the One Health approach has become fundamental in the control of pandemic phenomena, by arguing the necessity to place it at the basis not only of health policies but also of intersectoral policies. METHODS: The documents of the world organizations published before and after the pandemic were analyzed and studied in order to unpack the close relationship between new lifestyles and the increase of health risks. RESULTS: It emerged that the One Health approach is a paradigm that has been advanced for more than 30 years, but due to the inadequacy of local and world health policies, this approach was never translated into concrete actions to protect health, feeding problems at the cause of the COVID-19 pandemic. CONCLUSIONS: Having ascertained that the adoption of a One Health approach can no longer be postponed, this must be insisted on several interconnected sectors that establish the new concept of healthcare which, in addition to being interdisciplinary, necessarily takes on a global perspective.


Subject(s)
COVID-19 , One Health , COVID-19/epidemiology , COVID-19/prevention & control , Global Health , Humans , Pandemics/prevention & control , Rome
7.
Int J Risk Saf Med ; 33(2): 167-176, 2022.
Article in English | MEDLINE | ID: covidwho-1686422

ABSTRACT

BACKGROUND: Point 7 of the Rome Declaration is aimed at improving data sharing and technological and knowledge transfer as instruments to implement health policies. OBJECTIVE: The objective of the current paper is to understand if the legal framework (especially at a transnational level) may actually help to achieve the objectives laid down by Principle 7 or if some interpretative or legislative actions will be necessary. METHODS: The paper analyses the legal sources at international and EU levels. RESULTS: The applicable rules are based on the idea that the information and material are forms of 'property' of the individuals or of the states (i.e., the sovereign). According to the traditional idea of property, the owner has a sort of absolute power over the res and is entitled to exclude others from any rights over the thing. The 'property paradigm' may be useful to protect some relevant interests, but it can also affect collective interests, such as those concerning health during the COVID-19 pandemic. CONCLUSIONS: In order to build a global system for the exchange of data and materials as provided for by Principle 7 of the Rome Declaration, a new legal approach should be elaborated which takes into consideration the international corpus of fundamental rights, including research freedom, the right to health and the principle of transnational 'digital' solidarity.


Subject(s)
COVID-19 , COVID-19/prevention & control , Health Policy , Humans , Pandemics/prevention & control , Rome
8.
Int J Risk Saf Med ; 33(2): 95-102, 2022.
Article in English | MEDLINE | ID: covidwho-1686421

ABSTRACT

BACKGROUND: The Global Health Summit was held in Rome on 21 May 2021, co-hosted by the European Commission and Italy, as chair of the G20. Leaders, heads of regional and international organizations met to share lessons learned from the COVID-19 pandemic and to define the path ahead. OBJECTIVE: The present paper analyses the Rome Declaration as the first global health programme shared among the G20 Member States and based on the One-Health approach. METHODS: Documents such as preparatory work, official documents and observations from international organizations were analysed in order to provide a comprehensive review of the Rome Declaration. RESULTS: Core principles of the Rome Declarations have emerged as well as the goal to improve cooperation among existing international organisations and national authorities. CONCLUSIONS: Governments' future decisions will be the key to determine the end of the pandemic. The interconnected impacts on health, the environment, and social and economic dimensions will be a central theme of the overall narrative aiming at bringing the G20 process towards achieving a more inclusive and sustainable society.


Subject(s)
COVID-19 , Pandemics , COVID-19/epidemiology , Global Health , Government , Humans , Pandemics/prevention & control , Rome
9.
Environ Health ; 21(1): 17, 2022 01 16.
Article in English | MEDLINE | ID: covidwho-1630544

ABSTRACT

BACKGROUND: Air pollution is one of the main concerns for the health of European citizens, and cities are currently striving to accomplish EU air pollution regulation. The 2020 COVID-19 lockdown measures can be seen as an unintended but effective experiment to assess the impact of traffic restriction policies on air pollution. Our objective was to estimate the impact of the lockdown measures on NO2 concentrations and health in the two largest Italian cities. METHODS: NO2 concentration datasets were built using data deriving from a 1-month citizen science monitoring campaign that took place in Milan and Rome just before the Italian lockdown period. Annual mean NO2 concentrations were estimated for a lockdown scenario (Scenario 1) and a scenario without lockdown (Scenario 2), by applying city-specific annual adjustment factors to the 1-month data. The latter were estimated deriving data from Air Quality Network stations and by applying a machine learning approach. NO2 spatial distribution was estimated at a neighbourhood scale by applying Land Use Random Forest models for the two scenarios. Finally, the impact of lockdown on health was estimated by subtracting attributable deaths for Scenario 1 and those for Scenario 2, both estimated by applying literature-based dose-response function on the counterfactual concentrations of 10 µg/m3. RESULTS: The Land Use Random Forest models were able to capture 41-42% of the total NO2 variability. Passing from Scenario 2 (annual NO2 without lockdown) to Scenario 1 (annual NO2 with lockdown), the population-weighted exposure to NO2 for Milan and Rome decreased by 15.1% and 15.3% on an annual basis. Considering the 10 µg/m3 counterfactual, prevented deaths were respectively 213 and 604. CONCLUSIONS: Our results show that the lockdown had a beneficial impact on air quality and human health. However, compliance with the current EU legal limit is not enough to avoid a high number of NO2 attributable deaths. This contribution reaffirms the potentiality of the citizen science approach and calls for more ambitious traffic calming policies and a re-evaluation of the legal annual limit value for NO2 for the protection of human health.


Subject(s)
Air Pollutants , Air Pollution , COVID-19 , Air Pollutants/analysis , Air Pollution/analysis , Cities , Communicable Disease Control , Environmental Monitoring , Humans , Italy/epidemiology , Machine Learning , Nitrogen Dioxide , Particulate Matter/analysis , Rome/epidemiology , SARS-CoV-2
10.
Nutrients ; 13(12)2021 Dec 17.
Article in English | MEDLINE | ID: covidwho-1580556

ABSTRACT

The introduction of lockdowns and other containment measures during the COVID-19 pandemic substantially altered people's lifestyle and dietary behavior. Several studies evaluated the short-term effects of these measures; yet reports on long-term consequences are scarce. We sought to address this gap in the literature by analyzing dietary and lifestyle data collected at an obesity center in Rome, Italy. The Italian region of Lazio was hit hard by the pandemic. To evaluate the potential health impacts, we compared the pre- and post-lockdown data of 118 individuals. Contrary to the common belief that lockdown had adverse effects solely on people's dietary habits, we observed a significantly increased consumption of raw vegetables, whole grains, and water in our study sample. Favorable effects, however, were also accompanied by adverse trends, such as a higher prevalence of sleeping difficulties. Our data emphasize that the lockdowns associated with the pandemic also influenced participants' social behavior, with less individuals reporting eating out or in company. Our study highlights the substantial impact of lockdowns on many dimensions of life. As such, it is of utmost importance in the critical evaluation of such stringent containment measures.


Subject(s)
COVID-19 , Exercise , Feeding Behavior , Life Style , Pandemics , Quarantine , SARS-CoV-2 , Adult , Aged , COVID-19/epidemiology , COVID-19/physiopathology , COVID-19/prevention & control , Female , Humans , Male , Middle Aged , Rome/epidemiology
11.
J Med Life ; 14(4): 492-497, 2021.
Article in English | MEDLINE | ID: covidwho-1535090

ABSTRACT

Recent data suggest that the prevalence of Helicobacter pylori (HP) infection in Romania has been declining in the last 30 years. However, there are no studies regarding HP prevalence among medical students. The objectives of this study were to estimate the prevalence of HP infection and assess the prevalence of dyspepsia in medical students and the relationship between dyspepsia and infection. We included 150 students from the Iuliu Hatieganu University of Medicine and Pharmacy of Cluj-Napoca, Romania (102 females and 48 males, mean age 21 years). Each student completed a lifestyle questionnaire, personal history, family history as well as the Rome IV questionnaire for functional dyspepsia. The status of HP infection was determined using the C13-urea respiratory test. The prevalence of HP infection was 25.33%, and 18% met the Rome IV criteria for functional dyspepsia. 37% of students with functional dyspepsia had a positive HP test. Of all students, 8% had a history of HP infection. Those with a history of HP infection had a 4.45% (95% CI 1.6 - 12.37) higher risk of having positive Rome IV criteria for functional dyspepsia than those with no previous history of infection (p=0.008). Thus, the present study adds to the body of evidence regarding HP prevalence among medical students, 25.33% being positive. We found no statistically significant correlation between HP infection and functional dyspepsia. Those with a history of HP infection had a higher risk of functional dyspepsia.


Subject(s)
Dyspepsia , Helicobacter Infections , Helicobacter pylori , Students, Medical , Adult , Dyspepsia/diagnosis , Dyspepsia/epidemiology , Female , Helicobacter Infections/diagnosis , Helicobacter Infections/epidemiology , Humans , Male , Romania/epidemiology , Rome , Young Adult
12.
Sci Rep ; 11(1): 21136, 2021 10 27.
Article in English | MEDLINE | ID: covidwho-1493228

ABSTRACT

The COVID-19 pandemic is impressively challenging the healthcare system. Several prognostic models have been validated but few of them are implemented in daily practice. The objective of the study was to validate a machine-learning risk prediction model using easy-to-obtain parameters to help to identify patients with COVID-19 who are at higher risk of death. The training cohort included all patients admitted to Fondazione Policlinico Gemelli with COVID-19 from March 5, 2020, to November 5, 2020. Afterward, the model was tested on all patients admitted to the same hospital with COVID-19 from November 6, 2020, to February 5, 2021. The primary outcome was in-hospital case-fatality risk. The out-of-sample performance of the model was estimated from the training set in terms of Area under the Receiving Operator Curve (AUROC) and classification matrix statistics by averaging the results of fivefold cross validation repeated 3-times and comparing the results with those obtained on the test set. An explanation analysis of the model, based on the SHapley Additive exPlanations (SHAP), is also presented. To assess the subsequent time evolution, the change in paO2/FiO2 (P/F) at 48 h after the baseline measurement was plotted against its baseline value. Among the 921 patients included in the training cohort, 120 died (13%). Variables selected for the model were age, platelet count, SpO2, blood urea nitrogen (BUN), hemoglobin, C-reactive protein, neutrophil count, and sodium. The results of the fivefold cross-validation repeated 3-times gave AUROC of 0.87, and statistics of the classification matrix to the Youden index as follows: sensitivity 0.840, specificity 0.774, negative predictive value 0.971. Then, the model was tested on a new population (n = 1463) in which the case-fatality rate was 22.6%. The test model showed AUROC 0.818, sensitivity 0.813, specificity 0.650, negative predictive value 0.922. Considering the first quartile of the predicted risk score (low-risk score group), the case-fatality rate was 1.6%, 17.8% in the second and third quartile (high-risk score group) and 53.5% in the fourth quartile (very high-risk score group). The three risk score groups showed good discrimination for the P/F value at admission, and a positive correlation was found for the low-risk class to P/F at 48 h after admission (adjusted R-squared = 0.48). We developed a predictive model of death for people with SARS-CoV-2 infection by including only easy-to-obtain variables (abnormal blood count, BUN, C-reactive protein, sodium and lower SpO2). It demonstrated good accuracy and high power of discrimination. The simplicity of the model makes the risk prediction applicable for patients in the Emergency Department, or during hospitalization. Although it is reasonable to assume that the model is also applicable in not-hospitalized persons, only appropriate studies can assess the accuracy of the model also for persons at home.


Subject(s)
COVID-19/mortality , Machine Learning , Pandemics , SARS-CoV-2 , Aged , Aged, 80 and over , Blood Cell Count , Blood Chemical Analysis , COVID-19/blood , Cohort Studies , Female , Hospital Mortality , Humans , Male , Middle Aged , Models, Statistical , Multivariate Analysis , Oxygen/blood , Pandemics/statistics & numerical data , ROC Curve , Risk Factors , Rome/epidemiology
13.
Basic Clin Pharmacol Toxicol ; 130(1): 200-207, 2022 Jan.
Article in English | MEDLINE | ID: covidwho-1488179

ABSTRACT

The transfer of a chemical product from its original container to an unlabelled secondary container by consumers is a potential health hazard that may result in unintentional exposures and intoxications. The aim of this study was to describe the pattern of prevalence of exposures to transferred products in Italy from year 2017, when the new European labelling regulation for chemicals became fully operative, to 2020, year of the coronavirus 19 disease first outbreak. Calls to the Poison Control Centre (PCC) of Policlinico Umberto I Hospital - Sapienza University of Rome were analysed retrospectively for characteristics, clinical presentation and circumstances related to the event. We registered 198 cases of interest. There was a reduction in cases from 2017 (4.9%) to 2019 (2.2%), followed by an increased prevalence in 2020 (4.2%) mainly due to the months "post-lockdown." The transferred product was very frequently diluted, and an empty drinking bottle was usually used as secondary container. Exposures were mostly of minor severity, and no deaths occurred. The study highlights the importance of PCCs data in the evaluation of the hazard communication to users through labels and advises for public campaigns to promote safe behaviours during future lockdowns to prevent exposures at a later period.


Subject(s)
COVID-19/epidemiology , Environmental Exposure/statistics & numerical data , Hazardous Substances/toxicity , Poisoning/epidemiology , Product Labeling/legislation & jurisprudence , Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Italy/epidemiology , Male , Middle Aged , Poison Control Centers , Product Packaging , Retrospective Studies , Rome
14.
Environ Pollut ; 291: 118191, 2021 Dec 15.
Article in English | MEDLINE | ID: covidwho-1427873

ABSTRACT

Between 9 March and 18 May 2020, strict lockdown measures were adopted in Italy for containing the COVID-19 pandemic: in Rome, despite vehicular traffic on average was more than halved, it was not observed a evident decrease of the airborne particulate matter (PM) concentrations, as assessed by air quality data. In this study, daily PM10 filters were collected from selected automated stations operated in Rome by the regional network of air quality monitoring: their magnetic properties - including magnetic susceptibility, hysteresis parameters and FORC (first order reversal curves) diagrams - were compared during and after the lockdown, for outlining the impact of the COVID-19 measures on airborne particulate matter. In urban traffic sites, the PM10 concentrations did not significantly change after the end of the lockdown, when vehicular traffic promptly returned to its usual levels; conversely, the average volume and mass magnetic susceptibilities approximately doubled, and the linear correlation between volume magnetic susceptibility and PM10 concentration became significant, pointing out the link between PM10 concentrations and the increasing levels of traffic-related magnetic emissions. Magnetite-like minerals, attributed to non-exhaust brakes emissions, dominated the magnetic fraction of PM10 near urban traffic sites, with natural magnetic components emerging in background sites and during exogenous dusts atmospheric events. Magnetic susceptibility constituted a fast and sensitive proxy of vehicular particulate emissions: the magnetic properties can play a relevant role in the source apportionment of PM10, especially when unsignificant variations in its concentration levels may mask important changes in the traffic-related magnetic fraction. As a further hint, increasing attention should be drawn to the reduction of brake wear emissions, that are overcoming by far fuel exhausts as the main particulate pollutant in traffic contexts.


Subject(s)
Air Pollutants , Air Pollution , COVID-19 , Air Pollutants/analysis , Air Pollution/analysis , Communicable Disease Control , Environmental Monitoring , Humans , Italy , Magnetic Phenomena , Pandemics , Particulate Matter/analysis , Rome , SARS-CoV-2 , Vehicle Emissions/analysis
16.
AIDS Res Hum Retroviruses ; 37(8): 624-626, 2021 08.
Article in English | MEDLINE | ID: covidwho-1322601

ABSTRACT

Coronavirus disease 2019 (COVID-19) pandemic has reduced the access of HIV patients to reference centers. However, retention-in-care is critical to maintain adherence to therapy and viral suppression. During lockdown in Italy, our center implemented several measures to ensure HIV-care continuum. To assess whether these efforts were successful, we investigated HIV viral load trend for a 1-year period (September 2019-August 2020), which included lockdown and partial lockdown months in our country. No significant changes overtime in the proportion of undetectable HIV-RNA were observed. Continuity of service made it possible to maintain viral suppression in our patients.


Subject(s)
COVID-19/epidemiology , HIV Infections/epidemiology , HIV Infections/virology , Medication Adherence/statistics & numerical data , Viral Load , COVID-19/prevention & control , Communicable Disease Control , Female , HIV Infections/drug therapy , Humans , Male , Pandemics , Rome/epidemiology , SARS-CoV-2
17.
Int J Environ Res Public Health ; 18(14)2021 Jul 08.
Article in English | MEDLINE | ID: covidwho-1302336

ABSTRACT

The COVID-19 pandemic has severely tested the mental health of frontline health care workers. A repeated cross-sectional study can provide information on how their mental health evolved during the various phases of the pandemic. The intensivists of a COVID-19 hub hospital in Rome were investigated with a baseline survey during the first wave of the pandemic in April 2020, and they were contacted again in December 2020, during the second wave. Of the 205 eligible workers, 152 responded to an online questionnaire designed to measure procedural justice, occupational stress (effort/reward imbalance), sleep quality, anxiety, depression, burnout, job satisfaction, happiness, and turnover intention. Workers reported a further increase in workload and compassion fatigue, which had already risen during the first wave, and a marked reduction in the time devoted to meditation and mental activities. A low level of confidence in the adequacy of safety procedures and the need to work in isolation, together with an increased workload and lack of time for meditation, were the most significant predictors of occupational stress in a stepwise linear regression model. Occupational stress was, in turn, a significant predictor of insomnia, anxiety, low job satisfaction, burnout, and intention to leave the hospital. The number of workers manifesting symptoms of depression increased significantly to exceed 60%. Action to prevent occupational risks and enhance individual resilience cannot be postponed.


Subject(s)
COVID-19 , Pandemics , Anxiety/epidemiology , Cross-Sectional Studies , Depression/epidemiology , Health Personnel , Hospitals , Humans , Italy/epidemiology , Rome/epidemiology , SARS-CoV-2
18.
J Anal Psychol ; 66(3): 379-398, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1299069

ABSTRACT

Most of the clinical experiences discussed in this article arose from monthly Zoom meetings at Rome's Italian Centre of Analytical Psychology (CIPA). We set up a discussion group in April 2020, one month after lockdown began in Italy, and these monthly online meetings continue to this day. All senior analysts and analysts-in-training at Rome's CIPA, whose backgrounds range from child and adolescent psychotherapy to adult psychotherapy and analysis, to sandplay therapy and medicine and psychiatry, have been participating in these meetings. The group discussions focus on the present time and its impact on us, as well as on our relationships with patients. By further developing these reflections during the lockdown in Italy (9 March - 3 May 2020), it is fair to ask whether a sense of unreality, depersonalization, or derealization has occurred, either in the therapist or patient, and if so, whether it is possible that therapists miss the human contact more than clients. We will mainly refer to clinical and personal experiences as our most precious guidelines.


La plupart des expériences cliniques discutées dans cet article proviennent de rencontres mensuelles par Zoom à la CIPA, le Centre de Psychologie Analytique Italien, à Rome. Nous avons mis en place en avril 2020 un groupe de discussion, un mois après que le confinement ait commencé en Italie. Ces réunions mensuelles, en ligne, se poursuivent jusqu'à ce jour. Les analystes confirmés et les analystes en formation à la CIPA participent à ces rencontres. Leurs contextes sont variés: de la psychothérapie d'enfants et d'adolescents à la psychothérapie d'adultes et à l'analyse, et également la thérapie par le jeu de sable, la médecine et la psychiatrie. Les discussions se concentrent sur le temps présent et son impact sur nous, et sur nos relations avec nos patients. En poussant plus loin les réflexions durant le confinement en Italie (du 9 mars au 3 mai 2020), il est pertinent de se demander s'il s'est produit un sentiment d'irréalité, de dépersonnalisation ou déréalisation, chez le thérapeute ou chez le patient. Et si c'est le cas, est-il envisageable que le contact humain manque aux thérapeutes plus qu'aux clients? Notre consigne la plus précieuse sera de nous appuyer principalement sur des expériences cliniques et personnelles.


La mayor parte de la experiencia clínica descripta en este artículo emergió de los encuentros mensuales vía Zoom del Centro de Psicología Analítica de Roma (CIPA). Creamos un grupo de discusión en Abril 2020, un mes después del comienzo del confinamiento, y estos encuentros mensuales virtuales continúan hasta estos días. Todos los analistas con antigüedad, y analistas en formación en la CIPA de Roma, cuyos antecedentes van desde psicoterapia con niños y adolescentes hasta psicoterapia y análisis de adultos, terapia de juego de arena, medicina y psiquiatría, han participado de estos encuentros. La discusión del grupo se focalizó en el tiempo presente y su impacto en todos nosotros, así como en nuestras relaciones con los pacientes. Al continuar desarrollando estas reflexiones surgidas durante el confinamiento en Italia (9 de Marzo - 3 de Mayo 2020), es válido preguntar si ha tenido lugar un sentido de no realidad, despersonalización o desrealización, en el terapeuta o en el paciente, y de ser así, si es posible que los terapeutas hayan extrañado el contacto humano más que los pacientes. Haremos referencia principalmente a experiencias personales y clínicas como nuestras guías más preciosas.


Subject(s)
COVID-19 , Personal Narratives as Topic , Physical Distancing , Professional-Patient Relations , Psychoanalytic Therapy , Telemedicine , Adult , Humans , Middle Aged , Rome , Telecommunications , Young Adult
19.
Sci Rep ; 11(1): 12762, 2021 06 17.
Article in English | MEDLINE | ID: covidwho-1275947

ABSTRACT

The aim of this study was to evaluate the role of baseline lymphocyte subset counts in predicting the outcome and severity of COVID-19 patients. Hospitalized patients confirmed to be infected with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) were included and classified according to in-hospital mortality (survivors/nonsurvivors) and the maximal oxygen support/ventilation supply required (nonsevere/severe). Demographics, clinical and laboratory data, and peripheral blood lymphocyte subsets were retrospectively analyzed. Overall, 160 patients were retrospectively included in the study. T-lymphocyte subset (total CD3+, CD3+ CD4+, CD3+ CD8+, CD3+ CD4+ CD8+ double positive [DP] and CD3+ CD4- CD8- double negative [DN]) absolute counts were decreased in nonsurvivors and in patients with severe disease compared to survivors and nonsevere patients (p < 0.001). Multivariable logistic regression analysis showed that absolute counts of CD3+ T-lymphocytes < 524 cells/µl, CD3+ CD4+ < 369 cells/µl, and the number of T-lymphocyte subsets below the cutoff (T-lymphocyte subset index [TLSI]) were independent predictors of in-hospital mortality. Baseline T-lymphocyte subset counts and TLSI were also predictive of disease severity (CD3+ < 733 cells/µl; CD3+ CD4+ < 426 cells/µl; CD3+ CD8+ < 262 cells/µl; CD3+ DP < 4.5 cells/µl; CD3+ DN < 18.5 cells/µl). The evaluation of peripheral T-lymphocyte absolute counts in the early stages of COVID-19 might represent a useful tool for identifying patients at increased risk of unfavorable outcomes.


Subject(s)
CD4-Positive T-Lymphocytes , CD8-Positive T-Lymphocytes , COVID-19/blood , COVID-19/mortality , SARS-CoV-2/genetics , Severity of Illness Index , T-Lymphocyte Subsets , Aged , Aged, 80 and over , COVID-19/epidemiology , COVID-19/virology , Female , Hospital Mortality , Humans , Lymphocyte Count , Male , Middle Aged , Nasopharynx/virology , Retrospective Studies , Reverse Transcriptase Polymerase Chain Reaction , Risk Factors , Rome/epidemiology
20.
Int J Cardiol ; 338: 278-285, 2021 09 01.
Article in English | MEDLINE | ID: covidwho-1275354

ABSTRACT

BACKGROUND: Coronavirus disease 2019 (COVID-19) is a pandemic disease that is causing a public health emergency. Characteristics and clinical significance of myocardial injury remain unclear. METHODS: This retrospective single-center study analyzed 189 patients who received a COVID-19 diagnosis out of all 758 subjects with a high sensitive troponin I (Hs-TnI) measurement within the first 24 h of admission at the Policlinico A.Gemelli (Rome, Italy) between February 20th 2020 to April 09th 2020. RESULTS: The prevalence of myocardial injury in our COVID-19 population is of 16%. The patients with cardiac injury were older, had a greater number of cardiovascular comorbidities and higher values of acute phase and inflammatory markers and leucocytes. They required more frequently hospitalization in Intensive Care Unit (10 [32.3%] vs 18 [11.4%]; p = .003) and the mortality rate was significantly higher (17 [54.8%] vs. 15 [9.5%], p < .001). Among patients in ICU, the subjects with myocardial injury showed an increase need of endotracheal intubation (8 out of 9 [88%] vs 7 out of 19[37%], p = .042). Multivariate analyses showed that hs-TnI can significantly predict the degree of COVID-19 disease, the intubation need and in-hospital mortality. CONCLUSIONS: In this study we demonstrate that hs-Tn can significantly predict disease severity, intubation need and in-hospital death. Therefore, it may be reasonable to use Hs-Tn as a clinical tool in COVID-19 patients in order to triage them into different risk groups and can play a pivotal role in the detection of subjects at high risk of cardiac impairment during both the early and recovery stage.


Subject(s)
COVID-19 , Pandemics , COVID-19 Testing , Hospital Mortality , Humans , Italy/epidemiology , Prevalence , Retrospective Studies , Rome , SARS-CoV-2 , Troponin
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