Prospective Study of Sars-cov2 Associated Coagulopathy and Role of Complement Activation (preprint)

Sars-CoV2 associated coagulopathy is a complex entity. Platelets, coagulation factors, fibrinolysis, inflammatory cytokines, immunothrombosis, antiphospholipd antibodies, von Willebrand factor/ADAMTS13 axis, complement system have all been demonstrated to be actively involved in the determination of thrombotic events. Til now retrospective studies have analyzed the activaction of vWF/ADAMTS13 axis and complement involvement. We performed a prospective study with the aim of describing clinical and laboratoristic features of Sars-CoV2 associated coagulopathy and its relationship with complement activation. Biochemical variables, vWF/ADAMTS13 axis, complement factors of the enrolled patients have been analyzed. These variables have been correlated to clinical outcome of the disease. Covid associated coagulopathy is neither a Trombotic Trombocitopenc Purpura (TTP) nor and atypical hemolytic uremic syndrome (aSEU). Nevertheless, imbalance of vWF/Adamts13 axis and complement activation simultaneously occurre and are significantly higher in the severe form of disease.

Understanding the environmental factors related to the decrease in Pediatric Emergency Department referrals for acute asthma during the SARS-CoV-2 pandemic (preprint)

Background: Asthma exacerbations, a common reason for Pediatric Emergency Department (PED) referral, can be triggered by multiple factors, including infections, air pollution and allergens. Lockdown measures and other public health interventions during the SARS-CoV-2 pandemic determined radical changes to behavioral and social habits, that were reflected by a reduction in the transmission of all respiratory pathogens and in the emissions of relevant air pollution anthropogenic sources. Objective: This study aims to describe how restrictions during SARS-CoV-2 pandemic impacted the PED referral for asthma exacerbations and their potentially associated environmental triggers in densely populated urban areas. Methods: PED referrals for acute asthma from 2015 to 2020 were compared to air pollution and pollen data. To this purpose, historical daily concentration records of PM2.5, PM10 (including specific chemical tracers), as well as NO2, C6H6, tree, grass and weed pollen were analyzed. Results: In 2020, asthma-related PED referrals decreased up to 85%, compared to the average referral rate of the previous 5 years (P<0.01). The drastic drop in PED referrals was associated with a reduction of high-priority cases by 50-60%, unlike PED referrals for overall diagnoses, showing a larger contribution for severe outcomes. A concomitant diminished contribution of traffic-related air pollution was shown. Conclusions: The lower rate of asthma exacerbations in childhood can be related to synergic interactions of the multiple effects of lockdown measures which induced lower viral infection rates and decreased exposure to outdoor allergens. The reduction of traffic-related air pollution determined a weakening of inflammatory properties of urban PM.