RESUMEN
Background and Aim: In January 2021, vaccination against CoViD-19 was started in Italy. F. Miulli Regional Hospital, in Acquaviva delle Fonti (BA), has prepared a vaccination plan in order to cover the entire health care population which, starting from January 6, 2021, led to the vaccination of 1,700 subjects. Purpose of the study was to evaluate the impact of SARS-CoV-2 vaccination on healthcare personnel. Primary outcomes were: the number of infections detected after vaccination and hospitalizations for SARS-CoV-2 infection. Materials and Methods: Nasopharyngeal swabs were analyzed with reverse transcription-polymerase chain reaction techniques. Vaccination campaign was carried out in the period January-February 2021. The data were compared according to three periods: time 0: March-April 2020;time 1: October2020-January 2021;time 2 (post vaccine): February-April 2021. Results: The swabs analyzed were respectively: Time 0: 1.077;Time 1: 9.043;Time 2: 4.013. The positive tests and their percentage, relative to the swabs examined in the three times, are: Time 0: 17 cases (1.57%);Time 1: 137 cases (1.51%);Time 2: 15 cases (0.37%). Furthermore, none of the positive subjects at time 2 required hospitalization, compared to 3.2% of hospitalizations which occurred between time 0 and time 1. Conclusions: Vaccination against SARS-CoV-2 resulted in a 75.3% reduction in infections in vaccinated subjects and a 100% reduction in hospitalizations, indicating a high protective effect for both infection and disease expression.
RESUMEN
Background and Aim of the study: Data on the recent SARS-Cov-2 pandemic show that women have a lower incidence of infectionsand more favorable outcomes. It is not clear whether the sex disparities occur in all age groups and whether it may depend on adifferent immune response. The aim of the study was to verify thedifferences between males (M) and females (F), comparing theimmune response and the outcomes in the two groups.Methods: We studied all SARS-Cov-2 infected patients hospitalized from the 10th of March to 31th of May 2020. At the time ofadmission, in addition to the common laboratory tests and inflammatory parameters (IL6, CRP), we evaluated B and T cells (CD3),helper/suppressor ratio (CD4/CD8), and NK cells (CD56). Results: 152 patients, 91 M (59.8%) were analyzed. The averageage was 68±17 years;the F group was older (76±14 vs 63±16;p <0.001), with a higher percentage of subjects >75 years: 59%vs 27.9% (p <0.001). A higher CD4/CD8 ratio was found in subjects >75 years of age compared to those aged 60-75 (2.3±1.2vs 1.9±1.4;p<0.05) and in F group (2.8±2.3 vs 2.2±1.4;p<0.05). Interestingly, an inverse correlation between IL6 and CD3was found in both sexes, but highly significant in the M group(p<0.001;r-0.48). Finally, a higher number of in-hospital deathswere found in the F group: 23.9% vs 9.9% (p <0.03).Conclusions: SARS-Cov-2 infection affects mainly M subjects,that show an inverse correlation between IL6 and CD3 cells. TheF group over 75 years has a higher CD4 / CD8 ratio and highermortality.
RESUMEN
Background and Aim of the study: Several studies show that microbial co-infection increases the risk of disease severity in humans, but there is limited knowledge on co-infection amongpatients with coronavirus disease 2019 (COVID-19). The aim ofthe study was to evaluate co-infections with other pathogensamong COVID-19 cases. Methods: In this study, we analyzed the laboratory-confirmedCOVID-19 consecutive patients admitted at Miulli General Hospitalfrom the 17th of March to the 31th of May 2020. We included patients in all settings, either in Covid wards and in ICU. We soughtto define the prevalence of patients with bacterial and fungal coinfections.Results: Overall, 233 patients (M 59%;age 67±18 years) were examined;52 (22.3%) of them were co-infected with one or morepathogens;in total 27 respiratory pathogens were found. Copathogens included different bacteria such as Staphylococcus aureus, Klebsiella pneumoniae, Mycoplasma, Chlamydia and Candidaspecies. In addition, 7.7% of patients had pathogens with resistancegenes. Most co-infections occurred within 5 days of onset of COVID-19 disease. A higher prevalence of ICU patients had bacterial coinfections than patients in a mixed ward (72.7% vs 17.1%;p<0.001), and the fungal co-infections and bacterial-fungal co-infections were more prevalent in severe COVID-19 cases.Conclusions: A low proportion of COVID-19 patients have a bacterial co-infection;while in ICU the prevalence increases. These results suggest that routine antibiotics might not be indicated inpatients with COVID-19.
RESUMEN
Introduction and Aim of the study: The unexpected COVID-19pandemic began in December 2019 in Wuhan and rapidly spreadworldwide, continues to challenge the medical community. The understanding of host characteristics at presentation could lead theway towards a better management. We analyzed data collectedform a cohort of patients admitted for Sars-CoV-2 infection to evaluate the determinants of disease severity.Materials and Methods: Data were collected retrospectively frommedical records of patients admitted at F. Miulli General HospitalCOVID department from February to May 2020. CD3, CD4, CD8,CD19, CD56, WBC, lymphocytes on admission were analyzed inrespect of on the basis of outcomes and need for resuscitation or not. A descriptive analysis was performed (t-test for continuousdata with normal distribution).Results: We studied 127 patients, 80 M, 47 F, mean age 66±15years. A statistically significant higher in CD3 (p <0.01-0.01), CD4(p<0.01-0.04), CD8 (p <0.01-0.0.05) and lower in lymphocytescount (p <0.01-0.001) decrease was observed in patients withfatal outcome and in ones who need for resuscitation (in bracketsthe respective p values). WBC counts only show a significant reduction in the recovery analysis (p<0.01-0.11).Conclusions: Our results confirm that a different immunologic profile can predict the clinical course of the disease. These evidencescould help to assess an individualize therapeutic management ofCOVID19 patients.