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Aim of the Study: We aimed to evaluate the virus spreading among a migrant population previously excluded by community surveillance programs. Method(s): We conducted a retrospective study, collecting data about people without SARS-CoV-2-related symptoms who attended the outpatient clinic for undocumented migrants from November 1, 2020, to April 30, 2021. Patients who performed a nasopharyngeal swab and serologic test to evaluate the presence of antibody anti-SARS-CoV-2 were enrolled. Result(s): Overall, 240 people were included in our study. Of them, 15 (6.3%) were female, with a median age of 27.0 years (interquartile range [IQR], 24.3-32.1 years). Thirty-seven patients (15.4%) tested positive for SARS-CoV-2 at the nasopharyngeal swab during the study period. Of these, 16 had positive or low positive results for immunoglobulin G (IgG) and 3 tested positive for both IgG and IgM. Besides, 22 participants (9.2%) resulted positive to serological testing, but negative to polymerase chain reaction testing. The median age of SARS-CoV-2 positive patients (n = 59) was significantly higher than negative (29.6 [IQR, 25.0-35.0] vs 26.8 [IQR, 24.2-31.5], P = 0.022). Among positive patients, the most frequent nationality was Bangladeshi, with 24 people (40.7%, P < 0.001). The highest percentage of positive was found among the same nationality (51.1% of Bangladeshi tested positive). Conclusion(s): Our data underline the significantly higher prevalence of SARS-CoV-2 infection in the undocumented migrant population in respect of the general population of Piacenza province in the same period (15.4% vs 5.9%, P < 0.001). The extension of surveillance programs to the whole population, thus including undocumented people, is crucial to curb the spreading of the virus.Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
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Introduction: Acquired thrombotic thrombocytopenic purpura (TTP) is a severe, rare, thrombotic microangiopathy (TMA). A diagnosis of acquired TTP is confirmed by a severe deficiency (< 10%) of ADAMTS13 activity. Recently, maybe because of Sars-COV2 Pandemic, in our laboratory we had the impression that normal reference ranges of our ADAMT13 activity assay HemosiL Acustar ADAMTS13 rapid immunoassay, could be larger than manufacturer's. The objective of this study was to evaluate whether manufacturer's are suitable normal reference values for this assay in our laboratory Methods: To evaluate manufacturer's reference limits (60-130.6%) in our laboratory we decided to assay with HemosIL Acustar ADAMTS13 activity test 30 plasma samples from normal subjects. Result(s): 3 out of 20 normal subjects tested showed ADAMTS13 activity outside manufacturer's limits (1 below 60.6% and 2 above 130.6%), therefore even if calculated in a small number of subjects (30 individuals) we decide to try to calculate in house ADAMTS13 reference values. They ranged from 47.5 (10th perc.), 72.5 (25th perc.) and 41.6 (mean- 2sd) to 150.0 (99th perce.), 119,6 (75th perc.) and 152.7 (mean+2sd). To investigate the analytical performance of manufacturer's and calculated cut-offs limits, we re-evaluate one year of ADAMTS13 activity results (95 subjects). ADAMTS13 activity was severely reduced (< 0.7%) in 10 acute TTPs;20 patients with Hemolytic Uremic Syndrome showed ADAMTS13 activity above manufacturer's and in all calculated cut-offs;21/45 patients with TTPs in remission phase showed ADAMTS activity below all in house calculated cut off and 24/45 showed ADAMTS activity below manufacturer's;12/20 other patients showed ADAMTS activity below all in house calculated and manufacturer's cut offs, all of them were Sars COV2 positive subjects Conclusion(s): In conclusion HemosiL Acustar ADAMTS13 activity calculated cut-offs in our laboratory were larger than manufacturer's reference range. By the analysis of one year ADAMTS13 activity dosages both manufacturer's and calculated cut-offs showed similar performances but our calculated reference ranges even if obtained by the analysis of a small number of normal subjects were found to be more similar to literature ELISA (40-130%) and FRET (45-147%) ADAMTS13 activity normal values.
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OBJECTIVE: Since the start of the COVID-19 pandemic, millions of people have been infected with thousands of deaths. Few data regarding factors that increase the risk of infection are available. Our study aimed to evaluate all people living in retirement homes (PLRNH) and identify factors that could increase infection risk in a close community. MATERIALS AND METHODS: We conducted a retrospective study enrolling all PLRNH, where at least one SARS-CoV-2 infected person was present. Variables were compared with Student's t-test or Pearson chi-square test as appropriate. Uni- and multivariate analyses were conducted to evaluate variables' influence on the infection. RESULTS: We included 452 PLRNH; 144 (31.7%) were male, with a mean age of 82.2±8.6 years. People with a positive swab for SARS-CoV-2 were 306 (67.4%). A significant difference between SARS-CoV-2 infected and not infected was observed in the percentage of those receiving chronic treatment with Angiotensin II receptor blockers (ARBs) (18.6% vs. 9.5%, p=0.012). On the contrary, there was no difference in the proportion of those receiving ACE inhibitors (ACE-I) (21.2% vs. 23.6%, p=0.562). At multivariate analysis, people with mental illness and cancer had an increased risk of being infected. Furthermore, receiving ARBs as a chronic treatment was an independent predictor of infection risk [OR 1.95 (95% CI 1.03-3.72) p=0.041]. CONCLUSIONS: Our data suggest that, in close communities, such as retirement nursing homes, the receipt of ARBs increased the risk of acquiring SARS-CoV-2 infection. However, before changing an important chronic treatment in a fragile population, such as the elderly living in retirement nursing homes, clinicians should carefully evaluate the risk-benefit ratio.