16-months post-discharge outcome in a cohort of confirmed COVID-19 subjects

Background: Little is known about the long-term re-hospitalization of patients with confirmed infection by SARS CoV 2 discharged from hospital. Aim: The aim of our retrospective cohort study was to identify death and re-hospitalization outcomes in a 16-month follow-up in a population of subjects already hospitalized for Covid-19. Materials and Methods: The study was conducted in the metropolitan area of Bari (population: 472,385 inhabitants) by examining the patients hospitalized from 17/03/2020 to 28/05/2021 at the Covid Unit of the F. Miulli hospital in Acquaviva delle Fonti. Results: 1238 patients (754 males, 60.9%, median 70 years) were hospitalized in Covid Unit: 1060 (85.6%) (M 60.1% median 71 years) were hospitalized in non-intensive wards, while 178 (14.4%) (M 65.7%, median 69 aa), passed through the IT. At follow-up, 922 subjects were still alive;66 deceased (7.2% of the total, 37.8% males, median 80 years). Analyzing only the data of patients residing in the metropolitan area, where the hospital is the reference, 780 patients discharged alive were examined. Of these, 11.2% were rehospitalized at least once, 30 died (4.3%). Mortality on re-admission to hospital was 17.2%. A third of the re-admissions were unrelated to Covid. Infections, pneumonia and cardiovascular disease were the most represented reason for hospitalization. Conclusions: Data show that at a follow-up of 16 months 92.8% of the subjects were still alive, while 7.2% had died, mainly elderly women. 11.2% of those discharged from the Covid ward have been re-admitted to the hospital at least once.

Severity level and ventilation procedures in COVID-19 patients in a semi-intensive care unit

Introduction and Purpose of the study: SARS-CoV2 infection is characterized by massive involvement of the respiratory system. During the various waves, the patients admitted to the Covid wards presented different degrees of pulmonary involvement and numerous comorbidities. Administration of oxygen therapy was the prevalent measure in almost all subjects. The aim of our study was to verify the level of severity and ventilation procedures in a group of subjects hospitalized for SARS-CoV2 infection. Materials and Methods: 388 subjects admitted to the semi-intensive Covid Unit of the F. Miulli Hospital in 2020 were retrospectively analyzed, by examining the SDOs. The main diagnoses and procedures performed were identified. A severity cluster was identified characterized by death, ventilation and hospitalization in the semi-intensive area (cut off at 14 days). Results: 82 were the deceased (21.1%). The main diagnoses most represented were: 84.2% respiratory failure, 3.3% heart failure, 2.5% pulmonary embolism and 1.5% septicemia. Regarding the procedures, 31.9% underwent C-PAP ventilation, while 0.7% underwent non-invasive mechanical ventilation. 64% of the subjects had a severe degree of disease evidenced by the composite cluster of deaths, ventilation and at least 14 nights in semi-intensive care. Conclusions: Our data shows that in the face of almost all patients with respiratory failure, about one third underwent ventilation procedures (C-PAP and NIV). More than half of the subjects had a severe degree of disease.

Prevalence of HCV in people hospitalized for COVID-19

Introduction: In our country, the percentage of subjects infected with HCV is about 2% of the general population, with a gradient that increases from the North to the South and the islands. The decline in hepatitis C treatments is sensationally evident. The WHO had set the goal of its elimination by 2030, a result made achievable thanks to the new direct-acting antiviral drugs (DAA), which allow the virus to be eradicated in definitively, quickly and without side effects. The pandemic has slowed both screening and treatment. Purpose of the study: Evaluate the prevalence of subjects positive for hepatitis C antigen (HCV +) in all hospitalized for Covid-19. Materials and Methods: 839 subjects admitted to the Covid Unit of the F. Miulli Hospital in Acquaviva delle Fonti were retrospectively assessed. Results: The prevalence of HCV+subjects was 4.7%. No statistically significant differences were found when comparing the main laboratory tests. No difference emerged regarding the outcomes (length of hospitalization and death) which are similar in the two groups. Conclusions: The prevalence of HCV+subjects in the Covid-19 population is double that of the general population. A project is underway in our hospital which provides for the screening of all over 50 year olds hospitalized in order to bring out HCV+subjects and direct them to an outpatient diagnostic confirmation path and any specific eradicating therapy.

Compositional and Morphological Characterization of 'Sorrento' and 'Chandler' Walnuts.

In Italy, most of the cultivated walnuts belong to the Sorrento ecotype, and they are considered commercially valuable due to their specific organoleptic characteristics. The aim of this study is to evaluate and compare the morphological and compositional characteristics of walnuts sampled from 'Sorrento' trees cultivated in different locations in Campania and trees of both the 'Chandler' and 'Sorrento' varieties derived from the same location. The results demonstrated that 'Sorrento' and 'Chandler' walnuts have different biometric characteristics and a different fat content, with the highest fat content being found in the 'Sorrento' variety. Regarding the fatty acid (FA) composition, the content of monounsaturated and saturated fatty acids (MUFAs and SFAs) was highest in the 'Sorrento' variety (from 13 to 15% for MUFAs and from 11 to 13% for SFAs), while the polyunsaturated fatty acids (PUFAs) content was highest in the 'Chandler' variety (77%). The total phenolics content (TPC) was highest in the 'Sorrento' variety (from 910 to 1230 mg GAE/100 g), while no difference in γ-tocopherol content was found. Furthermore, the influence of walnut area cultivation was shown for fat content, FA composition and TPC. Therefore, both walnut varieties demonstrated good nutritional properties considering the PUFAs and γ-tocopherol content.

Advanced 3D Deep Non-Local Embedded System for Self-Augmented X-Ray-based COVID-19 Assessment

COVID-19 diagnosis using chest x-ray (CXR) imaging has a greater sensitivity and faster acquisition procedures than the Real-Time Polimerase Chain Reaction (RT-PCR) test, also requiring radiology machinery that is cheap and widely available. To process the CXR images, methods based on Deep Learning (DL) are being increasingly used, often in combination with data augmentation techniques. However, no method in the literature performs data augmentation in which the augmented training samples are processed collectively as a multi-channel image. Furthermore, no approach has yet considered a combination of attention-based networks with Convolutional Neural Networks (CNN) for COVID-19 detection. In this paper, we propose the first method for COVID-19 detection from CXR images that uses an innovative self-augmentation scheme based on reinforcement learning, which combines all the augmented images in a 3D deep volume and processes them together using a novel non-local deep CNN, which integrates convolutional and attention layers based on non-local blocks. Results on publicly-available databases exhibit a greater accuracy than the state of the art, also showing that the regions of CXR images influencing the decision are consistent with radiologists' observations.

Temporin G, an amphibian antimicrobial peptide against influenza and parainfluenza respiratory viruses: Insights into biological activity and mechanism of action.

Treatment of respiratory viral infections remains a global health concern, mainly due to the inefficacy of available drugs. Therefore, the discovery of novel antiviral compounds is needed; in this context, antimicrobial peptides (AMPs) like temporins hold great promise. Here, we discovered that the harmless temporin G (TG) significantly inhibited the early life-cycle phases of influenza virus. The in vitro hemagglutinating test revealed the existence of TG interaction with the viral hemagglutinin (HA) protein. Furthermore, the hemolysis inhibition assay and the molecular docking studies confirmed a TG/HA complex formation at the level of the conserved hydrophobic stem groove of HA. Remarkably, these findings highlight the ability of TG to block the conformational rearrangements of HA2 subunit, which are essential for the viral envelope fusion with intracellular endocytic vesicles, thereby neutralizing the virus entry into the host cell. In comparison, in the case of parainfluenza virus, which penetrates host cells upon a membrane-fusion process, addition of TG to infected cells provoked ~1.2 log reduction of viral titer released in the supernatant. Nevertheless, at the same condition, an immunofluorescent assay showed that the expression of viral hemagglutinin/neuraminidase protein was not significantly reduced. This suggested a peptide-mediated block of some late steps of viral replication and therefore the impairment of the extracellular release of viral particles. Overall, our results are the first demonstration of the ability of an AMP to interfere with the replication of respiratory viruses with a different mechanism of cell entry and will open a new avenue for the development of novel therapeutic approaches against a large variety of respiratory viruses, including the recent SARS-CoV2.

Teacher support in COVID-19 pandemic to develop blended learning disruptive models in higher education

Covid-19 pandemic has created significant changes in higher education institutions. After university lockdown, a transition from face-to-face learning to distance learning was unavoidable and several teachers and students had to approach new technologies. The DELTA (Digital Education for Learning and Teaching Advances) Research Group provided support to six degree programs at the University of Turin: each professor received specific trainings and the group constantly helped and checked the implementation of the online courses. In this paper the support provided during the emergency period has been analysed in order to evaluate the improvements in teaching methodologies, and to assess professors' transition to future blended learning disruptive models. The results show an important change in methodology for some courses, aiming at improving the online learning processes. The research data analysis and qualitative study about the usage of the Digital Learning Environment describe the courses' disruptive models. They are useful to understand which elements of the emergency response turned out to be positive and which ones to be unfavourable, in order to be able to redesign post-Covid higher education. © 2020 17th International Conference on Cognition and Exploratory Learning in Digital Age, CELDA 2020. All rights reserved.