[Risk stratification nomogram for COVID-19 patients with interstitial pneumonia in the emergency department : A retrospective multicenter study]. / Nomogramm zur Risikostratifizierung von COVID-19-Patienten mit interstitieller Pneumonie in der Notaufnahme : Eine retrospektive multizentrische Studie.

BACKGROUND: There is currently no reliable method to identify which COVID-19 patients in the emergency department will experience rapid disease progression and death. AIM: The aim of this work is to investigate predictive risk factors for 30-day mortality in COVID-19 (coronavirus disease 2019) patients with interstitial pneumonia using patient history, and clinical and laboratory parameters and to develop a nomogram for risk stratification in the emergency department. METHODS: A retrospective, multicenter study was conducted in a cohort of 164 patients with COVID-19 pneumonia in the emergency departments of hospitals in Merano and Bressanone from 1 March 2020 to 31 March 2020. Patients were diagnosed as positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) using fluorescence reverse transcription polymerase chain reaction (RT-PCR). A nomogram for risk stratification of 30-day mortality of COVID-19 patients was developed based on the parameters studied. RESULTS: In all, 35 (21.3%) of 164 COVID-19 patients with interstitial pneumonia died within 30 days of admission to the emergency department. Multivariate analysis method revealed that cognitive deterioration (odds ratio [OR]: 8.330; p = 0.004), lymphocytopenia (OR: 4.229; p = 0.049), renal function deterioration (OR: 4.841; p = 0.028), peripheral oxygen saturation < 93% (OR: 17.871; p = 0.002), age > 75 years (OR: 2.925; p = 0.032), elevated C­reactive protein (OR: 6.504; p = 0.005), low monocyte count (OR: 0.504; p = 0.004), and comorbidity (OR 5.862; p = 0.019) were associated with 30-day mortality. Using these eight parameters, a nomogram was developed that showed good discrimination with an area under the ROC curve of 0.937. CONCLUSION: The initial evaluation of the patient history, and the clinical and laboratory data collected in the emergency department provides important prognostic information for risk stratification of COVID-19 patients in the emergency department and for early identification of patients with risk for critical disease course.

A retrospective analysis of 144 patients with aggressive non-Hodgkin's lymphoma: impact of autologous stem cell transplantation in first remission on outcome.

BACKGROUND AND OBJECTIVES: To analyze the impact of a sequential program including autologous stem cell transplantation in first remission on the outcome of patients with aggressive non-Hodgkin's lymphoma. DESIGN AND METHODS: Patients aged less than 60 years old, with an aggressive non-Hodgkin's lymphoma and at least a partial response after first line therapy (chemotherapy +/- radiotherapy) were included in the study. RESULTS: One hundred and forty-four patients were registered: of them 126 reached at least a partial response after first line therapy and 71 ( 56.5%) were then submitted to autologous stem cell transplantation. The overall survival (OS) and progression-free survival (PFS) of the whole population were respectively 70% and 63% at a median follow-up from diagnosis of 51 months (7-115). The PFS of the transplanted group was 93% at a median follow-up from diagnosis of 54 months (20-155); the PFS of the non-transplanted patients was 43.5% at a median follow-up from diagnosis of 30 months (8-109) (p <0.0001). INTERPRETATION AND CONCLUSIONS: The two groups (transplanted vs not transplanted patients in remission after induction therapy) were homogeneous concerning the major risk factors (stage III Eth IV Eth p = 0.26; performance status Eth p = 0.25; B-symptoms Eth p = 0. 3; LDH level Eth p = 0.4; extranodal disease Eth p=0.4; bulky disease Eth p = 0.7): so we compared them in order to discover clinical features at diagnosis adversely affected PFS. In a multivariate analysis, factors which adversely affected PFS were: LDH level Eth p = 0.03; number of extranodal sites Eth p = 0.04; not performing the transplant Eth p = 0.02. When patients were stratified by number of extranodal sites and by LDH level, only the transplant being performed retained its positive influence Eth p = 0.04.

Pilot study on the safety and efficacy of intravenous natural beta-interferon therapy in patients with chronic hepatitis C unresponsive to alpha-interferon.

BACKGROUND: Since a large fraction of patients affected by chronic hepatitis C do not respond to alpha-interferon therapy, we planned a pilot study of intravenous beta-interferon therapy in Italian patients non responsive to several courses of alpha-interferon. METHODS: Ten Italian patients with chronic hepatitis C were treated intravenously with beta-interferon to assess the biochemical and virological responses. Each patient received intravenously 6 MU of beta-interferon daily for 7 days a week for a period of 2 months; in responders, this treatment was followed by intramuscular beta-interferon administration 6 MU three times a week for an additional 8 weeks. RESULTS: All the patients were infected by the genotype 1b of hepatitis C virus and had a high serum concentration of HCV-RNA (4.1 +/- 3.3 x 10(7) copies/ml). During intravenous therapy, 4 patients (40%) showed a complete return to normal of alanino-aminotransferase and 3 cases became HCV-RNA negative. During intramuscular beta-interferon administration, two patients breakthrough. At the end of the follow-up (six months after the end of the treatment) two patients only showed return to normal of alanino-aminotransferase, but one of them remained HCV-RNA positive. CONCLUSIONS: These results indicate that even genotype 1b of hepatitis C virus can be suppressed by intravenous beta-interferon therapy, as previously described in similar cases in Japan. The rate of sustained biochemical and virologic response was, however, low, suggesting that further studies are needed to define the best regimen to achieve eradication of hepatitis C virus infection.