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Bilancini S, Lucchi M, Tucci S, Pomella F, Vittori G, Mollo PE, Trevisan G. Red Palms' Syndrome and Red Fingers' Syndrome: A Mini Review. Angiology 2024; 75:717-724. [PMID: 37410889 DOI: 10.1177/00033197231185459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/08/2023]
Abstract
Red palms syndrome consists of an intense redness on the palms of the hands and, occasionally, the soles of the feet. This infrequent condition may be primary or secondary. The primary forms are either familial or sporadic. They are always benign and do not require treatment. The secondary forms may have a poor prognosis related to the underlying disease, for which early identification and treatment are imperative. Red fingers syndrome is also rare. It manifests as a persistent redness on the fingers or toes pulp. It is typically secondary either to infectious diseases like human immunodeficiency virus, hepatitis C virus and chronic hepatitis B or to Myeloproliferative Disorders, such as Thrombocythemia and Polycythemia vera. Manifestations spontaneously regress over months or years without trophic alterations. Treatment is limited to that of the underlying condition. Aspirin has been shown effective in Myeloproliferative Disorders.
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Affiliation(s)
| | - Massimo Lucchi
- Institute of Angiology Jean Francois Merlen, Frosinone, Italy
| | - Sandro Tucci
- Institute of Angiology Jean Francois Merlen, Frosinone, Italy
| | - Federica Pomella
- Department of Angiology, ASL Frosinone (Local Unit of the National Health Service), Frosinone, Italy
| | - Giulia Vittori
- Institute of Angiology Jean Francois Merlen, Frosinone, Italy
| | | | - Giusto Trevisan
- Department of Medical Sciences, University of Trieste, Trieste, Italy
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Garofalo E, Biamonte F, Palmieri C, Battaglia AM, Sacco A, Biamonte E, Neri G, Antico GC, Mancuso S, Foti G, Torti C, Costanzo FS, Longhini F, Bruni A. Severe and mild-moderate SARS-CoV-2 vaccinated patients show different frequencies of IFNγ-releasing cells: An exploratory study. PLoS One 2023; 18:e0281444. [PMID: 36757971 PMCID: PMC9910754 DOI: 10.1371/journal.pone.0281444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 01/23/2023] [Indexed: 02/10/2023] Open
Abstract
BACKGROUND Despite an apparent effective vaccination, some patients are admitted to the hospital after SARS-CoV-2 infection. The role of adaptive immunity in COVID-19 is growing; nonetheless, differences in the spike-specific immune responses between patients requiring or not hospitalization for SARS-CoV-2 infection remains to be evaluated. In this study, we aim to evaluate the spike-specific immune response in patients with mild-moderate or severeSARS-CoV-2 infection, after breakthrough infection following two doses of BNT162b2 mRNA vaccine. METHODS We included three cohorts of 15 cases which received the two BNT162b2 vaccine doses in previous 4 to 7 months: 1) patients with severe COVID-19; 2) patients with mild-moderate COVID-19 and 3) vaccinated individuals with a negative SARS-CoV-2 molecular pharyngeal swab (healthy subjects). Anti-S1 and anti-S2 specific SARS-CoV-2 IgM and IgG titers were measured through a chemiluminescence immunoassay technology. In addition, the frequencies of IFNγ-releasing cells were measured by ELISpot. RESULTS The spike-specific IFNγ-releasing cells were significantly lower in severe patients (8 [0; 26] s.f.c.×106), as compared to mild-moderate patients (135 [64; 159] s.f.c.×106; p<0.001) and healthy subjects (103 [50; 188] s.f.c.×106; p<0.001). The anti-Spike protein IgG levels were similar among the three cohorts of cases (p = 0.098). All cases had an IgM titer below the analytic sensitivity of the test. The Receiver Operating Curve analysis indicated the rate of spike-specific IFNγ-releasing cells can discriminate correctly severe COVID-19 and mild-moderate patients (AUC: 0.9289; 95%CI: 0.8376-1.000; p< 0.0001), with a diagnostic specificity of 100% for s.f.c. > 81.2 x 106. CONCLUSIONS 2-doses vaccinated patients requiring hospitalization for severe COVID-19 show a cellular-mediated immune response lower than mild-moderate or healthy subjects, despite similar antibody titers.
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Affiliation(s)
- Eugenio Garofalo
- Department of Medical and Surgical Sciences, Anesthesia and Intensive Care Unit, University Hospital Mater Domini, Magna Graecia University, Catanzaro, Italy
| | - Flavia Biamonte
- Department of Experimental and Clinical Medicine, "Magna Graecia" University of Catanzaro, Catanzaro, Italy
- Interdepartmental Center of Services (CIS), Molecular Genomics and Pathology, "Magna Græcia" University of Catanzaro, Catanzaro, Italy
| | - Camillo Palmieri
- Department of Experimental and Clinical Medicine, "Magna Graecia" University of Catanzaro, Catanzaro, Italy
| | - Anna Martina Battaglia
- Department of Experimental and Clinical Medicine, "Magna Graecia" University of Catanzaro, Catanzaro, Italy
| | - Alessandro Sacco
- Department of Experimental and Clinical Medicine, "Magna Graecia" University of Catanzaro, Catanzaro, Italy
| | - Eugenio Biamonte
- Department of Medical and Surgical Sciences, Anesthesia and Intensive Care Unit, University Hospital Mater Domini, Magna Graecia University, Catanzaro, Italy
| | - Giuseppe Neri
- Department of Medical and Surgical Sciences, Anesthesia and Intensive Care Unit, University Hospital Mater Domini, Magna Graecia University, Catanzaro, Italy
| | | | - Serafina Mancuso
- Unit of Biochimica Clinica, University Hospital Mater Domini, Catanzaro, Italy
| | - Giuseppe Foti
- Unit of Infectious Disease, Grand Metropolitan Hospital, Reggio Calabria, Italy
| | - Carlo Torti
- Department of Medical and Surgical Sciences, Unit of Infectious and Tropical Diseases, "Magna Graecia" University, Catanzaro, Italy
| | - Francesco Saverio Costanzo
- Department of Experimental and Clinical Medicine, "Magna Graecia" University of Catanzaro, Catanzaro, Italy
- Interdepartmental Center of Services (CIS), Molecular Genomics and Pathology, "Magna Græcia" University of Catanzaro, Catanzaro, Italy
| | - Federico Longhini
- Department of Medical and Surgical Sciences, Anesthesia and Intensive Care Unit, University Hospital Mater Domini, Magna Graecia University, Catanzaro, Italy
| | - Andrea Bruni
- Department of Medical and Surgical Sciences, Anesthesia and Intensive Care Unit, University Hospital Mater Domini, Magna Graecia University, Catanzaro, Italy
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3
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Garofalo E, Cammarota G, Neri G, Macheda S, Biamonte E, Pasqua P, Guzzo ML, Longhini F, Bruni A. Bivalirudin vs. Enoxaparin in Intubated COVID-19 Patients: A Pilot Multicenter Randomized Controlled Trial. J Clin Med 2022; 11:jcm11205992. [PMID: 36294312 PMCID: PMC9604898 DOI: 10.3390/jcm11205992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 09/15/2022] [Accepted: 10/08/2022] [Indexed: 11/23/2022] Open
Abstract
(1) Background: In COVID-19 patients, the occurrence of thromboembolic complications contributes to disease progression and mortality. In patients at increased risk for thrombotic complications, therapeutic enoxaparin should be considered. However, critically ill COVID-19 patients could develop resistance to enoxaparin. Bivalirudin, a thrombin inhibitor, may be an alternative. This pilot multicenter randomized controlled trial aims to ascertain if bivalirudin may reduce the time spent under invasive mechanical ventilation, as compared to enoxaparin. (2) Methods: Intubated COVID-19 patients at risk for thrombo-embolic complications were randomized to receive therapeutic doses of enoxaparin or bivalirudin. We ascertained the time spent under invasive mechanical ventilation during the first 28 days from Intensive Care Unit (ICU) admission. A standardized weaning protocol was implemented in all centers. In addition, we assessed the occurrence of thromboembolic complications, the number of patients requiring percutaneous tracheostomy, the gas exchange, the reintubation rate, the ICU length of stay, the ICU and 28-days mortalities. (3) Results: We enrolled 58 consecutive patients. Bivalirudin did not reduce the time spent under invasive mechanical ventilation as compared to enoxaparin (12 [8; 13] vs. 13 [10; 15] days, respectively; p = 0.078). Thrombotic (p = 0.056) and embolic (p = 0.423) complications, need for tracheostomy (p = 0.423) or reintubation (p = 0.999), the ICU length of stay (p = 0.076) and mortality (p = 0.777) were also similar between treatments. Patients randomized to bivalirudin showed a higher oxygenation at day 7 and 15 after randomization, when compared to enoxaparin group. (4) Conclusions: In intubated COVID-19 patients at increased risk for thromboembolic complications, bivalirudin did not reduce the time spent under invasive mechanical ventilation, nor improved any other clinical outcomes.
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Affiliation(s)
- Eugenio Garofalo
- Anesthesia and Intensive Care Unit, Department of Medical and Surgical Sciences, “Magna Graecia” University, 88100 Catanzaro, Italy
| | - Gianmaria Cammarota
- Department of Anesthesia and Intensive Care Medicine, University of Perugia, 06121 Perugia, Italy
| | - Giuseppe Neri
- Anesthesia and Intensive Care Unit, Department of Medical and Surgical Sciences, “Magna Graecia” University, 88100 Catanzaro, Italy
| | - Sebastiano Macheda
- Anesthesia and Intensive Care Unit, Grande Ospedale Metropolitano, 89121 Reggio Calabria, Italy
| | - Eugenio Biamonte
- Anesthesia and Intensive Care Unit, Department of Medical and Surgical Sciences, “Magna Graecia” University, 88100 Catanzaro, Italy
| | - Pino Pasqua
- Anesthesia and Intensive Care Unit, Annunziata Hospital, 87100 Cosenza, Italy
| | - Maria Laura Guzzo
- Anesthesia and Intensive Care Unit, “Pugliese Ciaccio” Hospital, 88100 Catanzaro, Italy
| | - Federico Longhini
- Anesthesia and Intensive Care Unit, Department of Medical and Surgical Sciences, “Magna Graecia” University, 88100 Catanzaro, Italy
- Correspondence: ; Tel.: +39-34-7539-5967
| | - Andrea Bruni
- Anesthesia and Intensive Care Unit, Department of Medical and Surgical Sciences, “Magna Graecia” University, 88100 Catanzaro, Italy
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Neale H, Hawryluk EB. COVID-19 Pediatric Dermatology. Dermatol Clin 2021; 39:505-519. [PMID: 34556241 PMCID: PMC8165089 DOI: 10.1016/j.det.2021.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Holly Neale
- Department of Dermatology, Massachusetts General Hospital, Boston, MA, USA; University of Massachusetts Medical School, Worcester, MA, USA
| | - Elena B Hawryluk
- Department of Dermatology, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA; Boston Children's Hospital, Boston, MA, USA.
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Cazzato G, Foti C, Colagrande A, Cimmino A, Scarcella S, Cicco G, Sablone S, Arezzo F, Romita P, Lettini T, Resta L, Ingravallo G. Skin Manifestation of SARS-CoV-2: The Italian Experience. J Clin Med 2021; 10:jcm10081566. [PMID: 33917774 PMCID: PMC8068198 DOI: 10.3390/jcm10081566] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 03/26/2021] [Accepted: 04/05/2021] [Indexed: 02/05/2023] Open
Abstract
At the end of December 2019, a new coronavirus denominated Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) was identified in Wuhan, Hubei province, China. Less than three months later, the World Health Organization (WHO) declared coronavirus disease-19 (COVID-19) to be a global pandemic. Growing numbers of clinical, histopathological, and molecular findings were subsequently reported, among which a particular interest in skin manifestations during the course of the disease was evinced. Today, about one year after the development of the first major infectious foci in Italy, various large case series of patients with COVID-19-related skin manifestations have focused on skin specimens. However, few are supported by histopathological, immunohistochemical, and polymerase chain reaction (PCR) data on skin specimens. Here, we present nine cases of COVID-positive patients, confirmed by histological, immunophenotypical, and PCR findings, who underwent skin biopsy. A review of the literature in Italian cases with COVID-related skin manifestations is then provided.
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Affiliation(s)
- Gerardo Cazzato
- Section of Pathology, University of Bari ‘Aldo Moro’, 70121 Bari, Italy; (G.C.); (A.C.); (A.C.); (S.S.); (G.C.); (T.L.); (L.R.)
| | - Caterina Foti
- Section of Dermatology and Venereology, University of Bari ‘Aldo Moro’, 70121 Bari, Italy; (C.F.); (P.R.)
| | - Anna Colagrande
- Section of Pathology, University of Bari ‘Aldo Moro’, 70121 Bari, Italy; (G.C.); (A.C.); (A.C.); (S.S.); (G.C.); (T.L.); (L.R.)
| | - Antonietta Cimmino
- Section of Pathology, University of Bari ‘Aldo Moro’, 70121 Bari, Italy; (G.C.); (A.C.); (A.C.); (S.S.); (G.C.); (T.L.); (L.R.)
| | - Sara Scarcella
- Section of Pathology, University of Bari ‘Aldo Moro’, 70121 Bari, Italy; (G.C.); (A.C.); (A.C.); (S.S.); (G.C.); (T.L.); (L.R.)
| | - Gerolamo Cicco
- Section of Pathology, University of Bari ‘Aldo Moro’, 70121 Bari, Italy; (G.C.); (A.C.); (A.C.); (S.S.); (G.C.); (T.L.); (L.R.)
| | - Sara Sablone
- Section of Forensic Medicine, University of Bari ‘Aldo Moro’, 70121 Bari, Italy;
| | - Francesca Arezzo
- Section of Gynecologic and Obstetrics Clinic, University of Bari ‘Aldo Moro’, 70121 Bari, Italy;
| | - Paolo Romita
- Section of Dermatology and Venereology, University of Bari ‘Aldo Moro’, 70121 Bari, Italy; (C.F.); (P.R.)
| | - Teresa Lettini
- Section of Pathology, University of Bari ‘Aldo Moro’, 70121 Bari, Italy; (G.C.); (A.C.); (A.C.); (S.S.); (G.C.); (T.L.); (L.R.)
| | - Leonardo Resta
- Section of Pathology, University of Bari ‘Aldo Moro’, 70121 Bari, Italy; (G.C.); (A.C.); (A.C.); (S.S.); (G.C.); (T.L.); (L.R.)
| | - Giuseppe Ingravallo
- Section of Pathology, University of Bari ‘Aldo Moro’, 70121 Bari, Italy; (G.C.); (A.C.); (A.C.); (S.S.); (G.C.); (T.L.); (L.R.)
- Correspondence:
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Ludvigsson JF. Case report and systematic review suggest that children may experience similar long-term effects to adults after clinical COVID-19. Acta Paediatr 2021; 110:914-921. [PMID: 33205450 PMCID: PMC7753397 DOI: 10.1111/apa.15673] [Citation(s) in RCA: 195] [Impact Index Per Article: 65.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 11/13/2020] [Accepted: 11/16/2020] [Indexed: 12/15/2022]
Abstract
Aim Persistent symptoms in adults after COVID‐19 are emerging and the term long COVID is increasingly appearing in the literature. However, paediatric data are scarce. Methods This paper contains a case report of five Swedish children and the long‐term symptoms reported by their parents. It also includes a systematic literature review of the MEDLINE, EMBASE and Web of Science databases and the medRxiv/bioRxiv pre‐print servers up to 2 November 2020. Results The five children with potential long COVID had a median age of 12 years (range 9–15) and four were girls. They had symptoms for 6–8 months after their clinical diagnoses of COVID‐19. None were hospitalised at diagnosis, but one was later admitted for peri‐myocarditis. All five children had fatigue, dyspnoea, heart palpitations or chest pain, and four had headaches, difficulties concentrating, muscle weakness, dizziness and sore throats. Some had improved after 6–8 months, but they all suffered from fatigue and none had fully returned to school. The systematic review identified 179 publications and 19 of these were deemed relevant and read in detail. None contained any information on long COVID in children. Conclusion Children may experience similar long COVID symptoms to adults and females may be more affected.
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Affiliation(s)
- Jonas F. Ludvigsson
- Department of Medical Epidemiology and Biostatistics Karolinska Institutet Stockholm Sweden
- Department of Paediatrics Orebro University Hospital Orebro Sweden
- Division of Epidemiology and Public Health School of Medicine University of Nottingham Nottingham UK
- Department of Medicine Columbia University College of Physicians and Surgeons New York New York USA
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