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Ralli M, Colizza A, D’Aguanno V, Scarpa A, Russo G, Petrone P, Grassia R, Guarino P, Capasso P. Risk of SARS-CoV-2 contagion in otolaryngology specialists. ACTA OTORHINOLARYNGOLOGICA ITALICA : ORGANO UFFICIALE DELLA SOCIETA ITALIANA DI OTORINOLARINGOLOGIA E CHIRURGIA CERVICO-FACCIALE 2022; 42:S58-S67. [PMID: 35763275 PMCID: PMC9137374 DOI: 10.14639/0392-100x-suppl.1-42-2022-06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 01/31/2022] [Indexed: 06/15/2023]
Abstract
COVID-19 has rapidly spread in the past two years with a profound impact on otolaryngological activities, which has undergone radical transformation to guarantee diagnostic and therapeutic procedures mainly in oncology and urgent patients, while ensuring protection for healthcare personnel and patients. During the initial phases of the pandemic, scheduled visits and elective surgeries were postponed leading to a delay in the diagnosis and treatment of several diseases, including head and neck cancer, with a shift toward more advanced cancer stages and more aggressive treatments. Aerosol and droplets are the main routes of transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), thus leading to a high risk of contagion during otolaryngology visits and surgery. Therefore, the correct use of personal protective equipment (PPE) and attention to procedure-specific risks and measures to avoid contagion are of utmost importance for healthcare professionals, and especially for those dealing with otolaryngology diseases. This narrative review highlights that otolaryngological activity implies a high risk of contagion during outpatient visit, surgery, or urgent conditions. The correct use of PPE, evaluation of procedure-specific risks and reduction of non-urgent procedures are considered the main strategies to limit contagion.
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Affiliation(s)
- Massimo Ralli
- Department of Sense Organs. Sapienza University of Rome, Rome, Italy
| | - Andrea Colizza
- Department of Sense Organs. Sapienza University of Rome, Rome, Italy
| | | | - Alfonso Scarpa
- Department of Medicine, Surgery and Dentistry. University of Salerno, Salerno, Italy
| | - Gennaro Russo
- Otolaryngology Unit, AORN dei Colli, V. Monaldi Hospital, Napoli, Italy
| | | | - Rosa Grassia
- Otolaryngology Unit, AORN dei Colli, V. Monaldi Hospital, Napoli, Italy
| | - Pierre Guarino
- Otolaryngology Unit, Santo Spirito Hospital, Pescara, Italy
| | - Pasquale Capasso
- Otolaryngology Unit, AORN dei Colli, V. Monaldi Hospital, Napoli, Italy
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Campo F, Venuti A, Pimpinelli F, Abril E, Blandino G, Conti L, De Virgilio A, De Marco F, Di Noia V, Di Domenico EG, Di Martino S, Ensoli F, Giannarelli D, Mandoj C, Mazzola F, Moretto S, Petruzzi G, Petrone F, Pichi B, Pontone M, Vidiri A, Vujovic B, Piaggio G, Sperandio E, Rosati V, Cognetti F, Morrone A, Ciliberto G, Pellini R. Antibody Persistence 6 Months Post-Vaccination with BNT162b2 among Health Care Workers. Vaccines (Basel) 2021; 9:vaccines9101125. [PMID: 34696233 PMCID: PMC8538824 DOI: 10.3390/vaccines9101125] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 09/17/2021] [Accepted: 09/24/2021] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND We present immunogenicity data 6 months after the first dose of BNT162b2 in correlation with age, gender, BMI, comorbidities and previous SARS-CoV-2 infection. METHODS An immunogenicity evaluation was carried out among health care workers (HCW) vaccinated at the Istituti Fisioterapici Ospitalieri (IFO). All HCW were asked to be vaccine by the national vaccine campaign at the beginning of 2021. Serum samples were collected on day 1 just prior to the first dose of the vaccine and on day 21 just prior to the second vaccination dose. Thereafter sera samples were collected 28, 49, 84 and 168 days after the first dose of BNT162b2. Quantitative measurement of IgG antibodies against S1/S2 antigens of SARS-CoV-2 was performed with a commercial chemiluminescent immunoassay. RESULTS Two hundred seventy-four HWCs were analyzed, 175 women (63.9%) and 99 men (36.1%). The maximum antibody geometric mean concentration (AbGMC) was reached at T2 (299.89 AU/mL; 95% CI: 263.53-339.52) with a significant increase compared to baseline (p < 0.0001). Thereafter, a progressive decrease was observed. At T5, a median decrease of 59.6% in COVID-19 negative, and of 67.8% in COVID-19 positive individuals were identified with respect to the highest antibody response. At T1, age and previous COVID-19 were associated with differences in antibody response, while at T2 and T3 differences in immune response were associated with age, gender and previous COVID-19. At T4 and T5, only COVID-19 positive participants demonstrated a greater antibody response, whereas no other variables seemed to influence antibody levels. CONCLUSIONS Overall our study clearly shows antibody persistence at 6 months, albeit with a certain decline. Thus, the use of this vaccine in addressing the COVID-19 pandemic is supported by our results that in turn open debate about the need for further boosts.
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Affiliation(s)
- Flaminia Campo
- Department Otolaryngology Head and Neck Surgery, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), 00144 Rome, Italy; (F.C.); (F.M.); (S.M.); (G.P.); (B.P.); (V.R.); (R.P.)
| | - Aldo Venuti
- HPV Unit, UOSD Tumor Immunology and Immunotherapy, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), 00144 Rome, Italy
- Correspondence:
| | - Fulvia Pimpinelli
- Department of Microbiology and Virology, IRCCS San Gallicano Dermatological Institute, Istituti Fisioterapici Ospitalieri (IFO), 00144 Rome, Italy; (F.P.); (E.A.); (E.G.D.D.); (F.E.); (M.P.)
| | - Elva Abril
- Department of Microbiology and Virology, IRCCS San Gallicano Dermatological Institute, Istituti Fisioterapici Ospitalieri (IFO), 00144 Rome, Italy; (F.P.); (E.A.); (E.G.D.D.); (F.E.); (M.P.)
| | - Giovanni Blandino
- Oncogenomic and Epigenetic Unit, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), 00144 Rome, Italy;
| | - Laura Conti
- Department Clinical Pathology and Cancer Biobank, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), 00144 Rome, Italy; (L.C.); (C.M.)
| | - Armando De Virgilio
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20072 Milan, Italy;
- IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy
| | - Federico De Marco
- RIDAIT Department, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), 00144 Rome, Italy;
| | - Vincenzo Di Noia
- Medical Oncology, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy; (V.D.N.); (F.C.)
| | - Enea Gino Di Domenico
- Department of Microbiology and Virology, IRCCS San Gallicano Dermatological Institute, Istituti Fisioterapici Ospitalieri (IFO), 00144 Rome, Italy; (F.P.); (E.A.); (E.G.D.D.); (F.E.); (M.P.)
| | - Simona Di Martino
- Department of Pathology, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), 00144 Rome, Italy;
| | - Fabrizio Ensoli
- Department of Microbiology and Virology, IRCCS San Gallicano Dermatological Institute, Istituti Fisioterapici Ospitalieri (IFO), 00144 Rome, Italy; (F.P.); (E.A.); (E.G.D.D.); (F.E.); (M.P.)
| | - Diana Giannarelli
- Biostatistical Unit, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), 00144 Rome, Italy;
| | - Chiara Mandoj
- Department Clinical Pathology and Cancer Biobank, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), 00144 Rome, Italy; (L.C.); (C.M.)
| | - Francesco Mazzola
- Department Otolaryngology Head and Neck Surgery, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), 00144 Rome, Italy; (F.C.); (F.M.); (S.M.); (G.P.); (B.P.); (V.R.); (R.P.)
| | - Silvia Moretto
- Department Otolaryngology Head and Neck Surgery, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), 00144 Rome, Italy; (F.C.); (F.M.); (S.M.); (G.P.); (B.P.); (V.R.); (R.P.)
| | - Gerardo Petruzzi
- Department Otolaryngology Head and Neck Surgery, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), 00144 Rome, Italy; (F.C.); (F.M.); (S.M.); (G.P.); (B.P.); (V.R.); (R.P.)
| | - Fabrizio Petrone
- U.O.C. DITRAR, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), 00144 Rome, Italy;
| | - Barbara Pichi
- Department Otolaryngology Head and Neck Surgery, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), 00144 Rome, Italy; (F.C.); (F.M.); (S.M.); (G.P.); (B.P.); (V.R.); (R.P.)
| | - Martina Pontone
- Department of Microbiology and Virology, IRCCS San Gallicano Dermatological Institute, Istituti Fisioterapici Ospitalieri (IFO), 00144 Rome, Italy; (F.P.); (E.A.); (E.G.D.D.); (F.E.); (M.P.)
| | - Antonello Vidiri
- Department of Radiology and Diagnostic Imaging, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), 00144 Rome, Italy;
| | - Branka Vujovic
- Medical Direction, IRCCS Regina Elena National Cancer Institute and San Gallicano Institute, 00144 Rome, Italy;
| | - Giulia Piaggio
- Department of Research, IRCSS Technological Innovation & Advanced Diagnostics, Regina Elena National Cancer Institute, 00144 Rome, Italy;
| | - Eleonora Sperandio
- UOSD Clinical Trial Center, Biostatistic and Bionformatic, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), 00144 Rome, Italy;
| | - Valentina Rosati
- Department Otolaryngology Head and Neck Surgery, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), 00144 Rome, Italy; (F.C.); (F.M.); (S.M.); (G.P.); (B.P.); (V.R.); (R.P.)
| | - Francesco Cognetti
- Medical Oncology, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy; (V.D.N.); (F.C.)
| | - Aldo Morrone
- Scientific Direction, IRCCS San Gallicano Dermatological Institute, Istituti Fisioterapici Ospitalieri (IFO), 00144 Rome, Italy;
| | - Gennaro Ciliberto
- Scientific Direction, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), 00144 Rome, Italy;
| | - Raul Pellini
- Department Otolaryngology Head and Neck Surgery, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), 00144 Rome, Italy; (F.C.); (F.M.); (S.M.); (G.P.); (B.P.); (V.R.); (R.P.)
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Azzolini C, Donati S, Premi E, Baj A, Siracusa C, Genoni A, Grossi PA, Azzi L, Sessa F, Dentali F, Severgnini P, Minoja G, Cabrini L, Chiaravalli M, Veronesi G, Carcano G, Maffioli LS, Tagliabue A. SARS-CoV-2 on Ocular Surfaces in a Cohort of Patients With COVID-19 From the Lombardy Region, Italy. JAMA Ophthalmol 2021; 139:956-963. [PMID: 33662099 PMCID: PMC7934077 DOI: 10.1001/jamaophthalmol.2020.5464] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 10/10/2020] [Indexed: 01/08/2023]
Abstract
Importance Since February 2020, coronavirus disease 2019 (COVID-19) has spread rapidly all over the world, with an epidemiological cluster in Lombardy, Italy. The viral communicability may be mediated by various body fluids, but insufficient information is available on the presence of the virus in human tears. Objectives To investigate the rate of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in tears collected from patients with COVID-19 by means of real-time reverse transcriptase-polymerase chain reaction (rRT-PCR) assay and to assess the association of virus presence with concomitant clinical conditions. Design, Setting, and Participants Cross-sectional study conducted between April 9 and May 5, 2020. The setting was intensive care units at Azienda Socio-Sanitaria Territoriale (ASST) Sette-Laghi Hospital, University of Insubria, in Varese, Lombardy, Italy. A conjunctival swab was performed in 91 patients hospitalized for COVID-19, which was clinically diagnosed by rRT-PCR assay on nasopharyngeal swabs and by radiological imaging. Conjunctival swabs from 17 additional healthy volunteer participants with no symptoms of COVID-19 were examined to evaluate the availability and applicability of the conjunctival swab test. Exposure SARS-CoV-2 detection by means of rRT-PCR assay performed on the collected samples obtained by conjunctival swabs. Main Outcomes and Measures Conjunctival swab and nasopharyngeal swab results are reported, as well as demographic and clinical data. Results A total of 108 participants (mean [SD] age, 58.7 [14.2] years; 55 female and 53 male) were tested for SARS-CoV-2 using rRT-PCR assay, including 91 patients hospitalized with COVID-19 and 17 were healthy volunteers. SARS-CoV-2 was found on the ocular surface in 52 of 91 patients with COVID-19 (57.1%; 95% CI, 46.3%-67.5%), with a wide variability in the mean viral load from both eyes. Among a subset of 41 patients, concordance of 63.0% (95% CI, 41.0%-81.0%) was found between positive conjunctival and nasopharyngeal swab test results when performed within 2 days of each other. In 17 of these patients, nasopharyngeal swab results were negative for SARS-CoV-2. In 10 of these 17 patients, conjunctival swab results were positive for the virus. Conclusions and Relevance In this study, SARS-CoV-2 RNA was found on the ocular surface in a large part of this cohort of patients with COVID-19, although the infectivity of this material could not be determined. Because patients may have positive test results with a conjunctival swab and negative results with a nasopharyngeal swab, use of the slightly invasive conjunctival swab may be considered as a supplementary diagnostic test.
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Affiliation(s)
- Claudio Azzolini
- Unit of Ophthalmology, Azienda Socio-Sanitaria Territoriale (ASST) dei Sette Laghi, Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Simone Donati
- Unit of Ophthalmology, Azienda Socio-Sanitaria Territoriale (ASST) dei Sette Laghi, Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Elias Premi
- Unit of Ophthalmology, Azienda Socio-Sanitaria Territoriale (ASST) dei Sette Laghi, Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Andreina Baj
- Laboratory of Microbiology, ASST dei Sette Laghi, Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Claudia Siracusa
- Laboratory of Medicine, Service of Cytogenetics and Medical Genetics, ASST dei Sette Laghi, Varese, Italy
| | - Angelo Genoni
- Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy
| | - Paolo A. Grossi
- Unit of Infectious and Tropical Diseases, ASST dei Sette Laghi, Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Lorenzo Azzi
- Unit of Oral Medicine and Pathology, ASST dei Sette Laghi, Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Fausto Sessa
- Unit of Pathology, ASST dei Sette Laghi, Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Francesco Dentali
- Unit of High Intensity Medicine, ASST dei Sette Laghi, Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Paolo Severgnini
- Cardiosurgery Intensive Care Unit, ASST dei Sette Laghi, Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy
| | - Giulio Minoja
- Transplants Intensive Care Unit, ASST dei Sette Laghi, Varese, Italy
| | - Luca Cabrini
- Intensive Care Unit, ASST dei Sette Laghi, Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy
| | | | - Giovanni Veronesi
- Research Center in Epidemiology and Preventive Medicine (EPIMED), Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Giulio Carcano
- Unit of General, Emergency and Transplant Surgery, ASST dei Sette Laghi, Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | | | - Angelo Tagliabue
- Unit of Oral Medicine and Pathology, ASST dei Sette Laghi, Department of Medicine and Surgery, University of Insubria, Varese, Italy
- Chancellor, University of Insubria, Varese, Italy
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