1
|
Mancon A, Raccagni AR, Gagliardi G, Moschese D, Rizzo A, Giacomelli A, Cutrera M, Salari F, Bracchitta F, Antinori S, Gori A, Rizzardini G, Castagna A, Gismondo MR, Nozza S, Mileto D. Evaluation of analytical performance of the STANDARD TM M10 MPX/OPX assay for the simultaneous DNA detection and clade attribution of Monkeypox virus. Emerg Microbes Infect 2024; 13:2337666. [PMID: 38572513 PMCID: PMC11018020 DOI: 10.1080/22221751.2024.2337666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Accepted: 03/27/2024] [Indexed: 04/05/2024]
Abstract
Monkeypox virus (MPXV) infection confirmation needs reliable polymerase chain reaction (PCR) assays; in addition, viral clade attribution is a key factor in containment measures, considering a more severe syndrome in clade I and the possibility of simultaneous circulation. This study evaluates the performance of all-in-one STANDARD M10 MPX/OPX (SD BIOSENSOR, South Korea - M10). Frozen samples from 205 subjects were selected and stratified according to routine test results (RealStar® Orthopoxvirus PCR Kit 1.0, Altona DIAGNOTICS, Germany - RS; RS-1): in detail, 100 negative skin lesions (SL) and 200 positive samples at the variable stage of infection were analysed. Positive samples were retested with RS (RS-2). Positive and Negative Percent Agreements (PPA, NPA) were calculated. The median (IQR) Ct values of RS and M10 (OPXV target) assays were highly similar. The PPA of M10 compared to RS-1 was 89.5% considering system interpretation, and 96.0% when the operator classified results as positive if any target was detected; NPA was 100%. Comparing the RS-2 run and M10, an overall concordance of 95.3% between assays was found; however, considering operator interpretation, M10 returned more positive results than RS-2. The occurrence of False-Negative results was likely associated with the influence of thawing on low viral concentration; no False-Positive tests were observed. All samples collected at the time of Mpox diagnosis were positive and M10 correctly attributed the clade (West-Africa/II). The M10 MPX/OPX assay demonstrated high reliability in confirming MPXV infection and clade attribution.
Collapse
Affiliation(s)
- Alessandro Mancon
- Laboratory of Clincal Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco, Milan, Italy
| | | | | | - Davide Moschese
- Department of Infectious Diseases, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Alberto Rizzo
- Laboratory of Clincal Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Andrea Giacomelli
- Department of Infectious Diseases, ASST Fatebenefratelli Sacco, Milan, Italy
| | | | | | | | - Spinello Antinori
- University of Milan, Milan, Italy
- Department of Infectious Diseases, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Andrea Gori
- University of Milan, Milan, Italy
- Department of Infectious Diseases, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Giuliano Rizzardini
- Department of Infectious Diseases, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Antonella Castagna
- Vita-Salute San Raffaele University, Milan, Italy
- Department of Infectious Diseases, San Raffaele Hospital, Milan, Italy
| | - Maria Rita Gismondo
- Laboratory of Clincal Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco, Milan, Italy
- University of Milan, Milan, Italy
| | - Silvia Nozza
- Vita-Salute San Raffaele University, Milan, Italy
| | - Davide Mileto
- Laboratory of Clincal Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco, Milan, Italy
- CNR-SCITEC, Istituto di Scienze e Tecnologie Chimiche “Giulio Natta”, via C. Golgi 19, 20133Milan, Italy
| |
Collapse
|
2
|
Piralla A, Mileto D, Rizzo A, Ferrari G, Giardina F, Gaiarsa S, Petazzoni G, Bianchi M, Salari F, Bracchitta F, Sammartino JC, Ferrari A, Gagliardi G, Mancon A, Fenizia C, Biasin M, Rovida F, Paolucci S, Percivalle E, Lombardi A, Micheli V, Nozza S, Castagna A, Moschese D, Antinori S, Gori A, Bonfanti P, Rossotti R, D'Arminio Monforte A, Attanasi F, Tirani M, Cereda D, Baldanti F, Gismondo MR. Dynamics of viral DNA shedding and culture viral DNA positivity in different clinical samples collected during the 2022 mpox outbreak in Lombardy, Italy. Travel Med Infect Dis 2024; 59:102698. [PMID: 38556220 DOI: 10.1016/j.tmaid.2024.102698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 02/15/2024] [Accepted: 02/17/2024] [Indexed: 04/02/2024]
Abstract
BACKGROUND Mpox virus (MPXV) has recently spread outside of sub-Saharan Africa. This large multicentre study was conducted in Lombardy, the most densely populated Italian region accounting for more than 40% of Italian cases. The present study aims to: i) evaluate the presence and the shedding duration of MPXV DNA in different body compartments correlating the MPXV viability with the time to onset of symptoms; ii) provide evidence of MPXV persistence in different body compartment as a source of infection and iii) characterize the MPXV evolution by whole genome sequencing (WGS) during the outbreak occurred in Italy. MATERIAL AND METHODS The study included 353 patients with a laboratory-confirmed diagnosis of MPXV infection screened in several clinical specimens in the period May 24th - September 1st, 2022. Viral isolation was attempted from different biological matrices and complete genome sequencing was performed for 61 MPXV strains. RESULTS MPXV DNA detection was more frequent in the skin (94.4%) with the longest median time of viral clearance (16 days). The actively-replicating virus in cell culture was obtained for 123/377 (32.6%) samples with a significant higher viral quantity on isolation positive samples (20 vs 31, p < 0.001). The phylogenetic analysis highlighted the high genetic identity of the MPXV strains collected, both globally and within the Lombardy region. CONCLUSION Skin lesion is gold standard material and the high viral load and the actively-replicating virus observed in genital sites confirms that sexual contact plays a key role in the viral transmission.
Collapse
Affiliation(s)
- Antonio Piralla
- Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Davide Mileto
- Clinical Microbiology, Virology and Bioemergency Diagnostics, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
| | - Alberto Rizzo
- Clinical Microbiology, Virology and Bioemergency Diagnostics, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
| | - Guglielmo Ferrari
- Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Federica Giardina
- Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, Università degli Studi di Pavia, Pavia, Italy
| | - Stefano Gaiarsa
- Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Greta Petazzoni
- Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Micol Bianchi
- Clinical Microbiology, Virology and Bioemergency Diagnostics, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
| | - Federica Salari
- Clinical Microbiology, Virology and Bioemergency Diagnostics, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
| | - Fiorenza Bracchitta
- Clinical Microbiology, Virology and Bioemergency Diagnostics, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
| | - Josè Camilla Sammartino
- Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, Università degli Studi di Pavia, Pavia, Italy
| | - Alessandro Ferrari
- Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Gloria Gagliardi
- Clinical Microbiology, Virology and Bioemergency Diagnostics, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
| | - Alessandro Mancon
- Clinical Microbiology, Virology and Bioemergency Diagnostics, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
| | - Claudio Fenizia
- Department of Biomedical and Clinical Sciences "L.Sacco", University of Milan, Italy
| | - Mara Biasin
- Department of Biomedical and Clinical Sciences "L.Sacco", University of Milan, Italy
| | - Francesca Rovida
- Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, Università degli Studi di Pavia, Pavia, Italy
| | - Stefania Paolucci
- Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Elena Percivalle
- Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Alessandra Lombardi
- Clinical Microbiology, Virology and Bioemergency Diagnostics, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
| | - Valeria Micheli
- Clinical Microbiology, Virology and Bioemergency Diagnostics, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
| | - Silvia Nozza
- Clinic of Infectious Diseases, Vita-Salute University, San Raffaele Scientific Institute, Milan, Italy
| | - Antonella Castagna
- Clinic of Infectious Diseases, Vita-Salute University, San Raffaele Scientific Institute, Milan, Italy
| | - Davide Moschese
- I Division of Infectious Diseases, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Spinello Antinori
- Department of Biomedical and Clinical Science, Università degli Studi di Milano, III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Andrea Gori
- Department of Infectious Diseases Ospedale "Luigi Sacco", Centre for Multidisciplinary Research in Health Science (MACH), University of Milan, Italy
| | - Paolo Bonfanti
- Department of Infectious Diseases, San Gerardo Hospital - University of Milano Bicocca, Monza, Italy
| | - Roberto Rossotti
- Department of Infectious Diseases, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Antonella D'Arminio Monforte
- Clinic of Infectious Diseases, Department of Health Sciences, ASST Santi Paolo E Carlo, University of Milan, Milan, Italy
| | | | - Marcello Tirani
- Directorate General for Health, Lombardy Region, Milan, Italy
| | - Danilo Cereda
- Directorate General for Health, Lombardy Region, Milan, Italy
| | - Fausto Baldanti
- Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, Università degli Studi di Pavia, Pavia, Italy.
| | - Maria Rita Gismondo
- Clinical Microbiology, Virology and Bioemergency Diagnostics, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy; Department of Biomedical and Clinical Sciences "L.Sacco", University of Milan, Italy
| |
Collapse
|
3
|
Moschese D, Raccagni AR, Giacomelli A, Piralla A, Rossotti R, Raimondi A, Tesoro D, Vezzosi L, Gulletta M, Clementi N, Venturelli S, Benardon S, Ricaboni D, Bernacchia D, Mancon A, Rovida F, Attanasi F, Cereda D, Gismondo MR, Gori A, Rizzardini G, Antinori S, Baldanti F, Marzano AV, Marchetti G, Castelli F, Castagna A, Nozza S, Mileto D. Surge of Mpox cases in Lombardy region, Italy, October 2023 - January 2024. Clin Infect Dis 2024:ciae184. [PMID: 38573320 DOI: 10.1093/cid/ciae184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 02/16/2024] [Accepted: 03/29/2024] [Indexed: 04/05/2024] Open
Affiliation(s)
- Davide Moschese
- I Division of Infectious Diseases, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, Milan, Italy
| | | | - Andrea Giacomelli
- III Division of Infectious Diseases, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Antonio Piralla
- Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Roberto Rossotti
- Department of Infectious Diseases, ASST Grande Ospedale Metropolitano Niguarda, School of Medicine and Surgery, Milan, Italy
| | - Alessandro Raimondi
- Department of Infectious Diseases, ASST Grande Ospedale Metropolitano Niguarda, School of Medicine and Surgery, Milan, Italy
| | - Daniele Tesoro
- Unit of Infectious Diseases, ASST Santi Paolo e Carlo, Milan, Italy
| | - Luigi Vezzosi
- General Directorate of Welfare, Regione Lombardia, Milan, Italy
| | - Maurizio Gulletta
- Department of Infectious and Tropical Diseases, ASST Spedali Civili, Brescia, Italy
| | - Nicola Clementi
- Laboratory of Microbiology and Virology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | | | - Susanna Benardon
- Dermatology Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Dario Bernacchia
- Infectious Diseases Unit, ASST Ovest Milanese, Legnano General Hospital, Legnano, Italy
| | - Alessandro Mancon
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Francesca Rovida
- Department of Clinical-Surgical, Diagnostic, and Pediatric Sciences, University of Pavia, Pavia, Italy
- Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | | | - Danilo Cereda
- General Directorate of Welfare, Regione Lombardia, Milan, Italy
| | - Maria Rita Gismondo
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, Milan, Italy
- Department of Biomedical and Clinical Sciences L. Sacco, University of Milan, Milan, Italy
| | - Andrea Gori
- Department of Biomedical and Clinical Sciences L. Sacco, University of Milan, Milan, Italy
- Centre for Multidisciplinary Research in Health Science (MACH), University of Milan, Milan, Italy
- II Infectious Diseases Unit, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Giuliano Rizzardini
- I Division of Infectious Diseases, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Spinello Antinori
- III Division of Infectious Diseases, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, Milan, Italy
- Department of Biomedical and Clinical Sciences L. Sacco, University of Milan, Milan, Italy
| | - Fausto Baldanti
- Department of Clinical-Surgical, Diagnostic, and Pediatric Sciences, University of Pavia, Pavia, Italy
- Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Angelo Valerio Marzano
- Dermatology Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Giulia Marchetti
- Unit of Infectious Diseases, ASST Santi Paolo e Carlo, Milan, Italy
- Department of Health Sciences, University of Milan, Milan, Italy
| | - Francesco Castelli
- Department of Infectious and Tropical Diseases, ASST Spedali Civili, Brescia, Italy
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Antonella Castagna
- Infectious Diseases Unit, Vita Salute San Raffaele University, Milan, Italy
- Infectious Diseases Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Silvia Nozza
- Infectious Diseases Unit, Vita Salute San Raffaele University, Milan, Italy
- Infectious Diseases Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Davide Mileto
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, Milan, Italy
| |
Collapse
|
4
|
Candela C, Galli L, Rizzo A, Mileto D, Canetti D, Gianotti N, Raccagni AR, Bertoni C, Lucente MF, Gismondo MR, Castagna A, Nozza S. Mpox DNA clearance in semen over 6-month follow-up. J Med Virol 2023; 95:e29259. [PMID: 38037499 DOI: 10.1002/jmv.29259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 09/29/2023] [Accepted: 11/11/2023] [Indexed: 12/02/2023]
Abstract
Sexual intercourse is a well-established way of transmission of mpox infection. However, it is still uncertain whether semen may represent a viral reservoir. The aim of the study was to evaluate the clearance of viral DNA in semen samples from individuals diagnosed with mpox infection over 6-month follow-up. This prospective, observational, single-center study was conducted at IRCCS San Raffaele Scientific Institute, Milan, Italy, between May and October 2022 in 140 individuals who attended Sexual Health Clinic and diagnosed with mpox infection. Semen samples were collected and analyzed by real-time polymerase chain reaction assays. The baseline collection was performed in 64 (46%) of 140 men diagnosed with mpox infection. The viral DNA was detected in 43 (67%) with median cycle threshold (Ct) 34 (interquartile range [IQR] 31-36). The research was repeated in 32 (74%) and viral DNA clearance was observed in all within 6 months in a median time of 10.5 days (IQR 7-33). Viral clearance occurred in all tested individuals, mostly within 2 weeks since the first positive test. These findings suggest a transient presence of viral DNA in semen and do not support the hypothesis of reservoir. More studies on mpox DNA detection in semen with viral culture and extended follow-up are needed.
Collapse
Affiliation(s)
| | - Laura Galli
- Infectious Diseases Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Alberto Rizzo
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, Sacco Hospital, Milan, Italy
| | - Davide Mileto
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, Sacco Hospital, Milan, Italy
| | - Diana Canetti
- Infectious Diseases Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Nicola Gianotti
- Infectious Diseases Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | | | | | | | - Maria Rita Gismondo
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, Sacco Hospital, Milan, Italy
| | - Antonella Castagna
- Vita-Salute San Raffaele University, Milan, Italy
- Infectious Diseases Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Silvia Nozza
- Vita-Salute San Raffaele University, Milan, Italy
- Infectious Diseases Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| |
Collapse
|
5
|
Moschese D, Bianchi M, Cossu MV, Salari F, Giacomelli A, Rizzo A, Lazzarin S, Sabaini F, Nozza S, Mileto D, Gori A, Antinori S, Gismondo MR, Rizzardini G. Neutralizing Antibody Titers Induced by JYNNEOS Vaccine in Unrecognized Previous Mpox Virus-Exposed Individuals. Clin Infect Dis 2023; 77:1484-1485. [PMID: 37417271 DOI: 10.1093/cid/ciad412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 07/05/2023] [Indexed: 07/08/2023] Open
Affiliation(s)
- Davide Moschese
- I Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
| | - Micol Bianchi
- Laboratory of Clinical Microbiology, Luigi Sacco Hospital, Milan, Italy
| | - Maria Vittoria Cossu
- I Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
| | - Federica Salari
- Laboratory of Clinical Microbiology, Luigi Sacco Hospital, Milan, Italy
| | - Andrea Giacomelli
- III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
| | - Alberto Rizzo
- Laboratory of Clinical Microbiology, Luigi Sacco Hospital, Milan, Italy
| | - Samuel Lazzarin
- III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
| | - Federico Sabaini
- III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
| | - Silvia Nozza
- Infectious Diseases Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Davide Mileto
- Laboratory of Clinical Microbiology, Luigi Sacco Hospital, Milan, Italy
| | - Andrea Gori
- Infectious Disease Unit II, Ospedale Luigi Sacco, ASST Fatebenefratelli Sacco, Milano, Italy
- Department of Pathophysiology and Transplantation, School of Medicine and Surgery, University of Milan, Milan, Italy
- Centre for Multidisciplinary Research in Health Science, University of Milan, Milan, Italy
| | - Spinello Antinori
- III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
- Dipartimento di Scienze Biomediche e Cliniche Luigi Sacco, Università degli Studi di Milano, Milano, Italy
| | - Maria Rita Gismondo
- Laboratory of Clinical Microbiology, Luigi Sacco Hospital, Milan, Italy
- Dipartimento di Scienze Biomediche e Cliniche Luigi Sacco, Università degli Studi di Milano, Milano, Italy
| | - Giuliano Rizzardini
- I Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
| |
Collapse
|
6
|
Moschetta N, Raccagni AR, Bianchi M, Diotallevi S, Lolatto R, Candela C, Uberti Foppa C, Gismondo MR, Castagna A, Nozza S, Mileto D. Mpox neutralising antibodies at 6 months from mpox infection or MVA-BN vaccination: a comparative analysis. Lancet Infect Dis 2023; 23:e455-e456. [PMID: 37837982 DOI: 10.1016/s1473-3099(23)00571-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 09/07/2023] [Accepted: 09/07/2023] [Indexed: 10/16/2023]
Affiliation(s)
| | | | - Micol Bianchi
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, Ospedale Sacco, Milan, Italy
| | - Sara Diotallevi
- Infectious Diseases Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Riccardo Lolatto
- Infectious Diseases Unit, San Raffaele Scientific Institute, Milan, Italy
| | | | - Caterina Uberti Foppa
- Vita-Salute San Raffaele University, 20132 Milan, Italy; Department of Biomedical and Clinical Sciences "L Sacco", University of Milan, Italy
| | - Maria Rita Gismondo
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, Ospedale Sacco, Milan, Italy; Infectious Diseases Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Antonella Castagna
- Vita-Salute San Raffaele University, 20132 Milan, Italy; Department of Biomedical and Clinical Sciences "L Sacco", University of Milan, Italy
| | - Silvia Nozza
- Vita-Salute San Raffaele University, 20132 Milan, Italy; Department of Biomedical and Clinical Sciences "L Sacco", University of Milan, Italy
| | - Davide Mileto
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, Ospedale Sacco, Milan, Italy
| |
Collapse
|
7
|
Moschese D, Giacomelli A, Mileto D. Ongoing sporadic monkeypox cases: neutralising antibody detection in asymptomatic individuals. Lancet Microbe 2023; 4:e765. [PMID: 37385285 PMCID: PMC10292826 DOI: 10.1016/s2666-5247(23)00185-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 06/12/2023] [Indexed: 07/01/2023]
Affiliation(s)
- Davide Moschese
- Department of Infectious Diseases, Luigi Sacco University Hospital, ASST Fatebenefratelli Sacco, 20157 Milan, Italy.
| | - Andrea Giacomelli
- Department of Infectious Diseases, Luigi Sacco University Hospital, ASST Fatebenefratelli Sacco, 20157 Milan, Italy
| | - Davide Mileto
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, Luigi Sacco University Hospital, ASST Fatebenefratelli Sacco, 20157 Milan, Italy
| |
Collapse
|
8
|
Bruzzesi E, Raccagni AR, Mileto D, Candela C, Canetti D, Castagna A, Nozza S, Tamburini AM. Isolated monkeypox proctitis among men who have sex with men. Infection 2023; 51:1597-1598. [PMID: 37273166 DOI: 10.1007/s15010-023-02051-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 05/12/2023] [Indexed: 06/06/2023]
Affiliation(s)
| | | | - Davide Mileto
- Clinical Microbiology, Virology and Bioemergency Diagnostics, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
| | | | - Diana Canetti
- Infectious Diseases Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Antonella Castagna
- Vita-Salute San Raffaele University, Milan, Italy
- Infectious Diseases Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Silvia Nozza
- Vita-Salute San Raffaele University, Milan, Italy
| | - Andrea Marco Tamburini
- Vita-Salute San Raffaele University, Milan, Italy.
- Gastrointestinal Surgery Unit, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy.
| |
Collapse
|
9
|
Raccagni AR, Gianotti N, Moro M, Mileto D, Gordo Perez V, Castagna A, Nozza S. Mpox Virus: Control of In-Hospital Occupational Transmission Experience from a Tertiary Level Hospital in Milan, Italy. Life (Basel) 2023; 13:1705. [PMID: 37629562 PMCID: PMC10455684 DOI: 10.3390/life13081705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 08/06/2023] [Accepted: 08/06/2023] [Indexed: 08/27/2023] Open
Abstract
Mpox has caused a global outbreak since May 2022, particularly affecting people belonging to key populations, but cases among healthcare providers have been reported. The aim of this work is to present the experience of the Infectious Diseases Unit of San Raffaele Scientific Institute, Milan, Italy with respect to infection control and prevention of mpox occupational transmission. Between May-November 2022, 140 individuals were diagnosed with mpox and six required hospitalization. Overall, 12 medical doctors and 22 nurses provided care to people with mpox. A hospital policy aimed at controlling viral transmission was implemented in May 2022. Protective equipment was used for all healthcare providers. One accidental puncture occurred with a scalpel contaminated with blood from a mpox viremic individual (mpox plasma cycle threshold = 36); no mpox related symptoms were observed and mpox testing ruled out transmission. Six months following exposure, neutralizing antibodies were not detectable, ruling out contagion. Overall, we observed no mpox transmission among healthcare workers, despite the number of visits and procedures performed, including bodily-fluids sampling, and even following puncture with contaminated blood. Hospital preparedness for the management of new infectious disease outbreaks, with rapid implementation of policies aimed at controlling infection, is paramount to avoid occupational transmission.
Collapse
Affiliation(s)
- Angelo Roberto Raccagni
- Infectious Diseases Unit, Vita-Salute San Raffaele University, 20132 Milan, Italy; (A.C.); (S.N.)
| | - Nicola Gianotti
- Infectious Diseases Unit, San Raffaele Scientific Institute, 20132 Milan, Italy; (N.G.); (V.G.P.)
| | - Matteo Moro
- Infection Control, Chief Medical Office, San Raffaele Scientific Institute, 20132 Milan, Italy;
| | - Davide Mileto
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, L. Sacco University Hospital, 20122 Milan, Italy;
| | - Victoria Gordo Perez
- Infectious Diseases Unit, San Raffaele Scientific Institute, 20132 Milan, Italy; (N.G.); (V.G.P.)
| | - Antonella Castagna
- Infectious Diseases Unit, Vita-Salute San Raffaele University, 20132 Milan, Italy; (A.C.); (S.N.)
- Infectious Diseases Unit, San Raffaele Scientific Institute, 20132 Milan, Italy; (N.G.); (V.G.P.)
| | - Silvia Nozza
- Infectious Diseases Unit, Vita-Salute San Raffaele University, 20132 Milan, Italy; (A.C.); (S.N.)
- Infectious Diseases Unit, San Raffaele Scientific Institute, 20132 Milan, Italy; (N.G.); (V.G.P.)
| |
Collapse
|
10
|
Raccagni AR, Mileto D, Rizzo A, Gismondo MR, Castagna A, Nozza S. Late positivization of oropharyngeal, plasma, anal, semen, and urine specimens which tested negative at the time of mpox diagnosis. Clin Microbiol Infect 2023; 29:1096-1097. [PMID: 37182641 DOI: 10.1016/j.cmi.2023.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 04/20/2023] [Accepted: 05/06/2023] [Indexed: 05/16/2023]
Affiliation(s)
| | - Davide Mileto
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, Luigi Sacco Hospital, Milan, Italy
| | - Alberto Rizzo
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, Luigi Sacco Hospital, Milan, Italy
| | - Maria Rita Gismondo
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, Luigi Sacco Hospital, Milan, Italy
| | - Antonella Castagna
- Vita-Salute San Raffaele University, Milan, Italy; Infectious Diseases Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Silvia Nozza
- Vita-Salute San Raffaele University, Milan, Italy; Infectious Diseases Unit, San Raffaele Scientific Institute, Milan, Italy
| |
Collapse
|
11
|
Rizzo A, Moschese D, Trentacapilli B, Cossu MV, Giacomelli A, Salari F, Bianchi M, Raccagni AR, Micheli V, Gori A, Messina E, Antinori S, Gismondo MR, Castagna A, Mileto D, Rizzardini G, Lombardi A, Nozza S. Viral bloodstream detection in mpox patients: An observational multicentric study. J Infect 2023; 87:54-56. [PMID: 37030631 DOI: 10.1016/j.jinf.2023.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 04/03/2023] [Indexed: 04/10/2023]
Affiliation(s)
- Alberto Rizzo
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, "Luigi Sacco" Hospital, ASST Fatebenefratelli Sacco, Milan, Italy.
| | - Davide Moschese
- I Division of Infectious Diseases, "Luigi Sacco" Hospital, ASST Fatebenefratelli Sacco, Milan, Italy.
| | | | - Maria Vittoria Cossu
- I Division of Infectious Diseases, "Luigi Sacco" Hospital, ASST Fatebenefratelli Sacco, Milan, Italy.
| | - Andrea Giacomelli
- III Division of Infectious Diseases, "Luigi Sacco" Hospital, ASST Fatebenefratelli Sacco, Milan, Italy.
| | - Federica Salari
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, "Luigi Sacco" Hospital, ASST Fatebenefratelli Sacco, Milan, Italy.
| | - Micol Bianchi
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, "Luigi Sacco" Hospital, ASST Fatebenefratelli Sacco, Milan, Italy
| | | | - Valeria Micheli
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, "Luigi Sacco" Hospital, ASST Fatebenefratelli Sacco, Milan, Italy.
| | - Andrea Gori
- II Division of Infectious Diseases, "Luigi Sacco" Hospital, ASST Fatebenefratelli Sacco, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.
| | - Emanuela Messina
- Infectious Diseases Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Spinello Antinori
- III Division of Infectious Diseases, "Luigi Sacco" Hospital, ASST Fatebenefratelli Sacco, Milan, Italy; Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milan, Milan, Italy.
| | - Maria Rita Gismondo
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, "Luigi Sacco" Hospital, ASST Fatebenefratelli Sacco, Milan, Italy; Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milan, Milan, Italy.
| | - Antonella Castagna
- Infectious Diseases Unit, Vita-Salute San Raffaele University, Milan, Italy.
| | - Davide Mileto
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, "Luigi Sacco" Hospital, ASST Fatebenefratelli Sacco, Milan, Italy.
| | - Giuliano Rizzardini
- I Division of Infectious Diseases, "Luigi Sacco" Hospital, ASST Fatebenefratelli Sacco, Milan, Italy.
| | - Alessandra Lombardi
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, "Luigi Sacco" Hospital, ASST Fatebenefratelli Sacco, Milan, Italy.
| | - Silvia Nozza
- Infectious Diseases Unit, Vita-Salute San Raffaele University, Milan, Italy.
| |
Collapse
|
12
|
Raccagni AR, Leoni D, Ciccullo A, Verdenelli S, Cattelan AM, Di Giambenedetto S, Falcone M, Mileto D, Castagna A, Nozza S. Rapid improvement of severe Mpox lesions with oral tecovirimat. J Med Virol 2023; 95:e28825. [PMID: 37246746 DOI: 10.1002/jmv.28825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 05/10/2023] [Accepted: 05/15/2023] [Indexed: 05/30/2023]
Affiliation(s)
| | - Davide Leoni
- Tropical and Infectious Diseases Unit, University Hospital of Padova, Padova, Italy
| | - Arturo Ciccullo
- UOC Infectious Diseases, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Stefano Verdenelli
- Infectious Diseases Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliera Universitaria Pisana, University of Pisa, Pisa, Italy
| | - Anna Maria Cattelan
- Tropical and Infectious Diseases Unit, University Hospital of Padova, Padova, Italy
| | | | - Marco Falcone
- Infectious Diseases Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliera Universitaria Pisana, University of Pisa, Pisa, Italy
| | - Davide Mileto
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, Ospedale Sacco, Milan, Italy
| | - Antonella Castagna
- Infectious Diseases Unit, Vita-Salute San Raffaele University, Milan, Italy
- Infectious Diseases Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Silvia Nozza
- Infectious Diseases Unit, Vita-Salute San Raffaele University, Milan, Italy
- Infectious Diseases Unit, San Raffaele Scientific Institute, Milan, Italy
| |
Collapse
|
13
|
Raccagni AR, Canetti D, Mileto D, Tamburini AM, Candela C, Albarello L, Bracchitta F, Mancon A, Micheli V, Gismondo MR, Castagna A, Nozza S. Two individuals with potential monkeypox virus reinfection. Lancet Infect Dis 2023; 23:522-524. [PMID: 37031694 PMCID: PMC10079276 DOI: 10.1016/s1473-3099(23)00185-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Revised: 02/28/2023] [Accepted: 03/02/2023] [Indexed: 04/11/2023]
Affiliation(s)
| | - Diana Canetti
- Infectious Diseases Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Davide Mileto
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, Ospedale Sacco, Milan, Italy
| | - Andrea Marco Tamburini
- Gastrointestinal Surgery Unit, Vita Salute San Raffaele University, Milan, Italy; Gastrointestinal Surgery Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Caterina Candela
- Infectious Diseases Unit, Vita Salute San Raffaele University, Milan, Italy
| | - Luca Albarello
- Department of Pathology, Vita Salute San Raffaele University, Milan, Italy; Department of Pathology, San Raffaele Scientific Institute, Milan, Italy
| | - Fiorenza Bracchitta
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, Ospedale Sacco, Milan, Italy
| | - Alessandro Mancon
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, Ospedale Sacco, Milan, Italy
| | - Valeria Micheli
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, Ospedale Sacco, Milan, Italy
| | - Maria Rita Gismondo
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, Ospedale Sacco, Milan, Italy; Department of Biomedical and Clinical Sciences Luigi Sacco University Hospital, University of Milan, Italy
| | - Antonella Castagna
- Infectious Diseases Unit, Vita Salute San Raffaele University, Milan, Italy; Infectious Diseases Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Silvia Nozza
- Infectious Diseases Unit, Vita Salute San Raffaele University, Milan, Italy; Infectious Diseases Unit, San Raffaele Scientific Institute, Milan, Italy
| |
Collapse
|
14
|
Cossu MV, Mileto D, Giacomelli A, Oreni L, Bracchitta F, Pellicciotta M, Salari F, Petri F, Meraviglia P, Antinori S, Rizzardini G, Ridolfo AL. Comorbidity Burden and Suboptimal Immunological Responses to Coronavirus Disease 2019 Vaccination in People Living with Human Immunodeficiency Virus. J Infect Dis 2023; 227:733-735. [PMID: 35796710 PMCID: PMC9278213 DOI: 10.1093/infdis/jiac286] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 07/05/2022] [Indexed: 12/02/2022] Open
Affiliation(s)
- Maria Vittoria Cossu
- I Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
| | - Davide Mileto
- Laboratory of Clinical Microbiology, Virology and Bioemergency Diagnostics, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
| | - Andrea Giacomelli
- III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
| | - Letizia Oreni
- III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
| | - Fiorenza Bracchitta
- Laboratory of Clinical Microbiology, Virology and Bioemergency Diagnostics, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
| | - Martina Pellicciotta
- I Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
| | - Federica Salari
- Laboratory of Clinical Microbiology, Virology and Bioemergency Diagnostics, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
| | - Francesco Petri
- I Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
| | - Paola Meraviglia
- I Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
| | - Spinello Antinori
- III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy.,Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, Milan, Italy
| | - Giuliano Rizzardini
- I Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
| | - Anna Lisa Ridolfo
- III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
| |
Collapse
|
15
|
Raccagni AR, Mileto D, Candela C, Bruzzesi E, Bracchitta F, Marcatti M, Curreli D, Ciceri F, Gismondo MR, Castagna A, Nozza S. Monkeypox infection in a hemopoietic stem cell and heart transplant recipient. J Med Virol 2023; 95:e28304. [PMID: 36372449 DOI: 10.1002/jmv.28304] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 11/10/2022] [Indexed: 11/15/2022]
Affiliation(s)
| | - Davide Mileto
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, Ospedale Sacco, Milan, Italy
| | - Caterina Candela
- Infectious Diseases Unit, Vita-Salute San Raffaele University, Milan, Italy
| | - Elena Bruzzesi
- Infectious Diseases Unit, Vita-Salute San Raffaele University, Milan, Italy
| | - Fiorenza Bracchitta
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, Ospedale Sacco, Milan, Italy.,Department of Biomedical and Clinical Sciences "L.Sacco", University of Milan, Milan, Italy
| | - Magda Marcatti
- Hematology Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Daniele Curreli
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, Ospedale Sacco, Milan, Italy.,Department of Biomedical and Clinical Sciences "L.Sacco", University of Milan, Milan, Italy
| | - Fabio Ciceri
- Infectious Diseases Unit, Vita-Salute San Raffaele University, Milan, Italy.,Hematology Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Maria Rita Gismondo
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, Ospedale Sacco, Milan, Italy.,Department of Biomedical and Clinical Sciences "L.Sacco", University of Milan, Milan, Italy
| | - Antonella Castagna
- Infectious Diseases Unit, Vita-Salute San Raffaele University, Milan, Italy.,Infectious Diseases Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Silvia Nozza
- Infectious Diseases Unit, San Raffaele Scientific Institute, Milan, Italy
| |
Collapse
|
16
|
Moschese D, Farinacci D, Pozza G, Ciccullo A, Cossu MV, Giacomelli A, Borgonovo F, Mileto D, Santangelo R, Tamburrini E, Rizzardini G, Antinori S, Giambenedetto SD. Is smallpox vaccination protective against human monkeypox? J Med Virol 2023; 95:e28077. [PMID: 35993271 DOI: 10.1002/jmv.28077] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 08/03/2022] [Accepted: 08/09/2022] [Indexed: 01/11/2023]
Affiliation(s)
- Davide Moschese
- I Division of Infectious Diseases, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Damiano Farinacci
- Institute of Clinical Infectious Diseases, Catholic University of the Sacred Heart, Rome, Italy.,Infectious Diseases Unit, Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Giacomo Pozza
- III Division of Infectious Diseases, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Arturo Ciccullo
- Institute of Clinical Infectious Diseases, Catholic University of the Sacred Heart, Rome, Italy.,UOC of Infectious Diseases, St. Salvatore Hospital, L'Aquila, Italy
| | - Maria Vittoria Cossu
- I Division of Infectious Diseases, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Andrea Giacomelli
- III Division of Infectious Diseases, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Fabio Borgonovo
- I Division of Infectious Diseases, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Davide Mileto
- Clinical Microbiology, Virology and Bioemergency Diagnostics, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Rosaria Santangelo
- Department of Basic Biotechnological, Clinical Intensivological and Perioperative Sciences, Catholic University of the Sacred Heart, Rome, Italy.,Department of Infectology and Laboratory Sciences, Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Enrica Tamburrini
- Institute of Clinical Infectious Diseases, Catholic University of the Sacred Heart, Rome, Italy.,Infectious Diseases Unit, Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Giuliano Rizzardini
- I Division of Infectious Diseases, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Spinello Antinori
- III Division of Infectious Diseases, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, Milan, Italy.,Department of Biomedical and Clinical Sciences, Università Degli Studi di Milano, Milan, Italy
| | - Simona Di Giambenedetto
- Institute of Clinical Infectious Diseases, Catholic University of the Sacred Heart, Rome, Italy.,Infectious Diseases Unit, Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| |
Collapse
|
17
|
Rizzo A, Foschi A, Bracchitta F, Faggion I, Salari F, Borgonovo F, Fusetti C, Mileto D, Rizzardini G, Lombardi A, Gismondo MR, Micheli V. Persistent detection and sequencing of SARS-CoV-2 in the bloodstream of an immunocompromised patient. J Med Virol 2023; 95:e28381. [PMID: 36478593 PMCID: PMC9877964 DOI: 10.1002/jmv.28381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 11/28/2022] [Accepted: 12/04/2022] [Indexed: 12/12/2022]
Affiliation(s)
- Alberto Rizzo
- Laboratory of Clinical Microbiology, Virology and BioemergenciesASST Fatebenefratelli Sacco ‐ L. Sacco HospitalMilanItaly
| | - Antonella Foschi
- Department of Infectious DiseasesASST Fatebenefratelli Sacco ‐ L. Sacco HospitalMilanItaly
| | - Fiorenza Bracchitta
- Laboratory of Clinical Microbiology, Virology and BioemergenciesASST Fatebenefratelli Sacco ‐ L. Sacco HospitalMilanItaly
| | - Ivano Faggion
- Department of Infectious DiseasesASST Fatebenefratelli Sacco ‐ L. Sacco HospitalMilanItaly
| | - Federica Salari
- Laboratory of Clinical Microbiology, Virology and BioemergenciesASST Fatebenefratelli Sacco ‐ L. Sacco HospitalMilanItaly
| | - Fabio Borgonovo
- Department of Infectious DiseasesASST Fatebenefratelli Sacco ‐ L. Sacco HospitalMilanItaly
| | - Chiara Fusetti
- Department of Infectious DiseasesASST Fatebenefratelli Sacco ‐ L. Sacco HospitalMilanItaly
| | - Davide Mileto
- Laboratory of Clinical Microbiology, Virology and BioemergenciesASST Fatebenefratelli Sacco ‐ L. Sacco HospitalMilanItaly
| | - Giuliano Rizzardini
- Department of Infectious DiseasesASST Fatebenefratelli Sacco ‐ L. Sacco HospitalMilanItaly
| | - Alessandra Lombardi
- Laboratory of Clinical Microbiology, Virology and BioemergenciesASST Fatebenefratelli Sacco ‐ L. Sacco HospitalMilanItaly
| | - Maria R. Gismondo
- Laboratory of Clinical Microbiology, Virology and BioemergenciesASST Fatebenefratelli Sacco ‐ L. Sacco HospitalMilanItaly
| | - Valeria Micheli
- Laboratory of Clinical Microbiology, Virology and BioemergenciesASST Fatebenefratelli Sacco ‐ L. Sacco HospitalMilanItaly
| |
Collapse
|
18
|
Rizzo A, Pozza G, Salari F, Giacomelli A, Mileto D, Cossu MV, Mancon A, Gagliardi G, Micol B, Micheli V, Capetti A, Antinori S, Gismondo MR, Olivieri P, Lombardi A. Concomitant diagnosis of sexually transmitted infections and human monkeypox in patients attending a sexual health clinic in Milan, Italy. J Med Virol 2023; 95:e28328. [PMID: 36415133 DOI: 10.1002/jmv.28328] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 11/16/2022] [Accepted: 11/18/2022] [Indexed: 11/25/2022]
Abstract
In 2022, many monkeypox (MPX) outbreaks have been documented in countries where MPX was not endemic. It spread all around the world, especially in European Union and United States. While MPX is classically considered to be transmitted through close contact with lesions, the hypothesis of sexual transmission has been proposed. This study considered a total of 49 patients suspected for MPX that were also tested for other sexually transmitted infections (STIs), including Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium, and Trichomonas vaginalis. The data from coinfected patients suggested that MPXV and STIs might share the same route of inoculum, corroborating the hypothesis of possible sexual transmission for the emerging poxvirus. And like any other STI, MPX should be considered without stigmatization.
Collapse
Affiliation(s)
- Alberto Rizzo
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco-L. Sacco Hospital, Milan, Italy
| | - Giacomo Pozza
- III Division of Infectious Diseases, ASST Fatebenefratelli Sacco-L. Sacco Hospital, Milan, Italy
| | - Federica Salari
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco-L. Sacco Hospital, Milan, Italy
| | - Andrea Giacomelli
- III Division of Infectious Diseases, ASST Fatebenefratelli Sacco-L. Sacco Hospital, Milan, Italy
| | - Davide Mileto
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco-L. Sacco Hospital, Milan, Italy
| | - Maria Vittoria Cossu
- I Division of Infectious Diseases, ASST Fatebenefratelli Sacco-L. Sacco Hospital, Milan, Italy
| | - Alessandro Mancon
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco-L. Sacco Hospital, Milan, Italy
| | - Gloria Gagliardi
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco-L. Sacco Hospital, Milan, Italy
| | - Bianchi Micol
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco-L. Sacco Hospital, Milan, Italy
| | - Valeria Micheli
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco-L. Sacco Hospital, Milan, Italy
| | - Amedeo Capetti
- I Division of Infectious Diseases, ASST Fatebenefratelli Sacco-L. Sacco Hospital, Milan, Italy
| | - Spinello Antinori
- III Division of Infectious Diseases, ASST Fatebenefratelli Sacco-L. Sacco Hospital, Milan, Italy.,Department of Biomedical and Clinical Sciences, Università Degli Studi di Milano, Milan, Italy
| | - Maria Rita Gismondo
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco-L. Sacco Hospital, Milan, Italy
| | - Pietro Olivieri
- Medical Management Unit, ASST Fatebenefratelli Sacco-L. Sacco Hospital, Milan, Italy
| | - Alessandra Lombardi
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco-L. Sacco Hospital, Milan, Italy
| |
Collapse
|
19
|
Bertoni C, Raccagni AR, Candela C, Bruzzesi E, Mileto D, Canetti D, Rizzo A, Morsica G, Castagna A, Nozza S. Beyond stigma: Monkeypox infection in a 27-year-old woman. J Med Virol 2023; 95:e28421. [PMID: 36546405 DOI: 10.1002/jmv.28421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 12/10/2022] [Accepted: 12/16/2022] [Indexed: 12/24/2022]
Affiliation(s)
- Costanza Bertoni
- Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, Milan, Italy.,Infectious Diseases Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Angelo Roberto Raccagni
- Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, Milan, Italy.,Infectious Diseases Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Caterina Candela
- Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, Milan, Italy.,Infectious Diseases Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Elena Bruzzesi
- Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, Milan, Italy.,Infectious Diseases Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Davide Mileto
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, Sacco Hospital, Milan, Italy
| | - Diana Canetti
- Infectious Diseases Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Alberto Rizzo
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, Sacco Hospital, Milan, Italy.,University of Milan, Milan, Italy
| | - Giulia Morsica
- Infectious Diseases Unit, San Raffaele Scientific Institute, Milan, Italy.,Laboratory of Clinical Microbiology, Virology and Bioemergencies, Sacco Hospital, Milan, Italy
| | - Antonella Castagna
- Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, Milan, Italy.,Infectious Diseases Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Silvia Nozza
- Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, Milan, Italy.,Infectious Diseases Unit, San Raffaele Scientific Institute, Milan, Italy
| |
Collapse
|
20
|
Raccagni AR, Candela C, Bruzzesi E, Mileto D, Canetti D, Rizzo A, Castagna A, Nozza S. Real-life use of cidofovir for the treatment of severe monkeypox cases. J Med Virol 2023; 95:e28218. [PMID: 36229902 DOI: 10.1002/jmv.28218] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 10/11/2022] [Accepted: 10/12/2022] [Indexed: 01/11/2023]
Affiliation(s)
| | - Caterina Candela
- Infectious Diseases Unit, Vita-Salute San Raffaele University, Milan, Italy
| | - Elena Bruzzesi
- Infectious Diseases Unit, Vita-Salute San Raffaele University, Milan, Italy
| | - Davide Mileto
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, Ospedale Sacco, Milan, Italy
| | - Diana Canetti
- Infectious Diseases Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Alberto Rizzo
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, Ospedale Sacco, Milan, Italy.,Laboratory of Clinical Microbiology, Virology and Bioemergencies, University of Milan, Milan, Italy
| | - Antonella Castagna
- Infectious Diseases Unit, Vita-Salute San Raffaele University, Milan, Italy.,Infectious Diseases Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Silvia Nozza
- Infectious Diseases Unit, San Raffaele Scientific Institute, Milan, Italy
| |
Collapse
|
21
|
Moschese D, Pozza G, Giacomelli A, Mileto D, Cossu MV, Beltrami M, Rizzo A, Gismondo MR, Rizzardini G, Antinori S. Natural history of human Monkeypox in individuals attending a sexual health clinic in Milan, Italy. J Infect 2023; 86:e18-e20. [PMID: 36007659 PMCID: PMC9628937 DOI: 10.1016/j.jinf.2022.08.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 08/18/2022] [Indexed: 02/04/2023]
Affiliation(s)
- Davide Moschese
- I Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Via G.B. Grassi 74, Milan 20157, Italy,Corresponding author
| | - Giacomo Pozza
- III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Via G.B. Grassi 74, Milan 20157, Italy
| | - Andrea Giacomelli
- III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Via G.B. Grassi 74, Milan 20157, Italy
| | - Davide Mileto
- Clinical Microbiology, Virology and Bioemergency Diagnostics, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Via G.B. Grassi 74, Milan 20157, Italy
| | - Maria Vittoria Cossu
- I Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Via G.B. Grassi 74, Milan 20157, Italy
| | - Martina Beltrami
- III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Via G.B. Grassi 74, Milan 20157, Italy
| | - Alberto Rizzo
- Clinical Microbiology, Virology and Bioemergency Diagnostics, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Via G.B. Grassi 74, Milan 20157, Italy
| | - Maria Rita Gismondo
- Clinical Microbiology, Virology and Bioemergency Diagnostics, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy, Department of Biomedical and Clinical Sciences, Università Degli Studi di Milano, Via G.B. Grassi 74, Milan 20157, Italy
| | - Giuliano Rizzardini
- I Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Via G.B. Grassi 74, Milan 20157, Italy
| | - Spinello Antinori
- Department of Biomedical and Clinical Sciences, Università Degli Studi di Milano, Italy, III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Via G.B. Grassi 74, Milan 20157, Italy
| |
Collapse
|
22
|
Rizzo A, Mileto D, Moschese D, Candela C, Mancon A, Giacomelli A, Raccagni AR, Salari F, Cossu MV, Micheli V, Castagna A, Rizzardini G, Lombardi A, Nozza S, Gismondo MR. Role of multi-site sampling in the diagnosis of human Monkeypox. J Infect 2022; 86:154-225. [PMID: 36521564 PMCID: PMC9743791 DOI: 10.1016/j.jinf.2022.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 12/09/2022] [Indexed: 12/14/2022]
Affiliation(s)
- Alberto Rizzo
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, "Luigi Sacco" Hospital, ASST Fatebenefratelli Sacco, Via G.B. Grassi 74, Milan 20157, Italy.
| | - Davide Mileto
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, "Luigi Sacco" Hospital, ASST Fatebenefratelli Sacco, Via G.B. Grassi 74, Milan 20157, Italy
| | - Davide Moschese
- I Division of Infectious Diseases, "Luigi Sacco" Hospital, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Caterina Candela
- Infectious Diseases Unit, Vita-Salute San Raffaele University, Milan, Italy
| | - Alessandro Mancon
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, "Luigi Sacco" Hospital, ASST Fatebenefratelli Sacco, Via G.B. Grassi 74, Milan 20157, Italy
| | - Andrea Giacomelli
- Division of Infectious Diseases, "Luigi Sacco" Hospital, ASST Fatebenefratelli Sacco, Milan, Italy
| | | | - Federica Salari
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, "Luigi Sacco" Hospital, ASST Fatebenefratelli Sacco, Via G.B. Grassi 74, Milan 20157, Italy
| | - Maria Vittoria Cossu
- I Division of Infectious Diseases, "Luigi Sacco" Hospital, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Valeria Micheli
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, "Luigi Sacco" Hospital, ASST Fatebenefratelli Sacco, Via G.B. Grassi 74, Milan 20157, Italy
| | - Antonella Castagna
- Infectious Diseases Unit, Vita-Salute San Raffaele University, Milan, Italy,Infectious Diseases Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Giuliano Rizzardini
- I Division of Infectious Diseases, "Luigi Sacco" Hospital, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Alessandra Lombardi
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, "Luigi Sacco" Hospital, ASST Fatebenefratelli Sacco, Via G.B. Grassi 74, Milan 20157, Italy
| | - Silvia Nozza
- Infectious Diseases Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Maria Rita Gismondo
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, "Luigi Sacco" Hospital, ASST Fatebenefratelli Sacco, Via G.B. Grassi 74, Milan 20157, Italy,Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milan, Milan, Italy
| |
Collapse
|
23
|
Raccagni AR, Candela C, Mileto D, Bruzzesi E, Canetti D, Bertoni C, Castagna A, Nozza S. Breakthrough monkeypox infection among individuals previously immunized with smallpox or monkeypox vaccination. J Infect 2022; 86:154-225. [PMID: 36481365 PMCID: PMC9721380 DOI: 10.1016/j.jinf.2022.12.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 12/01/2022] [Indexed: 12/12/2022]
Affiliation(s)
| | | | - Davide Mileto
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, Ospedale Sacco, Milan, Italy
| | | | - Diana Canetti
- Infectious Diseases Unit, San Raffaele Scientific Institute, Milan, Italy
| | | | - Antonella Castagna
- Vita-Salute San Raffaele University, Milan, Italy,Infectious Diseases Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Silvia Nozza
- Infectious Diseases Unit, San Raffaele Scientific Institute, Milan, Italy
| |
Collapse
|
24
|
Mileto D, Micheli V, Fenizia C, Cutrera M, Gagliardi G, Mancon A, Bracchitta F, De Silvestri A, Rizzardini G, Lombardi A, Biasin M, Gismondo MR. Reduced neutralization of SARS-CoV-2 Omicron variant by BNT162b2 vaccinees' sera: a preliminary evaluation. Emerg Microbes Infect 2022; 11:790-792. [PMID: 35196967 PMCID: PMC8920392 DOI: 10.1080/22221751.2022.2045878] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Affiliation(s)
- D Mileto
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco, L. Sacco University Hospital, Milan, Italy
| | - V Micheli
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco, L. Sacco University Hospital, Milan, Italy
| | - C Fenizia
- Department of Biomedical and Clinical Sciences L. Sacco, University of Milan, Milan, Italy.,Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - M Cutrera
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco, L. Sacco University Hospital, Milan, Italy
| | - G Gagliardi
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco, L. Sacco University Hospital, Milan, Italy
| | - A Mancon
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco, L. Sacco University Hospital, Milan, Italy
| | - F Bracchitta
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco, L. Sacco University Hospital, Milan, Italy
| | - A De Silvestri
- Clinical Epidemiology and Biometeric Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - G Rizzardini
- Division of Infectious Diseases, ASST Fatebenefratelli Sacco, L. Sacco University Hospital, Milan, Italy
| | - A Lombardi
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco, L. Sacco University Hospital, Milan, Italy
| | - M Biasin
- Department of Biomedical and Clinical Sciences L. Sacco, University of Milan, Milan, Italy
| | - M R Gismondo
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco, L. Sacco University Hospital, Milan, Italy
| |
Collapse
|
25
|
Mancon A, Rizzo A, Mileto D, Grosso S, Foschi A, Cutrera M, Capetti A, Faggion I, Anselmo A, Monte A, Fillo S, Rizzardini G, Gismondo MR, Micheli V. Viro-immunological evaluation in an immunocompromised patient with long-lasting SARS-CoV-2 infection. Emerg Microbes Infect 2022; 11:786-789. [PMID: 35209808 PMCID: PMC8920372 DOI: 10.1080/22221751.2022.2045877] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- A Mancon
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco - University of Milan, Milan, Italy
| | - A Rizzo
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco - University of Milan, Milan, Italy
| | - D Mileto
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco - University of Milan, Milan, Italy
| | - S Grosso
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco - University of Milan, Milan, Italy
| | - A Foschi
- Department of Infectious Diseases, ASST Fatebenefratelli Sacco, Milan, Italy
| | - M Cutrera
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco - University of Milan, Milan, Italy
| | - A Capetti
- Department of Infectious Diseases, ASST Fatebenefratelli Sacco, Milan, Italy
| | - I Faggion
- Department of Infectious Diseases, ASST Fatebenefratelli Sacco, Milan, Italy
| | - A Anselmo
- Scientific Department Army Medical Center, Rome, Italy
| | - A Monte
- Scientific Department Army Medical Center, Rome, Italy
| | - S Fillo
- Scientific Department Army Medical Center, Rome, Italy
| | - G Rizzardini
- Department of Infectious Diseases, ASST Fatebenefratelli Sacco, Milan, Italy
| | - M R Gismondo
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco - University of Milan, Milan, Italy.,L. Sacco Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - V Micheli
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco - University of Milan, Milan, Italy
| |
Collapse
|
26
|
Borgonovo F, Stangalini CA, Tinelli C, Mariani C, Mileto D, Cossu MV, Abbati L, Bilardo L, Gagliardi G, Cutrera M, Pellicciotta M, Armiento L, Dedivitiis G, Capetti AF, Rizzardini G. Decay rate of antiS1/S2 IgG serum levels after 6 months of BNT162b2 vaccination in a cohort of COVID-19-naive and COVID-19-experienced subjects. Hum Vaccin Immunother 2022; 18:2060018. [PMID: 35511791 PMCID: PMC9897653 DOI: 10.1080/21645515.2022.2060018] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 03/15/2022] [Accepted: 03/28/2022] [Indexed: 02/06/2023] Open
Abstract
Vaccination toward SARS-CoV-2 reduced mortality and 'boosters' are being implemented. We offer scientific contribution about IgG production in the COVID-19 experienced population. From January 2021 to March 2021, 183 residents and staff from the Elderly Nursing Home "San Giuseppe Moscati" who had received two doses of the BNT162b2 vaccine were enrolled. The antibody response was assessed by the DiaSorin LIAISON-CLIA S1/S2® IgG solution. Cutoff levels for response (>39 BAU/mL) and neutralizing activity (>208 BAU/mL) were derived from DiaSorin official data. Serology was assessed before and after the first vaccination, and 2 weeks and 6 months after the second vaccination. Anti-S IgG in COVID-19 experienced, baseline IgG producers spiked after the first vaccination to median 5044 BAU/mL and decayed at 6 months to 2467.4 BAU/mL. Anti-S IgG in COVID-19 experienced, baseline IgG non-producers spiked after the second vaccination to median 1701.7 BAU/mL and decayed at 6 months to 904.8 BAU/mL. Anti-S IgG in COVID-19 naïve subjects spiked after the second vaccination to median 546 BAU/mL and decayed at 6 months to 319.8 BAU/mL. The differences between sequential timepoint levels in each group were statistically significant (p < .0001). Serology analysis revealed different kinetics between COVID-19 experienced subjects depending on baseline response, possibly predicting different IgG persistence in blood.
Collapse
Affiliation(s)
- Fabio Borgonovo
- 1st Division of Infectious Diseases, ‘Luigi Sacco’ University Hospital, Milano, Italy
| | | | - Carmine Tinelli
- Biometrics and Clinical Statistics Service, Scientific Direction, Fondazione IRCCS Policlinico, Pavia, Italy
| | - Chiara Mariani
- 1st Division of Infectious Diseases, ‘Luigi Sacco’ University Hospital, Milano, Italy
| | - Davide Mileto
- Clinical Microbiology Unit, ‘Luigi Sacco’ University Hospital, Milano, Italy
| | - Maria Vittoria Cossu
- 1st Division of Infectious Diseases, ‘Luigi Sacco’ University Hospital, Milano, Italy
| | - Laura Abbati
- ’San Giuseppe Moscati’ Foundation, Milano, Italy
| | - Lara Bilardo
- ’San Giuseppe Moscati’ Foundation, Milano, Italy
| | - Gloria Gagliardi
- Clinical Microbiology Unit, ‘Luigi Sacco’ University Hospital, Milano, Italy
| | - Miriam Cutrera
- Clinical Microbiology Unit, ‘Luigi Sacco’ University Hospital, Milano, Italy
| | - Martina Pellicciotta
- 1st Division of Infectious Diseases, ‘Luigi Sacco’ University Hospital, Milano, Italy
| | - Luciana Armiento
- 1st Division of Infectious Diseases, ‘Luigi Sacco’ University Hospital, Milano, Italy
| | - Gianfranco Dedivitiis
- 1st Division of Infectious Diseases, ‘Luigi Sacco’ University Hospital, Milano, Italy
| | - Amedeo F. Capetti
- 1st Division of Infectious Diseases, ‘Luigi Sacco’ University Hospital, Milano, Italy
| | - Giuliano Rizzardini
- 1st Division of Infectious Diseases, ‘Luigi Sacco’ University Hospital, Milano, Italy
- School of Medicine, University of the Witwatersrand, Johannesburg, South Africa
| |
Collapse
|
27
|
Raccagni AR, Mileto D, Canetti D, Tamburini AM, Rizzo A, Bruzzesi E, Castagna A, Nozza S. Monkeypox and pan-resistant Campylobacter spp infection in Entamoeba histolytica and Chlamydia trachomatis re-infection in a man who have sex with men. J Infect 2022; 85:436-480. [PMID: 35788011 DOI: 10.1016/j.jinf.2022.06.028] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 06/27/2022] [Indexed: 11/25/2022]
Affiliation(s)
| | - Davide Mileto
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, Ospedale Sacco, Milan, Italy
| | - Diana Canetti
- Infectious Diseases Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Andrea Marco Tamburini
- Vita-Salute San Raffele University, Via Stamira D'Ancona 20, Milan 20127, Italy; Gastrointestinal Surgery Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Alberto Rizzo
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, Ospedale Sacco, Milan, Italy; University of Milan, Milan, Italy
| | - Elena Bruzzesi
- Vita-Salute San Raffele University, Via Stamira D'Ancona 20, Milan 20127, Italy
| | - Antonella Castagna
- Vita-Salute San Raffele University, Via Stamira D'Ancona 20, Milan 20127, Italy; Infectious Diseases Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Silvia Nozza
- Infectious Diseases Unit, San Raffaele Scientific Institute, Milan, Italy
| |
Collapse
|
28
|
Mileto D, Riva A, Cutrera M, Moschese D, Mancon A, Meroni L, Giacomelli A, Bestetti G, Rizzardini G, Gismondo MR, Antinori S. New challenges in human monkeypox outside Africa: A review and case report from Italy. Travel Med Infect Dis 2022; 49:102386. [PMID: 35738529 PMCID: PMC9528171 DOI: 10.1016/j.tmaid.2022.102386] [Citation(s) in RCA: 77] [Impact Index Per Article: 38.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 06/13/2022] [Accepted: 06/16/2022] [Indexed: 12/17/2022]
Abstract
BACKGROUND Human monkeypox (MPX) is a neglected zoonotic disease caused by the MPX virus a double-stranded DNA virus which belongs to the Poxviridae family genus Orthopoxvirus. It is endemic in the rural rainforests of Central and Western Africa where it is responsible of human sporadic cases and outbreaks since 1970. Outside Africa MPXV caused an outbreak in 2003 in the United States linked to importation of infected rodents from Ghana and a few travel-related cases in the USA, United Kingdom, Israel and Singapore. Actually, a worldwide outbreak with more than 1200 confirmed cases mainly concentrated among men who have sex with men is ongoing. CASE REPORT We present the case of an Italian man living in Portugal that was diagnosed with MPX at our clinic in Milan, Italy. Monkeypox virus infection was confirmed by a specific homemade Real-Time PCR. Samples obtained from different sites (pharynx, skin lesions, anal ulcer, seminal fluid) turned all positive with different viral load. CONCLUSIONS Our report illustrates the challenge of a disease that seems to present in a different way from classic description with possible human-to-human transmission through sexual contact.
Collapse
Affiliation(s)
- Davide Mileto
- Clinical Microbiology, Virology and Bioemergency Diagnostics, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
| | - Agostino Riva
- Department of Biomedical and Clinical Sciences, Università Degli Studi di Milano, Italy; III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
| | - Miriam Cutrera
- Clinical Microbiology, Virology and Bioemergency Diagnostics, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
| | - Davide Moschese
- I Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
| | - Alessandro Mancon
- Clinical Microbiology, Virology and Bioemergency Diagnostics, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
| | - Luca Meroni
- III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
| | - Andrea Giacomelli
- III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
| | - Giovanna Bestetti
- III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
| | - Giuliano Rizzardini
- I Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
| | - Maria Rita Gismondo
- Clinical Microbiology, Virology and Bioemergency Diagnostics, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy; Department of Biomedical and Clinical Sciences, Università Degli Studi di Milano, Italy
| | - Spinello Antinori
- Department of Biomedical and Clinical Sciences, Università Degli Studi di Milano, Italy; III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy.
| |
Collapse
|
29
|
Moschese D, Pozza G, Mileto D, Giacomelli A, Cutrera M, Cossu MV, Matone M, Beltrami M, Salari F, Antinori S, Lombardi A, Rizzardini G. Isolation of viable monkeypox virus from anal and urethral swabs, Italy, May to July 2022. Euro Surveill 2022; 27. [PMID: 36082684 PMCID: PMC9461308 DOI: 10.2807/1560-7917.es.2022.27.36.2200675] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Anal and urethral samples from confirmed cases of monkeypox were screened for monkeypox virus (MPXV) by real-time PCR. Isolation of the virus was subsequently attempted in cell culture. Actively-replicating virus was demonstrated in 13 of 18 and 11 of 15 PCR-positive anal and urethral swabs, respectively, collected within 7 days from symptoms onset. Two asymptomatic secondary cases had detectable MPXV genetic material in urethral secretion and for one, MPXV was successfully isolated, supporting a potential MPXV sexual transmission hypothesis.
Collapse
Affiliation(s)
- Davide Moschese
- I Division of Infectious Diseases, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Giacomo Pozza
- III Division of Infectious Diseases, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Davide Mileto
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Andrea Giacomelli
- III Division of Infectious Diseases, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Miriam Cutrera
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Maria Vittoria Cossu
- I Division of Infectious Diseases, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Maddalena Matone
- I Division of Infectious Diseases, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Martina Beltrami
- III Division of Infectious Diseases, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Federica Salari
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Spinello Antinori
- Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, Italy; III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
| | - Alessandra Lombardi
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Giuliano Rizzardini
- I Division of Infectious Diseases, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, Milan, Italy
| |
Collapse
|
30
|
D'Addio F, Sabiu G, Usuelli V, Assi E, Abdelsalam A, Maestroni A, Seelam AJ, Ben Nasr M, Loretelli C, Mileto D, Rossi G, Pastore I, Montefusco L, Morpurgo PS, Plebani L, Rossi A, Chebat E, Bolla AM, Lunati ME, Mameli C, Macedoni M, Antinori S, Rusconi S, Gallieni M, Berra C, Folli F, Galli M, Gismondo MR, Zuccotti G, Fiorina P. Immunogenicity and Safety of SARS-CoV-2 mRNA Vaccines in a Cohort of Patients With Type 1 Diabetes. Diabetes 2022; 71:1800-1806. [PMID: 35551366 DOI: 10.2337/db22-0053] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 04/30/2022] [Indexed: 11/13/2022]
Abstract
Patients with type 1 diabetes (T1D) may develop severe outcomes during coronavirus disease 2019 (COVID-19), but their ability to generate an immune response against the SARS-CoV-2 mRNA vaccines remains to be established. We evaluated the safety, immunogenicity, and glycometabolic effects of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mRNA vaccines in patients with T1D. A total of 375 patients (326 with T1D and 49 subjects without diabetes) who received two doses of the SARS-CoV-2 mRNA vaccines (mRNA-1273, BNT162b2) between March and April 2021 at ASST Fatebenefratelli Sacco were included in this monocentric observational study. Local and systemic adverse events were reported in both groups after SARS-CoV-2 mRNA vaccination, without statistical differences between them. While both patients with T1D and subjects without diabetes exhibited a parallel increase in anti-SARS-CoV-2 spike titers after vaccination, the majority of patients with T1D (70% and 78%, respectively) did not show any increase in the SARS-CoV-2-specific cytotoxic response compared with the robust increase observed in all subjects without diabetes. A reduced secretion of the T-cell-related cytokines interleukin-2 and tumor necrosis factor-α in vaccinated patients with T1D was also observed. No glycometabolic alterations were evident in patients with T1D using continuous glucose monitoring during follow-up. Administration of the SARS-CoV-2 mRNA vaccine is associated with an impaired cellular SARS-CoV-2-specific cytotoxic immune response in patients with T1D.
Collapse
Affiliation(s)
- Francesca D'Addio
- International Center for T1D, Pediatric Clinical Research Center Romeo ed Enrica Invernizzi, Dipartimento di Scienze Biomediche e Cliniche L. Sacco, Università di Milano, Milan, Italy
- Division of Endocrinology, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Gianmarco Sabiu
- International Center for T1D, Pediatric Clinical Research Center Romeo ed Enrica Invernizzi, Dipartimento di Scienze Biomediche e Cliniche L. Sacco, Università di Milano, Milan, Italy
- Nephrology and Dialysis Unit, ASST Fatebenefratelli Sacco, and Dipartimento di Scienze Biomediche e Cliniche L. Sacco, Università di Milano, Milan, Italy
| | - Vera Usuelli
- International Center for T1D, Pediatric Clinical Research Center Romeo ed Enrica Invernizzi, Dipartimento di Scienze Biomediche e Cliniche L. Sacco, Università di Milano, Milan, Italy
| | - Emma Assi
- International Center for T1D, Pediatric Clinical Research Center Romeo ed Enrica Invernizzi, Dipartimento di Scienze Biomediche e Cliniche L. Sacco, Università di Milano, Milan, Italy
| | - Ahmed Abdelsalam
- International Center for T1D, Pediatric Clinical Research Center Romeo ed Enrica Invernizzi, Dipartimento di Scienze Biomediche e Cliniche L. Sacco, Università di Milano, Milan, Italy
| | - Anna Maestroni
- International Center for T1D, Pediatric Clinical Research Center Romeo ed Enrica Invernizzi, Dipartimento di Scienze Biomediche e Cliniche L. Sacco, Università di Milano, Milan, Italy
| | - Andy Joe Seelam
- International Center for T1D, Pediatric Clinical Research Center Romeo ed Enrica Invernizzi, Dipartimento di Scienze Biomediche e Cliniche L. Sacco, Università di Milano, Milan, Italy
| | - Moufida Ben Nasr
- International Center for T1D, Pediatric Clinical Research Center Romeo ed Enrica Invernizzi, Dipartimento di Scienze Biomediche e Cliniche L. Sacco, Università di Milano, Milan, Italy
| | - Cristian Loretelli
- International Center for T1D, Pediatric Clinical Research Center Romeo ed Enrica Invernizzi, Dipartimento di Scienze Biomediche e Cliniche L. Sacco, Università di Milano, Milan, Italy
| | - Davide Mileto
- Diagnostic Services, Clinical Microbiology, Virology and Bioemergence Diagnostics, ASST Fatebenefratelli Sacco, and Dipartimento di Scienze Biomediche e Cliniche L. Sacco, Università di Milano, Milan, Italy
| | - Giada Rossi
- International Center for T1D, Pediatric Clinical Research Center Romeo ed Enrica Invernizzi, Dipartimento di Scienze Biomediche e Cliniche L. Sacco, Università di Milano, Milan, Italy
| | - Ida Pastore
- Division of Endocrinology, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Laura Montefusco
- Division of Endocrinology, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Paola S Morpurgo
- Division of Endocrinology, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Laura Plebani
- Division of Endocrinology, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Antonio Rossi
- Division of Endocrinology, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Enrica Chebat
- Division of Endocrinology, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Andrea M Bolla
- Division of Endocrinology, ASST Fatebenefratelli Sacco, Milan, Italy
| | | | - Chiara Mameli
- Pediatric Department, Buzzi Children's Hospital, and Dipartimento di Scienze Biomediche e Cliniche L. Sacco, Università di Milano, Milan, Italy
| | - Maddalena Macedoni
- Pediatric Department, Buzzi Children's Hospital, and Dipartimento di Scienze Biomediche e Cliniche L. Sacco, Università di Milano, Milan, Italy
| | - Spinello Antinori
- Department of Infectious Diseases, ASST Fatebenefratelli Sacco, and Dipartimento di Scienze Biomediche e Cliniche L. Sacco, Università di Milano, Milan, Italy
| | - Stefano Rusconi
- Department of Infectious Diseases, ASST Fatebenefratelli Sacco, and Dipartimento di Scienze Biomediche e Cliniche L. Sacco, Università di Milano, Milan, Italy
| | - Maurizio Gallieni
- Nephrology and Dialysis Unit, ASST Fatebenefratelli Sacco, and Dipartimento di Scienze Biomediche e Cliniche L. Sacco, Università di Milano, Milan, Italy
| | - Cesare Berra
- Metabolic Diseases and Diabetes, Multimedica IRCCS, Sesto San Giovanni, Milan, Italy
| | - Franco Folli
- Endocrinology and Metabolism, Department of Health Science, Università di Milano, ASST Santi Paolo e Carlo, Milan, Italy
| | - Massimo Galli
- Department of Infectious Diseases, ASST Fatebenefratelli Sacco, and Dipartimento di Scienze Biomediche e Cliniche L. Sacco, Università di Milano, Milan, Italy
| | - Maria Rita Gismondo
- Diagnostic Services, Clinical Microbiology, Virology and Bioemergence Diagnostics, ASST Fatebenefratelli Sacco, and Dipartimento di Scienze Biomediche e Cliniche L. Sacco, Università di Milano, Milan, Italy
| | - Gianvincenzo Zuccotti
- Pediatric Department, Buzzi Children's Hospital, and Dipartimento di Scienze Biomediche e Cliniche L. Sacco, Università di Milano, Milan, Italy
| | - Paolo Fiorina
- International Center for T1D, Pediatric Clinical Research Center Romeo ed Enrica Invernizzi, Dipartimento di Scienze Biomediche e Cliniche L. Sacco, Università di Milano, Milan, Italy
- Division of Endocrinology, ASST Fatebenefratelli Sacco, Milan, Italy
- Nephrology Division, Boston Children's Hospital, Harvard Medical School, Boston, MA
| |
Collapse
|
31
|
Raccagni AR, Candela C, Mileto D, Canetti D, Bruzzesi E, Rizzo A, Castagna A, Nozza S. Monkeypox infection among men who have sex with men: PCR testing on seminal fluids. J Infect 2022; 85:573-607. [PMID: 35914609 PMCID: PMC9556608 DOI: 10.1016/j.jinf.2022.07.022] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 07/26/2022] [Indexed: 11/20/2022]
Affiliation(s)
| | - Caterina Candela
- Vita-Salute San Raffaele University, Via Stamira D'Ancona 20, Milano, Milan 20127, Italy
| | - Davide Mileto
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, Ospedale Sacco, Milan, Italy
| | - Diana Canetti
- Infectious Diseases Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Elena Bruzzesi
- Vita-Salute San Raffaele University, Via Stamira D'Ancona 20, Milano, Milan 20127, Italy
| | - Alberto Rizzo
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, Ospedale Sacco, Milan, Italy; University of Milan, Milan, Italy
| | - Antonella Castagna
- Vita-Salute San Raffaele University, Via Stamira D'Ancona 20, Milano, Milan 20127, Italy; Infectious Diseases Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Silvia Nozza
- Infectious Diseases Unit, San Raffaele Scientific Institute, Milan, Italy
| |
Collapse
|
32
|
Fenizia C, Cetin I, Mileto D, Vanetti C, Saulle I, Di Giminiani M, Saresella M, Parisi F, Trabattoni D, Clerici M, Biasin M, Savasi V. Pregnant Women Develop a Specific Immunological Long-Lived Memory Against SARS-COV-2. Front Immunol 2022; 13:827889. [PMID: 35251011 PMCID: PMC8889908 DOI: 10.3389/fimmu.2022.827889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 01/24/2022] [Indexed: 12/04/2022] Open
Abstract
It is well established that pregnancy induces deep changes in the immune system. This is part of the physiological adaptation of the female organism to the pregnancy and the immunological tolerance toward the fetus. Indeed, over the three trimesters, the suppressive T regulatory lymphocytes are progressively more represented, while the expression of co-stimulatory molecules decreases overtime. Such adaptations relate to an increased risk of infections and progression to severe disease in pregnant women, potentially resulting in an altered generation of long-lived specific immunological memory of infection contracted during pregnancy. How potent is the immune response against SARS-CoV-2 in infected pregnant women and how long the specific SARS-CoV-2 immunity might last need to be urgently addressed, especially considering the current vaccinal campaign. To address these questions, we analyzed the long-term immunological response upon SARS-CoV-2 infection in pregnant women from delivery to a six-months follow-up. In particular, we investigated the specific antibody production, T cell memory subsets, and inflammation profile. Results show that 80% developed an anti-SARS-CoV-2-specific IgG response, comparable with the general population. While IgG were present only in 50% of the asymptomatic subjects, the antibody production was elicited by infection in all the mild-to-critical patients. The specific T-cell memory subsets rebalanced over-time, and the pro-inflammatory profile triggered by specific SARS-CoV-2 stimulation faded away. These results shed light on SARS-CoV-2-specific immunity in pregnant women; understanding the immunological dynamics of the immune system in response to SARS-CoV-2 is essential for defining proper obstetric management of pregnant women and fine tune gender-specific vaccinal plans.
Collapse
Affiliation(s)
- Claudio Fenizia
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.,Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Irene Cetin
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy.,Department of Woman, Mother and Neonate Buzzi Children's Hospital, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Davide Mileto
- Clinical Microbiology, Virology and Bio-emergence Diagnosis, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Claudia Vanetti
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.,Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Irma Saulle
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.,Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Maria Di Giminiani
- Unit of Obstetrics and Gynecology, ASST Fatebenefratelli-Sacco, Milan, Italy
| | | | - Francesca Parisi
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy.,Unit of Obstetrics and Gynecology, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Daria Trabattoni
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Mario Clerici
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.,Fondazione don Carlo Gnocchi, IRCCS, Milan, Italy
| | - Mara Biasin
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Valeria Savasi
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy.,Unit of Obstetrics and Gynecology, ASST Fatebenefratelli-Sacco, Milan, Italy
| |
Collapse
|
33
|
Micheli V, Bracchitta F, Rizzo A, Mancon A, Mileto D, Lombardi A, Stefanelli P, Gismondo MR. First identification of the new SARS-CoV-2 Omicron variant (B.1.1.529) in Italy. Clin Infect Dis 2022; 75:522-524. [PMID: 35061887 PMCID: PMC8807288 DOI: 10.1093/cid/ciab1044] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Indexed: 11/12/2022] Open
Abstract
We identified the first case in Italy of SARS-CoV-2 B.1.1.529 variant by whole genome sequencing in an Italian subject travelling from Mozambique. Specific mutation profiles deserve further investigations to clarify potential effects on vaccination efficacy. This case highlights the crucial role of rapid and continuous surveillance of SARS-CoV-2 variant circulation.
Collapse
Affiliation(s)
- Valeria Micheli
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco. Milan, Italy
| | - Fiorenza Bracchitta
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco. Milan, Italy
| | - Alberto Rizzo
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco. Milan, Italy
| | - Alessandro Mancon
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco. Milan, Italy
| | - Davide Mileto
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco. Milan, Italy
| | - Alessandra Lombardi
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco. Milan, Italy
| | - Paola Stefanelli
- Dep. of Infectious Diseases, Istituto Superiore di Sanità. Rome, Italy
| | - Maria Rita Gismondo
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco. Milan, Italy
| |
Collapse
|
34
|
Moschese D, Giacomelli A, Beltrami M, Pozza G, Mileto D, Reato S, Zacheo M, Corbellino M, Rizzardini G, Antinori S. Hospitalisation for monkeypox in Milan, Italy. Travel Med Infect Dis 2022; 49:102417. [PMID: 35934310 PMCID: PMC9760088 DOI: 10.1016/j.tmaid.2022.102417] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Revised: 07/28/2022] [Accepted: 07/30/2022] [Indexed: 12/24/2022]
Abstract
During the current multi-country outbreak of human monkeypox the hospitalisation rate observed in Milan, Italy was 8.8%. Bacterial superinfection and severe perianal pain were the main cause of hospitalisation requiring antibiotic treatment and analgesic therapy. One patient was treated with Cidofovir. All hospitalised patients were discharged and the outcome was favourable with full recovery.
Collapse
Affiliation(s)
- Davide Moschese
- I Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
| | - Andrea Giacomelli
- III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
| | - Martina Beltrami
- III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy,Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, Italy
| | - Giacomo Pozza
- III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy,Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, Italy
| | - Davide Mileto
- Clinical Microbiology, Virology and Bioemergency Diagnostics, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
| | - Serena Reato
- III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy,Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, Italy
| | - Martina Zacheo
- III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy,Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, Italy
| | - Mario Corbellino
- III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
| | - Giuliano Rizzardini
- I Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
| | - Spinello Antinori
- III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy,Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, Italy,Corresponding author. Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, Via GB Grassi 74, 20157, Milano, Italy
| |
Collapse
|
35
|
Camporesi A, De Silvestri A, Diotto V, Ferrario S, Eccher L, De Ferrari A, Messina F, Pelizzo G, Mileto D, Calcaterra V, Buonsenso D. Very High Negative Concordance Rate of RT-PCR for SARS-CoV-2 in Nasopharyngeal Swab and Tracheo-Bronchial Aspirate in Children. Front Pediatr 2022; 10:866111. [PMID: 35692973 PMCID: PMC9174601 DOI: 10.3389/fped.2022.866111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 04/11/2022] [Indexed: 11/13/2022] Open
Abstract
UNLABELLED Reliable testing methods for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in children are essential to allow normal activities. Diagnosis of SARS-CoV-2 infection is currently based on real-time reverse transcriptase-polymerase chain reaction (RT-PCR) performed on nasopharyngeal (NP) swabs; concerns have been raised regarding NP swab accuracy in children to detect the virus because of potential lack of cooperation of the patients or due to general uncertainties about concordance between high and low respiratory tract specimens in children. The aim of the study (IRB approval: ST/2020/405) is to prospectively compare RT-PCR results on NP and tracheo-bronchial aspirate (TA) in children admitted to the hospital for surgery or admitted to the Pediatric Intensive Care Unit (PICU) of a tertiary children hospital in Milano, Italy, during a peak of COVID-19 infections in the city. A total of 385 patients were enrolled in the study: 364 from surgical theater and 21 from PICU. Two patients (0.5%) tested positive on TA and were negative on NP; both cases occurred in November 2020, during a peak of infection in the city. Specificity of NP swab was.995 (95% CI: 0.980-0.999). Two patients with positive NP swabs tested negative on TA. CONCLUSION Our study shows that the specificity of SARS-CoV-2 RT-PCR on TA swab, compared to results of SARS-CoV-2 RT-PCR on NP, was very high for negative cases in our pediatric cohort during a period of high epidemiological pressure.
Collapse
Affiliation(s)
- Anna Camporesi
- Department of Pediatric Anesthesia and Intensive Care, "Vittore Buzzi" Children's Hospital, Milan, Italy
| | - Annalisa De Silvestri
- Clinical Epidemiology and Biometry Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Veronica Diotto
- Department of Pediatric Anesthesia and Intensive Care, "Vittore Buzzi" Children's Hospital, Milan, Italy
| | - Stefania Ferrario
- Department of Pediatric Anesthesia and Intensive Care, "Vittore Buzzi" Children's Hospital, Milan, Italy
| | - Laura Eccher
- Department of Pediatric Anesthesia and Intensive Care, "Vittore Buzzi" Children's Hospital, Milan, Italy
| | - Alessandra De Ferrari
- Department of Pediatric Anesthesia and Intensive Care, "Vittore Buzzi" Children's Hospital, Milan, Italy
| | - Francesco Messina
- Pediatric Ear, Nose and Throat Unit, "Vittore Buzzi" Children's Hospital, Milan, Italy
| | - Gloria Pelizzo
- Department of Pediatric Surgery, "V. Buzzi" Children's Hospital, University of Milan, Milan, Italy.,Department of Biomedical and Clinical Sciences, "Luigi Sacco" University Hospital, Milan, Italy
| | - Davide Mileto
- Clinical Microbiology, Virology, and Bio-Emergence Diagnosis, ASST Fatebenefratelli-Sacco, Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Valeria Calcaterra
- Department of Pediatrics, "Vittore Buzzi" Children's Hospital, Milan, Italy
| | - Danilo Buonsenso
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario "A. Gemelli", Rome, Italy
| |
Collapse
|
36
|
Mileto D, Fenizia C, Cutrera M, Gagliardi G, Gigantiello A, De Silvestri A, Rizzo A, Mancon A, Bianchi M, De Poli F, Cuomo M, Burgo I, Longo M, Rimoldi SG, Pagani C, Grosso S, Micheli V, Rizzardini G, Grande R, Biasin M, Gismondo MR, Lombardi A. SARS-CoV-2 mRNA vaccine BNT162b2 triggers a consistent cross-variant humoral and cellular response. Emerg Microbes Infect 2021; 10:2235-2243. [PMID: 34749573 PMCID: PMC8648019 DOI: 10.1080/22221751.2021.2004866] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 11/04/2021] [Accepted: 11/07/2021] [Indexed: 11/06/2022]
Abstract
As the SARS-CoV-2 pandemic continues to rage worldwide, the emergence of numerous variants of concern (VOC) represents a challenge for the vaccinal protective efficacy and the reliability of commercially available high-throughput immunoassays. Our study demonstrates the administration of two doses of the BNT162b2 vaccine that elicited a robust SARS-CoV-2-specific immune response which was assessed up to 3 months after full vaccination in a cohort of 37 health care workers (HCWs). SARS-CoV-2-specific antibody response, evaluated by four commercially available chemiluminescence immunoassays (CLIA), was qualitatively consistent with the results provided by the gold-standard in vitro neutralization assay (NTA). However, we could not observe a correlation between the quantity of the antibody detected by CLIA assays and their neutralizing activity tested by NTA. Almost all subjects developed a SARS-CoV-2-specific T-cell response. Moreover, vaccinated HCWs developed a similar protective neutralizing antibodies response against the EU (B.1), Alpha (B.1.1.7), Gamma (P.1), and Eta (B.1.525) SARS-CoV-2 variants, while Beta (B.1.351) and Delta (B.1.617.2) strains displayed a consistent partial immune evasion. These results underline the importance of a solid vaccine-elicited immune response and a robust antibody titre. We believe that these relevant results should be taken into consideration in the definition of future vaccinal strategies.
Collapse
Affiliation(s)
- D. Mileto
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco, L. Sacco University Hospital, Milan, Italy
| | - C. Fenizia
- Department of Biomedical and Clinical Sciences “L. Sacco”, University of Milan, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - M. Cutrera
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco, L. Sacco University Hospital, Milan, Italy
| | - G. Gagliardi
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco, L. Sacco University Hospital, Milan, Italy
| | - A. Gigantiello
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco, L. Sacco University Hospital, Milan, Italy
| | - A. De Silvestri
- Clinical Epidemiology and Biometeric Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - A. Rizzo
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco, L. Sacco University Hospital, Milan, Italy
| | - A. Mancon
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco, L. Sacco University Hospital, Milan, Italy
| | - M. Bianchi
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco, L. Sacco University Hospital, Milan, Italy
| | - F. De Poli
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco, L. Sacco University Hospital, Milan, Italy
| | - M. Cuomo
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco, L. Sacco University Hospital, Milan, Italy
| | - I. Burgo
- Hematology and Transfusion Medicine, ASST Fatebenefratelli Sacco, L. Sacco University Hospital, Milan
| | - M. Longo
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco, L. Sacco University Hospital, Milan, Italy
| | - S. G. Rimoldi
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco, L. Sacco University Hospital, Milan, Italy
| | - C. Pagani
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco, L. Sacco University Hospital, Milan, Italy
| | - S. Grosso
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco, L. Sacco University Hospital, Milan, Italy
| | - V. Micheli
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco, L. Sacco University Hospital, Milan, Italy
| | - G. Rizzardini
- Division of Infectious Diseases, ASST Fatebenefratelli Sacco, L. Sacco University Hospital, Milan, Italy
| | - R. Grande
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco, L. Sacco University Hospital, Milan, Italy
| | - M. Biasin
- Department of Biomedical and Clinical Sciences “L. Sacco”, University of Milan, Milan, Italy
| | - M. R. Gismondo
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco, L. Sacco University Hospital, Milan, Italy
| | - A. Lombardi
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco, L. Sacco University Hospital, Milan, Italy
| |
Collapse
|
37
|
Mileto D, Mancon A, Staurenghi F, Rizzo A, Econdi S, Gismondo MR, Guidotti M. Inactivation of SARS-CoV-2 in the Liquid Phase: Are Aqueous Hydrogen Peroxide and Sodium Percarbonate Efficient Decontamination Agents? J Chem Health Saf 2021; 28:260-267. [PMID: 37556234 PMCID: PMC7901233 DOI: 10.1021/acs.chas.0c00095] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Indexed: 12/23/2022]
Abstract
A diluted 3% w/w hydrogen peroxide solution acidified to pH 2.5 by adding citric acid inactivated SARS-CoV-2 virus by more than 4 orders of magnitude in 5 min. After a contact time of 15 min, no viral replication was detected. Aqueous solutions of sodium percarbonate inactivated coronavirus by >3 log10 diminution in 15 min. Conversely, H2O2 solutions with no additives displayed a scarce virucidal activity (1.1 log10 diminution in 5 min), confirming that a pH-modifying ingredient is necessary to have a H2O2-based disinfectant active against the novel coronavirus.
Collapse
Affiliation(s)
- Davide Mileto
- Laboratory of Clinical Microbiology, Virology and
Bioemergency, ASST Fatebenefratelli Sacco, University Hospital L.
Sacco, 20157 Milan, Italy
| | - Alessandro Mancon
- Laboratory of Clinical Microbiology, Virology and
Bioemergency, ASST Fatebenefratelli Sacco, University Hospital L.
Sacco, 20157 Milan, Italy
| | - Federica Staurenghi
- Laboratory of Clinical Microbiology, Virology and
Bioemergency, ASST Fatebenefratelli Sacco, University Hospital L.
Sacco, 20157 Milan, Italy
| | - Alberto Rizzo
- Laboratory of Clinical Microbiology, Virology and
Bioemergency, ASST Fatebenefratelli Sacco, University Hospital L.
Sacco, 20157 Milan, Italy
| | - Stefano Econdi
- CNR-SCITEC, Istituto di Scienze e
Tecnologie Chimiche “Giulio Natta”, via C. Golgi 19, 20133
Milan, Italy
- Department of Chemistry, University of
Milan, via C. Golgi 19, 20133 Milan, Italy
| | - Maria Rita Gismondo
- Laboratory of Clinical Microbiology, Virology and
Bioemergency, ASST Fatebenefratelli Sacco, University Hospital L.
Sacco, 20157 Milan, Italy
| | - Matteo Guidotti
- CNR-SCITEC, Istituto di Scienze e
Tecnologie Chimiche “Giulio Natta”, via C. Golgi 19, 20133
Milan, Italy
| |
Collapse
|
38
|
Pezzati L, Giacomelli A, Mileto D, Conti F, Gagliardi G, Rizzo A, Milazzo L, Schiuma M, Covizzi A, Siano M, Bassoli C, Passerini M, Piscaglia M, Torre A, Oreni L, Rizzardini G, Galli M, Ridolfo AL, Antinori S. Rapid lateral-flow immunochromatographic tests to assess anti N/S IgG seropositivity after BNT162b2 vaccine: A cross-sectional study: Rapid lateral-flow immunochromatographic tests after BNT162b2 vaccine. J Infect 2021; 83:381-412. [PMID: 34062183 PMCID: PMC8164509 DOI: 10.1016/j.jinf.2021.05.029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 05/17/2021] [Accepted: 05/18/2021] [Indexed: 12/24/2022]
Affiliation(s)
- Laura Pezzati
- Infectious Diseases Department, ASST Fatebenefratelli-Sacco, Milan, Italy; Department of Biomedical and Clinical Sciences, Università di Milano, Milan, Italy.
| | - Andrea Giacomelli
- Infectious Diseases Department, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Davide Mileto
- Laboratory of Clinical Microbiology, Virology and Bioemergencies Diagnostics, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Federico Conti
- Infectious Diseases Department, ASST Fatebenefratelli-Sacco, Milan, Italy; Department of Biomedical and Clinical Sciences, Università di Milano, Milan, Italy
| | - Gloria Gagliardi
- Laboratory of Clinical Microbiology, Virology and Bioemergencies Diagnostics, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Alberto Rizzo
- Laboratory of Clinical Microbiology, Virology and Bioemergencies Diagnostics, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Laura Milazzo
- Infectious Diseases Department, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Marco Schiuma
- Infectious Diseases Department, ASST Fatebenefratelli-Sacco, Milan, Italy; Department of Biomedical and Clinical Sciences, Università di Milano, Milan, Italy
| | - Alice Covizzi
- Infectious Diseases Department, ASST Fatebenefratelli-Sacco, Milan, Italy; Department of Biomedical and Clinical Sciences, Università di Milano, Milan, Italy
| | - Matteo Siano
- Infectious Diseases Department, ASST Fatebenefratelli-Sacco, Milan, Italy; Department of Biomedical and Clinical Sciences, Università di Milano, Milan, Italy
| | - Cinzia Bassoli
- Infectious Diseases Department, ASST Fatebenefratelli-Sacco, Milan, Italy; Department of Biomedical and Clinical Sciences, Università di Milano, Milan, Italy
| | - Matteo Passerini
- Infectious Diseases Department, ASST Fatebenefratelli-Sacco, Milan, Italy; Department of Biomedical and Clinical Sciences, Università di Milano, Milan, Italy
| | - Marco Piscaglia
- Infectious Diseases Department, ASST Fatebenefratelli-Sacco, Milan, Italy; Department of Biomedical and Clinical Sciences, Università di Milano, Milan, Italy
| | - Alessandro Torre
- Infectious Diseases Department, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Letizia Oreni
- Infectious Diseases Department, ASST Fatebenefratelli-Sacco, Milan, Italy
| | | | - Massimo Galli
- Infectious Diseases Department, ASST Fatebenefratelli-Sacco, Milan, Italy; Department of Biomedical and Clinical Sciences, Università di Milano, Milan, Italy
| | - Anna Lisa Ridolfo
- Infectious Diseases Department, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Spinello Antinori
- Infectious Diseases Department, ASST Fatebenefratelli-Sacco, Milan, Italy; Department of Biomedical and Clinical Sciences, Università di Milano, Milan, Italy
| |
Collapse
|
39
|
Micheli V, Mancon A, Malara A, Mileto D, Villani PG, Rizzo A, Pagani C, Alquati O, Gismondo MR. What was behind the first recognition and characterization of autochthonous SARS-CoV-2 transmission in Italy: The impact on European scenario. Clin Case Rep 2021; 9:e04154. [PMID: 34178331 PMCID: PMC8209863 DOI: 10.1002/ccr3.4154] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 03/08/2021] [Accepted: 03/14/2021] [Indexed: 11/08/2022] Open
Abstract
An Italian male with no link to China Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) epidemic presented at Emergency Room (ER) with severe respiratory impairment. The RT-PCR on 20 February 2020, nasopharyngeal swab revealed SARS-CoV-2 infection, confirmed with viral culture and sequencing. This was the first identified autochthonous SARS-CoV-2 transmission in Italy, that unveiled global pathogen diffusion. This clinical case highlights an underestimation of SARS-CoV-2 circulation, making initial containment measures unfit to face the real situation and delaying the management of potentially affected SARS-CoV-2 patients.
Collapse
Affiliation(s)
- Valeria Micheli
- Laboratory of Clinical Microbiology, Virology and BioemergenciesASST Fatebenefratelli Sacco – University of MilanMilanItaly
| | - Alessandro Mancon
- Laboratory of Clinical Microbiology, Virology and BioemergenciesASST Fatebenefratelli Sacco – University of MilanMilanItaly
| | - Annalisa Malara
- Anesthesia and ICU Department Maggiore HospitalASST LodiLodiItaly
| | - Davide Mileto
- Laboratory of Clinical Microbiology, Virology and BioemergenciesASST Fatebenefratelli Sacco – University of MilanMilanItaly
| | | | - Alberto Rizzo
- Laboratory of Clinical Microbiology, Virology and BioemergenciesASST Fatebenefratelli Sacco – University of MilanMilanItaly
| | - Cristina Pagani
- Laboratory of Clinical Microbiology, Virology and BioemergenciesASST Fatebenefratelli Sacco – University of MilanMilanItaly
| | - Omar Alquati
- Anesthesia and ICU Department Maggiore HospitalASST LodiLodiItaly
| | - Maria Rita Gismondo
- Laboratory of Clinical Microbiology, Virology and BioemergenciesASST Fatebenefratelli Sacco – University of MilanMilanItaly
| |
Collapse
|
40
|
Capetti AF, Borgonovo F, Mileto D, Gagliardi G, Mariani C, Lupo A, Dedivitiis G, Meraviglia P, Pellicciotta M, Armiento L, Cossu MV, Rizzardini G. One-year durability of anti-spike IgG to SARS-CoV-2: Preliminary data from the anticrown prospective observational study one year durability of COVID-19 anti-spike IgG. J Infect 2021; 83:237-279. [PMID: 34052240 PMCID: PMC8158344 DOI: 10.1016/j.jinf.2021.05.023] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 05/23/2021] [Indexed: 11/16/2022]
Affiliation(s)
- Amedeo F Capetti
- Department of Infectious Diseases, Luigi Sacco University Hospital, ASST Fatebenefratelli-Sacco, Milan, Italy.
| | - Fabio Borgonovo
- Department of Infectious Diseases, Luigi Sacco University Hospital, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Davide Mileto
- Clinical Microbiology Unit, Luigi Sacco University Hospital, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Gloria Gagliardi
- Clinical Microbiology Unit, Luigi Sacco University Hospital, ASST Fatebenefratelli-Sacco, Milan, Italy
| | | | - Angelica Lupo
- Department of Infectious Diseases, Luigi Sacco University Hospital, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Gianfranco Dedivitiis
- Department of Infectious Diseases, Luigi Sacco University Hospital, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Paola Meraviglia
- Department of Infectious Diseases, Luigi Sacco University Hospital, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Martina Pellicciotta
- Department of Infectious Diseases, Luigi Sacco University Hospital, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Luciana Armiento
- Department of Infectious Diseases, Luigi Sacco University Hospital, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Maria V Cossu
- Department of Infectious Diseases, Luigi Sacco University Hospital, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Giuliano Rizzardini
- Department of Infectious Diseases, Luigi Sacco University Hospital, ASST Fatebenefratelli-Sacco, Milan, Italy
| |
Collapse
|
41
|
Schiuma M, Pezzati L, Ballone E, Borghi B, Osio M, Mattavelli D, Galimberti L, Corbellino M, Mileto D, Zanchetta N, Antinori S. Case Report: A Fatal Case of West Nile Virus Meningoencephalomyelitis in a Woman with Systemic Lupus Erythematosus Initially Misdiagnosed as SARS-CoV-2 Infection. Am J Trop Med Hyg 2021; 104:1716-1718. [PMID: 33782207 PMCID: PMC8103457 DOI: 10.4269/ajtmh.21-0041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 03/08/2021] [Indexed: 11/07/2022] Open
Abstract
We present a fatal case of West Nile virus meningoencephalomyelitis initially misdiagnosed as COVID-19 in a 63-year-old Egyptian woman with a previous diagnosis of systemic lupus erythematosus. The patient's medical history and immunosuppressive therapy, as well as the COVID-19 pandemic, substantially broadened the differential diagnosis of her encephalitis.
Collapse
Affiliation(s)
- Marco Schiuma
- III Division of Infectious Diseases, Luigi Sacco Hospital, Milan, Italy;,Department of Biomedical and Clinical Sciences “Luigi Sacco”, Università degli Studi di Milano, Milano, Italy
| | - Laura Pezzati
- III Division of Infectious Diseases, Luigi Sacco Hospital, Milan, Italy;,Department of Biomedical and Clinical Sciences “Luigi Sacco”, Università degli Studi di Milano, Milano, Italy
| | | | | | | | | | - Laura Galimberti
- III Division of Infectious Diseases, Luigi Sacco Hospital, Milan, Italy
| | - Mario Corbellino
- III Division of Infectious Diseases, Luigi Sacco Hospital, Milan, Italy
| | - Davide Mileto
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, Luigi Sacco Hospital, Milan, Italy
| | - Nadia Zanchetta
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, Luigi Sacco Hospital, Milan, Italy
| | - Spinello Antinori
- III Division of Infectious Diseases, Luigi Sacco Hospital, Milan, Italy;,Department of Biomedical and Clinical Sciences “Luigi Sacco”, Università degli Studi di Milano, Milano, Italy;,Address correspondence to Spinello Antinori, Department of Biomedical and Clinical Sciences “Luigi Sacco,” Università degli Studi di Milano, Via GB Grassi 74, Milano 20157, Italy. E-mail:
| |
Collapse
|
42
|
De Benedetti S, Di Pisa F, Fassi EMA, Cretich M, Musicò A, Frigerio R, Mussida A, Bombaci M, Grifantini R, Colombo G, Bolognesi M, Grande R, Zanchetta N, Gismondo MR, Mileto D, Mancon A, Gourlay LJ. Structure, Immunoreactivity, and In Silico Epitope Determination of SmSPI S. mansoni Serpin for Immunodiagnostic Application. Vaccines (Basel) 2021; 9:vaccines9040322. [PMID: 33915716 PMCID: PMC8066017 DOI: 10.3390/vaccines9040322] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 03/17/2021] [Accepted: 03/19/2021] [Indexed: 11/16/2022] Open
Abstract
The human parasitic disease Schistosomiasis is caused by the Schistosoma trematode flatworm that infects freshwaters in tropical regions of the world, particularly in Sub-Saharan Africa, South America, and the Far-East. It has also been observed as an emerging disease in Europe, due to increased immigration. In addition to improved therapeutic strategies, it is imperative to develop novel, rapid, and sensitive diagnostic tests that can detect the Schistosoma parasite, allowing timely treatment. Present diagnosis is difficult and involves microscopy-based detection of Schistosoma eggs in the feces. In this context, we present the 3.22 Å resolution crystal structure of the circulating antigen Serine protease inhibitor from S. mansoni (SmSPI), and we describe it as a potential serodiagnostic marker. Moreover, we identify three potential immunoreactive epitopes using in silico-based epitope mapping methods. Here, we confirm effective immune sera reactivity of the recombinant antigen, suggesting the further investigation of the protein and/or its predicted epitopes as serodiagnostic Schistosomiasis biomarkers.
Collapse
Affiliation(s)
- Stefano De Benedetti
- Department of Biosciences, Università degli Studi di Milano, Via Celoria 26, 20133 Milano, Italy; (S.D.B.); (F.D.P.); (M.B.)
| | - Flavio Di Pisa
- Department of Biosciences, Università degli Studi di Milano, Via Celoria 26, 20133 Milano, Italy; (S.D.B.); (F.D.P.); (M.B.)
| | - Enrico Mario Alessandro Fassi
- Consiglio Nazionale delle Ricerche, Istituto di Scienze e Tecnologie Chimiche “Giulio Natta” (SCITEC), Via Mario Bianco 9, 20131 Milano, Italy; (E.M.A.F.); (M.C.); (A.M.); (R.F.); (A.M.)
- Dipartimento di Scienze Farmaceutiche, Università degli Studi di Milano, Via L. Mangiagalli 25, 20133 Milano, Italy
| | - Marina Cretich
- Consiglio Nazionale delle Ricerche, Istituto di Scienze e Tecnologie Chimiche “Giulio Natta” (SCITEC), Via Mario Bianco 9, 20131 Milano, Italy; (E.M.A.F.); (M.C.); (A.M.); (R.F.); (A.M.)
| | - Angelo Musicò
- Consiglio Nazionale delle Ricerche, Istituto di Scienze e Tecnologie Chimiche “Giulio Natta” (SCITEC), Via Mario Bianco 9, 20131 Milano, Italy; (E.M.A.F.); (M.C.); (A.M.); (R.F.); (A.M.)
| | - Roberto Frigerio
- Consiglio Nazionale delle Ricerche, Istituto di Scienze e Tecnologie Chimiche “Giulio Natta” (SCITEC), Via Mario Bianco 9, 20131 Milano, Italy; (E.M.A.F.); (M.C.); (A.M.); (R.F.); (A.M.)
| | - Alessandro Mussida
- Consiglio Nazionale delle Ricerche, Istituto di Scienze e Tecnologie Chimiche “Giulio Natta” (SCITEC), Via Mario Bianco 9, 20131 Milano, Italy; (E.M.A.F.); (M.C.); (A.M.); (R.F.); (A.M.)
| | - Mauro Bombaci
- Istituto Nazionale Genetica Molecolare, Padiglione Romeo ed Enrica Invernizzi, IRCCS Ospedale Maggiore Policlinico, 20122 Milan, Italy; (M.B.); (R.G.)
| | - Renata Grifantini
- Istituto Nazionale Genetica Molecolare, Padiglione Romeo ed Enrica Invernizzi, IRCCS Ospedale Maggiore Policlinico, 20122 Milan, Italy; (M.B.); (R.G.)
| | - Giorgio Colombo
- Dipartimento di Chimica, Università di Pavia, V.le Taramelli 12, 27100 Pavia, Italy;
| | - Martino Bolognesi
- Department of Biosciences, Università degli Studi di Milano, Via Celoria 26, 20133 Milano, Italy; (S.D.B.); (F.D.P.); (M.B.)
- Centro di Ricerca Pediatrica Romeo ed Enrica Invernizzi, Università degli Studi di Milano, 20133 Milano, Italy
| | - Romualdo Grande
- UOC Microbiologia Clinica, Virologia e Diagnostica delle Bioemergenze ASST FBF Sacco, 20157 Milano, Italy; (R.G.); (N.Z.); (M.R.G.); (D.M.); (A.M.)
| | - Nadia Zanchetta
- UOC Microbiologia Clinica, Virologia e Diagnostica delle Bioemergenze ASST FBF Sacco, 20157 Milano, Italy; (R.G.); (N.Z.); (M.R.G.); (D.M.); (A.M.)
| | - Maria Rita Gismondo
- UOC Microbiologia Clinica, Virologia e Diagnostica delle Bioemergenze ASST FBF Sacco, 20157 Milano, Italy; (R.G.); (N.Z.); (M.R.G.); (D.M.); (A.M.)
- Clinical Microbiology, Virology and Bioemergency Unit, Department of Biomedical and Clinical Sciences, Luigi Sacco Hospital, University of Milan, 20157 Milan, Italy
| | - Davide Mileto
- UOC Microbiologia Clinica, Virologia e Diagnostica delle Bioemergenze ASST FBF Sacco, 20157 Milano, Italy; (R.G.); (N.Z.); (M.R.G.); (D.M.); (A.M.)
| | - Alessandro Mancon
- UOC Microbiologia Clinica, Virologia e Diagnostica delle Bioemergenze ASST FBF Sacco, 20157 Milano, Italy; (R.G.); (N.Z.); (M.R.G.); (D.M.); (A.M.)
| | - Louise Jane Gourlay
- Department of Biosciences, Università degli Studi di Milano, Via Celoria 26, 20133 Milano, Italy; (S.D.B.); (F.D.P.); (M.B.)
- Correspondence: ; Tel.: +39-(0)2-5031-4914
| |
Collapse
|
43
|
Capetti AF, Stangalini CA, Borgonovo F, Mileto D, Oreni L, Dedivitiis G, Lupo A, Cossu MV, Bilardo L, Giacomelli A, Galli M, Rizzardini G. Impressive boosting of anti-S1/S2 IgG production in COVID-19-experienced patients after the first shot of the BNT162b2 mRNA COVID-19 Vaccine. Clin Infect Dis 2021; 73:e1402-e1403. [PMID: 33693610 PMCID: PMC7989538 DOI: 10.1093/cid/ciab214] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Amedeo F Capetti
- 1st Division of Infectious Diseases, 'Luigi Sacco' University Hospital, Milan, Italy
| | | | - Fabio Borgonovo
- 1st Division of Infectious Diseases, 'Luigi Sacco' University Hospital, Milan, Italy
| | - Davide Mileto
- Clinical Microbiology Unit, 'Luigi Sacco' University Hospital, Milan, Italy
| | - Letizia Oreni
- Università di Milano, Dipartimento di Scienze Biomediche e Clinche L. Sacco, Milan, Italy
| | - Gianfranco Dedivitiis
- 1st Division of Infectious Diseases, 'Luigi Sacco' University Hospital, Milan, Italy
| | - Angelica Lupo
- Università di Milano, Dipartimento di Scienze Biomediche e Clinche L. Sacco, Milan, Italy
| | - Maria V Cossu
- 1st Division of Infectious Diseases, 'Luigi Sacco' University Hospital, Milan, Italy
| | | | - Andrea Giacomelli
- Università di Milano, Dipartimento di Scienze Biomediche e Clinche L. Sacco, Milan, Italy
| | - Massimo Galli
- Università di Milano, Dipartimento di Scienze Biomediche e Clinche L. Sacco, Milan, Italy
| | - Giuliano Rizzardini
- 1st Division of Infectious Diseases, 'Luigi Sacco' University Hospital, Milan, Italy.,School of Medicine, University of the Witwatersrand, Johannesburg, South Africa
| |
Collapse
|
44
|
Rimoldi SG, Stefani F, Gigantiello A, Polesello S, Comandatore F, Mileto D, Maresca M, Longobardi C, Mancon A, Romeri F, Pagani C, Cappelli F, Roscioli C, Moja L, Gismondo MR, Salerno F. Presence and infectivity of SARS-CoV-2 virus in wastewaters and rivers. Sci Total Environ 2020. [PMID: 32693284 DOI: 10.1101/2020.05.01.20086009] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
The presence of SARS-CoV-2 in raw wastewaters has been demonstrated in many countries affected by this pandemic. Nevertheless, virus presence and infectivity in treated wastewaters, but also in the receiving water bodies are still poorly investigated. In this study, raw and treated samples from three wastewater treatment plants, and three river samples within the Milano Metropolitan Area, Italy, were surveyed for SARS-CoV-2 RNA detection by means of real time RT-PCR and infectivity test on culture cells. SARS-CoV-2 RNA was detected in raw, but not in treated wastewaters (four and two samples, respectively, sampled in two dates). The isolated virus genome was sequenced, and belonged to the strain most spread in Europe and similar to another found in the same region. RNA presence in raw wastewater samples decreased after eight days, probably following the epidemiological trend estimated for the area. Virus infectivity was always null, indicating the natural decay of viral pathogenicity in time from emission. Samples from receiving rivers (three sites, sampled in the same dates as wastewaters) showed in some cases a positivity to real time RT-PCR, probably due to non-treated, or inefficiently treated discharges, or to the combined sewage overflows. Nevertheless, also for rivers infectivity was null. Risks for public health should be limited, although a precautionary approach to risk assessment is here advocated, giving the preliminary nature of the presented data.
Collapse
Affiliation(s)
| | - Fabrizio Stefani
- Water Research Institute-National Research Council (IRSA-CNR), Brugherio, MB, Italy.
| | - Anna Gigantiello
- University Hospital "L. Sacco", ASST Fatebenefratelli Sacco, Milan, Italy
| | - Stefano Polesello
- Water Research Institute-National Research Council (IRSA-CNR), Brugherio, MB, Italy
| | | | - Davide Mileto
- University Hospital "L. Sacco", ASST Fatebenefratelli Sacco, Milan, Italy
| | - Mafalda Maresca
- University Hospital "L. Sacco", ASST Fatebenefratelli Sacco, Milan, Italy
| | | | - Alessandro Mancon
- University Hospital "L. Sacco", ASST Fatebenefratelli Sacco, Milan, Italy
| | - Francesca Romeri
- University Hospital "L. Sacco", ASST Fatebenefratelli Sacco, Milan, Italy
| | - Cristina Pagani
- University Hospital "L. Sacco", ASST Fatebenefratelli Sacco, Milan, Italy
| | - Francesca Cappelli
- Water Research Institute-National Research Council (IRSA-CNR), Brugherio, MB, Italy; Department of Science and High Technology, University of Insubria, Via Valleggio 11, 22100 Como, Italy
| | - Claudio Roscioli
- Water Research Institute-National Research Council (IRSA-CNR), Brugherio, MB, Italy
| | - Lorenzo Moja
- Department of Biomedical Sciences for Health, University of Milan, Italy
| | | | - Franco Salerno
- Water Research Institute-National Research Council (IRSA-CNR), Brugherio, MB, Italy
| |
Collapse
|
45
|
Mileto D, Foschi A, Mancon A, Merli S, Staurenghi F, Pezzati L, Rizzo A, Conti F, Romeri F, Bernacchia D, Meroni R, Rizzardini G, Gismondo MR, Micheli V. A case of extremely prolonged viral shedding: Could cell cultures be a diagnostic tool to drive COVID-19 patient discharge? Int J Infect Dis 2020; 104:631-633. [PMID: 33227514 PMCID: PMC7679112 DOI: 10.1016/j.ijid.2020.11.161] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 11/11/2020] [Accepted: 11/14/2020] [Indexed: 12/21/2022] Open
Abstract
This study addressed the case of a patient with prolonged COVID-19 viral shedding, reported by Real-Time PCR, until 71 days from symptom onset. However, viral culture received negative results after 30 days from symptom onset. Therefore, viral culture may be a worthwhile test for patients requiring discharge, in particular for those presenting prolonged viral shedding.
Collapse
Affiliation(s)
- Davide Mileto
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco, Milan, Italy.
| | - Antonella Foschi
- Department of Infectious Diseases, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Alessandro Mancon
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Stefania Merli
- Department of Infectious Diseases, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Federica Staurenghi
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Laura Pezzati
- Department of Infectious Diseases, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Alberto Rizzo
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Federico Conti
- Department of Infectious Diseases, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Francesca Romeri
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Dario Bernacchia
- Department of Infectious Diseases, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Rachele Meroni
- Department of Internal Medicine, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Giuliano Rizzardini
- Department of Infectious Diseases, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Maria Rita Gismondo
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Valeria Micheli
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco, Milan, Italy
| |
Collapse
|
46
|
Rimoldi SG, Stefani F, Gigantiello A, Polesello S, Comandatore F, Mileto D, Maresca M, Longobardi C, Mancon A, Romeri F, Pagani C, Cappelli F, Roscioli C, Moja L, Gismondo MR, Salerno F. Presence and infectivity of SARS-CoV-2 virus in wastewaters and rivers. Sci Total Environ 2020; 744:140911. [PMID: 32693284 PMCID: PMC7358170 DOI: 10.1016/j.scitotenv.2020.140911] [Citation(s) in RCA: 307] [Impact Index Per Article: 76.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 07/09/2020] [Accepted: 07/10/2020] [Indexed: 04/13/2023]
Abstract
The presence of SARS-CoV-2 in raw wastewaters has been demonstrated in many countries affected by this pandemic. Nevertheless, virus presence and infectivity in treated wastewaters, but also in the receiving water bodies are still poorly investigated. In this study, raw and treated samples from three wastewater treatment plants, and three river samples within the Milano Metropolitan Area, Italy, were surveyed for SARS-CoV-2 RNA detection by means of real time RT-PCR and infectivity test on culture cells. SARS-CoV-2 RNA was detected in raw, but not in treated wastewaters (four and two samples, respectively, sampled in two dates). The isolated virus genome was sequenced, and belonged to the strain most spread in Europe and similar to another found in the same region. RNA presence in raw wastewater samples decreased after eight days, probably following the epidemiological trend estimated for the area. Virus infectivity was always null, indicating the natural decay of viral pathogenicity in time from emission. Samples from receiving rivers (three sites, sampled in the same dates as wastewaters) showed in some cases a positivity to real time RT-PCR, probably due to non-treated, or inefficiently treated discharges, or to the combined sewage overflows. Nevertheless, also for rivers infectivity was null. Risks for public health should be limited, although a precautionary approach to risk assessment is here advocated, giving the preliminary nature of the presented data.
Collapse
Affiliation(s)
| | - Fabrizio Stefani
- Water Research Institute-National Research Council (IRSA-CNR), Brugherio, MB, Italy.
| | - Anna Gigantiello
- University Hospital "L. Sacco", ASST Fatebenefratelli Sacco, Milan, Italy
| | - Stefano Polesello
- Water Research Institute-National Research Council (IRSA-CNR), Brugherio, MB, Italy
| | | | - Davide Mileto
- University Hospital "L. Sacco", ASST Fatebenefratelli Sacco, Milan, Italy
| | - Mafalda Maresca
- University Hospital "L. Sacco", ASST Fatebenefratelli Sacco, Milan, Italy
| | | | - Alessandro Mancon
- University Hospital "L. Sacco", ASST Fatebenefratelli Sacco, Milan, Italy
| | - Francesca Romeri
- University Hospital "L. Sacco", ASST Fatebenefratelli Sacco, Milan, Italy
| | - Cristina Pagani
- University Hospital "L. Sacco", ASST Fatebenefratelli Sacco, Milan, Italy
| | - Francesca Cappelli
- Water Research Institute-National Research Council (IRSA-CNR), Brugherio, MB, Italy; Department of Science and High Technology, University of Insubria, Via Valleggio 11, 22100 Como, Italy
| | - Claudio Roscioli
- Water Research Institute-National Research Council (IRSA-CNR), Brugherio, MB, Italy
| | - Lorenzo Moja
- Department of Biomedical Sciences for Health, University of Milan, Italy
| | | | - Franco Salerno
- Water Research Institute-National Research Council (IRSA-CNR), Brugherio, MB, Italy
| |
Collapse
|
47
|
Fenizia C, Biasin M, Cetin I, Vergani P, Mileto D, Spinillo A, Gismondo MR, Perotti F, Callegari C, Mancon A, Cammarata S, Beretta I, Nebuloni M, Trabattoni D, Clerici M, Savasi V. Analysis of SARS-CoV-2 vertical transmission during pregnancy. Nat Commun 2020; 11:5128. [PMID: 33046695 PMCID: PMC7552412 DOI: 10.1038/s41467-020-18933-4] [Citation(s) in RCA: 248] [Impact Index Per Article: 62.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Accepted: 09/18/2020] [Indexed: 12/18/2022] Open
Abstract
The impact of SARS-CoV-2 infection during gestation remains unclear. Here, we analyse the viral genome on maternal and newborns nasopharyngeal swabs, vaginal swabs, maternal and umbilical cord plasma, placenta and umbilical cord biopsies, amniotic fluids and milk from 31 mothers with SARS-CoV-2 infection. In addition, we also test specific anti-SARS-CoV-2 antibodies and expression of genes involved in inflammatory responses in placentas, and in maternal and umbilical cord plasma. We detect SARS-CoV-2 genome in one umbilical cord blood and in two at-term placentas, in one vaginal mucosa and in one milk specimen. Furthermore, we report the presence of specific anti-SARS-CoV-2 IgM and IgG antibodies in one umbilical cord blood and in one milk specimen. Finally, in the three documented cases of vertical transmission, SARS-CoV-2 infection was accompanied by a strong inflammatory response. Together, these data support the hypothesis that in utero SARS-CoV-2 vertical transmission, while low, is possible. These results might help defining proper obstetric management of COVID-19 pregnant women, or putative indications for mode and timing of delivery.
Collapse
MESH Headings
- Adolescent
- Adult
- Antibodies, Viral/analysis
- Betacoronavirus/genetics
- Betacoronavirus/immunology
- Betacoronavirus/isolation & purification
- COVID-19
- Coronavirus Infections/diagnosis
- Coronavirus Infections/pathology
- Coronavirus Infections/transmission
- Coronavirus Infections/virology
- Female
- Genome, Viral
- Humans
- Infant, Newborn
- Infectious Disease Transmission, Vertical
- Inflammation
- Middle Aged
- Pandemics
- Pneumonia, Viral/diagnosis
- Pneumonia, Viral/pathology
- Pneumonia, Viral/transmission
- Pneumonia, Viral/virology
- Pregnancy
- Pregnancy Complications, Infectious/diagnosis
- Pregnancy Complications, Infectious/pathology
- Pregnancy Complications, Infectious/virology
- SARS-CoV-2
- Young Adult
Collapse
Affiliation(s)
- Claudio Fenizia
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Mara Biasin
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Irene Cetin
- Department of Woman, Mother and Neonate Buzzi Children's Hospital, ASST Fatebenefratelli-Sacco, Department of Biomedical and Clinical Sciences, Milan, Italy
| | - Patrizia Vergani
- Department of Maternal Fetal Medicine, Fondazione MBBM, San Gerardo Hospital, University of Milan-Bicocca, Monza, Italy
| | - Davide Mileto
- Clinical Microbiology, Virology and Bio-emergence Diagnosis, ASST Fatebenefratelli-Sacco, Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Arsenio Spinillo
- Department of Obstetrics and Gynecology, IRCCS Fondazione Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - Maria Rita Gismondo
- Clinical Microbiology, Virology and Bio-emergence Diagnosis, ASST Fatebenefratelli-Sacco, Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Francesca Perotti
- Department of Obstetrics and Gynecology, IRCCS Fondazione Policlinico San Matteo, Pavia, Italy
| | - Clelia Callegari
- Department of Maternal Fetal Medicine, Fondazione MBBM, San Gerardo Hospital, University of Milan-Bicocca, Monza, Italy
| | - Alessandro Mancon
- Clinical Microbiology, Virology and Bio-emergence Diagnosis, ASST Fatebenefratelli-Sacco, Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Selene Cammarata
- Unit of Obstetrics and Gynecology, ASST Fatebenefratelli-Sacco, Department of Biological and Clinical Sciences, University of Milan, Milan, Italy
| | - Ilaria Beretta
- Division of Infectious Diseases, San Gerardo Hospital, ASST Monza, Monza, Italy
| | - Manuela Nebuloni
- Pathology Unit, ASST Fatebenfretalli-Sacco, Department of Biological and Clinical Sciences, University of Milan, Milan, Italy
| | - Daria Trabattoni
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Mario Clerici
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
- IRCCS Fondazione don Carlo Gnocchi, Milan, Italy
| | - Valeria Savasi
- Unit of Obstetrics and Gynecology, ASST Fatebenefratelli-Sacco, Department of Biological and Clinical Sciences, University of Milan, Milan, Italy.
| |
Collapse
|
48
|
Micheli V, Rimoldi SG, Romeri F, Comandatore F, Mancon A, Gigantiello A, Perini M, Mileto D, Pagani C, Lombardi A, Gismondo MR. Geographical reconstruction of the SARS-CoV-2 outbreak in Lombardy (Italy) during the early phase. J Med Virol 2020; 93:1752-1757. [PMID: 32816316 PMCID: PMC7461481 DOI: 10.1002/jmv.26447] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 08/17/2020] [Accepted: 08/18/2020] [Indexed: 12/30/2022]
Abstract
The first identification of autochthonous transmission of SARS‐CoV‐2 in Italy was documented by the Laboratory of Clinical Microbiology, Virology and Bioemergencies of L. Sacco Hospital (Milano, Italy) on 20th February 2020 in a 38 years old male patient, who was found positive for pneumonia at the Codogno Hospital. Thereafter Lombardy has reported the highest prevalence of COVID‐19 cases in the country, especially in Milano, Brescia and Bergamo provinces. The aim of this study was to assess the potential presence of different viral clusters belonging to the six main provinces involved in Lombardy COVID‐19 cases in order to highlight peculiar province‐dependent viral characteristics. A phylogenetic analysis was conducted on 20 full length genomes obtained from patients addressing to several Lombard hospitals from February 20th to April 4th, 2020, aligned with 41 Italian viral genome assemblies available on GISAID database as of 30th March, 2020: two main monophyletic clades, containing 8 and 53 isolates, respectively, were identified. Noteworthy, Bergamo isolates mapped inside the small clade harbouring M gene D3G mutation. The molecular clock analysis estimated a cluster divergence approximately one month before the first patient identification, supporting the hypothesis that different SARS‐CoV‐2 strains had spread worldwide at different times, but their presence became evident only in late February along with Italian epidemic emergence. Therefore, this epidemiological reconstruction suggests that virus initial circulation in Lombardy was ascribable to multiple introduction. The phylogenetic reconstruction robustness, however, will be improved when more genomic sequences are available, in order to guarantee a complete epidemiological surveillance. Northern Italy was the most SARS‐CoV‐2 pandemic interested country area. A phylogeographical analysis was conducted to investigate virus entry and circulation in Italy. Two main monophyletic clades were identified, containing 8 and 53 isolates, respectively. The estimated cluster divergence in mid January supported the hypothesis of different viral strains spreading at different times and multiple inputs Lombardy region.
Collapse
Affiliation(s)
- Valeria Micheli
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco, L. Sacco University Hospital, Milan, Italy
| | - Sara G Rimoldi
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco, L. Sacco University Hospital, Milan, Italy
| | - Francesca Romeri
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco, L. Sacco University Hospital, Milan, Italy
| | - Francesco Comandatore
- Department of Biomedical and Clinical Sciences, Romeo ed Enrica Invernizzi Pediatric Research Center, L. Sacco University Hospital, University of Milan, Milan, Italy
| | - Alessandro Mancon
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco, L. Sacco University Hospital, Milan, Italy
| | - Anna Gigantiello
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco, L. Sacco University Hospital, Milan, Italy
| | - Matteo Perini
- Department of Biomedical and Clinical Sciences, Romeo ed Enrica Invernizzi Pediatric Research Center, L. Sacco University Hospital, University of Milan, Milan, Italy
| | - Davide Mileto
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco, L. Sacco University Hospital, Milan, Italy
| | - Cristina Pagani
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco, L. Sacco University Hospital, Milan, Italy
| | - Alessandra Lombardi
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco, L. Sacco University Hospital, Milan, Italy
| | - Maria R Gismondo
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco, L. Sacco University Hospital, Milan, Italy
| |
Collapse
|
49
|
Antinori S, Cossu MV, Ridolfo AL, Rech R, Bonazzetti C, Pagani G, Gubertini G, Coen M, Magni C, Castelli A, Borghi B, Colombo R, Giorgi R, Angeli E, Mileto D, Milazzo L, Vimercati S, Pellicciotta M, Corbellino M, Torre A, Rusconi S, Oreni L, Gismondo MR, Giacomelli A, Meroni L, Rizzardini G, Galli M. Compassionate remdesivir treatment of severe Covid-19 pneumonia in intensive care unit (ICU) and Non-ICU patients: Clinical outcome and differences in post-treatment hospitalisation status. Pharmacol Res 2020; 158:104899. [PMID: 32407959 PMCID: PMC7212963 DOI: 10.1016/j.phrs.2020.104899] [Citation(s) in RCA: 134] [Impact Index Per Article: 33.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 05/03/2020] [Accepted: 05/04/2020] [Indexed: 02/06/2023]
Abstract
SARS-CoV-2 is causing an increasing number of deaths worldwide because no effective treatment is currently available. Remdesivir has shown in vitro activity against coronaviruses and is a possible antiviral treatment for SARS-CoV-2 infection. This prospective (compassionate), open-label study of remdesivir, which was conducted at Luigi Sacco Hospital, Milan, Italy, between February 23 and March 20, 2020, involved patients with SARS-CoV-2 pneumonia aged ≥18 years undergoing mechanical ventilation or with an oxygen saturation level of ≤94 % in air or a National Early Warning Score 2 of ≥4. The primary outcome was the change in clinical status based on a 7-category ordinal scale (1 = not hospitalised, resuming normal daily activities; 7 = deceased). The 35 patients enrolled from February 23 to March 20, 2020, included 18 in intensive care unit (ICU), and 17 in our infectious diseases ward (IDW). The 10-day course of remdesivir was completed by 22 patients (63 %) and discontinued by 13, of whom eight (22.8 %) discontinued because of adverse events. The median follow-up was 39 days (IQR 25-44). At day 28, 14 (82.3 %) patients from IDW were discharged, two were still hospitalized and one died (5.9 %), whereas in ICU 6 (33.3 %) were discharged, 8 (44.4 %) patients died, three (16.7 %) were still mechanically ventilated and one (5.6 %) was improved but still hospitalized. Hypertransaminasemia and acute kidney injury were the most frequent severe adverse events observed (42.8 % and 22.8 % of the cases, respectively). Our data suggest that remdesivir can benefit patients with SARS-CoV-2 pneumonia hospitalised outside ICU where clinical outcome was better and adverse events are less frequently observed. Ongoing randomised controlled trials will clarify its real efficacy and safety, who to treat, and when.
Collapse
Affiliation(s)
- Spinello Antinori
- Luigi Sacco Department of Biomedical and Clinical Sciences, University of Milan, Italy; Department of Infectious Diseases, ASST Fatebenefratelli-Sacco, Milan, Italy.
| | | | - Anna Lisa Ridolfo
- Department of Infectious Diseases, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Roberto Rech
- Intensive Care Unit, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Cecilia Bonazzetti
- Luigi Sacco Department of Biomedical and Clinical Sciences, University of Milan, Italy
| | - Gabriele Pagani
- Luigi Sacco Department of Biomedical and Clinical Sciences, University of Milan, Italy
| | - Guido Gubertini
- Department of Infectious Diseases, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Massimo Coen
- Department of Infectious Diseases, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Carlo Magni
- Department of Infectious Diseases, ASST Fatebenefratelli-Sacco, Milan, Italy
| | | | - Beatrice Borghi
- Intensive Care Unit, ASST Fatebenefratelli-Sacco, Milan, Italy
| | | | - Riccardo Giorgi
- Department of Infectious Diseases, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Elena Angeli
- Department of Infectious Diseases, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Davide Mileto
- Diagnostic Services, Clinical Microbiology, Virology and Bioemergence Diagnostics, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Laura Milazzo
- Department of Infectious Diseases, ASST Fatebenefratelli-Sacco, Milan, Italy
| | | | | | - Mario Corbellino
- Department of Infectious Diseases, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Alessandro Torre
- Department of Infectious Diseases, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Stefano Rusconi
- Luigi Sacco Department of Biomedical and Clinical Sciences, University of Milan, Italy; Department of Infectious Diseases, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Letizia Oreni
- Department of Infectious Diseases, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Maria Rita Gismondo
- Diagnostic Services, Clinical Microbiology, Virology and Bioemergence Diagnostics, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Andrea Giacomelli
- Luigi Sacco Department of Biomedical and Clinical Sciences, University of Milan, Italy; Department of Infectious Diseases, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Luca Meroni
- Department of Infectious Diseases, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Giuliano Rizzardini
- Department of Infectious Diseases, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Massimo Galli
- Luigi Sacco Department of Biomedical and Clinical Sciences, University of Milan, Italy; Department of Infectious Diseases, ASST Fatebenefratelli-Sacco, Milan, Italy
| |
Collapse
|
50
|
Morena V, Milazzo L, Oreni L, Bestetti G, Fossali T, Bassoli C, Torre A, Cossu MV, Minari C, Ballone E, Perotti A, Mileto D, Niero F, Merli S, Foschi A, Vimercati S, Rizzardini G, Sollima S, Bradanini L, Galimberti L, Colombo R, Micheli V, Negri C, Ridolfo AL, Meroni L, Galli M, Antinori S, Corbellino M. Off-label use of tocilizumab for the treatment of SARS-CoV-2 pneumonia in Milan, Italy. Eur J Intern Med 2020; 76:36-42. [PMID: 32448770 PMCID: PMC7241995 DOI: 10.1016/j.ejim.2020.05.011] [Citation(s) in RCA: 132] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 05/05/2020] [Accepted: 05/06/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND Tocilizumab, a humanized monoclonal antibody, targets IL-6 receptors blocking downstream pro-inflammatory effects of IL-6. In preliminary reports it was suggested to be beneficial in patients with severe COVID-19. METHODS In this open-label prospective study we describe clinical characteristics and outcome of 51 patients hospitalized with confirmed and severe COVID-19 pneumonia treated with tocilizumab intravenously. All patients had elevated IL-6 plasma level (>40 pg/mL) and oxygen saturation <93% in ambient air. Clinical outcomes, oxygen support, laboratory data and adverse events were collected over a follow-up of 30 days. RESULTS Forty-five patients (88%) were on high-flow oxygen supplementation, six of whom with invasive ventilation. From baseline to day 7 after tocilizumab we observed a dramatic drop of body temperature and CRP value with a significant increase in lymphocyte count (p<0.001). Over a median follow-up time of 34 days from tocilizumab, 34 patients (67%) showed an improvement in their clinical severity class; 31 were discharged; 17 (33%) showed a worsening of their clinical status, of these 14 died (27%). The mortality rate was significantly associated with mechanical ventilation at baseline (83.3% vs 20% of patients on non-invasive oxygen support; p=0.0001). The most frequent side effects were an increase of hepatic enzymes (29%), thrombocytopenia (14%), and serious bacterial and fungal infections (27%). CONCLUSION Tocilizumab exerts a rapidly beneficial effect on fever and inflammatory markers, although no significant impact on the clinical outcome can be inferred by our results. Critically ill patients seem to have a high risk of serious infections with this drug.
Collapse
MESH Headings
- Antibodies, Monoclonal, Humanized/administration & dosage
- Antibodies, Monoclonal, Humanized/adverse effects
- Antiviral Agents/adverse effects
- Betacoronavirus/drug effects
- Betacoronavirus/isolation & purification
- COVID-19
- Coronavirus Infections/blood
- Coronavirus Infections/epidemiology
- Coronavirus Infections/physiopathology
- Coronavirus Infections/therapy
- Female
- Fever/diagnosis
- Fever/drug therapy
- Humans
- Italy/epidemiology
- Lymphocyte Count/methods
- Male
- Middle Aged
- Outcome and Process Assessment, Health Care
- Pandemics
- Pneumonia, Viral/blood
- Pneumonia, Viral/diagnosis
- Pneumonia, Viral/drug therapy
- Pneumonia, Viral/epidemiology
- Pneumonia, Viral/etiology
- Pneumonia, Viral/physiopathology
- Pneumonia, Viral/therapy
- Receptors, Interleukin-6/antagonists & inhibitors
- Respiration, Artificial/methods
- Respiratory Insufficiency/etiology
- Respiratory Insufficiency/therapy
- Retrospective Studies
- SARS-CoV-2
Collapse
Affiliation(s)
- Valentina Morena
- Luigi Sacco Department of Biomedical and Clinical Sciences, University of Milan, Italy
| | - Laura Milazzo
- Department of Infectious Diseases, ASST Fatebenefratelli Sacco, Milan, Italy.
| | - Letizia Oreni
- Department of Infectious Diseases, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Giovanna Bestetti
- Department of Infectious Diseases, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Tommaso Fossali
- Department of Anesthesiology and Intensive Care, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
| | - Cinzia Bassoli
- Luigi Sacco Department of Biomedical and Clinical Sciences, University of Milan, Italy
| | - Alessandro Torre
- Department of Infectious Diseases, ASST Fatebenefratelli Sacco, Milan, Italy
| | | | - Caterina Minari
- Department of Anesthesiology and Intensive Care, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
| | - Elisabetta Ballone
- Department of Anesthesiology and Intensive Care, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
| | - Andrea Perotti
- Department of Anesthesiology and Intensive Care, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
| | - Davide Mileto
- Microbiology, Virology and Bioemergence Diagnostics, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Fosca Niero
- Department of Infectious Diseases, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Stefania Merli
- Department of Infectious Diseases, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Antonella Foschi
- Department of Infectious Diseases, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Stefania Vimercati
- Clinical Pathology Laboratory, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Giuliano Rizzardini
- Department of Infectious Diseases, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Salvatore Sollima
- Department of Infectious Diseases, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Lucia Bradanini
- Luigi Sacco Department of Biomedical and Clinical Sciences, University of Milan, Italy
| | - Laura Galimberti
- Department of Infectious Diseases, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Riccardo Colombo
- Department of Anesthesiology and Intensive Care, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
| | - Valeria Micheli
- Microbiology, Virology and Bioemergence Diagnostics, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Cristina Negri
- Department of Infectious Diseases, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Anna Lisa Ridolfo
- Department of Infectious Diseases, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Luca Meroni
- Department of Infectious Diseases, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Massimo Galli
- Department of Infectious Diseases, ASST Fatebenefratelli Sacco, Milan, Italy; Luigi Sacco Department of Biomedical and Clinical Sciences, University of Milan, Italy
| | - Spinello Antinori
- Department of Infectious Diseases, ASST Fatebenefratelli Sacco, Milan, Italy; Luigi Sacco Department of Biomedical and Clinical Sciences, University of Milan, Italy
| | - Mario Corbellino
- Department of Infectious Diseases, ASST Fatebenefratelli Sacco, Milan, Italy
| |
Collapse
|