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Nicastri E, D'Abramo A, Faggioni G, De Santis R, Mariano A, Lepore L, Molinari F, Petralito G, Fillo S, Munzi D, Corpolongo A, Bordi L, Carletti F, Castiletti C, Colavita F, Lalle E, Bevilacqua N, Giancola ML, Scorzolini L, Lanini S, Palazzolo C, De Domenico A, Spinelli MA, Scognamiglio P, Piredda P, Iacomino R, Mone A, Puro V, Petrosillo N, Battistini A, Vairo F, Lista F, Ippolito G. Coronavirus disease (COVID-19) in a paucisymptomatic patient: epidemiological and clinical challenge in settings with limited community transmission, Italy, February 2020. Euro Surveill 2020; 25. [PMID: 32209164 PMCID: PMC7096776 DOI: 10.2807/1560-7917.es.2020.25.11.2000230] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [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] [Indexed: 12/18/2022] Open
Abstract
Data concerning the transmission of the novel severe acute respiratory syndrome coronavirus (SARS-CoV-2) in paucisymptomatic patients are lacking. We report an Italian paucisymptomatic case of coronavirus disease 2019 with multiple biological samples positive for SARS-CoV-2. This case was detected using the World Health Organization protocol on cases and contact investigation. Current discharge criteria and the impact of extra-pulmonary SARS-CoV-2 samples are discussed.
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Affiliation(s)
- Emanuele Nicastri
- National Institute for Infectious Diseases 'Lazzaro Spallanzani' IRCCS, Rome, Italy
- These authors contributed equally to this article and share first authorship
| | - Alessandra D'Abramo
- National Institute for Infectious Diseases 'Lazzaro Spallanzani' IRCCS, Rome, Italy
- These authors contributed equally to this article and share first authorship
| | | | | | - Andrea Mariano
- National Institute for Infectious Diseases 'Lazzaro Spallanzani' IRCCS, Rome, Italy
| | - Luciana Lepore
- National Institute for Infectious Diseases 'Lazzaro Spallanzani' IRCCS, Rome, Italy
| | | | | | - Silvia Fillo
- Scientific Department, Italian Army Medical Center, Rome, Italy
| | - Diego Munzi
- Scientific Department, Italian Army Medical Center, Rome, Italy
| | - Angela Corpolongo
- National Institute for Infectious Diseases 'Lazzaro Spallanzani' IRCCS, Rome, Italy
| | - Licia Bordi
- National Institute for Infectious Diseases 'Lazzaro Spallanzani' IRCCS, Rome, Italy
| | - Fabrizio Carletti
- National Institute for Infectious Diseases 'Lazzaro Spallanzani' IRCCS, Rome, Italy
| | - Concetta Castiletti
- National Institute for Infectious Diseases 'Lazzaro Spallanzani' IRCCS, Rome, Italy
| | - Francesca Colavita
- National Institute for Infectious Diseases 'Lazzaro Spallanzani' IRCCS, Rome, Italy
| | - Eleonora Lalle
- National Institute for Infectious Diseases 'Lazzaro Spallanzani' IRCCS, Rome, Italy
| | - Nazario Bevilacqua
- National Institute for Infectious Diseases 'Lazzaro Spallanzani' IRCCS, Rome, Italy
| | | | - Laura Scorzolini
- National Institute for Infectious Diseases 'Lazzaro Spallanzani' IRCCS, Rome, Italy
| | - Simone Lanini
- National Institute for Infectious Diseases 'Lazzaro Spallanzani' IRCCS, Rome, Italy
| | - Claudia Palazzolo
- National Institute for Infectious Diseases 'Lazzaro Spallanzani' IRCCS, Rome, Italy
| | | | | | - Paola Scognamiglio
- National Institute for Infectious Diseases 'Lazzaro Spallanzani' IRCCS, Rome, Italy
| | - Paolo Piredda
- Clinical Sciences Department, Italian Army Medical Center, Rome, Italy
| | - Raffaele Iacomino
- Clinical Sciences Department, Italian Army Medical Center, Rome, Italy
| | - Andrea Mone
- Clinical Sciences Department, Italian Army Medical Center, Rome, Italy
| | - Vincenzo Puro
- National Institute for Infectious Diseases 'Lazzaro Spallanzani' IRCCS, Rome, Italy
| | - Nicola Petrosillo
- National Institute for Infectious Diseases 'Lazzaro Spallanzani' IRCCS, Rome, Italy
| | | | - Francesco Vairo
- National Institute for Infectious Diseases 'Lazzaro Spallanzani' IRCCS, Rome, Italy
| | - Florigio Lista
- Scientific Department, Italian Army Medical Center, Rome, Italy
- These authors contributed equally to this article and share last authorship
| | - Giuseppe Ippolito
- National Institute for Infectious Diseases 'Lazzaro Spallanzani' IRCCS, Rome, Italy
- These authors contributed equally to this article and share last authorship
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Orgiano L, Cubeddu A, Camera S, Mascia R, Dessi M, Pedditzi E, Murru M, Piredda P, Barca M, Saba E, Palmas V, Camboni T, Massa E, Astara G, Manzin A, Madeddu C, Scartozzi M. CREAM study: Clinical correlation between immunotherapy-RElated clinical outcome and intestinal microbiote in metastatic patients. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.5_suppl.tps215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
TPS215 Background: It's known that composition of intestinal flora can influence the development of inflammatory gastrointestinal diseases, even though the association of inflammation with specific intestinal microbes is still unknown, because the inflammation and its treatment can change the composition of microbiote. Some bacterial species are essential to maintain the mucosal physiological tolerance, although species such as Bacteroides, Clostridium and Faecalibacterium can induce the up-regulation of T-cells and stimulate the production of anti-inflammatory cytokines. Innovative therapies such as anti-CTLA-4 antibody and inhibitors of the PD-1 receptor are particularly involved in the up-regulation of lymphocyte system: among their side effects, the most relevant are those immune-mediated such as hypophysitis, thyroiditis and colitis. In particular this last one usually occurs within 16weeks from the start of treatment: about one third of patients develop intestinal inflammation of any grade as a result of immune system dysregulation. So, the high incidence of colitis in patients treated with immunotherapy offers the possibility to characterize the intestinal microbiote before the development of immune-mediated inflammation. In addition, our curiosity has been oriented to the response to immunotherapy and the HLA class expressed by our patients: which any better predictor of response to immunological treatment than this one? Methods: Our is a single-center study of clinical and biological parameters prospectively stratified. Specifically, we collect from patients eligible for immunotherapy a blood sample to analyze HLA class and an other one to analyze serum cytokines levels, inflammatory indices and a sample of fecal material at baseline and at least after 3 administrations of treatment: actually we enrolled 34 out of 40 planned patients; we suppose to complete the enrollment in 2 months. According to preliminary data published in literature, we expect to find an alteration of intestinal microbiote in metastatic patients treated with immunotherapy. Once we'll identify it, we want to assess whether there is any correlation with the patient's clinical outcome.
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Affiliation(s)
- Laura Orgiano
- AOU Cagliari, Department of Medical Oncology, Monserrato, Italy
| | - Alessio Cubeddu
- Medical Oncology Department, University Hospital, University of Cagliari, Cagliari, Italy
| | | | - Roberta Mascia
- Medical Oncology Department, University Hospital, University of Cagliari, Cagliari, Italy
| | - Mariele Dessi
- Medical Oncology Department, University Hospital, University of Cagliari, Cagliari, Italy
| | | | | | | | | | | | | | | | - Elena Massa
- Medical Oncology Department, University Hospital, University of Cagliari, Cagliari, Italy
| | - Giorgio Astara
- Medical Oncology Department, University Hospital, University of Cagliari, Cagliari, Italy
| | | | - Clelia Madeddu
- Department of Internal Medical Sciences, Service of Medical Oncology, University of Cagliari, Cagliari, Italy
| | - Mario Scartozzi
- Medical Oncology Department, University Hospital, University of Cagliari, Cagliari, Italy
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Orgiano L, Cubeddu A, Mascia R, Lai E, Dessì M, Pedditzi E, Piredda P, Saba E, Palmas V, Camboni T, Massa E, Astara G, Manzin A, Madeddu C, Scartozzi M. CREAM study: Clinical correlation between immunotherapy-RElated colitis And intestinal Microbiote in metastatic patients. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx436.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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