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Curcio R, Paolucci F, Miano N, Pirera E, Monaco C. Should prothrombin complex concentrate be given to all patients with trauma at risk of massive transfusion? Intern Emerg Med 2024; 19:557-559. [PMID: 38114850 DOI: 10.1007/s11739-023-03485-4] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 11/07/2023] [Indexed: 12/21/2023]
Affiliation(s)
- Rosa Curcio
- Unit of Internal Medicine, ''Santa Maria'' University Hospital, P.Le Tristano Di Ioannuccio, 1, 05100, Terni, Italy.
| | - Fernanda Paolucci
- Department of Internal Medicine, Clinica Medica, AOUM, Ancona, Italy
| | - Nicoletta Miano
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Edoardo Pirera
- Department of Promoting Health, Maternal-Infant, Excellence and Internal and Specialized Medicine (Promise) G. D'Alessandro, University of Palermo, Palermo, Italy
| | - Cinzia Monaco
- General Medicine, IRCCS Sacro Cuore Don Calabria, Negrar, Verona, Italy
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2
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Pucci G, Curcio R, Muiesan ML. Hypertension diagnosis and control in Italy. Combining forces in the same direction. Intern Emerg Med 2023; 18:2165-2167. [PMID: 37777969 DOI: 10.1007/s11739-023-03437-y] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Accepted: 09/13/2023] [Indexed: 10/03/2023]
Affiliation(s)
- Giacomo Pucci
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy.
- Unit of Internal Medicine, Santa Maria University Hospital, Piazzale Tristano di Joannuccio, 1, IT-05100, Terni, Italy.
| | - Rosa Curcio
- Unit of Internal Medicine, Santa Maria University Hospital, Piazzale Tristano di Joannuccio, 1, IT-05100, Terni, Italy
| | - Maria Lorenza Muiesan
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
- Internal Medicine, ASST Spedali Civili of Brescia, Brescia, Italy
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3
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Curcio R, Poli G, Fabi C, Sugoni C, Pasticci MB, Ferranti R, Rossi M, Folletti I, Sanesi L, Santoni E, Dominioni I, Cavallo M, Morgana G, Mordeglia L, Luca G, Pucci G, Brancorsini S, Vaudo G. Exosomal miR-17-5p, miR-146a-3p, and miR-223-3p Correlate with Radiologic Sequelae in Survivors of COVID-19-Related Acute Respiratory Distress Syndrome. Int J Mol Sci 2023; 24:13037. [PMID: 37685844 PMCID: PMC10488112 DOI: 10.3390/ijms241713037] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 08/16/2023] [Accepted: 08/19/2023] [Indexed: 09/10/2023] Open
Abstract
We investigated the association between circulating microRNAs (miRNAs) potentially involved in the lung inflammatory process and fibrosis development among COVID-19-related acute respiratory distress syndrome (ARDS) survivors. At 4 ± 2 months from clinical recovery, COVID-19-related ARDS survivors matched for age, sex, and clinical characteristics underwent chest high-resolution computerized tomography (HRCT) and were selected based on imaging pattern evolution into fully recovered (N = normal), pulmonary opacities (PO) and fibrosis-like lesions (FL). Based on the previous literature, we performed plasma miRNA profiling of exosomal miRNAs belonging to the NLRP3-inflammasome platform with validated (miR-17-5p, miR-223-3p) and putative targets (miR-146a-5p), miRNAs involved in the post-transcriptional regulation of acute phase cytokines (miR128-3p, miR3168, miR125b-2-3p, miR106a-5p), miRNAs belonging to the NLRP4-inflammasome platform (miR-141-3p) and miRNAs related to post-transcriptional regulation of the fibrosis process (miR-21-5p). miR-17-5p, miR-223-3p, and miR-146a-5p were significantly down-regulated in patients with FL when compared to patients with PO. miR-146a-5p was also down-regulated in patients with FL than in N. The expression of the remaining miRNAs did not differ by group. In patients with long-term pulmonary radiological sequelae following COVID-19-related ARDS, a down-regulation of miR-17-5p, miR-146a-3p, and miR-223-3p correlated to fibrosis development in patients showing persistent hyper-reactivity to inflammatory stimulation. Our results support the hypothesis that NLRP3-Inflammasome could be implicated in the process of fibrotic evolution of COVID-19-associated ARDS.
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Affiliation(s)
- Rosa Curcio
- Unit of Internal Medicine, Santa Maria Terni Hospital, 05100 Terni, Italy
| | - Giulia Poli
- Department of Medicine and Surgery, University of Perugia, 06132 Perugia, Italy
| | - Consuelo Fabi
- Department of Medicine and Surgery, University of Perugia, 06132 Perugia, Italy
| | - Chiara Sugoni
- Department of Medicine and Surgery, University of Perugia, 06132 Perugia, Italy
| | - Maria Bruna Pasticci
- Department of Medicine and Surgery, University of Perugia, 06132 Perugia, Italy
- Infectious Diseases Unit, Santa Maria Terni Hospital, 05100 Terni, Italy
| | - Roberto Ferranti
- Unit of Radiology, Santa Maria Terni Hospital, 05100 Terni, Italy
| | - Monica Rossi
- Unit of Radiology, Santa Maria Terni Hospital, 05100 Terni, Italy
| | - Ilenia Folletti
- Department of Medicine and Surgery, University of Perugia, 06132 Perugia, Italy
- Section of Occupational Medicine, Santa Maria Terni Hospital, 05100 Terni, Italy
| | - Leandro Sanesi
- Unit of Internal Medicine, Santa Maria Terni Hospital, 05100 Terni, Italy
| | - Edoardo Santoni
- Unit of Internal Medicine, Santa Maria Terni Hospital, 05100 Terni, Italy
- Department of Medicine and Surgery, University of Perugia, 06132 Perugia, Italy
| | - Irene Dominioni
- Unit of Internal Medicine, Santa Maria Terni Hospital, 05100 Terni, Italy
- Department of Medicine and Surgery, University of Perugia, 06132 Perugia, Italy
| | | | - Giovanni Morgana
- Unit of Internal Medicine, Santa Maria Terni Hospital, 05100 Terni, Italy
- Department of Medicine and Surgery, University of Perugia, 06132 Perugia, Italy
| | - Lorenzo Mordeglia
- Unit of Internal Medicine, Santa Maria Terni Hospital, 05100 Terni, Italy
- Department of Medicine and Surgery, University of Perugia, 06132 Perugia, Italy
| | - Giovanni Luca
- Department of Medicine and Surgery, University of Perugia, 06132 Perugia, Italy
| | - Giacomo Pucci
- Unit of Internal Medicine, Santa Maria Terni Hospital, 05100 Terni, Italy
- Department of Medicine and Surgery, University of Perugia, 06132 Perugia, Italy
| | - Stefano Brancorsini
- Department of Medicine and Surgery, University of Perugia, 06132 Perugia, Italy
| | - Gaetano Vaudo
- Unit of Internal Medicine, Santa Maria Terni Hospital, 05100 Terni, Italy
- Department of Medicine and Surgery, University of Perugia, 06132 Perugia, Italy
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Airale L, Borrelli F, Arrivi A, Baracchi A, Bertacchini F, Cartella I, Curcio R, Izzo R, Lembo M, Mancusi C, Manzi MV, Milani M, Moreo A, Paini A, Pucci G, Ruscelli F, Salvetti M, Soldati M, Milan A. Ascending aorta dilatation is associated to hard cardiovascular events, follow-up from multicentric ARGO-Perspective project. Hypertens Res 2023; 46:2016-2023. [PMID: 37328694 DOI: 10.1038/s41440-023-01340-9] [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: 01/23/2023] [Revised: 04/30/2023] [Accepted: 05/18/2023] [Indexed: 06/18/2023]
Abstract
Aortic root dilatation has been proposed as hypertension-mediated organ damage (HMOD). Nevertheless, the role of the aortic root dilatation as a possible additional HMOD is still unclear since studies conducted so far are quite heterogeneous regarding the type of population analyzed, the aortic tract considered, and the type of outcomes accounted for. The aim of the present study is to assess whether the presence of aortic dilatation is associated with strong cardiovascular (CV) events (MACE: heart failure, CV death, stroke, acute coronary syndrome, myocardial revascularization) in a population of patients affected by essential hypertension. Four hundred forty-five hypertensive patients from six Italian hospitals were recruited as part of ARGO-SIIA study1. For all centers, follow-up was obtained by re-contacting all patients by telephone and through the hospital's computer system. Aortic dilatation (AAD) was defined through absolute sex-specific thresholds as in previous studies (41 mm for males, 36 mm for females). Median follow-up was 60 months. AAD was found to be associated with the occurrence of MACE (HR = 4.07 [1.81-9.17], p < 0.001). This result was confirmed after correction for main demographic characteristics such as age, sex and BSA (HR = 2.91 [1.18-7.17], p = 0.020). At penalized Cox regression, age, left atrial dilatation, left ventricular hypertrophy and AAD were identified as best predictor of MACEs and AAD resulted a significant predictor of MACEs even after correction for these confounders (HR = 2.43 [1.02-5.78], p = 0.045). The presence of AAD was found to be associated with an increased risk of MACE independently of for major confounders, including established HMODs. AAD ascending aorta dilatation, LAe left atrial enlargement, LVH left ventricular hypertrophy, MACEs major adverse cardiovascular events, SIIA Società Italiana dell'Ipertensione Arteriosa (Italian Society for Arterial Hypertension).
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Affiliation(s)
- Lorenzo Airale
- Department of Medical Sciences, Hypertension Center-University of Torino-AOU Città della Salute e della Scienza di Torino, Torino, Italy
| | - Francesco Borrelli
- Department of Medical Sciences, Hypertension Center-University of Torino-AOU Città della Salute e della Scienza di Torino, Torino, Italy
| | - Alessio Arrivi
- SC Medicina Interna, Azienda Ospedaliero-Universitaria di Terni, Terni, Italy
| | - Alessandro Baracchi
- Cardiothoracic and Vascular Department, S. Orsola-Malpighi University Hospital, Bologna, Italy
| | - Fabio Bertacchini
- Department of Internal Medicine, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Iside Cartella
- Echo Lab, Cardiologia IV, De Gasperis Department, ASST Niguarda Ca Granda e Dip Medicina e Chirurgia, Università Milano Bicocca, Milano, Italy
| | - Rosa Curcio
- SC Medicina Interna, Azienda Ospedaliero-Universitaria di Terni, Terni, Italy
| | - Raffaele Izzo
- Hypertension Research Center, Federico II University Hospital, Napoli, Italy
| | - Maria Lembo
- Hypertension Research Center, Federico II University Hospital, Napoli, Italy
| | - Costantino Mancusi
- Hypertension Research Center, Federico II University Hospital, Napoli, Italy
| | - Maria Virgina Manzi
- Hypertension Research Center, Federico II University Hospital, Napoli, Italy
| | - Martina Milani
- Echo Lab, Cardiologia IV, De Gasperis Department, ASST Niguarda Ca Granda e Dip Medicina e Chirurgia, Università Milano Bicocca, Milano, Italy
| | - Antonella Moreo
- Echo Lab, Cardiologia IV, De Gasperis Department, ASST Niguarda Ca Granda e Dip Medicina e Chirurgia, Università Milano Bicocca, Milano, Italy
| | - Anna Paini
- Department of Internal Medicine, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Giacomo Pucci
- SC Medicina Interna, Azienda Ospedaliero-Universitaria di Terni, Terni, Italy
| | - Federico Ruscelli
- Cardiothoracic and Vascular Department, S. Orsola-Malpighi University Hospital, Bologna, Italy
| | - Massimo Salvetti
- Department of Internal Medicine, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Mario Soldati
- Cardiothoracic and Vascular Department, S. Orsola-Malpighi University Hospital, Bologna, Italy
| | - Alberto Milan
- Department of Medical Sciences, Hypertension Center-University of Torino-AOU Città della Salute e della Scienza di Torino, Torino, Italy.
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Pucci G, Martina MR, Bianchini E, D’abbondanza M, Curcio R, Battista F, Anastasio F, Crapa ME, Sanesi L, Gemignani V, Vaudo G. Relationship between measures of adiposity, blood pressure and arterial stiffness in adolescents. The MACISTE study. J Hypertens 2023; 41:1100-1107. [PMID: 37071447 PMCID: PMC10241423 DOI: 10.1097/hjh.0000000000003433] [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: 10/01/2022] [Accepted: 03/06/2023] [Indexed: 04/19/2023]
Abstract
OBJECTIVE Children and adolescents with adiposity excess are at increased risk of future cardiovascular (CV) disease. Fat accumulation promotes the development of elevated blood pressure (BP) and arterial stiffness, two main determinants of CV risk which are strongly inter-related. We aimed at investigating whether the association between overweight and arterial stiffness, taken at different arterial segments, is mediated by increased BP or is BP-independent. METHODS Three hundred and twenty-two Italian healthy adolescents (mean age 16.9±1.4 years, 12% with overweight) attending the "G. Donatelli" High School in Terni, Italy, underwent measurement of arterial stiffness by arterial tonometry (aortic stiffness) and semiautomatical detection of pressure-volume ratio of the common carotid (carotid stiffness). The mediator effect of BP was tested for each anthropometric or biochemical measure of fat excess related to arterial stiffness. RESULTS Both carotid and aortic stiffness showed positive correlations with body mass index, waist, hip, and neck circumferences (NC). Only carotid stiffness, but not aortic stiffness, was associated with serum markers of fat accumulation and metabolic impairment such as insulin, homeostatic model of insulin resistance (HOMA-IR), serum gamma-glutamyl transferase (sGGT) and uric acid. The association with NC was stronger for carotid than for aortic stiffness (Fisher z -to- R 2.07, P = 0.04), and independent from BP. CONCLUSIONS In healthy adolescents, fat accumulation is associated with arterial stiffness. The degree of this association differs by arterial segments, since carotid stiffness is more strongly associated to adipose tissue excess than aortic stiffness and shows a BP-independent association with NC whereas aortic stiffness does not.
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Affiliation(s)
- Giacomo Pucci
- Department of Medicine and Surgery, University of Perugia – Unit of Internal Medicine, “Santa Maria” University Hospital, Terni
| | - Maria R. Martina
- Institute of Clinical Physiology, Italian National Research Council, Pisa
| | | | - Marco D’abbondanza
- Department of Medicine and Surgery, University of Perugia – Unit of Internal Medicine, “Santa Maria” University Hospital, Terni
| | - Rosa Curcio
- Department of Medicine and Surgery, University of Perugia – Unit of Internal Medicine, “Santa Maria” University Hospital, Terni
| | - Francesca Battista
- Sports and Exercise Medicine Division, Department of Medicine, University of Padova, Padova
| | | | - Mariano E. Crapa
- U.O. Medicina Interna, Asl Taranto, Presidio Ospedaliero Occidentale, Castellaneta, Italy
| | - Leandro Sanesi
- Department of Medicine and Surgery, University of Perugia – Unit of Internal Medicine, “Santa Maria” University Hospital, Terni
| | - Vincenzo Gemignani
- Institute of Clinical Physiology, Italian National Research Council, Pisa
| | - Gaetano Vaudo
- Department of Medicine and Surgery, University of Perugia – Unit of Internal Medicine, “Santa Maria” University Hospital, Terni
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Pucci G, D'Abbondanza M, Curcio R, Alcidi R, Campanella T, Chiatti L, Arrivi A, Bisogni V, Veca V, Vaudo G. Importance of central BP assessment in ISH of the young. Which devices are best suited for practical use? Minerva Med 2022; 113:779-787. [PMID: 35266660 DOI: 10.23736/s0026-4806.22.07940-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Isolated systolic hypertension (ISH), defined as brachial systolic blood pressure (bSBP) ≥140 mmHg and diastolic blood pressure (DBP) <90 mmHg, is highly prevalent among young subjects and in the elderly. The prognostic significance of ISH in young individuals remains the object of large debate which might be solved, at least in part, if considering the prognostic role of central BP. For any given value of pBP, the cardiovascular (CV) risk is better defined by central BP (cBP). Young individuals with ISH have long been considered at low CV risk, given the assumption that a "spurious hypertension" phenotype characterized by elevated peripheral (brachial) BP (pBP), normal cBP, and elevated BP amplification was often found in this population. However, this remains to be proven, because many other studies found no differences in BP amplification between ISH and sisto-diastolic hypertension. Despite numerous attempts, methodologies for cBP assessment by non-invasive devices are currently not standardized. As a result, different devices could provide different cBP values despite using the same biological signals. Devices providing accurate estimates of BP amplification as a dimensionless ratio between amplitudes of central and peripheral arterial waveforms might be well suited for clinical purposes in young individuals with ISH. There is urgent need of well-designed prospective studies aiming at longitudinally evaluating the amount of CV risk associated with elevated cBP in young subjects with ISH and their related incremental prognostic value.
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Affiliation(s)
- Giacomo Pucci
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy - .,Unit of Internal Medicine, S. Maria University Hospital, Terni, Italy -
| | - Marco D'Abbondanza
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy.,Unit of Internal Medicine, S. Maria University Hospital, Terni, Italy
| | - Rosa Curcio
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy.,Unit of Internal Medicine, S. Maria University Hospital, Terni, Italy
| | - Riccardo Alcidi
- Unit of Internal Medicine, S. Maria University Hospital, Terni, Italy
| | - Tommaso Campanella
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy.,Unit of Internal Medicine, S. Maria University Hospital, Terni, Italy
| | - Lorenzo Chiatti
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy.,Unit of Internal Medicine, S. Maria University Hospital, Terni, Italy
| | - Alessio Arrivi
- Unit of Cardiology, S. Maria University Hospital, Terni, Italy
| | - Valeria Bisogni
- Unit of Internal Medicine, S. Maria University Hospital, Terni, Italy
| | - Vito Veca
- Unit of Internal Medicine, S. Maria University Hospital, Terni, Italy
| | - Gaetano Vaudo
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy.,Unit of Internal Medicine, S. Maria University Hospital, Terni, Italy
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Pucci G, D'Abbondanza M, Curcio R, Alcidi R, Campanella T, Chiatti L, Gandolfo V, Veca V, Casarola G, Leone MC, Rossi R, Alberti A, Sanesi L, Cavallo M, Vaudo G. Handgrip strength is associated with adverse outcomes in patients hospitalized for COVID-19-associated pneumonia. Intern Emerg Med 2022; 17:1997-2004. [PMID: 35930184 PMCID: PMC9362345 DOI: 10.1007/s11739-022-03060-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Accepted: 07/18/2022] [Indexed: 12/25/2022]
Abstract
Handgrip strength (HGS), a simple tool for the evaluation of muscular strength, is independently associated with negative prognosis in many diseases. It is unknown whether HGS is prognostically relevant in COVID-19. We evaluated the ability of HGS to predict clinical outcomes in people with COVID-19-related pneumonia. 118 patients (66% men, 63 ± 12 years), consecutively hospitalized to the "Santa Maria" Terni University Hospital for COVID-19-related pneumonia and respiratory failure, underwent HGS measurement (Jamar hand-dynamometer) at ward admission. HGS was normalized to weight2/3 (nHGS) The main end-point was the first occurrence of death and/or endotracheal intubation at 14 days. Twenty-two patients reached the main end-point. In the Kaplan-Meyer analysis, the Log rank test showed significant differences between subjects with lower than mean HGS normalized to weight2/3 (nHGS) (< 1.32 kg/Kg2/3) vs subjects with higher than mean nHGS. (p = 0.03). In a Cox-proportional hazard model, nHGS inversely predicted the main end-point (hazard ratio, HR = 1.99 each 0.5 kg/Kg2/3 decrease, p = 0.03), independently from age, sex, body mass index, ratio of partial pressure arterial oxygen and fraction of inspired oxygen (PaO2/FiO2 ratio), hypertension, diabetes, estimated glomerular filtration rate and history of previous cardiovascular cardiovascular disease. These two latter also showed independent association with the main end-point (HR 1.30, p = 0.03 and 3.89, p < 0.01, respectively). In conclusion, nHGS measured at hospital admission, independently and inversely predicts the risk of poor outcomes in people with COVID-19-related pneumonia. The evaluation of HGS may be useful in early stratifying the risk of adverse prognosis in COVID-19.
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Affiliation(s)
- Giacomo Pucci
- Department of Medicine and Surgery, University of Perugia, Unit of Internal Medicine, Terni University Hospital, Piazzale Tristano Di Joannuccio, 1, T05100, Terni, Italy.
- COVID Unit, Terni University Hospital, Terni, Italy.
| | - Marco D'Abbondanza
- Department of Medicine and Surgery, University of Perugia, Unit of Internal Medicine, Terni University Hospital, Piazzale Tristano Di Joannuccio, 1, T05100, Terni, Italy
- COVID Unit, Terni University Hospital, Terni, Italy
| | - Rosa Curcio
- Department of Medicine and Surgery, University of Perugia, Unit of Internal Medicine, Terni University Hospital, Piazzale Tristano Di Joannuccio, 1, T05100, Terni, Italy
- COVID Unit, Terni University Hospital, Terni, Italy
| | - Riccardo Alcidi
- Department of Medicine and Surgery, University of Perugia, Unit of Internal Medicine, Terni University Hospital, Piazzale Tristano Di Joannuccio, 1, T05100, Terni, Italy
- COVID Unit, Terni University Hospital, Terni, Italy
| | - Tommaso Campanella
- Department of Medicine and Surgery, University of Perugia, Unit of Internal Medicine, Terni University Hospital, Piazzale Tristano Di Joannuccio, 1, T05100, Terni, Italy
- COVID Unit, Terni University Hospital, Terni, Italy
| | - Lorenzo Chiatti
- Department of Medicine and Surgery, University of Perugia, Unit of Internal Medicine, Terni University Hospital, Piazzale Tristano Di Joannuccio, 1, T05100, Terni, Italy
- COVID Unit, Terni University Hospital, Terni, Italy
| | - Vito Gandolfo
- Department of Medicine and Surgery, University of Perugia, Unit of Internal Medicine, Terni University Hospital, Piazzale Tristano Di Joannuccio, 1, T05100, Terni, Italy
- COVID Unit, Terni University Hospital, Terni, Italy
| | - Vito Veca
- Department of Medicine and Surgery, University of Perugia, Unit of Internal Medicine, Terni University Hospital, Piazzale Tristano Di Joannuccio, 1, T05100, Terni, Italy
- COVID Unit, Terni University Hospital, Terni, Italy
| | - Genni Casarola
- Department of Medicine and Surgery, University of Perugia, Unit of Internal Medicine, Terni University Hospital, Piazzale Tristano Di Joannuccio, 1, T05100, Terni, Italy
- COVID Unit, Terni University Hospital, Terni, Italy
| | - Maria Comasia Leone
- Department of Medicine and Surgery, University of Perugia, Unit of Internal Medicine, Terni University Hospital, Piazzale Tristano Di Joannuccio, 1, T05100, Terni, Italy
- COVID Unit, Terni University Hospital, Terni, Italy
| | - Rachele Rossi
- Department of Medicine and Surgery, University of Perugia, Unit of Internal Medicine, Terni University Hospital, Piazzale Tristano Di Joannuccio, 1, T05100, Terni, Italy
- COVID Unit, Terni University Hospital, Terni, Italy
| | - Alessio Alberti
- Department of Medicine and Surgery, University of Perugia, Unit of Internal Medicine, Terni University Hospital, Piazzale Tristano Di Joannuccio, 1, T05100, Terni, Italy
- COVID Unit, Terni University Hospital, Terni, Italy
| | - Leandro Sanesi
- Department of Medicine and Surgery, University of Perugia, Unit of Internal Medicine, Terni University Hospital, Piazzale Tristano Di Joannuccio, 1, T05100, Terni, Italy
- COVID Unit, Terni University Hospital, Terni, Italy
| | - Massimiliano Cavallo
- Department of Medicine and Surgery, University of Perugia, Unit of Internal Medicine, Terni University Hospital, Piazzale Tristano Di Joannuccio, 1, T05100, Terni, Italy
- COVID Unit, Terni University Hospital, Terni, Italy
| | - Gaetano Vaudo
- Department of Medicine and Surgery, University of Perugia, Unit of Internal Medicine, Terni University Hospital, Piazzale Tristano Di Joannuccio, 1, T05100, Terni, Italy
- COVID Unit, Terni University Hospital, Terni, Italy
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8
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Curcio R, Gandolfo V, Alcidi R, Giacomino L, Campanella T, Casarola G, Rossi R, Chiatti L, D'abbondanza M, Commissari R, Gresele P, Pucci G, Vaudo G. VACCINE-INDUCED MASSIVE PULMONARY EMBOLISM AND THROMBOCYTOPENIA FOLLOWING A SINGLE DOSE OF JANSSEN AD26.COV2.S VACCINATION. Int J Infect Dis 2022; 116:154-156. [PMID: 34986404 PMCID: PMC8720302 DOI: 10.1016/j.ijid.2021.12.345] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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: 08/16/2021] [Revised: 12/01/2021] [Accepted: 12/18/2021] [Indexed: 12/01/2022] Open
Abstract
Vaccine-induced immune thrombotic thrombocytopenia (VITT) has emerged as a rare side effect of adenoviral vector-based vaccines against Coronavirus disease 2019 (COVID-19), and it is most frequently reported after Vaxzevria (AstraZeneca) vaccine. We described a case of severe thrombocytopenia associated with massive pulmonary embolism and portal vein thrombosis, occurring 13 days after the administration of the single dose adeno viral vector-based vaccine Ad26.COV2.S (Janssen vaccines, Leiden, Netherlands). Based on an early clinical suspect, the patient quickly received treatment with corticosteroids and intravenous immunoglobulins, followed by a rapid increase in platelet count that allowed full dose anticoagulation to be timely administered. Treatment with intravenous immunoglobulins, however, could mask the ability of anti-PF4-heparin antibodies to bind and activate platelets in the presence of heparin, leading to false negative results at the immunoassay functional test. Therefore, if VITT is suspected, blood samples for diagnostic confirmation should be collected prior to any treatment to improve diagnostic performance.
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Affiliation(s)
- Rosa Curcio
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy; Unit of Internal Medicine, "Santa Maria" Terni University Hospital, Terni, Italy
| | - Vito Gandolfo
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy; Unit of Internal Medicine, "Santa Maria" Terni University Hospital, Terni, Italy
| | - Riccardo Alcidi
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy; Unit of Internal Medicine, "Santa Maria" Terni University Hospital, Terni, Italy
| | - Luciano Giacomino
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy; Unit of Emergency, "Santa Maria" Terni University Hospital, Terni, Italy
| | - Tommaso Campanella
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy; Unit of Internal Medicine, "Santa Maria" Terni University Hospital, Terni, Italy
| | - Genni Casarola
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy; Unit of Internal Medicine, "Santa Maria" Terni University Hospital, Terni, Italy
| | - Rachele Rossi
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy; Unit of Internal Medicine, "Santa Maria" Terni University Hospital, Terni, Italy
| | - Lorenzo Chiatti
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy; Unit of Internal Medicine, "Santa Maria" Terni University Hospital, Terni, Italy
| | - Marco D'abbondanza
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy; Unit of Internal Medicine, "Santa Maria" Terni University Hospital, Terni, Italy
| | - Rita Commissari
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy; Unit of Emergency, "Santa Maria" Terni University Hospital, Terni, Italy
| | - Paolo Gresele
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Giacomo Pucci
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy; Unit of Internal Medicine, "Santa Maria" Terni University Hospital, Terni, Italy.
| | - Gaetano Vaudo
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy; Unit of Internal Medicine, "Santa Maria" Terni University Hospital, Terni, Italy
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9
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Anastasio F, LA Macchia T, Rossi G, D'Abbondanza M, Curcio R, Vaudo G, Pucci G. Mid-term impact of mild-moderate COVID-19 on cardiorespiratory fitness in élite athletes. J Sports Med Phys Fitness 2021; 62:1383-1390. [PMID: 34758007 DOI: 10.23736/s0022-4707.21.13226-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Mid- and long-term sequelae of COVID-19 on cardiorespiratory fitness are unknown. Aim of the study was to assess the mid-term impact of mild-moderate COVID-19 on cardiorespiratory fitness evaluated by cardiopulmonary exercise testing (CPET) in élite athletes. METHODS 13 elite cross-country skiers with previous mild-moderate COVID-19 symptoms underwent CPET before resuming seasonal training (COVID athletes). 13 élite detrained cross-country skiers, matched for principal confounding factors, were taken as controls (control group). Resting peripheral oxygen saturation, pulmonary function test, echocardiography, bioelectrical impedance analysis and CPET (modified XELG2, Woodway, USA) were performed in all participants. RESULTS Median recovery time in COVID athletes was 34 days (IQR 33-38 days). COVID athletes reached earlier the onset of the aerobic threshold (4'48" vs 6'28", R2=0.15, F=4.37, p<0.05)than controls, whereas the time to anaerobic threshold and maximal efforts did not significantly differ between groups. Oxygen consumption was lower at the aerobic threshold in COVID athletes than controls (VO2/kg 28.6 mL/min vs. 38.9 mL/min, R2=0.39, F=15.34, p<0.01), whereas no significant difference between groups was found both at the aerobic threshold and at peak exercise (all p<0.05). Findings from resting echocardiography and pulmonary function test were similar between the two groups. CONCLUSIONS Élite cross-country athletes, previously affected by mild-moderate COVID-19, reached earlier the aerobic threshold than controls, whereas the remaining CPET parameters did not differ between groups. Such changes were not associated with any detectable difference in resting pulmonary and cardiac examination. Subjects affected by mild-moderate COVID-19 may require a longer time course of re-adaptation to aerobic exercise.
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Affiliation(s)
- Fabio Anastasio
- ASLCN1, Cardiology Unit, Hospital of Mondovì, Mondovì, Cuneo, Italy -
| | | | - Giulio Rossi
- ASST Valtellina and Alto Lario, Sport Medicine, Eugenio Morelli Hospital, Sondalo, Sondrio, Italy
| | - Marco D'Abbondanza
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy.,Unit of Internal Medicine, Terni University Hospital, Terni, Italy
| | - Rosa Curcio
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy.,Unit of Internal Medicine, Terni University Hospital, Terni, Italy
| | - Gaetano Vaudo
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy.,Unit of Internal Medicine, Terni University Hospital, Terni, Italy
| | - Giacomo Pucci
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy.,Unit of Internal Medicine, Terni University Hospital, Terni, Italy
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10
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Casarola G, D'Abbondanza M, Curcio R, Alcidi R, Campanella T, Rossi R, Fusaro J, Gandolfo V, Di Giuli C, Laoreti C, Veca V, Leone MC, Pucci G, Vaudo G. Efficacy of convalescent plasma therapy in immunocompromised patients with COVID-19: A case report. Clin Infect Pract 2021; 12:100096. [PMID: 34490417 PMCID: PMC8408049 DOI: 10.1016/j.clinpr.2021.100096] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 05/15/2021] [Revised: 08/25/2021] [Accepted: 08/26/2021] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Management of immunocompromised COVID-19 patients is the object of current debate. Accumulating evidence suggest that treatment with high-titer COVID-19 convalescent plasma (CCP) may be effective in this characteristic clinical scenario. CASE REPORT A 52-years old immunocompromised female patient, previously treated with rituximab for low grade B-cell lymphoma, showed prolonged SARS-CoV-2 shedding and a long-term course of signs of severe COVID-19. A first cycle of treatment with remdesivir, a nucleotide analogue prodrug effective in inhibiting SARS-CoV-2 replication, did not provide fully and sustained clinical remission. A second hospitalization was deemed necessary after 10 days from the first hospital discharge due to recrudescence of symptoms of severe COVID-19 and the evidence of bilateral interstitial pneumonia at the chest-CT scan. Clinical and radiological findings completely disappeared after CCP administration. The viral culture confirmed the absence of SARS-CoV-2-related cytopathic effect. The clinical evaluation, performed two months after hospital discharge, was unremarkable. RESULTS Findings from our case report suggest that the host T-cell specific response to SARS-CoV-2 is not sufficient to reduce viral load in the absence of neutralizing antibodies. Acquired immune antibodies and/or related components passively infused with CCP might help in boosting the plasma recipient response to the virus and promoting complete viral clearance. CONCLUSIONS Independently from negative results in immunocompetent individuals, the potential effectiveness of CCP infusion in selected cohorts of patients with primary or secondary impaired immune response should be tested. Further research about mechanisms of host response in immunocompromised patients with SARS-CoV-2 infection is required.
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Affiliation(s)
- Genni Casarola
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy,COVID-1 Unit, Terni University Hospital, Terni, Italy
| | - Marco D'Abbondanza
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy,COVID-1 Unit, Terni University Hospital, Terni, Italy
| | - Rosa Curcio
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy,COVID-1 Unit, Terni University Hospital, Terni, Italy
| | - Riccardo Alcidi
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy,COVID-1 Unit, Terni University Hospital, Terni, Italy
| | - Tommaso Campanella
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy,COVID-1 Unit, Terni University Hospital, Terni, Italy
| | - Rachele Rossi
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy,COVID-1 Unit, Terni University Hospital, Terni, Italy
| | - Jessica Fusaro
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy,Unit of Internal Medicine, “S.Maria della Misericordia” University Hospital, Perugia
| | - Vito Gandolfo
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy,COVID-1 Unit, Terni University Hospital, Terni, Italy
| | - Cinzia Di Giuli
- Clinical Infectious Disease, Terni University Hospital, Terni, Italy
| | - Chiara Laoreti
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy,Unit of Internal Medicine, “S.Maria della Misericordia” University Hospital, Perugia
| | - Vito Veca
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy,COVID-1 Unit, Terni University Hospital, Terni, Italy
| | - Maria Comasia Leone
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy,COVID-1 Unit, Terni University Hospital, Terni, Italy
| | - Giacomo Pucci
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy,COVID-1 Unit, Terni University Hospital, Terni, Italy,Corresponding author at: Department of Medicine and Surgery, University of Perugia, Unit of Internal Medicine, Terni University Hospital, Piazzale Tristano di Joannuccio, 1, IT-05100 Terni, Italy
| | - Gaetano Vaudo
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy,COVID-1 Unit, Terni University Hospital, Terni, Italy
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11
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Filipazzi V, Dalu D, Isabella L, Tosca N, Ferrario S, Gambaro A, Somma L, Fasola C, Pellegrini I, Bombonati G, Curcio R, Damiani E, Cattaneo M. Efficacy and safety of Nab-paclitaxel plus gemcitabine in metastatic pancreatic cancer. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx425.030] [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: 11/13/2022] Open
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12
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Cappello A, Dolce V, Iacopetta D, Martello M, Fiorillo M, Curcio R, Muto L, Dhanyalayam D. Bergamot (Citrus bergamia Risso) Flavonoids and Their Potential Benefits in Human Hyperlipidemia and Atherosclerosis: an Overview. Mini Rev Med Chem 2016; 16:619-29. [DOI: 10.2174/1389557515666150709110222] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2014] [Revised: 03/06/2015] [Accepted: 07/05/2015] [Indexed: 11/22/2022]
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13
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Curcio R, Nicoli R, Rudaz S, Veuthey JL. Evaluation of an in-capillary approach for performing quantitative cytochrome P450 activity studies. Anal Bioanal Chem 2010; 398:2163-71. [DOI: 10.1007/s00216-010-4175-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2010] [Revised: 08/25/2010] [Accepted: 08/29/2010] [Indexed: 11/28/2022]
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14
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Cecchini M, Curcio R, Pappalardo M, Melki R, Caflisch A. A molecular dynamics approach to the structural characterization of amyloid aggregation. J Mol Biol 2006; 357:1306-21. [PMID: 16483608 DOI: 10.1016/j.jmb.2006.01.009] [Citation(s) in RCA: 71] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2005] [Revised: 11/21/2005] [Accepted: 01/04/2006] [Indexed: 10/25/2022]
Abstract
A novel computational approach to the structural analysis of ordered beta-aggregation is presented and validated on three known amyloidogenic polypeptides. The strategy is based on the decomposition of the sequence into overlapping stretches and equilibrium implicit solvent molecular dynamics (MD) simulations of an oligomeric system for each stretch. The structural stability of the in-register parallel aggregates sampled in the implicit solvent runs is further evaluated using explicit water simulations for a subset of the stretches. The beta-aggregation propensity along the sequence of the Alzheimer's amyloid-beta peptide (Abeta(42)) is found to be highly heterogeneous with a maximum in the segment V(12)HHQKLVFFAE(22) and minima at S(8)G(9), G(25)S(26), G(29)A(30), and G(38)V(39), which are turn-like segments. The simulation results suggest that these sites may play a crucial role in determining the aggregation tendency and the fibrillar structure of Abeta(42). Similar findings are obtained for the human amylin, a 37-residue peptide that displays a maximal beta-aggregation propensity at Q(10)RLANFLVHSSNN(22) and two turn-like sites at G(24)A(25) and G(33)S(34). In the third application, the MD approach is used to identify beta-aggregation "hot-spots" within the N-terminal domain of the yeast prion Ure2p (Ure2p(1-94)) and to design a double-point mutant (Ure2p-N4748S(1-94)) with lower beta-aggregation propensity. The change in the aggregation propensity of Ure2p-N4748S(1-94) is verified in vitro using the thioflavin T binding assay.
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Affiliation(s)
- M Cecchini
- Department of Biochemistry, University of Zurich, Winterthurerstrasse 190, CH-8057 Zurich, Switzerland
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15
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Cristaldi R, Bonaventura S, Branca S, Curcio R. [Effects of cigarette smoke on non esterified fatty acids of the plasma in normal subjects and in coronary disease patients]. Boll Soc Ital Cardiol 1965; 10:245-250. [PMID: 5830330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
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