Outpatient Testing for HIV in Italy, 2018–2023—Preliminary Data

Microorganisms, Год журнала: 2025, Номер 13(3), С. 655 - 655

Опубликована: Март 13, 2025

HIV testing is crucial towards the control of Acquired Immune Deficiency Syndrome (AIDS) epidemic. Monitoring trends human immunodeficiency virus (HIV) over time may help interpret incidence new diagnoses and effectiveness strategies. We started a research project aimed at assessing rates for infection among Italian outpatients in 2018–2023. Numeric data screening, confirmatory, monitoring tests obtained by national register were compared with numbers adult residents, newly diagnosed infections, patients undergoing treatment. The number screening declined from 1,133,377 2018 to 889,972 2020 increased 1,096,822 2023. HIV-RNA showed similar pattern, whereas confirmatory immunoblots did not vary significantly time. ratio residents was higher North-West (2.87%) North-East (2.31%) Italy South islands (1.47%), indicating that should be enhanced latter area. observed differences between infections geographic Discrepancies needed each diagnosis suggest repeated on people already possible reporting issues. regional levels can provide essential epidemiology plan relevant strategies

Язык: Английский

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Decoding the historical tale: COVID-19 impact on haematological malignancy patients—EPICOVIDEHA insights from 2020 to 2022

EClinicalMedicine, Год журнала: 2024, Номер 71, С. 102553 - 102553

Опубликована: Март 18, 2024

BackgroundThe COVID-19 pandemic heightened risks for individuals with hematological malignancies due to compromised immune systems, leading more severe outcomes and increased mortality. While interventions like vaccines, targeted antivirals, monoclonal antibodies have been effective the general population, their benefits these patients may not be as pronounced.MethodsThe EPICOVIDEHA registry (National Clinical Trials Identifier, NCT04733729) gathers data from malignancy since pandemic's start worldwide. It spans various global locations, allowing comprehensive analysis over first three years (2020–2022).FindingsThe collected January 2020 December 2022, involving 8767 cases in 152 centers across 41 countries, 42% being female. Over this period, there was a significant reduction critical infections an overall decrease mortality 29% 4%. However, hospitalization, particularly ICU, remained associated higher rates. Factors contributing included age, multiple comorbidities, active at onset, pulmonary symptoms, hospitalization. On positive side, vaccination one two doses or doses, well encountering were improved survival.InterpretationPatients still face elevated risks, despite reductions rates time. Hospitalization, especially ICUs, remains concern. The study underscores importance of timing exposure 2022 enhanced survival patient group. Ongoing monitoring are essential support vulnerable emphasizing role timely diagnosis prompt treatment preventing cases.FundingNot applicable.

Язык: Английский

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Examining potential Long COVID effects through utilization of healthcare resources: a retrospective, population-based, matched cohort study comparing individuals with and without prior SARS-CoV-2 infection

European Journal of Public Health, Год журнала: 2024, Номер 34(3), С. 592 - 599

Опубликована: Янв. 18, 2024

Abstract Background A significant proportion of individuals reports persistent clinical manifestations following SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) infection. Nevertheless, knowledge the burden this condition—often referred to as ‘Long COVID’—on health care system remains limited. This study aimed evaluate healthcare utilization potentially related Long COVID. Methods Population-based, retrospective, multi-center cohort that analyzed hospital admissions and outpatient visits diagnostic tests between adults aged 40 years older recovered from infection occurred February 2020 December 2021 matched unexposed during a 6-month observation period. Healthcare was by considering setting for [non-hospitalized, hospitalized intensive unit (ICU)-admitted] proxy severity epidemic phases characterized different variants. Data were retrieved regional administrative databases three Italian Regions. Results The final consisted 307 994 previously infected with uninfected individuals. Among exposed individuals, 92.2% not infection, 7.3% in non-ICU ward 0.5% admitted ICU. Individuals (vs. unexposed), especially those or ICU, reported higher (range pooled Incidence Rate Ratios across phases; non-hospitalized: 1.11–1.33, hospitalized: 1.93–2.19, ICU-admitted: 3.01–3.40), (non-hospitalized: 1.35–1.84, 2.86–3.43, 4.72–7.03) hospitalizations 1.00–1.52, 1.87–2.36, 4.69–5.38). Conclusions found associated increased use 6 months association mainly driven severity.

Язык: Английский

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Relative effectiveness of bivalent Original/Omicron BA.4-5 mRNA vaccine in preventing severe COVID-19 in persons 60 years and above during SARS-CoV-2 Omicron XBB.1.5 and other XBB sublineages circulation, Italy, April to June 2023

Eurosurveillance, Год журнала: 2023, Номер 28(32)

Опубликована: Авг. 10, 2023

During predominant circulation of SARS-CoV-2 Omicron XBB.1.5 and other XBB sublineages (April-June 2023), we found that a second or third booster Comirnaty bivalent Original/Omicron BA.4-5 mRNA vaccine, versus first received at least 120 days earlier, was effective in preventing severe COVID-19 for more than 6 months post-administration persons 60 years above. In view autumn 2023 vaccination campaigns, use vaccines might be warranted until monovalent targeting XBB.1 become available.

Язык: Английский

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Estimating SARS‐CoV‐2 infections and associated changes in COVID‐19 severity and fatality

Influenza and Other Respiratory Viruses, Год журнала: 2023, Номер 17(8)

Опубликована: Авг. 1, 2023

Abstract Background The difficulty in identifying SARS‐CoV‐2 infections has not only been the major obstacle to control COVID‐19 pandemic but also quantify changes proportion of resulting hospitalization, intensive care unit (ICU) admission, or death. Methods We developed a model transmission and vaccination informed by official estimates time‐varying reproduction number estimate that occurred Italy between February 2020 2022. Model outcomes were compared with Italian National surveillance data infection ascertainment ratio (IAR), hospitalization (IHR), ICU (IIR), fatality (IFR) five different sub‐periods associated dominance ancestral lineages Alpha, Delta, Omicron BA.1 variants. Results that, over first 2 years pandemic, IAR ranged 15% 40% (range 95%CI: 11%–61%), peak value second half 2020. IHR, IIR, IFR consistently decreased throughout 22–44‐fold reductions initial phase period. At end study period, we an IHR 0.24% (95%CI: 0.17–0.36), IIR 0.015% 0.011–0.023), 0.05% 0.04–0.08). Conclusions Since 2021, dominant variant, rollout, shift younger ages have reduced ascertainment. same factors, combined improvement patient management care, contributed massive reduction severity COVID‐19.

Язык: Английский

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Confounding amplifies the effect of environmental factors on COVID-19

Infectious Disease Modelling, Год журнала: 2024, Номер 9(4), С. 1163 - 1174

Опубликована: Июнь 21, 2024

The global COVID-19 pandemic has severely impacted human health and socioeconomic development, posing an enormous public challenge. Extensive research been conducted into the relationship between environmental factors transmission of COVID-19. However, numerous influence development outbreaks, presence confounding effects on mechanism action complicates assessment role in spread Direct estimation without removing will be biased. To overcome this critical problem, we developed a Double Machine Learning (DML) causal model to estimate debiased influencing outbreaks Chinese cities. Comparative experiments revealed that traditional multiple linear regression overestimated impact factors. Environmental are not dominant cause widespread China 2022. In addition, by further analyzing factors, it was verified there is significant heterogeneity effect changes with regional environment. It therefore recommended when exploring mechanisms which epidemics, must handled carefully order obtain clean quantitative results. This study offers more precise representation pandemic, as well framework for accurately quantifying outbreak.

Язык: Английский

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Risk of breakthrough infection and hospitalisation after COVID-19 primary vaccination by HIV status in four Italian regions during 2021

BMC Public Health, Год журнала: 2024, Номер 24(1)

Опубликована: Июнь 11, 2024

Abstract Background As of 2024, vaccination remains the main mitigation measure against COVID-19, but there are contradictory results on whether people living with HIV (PLWH) less protected by vaccines than without (PLWoH). In this study we compared risk SARS-CoV-2 infection and COVID-19 hospitalisation following full in PLWH PLWoH. Methods We linked data from registry, surveillance system healthcare/pharmacological registries four Italian regions. identified fully vaccinated (14 days post completion primary cycle) matched them at a ratio 1:4 PLWoH week vaccine administration, age, sex, region residence comorbidities. Follow-up started January 24, 2021, lasted for maximum 234 days. used Kaplan-Meier estimator to calculate cumulative incidence both groups, risks using differences ratios taking as reference group. Results 42,771 171,084 The overall breakthrough was similar groups rate (RR) 1.10 (95% confidence interval (CI):0.80–1.53). absolute difference between end period 8.28 events per 10,000 person-days group (95%CI:-18.43-40.29). There non-significant increase among (RR:1.90; 95%CI:0.93–3.32) which corresponds 6.73 hospitalisations individuals (95%CI: -0.57 14.87 10,000). Conclusions Our findings suggest were not increased or cycle mRNA vaccination.

Язык: Английский

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Exposure to obinutuzumab does not affect outcomes of SARS‐CoV‐2 infection in vaccinated patients with newly diagnosed advanced‐stage follicular lymphoma

British Journal of Haematology, Год журнала: 2024, Номер unknown

Опубликована: Июль 22, 2024

Summary URBAN is a multicentric, ambispective study evaluating the effectiveness and safety of obinutuzumab‐based immuno‐chemotherapy maintenance in patients with untreated advanced follicular lymphoma (FL). The began before COVID‐19 emergency declaration Italy. It currently ongoing for follow‐up, enrolment timeline encompassed different stages pandemic, various vaccination roll‐out phases prevalence SARS‐CoV‐2 variants. Outcomes interest present sub‐analysis included infection rates COVID‐19‐related hospitalizations/deaths. At data cut‐off, 86 (28.8%) 213 (71.2%) were treated during/after outbreak respectively; 294 (98.3%) completed induction, 31 (10.4%) 170 (56.9%) still on maintenance. Overall, 245 (81.9%) received at least one vaccine dose: 13.5%, 31.4% 55.1% one, two three doses respectively. We observed substantial decrease mortality pre‐ versus post‐vaccination phases, along reduction outcomes due to shift from alpha/delta omicron variant predominance. No differences emerged between given or not, although schedule was modified 65% cases. To our knowledge, represents largest dataset FL extensively exposed obinutuzumab. ClinicalTrials.gov identifier: NCT04034056.

Язык: Английский

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The impact of underreported infections on vaccine effectiveness estimates derived from retrospective cohort studies

International Journal of Epidemiology, Год журнала: 2024, Номер 53(3)

Опубликована: Апрель 11, 2024

Abstract Background Surveillance data and vaccination registries are widely used to provide real-time vaccine effectiveness (VE) estimates, which can be biased due underreported (i.e. under-ascertained under-notified) infections. Here, we investigate how the magnitude direction of this source bias in retrospective cohort studies vary under different circumstances, including levels underreporting, heterogeneities underreporting across vaccinated unvaccinated, pathogen circulation. Methods We developed a stochastic individual-based model simulating transmission dynamics respiratory virus large-scale campaign. Considering baseline scenario with 22.5% yearly attack rate 30% reporting ratio, explored fourteen alternative scenarios, each modifying one or more assumptions. Using synthetic individual-level surveillance produced by model, estimated VE against documented infection taking as reference either unvaccinated recently individuals (within 14 days post-administration). Bias was quantified comparing estimates known assumed model. Results were accurate when assuming homogeneous ratios, even at low (10%), moderate rates (<50%). A substantial downward estimation arose exceeding 50%. Mild ratios between strongly if cases likely reported upward otherwise, particularly individuals. Conclusions In observational studies, high differences may result estimates. This study underscores critical importance monitoring quality understanding biases adequately inform public health decisions.

Язык: Английский

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Complexity and Diversity of the Neurological Spectrum of SARS-CoV-2 over Three Waves of COVID-19

Journal of Clinical Medicine, Год журнала: 2024, Номер 13(12), С. 3477 - 3477

Опубликована: Июнь 14, 2024

Background/Objectives: SARS-CoV-2 continually mutates, with five identified variants. Many neurological manifestations were observed during the COVID-19 pandemic, differences between virus The aim of this study is to assess frequency and characteristics in hospitalized patients over three waves Poland comparison analysis correlation course infection. Methods: This retrospective single-center included 600 consecutive adults confirmed COVID-19, 3 (pre-Delta, Delta Omicron) Poland. Demographic clinical information collected compared across periods. Results: median age group was 68, lower wave. In Omicron period, disease severity at admission inflammatory markers concentration lowest. Neurological 49%. most common altered mentation, headache, myalgia, mood disorder, ischemic stroke encephalopathy. Smell taste disturbances (STDs) less frequent period. complications predominant pre-Delta Ischemic more often Altered mentation related higher admission, worse lab test results, ICU mortality, while headache reduced mortality. Pre-existing dementia Conclusions: are frequent, a rate STDs period cerebrovascular diseases Headache improves comorbidities increase

Язык: Английский

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