Outcome of COVID-19 patients with haematological malignancies after the introduction of vaccination and monoclonal antibodies. Results from the HM-COV 2.0 study

Patients with haematological malignancies (HM) and SARS-CoV-2 infection present a higher risk of severe COVID-19 and mortality. The aim of the study was to investigate whether vaccination and monoclonal antibodies (mAbs) have modified the outcomes of HM patients with COVID-19. This is a single-centre retrospective study in HM patients hospitalized due to SARS-CoV-2 infection from March 2020 to April 2022. Patients were divided into PRE-V-mAb group (patients hospitalized before the introduction of vaccination and mAbs) and POST-V-mAb group (patients hospitalized after the use of vaccine and mAbs). A total of 126 patients were included (65 PRE-V-mAb and 61 POST-V-mAb). POST-V-mAb patients showed a significantly lower risk of intensive care unit (ICU) admission (8.2% vs. 27.7%, p = 0.005), shorter viral shedding [17 (IQR 10–28) vs. 24 days (IQR 15–50), p = 0.011] and shorter hospitalization length [13 (IQR 7–23) vs. 20 (IQR 14–41) days, p = 0.0003] compared to the PRE-V-mAb group. Nevertheless, both in-hospital and 30-day mortality rates did not significantly differ between the two groups (29.5% POST-V-mAb vs. 36.9% PRE-V-mAb and 21.3% POST-V-mAb vs. 29.2% PRE-V-mAb, respectively). At the multivariable analysis, an active malignancy (p = 0.042), a critical COVID-19 at admission (p = 0.025) and the need for high-level of oxygen support at respiratory worsening [either HFNC/CPAP (p = 0.022) or mechanical ven- tilation (p = 0.011)] were independently associated with in-hospital mortality. In the subgroup of POST-V-mAb patients, receiving therapy with mAbs was a protective factor (p = 0.033). Despite the new therapeutic and preventive strategies avail- able, HM patients with COVID-19 disease represent an extremely vulnerable group with still high mortality rates

Association between PaO2/FiO2 ratio and thrombotic events in COVID-19 patients

PaO2/FiO(2) (P/F ratio) is considered a marker of hypoxia/hypoxemia and mortality. Several prothrombotic changes are associated with the decrease of P/F ratio. The role of P/F ratio in patients with arterial and venous thrombosis remains unclear. The aim of this study was to assess in patients with coronavirus disease 2019 (COVID-19), the association between P/F ratio and arterial/venous thrombosis. One thousand and four hundred and six COVID-19 patients were recruited; 289 (21%) patients had P/F ratio < 200 and 1117 (79%) >= 200. Compared to the patients with P/F ratio >= 200, those with P/F ratio < 200 were older and with higher levels of glycemia, D-dimer and lower levels of albumin. Multiple linear regression analysis showed that albumin (standardized coefficient beta: 0.156; SE: 0.001; p = 0.0001) and D-dimer (standardized coefficient beta: -0.135; SE: 0.0001; p = 0.0001) were associated with P/F ratio. During the hospitalization 159 patients were transferred in intensive care unit (ICU), 253 patients died, 156 patients had arterial or venous thrombotic events. A bivariate logistic analysis was performed to analyze the predictors of thrombosis in COVID-19 patients; P/F ratio < 200 (Odds Ratio: [OR] 1.718, 95% Confidence Interval [CI] 1.085-2.718, p = 0.021), albumin (OR 1.693, 95% CI 1.055-2.716, p = 0.029), D-dimer (OR 3.469, 95% CI 2.110-5.703, p < 0.0001), coronary artery disease (CAD) (OR 1.800, 95% CI 1.086-2.984, p = 0.023) and heart failure (OR 2.410 95% CI 1.385-4.193, p = 0.002) independently predicted thrombotic events in this population. This study suggests that the P/F ratio is associated with thrombotic events by promoting a hypercoagulation state in patients hospitalized for COVID-19

Prognostic Value of 12-Leads Electrocardiogram at Emergency Department in Hospitalized Patients with Coronavirus Disease-19

BackgroundElectrocardiogram (ECG) offers a valuable resource easily available in the emergency setting.ObjectiveAim of the study was to describe ECG alterations on emergency department (ED) presentation or that developed during hospitalization in SARS-CoV-2-infected patients and their association with 28-day mortality.MethodsA retrospective, single-center study including hospitalized patients with SARS-CoV-2 was conducted. ECG was recorded on ED admission to determine: heart rhythm, rate, and cycle; atrio-ventricular and intra-ventricular conduction; right ventricular strain; and ventricular repolarization. A specialized cardiologist blinded for the outcomes performed all 12-lead ECG analyses and their interpretation.Results190 patients were included, with a total of 24 deaths (12.6%). Age (p < 0.0001) and comorbidity burden were significantly higher in non-survivors (p < 0.0001). Atrial fibrillation (AF) was more frequent in non-survivors (p < 0.0001), alongside a longer QTc interval (p = 0.0002), a lower Tp-e/QTc ratio (p = 0.0003), and right ventricular strain (p = 0.013). Remdesivir administration was associated with bradycardia development (p = 0.0005) but no increase in mortality rates. In a Cox regression model, AF (aHR 3.02 (95% CI 1.03-8.81); p = 0.042), QTc interval above 451 ms (aHR 3.24 (95% CI 1.09-9.62); p = 0.033), and right ventricular strain (aHR 2.94 (95% CI 1.01-8.55); p = 0.047) were associated with higher 28-day mortality risk.ConclusionsQTc interval > 451 ms, right ventricular strain, and AF are associated with higher mortality risk in SARS-CoV-2 hospitalized patients. ECG recording and its appropriate analysis offers a simple, quick, non-expensive, and validated approach in the emergency setting to guide COVID-19 patients' stratification

NEUROLOGICAL COMPLICATIONS IN ADULT ALLOGENEIC HEMATOPOIETIC STEM CELL TRANSPLANT PATIENTS: RESULTS FROM A RETROSPECTIVE MULTICENTRE STUDY

Patients undergoing allogeneic hematopoietic stem cell transplant (HSCT) are exposed to a number of neurological complications that may be related to drugs, infections, metabolic alterations, cerebrovascular events and immune-\uadmediated disorders including myositis, myasthenia gravis, Guillain-\uadBarr\ue8-\uadlike demyelinating polyneuropathy and central nervous system (CNS) manifestations of graft versus host disease (GVHD). The multifactorial etiology of neurological complications in HSCT patients makes diagnosis difficult. However a timely and rigorous characterization of such complications should be obtained in the attempt to avoid fatal outcomes or long-\uadterm effects. Data regarding neurological complications in HSCT patients derives from small series and varies largely in respect to incidence and severity. Aim of this study is to describe incidence, characteristics and outcome of neurological complications in a large series of consecutive HSCT patients

Functionalization and use of grape stalks as poly(butylene succinate) (PBS) reinforcing fillers

Grape stalks are a lignocellulosic biomass, which is a very complex material, whose easy and profitable fractionation to obtain its basic components is still not available. Therefore, alternative ways to try and make use of grape stalks are currently being explored. In the present study, the possible use of dried and milled grape stalks as filler in bio-composites was assessed using polybutylene succinate as a basic polymer. The tensile specimens produced using 10% grape stalk powder as it is and functionalized through pre-extrusion acetylation and silylation, and silylation in situ were characterized for their structural, mechanical, thermal, morphological, and color properties. The bio-composites showed to be stiffer than the control polymer, with an increase of Young’s modulus from 616 MPa to 732 MPa in the specimens obtained with acetylated grape stalk powder. This led to a potentially new method to valorize by-products of the wine industry such as grape stalks in order to recover raw materials which could prove useful in the biomaterials and bio-composites sector

Grape stalk: a first attempt to disentangle its fibres via electrostatic separation

International audienceThe aim of the study was to assess the effectiveness of the electrostatic separation on fractionation and deconstruction of the grape stalks lignocellulosic biomass. After the measurements of their physical properties, the eight fractions obtained were extracted with hot water and then with hot 2% sulphuric acid.In aqueous extracts, the concentrations of glucose and fructose of samples collected in the jars under the positive electrode were as high as 13.5 and 11.6 g/100 g d.w., respectively. As for acid hydrolysis, the concentration of furfural and HMF were 1996–2600 and 144–291 mg/kg d.w., respectively.The results showed the opportunity of using grape stalks as a source of fermentable sugars, as well as a potential source of furanic compounds. This technique can represent a new and affordable method of lignocellulosic biomass pre-treatment which can easily be integrated into a biorefinery to favour partial fractionation and better exposure of the fractions to a subsequent enzymatic or chemical attack

The {HONEY}: a radially-compliant scaffold for osteochondral defects of a critical size

none9noneIzzo Daniela; Scalera Francesca; Palazzo Barbara; Cancelli Antonia Nadia; Scialla Stefania; Barca Amilcare; Sannino Alessandro; Peretti Giuseppe; Gervaso FrancescaIzzo, Daniela; Scalera, Francesca; Palazzo, Barbara; Cancelli, ANTONIA NADIA; Scialla, Stefania; Barca, Amilcare; Sannino, Alessandro; Peretti, Giuseppe; Gervaso, Francesc

Strategies to improve bioactivity of hydroxyapatite bone scaffolds

Two different approaches are proposed in this study to enhance the bioactivity of hydroxyapatite-based scaffolds for bone tissue regeneration. The first method consists in a structural modification of Hydroxyapatite (HA) through doping it with Magnesium (1,3% wt) while the second one in using HA in combination with a calcium silicate, i.e. Wollastonite (WS), to form a composite bioceramic. Scaffolds with high and strongly interconnected porosity (pores ranging from 300 to 800 µm) were produced throughout both procedures. Higher mechanical properties in compression were obtained when the composite Ws/HA bioceramic was adopted. That one showed a weight loss after 6 months in physiological solution seven times higher than doped HA. Preliminary in vitro tests highlighted that both kinds of scaffold allowed the adhesion of MG63, without significant differences in terms of vitality, indicating a good biocompatibility of both used biomaterials.</jats:p