Stuck Outside and Inside: An Exploratory Study on the Effects of the COVID-19 Outbreak on Italian Parents and Children\u2019s Internalizing Symptoms

The Covid-19 outbreak and the subsequent lockdown have profoundly impacted families\u2019 daily life, challenging their psychological resilience. Our study aimed to investigate the immediate psychological consequences of the pandemic on Italian parents and children focusing on internalizing and post-traumatic symptoms. We also wanted to explore the impact of possible risk and resilience factors, e.g., lifestyle and behaviors, emotional and cognitive beliefs, on parents and children\u2019s reaction to the emergency distress. An online survey was administered during the country\u2019s nationwide lockdown to 721 Italian parents of at least one child aged between 6 and 18 years. The respondent completed the survey for himself/herself and his/her child. The survey included socio-demographic items and validated questionnaires on parents\u2019 post-traumatic stress symptoms, depression and anxiety levels, and on children\u2019s internalizing problems. Parents were asked to fill the questionnaires twice: once referring to the current emergency condition and once recalling how they and their child felt a few months before Covid-19 outbreak. Multiple regression analyses showed that specific demographic characteristics (i.e., sex and age) and psychological factors of children and parents, such as fear of contagion and the opportunity to think about possible secondary positive effects of the pandemic, had a predictive value on the presence of internalizing symptoms of both parents and children. Moreover, parents\u2019 behaviors during the lockdown period (i.e., employment status and sport practiced) were significantly related to their own internalizing symptoms; these symptoms, in turn, had a strong and positive predictive value on children\u2019s internalizing problems. Besides, analyses of variance showed that internalizing symptoms of parents and children were significantly higher during the Covid-19 pandemic than before it started. In addition to showing a direct effect of the pandemic on the psychological health of parents and children, the present results also give a series of important information on how parents perceive, and therefore influence, their children in this period of emergency. Our findings thus highlight the urgent need to provide parents with adequate support to take care of their own psychological wellbeing and to help their children coping with the direct and indirect effects of the pandemic

The Impact of the COVID-19 Pandemic on Affect, Fear, and Personality of Primary School Children Measured During the Second Wave of Infections in 2020

In relation to the COVID-19 pandemic outbreak, a large body of research has identified a negative impact on individuals' affectivity, frequently documented by increased prevalence of anxiety and depression symptoms. For children, this research was less extensive, was mainly based on caregivers' reports and neglected personality assessment. In order to measure the impact of the pandemic, and the fears it caused, on primary school children's affect and personality, 323 (180 boys and 143 girls) Italian third, fourth and fifth graders were assessed between October and November 2020, namely during the second wave of COVID-19 infections in Italy, with validated self-reports of affect (Positive and Negative Affect Scale for Children, PANAS-C), fear of COVID-19 (Fear of COVID-19 Scale, FCV-19S) and personality (junior Temperament and Character Inventory, jTCI). In comparison with PANAS-C and jTCI normative scores collected prior to the pandemic, data obtained from children in 2020 showed unchanged affect scores in the overall sample, a decrease of Positive Affect in girls, and a decrease in the Harm Avoidance and an increase in the Self-Transcendence scales of personality. Fear of COVID-19 scores were positively correlated with Negative Affect scores and negatively predicted by children's personality profile of resilience (calculated using scores on the Harm Avoidance and the Self-Directedness scales of personality). These results suggested that Italian primary school children, especially boys, maintained their pre-pandemic levels of affect (or restored them after the first COVID-19 wave) and partially diverged from the typical development of personality in an apparently positive sense, namely toward more courageous/optimistic and spiritual profiles. This sort of children's post-traumatic growth might also be attributed to children's family and education systems, which should continue to be supported to promote and maintain community mental health

The assessment of IFN-gamma and its regulatory cytokines in the plasma and bronchoalveolar lavage fluid of patients with active pulmonary tuberculosis

OBJECTIVES: To assess the role of IFN-gamma and its regulatory cytokines in active pulmonary tuberculosis (TB). DESIGN: Cytokines were measured in the plasma of TB patients and healthy subjects with different risk for TB exposure. In addition, cytokine profile was assessed in the bronchoalveolar lavage fluid (BALf) of six TB patients and nine normal controls. RESULTS: Circulating IFN-gamma, IL-10 and IL-18 were higher in TB patients than in control groups. Plasma IL-12 levels were extremely variable, and no difference was observed among study groups. An inverse correlation between plasma IFN-gamma and IL-10 levels was found in TB patients. Furthermore, circulating IL-18 correlated with IL-10 but not with IFN-gamma levels. Finally, IFN-gamma, IL-18 and IL-12 were increased in the BALf of TB patients, whereas no difference was observed in IL-10 levels. CONCLUSIONS: In human TB, at least at certain disease stages, there is a differential compartmentalization of the IFN-gamma-regulatory factors IL-12 and IL-10, the former being concentrated in the lungs and the latter being present in peripheral circulation. In addition, our findings address more critically the role of IL-18 in the host response to tuberculosis infection in humans

Acute Chlamydia pneumoniae and Mycoplasma pneumoniae infections in community-acquired pneumonia and exacerbations of COPD or asthma: therapeutic considerations

Rates of acute Chlamydia pneumoniae and Mycoplasma pneumoniae infections were determined in 115 adults hospitalized for community-acquired pneumonia (CAP), purulent exacerbations of COPD and acute exacerbations of bronchial asthma, by means of serology and molecular methods. Results were compared with those obtained in a matched control group. Common respiratory pathogens were isolated by cultures in 22.5% and 22.2% of CAP and exacerbated COPD patients, respectively. Cultures from exacerbated asthma patients were always negative. Serological and molecular evidence of current C. pneumoniae infection was obtained in 10.0%, 8.9% and 3.3% of CAP, COPD and asthma cases. The corresponding rates of acute M. pneumoniae infection were 17.5%, 6.7% and 3.3%, respectively. Finally, no difference was found between typical and atypical pathogen rates. These findings highlight the importance of taking into account C. pneumoniae and M. pneumoniae infections in guiding the choice of empirical antibacterial treatment for CAP and purulent exacerbations of COPD

Evaluation with enzyme-linked immunosorbent assay spot detection of the frequency of interferon-gamma-producing T cells in bronchoalveolar lavage is useful in identifying lung transplant patients at higher risk of acute rejection.

ACUTE REJECTION (AR) of the graft is still an important clinical problem in lung transplanted patients despite an improvement of immunosuppressive regiments. The clinical importance of the prevention and early treatment of AR is due to its association with a higher morbidity and mortality and the subsequent development of chronic rejection: obliterans bronchiolitis. AR diagnosis is made based on histologic examination of multiple transbronchial biopsies. The cytologic analysis of broncho-alveolar lavage (BAL) has been evaluated as a potential diagnostic tool in lung transplant (Tx) but has revealed a clinical role only in the diagnosis of pulmonary infections

Cytokine profile of bronchoalveolar lavage in systemic sclerosis with interstitial lung disease: comparison with usual interstitial pneumonia

Interstitial lung disease (ILD), which often develops in systemic sclerosis (SSc), is associated with a better prognosis than idiopathic usual interstitial pneumonia (UIP) because only a limited number of patients with SSc progress to end stage fibrosis. Mechanisms driving the fibrotic evolution of ILD are still poorly understood, but, recently, on the basis of animal models, a pathogenetic role has been ascribed to an imbalance in the local Th1/Th2 response, with an expansion of the Th2 profile

Monocyte chemoattractant protein-1 levels in bronchoalveolar lavage fluid of lung-transplanted patients treated with tacrolimus as rescue treatment for refractory acute rejection

BACKGROUND: Cytokines are important mediators of the complex process of extravasation and influx of peripheral mononuclear cells into a site of graft injury, an action that may be affected by the immunosuppressive regimen. The aim of this study was to compare the effect of different immunosuppressive regimens on cytokine expression in the grafted lung. METHODS: We analyzed the cytokine profiles in broncho-alveolar lavage fluid (BAL-F) from 18 lung transplanted patients undergoing a shift from a cyclosporine- to a tacrolimus-based triple therapy regimen due to refractory acute rejection. RESULTS: Three months after the conversion to tacrolimus, BAL-F levels of interleukin 8 (IL8), IL18, IL12 and IL10 were not significantly different than those measured before conversion. In contrast, monocyte chemoattractant protein-1 (MCP-1) levels showed a significant and sustained decrease in BAL-F during tacrolimus therapy. In addition the levels of gamma interferon (IFN-gamma) in the BAL-F were decreased albeit not significantly. CONCLUSIONS: These findings suggest that the clinical and functional stabilization of patients observed after conversion to a tacrolimus based regimen, may be due, at least in part, to the induced down-regulation of MCP-1 production

BAL cytokine profile in different interstitial lung diseases: a focus on systemic sclerosis

Background and aim: Fibrosing alveolitis develops in up to 80% of systemic sclerosis patients (SSc) but progression to end stage fibrosis occurs in about 15% of cases. Mechanisms leading to the process remain mostly unknown. We compared cytokine profiles of broncho-alveolar lavage fluids (BAL-f) from patients with SSc associated interstitial lung disease (SSc-ILD) (n. 34), idiopathic pulmonary fibrosis (IPF) (n. 13), stage 11 sarcoidosis (n. 14) and 9 controls. Methods: Interleukin (IL) 8, monocyte chemoattractant protein I (MCP-1), gamma-interferon (IFN-gamma), IL12, IL18 and IL10 and transforming growth factor-beta (TGF-beta) were assessed by ELISA in concentrated BAL-f. Results: Levels of IL8 and MCP-1 were significantly elevated in SSc-ILD and in IPF as compared with controls (Mann Whitney test p < 0.05), while MCP-1 values were significantly lower in SSc-ILD than in IPF. A significant correlation between neutrophils and IL8 levels (p = 0.047), as well as between cosinophils and MCP-1 levels (p = 0.004) was also observed. IFN-gamma levels were slightly higher than normal only in sarcoidosis (p = 0.06), whereas IL12 levels increased both in sarcoidosis and SSc-ILD (p < 0.05). No differences were found in IL18 and TGF-beta levels. Finally, IL10 levels were higher in SSc-ILD and sarcoidosis than in controls and IPF (p < 0.05). Conclusion: BAL-f cytokine profile differentiates ILD associated with SSc from IPF. The lower expression of MCP-1 and the higher expression of the anti-fibrotic IL12 and the anti-inflammatory IL10, observed both in sarcoidosis and in SSc-ILD, could account for the better prognosis of these ILDs. Further longitudinal studies are required to confirm whether a different cytokine phenotype may be considered predictive of clinical outcome in SSc-ILD

Cytokine profile of broncho-alveolar lavage in BOOP and UIP

BACKGROUND: The aim of our study was to compare clinical and BAL features of patients with bronchiolitis obliterans organizing pneumonia (BOOP) with those of patients with usual interstitial pneumonia (UIP) and control subjects. PATIENTS AND METHODS: This study reports on 14 patients with idiopathic BOOP. Diagnosis was made upon histology. Lung function tests were mostly normal. Chest X-ray and CT showed always a patchy consolidation, often associated with ground glass pattern. BAL was performed for cytology and for ELISA assessment of several cytokines (IL8, ILI0, IL12, gamma-interferon, IL 18, monocyte chemoattractant protein- 1). RESULTS: Cytology of BAL in BOOP showed a pattern of lymphocytic alveolitis (Lymphocytes: 0.36 x 10(6)/ml) associated with an increase in neutrophil and eosinophil counts (0.13 and 0.04 x 10(6)/ml respectively). Mean BALf levels in pg/ml of MCP-1, IL12 and IL18 were significantly increased in BOOP with respect to controls and UIP patients, while in UIP patients only a significant increase of IL8, MCP-1 and IL18 with respect to controls was detected. In addition, BALf levels of IL10, an anti-inflammatory cytokine, were significantly higher in BOOP patients with respect to controls and UIP patients. CONCLUSION: These findings are consistent with a marked degree of macrophage and lymphocyte activation in BOOP with an expansion of T helper-1 response. The concomitant increase of IL10 could be related to a limitation of the inflammatory process and the fibrotic evolution typical of this clinical picture