Unusual aspects of the SARS-CoV-2 pandemic. From the development of a new protocol for reviving virions from faeces to the test of a new drug

Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2) belongs to the Coronaviridae family, genus Betacoronavirus. Infection by SARS-CoV-2 can cause Coronavirus Disease (COVID-19). This is an infectious disease that can have a wide range of symptoms. Most people infected show mild to moderate respiratory illness and recover without special treatment. However, some patients can develop a serious illness and require medical attention. The virus can spread mainly from an infected person's mouth or nose in small liquid particles when they cough, sneeze, speak or breathe. These particles range from larger respiratory droplets to smaller aerosols and can stay suspended in the air in an indoor space for minutes or even hours. It has also been widely demonstrated that the virus can be found in the environment such as in waste-waters. It remains unclear and controversial if the faecal transmission has a crucial role in the human-to-human transmission of the virus. The experiments reported in this PhD thesis were conducted with the Virology Research Group and The Clinical Virology Research Group at the University of Oslo/Oslo University Hospital, Norway. They had two aims: first, to investigate the possibility of reviving SARS-CoV-2 virions from faeces of COVID-19-positive patients; and second, to study a new solution called Drug X as a new treatment for defeating SARS-CoV-2. Our preliminary results showed that for the 13,5% of faeces samples, it was possible to revive SARS-CoV-2 viable virions using the Vero-E6 cell line. This ideally indicated the possibility for positive patients to transmit the virus to naïve people. At the same time, it was possible to establish the highest concentration of Drug X can be used, so the highest concentration where the cells survive. It was compared with other acid solutions concluding that although our results showed that Drug X does not affect SARS-CoV-2 infection, this research lays the foundations to explore other similar solutions as a valuable treatment for COVID-19. A detailed exploration of the cellular and molecular functions of SARS-CoV-2 infection is still necessary to better understand virus-host cell interactions to provide novel ways to treat COVID-19 and limit virus circulation

No evidence of SARS-CoV-2 in hospitalized patients with severe acute respiratory syndrome in five Italian hospitals from 1st November 2019 to 29th February 2020

Background On 9th January 2020, China CDC reported a novel coronavirus (later named SARS-CoV-2) as the causative agent of the coronavirus disease 2019 (COVID-19). Identifying the first appearance of virus is of epidemiological importance to tracking and mapping the spread of SARS-CoV-2 in a country. We therefore conducted a retrospective observational study to detect SARS-CoV-2 in oropharyngeal samples collected from hospitalized patients with a Severe Acute Respiratory Infection (SARI) enrolled in the DRIVE (Development of Robust and Innovative Vaccine Effectiveness) study in five Italian hospitals (CIRI-IT BIVE hospitals network) (1st November 2019 – 29th February 2020). Objectives To acquire new information on the real trend in SARS-CoV-2 infection during pandemic phase I and to determine the possible early appearance of the virus in Italy. Materials and methods Samples were tested for influenza [RT-PCR assay (A/H1N1, A/H3N2, B/Yam, B/Vic)] in accordance with the DRIVE study protocol. Subsequently, swabs underwent molecular testing for SARS-COV-2. [one-step real-time multiplex retro-transcription (RT) PCR]. Results In the 1683 samples collected, no evidence of SARS-CoV-2 was found. Moreover, 28.3% (477/1683) of swabs were positive for influenza viruses, the majority being type A (358 vs 119 type B). A/H3N2 was predominant among influenza A viruses (55%); among influenza B viruses, B/Victoria was prevalent. The highest influenza incidence rate was reported in patients aged 0–17 years (40.3%) followed by those aged 18–64 years (24.4%) and ≥65 years (14.8%). Conclusions In Italy, some studies have shown the early circulation of SARS-CoV-2 in northern regions, those most severely affected during phase I of the pandemic. In central and southern regions, by contrast no early circulation of the virus was registered. These results are in line with ours. These findings highlight the need to continue to carry out retrospective studies, in order to understand the epidemiology of the novel coronavirus, to better identify the clinical characteristics of COVID-19 in comparison with other acute respiratory illnesses (ARI), and to evaluate the real burden of COVID-19 on the healthcare system

Novel Management of Granuloma Formation Secondary to Dermal Filler with Intralesional 1444 nm Nd:YAG Laser Technique

Background: Dermal fillers for soft tissue for the treatment of face sagging, volume loss, and wrinkles have become popular among patients of all ages and ethnicities, and their use is becoming increasingly widespread. Aim: the goal of this study was to evaluate the effectiveness and safety of a micro-pulsed, 1444 nm Nd:YAG laser on dermal filler complications, in particular on granuloma management. Methods: A subcutaneous, 1444 nm Nd:YAG laser was used on five female patients (range age 52–68 years) with hyaluronic filler granulomas located on the face (two on the cheek area and three on the lips); three patients had self-injected the filler, buying it online. Before and after the therapy, the patients received a skin ultrasound to determine the form and location of the granulomas and to determine if there had been a full or partial resolution. During this study, all possible adverse effects at the treatment site were monitored. The 5-point Global Aesthetic Improvement Scale (GAIS) (0 point—no change; 1 point—25%, mild improvement; 2 points—50%, moderate improvement; 3 points—75%, good improvement; 4 points—100%, excellent improvement) was recorded at a 3-month follow-up. Results: good results were obtained in the treatment of filler granulomas with the intralesional 1444 nm laser, even if just a single treatment was performed (one intervention was effective for curing granulomas up to 5 mm in diameter). Three patients were satisfied with excellent improvement, and two patients experienced good improvement. The results are functional and aesthetically satisfying, as shown by photographic assessment. At the last follow-up, the granuloma had reduced or completely disappeared in all cases, and no infections, burns, scarring or fibrosis, episodes of severe bleeding, or other serious adverse effects had been reported. All subjects tolerated the post-treatment period well. Conclusions: Our findings showed that granuloma treatment with an intralesional 1444 nm Nd:YAG laser is a minimally invasive, easy, fast, efficient, and low-risk procedure

Health Technology Assessment (HTA) sull’introduzione di coorti aggiuntive per la vaccinazione contro il meningococco con vaccini quadrivalenti coniugati in Italia = Health Technology Assessment (HTA) of the introduction of additional cohorts for anti-meningococcal vaccination with quadrivalent conjugate vaccines in Italy

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