Symptomatic COVID-19 in pregnancy: hospital cohort data between may 2020 and april 2021, risk factors and medicolegal implications

Pregnancy does not appear to increase susceptibility to SARS-CoV-2 infection, but some physiological changes, such as the reduction of residual functional volumes, elevation of the diaphragm, and impaired cellular immunity, may increase the risk of severe disease and result in a higher risk of complications. The article's primary objective is to evaluate the factors associated with symptomatic COVID-19 disease in pregnancy. The secondary objective is to describe maternal and neonatal outcomes and cases of vertical transmission of the infection. All pregnant women hospitalized with SARS-CoV2 infection were included in a prospective study in the UOC of Obstetrics and Gynecology, AOOR Villa Sofia-Cervello, Palermo, between May 2020 and April 2021. The patients who requested the termination of the pregnancy according to Law 194/78 were excluded. We included 165 pregnancies with a total number of 134 deliveries. Overall, 88.5% of the patients were asymptomatic at the time of admission and 11.5% were symptomatic. Of them, 1.8% of the patients required hospital admission in the intensive care unit. Symptoms occurrences were positively associated with the increase in maternal BMI (OR 1.17; p = 0.002), the prematurity (OR 4.71; p = 0.022), and at a lower birth weight (OR 0.99; p = 0.007). One infant tested positive for SARS-CoV2 nasopharyngeal swab; 11.4% of newborns had IgG anti SARS-CoV2 at birth; IgM was positive in 2.4% of newborns. There was no difference statistically significant difference in the vertical transmission of the infection among the group of symptomatic pregnant women and that of asymptomatic pregnant women

Seroprevalence and occupational risk survey for Coxiella burnetii among exposed workers in Sicily, Southern Italy.

Objectives: The aim of this survey was to assess the seroprevalence of antibodies against Coxiella burnetii (C. burnetii) in subjects at risk of exposure in Sicily, Southern Italy. Material and Methods: Prevalence of IgG antibodies to C. burnetii phase II antigens was evaluated by ELISA in a group of 140 workers at risk of exposure (38 veterinarians, 38 slaughterhouse workers, 44 livestock handlers, 20 laboratory and technical personnel) included in a medical surveillance program and in 42 control subjects. Positive samples were classified as suggestive of prior exposure to C. burnetii. Results: Antibodies against C. burnetii were detected in 88 out of 140 (62.9%) exposed workers and in 6 out of 42 (14.3%) subjects of the control group. The variables evaluated did not seem to have a significant effect on seropositivity to Coxiella with the exception of symptoms in the last 6 months preceding the survey. Conclusions: Our study demonstrated a high seroprevalence of C. burnetii in the group of exposed workers in comparison to non-exposed subjects of the control group. Clinical illness appears to be rare; nevertheless, physicians should consider Q fever in patients with compatible symptoms and occupational exposure to animals and their products. As aerosols represent the main route of infection in animals and humans, these workers are strongly advised to wear respiratory masks. In addition, occupational physicians should consider routine serologic evaluation and vaccination of occupationally exposed workers

Immunological effects of occupational exposure to lead

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