We quantify the effect of mobility habits in the spread of the Coronavirus in Italy. • Daily COVID-19 cases are directly related to the mobility habits performed 21 days before. • Population density, PM pollutant and number of tests per day have a direct relationship with the infection. • Temperature has an inverse relationship with the spread of the virus. • The areas close to the outbreak had a higher risk of contagion (time-decay phenomena).

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Starting from 1st case in Italy, on February 20th, 2020, CO-rona VI-rus D-isease 2019 (COVID-19) pandemic spread to whole Italian territory, with different regional distribution. Tuscany has been classified as medium diffusion area (40-100 cases/100000 inhabitants). In this context, all healthcare structures reviewed their organization to meet new needs. Our study’s objectives were description of organizational model outlined to safely manage Emergency Department (ED) and analysis of patients’ flows within Hospital of Pisa during pandemic. The ED has been reorganized with dedicated areas for examination and waiting for tests results. A similar reduction (-62%) of ED accesses comparing to the same period of 2019 and the previous months of 2020 was observed. Hospital Task Force arranged for progressive activation of Units by modules, according to territorial needs. From the beginning of March to the end of April 2020, 315 COVID-19 patients were hospitalized. Overall, a 45% reduction in hospital admissions compared to the same period of 2019 was observed, with increased mortality (4% versus 2%). The University Hospital of Pisa efficiently managed COVID-19 emergency with a logistical reorganization of ED.

Background: Tuberous sclerosis complex (TSC) is an autosomal dominant disorder. It is characterized by seizures, mental retardation and hamartomatous lesions, including facial angiofibroma, subependymal giant cell astrocytoma, cardiac rhabdomyoma and renal angiomyolipoma (AML). AMLs can bleed severely in the retroperitoneal space.

In Italy, the coronavirus disease 2019 (COVID-19) emergency took hold in Lombardy and Veneto at the end of February 2020 and spread unevenly among the other regions in the following weeks. In Tuscany, the progressive increase of hospitalized COVID-19 patients required the set-up of a regional task force to prepare for and effectively respond to the emergency. In this case report, we aim to describe the key elements that have been identified and implemented in our center, a 1082-bed hospital located in the Pisa district, to rapidly respond to the COVID-19 outbreak in order to guarantee safety of patients and healthcare workers.

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