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The aim of the study was to assess simultaneously several potential predictors of outcome (co-morbidity, previous and in-hospital treatment, radiologic Brixia score) in patients with COVID-19. This retrospective cohort study included 258 consecutive patients with confirmed COVID-19 admitted to a medical ward at the Montichiari Hospital, Brescia, Italy from February 28th to April 30th, 2020. Patients had COVID-19 related pneumonia with respiratory failure, and were treated with hydroxychloroquine, lopinavir plus ritonavir. In some patients additional treatment with tocilizumab, dexamethasone and enoxaparin was adopted. Outcomes (death or recovery) were assessed at the end of the discharge period or at the end the follow-up (August 2020).  During hospitalization, 59 patients died, while 6 died after discharge. The following variables were demonstrated to be associated with a worse prognosis: Radiologic Brixia score higher than 8, presence at baseline of hypertension, diabetes, chronic obstructive pulmonary disease, heart disease, cancer, previous treatment with ACE-inhibitors or anti-platelet drugs. Anticoagulant treatment during hospital admission with enoxaparin at a dose higher than 4000 U per was associated to a better prognosis. In conclusion, our study demonstrates that some co-morbidities and cardiovascular risk factors may affect prognosis. The radiologic Brixia score may be a useful tool for stratifying the risk of death at baseline. Anticoagulant treatment with enoxaparin might be associated to a clinical benefit in terms of survival in patients with COVID-19.

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Despite of technological innovations, noisy environments still constitute a challenging and stressful situation for words recognition by hearing impaired subjects. The evaluation of the mental workload imposed by the noisy environments for the recognition of the words in prelingually deaf children is then of paramount importance since it could affect the speed of the learning process during scholar period.The aim of the present study was to investigate different electroencephalographic (EEG) power spectral density (PSD) components (in theta 4-8 Hz - and alpha - 8-12 Hz - frequency bands) to estimate the mental workload index in different noise conditions during a word recognition task in prelingually deaf children, a population not yet investigated in relation to the workload index during auditory tasks. A pilot study involving a small group of prelingually deaf children was then subjected to EEG recordings during an auditory task composed by a listening and a successive recognition of words with different noise conditions. Results showed that in the pre-word listening phase frontal EEG PSD in theta band and the ratio of the frontal EEG PSD in theta band and the parietal EEG PSD in alpha band (workload index; IWL) reported highest values in the most demanding noise condition. In addition, in the phase preceding the word forced-choice task the highest parietal EEG PSD in alpha band and IWL values were reported at the presumably simplest condition (noise emitted in correspondence of the subject's deaf ear). These results could suggest the prominence of EEG PSD theta component activity in the pre-word listening phase. In addition, a more challenging noise situation in the pre-choice phase would be so "over-demanding" to fail to enhance both the alpha power and the IWL in comparison to the already demanding "simple" condition.

a b s t r a c tUnilateral hearing loss constitutes a field of growing interest in the scientific community. In fact, this kind of patients represent a unique and physiological way to investigate how neuroplasticity overcame unilateral deafferentation by implementing particular strategies that produce apparently next-to-normal hearing behavioural performances. This explains why such patients have been underinvestigated for a long time. Thanks to the availability of techniques able to study the cerebral activity underlying the mentioned behavioural outcomes, the aim of the present research was to elucidate whether different electroencephalographic (EEG) patterns occurred in unilateral hearing loss (UHL) children in comparison to normal hearing (NH) controls during speech-in-noise listening. Given the intrinsic lateralized nature of such patients, due to the unilateral side of hearing impairment, the experimental question was to assess whether this would reflect a different EEG pattern while performing a word in noise recognition task varying the direction of the noise source. Results showed a correlation between the period of deafness and the cortical activity asymmetry toward the hearing ear side in the frontal, parietal and occipital areas in all the experimental conditions. Concerning alpha and beta activity in the frontal and central areas highlighted that in the NH group, the lateralization was always left-sided during the Quiet condition, while it was right-sided in noise conditions; this evidence was not, however, detected also in the UHL group. In addition, focusing on the theta and alpha activity in the frontal areas (Broca area) during noise conditions, while the activity was always left-lateralized in the NH group, it was ipsilateral to the direction of the background noise in the UHL group, and of a weaker extent than in NH controls. Furthermore, in noise conditions, only the UHL group showed a higher theta activity in the temporal areas ipsilateral to the side where the background noise was directed to. Finally, in the case of bilateral noise (background noise and word signal both coming from the same two sources), the theta and alpha activity in the frontal areas (Broca area) was left-lateralized in the case of the NH group and lateralized towards the side of the better hearing ear in the case of the UHL group.

In deaf children, huge emphasis was given to language; however, emotional cues decoding and production appear of pivotal importance for communication capabilities. Concerning neurophysiological correlates of emotional processing, the gamma band activity appears a useful tool adopted for emotion classification and related to the conscious elaboration of emotions. Starting from these considerations, the following items have been investigated: (i) whether emotional auditory stimuli processing differs between normal-hearing (NH) children and children using a cochlear implant (CI), given the non-physiological development of the auditory system in the latter group; (ii) whether the age at CI surgery influences emotion recognition capabilities; and (iii) in light of the right hemisphere hypothesis for emotional processing, whether the CI side influences the processing of emotional cues in unilateral CI (UCI) children. To answer these matters, 9 UCI (9.47 ± 2.33 years old) and 10 NH (10.95 ± 2.11 years old) children were asked to recognize nonverbal vocalizations belonging to three emotional states: positive (achievement, amusement, contentment, relief), negative (anger, disgust, fear, sadness), and neutral (neutral, surprise). Results showed better performances in NH than UCI children in emotional states recognition. The UCI group showed increased gamma activity lateralization index (LI) (relative higher right hemisphere activity) in comparison to the NH group in response to emotional auditory cues. Moreover, LI gamma values were negatively correlated with the percentage of correct responses in emotion recognition. Such observations could be explained by a deficit in UCI children in engaging the left hemisphere for more demanding emotional task, or alternatively by a higher conscious elaboration in UCI than NH children. Additionally, for the UCI group, there was no difference between the CI side and the contralateral side in gamma activity, but a higher gamma activity in the right in comparison to the left hemisphere was found. Therefore, the CI side did not appear to influence the physiologic hemispheric lateralization of emotional processing. Finally, a negative correlation was shown between the age at the CI surgery and the percentage of correct responses in emotion recognition and then suggesting the occurrence of a sensitive period for CI surgery for best emotion recognition skills development.

The aim of the study was to assess the short-term consequences of SARS-CoV-2-related pneumonia, also in relation to radiologic/laboratory/clinical indices of risk at baseline. This prospective follow-up cohort study included 94 patients with confirmed COVID-19 admitted to a medical ward at the Montichiari Hospital, Brescia, Italy from February 28th to April 30th, 2020. Patients had COVID-19 related pneumonia with respiratory failure. Ninety-four patients out of 193 survivors accepted to be re-evaluated after discharge, on average after 4 months. In ¼ of the patients an evidence of pulmonary fibrosis was detected, as indicated by an altered diffusing capacity of the lung for carbon monoxide (DLCO); in 6–7% of patients the alteration was classified as of moderate/severe degree. We also evaluated quality of life thorough a structured questionnaire: 52% of the patients still lamented fatigue, 36% effort dyspnea, 10% anorexia, 14% dysgeusia or anosmia, 31% insomnia and 21% anxiety. Finally, we evaluated three prognostic indices (the Brixia radiologic score, the Charlson Comorbidity Index and the 4C mortality score) in terms of prediction of the clinical consequences of the disease. All of them significantly predicted the extent of short-term lung involvement. In conclusion, our study demonstrated that SARS-CoV-2-related pneumonia is associated to relevant short-term clinical consequences, both in terms of persistence of symptoms and in terms of impairment of DLCO (indicator of a possible development of pulmonary fibrosis); some severity indices of the disease may predict short-term clinical outcome. Further studies are needed to ascertain whether such manifestations may persist long-term.

SummaryObjectives: The aim of the present study is to investigate the variations of the electroencephalographic (EEG) alpha rhythm in order to measure the appreciation of bilateral and unilateral young cochlear implant users during the observation of a musical cartoon. The cartoon has been modified for the generation of three experimental conditions: one with the original audio, another one with a distorted sound and, finally, a mute version.Methods: The EEG data have been recorded during the observation of the cartoons in the three experimental conditions. The frontal alpha EEG imbalance has been calculated as a measure of motivation and pleasantness to be compared across experimental populations and conditions.Results: The EEG frontal imbalance of the alpha rhythm showed significant variations during the perception of the different cartoons. In particular, the pattern of activation of normal-hearing children is very similar to the one elicited by the bilateral implanted patients. On the other hand, results related to the unilateral subjects do not present significant variations of the imbalance index across the three cartoons.Conclusion: The presented results suggest that the unilateral patients could not appreciate the difference in the audio format as well as bilaterally implanted and normal hearing subjects. The frontal alpha EEG imbalance is a useful tool to detect the differences in the appreciation of audiovisual stimuli in cochlear implant patients.