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Little is known regarding coronavirus disease 2019 (COVID-19) clinical spectrum in non-Asian populations. We herein describe the impact of COVID-19 on liver function in 100 COVID-19 consecutive patients (median age 70 years, range 25–97; 79 males) who were admitted to our internal medicine unit in March 2020. We retrospectively assessed liver function tests, taking into account demographic characteristics and clinical outcome. A patient was considered as having liver injury when alanine aminotransferase (ALT) was > 50 mU/ml, gamma-glutamyl transpeptidase (GGT) > 50 mU/ml, or total bilirubin > 1.1 mg/dl. Spearman correlation coefficient for laboratory data and bivariable analysis for mortality and/or need for intensive care were assessed. A minority of patients (18.6%) were obese, and most patients were non- or moderate-drinkers (88.5%). Liver function tests were altered in 62.4% of patients, and improved during follow-up. None of the seven patients with known chronic liver disease had liver decompensation. Only one patient developed acute liver failure. In patients with altered liver function tests, PaO2/FiO2 < 200 was associated with greater mortality and need for intensive care (HR 2.34, 95% CI 1.07–5.11, p = 0.033). To conclude, a high prevalence of altered liver function tests was noticed in Italian patients with COVID-19, and this was associated with worse outcomes when developing severe acute respiratory distress syndrome.

Preliminary evidence supports the notion that COVID-19 patients may have an increased susceptibility to develop venous thromboembolism (VTE). However, the magnitude of this association still needs to be defined. Furthermore, clinical predictors of thrombogenesis, and the relationship with the inflammatory status are currently unknown. On this basis, we conducted a retrospective, observational study on 259 consecutive COVID-19 patients admitted to an academic tertiary referral hospital in Northern Italy between March 19th and April 6th, 2020. Records of COVID-19 patients with a definite VTE event were reviewed for demographic information, co-morbidities, risk factors for VTE, laboratory tests, and anticoagulation treatment. Twenty-five cases among 259 COVID-19 patients developed VTE (9.6%), all of them having a Padua score > 4, although being under standard anticoagulation prophylaxis since hospital admission. In the VTE subcohort, we found a significant positive correlation between platelet count (PLT) and either C reactive protein (CRP) (p < 0.0001) or lactate dehydrogenase (LDH) (p = 0.0013), while a significant inverse correlation was observed between PLT and mean platelet volume (p < 0.0001). Platelet-to-lymphocyte ratio significantly correlated with CRP (p < 0.0001). The majority of VTE patients was male and younger compared to non-VTE patients (p = 0.002 and p = 0.005, respectively). No significant difference was found in d-dimer levels between VTE and non VTE patients, while significantly higher levels of LDH (p = 0.04) and IL-6 (p = 0.04) were observed in VTE patients in comparison to non-VTE patients. In conclusion, our findings showed a quite high prevalence of VTE in COVID-19 patients. Raised inflammatory indexes and increased serum levels of pro-inflammatory cytokines should raise the clinical suspicion of VTE.

The understanding of public debates over mineral exploration and mining largely originates from exceptional situations such as mining accidents of conflicts. Less is known about how mining is portrayed and understood under more conventional settings. What storylines dominate the local day-to-day public debate? This article presents results from a comparative case study focusing on newspaper coverage of mineral exploration and mining in three European countries representing different geological and socio-economic contexts. Newspaper articles from the Geyer-Erzgebirge region in Germany, the Andalusia region in Spain, and Northern Finland are studied. The sample looks into the period between September 2018 and February 2020 and shows that regional newspapers report about mining issues relatively intensively even in the absence of major accidents or other media events causing peaks of attention. The tone of the articles is generally neutral to positive towards mining activities, reflecting the specific local settings, historical experiences, and future expectations. Despite the different contexts of the three countries, there were considerable similarities to the topics highlighted, including common themes of mining revival, mining events and social interaction, history of mining, and damages related to mining. Past, present, and future employment opportunities related directly or indirectly to the mining sector are key storylines. Another recurrent underlying theme is the need to balance environment and safety risks and socio-economic prosperity, typically covered through ordinary disputes among the mining sector, public authorities, regional non-governmental organizations, and local initiatives.

Drastic measures are required to meet the standards of the Paris Agreement and limit the increase of global average temperatures well below 2°C compared to pre-industrial levels. Mining activities are typically considered as unsustainable but, at the same time, metals such as cobalt and lithium are essential to sustain the energy transition. Several sustainability goals defined by the United Nations (UN) require large quantities of raw materials. Exploration and extractives activities are required in order to contribute to meeting sustainability standards. Future sourcing of metals will need to implement procedures that go well beyond current ecological, economic, and social requirements and practices. In this paper we assess the usual sustainability criteria and how they apply to the extractives sector. Sustainability can only be achieved if one accepts that the natural capital can be substituted by other forms of capital (so called weak concept of sustainability). Sourcing the raw materials increasingly demanded by our societies will need transparent and inclusive stakeholder participation as well as a holistic understanding of the impact of extractives activities to reach this weak sustainability status. Our analysis shows that the sustainability of mining cannot be reached without harmonized political instruments and investment policies that take the three pillars of environmental, economic, and social sustainability as a major priority.

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