Clinical Management of Adult Patients with COVID-19 Outside Intensive Care Units: Guidelines from the Italian Society of Anti-Infective Therapy (SITA) and the Italian Society of Pulmonology (SIP)

Bassetti, Matteo; Giacobbe, Daniele Roberto; Bruzzi, Paolo; Barisione, Emanuela; Centanni, Stefano; Castaldo, Nadia; Corcione, Silvia; Rosa, Francesco Giuseppe De; Marco, Fabiano Di; Gori, Andrea; Gramegna, Andrea; Granata, Guido; Gratarola, Angelo; Maraolo, Alberto Enrico; Mikulska, Małgorzata; Lombardi, Andrea; Pea, Federico; Petrosillo, Nicola; Radovanovic, Dejan; Santus, Pierachille; Signori, Alessio; Sozio, Emanuela; Tagliabue, Elena; Tascini, Carlo; Vancheri, Carlo; Vena, Antonio; Viale, Pierluigi; Blasi, Francesco

doi:10.1007/s40121-021-00487-7

Cited by 32 publications

(38 citation statements)

References 279 publications

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“…Patients that satisfied criteria for severe pneumonia according to the American Thoracic Society/Infectious Diseases Society of America (ATS/IDSA) guidelines [15] received in vein methylprednisolone at a maximal dose of 1 mg/kg as also suggested by Salton and coworkers [16] and as previously published [1,13]. According to national recommendations [17], and as reported elsewhere [1,13], unless contraindicated, all patients received prophylactic low molecular weight heparin (LMWH) at admission. If signs of deep vein thrombosis or pulmonary embolism were detected or patients showed D-dimer values > 3000 mg/L fibrinogen equivalent units (FEU), a therapeutic dose of LMWH was introduced.…”

Section: In-hospital Treatmentmentioning

confidence: 98%

Anti-Inflammatory Effects of Immunostimulation in Patients with COVID-19 Pneumonia

Santus

Radovanovic

Garziano

et al. 2021

JCM

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Background: The effects of immunomodulators in patients with Coronavirus Disease 2019 (COVID-19) pneumonia are still unknown. We investigated the cellular inflammatory and molecular changes in response to standard-of-care + pidotimod (PDT) and explored the possible association with blood biomarkers of disease severity. Methods: Clinical characteristics and outcomes, neutrophil-to-lymphocyte ratio (NLR), plasma and cell supernatant chemokines, and gene expression patterns after SARS-CoV-2 and influenza (FLU) virus in vitro stimulation were assessed in 16 patients with mild-moderate COVID-19 pneumonia, treated with standard of care and PDT 800 mg twice daily (PDT group), and measured at admission, 7 (T1), and 12 (T2) days after therapy initiation. Clinical outcomes and NLR were compared with age-matched historical controls not exposed to PDT. Results: Hospital stay, in-hospital mortality, and intubation rate did not differ between groups. At T1, NLR was 2.9 (1.7–4.6) in the PDT group and 5.5 (3.4–7.1) in controls (p = 0.037). In the PDT group, eotaxin and IL-4 plasma concentrations progressively increased (p < 0.05). Upon SARS-CoV-2 and FLU-specific stimulation, IFN-γ was upregulated (p < 0.05), while at genetic transcription level, Pathogen Recognition Receptors (TRLs) were upregulated, especially in FLU-stimulated conditions. Conclusions: Immunomodulation exerted by PDT and systemic corticosteroids may foster a restoration in the innate response to the viral infection. These results should be confirmed in larger RCTs.

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Section: In-hospital Treatmentmentioning

confidence: 98%

Anti-Inflammatory Effects of Immunostimulation in Patients with COVID-19 Pneumonia

Santus

Radovanovic

Garziano

et al. 2021

JCM

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“…The CT scan showed bilateral ground-glass opacities and dilated segmental and subsegmental vessels. The patient had a mild COVID-19 clinical presentation (fever, non-productive cough) with no respiratory failure (peripheral, non-invasive blood oxygen saturation measurement was 97% at room air) and for which no oxygen supplementation and no antiviral, immunomodulatory, or corticosteroid therapy was eventually necessary in line with current guidelines for mild infections [ 4 ]. Notwithstanding the mild COVID-19 presentation, he worsened clinically from the general point of view, necessitating hemodialytic treatment and progressing to cachexia.…”

Section: Case Reportmentioning

confidence: 99%

Mycobacterium tuberculosis Surgical Site Infection after Cardiac Surgery in the COVID-19 Era: A Case Report

Parolari

Sepulcri

Salsano

et al. 2022

Infectious Disease Reports

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Infection of surgical wounds with acid-fast bacilli, including tubercle bacilli, is rare, and is poorly described in the literature. We present the case of a 74-year-old male who developed a sternal wound infection after cardiac surgery due to Mycobacterium tuberculosis complex, diagnosed post-mortem. SARS-CoV-2 infection contributed to worsened clinical conditions and surgical site infection. A high degree of suspicion to avoid unnecessary treatments and progression to severe disease with dismal prognosis is necessary in these types of infections.

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“…Recently, the Italian Society of Anti-Infective Therapy and the Italian Society of Pulmonology guidelines highlighted that colchicine may be considered in outpatients with COVID-19, if other randomized trials replicate COLCORONA’s favorable findings [ 110 ].…”

Section: Colchicine and Covid-19 Infectionmentioning

confidence: 99%

Immunologic Dysregulation and Hypercoagulability as a Pathophysiologic Background in COVID-19 Infection and the Immunomodulating Role of Colchicine

Vrachatis

Papathanasiou

Giotaki

et al. 2021

JCM

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In 2020, SARS-COV-2 put health systems under unprecedented resource and manpower pressure leading to significant number of deaths. Expectedly, researchers sought to shed light on the pathophysiologic background of this novel disease (COVID-19) as well as to facilitate the design of effective therapeutic modalities. Indeed, early enough the pivotal role of inflammatory and thrombotic pathways in SARS-COV-2 infection has been illustrated. The purpose of this article is to briefly present the epidemiologic and clinical features of COVID-19, analyze the pathophysiologic importance of immunologic dysregulation and hypercoagulability in developing disease complications and finally to present an up-to-date systematic review of colchicine’s immunomodulating capacity in view of hindering coronavirus complications.

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Clinical Management of Adult Patients with COVID-19 Outside Intensive Care Units: Guidelines from the Italian Society of Anti-Infective Therapy (SITA) and the Italian Society of Pulmonology (SIP)

Cited by 32 publications

References 279 publications

Anti-Inflammatory Effects of Immunostimulation in Patients with COVID-19 Pneumonia

Anti-Inflammatory Effects of Immunostimulation in Patients with COVID-19 Pneumonia

Mycobacterium tuberculosis Surgical Site Infection after Cardiac Surgery in the COVID-19 Era: A Case Report

Immunologic Dysregulation and Hypercoagulability as a Pathophysiologic Background in COVID-19 Infection and the Immunomodulating Role of Colchicine

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