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Highlights Hyperinflammation in COVID-19 activates blood coagulation increasing thrombotic risk. Tocilizumab blocks IL-6 receptor and may improve inflammatory-induced hypercoagulability. Tocilizumab was associated with rapid and sustained coagulation improvement. These benefits were consistent independently of thromboprophylaxis dose.

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 The influence of antiretroviral therapy on co-receptor tropism remains controversial. To 25 verify if co-receptor tropism shift was affected by HAART, the evolution of proviral DNA V3 26 genotype after 12 months of a new antiretroviral regimen was compared between 27 responder and non-responder patients. 28Baseline blood samples were collected from 36 patients infected with HIV-1 subtype-B (18 29 naïve and 18 experienced) for virus isolation and env V3 genotyping from plasma HIV-1 30 RNA and PBMC DNA. DNA V3 genotyping was repeated after 12 months from initiating 31 HAART. WebPSSM was used for categorizing V3 sequences into X4 or R5; for analysis 32 purposes, dual/mixed viruses were considered as X4. 33From the 10 (28%) patients changing their proviral DNA V3 genotype during therapy, six 34shifted from R5-to-X4 and four from X4-to-R5. The lack of reaching virological suppression 35 was not associated with an X4-to-R5 (p=0.25) or R5-to-X4 (p=0.14) shift; time-to-viral 36 suppression and CD4 increase were similar in both groups. No association was found 37 between tropism shift and patient baseline characteristics including age, sex, CDC stage, 38 CD4 count, viral load, exposure and length of previous HAART, enfuvirtide use in the new 39 regimen, number of reverse-transcriptase and protease resistance-associated mutations. 40Conversely, CD4 nadir was correlated to emergence of X4 virus in proviral DNA (mean 41 27.2±30.6 in R5-to-X4 shifting patients vs 161.6±150.6 in non-shifting patients, p=0.02). 42The occurrence of a tropism shift in both directions was independent of HAART use, 43 irrespective of its efficacy. The CD4 count nadir was the only baseline characteristic able 44 to predict an R5-to-X4 viral shift. 45

The aim of this article is to retrospectively evaluate the patient characteristics and the most common infectious diseases in immigrant patients hospitalized in 46 Italian infectious disease clinics during 2002. The main Italian infectious disease clinics were invited to fill in a questionnaire that regarded the number and type of hospital admissions, the country of origin, and demographic features (age, sex, and resident state) of immigrants. A total of 46 clinics including 2255 patients participated in the study. Most patients were men (63%) with an age between 16 and 40 years (63.4%) covered by the National Health Service (71%) and coming from Africa (44.3%). The main infectious diseases observed were: 378 (16.76%) cases of HIV infection, 303 (13.43%) cases of tuberculosis diseases, 282 (12.5%) cases of various forms of viral hepatitis, 177 (7.84%) cases of respiratory diseases, and 196 (8.69%) gastrointestinal diseases. Tropical diseases found were 134 (5.94%) including 95 cases of malaria (70.9%). In conclusion, a broad range of diseases was noted in immigrants which were directly correlated with conditions of poverty. Only a few tropical diseases were diagnosed and therefore the immigrant should not be considered as an infectious disease carrier.

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