Italy was one of the nations most affected by SARS-CoV-2. During the pandemic period, the national government approved some restrictions to reduce diffusion of the virus. We aimed to evaluate changes in in-hospital mortality and its possible relation with patient comorbidities and different restrictive public health measures adopted during the 2020 pandemic period. We analyzed the hospital discharge records of inpatients from public and private hospitals in Apulia (Southern Italy) from 1 January 2019 to 31 December 2020. The study period was divided into four phases according to administrative restriction. The possible association between in-hospital deaths, hospitalization period, and covariates such as age group, sex, Charlson comorbidity index (CCI) class, and length of hospitalization stay (LoS) class was evaluated using a multivariable logistic regression model. The risk of death was slightly higher in men than in women (OR 1.04, 95% CI: 1.01–1.07) and was lower for every age group below the >75 years age group. The risk of in-hospital death was lower for hospitalizations with a lower CCI score. In summary, our analysis shows a possible association between in-hospital mortality in non-COVID-19-related diseases and restrictive measures of public health. The risk of hospital death increased during the lockdown period.

Introduction: Molnupiravir and Nirmatrelvir/r (NMV-r) have been proven to reduce severe Coronavirus Disease 2019 (COVID-19) in unvaccinated high-risk individuals. Data regarding their impact in fully vaccinated vulnerable subjects with mild-to-moderate COVID-19 are still limited, particularly in the era of Omicron and sub-variants. Methods: Our retrospective study aimed to compare the safety profile and effectiveness of the two antivirals in all consecutive high-risk outpatients between 11 January and 10 July 2022. A logistic regression model was carried out to assess factors associated with the composite outcome defined as all-cause hospitalization and/or death at 30 days. Results: A total of 719 individuals were included: 554 (77%) received Molnupiravir, whereas 165 (23%) were NMV-r users. Overall, 43 all-cause hospitalizations (5.9%) and 13 (1.8%) deaths were observed at 30 days. A composite outcome occurred in 47 (6.5%) individuals. At multivariate analysis, male sex [OR 3.785; p = 0.0021], age ≥ 75 [OR 2.647; p = 0.0124], moderate illness [OR 16.75; p < 0.001], and treatment discontinuation after medical decision [OR 8.148; p = 0.0123] remained independently associated with the composite outcome. Conclusions: No differences between the two antivirals were observed. In this real-life setting, the early use of both of the oral antivirals helped limit composite outcome at 30 days among subjects who were at high risk of disease progression.

There is a lack of evidence on the impact on body composition of high protein intake and types of protein substitutes in PKU patients—particularly in adolescents, who are more inclined to dietary transgressions. In this observational, cross-sectional study, PKU patients were observed during prepubertal age (p) or after the pubertal spurt (P), assessing body composition and bone quality and correlating these parameters with dietary compliance and types of protein substitutes. Anthropometric and dietary data were evaluated together with bioelectrical impedance analysis (BIA), quantitative ultrasound (QUS) and branched-chain amino acids (BCAAs). A total of 36 patients (16 males, 17 prepubertal and 19 post-pubertal; mean ± SD age 11.4 ± 3.9 years) were included. A higher BMI was observed in adolescents (p-value: 0.018). The BIA revealed a significant increase in total body water (TBW) and muscle mass (MM) in P subjects either compliant (p-value: 0.001) or non-compliant with the diet (p-value: 0.001). MM content correlated with increased Phe intake (r = 0.63; p < 0.001). In the subgroup of five patients taking L-AAs and glycomacropeptides (GMPs), BCAA values tended to be lower than those taking only L-AA mixtures, with a significant trend for valine. Maintenance of body composition parameters within the normal range—for both fat and muscle mass—and levels of BCAAs can be helpful in reducing the risk of becoming overweight in adulthood. Further studies are needed to confirm these findings.

The aim of this study was to investigate the spatiotemporal association between socioeconomic deprivation and the incidence of COVID-19 and how this association changes through the seasons due to the existence of restrictive public health measures. A retrospective observational study was conducted among COVID-19 cases that occurred in the Apulia region from 29 February 2020 to 31 December 2021, dividing the period into four phases with different levels of restrictions. A generalized estimating equation (GEE) model was applied to test the independent effect of deprivation on the incidence of COVID-19, taking into account age, sex, and regional incidence as possible confounding effects and covariates, such as season and levels of restrictions, as possible modifying effects. The highest incidence was in areas with a very high deprivation index (DI) in winter. During total lockdown, no rate ratio between areas with different levels of DI was significant, while during soft lockdown, areas with very high DI were more at risk than all other areas. The effects of social inequalities on the incidence of COVID-19 changed in association with the seasons and restrictions on public health. Disadvantaged areas showed a higher incidence of COVID-19 in the cold seasons and in the phases of soft lockdown.