Covid‐19: Time for a paradigm change

Buonaguro, Luigi; Ascierto, Paolo A.; Morse, Gene D.; Buonaguro, Luigi; Puzanov, Igor; Tornesello, Maria Lina; Bréchot, Christian; Gallo, Robert C.

doi:10.1002/rmv.2134

Cited by 53 publications

(66 citation statements)

References 13 publications

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“…SARS‐CoV‐2 pandemic is now a global threat and little is known about its impact on some vulnerable subgroups, such as immunosuppressed patients. Recent evidence highlighted that immunosuppression may not increase the risk of pulmonary disease severity, as SARS‐CoV‐2‐related damage to lung tissue has shown to be related to a dysregulated host innate immune response 1‐3 . People living with HIV/AIDS (PLWHA) represent a special population, particularly those with severe immunosuppression and a high viral load, as being at higher risk of infections, including common viral infections.…”

Section: Introductionmentioning

confidence: 99%

SARS‐CoV‐2 infection in people living withHIV: a systematic review

Costenaro

Minotti

Barbieri

et al. 2020

Reviews in Medical Virology

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Summary Background and setting Little is known about SARS‐CoV‐2 impact on some vulnerable subgroups, such as people living with HIV/AIDS (PLWHA). In our study we reviewed the current knowledge on SARS‐CoV‐2 cases in PLWHA. Methods A systematic review was conducted by searching the MEDLINE, EMBASE and Google Scholar databases. Studies reporting data on PLWHA affected by SARS‐CoV‐2 were considered for inclusion. The aim of this study was the systematic characterization of cases of SARS‐CoV‐2 infection among PLWHA, particularly focusing on age, clinical findings at diagnosis, radiological features, therapeutic management and clinical outcomes. Results Twenty three relevant articles were identified, which reported 164 adults with both HIV and SARS‐CoV‐2 infection. Of those, the large majority were males (120/142, 84.5%), often with one or more comorbidities. Fifteen cases needed intensive care treatment and 16 died. For each group, respectively three patients had underlying comorbidities. There were no studies on children. The included studies were mostly retrospective or case series/reports (19 studies). The overall risk of bias was moderate, due to the study types and characteristics. Conclusion It is still unclear if HIV infection may influence SARS‐CoV‐2 infection and disease course, however some PLWHA and particularly males affected by ARV‐related complications may be at greater risk of severe Covid‐19 course.

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Section: Introductionmentioning

confidence: 99%

SARS‐CoV‐2 infection in people living withHIV: a systematic review

Costenaro

Minotti

Barbieri

et al. 2020

Reviews in Medical Virology

View full text Add to dashboard Cite

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“…1] and the Hospital management (lead coordinated by the General Director), worried about the risk of the fragile patients present in the Cancer Institute, for their age and their comorbidity, started to elaborate possible COVID-19 therapeutic strategies as well as established the COVID-19 Crisis Unit, coordinated by the Medical Director. The therapeutic strategy based on inhibition of IL-6R has been previously published [9][10][11] and will not be furthermore elaborate in this article, which will be focused on the strategies adopted to prevent COVID-19 spreading among the susceptible cancer patients and their care givers, as well as the Cancer Institute Health workers. Moreover, the IRCCS Pascale under the coordination of the Scienti c Director participated to COVID-19 Research Programs launched by the Campania Regional Government, as well as by the Italian Ministry of Health.…”

Section: Introductionmentioning

confidence: 99%

The Clinical and Translational Research Activities at the INT – IRCCS “Fondazione Pascale” Center (Naples, Italy) during the COVID-19 Pandemic

Buonaguro¹,

Botti

Ascierto

et al. 2020

Preprint

Self Cite

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COVID-19 pandemic following the outbreak in China and Western Europe, where it finally lost the momentum, is now devastating North and South America. It has not been identified the reason and the molecular mechanisms of the two different patterns of the pulmonary host responses to virus from a minimal disease in young subjects to a severe distress syndrome (ARDS) in older subjects, particularly those with previous chronic diseases (including diabetes) and Cancer. The Management of the Istituto Nazionale Tumori - IRCCS “Fondazione Pascale” in Naples [INT-Pascale], along with all Health professionals decided not to interrupt the treatment of those hospitalized and to continue, even if after a careful triage in order not to allow SARS-CoV-2 positive subjects to access, to take care of cancer patients with serious conditions. Although very few (n=3) patients developed a symptomatic COVID-19 and required the transfer to a COVID-19 area of the Institute, no patients died during the Hospitalization and completed their oncology treatment. Besides monitoring of the patients, all employees of the Institute (physicians, nurses, researchers, lawyers, accountants, gatekeepers, guardians, janitors) have been tested for a possible exposure. Personnel identified as positive, has been promptly subjected to home quarantine and subdued to health surveillance. One severe case of respiratory distress has been reported in a positive employees and one death of a family member. Further steps to home monitoring of COVID-19 clinical course have been taken with the development of remote Wi-Fi connected digital devices for the detection of early signs of respiratory distress, including heart rate and oxygen saturation. In conclusion cancer care has been performed and continued safely also during COVID-19 pandemic and further remote home strategies are in progress to ensure the appropriate monitoring of cancer patients.

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“…The speed of the epidemic and the associated damages were evident from the rst week of March [ Fig.1] and the Hospital Management (led by the Director General, Dr Attilio Bianchi), concerned about the risk of frail patients present in the Cancer Institute, for their age and their comorbidities, has begun to develop possible COVID-19 therapeutic strategies in addition to establishing the COVID-19 Crisis unit, coordinated by the Medical Director. The therapeutic strategy based on inhibition of IL-6R has been previously published [9][10][11] and will not be furthermore elaborate in this article, which will be focused on the strategies adopted to prevent COVID-19 spreading among the susceptible cancer patients and their care givers, as well as the Cancer Institute Health workers. Moreover, the IRCCS Pascale under the coordination of the Scienti c Director participated to COVID-19 Research Programs launched by the Campania Regional Government, as well as by the Italian Ministry of Health.…”

Section: Introductionmentioning

confidence: 99%

“…The established COVID-19 crisis units prevented the transmission of the infection to the hospitalized "fragile" cancer patients (particularly onco-hematological patients), immediately intercepting COVID-19 positive patients at the hospital admission, promptly identifying COVID-19 positive patients (n=2), and transferring them to a temporary quarantine section of the semi-intensive care unit, as well as health workers infected outside of the Institute and activation of the mandatory home quarantine procedure. The Institute quick reaction at the mounting epidemics, even in absence of COVID-19 patients, achieved highly relevant research results and in particular highlighted the anaphylactoid component of the Acute Respiratory Distress Syndrome (ARDS) and the possibility of introducing anti-IL-6/IL-6R axis available drugs in particular Tocilizumab during the cytokine storm with drastic reduction of the Intensive Care Units (ICU) occupancy and the following intubation(9)(10)(11). Thisinnovative treatment approach led to the elaboration of the Phase II clinical trial TOCIVID-19 [EudraCT number 2020-001110-38 -ClinicaltTrials.gov NCT04317092] approved by AIFA (the Italian Drug Agency) on March 17 th [93], representing the rst non-pro t anti-COVID-19 Italian clinical trial [94].…”

mentioning

confidence: 99%

The Clinical and Translational Research Activities at the INT – IRCCS “Fondazione Pascale” Cancer Center (Naples, Italy) during the COVID-19 Pandemic

Buonaguro

Botti

Ascierto

et al. 2020

Preprint

Self Cite

View full text Add to dashboard Cite

COVID-19 pandemic following the outbreak in China and Western Europe, where it finally lost the momentum, is now devastating North and South America. It has not been identified the reason and the molecular mechanisms of the two different patterns of the pulmonary host responses to virus from a minimal disease in young subjects to a severe distress syndrome (ARDS) in older subjects, particularly those with previous chronic diseases (including diabetes) and Cancer. The Management of the Istituto Nazionale Tumori - IRCCS “Fondazione Pascale” in Naples [INT-Pascale], along with all Health professionals decided not to interrupt the treatment of those hospitalized and to continue, even if after a careful triage in order not to allow SARS-CoV-2 positive subjects to access, to take care of cancer patients with serious conditions. Although very few (n=3) patients developed a symptomatic COVID-19 and required the transfer to a COVID-19 area of the Institute, no patients died during the Hospitalization and completed their oncology treatment. Besides monitoring of the patients, all employees of the Institute (physicians, nurses, researchers, lawyers, accountants, gatekeepers, guardians, janitors) have been tested for a possible exposure. Personnel identified as positive, has been promptly subjected to home quarantine and subdued to health surveillance. One severe case of respiratory distress has been reported in a positive employees and one death of a family member. Further steps to home monitoring of COVID-19 clinical course have been taken with the development of remote Wi-Fi connected digital devices for the detection of early signs of respiratory distress, including heart rate and oxygen saturation.In conclusion cancer care has been performed and continued safely also during COVID-19 pandemic and further remote home strategies are in progress to ensure the appropriate monitoring of cancer patients.

show abstract

Covid‐19: Time for a paradigm change

Cited by 53 publications

References 13 publications

SARS‐CoV‐2 infection in people living withHIV: a systematic review

SARS‐CoV‐2 infection in people living withHIV: a systematic review

The Clinical and Translational Research Activities at the INT – IRCCS “Fondazione Pascale” Center (Naples, Italy) during the COVID-19 Pandemic

The Clinical and Translational Research Activities at the INT – IRCCS “Fondazione Pascale” Cancer Center (Naples, Italy) during the COVID-19 Pandemic

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