Publications by authors named "Giulio Viceconte"

Background: The combination of antivirals and monoclonal antibodies (mAbs) in the first phase of COVID-19 has demonstrated to reduce time to viral clearance, but the superiority of combination compared to antiviral monotherapy is still debated.

Research Design And Methods: In an observational, prospective study, we enrolled immunocompromised outpatients with mild-to-moderate COVID-19 treated with one antiviral monotherapy within 7 days from symptoms onset, with or without sotrovimab from January 1, 2024 to October 31, 2024, and we compared them to an identical cohort of patients treated with a combination of one antiviral and sotrovimab, from May 1, 2023 to December 30, 2023. 1st of May 2023 and 31st of October 2024.

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Scope: Interpretation of rapid and advanced microbiological test results remains nonstandardized, with no existing reference guidelines. This study aimed to analyze the existing evidence and provide expert guidance on the use of these techniques in critically ill patients.

Methods: A Delphi consensus process was conducted by a multidisciplinary panel of experts, including microbiologists, infectious disease specialists, intensivists, surgeons, and pulmonologists.

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Invasive fungal infections (IFIs) are a major complication in patients with acute myeloid leukemia (AML), particularly during chemotherapy-induced neutropenia. Posaconazole is the standard drug for primary antifungal prophylaxis (PAP), but its use is limited by oral bioavailability and CYP3A4 interactions. This study aims to evaluate the clinical efficacy and safety of intravenous caspofungin versus oral posaconazole as PAP in AML patients during their first cycle of chemotherapy and assess their subsequent impact on clinical outcomes.

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West Nile Virus (WNV) infection is endemic in Italy, but it has rarely reported in humans in Southern Italy. We report the first human outbreak of WNV infection in the Campania region, Italy. Five confirmed and seven probable cases of WNV were identified from August to September 2024.

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Belatacept is a chimeric protein that acts as a selective blocker of T-lymphocyte co-stimulation. It has been proposed for the prevention of kidney transplant rejection. This paper reports a literature review on pharmacological characteristics of belatacept and genetic factors influencing its efficacy and safety profile.

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We conducted a real-life case-control study among outpatients with Omicron SARS-CoV-2 infection to assess the effectiveness of molnupiravir (MNP) in reducing hospital admission, admission to the intensive care unit, and death at day 28. Cases were SARS-CoV-2-positive patients seeking medical care within five days of symptom onset from 1 January to 31 December 2022, who received MNP. Controls were selected from a regional database among positive subjects who did not receive antiviral treatment for SARS-CoV-2.

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Outcomes are reported for 6 adults receiving rezafungin for chronic, hard-to-treat, invasive candidiasis (including ) during an early access program. Rezafungin was well tolerated and administered via once-weekly outpatient intravenous infusion for up to 39 weeks during the program, enabling hospital discharge and replacing daily antifungal infusions.

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Background: Ritonavir-boosted nirmatrelvir (N/r) is an antiviral which targets the main viral protease, administered to prevent the progression of SARS-CoV-2 infection in patients at high risk for severe COVID-19. We present a real-life case-control study evaluating the efficacy of N/r therapy in SARS-CoV-2 omicron variants positive outpatients in Campania region, Italy, with the aim of assessing the occurrence of three outcomes (hospital admission, admission in ICU and death) in cases and controls.

Methods: We enrolled SARS-CoV-2 positive subjects that came to our attention in Early antiviral treatment ambulatory of Infectious Diseases ward of University Federico II of Naples, Italy from January 1st, 2022, to December 31st, 2022, during the first five days from symptoms occurrence.

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Carbapenem-resistant (CRAB) poses significant challenges in healthcare due to its multidrug resistance and high mortality rates among critically ill patients. We enrolled 45 patients. Cefiderocol was administered to 40% of patients, often (38.

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Article Synopsis
  • Thymic epithelial tumors (TETs) are rare tumors often linked to immune issues, like Good's syndrome (GS), which increases mortality risk from infections.
  • The study reviewed COVID-19 incidence and severity among TET patients from March 2020 to April 2023, noting that about 66% of participants contracted COVID-19, regardless of GS presence.
  • Results showed a significant correlation between GS and increased COVID-19 severity, with 45% of GS patients experiencing higher severity scores compared to just 7.7% in patients without GS.
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Article Synopsis
  • Spondylodiscitis is a rare condition with limited treatment options, requiring long-term therapy, typically lasting up to twelve months, and azoles are the only available oral treatment for home therapy.
  • The case study reports a 68-year-old paraplegic patient who experienced reduced efficacy from azole treatment and was successfully treated with 200 mg of rezafungin weekly for 26 weeks after unsatisfactory results with voriconazole and liposomal amphotericin B.
  • Rezafungin demonstrates a promising alternative for treating Candida-related osteomyelitis, especially in cases where standard therapies fail or are poorly tolerated, with the patient showing full recovery without side effects.
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Background: pneumonia (PJP) is an invasive fungal infection (IFI) that occurs mainly in immunocompromised hosts. After observing a high prevalence of PJP as a complication of COVID-19 in immunocompetent patients, we conducted a study to evaluate the prevalence of colonization with PCR on oral washing samples (OWS) among non-immunocompromised and non-critical patients admitted with COVID-19 pneumonia at our university hospital.

Methods: All patients over 18 years of age admitted to the Infectious Diseases Unit for SARS-CoV-2 pneumonia between July 2021 and December 2022 were included.

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Background: Morbidity and mortality are higher in immunocompromised patients affected by COVID-19 than in the general population. Some authors have successfully used antiviral combination, but never in the early phase of the infection.

Methods: We conducted a retrospective cohort study to determine the efficacy and safety of the combination of two antivirals, with and without a monoclonal antibody (mAb), in both the early (within 10 days of symptoms) and in a later phase (after 10 days) of SARS-CoV-2 infection in immunocompromised patients admitted to our Facility.

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Background: Very few cases of pneumonia (PJP) have been reported in COVID-19 so far, and mostly in patients with concomitant HIV infection or in solid-organ transplant recipients. Despite COVID-19 being associated with lymphopenia and the use of steroids, there are no studies specifically aimed at investigating the risk factors for PJP in COVID-19.

Methods: A retrospective case-control study was performed.

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Article Synopsis
  • The intestinal microbiota is crucial for maintaining overall health and can influence various diseases, including chronic liver conditions like those caused by the Hepatitis C virus (HCV).
  • Recent advancements in antiviral treatments, specifically direct-acting antiviral agents (DAAs), have led to a high success rate in clearing HCV infections (around 95%).
  • A study involving 12 patients treated with DAAs revealed a decrease in harmful gut bacteria and an increase in microbial diversity after treatment, especially notable in patients without advanced liver cirrhosis.
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Objective: The aim of this study was to report the use casirivimab/imdevimab therapy in pregnant women with moderate coronavirus disease 2019 (COVID-19).

Study Design: We report 12 cases of unvaccinated pregnant patients with mild-to-moderate COVID-19 treated with casirivimab/imdevimab.

Results: Twelve unvaccinated pregnant patients with mild-to-moderate COVID-19 received casirivimab/imdevimab at the dose of 1200/1200 mg by intravenous infusion over 60 minutes.

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This article reports the study protocol of a nationwide multicentric study in seven Italian regions aimed at assessing the effectiveness of a digitally supported approach for the early screening of frailty risk factors in community-dwelling older adults. SUNFRAIL+ is a prospective observational cohort study aimed at carrying out a multidimensional assessment of community-dwelling older adults through an IT platform, which allows to connect the items of the SUNFRAIL frailty assessment tool with a cascading multidimensional in-depth assessment of the bio-psycho-social domains of frailty. Seven centers in seven Italian regions will administer the SUNFRAIL questionnaire to 100 older adults.

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Since 2020, COVID-19 pandemic has spread worldwide causing a huge number of cases and casualties. Among direct anti SARS-CoV-2 agents available for the treatment of COVID-19, only remdesivir and casirivimab/imdevimab have been approved for severe disease. As they act at different levels in blocking viral replication, it is theoretically possible to combine them.

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Invasive fungal infections (IFIs) represent a severe complication of COVID-19, yet they are under-estimated. We conducted a retrospective analysis including all the COVID-19 patients admitted to the Infectious Diseases Unit of the Federico II University Hospital of Naples until the 1 July 2021. Among 409 patients, we reported seven cases of IFIs by Candida spp.

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The gut microbiota plays a fundamental role in Hepatitis C Virus (HCV)-related liver disease. Indeed, HCV infection alters the gut microbiota, whereas intestinal dysbiosis induces an underlying inflammatory state. This status may lead to liver disease progression.

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We evaluated the role of CRP and other laboratory parameters in predicting the worsening of clinical conditions during hospitalization, ICU admission, and fatal outcome among patients with COVID-19. Consecutive adult inpatients with SARS-CoV-2 infection and respiratory symptoms treated in three different COVID centres were enrolled, and they were tested for laboratory parameters within 48 h from admission. Three-hundred ninety patients were enrolled.

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Purpose: To assess clinical, laboratory and radiological differences between Delta and Alpha SARS-CoV-2 variants.

Materials And Methods: Twenty SARS-CoV-2 patients admitted from 30th of August to 30th of October 2021 (period with estimated highest prevalence of Delta variant circulation in Italy) were enrolled. Patients were matched in a 1:1 ratio with same gender and same age +/- 2 years controls admitted from 1st of September 2020 to 30th of January 2021 (predominant circulation of Alpha variant).

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Campania is the sixth poorest region of Italy, and it is the region with the highest income inequality. The secondary attack rates of SARS-CoV-2 among households are found to be substantially heterogeneous among published studies and are influenced by socio-economic factors. We conducted a retrospective study to describe the role of socio-economic factors in the household transmission of SARS-CoV-2 among patients living in Campania Region and referring to "Federico II" Hospital.

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Objective: Our objective was to evaluate the safety and efficacy of casirivimab/imdevimab therapy in pregnant women with severe coronavirus disease 2019 (COVID-19) requiring oxygen therapy.

Study Design: This was a prospective case series study aimed to evaluate the safety and efficacy of casirivimab/imdevimab therapy in unvaccinated pregnant women with severe COVID-19. Inclusion criteria were severe acute respiratory syndrome coronavirus 2 infection documented with polymerase chain reaction, pregnancy, severe COVID-19 requiring oxygen therapy, duration of symptoms of 10 days or less, and able to provide informed consent.

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