Long-term symptoms after SARS-CoV-2 infection in a cohort of people living with HIV.

BACKGROUND: Our Hospital in Northern Italy assists 3817 people living with HIV (PLWH) and has faced the impact of COVID-19. Little is known about the impact of HIV infection on the risk of post-COVID-19 conditions (PCCs) onset. We aim to assess the incidence of PCC in PLWH and the factors associated with its occurrence. METHODS: We performed a retrospective, observational study including all PLWH > 18 years registered in the Brescia Health Protection Agency database, assessing SARS-CoV-2 burden, vaccination status, socio-demographic, and viro-immunological parameters from February 2020 until May 2022. Persistence of self-reported symptoms (clustered into gastrointestinal, respiratory, osteo-muscular, and neuro-behavioral symptoms) was evaluated after 3 months by a telephone-administered questionnaire. We estimated the associations between all variables and outcomes through univariate and multivariable logistic models. RESULTS: In the study period, 653 PLWH were diagnosed with SARS-CoV-2 infection (17.1%). We observed 19 (2.9%) reinfections, 71 (10.9%) hospitalizations, and 3 (0.5%) deaths. We interviewed 510/653 PLWH (78%), and 178 (PCCs prevalence 34.9%; CI 95% 30.7-39.2) reported persistent symptoms. Asthenia/fatigue was the most reported symptom (60/178), followed by muscular pain (54/178). In the multivariate regression model, there was a lower risk of PCCs in males respect to females (adjusted OR = 0.64; CI 95% 0.99-3.66), while hospitalization during acute infection was associated with an increased the risk of PCCs (adjusted OR = 1.9; CI 95% 0.99-3.66). Notably, no viro-immunological variable modified the PCCs risk onset. CONCLUSIONS: Our study highlights a substantial prevalence of PCCs among PLWH, three months post-SARS-CoV-2 infection, independent of viro-immunological features or vaccination status.

Case report: An occult hepatitis B virus infection reactivation in an HIV/HCV coinfected patient during an immune reconstitution inflammatory syndrome.

The natural history of occult hepatitis B virus infection (OBI) and the mechanism involved in HBV reactivation are only partially understood. As regards people living with HIV (PLWH), HBV reactivation is estimated to occur with an incidence ratio of 0.019 cases per 100 person-year. Here we report the case of OBI reactivation in a HIV/HCV co-infected patient followed for 25 years at our Infectious Diseases Unit, but, unfortunately, lost to follow-up about 19 months after Direct-acting antivirals (DAAs) treatment. At re-engagement, blood tests showed high replication of plasmatic HIV-RNA along with severe immunosuppression and normal levels of liver enzymes. However, 3 months after ART reintroduction, an immune reconstitution inflammatory syndrome (IRIS) was diagnosed with high detectable HBV-DNA load and transaminase elevation. Our case report shows how the balance between the virus and the host immune system is quite a dynamic process that might significantly impact the course of the disease. The aim of this case report is to bring to the attention of physicians that, although OBI reactivation is a rather rare occurrence, even amongst PLWH, its potential consequences compel to a high alertness on the matter. Therefore, especially in patients with an impaired immune system and on a tenofovir or lamivudine-sparing regimen, HBV serological and virological markers should always be strictly monitored, even in the absence of a hepatitis flare.

Exploring the use of WeChat for qualitative social research: The case of Italian digital diaspora in Shanghai.

The widespread use of digital communication technologies has created new opportunities for social research. In this paper, we explore the limits and potentials of using messaging and social media apps as tools for qualitative research. Building upon our research on Italian migration to Shanghai, we discuss in detail the methodological choice of using WeChat for teamwork, remote sampling strategies, and conducting interviews. The paper highlights the benefits that researchers may have from employing the same technology that the studied community uses in their daily life as a research tool, and advocates for a flexible approach to research that adapts its tools and methods to the specific requirements and characteristics of the fieldwork. In our case, this strategy allowed us to emphasize that WeChat represents a digital migratory space which played a crucial role in understanding and making of the Italian digital diaspora in China.

Comparison of Monocyte Distribution Width (MDW) and Procalcitonin for early recognition of sepsis.

We carried out a prospective observational study to evaluate whether Monocyte Distribution Width (MDW) may play a role in identifying patients with sepsis in comparison with Procalcitonin (PCT). We prospectively enrolled all consecutive patients hospitalized at the Infectious Diseases Unit of Pescara General Hospital for bacterial infection or sepsis. MDW values were collected for all patients. Clinical characteristics, demographic data, past and present medical history, microbiological results, PCT, as well as neutrophil and monocytes indices at entry were compared in the 2 groups. Two-hundred-sixty patients were enrolled, 63.5% males, aged 59.1±19.5 years. Sepsis was diagnosed in 105 (40.4%); in 60 (57.1%) at least 1 microorganism was isolated from blood cultures. In multivariate models, MDW as a continuous variable (OR:1.57 for each unit increase; 95%CI: 1.31-1.87, p<0.001) and PCT˃1 ng/mL (OR: 48.5; 95%CI: 14.7-160.1, p<0.001) were independently associated with sepsis. Statistical best cut points associated with sepsis were 22.0 for MDW and 1.0 ng/mL for PCT whereas MDW values<20 were invariably associated with negative blood cultures. At ROC curve analysis, the AUC of MDW (0.87) was nearly overlapping that of PCT (0.88). Our data suggest that incorporating MDW within current routine WBC counts and indices may be of remarkable use for detection of sepsis. Further research is warranted.

Late vitreomacular traction in toxoplasma retinochoroiditis resolved by vitrectomy.

This paper reports a case of late vitreomacular traction in a young patient secondary to toxoplasma retinochoroiditis resolved by vitrectomy. A 17-year-old female with chronic inflammatory bowel disease developed severe vitreomacular traction 8 months after resolution of ocular toxoplasmosis with medical therapy. Best-corrected visual acuity, full ophthalmic slit-lamp examination, colour fundus photography, spectral domain optical coherence tomography, and fluorescein angiography were performed. The patient underwent vitrectomy with removal of the clinically evident posterior hyaloid. Vitrectomy was rapidly successful in resolving the vitreomacular traction, with full recovery in best-corrected visual acuity of 20/20. Vitreoretinal traction in patients with previous toxoplasma retinochoroiditis may appear several months after resolution of the inflammatory condition. We suggest observing carefully for possible development of late vitreoretinal traction during follow-up of such patients.

Method validation for determination of cadmium and lead in offal by means of quadrupole inductively coupled plasma mass spectrometry.

Offal includes viscera and internal organs that have been removed from butchered animals, that may be either directly eaten or processed for the production of other foodstuff. Such organs are able to accumulate high concentrations of potentially toxic heavy metals posing a risk for human health when ingested. Because high levels of Cd and Pb may produce damages to humans, Commission Regulation no. 1881/2006 and its amendment established maximum levels for those two elements in edible bovine, porcine, and ovine offal. In the present study, a method based on microwave acid-assisted digestion and quadrupole inductively coupled plasma mass spectrometric quantification of Cd and Pb in offal was validated according to the EU common standards. The main parameters evaluated in the validation process were: the detection and the quantification limits (LoD, LoQ), the recovery, the repeatability, the within-laboratory reproducibility, the linearity range, and the standard measurement uncertainty. The results obtained for LoD and LoQ in microg kg(-1) were, respectively, Cd, 1.8 and 5.4; Pb, 5.1 and 15.5; meanwhile, the mean recovery was about 98% for Cd and 103% for Pb. Repeatability was around 5% for Cd and 4% for Pb. The expanded standard measurement uncertainty, expressed as percentage and with a coverage factor of 2, was estimated as follows: Cd, 4.9%; Pb, 8.7%. For both elements, the main contribution was due to the within-laboratory reproducibility of the measurements.

Calcium, copper, iron, magnesium, silicon and zinc content of hair in Parkinson's disease.

The aetiology of Parkinson's disease (PD) is still unknown, but some hypotheses have focused on the imbalances in body levels of metals as co-factors of risk. To assess whether hair could be a reliable marker of possible changes, calcium (Ca), copper (Cu), iron (Fe), magnesium (Mg), silicon (Si) and zinc (Zn) were determined in hair from 81 patients affected by PD and 17 age-matched controls. Care was taken to eliminate external contamination of the hair by thorough washing. Digestion of the matrix was achieved by an acid-assisted microwave procedure. Quantification of the elements was performed by inductively coupled plasma atomic emission spectrometry. Results indicated significantly lower levels of Fe in the hair of patients (p=0.018) compared with controls. Ca and Mg levels were slightly lower while Zn levels were higher in patients, although these differences were not significant; neither were variations in Cu and Si. Ca and Mg were at least 1.5 times higher in females than in males in both controls and patients. In addition, Ca correlated positively with Mg in both groups and in both sexes (p-value always less than 0.03), and negatively with age in patients (p<0.01). Finally, element levels did not correlate with either the duration or the severity of the disease or with anti-Parkinson treatment.