Characterization of an influenza B virus isolated from a fatal case of myocarditis in a pediatric patient in Italy.

Influenza B is one of the infective agents that can cause rapid and fatal myocarditis in children. Here, we describe a fatal case of myocarditis in a previously healthy child, after infection with an influenza B/Victoria-lineage virus during the 2022-23 epidemic season in Italy. Influenza B virus was isolated also in a second case, a younger family member showing only a mild influenza-like illness. Genotypic and phenotypic analyses have been performed on both virus samples and results showed that HA1 sequences were identical and genetically and antigenically related to other B viruses circulating in 2022-23 season in Italy. However, a D129N substitution was found in the receptor binding domain of the HA of the two viruses, not detected in other circulating viruses in Italy but only in a proportion of those circulating in other European countries. Phenotypic analyses assessed the susceptibility towards either neuraminidase inhibitors and baloxavir. Annual influenza vaccination remains one of the best interventions to prevent complications such as myocarditis, particularly in children.

An overview on the use of ultraviolet radiation to disinfect air and surfaces.

Background and aim Ultraviolet radiation (UV) is the portion of the electromagnetic spectrum of wavelengths between 200 and 400 nm divided into three bands called UVA, UVB and UVC. Due its well-described antimicrobial activity, UVC can represent a useful tool for disinfect surfaces, water, and air. The aim of this study was to illustrate the studies over time ultraviolet germicidal irradiation (UVGI) to disinfect air and surfaces. Methods Articles on Scopus published until April 14, 2023, were considered. Many issues involving UV were deepened crosschecking with e.g., "air", "surfaces", "disinfection", "bacteria", "fungi", "operating theatres". According to the case, the following variables were considered: years and related number of articles, sources of publications, subject areas, type of document published, type of journal, nationalities of the authors. Results Since 30's, 287 448 articles on UV have been published. Among UVGI, 22 159 articles covered bacteria issue, followed by fungi and viruses with about 12000 both. UVGI was addressed by 1941 and 931 articles for surfaces and air respectively. Of these, 122 were performed in operating theatres. Since 1987 works have been published on spacecraft and since 2000, on the use of UVGI robots for disinfect air and surfaces. Conclusions Our study shows the studies on UVGI and related issues. It also shows most recently perspectives about the applications e.g. during prolonged human-crewed missions on spacecrafts, to inactivate microorganisms in environments where the exchange of air is impossible.

An overview of the studies on microbial air contamination in operating theatres and related issues over time: a useful tool for a multidisciplinary approach.

Background and aim Surgical site infection (SSI) is a major complication following surgery associated with increased morbidity and mortality, as well as increased health and not health costs. A variety of factors affect airborne contamination in operating theatres (OT). Following the Medical Research Council study showing a correlation between microbial air contamination and SSI incidence in prosthetic joint surgery ultraclean OTs have been recommended for this type of surgery, while OTs supplied by turbulent airflow plants are recommended for other types of surgery. The aim of this study was to illustrate the studies on this topic. Methods Scopus was considered for articles published until January 2023 on OTs and air contamination in article title or abstract or keywords. Many issues were deepened: "microbial", "bacterial", "fungi", "viruses", "surgical site/wound infection", "monitoring/sampling", "air changes", "behaviour", "door openings", "particles", turbulent flow", "unidirectional flow". Results Total papers published were 907 and 249 papers faced monitoring/sampling. A total of 313 papers investigated airborne bacterial contamination and 63 papers investigated fungal air contamination. There were 218 papers that have evaluated particle contamination in OTs. Many other issues were deepened. Conclusions This study shows a picture of the studies on biological air contamination in OTs and related issues over time. We think that the results of our study will provide a useful tool to increase awareness towards a better sharing of aims, approaches, and results, above all in the interest of the patients, but also of the health services of the different countries. (www.actabiomedica.it).

A descriptive analysis of COVID-19 associated mortality in Parma Province: concordance between official national mortality register provided by ISTAT (National Institute of Statistics) and local ADS (Automated Data System) real-time surveillance flow.

BACKGROUND AND AIM: The Public Health Department of the Parma Local Health Authority (AUSL) has implemented a computerized system called ADS (Automated Data System) to collect data on COVID-19 cases and related deaths, as required by the Emilia-Romagna Region and the Italian Ministry of Health, to improve the daily flow of real-time information. However, official mortality data for all causes was collected even from the National Institute of Statistics (ISTAT) through death forms that were completed by certifying doctors in each municipality. This analysis aims to verify the agreement between the data collected by ISTAT and the data collected by ADS. METHODS: The study period went from January 1st to December 31st, 2021. The population under observation consisted of residents in the province of Parma who died due to COVID-19, as identified through the ISTAT and/or ADS data flow. RESULTS: In 2021, a total of 448 deaths due to COVID-19 were reported in the Parma Province, with a median age of 83 years. The ADS system identified 408 of these deaths, whereas ISTAT certified only 347. Three hundred and seven deaths were identified by both flows. CONCLUSIONS: The survey suggests that the ADS surveillance system may have overestimated the COVID-19 mortality data compared to the ISTAT flow. The ADS has been valuable in the immediate response to emergencies, providing a more sensitive system that prioritizes the precautionary principle and enables decisions aimed at minimizing risks for vulnerable populations. However, it is not recommended for routine surveillance, as it is less reliable compared to the ISTAT flow.

Consumption of Energy Drinks among Italian University students: a cross-sectional multicenter study.

PURPOSE: The aim of the study was to evaluate the caffeinated Energy Drinks (EDs) consumption among a large sample of Italian undergraduates and its association with some of the major lifestyle risk factors. METHODS: Students attending twelve public Italian universities were involved between October 2021 and May 2022. Information on socio-demographic characteristics, ED consumption, and on health-related behaviors of participants was collected by the use of a web-based questionnaire. RESULTS: A total of 2165 students participated in the study and 15.2% of them reported having used caffeinated EDs in the last six months, mainly once a month (41.5%). In comparison with non-users, ED users showed a higher proportion of males (p < 0.001) and a higher father's educational level (p = 0.003), came mainly from Northern universities (p = 0.004) and life sciences degree courses (p < 0.001). Besides, ED users reported higher BMI values (p = 0.003), more particular dietary regimens (p < 0.001), higher levels of weekly moderate-vigorous physical activity (p < 0.001) and participation in sports (p < 0.001) and in team sports (p = 0.003), and higher proportion of smokers (p < 0.001) and alcohol drinkers (p = 0.005). ED use was negatively related with female gender (OR 0.546; 95% CI 0.374-0.798), the Mediterranean diet (OR 0.587; 95% CI 0.362-0.951) and coming from the center of Italy (OR 0.500; 95% CI 0.275-0.909) and positively associated with tobacco smoke (OR 1.712; 95% CI 1.176-2.492) and participation in a team sport (OR 1.686; 95% CI 1.051-2.707). CONCLUSION: These findings could encourage figures engaged in education to increase the students' awareness on this issue in order to prevent the excessive use of EDs and associated unhealthy behaviors, especially in the most interested subgroups.

Air microbial sampling in operating theatres by active and passive methods: equation correlation from the GISIO-ISChIA study results and comparison with the EU GGMP recommendation, towards the definition of threshold values.

The aim of this study was to calculate the equation of correlation between the microbial air contamination values obtained by active sampling (colony-forming units per cubic metre, CFU/m3) and by passive sampling (Index of microbial air contamination, IMA), by using the data from the ISChIA study, and to compare the values obtained with the recommended limits defined by the EU Guidelines to Good Manufacturing Practice (EU GGMP), 2008, for clean areas used to manufacture sterile medicinal products. Air sampling was performed during 335 elective prosthesis procedures. Correlation between CFU/m3 and IMA values was evaluated using the Spearman test; p<0.05 was considered to indicate significance. This equation was used to calculate the IMA values corresponding to the CFU/m3 recommended threshold values by EU GGMP for the different Grades of microbial contamination. The following correlation equation was obtained: y = 1.86 + 0.12x, where "x" = cfu/m3 value and "y" = IMA value. The relationships between CFU/m3 and IMA values obtained from active and passive sampling during the ISChIA study showed to be in line to those suggested by the EU GGMP for pharmaceutical manufacturing for Grade C and D. This study shows that the EU GGMP relationship could be considered valid also for operating theatres. Both methods, active and passive samplings, can be used to evaluate microbial air quality and highlight critical situations; however, in particular during the activity, passive sampling estimating the risk posed by airborne microorganisms to the surgical wound, can be considered more relevant, and for its simplicity, economy and standardization, can be suggested for routine microbial monitoring.

Assessment of dietary supplement consumption among Italian university students: The multicenter DiSCo study.

OBJECTIVES: The aim of this study was to analyze the consumption of dietary supplements (DSs) and related sociodemographic characteristics or behaviors in Italian undergraduates. METHODS: A questionnaire-based, cross-sectional study was carried out between October 2021 and May 2022 involving undergraduates from 12 public universities. The use of DSs in the previous 6 mo, the aim and reason for use, the purchasing channel, and related adverse effects were explored and compared by sex. A logistic regression was performed to highlight possible associations between sociodemographic, anthropometric, and behavioral characteristics of participants and supplement consumption. RESULTS: The use of DSs was reported by 71.5% of the 2165 respondents. Supplementation was related to sex (odds ratio [OR] 0.690; 95% confidence interval [CI], 0.516-0.924, for men), vegetarian or vegan (OR 4.814; 95% CI, 1.669-13.887) and other particular diet regimens (OR 1.819; 95% CI, 1.282-2.580), sport (OR 1.688; 95% CI, 1.116-2.553), and type of sport (OR 0.629; 95% CI, 0.423-0.936, for team sports). Women were more likely to use DSs following a doctor's prescription and to buy them in a pharmacy (P < 0.001) but reported more adverse effects (P = 0.018) than men. The main aim pursued was general health; proteins, amino acids, and non-caffeinated energy supplements were consumed to improve physical performance and caffeinated energy supplements for mental performance. CONCLUSIONS: Diet supplementation was common in the sample examined, especially in women, and associated with particular dietary regimens and sports, especially individual sports. Female consumers follow specialists' indications more than males. These results highlight the need for educational interventions about diet supplementation for this category of users.

The scenario of the studies on ragweed (Ambrosia Sp.) and related issues from its beginning to today: a useful tool for future goals in a one health approach.

BACKGROUND AND AIM: Airborne ragweed pollen is one of the agents of respiratory allergies in our changing environment. The monitoring of pollen is essential to manage pollen allergy and to improve its forecasting methods. Moreover, the control and fight against ragweed plants is important. Aim of this study is to understand the scenario of the studies on ragweed over time. METHODS: We searched PubMed and Scopus for articles published until July 2022 reporting the words "ragweed". Articles written in all languages were included. RESULTS: Scopus was the database with the highest number of published papers. Among the papers on ragweed, the papers citing the word "allergy" were 59.4% in PubMed and 37,6% in Scopus. The subject areas more addressed were medicine, immunology, genetics/molecular biology, but agricultural/biological sciences too and, interestingly, other subjects like social sciences, art, humanistic, etc.). Among the top 40 institutions supporting research, 8 were European, 4 Asian, 1 Russian and 21 were American, the other 6 were pharmaceutical companies. CONCLUSIONS: This study shows a picture of the ragweed studies and some related subjects over time. A gap between the number of biomedical and not biomedical issues was evident. There is a need for greater involvement of institutions into support of knowledge and fight ragweed. The results will provide a useful tool to identify future goals in a global approach of ragweed related issues.

Transforming waiting pauses into opportunity for physical activity: the "Activate your Wait" pilot study.

BACKGROUND AND AIM: Physical activity is recognized as a major health determinant. However, the prevalence of inactivity can be as high as 80% in some adult subpopulations. From the urgent need to implement strategies to fight sedentary behaviour, considering that physical activity is defined as any bodily movement produced by skeletal muscles that require energy expenditure, the pilot study "Activate your Wait" was born. The project aim is to transform waiting pauses during everyday life into opportunities to perform simple stretching and active mobilization exercises. METHODS: The pilot study was carried out in 2019 at Terme S. Egidio (Italy). It was divided in three phases: in the pre-intervention a questionnaire was used to evaluate the interest in the project (96 responders); during the intervention, examples of simple exercises that people can do by themselves were illustrated and undertaken by about 120 participants; in the post-intervention an evaluation questionnaire was administered (71 responders). RESULTS: The intervention aroused enthusiastic participation and high approval and resulted in an increase both in willingness to perform exercises during daily waiting pauses (68% vs 94%) and belief in positive results of physical activity on health (74% vs 96%). CONCLUSIONS: In a context where the opportunities for physical activity are decreasing and a sedentary lifestyle has reached a high level, this project represents a contribution to the increase in the awareness of the importance of physical activity and the promotion of the culture of movement in the entire population, with an opportunity of easy accessibility in different contexts of life, at all ages.

Stress in Medical Students: PRIMES, an Italian, Multicenter Cross-Sectional Study.

Medical students (MSs) are healthcare workers and must also cope with education-related stressors. This study aims to assess factors associated with perceived stress in Italian MSs. A cross-sectional study was conducted in 12 Italian medical schools (MSCs) in November 2018. A questionnaire assessed socio-demographic characteristics, habits, opinions about MSC, and concerns about the future. Stress was assessed with the PSS-10. Descriptive and univariable tests were performed. A linear model was fitted to find associations of the PSS-10 score with characteristics. There were 2513 collected questionnaires. Median PSS-10 score was 18 (IQR 11). Median age was 22 (IQR 4) and 61% of the sample was female. Female gender, being part of a sexual minority, poor financial situation, competitive atmosphere, having hobbies, resting, and sleeping hindered by MSC were characteristics associated with higher PSS-10 scores. Current relationship, good family relationship, and no concerns about the future were protective factors. Being part of sexual minorities had greater effects in students not living away from home, while in the other group it was not having satisfying friendships. Medical students suffer higher levels of stress than the general population, and many MSC stressors are associated. Living away from home modifies risk and protective factors, offering the possibility to tailor group-specific interventions.

What about Your Body Ornament? Experiences of Tattoo and Piercing among Italian Youths.

BACKGROUND: tattooing and piercing are increasingly common, especially among youths. However, several health complications may be associated with these practices if basic hygiene rules are not respected. This multicenter study was aimed at exploring tattoo and piercing experiences reported by a large sample of Italian undergraduate students through a public health perspective. METHODS: tattooed and/or pierced students attending 12 Italian universities were asked to complete a web-based questionnaire regarding their body art experience. RESULTS: out of 1472 respondents, 833 (56.6%) were tattooed and 1009 (68.5%) were pierced. The greatest proportion of tattooed students (93.9%) got her/his first tattoo in a tattoo studio, while most of the pierced were serviced in a jewelry store (48.0%). The pierced ones were less informed on health issues related to the procedure (56.0% versus 77.8% of tattooed p < 0.001), and tattooists were reportedly more attentive to hygiene rules (instrument sterilization 91.5% versus 79.1% of piercers, p < 0.001; use of disposable gloves 98.2% versus 71% of piercers, p < 0.001). CONCLUSIONS: educational interventions for both professionals and communities are needed to improve the awareness and the control of health risks related to body art throughout the Italian territory.

Virological surveillance of SARS-CoV-2 in an Italian Northern area: differences in gender, age and Real Time RT PCR cycle threshold (Ct) values in three epidemic periods.

BACKGROUND AND AIM OF THE WORK: Coronavirus Disease 2019 (COVID-19), caused by the novel severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), is a global public health emergency. The aim of this study was to investigate cases characteristics and Real Time RT PCR cycle threshold (Ct) values distribution of COVID-19 in an Italian Northern area during three periods: first period, February-May 2020; second period, June-August 2020; third period, September 2020-February 2021. METHODS: Real Time RT PCR was used to detect SARS-CoV-2 in respiratory samples (oro/nasopharyngeal swabs). RESULTS: A total of 254,744 samples were tested during the study period. Out of 20,188 positive samples (7.92%), 10,303 were females (51.04%) and 9,885 were males (48.96%). The percentage of positivity varied during the three different periods: 14.1% in the first period, 1.4% in the second and 9.2% in the third. The lowest Ct values were observed in the first phase of pandemic, with an overall average of 25.64. Overall average of the Ct values was lower in males than in females, 26.29 ± 6.04 and 26.84 ± 5.99 respectively. The oldest patients recorded lower Ct values. CONCLUSIONS: The findings of our study represent further evidence in support of the fact that male sex and older age showed lower Ct values, which means higher viral loads and higher infectious potential. These knowledges are useful to better understand the epidemiological aspects of COVID-19 and to perform effective Public Health Policies.

Assessing Undergraduates' Perception of Risks Related to Body Art in Italy: The SUPeRBA Multicenter Cross-Sectional Study.

Tattooing and piercing may lead to health complications. The present multicenter cross-sectional study aimed to assess awareness and knowledge of health risks related to body art and to identify their possible determinants among a large sample of undergraduates in Italy. A web-based questionnaire collecting information on socio-demographic characteristics, awareness, knowledge, and some potential predictors was administered to undergraduates attending twelve Italian universities. The level of knowledge was expressed as the number of correct answers (0-11 for tattooing, 0-14 for piercing). A total of 2985 participants (mean age 23.15 ± 3.99, 73.9% F) participated in the study. Although 95.4% of the respondents were aware of possible health consequences of body art, a low level of specific knowledge was registered for both tattooing (mean number of correct answers 5.38 ± 2.39) and piercing (5.93 ± 3.12) consequences. Lower knowledge was associated with the attendance of non-life science course and with lower duration of academic education for both tattoo and piercing. Lower knowledge of tattooing risks was related with commuter status, while lower knowledge of piercing risks was associated with lower father's education. These findings highlight the need to enhance information campaigns targeted to youths to increase their awareness of possible health risk of body art.

Epidemiology of SARS-CoV-2 Infection Evaluated by Immunochromatographic Rapid Testing for the Determination of IgM and IgG Against SARS-CoV-2 in a Cohort of Mask Wearing Workers in the Metal-Mechanical Sector in an Area With a High Incidence of COVID-19.

Background: Although the diagnosis of new coronavirus 2019 (COVID-19) is made through the identification of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in respiratory secretions by means of molecular methods, a more accurate estimation of SARS-CoV-2 circulation can be obtained by seroprevalence studies. The main aim of this study was to evaluate the true epidemiology of SARS-CoV-2 infection among workers in the metal-mechanical sector who never stopped working during the pandemic period in an area with a high incidence of COVID-19 and to define whether and how they could continue the work without appreciable risks during a second wave. Methods: A total of 815 metal-mechanical workers who had never stopped working even during the pandemic period in three different factories in the Emilia-Romagna Region, Italy, and who had always used face masks during working hours, underwent a capillary blood rapid test for the determination of IgM and IgG against SARS-CoV-2 (COVID-19 IgG/IgM Rapid test, PrimaLab, Modena, Italy). In the event of a positive test, a nasopharyngeal was performed and tested for the presence of SARS-CoV-2. Results: The detection of serum IgG/IgM against SARS-CoV-2 was significantly more common among workers employed in Parma (21/345, 6.1%) than among those employed in Calerno (7/242, 2.9%) or in Spilamberto (3/228, 1.3%) (p <0.001). The analysis of the role of the different variables as predictors of seropositivity for IgG/IgM against SARS-CoV-2 revealed that the presence of specific antibodies was strictly associated with a previous history of COVID-19-like symptoms (odds ratio [OR] 3.95, 95% confidence interval [CI] 1.9-8.2) and household members with COVID-19-like symptoms (OR 2.20, 95% CI 1.04-4.82). Conclusion: This study shows that seropositivity to SARS-CoV-2 is low even among employees who did not interrupt their work during the lockdown phase in a region with a high incidence of COVID-19. The use of face masks appears effective in the avoidance of the transmission of SARS-CoV-2 in factories even in the presence of asymptomatic or mildly symptomatic workers, suggesting that work activities can continue if adequate infection control measures are used during a second wave.

Clinical efficacy of medical hydrology: an umbrella review.

The aim of this research was to summarize available scientific evidence on the efficacy of medical hydrology for the management of any health condition. The search was conducted on 26th March 2021, in the following databases: Medline (via PubMed), EMBASE, Web of Science, Cochrane Library, and Google Scholar. All relevant literature reviews investigating the clinical efficacy of interventions characterized by the use of natural mineral waters and muds were included. The quality of studies was assessed with the "AMSTAR 2" tool. After article screening, 49 reviews were included in this work. Overall, retrieved scientific evidence suggests that spa therapy is beneficial for patients affected by some specific musculoskeletal conditions, with improvements potentially lasting up to 9 months. Moreover, balneotherapy can be an integrative support for the management of chronic venous insufficiency and some inflammatory skin diseases like psoriasis. The role of spa therapy in rehabilitation appears relevant as well. More limited, although interesting evidence exists for inhalation and hydropinic therapies. Globally, retrieved evidence suggests that, besides individual wellbeing, medical hydrology can be useful for public health. In particular, higher-quality studies seem to support the integrative use of spa-related interventions for conditions like osteoarthritis, fibromyalgia, low back pain of rheumatic origin, and chronic venous insufficiency. However, the body of evidence has some limitations and further clinical trials should be designed for each relevant application to consolidate and expand acquired knowledge.

Chest radiography or computed tomography for COVID-19 pneumonia? Comparative study in a simulated triage setting.

INTRODUCTION: For the management of patients referred to respiratory triage during the early stages of the severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) pandemic, either chest radiography or computed tomography (CT) were used as first-line diagnostic tools. The aim of this study was to compare the impact on the triage, diagnosis and prognosis of patients with suspected COVID-19 when clinical decisions are derived from reconstructed chest radiography or from CT. METHODS: We reconstructed chest radiographs from high-resolution CT (HRCT) scans. Five clinical observers independently reviewed clinical charts of 300 subjects with suspected COVID-19 pneumonia, integrated with either a reconstructed chest radiography or HRCT report in two consecutive blinded and randomised sessions: clinical decisions were recorded for each session. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and prognostic value were compared between reconstructed chest radiography and HRCT. The best radiological integration was also examined to develop an optimised respiratory triage algorithm. RESULTS: Interobserver agreement was fair (Kendall's W=0.365, p<0.001) by the reconstructed chest radiography-based protocol and good (Kendall's W=0.654, p<0.001) by the CT-based protocol. NPV assisted by reconstructed chest radiography (31.4%) was lower than that of HRCT (77.9%). In case of indeterminate or typical radiological appearance for COVID-19 pneumonia, extent of disease on reconstructed chest radiography or HRCT were the only two imaging variables that were similarly linked to mortality by adjusted multivariable models CONCLUSIONS: The present findings suggest that clinical triage is safely assisted by chest radiography. An integrated algorithm using first-line chest radiography and contingent use of HRCT can help optimise management and prognostication of COVID-19.

Therapeutic strategies against COVID-19.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a novel coronavirus that mainly affects the upper and lower respiratory tract and is responsible for extremely different degrees of disease, ranging from flu-like symptoms to atypical pneumonia that may evolve to acute respiratory distress syndrome and, ultimately, death. No specific therapy for SARS-CoV-2 has yet been identified, but since the beginning of the outbreak, several pre-existing therapeutics have been reconsidered for the treatment of infected patients. The aim of this article is to discuss current therapeutics against SARS-CoV-2. A literature review was performed using PubMed, collecting data from English-language articles published until June 20th, 2020. Literature analysis showed that with the acquisition of more in-depth knowledge on the characteristics of SARS-CoV-2 and the pathogenesis of the different clinical manifestations, a more rationale use of available drugs has become possible. However, the road to defining which drugs are effective and which schedules of administration must be used to maximize efficacy and minimize adverse events is still very long. To date, it is only clear that no drug can alone cope with all the problems posed by SARS-CoV-2 infection and effective antivirals and inflammatory drugs must be given together to reduce COVID-19 clinical manifestations. Moreover, choice of therapy must always be tailored on clinical manifestations and, when they occur, drugs able to fight coagulopathy and venous thromboembolism that may contribute to respiratory deterioration must be prescribed.

Virological surveillance of SARS-CoV-2 in an Italian northern area: comparison of Real Time RT PCR cycle threshold (Ct) values in three epidemic periods.

Aim of the study was to investigate the differences in Ct values in nasopharingeal swabs collected in three SARS-CoV-2 epidemic periods: first one from February 23 to March 25 (14 days from lockdown started on March 11); the second one from  March  26 to May 18 (14 days  from the end of strict lockdown on May 4) and the third one from May 19 until June 15. Viral RNA was detected in nasopharyngeal swabs obtained both from inpatients and outpatients. COVID-19 infection was confirmed according to the Ct values for N1 and N2 genes ascertained by Real-Time RT-PCR assay as described by the CDC. We calculated the prevalence of nasopharyngeal swabs tested positive for SARS-CoV-2, the mean and median of the Cts and the percentage of samples equal or below the Ct value of 25 in the 3 periods considered. The average value of Ct increased, going from 24.80 in the first epidemic period to 26.64 in the second period to 28.50 in the third period (p <0.001). The percentage of samples with Ct lower than or equal to 25 also decreased sharply from 54.7% to 20.0%. These findings need to be integrated with epidemiological and clinical data.

Detection of SARS-CoV-2 on hospital surfaces.

The COVID-19 pandemic, affecting 213 countries, with more than 10 million cases and over 500,000 deaths is still causing serious health, social and economic emergency worldwide. Italian Northern regions are among the most badly affected areas. Surfaces represent matrices to which particular attention should be paid for prevention and control of SARS-CoV-2 transmission. A few studies have highlighted virus presence on surfaces. We report the evidence of its presence on hospital surfaces, in a single room hosting a patient whose nose-pharyngeal swab resulted positive for SARS-CoV-2 RNA at the admission. The surfaces sampling was carried out using pre-wetted swabs followed by extraction and amplification of viral RNA by reverse Real-Time Polymerase Chain Reaction (rRT-PCR). A total of 4/15 (26.66%) surfaces were positive for SARS-CoV-2 RNA: the right bed rail, the call button, the bed trapeze bar, the stethoscope; moreover, the patient's inner surgical mask was positive, showing the emission of the virus from the patient. This study is a further confirmation that the surfaces represent a potential vehicle of transmission. This supports the need for strict adherence to hand and environmental hygiene.

Vaccines against Coronaviruses: The State of the Art.

The emerging epidemic caused by the new coronavirus SARS-CoV-2 represents the most important socio-health threat of the 21st century. The high contagiousness of the virus, the strong impact on the health system of the various countries and the absence to date of treatments able to improve the prognosis of the disease make the introduction of a vaccine indispensable, even though there are currently no approved human coronavirus vaccines. The aim of the study is to carry out a review of the medical literature concerning vaccine candidates for the main coronaviruses responsible for human epidemics, including recent advances in the development of a vaccine against COVID-19. This extensive review carried out on the vaccine candidates of the main epidemic coronaviruses of the past has shown that the studies in animal models suggest a high efficacy of potential vaccines in providing protection against viral challenges. Similar human studies have not yet been carried out, as the main trials are aimed at assessing mainly vaccine safety and immunogenicity. Whereas the severe acute respiratory syndrome (SARS-CoV) epidemic ended almost two decades ago and the Middle East respiratory syndrome (MERS-CoV) epidemic is now better controlled, as it is less contagious due to the high lethality of the virus, the current SARS-CoV-2 pandemic represents a problem that is certainly more compelling, which pushes us to accelerate the studies not only for the production of vaccines but also for innovative pharmacological treatments. SARS-CoV-2 vaccines might come too late to affect the first wave of this pandemic, but they might be useful if additional subsequent waves occur or in a post-pandemic perspective in which the virus continues to circulate as a seasonal virus.