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Special Issue "COVID-19: COVID-19 Epidemiological and Clinical Challenges"

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Global Health".

Deadline for manuscript submissions: closed (31 March 2022) | Viewed by 23246

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Special Issue Editors

Dr. Prisco Piscitelli

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Guest Editor

1. Euro Mediterranean Scientific Biomedical Institute (ISBEM), 72023 Mesagne, Italy
2. Italian Society of Environmental Medicine (SIMA), 20123 Milan, Italy
Interests: epidemiology; preventive medicine; occupational medicine; environmental medicine; global health; air pollution; indoor pollution; radon; infectious diseases
Special Issues, Collections and Topics in MDPI journals

Prof. Dr. Ivan Gentile
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Guest Editor

Dipartimento di Medicina clinica e Chirurgia, Università degli Studi di Napoli Federico II, 80131 Naples, Italy
Interests: COVID-19; bacterial and fungal infections, antibiotics, HIV and AIDS, HCV, HBV
Special Issues, Collections and Topics in MDPI journals

Prof. Dr. Alessandro Miani

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Guest Editor

1. Italian Society of Environmental Medicine (SIMA), 20123 Milan, Italy
2. Department of Environmental Science and Policy, University of Milan, 20149 Milan, Italy
Interests: primary prevention; indoor pollution; sustainability; public health; environmental medicine
Special Issues, Collections and Topics in MDPI journals

Dr. Loreto Gesualdo

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Guest Editor

Dipartimento della Emergenza e Trapianti d´Organo (DETO), Università degli Studi di Bari Aldo Moro, Università di Bari, Bari, Italy
Interests: nephrology; epidemiology; preventive medicine; precision medicine; occupational medicine; environmental medicine; personalized medicine

Special Issue Information

Dear Colleagues,

The COVID-19 pandemic has had a dramatic impact on both the population and healthcare systems across the world since 2020. As we are in the second year of the pandemic, it is time to assess the epidemiological burden and characteristics of COVID-19 spread and lethality among the general population and specific subgroups in different nations. At the same time, it is time to evaluate the efficacy of treatments that have been used for more than a year, as well as resume the follow-up of patients who were diagnosed or hospitalized due to COVID-19.

This Special Issue on “COVID-19: Epidemiological and Clinical Challenges” is aimed at stimulating clinicians and researchers working in the field of infectious diseases, virology, epidemiology, preventive medicine and public health, internal medicine, pulmonology, radiology, neurology, cardiology, etc. to share their research or experiences with the scientific community, from the perspective of common advances of knowledge that will lead us out of this health emergency.

Articles addressing epidemiological issues, treatment protocols, follow-up of small numbers or large cohorts of patients, as well as epidemiological or clinical surveys are solicited: systematic reviews, meta-analyses, original research articles, short articles, and commentaries are welcome and expected to add relevant information to the current knowledge.

Dr. Prisco Piscitelli
Prof. Dr. Ivan Gentile
Dr. Alessandro Miani
Dr. Loreto Gesualdo
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

COVID-19
epidemiology
prevention
diagnosis
treatment
follow-up

Published Papers (6 papers)

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Research

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8 pages, 3825 KiB

Open AccessArticle

Analysis of Experiences in Preventing COVID-19 in Hemodialysis Centers of the North of Poland before the Era of Vaccination

Bogdan Biedunkiewicz

Leszek Tylicki

Ewelina Puchalska-Reglińska

and

Alicja Dębska-Ślizień

Int. J. Environ. Res. Public Health 2022, 19(2), 684; https://doi.org/10.3390/ijerph19020684 - 07 Jan 2022

Cited by 4 | Viewed by 1090

Abstract

Background: The appearance of very contagious SARS-CoV-2 variants and waning vaccine immunity may indicate the need to return to using universal methods of preventing the spread of COVID-19. Methods: We performed a multicenter retrospective cohort survey study to describe the methods used in dialysis units to prevent and control the spread of SARS-CoV-2 and also the association between these methods and the incidence of COVID-19 among hemodialyzed (HD) patients before the era of vaccination. The study population included all maintenance HD patients (n = 1569) in 14 dialysis units in the Pomeranian Voivodeship. Results: The group of 352 patients (199 men, 153 female) were confirmed for COVID-19. The absolute cumulative incidence in the studied period was 22.4%. It varied widely by dialysis units, ranging from 9.4% to 36.9%. Universal preventive methods were applied by all units. Different additional methods were implemented in some stations with varying frequency (36–86%). In order to quantify the scale of the applied additional preventive methods, we calculated a summary prevention index (PI), i.e., one point for one additional method. Lower incidence was found in centers applying dialysis in isolation of patients hospitalized due to diseases requiring hospitalization (17.42% ± 6.89 vs. 26.54 ± 6.34; p = 0.028) and higher incidence in medium-size dialysis centers (ANOVA F: p = 0.017). Significant inverse correlation between PI and incidence was demonstrated as well (r = −0.759; p = 0.002). Conclusions: The higher the number of implemented preventive measures, the lower the risk of COVID-19 infection in HD patients. Among applied procedures the isolation of hospitalized patients is of significant importance. The measures proved to be effective in prevention before the vaccination era should be continued, as the threat of SARS-CoV-2 still exists. Full article

(This article belongs to the Special Issue COVID-19: COVID-19 Epidemiological and Clinical Challenges)

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7 pages, 628 KiB

Open AccessArticle

Pneumocystis jirovecii Pneumonia in Non-HIV Patients Recovering from COVID-19: A Single-Center Experience

Nicola Schiano Moriello

Antonio Riccardo Buonomo

and Federico II COVID-19 Team

Int. J. Environ. Res. Public Health 2021, 18(21), 11399; https://doi.org/10.3390/ijerph182111399 - 29 Oct 2021

Cited by 22 | Viewed by 2254

Abstract

Objective: to describe a single-center experience of Pneumocystis jirovecii pneumonia (PJP) in non-HIV patients recovering from COVID-19. Methods: We report the cases of five non-HIV patients with COVID-19 who also developed PJP at a University Hospital. Results: With the exception of one subject, who experienced an atypical and prolonged course of COVID-19, all the patients developed PJP after the clinical resolution of COVID-19 pneumonia. All but one patient had no pre-existing immunosuppressive conditions or other risk factors for PJP development at COVID-19 diagnosis. Nonetheless, following the course of COVID-19 infection, all the patients fulfilled at least one host factor for PJP; indeed, all the patients had received at least 2 weeks of high-dose steroids and three out of five had a CD4+ cell count <200/mm³. Conclusions: The use of corticosteroids for COVID-19 respiratory impairment seems to be the most common risk factor for PJP, together with viral-induced and iatrogenic lymphopenia. The worsening in respiratory function and the characteristic radiological picture during or after COVID-19 pneumonia should raise the suspicion of PJP, even in immunocompetent patients. PJP primary chemoprophylaxis can be considered in selected high-risk COVID-19 patients, but further studies are needed. Full article

(This article belongs to the Special Issue COVID-19: COVID-19 Epidemiological and Clinical Challenges)

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14 pages, 967 KiB

Open AccessArticle

Evaluation of Residual Infectivity after SARS-CoV-2 Aerosol Transmission in a Controlled Laboratory Setting

and

Int. J. Environ. Res. Public Health 2021, 18(21), 11172; https://doi.org/10.3390/ijerph182111172 - 24 Oct 2021

Cited by 6 | Viewed by 4182

Abstract

Severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) is mainly transmitted through respiratory droplets, aerosols, or direct contact with fomites from an infected subject. It has been reported that SARS-CoV-2 is stable and viable in aerosol up to 16 h in controlled laboratory conditions. However, the aerosolization conditions varied a lot between the studies. In this work, an experimental laboratory model of SARS-CoV-2 aerosolization was established, employing an impinger nebulizer, a cylindrical chamber for aerosol travel, and a SKC biosampler for the collection of particles. The efficiency of the system was assessed based on the molecular determination of the viral load in the nebulizer after the aerosolization and in the aerosol collected at the end of the travel. Moreover, the residual infectivity was tested in vitro on the Vero E6 cell line, through the observation of the cytopathic effect (CPE), and the quantification of the viral load in the supernatants at 7 days post inoculation (dpi). A high RNA viral load was found in the SKC biosampler after aerosolization, indicating that it was possible to transport a high virus titer through the 30-cm chamber with all the dilutions (initial 10⁵, 10⁴, 10³ plaque forming unit—PFU/mL). At the 7 dpi, an increment of the RNA viral load was determined for the dilutions 10⁵ and 10⁴ PFU/mL tested, while only the initial 10⁵ PFU/mL resulted in visible CPE. Our findings allowed us to achieve the resilience of SARS-CoV-2 in aerosol form, at a concentration comparable to those reported for clinical samples. This mode of transmission should be considered for the mitigation and preventive measures to counteract SARS-CoV-2 spreading. Full article

(This article belongs to the Special Issue COVID-19: COVID-19 Epidemiological and Clinical Challenges)

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15 pages, 5190 KiB

Open AccessArticle

Lactoferrin as Antiviral Treatment in COVID-19 Management: Preliminary Evidence

Int. J. Environ. Res. Public Health 2021, 18(20), 10985; https://doi.org/10.3390/ijerph182010985 - 19 Oct 2021

Cited by 44 | Viewed by 7431

Abstract

Lactoferrin (Lf), a multifunctional cationic glycoprotein synthesized by exocrine glands and neutrophils, possesses an in vitro antiviral activity against SARS-CoV-2. Thus, we conducted an in vivo preliminary study to investigate the antiviral effect of oral and intranasal liposomal bovine Lf (bLf) in asymptomatic and mild-to-moderate COVID-19 patients. From April 2020 to June 2020, a total of 92 mild-to-moderate (67/92) and asymptomatic (25/92) COVID-19 patients were recruited and divided into three groups. Thirty-two patients (14 hospitalized and 18 in home-based isolation) received only oral and intranasal liposomal bLf; 32 hospitalized patients were treated only with standard of care (SOC) treatment; and 28, in home-based isolation, did not take any medication. Furthermore, 32 COVID-19 negative, untreated, healthy subjects were added for ancillary analysis. Liposomal bLf-treated COVID-19 patients obtained an earlier and significant (p < 0.0001) SARS-CoV-2 RNA negative conversion compared to the SOC-treated and untreated COVID-19 patients (14.25 vs. 27.13 vs. 32.61 days, respectively). Liposomal bLf-treated COVID-19 patients showed fast clinical symptoms recovery compared to the SOC-treated COVID-19 patients. In bLf-treated patients, a significant decrease in serum ferritin, IL-6, and D-dimers levels was observed. No adverse events were reported. These observations led us to speculate a potential role of bLf in the management of mild-to-moderate and asymptomatic COVID-19 patients. Full article

(This article belongs to the Special Issue COVID-19: COVID-19 Epidemiological and Clinical Challenges)

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Review

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11 pages, 770 KiB

Open AccessReview

Functional and Psychological Changes after Exercise Training in Post-COVID-19 Patients Discharged from the Hospital: A PRISMA-Compliant Systematic Review

Amir Hossein Ahmadi Hekmatikar

João Batista Ferreira Júnior

Shahnaz Shahrbanian

and

Katsuhiko Suzuki

Int. J. Environ. Res. Public Health 2022, 19(4), 2290; https://doi.org/10.3390/ijerph19042290 - 17 Feb 2022

Cited by 36 | Viewed by 5398

Abstract

Millions of people worldwide are infected with COVID-19, and COVID-19 survivors have been found to suffer from functional disabilities and mental disorders such as depression and anxiety. This is a matter of concern because COVID-19 is still not over. Because reinfection is still possible in COVID-19 survivors, decreased physical function and increased stress and anxiety can lower immune function. However, the optimal exercise intensity and volume appear to remain unknown. Therefore, the current systematic review aimed to evaluate the effect of resistance or aerobic exercises in post-COVID-19 patients after hospital discharge. We conducted searches in the Scopus, SciELO, PubMed, Web of Science, Science Direct, and Google Scholar databases. Studies that met the following criteria were included: (i) English language, (ii) patients with COVID-19 involved with resistance or aerobic exercise programs after hospital discharge. Out of 381 studies reviewed, seven studies met the inclusion criteria. Evidence shows that exercise programs composed of resistance exercise (e.g., 1–2 sets of 8–10 repetitions at 30–80% of 1RM) along with aerobic exercise (e.g., 5 to 30 min at moderate intensity) may improve the functional capacity and quality of life (reduce stress and mental disorders) in post-COVID-19 patients. In addition, only one study reported reinfection of three subjects involved with the exercise program, suggesting that exercise programs may be feasible for the rehabilitation of the patients. A meta-analysis was not conducted because the included studies have methodological heterogeneities, and they did not examine a control group. Consequently, the results should be generalized with caution. Full article

(This article belongs to the Special Issue COVID-19: COVID-19 Epidemiological and Clinical Challenges)

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4 pages, 252 KiB

Open AccessBrief Report

Monoclonal Antibodies against SARS-CoV-2: Potential Game-Changer Still Underused

Ivan Gentile

Alberto Enrico Maraolo

Antonio Riccardo Buonomo

Mariano Nobile

Prisco Piscitelli

Alessandro Miani

and

Nicola Schiano Moriello

Int. J. Environ. Res. Public Health 2021, 18(21), 11159; https://doi.org/10.3390/ijerph182111159 - 24 Oct 2021

Cited by 10 | Viewed by 1892

Abstract

Even several months after the start of a massive vaccination campaign against COVID-19, mortality and hospital admission are still high in many countries. Monoclonal antibodies against SARS-CoV-2 are the ideal complement to vaccination in infected subjects who are at high risk for progression to severe disease. Based on data of the Italian Ministry of Health, in the period April–August 2021, monoclonal antibodies were prescribed to 6322 patients. In the same period, 70,022 patients over 70 years old became infected with SARS-CoV-2. Even considering that all monoclonal antibodies were prescribed to this category of patients, we calculated that only 9% of these subjects received the treatment. Moreover, using efficacy data provided by clinal trials, we estimated the potential benefit in terms of reduction of hospital admissions and deaths. Considering utilisation of monoclonal antibodies in half infected patients over 70 years, we estimated that hospital admissions and deaths might have been reduced by 7666 and 3507, respectively. Finally, we calculated the economic benefit of monoclonal use. In the same scenario (50% use of monoclonal antibodies to patients over 70), we estimated potential savings of USD 117,410,105. In conclusion, monoclonal antibodies were used in a small proportion of patients over 70 in Italy. A more extensive use might have resulted in a marked decrease in hospital admissions, deaths and in conspicuous saving for the health system. Full article

(This article belongs to the Special Issue COVID-19: COVID-19 Epidemiological and Clinical Challenges)

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