The New Challenges in Infectious Diseases

A special issue of Life (ISSN 2075-1729). This special issue belongs to the section "Epidemiology".

Deadline for manuscript submissions: closed (31 December 2020) | Viewed by 28854

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Guest Editor
Department of Mental Health and Public Medicine, University of Campania Luigi Vanvitelli, 80138 Naples, Italy
Interests: infectious diseases; epidemiological, virological, and clinical characteristics of hepatitis viruses (A, B, Delta, and C) infection; HIV infection; AIDS; hospitalization-associated infections; SARS-CoV-2 infection
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Special Issue Information

Dear Colleagues,

Infectious diseases have characterized human history, and currently present several challenges. For example, during the last few decades the wide spread of antimicrobial resistance has become a global health problem, significantly increasing the overall hospital mortality, the need for ICU admission, the length of stay, and consequently the healthcare costs. To tackle the emergence of resistance, regulatory authorities and scientific societies have released guidelines that recommend the implementation of interventions, generally referred to as “Antibiotic Stewardship Programmes”, to improve the appropriateness of antibiotic prescriptions, including the indication, the choice of molecule, the route of administration, and the duration of therapy. Another challenge is presented by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. The COVID-19 pandemic represents the greatest global public health threat of the last several decades, with devastating effects not only on public health but also on economy and financial sectors.

Finally, some known infections such as HCV and HIV, due to the development of very efficacious antiviral treatment, currently have a good prognosis. However, for these infections the challenge is represented by the case finding and linkage-to-care of positive subjects, not only in difficult-to-reach populations such as intravenous drug users, prisoners, and immigrants, but also in the general population. For example, since the high efficacy of direct anti-viral agents (DAA) treatment, the World Health Organization (WHO) in 2015 suggested that HCV could be eliminated by HCV treatment within 2030 (i.e., 90% reduction in new chronic infections, 65% reduction in mortality).

Authors are cordially invited to contribute original research papers or reviews to this Special Issue of Life.

Prof. Dr. Nicola Coppola
Guest Editor

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Keywords

  • infectious diseases
  • HCV
  • HBV
  • HIV
  • multidrug-resistant microorganisms
  • COVID-19
  • antimicrobial stewardship

Published Papers (9 papers)

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Research

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8 pages, 235 KiB  
Article
Clinical Features of Patients with Home Isolation Sars-Cov-2 Infection: A Multicenter Retrospective Study in Southern Italy
by Mariantonietta Pisaturo, Giulia De Angelis, Paolo Maggi, Vincenzo Sangiovanni, Fabio Giuliano Numis, Ivan Gentile, Alfonso Masullo, Carolina Rescigno, Giosuele Calabria, Angelo Salomone Megna, Michele Gambardella, Elio Manzillo, Giancarlo Giolitto, Annamaria Rossomando, Antonio Riccardo Buonomo, Margherita Macera, Vincenzo Messina, Antonio Pagano, Raffaella Pisapia, Nunzia Farella, Giorgio Bosso, Nicola Coppola and CoviCam Groupadd Show full author list remove Hide full author list
Life 2021, 11(4), 347; https://doi.org/10.3390/life11040347 - 16 Apr 2021
Cited by 3 | Viewed by 1957
Abstract
To describe epidemiological and clinical features of patients confirmed as having SARS-CoV-2 infection and managed in isolation at home. We performed a multicenter retrospective study enrolling all SARS-CoV-2-positive adults evaluated from 28 February to 31 May 2020 at one of nine COVID-19 Units [...] Read more.
To describe epidemiological and clinical features of patients confirmed as having SARS-CoV-2 infection and managed in isolation at home. We performed a multicenter retrospective study enrolling all SARS-CoV-2-positive adults evaluated from 28 February to 31 May 2020 at one of nine COVID-19 Units in southern Italy: we included patients receiving care at home and those admitted to hospital. We defined patients with not-severe disease if they were asymptomatic or experienced a mild infection that did not need oxygen (O2) therapy and those with a severe infection if hospitalized and required O2 therapy. We enrolled 415 patients with SARS-CoV-2 infection: 77 were managed in isolation at home, 338 required hospital management. The 77 patients in home isolation were less frequently male than hospitalized patients (55% vs. 64%; <0.01) and were younger (median age 45 years (IQR:19) vs. 62 (IQR 22); p < 0.01), had a lower Charlson comorbidity index (median 0 (IQR2) vs. 6 (IQR 3); p < 0.01), and included fewer subjects with an underlying chronic disease (36% vs. 59%; p < 0.01). According to a binomial logistic regression analysis, a younger age (OR: 0.96 (95% IC: 0.94–0.98), p < 0.01) and a low Charlson comorbidity index (OR: 0.66 (95% IC: 0.54–0.83); p < 0.01) were independent factors associated with at-home management. The identification of subjects with SARS-CoV-2 infection who could be managed in home isolation is useful in clinical practice. A younger age and no comorbidities were identified as factors independently associated with home management. Full article
(This article belongs to the Special Issue The New Challenges in Infectious Diseases)
9 pages, 244 KiB  
Article
Directly Acting Antiviral-Based Treatment for HCV-Infected Persons Who Inject Drugs: A Multicenter Real-Life Study
by Vincenzo Messina, Lorenzo Onorato, Giovanni Di Caprio, Ernesto Claar, Vincenzo Iovinella, Antonio Russo, Valerio Rosato, Angela Salzillo, Riccardo Nevola, Filomena Simeone, Fabio Curcio, Mariantonietta Pisaturo and Nicola Coppola
Life 2021, 11(1), 17; https://doi.org/10.3390/life11010017 - 30 Dec 2020
Cited by 7 | Viewed by 1839
Abstract
Background: We aimed to evaluate the factors associated with a virological response in a cohort of Hepatitis C virus (HCV)-infected people who inject drugs (PWID) treated with direct acting antivirals (DAAs). Methods: We conducted a multicenter retrospective cohort study enrolling HCV-infected PWID treated [...] Read more.
Background: We aimed to evaluate the factors associated with a virological response in a cohort of Hepatitis C virus (HCV)-infected people who inject drugs (PWID) treated with direct acting antivirals (DAAs). Methods: We conducted a multicenter retrospective cohort study enrolling HCV-infected PWID treated with DAAs. The primary outcome evaluated was the sustained virological response (SVR12) rate. Results: Five hundred and twenty HCV-infected PWID treated with all-oral DAA-based regimens were enrolled; a total of 168 (32.3%) patients presented genotype 1a, 109 (21.0%) genotype 1b, and 174 (33.5%) genotype 3; a total 152 of the 520 subjects (29.2%) were cirrhotics; a total 118 (22.7%) and 373 (71.7%) were treated with DAA regimens of second and third generation, respectively; a total 169 (33.6%) patients were receiving an opioid agonist at the start of antiviral therapy. Only 11 subjects (2.1%) did not show an SVR12. A significant correlation was found between treatment with opioid substitution therapy (p < 0.001), Human Immunodeficiency Virus (HIV) coinfection (p = 0.002), and treatment with first- or second-generation regimens (p = 0.0015) and HCV failure. Upon multivariate analysis, treatment with a first- or second-generation DAA was the only factor independently associated with failure (OR 10.4, 95% CI: 1.43 to 76.1, p = 0.02). Conclusions: Treatment with DAAs led to a high SVR12 rate (97.9%) in a large cohort of HCV-infected PWID. The only predictor of viral failure found in our analysis was treatment with first- and second-generation DAA. Full article
(This article belongs to the Special Issue The New Challenges in Infectious Diseases)
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9 pages, 599 KiB  
Article
Screening, Linkage to Care and Treatment of Hepatitis C Infection in Primary Care Setting in the South of Italy
by Anna Citarella, Simona Cammarota, Francesca F. Bernardi, Carmine Coppola, Maria D’Antò, Marianna Fogliasecca, Elio Giusto, Mario Masarone, Angelo Salomone Megna, Carmine Sellitto, Rosa Servodio, Massimo Smaldone, Laura Staiano, Ugo Trama, Valeria Conti and Marcello Persico
Life 2020, 10(12), 359; https://doi.org/10.3390/life10120359 - 18 Dec 2020
Cited by 8 | Viewed by 2245
Abstract
Hepatitis C virus (HCV) infection remains a pressing public health issue. Our aim is to assess the linkage to care of patients with HCV diagnosis and to support the proactive case-finding of new HCV-infected patients in an Italian primary care setting. This was [...] Read more.
Hepatitis C virus (HCV) infection remains a pressing public health issue. Our aim is to assess the linkage to care of patients with HCV diagnosis and to support the proactive case-finding of new HCV-infected patients in an Italian primary care setting. This was a retrospective cohort study of 44 general practitioners (GPs) who managed 63,955 inhabitants in the Campania region. Adults with already known HCV diagnosis or those with HCV high-risk profile at June 2019 were identified and reviewed by GPs to identify newly diagnosed of HCV and to assess the linkage to care and treatment for the HCV patients. Overall, 698 HCV patients were identified, 596 with already known HCV diagnosis and 102 identified by testing the high-risk group (2614 subjects). The 38.8% were already treated with direct-acting antivirals, 18.9% were referred to the specialist center and 42.3% were not sent to specialist care for treatment. Similar proportions were found for patients with an already known HCV diagnosis and those newly diagnosed. Given that the HCV infection is often silent, case-finding needs to be proactive and based on risk information. Our findings suggested that there needs to be greater outreach, awareness and education among GPs in order to enhance HCV testing, linkage to care and treatment. Full article
(This article belongs to the Special Issue The New Challenges in Infectious Diseases)
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8 pages, 968 KiB  
Article
One-Seventh of Patients with COVID-19 Had Olfactory and Gustatory Abnormalities as Their Initial Symptoms: A Systematic Review and Meta-Analysis
by Hsin Chi, Nan-Chang Chiu, Chun-Chih Peng, Chao-Hsu Lin, Yu-Lin Tai, Ming-Dar Lee, Yu-Jyun Cheng, Boon Fatt Tan and Chien-Yu Lin
Life 2020, 10(9), 158; https://doi.org/10.3390/life10090158 - 22 Aug 2020
Cited by 18 | Viewed by 3450
Abstract
Coronavirus disease 2019 (COVID-19) patients exhibited protean clinical manifestations. Olfactory and gustatory abnormalities (anosmia and ageusia) were observed in COVID-19 patients, but the reported prevalence varied. In this systematic review, the prevalence of olfactory and gustatory abnormalities (OGA) was evaluated in laboratory-confirmed COVID-19 [...] Read more.
Coronavirus disease 2019 (COVID-19) patients exhibited protean clinical manifestations. Olfactory and gustatory abnormalities (anosmia and ageusia) were observed in COVID-19 patients, but the reported prevalence varied. In this systematic review, the prevalence of olfactory and gustatory abnormalities (OGA) was evaluated in laboratory-confirmed COVID-19 patients. On 8 May 2020, 14,506 articles were screened, while 12 of them were enrolled. A total of 1739 COVID-19 patients were analyzed, with a wide range of prevalence observed (5.6–94%). The pooled prevalence was 48.5% with high heterogeneity (I2, 98.8%; p < 0.0001). In total, 15.5% had OGA as their first symptom (I2, 22.6%; p = 0.27) among the patients analyzed. Contradictory to COVID-19 negative controls, patients with COVID-19 had a higher risk of OGA (odds ratio, 5.3; I2, 66.5%; p = 0.03). In conclusion, approximately half of COVID-19 patients had OGA, and one-seventh of them had OGA as their initial symptoms. OGA were cardinal symptoms of COVID-19, which may serve as clues for early diagnosis. Diagnostic testing for SARS-CoV-2 was suggested in patients with OGA during the COVID-19 pandemic to ensure timely diagnosis and appropriate quarantine. Full article
(This article belongs to the Special Issue The New Challenges in Infectious Diseases)
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Review

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17 pages, 1105 KiB  
Review
HBV/HDV Co-Infection: Epidemiological and Clinical Changes, Recent Knowledge and Future Challenges
by Caterina Sagnelli, Evangelista Sagnelli, Antonio Russo, Mariantonietta Pisaturo, Laura Occhiello and Nicola Coppola
Life 2021, 11(2), 169; https://doi.org/10.3390/life11020169 - 22 Feb 2021
Cited by 28 | Viewed by 4947
Abstract
Several investigations have been published on Hepatitis Delta Virus (HDV) infection in recent years, from which we have drawn the salient data to provide readers with useful information to improve their knowledge on the subject. HDV genotypes 5–8 have been recently imported to [...] Read more.
Several investigations have been published on Hepatitis Delta Virus (HDV) infection in recent years, from which we have drawn the salient data to provide readers with useful information to improve their knowledge on the subject. HDV genotypes 5–8 have been recently imported to Western countries from central Africa, whose clinical relevance deserves further investigation. Ongoing HDV replication has been identified as an independent predictor of progression to cirrhosis and HCC for patients with HDV chronic hepatitis (HDV-CH). Long-term treatments of HDV-CH with standard or pegylated interferon alfa (peg-IFN-α) have all been unsatisfactory, leading to a sustained virological response (SVR) only in 20–30% of patients treated, faced with a poor tolerability and frequent serious adverse reactions; the addition of HBV nucleo(s)tide analogues to peg-IFN- α did not improve the rate of SVR. The improved knowledge of the HDV life cycle has allowed the development of direct acting agents towards key-points of the HDV life cycle, namely bulevirtide, lonafarnib and nucleic acid polymers. Preliminary data have shown that these drugs are more effective than interferon-based therapies, but adverse reactions are also common, which however seem toned down in combination therapy with other antivirals. Full article
(This article belongs to the Special Issue The New Challenges in Infectious Diseases)
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12 pages, 315 KiB  
Review
The Aging Bowel Dysfunction and Elderly Vulnerability towards COVID-19 Infection
by Aaron Lerner and Mark F. McCarty
Life 2021, 11(2), 97; https://doi.org/10.3390/life11020097 - 28 Jan 2021
Cited by 5 | Viewed by 3192
Abstract
Severe acute respiratory syndrome coronavirus 2, primarily a respiratory tract virus, also affects the enteric organs. The most affected sector of the community are the retirement and nursing home elderly residents. Along their life the senescent gastrointestinal functions are deteriorating and failing to [...] Read more.
Severe acute respiratory syndrome coronavirus 2, primarily a respiratory tract virus, also affects the enteric organs. The most affected sector of the community are the retirement and nursing home elderly residents. Along their life the senescent gastrointestinal functions are deteriorating and failing to fully execute their digestive, absorptive, mucosal barriers, and immune protective duties. Adding the decreased motility, increased intestinal permeability, dysbiosis, morbid chronic disease background, the consumed polypharmacy enteric adverse effects to the presence of the SARS-CoV-2 host receptor along the intestinal tracts put the basis for the current hypothesis. It is hypothesized that the disadvantages and failures of the aging enteric tract contribute to the elderly morbidity and mortality during the current new coronavirus pandemic. In a more optimistic look, several nutraceuticals can prevent or restore the dysfunctional intestinal barrier functions, mainly in the elderly and potentially in those who are SARS-CoV-2 infected. Full article
(This article belongs to the Special Issue The New Challenges in Infectious Diseases)
13 pages, 1931 KiB  
Review
Cardiovascular System in COVID-19: Simply a Viewer or a Leading Actor?
by Filiberto Fausto Mottola, Nicoletta Verde, Riccardo Ricciolino, Marco Di Di Mauro, Marco Giuseppe Migliaccio, Vincenzo Carfora, Giorgio Spiniello, Nicola Coppola and Vanvitelli COVID-19 Group
Life 2020, 10(9), 165; https://doi.org/10.3390/life10090165 - 27 Aug 2020
Cited by 7 | Viewed by 3862
Abstract
As of January 2020, a new pandemic has spread from Wuhan and caused thousands of deaths worldwide. Several studies have observed a relationship between coronavirus disease (COVID-19) infection and the cardiovascular system with the appearance of myocardial damage, myocarditis, pericarditis, heart failure and [...] Read more.
As of January 2020, a new pandemic has spread from Wuhan and caused thousands of deaths worldwide. Several studies have observed a relationship between coronavirus disease (COVID-19) infection and the cardiovascular system with the appearance of myocardial damage, myocarditis, pericarditis, heart failure and various arrhythmic manifestations, as well as an increase in thromboembolic risk. Cardiovascular manifestations have been highlighted especially in older and more fragile patients and in those with multiple cardiovascular risk factors such as cancer, diabetes, obesity and hypertension. In this review, we will examine the cardiac involvement associated with SARS-CoV-2 infection, focusing on the pathophysiological mechanism underlying manifestations and their clinical implication, taking into account the main scientific papers published to date. Full article
(This article belongs to the Special Issue The New Challenges in Infectious Diseases)
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Other

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5 pages, 520 KiB  
Perspective
Chilblain-Like Lesions during COVID-19 Pandemic: The State of the Art
by Andrea Bassi, Teresa Russo, Giuseppe Argenziano, Carlo Mazzatenta, Elisabetta Venturini, Iria Neri and Vincenzo Piccolo
Life 2021, 11(1), 23; https://doi.org/10.3390/life11010023 - 2 Jan 2021
Cited by 16 | Viewed by 3954
Abstract
SARS-CoV-2 infection has spread all over the world in the last year, causing millions of COVID-19 cases among humans with a large variability of symptoms and signs, including those on the skin. Among these, a contemporary cluster of chilblain-like lesions with no certain [...] Read more.
SARS-CoV-2 infection has spread all over the world in the last year, causing millions of COVID-19 cases among humans with a large variability of symptoms and signs, including those on the skin. Among these, a contemporary cluster of chilblain-like lesions with no certain relationship with the infection has been reported. The aim of this paper is to delineate a profile of chilblain-like lesions and to establish the state-of-the-art knowledge about this new phenomenon. Full article
(This article belongs to the Special Issue The New Challenges in Infectious Diseases)
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9 pages, 215 KiB  
Case Report
Long-Term SARS-CoV-2 Infection Associated with Viral Dissemination in Different Body Fluids Including Bile in Two Patients with Acute Cholecystitis
by Rossana Scutari, Lorenzo Piermatteo, Matteo Ciancio Manuelli, Marco Iannetta, Romina Salpini, Ada Bertoli, Claudia Alteri, Patrizia Saccomandi, Maria Concetta Bellocchi, Vincenzo Malagnino, Elisabetta Teti, Daniele Sforza, Leandro Siragusa, Michele Grande, Loredana Sarmati, Valentina Svicher, Massimo Andreoni and Francesca Ceccherini-Silberstein
Life 2020, 10(11), 302; https://doi.org/10.3390/life10110302 - 23 Nov 2020
Cited by 14 | Viewed by 2242
Abstract
Our study aimed to investigate the kinetics of SARS-CoV-2 RNA in bile and in different body fluids of two SARS-CoV-2 positive patients with acute cholecystitis by innovative droplet digital PCR (ddPCR) assays. For each patient, nasopharyngeal- and rectal swabs, bile, urine, and plasma [...] Read more.
Our study aimed to investigate the kinetics of SARS-CoV-2 RNA in bile and in different body fluids of two SARS-CoV-2 positive patients with acute cholecystitis by innovative droplet digital PCR (ddPCR) assays. For each patient, nasopharyngeal- and rectal swabs, bile, urine, and plasma samples were collected at different time points for SARS-CoV-2 RNA quantification by two ddPCR assays. For both patients, ddPCR revealed persistent and prolonged detection of viral RNA in the nasopharyngeal swab despite triple-negative or single-positive results by qRT-PCR. In Patient 1, SARS-CoV-2 RNA dropped more rapidly in bile and rectal-swab and declined slowly in nasopharyngeal swab and plasma, becoming undetectable in all compartments 97 days after symptoms started. Conversely, in patient 2, SARS-CoV-2 RNA was detected, even if at low copies, in all body samples (with the exception of urine) up to 75 days after the onset of symptoms. This study highlights that SARS-CoV-2 RNA can persist for a prolonged time in respiratory samples and in several biological samples despite negativity to qRT-PCR, supporting SARS-CoV-2’s ability to provoke persistent and disseminated infection and therefore to contribute to extra-pulmonary clinical manifestations. Full article
(This article belongs to the Special Issue The New Challenges in Infectious Diseases)
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