Publications by authors named "Cesare Ernesto Maria Gruber"

Article Synopsis
  • Dengue virus (DENV) is spreading to new temperate regions, including Europe, due to global trade and climate change, resulting in local outbreaks even among non-travelers.
  • A study in the Latium Region from August to November 2023 investigated local DENV infections caused by serotypes 1, 2, and 3, using advanced sequencing techniques for genetic analysis.
  • The findings revealed that the predominant DENV-1 strain, which originated from South America, had led to 42 local infections in Rome, indicating adaptation of the virus to human hosts and changes in how it interacts with antibodies and cell receptors.
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Enteroviruses (EVs) are ubiquitous viruses that circulate worldwide, causing sporadic or epidemic infections, typically during the summer and fall. They cause a broad spectrum of illnesses, ranging from an unspecified febrile clinical presentation to a severe illness. EVs are recognized to be the most frequent etiological agents of aseptic meningitis in children.

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Molnupiravir, an oral direct-acting antiviral effective in vitro against SARS-CoV-2, has been largely employed during the COVID-19 pandemic, since December 2021. After marketing and widespread usage, a progressive increase in SARS-CoV-2 lineages characterized by a higher transition/transversion ratio, a characteristic signature of molnupiravir action, appeared in the Global Initiative on Sharing All Influenza Data (GISAID) and International Nucleotide Sequence Database Collaboration (INSDC) databases. Here, we assessed the drug effects by SARS-CoV-2 whole-genome sequencing on 38 molnupiravir-treated persistently positive COVID-19 outpatients tested before and after treatment.

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Article Synopsis
  • The COVID-19 pandemic has led to rapid mutations of the virus SARS-CoV-2, resulting in the emergence of new variants that affect public health.
  • The Lazio region has established a genomic sequencing laboratory network (WGSnet-Lazio) to closely monitor these variants and work alongside an epidemiological surveillance center (SERESMI).
  • Data collected from February 2020 to October 2022 show that this sequencing effort is effective for understanding variant circulation and supporting public health efforts during the pandemic.
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The SARS-CoV-2 Delta variant of concern (VOC) was often associated with serious clinical course of the COVID-19 disease. Herein, we investigated the selective pressure, gene flow and evaluation on the frequencies of mutations causing amino acid substitutions in the Delta variant in three Italian regions. A total of 1500 SARS-CoV-2 Delta genomes, collected in Italy from April to October 2021 were investigated, including a subset of 596 from three Italian regions.

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Between August and September 2023, three distinct autochthonous dengue virus transmission events occurred in Lazio, Italy, with the main event in Rome. The events involved three different dengue serotypes. No link with previous imported cases was identified.

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Mutations in the SARS-CoV-2 Spike glycoprotein can affect monoclonal antibody efficacy. Recent findings report the occurrence of resistant mutations in immunocompromised patients after tixagevimab/cilgavimab treatment. More recently, the Food and Drug Agency revoked the authorization for tixagevimab/cilgavimab, while this monoclonal antibody cocktail is currently recommended by the European Medical Agency.

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Despite the higher transmissibility of Omicron Variant of Concern (VOC), several reports have suggested lower risk for hospitalization and severe outcomes compared to previous variants of SARS-CoV-2. This study, enrolling all COVID-19 adults admitted to a reference hospital who underwent both the S-gene-target-failure test and VOC identification by Sanger sequencing, aimed to describe the evolving prevalence of Delta and Omicron variants and to compare the main in-hospital outcomes of severity, during a trimester (December 2021 to March 2022) of VOCs' cocirculation. Factors associated with clinical progression to noninvasive ventilation (NIV)/mechanical ventilation (MV)/death within 10 days and to MV/admission to intensive care unit (ICU)/death within 28 days, were investigated through multivariable logistic regressions.

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Article Synopsis
  • Whole-genome sequencing (WGS) has been applied to analyze the mpox virus (MPXV) from a 2022 outbreak, focusing on long-term infections in individual patients.
  • Research involved 51 samples from five patients, revealing significant genetic changes in samples from two immunocompromised patients with advanced HIV-1, showcasing high intra-host variability and tissue-specific mutations.
  • No notable sequence differences were found in three patients with rapid viral clearance, indicating that MPXV can adapt within its host environment and may contribute to viral persistence and related clinical implications.
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  • SARS-CoV-2 rapidly evolves with various variants, and Next-Generation Sequencing (NGS) is the best method for tracking these variants, but it’s not practical in low-resource labs.* -
  • The study compared TaqPath and Novaplex assays for detecting Omicron variants and found that TaqPath often reported negative results despite other assays confirming positives; Novaplex effectively identified all samples as Omicron subtypes.* -
  • Allplex showed a high agreement for identifying Delta variants, while issues with undetermined results seemed linked to low viral loads, highlighting challenges in accurately typing variants with less effective assays.*
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Article Synopsis
  • COVID-19 cases surged in China by the end of 2022, prompting some countries to enhance testing for travelers.
  • In Italy, 556 passengers arriving from two Chinese provinces were screened in late December 2022, with 126 (22.7%) testing positive for SARS-CoV-2.
  • Whole genome sequencing of 61 positive samples showed Omicron variants, specifically sub-lineages BA.5.2.48, BF.7.14, and BQ.1.1, consistent with recent data from China.
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Background And Objectives: HIV-1 provirus integration in host genomes provides a lifelong reservoir of virally infected cells. Although not able to generate viral progeny, the expression of defective proviruses has been associated with activation. Provirus integration may influence host gene transcription and shifts may occur during disease progression or antiretroviral therapy (ART).

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A large number of SARS-CoV-2 mutations in a short period of time has driven scientific research related to vaccines, new drugs, and antibodies to combat the new variants of the virus. Herein, we present a web portal containing the structural information, the tridimensional coordinates, and the molecular dynamics trajectories of the SARS-CoV-2 spike protein and its main variants. The Spike Mutants website can serve as a rapid online tool for investigating the impact of novel mutations on virus fitness.

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We report two cases of SARS-CoV-2 recombinant variant XE detected in nasopharyngeal swabs (NPS) of hospitalized patients with no evident epidemiological link in Lazio, Central Italy. Whole-Genome Sequencing (WGS) performed on an Ion Torrent GSS5 platform according to Italian flash surveys showed genomes corresponding to the PANGOLIN unclassified lineage and the Nextclade XE clade. Further analyses were then carried out to investigate more deeply the genetic characteristics of these XE-like sequences.

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  • An outbreak of monkeypox has been occurring in non-endemic countries since May 2022, with reported cases in Italy involving young adult men who engaged in condomless sexual intercourse.
  • Four patients in Italy tested positive for monkeypox viral DNA in their seminal fluid but are currently in good health and do not require antiviral treatment.
  • The study highlights the need for further investigation into the potential sexual transmission of the monkeypox virus, as most other viruses found in semen lack evidence of sexual transmission.
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Background: Vaccines for coronavirus disease 2019 (COVID-19) are proving to be very effective in preventing severe illness; however, although rare, post-vaccine infections have been reported. The present study focuses on virological and serological features of 94 infections that occurred in Lazio Region (Central Italy) between 27 December 2020, and 30 March 2021, after one or two doses of mRNA BNT162b2 vaccine.

Methods: We evaluated clinical features, virological (viral load; viral infectiousness; genomic characterisation), and serological (anti-nucleoprotein Ig; anti-Spike RBD IgG; neutralising antibodies, nAb) characteristics of 94 post-vaccine infections at the time of diagnosis.

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Article Synopsis
  • Since December 2019, the rapid spread of SARS-CoV-2 has led to a global pandemic, with disease severity varying based on individual health conditions and a lack of effective prognostic markers.
  • Researchers conducted 16S rRNA gene sequencing on 21 COVID-19 patients, revealing significant alterations in their nasal/oropharyngeal microbiota compared to controls, with specific metrics (Chao1 and Shannon indices) indicating varying levels of microbiota diversity.
  • Notably, ICU patients exhibited complete depletion of certain bacterial groups, while other coronaviruses showed different microbiota profiles, suggesting that understanding these microbial changes could aid in patient stratification and potential new treatment approaches.
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We report phylogenetic and mutational analysis by NGS of six SARS-CoV-2 strains from patients flying from Bangladesh to Italy (July 2020). Data suggest that no further circulation of such imported strains occurred in Italy, stating the efficacy of early screening at the point of entry and supporting the importance of molecular epidemiology in monitoring the efficacy of control measures.

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COronaVIrus Disease-2019 (COVID-19) is a pandemic respiratory infection caused by a new betacoronavirus, the Severe Acute Respiratory Syndrome-CoronaVirus-2 (SARS-CoV-2). Few data are reported on the gut microbiota in COVID-19 patients. 16S rRNA gene sequencing was performed to reveal an altered composition of the gut microbiota in patients with COVID-19 pneumonia admitted in intensive care unit (ICU) (i-COVID19), or in infectious disease wards (w-COVID19) as compared to controls (CTRL).

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We report whole-genome and intra-host variability of SARS-Cov-2 assessed by next generation sequencing (NGS) in upper (URT) and lower respiratory tract (LRT) from COVID-19 patients. The aim was to identify possible tissue-specific patterns and signatures of variant selection for each respiratory compartment. Six patients, admitted to the Intensive Care Unit, were included in the study.

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We report phylogenetic and mutational analysis of severe acute respiratory syndrome coronavirus 2 virus strains from the Lazio region of Italy and provide information about the dynamics of virus spread. Data suggest effective containment of clade V strains, but subsequently, multiple waves of clade G strains were circulating widely in Europe.

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