Publications by authors named "Laura Scorzolini"

Chagas disease (CD) is a parasitic infection endemic in Latin America and also affects patients in Western countries due to migration flows. This has a significant impact on health services worldwide due to its high morbidity and mortality burden. This paper aims to share our experience at the National Institute for Infectious Diseases "Lazzaro Spallanzani", IRCCS, in Rome, Italy, where to date, a total of 47 patients-mainly Bolivian women-diagnosed with CD have received treatment with benznidazole, with all but one presenting with chronic disease.

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In the recent 2022 monkeypox (Mpox) global outbreak, cases have been mostly documented among men who have sex with men. Proctitis was reported in almost 14% of cases. In this study, four Mpox-confirmed cases requiring hospitalizations for severe proctitis were characterized by clinical, virological, microbiological, endoscopic, and histological aspects.

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Aero-medical evacuation has been considered as a feasible and safe treatment option during COVID pandemic, particularly when the needs of affected patients exceed what local clinics and hospitals are supposed to provide. In this article, we analyzed the clinical course of 17 patients medically evacuated to the "L. Spallanzani" Institute in Rome, Italy from foreign countries, mainly Africa and Eastern Europe, who had COVID-19 pneumonia with, or without, coinfections such as malaria, HIV, tuberculosis and microbiologically confirmed sepsis syndrome.

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Monoclonal antibodies are laboratory-made proteins that mimic the immune system's ability to fight off harmful microorganisms, including viruses such as Severe Acute Respiratory Syndrome-CoronaVirus-2 (SARS-CoV-2). The US Food and Drug Administration (FDA) and the European Medical Agency (EMA) have already authorized monoclonal antibodies of anti-SARS-CoV-2 to treat mild to moderate CoronaVIrus Disease-2019 (COVID-19) in patients at risk of developing severe disease. More recently, monoclonal antibodies anti-SARS-CoV-2 have been authorized for primary and secondary prophylaxis in patients at high risk of severe disease for background comorbidity.

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Article Synopsis
  • The COVID-19 pandemic, caused by SARS-CoV-2, has led to over 6 million deaths in two years, prompting research into drug repurposing for faster treatment solutions.
  • Researchers identified raloxifene, a Selective Estrogen Receptor Modulator, as a potential treatment for mild-to-moderate COVID-19 through virtual screening of viral proteins and in vitro testing in infected cell lines.
  • The study reveals raloxifene’s interaction with the virus's Spike protein and its role in counteracting viral effects, paving the way for further clinical studies to understand its efficacy against various SARS-CoV-2 variants.
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Background: Current available therapeutic options for Coronavirus Disease-2019 (COVID-19) are primarily focused on treating hospitalized patients, and there is a lack of oral therapeutic options to treat mild to moderate outpatient COVID-19 and prevent clinical progression. Raloxifene was found as a promising molecule to treat COVID-19 due to its activity to modulate the replication of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and act as an immunomodulator to decrease proinflammatory cytokines.

Methods: This was a phase 2 multicenter, randomized, placebo-controlled trial to evaluate the efficacy and safety of raloxifene in adult patients with mild to moderate COVID-19 between October 2020 to June 2021 in five centers located in Italy.

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Most patients infected with SARS-CoV-2 (COVID-19) experience mild, non-specific symptoms, but many develop severe symptoms associated with an excessive inflammatory response. Elevated plasma concentrations of soluble urokinase plasminogen activator receptor (suPAR) provide early warning of progression to severe respiratory failure (SRF) or death, but access to suPAR testing may be limited. The Severe COvid Prediction Estimate (SCOPE) score, derived from circulating concentrations of C-reactive protein, D- dimers, interleukin-6, and ferritin among patients not receiving non-invasive or invasive mechanical ventilation during the SAVE-MORE study, offers predictive accuracy for progression to SRF or death within 14 days comparable to that of a suPAR concentration of ≥6 ng/mL (area under receiver operator characteristic curve 0.

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Article Synopsis
  • * A phase 1 clinical trial involved 90 healthy participants from two age groups (young and older adults), testing the safety and immune response of a single-dose vaccination.
  • * Results showed that the vaccine was generally safe, with mostly mild side effects, and effectively generated immune responses, including the production of neutralizing antibodies and a strong T cell response in nearly all participants, supporting further development of GRAd-COV2.
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The ongoing coronavirus disease 2019 (COVID-19) pandemic caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) necessitates strategies to identify prophylactic and therapeutic drug candidates to enter rapid clinical development. This is particularly true, given the uncertainty about the endurance of the immune memory induced by both previous infections or vaccines, and given the fact that the eradication of SARS-CoV-2 might be challenging to reach, given the attack rate of the virus, which would require unusually high protection by a vaccine. Here, we show how raloxifene, a selective estrogen receptor modulator with anti-inflammatory and antiviral properties, emerges as an attractive candidate entering clinical trials to test its efficacy in early-stage treatment COVID-19 patients.

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  • The study analyzed the effectiveness of hydroxychloroquine (HCQ) in treating COVID-19 by observing 4,396 patients hospitalized in Italy from February to May 2020, revealing mixed results from previous research.
  • Two patient clusters were identified: a younger, healthier group at lower risk of death and an older, sicker group at higher risk, highlighting differing impacts of HCQ on these populations.
  • HCQ appeared to significantly reduce mortality risk in the lower risk cluster, suggesting that it may be more beneficial for patients with fewer comorbidities, potentially clarifying debates around its efficacy in COVID-19 treatment.
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Protease inhibitors have been considered as possible therapeutic agents for COVID-19 patients. To describe the association between lopinavir/ritonavir (LPV/r) or darunavir/cobicistat (DRV/c) use and in-hospital mortality in COVID-19 patients. Multicenter observational study of COVID-19 patients admitted in 33 Italian hospitals.

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Background: Post-artesunate delayed haemolysis (PADH) is common after severe malaria episodes. PADH is related to the "pitting" phenomenon and the synchronous delayed clearance of once-infected erythrocytes, initially spared during treatment. However, direct antiglobulin test (DAT) positivity has been reported in several PADH cases, suggesting a contribution of immune-mediated erythrocyte clearance.

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Article Synopsis
  • The study analyzed COVID-19 patients in a hospital in Italy to explore factors influencing prolonged SARS-CoV-2 RNA shedding and viral clearance.
  • It found that patients with comorbidities, lymphopenia, or moderate/severe respiratory issues had lower chances of viral clearance, with a median viral shedding duration of 18 days.
  • Achieving viral clearance significantly improved clinical recovery rates and reduced the risk of death or the need for mechanical ventilation, emphasizing the necessity for timely hospital admission for symptomatic patients.
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Background: The pathogenesis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection remains unclear. We report the detection of viral RNA from different anatomical districts and the antibody profile in the first 2 COVID-19 cases diagnosed in Italy.

Methods: We tested for SARS-CoV-2 RNA clinical samples, either respiratory and nonrespiratory (ie, saliva, serum, urine, vomit, rectal, ocular, cutaneous, and cervico-vaginal swabs), longitudinally collected from both patients throughout the hospitalization.

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Article Synopsis
  • - The study investigated whether administering heparin in hospitals improves survival rates among COVID-19 patients, due to a linked hypercoagulable condition that can worsen the disease.
  • - An analysis of 2,574 patients across Italy showed that 70.1% received heparin, leading to significantly lower death rates (7.4 vs. 14.0 per 1,000 person-days) among those treated with heparin.
  • - The findings suggest that heparin is associated with a 40% reduction in death risk, especially for critically ill patients, indicating its potential benefit, although further randomized clinical trials are necessary for definitive guidance.
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  • A study investigated factors contributing to in-hospital death among COVID-19 patients in Italy, analyzing data from 3,894 hospitalized individuals from February to May 2020.
  • Key findings showed that impaired renal function, high levels of C-reactive protein, and older age were significant predictors of mortality, with the highest death rates found in Northern Italy (15.6%) compared to Central/Southern regions (6.4%).
  • The results indicated that factors like obesity, tobacco use, and cardiovascular conditions did not correlate with mortality risk, emphasizing the importance of renal health and inflammation in COVID-19 outcomes.
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Background: Remdesivir is a prodrug of the nucleoside analogue GS-441524 and is under evaluation for treatment of SARS-CoV-2-infected patients.

Objectives: To evaluate the pharmacokinetics of remdesivir and GS-441524 in plasma, bronchoalveolar aspirate (BAS) and CSF in two critically ill COVID-19 patients.

Methods: Remdesivir was administered at 200 mg loading dose on the first day followed by 12 days of 100 mg in two critically ill patients.

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Data concerning the transmission of the novel severe acute respiratory syndrome coronavirus (SARS-CoV-2) in paucisymptomatic patients are lacking. We report an Italian paucisymptomatic case of coronavirus disease 2019 with multiple biological samples positive for SARS-CoV-2. This case was detected using the World Health Organization protocol on cases and contact investigation.

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A novel coronavirus (SARS-CoV-2) has been identified as the causative pathogen of an ongoing outbreak of respiratory disease, now named COVID-19. Most cases and sustained transmission occurred in China, but travel-associated cases have been reported in other countries, including Europe and Italy. Since the symptoms are similar to other respiratory infections, differential diagnosis in travellers arriving from countries with wide-spread COVID-19 must include other more common infections such as influenza and other respiratory tract diseases.

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In Italy, malaria continues to be one of the most common imported parasitoses; therefore, continuous surveillance of epidemiological data and clinical management is needed. In 2016, the National Institute for Infectious Diseases 'Lazzaro Spallanzani' in Rome promoted a retrospective questionnaire-based survey to assess the clinical management of imported malaria cases in Italy in 2015. The questionnaire was sent to 104 Tropical and/or Infectious Diseases Units in the country, and 37 of them filled out and returned the questionnaires.

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Objectives: This study aims to identify the risk factors for intensive care (IC) in severe malaria patients admitted to the "Lazzaro Spallanzani" National Institute for Infectious Diseases, Rome, Italy.

Methods: All patients with confirmed severe malaria and hospitalized between 2007 and 2015 were included in the analysis and stratified into two groups: those requiring IC and those who did not. Five prognostic malaria scores were estimated; clinical severity at IC unit admission was assessed using the Sequential Organ Failure Assessment and the quick-Sequential Organ Failure Assessment scores.

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Congenital malaria (CM) is uncommon in both malaria-endemic and non-endemic countries. It may be caused by any spp., although and are the more frequent etiologic agents.

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