Publications by authors named "Nicola Schiano Moriello"

Background: Ritonavir-boosted nirmatrelvir (N/r) is an antiviral which targets the main viral protease, administered to prevent the progression of SARS-CoV-2 infection in patients at high risk for severe COVID-19. We present a real-life case-control study evaluating the efficacy of N/r therapy in SARS-CoV-2 omicron variants positive outpatients in Campania region, Italy, with the aim of assessing the occurrence of three outcomes (hospital admission, admission in ICU and death) in cases and controls.

Methods: We enrolled SARS-CoV-2 positive subjects that came to our attention in Early antiviral treatment ambulatory of Infectious Diseases ward of University Federico II of Naples, Italy from January 1st, 2022, to December 31st, 2022, during the first five days from symptoms occurrence.

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Carbapenem-resistant (CRAB) poses significant challenges in healthcare due to its multidrug resistance and high mortality rates among critically ill patients. We enrolled 45 patients. Cefiderocol was administered to 40% of patients, often (38.

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Article Synopsis
  • Thymic epithelial tumors (TETs) are rare tumors often linked to immune issues, like Good's syndrome (GS), which increases mortality risk from infections.
  • The study reviewed COVID-19 incidence and severity among TET patients from March 2020 to April 2023, noting that about 66% of participants contracted COVID-19, regardless of GS presence.
  • Results showed a significant correlation between GS and increased COVID-19 severity, with 45% of GS patients experiencing higher severity scores compared to just 7.7% in patients without GS.
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Introduction: The introduction of direct-acting antivirals (DAAs) has significantly transformed the therapeutic landscape for chronic C hepatitis virus (HCV) infection. However, there is still room for further improvement in optimizing therapy efficacy and minimizing adverse effects.

Areas Covered: This review is devoted to the rationale for adopting a personalized approach to HCV therapy.

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Article Synopsis
  • The intestinal microbiota is crucial for maintaining overall health and can influence various diseases, including chronic liver conditions like those caused by the Hepatitis C virus (HCV).
  • Recent advancements in antiviral treatments, specifically direct-acting antiviral agents (DAAs), have led to a high success rate in clearing HCV infections (around 95%).
  • A study involving 12 patients treated with DAAs revealed a decrease in harmful gut bacteria and an increase in microbial diversity after treatment, especially notable in patients without advanced liver cirrhosis.
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Background: Ceftobiprole is approved in Europe for treatment of community-acquired pneumonia and non-ventilator-associated hospital-acquired pneumonia (HAP) in adults. Real-world data are limited.

Methods: This multi-centre, observational, ambispective investigator-initiated study was undertaken in Italy from January 2018 to December 2019 in order to evaluate the use of ceftobiprole in a real-world setting.

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Since 2020, COVID-19 pandemic has spread worldwide causing a huge number of cases and casualties. Among direct anti SARS-CoV-2 agents available for the treatment of COVID-19, only remdesivir and casirivimab/imdevimab have been approved for severe disease. As they act at different levels in blocking viral replication, it is theoretically possible to combine them.

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Diabetes mellitus represents one of the most frequent comorbidities among patients with COVID-19, constituting a risk factor for a more severe prognosis than that of non-diabetic patients. However, the pathophysiological mechanism underlying this unfavorable outcome is still not completely clear. The goal of our study was to evaluate the potential role of antidiabetic therapy in the evolution of COVID-19.

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Tackling antibiotic resistance represents one of the major challenges in modern medicine, and limiting antibiotics' overuse represents the first step in this fight. Most antibiotics are prescribed in primary care settings, and lower respiratory tract infections (LRTIs) are one of the most common indications for their prescription. An expert panel conducted an extensive report on C-reactive protein point-of-care (CRP POC) testing in the evaluation of LRTIs and its usefulness to limit antibiotic prescriptions.

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The gut microbiota plays a fundamental role in Hepatitis C Virus (HCV)-related liver disease. Indeed, HCV infection alters the gut microbiota, whereas intestinal dysbiosis induces an underlying inflammatory state. This status may lead to liver disease progression.

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Surgical site infections are an increasingly important issue in nosocomial infections. The progressive increase in antibiotic resistance, the ever-increasing number of interventions and the ever-increasing complexity of patients due to their comorbidities amplify this problem. In this perspective, it is necessary to consider all the risk factors and all the current preventive and prophylactic measures which are available.

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Despite the lightning-fast advances in the management of SARS-CoV after 2 years of pandemic, COVID-19 continues to pose a challenge for fragile patients, who could benefit from early administration of monoclonal antibodies (mAbs) to reduce the risk of severe disease progression. We conducted a prospective study to evaluate the effectiveness of mAbs against SARS-CoV-2 among patients at risk for severe disease progression, namely elderly and those with comorbidities, before the omicron variant surge. Patients were treated with either casirivimab/imdevimab, sotrovimab, or bamlanivimab/etesevimab.

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Molnupiravir and nirmatrelvir were the first available oral antivirals (OAs) active against SARS-CoV-2. Trials evaluating the efficacy of OAs involved patients unvaccinated and infected with variants different from those currently circulating. We conducted a retrospective study on patients with confirmed SARS-CoV-2 infection treated with OAs during the omicron surge in Italy in order to provide real-life data on the efficacy and safety of OAs during the omicron surge of the COVID-19 pandemic.

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Vaccination against SARS-CoV2 represents a key weapon to prevent COVID-19, but lower response rates to vaccination have frequently been reported in solid organ transplant recipients. The aim of our study was to evaluate the rate of seroconversion to SARS-CoV-2 mRNA vaccines in a cohort of kidney transplant recipients and the potential role of the different immunosuppressive regimens. We conducted an observational retrospective cohort study in kidney transplant patients vaccinated for COVID-19.

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Campania is the sixth poorest region of Italy, and it is the region with the highest income inequality. The secondary attack rates of SARS-CoV-2 among households are found to be substantially heterogeneous among published studies and are influenced by socio-economic factors. We conducted a retrospective study to describe the role of socio-economic factors in the household transmission of SARS-CoV-2 among patients living in Campania Region and referring to "Federico II" Hospital.

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Introduction: Mother-to-child transmission (MTCT) is mainly responsible for the global pediatric HIV and HBV epidemic. Vertical transmission can be prevented and reduced through a series of interventions at the primary healthcare level, including extensive screening of pregnant women, administration of antivirals or immune-based treatments, counselling on type of delivery and breastfeeding.

Areas Covered: In this narrative review, approved therapeutic options for the treatment of pregnant women living with HIV or HBV are discussed with special focus on efficacy and safety profiles of each agent or drug class examined.

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Background: Monoclonal antibodies have been a milestone in the treatment of multiple sclerosis (MS). Infective complications have been observed in patients on agents targeting lymphoid cells' surface antigens, namely anti-CD52 (alemtuzumab) and anti-CD20 agents (ocrelizumab and rituximab). Despite increasing emerging data, there is no standardized consensus regarding pre-treatment testing, vaccinations, and patient education before and during MS therapy or optimal infection-control strategies.

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Article Synopsis
  • - Clinical outcomes between the first and second waves of COVID-19 in Europe showed that patients in the second wave had significantly lower levels of iNOS, IL-6, and IL-10 compared to those in the first wave, indicating a less severe illness.
  • - Serum levels of iNOS and inflammatory markers (IL-6 and IL-10) correlated with the severity of COVID-19 in the first wave but did not do so in the second wave, suggesting a shift in the disease's impact over time.
  • - In severe cases during the second wave, patients who were treated with steroids or azithromycin before hospitalization had decreased iNOS levels, leading to concerns about their immune response, and highlighting the potential need for
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Ivan Gentile and Nicola Schiano Moriello discuss the potential of monoclonal antibody prophylaxis against COVID-19 infection in immunocompromised patients.

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Objective: to describe a single-center experience of 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.

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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.

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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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KL-6 is a sialoglycoprotein antigen which proved elevated in the serum of patients with different interstitial lung diseases, especially in those with a poorer outcome. Given that interstitial pneumonia is the most common presentation of SARS-CoV2 infection, we evaluated the prognostic role of KL-6 in patients with COVID-19 pneumonia. Patients with COVID-19 pneumonia were prospectively enrolled.

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