Background: Lung ultrasound (LU) is becoming an increasingly important diagnostic tool in detecting lung involvement in Corona Virus Disease 2019 (COVID-19). The aim of this study was to ascertain the likelihood of finding LU abnormalities; mimicking lung involvement; in COVID-19 negative healthy individuals. Methods: We performed LU on 265 healthcare workers; not presenting COVID-19 major symptoms and in good health; during the course of a serological screening program for COVID-19 in our General Hospital. LU results were reported as total Lung Ultrasound Score (LUS) using a 12-zone method of reporting. Results: 250/265 subjects were included in the COVID-19 negative group. LU was not completely normal (LUS ≠ 0) in 65/250 COVID-19 negative subjects (26%) and in 12/15 (80%) poorly symptomatic COVID-19 positive subjects; with a multifocal pattern in 12.7% vs. 66.7% of cases respectively. Age and COVID-19 positivity were independent predictors of total LUS. A total LUS ≥ 2 had a sensitivity of 66.67% and a specificity of 85.60% in detecting COVID-19 positivity. Conclusions: A slightly altered LU can be quite frequent in healthy COVID-19 negative subjects. LU can have a role in confirming but not screening COVID-19 poorly symptomatic cases.

The advent of directly acting antivirals (DAA) has determined a showy change in the management of hepatitis C virus (HCV) infection, the most common cause of hepatocellular carcinoma (HCC) in many countries. It was demonstrated that the achievement of sustained virologic response (SVR) with interferon (IFN) reduces the incidence of HCC. Recently, published data in the literature suggested an increased risk of HCC after IFN free treatments. The mechanism evoked to explain this trend is the deregulation of antitumor response, following the sudden decrease of HCV viral load, due to immune subversion which could favour the progressive development of pre-existing neoplastic clones. The lack of randomised controlled trials (RCTs) with control groups of patients and the fact that majority of studies are limited by retrospective settings, recruitment bias and lack of clinical goals scheduled at the start of treatment make difficult an adequate analysis of data. Main evidence seems to confirm that DAA therapy has not a carcinogenic effect per se but can lead to the earlier manifestation of latent tumours still present but underestimated. At present patients with HCV infection should be encouraged initiating DAA therapy to prevent cirrhosis and HCC but intensive screening is necessary to exclude HCC before initiating DAA. Curing HCV infection does not eliminate the possibility of ongoing liver disease and HCC, as such an adequate monitoring should continue for an indefinite period after SVR.