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Background Several studies have reported a low prevalence of current smoking among hospitalized COVID-19 cases; however, no definitive conclusions can be drawn. Objective We investigated the association of tobacco smoke exposure with nasopharyngeal swab (NPS) test results for SARS-CoV-2 infection and disease severity accounting for possible confounders. Methods The nationwide, self-administered, cross-sectional web-based Italian National Epidemiological Survey on COVID-19 (EPICOVID19) was administered to an Italian population of 198,822 adult volunteers who filled in an online questionnaire between April 13 and June 2, 2020. For this study, we analyzed 6857 individuals with known NPS test results. The associations of smoking status and the dose-response relationship with a positive NPS test result and infection severity were calculated as odds ratios (ORs) with 95% CIs by means of logistic and multinomial regression models adjusting for sociodemographic, clinical, and behavioral characteristics. Results Out of the 6857 individuals (mean age 47.9 years, SD 14.1; 4516/6857, 65.9% female), 63.2% (4334/6857) had never smoked, 21.3% (1463/6857) were former smokers, and 15.5% (1060/6857) were current smokers. Compared to nonsmokers, current smokers were younger, were more educated, were less affected by chronic diseases, reported COVID-19–like symptoms less frequently, were less frequently hospitalized, and less frequently tested positive for COVID-19. In multivariate analysis, current smokers had almost half the odds of a positive NPS test result (OR 0.54, 95% CI 0.45-0.65) compared to nonsmokers. We also found a dose-dependent relationship with tobacco smoke: mild smokers (adjusted OR [aOR] 0.76, 95% CI 0.55-1.05), moderate smokers (aOR 0.56, 95% CI 0.42-0.73), and heavy smokers (aOR 0.38, 95% CI 0.27-0.53). This inverse association also persisted when considering the severity of the infection. Current smokers had a statistically significantly lower probability of having asymptomatic (aOR 0.50, 95% CI 0.27-0.92), mild (aOR 0.65, 95% CI 0.53-0.81), and severe infections (aOR 0.27, 95% CI 0.17-0.42) compared to those who never smoked. Conclusions Current smoking was negatively associated with SARS-CoV-2 infection with a dose-dependent relationship. Ad hoc experimental studies are needed to elucidate the mechanisms underlying this association. Trial Registration ClinicalTrials.gov NCT04471701; https://clinicaltrials.gov/ct2/show/NCT04471701
Federica Prinelli; Fabrizio Bianchi; Gaspare Drago; Silvia Ruggieri; Aleksandra Sojic; Nithiya Jesuthasan; Sabrina Molinaro; Luca Bastiani; Stefania Maggi; Marianna Noale; Massimo Galli; Andrea Giacomelli; Raffaele Antonelli Incalzi; Fulvio Adorni; Fabio Cibella; EPICOVID19 Working Group. Association Between Smoking and SARS-CoV-2 Infection: Cross-sectional Study of the EPICOVID19 Internet-Based Survey. JMIR Public Health and Surveillance 2021, 7, e27091 .
AMA StyleFederica Prinelli, Fabrizio Bianchi, Gaspare Drago, Silvia Ruggieri, Aleksandra Sojic, Nithiya Jesuthasan, Sabrina Molinaro, Luca Bastiani, Stefania Maggi, Marianna Noale, Massimo Galli, Andrea Giacomelli, Raffaele Antonelli Incalzi, Fulvio Adorni, Fabio Cibella, EPICOVID19 Working Group. Association Between Smoking and SARS-CoV-2 Infection: Cross-sectional Study of the EPICOVID19 Internet-Based Survey. JMIR Public Health and Surveillance. 2021; 7 (4):e27091.
Chicago/Turabian StyleFederica Prinelli; Fabrizio Bianchi; Gaspare Drago; Silvia Ruggieri; Aleksandra Sojic; Nithiya Jesuthasan; Sabrina Molinaro; Luca Bastiani; Stefania Maggi; Marianna Noale; Massimo Galli; Andrea Giacomelli; Raffaele Antonelli Incalzi; Fulvio Adorni; Fabio Cibella; EPICOVID19 Working Group. 2021. "Association Between Smoking and SARS-CoV-2 Infection: Cross-sectional Study of the EPICOVID19 Internet-Based Survey." JMIR Public Health and Surveillance 7, no. 4: e27091.
Fabrizio Bianchi; Carla Ancona; Lucia Bisceglia; Francesco Forastiere; Andrea Ranzi. [Health impact: considering only a plant assessment is not enough, an area assessment is also needed]. 2021, 45, 117 -121.
AMA StyleFabrizio Bianchi, Carla Ancona, Lucia Bisceglia, Francesco Forastiere, Andrea Ranzi. [Health impact: considering only a plant assessment is not enough, an area assessment is also needed]. . 2021; 45 (1-2):117-121.
Chicago/Turabian StyleFabrizio Bianchi; Carla Ancona; Lucia Bisceglia; Francesco Forastiere; Andrea Ranzi. 2021. "[Health impact: considering only a plant assessment is not enough, an area assessment is also needed]." 45, no. 1-2: 117-121.
The study analyzed the association of the fear of contagion for oneself and for family members (FMs) during the first wave of the COVID-19 pandemic, with demographic and socioeconomic status (SES) and health factors. The study was performed within the EPICOVID19 web-based Italian survey, involving adults from April–June 2020. Out of 207,341 respondents, 95.9% completed the questionnaire (60% women with an average age of 47.3 vs. 48.9 years among men). The association between fear and demographic and SES characteristics, contacts with COVID-19 cases, nasopharyngeal swab, self-perceived health, flu vaccination, chronic diseases and specific symptoms was analyzed by logistic regression model; odds ratios adjusted for sex, age, education and occupation were calculated (aORs). Fear for FMs prevailed over fear for oneself and was higher among women than men. Fear for oneself decreased with higher levels of education and in those who perceived good health. Among those vaccinated for the flu, 40.8% responded they had feelings of fear for themselves vs. 34.2% of the not vaccinated. Fear increased when diseases were declared and it was higher when associated with symptoms such as chest pain, olfactory/taste disorders, heart palpitations (aORs > 1.5), lung or kidney diseases, hypertension, depression and/or anxiety. Trends in fear by region showed the highest percentage of positive responses in the southern regions. The knowledge gained from these results should be used to produce tailored messages and shared public health decisions.
Liliana Cori; Olivia Curzio; Fulvio Adorni; Federica Prinelli; Marianna Noale; Caterina Trevisan; Loredana Fortunato; Andrea Giacomelli; Fabrizio Bianchi. Fear of COVID-19 for Individuals and Family Members: Indications from the National Cross-Sectional Study of the EPICOVID19 Web-Based Survey. International Journal of Environmental Research and Public Health 2021, 18, 3248 .
AMA StyleLiliana Cori, Olivia Curzio, Fulvio Adorni, Federica Prinelli, Marianna Noale, Caterina Trevisan, Loredana Fortunato, Andrea Giacomelli, Fabrizio Bianchi. Fear of COVID-19 for Individuals and Family Members: Indications from the National Cross-Sectional Study of the EPICOVID19 Web-Based Survey. International Journal of Environmental Research and Public Health. 2021; 18 (6):3248.
Chicago/Turabian StyleLiliana Cori; Olivia Curzio; Fulvio Adorni; Federica Prinelli; Marianna Noale; Caterina Trevisan; Loredana Fortunato; Andrea Giacomelli; Fabrizio Bianchi. 2021. "Fear of COVID-19 for Individuals and Family Members: Indications from the National Cross-Sectional Study of the EPICOVID19 Web-Based Survey." International Journal of Environmental Research and Public Health 18, no. 6: 3248.
BACKGROUND Several studies have reported a low prevalence of current smoking among hospitalized COVID-19 cases; however, no definitive conclusions can be drawn. OBJECTIVE We investigated the association of tobacco smoke exposure with nasopharyngeal swab (NPS) test results for SARS-CoV-2 infection and disease severity accounting for possible confounders. METHODS The nationwide, self-administered, cross-sectional web-based Italian National Epidemiological Survey on COVID-19 (EPICOVID19) was administered to an Italian population of 198,822 adult volunteers who filled in an online questionnaire between April 13 and June 2, 2020. For this study, we analyzed 6857 individuals with known NPS test results. The associations of smoking status and the dose-response relationship with a positive NPS test result and infection severity were calculated as odds ratios (ORs) with 95% CIs by means of logistic and multinomial regression models adjusting for sociodemographic, clinical, and behavioral characteristics. RESULTS Out of the 6857 individuals (mean age 47.9 years, SD 14.1; 4516/6857, 65.9% female), 63.2% (4334/6857) had never smoked, 21.3% (1463/6857) were former smokers, and 15.5% (1060/6857) were current smokers. Compared to nonsmokers, current smokers were younger, were more educated, were less affected by chronic diseases, reported COVID-19–like symptoms less frequently, were less frequently hospitalized, and less frequently tested positive for COVID-19. In multivariate analysis, current smokers had almost half the odds of a positive NPS test result (OR 0.54, 95% CI 0.45-0.65) compared to nonsmokers. We also found a dose-dependent relationship with tobacco smoke: mild smokers (adjusted OR [aOR] 0.76, 95% CI 0.55-1.05), moderate smokers (aOR 0.56, 95% CI 0.42-0.73), and heavy smokers (aOR 0.38, 95% CI 0.27-0.53). This inverse association also persisted when considering the severity of the infection. Current smokers had a statistically significantly lower probability of having asymptomatic (aOR 0.50, 95% CI 0.27-0.92), mild (aOR 0.65, 95% CI 0.53-0.81), and severe infections (aOR 0.27, 95% CI 0.17-0.42) compared to those who never smoked. CONCLUSIONS Current smoking was negatively associated with SARS-CoV-2 infection with a dose-dependent relationship. Ad hoc experimental studies are needed to elucidate the mechanisms underlying this association. CLINICALTRIAL ClinicalTrials.gov NCT04471701; https://clinicaltrials.gov/ct2/show/NCT04471701
Federica Prinelli; Fabrizio Bianchi; Gaspare Drago; Silvia Ruggieri; Aleksandra Sojic; Nithiya Jesuthasan; Sabrina Molinaro; Luca Bastiani; Stefania Maggi; Marianna Noale; Massimo Galli; Andrea Giacomelli; Raffaele Antonelli Incalzi; Fulvio Adorni; Fabio Cibella; EPICOVID19 Working Group. Association Between Smoking and SARS-CoV-2 Infection: Cross-sectional Study of the EPICOVID19 Internet-Based Survey (Preprint). 2021, 1 .
AMA StyleFederica Prinelli, Fabrizio Bianchi, Gaspare Drago, Silvia Ruggieri, Aleksandra Sojic, Nithiya Jesuthasan, Sabrina Molinaro, Luca Bastiani, Stefania Maggi, Marianna Noale, Massimo Galli, Andrea Giacomelli, Raffaele Antonelli Incalzi, Fulvio Adorni, Fabio Cibella, EPICOVID19 Working Group. Association Between Smoking and SARS-CoV-2 Infection: Cross-sectional Study of the EPICOVID19 Internet-Based Survey (Preprint). . 2021; ():1.
Chicago/Turabian StyleFederica Prinelli; Fabrizio Bianchi; Gaspare Drago; Silvia Ruggieri; Aleksandra Sojic; Nithiya Jesuthasan; Sabrina Molinaro; Luca Bastiani; Stefania Maggi; Marianna Noale; Massimo Galli; Andrea Giacomelli; Raffaele Antonelli Incalzi; Fulvio Adorni; Fabio Cibella; EPICOVID19 Working Group. 2021. "Association Between Smoking and SARS-CoV-2 Infection: Cross-sectional Study of the EPICOVID19 Internet-Based Survey (Preprint)." , no. : 1.
Background Confirmed COVID-19 cases have been registered in more than 200 countries, and as of July 28, 2020, over 16 million cases have been reported to the World Health Organization. This study was conducted during the epidemic peak of COVID-19 in Italy. The early identification of individuals with suspected COVID-19 is critical in immediately quarantining such individuals. Although surveys are widely used for identifying COVID-19 cases, outcomes, and associated risks, no validated epidemiological tool exists for surveying SARS-CoV-2 infection in the general population. Objective We evaluated the capability of self-reported symptoms in discriminating COVID-19 to identify individuals who need to undergo instrumental measurements. We defined and validated a method for identifying a cutoff score. Methods Our study is phase II of the EPICOVID19 Italian national survey, which launched in April 2020 and included a convenience sample of 201,121 adults who completed the EPICOVID19 questionnaire. The Phase II questionnaire, which focused on the results of nasopharyngeal swab (NPS) and serological tests, was mailed to all subjects who previously underwent NPS tests. Results Of 2703 subjects who completed the Phase II questionnaire, 694 (25.7%) were NPS positive. Of the 472 subjects who underwent the immunoglobulin G (IgG) test and 421 who underwent the immunoglobulin M test, 22.9% (108/472) and 11.6% (49/421) tested positive, respectively. Compared to NPS-negative subjects, NPS-positive subjects had a higher incidence of fever (421/694, 60.7% vs 391/2009, 19.5%; P<.001), loss of taste and smell (365/694, 52.6% vs 239/2009, 11.9%; P<.001), and cough (352/694, 50.7% vs 580/2009, 28.9%; P<.001). With regard to subjects who underwent serological tests, IgG-positive subjects had a higher incidence of fever (65/108, 60.2% vs 43/364, 11.8%; P<.001) and pain in muscles/bones/joints (73/108, 67.6% vs 71/364, 19.5%; P<.001) than IgG-negative subjects. An analysis of self-reported COVID-19 symptom items revealed a 1-factor solution, the EPICOVID19 diagnostic scale. The following optimal scores were identified: 1.03 for respiratory problems, 1.07 for chest pain, 0.97 for loss of taste and smell 0.97, and 1.05 for tachycardia (ie, heart palpitations). These were the most important symptoms. For adults aged 18-84 years, the cutoff score was 2.56 (sensitivity: 76.56%; specificity: 68.24%) for NPS-positive subjects and 2.59 (sensitivity: 80.37%; specificity: 80.17%) for IgG-positive subjects. For subjects aged ≥60 years, the cutoff score was 1.28, and accuracy based on the presence of IgG antibodies improved (sensitivity: 88.00%; specificity: 89.58%). Conclusions We developed a short diagnostic scale to detect subjects with symptoms that were potentially associated with COVID-19 from a wide population. Our results support the potential of self-reported symptoms in identifying individuals who require immediate clinical evaluations. Although these results come from the Italian pandemic period, this short diagnostic scale could be optimized and tested as a screening tool for future similar pandemics.
Luca Bastiani; Loredana Fortunato; Stefania Pieroni; Fabrizio Bianchi; Fulvio Adorni; Federica Prinelli; Andrea Giacomelli; Gabriele Pagani; Stefania Maggi; Caterina Trevisan; Marianna Noale; Nithiya Jesuthasan; Aleksandra Sojic; Carla Pettenati; Massimo Andreoni; Raffaele Antonelli Incalzi; Massimo Galli; Sabrina Molinaro. Rapid COVID-19 Screening Based on Self-Reported Symptoms: Psychometric Assessment and Validation of the EPICOVID19 Short Diagnostic Scale. Journal of Medical Internet Research 2021, 23, e23897 .
AMA StyleLuca Bastiani, Loredana Fortunato, Stefania Pieroni, Fabrizio Bianchi, Fulvio Adorni, Federica Prinelli, Andrea Giacomelli, Gabriele Pagani, Stefania Maggi, Caterina Trevisan, Marianna Noale, Nithiya Jesuthasan, Aleksandra Sojic, Carla Pettenati, Massimo Andreoni, Raffaele Antonelli Incalzi, Massimo Galli, Sabrina Molinaro. Rapid COVID-19 Screening Based on Self-Reported Symptoms: Psychometric Assessment and Validation of the EPICOVID19 Short Diagnostic Scale. Journal of Medical Internet Research. 2021; 23 (1):e23897.
Chicago/Turabian StyleLuca Bastiani; Loredana Fortunato; Stefania Pieroni; Fabrizio Bianchi; Fulvio Adorni; Federica Prinelli; Andrea Giacomelli; Gabriele Pagani; Stefania Maggi; Caterina Trevisan; Marianna Noale; Nithiya Jesuthasan; Aleksandra Sojic; Carla Pettenati; Massimo Andreoni; Raffaele Antonelli Incalzi; Massimo Galli; Sabrina Molinaro. 2021. "Rapid COVID-19 Screening Based on Self-Reported Symptoms: Psychometric Assessment and Validation of the EPICOVID19 Short Diagnostic Scale." Journal of Medical Internet Research 23, no. 1: e23897.
We aimed to assess the reported rate of flu vaccination in the 2019/2020 season for respondents to the Italian nationwide online EPICOVID 19 survey. A national convenience sample of volunteers aged 18 or older was assessed between 13 April and 2 June 2020. Flu vaccine rates were calculated for all classes of age. The association between the independent variables and the flu vaccine was assessed by applying a multivariable binary logistic regression model. Of the 198,822 respondents, 41,818 (21.0%) reported having received a flu vaccination shot during the last influenza season. In particular, 15,009 (53.4%) subjects aged 65 years or older received a flu vaccination shot. Being 65 years aged or older (Adjusted Odds Ratios (aOR) 3.06, 95% Confidence Interval (CI) 2.92–3.20) and having a high education level (aOR 1.34. 95%CI 1.28–1.41) were independently associated to flu vaccination. Heart and lung diseases were the morbidities associated with the higher odds of being vaccinated (aOR 1.97 (95%CI 1.86–2.09) and aOR 1.92 (95%CI 1.84–2.01), respectively). Nursing home residents aged ≥ 65 years showed lower odds of being vaccinated (aOR 0.39 (95%CI 0.28–0.54)). Our data indicate the need for an urgent public heath effort to fill the gap of missed vaccination opportunities reported in the past flu seasons.
Andrea Giacomelli; Massimo Galli; Stefania Maggi; Gabriele Pagani; Raffaele Antonelli Incalzi; Claudio Pedone; Mauro Di Bari; Marianna Noale; Caterina Trevisan; Fabrizio Bianchi; Marcello Tavio; Massimo Andreoni; Claudio Mastroianni; Aleksandra Sojic; Federica Prinelli; Fulvio Adorni. Missed Opportunities of Flu Vaccination in Italian Target Categories: Insights from the Online EPICOVID 19 Survey. Vaccines 2020, 8, 669 .
AMA StyleAndrea Giacomelli, Massimo Galli, Stefania Maggi, Gabriele Pagani, Raffaele Antonelli Incalzi, Claudio Pedone, Mauro Di Bari, Marianna Noale, Caterina Trevisan, Fabrizio Bianchi, Marcello Tavio, Massimo Andreoni, Claudio Mastroianni, Aleksandra Sojic, Federica Prinelli, Fulvio Adorni. Missed Opportunities of Flu Vaccination in Italian Target Categories: Insights from the Online EPICOVID 19 Survey. Vaccines. 2020; 8 (4):669.
Chicago/Turabian StyleAndrea Giacomelli; Massimo Galli; Stefania Maggi; Gabriele Pagani; Raffaele Antonelli Incalzi; Claudio Pedone; Mauro Di Bari; Marianna Noale; Caterina Trevisan; Fabrizio Bianchi; Marcello Tavio; Massimo Andreoni; Claudio Mastroianni; Aleksandra Sojic; Federica Prinelli; Fulvio Adorni. 2020. "Missed Opportunities of Flu Vaccination in Italian Target Categories: Insights from the Online EPICOVID 19 Survey." Vaccines 8, no. 4: 669.
In recent years, the presence in the environment of chemical compounds with thyroid-disrupting effects is progressively increased. This phenomenon has risen concern for human health as the preservation of thyroid system homeostasis is essential for fetal development and for maintaining psychological and physiological wellbeing. An increasing number of studies explored the role of different classes of toxicants in the occurrence and severity of thyroid diseases, but large epidemiological studies are limited and only a few animal or in vitro studies have attempted to identify the mechanisms of chemical action. Recently, epigenetic changes such as alteration of methylation status or modification of non-coding RNAs have been suggested as correlated to possible deleterious effects leading to different thyroid disorders in susceptible individuals. This review aims to analyze the epigenetic alterations putatively induced by chemical exposures and involved in the onset of frequent thyroid diseases such as thyroid cancer, autoimmune thyroiditis and disruption of fetal thyroid homeostasis.
Letizia Pitto; Francesca Gorini; Fabrizio Bianchi; Elena Guzzolino. New Insights into Mechanisms of Endocrine-Disrupting Chemicals in Thyroid Diseases: The Epigenetic Way. International Journal of Environmental Research and Public Health 2020, 17, 7787 .
AMA StyleLetizia Pitto, Francesca Gorini, Fabrizio Bianchi, Elena Guzzolino. New Insights into Mechanisms of Endocrine-Disrupting Chemicals in Thyroid Diseases: The Epigenetic Way. International Journal of Environmental Research and Public Health. 2020; 17 (21):7787.
Chicago/Turabian StyleLetizia Pitto; Francesca Gorini; Fabrizio Bianchi; Elena Guzzolino. 2020. "New Insights into Mechanisms of Endocrine-Disrupting Chemicals in Thyroid Diseases: The Epigenetic Way." International Journal of Environmental Research and Public Health 17, no. 21: 7787.
Editorial: Environment and Health
Mario Sprovieri; Ethel Eljarrat; Fabrizio Bianchi. Editorial: Environment and Health. Frontiers in Earth Science 2020, 8, 1 .
AMA StyleMario Sprovieri, Ethel Eljarrat, Fabrizio Bianchi. Editorial: Environment and Health. Frontiers in Earth Science. 2020; 8 ():1.
Chicago/Turabian StyleMario Sprovieri; Ethel Eljarrat; Fabrizio Bianchi. 2020. "Editorial: Environment and Health." Frontiers in Earth Science 8, no. : 1.
Coronavirus disease 2019 (COVID-19) has quickly become a worldwide health crisis. Although respiratory disease remains the main cause of morbidity and mortality in COVID patients, myocardial damage is a common finding. Many possible biological pathways may explain the relationship between COVID-19 and acute myocardial infarction (AMI). Increased immune and inflammatory responses, and procoagulant profile have characterized COVID patients. All these responses may induce endothelial dysfunction, myocardial injury, plaque instability, and AMI. Disease severity and mortality are increased by cardiovascular comorbidities. Moreover, COVID-19 has been associated with air pollution, which may also represent an AMI risk factor. Nonetheless, a significant reduction in patient admissions following containment initiatives has been observed, including for AMI. The reasons for this phenomenon are largely unknown, although a real decrease in the incidence of cardiac events seems highly improbable. Instead, patients likely may present delayed time from symptoms onset and subsequent referral to emergency departments because of fear of possible in-hospital infection, and as such, may present more complications. Here, we aim to discuss available evidence about all these factors in the complex relationship between COVID-19 and AMI, with particular focus on psychological distress and the need to increase awareness of ischemic symptoms.
Francesca Gorini; Kyriazoula Chatzianagnostou; Annamaria Mazzone; Elisa Bustaffa; Augusto Esposito; Sergio Berti; Fabrizio Bianchi; Cristina Vassalle. “Acute Myocardial Infarction in the Time of COVID-19”: A Review of Biological, Environmental, and Psychosocial Contributors. International Journal of Environmental Research and Public Health 2020, 17, 7371 .
AMA StyleFrancesca Gorini, Kyriazoula Chatzianagnostou, Annamaria Mazzone, Elisa Bustaffa, Augusto Esposito, Sergio Berti, Fabrizio Bianchi, Cristina Vassalle. “Acute Myocardial Infarction in the Time of COVID-19”: A Review of Biological, Environmental, and Psychosocial Contributors. International Journal of Environmental Research and Public Health. 2020; 17 (20):7371.
Chicago/Turabian StyleFrancesca Gorini; Kyriazoula Chatzianagnostou; Annamaria Mazzone; Elisa Bustaffa; Augusto Esposito; Sergio Berti; Fabrizio Bianchi; Cristina Vassalle. 2020. "“Acute Myocardial Infarction in the Time of COVID-19”: A Review of Biological, Environmental, and Psychosocial Contributors." International Journal of Environmental Research and Public Health 17, no. 20: 7371.
We aimed to assess the reported rate of flu vaccination in the season 2019/2020 in respondents to the Italian nationwide online EPICOVID 19 survey. A national convenience sample of volunteers aged 18 or older was assessed between 13th April and 2nd June 2020. Flu vaccine rates were calculated for all classes of age. The association between the independent variables and the flu vaccine was assessed by applying a multivariable binary logistic regression model. Of the 198,822 respondents 41,818 (21.0%) reported to have received a flu vaccination shot during the last influenza season. In particular, 15,009 (53.4%) subjects aged 65 years or older received a flu vaccination shot. Being 65 years aged or older (aOR 3.06, 95%CI 2.92-3.20) and having a high education level (aOR 1.34. 95%CI 1.28-1.41) were independently associated to flu vaccination. Heart and lung diseases were the morbidities associated with the higher odds of being vaccinated [aOR 1.97 (95%CI 1.86-2.09) and aOR 1.92 (95%CI 1.84-2.01), respectively]. Nursing home residents aged ≥ 65 years showed a lower odds of being vaccinated [aOR 0.39 (95%CI 0.28-0.54)]. Our data claims for an urgent public heath effort to fill the gap of missed vaccination opportunities reported in the past flu seasons.
Andrea Giacomelli; Massimo Galli; Stefania Maggi; Gabriele Pagani; Raffaele Antonelli Incalzi; Claudio Pedone; Mauro di Bari; Marianna Noale; Caterina Trevisan; Fabrizio Bianchi; Marcello Tavio; Massimo Andreoni; Claudio Mastroianni; Aleksandra Sojic; Federica Prinelli; Fulvio Adorni. Missed opportunities of flu vaccination in Italian target categories: insights from the online EPICOVID 19 survey. 2020, 1 .
AMA StyleAndrea Giacomelli, Massimo Galli, Stefania Maggi, Gabriele Pagani, Raffaele Antonelli Incalzi, Claudio Pedone, Mauro di Bari, Marianna Noale, Caterina Trevisan, Fabrizio Bianchi, Marcello Tavio, Massimo Andreoni, Claudio Mastroianni, Aleksandra Sojic, Federica Prinelli, Fulvio Adorni. Missed opportunities of flu vaccination in Italian target categories: insights from the online EPICOVID 19 survey. . 2020; ():1.
Chicago/Turabian StyleAndrea Giacomelli; Massimo Galli; Stefania Maggi; Gabriele Pagani; Raffaele Antonelli Incalzi; Claudio Pedone; Mauro di Bari; Marianna Noale; Caterina Trevisan; Fabrizio Bianchi; Marcello Tavio; Massimo Andreoni; Claudio Mastroianni; Aleksandra Sojic; Federica Prinelli; Fulvio Adorni. 2020. "Missed opportunities of flu vaccination in Italian target categories: insights from the online EPICOVID 19 survey." , no. : 1.
Background Understanding the occurrence of symptoms resembling those of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in a large nonhospitalized population at the peak of the epidemic in Italy is of paramount importance; however, data are currently scarce. Objective The aims of this study were to evaluate the association of self-reported symptoms with SARS-CoV-2 nasopharyngeal swab (NPS) test results in nonhospitalized individuals and to estimate the occurrence of symptoms associated with coronavirus disease (COVID-19) in a larger nontested population. Methods EPICOVID19 is a self-administered cross-sectional voluntary web-based survey of adults throughout Italy who completed an anonymous questionnaire in the period of April 13 to 21, 2020. The associations between symptoms potentially related to SARS-CoV-2 infection and NPS results were calculated as adjusted odds ratios (aORs) with 95% CIs by multiple logistic regression analysis controlling for age, sex, education, smoking habits, and number of comorbidities. Thereafter, for each symptom and for combinations of the symptoms, we calculated the sensitivity, specificity, accuracy, and areas under the curve (AUCs) in a receiver operating characteristic (ROC) analysis to estimate the occurrence of COVID-19–like infection in the nontested population. Results A total of 171,310 people responded to the survey, of whom 102,543 (59.9%) were women; mean age 47.4 years. Out of the 4785 respondents with known NPS test results, 4392 were not hospitalized. Among the 4392 nonhospitalized respondents, those with positive NPS tests (856, 19.5%) most frequently reported myalgia (527, 61.6%), olfactory and taste disorders (507, 59.2%), cough (466, 54.4%), and fever (444, 51.9%), whereas 7.7% were asymptomatic. Multiple regression analysis showed that olfactory and taste disorders (aOR 10.3, 95% CI 8.4-12.7), fever (aOR 2.5, 95% CI 2.0-3.1), myalgia (aOR 1.5, 95% CI 1.2-1.8), and cough (aOR 1.3, 95% CI 1.0-1.6) were associated with NPS positivity. Having two to four of these symptoms increased the aOR from 7.4 (95% CI 5.6-9.7) to 35.5 (95% CI 24.6-52.2). The combination of the four symptoms showed an AUC of 0.810 (95% CI 0.795-0.825) in classifying positive NPS test results and then was applied to the nonhospitalized and nontested sample (n=165,782). We found that 7739 to 20,103 of these 165,782 respondents (4.4% to 12.1%) had experienced symptoms suggestive of COVID-19 infection. Conclusions Our results suggest that self-reported symptoms are reliable indicators of SARS-CoV-2 infection in a pandemic context. A nonnegligible number of symptomatic respondents (up to 12.1%) were undiagnosed and potentially contributed to the spread of the infection. Trial Registration ClinicalTrials.gov NCT04471701; https://clinicaltrials.gov/ct2/show/NCT04471701
Fulvio Adorni; Federica Prinelli; Fabrizio Bianchi; Andrea Giacomelli; Gabriele Pagani; Dario Bernacchia; Stefano Rusconi; Stefania Maggi; Caterina Trevisan; Marianna Noale; Sabrina Molinaro; Luca Bastiani; Loredana Fortunato; Nithiya Jesuthasan; Aleksandra Sojic; Carla Pettenati; Marcello Tavio; Massimo Andreoni; Claudio Mastroianni; Raffaele Antonelli Incalzi; Massimo Galli. Self-Reported Symptoms of SARS-CoV-2 Infection in a Nonhospitalized Population in Italy: Cross-Sectional Study of the EPICOVID19 Web-Based Survey. JMIR Public Health and Surveillance 2020, 6, e21866 .
AMA StyleFulvio Adorni, Federica Prinelli, Fabrizio Bianchi, Andrea Giacomelli, Gabriele Pagani, Dario Bernacchia, Stefano Rusconi, Stefania Maggi, Caterina Trevisan, Marianna Noale, Sabrina Molinaro, Luca Bastiani, Loredana Fortunato, Nithiya Jesuthasan, Aleksandra Sojic, Carla Pettenati, Marcello Tavio, Massimo Andreoni, Claudio Mastroianni, Raffaele Antonelli Incalzi, Massimo Galli. Self-Reported Symptoms of SARS-CoV-2 Infection in a Nonhospitalized Population in Italy: Cross-Sectional Study of the EPICOVID19 Web-Based Survey. JMIR Public Health and Surveillance. 2020; 6 (3):e21866.
Chicago/Turabian StyleFulvio Adorni; Federica Prinelli; Fabrizio Bianchi; Andrea Giacomelli; Gabriele Pagani; Dario Bernacchia; Stefano Rusconi; Stefania Maggi; Caterina Trevisan; Marianna Noale; Sabrina Molinaro; Luca Bastiani; Loredana Fortunato; Nithiya Jesuthasan; Aleksandra Sojic; Carla Pettenati; Marcello Tavio; Massimo Andreoni; Claudio Mastroianni; Raffaele Antonelli Incalzi; Massimo Galli. 2020. "Self-Reported Symptoms of SARS-CoV-2 Infection in a Nonhospitalized Population in Italy: Cross-Sectional Study of the EPICOVID19 Web-Based Survey." JMIR Public Health and Surveillance 6, no. 3: e21866.
The outbreak of coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has rapidly spread worldwide. A number of serious effects on various organs and systems have been reported in humans, and recently emerging evidence on the potential association between the infection and thyroid dysfunction are attracting attention from the scientific community. This editorial critically summarizes the main findings on this topic published so far and defines research lines according to the translational approach from the bench to the bed to epidemiological studies and back again, aimed at patient care and effective public health measures.
Francesca Gorini; Fabrizio Bianchi; Giorgio Iervasi. COVID-19 and Thyroid: Progress and Prospects. International Journal of Environmental Research and Public Health 2020, 17, 6630 .
AMA StyleFrancesca Gorini, Fabrizio Bianchi, Giorgio Iervasi. COVID-19 and Thyroid: Progress and Prospects. International Journal of Environmental Research and Public Health. 2020; 17 (18):6630.
Chicago/Turabian StyleFrancesca Gorini; Fabrizio Bianchi; Giorgio Iervasi. 2020. "COVID-19 and Thyroid: Progress and Prospects." International Journal of Environmental Research and Public Health 17, no. 18: 6630.
The adverse health effects of exposure to air pollutants, notably to particulate matter (PM), are well-known, as well as the association with measured or estimated concentration levels. The role of perception can be relevant in exploring effects and pollution control actions. The purpose of this study was to explore studies that analyse people’s perception, together with the measurement of air pollution, in order to elucidate the relationship between them. We conducted a systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. In March 2020, PubMed, EMBASE, and Scopus databases were explored in an attempt to search for studies published from 2000 to 2020. The review included 38 studies, most of which were conducted in China (n = 13) and the United States (n = 11) and published over the last four years (n = 26). Three studies were multicenter investigations, while five articles were based on a national-level survey. The air quality (AQ) was assessed by monitoring stations (n = 24) or dispersion models (n = 7). Many studies were population questionnaire-based, air monitoring and time-series studies, and web-based investigations. A direct association between exposure and perception emerged in 20 studies. This systematic review has shown that most of the studies establish a relationship between risk perception measurement. A broad spectrum of concepts and notions related to perception also emerged, which is undoubtedly an indicator of the wealth of available knowledge and is promising for future research.
Liliana Cori; Gabriele Donzelli; Francesca Gorini; Fabrizio Bianchi; Olivia Curzio. Risk Perception of Air Pollution: A Systematic Review Focused on Particulate Matter Exposure. International Journal of Environmental Research and Public Health 2020, 17, 6424 .
AMA StyleLiliana Cori, Gabriele Donzelli, Francesca Gorini, Fabrizio Bianchi, Olivia Curzio. Risk Perception of Air Pollution: A Systematic Review Focused on Particulate Matter Exposure. International Journal of Environmental Research and Public Health. 2020; 17 (17):6424.
Chicago/Turabian StyleLiliana Cori; Gabriele Donzelli; Francesca Gorini; Fabrizio Bianchi; Olivia Curzio. 2020. "Risk Perception of Air Pollution: A Systematic Review Focused on Particulate Matter Exposure." International Journal of Environmental Research and Public Health 17, no. 17: 6424.
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and associated COVID-19 have caused a global emergency that requires an engaged, integrated, interdisciplinary, and rapid response from the scientific community. Climate change, ecological change, and biodiversity loss might have played an important role in the occurrence of this zoonotic pandemic. Climatic and environmental factors, such as temperature, humidity, and air pollution, are potentially influencing the transmission, spread, and severity of SARS-CoV-2 infection. Strong scientific evidence about the contributions of these environmental determinants in the COVID-19 pandemic is needed, in combination with an understanding of the role of other important societal factors and public health interventions. This evidence will support the public health community in responding to the current crisis, and inform strategies to prevent the recurring effects of the COVID-19 pandemic and future emergencies.
Ariana Zeka; Aurelio Tobias; Giovanni Leonardi; Fabrizio Bianchi; Paolo Lauriola; Helen Crabbe; Sotiris Vardoulakis; Yuming Guo; Yasushi Honda; Antonio Gasparrini; Masahiro Hashizume; Ana Maria Vicedo; Lisbeth E Knudsen; Francesco Sera; Matthew Ashworth. Responding to COVID-19 requires strong epidemiological evidence of environmental and societal determining factors. The Lancet Planetary Health 2020, 4, e375 -e376.
AMA StyleAriana Zeka, Aurelio Tobias, Giovanni Leonardi, Fabrizio Bianchi, Paolo Lauriola, Helen Crabbe, Sotiris Vardoulakis, Yuming Guo, Yasushi Honda, Antonio Gasparrini, Masahiro Hashizume, Ana Maria Vicedo, Lisbeth E Knudsen, Francesco Sera, Matthew Ashworth. Responding to COVID-19 requires strong epidemiological evidence of environmental and societal determining factors. The Lancet Planetary Health. 2020; 4 (9):e375-e376.
Chicago/Turabian StyleAriana Zeka; Aurelio Tobias; Giovanni Leonardi; Fabrizio Bianchi; Paolo Lauriola; Helen Crabbe; Sotiris Vardoulakis; Yuming Guo; Yasushi Honda; Antonio Gasparrini; Masahiro Hashizume; Ana Maria Vicedo; Lisbeth E Knudsen; Francesco Sera; Matthew Ashworth. 2020. "Responding to COVID-19 requires strong epidemiological evidence of environmental and societal determining factors." The Lancet Planetary Health 4, no. 9: e375-e376.
BACKGROUND Confirmed COVID-19 cases have been registered in more than 200 countries, and as of July 28, 2020, over 16 million cases have been reported to the World Health Organization. This study was conducted during the epidemic peak of COVID-19 in Italy. The early identification of individuals with suspected COVID-19 is critical in immediately quarantining such individuals. Although surveys are widely used for identifying COVID-19 cases, outcomes, and associated risks, no validated epidemiological tool exists for surveying SARS-CoV-2 infection in the general population. OBJECTIVE We evaluated the capability of self-reported symptoms in discriminating COVID-19 to identify individuals who need to undergo instrumental measurements. We defined and validated a method for identifying a cutoff score. METHODS Our study is phase II of the EPICOVID19 Italian national survey, which launched in April 2020 and included a convenience sample of 201,121 adults who completed the EPICOVID19 questionnaire. The Phase II questionnaire, which focused on the results of nasopharyngeal swab (NPS) and serological tests, was mailed to all subjects who previously underwent NPS tests. RESULTS Of 2703 subjects who completed the Phase II questionnaire, 694 (25.7%) were NPS positive. Of the 472 subjects who underwent the immunoglobulin G (IgG) test and 421 who underwent the immunoglobulin M test, 22.9% (108/472) and 11.6% (49/421) tested positive, respectively. Compared to NPS-negative subjects, NPS-positive subjects had a higher incidence of fever (421/694, 60.7% vs 391/2009, 19.5%; P<.001), loss of taste and smell (365/694, 52.6% vs 239/2009, 11.9%; P<.001), and cough (352/694, 50.7% vs 580/2009, 28.9%; P<.001). With regard to subjects who underwent serological tests, IgG-positive subjects had a higher incidence of fever (65/108, 60.2% vs 43/364, 11.8%; P<.001) and pain in muscles/bones/joints (73/108, 67.6% vs 71/364, 19.5%; P<.001) than IgG-negative subjects. An analysis of self-reported COVID-19 symptom items revealed a 1-factor solution, the EPICOVID19 diagnostic scale. The following optimal scores were identified: 1.03 for respiratory problems, 1.07 for chest pain, 0.97 for loss of taste and smell 0.97, and 1.05 for tachycardia (ie, heart palpitations). These were the most important symptoms. For adults aged 18-84 years, the cutoff score was 2.56 (sensitivity: 76.56%; specificity: 68.24%) for NPS-positive subjects and 2.59 (sensitivity: 80.37%; specificity: 80.17%) for IgG-positive subjects. For subjects aged ≥60 years, the cutoff score was 1.28, and accuracy based on the presence of IgG antibodies improved (sensitivity: 88.00%; specificity: 89.58%). CONCLUSIONS We developed a short diagnostic scale to detect subjects with symptoms that were potentially associated with COVID-19 from a wide population. Our results support the potential of self-reported symptoms in identifying individuals who require immediate clinical evaluations. Although these results come from the Italian pandemic period, this short diagnostic scale could be optimized and tested as a screening tool for future similar pandemics.
Luca Bastiani; Loredana Fortunato; Stefania Pieroni; Fabrizio Bianchi; Fulvio Adorni; Federica Prinelli; Andrea Giacomelli; Gabriele Pagani; Stefania Maggi; Caterina Trevisan; Marianna Noale; Nithiya Jesuthasan; Aleksandra Sojic; Carla Pettenati; Massimo Andreoni; Raffaele Antonelli Incalzi; Massimo Galli; Sabrina Molinaro. Rapid COVID-19 Screening Based on Self-Reported Symptoms: Psychometric Assessment and Validation of the EPICOVID19 Short Diagnostic Scale (Preprint). 2020, 1 .
AMA StyleLuca Bastiani, Loredana Fortunato, Stefania Pieroni, Fabrizio Bianchi, Fulvio Adorni, Federica Prinelli, Andrea Giacomelli, Gabriele Pagani, Stefania Maggi, Caterina Trevisan, Marianna Noale, Nithiya Jesuthasan, Aleksandra Sojic, Carla Pettenati, Massimo Andreoni, Raffaele Antonelli Incalzi, Massimo Galli, Sabrina Molinaro. Rapid COVID-19 Screening Based on Self-Reported Symptoms: Psychometric Assessment and Validation of the EPICOVID19 Short Diagnostic Scale (Preprint). . 2020; ():1.
Chicago/Turabian StyleLuca Bastiani; Loredana Fortunato; Stefania Pieroni; Fabrizio Bianchi; Fulvio Adorni; Federica Prinelli; Andrea Giacomelli; Gabriele Pagani; Stefania Maggi; Caterina Trevisan; Marianna Noale; Nithiya Jesuthasan; Aleksandra Sojic; Carla Pettenati; Massimo Andreoni; Raffaele Antonelli Incalzi; Massimo Galli; Sabrina Molinaro. 2020. "Rapid COVID-19 Screening Based on Self-Reported Symptoms: Psychometric Assessment and Validation of the EPICOVID19 Short Diagnostic Scale (Preprint)." , no. : 1.
The present study aims to evaluate whether influenza and pneumococcal vaccinations are associated with positive nasopharyngeal swab (NPS) testing to detect SARS-CoV-2. Data from the Italian cross-sectional web-based survey (EPICOVID19), based on a self-selection sample of individuals aged ≥18, were considered. The probability of a positive SARS-CoV-2 NPS test result as a function of influenza or anti-pneumococcal vaccination was evaluated using multivariable logistic regression, stratifying analysis by age (<65 years, ≥65 years). From April 2020, 170,731 individuals aged <65 years and 28,097 ≥65 years filled out the EPICOVID19 questionnaire. Influenza and anti-pneumococcal vaccinations were received, respectively, by 16% and 2% of those <65 years, and by 53% and 13% of those ≥65 years. SARS-CoV-2 NPS testing was reported by 6680 participants. Anti-pneumococcal and influenza vaccinations were associated with a decreased probability of a SARS-CoV-2 NPS positive test in the younger participants (OR = 0.61, 95% CI 0.41–0.91; OR = 0.85, 95%CI 0.74–0.98; respectively). A significantly lower probability of a positive test result was detected in the individuals ≥65 years who received anti-pneumococcal vaccination (OR = 0.56, 95%CI 0.33–0.95). These results need to be confirmed by further investigations, but they are relevant given the probable coexistence of influenza, bacterial infections, and COVID-19 over the coming autumn–winter season.
Marianna Noale; Caterina Trevisan; Stefania Maggi; Raffaele Antonelli Incalzi; Claudio Pedone; Mauro Di Bari; Fulvio Adorni; Nithiya Jesuthasan; Aleksandra Sojic; Massimo Galli; Andrea Giacomelli; Sabrina Molinaro; Fabrizio Bianchi; Claudio Mastroianni; Federica Prinelli; on Group. The Association between Influenza and Pneumococcal Vaccinations and SARS-Cov-2 Infection: Data from the EPICOVID19 Web-Based Survey. Vaccines 2020, 8, 471 .
AMA StyleMarianna Noale, Caterina Trevisan, Stefania Maggi, Raffaele Antonelli Incalzi, Claudio Pedone, Mauro Di Bari, Fulvio Adorni, Nithiya Jesuthasan, Aleksandra Sojic, Massimo Galli, Andrea Giacomelli, Sabrina Molinaro, Fabrizio Bianchi, Claudio Mastroianni, Federica Prinelli, on Group. The Association between Influenza and Pneumococcal Vaccinations and SARS-Cov-2 Infection: Data from the EPICOVID19 Web-Based Survey. Vaccines. 2020; 8 (3):471.
Chicago/Turabian StyleMarianna Noale; Caterina Trevisan; Stefania Maggi; Raffaele Antonelli Incalzi; Claudio Pedone; Mauro Di Bari; Fulvio Adorni; Nithiya Jesuthasan; Aleksandra Sojic; Massimo Galli; Andrea Giacomelli; Sabrina Molinaro; Fabrizio Bianchi; Claudio Mastroianni; Federica Prinelli; on Group. 2020. "The Association between Influenza and Pneumococcal Vaccinations and SARS-Cov-2 Infection: Data from the EPICOVID19 Web-Based Survey." Vaccines 8, no. 3: 471.
Chronic arsenic (As) exposure is a critical public health issue. The As metabolism can be influenced by many factors. The objective of this study is to verify if these factors influence As metabolism in four Italian areas affected by As pollution. Descriptive analyses were conducted on 271 subjects aged 20–49 in order to assess the effect of each factor considered on As methylation. Percentages of metabolites of As in urine, primary and secondary methylation indexes were calculated as indicators for metabolic capacity. The results indicate that women have a better methylation capacity (MC) than men, and drinking As-contaminated water from public aqueducts is associated with poorer MC, especially in areas with natural As pollution. In areas with anthropogenic As pollution occupational exposure is associated with a higher MC while smoking with a poorer MC. Dietary habits and genetic characteristics are probably implicated in As metabolism. BMI, alcohol consumption and polymorphism of the AS3MT gene seem not to influence As MC. Arsenic metabolism may be affected by various factors and in order to achieve a comprehensive risk assessment of As-associated disease, it is crucial to understand how these factors contribute to differences in As metabolism.
Elisa Bustaffa; Francesca Gorini; Fabrizio Bianchi; Fabrizio Minichilli. Factors Affecting Arsenic Methylation in Contaminated Italian Areas. International Journal of Environmental Research and Public Health 2020, 17, 5226 .
AMA StyleElisa Bustaffa, Francesca Gorini, Fabrizio Bianchi, Fabrizio Minichilli. Factors Affecting Arsenic Methylation in Contaminated Italian Areas. International Journal of Environmental Research and Public Health. 2020; 17 (14):5226.
Chicago/Turabian StyleElisa Bustaffa; Francesca Gorini; Fabrizio Bianchi; Fabrizio Minichilli. 2020. "Factors Affecting Arsenic Methylation in Contaminated Italian Areas." International Journal of Environmental Research and Public Health 17, no. 14: 5226.
Hydrogen sulfide (H2S) represents one of the main pollutants originating from both geologic phenomena such as volcanoes, geysers, fumaroles and hot springs, and geothermal plants that produce heat and electricity. Many increasing data suggest that H2S retains a variety of biological properties, and modulates many pathways related to cardiovascular pathophysiology although its role as beneficial/adverse determinant on cardiovascular disease (CVD) is not clearly established. In this review, the current knowledge on the association between H2S exposure and risk of CVD in geothermal areas has been examined. The few epidemiological studies carried out in geothermal areas suggest, in some cases, a protective role of H2S towards CVD, while in others a positive association between exposure to H2S and increased incidence of CVD. Most of the studies have an ecological design that does not allow to produce evidence to support a causal relationship and also often lack for an adequate adjustment for individual CVD risk factors. The review has also considered the potential role of two other aspects not sufficiently explored in this relationship: the production of endogenous H2S that is a gasotransmitter producing beneficial effects on cardiovascular function at low concentration and the intake of H2S-releasing drugs for the treatment of patients affected by hypertension, inflammatory diseases, and CVD. Thus, a threshold effect of H2S and the shift of action as beneficial/adverse determinant given by the synergy of exogenous exposure and endogenous production cannot be excluded. In this complex scenario, an effort is warranted in the future to include a more comprehensive evaluation of risk for CVD in relation to H2S emissions, especially in geothermal areas.
Francesca Gorini; Elisa Bustaffa; Kyriazoula Chatzianagnostou; Fabrizio Bianchi; Cristina Vassalle. Hydrogen sulfide and cardiovascular disease: Doubts, clues, and interpretation difficulties from studies in geothermal areas. Science of The Total Environment 2020, 743, 140818 .
AMA StyleFrancesca Gorini, Elisa Bustaffa, Kyriazoula Chatzianagnostou, Fabrizio Bianchi, Cristina Vassalle. Hydrogen sulfide and cardiovascular disease: Doubts, clues, and interpretation difficulties from studies in geothermal areas. Science of The Total Environment. 2020; 743 ():140818.
Chicago/Turabian StyleFrancesca Gorini; Elisa Bustaffa; Kyriazoula Chatzianagnostou; Fabrizio Bianchi; Cristina Vassalle. 2020. "Hydrogen sulfide and cardiovascular disease: Doubts, clues, and interpretation difficulties from studies in geothermal areas." Science of The Total Environment 743, no. : 140818.
Liliana Cori; Fabrizio Bianchi. Covid-19 and air pollution: communicating the results of geographic correlation studies. 2020, 44, 120 -123.
AMA StyleLiliana Cori, Fabrizio Bianchi. Covid-19 and air pollution: communicating the results of geographic correlation studies. . 2020; 44 ():120-123.
Chicago/Turabian StyleLiliana Cori; Fabrizio Bianchi. 2020. "Covid-19 and air pollution: communicating the results of geographic correlation studies." 44, no. : 120-123.
BACKGROUND Understanding the occurrence of symptoms resembling those of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in a large nonhospitalized population at the peak of the epidemic in Italy is of paramount importance; however, data are currently scarce. OBJECTIVE The aims of this study were to evaluate the association of self-reported symptoms with SARS-CoV-2 nasopharyngeal swab (NPS) test results in nonhospitalized individuals and to estimate the occurrence of symptoms associated with coronavirus disease (COVID-19) in a larger nontested population. METHODS EPICOVID19 is a self-administered cross-sectional voluntary web-based survey of adults throughout Italy who completed an anonymous questionnaire in the period of April 13 to 21, 2020. The associations between symptoms potentially related to SARS-CoV-2 infection and NPS results were calculated as adjusted odds ratios (aORs) with 95% CIs by multiple logistic regression analysis controlling for age, sex, education, smoking habits, and number of comorbidities. Thereafter, for each symptom and for combinations of the symptoms, we calculated the sensitivity, specificity, accuracy, and areas under the curve (AUCs) in a receiver operating characteristic (ROC) analysis to estimate the occurrence of COVID-19–like infection in the nontested population. RESULTS A total of 171,310 people responded to the survey, of whom 102,543 (59.9%) were women; mean age 47.4 years. Out of the 4785 respondents with known NPS test results, 4392 were not hospitalized. Among the 4392 nonhospitalized respondents, those with positive NPS tests (856, 19.5%) most frequently reported myalgia (527, 61.6%), olfactory and taste disorders (507, 59.2%), cough (466, 54.4%), and fever (444, 51.9%), whereas 7.7% were asymptomatic. Multiple regression analysis showed that olfactory and taste disorders (aOR 10.3, 95% CI 8.4-12.7), fever (aOR 2.5, 95% CI 2.0-3.1), myalgia (aOR 1.5, 95% CI 1.2-1.8), and cough (aOR 1.3, 95% CI 1.0-1.6) were associated with NPS positivity. Having two to four of these symptoms increased the aOR from 7.4 (95% CI 5.6-9.7) to 35.5 (95% CI 24.6-52.2). The combination of the four symptoms showed an AUC of 0.810 (95% CI 0.795-0.825) in classifying positive NPS test results and then was applied to the nonhospitalized and nontested sample (n=165,782). We found that 7739 to 20,103 of these 165,782 respondents (4.4% to 12.1%) had experienced symptoms suggestive of COVID-19 infection. CONCLUSIONS Our results suggest that self-reported symptoms are reliable indicators of SARS-CoV-2 infection in a pandemic context. A nonnegligible number of symptomatic respondents (up to 12.1%) were undiagnosed and potentially contributed to the spread of the infection. CLINICALTRIAL ClinicalTrials.gov NCT04471701; https://clinicaltrials.gov/ct2/show/NCT04471701
Fulvio Adorni; Federica Prinelli; Fabrizio Bianchi; Andrea Giacomelli; Gabriele Pagani; Dario Bernacchia; Stefano Rusconi; Stefania Maggi; Caterina Trevisan; Marianna Noale; Sabrina Molinaro; Luca Bastiani; Loredana Fortunato; Nithiya Jesuthasan; Aleksandra Sojic; Carla Pettenati; Marcello Tavio; Massimo Andreoni; Claudio Mastroianni; Raffaele Antonelli Incalzi; Massimo Galli. Self-Reported Symptoms of SARS-CoV-2 Infection in a Nonhospitalized Population in Italy: Cross-Sectional Study of the EPICOVID19 Web-Based Survey (Preprint). 2020, 1 .
AMA StyleFulvio Adorni, Federica Prinelli, Fabrizio Bianchi, Andrea Giacomelli, Gabriele Pagani, Dario Bernacchia, Stefano Rusconi, Stefania Maggi, Caterina Trevisan, Marianna Noale, Sabrina Molinaro, Luca Bastiani, Loredana Fortunato, Nithiya Jesuthasan, Aleksandra Sojic, Carla Pettenati, Marcello Tavio, Massimo Andreoni, Claudio Mastroianni, Raffaele Antonelli Incalzi, Massimo Galli. Self-Reported Symptoms of SARS-CoV-2 Infection in a Nonhospitalized Population in Italy: Cross-Sectional Study of the EPICOVID19 Web-Based Survey (Preprint). . 2020; ():1.
Chicago/Turabian StyleFulvio Adorni; Federica Prinelli; Fabrizio Bianchi; Andrea Giacomelli; Gabriele Pagani; Dario Bernacchia; Stefano Rusconi; Stefania Maggi; Caterina Trevisan; Marianna Noale; Sabrina Molinaro; Luca Bastiani; Loredana Fortunato; Nithiya Jesuthasan; Aleksandra Sojic; Carla Pettenati; Marcello Tavio; Massimo Andreoni; Claudio Mastroianni; Raffaele Antonelli Incalzi; Massimo Galli. 2020. "Self-Reported Symptoms of SARS-CoV-2 Infection in a Nonhospitalized Population in Italy: Cross-Sectional Study of the EPICOVID19 Web-Based Survey (Preprint)." , no. : 1.