Limited data are available regarding the occurrence and the extent of cardiac rhythm disturbances in patients with COVID-19 treated with Remdesivir. We present a case series of 52 patients who underwent daily electrocardiogram (ECG) examination after Remdesivir administration. Compared to baseline, a significant heart rate reduction was observed after initiation of Remdesivir; however, no case of severe bradycardia or arrhythmias leading to significant clinical complications or Remdesivir discontinuation occurred. Heart rate reduction was proportional to baseline heart rate values (r=0.75, p<0.001). By multivariate analysis, a less severe clinical presentation of Covid-19 (beta=0.47, p<0.01) was related to lower heart rate levels observed after Remdesivir administration. Despite a significant reduction in heart rate observed after Remdesivir administration, no severe cardiovascular toxicity was observed in Covid-19 patients, even in the case of cardiovascular comorbidities.

Achromobacter xylosoxidans is a Gram-negative aerobic opportunistic bacterium, belonging to the order of Burkholderiales, that can cause infections of virtually all body districts in patients with underlying diseases. However, A. xylosoxidans has rarely been associated with infective endocarditis. The treatment of A. xylosoxidans infections is complicated by both intrinsic and acquired resistance. Here we report on a case of aortic endocarditis by A. xylosoxidans in a Non-Hodgkin lymphoma patient treated with a combination of cefiderocol and other antibiotics, and summarize the available literature.

The aim of this study is to describe the features, the outcomes, and the clinical issues related to Remdesivir administration of a cohort of 220 patients (pts) with COVID-19 hospitalized throughout the last two pandemic waves in Italy. One hundred and nine pts were enrolled from 1 September 2020, to 28 February 2021 (Group A) and 111 from 1 March to 30 September 2021 (Group B). Notably, no differences were reported between the two groups neither in the timing of hospitalization. nor in the timing of Remdesivir administration from symptoms onset. Remarkably, a higher proportion of pts with severe COVID-19 was observed in Group B (25% vs. 10%, p < 0.001). At univariate and multivariate analysis, rather than the timing of Remdesivir administration, age, presence of coexisting conditions, D-dimers, and O2 flow at admission correlated positively to progression to non-invasive ventilation, especially for patients in Group B. However, the rate of admission in the Intensive Care Unit and/or death was comparable in the two groups (7% vs. 4%). Negligible variations in serum GOT, GPT, GGT, and eGFR levels were detected. A mean reduction in heart rate was noticed within the first three days of antiviral treatment (p < 0.001). Low rate of ICU admission, high rate of clinical recovery, and good drug safety were observed in COVID-19 patients treated with Remdesivir during two diverse pandemic waves.

Background: Advanced HIV disease (AHD) remains highly prevalent and is associated with increased morbidity and mortality. Missed opportunities for early diagnosis continue to represent a major public health challenge. Methods: We conducted a multicenter retrospective cohort study including antiretroviral-naive people with HIV (PWH) presenting with AHD (CD4 < 200 cells/µL and/or AIDS) diagnosed between 1 January 2019 and 31 December 2024 in four Italian infectious diseases units. Demographic, clinical and viro-immunological data were collected at baseline and during follow up. Information on healthcare contacts, HIV-related symptoms, and prior HIV testing in the two years preceding diagnosis was obtained through structured interviews. Results: Among 658 newly diagnosed participants with HIV, 224 (34%) presented with AHD, of whom 54% presented with AIDS. Most participants (86.2%) had never undergone HIV testing before diagnosis. In the year preceding diagnosis 29.3% accessed healthcare services for symptoms compatible with HIV infection without being tested for HIV. At one year, 84.2% achieved virological suppression, with a median CD4 count of 260 cells/µL. Overall loss to follow-up was 27.2%. Five-year survival was significantly higher in non-AIDS presenters compared with AIDS presenters (100% vs. 85%, p = 0.005). Conclusions: Missed diagnostic opportunities remain frequent among PWH presenting with AHD, despite prior healthcare contacts. Wider implementation of indicator condition-guided HIV testing is urgently needed to reduce late diagnosis and improve long-term outcomes.

We sought to assess the impact of SarsCov-2 vaccination on admission12-lead electrocardiogram of hospitalized patients. We retrospectively analyzed and compared admission 12-lead electrocardiograms of all patients hospitalized in dedicated Internal Medicine Unit for Covid-19 both in pre-vaccination period (PV) and after vaccination (V). 667 consecutive Covid-19 in-patients were enrolled in the study: PV hospitalized patients were older (68vs57 years, p < 0.01), had higher rates of atrial fibrillation/flutter (13%vs2.5%, p < 0.01), any arrhythmia (26%vs8%, p < 0.01), and ST-T abnormalities (22%vs7.4%, p < 0.01). Mortality rates in hospitalized Covid-19 patients were higher before vaccination period (20%vs4%, p < 0.01). Minimal vaccination coverage of population (V period) was inversely and independently associated with in-hospital mortality (odds ratio 0.09, 95%CI 0.01–0.68, p < 0.05). SarsCov-2 vaccination campaign and even partial coverage of local population was associated with less frequent abnormalities at admission ECG in hospitalized non-critically hill Covid-19 patients and lower mortality.