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Maria Flacco
Department of Medical Sciences, University of Ferrara, 44121 Ferrara, Italy

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Journal article
Published: 10 June 2021 in Vaccines
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This retrospective cohort study compared the rates of virologically-confirmed SARS-CoV-2 infections, symptomatic or lethal COVID-19 among the residents of the Italian province of Pescara who received one or two doses of COVID-19 vaccines, versus the unvaccinated. The official data of the National Health System were used, and a total of 69,539 vaccinated adults were compared with 175,687 unvaccinated. Among the subjects who received at least one vaccine dose, 85 infections (0.12%), 18 severe and 3 lethal COVID-19 cases were recorded after an average follow-up of 38 days. Among the unvaccinated, the numbers were 6948 (4.00%), 933 (0.53%) and 241 (0.14%), respectively. The serious adverse event reports—yet unconfirmed—were 24 out of 102,394 administered doses. In a Cox model, adjusting for age, gender, and selected comorbidities, the effectiveness of either BNT162b2, ChAdOx1 nCoV-19 or mRNA-1273 vaccines was higher than 95% in preventing infections (mostly due to B.1.1.7 variant), symptomatic or lethal COVID-19. No differences were observed across genders, and among the 691 subjects who received the second dose of vaccine later than the recommended date. Although preliminary, these findings support current immunization policies and may help reducing vaccine hesitancy.

ACS Style

Maria Flacco; Graziella Soldato; Cecilia Acuti Martellucci; Roberto Carota; Rossano Di Luzio; Antonio Caponetti; Lamberto Manzoli. Interim Estimates of COVID-19 Vaccine Effectiveness in a Mass Vaccination Setting: Data from an Italian Province. Vaccines 2021, 9, 628 .

AMA Style

Maria Flacco, Graziella Soldato, Cecilia Acuti Martellucci, Roberto Carota, Rossano Di Luzio, Antonio Caponetti, Lamberto Manzoli. Interim Estimates of COVID-19 Vaccine Effectiveness in a Mass Vaccination Setting: Data from an Italian Province. Vaccines. 2021; 9 (6):628.

Chicago/Turabian Style

Maria Flacco; Graziella Soldato; Cecilia Acuti Martellucci; Roberto Carota; Rossano Di Luzio; Antonio Caponetti; Lamberto Manzoli. 2021. "Interim Estimates of COVID-19 Vaccine Effectiveness in a Mass Vaccination Setting: Data from an Italian Province." Vaccines 9, no. 6: 628.

Journal article
Published: 12 November 2020 in Open Forum Infectious Diseases
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This retrospective cohort study included all the subjects diagnosed with severe acute respiratory syndrome coronavirus 2 infection (n = 2493) in 2 Italian provinces. Two hundred fifty-eight persons died, after a median of 14.0 ± 11.0 days. Adjusting for age, gender, and main comorbidities, the ≥28-day case-fatality rate did not decrease from March to April 2020 (adjusted hazard ratio, 0.93; P = .6).

ACS Style

Maria Elena Flacco; Cecilia Acuti Martellucci; Francesca Bravi; Giustino Parruti; Alfonso Mascitelli; Lorenzo Mantovani; Stefania Boccia; Lamberto Manzoli. Severe Acute Respiratory Syndrome Coronavirus 2 Lethality Did not Change Over Time in Two Italian Provinces. Open Forum Infectious Diseases 2020, 7, ofaa556 .

AMA Style

Maria Elena Flacco, Cecilia Acuti Martellucci, Francesca Bravi, Giustino Parruti, Alfonso Mascitelli, Lorenzo Mantovani, Stefania Boccia, Lamberto Manzoli. Severe Acute Respiratory Syndrome Coronavirus 2 Lethality Did not Change Over Time in Two Italian Provinces. Open Forum Infectious Diseases. 2020; 7 (12):ofaa556.

Chicago/Turabian Style

Maria Elena Flacco; Cecilia Acuti Martellucci; Francesca Bravi; Giustino Parruti; Alfonso Mascitelli; Lorenzo Mantovani; Stefania Boccia; Lamberto Manzoli. 2020. "Severe Acute Respiratory Syndrome Coronavirus 2 Lethality Did not Change Over Time in Two Italian Provinces." Open Forum Infectious Diseases 7, no. 12: ofaa556.

Other
Published: 24 May 2020
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BackgroundSome experts recently reported that SARS-CoV-2 lethality decreased considerably, but no evidence is yet available. This retrospective cohort study aimed to evaluate whether SARS-CoV-2 case-fatality rate decreased with time, adjusting for several potential confounders.MethodsWe included all subjects diagnosed with SARS-CoV-2 infection in Ferrara and Pescara provinces, Italy. Information were collected from local registries, clinical charts, and electronic health records. We compared the case-fatality rate (after ≥28 days of follow-up) of the subjects diagnosed during April and March, 2020. We used Cox proportional hazards analysis and random-effect logistic regression, adjusting for age, gender, hypertension, type II diabetes, major cardiovascular diseases (CVD), chronic obstructive pulmonary diseases (COPD), cancer and renal disease.ResultsThe sample included 2493 subjects (mean age 58.6y; 47.7% males). 258 persons deceased, after a mean of 16.1 days of follow-up. The mean age of those who died substantially increased from March (78.1±11.0y) to April (84.3±10.2y). From March to April, the case-fatality rate did not decrease in the total sample (9.5% versus 12.1%; adjusted hazard ratio 0.93; 95% Confidence Interval: 0.71-1.21; p=0.6), and in any age-class.ConclusionsIn this sample, SARS-CoV-2 case-fatality rate did not decrease over time, in contrast with recent claims of a substantial improvement of SARS-CoV-2 clinical management. The findings require confirmation from larger datasets.Author summaryWhy was this study done?Some experts recently reported that SARS-CoV-2 lethality decreased considerably, but no evidence is yet available.What did the researchers do and find?We carried out a retrospective cohort study on 2493 SARS-CoV-2 infected subjects from two Italian provinces, evaluating the potential variation of the case-fatality rate over time.From March to April, SARS-CoV-2 case-fatality rate did not decrease, overall and in any age-class.What do these findings mean?The therapies and clinical management of SARS-CoV-2 infected subjects did not determine a substantial change of the clinical course of the disease from March to April, 2020.

ACS Style

Maria Elena Flacco; Cecilia Acuti Martellucci; Francesca Bravi; Giustino Parruti; Alfonso Mascitelli; Lorenzo Mantovani; Stefania Boccia; Lamberto Manzoli. SARS-CoV-2 lethality did not change over time in two Italian Provinces. 2020, 1 .

AMA Style

Maria Elena Flacco, Cecilia Acuti Martellucci, Francesca Bravi, Giustino Parruti, Alfonso Mascitelli, Lorenzo Mantovani, Stefania Boccia, Lamberto Manzoli. SARS-CoV-2 lethality did not change over time in two Italian Provinces. . 2020; ():1.

Chicago/Turabian Style

Maria Elena Flacco; Cecilia Acuti Martellucci; Francesca Bravi; Giustino Parruti; Alfonso Mascitelli; Lorenzo Mantovani; Stefania Boccia; Lamberto Manzoli. 2020. "SARS-CoV-2 lethality did not change over time in two Italian Provinces." , no. : 1.

Other
Published: 23 May 2020
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Aims: This retrospective case-control study was aimed at identifying potential independent predictors of severe/lethal COVID-19, including the treatment with Angiotensin-Converting Enzyme inhibitors (ACEi) and/or Angiotensin II Receptor Blockers (ARBs). Methods and Results: All adults with SARS-CoV-2 infection in two Italian provinces were followed for a median of 24 days. ARBs and/or ACEi treatments, and hypertension, diabetes, cancer, COPD, renal and major cardiovascular diseases (CVD) were extracted from clinical charts and electronic health records, up to two years before infection. The sample consisted of 1603 subjects (mean age 58.0y; 47.3% males): 454 (28.3%) had severe symptoms, 192 (12.0%) very severe or lethal disease (154 deaths; mean age 79.3 years; 70.8% hypertensive, 42.2% with CVD). The youngest deceased person aged 44 years. Among hypertensive subjects (n=543), the proportion of those treated with ARBs or ACEi were 88.4%, 78.7% and 80.6% among patients with mild, severe and very severe/lethal disease, respectively. At multivariate analysis, no association was observed between therapy and disease severity (Adjusted OR for very severe/lethal COVID-19: 0.87; 95% CI: 0.50-1.49). Significant predictors of severe disease were older age (with AORs largely increasing after 70 years of age), male gender (AOR: 1.76; 1.40-2.23), diabetes (AOR: 1.52; 1.05-2.18), CVD (AOR: 1.88; 1.32-2.70) and COPD (1.88; 1.11-3.20). Only gender, age and diabetes also predicted very severe/lethal disease. Conclusion: No association was found between COVID-19 severity and treatment with ARBs and/or ACEi, supporting the recommendation to continue medication for all patients unless otherwise advised by their physicians.

ACS Style

Francesca Bravi; Maria Elena Flacco; Tiziano Carradori; Carlo Alberto Volta; Giuseppe Cosenza; Aldo De Togni; Cecilia Acuti Martellucci; Giustino Parruti; Lorenzo Mantovani; Lamberto Manzoli. Predictors of severe or lethal COVID-19, including Angiotensin Converting Enzyme Inhibitors and Angiotensin II Receptor Blockers, in a sample of infected Italian citizens. 2020, 1 .

AMA Style

Francesca Bravi, Maria Elena Flacco, Tiziano Carradori, Carlo Alberto Volta, Giuseppe Cosenza, Aldo De Togni, Cecilia Acuti Martellucci, Giustino Parruti, Lorenzo Mantovani, Lamberto Manzoli. Predictors of severe or lethal COVID-19, including Angiotensin Converting Enzyme Inhibitors and Angiotensin II Receptor Blockers, in a sample of infected Italian citizens. . 2020; ():1.

Chicago/Turabian Style

Francesca Bravi; Maria Elena Flacco; Tiziano Carradori; Carlo Alberto Volta; Giuseppe Cosenza; Aldo De Togni; Cecilia Acuti Martellucci; Giustino Parruti; Lorenzo Mantovani; Lamberto Manzoli. 2020. "Predictors of severe or lethal COVID-19, including Angiotensin Converting Enzyme Inhibitors and Angiotensin II Receptor Blockers, in a sample of infected Italian citizens." , no. : 1.