POS1246 COVID-19 IN ITALIAN PATIENTS WITH RHEUMATIC AUTOIMMUNE SYSTEMIC DISEASES: RESULTS OF A NATIONWIDE SURVEY STUDY

Background:SARS-CoV-2 infection poses a serious challenge for patients with rheumatic autoimmune systemic diseases (ASD), characterized by marked immune-system dysregulation and frequent visceral organ involvement.Objectives:To evaluate the impact of Covid-19 pandemic in a large series of Italian patients with ASD.Methods:Our multicenter telephone survey (8-week period, March-April 2020) included a large series of 2,994 patients (584 M, 2,410 F, mean age 58.9±13.4SD years) with ASD followed at 34 tertiary referral centers of 14 regions of northern, central, and southern Italian macro areas, characterized by different prevalence of SARS-CoV-2 infection. According to currently used criteria, Covid-19 was classified as definite Covid-19 (signs or symptoms of Covid-19 confirmed by positive oral/nasopharyngeal swabs at PCR testing) or highly suspected Covid-19 (signs or symptoms highly suggestive of Covid-19, but not confirmed by PCR testing due to limited availability of virological tests in that period). The results were analyzed performing the Odds Ratio by Java-Stat 2-way Contingency Table Analysis.Results:The main findings of the survey study revealed a significantly increased prevalence of Covid-19 in:a.the whole series of ASD patients (definite Covid-19: 22/2994, 0.73%; p=0.0007;definite Covid-19 plus highly suspected Covid-19: 74/2,994, 2.47%; p<0.0001) when compared to Italian general population of Covid-19 infected individuals (349/100000 = 0.34%; data from Italian Superior Institute of Health;https://www.epicentro.iss.it/en/coronavirus/sars-cov-2-national-surveillance-system).b.the subgroup of patients with connective tissue diseases or systemic vasculitis (n = 1,901) compared to the subgroup of inflammatory arthritis (n = 1,093), namely rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis (definite Covid-19: 19/1,901, 0.99%, vs 3/1,093, 0.27%; p=0.036; definite Covid-19 plus highly suspected Covid-19: 69/1,901, 3.6%, vs 5/1,093, 0.45%; p<0.0001)c.the subgroup of patients with pre-existing interstitial lung involvement (n = 526) compared to those without (n = 2,468) (definite Covid-19: 10/526, 1.90%, vs 12/2,468, 0.48%; p=0.0015; definite Covid-19 plus highly suspected Covid-19: 33/526, 6.27%, vs 41/2,468, 1.66%; p<0.0001).Of interest, the prevalence of Covid-19 did not correlate with presence/absence of different comorbidities, mainly diabetes, cardio-vascular and/or renal disorders, as well as of ongoing treatments with biological DMARDs; while patients treated with conventional DMARDs showed a significantly lower prevalence of Covid-19 compared to those without. Covid-19 was more frequently observed in the patients’ populations from northern and central compared to southern Italian macro area with lower diffusion of pandemic. Clinical manifestations of Covid-19, observed in 74 patients, were generally mild or moderate; 4/9 individuals requiring hospital admission died for severe pneumonia.Conclusion:The prevalence of Covid-19 observed in ASD patients during the first wave of pandemic was significantly higher than that observed in Italian general population; moreover, the actual prevalence of Covid-19 might be underestimated due to the high number of mild variants as well as the possible clinical overlapping between these two conditions. Patients with ASD should be invariably regarded as ‘frail patients’ during the pandemic course, considering the risk of worse outcome in the acute phase of Covid-19, as well as the potential long-term effects of viral infection.The statistically significant association of Covid-19 with connective tissue diseases/systemic vasculitis, as well as with pre-existing interstitial lung involvement, suggests the presence of distinct clinico-pathological ASD subsets, characterized by markedly different patients’ vulnerability to SARS-CoV-2 infection.Disclosure of Interests:None declared

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COVID-19 and rheumatic autoimmune systemic diseases: report of a large Italian patients series

Clinical Rheumatology ◽

10.1007/s10067-020-05334-7 ◽

2020 ◽

Vol 39 (11) ◽

pp. 3195-3204 ◽

Cited By ~ 3

Author(s):

Clodoveo Ferri ◽

◽

Dilia Giuggioli ◽

Vincenzo Raimondo ◽

Massimo L’Andolina ◽

...

Keyword(s):

Immune System ◽

General Population ◽

Connective Tissue ◽

Inflammatory Arthritis ◽

Systemic Disease ◽

Management Strategies ◽

Connective Tissue Diseases ◽

Systemic Diseases ◽

High Exposure ◽

Disease Modifying

Abstract Introduction Covid-19 infection poses a serious challenge for immune-compromised patients with inflammatory autoimmune systemic diseases. We investigated the clinical-epidemiological findings of 1641 autoimmune systemic disease Italian patients during the Covid-19 pandemic. Method This observational multicenter study included 1641 unselected patients with autoimmune systemic diseases from three Italian geographical areas with different prevalence of Covid-19 [high in north (Emilia Romagna), medium in central (Tuscany), and low in south (Calabria)] by means of telephone 6-week survey. Covid-19 was classified as (1) definite diagnosis of Covid-19 disease: presence of symptomatic Covid-19 infection, confirmed by positive oral/nasopharyngeal swabs; (2) highly suspected Covid-19 disease: presence of highly suggestive symptoms, in absence of a swab test. Results A significantly higher prevalence of patients with definite diagnosis of Covid-19 disease, or with highly suspected Covid-19 disease, or both the conditions together, was observed in the whole autoimmune systemic disease series, compared to “Italian general population” (p = .030, p = .001, p = .000, respectively); and for definite + highly suspected diagnosis of Covid-19 disease, in patients with autoimmune systemic diseases of the three regions (p = .000, for all comparisons with the respective regional general population). Moreover, significantly higher prevalence of definite + highly suspected diagnosis of Covid-19 disease was found either in patients with various “connective tissue diseases” compared to “inflammatory arthritis group” (p < .000), or in patients without ongoing conventional synthetic disease-modifying anti-rheumatic drugs treatments (p = .011). Conclusions The finding of a higher prevalence of Covid-19 in patients with autoimmune systemic diseases is particularly important, suggesting the need to develop valuable prevention/management strategies, and stimulates in-depth investigations to verify the possible interactions between Covid-19 infection and impaired immune-system of autoimmune systemic diseases. Key Points• Significantly higher prevalence of Covid-19 is observed in a large series of patients with autoimmune systemic diseases compared to the Italian general population, mainly due to patients’ increased susceptibility to infections and favored by the high exposure to the virus at medical facilities before the restriction measures on individual movement.• The actual prevalence of Covid-19 in autoimmune systemic diseases may be underestimated, possibly due to the wide clinical overlapping between the two conditions, the generally mild Covid-19 disease manifestations, and the limited availability of virological testing.• Patients with “connective tissue diseases” show a significantly higher prevalence of Covid-19, possibly due to deeper immune-system impairment, with respect to “inflammatory arthritis group”.• Covid-19 is more frequent in the subgroup of autoimmune systemic diseases patients without ongoing conventional synthetic disease-modifying anti-rheumatic drugs, mainly hydroxyl-chloroquine and methotrexate, which might play some protective role against the most harmful manifestations of Covid-19.

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Surveillance of COVID-19 school outbreaks, Germany, March to August 2020

Eurosurveillance ◽

10.2807/1560-7917.es.2020.25.38.2001645 ◽

2020 ◽

Vol 25 (38) ◽

Cited By ~ 10

Author(s):

Eveline Otte im Kampe ◽

Ann-Sophie Lehfeld ◽

Silke Buda ◽

Udo Buchholz ◽

Walter Haas

Keyword(s):

General Population ◽

Surveillance System ◽

Detrimental Effect ◽

Preventive Measures ◽

National Surveillance ◽

School Closures ◽

System Data ◽

Time Periods ◽

Low Incidence ◽

National Surveillance System

Mitigation of the coronavirus disease (COVID-19) pandemic in Germany included school closures in early March 2020. After reopening in April, preventive measures were taken in schools. We analysed national surveillance system data on COVID-19 school outbreaks during different time periods. After reopening, smaller outbreaks (average: 2.2/week) occurred despite low incidence in the general population. School closures might have a detrimental effect on children and should be applied only cautiously and in combination with other measures.

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Sero-epidemiology as a tool to study the incidence of Salmonella infections in humans

Epidemiology and Infection ◽

10.1017/s0950268807009314 ◽

2007 ◽

Vol 136 (7) ◽

pp. 895-902 ◽

Cited By ~ 41

Author(s):

J. SIMONSEN ◽

M. A. STRID ◽

K. MØLBAK ◽

K. A. KROGFELT ◽

A. LINNEBERG ◽

...

Keyword(s):

General Population ◽

Antibody Response ◽

Surveillance System ◽

Population Based ◽

National Surveillance ◽

Serum Samples ◽

Salmonella Infections ◽

Kinetics Of ◽

Foodborne Infections ◽

National Surveillance System

SUMMARYAlthough most foodborne infections are undiagnosed, the incidence of these infections is usually calculated from reported cases. We present a novel population-based method to estimate the incidence of non-typhoid Salmonella infections. From 154 patients with confirmed Salmonella serotype Enteritidis infection, we determined the kinetics of the antibody response. The estimated mean responses for the three classes of serum antibodies were combined such that the time from infection could be estimated from antibody measurements. Next, serum samples collected in 1983, 1986, 1992, and 1999 from the general population were analysed for antibodies. We demonstrated how these measurements can be translated into an estimate of the general incidence. Based on serology markers there were 13 exposures leading to seroresponse of Salmonella Enteritidis/1000 person-years in 1983; the similar number in 1999 was 217. This trend confirms the increase in the number of culture-confirmed cases reported to the national surveillance system.

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Building a National Surveillance System for Malpractice Claims

Health Services Research ◽

10.1111/1475-6773.12623 ◽

2016 ◽

Vol 51 ◽

pp. 2642-2648 ◽

Cited By ~ 6

Author(s):

Michelle M. Mello ◽

David M. Studdert

Keyword(s):

Surveillance System ◽

National Surveillance ◽

Malpractice Claims ◽

National Surveillance System

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Healthcare-associated infections in high-risk neonates: Temporal trends in a national surveillance system

Early Human Development ◽

10.1016/j.earlhumdev.2021.105394 ◽

2021 ◽

pp. 105394

Author(s):

Ralciane P. Menezes ◽

Sávia G.O. Melo ◽

Murilo B. Oliveira ◽

Felipe F. Silva ◽

Priscila G.V. Alves ◽

...

Keyword(s):

High Risk ◽

Surveillance System ◽

Temporal Trends ◽

Healthcare Associated Infections ◽

National Surveillance ◽

Healthcare Associated ◽

National Surveillance System

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Reducing neonatal nosocomial bloodstream infections through participation in a national surveillance system

Journal of Hospital Infection ◽

10.1016/j.jhin.2006.12.020 ◽

2007 ◽

Vol 65 (4) ◽

pp. 319-325 ◽

Cited By ~ 79

Author(s):

F. Schwab ◽

C. Geffers ◽

S. Bärwolff ◽

H. Rüden ◽

P. Gastmeier

Keyword(s):

Surveillance System ◽

Bloodstream Infections ◽

National Surveillance ◽

National Surveillance System

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Human dirofilariasis due to Dirofilaria repens in Ukraine, an emergent zoonosis: epidemiological report of 1465 cases

Acta Parasitologica ◽

10.2478/s11686-013-0187-x ◽

2013 ◽

Vol 58 (4) ◽

Cited By ~ 43

Author(s):

Rusłan Sałamatin ◽

Tamara Pavlikovska ◽

Olga Sagach ◽

Svitlana Nikolayenko ◽

Vadim Kornyushin ◽

...

Keyword(s):

Skin Lesion ◽

Surveillance System ◽

Mammary Glands ◽

Dirofilaria Repens ◽

National Surveillance ◽

Registration System ◽

Western Ukraine ◽

Human Dirofilariasis ◽

Analysis Point ◽

National Surveillance System

AbstractThe filarial nematode Dirofilaria repens is currently considered to be one of the most extensively spreading human and animal parasites in Europe. In Ukraine, reporting cases of dirofilariasis has been mandatory since 1975, and the disease was included in the national surveillance system for notifiable diseases. Up until December 31st 2012, a total of 1533 cases have been registered, with 1465 cases occurring within the previous 16 years. Most of the cases of dirofilariasis were registered in 6 regions: Kyiv, and the Donetsk, Zaporizhzhya, Dnipropetrovsk, Kherson and Chernihiv oblasts. In the years 1997–2002 the highest incidence rate was noted in the Kherson oblast in the south of the country (9.79 per 100 000 people), and the lowest in western Ukraine (0.07–1.68 per 100 000 people). D. repens infections were registered in all oblasts. Parasitic lesions were most often located in the head, the subconjunctival tissue and around the eyes. D. repens lesions were also found in the limbs, torso, male sexual organs, and female mammary glands. Dirofilariasis was diagnosed in persons aged from 11 months to 90 years old, most often among people between 21–40 years of age. Most patients had only one parasitic skin lesion; the majority of isolated nematodes were female. The results of our analysis point to a constant increase in D. repens dirofilariasis incidence in humans in Ukraine. Despite educational efforts, infections have become more frequent and the territory in which the disease occurs has enlarged to encompass the whole of Ukraine. Nevertheless, the Ukrainian sanitary-epidemiological services managed to achieve some measure of success, e.g. by creating a registration system for D. repens infections and establishing proper diagnostics for the disease.

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