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Pathogens
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The Impact of COVID-19 Pandemia on Infection Disease
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The Impact of COVID-19 Pandemia on Infection Disease

A special issue of Pathogens (ISSN 2076-0817). This special issue belongs to the section "Viral Pathogens".

Deadline for manuscript submissions: closed (29 February 2024) | Viewed by 17997

Special Issue Editor

Dr. Caterina Sagnelli

E-Mail Website
Guest Editor
Department of Mental Health and Public Medicine, University of Campania Luigi Vanvitelli, 80131 Naples, Italy
Interests: viral hepatitis; HIV infection; infection diseases; epidemiology; diagnosis; management; treatment
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The COVID-19 pandemic has significantly impaired the screening, laboratory checks, clinical surveillance, new diagnosis, and treatment of infectious diseases. In particular, the closure of Infectious Diseases and Internal Medicine Units for their transformation into COVID-19 departments has aggravated the  management of infections and has also had a severe impact on chronic diseases and certain populations such as chronic hepatitis, diabetes, the elderly, and fragile subjects, worsening their clinical outcome, increasing their mortality, and reducing their access to medical care.

This Special Issue aims to evaluate the direct and indirect negative effects of COVID-19 on the infection control sector as well as on  other infectious diseases such as chronic hepatitis, neglected infections, and infectious diseases in immunosuppressed patients and on the quality of life of patients in terms of epidemiology, prevention, treatment, virology, pathophysiology, diversity, and evolution.

Original research articles, reviews, short reports, and communications on the impact of the COVID-19 pandemic in clinical settings involving immunocompromised patients, the elderly, fragile subjects, and health professionals are welcome. In addition, we will cover other clinical and basic research to improve our knowledge and to investigate how all of these new developments can adjusted for in clinical practice.

Dr. Caterina Sagnelli
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Pathogens is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • infection control
  • viral hepatitis
  • chronic hepatitis
  • neglected infection
  • immunosuppression
  • immunosuppressive therapies
  • transplant
  • onco-hematological setting
  • liver diseases
  • infectious diseases
  • tropical diseases

Published Papers (8 papers)

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Research

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13 pages, 1226 KiB  
Article
Outcomes of Thoracoscopic Lobectomy after Recent COVID-19 Infection
by Beatrice Leonardi, Caterina Sagnelli, Giovanni Natale, Francesco Leone, Antonio Noro, Giorgia Opromolla, Damiano Capaccio, Francesco Ferrigno, Giovanni Vicidomini, Gaetana Messina, Rosa Maria Di Crescenzo, Antonello Sica and Alfonso Fiorelli
Pathogens 2023, 12(2), 257; https://0-doi-org.brum.beds.ac.uk/10.3390/pathogens12020257 - 05 Feb 2023
Viewed by 2025
Abstract
Background: The COVID-19 outbreak had a massive impact on lung cancer patients with the rise in the incidence and mortality of lung cancer. Methods: We evaluated whether a recent COVID-19 infection affected the outcome of patients undergoing thoracoscopic lobectomy for lung cancer using [...] Read more.
Background: The COVID-19 outbreak had a massive impact on lung cancer patients with the rise in the incidence and mortality of lung cancer. Methods: We evaluated whether a recent COVID-19 infection affected the outcome of patients undergoing thoracoscopic lobectomy for lung cancer using a retrospective observational mono-centric study conducted between January 2020 and August 2022. Postoperative complications and 90-day mortality were reported. We compared lung cancer patients with a recent history of COVID-19 infection prior to thoracoscopic lobectomy to those without recent COVID-19 infection. Univariable and multivariable analyses were performed. Results: One hundred and fifty-three consecutive lung cancer patients were enrolled. Of these 30 (19%), had a history of recent COVID-19 infection prior to surgery. COVID-19 was not associated with a higher complication rate or 90-day mortality. Patients with recent COVID-19 infection had more frequent pleural adhesions (p = 0.006). There were no differences between groups regarding postoperative complications, conversion, drain removal time, total drainage output, and length of hospital stay. Conclusions: COVID-19 infection did not affect the outcomes of thoracoscopic lobectomy for lung cancer. The treatment of these patients should not be delayed in case of recent COVID-19 infection and should not differ from that of the general population. Full article
(This article belongs to the Special Issue The Impact of COVID-19 Pandemia on Infection Disease)
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14 pages, 956 KiB  
Article
Acute Kidney Injury in Non-Intensive Care Unit (ICU) Hospitalizations for Coronavirus Disease (COVID-19)
by Fabrizio Fabrizi, Carlo M. Alfieri, Paolo Molinari, Francesco Tamborini, Marianna Tangredi, Anna Sikharulidze, Francesco Blasi, Anna Fracanzani, Walter Monzani, Flora Peyvandi and Giuseppe Castellano
Pathogens 2022, 11(11), 1272; https://0-doi-org.brum.beds.ac.uk/10.3390/pathogens11111272 - 31 Oct 2022
Cited by 4 | Viewed by 1221
Abstract
Background: Acute kidney injury (AKI) is a common complication among SARS-CoV-2-positive patients who undergo hospitalization. Abundant evidence exists concerning the epidemiology of AKI in patients hospitalized in the ICU for COVID-19 but limited data are available about the occurrence of AKI in SARS-CoV-2-positive [...] Read more.
Background: Acute kidney injury (AKI) is a common complication among SARS-CoV-2-positive patients who undergo hospitalization. Abundant evidence exists concerning the epidemiology of AKI in patients hospitalized in the ICU for COVID-19 but limited data are available about the occurrence of AKI in SARS-CoV-2-positive patients being hospitalized in a non-ICU setting. Aim and Methods: We have carried out a retrospective study to evaluate frequency and risk factors for AKI among patients consecutively admitted at a third-level university hospital starting from February 2020 (the beginning of the first wave of the SARS-CoV-2 pandemic); all patients were hospitalized outside the ICU. Results: A total of 387 SARS-CoV-2-positive patients were included in the current study; 372 (96.1%) had SARS-CoV-2-related pneumonia. In-hospital AKI onset was recorded in 119 (30.7%) patients, mainly with AKI stage 1 (n = 74, 62.2%); eighteen (4.6%) patients reported AKI stage 3 and six (1.5%) patients had HD-dependent AKI. There were 235 (60.7%) patients with severe COVID-19, and this was more common in patients developing AKI, 94.5% (86/119) vs. 86.1% (149/268), p = 0.02. Multivariate regression model (n = 144 patients) reported an independent and significant relationship between AKI occurrence and greater levels of ferritin (p = 0.036), IL-6 (p = 0.032), and azotemia at admission (p = 0.0001). A total of 69 (17.8%) SARS-CoV-2-positive patients died and strong predictors of in-hospital death resulted from age (p < 0.0001), serum ferritin (p < 0.0001) and white blood cells (p < 0.001). According to multivariable analysis (n = 163 patients), there was a consistent link between in-hospital death and AKI stage (1) (p = 0.021) and -stage (2) (p = 0.009). Our results support the notion that AKI occurs frequently among hospitalized COVID-19 patients even in a non-ICU setting and plays a pivotal role in the mortality of this population. Further studies are ongoing in order to clearly establish the frequency of AKI in patients with COVID-19; the mechanisms underlying kidney injury in this population are an area of active investigation. These data provide solid evidence to support close monitoring of COVID-19 patients for the development of AKI and measures taken to prevent this. Full article
(This article belongs to the Special Issue The Impact of COVID-19 Pandemia on Infection Disease)
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11 pages, 1193 KiB  
Article
Profile of Co-Infection Prevalence and Antibiotics Use among COVID-19 Patients
by Rita Greco, Vittorio Panetta, Maria Teresa Della Rocca, Adriana Durante, Giovanni Di Caprio and Paolo Maggi
Pathogens 2022, 11(11), 1250; https://0-doi-org.brum.beds.ac.uk/10.3390/pathogens11111250 - 28 Oct 2022
Cited by 6 | Viewed by 1145
Abstract
Bacterial co-infection in COVID-19 patients significantly contributes to the worsening of the prognosis based on morbidity and mortality. Information on the co-infection profile in such patients could help to optimize treatment. The purpose of this study was to describe bacterial co-infections associated with [...] Read more.
Bacterial co-infection in COVID-19 patients significantly contributes to the worsening of the prognosis based on morbidity and mortality. Information on the co-infection profile in such patients could help to optimize treatment. The purpose of this study was to describe bacterial co-infections associated with microbiological, clinical, and laboratory data to reduce or avoid a secondary infection. A retrospective cohort study was conducted at Sant’Anna and San Sebastiano Hospital from January 2020 to December 2021. Bacterial co-infection was detected in 14.3% of the COVID-19-positive patients. The laboratory findings on admission showed significant alterations in the median D-dimer, C-reactive protein, interleukin-6, and lactate dehydrogenase values compared to normal values. All inflammatory markers were significantly elevated. The most common pathogens isolated from blood cultures were E. faecalis and S. aureus. Instead, the high prevalence of respiratory tract infections in the COVID-19 patients was caused by P. aeruginosa (41%). In our study, 220 (82.4%) of the COVID-19 patients received antimicrobial treatment. Aminoglycosides and β-lactams/β-lactamase inhibitors showed the highest resistance rates. Our results showed that older age, underlying conditions, and abnormal laboratory parameters can be risk factors for co-infection in COVID-19 patients. The antibiotic susceptibility profile of bacterial pathogen infection provides evidence on the importance, for the clinicians, to rationalize and individualize antibiotic usage. Full article
(This article belongs to the Special Issue The Impact of COVID-19 Pandemia on Infection Disease)
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12 pages, 284 KiB  
Article
Molnupiravir as an Early Treatment for COVID-19: A Real Life Study
by Michela Pontolillo, Claudio Ucciferri, Paola Borrelli, Marta Di Nicola, Jacopo Vecchiet and Katia Falasca
Pathogens 2022, 11(10), 1121; https://0-doi-org.brum.beds.ac.uk/10.3390/pathogens11101121 - 29 Sep 2022
Cited by 8 | Viewed by 2188
Abstract
Objectives: Below we report our experience in the use of molnupiravir, the first antiviral drug against SARS-CoV-2 available to us, in the treatment of patients with COVID-19. Materials and Methods: We enrolled patients diagnosed with COVID-19 and comorbidities who were candidates for antiviral [...] Read more.
Objectives: Below we report our experience in the use of molnupiravir, the first antiviral drug against SARS-CoV-2 available to us, in the treatment of patients with COVID-19. Materials and Methods: We enrolled patients diagnosed with COVID-19 and comorbidities who were candidates for antiviral drug therapy. All patients received molnupiravir (800 mg twice daily). Blood chemistry checks were carried out at T0 and after 7/10 days after starting therapy (T1). Results: There were enrolled within the cohort 100 patients. There was 100.0% compliance with the antiviral treatment. No patient required hospitalization due to worsening of respiratory function or the appearance of serious side effects. The median downtime of viral load was ten days (IQR 8.0–13.0), regardless of the type of vaccination received. The patients who had a shorter distance from vaccination more frequently presented vomiting/diarrhea. During baseline and T1 we found significant differences in the median serum concentrations of the main parameters, in particular of platelets, RDW CV, neutrophils and lymphocytes, the eGFR, liver enzymes, as well as of the main inflammatory markers, CRP and Ferritin. Conclusion: Participants treated with molnupiravir, albeit in risk categories, demonstrated early clinical improvement, no need for hospitalization, and a low rate of adverse events. Full article
(This article belongs to the Special Issue The Impact of COVID-19 Pandemia on Infection Disease)
6 pages, 623 KiB  
Article
Genomic Epidemiology Unveil the Omicron Transmission Dynamics in Rome, Italy
by Maria Francesconi, Marta Giovanetti, Lucia De Florio, Marta Fogolari, Roberta Veralli, Cecilia De Flora, Silvia Spoto, Antonello Maruotti, Elisabetta Riva, Silvia Angeletti and Massimo Ciccozzi
Pathogens 2022, 11(9), 1011; https://0-doi-org.brum.beds.ac.uk/10.3390/pathogens11091011 - 04 Sep 2022
Cited by 2 | Viewed by 1660
Abstract
Since 2020, the COVID-19 pandemic represented an important worldwide burden. Well-structured surveillance by reliable and timely genomic data collection is crucial. In this study, a genomic monitoring analysis of all SARS-CoV-2 positive samples retrieved at the Fondazione Policlinico Universitario Campus Bio-Medico, in Rome, [...] Read more.
Since 2020, the COVID-19 pandemic represented an important worldwide burden. Well-structured surveillance by reliable and timely genomic data collection is crucial. In this study, a genomic monitoring analysis of all SARS-CoV-2 positive samples retrieved at the Fondazione Policlinico Universitario Campus Bio-Medico, in Rome, Italy, between December 2021 and June 2022, was performed. Two hundred and seventy-four SARS-CoV-2-positive samples were submitted to viral genomic sequencing by Illumina MiSeqII. Consensus sequences were generated by de novo assembling using the iVar tool and deposited on the GISAID database. Lineage assignment was performed using the Pangolin lineage classification. Sequences were aligned using ViralMSA and maximum-likelihood phylogenetic analysis was performed by IQ-TREE2. TreeTime tool was used to obtain dated trees. Our genomic monitoring revealed that starting from December 2021, all Omicron sub-lineages (BA.1, BA.2, BA.3, BA.4, and BA.5) were circulating, although BA.1 was still the one with the highest prevalence thought time in this early period. Phylogeny revealed that Omicron isolates were scattered throughout the trees, suggesting multiple independent viral introductions following national and international human mobility. This data represents a sort of thermometer of what happened from July 2021 to June 2022 in Italy. Genomic monitoring of the circulating variants should be encouraged considering that SARS-CoV-2 variants or sub-variants emerged stochastically and unexpectedly. Full article
(This article belongs to the Special Issue The Impact of COVID-19 Pandemia on Infection Disease)
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Review

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13 pages, 304 KiB  
Review
Prevention of HBV Reactivation in Hemato-Oncologic Setting during COVID-19
by Caterina Sagnelli, Antonello Sica, Massimiliano Creta, Alessandra Borsetti, Massimo Ciccozzi and Evangelista Sagnelli
Pathogens 2022, 11(5), 567; https://0-doi-org.brum.beds.ac.uk/10.3390/pathogens11050567 - 11 May 2022
Cited by 4 | Viewed by 2292
Abstract
Onco-hematologic patients are highly susceptible to SARS-CoV-2 infection and, once infected, frequently develop COVID-19 due to the immunosuppression caused by tumor growth, chemotherapy and immunosuppressive therapy. In addition, COVID-19 has also been recognized as a further cause of HBV reactivation, since its treatment [...] Read more.
Onco-hematologic patients are highly susceptible to SARS-CoV-2 infection and, once infected, frequently develop COVID-19 due to the immunosuppression caused by tumor growth, chemotherapy and immunosuppressive therapy. In addition, COVID-19 has also been recognized as a further cause of HBV reactivation, since its treatment includes the administration of corticosteroids and some immunosuppressive drugs. Consequently, onco-hematologic patients should undergo SARS-CoV-2 vaccination and comply with the rules imposed by lockdowns or other forms of social distancing. Furthermore, onco-hematologic facilities should be adapted to new needs and provided with numerically adequate health personnel vaccinated against SARS-CoV-2 infection. Onco-hematologic patients, both HBsAg-positive and HBsAg-negative/HBcAb-positive, may develop HBV reactivation, made possible by the support of the covalently closed circular DNA (cccDNA) persisting in the hepatocytic nuclei of patients with an ongoing or past HBV infection. This occurrence must be prevented by administering high genetic barrier HBV nucleo(t)side analogues before and throughout the antineoplastic treatment, and then during a long-term post-treatment follow up. The prevention of HBV reactivation during the SARS-CoV-2 pandemic is the topic of this narrative review. Full article
(This article belongs to the Special Issue The Impact of COVID-19 Pandemia on Infection Disease)

Other

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6 pages, 539 KiB  
Case Report
Characteristics of COVID-19 Infection in a Hospitalized Autoimmune Hepatitis Patient
by Vanessa Duarte da Costa, Wilian Jean Wiggers, Claudia Alexandra Pontes Ivantes, Rodrigo Jardim Monteiro da Fonseca, Alberto Martín Rivera Dávila, Otacilio C. Moreira, Beatriz Iandra da Silva Ferreira, Vanessa Salete de Paula, Lucas Lima da Silva, Alanna Calheiros Santos and Livia Melo Villar
Pathogens 2022, 11(9), 1054; https://0-doi-org.brum.beds.ac.uk/10.3390/pathogens11091054 - 16 Sep 2022
Viewed by 1531
Abstract
The coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), has become a major public health worldwide. Hepatic dysfunction has been seen in patients with COVID-19 and could be related to a viral cytopathic effect, an exacerbated immune reaction, [...] Read more.
The coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), has become a major public health worldwide. Hepatic dysfunction has been seen in patients with COVID-19 and could be related to a viral cytopathic effect, an exacerbated immune reaction, or drug-induced liver damage. Currently, routine modification of immunosuppressive therapy in patients with autoimmune hepatitis (AIH) before and after SARS-CoV-2 infection remains an important topic to be discussed. However, there is little evidence about this thematic to support any recommendation. Here, we described a case report in which the use of an immunosuppressive drug by a patient with diagnosed AIH might have influenced the COVID-19 clinical course with altered laboratory hematological and biochemical parameters during infection. Full article
(This article belongs to the Special Issue The Impact of COVID-19 Pandemia on Infection Disease)
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9 pages, 2253 KiB  
Case Report
Erythema Multiforme as Early Manifestation of COVID-19: A Case Report
by Gaspare Palaia, Elena Pernice, Daniele Pergolini, Alessandra Impellizzeri, Guido Migliau, Gianluca Gambarini, Umberto Romeo and Antonella Polimeni
Pathogens 2022, 11(6), 654; https://0-doi-org.brum.beds.ac.uk/10.3390/pathogens11060654 - 07 Jun 2022
Cited by 7 | Viewed by 5045
Abstract
Background: Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a viral infection involving multi-organ manifestations. The main oral symptoms of COVID-19 associated are taste loss and xerostomia, but literature has reported other oral manifestation, such as oral [...] Read more.
Background: Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a viral infection involving multi-organ manifestations. The main oral symptoms of COVID-19 associated are taste loss and xerostomia, but literature has reported other oral manifestation, such as oral blisters, ulcers, vesicles and other immunological lesions. This case report showed an Erythema Multiforme (EM) manifesting as oral mucosa lesions in a patient with a late diagnosis of COVID-19 infection. Case Presentation: A 30 years-old Caucasian woman was sent to an oral medicine office, in order to manage painful and oral mucosa lesions associated with target symmetrical skin lesions. Oral examination revealed extensive ulcers in the mouth and crusts on the lips. Based on clinical examinations, a diagnosis of Erythema Multiforme major was made and a drug therapy with steroids was administered. Five days after the specialist visit, the patient discovered that she was positive for COVID-19. The complete recovery occurred in 3 weeks. Conclusion: Confirming the literature studies, EM is an early disease associated with COVID-19 infection. Full article
(This article belongs to the Special Issue The Impact of COVID-19 Pandemia on Infection Disease)
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