Mese: Luglio 2020

Kratzel A, Todt D, V’kovski P, et al. Inactivation of Severe Acute Respiratory Syndrome Coronavirus 2 by WHO-Recommended Hand Rub Formulations and Alcohols. Emerg Infect Dis. 2020;26(7):1592-1595. doi:10.3201/eid2607.200915

Infection control instructions call for use of alcohol-based hand rub solutions to inactivate severe acute respiratory syndrome coronavirus 2. We determined the virucidal activity of World Health Organization-recommended hand rub formulations, at full strength and multiple dilutions, and of the active ingredients. All disinfectants demonstrated efficient virus inactivation.

Kamerlin SCL, Kasson PM. Managing COVID-19 spread with voluntary public-health measures: Sweden as a case study for pandemic control [published online ahead of print, 2020 Jul 1]. Clin Infect Dis. 2020;ciaa864. doi:10.1093/cid/ciaa864

Background: The COVID-19 pandemic has spread globally, causing extensive illness and mortality. In advance of effective antiviral therapies, countries have applied different public-health strategies to control spread and manage healthcare need. Sweden has taken a unique approach of not implementing strict closures, instead urging personal responsibility. We analyze the results of this and other potential strategies for pandemic control in Sweden.

Methods: We implemented individual-based modeling of COVID-19 spread in Sweden using population, employment, and household data. Epidemiological parameters for COVID-19 were validated on a limited date range; where substantial uncertainties remained, multiple parameters were tested. The effects of different public-health strategies were tested over a 160-day period, analyzed for their effects on ICU demand and death rate, and compared to Swedish data for April 2020.

Results: Swedish mortality rates fall intermediate between European countries that quickly imposed stringent public-health controls and countries that acted later. Models most closely reproducing reported mortality data suggest large portions of the population voluntarily self-isolate. Swedish ICU utilization rates remained lower than predicted, but a large fraction of deaths occurred in non-ICU patients. This suggests that patient prognosis was considered in ICU admission, reducing healthcare load at a cost of decreased survival in patients not admitted.

Conclusions: The Swedish COVID-19 strategy has thus far yielded a striking result: mild mandates overlaid with voluntary measures can achieve results highly similar to late-onset stringent mandates. However, this policy causes more healthcare demand and mortality than early stringent control and depends on continued public will.

Matar R, Alrahmani L, Monzer N, et al. Clinical Presentation and Outcomes of Pregnant Women with COVID-19: A Systematic Review and Meta-Analysis [published online ahead of print, 2020 Jun 23]. Clin Infect Dis. 2020;ciaa828. doi:10.1093/cid/ciaa828

Introduction: Descriptions of coronavirus disease-2019 (COVID-19) have focused on the non-pregnant adult population. This study aims to describe the clinical characteristics and perinatal outcomes of COVID-19 in pregnancy.

Methods: We searched databases from December 2019 to April 30th, 2020. Eligible studies reported clinical characteristics, radiological findings and/or laboratory testing of pregnant women during infection. Data were pooled across studies using random-effects model.

Results: Twenty-four studies (136 women) were included. Most common symptoms were fever (62.9%) and cough (36.8%). Laboratory findings included elevated C-Reactive Protein (57%) and lymphocytopenia (50%). Ground-glass opacity was the most common radiological finding (81.7%). Preterm birth rate was 37.7% and cesarean delivery rate was 76%. There was one maternal death. There were two fetal COVID-19 cases.

Conclusion: The clinical picture in pregnant women with COVID-19 did not differ from the non-pregnant population, however, the rate of preterm birth and cesarean delivery are considerably higher than international averages.

Yu N, Li W, Kang Q, et al. Clinical features and obstetric and neonatal outcomes of pregnant patients with COVID-19 in Wuhan, China: a retrospective, single-centre, descriptive study. Lancet Infect Dis. 2020;20(5):559-564. doi:10.1016/S1473-3099(20)30176-6

Background: In December, 2019, coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in Wuhan, China. The number of affected pregnant women is increasing, but scarce information is available about the clinical features of COVID-19 in pregnancy. This study aimed to clarify the clinical features and obstetric and neonatal outcomes of pregnant patients with COVID-19.

Methods: In this retrospective, single-centre study, we included all pregnant women with COVID-19 who were admitted to Tongji Hospital in Wuhan, China. Clinical features, treatments, and maternal and fetal outcomes were assessed.

Findings: Seven patients, admitted to Tongji Hospital from Jan 1, to Feb 8, 2020, were included in our study. The mean age of the patients was 32 years (range 29-34 years) and the mean gestational age was 39 weeks plus 1 day (range 37 weeks to 41 weeks plus 2 days). Clinical manifestations were fever (six [86%] patients), cough (one [14%] patient), shortness of breath (one [14%] patient), and diarrhoea (one [14%] patient). All the patients had caesarean section within 3 days of clinical presentation with an average gestational age of 39 weeks plus 2 days. The final date of follow-up was Feb 12, 2020. The outcomes of the pregnant women and neonates were good. Three neonates were tested for SARS-CoV-2 and one neonate was infected with SARS-CoV-2 36 h after birth.

Interpretation: The maternal, fetal, and neonatal outcomes of patients who were infected in late pregnancy appeared very good, and these outcomes were achieved with intensive, active management that might be the best practice in the absence of more robust data. The clinical characteristics of these patients with COVID-19 during pregnancy were similar to those of non-pregnant adults with COVID-19 that have been reported in the literature.

De Bernardo G, Giordano M, Zollo G, et al. The clinical course of SARS-CoV-2 positive neonates [published online ahead of print, 2020 Jul 6]. J Perinatol. 2020;1-8. doi:10.1038/s41372-020-0715-0

The COVID-19 pneumonia was firstly reported in Wuhan, China, in December 2019. The disease had a rapid spread all over the word becoming an international public health emergency. Limited data were available on COVID-19 positive neonates. We reviewed relevant literature to understand the clinical course of disease and transmission routes in affected neonates. The aim of the study was evaluating the clinical course and prognosis of SARS-CoV-2 positive neonates. Based on current literature, the hypothesis of vertical transmission of SARS-CoV-2, though conceivable, remains unproven. A research conducted on PubMed database from December 2019 to April 27, 2020 revealed that were reported 25 neonates affected by SARS-CoV-2. Main symptoms were fever, cough, or shortness of breath but often these neonates did not show other symptoms during length stay in hospital. No deaths occurred.

IN ITALIA CULLE SEMPRE PIU’ VUOTE

Ulteriore record negativo di nascite, immigrazione in netto calo e aumento degli italiani che fuggono all’estero. Questo il poco confortante quadro del Paese che offre il Bilancio demografico nazionale dell’Istat.
Nel 2019 un nuovo minimo storico della natalità, a partire dall’Unità d’Italia: gli iscritti in anagrafe per nascita sono infatti appena 420.170, con una diminuzione di oltre 19 mila unità rispetto al 2018 e con una maggiore incidenza al centro-sud.
Tra le problematiche che la denatalità italiana mette in luce ci sono le donne e i giovani.
“Gli interventi del Family Act sembrano andare nella direzione giusta, ma purtroppo c’è un ritardo di 10 anni”. Così il Presidente SIN Fabio Mosca interviene sul problema, in un’intervista per l’agenzia Dire.

Dire.it

COVID-19 E GRAVIDANZA. I PRIMI DATI ITALIANI DALL’ISS

Esiti materni e neonatali meno gravi di altre malattie virali come Sars e Mers: i primi dati italiani sugli effetti dell’infezione da Sars-Cov2 in gravidanza sono buoni anche nel nostro Paese. Lo dicono i risultati di uno studio del gruppo di ricerca di Serena Donati dell’Istituto Superiore di Sanità, presentati in un webinar il 2 luglio scorso.
Per le mamme, la gran parte dei quadri clinici è stata lieve o moderata, su 146 casi solo 7 sono state le manifestazioni più serie ed anche per i neonati la situazione è stata più positiva del previsto, con 4 casi gravi, ma nessuna morte neonatale. Più critica, ma sempre moderata, la situazione dei parti pretermine, che sono stati più frequenti rispetto alla popolazione generale (19,2% rispetto al 7% circa).

Oggiscienza.it

Attualità e criticità nello screening audiologico neonatale – Webinar, 1 Luglio 2020

Si è svolto lo scorso 1° luglio il webinar sul tema dello screening audiologico neonatale, organizzato dal gruppo di studio Organi di senso e inserito nel piano formativo della Società Italiana di Neonatologia. All’evento hanno partecipato le principali figure coinvolte nel programma di prevenzione della sordità congenita, quali neonatologi, pediatri, audiologi, otorinolaringoiatri, specializzandi, tecnici audiometristi, infermieri e logopedisti. La consistente partecipazione ha permesso di raggiungere gli obiettivi prefissati in fase di progettazione dell’evento formativo, ovvero di aggiornamento sullo stato attuale del programma di screening sul territorio nazionale, di revisione dei fattori di rischio e di analisi delle criticità organizzative, metodologiche e cliniche, comprese quelle relative alla sorveglianza audiologica successiva alle prime fasi del programma di prevenzione. I prossimi appuntamenti di formazione che vedranno ancora coinvolto il GdS Organi di Senso sono il corso precongressuale “Screening uditivo e visivo del neonato: aspetti organizzativi e metodologici”, che si terrà il 7 ottobre in occasione del Congresso Nazionale SIN di Venezia, e il webinar “Attualità in tema di retinopatia della prematurità” in programma il 24 novembre.

Segretario del GdS di Organi di Senso
Salvatore Aversa

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La SIN è una società, non a fini di lucro, che persegue e allarga gli scopi ed obiettivi del Gruppo di Lavoro di Neonatologia della Società Italiana di Pediatria (SIP).