Campania Region Of Italy Research Articles

Direct and Remote Sensing Monitoring of Plant Salinity Stress in a Coastal Back-Barrier Environment: Mediterranean Pine Forest Stress and Mortality as a Case Study

The increase in atmospheric and soil temperatures in recent decades has led to unfavorable conditions for plants in many Mediterranean coastal environments. A typical example can be found along the coast of the Campania region in Italy, within the “Volturno Licola Falciano Natural Reserve”, where a pine forest suffered a dramatic loss of trees in 2021. New pines were planted in 2023 to replace the dead ones, with a larger tree layout and interspersed with Mediterranean bushes to replace the dead pine forest. A direct (in situ) monitoring program was planned to analyze the determinants of the pine salinity stress, coupled with Sentinel-2 L2A data; in particular, multispectral indices NDVI and NDMI were provided by the EU Copernicus service for plant status and water stress level information. Both the vadose zone and shallow groundwater were monitored with continuous logging probes. Vadose zone monitoring indicated that salinity peaked at a 30 cm soil depth, with values up to 1.9 g/L. These harsh conditions, combined with air temperatures reaching peaks of more than 40 °C, created severe difficulties for pine growth. The results of the shallow groundwater monitoring showed that the groundwater salinity was low (0.35–0.4 g/L) near the shoreline since the dune environment allowed rapid rainwater infiltration, preventing seawater intrusion. Meanwhile, salinity increased inland, reaching a peak at the end of the summer, with values up to 2.8 g/L. In November 2023, salts from storm-borne aerosols (“sea spray”) deposited on the soil caused the sea-facing portion of the newly planted pines to dry out. Differently, the pioneer vegetation of the Mediterranean dunes, directly facing the sea, was not affected by the massive deposition of sea spray. The NDMI and NDVI data were useful in distinguishing the old pine trees suffering from increasing stress and final death but were not accurate in detecting the stress conditions of newly planted, still rather short pine trees because their spectral reflectance largely interfered with the adjacent shrub growth. The proposed coupling of direct and remote sensing monitoring was successful and could be applied to detect the main drivers of plant stress in many other Mediterranean coastal environments.

Comparison of Volatile Organic Compounds, Quality, and Nutritional Parameters from Local Italian and International Apple Cultivars

Apple cultivars ‘Annurca’ and ‘Limoncella’ are grown locally in the Campania region of Italy and are valued for their distinctive flavour and characteristics, including a high content of nutritionally important bioactive compounds. However, apples are typically stored chilled for several months before consumption, so it is important to assess if the valuable characteristics are still present after postharvest storage. Here, we compare the quality, nutritional parameters, and aroma of these two cultivars with two widely grown international cultivars, ‘Golden Delicious’ and ‘Fuji’, after 60 days of storage. The aroma profiles of all four apples were analysed using thermal desorption and gas chromatography–time-of-flight mass spectrometry. We show that the local cultivars are distinct from the international cultivars in their bioactive compound content and their antioxidant activity. ‘Limoncella’ shows high sugar content, which may be acting as a cryoprotectant during storage, and high total phenolics in the flesh, which is of nutritional interest. We identified 104 volatile organic compounds (VOCs) and showed that the overall aroma profile is distinct for each cultivar, containing 11 published odorant compounds. The ‘Annurca’ profile is uniquely low in esters. Seven VOCs retain good discrimination across the four cultivars and, together with the quality and nutritional data, separate the two local cultivars from the international cultivars by hierarchical clustering. Overall, the data emphasize the unique characteristics of the two local cultivars and their value.

The "Working Group Land of Fires" Platform for emergency management, data sharing and dissemination.

Over the last decades, the Campania Region in Italy has faced an environmental crisis due to the widespread illegal dumping and burning of waste. This has led to the area being notoriously known as the Land of Fires (Terra dei Fuochi - TdF), sparking serious concerns about public health and threatening the region's agricultural sector, one of its economic mainstays. In such a context, a timely, accurate, and reliable flow of information, aimed both at the population and at stakeholders, is crucial for establishing a proper dialogue between institutions and people, driving the empowerment of citizens. To address this crisis, the Italian Government introduced Law 6 of 2014, establishing a multidisciplinary Working Group tasked with identifying and mapping the sites affected by spills and illegal disposal in the territory. The TdF-WG defined a scientific methodology for classifying these sites in terms of prohibition on the cultivation of specific crops, consequently allowing the adoption of appropriate clean up and restoration measures for the impacted sites. This paper describes the data collection process and the IT platform commissioned by the Government to the IZS-TE and used by the TdF-WG to exchange data, knowledge, and technology, thereby fostering efficient and effective crisis management.

A web‐based operational tool for the identification of best practices in European agricultural systems

AbstractUnder the same perspective of the Sustainable Development Goal (SDG) 15.3 aiming to restore degraded land and soil, one of the current priorities of the new Common Agriculture Policy (CAP) is to overcome the serious environmental problems raised by intensive agriculture. Despite the steps forward guaranteed by new technologies and innovations (e.g., IoT, precision agriculture), the availability of real operational tools, which could help the member states fulfil the high requirements and expectations of the new CAP and SDGs, is still lacking. To fill this gap, in the H2020 LandSupport project, the web‐based best practice tool was developed to identify, on‐the‐fly, optimized agronomic solutions to help achieve land‐degradation neutrality. The tool's core is the ARMOSA process‐based model, which dynamically simulates the continuum soil–plant–atmosphere, combining several cropping systems, crops, nitrogen fertilization rates, tillage solutions, and crop residue management for specific regions of interest. It provides a synthetic “Best Practice index” to identify the optimized local solutions, which combines the production, nitrate leaching, and SOC_change, according to the end‐user dynamic requests. The tool was implemented for three case studies: Marchfeld Region in Austria, Zala County in Hungary, and Campania Region in Italy, which are representative of a variety of different pedoclimatic conditions. In the present work, we report three possible cases of use in supporting best practices aiming toward soil and water conservation: (i) crop production optimization; (ii) impact of management practices (i.e., cover crops) over soil carbon; (iii) lowering the impact of nitrate leaching.

Use of Honey Bees and Hive Products as Bioindicators to Assess Environmental Contamination in Targeted Areas of the Campania Region (Italy).

In recent years, biomonitoring has gained more attention, particularly when assessing the environmental health of significant areas, such as those near waste-to-energy facilities. These requirements coincide with the chance to detect environmental pollutants using sensitive organisms. Bees were shown to be quite effective in evaluating the presence of certain compounds by analyzing their associated matrices, such as pollen, honey, or wax. In our study, we employed the honey bee (Apis mellifera) as an indicator to initially monitor the vicinity of the waste-to-energy plant in Acerra, which is situated in the Campania region of Italy. The primary aim was to determine whether the facility was accountable for any environmental releases of dioxins or dioxin-like compounds. Then, we assessed the presence of additional pollutants in the same area, including trace elements, polycyclic aromatic hydrocarbons, and pesticides, released by human activities. To obtain further information about environmental quality, a second biomonitoring station was installed near the Caivano S.T.I.R. (Waste Shredding, Sifting, and Packaging Plant). The results showed the dioxin levels did not exceed predetermined limitations at the Acerra site, thus demonstrating the efficacy of the waste-to-energy facility and the bees' ability to detect the presence of other pollutants. Additionally, this biomonitoring system exhibited sensitivity to environmental variations, thereby enabling the evaluation of xenobiotic flux between two proximate zones and across temporal scales. This pioneering study suggests the advantages of utilizing bees to detect a wide range of contaminants, thereby providing valuable insights into environmental quality and potential health risks for both ecosystems and human populations.

Incidence and Prevalence of Dementia: A 2015–2020 Population-Based Study in the Campania Region of Italy

Plain Language SummaryDementia is a loss of memory and other functions related to thinking and to the ability to do everyday chores, usually occurring in the elderly and getting worse over time. The most common kind is Alzheimer’s dementia. Here, we estimated the number of people who are sick with dementia (prevalence) and how many new cases of dementia there are (incidence) in the Campania region (South Italy) from 2015 to 2020. We included individuals aged 65 years and above who have used dementia medications, were admitted to hospitals due to dementia, and/or had payment exemptions for dementia. Among 1,118,545 individuals older than 65 years living in the Campania region of Italy (among 5,624,260 inhabitants), we identified 80,392 people older than 65 years with dementia (62.4% females; age about 80 years), among which 35,748 people had Alzheimer’s dementia (63.0% females; age about 79 years). Based on these numbers, we estimated 77 people living with dementia per 1,000 people (85 for females and 67 for males) and 34 with Alzheimer’s dementia per 1,000 people (37 for females and 29 for males). The number of new cases per year was 82 per 100,000 for any dementia and 59 for Alzheimer’s dementia. We showed that our data were accurate by comparing results of tests measuring memory and other functions and found that only 1.7–3.0% of cases remained undetected. These measures will be important to identify risk factors, guide prevention strategies, and improve care and support for affected individuals and their families.

Real-Life Effectiveness and Safety of Guselkumab in Patients with Psoriasis Who Have an Inadequate Response to Ustekinumab: A 3-Year Multicenter Study.

Background: Guselkumab is the first approved human IgG1λ monoclonal antibody selectively targeting the p19 subunit of IL23. Its effectiveness and safety were widely reported by clinical trials. However, these results must be confirmed in real life since its safety deals with more complicated subjects with respect to trials. Currently, real-life data on the use of guselkumab following treatment failure with ustekinumab are limited, and existing studies usually show a small cohort and/or a reduced follow-up period. In this context, the aim of our study was to evaluate the use of guselkumab in patients who previously did not respond to ustekinumab after up to 3 years of treatment. Methods: A multicenter retrospective study was performed. The study enrolled patients affected by moderate-to-severe plaque psoriasis undergoing treatment with guselkumab who were attending the Psoriasis Center of nine different centers in the Campania region of Italy. Demographic and clinical features were collected for each patient at baseline. Moreover, data on psoriasis severity and adverse events (AEs) were collected at each follow-up visit (week (W)16-W36-W52-W104-W156). Results: A total of 112 patients (70 male, 62.5%; mean age 54.8 ± 11.7 years old) were enrolled. Of these, 48 (42.9%), 34 (30.4%), and 16 (14.3%) reached 1, 2, and 3 years, respectively, of follow-up under guselkumab. A statistically significant clinical improvement was observed since W16, and sustained effectiveness was reported at each timepoint up to W156. No serious AEs were collected. Moreover, a sub analysis on the body mass index, involvement of difficult-to-treat areas, and presence of psoriatic arthritis (PsA) showed that the presence of PsA or palmoplantar psoriasis was associated with a reduced clinical improvement at W16 and W36, without differences from W52. In contrast, the efficacy of guselkumab does not seem to be affected by the BMI, involvement of fingernails, or location in the genital or scalp area. Conclusions: To sum up, our long-term real-life multicenter retrospective study confirmed the efficacy and safety of guselkumab following ustekinumab discontinuation up to 156 weeks of treatment.

Bridging the gap in fishing effort mapping: a spatially-explicit fisheries dataset for Campanian MPAs, Italy

Recent technological advancements have facilitated the extensive collection of movement data from large-scale fishing vessels, yet a significant data gap remains for small-scale fisheries. This gap hinders the development of consistent exploitation patterns and meeting the information needs for marine spatial planning in fisheries management. This challenge is specifically addressed in the Campania region of Italy, where several Marine Protected Areas support biodiversity conservation and fisheries management. The authors have created a spatially-explicit dataset that encompasses both large-scale (vessels exceeding 12 meters in length) and small-scale (below 12 meters) fishing efforts. This dataset (available at https://doi.org/10.6084/m9.figshare.23592006) is derived from vessel tracking data and participatory mapping. It offers insights into potential conflicts between different fishing segments and their interactions with priority species and habitats. The data can assist researchers and coastal management stakeholders in formulating policies that reduce resource competition and promote ecosystem-based fisheries management. Furthermore, the provided mapping approach is adaptable for other regions and decision-making frameworks, as we are committed to sharing the tools and techniques we employed.

Environmental justice: geostatistical analysis of environmental hazards and socioeconomic factors—the case of Italy

AbstractThe analysis of environmental issues and the pursuit of environmental justice have gained significant attention in modern times. While progress has been made in understanding environmental impacts and establishing the right to access environmental information, the need to examine environmental inequalities persists. This study aimed to propose a methodology to identify and analyse potential ‘sacrifice zones’ within a region of interest using: (i) Exploratory Spatial Data Analysis (ESDA), (ii) Municipal Risk Indicators, and (iii) Spatial Autoregressive (SAR) models. The relationship between environmental hazards and social disadvantage in the Campania region of Italy was estimated and the findings of this preliminary study in this area are presented. Our preliminary results: (i) reveal a non-random distribution of contaminated sites and waste management plants (ii) localize the ‘sacrifice zones’ that are predominantly located in municipalities between the provinces of Naples and Caserta, (iii) show a disproportionately burdened with higher environmental risk and greater social vulnerability in some specific areas. Further investigations are required to replicate the results of this study under different environmental conditions. Additionally, enabling more precise identification of affected populations and areas subjected to heightened environmental pressures that would enhance the potential of the proposed approach. The proposed methodology can be adapted to different spatial contexts and data sources.

The Nitrate Fate Tool: A Decision Support System for the Assessment of the Groundwater Vulnerability to Nitrate in Support of Sustainable Development Goals

This article introduces a new web-based and freely accessible tool, the Nitrate Fate tool (NFt), for the assessment of groundwater vulnerability to nitrate pollution in a variety of pedoclimatic conditions. The contamination of water resources by nitrate, in fact, represents a growing and persistent global environmental problem, and the utilization of practical tools to assist personnel working in the agricultural sector is key for mitigating the impact on land use, while maintaining farmers’ incomes. The (NFt) has been developed and integrated into the geospatial decision support system, LandSupport, as a way to support multiple stakeholders in conducting the so-called what-if scenario analysis (e.g., what would happen to the crop production if I substitute a quote of inorganic fertilizer with the same quote of an organic one?). The tool couples a state-of-art crop-growth model—which simulates crop growth dynamics, the nitrogen and carbon cycles—with a novel transfer function model in order to assess the transport of nitrate through the unsaturated zone to the groundwater table. Within the LandSupport platform, the results are shown both as coloured maps and as cumulative charts representing the travel times and the concentrations of root leachate to groundwater table depths. This work details the tool’s rationale, the coupling of the models, and their implementation. Moreover, this article shows examples of applications supporting several public authorities and end-users, underlining that, by combining all of the information on soils, groundwater table depths, management and climates, it is possible to obtain a comprehensive understanding of nitrogen transport dynamics. Two case studies are presented: the Piana del Sele and the eastern plain of Naples, both located in the Campania region of Italy. The results of the tool’s applications reveal significant groundwater vulnerability in both plains, mainly due to the shallow groundwater table depths, resulting in remarkably fast mean nitrate travel times ranging from 0 to 6 years. Finally, the tool provides a reproducible and replicable solution, and future implementation is foreseen for additional case studies all over the world.

New Opportunities Model for Monitoring, Analyzing and Forecasting the Official Statistics on Coronavirus Disease Pandemic

At the beginning of 2020, it became obvious that the coronavirus disease 2019 (COVID-19) pandemic will have a fairly significant scale and duration. There was an unmet need for the analysis and forecast of the development of events. The forecast was needed to make the managerial decisions in terms of knowledge on the dynamics of the pandemic, considering and analyzing the incoming official statistics about the pandemic, modeling and predicting the behavior of this statistics. Due to the objective and subjective factors, the available statistics is far from the unknown true data regarding the pandemic. Therefore, strictly speaking, it was necessary to model and predict not the dynamics of the pandemic, but the dynamics of the official (i.e. government) statistics on the pandemic. This paper proposes a new model, referred to as the new opportunities model, to monitor, analyze and forecast the government statistics on COVID-19 pandemic. A modeling approach is offered in this regard. The modeling approach is important as it answers simple questions on what awaits us in the near future, which is the current phase of the pandemic and when all this will be over. The new opportunities model is applied to three different countries in terms of area, economy and population, namely Russia, Romania and Moldova, plus the Campania region in Italy, and proves to be efficient over other similar models including the classical Susceptible-Infected (SI) model.

First serological evidence of SARS-CoV-2 natural infection in small ruminants

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) emerged in late December 2019 and spread worldwide, quickly becoming a pandemic. This zoonotic coronavirus shows a broad host range, including wildlife and domestic animals. Small ruminants are shown to be susceptible to SARS-CoV-2 but, to date, no natural infection has been reported. Herein, we performed a survey for SARS-CoV-2 among sheep and goats in the Campania region of Italy using an indirect multispecies ELISA. Next, positive sera were submitted to virus serum neutralization for the quantification of specific neutralizing antibodies. Out of 612 sheep and goats, 23 were found ELISA positive (3.75%) and 1 of them showed 1:20 neutralizing antibodies titer. No significant difference was found between the two species, as well as between male and female, geographical location and age. Our findings demonstrate that natural infection can occur in flocks in a field situation. Moreover, low susceptibility to SARS-CoV-2 is reported for sheep and goats, nevertheless, the continuous mutations of this virus open new scenarios on viral host range and tropism, highlighting the importance of investigating animal species that could represent ongoing or future possible hosts.

Retrospective Serosurvey of Three Porcine Coronaviruses among the Wild Boar (Sus scrofa) Population in the Campania Region of Italy.

The growing interest in porcine coronaviruses (CoVs) is due to both their negative effect on the swine industry and their propensity to mutate and overcome host barriers. Since information on CoVs in wild boar (Sus scrofa) is limited, especially in Italy, a serosurvey was conducted to assess the epidemiologic situation in the Campania region and to clarify the role of wild boar as reservoirs for enteric (porcine epidemic diarrhea virus [PEDV], transmissible gastroenteritis virus [TGEV]) and respiratory (respiratory coronavirus [PRCV]) swine CoVs. During the 2016-17 hunting season, serum samples were collected from 444 wild boars and tested for antibodies to enteric (PEDV, TGEV) and respiratory (PRCV) porcine CoVs by enzyme-linked immunosorbent assay. The highest seroprevalence in wild boars was for PEDV, with a positivity of 3.83% (95% confidence interval [CI] 2.05-5.6), whereas very low seroprevalences were found for TGEV and PRCV (0.67% positivity; 95% CI 0-1.44 in both cases). There was no statistical association between seropositivity to CoVs, sex, and location, whereas the prevalence of seropositive animals was positively correlated with young age (0-12 mo old). Our data confirm the presence of CoVs in wild boars in the Campania region. Our data are in agreement with the results of similar studies from other European countries, which attribute a minor role to wild boar in the transmission of these infections to domestic pigs. Our results suggest that continuous serologic surveys are necessary to monitor wild animals and detect emerging threats to livestock and humans.

The contribution of persistent organic pollutants to the environmental changes in Campania region, Italy: Results from the Campania Trasparente project

Over the last two decades, the Campania region in Italy has been the focus of public debate and concern about environmental issues. Using data from soil, water, air, vegetables, animal products, and human blood, a multimedia monitoring study was performed to measure the contribution of persistent organic pollutants (POPs) to pollution in the region. We report results for a range of POPs in the air, including organochlorine pesticides (OCPs), polycyclic aromatic hydrocarbons (PAHs), polychlorinated biphenyls (PCBs), polybrominated diphenyl ethers (PBDEs), and phthalate esters (PAEs). Most of these chemicals are ubiquitous, with higher concentrations occurring in the urban and metropolitan territory of Naples. The residues of OCPs are attributed to their historical use; however, evidence of recent usage of technical Endosulfan exists in some areas. Although petrogenic sources are widespread, the pyrogenic source has dominated the release of PAHs. The Naples metropolitan area (NMA) serves as a regional emitter of POPs, and the long-term soil re-emission of some POPs does still exist. There are certain risks related to soil-borne PAHs, mainly in the urban (e.g., the Bagnoli brownfield site) and NMA, and more subordinately, in other provincial areas.

A geospatial decision support system for ecotourism: a case study in the Campania region of Italy

A geospatial decision support system for ecotourism: a case study in the Campania region of Italy

A geospatial decision support system for ecotourism: a case study in the Campania region of Italy

Nowadays, the business of ecotourism and rural tourism is a very important activity for many inland areas, enabling them to both produce important income and sustain the rural economy. Moreover, sustainable tourism is included in the UN 17th Sustainable Development Goal, which is to be achieved by 2030 (SDG 8.9 and SDG 12). Recent progress in digital tourism promises to deliver important changes to this activity, but most of this progress is addressed at well-known tourist destinations, so not dealing with the challenge of inland, rural and ecotourism. It is within this framework that this paper attempts to demonstrate that a new type of geoSpatial Decision Support System (S-DSS), developed on a Geospatial Cyberinfrastructure (GCI) and with a substantial interdisciplinary core, could provide a valuable web-based operational tool which may be offered to both ecotourism and rural tourism end-users, planners and policy makers, so that they might better plan and manage this type of sustainable tourism. The S-DSS platform has also been designed to encourage use by the multi-user community (farmers, tourism enterprises, associations and public bodies). The methodology is linked to the creation of a GCI platform (www.landsupport.eu) that supports the acquisition, management, processing and analysis of both static (e.g. soil, geology) and dynamic data (e.g. environmental and daily climatic data), together with data visualization and computer on-the-fly applications, in order to perform modelling, all of which is potentially accessible via the Web. The S-DSS tool known as EcoSmarTour is demonstrated through a case study of the Campania region (South Italy) and, by connecting database and modelling, it aims to deliver a large amount of information that will improve knowledge of the territory, manage scenario analysis, produce maps and evaluate potential ecotourism footpaths or areas of interest, thus enabling the provision of better information on the entire ecotourism sector. The tool will also be demonstrated through reference to a short selection of additional use cases from elsewhere in Europe. Most importantly, the approach adopted is highly transferable because it relies on very general algorithms that can be easily applied wherever the necessary data are available.

NGS analysis of nasopharyngeal microbiota in SARS-CoV-2 positive patients during the first year of the pandemic in the Campania Region of Italy

Since its first appearance, the SARS-CoV-2 has spread rapidly in the human population, reaching the pandemic scale with >280 million confirmed infections and more than 5 million deaths to date (https://covid19.who.int/). These data justify the urgent need to enhance our understanding of SARS-CoV-2 effects in the respiratory system, including those linked to co-infections.The principal aim of our study is to investigate existing correlations in the nasopharynx between the bacterial community, potential pathogens, and SARS-CoV-2 infection.The main aim of this study was to provide evidence pointing to possible relationships between components of the bacterial community and SARS-CoV-2 in the nasopharynx. Meta-transcriptomic profiling of the nasopharyngeal microbial community was carried out in 89 SARS-Cov-2 positive subjects from the Campania Region in Italy. To this end, RNA extracted from nasopharyngeal swabs collected at different times during the initial phases of the pandemic was analyzed by Next-Generation Sequencing (NGS). Results show a consistently high presence of members of the Proteobacteria (41.85%), Firmicutes (28.54%), and Actinobacteria (16.10%) phyla, and an inverted correlation between the host microbiome, co-infectious bacteria, and super-potential pathogens such as Staphylococcus aureus, Klebsiella pneumoniae, Streptococcus pneumoniae, Pseudomonas aeruginosa, Acinetobacter baumannii, and Neisseria gonorrhoeae.In depth characterization of microbiota composition in the nasopharynx can provide clues to understand its potential contribution to the clinical phenotype of Covid-19, clarifying the interaction between SARS-Cov-2 and the bacterial flora of the host, and highlighting its dysbiosis and the presence of pathogens that could affect the patient's disease progression and outcome.

Assessing the effects of local contexts on the mobility choices of university students in Campania region in Italy

The mobility of university students in Italy has been framed as a phenomenon linked to so-called intellectual migrations and as a subset of the historical and consolidated internal migration path explained in terms of South–North trajectory. This study describes the most important mobility trajectories of students across macro-areas and disciplinary fields, and then evaluates, using a multilevel logistic regression model, the factors that encouraged student cohort, who were enrolled in a degree program in the academic years 2014–2015, to move elsewhere from the Campania region. Beyond fixed and interaction effects related to the students’ personal characteristics, the model included possible random effects linked to the high schools attended by the students to capture the possible influence of the local context on migration choices.

Nasopharyngeal virome analysis of COVID-19 patients during three different waves in Campania region of Italy.

From December 2019, severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection has spread rapidly, leading to a global pandemic. Little is known about possible relationships between SARS‐CoV‐2 and other viruses in the respiratory system affecting patient prognosis and outcomes. This study aims to characterize respiratory virome profiles in association with SARS‐CoV‐2 infection and disease severity, through the analysis in 89 nasopharyngeal swabs collected in a patient's cohort from the Campania region (Southern Italy). Results show coinfections with viral species belonging to Coronaviridae, Retroviridae, Herpesviridae, Poxviridae, Pneumoviridae, Pandoraviridae, and Anelloviridae families and only 2% of the cases (2/89) identified respiratory viruses.

Interferon beta for the treatment of multiple sclerosis in the Campania Region of Italy: Merging the real-life to routinely collected healthcare data.

We aim to overcome limitations of previous clinical and population-based studies by merging a clinical registry to routinely-collected healthcare data, and to specifically describe differences in clinical outcomes, healthcare resource utilization and costs between interferon beta formulations for multiple sclerosis (MS). We included 850 patients with MS treated with interferon beta formulations, from 2015 to 2019, seen at the MS Clinical Care and Research Centre (Federico II University of Naples, Italy) and with linkage to routinely-collected healthcare data (prescription data, hospital admissions, outpatient services). We extracted and computed clinical outcomes (relapses, 6-month EDSS progression using a roving EDSS as reference), persistence (time spent on a specific interferon beta formulation), adherence (medication possession ratio (MPR)), healthcare resource utilization and costs (annualized hospitalization rate (AHR), costs for hospital admissions and DMTs). To evaluate differences between interferon beta formulations, we used linear regression (adherence), Poisson regression (AHR), mixed-effect regression (costs), and Cox-regression models (time varying variables); covariates were age, sex, treatment duration, baseline EDSS and adherence. Looking at clinical outcomes, rates of relapses and EDSS progression were lower than studies run on previous cohorts; there was no differences in relapse risk between interferon beta formulations. Risk of discontinuation was higher for Betaferon®/Extavia® (HR = 3.28; 95%CI = 2.11, 5.12; p<0.01). Adherence was lower for Betaferon®/Extavia® (Coeff = -0.05; 95%CI = -0.10, -0.01; p = 0.02), and Avonex® (Coeff = -0.06; 95%CI = -0.11, -0.02; p<0.01), when compared with Rebif® and Plegridy® (Coeff = 0.08; 95%CI = 0.01, 0.16; p = 0.02). AHR and costs for MS hospital admissions were higher for Betaferon®/Extavia® (IRR = 2.38; 95%CI = 1.01, 5.55; p = 0.04; Coeff = 14.95; 95%CI = 1.39, 28.51; p = 0.03). We have showed the feasibility of merging routinely-collected healthcare data to a clinical registry for future MS research, and have confirmed interferon beta formulations play an important role in the management of MS, with positive clinical outcomes. Differences between interferon beta formulations are mostly driven by adherence and healthcare resource utilization.