Outbreak In Italy Research Articles

Emotional distress in Catholic priests and religious sisters during COVID-19: the mediational role of trait positivity

ABSTRACT The present study focused on the mediating role of positivity in the relationship between emotional stability, conscientiousness, with positive affect, negative affect, and anxiety, among priests and religious sisters during the COVID-19 outbreak in Italy. We examined the role of positivity as a basic disposition predisposing individuals to a positive mode of viewing reality for priests and religious sisters during the quarantine. We used data from 205 religious participants, collected during the initial phase of the COVID-19 outbreak. Results revealed that emotional stability and conscientiousness significantly and indirectly predicted positive affectivity, but were significant and negative indirect predictors of negative affect, and state anxiety. This study emphasizes the protective role of positivity in the specific population of priests and religious sisters during a pandemic outbreak.

The psychological impact of COVID-19 on women’s wellbeing during pregnancy and postpartum one year after pandemic outbreak in Italy. A Systematic review

Background. Coronavirus (COVID-19) contagion prevalence and the severity of its symptoms do not seem different for pregnant and postpartum women than the general population. Nevertheless, the possible traumatic experiences related to the spread of covid-19 show negative effects on women’s mental health during the childbearing and postnatal period. Although international reviews observed this phenomenon worldwide, an in-depth exploration of Italian pregnant and postpartum women’s wellbeing is needed, considering the specific phases of the virus spread and the restrictive measures imposed by Italian government throughout the last year. Aim. This research aims to identify and discuss existing studies on women’s antenatal and postnatal mental health during the first year of the pandemic in Italy. Method . In accordance with PRISMA guidelines, a systematic review was conducted, using the following databases: Web of Science, Embase, EBSCO (APA PsycArticles, APA PsycInfo; Psychology and Behavioral Sciences Collection; MEDLINE), Pubmed and other sources. Results. Eleven articles were included in the review and three meaning trajectories were identified: Pregnancy and postpartum continuum – from anxiety to depression and post-traumatic stress; Risk dimensions: previous psychopathologies and the lack of social support; Focus on others health before themselves. Conclusion. Findings suggest different vulnerable areas, such as a high fear for others health and the loss of the protective dimension of social support for pregnant and postpartum women’s wellbeing in Italy. This evidence might help to project useful and specific psychological screening and intervention programmes for perinatal clinic.

Discriminating Xylella fastidiosa from Verticillium dahliae infections in olive trees using thermal- and hyperspectral-based plant traits

Globally, olive (Olea europaea L.) productivity is threatened by plant pathogens, particularly the fungus Verticillium dahliae (Vd) and the bacterium Xylella fastidiosa (Xf). Infections by these pathogens restrict water and nutrient flow through xylem, producing a similar set of symptoms that can also be confounded with water stress. Conventional in situ monitoring techniques are time consuming and expensive, necessitating the development of large-scale detection methods. Airborne hyperspectral and thermal imagery have been successfully used to detect both Xf and Vd infection symptoms independently, i.e., when only one of the two diseases is present. Nevertheless, the discrimination of Vd from Xf infections in contexts where both pathogens are present has not been addressed to date. This study proposes a three-stage machine learning algorithm to distinguish Vd infections from Xf infections, using a series of datasets from 27 olive orchards affected by Xf and Vd outbreaks in Italy and Spain between 2011 and 2017. Plant traits were derived from airborne hyperspectral and thermal imagery, including physiological indices from radiative transfer model inversion, Solar-induced Fluorescence emission (SIF@760), the Crop Water Stress Index (CWSI), and a selection of narrow–band hyperspectral indices. Several distinct spectral traits successfully discriminated Xf from Vd infections. The three-stage method generated a false-positive rate of 9%, an overall accuracy (OA) of 98%, and a kappa coefficient (κ) of 0.7 when identifying Vd infections using a mixed Vd + Xf dataset. When identifying Xf infections, the false-positive rate was 4%, the OA was 92%, and κ was 0.8. These results indicate that hyperspectral and thermal traits can be used to discriminate Xf from Vd infection caused by the two xylem–limited pathogens that trigger similar visual symptoms.

Spatio-temporal Object-Oriented Bayesian Network modelling of the COVID-19 Italian outbreak data

The spatial epidemic dynamics of COVID-19 outbreak in Italy were modelled by means of an Object-Oriented Bayesian Network in order to explore the dependence relationships, in a static and a dynamic way, among the weekly incidence rate, the intensive care units occupancy rate and that of deaths. Following an autoregressive approach, both spatial and time components have been embedded in the model by means of spatial and time lagged variables. The model could be a valid instrument to support or validate policy makers’ decisions strategies.

Vitamin A in Children Hospitalized for Measles in a High-income Country.

Worldwide medical authorities recommend vitamin A supplementation for severe measles requiring hospitalization; however, evidence supporting its use in high-income countries is lacking. A nationwide vitamin A shortage reported in concomitance with a recent measles outbreak in Italy provided an opportunity to test the effectiveness of vitamin A in a high-income setting, approximating an unbiased allocation. We conducted a prospective controlled cohort study involving children admitted for measles to a tertiary-care hospital in Southern Italy. The primary outcome was the duration of fever. Secondary outcomes included the length of hospitalization, rate of complications, need for antibiotic treatment and body temperature. A total of 108 inpatient children (36% female, median age 16.3 months) were enrolled; 36 received 2 doses of oil-based vitamin A according to age, and 72 matched controls received standard care. There were no significant differences between the study groups in the duration of fever (7.03 ± 2.67 vs. 6.82 ± 3.27, P = 0.72), length of hospitalization (median, 5.0 vs. 5.0 days, P = 0.50), maximum body temperature (median, 39°C in both groups, P = 0.23), rate of organ (69.4% vs. 63.9%, P = 0.72) and hematologic complications (41.7% vs. 59.7%, P = 0.12), or need for antibiotic treatment (66.7% vs. 61.1%, P = 0.72). Overall, vitamin A supplementation did not reduce the risk of any complications (relative risk, 1.33; 95% confidence intervals: 0.59-2.96). Vitamin A does not change the clinical course of measles infection or the rate of complications in children hospitalized in a high-income country. EU PAS 31805.

Understanding protection from SARS-CoV-2 using metabolomics

The COVID-19 pandemic is still raging in most countries. Although the recent mass vaccination campaign has opened a new chapter in the battle against SARS-CoV-2, the world is still far from herd immunity. There is an urgent need to identify healthy people at high risk of contracting COVID-19, as well as supplements and nutraceuticals that can reduce the risk of infection or mitigate symptoms. In the present study, a metabolic phenotype that could protect individuals from SARS-CoV-2 infection or predispose them to developing COVID-19 was investigated. Untargeted metabolomics was performed on serum samples collected from 51 healthcare workers who were in good health at the beginning of the COVID-19 outbreak in Italy, and who were later exposed to the same risk of developing COVID-19. Half of them developed COVID-19 within three weeks of the blood collection. Our results demonstrate the presence of a specific signature associated with protection from SARS-CoV-2. Circulating monolaurin, which has well-known antiviral and antibacterial properties, was higher in protected subjects, suggesting a potential defensive role against SARS-CoV-2 infection; thus, dietary supplements could boost the immune system against this infection. In addition, our data demonstrate that people with higher levels of cholesterol are at higher risk of developing COVID-19. The present study demonstrates that metabolomics can be of great help for developing personalized medicine and for supporting public healthcare strategies. Studies with larger cohorts of subjects are necessary to confirm our findings.

School openings and the COVID-19 outbreak in Italy. A provincial-level analysis using the synthetic control method

Schools have been central in the debate about COVID-19. On the one hand, many have argued that they should be kept open, given their importance to youngsters and the future of the country, and the effort many countries have made in establishing protocols to keep them safe. On the other hand, it has been argued that open schools further the spread of the virus, given that these are places with large-scale interaction between teenagers and adults accompanying their children, as well as a major source of congestion on public transportation. We aim to identify the effect of school openings on the spread of COVID-19 contagion. Italy offers an interesting quasi-experimental setting in this regard due to the scattered openings that schools have experienced. By means of a quantitative analysis, employing a synthetic control method approach, we find that Bolzano, the first province in Italy to open schools after the summer break, had far more cases than its synthetic counterfactual, built from a donor pool formed from the other Italian provinces. Results confirm the hypothesis that despite the precautions, opening schools causes an increase in the infection rate, and this must be taken into account by policymakers.

Psychological precursors of individual differences in COVID-19 lockdown adherence: Moderated-moderation by personality and moral cognition measures

The COVID-19 pandemic forced the worldwide introduction of containment measures. This emergency scenario produced a conflict between personal freedom and public health, highlighting differences in individual behaviours influenced by psychological traits and moral considerations. In this context, a detailed characterisation of the psychological variables predicting adherence to containment measures is crucial to enhance public awareness and compliance.During the first virus outbreak in Italy, we assessed whether adherence to government measures was explained by the interacting effects of personality traits and moral dispositions. Through an online questionnaire, we collected data on individual endogenous variables related to personality traits, locus of control, and moral dispositions, alongside the tendency to breach the lockdown for outdoor physical activity. The results showed that individual measures of novelty-seeking, harm-avoidance and authority concerns interacted in driving the adherence to the national lockdown: MFQ-Authority moderated the facilitatory effect of novelty-seeking on lockdown violation, but this moderation was itself moderated by higher TCI-harm-avoidance. By assessing a model forecasting the likelihood of violating restrictive norms, these findings show the potential of personality and moral foundation assessments in informing prevention policies and emergency interventions by political and scientific institutions.

Is administered competition suitable for dealing with a public health emergency? Lessons from the local healthcare system at the centre of early COVID-19 outbreak in Italy.

The Lombardy Region, Italy, was the most severely affected by the COVID-19 outbreak. In absence of effective treatments and with basic hygiene measures made mandatory, Lombardy response to COVID-19 relied on its healthcare system characteristics, the administered competition or "quasi-market" model. The aim of the study was to review the strengths and weaknesses of Lombardy's response during the first wave of the COVID-19 epidemic, to explore whether the healthcare model influenced crisis management and describe which policies could help to contain future outbreaks. The results are expected to provide similar healthcare systems with lessons to avoid mistakes and learn from best practice. Data for quantitative analyses on the performance of the Lombardy and Veneto Regions healthcare systems were derived from existing government sources including the Italian Civil Protection Agency and the Ministry of Health. Lombardian quasi-market model, traditionally characterized by a strong hospital network, was held responsible for many suboptimal outcomes. According to critics, years of disinvestments in community care resulted in a hospital overload. However, the same model was responsible for other positive outcomes which have been substantially neglected, such as the opportunity to test for effective containment treatments in a safe environment and rapidly extend the number of beds. The performance of a quasi-market model against public health emergencies largely depends on integration between policy-makers and balance between healthcare providers, which require clear regulation. Reducing institutional fragmentation between levels of governance, improving the coordination of healthcare facilities and adopting telemedicine technologies are means by which healthcare networks could strengthen their resilience against future outbreaks.

An Italian multicenter analysis of emergency admissions and treatment of upper tract urolithiasis during the lockdown and reopening phases of the COVID-19 pandemic: Are we ready for a second wave of the outbreak?

ObjectivesTo assess if the lockdown period (March–April 2020) during the coronavirus disease‐19 outbreak in Italy influenced the number, presentation, and treatment of urgent admissions to the emergency department for ureteral lithiasis, and to evaluate the same variables during the reopening phase (May–June 2020).MethodsWe performed a retrospective analysis of patients admitted to the emergency department of three different hospitals (two coronavirus disease‐19 hubs). Demographics and data on acute pyelonephritis, acute kidney injury, urinoma, hematuria, inpatient admission/discharge home, and type of treatment were gathered and compared with the same periods in 2019.ResultsA total of 516 patients were admitted during the study period, of whom 62.4% were male. Their mean age was 58.86 ± 16.24 years. The number of admissions decreased significantly, by 51.25% (P = 0.003), during lockdown compared to 2019 (78 vs 160 admissions). The number of admissions in the reopening phase (May–June 2020) was in line with that in 2019 (n = 138). The number of hospitalizations (P = 0.005), acute obstructive pyelonephritis (P = 0.019), and complications (P = 0.02) was statistically significantly higher during lockdown compared to 2019. The increase in the rate of surgical procedures nearly reached significance (P = 0.059). The odds of having complications and being hospitalized were almost fivefold (odds ratio 4.68, 95% confidence interval 1.98–11.07) and twofold greater (odds ratio 2.39, 95% confidence interval 1.29–4.43) compared to the same period in 2019. No difference was noted between May–June 2020 and 2019.ConclusionThe coronavirus disease‐19 lockdown period provoked a meaningful reduction in symptomatic ureteral lithiasis admission. Most patients presented with complicated disease, which required an increased rate of interventional procedures compared to the equivalent period in 2019. Admissions reverted to normal levels during the reopening phase.

The early weeks of the Italian Covid-19 outbreak: sentiment insights from a Twitter analysis

• A novel approach to analyse population reaction to COVID-19 was presented. • Positive and negative outbreak in Italy have been measured from tweets • The higher the number of cases the higher interest rate on coronavirus. • The negative outbreak overcomes the positive one but tends to diminish over time • Differences among Regions in terms of interest smoothened after the national lockdown.

Corrigendum: Together Apart: The Mitigating Role of Digital Communication Technologies on Negative Affect During the COVID-19 Outbreak in Italy

[This corrects the article DOI: 10.3389/fpsyg.2020.554678.].

Control with uncertain data of socially structured compartmental epidemic models

The adoption of containment measures to reduce the amplitude of the epidemic peak is a key aspect in tackling the rapid spread of an epidemic. Classical compartmental models must be modified and studied to correctly describe the effects of forced external actions to reduce the impact of the disease. The importance of social structure, such as the age dependence that proved essential in the recent COVID-19 pandemic, must be considered, and in addition, the available data are often incomplete and heterogeneous, so a high degree of uncertainty must be incorporated into the model from the beginning. In this work we address these aspects, through an optimal control formulation of a socially structured epidemic model in presence of uncertain data. After the introduction of the optimal control problem, we formulate an instantaneous approximation of the control that allows us to derive new feedback controlled compartmental models capable of describing the epidemic peak reduction. The need for long-term interventions shows that alternative actions based on the social structure of the system can be as effective as the more expensive global strategy. The timing and intensity of interventions, however, is particularly relevant in the case of uncertain parameters on the actual number of infected people. Simulations related to data from the first wave of the recent COVID-19 outbreak in Italy are presented and discussed.

COVID-19 outbreak in Italy: estimation of reproduction numbers over 2 months prior to phase 2

PurposeTwo months after its first COVID-19 case, Italy counted more than 190,000 confirmed positive cases. From the beginning of April 2020, the nationwide lockdown started to show early effects by reducing the total cumulative incidence reached by the epidemic wave. Here we provide the reproduction number estimation both in space and in time from February 24 to April 24, 2020 over 2 months into the epidemic.MethodsThe aim of the present work was to provide a systematical mapping of the SARS-CoV-2 transmission dynamics spread to all regions of Italy. To do so, we estimated the basic reproduction number (R0), by using the maximum likelihood estimation method in the early stage of the epidemic. In addition, we determined time evolution of this parameter across the 2 months of the observational period. Finally, we linked Rt, with two indices, the first representing the number of contagious people and the latter the density of susceptibiltiy to infection of people in a region as recorded on April 24, 2020.ResultsOur estimates suggest a basic reproduction number averaged over all the regions of 3.29. Based on the SARS-CoV-2 transmission dynamics reported here, we gave a quantitative evaluation of the efficiency of the government measures to lower the reproduction number below 1 (control regime). We estimated that the worst-hit regions in Italy reached the control regime level (Rt < 1) in about a month.ConclusionOur work was carried out in the period between April and July,2020. We found that the mean value of time to reach the control regime across the whole country was about 31 days from February 24, 2020. Moreover, we highlighted the interplay between the reproduction number and two epidemiological/demographic indices to evaluate the “state of activity” of the epidemic, potentially helping in challenging decisions to continue, ease, or tighten restrictions.Supplementary InformationThe online version contains supplementary material available at 10.1007/s10389-021-01567-1.

A study on the possible merits of using symptomatic cases to trace the development of the COVID-19 pandemic.

In a recent work, we introduced a novel method to compute the effective reproduction number R_t and we applied it to describe the development of the COVID-19 outbreak in Italy. The study is based on the number of daily positive swabs as reported by the Italian Dipartimento di Protezione Civile. Recently, the Italian Istituto Superiore di Sanità made available the data relative of the symptomatic cases, where the reporting date is the date of beginning of symptoms instead of the date of the reporting of the positive swab. In this paper, we will discuss merits and drawbacks of this data, quantitatively comparing the quality of the pandemic indicators computed with the two samples.

Fleeing lockdown and its impact on the size of epidemic outbreaks in the source and target regions \u2013 a COVID-19 lesson

The COVID-19 pandemic forced authorities worldwide to implement moderate to severe restrictions in order to slow down or suppress the spread of the disease. It has been observed in several countries that a significant number of people fled a city or a region just before strict lockdown measures were implemented. This behavior carries the risk of seeding a large number of infections all at once in regions with otherwise small number of cases. In this work, we investigate the effect of fleeing on the size of an epidemic outbreak in the region under lockdown, and also in the region of destination. We propose a mathematical model that is suitable to describe the spread of an infectious disease over multiple geographic regions. Our approach is flexible to characterize the transmission of different viruses. As an example, we consider the COVID-19 outbreak in Italy. Projection of different scenarios shows that (i) timely and stricter intervention could have significantly lowered the number of cumulative cases in Italy, and (ii) fleeing at the time of lockdown possibly played a minor role in the spread of the disease in the country.

Mental Health and Endocrine Telemedicine Consultations in Transgender Subjects During the COVID-19 Outbreak in Italy: A Cross-Sectional Web-Based Survey

Transgender people are a vulnerable group with a higher incidence of mental health issues and, during the COVID-19 outbreak, they may have faced psychological, physical and social obstacles. To evaluate the impact of the pandemic and the access to health care services during the COVID-19 pandemic on the mental health of the transgender people living in Italy. An anonymous web-based survey was conducted among transgender people living in Italy. The survey consisted of 41 questions (to address socio-demographic and COVID-19 related variables, general health problems and trans-related health issues) and three validated questionnaires (the Impact of Event Scale [IES], the Beck Depression Inventory [BDI-II] and the SF-12. In total 108 respondents were included in the analysis, of these 73.1% were transmen and 26.9% transwomen. The mean age was 34.3 ± 11.7 years with 88.9% undergoing gender affirming hormonal treatment (GAHT). Of these respondents 55.6% were not working during the COVID-19 pandemic, mainly because they lost their jobs due to the lockdown (30.5%) or because they were otherwise unemployed (25.0%). Only four subjects were quarantined at home because of a positive COVID-19 swab. The mean total IES score was 21.1 ± 14.9 with 24.1% of subjects scoring over the cut-off score of 26 thereby suggesting a moderate-to-severe impact of the pandemic event. Mean BDI score was 8.6 ± 8.4. SF-12 total mean score was 96.1 ± 11.9 with a Mental Component Summary (MCS) score of 42.8 ± 9.1. Access to endocrinological consultations for hormonal prescription via telemedicine services was associated with better IES total scores (P=.01). Our results highlight the impact of the pandemic on the mental health of this particular population and how telemedicine services may serve to mitigate negative psychological effects. Internet-based surveys may select a group of people not necessary representative of the whole population. The self-reporting bias should also be considered. Those who responded to our survey were mainly from northern Italy were COVID-19 has had a greater impact. Vulnerable groups such as the transgender population should receive more consideration also during pandemic events and their access to health services especially for endocrine and mental health care should be improved. A nationwide plan for the extended use of telemedicine should be established with targeted intervention to reduce psychological distress. Gava G, Fisher AD, Alvisi S, etal. Mental Health and Endocrine Telemedicine Consultations in Transgender Subjects During the COVID-19 Outbreak in Italy: A Cross-Sectional Web-Based Survey. J Sex Med 2021;18:900-907.

The presence of care homes and excess deaths during the COVID-19 pandemic: Evidence from Italy.

This paper explores the relationship between the spatial distribution of excess deaths and the presence of care home facilities during the first wave of the COVID‐19 outbreak in Italy. Using registry‐based mortality data for Lombardy, one of the areas most severely hit by the pandemic we show that the presence of a care home in a municipality is associated with significantly higher excess death rates in the population. This effect appears to be driven by excess mortality in the elderly population of 70 years old and older. Our results are robust to controlling for the number of residents in each care home, suggesting that the presence of such facilities may have acted as one of factors contributing to the diffusion of COVID‐19 at the local level.

Point-of-care ultrasound (PoCUS) in the early diagnosis of novel coronavirus 2019 disease (COVID-19) in a first-level emergency department during a SARS-CoV-2 outbreak in Italy: a real-life analysis.

In December 2019, the severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) spread worldwide, challenging emergency departments (EDs) with the need of rapid diagnosis for appropriate allocation in dedicated setting. Many authors highlighted the role of lung ultrasound (LUS) in management of the novel coronavirus disease 2019 (COVID-19). The study aims to analyze the performance of LUS in the early identification of COVID-19 patients in ED during a SARS-CoV-2 outbreak. We prospectively collected consecutive adult patients admitted to a first-level ED in Powered by Editorial Manager® and ProduXion Manager® from Aries Systems Corporation Florence with history or symptoms suggestive for COVID-19 that underwent LUS during the ED management. LUS findings were categorized in 6 discrete main etiological patterns. “A”, “Cardiogenic B” and “Typical C” patterns were referred as non-COVID-19-suggestive, while “Atypical” B or C patterns, “Multiple Consolidations” pattern and “ARDS” pattern were referred as COVID-19-suggestive. The primary outcome was the diagnosis of SARS-CoV-2 infection. From 12 March to 12 May 2020, 360 patients were enrolled. COVID-19 suggestive LUS findings were significantly associated with final COVID-19 diagnosis (86% in COVID-19 vs 29% in non-COVID-19, p < 0.001). The presence in ED of at least one in positive swab OR a COVID-19-suggestive LUS showed a sensitivity of 97% and a negative predictive value (NPV) of 98%. In patients with known SARS-CoV-2 exposition in the last 14 days, a COVID-19-suggestive pattern at LUS had a positive predictive value (PPV) of 97% for COVID-19 diagnosis. Point-of-care ultrasound (PoCUS) is a valuable tool for diagnostic stratification during COVID-19 outbreaks. LUS can help physicians in identifying false-negative RT-PCR, improving its diagnostic sensitivity in ED.

Telework during COVID-19 outbreak: Impact on mental health among Italian workers

IntroductionSince February 2020, the outbreak of COVID-19 has spread to several countries worldwide, including Italy, leading to an uptake of telework.ObjectivesWe aim to evaluate the psychopathological impact of teleworking during the COVID-19 pandemic in Italy, identifying mental health determinants among home-based workers.Methods804 participants completed an online survey, including the psychometric scales “Depression, Anxiety and Stress Scale – 21 items” (DASS-21) and the “Insomnia Severity Index” (ISI). Teleworkers were also asked to provide information about their current work routine, home environment and clinical history.ResultsAt the DASS-21, 30% of the participants presented pathological levels of depression, 20.8% of anxiety and 30.7% of stress. At the ISI, 5% appeared to suffer from insomnia. Respondents with psychological and physical frailties, greater social isolation or inadequate working spaces manifested higher levels of psychiatric symptoms. Moreover, we also find a correlation of these symptoms with occupations in education. Telework was broadly appreciated and 87% of respondents expressed a willingness to maintain access to this arrangement.ConclusionsOur results document that about a third of our sample manifested psychopathological symptoms while teleworking during the COVID-19 outbreak in Italy. However, telework itself does not seem to be directly associated with increased psychiatric symptoms, which were instead exacerbated by COVID-19-related stressful circumstances, as well as by constitutional and social determinants of health. Going forward, authorities should promote adequate measures in order to guarantee a healthy approach to teleworking.DisclosureNo significant relationships.