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Article ; Online: Longitudinal Assessment of Mental Health Consequences of the COVID-19 Pandemic Long-Term Exposure on Health Care Workers from a North West Italian Hospital.

Caramello, Valeria / Gariglio, Valeria / Di Salvo, Gabriele / Maina, Giuseppe / Boccuzzi, Adriana

Disaster medicine and public health preparedness

2023 Volume 17, Page(s) e378

Abstract: Objective: To assess individual variation in anxiety, stress disorder, depression, insomnia, burnout, and resilience in health care workers (HCWs), 12 and 18 months after the beginning of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ... ...

Abstract	Objective: To assess individual variation in anxiety, stress disorder, depression, insomnia, burnout, and resilience in health care workers (HCWs), 12 and 18 months after the beginning of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. Methods: Prospective longitudinal study. Results: A total of 207 HCWs (74% female, 46% physicians, 44% nurses) answered; 50% scored over the cut-off for anxiety (GAD-7), 66% for PCL-C, 41% for depression (PHQ-9), 25% for ISI, and 15% started sleep inducers; 52% showed emotional exhaustion (EE), 68% detachment (DE), 39% professional efficacy (EF) at MBI; 27% completed the follow-up questionnaire 6 months later, showing a significant reduction in nearly all scores (GAD-7 median 11[5-15] vs 7[4-12] ( Conclusions: Nearly half of HCWs showed psychological distress, especially nurses, women, and the youngest. A mandatory job change, increasing intensity of care, working in a COVID-19 department, and being infected were negative factors; having a partner and living in a detached house were protective. Six months later, all the psychological domains showed individual improvement.
MeSH term(s)	Female ; Humans ; Adult ; Male ; COVID-19/epidemiology ; SARS-CoV-2 ; Pandemics ; Mental Health ; Longitudinal Studies ; Prospective Studies ; Health Personnel/psychology ; Anxiety/epidemiology ; Anxiety/etiology ; Hospitals ; Depression/epidemiology ; Depression/etiology
Language	English
Publishing date	2023-03-09
Publishing country	United States
Document type	Journal Article
ZDB-ID	2375268-3
ISSN	1938-744X ; 1935-7893
ISSN (online)	1938-744X
ISSN	1935-7893
DOI	10.1017/dmp.2023.42
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Article ; Online: Unmet Needs for a Rapid Diagnosis of Chikungunya Virus Infection.

Burdino, Elisa / Calleri, Guido / Caramello, Pietro / Ghisetti, Valeria

Emerging infectious diseases

2016 Volume 22, Issue 10, Page(s) 1837–1839

Abstract: Rapid Diagnosis of Chikungunya Virus Infection. ...

Abstract	Rapid Diagnosis of Chikungunya Virus Infection.
Language	English
Publishing date	2016
Publishing country	United States
Document type	Letter ; Research Support, Non-U.S. Gov't
ZDB-ID	1380686-5
ISSN	1080-6059 ; 1080-6040
ISSN (online)	1080-6059
ISSN	1080-6040
DOI	10.3201/eid2210.151784
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Article: Improvements throughout the Three Waves of COVID-19 Pandemic: Results from 4 Million Inhabitants of North-West Italy.

Caramello, Valeria / Catalano, Alberto / Macciotta, Alessandra / Dansero, Lucia / Sacerdote, Carlotta / Costa, Giuseppe / Aprà, Franco / Tua, Aldo / Boccuzzi, Adriana / Ricceri, Fulvio

Journal of clinical medicine

2022 Volume 11, Issue 15

Abstract: At the very beginning of the European spread of SARS-CoV-2, Piedmont was one of the most affected regions in Italy, with a strong impact on healthcare organizations. In this study, we evaluated the characteristics and outcomes of the COVID-19 patients in ...

Abstract	At the very beginning of the European spread of SARS-CoV-2, Piedmont was one of the most affected regions in Italy, with a strong impact on healthcare organizations. In this study, we evaluated the characteristics and outcomes of the COVID-19 patients in an entire region during the first three pandemic waves, identifying similarities and differences in the SARS-CoV-2 epidemic's timeline. We collected the health-administrative data of all the Piedmont COVID-19 patients infected during the first three pandemic waves (1 March 2020-15 April 2020; 15 October 2020-15 December 2020; 1 March 2021-15 April 2021, respectively). We compared differences among the waves in subjects positive for SARS-CoV-2 and in patients admitted to ICU. Overall, 18.621 subjects tested positive during the first wave (405 patients/day), 144.350 (2366.4 patients/day) in the second, and 81.823 (1778.8 patients/day) in the third. In the second and third waves, we observed a reduction in median age, comorbidity burden, mortality in outpatients, inpatients, and patients admitted to ICU, in intubation, invasive ventilation and tracheostomy, and a parallel increase in the use of CPAP. Our study confirmed a trend towards younger and healthier patients over time but also showed an independent effect of the period on mortality and ICU admission. The appearance of new viral variants, the starting of vaccination, and organizational improvements in tracking, outpatients and inpatients management could have influenced these trends.
Language	English
Publishing date	2022-07-25
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm11154304
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Article: Characteristics of patients affecting the duration of positivity at SARS-CoV-2: a cohort analysis of the first wave of epidemic in Italy.

Milani, Lorenzo / Cigliano, Fabrizio / Catalano, Alberto / Macciotta, Alessandra / Viola, Marco / Caramello, Valeria / Costa, Giuseppe / Ricceri, Fulvio / Sacerdote, Carlotta

Epidemiologia e prevenzione

2022 Volume 45, Issue 6, Page(s) 533–542

Abstract: Objectives: to investigate the characteristics of patients affecting the duration of positivity test by RT-PCR in the population of Piedmont, a Region of North-West of Italy. DESIGN: observational cohort study.: Setting and participants: from the ... ...

Title translation	Caratteristiche dei pazienti che influiscono sulla durata della positività a SARS-CoV-2: un’analisi di coorte nella prima ondata epidemica in Italia.
Abstract	Objectives: to investigate the characteristics of patients affecting the duration of positivity test by RT-PCR in the population of Piedmont, a Region of North-West of Italy. DESIGN: observational cohort study. Setting and participants: from the administrative database of the regional SARS-CoV-2 surveillance system, a cohort of all patients who tested positive by a RT-PCR assay to SARS-CoV-2 occurring from 22.02.2020 to 30.09.2020 in the Piedmont Region (N. 29,292) was obtained. The cohort has been linked to the hospital discharge database and to the vital statistics database. Main outcomes measures: outcome of the study was the risk of non negativization, estimated by fitting Generalizing Estimating Equation model (GEE), a longitudinal model which consider for each subject several records collected on fixed time intervals 15, 30, 45 or 60+ days from the first positive test. Negativization was defined as the condition in which two consecutive samples taken from the patient at least 24 hours apart were negative for the presence of SARS-CoV-2. Results: the median duration of positive RT-PCR was 27 days. A higher median of days until positive persistence was observed in people over 80 (34 days, IQR 25-49), female (28 days, IQR 18-40), symptomatic patients (28 days, IQR 19-40), hospitalized people (32 days, IQR 21-44), patients with Charlson's index >0 (34 days, IQR 23-49), patients host of elderly nursing homes (37 days, IQR 25-51). In the GEE multivariable model, the variables associated to the non negativization at all times intervals were: older age (at 15th day: class 65+, OR 2.56, 95%CI 2.39-2.74), female gender (at 15th day: OR 1.12, 95%CI 1.06-1.18), and to be hospitalized for COVID-19 (at 15th day: OR 1.38, 95%CI 1.29-1.48). The presence of comorbidities and of symptoms were associate with the non negativization at 15th day (respectively, class 4+: OR 1.29, 95%CI 1.08-1.56 and symptoms: OR 1.20, 95%CI 1.13-1.27), but not at 45th day. Conclusions: older age, female gender, presence of comorbidities and severity of disease (proxy hospitalization for COVID-19) were risk factors for non negativization at all times intervals. The presence of symptoms was a risk factors for the non negativization after 2 weeks from the first diagnosis and not at 45th day. Using a longitudinal model for the analysis of the dataset, it is possible to compare the weight of the variables included in the model at different times and correct an overestimation of the attributable risk after the first considered time interval.
MeSH term(s)	Aged ; COVID-19 ; Cohort Studies ; Female ; Hospitalization ; Humans ; Italy/epidemiology ; SARS-CoV-2
Language	English
Publishing date	2022-01-10
Publishing country	Italy
Document type	Journal Article ; Observational Study
ZDB-ID	1038112-0
ISSN	1120-9763
ISSN	1120-9763
DOI	10.19191/EP21.6.141
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Article ; Online: Comparison of Reverse Triage with National Early Warning Score, Sequential Organ Failure Assessment and Charlson Comorbidity Index to classify medical inpatients of an Italian II level hospital according to their resource's need.

Caramello, Valeria / Marulli, Giulia / Reimondo, Giuseppe / Fanto', Fausto / Boccuzzi, Adriana

Internal and emergency medicine

2019 Volume 14, Issue 7, Page(s) 1073–1082

Abstract: Resource allocation in our overcrowded hospitals would require classification of inpatients according to the severity of illness, the evolving risk and the clinical complexity. Reverse triage (RT) is a method used in disasters to identify inpatients ... ...

Abstract	Resource allocation in our overcrowded hospitals would require classification of inpatients according to the severity of illness, the evolving risk and the clinical complexity. Reverse triage (RT) is a method used in disasters to identify inpatients according to their use of hospital resources. The aim of this observational prospective study is to evaluate the use of RT in medical inpatients of an Italian Hospital and to compare the RT score with National Early Warning Score, Sequential Organ Failure Assessment and Charlson Comorbidity Index. Cluster sampling was performed on high dependency unit (HDU), geriatrics (Ger) and internal medicine (IM) wards. We calculate RT, NEWS, SOFA and CCI from inpatient charts. Length of stay (LOS), transfer to a higher level of care, death and discharge date were collected after 30 days. We obtained demographics, comorbidities, severity and clinical complexity of 260 inpatients. We highlighted differences in NEWS, SOFA and CCI in the three divisions. On the contrary RT score was uniformly high (median 7), with 85% of patients with RT = 8. NEWS, SOFA and CCI were higher in patients with higher RT score. We used the sum of the interventions listed by RT (RT sum) as a proxy of the level of care needed. RT-sum showed moderate correlation with NEWS (r = 0.52 Spearman, p < 0.001). RT-sum was the highest in HDU, related to the evolving severity of HDU patients. Ger patients that showed the highest CCI score (with all patients in the CCI ≥ 3 category) had the second highest RT-sum. RT score showed similar values in the majority of the inpatients regardless of differences in NEWS, SOFA and CCI in different ward subgroups. RT-sum is related both to evolving severity (NEWS) and to clinical complexity (CCI). RT and NEWS could predict inpatient level of care and resource need associated with CCI.
MeSH term(s)	Aged ; Comorbidity ; Early Warning Score ; Female ; Health Resources/classification ; Humans ; Inpatients/classification ; Italy ; Male ; Middle Aged ; Organ Dysfunction Scores ; Patient Acuity ; Severity of Illness Index ; Triage/methods ; Triage/trends
Language	English
Publishing date	2019-02-18
Publishing country	Italy
Document type	Journal Article
ZDB-ID	2454173-4
ISSN	1970-9366 ; 1828-0447
ISSN (online)	1970-9366
ISSN	1828-0447
DOI	10.1007/s11739-019-02049-9
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Article ; Online: A Novel Loss-of-Function

Paganoni, Alyssa J J / Amoruso, Federica / Porta Pelayo, Javier / Calleja-Pérez, Beatriz / Vezzoli, Valeria / Duminuco, Paolo / Caramello, Alessia / Oleari, Roberto / Fernández-Jaén, Alberto / Cariboni, Anna

International journal of molecular sciences

2022 Volume 23, Issue 10

Abstract: Intellectual disability (ID) is a neurological disorder arising from early neurodevelopmental defects. The underlying genetic and molecular mechanisms are complex, but are thought to involve, among others, alterations in genes implicated in axon guidance ...

Abstract	Intellectual disability (ID) is a neurological disorder arising from early neurodevelopmental defects. The underlying genetic and molecular mechanisms are complex, but are thought to involve, among others, alterations in genes implicated in axon guidance and/or neural circuit formation as demonstrated by studies on mouse models. Here, by combining exome sequencing with in silico analyses, we identified a patient affected by severe ID and cognitive regression, carrying a novel loss-of-function variant in the semaphorin 3E (
MeSH term(s)	Animals ; Cognition ; Humans ; Intellectual Disability/genetics ; Mice ; Mutation ; Semaphorins/genetics ; Semaphorins/metabolism ; Signal Transduction/physiology
Chemical Substances	SEMA3E protein, human ; Sema3e protein, mouse ; Semaphorins
Language	English
Publishing date	2022-05-18
Publishing country	Switzerland
Document type	Case Reports ; Journal Article
ZDB-ID	2019364-6
ISSN	1422-0067 ; 1422-0067 ; 1661-6596
ISSN (online)	1422-0067
ISSN	1422-0067 ; 1661-6596
DOI	10.3390/ijms23105632
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Article ; Online: Multimorbidity and SARS-CoV-2-Related Outcomes: Analysis of a Cohort of Italian Patients.

Catalano, Alberto / Dansero, Lucia / Gilcrease, Winston / Macciotta, Alessandra / Saugo, Carlo / Manfredi, Luca / Gnavi, Roberto / Strippoli, Elena / Zengarini, Nicolás / Caramello, Valeria / Costa, Giuseppe / Sacerdote, Carlotta / Ricceri, Fulvio

JMIR public health and surveillance

2023 Volume 9, Page(s) e41404

Abstract: Background: Since the outbreak of the COVID-19 pandemic, identifying the main risk factors has been imperative to properly manage the public health challenges that the pandemic exposes, such as organizing effective vaccination campaigns. In addition to ... ...

Abstract	Background: Since the outbreak of the COVID-19 pandemic, identifying the main risk factors has been imperative to properly manage the public health challenges that the pandemic exposes, such as organizing effective vaccination campaigns. In addition to gender and age, multimorbidity seems to be 1 of the predisposing factors coming out of many studies investigating the possible causes of increased susceptibility to SARS-CoV-2 infection and adverse outcomes. However, only a few studies conducted have used large samples. Objective: The objective is to evaluate the association between multimorbidity, the probability to be tested, susceptibility, and the severity of SARS-CoV-2 infection in the Piedmont population (Northern Italy, about 4 million inhabitants). For this purpose, we considered 5 main outcomes: access to the swab, positivity to SARS-CoV-2, hospitalization, intensive care unit (ICU) admission, and death within 30 days from the first positive swab. Methods: Data were obtained from different Piedmont health administrative databases. Subjects aged from 45 to 74 years and infections diagnosed from February to May 2020 were considered. Multimorbidity was defined both with the Charlson Comorbidity Index (CCI) and by identifying patients with previous comorbidities, such as diabetes and oncological, cardiovascular, and respiratory diseases. Multivariable logistic regression models (adjusted for age and month of infection and stratified by gender) were performed for each outcome. Analyses were also conducted by separating 2 age groups (45-59 and 60-74 years). Results: Of 1,918,549 subjects, 85,348 (4.4%) performed at least 1 swab, of whom 12,793 (14.9%) tested positive for SARS-CoV-2. Of these 12,793 subjects, 4644 (36.3%) were hospitalized, 1508 (11.8%) were admitted to the ICU, and 749 (5.9%) died within 30 days from the first positive swab. Individuals with a higher CCI had a higher probability of being swabbed but a lower probability of testing positive. We observed the same results when analyzing subjects with previous oncological and cardiovascular diseases. Moreover, especially in the youngest group, we identified a greater risk of being hospitalized and dying. Among comorbidities considered in the study, respiratory diseases seemed to be the most likely to increase the risk of having a positive swab and worse disease outcomes. Conclusions: Our study shows that patients with multimorbidity, although swabbed more frequently, are less likely to get infected with SARS-CoV-2, probably due to greater attention on protective methods. Moreover, a history of respiratory diseases is a risk factor for a worse prognosis of COVID-19. Nonetheless, whatever comorbidities affect the patients, a strong dose-response effect was observed between an increased CCI score and COVID-19 hospitalization, ICU admission, and death. These results are important in terms of public health because they help in identifying a group of subjects who are more prone to worse SARS-CoV-2 outcomes. This information is important for promoting targeted prevention and developing policies for the prioritization of public health interventions.
MeSH term(s)	Humans ; Middle Aged ; Aged ; SARS-CoV-2 ; COVID-19/epidemiology ; Multimorbidity ; Pandemics ; Comorbidity
Language	English
Publishing date	2023-02-09
Publishing country	Canada
Document type	Journal Article
ISSN	2369-2960
ISSN (online)	2369-2960
DOI	10.2196/41404
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Article ; Online: Improvements throughout the Three Waves of COVID-19 Pandemic

Valeria Caramello / Alberto Catalano / Alessandra Macciotta / Lucia Dansero / Carlotta Sacerdote / Giuseppe Costa / Franco Aprà / Aldo Tua / Adriana Boccuzzi / Fulvio Ricceri

Journal of Clinical Medicine, Vol 11, Iss 15, p

Results from 4 Million Inhabitants of North-West Italy

2022 Volume 4304

Abstract	At the very beginning of the European spread of SARS-CoV-2, Piedmont was one of the most affected regions in Italy, with a strong impact on healthcare organizations. In this study, we evaluated the characteristics and outcomes of the COVID-19 patients in an entire region during the first three pandemic waves, identifying similarities and differences in the SARS-CoV-2 epidemic’s timeline. We collected the health-administrative data of all the Piedmont COVID-19 patients infected during the first three pandemic waves (1 March 2020–15 April 2020; 15 October 2020–15 December 2020; 1 March 2021–15 April 2021, respectively). We compared differences among the waves in subjects positive for SARS-CoV-2 and in patients admitted to ICU. Overall, 18.621 subjects tested positive during the first wave (405 patients/day), 144.350 (2366.4 patients/day) in the second, and 81.823 (1778.8 patients/day) in the third. In the second and third waves, we observed a reduction in median age, comorbidity burden, mortality in outpatients, inpatients, and patients admitted to ICU, in intubation, invasive ventilation and tracheostomy, and a parallel increase in the use of CPAP. Our study confirmed a trend towards younger and healthier patients over time but also showed an independent effect of the period on mortality and ICU admission. The appearance of new viral variants, the starting of vaccination, and organizational improvements in tracking, outpatients and inpatients management could have influenced these trends.
Keywords	SARS-CoV-2 ; mortality ; intensive care units ; patients ; comorbidity ; epidemiology ; Medicine ; R
Subject code	610
Language	English
Publishing date	2022-07-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
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Article ; Online: Are antigenic tests useful for detecting SARS-CoV-2 infections in patients accessing to emergency departments? Results from a North-West Italy hospital.

Caramello, Valeria / Boccuzzi, Adriana / Basile, Vittoria / Ferraro, Anita / Macciotta, Alessandra / Catalano, Alberto / Costa, Giuseppe / Vineis, Paolo / Sacerdote, Carlotta / Ricceri, Fulvio

The Journal of infection

2021 Volume 83, Issue 2, Page(s) 237–279

MeSH term(s)	COVID-19 ; Emergency Service, Hospital ; Hospitals ; Humans ; Italy/epidemiology ; SARS-CoV-2
Language	English
Publishing date	2021-05-21
Publishing country	England
Document type	Letter ; Comment
ZDB-ID	424417-5
ISSN	1532-2742 ; 0163-4453
ISSN (online)	1532-2742
ISSN	0163-4453
DOI	10.1016/j.jinf.2021.05.012
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Article ; Online: Inpatient disposition in overcrowded hospitals: is it safe and effective to use reverse triage and readmission screening tools for appropriate discharge? An observational prospective study of an Italian II level hospital.

Caramello, Valeria / Marulli, Giulia / Reimondo, Giuseppe / Fanto', Fausto / Boccuzzi, Adriana

International journal of clinical practice

2018 , Page(s) e13281

Abstract: Background: Reverse triage (RT) identifies patients eligible for discharge and have been proposed to cope with daily surge. Nevertheless, early discharge could increase the rate of readmission. Our aim is to test the effectiveness and safety of RT alone ...

Abstract	Background: Reverse triage (RT) identifies patients eligible for discharge and have been proposed to cope with daily surge. Nevertheless, early discharge could increase the rate of readmission. Our aim is to test the effectiveness and safety of RT alone and with readmission screening tools (Identification Senior At Risk [ISAR], HOSPITAL, and Groeningen Frailty Index [GFI] scores) to predict appropriate discharge. Material and methods: We prospectively assessed every 4 days (t Results: Twenty-five (9.6%) out of 260 patients in our sample had an RT ≤3. Twenty-four (96%) of them compared with 205 (87%) of the RT >3 group (P = NS) were discharged. Patients with RT ≤3 were discharged significantly earlier (3.5 vs 8 days after t Conclusions: Reverse triage proved to be a safe and conservative tool, with high specificity alone and with readmission screening tools. RT correctly identifies patients that will be discharged earlier.
Language	English
Publishing date	2018-10-04
Publishing country	India
Document type	Journal Article
ZDB-ID	1386246-7
ISSN	1742-1241 ; 1368-5031
ISSN (online)	1742-1241
ISSN	1368-5031
DOI	10.1111/ijcp.13281
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