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Article ; Online: Alterations in the Expression of IFN Lambda, IFN Gamma and Toll-like Receptors in Severe COVID-19 Patients

Leonardo Sorrentino / Matteo Fracella / Federica Frasca / Alessandra D’Auria / Letizia Santinelli / Luca Maddaloni / Ginevra Bugani / Camilla Bitossi / Massimo Gentile / Giancarlo Ceccarelli / Ombretta Turriziani / Claudio Maria Mastroianni / Guido Antonelli / Gabriella d’Ettorre / Alessandra Pierangeli / Carolina Scagnolari

Microorganisms, Vol 11, Iss 689, p

2023 Volume 689

Abstract: Contradictory results have been reported regarding interferon (IFN) lambda (λ1–3) and IFN gamma (γ) production in COVID-19 patients. To gain insight into the roles played by these IFNs in SARS-CoV-2 infection, IFNλ1–3 and IFNγ mRNA expression was ... ...

Abstract	Contradictory results have been reported regarding interferon (IFN) lambda (λ1–3) and IFN gamma (γ) production in COVID-19 patients. To gain insight into the roles played by these IFNs in SARS-CoV-2 infection, IFNλ1–3 and IFNγ mRNA expression was evaluated in peripheral blood mononuclear cells (PBMCs) ( n = 32) and in cells of paired bronchoalveolar lavages (BALs) ( n = 12). Lower IFNλ1–3 values ( p < 0.001 for IFNλ1 and 3 and p = 0.013 for IFNλ2) in the PBMCs of severely ill patients were found compared to healthy donors ( n = 15). Reduced levels of IFNγ were also detected in patients’ PBMCs ( p < 0.01) and BALs ( p = 0.041) compared to healthy donors. The presence of secondary bacterial infections was associated with decreased IFNλ amounts in PBMCs ( p = 0.001, p = 0.015 and p = 0.003, respectively) but increased concentrations of IFNλ3 ( p = 0.022) in BALs. Patients with alterations in C-reactive protein, lactate dehydrogenase and D-dimer levels had decreased IFNλ1 and 3 ( p = 0.003 and p < 0.001) and increased IFNγ ( p = 0.08) in PBMCs. Analyzing Toll-like receptors (TLRs) involved in IFN production, we found that TLR3 was highly expressed ( p = 0.033) in patients with bacterial superinfections, while TLR7 and 8 ( p = 0.029 and p = 0.049) were reduced in BALs of deceased patients. Overall, severe COVID-19 might be characterized by dysregulation in IFNγ, IFNλ and TLR3, 7 and 8 production.
Keywords	interferon ; COVID-19 ; immunology ; Biology (General) ; QH301-705.5
Subject code	610
Language	English
Publishing date	2023-03-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: The Interplay between Host Defense, Infection, and Clinical Status in Septic Patients

Alessandro Lazzaro / Gabriella De Girolamo / Valeria Filippi / Giuseppe Pietro Innocenti / Letizia Santinelli / Giancarlo Ceccarelli / Enrico Maria Trecarichi / Carlo Torti / Claudio Maria Mastroianni / Gabriella d’Ettorre / Alessandro Russo

International Journal of Molecular Sciences, Vol 23, Iss 803, p

A Narrative Review

2022 Volume 803

Abstract: Sepsis is a life-threatening condition that arises when the body’s response to an infection injures its own tissues and organs. Despite significant morbidity and mortality throughout the world, its pathogenesis and mechanisms are not clearly understood. ... ...

Abstract	Sepsis is a life-threatening condition that arises when the body’s response to an infection injures its own tissues and organs. Despite significant morbidity and mortality throughout the world, its pathogenesis and mechanisms are not clearly understood. In this narrative review, we aimed to summarize the recent developments in our understanding of the hallmarks of sepsis pathogenesis (immune and adaptive immune response, the complement system, the endothelial disfunction, and autophagy) and highlight novel laboratory diagnostic approaches. Clinical management is also discussed with pivotal consideration for antimicrobic therapy management in particular settings, such as intensive care unit, altered renal function, obesity, and burn patients.
Keywords	sepsis ; pathogenesis ; management ; diagnosis ; antibiotic therapy ; Biology (General) ; QH301-705.5 ; Chemistry ; QD1-999
Language	English
Publishing date	2022-01-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Distribution of Interferon Lambda 4 Single Nucleotide Polymorphism rs11322783 Genotypes in Patients with COVID-19

Leonardo Sorrentino / Valentina Silvestri / Giuseppe Oliveto / Mirko Scordio / Federica Frasca / Matteo Fracella / Camilla Bitossi / Alessandra D’Auria / Letizia Santinelli / Lucia Gabriele / Alessandra Pierangeli / Claudio Maria Mastroianni / Gabriella d’Ettorre / Guido Antonelli / Antonio Caruz / Laura Ottini / Carolina Scagnolari

Microorganisms, Vol 10, Iss 363, p

2022 Volume 363

Abstract: Type III interferons (IFN-III), also known as IFN-Lambda, have a pivotal role during SARS-CoV-2 infection. IFN-Lambda response among individuals is heterogeneous and its association with COVID-19 symptoms severity needs to be further clarified. We ... ...

Abstract	Type III interferons (IFN-III), also known as IFN-Lambda, have a pivotal role during SARS-CoV-2 infection. IFN-Lambda response among individuals is heterogeneous and its association with COVID-19 symptoms severity needs to be further clarified. We analyzed the genotype frequencies of IFNL4 single nucleotide polymorphism (SNP) rs11322783 in patients with COVID-19 ( n = 128), in comparison with a validated data set of European healthy controls ( n = 14152). The IFNL4 SNP was also analyzed according to the haematological and clinical parameters of patients with COVID-19. The distributions of IFNL4 genotypes among SARS-CoV-2 positive patients [TT/TT 41.4% ( n = 53), TT/ΔG 47.7% ( n = 61) and ΔG/ΔG 10.9% ( n = 14)] and healthy controls were comparable. Different levels of white blood cells ( p = 0.036) and neutrophils ( p = 0.042) were found in the IFNL4 different genotypes in patients with COVID-19; the ΔG/ΔG genotype was more represented in the groups with low white blood cells and neutrophils. There were no differences in major inflammation parameters (C-reactive protein, D-dimer, Albumin, and Lactate-dehydrogenase (LDH)] and survival rate according to the IFNL4 genotypes. In conclusion, although patients with COVID-19 did not exhibit a different distribution of the IFNL4 SNP, the ΔG/ΔG genotype was associated with a lower count of immune cell populations. These findings need to be confirmed in larger groups of patients with COVID-19 and the role of IFNL4 SNP needs to be also investigated in other respiratory viral infections.
Keywords	COVID-19 ; IFN-Lambda4 ; single nucleotide polymorphism ; rs11322783 ; Biology (General) ; QH301-705.5
Subject code	610
Language	English
Publishing date	2022-02-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Cellular Immune Profiling of Lung and Blood Compartments in Patients with SARS-CoV-2 Infection

Pathogens, Vol 12, Iss 442, p

2023 Volume 442

Abstract: Background: SARS-CoV-2 related immunopathology may be the driving cause underlying severe COVID-19. Through an immunophenotyping analysis on paired bronchoalveolar lavage fluid (BALF) and blood samples collected from mechanically ventilated patients with ...

Abstract	Background: SARS-CoV-2 related immunopathology may be the driving cause underlying severe COVID-19. Through an immunophenotyping analysis on paired bronchoalveolar lavage fluid (BALF) and blood samples collected from mechanically ventilated patients with COVID-19-associated Acute Respiratory Distress Syndrome (CARDS), this study aimed to evaluate the cellular immune responses in survivors and non-survivors of COVID-19. Methods: A total of 36 paired clinical samples of bronchoalveolar lavage fluid (BALF) mononuclear cells (BALF-MC) and peripheral blood mononuclear cells (PBMC) were collected from 18 SARS-CoV-2-infected subjects admitted to the intensive care unit (ICU) of the Policlinico Umberto I, Sapienza University Hospital in Rome (Italy) for severe interstitial pneumonia. The frequencies of monocytes (total, classical, intermediate and non-classical) and Natural Killer (NK) cell subsets (total, CD56 bright and CD56 dim ), as well as CD4 + and CD8 + T cell subsets [naïve, central memory (TCM) and effector memory (TEM)], and those expressing CD38 and/or HLADR were evaluated by multiparametric flow cytometry. Results: Survivors with CARDS exhibited higher frequencies of classical monocytes in blood compared to non-survivors ( p < 0.05), while no differences in the frequencies of the other monocytes, NK cell and T cell subsets were recorded between these two groups of patients ( p > 0.05). The only exception was for peripheral naïve CD4 + T cells levels that were reduced in non-survivors ( p = 0.04). An increase in the levels of CD56 bright ( p = 0.012) and a decrease in CD56 dim ( p = 0.002) NK cell frequencies was also observed in BALF-MC samples compared to PBMC in deceased COVID-19 patients. Total CD4 + and CD8 + T cell levels in the lung compartment were lower compared to blood ( p = 0.002 and p < 0.01, respectively) among non-survivors. Moreover, CD38 and HLA-DR were differentially expressed by CD4 + and CD8 + T cell subsets in BALF-MC and in PBMC among SARS-CoV-2-infected patients who died from ...
Keywords	BALF ; PBMC ; SARS-CoV-2 ; cellular immune profile ; severe COVID-19 ; Medicine ; R
Subject code	333 ; 610
Language	English
Publishing date	2023-03-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Clinical Effects of Oral Bacteriotherapy on Anal HPV Infection and Related Dysplasia in HIV-Positive MSM

Eugenio Nelson Cavallari / Giancarlo Ceccarelli / Letizia Santinelli / Giuseppe Pietro Innocenti / Gabriella De Girolamo / Cristian Borrazzo / Ornella Spagnolello / Carolina Scagnolari / Stefano Arcieri / Antonio Ciardi / Alessandra Pierangeli / Claudio Maria Mastroianni / Gabriella d’Ettorre

Biomedicines, Vol 9, Iss 1738, p

Results from the “HPVinHIV” Trial

2021 Volume 1738

Abstract: Background. Anal HPV infection, anal dysplasia and, ultimately, anal cancer are particularly common in HIV-infected men who have sex with men. Treatment of anal dysplasia, aiming to prevent evolution to squamous cell carcinoma of the anus, is currently ... ...

Abstract	Background. Anal HPV infection, anal dysplasia and, ultimately, anal cancer are particularly common in HIV-infected men who have sex with men. Treatment of anal dysplasia, aiming to prevent evolution to squamous cell carcinoma of the anus, is currently limited to direct ablation and/or application of topical therapy. The aim of the present study is to investigate the effect of oral bacteriotherapy (Vivomixx® in EU, Visbiome® in USA) on anal HPV infection and HPV-related dysplasia of the anal canal in HIV-infected men who have sex with men. Methods. In this randomized, placebo-controlled, quadruple-blinded trial (NCT04099433), HIV-positive men who have sex with men with anal HPV infection and HPV-related dysplasia were randomized to receive oral bacteriotherapy or placebo for 6 months. Anal HPV test, anal cytology and high resolution anoscopy with biopsies of anal lesions were performed at baseline and at the end of the study. Safety and tolerability of oral bacteriotherapy were also evaluated. Interim analysis results were presented. Results. 20 participants concluded the study procedures to date. No serious adverse events were reported. In respect to participants randomized to placebo, individuals in the experimental arm showed higher rate of anal dysplasia regression ( p = 0.002), lower rate of onset of new anal dysplasia ( p = 0.023) and lower rates of worsening of persistent lesions ( p = 0.004). Clearance of anal HPV infection was more frequently observed in the bacteriotherapy group ( p = 0.067). Conclusion. Being an interim analysis, we limit ourselves to report the preliminary results of the current study. We refer the conclusions relating to the possible effectiveness of the intervention to the analysis of the definitive data.
Keywords	HPV ; HIV ; MSM ; anal dysplasia ; probiotics ; oral bacteriotherapy ; Biology (General) ; QH301-705.5
Subject code	610
Language	English
Publishing date	2021-11-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Post-Traumatic Stress Symptoms in Healthcare Workers Dealing with the COVID-19 Pandemic

Gabriele d’Ettorre / Giancarlo Ceccarelli / Letizia Santinelli / Paolo Vassalini / Giuseppe Pietro Innocenti / Francesco Alessandri / Alexia E. Koukopoulos / Alessandro Russo / Gabriella d’Ettorre / Lorenzo Tarsitani

International Journal of Environmental Research and Public Health, Vol 18, Iss 601, p

A Systematic Review

2021 Volume 601

Abstract: Prevention of post-traumatic stress symptoms (PTSS) in healthcare workers (HCWs) facing the current COVID-19 pandemic is a challenge worldwide as HCWs are likely to experience acute and chronic, often unpredictable, occupational stressors leading to PTSS. ...

Abstract	Prevention of post-traumatic stress symptoms (PTSS) in healthcare workers (HCWs) facing the current COVID-19 pandemic is a challenge worldwide as HCWs are likely to experience acute and chronic, often unpredictable, occupational stressors leading to PTSS. This review aims to analyze the literature to discover which topics have been focused on and what the latest developments are in managing the occupational risk of PTSS in HCWs during the current pandemic. For the purpose of this review, we searched for publications in MEDLINE/Pubmed using selected keywords. The articles were reviewed and categorized into one or more of the following categories based on their subject matter: risk assessment, risk management, occurrence rates. A total of 16 publications matched our inclusion criteria. The topics discussed were: “Risk Assessment”, “Occurrence Rates”, and “Risk Management”. Young age, low work experience, female gender, heavy workload, working in unsafe settings, and lack of training and social support were found to be predictors of PTSS. This review’s findings showed the need for urgent interventions aimed at protecting HCWs from the psychological impact of traumatic events related to the pandemic and leading to PTSS; healthcare policies need to consider preventive and management strategies toward PTSS, and the related psychic sequelae, in HCWs.
Keywords	post-traumatic stress disorder ; PTSD ; COVID-19 ; healthcare worker ; risk assessment ; risk management ; Medicine ; R
Subject code	150
Language	English
Publishing date	2021-01-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Unexpected increase of myocardial extracellular volume fraction in low cardiovascular risk HIV patients

Cristian Borrazzo / Gabriella d’Ettorre / Giancarlo Ceccarelli / Massimiliano Pacilio / Letizia Santinelli / Eugenio Nelson Cavallari / Ornella Spagnolello / Valeria Silvestri / Paolo Vassalini / Carolina Scagnolari / Marco Francone / Claudio Maria Mastroianni / Iacopo Carbone

Translational Medicine Communications, Vol 5, Iss 1, Pp 1-

2020 Volume 9

Abstract: Abstract Background People living with HIV (PLWH) are prone to develop sub-clinical Cardiovascular (CV) disease, despite the effectiveness of combined Antiretroviral Therapy (cART). Algorithms developed to predict CV risk in the general population could ... ...

Abstract	Abstract Background People living with HIV (PLWH) are prone to develop sub-clinical Cardiovascular (CV) disease, despite the effectiveness of combined Antiretroviral Therapy (cART). Algorithms developed to predict CV risk in the general population could be inaccurate when applied to PLWH. Myocardial Extra-Cellular Matrix (ECM) expansion, measured by computed tomography, has been associated with an increased CV vulnerability in HIV-negative population. Measurement of Myocardial Extra-Cellular Volume (ECV) by computed tomography or magnetic resonance, is considered a useful surrogate for clinical evaluation of ECM expansion. In the present study, we aimed to determine the extent of cardiovascular involvement in asymptomatic HIV-infected patients with the use of a comprehensive cardiac computed tomography (CCT) approach. Materials and methods In the present study, ECV in low atherosclerotic CV risk PLWH was compared with ECV of age and gender matched HIV- individuals. 53 asymptomatic HIV + individuals (45 males, age 48 (42.5–48) years) on effective cART (CD4 + cell count: 450 cells/µL (IQR: 328–750); plasma HIV RNA: <37 copies/ml in all subjects) and 18 age and gender matched controls (14 males, age 55 (44.5–56) years) were retrospectively enrolled. All participants underwent CCT protocol to obtain native and postcontrast Hounsfield unit values of blood and myocardium, ECM was calculated accordingly. Results The ECV was significantly higher in HIV + patients than in the control group (ECV: 31% (IQR: 28%-31%) vs. 27.4% (IQR: 25%-28%), p < 0.001). The duration of cART (standardized β = 0.56 (0.33–0.95), p = 0.014) and the years of exposure to HIV infection (standardized β = 0.53 (0.4–0.92), p < 0.001), were positively and strongly associated with ECV values. Differences in ECV (p < 0.001) were also observed regarding the duration of cART exposure (< 5 years, 5–10 years and > 10 years). Moreover, ECV was independently associated with age of participants (standardized β = 0.42 (0.33–0.89), p = 0.084). ...
Keywords	ECV ; CV risk ; CCT ; Medicine ; R
Subject code	610
Language	English
Publishing date	2020-11-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
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Article ; Online: Sex-related differences in markers of immune activation in virologically suppressed HIV-infected patients

Letizia Santinelli / Giancarlo Ceccarelli / Cristian Borrazzo / Giuseppe Pietro Innocenti / Federica Frasca / Eugenio Nelson Cavallari / Luigi Celani / Chiara Nonne / Claudio Maria Mastroianni / Gabriella d’Ettorre

Biology of Sex Differences, Vol 11, Iss 1, Pp 1-

2020 Volume 11

Abstract: Abstract Objectives Gender-specific studies remain a neglected area of biomedical research. Recent reports have emphasized that sex-related biological factors may affect disease progression during HIV-1 infection. The aim of this study was to investigate ...

Abstract	Abstract Objectives Gender-specific studies remain a neglected area of biomedical research. Recent reports have emphasized that sex-related biological factors may affect disease progression during HIV-1 infection. The aim of this study was to investigate the influence of sex on the levels of immune activation in the gut and in peripheral blood of individuals with HIV treated with fully suppressive antiretroviral therapy (ART). Methods Thirty individuals with HIV undergoing long-term fully suppressive ART were enrolled in this study. Lamina propria lymphocytes (LPL) and peripheral blood mononuclear cells (PBMCs) were isolated from gut biopsies collected by pancolonoscopy and peripheral blood samples. The expression of markers of immune activation was evaluated by multi-parametric flow cytometry. This is a sub analysis of ClinicalTrials.gov Identifier: NCT02276326 Results We observed differences in the levels of immune activation in the gut and in PBMCs, with values higher in the gut compartment compared to PBMCs. In addition, we found that the mean value of the levels of immune activation was higher in the women than in the men. Finally, we measured the markers of immune activation by mean relative difference (MRD) and confirmed the higher value in the women. Conclusion A significant sex-related difference in the level of immune activation was observed in a population of individuals with HIV on long-term ART. A more complete characterization of these differences may support the introduction of sex-specific approaches in the clinical management of individuals with HIV.
Keywords	HIV ; Sex ; Gut ; PBMC ; Immune activation ; Medicine ; R ; Physiology ; QP1-981
Subject code	610
Language	English
Publishing date	2020-05-01T00:00:00Z
Publisher	BMC
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Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Short-Term Probiotic Administration Increases Fecal-Anti Candida Activity in Healthy Subjects

Massimiliano De Angelis / Carolina Scagnolari / Alessandra Oliva / Eugenio Nelson Cavallari / Luigi Celani / Letizia Santinelli / Giuseppe Pietro Innocenti / Cristian Borrazzo / Giancarlo Ceccarelli / Vincenzo Vullo / Gabriella d’Ettorre

Microorganisms, Vol 7, Iss 6, p

2019 Volume 162

Abstract: Background: Candida albicans ’ ability to evade host immune responses represents a serious threat for vulnerable patients. Objectives: To investigate if (1) feces from healthy subjects exert anti- Candida activity; (2) fecal anti- Candida activity is ... ...

Abstract	Background: Candida albicans ’ ability to evade host immune responses represents a serious threat for vulnerable patients. Objectives: To investigate if (1) feces from healthy subjects exert anti- Candida activity; (2) fecal anti- Candida activity is modified by probiotic administration and (3) different probiotic differently modulate anti- Candida activity. Patients and methods: Feces from healthy donors were analyzed before and after seven days of dietary supplementation with two different probiotic formulations (VSL#3 ® Vivomixx ® ). Candida albicans was cultured with decreasing concentrations of diluted feces, obtained before and after the treatment period. The relationship between anti- Candida activity of feces, interferon-α, anti-interferon-α antibodies and the expression of MxA, ISG15 and IFNAR1 was also evaluated. Results: Feces obtained prior to probiotic intake and feces collected after supplementation with VSL#3 ® did not affect Candida albicans growth. On the contrary, a 3log 10 inhibition of Candida development was observed after Vivomixx ® intake. Interferon-α played a role in the inhibition of Candida growth. Conclusion: Fecal anti- Candida activity was not observed prior to probiotic supplementation. Seven days of administration of Vivomixx ® increased fecal anti- Candida activity, the same effect was not observed after intake of VSL#3 ® . The probiotic-induced anti- Candida activity seems to be related to an increased local production and release of interferon-α. Clinical trials are needed to determine if a short pretreatment with specific probiotic formulations may increase anti- Candida defenses in patients at risk.
Keywords	Candida ; fecal water ; probiotics ; Vivomixx ® ; VSL#3 ® ; Biology (General) ; QH301-705.5
Subject code	333 ; 610
Language	English
Publishing date	2019-06-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Diet Supplementation, Probiotics, and Nutraceuticals in SARS-CoV-2 Infection

Fabio Infusino / Massimiliano Marazzato / Massimo Mancone / Francesco Fedele / Claudio Maria Mastroianni / Paolo Severino / Giancarlo Ceccarelli / Letizia Santinelli / Elena Cavarretta / Antonino G. M. Marullo / Fabio Miraldi / Roberto Carnevale / Cristina Nocella / Giuseppe Biondi-Zoccai / Cristiano Pagnini / Sonia Schiavon / Francesco Pugliese / Giacomo Frati / Gabriella d’Ettorre

Nutrients, Vol 12, Iss 1718, p

A Scoping Review

2020 Volume 1718

Abstract: The severe acute respiratory syndrome coronavirus 2 (Sars-CoV-2) global pandemic is a devastating event that is causing thousands of victims every day around the world. One of the main reasons of the great impact of coronavirus disease 2019 (COVID-19) on ...

Abstract	The severe acute respiratory syndrome coronavirus 2 (Sars-CoV-2) global pandemic is a devastating event that is causing thousands of victims every day around the world. One of the main reasons of the great impact of coronavirus disease 2019 (COVID-19) on society is its unexpected spread, which has not allowed an adequate preparation. The scientific community is fighting against time for the production of a vaccine, but it is difficult to place a safe and effective product on the market as fast as the virus is spreading. Similarly, for drugs that can directly interfere with viral pathways, their production times are long, despite the great efforts made. For these reasons, we analyzed the possible role of non-pharmacological substances such as supplements, probiotics, and nutraceuticals in reducing the risk of Sars-CoV-2 infection or mitigating the symptoms of COVID-19. These substances could have numerous advantages in the current circumstances, are generally easily available, and have negligible side effects if administered at the already used and tested dosages. Large scientific evidence supports the benefits that some bacterial and molecular products may exert on the immune response to respiratory viruses. These could also have a regulatory role in systemic inflammation or endothelial damage, which are two crucial aspects of COVID-19. However, there are no specific data available, and rigorous clinical trials should be conducted to confirm the putative benefits of diet supplementation, probiotics, and nutraceuticals in the current pandemic.
Keywords	supplementation ; probiotics ; nutraceuticals ; SARS-CoV-2 ; COVID-19 ; Nutrition. Foods and food supply ; TX341-641 ; covid19
Language	English
Publishing date	2020-06-01T00:00:00Z
Publisher	MDPI AG
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