Catholic University of the Sacred Heart

About: Catholic University of the Sacred Heart is a education organization based out in Milan, Lombardia, Italy. It is known for research contribution in the topics: Population & Medicine. The organization has 13592 authors who have published 31048 publications receiving 853961 citations.

COVID-19 and haemostasis: a position paper from Italian Society on Thrombosis and Haemostasis (SISET).

Abstract: Arrived: 05/04/2020 Accepted: 07/04/2020 Correspondence: Marco Marietta e-mail: marco.marietta@unimore.it 1Department of Oncology and Haematology, University Hospital, Modena; 2Department of Medicine and Surgery, “Insubria” University, Varese; 3IRCCS “Ca’ Granda Maggiore” Hospital Foundation, “Angelo Bianchi Bonomi” Haemophilia and Thrombosis Center and “Fondazione Luigi Villa”, Milan; 4Department of Medicine and Translational Surgery, “Università Cattolica del Sacro Cuore”, Faculty of Medicine and Surgery, Rome; 5Department of Diagnostic Imaging, Oncological Radiotherapy and Haematology, Foundation \"A. Gemelli\" IRCCS University Hospital, Rome; 6Department of Medicine, Section of Internal and Cardiovascular Medicine, University of Perugia, Perugia; 7Immunohematology and Transfusion Medicine Department, “ASST Papa Giovanni XXIII”, Bergamo; 8Department of Experimental and Clinical Medicine, “Careggi” University Hospital, University of Florence, Italy The ongoing pandemic of Coronavirus disease 2019 (COVID-19) is severely challenging healthcare systems all around the world, with the need to provide intensive care to a previously inconceivable number of patients. The clinical spectrum of the disease is very wide, ranging from minor, unspecific symptoms, such as fever, dry cough and diarrhoea, sometimes combined with mild pneumonia and mild dyspnoea, to severe pneumonia with dyspnoea, tachypnoea and disturbed gas exchange, leading in approximately 5% of infected patients to severe lung dysfunction, a need for ventilation, shock or multiple (extra pulmonary) organ failure1. Among the several clinical and biochemical parameters associated with poor prognosis, increased D-dimer levels have gained particular attention as a predictor of the development of acute respiratory distress syndrome (ARDS), the need for admission to an intensive care unit (ICU) or death1-5. On the other hand, disease severity also correlates with pro-inf lammatory cytokines (i.e., IL-2, IL6, IL-7, IL-10, G-CSF, IP-10, MCP-1, MIP-1A and TNF-α), although it is not yet clear what is the cause of such a cytokine storm6. These findings are consistent with the already demonstrated close connection between thrombosis and inf lammation7,8, two processes that mutually reinforce each other. Indeed, both coagulation factors (proand anti-coagulants)9-11 and platelets12-14 are directly implicated in the modulation of the host immune response, displaying proinf lammatory functions that are independent from their haemostatic effects. All the above issues have been instrumental in spreading the feeling that COVID-19 is associated with the classical syndrome named disseminated intravascular coagulation (DIC) and the subsequent consumption coagulopathy. Moreover, it has been shown that heparin, beside its anticoagulant effects, also displays an anti-inf lammatory action, various immunomodulatory properties, and protects glycocalyx from shedding15. It has also been suggested that dipyridamole, an antiplatelet drug with antiviral and antioxidant properties, has beneficial effects in patients with COVID-1916. Despite such a tight interconnection between inf lammation and haemostasis abnormalities, no good evidence is available of the efficacy/safety of heparin and/or antiplatelet agents on sepsis patients, and many issues remain to be addressed, such as the proper timing, dosages and administration scheme of antithrombotic drugs17-19. Nevertheless, very recent data showed that low molecular weight heparin (LMWH) or unfractionated heparin (UFH) at prophylactic doses are associated with a reduced 28-day mortality in more severe COVID-19 patients displaying a sepsis-induced coagulopathy (SIC) score ≥4 (40.0% vs 64.2%, p=0.029) or D-dimer levels >6-fold the upper limit of © SI MT IP RO Sr l

Genetic PTX3 Deficiency and Aspergillosis in Stem-Cell Transplantation

Abstract: Background The soluble pattern-recognition receptor known as long pentraxin 3 (PTX3) has a nonredundant role in antifungal immunity. The contribution of single-nucleotide polymorphisms (SNPs) in PTX3 to the development of invasive aspergillosis is unknown. Methods We screened an initial cohort of 268 patients undergoing hematopoietic stem-cell transplantation (HSCT) and their donors for PTX3 SNPs modifying the risk of invasive aspergillosis. The analysis was also performed in a multicenter study involving 107 patients with invasive aspergillosis and 223 matched controls. The functional consequences of PTX3 SNPs were investigated in vitro and in lung specimens from transplant recipients. Results Receipt of a transplant from a donor with a homozygous haplotype (h2/h2) in PTX3 was associated with an increased risk of infection, in both the discovery study (cumulative incidence, 37% vs. 15%; adjusted hazard ratio, 3.08; P=0.003) and the confirmation study (adjusted odds ratio, 2.78; P=0.03), as well as with d...