Coronavirus in Campania, nobody in resuscitation for two weeks


The epidemic from Sars Cov-2 in Campania as in other regions it is gradually shutting down. The new cases are mostly asymptomatic and those few in hospital recover in a few days without ever landing in resuscitation. Even the increasingly rarefied deaths reported cases 50 days ago. In total in Campania 286 Covid patients are hospitalized with symptoms out of a total of 1184 positive. Few use the oxygen mask (5 or 6 al Cotugno including 2 oncology). Only 5 patients in intensive care (1 in Cotugno, transferred from Ruggi), 2 in Loreto, 1 in Ischia and 1 in Maddaloni) all following the first epidemic wave. No one at the Covid center of the seaside hospital where there are only 2 hospitalized. Of the 247 new cases registered since May 4, 90 percent are asymptomatic young patients (20 to 40 years of age) followed at home by Usca doctors. Few have mild symptoms (a few coughs, sneezing, vague intestinal problems, a few tenths of a fever). The home care protocol is based on hydroxychloroquine, an antibiotic, low molecular weight heparin, other symptoms, including some anti-inflammatories. As symptoms and fever persist (over 38), hospitalization starts (10 percent of those infected) but the course in the hospital is also benign (subject to comorbidities).

“At the moment there is no pathology – he confirms Enzo Schiavo, family doctor at the ASL Napoli 3 – not even in the home form. We learned about the stop to WHO testing of hydroxychloroquine after a study published in Lancet on thousands of patients. Certainly we will have to better evaluate the use of this drug especially compared to cardiological checks “. “Many of our patients – he adds Pina Tommasielli, Soccavo study – they ask to take the serological test privately and we prescribe them. In the case of positivity to IgG, IgM or both, there is an obligation to perform the swab. In order not to fall into quarantine, many go directly to the Cotugno tent or to the Fast Track of the hospital of the sea where it is possible to carry out the nasopharyngeal sampling. The Usca are also mobilized: today 100 swabs booked among the serological positive will be delivered at home ».

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“There are new cases but in small numbers – he explains Rodolfo Punzi, director of the Cotugno infectious emergency department – between yesterday and today we have hospitalized 3 new patients, around the hospital there are about sixty patients, 3 in intensive care, one transferred from Ruggi di Salerno for over a month in intensive care and two others negativizzati. Aside from the reduced numbers, the new cases emerge with a non-dramatic clinical picture. Today, patients already at risk for other pathologies are at risk. In therapy we will have to review some protocols in particular for the use of hydroxychloroquine which seems to worsen the mortality data. We keep a few patients in intensive diving because it is a new pavilion with single rooms. Dramatic cases that ended in resuscitation in 24 hours are now completely absent ». Among Campania clinicians there is also discussion of the data that arrives from Brescia where a mutant strain of Coronavirus would have been isolated which causes a less serious disease.

A review is also underway on the therapy front. antiviral Kaletra it does not change the outcome of the disease and has been set aside while the Remdesivir already used against Ebola. All empirical therapies for which there is no certainty. Me too’ hydroxychloroquine it does not seem to change the final outcome of the disease in hospital use, indeed some sudden deaths increase. To be verified a use in prophylaxis as recommended to the US President Trump by his medical staff and suggested by some doctors on the web. Instead they resist in the clinic cortisone and heparin low molecular weight, the latter capable of preventing thromboembolism. On the use of plasma work in progress at Cotugno: the first 8 batches of plasma must be sent to Spallanzani for the dosage of neutralizing antibodies. Promising the Tocilizumab of which more in-depth double-blind studies are expected (one takes the drug and another patient does not) today more complex precisely due to the lack of serious cases.
Last update: 07:00 © RESERVED REPRODUCTION

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