Challenges in the Management of SARS-CoV2 Infection: The Role of Oral Bacteriotherapy as Complementary Therapeutic Strategy to Avoid the Progression of COVID-19.
Identifieur interne : 001028 ( Main/Corpus ); précédent : 001027; suivant : 001029Challenges in the Management of SARS-CoV2 Infection: The Role of Oral Bacteriotherapy as Complementary Therapeutic Strategy to Avoid the Progression of COVID-19.
Auteurs : Gabriella D'Ettorre ; Giancarlo Ceccarelli ; Massimiliano Marazzato ; Giuseppe Campagna ; Claudia Pinacchio ; Francesco Alessandri ; Franco Ruberto ; Giacomo Rossi ; Luigi Celani ; Carolina Scagnolari ; Cristina Mastropietro ; Vito Trinchieri ; Gregorio Egidio Recchia ; Vera Mauro ; Guido Antonelli ; Francesco Pugliese ; Claudio Maria MastroianniSource :
- Frontiers in medicine [ 2296-858X ] ; 2020.
Abstract
Background: Gastrointestinal disorders are frequent in COVID-19 and SARS-CoV-2 has been hypothesized to impact on host microbial flora and gut inflammation, infecting intestinal epithelial cells. Since there are currently no coded therapies or guidelines for treatment of COVID-19, this study aimed to evaluate the possible role of a specific oral bacteriotherapy as complementary therapeutic strategy to avoid the progression of COVID-19. Methods: We provide a report of 70 patients positive for COVID-19, hospitalized between March 9th and April 4th, 2020. All the patients had fever, required non-invasive oxygen therapy and presented a CT lung involvement on imaging more than 50%. Forty-two patients received hydroxychloroquine, antibiotics, and tocilizumab, alone or in combination. A second group of 28 subjects received the same therapy added with oral bacteriotherapy, using a multistrain formulation. Results: The two cohorts of patients were comparable for age, sex, laboratory values, concomitant pathologies, and the modality of oxygen support. Within 72 h, nearly all patients treated with bacteriotherapy showed remission of diarrhea and other symptoms as compared to less than half of the not supplemented group. The estimated risk of developing respiratory failure was eight-fold lower in patients receiving oral bacteriotherapy. Both the prevalence of patients transferred to ICU and mortality were higher among the patients not treated with oral bacteriotherapy. Conclusions: A specific bacterial formulation showed a significant ameliorating impact on the clinical conditions of patients positive for SARS-CoV-2 infection. These results also stress the importance of the gut-lung axis in controlling the COVID-19 disease.
DOI: 10.3389/fmed.2020.00389
PubMed: 32733907
PubMed Central: PMC7358304
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Challenges in the Management of SARS-CoV2 Infection: The Role of Oral Bacteriotherapy as Complementary Therapeutic Strategy to Avoid the Progression of COVID-19.</title><author><name sortKey="D Ettorre, Gabriella" sort="D Ettorre, Gabriella" uniqKey="D Ettorre G" first="Gabriella" last="D'Ettorre">Gabriella D'Ettorre</name><affiliation><nlm:affiliation>Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Ceccarelli, Giancarlo" sort="Ceccarelli, Giancarlo" uniqKey="Ceccarelli G" first="Giancarlo" last="Ceccarelli">Giancarlo Ceccarelli</name><affiliation><nlm:affiliation>Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Marazzato, Massimiliano" sort="Marazzato, Massimiliano" uniqKey="Marazzato M" first="Massimiliano" last="Marazzato">Massimiliano Marazzato</name><affiliation><nlm:affiliation>Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Campagna, Giuseppe" sort="Campagna, Giuseppe" uniqKey="Campagna G" first="Giuseppe" last="Campagna">Giuseppe Campagna</name><affiliation><nlm:affiliation>Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Pinacchio, Claudia" sort="Pinacchio, Claudia" uniqKey="Pinacchio C" first="Claudia" last="Pinacchio">Claudia Pinacchio</name><affiliation><nlm:affiliation>Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Alessandri, Francesco" sort="Alessandri, Francesco" uniqKey="Alessandri F" first="Francesco" last="Alessandri">Francesco Alessandri</name><affiliation><nlm:affiliation>Department of Anesthesia and Intensive Care Medicine, Sapienza University of Rome, Rome, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Ruberto, Franco" sort="Ruberto, Franco" uniqKey="Ruberto F" first="Franco" last="Ruberto">Franco Ruberto</name><affiliation><nlm:affiliation>Department of Anesthesia and Intensive Care Medicine, Sapienza University of Rome, Rome, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Rossi, Giacomo" sort="Rossi, Giacomo" uniqKey="Rossi G" first="Giacomo" last="Rossi">Giacomo Rossi</name><affiliation><nlm:affiliation>School of Biosciences, Veterinary Medicine University of Camerino, Camerino, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Celani, Luigi" sort="Celani, Luigi" uniqKey="Celani L" first="Luigi" last="Celani">Luigi Celani</name><affiliation><nlm:affiliation>Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Scagnolari, Carolina" sort="Scagnolari, Carolina" uniqKey="Scagnolari C" first="Carolina" last="Scagnolari">Carolina Scagnolari</name><affiliation><nlm:affiliation>Laboratory of Virology, Department of Molecular Medicine, Affiliated to Istituto Pasteur Italia - Cenci Bolognetti Foundation, Sapienza University, Rome, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Mastropietro, Cristina" sort="Mastropietro, Cristina" uniqKey="Mastropietro C" first="Cristina" last="Mastropietro">Cristina Mastropietro</name><affiliation><nlm:affiliation>Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Trinchieri, Vito" sort="Trinchieri, Vito" uniqKey="Trinchieri V" first="Vito" last="Trinchieri">Vito Trinchieri</name><affiliation><nlm:affiliation>Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Recchia, Gregorio Egidio" sort="Recchia, Gregorio Egidio" uniqKey="Recchia G" first="Gregorio Egidio" last="Recchia">Gregorio Egidio Recchia</name><affiliation><nlm:affiliation>Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Mauro, Vera" sort="Mauro, Vera" uniqKey="Mauro V" first="Vera" last="Mauro">Vera Mauro</name><affiliation><nlm:affiliation>Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Antonelli, Guido" sort="Antonelli, Guido" uniqKey="Antonelli G" first="Guido" last="Antonelli">Guido Antonelli</name><affiliation><nlm:affiliation>Laboratory of Virology, Department of Molecular Medicine, Affiliated to Istituto Pasteur Italia - Cenci Bolognetti Foundation, Sapienza University, Rome, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Pugliese, Francesco" sort="Pugliese, Francesco" uniqKey="Pugliese F" first="Francesco" last="Pugliese">Francesco Pugliese</name><affiliation><nlm:affiliation>Department of Anesthesia and Intensive Care Medicine, Sapienza University of Rome, Rome, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Mastroianni, Claudio Maria" sort="Mastroianni, Claudio Maria" uniqKey="Mastroianni C" first="Claudio Maria" last="Mastroianni">Claudio Maria Mastroianni</name><affiliation><nlm:affiliation>Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.</nlm:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2020">2020</date><idno type="RBID">pubmed:32733907</idno><idno type="pmid">32733907</idno><idno type="doi">10.3389/fmed.2020.00389</idno><idno type="pmc">PMC7358304</idno><idno type="wicri:Area/Main/Corpus">001028</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">001028</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Challenges in the Management of SARS-CoV2 Infection: The Role of Oral Bacteriotherapy as Complementary Therapeutic Strategy to Avoid the Progression of COVID-19.</title><author><name sortKey="D Ettorre, Gabriella" sort="D Ettorre, Gabriella" uniqKey="D Ettorre G" first="Gabriella" last="D'Ettorre">Gabriella D'Ettorre</name><affiliation><nlm:affiliation>Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Ceccarelli, Giancarlo" sort="Ceccarelli, Giancarlo" uniqKey="Ceccarelli G" first="Giancarlo" last="Ceccarelli">Giancarlo Ceccarelli</name><affiliation><nlm:affiliation>Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Marazzato, Massimiliano" sort="Marazzato, Massimiliano" uniqKey="Marazzato M" first="Massimiliano" last="Marazzato">Massimiliano Marazzato</name><affiliation><nlm:affiliation>Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Campagna, Giuseppe" sort="Campagna, Giuseppe" uniqKey="Campagna G" first="Giuseppe" last="Campagna">Giuseppe Campagna</name><affiliation><nlm:affiliation>Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Pinacchio, Claudia" sort="Pinacchio, Claudia" uniqKey="Pinacchio C" first="Claudia" last="Pinacchio">Claudia Pinacchio</name><affiliation><nlm:affiliation>Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Alessandri, Francesco" sort="Alessandri, Francesco" uniqKey="Alessandri F" first="Francesco" last="Alessandri">Francesco Alessandri</name><affiliation><nlm:affiliation>Department of Anesthesia and Intensive Care Medicine, Sapienza University of Rome, Rome, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Ruberto, Franco" sort="Ruberto, Franco" uniqKey="Ruberto F" first="Franco" last="Ruberto">Franco Ruberto</name><affiliation><nlm:affiliation>Department of Anesthesia and Intensive Care Medicine, Sapienza University of Rome, Rome, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Rossi, Giacomo" sort="Rossi, Giacomo" uniqKey="Rossi G" first="Giacomo" last="Rossi">Giacomo Rossi</name><affiliation><nlm:affiliation>School of Biosciences, Veterinary Medicine University of Camerino, Camerino, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Celani, Luigi" sort="Celani, Luigi" uniqKey="Celani L" first="Luigi" last="Celani">Luigi Celani</name><affiliation><nlm:affiliation>Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Scagnolari, Carolina" sort="Scagnolari, Carolina" uniqKey="Scagnolari C" first="Carolina" last="Scagnolari">Carolina Scagnolari</name><affiliation><nlm:affiliation>Laboratory of Virology, Department of Molecular Medicine, Affiliated to Istituto Pasteur Italia - Cenci Bolognetti Foundation, Sapienza University, Rome, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Mastropietro, Cristina" sort="Mastropietro, Cristina" uniqKey="Mastropietro C" first="Cristina" last="Mastropietro">Cristina Mastropietro</name><affiliation><nlm:affiliation>Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Trinchieri, Vito" sort="Trinchieri, Vito" uniqKey="Trinchieri V" first="Vito" last="Trinchieri">Vito Trinchieri</name><affiliation><nlm:affiliation>Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Recchia, Gregorio Egidio" sort="Recchia, Gregorio Egidio" uniqKey="Recchia G" first="Gregorio Egidio" last="Recchia">Gregorio Egidio Recchia</name><affiliation><nlm:affiliation>Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Mauro, Vera" sort="Mauro, Vera" uniqKey="Mauro V" first="Vera" last="Mauro">Vera Mauro</name><affiliation><nlm:affiliation>Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Antonelli, Guido" sort="Antonelli, Guido" uniqKey="Antonelli G" first="Guido" last="Antonelli">Guido Antonelli</name><affiliation><nlm:affiliation>Laboratory of Virology, Department of Molecular Medicine, Affiliated to Istituto Pasteur Italia - Cenci Bolognetti Foundation, Sapienza University, Rome, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Pugliese, Francesco" sort="Pugliese, Francesco" uniqKey="Pugliese F" first="Francesco" last="Pugliese">Francesco Pugliese</name><affiliation><nlm:affiliation>Department of Anesthesia and Intensive Care Medicine, Sapienza University of Rome, Rome, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Mastroianni, Claudio Maria" sort="Mastroianni, Claudio Maria" uniqKey="Mastroianni C" first="Claudio Maria" last="Mastroianni">Claudio Maria Mastroianni</name><affiliation><nlm:affiliation>Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.</nlm:affiliation></affiliation></author></analytic><series><title level="j">Frontiers in medicine</title><idno type="ISSN">2296-858X</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><b>Background:</b> Gastrointestinal disorders are frequent in COVID-19 and SARS-CoV-2 has been hypothesized to impact on host microbial flora and gut inflammation, infecting intestinal epithelial cells. Since there are currently no coded therapies or guidelines for treatment of COVID-19, this study aimed to evaluate the possible role of a specific oral bacteriotherapy as complementary therapeutic strategy to avoid the progression of COVID-19. <b>Methods:</b> We provide a report of 70 patients positive for COVID-19, hospitalized between March 9th and April 4th, 2020. All the patients had fever, required non-invasive oxygen therapy and presented a CT lung involvement on imaging more than 50%. Forty-two patients received hydroxychloroquine, antibiotics, and tocilizumab, alone or in combination. A second group of 28 subjects received the same therapy added with oral bacteriotherapy, using a multistrain formulation. <b>Results:</b> The two cohorts of patients were comparable for age, sex, laboratory values, concomitant pathologies, and the modality of oxygen support. Within 72 h, nearly all patients treated with bacteriotherapy showed remission of diarrhea and other symptoms as compared to less than half of the not supplemented group. The estimated risk of developing respiratory failure was eight-fold lower in patients receiving oral bacteriotherapy. Both the prevalence of patients transferred to ICU and mortality were higher among the patients not treated with oral bacteriotherapy. <b>Conclusions:</b> A specific bacterial formulation showed a significant ameliorating impact on the clinical conditions of patients positive for SARS-CoV-2 infection. These results also stress the importance of the gut-lung axis in controlling the COVID-19 disease.</div></front></TEI><pubmed><MedlineCitation Status="PubMed-not-MEDLINE" Owner="NLM"><PMID Version="1">32733907</PMID><DateRevised><Year>2020</Year><Month>09</Month><Day>28</Day></DateRevised><Article PubModel="Electronic-eCollection"><Journal><ISSN IssnType="Print">2296-858X</ISSN><JournalIssue CitedMedium="Print"><Volume>7</Volume><PubDate><Year>2020</Year></PubDate></JournalIssue><Title>Frontiers in medicine</Title><ISOAbbreviation>Front Med (Lausanne)</ISOAbbreviation></Journal><ArticleTitle>Challenges in the Management of SARS-CoV2 Infection: The Role of Oral Bacteriotherapy as Complementary Therapeutic Strategy to Avoid the Progression of COVID-19.</ArticleTitle><Pagination><MedlinePgn>389</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.3389/fmed.2020.00389</ELocationID><Abstract><AbstractText><b>Background:</b> Gastrointestinal disorders are frequent in COVID-19 and SARS-CoV-2 has been hypothesized to impact on host microbial flora and gut inflammation, infecting intestinal epithelial cells. Since there are currently no coded therapies or guidelines for treatment of COVID-19, this study aimed to evaluate the possible role of a specific oral bacteriotherapy as complementary therapeutic strategy to avoid the progression of COVID-19. <b>Methods:</b> We provide a report of 70 patients positive for COVID-19, hospitalized between March 9th and April 4th, 2020. All the patients had fever, required non-invasive oxygen therapy and presented a CT lung involvement on imaging more than 50%. Forty-two patients received hydroxychloroquine, antibiotics, and tocilizumab, alone or in combination. A second group of 28 subjects received the same therapy added with oral bacteriotherapy, using a multistrain formulation. <b>Results:</b> The two cohorts of patients were comparable for age, sex, laboratory values, concomitant pathologies, and the modality of oxygen support. Within 72 h, nearly all patients treated with bacteriotherapy showed remission of diarrhea and other symptoms as compared to less than half of the not supplemented group. The estimated risk of developing respiratory failure was eight-fold lower in patients receiving oral bacteriotherapy. Both the prevalence of patients transferred to ICU and mortality were higher among the patients not treated with oral bacteriotherapy. <b>Conclusions:</b> A specific bacterial formulation showed a significant ameliorating impact on the clinical conditions of patients positive for SARS-CoV-2 infection. These results also stress the importance of the gut-lung axis in controlling the COVID-19 disease.</AbstractText><CopyrightInformation>Copyright © 2020 d'Ettorre, Ceccarelli, Marazzato, Campagna, Pinacchio, Alessandri, Ruberto, Rossi, Celani, Scagnolari, Mastropietro, Trinchieri, Recchia, Mauro, Antonelli, Pugliese and Mastroianni.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>d'Ettorre</LastName><ForeName>Gabriella</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ceccarelli</LastName><ForeName>Giancarlo</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Marazzato</LastName><ForeName>Massimiliano</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Campagna</LastName><ForeName>Giuseppe</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Pinacchio</LastName><ForeName>Claudia</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Alessandri</LastName><ForeName>Francesco</ForeName><Initials>F</Initials><AffiliationInfo><Affiliation>Department of Anesthesia and Intensive Care Medicine, Sapienza University of Rome, Rome, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ruberto</LastName><ForeName>Franco</ForeName><Initials>F</Initials><AffiliationInfo><Affiliation>Department of Anesthesia and Intensive Care Medicine, Sapienza University of Rome, Rome, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Rossi</LastName><ForeName>Giacomo</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>School of Biosciences, Veterinary Medicine University of Camerino, Camerino, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Celani</LastName><ForeName>Luigi</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Scagnolari</LastName><ForeName>Carolina</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Laboratory of Virology, Department of Molecular Medicine, Affiliated to Istituto Pasteur Italia - Cenci Bolognetti Foundation, Sapienza University, Rome, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Mastropietro</LastName><ForeName>Cristina</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Trinchieri</LastName><ForeName>Vito</ForeName><Initials>V</Initials><AffiliationInfo><Affiliation>Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Recchia</LastName><ForeName>Gregorio Egidio</ForeName><Initials>GE</Initials><AffiliationInfo><Affiliation>Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Mauro</LastName><ForeName>Vera</ForeName><Initials>V</Initials><AffiliationInfo><Affiliation>Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Antonelli</LastName><ForeName>Guido</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>Laboratory of Virology, Department of Molecular Medicine, Affiliated to Istituto Pasteur Italia - Cenci Bolognetti Foundation, Sapienza University, Rome, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Pugliese</LastName><ForeName>Francesco</ForeName><Initials>F</Initials><AffiliationInfo><Affiliation>Department of Anesthesia and Intensive Care Medicine, Sapienza University of Rome, Rome, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Mastroianni</LastName><ForeName>Claudio Maria</ForeName><Initials>CM</Initials><AffiliationInfo><Affiliation>Department of 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