Aim: To assess impairment in health status and psychological burden, subjects with Long Covid enrolled in a multidisciplinary follow-up outpatient programme underwent a multidimensional psychological assessment including Zung9s Self-rating Anxiety Scale (SAS), Impact of Event Scale-Revised (IES-R), Beck Depression Inventory-II (BDI-II), Functional Assessment of Chronic Illness Therapy, Fatigue subscale (FACIT-F), 12-Item Short-Form Health Survey (SF-12). Results: Ninety-nine subjects (36M; age 52.6±14.5) participated to a self-administered multidimensional psychological evaluation from january2021 to january 2022 (5.5±4.4 months after acute infection). Sixty-one out of 99 (61.6%) subjects (20M, age 48.7±14.5y) were treated at home during acute SARS-CoV-2 infection. Thirty-five patients (35.4%) had symptoms of post-traumatic stress disorder (PTSD), 21 patients (21.2%) had moderate to severe depressive symptoms, 47 (47.4%) exhibited clinically significative anxiety. No significant differences in symptoms and psychological evaluation were found in home treated, compared with the subgroup of 38 (38.3%) hospitalized subjects (16M, age59.0±13.0y). Irrespective of hospitalization, persistent asthenia was reported in 34 out of 63 females (54.0%), and in 11 males (30.6%) (p=.005); Clinically significant anxiety was found in 37(58.7%) females and in 7(19.4%) males (p=.001). Gender associated significant differences were found as well in FACIT-F, SAS, SF-12, but not in BDI-II and IES-R scores. Conclusion: Among a cohort of long covid subjects, gender differences were observed in symptoms reported and in psychological well-being.

OBJECTIVE:Critical limb ischemia (CLI) is the most severe manifestation of the peripheral arterial disease. To date, several prognostic factors have been identified but the data of long-term follow-up in real life setting are scarce. The aim of our study is to describe a large group of CLI patients and identify possible prognostic factors, in a long-term follow-up.PATIENTS AND METHODS:Case-control, retrospective study. 181 consecutive CLI patients with a minimum follow-up of 5 years were included in the study.RESULTS:Overall mortality was 15%, 24%, and 43% at 1, 2, and 5 years, respectively. Among known risk factors, only arterial hypertension was significantly correlated with survival rate; no differences were found between diabetics and non-diabetics. Patients treated with intravenous iloprost (46%), compared to untreated patients, showed a better (p < 0.0001) long-term outcome in terms of major amputation (6% vs. 21%), subsequent vascular surgery (4% vs. 32%) and survival rates (69% vs. 47%), at 5-year follow-up. Major amputations were significantly correlated with lower median forefoot transcutaneous values of O2 (0/3 mmHg, p < 0.001) and higher median values of CO2 (83/53 mmHg, p < 0.0001) in supine/dependent position, respectively.CONCLUSIONS:Our results confirm the poor prognosis of CLI patients in a very long-term follow-up and the severe metabolic damage caused by ischemia. A favourable role of iloprost was observed, in agreement with previous evidence in the literature.

OBJECTIVE Critical limb ischemia (CLI) patients have poor long-term prognosis. We showed that iloprost improves outcomes (major amputation and survival) up a 5-year follow-up, but it is not known if in this length of time the survival curves, of clinical responders and non-responders, differ. PATIENTS AND METHODS A retrospective study enrolling 102 consecutive patients between 2004-2008, with clinical and instrumental (ultrasound, angiography, transcutaneous tensiometry of oxygen TcpO2 and carbon dioxide TcpCO2 in the affected and contralateral limbs) diagnosis of critical ischemia. All patients received the best medical therapy. Iloprost was administered (0.5-2 ng/kg/min 6 hours/day for 2-4 weeks) in all patients initially considered unsuitable for revascularization, repeating it regularly in time every six-twelve months in the case of positive response. The minimum expected follow-up was 4 years. RESULTS 71.5% of patients were treated with iloprost and the responder rate was 71.2%. Most of the patients were regularly retreated with repeated cycles. Initial median supine TcpCO2 in symptomatic limb was higher in untreated patients than those treated (58 vs. 49 mmHg; p < 0.05) and in non-responders compared to responders (60 vs. 49 mmHg; p < 0.05). TcpCO2 directly and significantly correlated with the highest risk of mortality and seems to represent a new accurate prognostic criterion of unfavourable short and long-term response to prostanoid. In iloprost group, major amputations were significantly reduced. Revascularization was significantly higher in non-responders (57.1% vs. 11.5%; p < 0.05). There was a significantly higher prevalence of subsequent myocardial infarction in the non-iloprost group (27.6% vs. 9.6%; p < 0.05). The survival rate of non-responders was higher than untreated up until the second year (76.2% vs. 62%; p < 0.05). At 4 years we found higher survival in patients treated with iloprost (64.3% vs. 41% in untreated; p < 0.05) and in responders (75% vs. 38.1% in non-responders; p < 0.05). CONCLUSIONS Our results confirm the favourable role of iloprost on the long-term outcome in patients with CLI. In particular, the maximum benefit is obtained in responder patients treated with multiple cycles of infusion.