08.04.2020 – 15.15 – Faced with the general difficulty in carrying out the tests for the
detection of Covid-19, caused by the lack of material for the molecular analysis necessary for the swab tests and specifically by the scarce availability of reagents for the extraction of RNA (ribonucleic acid; the molecule that is involved in the coding, decoding and regulation of genes) from biological samples, an innovative response comes from Friuli Venezia Giulia.
The solution has been developed in the only laboratory of the University Health Authority of Udine, thanks to the team led by Dr. Francesco Ciaravella, head of the Laboratory Service Centre platform, and by the Director of the Department of Laboratory Medicine, Francesco Curcio, with the coordination of the heads of Virology and Microbiology, Corrado Pipan and Assunta Sartor, who, with the brilliant intuition of the coordinator of the molecular biology area of the Health Authority, Stefania Marzinotto, have managed to develop a method that makes it possible to detect the presence of the virus without the use of the kits, which are at the moment impossible to find.
As Marzinotto herself explains to the TGR Friuli Venezia Giulia, “This protocol was
born from the necessity to work without the need to extract the RNA with commercial kits, which, at the moment, are difficult to find worldwide”.
A new system, explains the biologist on the Messaggero Veneto, which “consists in processing the sample with physical methods, such as the sudden change of temperature, together with lytic enzymes and mild detergents”.
Specifically, it is a solution that allows “to sequence the material directly, without using the kit; the material that is collected via swab must be processed, we must verify the presence of some typical genes of the virus”. Tells Director Curcio.
“The phase that precedes the analysis of the sequence that tells us if there is the virus, or not, is the extraction of the RNA.
In this phase we usually use the conventional kit, which is now replaced by the new method”.
This solution is also beneficial in economic terms, with a saving of “around 90 per cent in terms of the cost of the kit”, explains Marzinotto, and above all in terms of time: “our protocol takes 22 minutes, unlike automated kits where it can last between two and six hours before having a return”.
The response time is in this way dramatically reduced, allowing the laboratory to move up to an analysis capacity from an average of 750 to 1,600 tests.
The work has now been sent to the research facilities’ rapid publication platform and many companies, both nationally and internationally, have contacted the laboratory and asked to make the protocol available.
Also, on the front of the therapies adopted in response to Covid-19, another great result comes again from Friuli Venezia Giulia and again from Udine, thanks to the team led by the director of the Department of Anesthesia and Intensive Care of the Health Authority of Udine “Central Friuli” Amato De Monte and the infectious diseases specialist Carlo Tascini, who runs the infectious diseases’ clinic.
The team has in fact developed a protocol that could now change the approach to the treatment in patients, especially for the most severe ones, who are at risk of hospitalization in intensive care.
This ozone therapy – already practiced in the hospitals of Udine and Tolmezzo – coupled with antiviral drugs which, are currently tested on some patients with pneumonia and breathing difficulties, has shown to cause a slowdown in inflammation and a reduction in lung damage”.
The procedure, illustrated by Dr. De Monte in “La Repubblica“, was used “at an early stage, on patients who risked being intubated, because of compromised breathing and who were already ventilated with a helmet or CPAP”.
Specifically, 200 milliliters of blood are taken from the patient, which then are left to interact with the ozone for about ten minutes and then reinjected; thus, for three or four times at most.
The infusion of ozone helps to strengthen the body’s response to the effects of the infection.
De Monte then explains how only after three sessions it was possible to see “sensational improvements, with a decisive reduction in the need for oxygen support“.
With regard to the therapy, on the basis of the positive results obtained so far, the request for authorization was sent to the Italian Medicines Agency AIFA, and to the Ethics Committee of the Spallanzani Institute in Rome, to proceed with a study of 200 patients. A process that aims at a recognition both from the methodological point of view and by the
international scientific community.
“The hope is to get an answer as soon as possible” adds De Monte “because the faster we can use it, the more people we will be able to help“.
Author: Nicole Petrucci
Michael Guggenbichler translation