LUCA D'ONOFRIO

Dottore di ricerca

ciclo: XXXV


supervisore: Prof.ssa Raffaella Buzzetti
relatore: Prof.ssa Raffaella Buzzetti

Titolo della tesi: COVID-19 AND DIABETES: EFFECTS OF A DANGEROUS RELATIONSHIP, FROM CLINICAL MANIFESTATION TO VACCINE EFFICACY

Rationale: At the end of 2019, SARS-CoV-2 was the cause of a pandemic disease named Covid-19, that deeply affect society worldwide. Diabetes mellitus has been described as one of the most important chronic conditions worsening the Covid-19 prognosis, which is worrisome considering that diabetes affects about half a billion people. For this reason, the aim of this project was to assess the relationship between diabetes mellitus and Covid-19 focusing on hospitalization, the impact of lockdown and vaccination. Methods: Four studies have been conducted. All of them with the common aim of elucidating the relationship between diabetes and Covid-19: 1) In the CoViDiab I study, a multicentre study, () we evaluate the risk profile of subjects with type 2 diabetes mellitus (T2D) hospitalized for Covid-19 comparing them with subjects with T2D without signs or symptoms of SARS-CoV-2 infection; 2) in the CoViDiab II, a multicentre retrospective study, we collected and compared data from patients hospitalized for Covid-19 with and without diabetes; 3) in the Glycalock study a retrospective multicentre study (), we compared the differences in glycaemic controls (in terms of HbA1c) in subjects with T2D exposed to lockdown with matched controls with T2D who attended the study centres 1 year before, with a stable glycaemic control; 4) Finally, in CoVaDiab I study, in a prospective monocentric study (), we evaluated efficacy of vaccination with mRNA vaccine towards SARS-CoV-2, in terms of antibody (Ab) response, in people with and without diabetes and we further assessed the short term effects of vaccination on glucose control in subjects with autoimmune diabetes (AD). Results: In CoViDiab study I, a case-control study, performed in subjects with T2D hospitalized for Covid-19 (n=79) compared to subjects with T2D but without Covid-19 (n=158), matched for age and gender, a higher prevalence of chronic obstructive pulmonary disease (COPD) (OR 3.72, 95%CI: 1.42–9.72, p = 0.007) and of chronic kidney disease were found (CKD) (OR 3.08, 95%CI: 1.18–8.06, p=0.022) but no difference in previous cardiovascular disease history. In the CoViDiab study II, 354 patients were enrolled (subjects with diabetes: n=81), and the risk of the primary composite outcome (any of mechanical ventilation, admission to an intensive care unit or death) was higher in subjects with diabetes (Adjusted Odds Ratio (adjOR) 2.04, 95%CI 1.12–3.73, p=0.020) compared to subjects without diabetes. In the Glycalock study, no difference in delta HbA1c was found between the lockdown and control groups (lockdown group −0.1% [−0.5%−0.3%] vs. control group −0.1% [−0.4% −0.2%]; p=0.482). In the lockdown group, subjects with worse psychological well-being, as evaluated by tertiles of the Psychological General Well-Being Index (PGWBS), showed a worsening of HbA1c (p=0.041 for the trend among PGWBS tertiles) and BMI (p=0.022). In the CoVaDiab study I, subjects with diabetes (n=128) showed decreased levels of Ab after one month of vaccination compared to controls (N=202) (1217[747-1887] BAU/mL Vs 1477[942-2556] BAU/mL, p=0.002), even after correction for age and gender (p=0.002). No difference was found between subjects with type 1 DM (T1D) and T2D. After six months, Ab levels significantly decreased in people with and without diabetes, with no differences between groups. Finally, in subjects with AD no significant differences were observed in glucose control, expressed as time in range evaluated by continuous glucose monitoring comparing the 3 days after the SARS-CoV-2 vaccine with the 14 days preceding the vaccine was observed. Conclusion: CKD and COPD and worse metabolic control were risk factors for hospitalization in subjects with diabetes and SARS-CoV-2 infection. Moreover, subjects with diabetes showed a worse prognosis during Covid-19. Subjects with diabetes, regardless of the type of diabetes and glycaemic control, showed an impaired response to vaccination, even if the vaccine was safe in terms of the effect on glucose control in the following days after the vaccination. Finally, subjects with poor psychological well-being may experience a worsening glycaemic control in distressing conditions, such as lockdown, highlighting the relevance of management of people with DM during these difficult times. Nevertheless, patients with good glycaemic control could cope well during distressing conditions, such as lockdown, pointing out the relevance of self-management of disease.

Produzione scientifica

  • 11573/1675564 - 2023 - Association of osteocalcin, osteoprotegerin, and osteopontin with cardiovascular disease and retinopathy in type 2 diabetes (01a Articolo in rivista)
    MADDALONI, ERNESTO; CORAGGIO, LUCIA; AMENDOLARA, ROCCO; BARONI, MARCO GIORGIO; CAVALLO, MARIA GISELLA; D'ONOFRIO, LUCA; LEONETTI, FRIDA; MORANO, SUSANNA; MORVIDUCCI, LELIO; PRUDENTE, SABRINA; PUGLIESE, GIUSEPPE; TRISCHITTA, VINCENZO; BUZZETTI, RAFFAELLA
  • 11573/972317 - 2017 - Pathophysiology of Bone Fragility in Patients with Diabetes (01a Articolo in rivista)
    PALERMO, ANDREA; D'ONOFRIO, LUCA; BUZZETTI, RAFFAELLA
  • 11573/972274 - 2017 - Vitamin K and osteoporosis: Myth or reality? (01g Articolo di rassegna (Review))
    PALERMO, ANDREA; D'ONOFRIO, LUCA; WATANABE, MIKIKO; BUZZETTI, RAFFAELLA
  • 11573/1086113 - 2018 - Serum sclerostin and bone turnover in latent autoimmune diabetes in adults (01a Articolo in rivista)
    LETO, GAETANO; MORETTI, CHIARA; ZAMPETTI, SIMONA; D'ONOFRIO, LUCA; CAMPAGNA, GIUSEPPE; PALERMO, ANDREA; BUZZETTI, RAFFAELLA
  • 11573/1111925 - 2018 - Relation Between Wrist Circumference and Left Ventricular Structure in Overweight Children (01a Articolo in rivista)
    ZAMPETTI, SIMONA; CAMPAGNA, GIUSEPPE; LETO, GAETANO; LUCANTONI, FEDERICA; D'ONOFRIO, LUCA; MARANDOLA, LIDIA; MORETTI, CHIARA; CHIESA, CLAUDIO; PACIFICO, LUCIA; BUZZETTI, RAFFAELLA
  • 11573/1680200 - 2016 - Serum chitotriosidase in postmenopausal women with severe osteoporosis (01a Articolo in rivista)
    D'ONOFRIO, LUCA; MADDALONI, ERNESTO
  • 11573/1181344 - 2018 - Espressione di sclerostina nelle placche aterosclerotiche di pazienti sottoposti a tea carotidea (04d Abstract in atti di convegno)
    D'ONOFRIO, LUCA; LETO, GAETANO; LUCANTONI, FEDERICA; CAMPAGNA, GIUSEPPE; FOFFI, CHIARA; MORETTI, CHIARA; CARLONE, ANGELA; MIGNOGNA, CARMEN; LUORDI, CECILIA; PALERMO, ANDREA; DELLA ROCCA, CARLO; BUZZETTI, RAFFAELLA
  • 11573/1206405 - 2019 - Sclerostin is expressed in the atherosclerotic plaques of patients who undergoing carotid endarterectomy (01a Articolo in rivista)
    LETO, GAETANO; D'ONOFRIO, LUCA; LUCANTONI, FEDERICA; ZAMPETTI, SIMONA; CAMPAGNA, GIUSEPPE; FOFFI, CHIARA; MORETTI, CHIARA; CARLONE, ANGELA; PALERMO, ANDREA; LEOPIZZI, MARTINA; PORTA, NATALE; LENZI, ANDREA; DELLA ROCCA, CARLO; BUZZETTI, RAFFAELLA
  • 11573/1663163 - 2023 - Reduced early response to SARS-CoV2 vaccination in people with type 1 and type 2 diabetes, a six months follow-up study. The CoVaDiab study I (01a Articolo in rivista)
    D'ONOFRIO, LUCA; AMENDOLARA, ROCCO; SIENA, ANTONIO; DE FATA, RICCARDO; CORAGGIO, LUCIA; MIGNOGNA, CARMEN; MORETTI, CHIARA; MADDALONI, ERNESTO; BUZZETTI, RAFFAELLA
  • 11573/872766 - 2015 - Effectiveness and safety of calcium and vitamin D treatment for postmenopausal osteoporosis (01a Articolo in rivista)
    IOZZINO, MARIO; D'ONOFRIO, LUCA; MADDALONI, ERNESTO
  • 11573/1677514 - 2023 - Impact of baseline kidney function on the effects of sodium-glucose co-transporter-2 inhibitors on kidney and heart failure outcomes: A systematic review and meta-analysis of randomized controlled trials (01a Articolo in rivista)
    MADDALONI, ERNESTO; D'ONOFRIO, LUCA; BUZZETTI, RAFFAELLA
  • 11573/1303942 - 2019 - Wrist circumference is a biomarker of adipose tissue dysfunction and cardiovascular risk in children with obesity (01a Articolo in rivista)
    LUORDI, CECILIA; MADDALONI, ERNESTO; BIZZARRI, CARMEN; ZAMPETTI, SIMONA; D'ONOFRIO, LUCA; MORETTI, CHIARA; BUZZETTI, RAFFAELLA
  • 11573/1203353 - 2018 - Variability in genes regulating vitamin D metabolism is associated with vitamin D levels in type 2 diabetes (01a Articolo in rivista)
    BERTOCCINI, LAURA; BAILETTI, DIEGO; ALESSI, ELENA; BAGELLA, FRANCESCO MARIA; BARCHETTA, ILARIA; CAPOCCIA, DANILA; COCCIA, FEDERICA; CONTI, FRANCESCO; D'ONOFRIO, LUCA; FILARDI, TIZIANA; INCANI, MICHELA; MORETTI, CHIARA; PEZZILLI, SERENA; PIBIRI, CARLOTTA; SENTINELLI, FEDERICA; TAVAGLIONE, FEDERICA; BUZZETTI, RAFFAELLA; CAVALLO, MARIA GISELLA; LEONETTI, FRIDA; MORANO, SUSANNA; MORVIDUCCI, LELIO; PRUDENTE, SABRINA; PUGLIESE, GIUSEPPE; TRISCHITTA, VINCENZO; BARONI, MARCO GIORGIO
  • 11573/1324544 - 2019 - Osteocalcin and sclerostin. Background characters or main actors in cardiovascular disease? (01b Commento, Erratum, Replica e simili)
    D'ONOFRIO, LUCA; MADDALONI, ERNESTO; BUZZETTI, RAFFAELLA
  • 11573/1347607 - 2019 - Chitotriosidase Activity Is Inversely Associated with Diastolic Blood Pressure and HbA1c but Not with Arterial Stiffness in Patients with Type 2 Diabetes without Complications (04d Abstract in atti di convegno)
    D'ONOFRIO, LUCA; LUORDI, CECILIA; MIGNOGNA, CARMEN; CARLONE, ANGELA; MORETTI, CHIARA; TARTAGLIONE, LIDA; MADDALONI, ERNESTO; LETO, GAETANO; MAZZAFERRO, SANDRO; BUZZETTI, RAFFAELLA
  • 11573/1691316 - 2023 - Lack of Association between Serum Chitotriosidase Activity and Arterial Stiffness in Type 2 Diabetes without Cardiovascular Complications (01a Articolo in rivista)
    D'ONOFRIO, LUCA; AMENDOLARA, ROCCO; MIGNOGNA, CARMEN; LETO, GAETANO; TARTAGLIONE, LIDA; MAZZAFERRO, SANDRO; MADDALONI, ERNESTO; BUZZETTI, RAFFAELLA
  • 11573/872773 - 2014 - Osteocalcin levels are inversely associated with Hba1c and BMI in adult subjects with long-standing type 1 diabetes (01a Articolo in rivista)
    MADDALONI, ERNESTO; D'ONOFRIO, LUCA; ANGELETTI, SILVIA
  • 11573/1444504 - 2020 - Clinical, Biochemical, and Radiological Profile of Normocalcemic Primary Hyperparathyroidism (01a Articolo in rivista)
    PALERMO, ANDREA; D'ONOFRIO, LUCA
  • 11573/1467150 - 2020 - Clinical features of patients with type 2 diabetes with and without Covid-19: a case control study (CoViDiab I) (01a Articolo in rivista)
    MADDALONI, ERNESTO; D'ONOFRIO, LUCA; ALESSANDRI, FRANCESCO; MIGNOGNA, CARMEN; CORAGGIO, LUCIA; STERPETTI, SARA; MEZZAROMA, IVANO; LICHTNER, MIRIAM; ROCCO, MONICA; MASTROIANNI, CLAUDIO MARIA; BUZZETTI, RAFFAELLA
  • 11573/1521661 - 2021 - Decrease of coronary heart disease risk with GLP1-receptor agonists or SGLT2 inhibitors therapy in patients with type 2 diabetes in primary cardiovascular prevention: a 24 months follow-up study (01a Articolo in rivista)
    D'ONOFRIO, LUCA; MIGNOGNA, CARMEN; CARLONE, ANGELA; MORETTI, CHIARA; MADDALONI, ERNESTO; BUZZETTI, RAFFAELLA
  • 11573/1521681 - 2021 - Risk of cardiac autonomic neuropathy in latent autoimmune diabetes in adults is similar to type 1 diabetes and lower compared to type 2 diabetes. A cross-sectional study (01a Articolo in rivista)
    MADDALONI, ERNESTO; MORETTI, CHIARA; STERPETTI, SARA; D'ONOFRIO, LUCA; BUZZETTI, RAFFAELLA
  • 11573/853495 - 2015 - Irisin is associated with osteoporotic fractures independently of bone mineral density, body composition or daily physical activity (01a Articolo in rivista)
    MADDALONI, ERNESTO; D'ONOFRIO, LUCA
  • 11573/1548715 - 2021 - Effects of the COVID-19 lockdown on glycaemic control in subjects with type 2 diabetes: the glycalock study (01a Articolo in rivista)
    D'ONOFRIO, LUCA; MADDALONI, ERNESTO; MIGNOGNA, CARMEN; STERPETTI, SARA; CORAGGIO, LUCIA; LUORDI, CECILIA; GUARISCO, GLORIA; LEONETTI, FRIDA; BUZZETTI, RAFFAELLA
  • 11573/1548713 - 2021 - Small nerve fiber damage and Langerhans cells in type 1 and type 2 diabetes and LADA measured by corneal confocal microscopy (01a Articolo in rivista)
    D'ONOFRIO, LUCA; BUZZETTI, RAFFAELLA
  • 11573/1580406 - 2021 - Corneal keratocyte density and corneal nerves are reduced in patients with severe obesity and improve after bariatric surgery (01a Articolo in rivista)
    D'ONOFRIO, LUCA
  • 11573/1580412 - 2020 - Corneal confocal microscopy compared with quantitative sensory testing and nerve conduction for diagnosing and stratifying the severity of diabetic peripheral neuropathy (01a Articolo in rivista)
    D'ONOFRIO, LUCA
  • 11573/1573616 - 2021 - Impact of cardiovascular disease on clinical outcomes in hospitalized patients with Covid-19. a systematic review and meta-analysis (01g Articolo di rassegna (Review))
    MADDALONI, ERNESTO; D'ONOFRIO, LUCA; SIENA, ANTONIO; LUORDI, CECILIA; MIGNOGNA, CARMEN; AMENDOLARA, ROCCO; BUZZETTI, RAFFAELLA
  • 11573/1573592 - 2021 - Short-term safety profile of Sars-Cov2 vaccination on glucose control. Continuous glucose monitoring data in people with autoimmune diabetes (01a Articolo in rivista)
    D'ONOFRIO, LUCA; CORAGGIO, LUCIA; ZURRU, ANNALISA; CARLONE, ANGELA; MIGNOGNA, CARMEN; MORETTI, CHIARA; MADDALONI, ERNESTO; BUZZETTI, RAFFAELLA
  • 11573/1550029 - 2019 - EVALUATION OF ARTERIAL STIFFNESS IN A COHORT OF TYPE 2 DIABETES PATIENTS (01h Abstract in rivista)
    TARTAGLIONE, LIDA; ROTONDI, SILVERIO; D'ONOFRIO, LUCA; BUZZETTI, RAFFAELLA
  • 11573/1579997 - 2021 - Optimal utility of h-reflex rdd as a biomarker of spinal disinhibition in painful and painless diabetic neuropathy (01a Articolo in rivista)
    D'ONOFRIO, LUCA
  • 11573/1612629 - 2021 - Investigational therapies targeting CD3 for prevention and treatment of type 1 diabetes (01g Articolo di rassegna (Review))
    MIGNOGNA, CARMEN; MADDALONI, ERNESTO; D'ONOFRIO, LUCA; BUZZETTI, RAFFAELLA
  • 11573/1630528 - 2022 - Development of a clinical risk score to predict death in patients with COVID-19 (01g Articolo di rassegna (Review))
    MADDALONI, ERNESTO; ALESSANDRI, FRANCESCO; D'ONOFRIO, LUCA; LETO, GAETANO; MASTROIANNI, CLAUDIO MARIA; MIGNOGNA, CARMEN; PUGLIESE, FRANCESCO; BUZZETTI, RAFFAELLA
  • 11573/1639821 - 2022 - Diastolic Pressure And Acr Are Modifiable Risk Factors Of Arterial Stiffness In T2DM Without Cardiovascular Disease (01a Articolo in rivista)
    TARTAGLIONE, LIDA; ROTONDI, SILVERIO; MADDALONI, ERNESTO; MIGNOGNA, CARMEN; D'ONOFRIO, LUCA; ZAMPETTI, SIMONA; CARLONE, ANGELA; MUCI, MARIA LUISA; MASTROLUCA, DANIELA; FASSINO, VALERIA; BUZZETTI, RAFFAELLA; MAZZAFERRO, SANDRO
  • 11573/1502585 - 2020 - Cardiometabolic multimorbidity is associated with a worse Covid-19 prognosis than individual cardiometabolic risk factors. A multicentre retrospective study (CoViDiab II) (01a Articolo in rivista)
    MADDALONI, ERNESTO; D'ONOFRIO, LUCA; ALESSANDRI, FRANCESCO; MIGNOGNA, CARMEN; MEZZAROMA, IVANO; LICHTNER, MIRIAM; ROCCO, MONICA; PUGLIESE, FRANCESCO; LENZI, ANDREA; MASTROIANNI, CLAUDIO MARIA; BUZZETTI, RAFFAELLA; AJASSA, CAMILLA; ALESSI, FEDERICA; ARONICA, RAISSA; BELVISI, VALERIA; CANDY, MATTEO; CAPUTI, ALESSANDRA; CASALI, ELENA; CAVALLARI, EUGENIO NELSON; CECCARELLI, GIANCARLO; CELANI, LUIGI; CIARDI, MARIA ROSA; CORAGGIO, LUCIA; CURTOLO, AMBROGIO; D'ETTORRE, GABRIELLA; DE GIORGI, FRANCESCA; DE GIROLAMO, GABRIELLA; FILIPPI, VALERIA; GNESSI, LUCIO; LUORDI, CLAUDIO; MORETTI, CHIARA; RECCHIA, GREGORIO EGIDIO; RIDOLFI, MARCO; ROMANI, FRANCESCO EUGENIO; RUSSO, GIANLUCA; RUBERTO, FRANCO GENNARO MARIA; SAVELLONI, GIULIA; SICCARDI, GUIDO; SIENA, ANTONIO; STERPETTI, SARA; VALERI, SERENA; VOLPICELLI, LORENZO; WATANABE, MIKIKO; FONDACO, LAURA; KERTUSHA, BLERTA; LEONETTI, FRIDA; MAROCCO, RAFFAELLA; ALAMPI, DANIELA
  • 11573/1643701 - 2022 - Corneal confocal microscopy identifies small nerve fibre damage in patients with hypertriglyceridemia (01a Articolo in rivista)
    D'ONOFRIO, LUCA; BUZZETTI, RAFFAELLA
  • 11573/1663161 - 2019 - Alpha-Tocopherol and contrast-induced nephropathy: a meta-analysis of randomized controlled trials (01a Articolo in rivista)
    D'ONOFRIO, LUCA
  • 11573/872519 - 2016 - Frailty and geography: Should these two factors be added to the ABCDE contemporary guide to diabetes therapy? (01b Commento, Erratum, Replica e simili)
    MADDALONI, ERNESTO; D'ONOFRIO, LUCA
  • 11573/927624 - 2016 - BMI and BMD: The potential interplay between obesity and bone fragility (01a Articolo in rivista)
    WATANABE, MIKIKO; D'ONOFRIO, LUCA
  • 11573/872536 - 2016 - Serum chitotriosidase in postmenopausal women with severe osteoporosis (01a Articolo in rivista)
    D'ONOFRIO, LUCA; DI ROSA, MANUELA
  • 11573/872538 - 2015 - Oral anti-diabetic drugs and fracture risk, cut to the bone: safe or dangerous? A narrative review (01g Articolo di rassegna (Review))
    D'ONOFRIO, LUCA
  • 11573/1111928 - 2018 - Wrist circumference is associated with increased systolic blood pressure in children with overweight/obesity (01a Articolo in rivista)
    ZAMPETTI, SIMONA; CAMPAGNA, GIUSEPPE; LUCANTONI, FEDERICA; MARANDOLA, LIDIA; D'ONOFRIO, LUCA; CHIESA, CLAUDIO; PACIFICO, LUCIA; VANIA, ANDREA; BUZZETTI, RAFFAELLA; LETO, GAETANO
  • 11573/1633232 - 2022 - Third dose of COVID-19 vaccine in diabetes. Relevance of good metabolic control to improve its efficacy (01b Commento, Erratum, Replica e simili)
    D'ONOFRIO, LUCA; BUZZETTI, RAFFAELLA
  • 11573/1663298 - 2020 - Diabetes, diabetic medications, and risk of fracture (02a Capitolo o Articolo)
    D'ONOFRIO, LUCA
  • 11573/1663160 - 2022 - Immunoreactivities Against Different Tyrosine-Phosphatase 2 (IA-2)(256-760) Protein Domains Characterize Distinct Phenotypes in Subjects With LADA (01a Articolo in rivista)
    TIBERTI, CLAUDIO; D'ONOFRIO, LUCA; PANIMOLLE, FRANCESCA; ZAMPETTI, SIMONA; MADDALONI, ERNESTO; BUZZETTI, RAFFAELLA
  • 11573/1579994 - 2021 - Spinal Inhibitory Dysfunction in Patients With Painful or Painless Diabetic Neuropathy (01a Articolo in rivista)
    D'ONOFRIO, LUCA
  • 11573/1550017 - 2018 - EVALUATION OF VASCULAR DAMAGE BY CARDIO-ANKLE VASCULAR INDEX (CAVI) IN TYPE 2 DIABETES PATIENTS (01h Abstract in rivista)
    TARTAGLIONE, LIDA; LETO, GAETANO; ROTONDI, SILVERIO; CARLONE, ANGELA; D'ONOFRIO, LUCA; MUCI, MARIA LUISA; MASTROLUCA, DANIELA; BUZZETTI, RAFFAELLA; MAZZAFERRO, SANDRO
  • 11573/1660193 - 2022 - The sodium–glucose co-transporter-2 (SGLT2) inhibitors reduce platelet activation and thrombus formation by lowering NOX2-related oxidative stress: a pilot study (01a Articolo in rivista)
    PIGNATELLI, PASQUALE; BARATTA, FRANCESCO; BUZZETTI, RAFFAELLA; D'AMICO, ALESSANDRA; CASTELLANI, VALENTINA; BARTIMOCCIA, SIMONA; SIENA, ANTONIO; D'ONOFRIO, LUCA; MADDALONI, ERNESTO; PINGITORE, ANNACHIARA; PASTORI, DANIELE; COCOMELLO, NICHOLAS; VIOLI, FRANCESCO; DEL BEN, MARIA; CAMMISOTTO, VITTORIA; CARNEVALE, ROBERTO
  • 11573/872770 - 2014 - Severe hypophosphatemic osteomalacia secondary to fanconi syndrome due to adefovir: A case report (01a Articolo in rivista)
    D'ONOFRIO, LUCA; MADDALONI, ERNESTO
  • 11573/1184860 - 2018 - Livelli aumentati di sclerostina in corso di diabete mellito tipo 2 e complicanze macrovascolari (04d Abstract in atti di convegno)
    D'ONOFRIO, LUCA; LUCANTONI, FEDERICA; LETO, GAETANO; CAMPAGNA, GIUSEPPE; FOFFI, CHIARA; MORETTI, CHIARA; CARLONE, ANGELA; MIGNOGNA, CARMEN; LUORDI, CECILIA; ZAMPETTI, SIMONA; LENZI, ANDREA; BUZZETTI, RAFFAELLA

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