Related health international organization there are two principal way of transmission of coronavirus covid-19: direct contact whit infected subject or by droplets. Other way under deep investigation by researcher is airborne transmission. Related the evidence presented in this work is possible to verify that in indoor settings this is possible. Relevant is the distance considered. Observing the role played by PM10 of polluted air in accelerared diffusion of covid- 19 in some world region Is interesting to observe the effect of musk use to reduce intake of this pollutans for a significative period. All this evidence must be applied in many healthcare settings like oncology or towards immunodepressed (or other kind of vulnerable condition) patiens also during access to hospitals. ICU settings are the hospital area subjected to severe procedure to prevent diffusion of  Covid - 19 and other infectious disease like MDR bacteria or some invasive fungal but according published evidences other area in hospital settings must be considered at risk of diffuse this kind of infectious disease.

The certainties of this coronavirus infection are it is a new coronavirus with human-to-human transmission. The genome varies up to 12% compared to the original bat coronavirus, <1% of healthy people die from the disease. The antibodies of the healed subjects neutralize the virus also for the other infected. Those who have had the virus perhaps without their knowledge because it is asymptomatic and have overcome it by treating it as a normal flu or even pneumonia, preserve its memory through specific antibodies and are protected. He cannot infect anyone after being healed. For relapses, the subjects are immunodeficient, they did not produce the antibodies or they are infected by a different or modified virus. The symptomatology of this coronavirus respiratory syndrome is considered moderate for the majority of cases as a simple cold, which can however deepen in the pulmonary bronchus and give "mild" pneumonia, according to the Chinese Center for Disease Control and Prevention , statement made at the end of February after the observation of about 90 thousand cases. 14% of confirmed cases became severe with serious pneumonia and dyspnoea. Another 5% of the patients had pulmonary collapse, septic shock and deficiency of several organs and correspond to the critical cases that led to the exit (2.3% of the total). The coronavirus that travels regularly in winter cause symptoms mostly colds. The cases infected by this new COVID - 19 develop severe forms only if there are previous diseases and in the elderly. Less than 1% of healthy subjects died of this new SARS, while cardio patients were 10.5%, diabetics 7.3%  and patients with chronic respiratory diseases, hypertension or cancer 6%.

Northern Italy, especially Lombardia and Veneto, has been affected by the COVID-19 coronavirus epidemic for weeks. Trying to isolate the carriers of the disease in connection with China is not an effective strategy to contain the disease, since the virus is transmitted like the flu virus and we can expect to have patients who have had no contact with possible carriers. According to Coronavirus genetic map, there are 3 isolated viruses in Italy. After that of Spallanzani (Rome) Covid 1 (Chinese), that of S. Raffaele Covid 2 (mutation of Chinese already known from the references) called Milanese, here is that of Sacco Hospital which is only a relative of the first two. It seems to be the same as that isolated in Finland, Germany, South America and it is hypothesized to have arrived in Europe long before the Chinese epidemic (November 2019 - March 2020). In Italy, however, the number of swabs and the procedures for carrying them out is essentially left to the arbitration of the Regions; a chaos that prevents any reference model from being determined. With this situation, it is not clear why among the various strategies that could have been adopted, after the home isolation of the population not engaged in certain work activities, there is even a quarantine for all people. Measure that it is not clear how long it can last.The real number of people infected in Italy is at least 4 or five times higher than that declared by the recovered patiens. Lombardia is the region in the first place for using tampons; this is the reason combined with the casual praxis to present as "coronavirus deaths" patients who, on the other hand, could have deaths associated with coronavirus (ie suffering from previous pathologies that caused death) that could explain the "mortality peak for COVID19" of Lombardia. It would be appropriate before identifying the primary cause of death in COVID19, carrying out the necessary pathological investigations and, above all, defining a standard to be applied throughout the national territory.

Northern Italy, especially Lombardia and Veneto, has been affected by the COVID-19 coronavirus epidemic for weeks. Trying to isolate the carriers of the disease in connection with China is not an effective strategy to contain the disease, since the virus is transmitted like the flu virus and we can expect to have patients who have had no contact with possible carriers. According to Coronavirus genetic map, there are 3 isolated viruses in Italy. After that of Spallanzani (Rome) Covid 1 (Chinese), that of S. Raffaele Covid 2 (mutation of Chinese already known from the references) called Milanese, here is that of Sacco Hospital which is only a relative of the first two. It seems to be the same as that isolated in Finland, Germany, South America and it is hypothesized to have arrived in Europe long before the Chinese epidemic (November 2019 - March 2020). In Italy, however, the number of swabs and the procedures for carrying them out is essentially left to the arbitration of the Regions; a chaos that prevents any reference model from being determined. With this situation, it is not clear why among the various strategies that could have been adopted, after the home isolation of the population not engaged in certain work activities, there is even a quarantine for all people. Measure that it is not clear how long it can last.The real number of people infected in Italy is at least 4 or five times higher than that declared by the recovered patiens. Lombardia is the region in the first place for using tampons; this is the reason combined with the casual praxis to present as "coronavirus deaths" patients who, on the other hand, could have deaths associated with coronavirus (ie suffering from previous pathologies that caused death) that could explain the "mortality peak for COVID19" of Lombardia. It would be appropriate before identifying the primary cause of death in COVID19, carrying out the necessary pathological investigations and, above all, defining a standard to be applied throughout the national territory.

Northern Italy, especially Lombardia and Veneto, has been affected by the COVID-19 coronavirus epidemic for weeks. Trying to isolate the carriers of the disease in connection with China is not an effective strategy to contain the disease, since the virus is transmitted like the flu virus and we can expect to have patients who have had no contact with possible carriers. According to Coronavirus genetic map, there are 3 isolated viruses in Italy. After that of Spallanzani (Rome) Covid 1 (Chinese), that of S. Raffaele Covid 2 (mutation of Chinese already known from the references) called Milanese, here is that of Sacco Hospital which is only a relative of the first two. It seems to be the same as that isolated in Finland, Germany, South America and it is hypothesized to have arrived in Europe long before the Chinese epidemic (November 2019 - March 2020). In Italy, however, the number of swabs and the procedures for carrying them out is essentially left to the arbitration of the Regions; a chaos that prevents any reference model from being determined. With this situation, it is not clear why among the various strategies that could have been adopted, after the home isolation of the population not engaged in certain work activities, there is even a quarantine for all people. Measure that it is not clear how long it can last.The real number of people infected in Italy is at least 4 or five times higher than that declared by the recovered patiens. Lombardia is the region in the first place for using tampons; this is the reason combined with the casual praxis to present as "coronavirus deaths" patients who, on the other hand, could have deaths associated with coronavirus (ie suffering from previous pathologies that caused death) that could explain the "mortality peak for COVID19" of Lombardia. It would be appropriate before identifying the primary cause of death in COVID19, carrying out the necessary pathological investigations and, above all, defining a standard to be applied throughout the national territory.

The outbreak of the coronavirus disease 2019 (COVID-19) has show a global spreading trend. Early and effective predictors of clinical outcomes are urgently needed to improve management of Covid-19 patients. Lung ultrasound (LUS) combined with D-Dimer (DD) testing could be a new strategy for early diagnosis in patients with suspected COVID-19 pneumonia associated with acute respiratory distress syndrome (ARDS) and helpful prevent the progression of intravascular pulmonary coagulopathy. Modern assay for D-dimer are monoclonal antibody based. The enzyme-linked immunosorbent assay (ELISA) is the reference method for D-dimer analysis. Elevated D-dimer levels are associated with clotting activation and fibrinolysis and can be used as indirect biomarkers of thrombosis than in combination with B-lines detected by lung ultrasound become highly sensitive in the diagnosis of pulmonary intravascular coagulopathy in COVID-19 pneumonia. Careful attention needs to be paid to the initial diagnosis, prevention and treatment of the prothrombotic and thrombotic state that can occur in a substantial percentage of COVID-19 patients. We believe that lung ultrasound early detection in COVID-19 and a rapid D-dimer assay may provide better prognosis in these patients.

Children are infected with the virus without suffering a serious disease and represent an important source of infection. It has been experimentally proven that young mice respond to lung tissue damage from viral infection through prostaglandins, while adult mice succumb. The angiotensinconverting enzyme (ACE) 2 receptor is particularly abundant on the cells of the lower lung pathways, whose situation explains the high incidence of bronchitis and pneumonia related to the severe infection of COVID-19. A fall in ACE2 activity in the elderly is partly responsible for the decreased ability to reduce the inflammatory response with old age. The reduction of ACE2 receptors in older adults puts them in a position where they are unable to cope with COVID-19. In Italy from the details of the medical records of the current hospitalized as well as those discharged healed and unfortunately the victims do not seem to have any foreigner in the sense of a non-EU citizen.Non-EU citizens are all covered by a tuberculosis vaccine which is part of a coverage protocol provided by the Local Health Unit.It seems that flu vaccination favors coronavirus infection, even greater than 36% as reported by an American military study. Both meningococcal and pneumociccic disease have been associated with the activity of influenza and respiratory syncytial viruses.The Istituto Superiore della Sanità recently stated that few deaths are from coronavirus and instead most put of them from other pathologies (cardiovascular, cancer, diabetes,etc.). This suggests that the overall clinical consequences of COVID-19 could ultimately be similar to that of severe seasonal flu, which has a fatality rate of approximately 0.1%, or pandemic influenza such as that of 1957 or 1968. , rather than those of SARS or MERS, characterized respectively by a fatality of 10% and 36%.

Children are infected with the virus without suffering a serious disease and represent an important source of infection. It has been experimentally proven that young mice respond to lung tissue damage from viral infection through prostaglandins, while adult mice succumb. The angiotensinconverting enzyme (ACE) 2 receptor is particularly abundant on the cells of the lower lung pathways, whose situation explains the high incidence of bronchitis and pneumonia related to the severe infection of COVID-19. A fall in ACE2 activity in the elderly is partly responsible for the decreased ability to reduce the inflammatory response with old age. The reduction of ACE2 receptors in older adults puts them in a position where they are unable to cope with COVID-19. In Italy from the details of the medical records of the current hospitalized as well as those discharged healed and unfortunately the victims do not seem to have any foreigner in the sense of a non-EU citizen.Non-EU citizens are all covered by a tuberculosis vaccine which is part of a coverage protocol provided by the Local Health Unit.It seems that flu vaccination favors coronavirus infection, even greater than 36% as reported by an American military study. Both meningococcal and pneumociccic disease have been associated with the activity of influenza and respiratory syncytial viruses.The Istituto Superiore della Sanità recently stated that few deaths are from coronavirus and instead most put of them from other pathologies (cardiovascular, cancer, diabetes,etc.). This suggests that the overall clinical consequences of COVID-19 could ultimately be similar to that of severe seasonal flu, which has a fatality rate of approximately 0.1%, or pandemic influenza such as that of 1957 or 1968. , rather than those of SARS or MERS, characterized respectively by a fatality of 10% and 36%.

Children are infected with the virus without suffering a serious disease and represent an important source of infection. It has been experimentally proven that young mice respond to lung tissue damage from viral infection through prostaglandins, while adult mice succumb. The angiotensinconverting enzyme (ACE) 2 receptor is particularly abundant on the cells of the lower lung pathways, whose situation explains the high incidence of bronchitis and pneumonia related to the severe infection of COVID-19. A fall in ACE2 activity in the elderly is partly responsible for the decreased ability to reduce the inflammatory response with old age. The reduction of ACE2 receptors in older adults puts them in a position where they are unable to cope with COVID-19. In Italy from the details of the medical records of the current hospitalized as well as those discharged healed and unfortunately the victims do not seem to have any foreigner in the sense of a non-EU citizen.Non-EU citizens are all covered by a tuberculosis vaccine which is part of a coverage protocol provided by the Local Health Unit.It seems that flu vaccination favors coronavirus infection, even greater than 36% as reported by an American military study. Both meningococcal and pneumociccic disease have been associated with the activity of influenza and respiratory syncytial viruses.The Istituto Superiore della Sanità recently stated that few deaths are from coronavirus and instead most put of them from other pathologies (cardiovascular, cancer, diabetes,etc.). This suggests that the overall clinical consequences of COVID-19 could ultimately be similar to that of severe seasonal flu, which has a fatality rate of approximately 0.1%, or pandemic influenza such as that of 1957 or 1968. , rather than those of SARS or MERS, characterized respectively by a fatality of 10% and 36%.

The spread of COVID-19 continues in China and in the world as the World Health Organization (WHO) baptized it, warned since 31-12-2019 of the new SARS (Severe Acute Respiratory Syndrome). The epidemic has its own basic reproduction number, Ro, which is considered less than 1 when it runs out of passage from one individual to another and tends to rise as in the previous SARS epidemic (2002-2003) between 2 and 4 to get to measles with values of 12-18. The current Ro is estimated between 2 and 3. More than 86 thousand are infected today 03-3-2020, with almost 3 thousand deaths. Flights to China have been suspended, while seasonal flu has infected and killed more people.