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Koshimichi H, Hisaka A. Analyzing the worldwide progression of COVID-19 cases and deaths using nonlinear mixed-effects model. PLoS One 2024; 19:e0306891. [PMID: 39133667 PMCID: PMC11318863 DOI: 10.1371/journal.pone.0306891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 06/25/2024] [Indexed: 08/15/2024] Open
Abstract
COVID-19 is an infectious disease that continues to spread worldwide. A precise estimation of the cases and deaths due to COVID-19 would allow for appropriate consideration of healthcare resource allocation, public health response, and vaccination and economic planning, to minimize social damage. In this study, we analyzed the progression of COVID-19 cases and deaths until January 2022 in 156 countries using a nonlinear mixed-effect model based on the SIR framework. Given the major changes in mortality from infection, risk of re-infection and social responses, the analysis was limited to the period before the emergence of the Omicron variant. The impact of infection prevention measures in various countries was assessed, with a specific focus on estimating the effectiveness of lockdowns, where the effect was assumed to change over time. By accounting for excess mortality, our analysis allowed the estimation of unreported cases and deaths, and thus providing a more comprehensive understanding of the impact of pandemic. In the analysis, we identified gross domestic product (GDP), proportion of people aged 65 years or older, latitude of the capital city on transmissibility of infection, and city population and cardiovascular death rate on mortality rate as significant influencing factors. Furthermore, the differences in transmissibility and mortality rates by variants and the effect of vaccination on the mortality rate were assessed. The transmissibility has increased by odds ratios of 1.2 to 1.4 in Beta, Gamma, and Delta variants; mortality rate has increased by odds ratios of 1.7, 2.2, and 1.4 in Beta, Gamma, and Delta variants, respectively; and vaccination decreased the mortality rate by odds ratios of 0.4 and 0.1 in Delta and other variants, respectively.
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Affiliation(s)
| | - Akihiro Hisaka
- Graduate School of Pharmaceutical Sciences, Chiba University, Chiba, Japan
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2
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Negri A, Barazzetti A, Rinzivillo A, Mariani R, Di Monte C. Cognitive and Relational Processes Associated to Mental Health in Italian High School Students during COVID-19 and Russian-Ukrainian War Outbreaks. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:508. [PMID: 38673420 PMCID: PMC11050012 DOI: 10.3390/ijerph21040508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 03/26/2024] [Accepted: 04/14/2024] [Indexed: 04/28/2024]
Abstract
The negative impact of the COVID-19 pandemic on mental health has been widely demonstrated; however, few studies have investigated the psychological processes involved in this impact, including core beliefs violation, meaning-making disruption, interpersonal support, or one's relational functioning. This study explored the mental health of 215 Italian adolescents during the COVID-19 pandemic and the subsequent outbreak of the Russian-Ukrainian war. By administering a set of questionnaires, several cognitive and emotional variables were investigated, including core belief violation, meaning attribution to the pandemic and war, attachment, and emotion regulation, social media addiction, and relationships with significant others and teachers. We conducted some descriptive, mean difference, correlational, and predictive analyses that revealed a significant association between core belief violation caused by war and pandemic, ability to integrate war and pandemic within personal meaning universe, the relational support received, and mental health. The relationship with teachers during these challenging periods improved significantly according to the respondents' opinion, becoming both more authoritative and empathic. This study offers insights into what cognitive and relational processes are useful to intervene on to reduce the distress of adolescents who are facing significant moments of crisis due to events that challenge their cognitive and emotional balance.
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Affiliation(s)
- Attà Negri
- Department of Human and Social Sciences, University of Bergamo, 24129 Bergamo, Italy;
| | - Arianna Barazzetti
- Department of Human and Social Sciences, University of Bergamo, 24129 Bergamo, Italy;
| | | | - Rachele Mariani
- Department of Dynamic and Clinical Psychology and Health Studies “Sapienza”, University of Rome, 00185 Rome, Italy; (R.M.); (C.D.M.)
| | - Cinzia Di Monte
- Department of Dynamic and Clinical Psychology and Health Studies “Sapienza”, University of Rome, 00185 Rome, Italy; (R.M.); (C.D.M.)
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3
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Zinna G, Pipitò L, Colomba C, Scichilone N, Licata A, Barbagallo M, Russo A, Almasio PL, Coppola N, Cascio A. COVID-19: The Development and Validation of a New Mortality Risk Score. J Clin Med 2024; 13:1832. [PMID: 38610597 PMCID: PMC11012743 DOI: 10.3390/jcm13071832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 03/11/2024] [Accepted: 03/13/2024] [Indexed: 04/14/2024] Open
Abstract
Background: The coronavirus disease 2019 (COVID-19) pandemic has found the whole world unprepared for its correct management. Italy was the first European country to experience the spread of the SARS-CoV-2 virus at the end of February 2020. As a result of hospital overcrowding, the quality of care delivered was not always optimal. A substantial number of patients admitted to non-ICU units could have been treated at home. It would have been extremely useful to have a score that, based on personal and clinical characteristics and simple blood tests, could have predicted with sufficient reliability the probability that a patient had or did not have a disease that could have led to their death. This study aims to develop a scoring system to identify which patients with COVID-19 are at high mortality risk upon hospital admission, to expedite and enhance clinical decision making. Methods: A retrospective analysis was performed to develop a multivariable prognostic prediction model. Results: Derivation and external validation cohorts were obtained from two Italian University Hospital databases, including 388 (10.31% deceased) and 1357 (7.68% deceased) patients with confirmed COVID-19, respectively. A multivariable logistic model was used to select seven variables associated with in-hospital death (age, baseline oxygen saturation, hemoglobin value, white blood cell count, percentage of neutrophils, platelet count, and creatinine value). Calibration and discrimination were satisfactory with a cumulative AUC for prediction mortality of 0.924 (95% CI: 0.893-0.944) in derivation cohorts and 0.808 (95% CI: 0.886-0.828) in external validation cohorts. The risk score obtained was compared with the ISARIC 4C Mortality Score, and with all the other most important scores considered so far, to evaluate the risk of death of patients with COVID-19. It performed better than all the above scores to evaluate the predictability of dying. Its sensitivity, specificity, and AUC were higher than the other COVID-19 scoring systems when the latter were calculated for the 388 patients in our derivation cohort. Conclusions: In conclusion, the CZ-COVID-19 Score may help all physicians by identifying those COVID-19 patients who require more attention to provide better therapeutic regimens or, on the contrary, by identifying those patients for whom hospitalization is not necessary and who could therefore be sent home without overcrowding healthcare facilities. We developed and validated a new risk score based on seven variables for upon-hospital admission of COVID-19 patients. It is very simple to calculate and performs better than all the other similar scores to evaluate the predictability of dying.
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Affiliation(s)
- Giuseppe Zinna
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90127 Palermo, Italy; (G.Z.); (L.P.); (C.C.); (N.S.); (A.L.); (M.B.); (P.L.A.)
- Department of Surgery, Dentistry, Paediatrics, and Gynaecology, Division of Cardiac Surgery, University of Verona Medical School, 37129 Verona, Italy
| | - Luca Pipitò
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90127 Palermo, Italy; (G.Z.); (L.P.); (C.C.); (N.S.); (A.L.); (M.B.); (P.L.A.)
| | - Claudia Colomba
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90127 Palermo, Italy; (G.Z.); (L.P.); (C.C.); (N.S.); (A.L.); (M.B.); (P.L.A.)
- Pediatric Infectious Disease Unit, ARNAS Civico-Di Cristina-Benfratelli Hospital, 90127 Palermo, Italy
| | - Nicola Scichilone
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90127 Palermo, Italy; (G.Z.); (L.P.); (C.C.); (N.S.); (A.L.); (M.B.); (P.L.A.)
| | - Anna Licata
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90127 Palermo, Italy; (G.Z.); (L.P.); (C.C.); (N.S.); (A.L.); (M.B.); (P.L.A.)
| | - Mario Barbagallo
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90127 Palermo, Italy; (G.Z.); (L.P.); (C.C.); (N.S.); (A.L.); (M.B.); (P.L.A.)
| | - Antonio Russo
- Section of Infectious Diseases, Department of Mental Health and Public Medicine, University of Campania “Luigi Vanvitelli”, Via Luciano Armanni 5, 80131 Naples, Italy; (A.R.); (N.C.)
| | - Piero Luigi Almasio
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90127 Palermo, Italy; (G.Z.); (L.P.); (C.C.); (N.S.); (A.L.); (M.B.); (P.L.A.)
| | - Nicola Coppola
- Section of Infectious Diseases, Department of Mental Health and Public Medicine, University of Campania “Luigi Vanvitelli”, Via Luciano Armanni 5, 80131 Naples, Italy; (A.R.); (N.C.)
| | - Antonio Cascio
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90127 Palermo, Italy; (G.Z.); (L.P.); (C.C.); (N.S.); (A.L.); (M.B.); (P.L.A.)
- Infectious and Tropical Disease Unit, AOU Policlinico “P. Giaccone”, Via del Vespro 129, 90127 Palermo, Italy
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Korsgaard SR. All-cause mortality and Japan's early countermeasures. Health Sci Rep 2024; 7:e1905. [PMID: 38361802 PMCID: PMC10867703 DOI: 10.1002/hsr2.1905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Revised: 01/22/2024] [Accepted: 01/29/2024] [Indexed: 02/17/2024] Open
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Fazzo L, Grande E, Zona A, Minelli G, Crialesi R, Iavarone I, Grippo F. Mortality rates from asbestos-related diseases in Italy during the first year of the COVID-19 pandemic. Front Public Health 2024; 11:1243261. [PMID: 38292377 PMCID: PMC10824953 DOI: 10.3389/fpubh.2023.1243261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 11/07/2023] [Indexed: 02/01/2024] Open
Abstract
Background and aim Patients with interstitial lung diseases, including asbestosis, showed high susceptibility to the SARS-CoV-2 virus and a high risk of severe COVID-19 symptoms. Italy, highly impacted by asbestos-related diseases, in 2020 was among the European countries with the highest number of COVID-19 cases. The mortality related to malignant mesotheliomas and asbestosis in 2020 and its relationship with COVID-19 in Italy are investigated. Methods All death certificates involving malignant mesotheliomas or asbestosis in 2010-2020 and those involving COVID-19 in 2020 were retrieved from the National Registry of Causes of Death. Annual mortality rates and rate ratios (RRs) of 2020 and 2010-2014 compared to 2015-2019 were calculated. The association between malignant pleural mesothelioma (MPM) and asbestosis with COVID-19 in deceased adults ≥80 years old was evaluated through a logistic regression analysis (odds ratios: ORs), using MPM and asbestosis deaths COVID-19-free as the reference group. The hospitalization for asbestosis in 2010-2020, based on National Hospital Discharge Database, was analyzed. Results In 2020, 746,343 people died; out of them, 1,348 involved MPM and 286 involved asbestosis. Compared to the period 2015-2019, the mortality involving the two diseases decreased in age groups below 80 years; meanwhile, an increasing trend was observed in subjects aged 80 years and older, with a relative mortality risks of 1.10 for MPM and 1.17 for asbestosis. In subjects aged ≥80 years, deaths with COVID-19 were less likely to have MPM in both genders (men: OR = 0.22; women: OR = 0.44), while no departure was observed for asbestosis. A decrease in hospitalization in 2020 with respect to those in 2010-2019 in all age groups, both considering asbestosis as the primary or secondary diagnosis, was observed. Conclusions The increasing mortality involving asbestosis and, even if of slight entity, MPM, observed in people aged over 80 years during the 1st year of the COVID-19 pandemic, aligned in part with the previous temporal trend, could be due to several factors. Although no positive association with COVID-19 mortality was observed, the decrease in hospitalizations for asbestosis among individuals aged over 80 years, coupled with the increase in deaths, highlights the importance of enhancing home-based assistance during the pandemic periods for vulnerable patients with asbestos-related conditions.
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Affiliation(s)
- Lucia Fazzo
- Department of Environment and Health, Istituto Superiore di Sanità, Rome, Italy
- World Health Organization Collaborating Centre for Environmental Health in Contaminated Sites, Rome, Italy
| | - Enrico Grande
- Integrated System for Health, Social Assistance and Welfare, Italian National Institute of Statistics, Rome, Italy
| | - Amerigo Zona
- Department of Environment and Health, Istituto Superiore di Sanità, Rome, Italy
- World Health Organization Collaborating Centre for Environmental Health in Contaminated Sites, Rome, Italy
| | - Giada Minelli
- Statistical Service, Istituto Superiore di Sanità, Rome, Italy
| | - Roberta Crialesi
- Integrated System for Health, Social Assistance and Welfare, Italian National Institute of Statistics, Rome, Italy
| | - Ivano Iavarone
- Department of Environment and Health, Istituto Superiore di Sanità, Rome, Italy
- World Health Organization Collaborating Centre for Environmental Health in Contaminated Sites, Rome, Italy
| | - Francesco Grippo
- Integrated System for Health, Social Assistance and Welfare, Italian National Institute of Statistics, Rome, Italy
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Fortuna D, Caselli L, Berti E, Moro ML. Mortality and healthcare assessment among patients with chronic disease over 2 years of COVID-19: a population-based study in a large hard-hit Italian region. BMJ Open 2023; 13:e073477. [PMID: 38149421 PMCID: PMC10711920 DOI: 10.1136/bmjopen-2023-073477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 11/07/2023] [Indexed: 12/28/2023] Open
Abstract
OBJECTIVES We aimed to provide a region-wide comprehensive account of the indirect effects of COVID-19 on patients with chronic disease, in terms of non-COVID-19 mortality, and access to both inpatient and outpatient health services over a 2-year pandemic period. DESIGN Population-based retrospective study. SETTING Adult patients, affected by at least 1 of 32 prevalent chronic conditions, residing in the Emilia-Romagna Region in Italy, during the years 2020 (N=1 791 189, 47.7% of the overall adult regional population) and 2021 (N=1 801 071, 47.8%). RESULTS Overall, non-COVID-19 mortality among patients with chronic disease during the pandemic (2.7%) did not differ substantially from the expected mortality (2.5%), based on a 3 years prepandemic period (2017-2019) and adjusting for the demographic and clinical characteristics of the population under study. Indeed, while the first pandemic wave was characterised by a significant non-COVID-19 excess mortality (March: +35%), the subsequent phases did not show such disruptive variations in non-COVID-19 deaths, which remained around or even below the excess mortality threshold. End-of-life care of patients with chronic disease, especially for non-COVID-19 cases, significantly shifted from hospitalisations (-19%), to homecare (ADI: +7%; w/o ADI: +9%). Overall, healthcare of patients without COVID-19 chronic disease decreased, with similar negative trends in hospitalisations (-15.5%), major procedures (-19.6%) and ER accesses (-23.7%). Homecare was the least affected by the pandemic, with an overall reduction of -9.8%. COVID-19 outbreak also impacted on different types of outpatient care. Rehabilitation therapies, specialist visits, diagnostic and lab tests were considerably reduced during the first pandemic wave and consequent lockdown, with access rates of patients without COVID-19 chronic disease below -60%. CONCLUSIONS This work thoroughly describes how a large and well-defined population of patients without COVID-19 chronic disease has been affected by the changes and reorganisation in the healthcare system during 2 years of the pandemic, highlighting health priorities and challenges in chronic disease management under conditions of limited resources.
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Affiliation(s)
- Daniela Fortuna
- Innovation in Healthcare and Social Services, Emilia-Romagna Region, Bologna, Emilia-Romagna, Italy
| | - Luana Caselli
- Innovation in Healthcare and Social Services, Emilia-Romagna Region, Bologna, Emilia-Romagna, Italy
| | - Elena Berti
- Innovation in Healthcare and Social Services, Emilia-Romagna Region, Bologna, Emilia-Romagna, Italy
| | - Maria Luisa Moro
- Regional Agency for Health and Social Care, Emilia-Romagna Region, Bologna, Emilia-Romagna, Italy
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Nova A, Fazia T, Bernardinelli L. Investigating mortality trends in Italy during the COVID-19 pandemic: life expectancy changes within provinces and vaccination campaign impact up to December 2022. Public Health 2023; 225:168-175. [PMID: 37925841 DOI: 10.1016/j.puhe.2023.09.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 09/01/2023] [Accepted: 09/29/2023] [Indexed: 11/07/2023]
Abstract
OBJECTIVES We used publicly available population data from 1 January 2019 up to 31 December 2022, to investigate mortality trends in Italy during the COVID-19 pandemic, evaluating changes in life expectancy (LE) at birth within provinces and the impact of COVID-19 vaccinations. STUDY DESIGN Aggregate data analysis. METHODS Annual period life tables were used to estimate sex-specific LEs within provinces from 2019 to 2022. We used Arriaga decomposition to analyze the contribution of age groups (<60 years and ≥60 years) to annual LE changes. We implemented a Quasi-Poisson regression model to estimate the number of averted deaths by the achieved COVID-19 vaccination rates from January 2021 up to December 2022, simulating a counterfactual scenario where vaccine doses were not administered. RESULTS The results revealed geographical heterogeneity in annual LE changes across Italian provinces during the pandemic. By the end of 2022, LE was below the prepandemic levels in 88% of provinces for females and in 76% for males. In addition, we estimated that the achieved vaccination rates averted 460,831 deaths (95% confidence interval: 250,976-707,920), corresponding to a 25% reduction in expected all-cause mortality. CONCLUSIONS Overall, the study highlighted the significant role of COVID-19 vaccinations in averting a considerable number of deaths and improving LE. However, by the end of 2022, LE had not fully recovered to prepandemic levels in many provinces. This could be attributed to concurrent factors, including enduring COVID-19 pandemic effects, intense summer heat waves and early onset of seasonal flu. Further research and continuous monitoring are essential to fully comprehend long-term mortality trends and optimize public health strategies.
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Affiliation(s)
- A Nova
- Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Italy.
| | - T Fazia
- Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Italy.
| | - L Bernardinelli
- Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Italy.
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Grande E, Grippo F, Crialesi R, Marchetti S, Frova L. Suicide mortality in Italy during the first year of the COVID-19 pandemic. J Affect Disord 2023; 339:776-780. [PMID: 37479041 DOI: 10.1016/j.jad.2023.07.101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 07/17/2023] [Accepted: 07/18/2023] [Indexed: 07/23/2023]
Abstract
BACKGROUND Italy was severely hit by COVID-19 during 2020 and great concern about the possible increase of suicide rates in the population has arisen since early pandemic phases. Analyses limited to March-April have shown a drop in suicides in both sexes. This study aims to analyze suicide mortality in Italy during the whole 2020 making comparisons with the pre-pandemic period 2015-19, by sex, age and geographic area. METHODS Official cause-of-death data with national coverage were used to analyze suicide mortality by sex, month, age class and geographic area in the population aged ≥10 years (54,595,179). The monthly number of suicide deaths in 2020 was compared to the average number in 2015-19. Age-specific and age-adjusted suicide rates in 2020 and in 2015-19 were compared using rate-ratios with 95 % confidence intervals. RESULTS Compared to 2015-19 a non-significant reduction of the overall suicide rate was observed during 2020, both in males (-3 %) and females (-7 %). Suicide rates non-significantly decreased in most age groups; an increase, although not statistically significant, was found among males aged ≥75 years and females aged ≥85 years. Suicide deaths reduced mainly in Central-Southern areas and the Islands, while they slightly increased in the North especially among males. LIMITATIONS Study limitations include accuracy of death certification and the relatively brief observation period. CONCLUSIONS The study contributes to the analysis of early effects of the COVID-19 pandemic on suicide mortality in the whole population highlighting sex, age and territorial differences and suggesting to monitor possible increases in a longer observation period.
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Affiliation(s)
- Enrico Grande
- National Institute of Statistics, Integrated system for health, social assistance and welfare, Rome, Italy.
| | - Francesco Grippo
- National Institute of Statistics, Integrated system for health, social assistance and welfare, Rome, Italy
| | - Roberta Crialesi
- National Institute of Statistics, Integrated system for health, social assistance and welfare, Rome, Italy
| | - Stefano Marchetti
- National Institute of Statistics, Integrated system for health, social assistance and welfare, Rome, Italy
| | - Luisa Frova
- National Institute of Statistics, Integrated system for health, social assistance and welfare, Rome, Italy
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Bové HM, Noer VR, Mousing CA. Being a Hospice Nurse in Times of the COVID-19 Pandemic: A Phenomenological Study of Providing End-of-Life Care. J Hosp Palliat Nurs 2023; 25:277-285. [PMID: 37302804 DOI: 10.1097/njh.0000000000000961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
End-of-life care changed during the COVID-19 pandemic, and the previous prevailing hospice philosophy and essential values of hospice care were suddenly under pressure. The aim was to explore hospice nurses' lived experience of providing end-of-life care to patients admitted in an out-hospital hospice setting during the COVID-19 pandemic. Data consist of 10 individual in-depth interviews of hospice nurses. A purposive sampling strategy was used, and the data collection and analysis was guided by a descriptive phenomenology. Providing end-of-life care was described through an existential dimension and a practical-related dimension. The pandemic and the ensuing constraints created an unfamiliar gap, triggering insecurity and unfamiliarity within nursing. Findings are elaborated in the following constituents: being a hospice nurse and providing end-of-life care. The latter constituent was further elucidated in additional perspectives: a new job position and bending the rules. Providing end-of-life care during the COVID-19 regime was a highly challenging and distressing experience due to the coercion of maintaining rules and restrictions as well as providing care. An experience of having to reinvent and work within a new agenda was present. Furthermore, the nurses experienced significant loss of job satisfaction and may be morally injured as well as highly exposed to secondary traumatization.
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Garcia-Ptacek S, Xu H, Annetorp M, Jerlardtz VB, Cederholm T, Engström M, Kivipelto M, Lundberg LG, Metzner C, Olsson M, Nyvang JS, Sühl Öberg C, Åkesson E, Religa D, Eriksdotter M. Temporal trends in hospitalizations and 30-day mortality in older patients during the COVID pandemic from March 2020 to July 2021. PLoS One 2023; 18:e0291237. [PMID: 37708110 PMCID: PMC10501674 DOI: 10.1371/journal.pone.0291237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Accepted: 08/24/2023] [Indexed: 09/16/2023] Open
Abstract
BACKGROUND A reduction in mortality risk of COVID-19 throughout the first wave of the pandemic has been reported, but less is known about later waves. This study aimed to describe changes in hospitalizations and mortality of patients receiving inpatient geriatric care for COVID-19 or other causes during the pandemic. METHODS Patients 70 years and older hospitalized in geriatric hospitals in Stockholm for COVID-19 or other causes between March 2020-July 2021 were included. Data on the incidence of COVID-positive cases and 30-day mortality of the total ≥ 70-year-old population, in relation to weekly hospitalizations and mortality after hospital admissions were analyzed. Findings The total number of hospitalizations was 5,320 for COVID-19 and 32,243 for non-COVID-cases. In COVID-patients, the 30-day mortality rate was highest at the beginning of the first wave (29% in March-April 2020), reached 17% at the second wave peak (November-December) followed by 11-13% in the third wave (March-July 2021). The mortality in non-COVID geriatric patients showed a similar trend, but of lower magnitude (5-10%). During the incidence peaks, COVID-19 hospitalizations displaced non-COVID geriatric patients. INTERPRETATION Hospital admissions and 30-day mortality after hospitalizations for COVID-19 increased in periods of high community transmission, albeit with decreasing mortality rates from wave 1 to 3, with a probable vaccination effect in wave 3. Thus, the healthcare system could not compensate for the high community spread of COVID-19 during the pandemic peaks, which also led to displacing care for non-COVID geriatric patients.
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Affiliation(s)
- Sara Garcia-Ptacek
- Department of Neurobiology, Division of Clinical Geriatrics, Karolinska Institutet, Care Sciences and Society, Stockholm, Sweden
- Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden
| | - Hong Xu
- Department of Neurobiology, Division of Clinical Geriatrics, Karolinska Institutet, Care Sciences and Society, Stockholm, Sweden
| | - Martin Annetorp
- Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden
| | | | - Tommy Cederholm
- Department of Neurobiology, Division of Clinical Geriatrics, Karolinska Institutet, Care Sciences and Society, Stockholm, Sweden
- Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden
| | - Malin Engström
- Department of Geriatric Medicine, Sabbatsbergsgeriatriken, Stockholm, Sweden
| | - Miia Kivipelto
- Department of Neurobiology, Division of Clinical Geriatrics, Karolinska Institutet, Care Sciences and Society, Stockholm, Sweden
- Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden
| | - Lars Göran Lundberg
- Department of Geriatric Medicine, Dalengeriatriken Aleris Närsjukvård AB, Stockholm, Sweden
| | - Carina Metzner
- Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden
| | - Maria Olsson
- Department of Geriatric Medicine, Capio Geriatrik Löwet, Stockholm, Sweden
- Department of Geriatric Medicine, Capio Geriatrik Sollentuna, Stockholm, Sweden
| | | | - Carina Sühl Öberg
- Department of Geriatric Medicine, Handengeriatriken, Aleris Närsjukvård AB, Stockholm, Sweden
| | - Elisabet Åkesson
- Department of Neurobiology, Division of Neurogeriatrics, Karolinska Institutet, Care Sciences and Society, Stockholm, Sweden
- R&D Unit, Stockholms Sjukhem, Stockholm, Sweden
| | - Dorota Religa
- Department of Neurobiology, Division of Clinical Geriatrics, Karolinska Institutet, Care Sciences and Society, Stockholm, Sweden
- Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden
| | - Maria Eriksdotter
- Department of Neurobiology, Division of Clinical Geriatrics, Karolinska Institutet, Care Sciences and Society, Stockholm, Sweden
- Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden
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Park H, Lee SM, Kim WJ, Chae Y. Analysis of compound health impacts of heatwave and COVID-19 in Korea from May to September in 2020. Sci Rep 2023; 13:14880. [PMID: 37689740 PMCID: PMC10492780 DOI: 10.1038/s41598-023-41880-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 09/01/2023] [Indexed: 09/11/2023] Open
Abstract
The number of non-accidental deaths and heat-related illnesses due to the co-occurrence of heatwaves and COVID-19 has been identified to estimate compound health impacts between two risks. We have analyzed data from historical years (2013-2019) to calculate the baseline values of the number of non-accidental deaths and heat-related illness patients from May to September using a quasi-Poisson generalized linear model and compared them to data from 2020 in Korea. We also assessed the relative risk and absolute cumulative number of non-accidental deaths and heat-related illnesses in the summer of 2020 in Seoul, Daegu, and Gyeongnam region of Korea. In the Summer of 2020, Korea experienced 0.8% of non-accidental excess deaths, with the highest in August, and 46% of reduction was observed in heat-related throughout the study period, except in Daegu, where excess of heat-related illness occurred in August. The relative risk (RR) of non-accidental deaths at 33.1 °C, was 1.00 (CI 0.99-1.01) and 1.04 (CI 1.02-1.07) in 2013-2019 and 2020, respectively. The RR of heat-related illness at 33.1 °C, was 1.44 (CI 1.42-1.45) and 1.59 (CI 1.54-1.64) in 2013-2019 and 2020, respectively. The absolute cumulative trends of non-accidental deaths and heat-related illnesses were similar in the three regions, indicating increased non-accidental deaths and decreased heat-related illnesses at similar temperatures in 2020. During the COVID-19 pandemic, the fear of infection by the virus and the limited access to healthcare services led to changes in health-seeking behaviors. These results indicate social distancing could have had adverse impacts on other health conditions. A comprehensive health risk assessment is important when facing simultaneous risks, such as heatwaves and pandemics, in the implementation of effective countermeasures.
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Affiliation(s)
- Haemin Park
- Korea Environment Institute, 370 Sicheong-Daero, Sejong, 30147, Republic of Korea
| | - Sang-Min Lee
- Korea Environment Institute, 370 Sicheong-Daero, Sejong, 30147, Republic of Korea
| | - Woo Joong Kim
- Korea Environment Institute, 370 Sicheong-Daero, Sejong, 30147, Republic of Korea
| | - Yeora Chae
- Korea Environment Institute, 370 Sicheong-Daero, Sejong, 30147, Republic of Korea.
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12
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Ashruf OS, Orozco Z, Kaelber DC. Risk and Severity of COVID-19 Infection in Monoclonal Gammopathy of Undetermined Significance: A 3-Year Propensity Matched Cohort Study. CLINICAL LYMPHOMA, MYELOMA & LEUKEMIA 2023; 23:626-632. [PMID: 37208255 PMCID: PMC10140469 DOI: 10.1016/j.clml.2023.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 04/21/2023] [Accepted: 04/24/2023] [Indexed: 05/21/2023]
Abstract
INTRODUCTION Monoclonal gammopathy of undetermined significance (MGUS) is a premalignant disorder causing monoclonal plasma cell proliferation in bone marrow. This population is at risk of developing multiple myeloma (MM) and severe viral infections; risk factors of severe COVID-19 infection. Using TriNetX, a global platform providing data of 120 million patients, we aimed to quantify the risk and severity of COVID-19 in MGUS patients. PATIENTS AND METHODS A retrospective cohort analysis was performed using the TriNetX Global Collaborative Network. From January 20, 2020, to January 20, 2023, we identified a cohort of 58,859 MGUS patients and compared to non-MGUS patients, determined by relevant diagnosis/LOINC test codes. After 1:1 propensity score-matching, we identified COVID-19 cases to quantify risk and identify patients who had been hospitalized, ventilated/intubated, and deceased to quantify severity. Measures of association and Kaplan-Meier analysis were conducted. RESULTS After propensity-score matching, there were 58,668 patients in both cohorts. MGUS patients were found to be at a reduced risk of contracting COVID-19 (RR 0.88, 95% CI 0.85-0.91). MGUS patients with COVID-19 showed higher mortality risk and decreased survival time compared to the general population (HR 1.14, 95% CI 1.01-1.27). MGUS patients with COVID-19 who were hospitalized exhibited significantly decreased survival time (log-rank test, P = 0.04). CONCLUSION As COVID-19 remains a looming health concern, especially amongst vulnerable populations, our analysis emphasizes the need for adequate vaccination and treatment regimens as well as an understanding of the severity of infection in MGUS patients and justification for precautionary measures.
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Affiliation(s)
- Omer S Ashruf
- Northeast Ohio Medical University, College of Medicine, Rootstown, OH, United States.
| | - Zara Orozco
- Northeast Ohio Medical University, College of Medicine, Rootstown, OH, United States
| | - David C Kaelber
- Center for Education and Training in Health Informatics, The Metro Health System and the Departments of Internal Medicine, Pediatrics, and Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, United States
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13
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Moreira I, Ferrer M, Vilagut G, Mortier P, Felez-Nobrega M, Domènech-Abella J, Haro JM, Alonso J. Social inequalities in mental and physical health derived from the COVID-19 pandemic in Spain beyond SARS-CoV-2 infection. Int J Equity Health 2023; 22:136. [PMID: 37488575 PMCID: PMC10367254 DOI: 10.1186/s12939-023-01933-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 06/12/2023] [Indexed: 07/26/2023] Open
Abstract
BACKGROUND Understanding the impact of the COVID-19 crisis on health involves conducting longitudinal studies to evaluate the inequalities that may have been exacerbated by the pandemic. The purpose of this study was to estimate differences in physical and mental health derived from the COVID-19 pandemic, beyond SARS-CoV-2 infection, in the Spanish general population according to the participants' level of education; and to assess the evolution of these differences from June 2020 (just after the lockdown) to nine months later (February-March 2021). METHODS This is a longitudinal prospective study of a representative sample of non-institutionalized Spanish adults, through computer-assisted telephone interviews. Mobility, self-care, usual activities, pain/discomfort and anxiety/depression problems were measured with EQ-5D-5L. Prevalence ratio (PR) between high and low education levels and adjusted PR were estimated by Poisson regression models. Analyses were stratified by gender. RESULTS A total of 2,000 participants answered both surveys. Individuals with low level of education reported more health problems in both genders, and absolute inequalities remained quite constant (mobility and self-care problems) or decreased (pain/discomfort and anxiety/depression problems). The greatest relative inequalities were observed just after the lockdown, with age-adjusted PR ranging from 1.31 (95%CI 1.08-1.59) for women and 1.34 (95%CI 1.05-1.69) for men in pain/discomfort to 2.59 (95%CI 0.98-6.81) for women and 4.03 (95%CI 1.52-10.70) for men in self-care; aPR decreased after nine months for most dimensions. CONCLUSIONS Prevalence of health problems increased during the COVID-19 pandemic in all education groups, but the increase was higher in women and men with a high level of education, suggesting that its impact appeared later in this group. Further analysis on the role of governmental economic aid given to vulnerable people might shed light on this evolution.
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Affiliation(s)
- Isabel Moreira
- Health Services Research Group, Hospital del Mar Research Institute, Doctor Aiguader 88, office 144, Barcelona, 08003, Spain
- Preventive Medicine and Public Health Training Unit PSMar-UPF-ASPB (Parc de Salut Mar - Universitat Pompeu Fabra - Agència de Salut Pública de Barcelona), Barcelona, Spain
| | - Montse Ferrer
- Health Services Research Group, Hospital del Mar Research Institute, Doctor Aiguader 88, office 144, Barcelona, 08003, Spain.
- CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.
- Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain.
| | - Gemma Vilagut
- Health Services Research Group, Hospital del Mar Research Institute, Doctor Aiguader 88, office 144, Barcelona, 08003, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Philippe Mortier
- Health Services Research Group, Hospital del Mar Research Institute, Doctor Aiguader 88, office 144, Barcelona, 08003, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | | | - Joan Domènech-Abella
- Parc Sanitari Sant Joan de Déu, Barcelona, Spain
- CIBER de Salud Mental (CIBERSAM), Madrid, Spain
| | - Josep-Maria Haro
- Parc Sanitari Sant Joan de Déu, Barcelona, Spain
- CIBER de Salud Mental (CIBERSAM), Madrid, Spain
- Instituto de Investigación del Hospital de la Princesa, Madrid, Spain
| | - Jordi Alonso
- Health Services Research Group, Hospital del Mar Research Institute, Doctor Aiguader 88, office 144, Barcelona, 08003, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
- Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain
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14
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Bezzio C, Vernero M, Costa S, Armuzzi A, Fiorino G, Ardizzone S, Roselli J, Carparelli S, Orlando A, Caprioli FA, Castiglione F, Viganò C, Ribaldone DG, Zingone F, Monterubbianesi R, Imperatore N, Festa S, Daperno M, Scucchi L, Ferronato A, Pastorelli L, Alimenti E, Balestrieri P, Ricci C, Cappello M, Felice C, Coppini F, Alvisi P, Di Luna I, Gerardi V, Variola A, Mazzuoli S, Lenti MV, Saibeni S. SARS-CoV-2 infection in patients with inflammatory bowel disease: comparison between the first and second pandemic waves. BMC Gastroenterol 2023; 23:230. [PMID: 37407913 DOI: 10.1186/s12876-023-02841-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 05/30/2023] [Indexed: 07/07/2023] Open
Abstract
BACKGROUND In Italy, the incidence of SARS-CoV-2 infection peaked in April and November 2020, defining two pandemic waves of coronavirus disease 2019 (COVID-19). This study compared the characteristics and outcomes of patients with inflammatory bowel disease (IBD) and SARS-CoV-2 infections between pandemic waves. METHODS Observational longitudinal study of IBD patients with SARS-CoV-2 infection. Patients with established diagnoses of IBD and of SARS-CoV-2 infection were consecutively enrolled in two periods: (i) first wave, from 1 March 2020 to 31 May 2020; and (ii) second wave, from 15 September to 15 December 2020. RESULTS We enrolled 937 IBD patients (219 in the first wave, 718 in the second wave). Patients of the first wave were older (mean ± SD: 46.3 ± 16.2 vs. 44.1 ± 15.4 years, p = 0.06), more likely to have ulcerative colitis (58.0% vs. 44.4%, p < 0.001) and comorbidities (48.9% vs. 38.9%; p < 0.01), and more frequently residing in Northern Italy (73.1% vs. 46.0%, p < 0.001) than patients of the second wave. There were no significant differences between pandemic waves in sex (male: 54.3% vs. 53.3%, p = 0.82) or frequency of active IBD (44.3% vs. 39.0%, p = 0.18). The rates of negative outcomes were significantly higher in the first than second wave: pneumonia (27.8% vs. 11.7%, p < 0.001), hospital admission (27.4% vs. 9.7%, p < 0.001), ventilatory support (11.9% vs. 5.4%, p < 0.003) and death (5.5% vs. 1.8%, p < 0.007). CONCLUSION Between the first and second SARS-CoV-2 pandemic waves, demographic, clinical and geographical features of IBD patients were different as were the symptoms and outcomes of infection. These differences are likely due to the different epidemiological situations and diagnostic possibilities between the two waves.
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Affiliation(s)
- Cristina Bezzio
- Gastroenterology Unit, Rho Hospital, ASST Rhodense, Corso Europa 250, 20017, Rho, MI, Italy.
| | - Marta Vernero
- Department of Medical Sciences, University of Turin, Turin, Italy
| | - Stefania Costa
- Department of Medical Sciences, University of Turin, Turin, Italy
- , UO Gastroenterology, ASST Milano Ovest, Legnano (MI), Legnano, Italy
| | - Alessandro Armuzzi
- IBD Unit, IRCCS Humanitas Research Hospital, Rozzano, MI, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, MI, Italy
| | - Gionata Fiorino
- Gastroenterology and Endoscopy Unit, IRCCS Ospedale San Raffaele and University Vita-Salute San Raffaele, Milan, Italy
| | - Sandro Ardizzone
- Gastroenterology Unit, ASST Fatebenefratelli Sacco, Milan, Italy
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Jenny Roselli
- Gastroenterology Department, IBD Referral Center, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Sonia Carparelli
- Gastroenterology and Endoscopy Unit, Fondazione IRCCS Casa Sollievo Della Sofferenza, San Giovanni Rotondo, Italy
| | | | - Flavio Andrea Caprioli
- Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, Università Degli Studi Di Milano, Milan, Italy
| | - Fabiana Castiglione
- Gastroenterology Unit, Department of Clinical Medicine and Surgery, University Federico II of Naples, Naples, Italy
| | - Chiara Viganò
- European Reference Network on Hepatological Diseases (ERN RARE-LIVER), Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
| | - Davide G Ribaldone
- Division of Gastroenterology, Department of Medical Sciences, Università Di Torino, Turin, Italy
| | - Fabiana Zingone
- Department of Surgical, Oncological and Gastroenterological Sciences - DISCOG, University Hospital, Padua, Italy
| | - Rita Monterubbianesi
- Gastroenterology and Endoscopy Unit, Azienda Ospedaliera San Camillo Forlanini, Rome, Italy
| | - Nicola Imperatore
- Gastroenterology and Endoscopy Unit, P.O. Santa Maria delle Grazie, Pozzuoli, Naples, Italy
| | | | - Marco Daperno
- Gastroenterology Unit, Mauriziano Hospital, Turin, Italy
| | - Ludovica Scucchi
- Department of Systems Medicine, University Tor Vergata, Rome, Italy
| | - Antonio Ferronato
- UOSD Endoscopia Digestiva, Ospedale Alto Vicentino, AULSS 7 Pedemontana, Santorso, VI, Italy
| | - Luca Pastorelli
- Gastroenterology and Liver Unit, School of Medicine at Ospedale San Paolo, Department of Health Sciences, ASST Santi Paolo E Carlo, University of Milan, Milan, Italy
| | | | - Paola Balestrieri
- Gastroenterology and Endoscopy Unit, Policlinico Campus Bio Medico, Rome, Italy
| | - Chiara Ricci
- Gastroenterology Unit, Clinical and Experimental Sciences Department, Spedali Civili Hospital, University of Brescia, Brescia, Italy
| | - Maria Cappello
- Gastroenterology and Hepatology Section, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
| | - Carla Felice
- Medicine 1 Unit, Ca' Foncello University Hospital, Department of Medicine (DIMED), University of Padova, Padova, Italy
| | - Francesca Coppini
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Patrizia Alvisi
- Pediatric Gastroenterology Unit, Maggiore Hospital, Bologna, Italy
| | - Imma Di Luna
- Gastroenterology Unit, Department of Clinical Medicine and Surgery, University Federico II of Naples, Naples, Italy
| | - Viviana Gerardi
- Medicine, Gastroenterology and Digestive Endoscopy Department, Fondazione Poliambulanza, Brescia, Italy
| | - Angela Variola
- IBD Unit, IRCCS Sacro Cuore Don Calabria, Negrar, VR, Italy
| | - Silvia Mazzuoli
- Gastroenterology and Artificial Nutrition Department, Ospedale Monsignor Raffaele Dimiccoli, Barletta, BT, Italy
| | - Marco Vincenzo Lenti
- Department of Internal Medicine and Medical Therapeutics, University of Pavia, Pavia, Italy; First Department of Internal Medicine, San Matteo Hospital Foundation, Pavia, Italy
| | - Simone Saibeni
- Gastroenterology Unit, Rho Hospital, ASST Rhodense, Corso Europa 250, 20017, Rho, MI, Italy
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15
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Mazzilli S, Scardina G, Collini F, Forni S, Gianolio G, Bisceglia L, Lopalco PL, Chieti A, Onder G, Vanacore N, Bonaccorsi G, Gemmi F, Tavoschi L. Hospital admission and mortality rates for non-Covid diseases among residents of the long-term care facilities before and during the pandemic: a cohort study in two Italian regions. ZEITSCHRIFT FUR GESUNDHEITSWISSENSCHAFTEN = JOURNAL OF PUBLIC HEALTH 2023:1-13. [PMID: 37361287 PMCID: PMC10185456 DOI: 10.1007/s10389-023-01925-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Accepted: 04/28/2023] [Indexed: 06/28/2023]
Abstract
Aim Long-term-care facility residents are a vulnerable population who experienced reduced healthcare access during the pandemic. This study aimed to assess the indirect impact of the COVID-19 pandemic, in terms of hospitalisation and mortality rates, among this population in two Italian Regions, Tuscany and Apulia, during 2020 in comparison with the pre-pandemic period. Subject and methods We conducted a retrospective cohort study on people residing in long-term-care facilities from 1 January 2018 to 31 December 2020 (baseline period: 1 January 2018-8 March 2020; pandemic period: and 9 March-31 December 2020). Hospitalisation rates were stratified by sex and major disease groups. Standardised weekly rates were estimated with a Poisson regression model. Only for Tuscany, mortality risk at 30 days after hospitalisation was calculated with the Kaplan-Meier estimator. Mortality risk ratios were calculated using Cox proportional regression models. Results Nineteen thousand two hundred and fifty individuals spent at least 7 days in a long-term-care facility during the study period. The overall mean non-Covid hospital admission rate per 100 000 residents/week was 144.1 and 116.2 during the baseline and pandemic periods, with a decrease to 99.7 and 77.3 during the first (March-May) and second lockdown (November-December). Hospitalisation rates decreased for all major disease groups. Thirty-day mortality risk ratios for non-Covid conditions increased during the pandemic period (1.2, 1.1 to 1.4) compared with baseline. Conclusion The pandemic resulted in worse non-COVID-related health outcomes for long-term-care facilities' residents. There is a need to prioritise these facilities in national pandemic preparedness plans and to ensure their full integration in national surveillance systems. Supplementary information The online version contains supplementary material available at 10.1007/s10389-023-01925-1.
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Affiliation(s)
- Sara Mazzilli
- Scuola Normale Superiore, Pisa, Italy
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Giuditta Scardina
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Francesca Collini
- Quality and Equity Unit, Regional Health Agency of Tuscany, Florence, Italy
| | - Silvia Forni
- Quality and Equity Unit, Regional Health Agency of Tuscany, Florence, Italy
| | - Giulio Gianolio
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Lucia Bisceglia
- Strategic Regional Health and Social Agency of Puglia (AReSS Puglia), Bari, Italy
| | - Pier Luigi Lopalco
- Department of Biological and Environmental Sciences and Technology, University of Salento, Lecce, Italy
| | - Antonio Chieti
- Strategic Regional Health and Social Agency of Puglia (AReSS Puglia), Bari, Italy
| | - Graziano Onder
- Department of Cardiovascular, Endocrine-Metabolic Diseases and Aging, National Institute of Health, Rome, Italy
| | - Nicola Vanacore
- National Centre for Disease Prevention and Health Promotion, National Institute of Health, Rome, Italy
| | | | - Fabrizio Gemmi
- Quality and Equity Unit, Regional Health Agency of Tuscany, Florence, Italy
| | - Lara Tavoschi
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
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16
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Zazzara MB, Colloca GF, Maraschini A, Bellieni A, Dispenza S, Meloni E, Ricciotti MA, Penco I, Minelli G, Onder G. Causes of deaths in long-term care and hospice care facilities during the first year of COVID-19 pandemic: a snapshot of Italy during 2020. Aging Clin Exp Res 2023; 35:1385-1392. [PMID: 37171537 PMCID: PMC10175910 DOI: 10.1007/s40520-023-02426-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 04/25/2023] [Indexed: 05/13/2023]
Abstract
BACKGROUND Older adults living in long-term care facilities (LTCF) have been severely affected by COVID-19. Hospice care (HC) facilities and palliative care are essential in treating patients dying from COVID-19. In Italy, little is known about the impact of COVID-19 on deaths in LTCF and the care provided in HC to COVID-19 patients. AIM To assess overall and case-specific mortality in 2020 in LTC and HC facilities in comparison to the previous five years (2015-2019). METHODS We performed a descriptive study using data derived from the Italian national "Cause of Death" registry-managed by the Italian National Institute of Statistics-on deaths occurred in LTC and HC facilities during 2020 and the period 2015-2019. RESULTS Number of deaths significantly increased in 2020 compared with 2015-2019 in LTCF (83,062 deaths vs. 59,200) and slightly decreased in hospices (38,788 vs. 39,652). COVID-19 caused 12.5% of deaths in LTCF and only 2% in hospices. Other than COVID-19, in 2020, cancer accounted for 77% of all deaths that occurred in HC, while cardiovascular diseases (35.6%) and psychotic and behavioral disorders (10%) were the most common causes of death in LTCF. Overall, 22% of the excess mortality registered in Italy during 2020 is represented by the deaths that occurred in LTCF. DISCUSSION AND CONCLUSION LTCF were disproportionally affected by COVID-19, while the response to the pandemic in HC was limited. These data can help plan strategies to limit the impact of future epidemics and to better understand residential care response to COVID-19 epidemic.
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Affiliation(s)
- Maria Beatrice Zazzara
- Fondazione Policlinico Universitario Agostino Gemelli IRCSS, Largo Agostino Gemelli 8, 00168, Rome, Italy.
| | | | - Alice Maraschini
- Statistical Service, Istituto Superiore di Sanità, Viale Regina Elena, 299, 00161, Rome, Italy
| | - Andrea Bellieni
- Fondazione Policlinico Universitario Agostino Gemelli IRCSS, Largo Agostino Gemelli 8, 00168, Rome, Italy
| | - Sabrina Dispenza
- Fondazione Policlinico Universitario Agostino Gemelli IRCSS, Largo Agostino Gemelli 8, 00168, Rome, Italy
| | - Eleonora Meloni
- Fondazione Policlinico Universitario Agostino Gemelli IRCSS, Largo Agostino Gemelli 8, 00168, Rome, Italy
| | - Maria Adelaide Ricciotti
- Fondazione Policlinico Universitario Agostino Gemelli IRCSS, Largo Agostino Gemelli 8, 00168, Rome, Italy
| | - Italo Penco
- Fondazione Sanità e Ricerca, Via Alessandro Poerio, 100, 00152, Rome, Italy
| | - Giada Minelli
- Statistical Service, Istituto Superiore di Sanità, Viale Regina Elena, 299, 00161, Rome, Italy
| | - Graziano Onder
- Fondazione Policlinico Universitario Agostino Gemelli IRCSS, Largo Agostino Gemelli 8, 00168, Rome, Italy
- Università Cattolica del Sacro Cuore, Largo Francesco Vito, 1, 00168, Rome, Italy
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17
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Kim JH, Ahn C, Park Y, Won M. Comparison of out-of-hospital cardiac arrests during the COVID-19 pandemic with those before the pandemic: an updated systematic review and meta-analysis. Front Public Health 2023; 11:1180511. [PMID: 37234770 PMCID: PMC10208072 DOI: 10.3389/fpubh.2023.1180511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 04/11/2023] [Indexed: 05/28/2023] Open
Abstract
The coronavirus disease of 2019 (COVID-19) pandemic, directly and indirectly, affected the emergency medical care system and resulted in worse out-of-hospital cardiac arrest (OHCA) outcomes and epidemiological features compared with those before the pandemic. This review compares the regional and temporal features of OHCA prognosis and epidemiological characteristics. Various databases were searched to compare the OHCA outcomes and epidemiological characteristics during the COVID-19 pandemic with before the pandemic. During the COVID-19 pandemic, survival and favorable neurological outcome rates were significantly lower than before. Survival to hospitalization, return of spontaneous circulation, endotracheal intubation, and use of an automated external defibrillator (AED) decreased significantly, whereas the use of a supraglottic airway device, the incidence of cardiac arrest at home, and response time of emergency medical service (EMS) increased significantly. Bystander CPR, unwitnessed cardiac arrest, EMS transfer time, use of mechanical CPR, and in-hospital target temperature management did not differ significantly. A subgroup analysis of the studies that included only the first wave with those that included the subsequent waves revealed the overall outcomes in which the epidemiological features of OHCA exhibited similar patterns. No significant regional differences between the OHCA survival rates in Asia before and during the pandemic were observed, although other variables varied by region. The COVID-19 pandemic altered the epidemiologic characteristics, survival rates, and neurological prognosis of OHCA patients. Review registration: PROSPERO (CRD42022339435).
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Affiliation(s)
- Jae Hwan Kim
- Department of Emergency Medicine, College of Medicine, Chung-Ang University, Seoul, Republic of Korea
| | - Chiwon Ahn
- Department of Emergency Medicine, College of Medicine, Chung-Ang University, Seoul, Republic of Korea
| | - Yeonkyung Park
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Veterans Health Service Medical Center, Seoul, Republic of Korea
| | - Moonho Won
- Department of Emergency Medicine, College of Medicine, Chung-Ang University, Seoul, Republic of Korea
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Bertuccio P, Perotti P, Mosconi G, Dalle Carbonare S, Manzoni F, Boschetti L, Marguati S, Paraluppi P, Blandi L, Gentile L, Gaeta M, Cecconami L, Odone A. The Effect of COVID-19 Pandemic on Overall and Cause-Specific Mortality in Pavia, Northern Italy: Updated Estimates for the Year 2021. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20085529. [PMID: 37107812 PMCID: PMC10138303 DOI: 10.3390/ijerph20085529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 04/12/2023] [Accepted: 04/14/2023] [Indexed: 05/11/2023]
Abstract
Excess mortality estimates are considered relevant indicators of direct and indirect pandemic effects on the population. Scant data have been published on cause-specific excess mortality. Using individual-level administrative data covering the Pavia province of Italian northern Lombardy region, we provided all-cause and cause-specific raw (RMR) and age-standardized (ASMR) mortality rates in 2021 and 2015-2019, the rate ratio, and 95% confidence intervals, overall and by sex. We obtained the excess deaths in 2021 as the difference between the number of observed and expected deaths from all causes and the two leading causes of death (all neoplasms and circulatory system diseases) by fitting over-dispersed quasi-Poisson regression models, accounting for temporal, seasonal and demographic changes. The total ASMR in 2021 was 972.4/100,000 (6836 certified deaths), with the highest ASMRs for circulatory system diseases (272.6/100,000) and all neoplasms (270.3/100,000), followed by COVID-19 (94.8/100,000 and 662 deaths). Compared to the expected, we estimated a total of 6.2% excess deaths in 2021 (7.2% in males and 5.4% in females), with no excess deaths from all neoplasms and a 6.2% reduction from circulatory system diseases. COVID-19 continued to affect total mortality in 2021, albeit to a lesser extent than in 2020, consistently with national patterns.
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Affiliation(s)
- Paola Bertuccio
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy
- Correspondence:
| | - Pietro Perotti
- Health Protection Agency of Pavia (ATS Pavia), 27100 Pavia, Italy
| | - Giansanto Mosconi
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy
| | | | - Federica Manzoni
- Health Protection Agency of Pavia (ATS Pavia), 27100 Pavia, Italy
| | | | - Stefano Marguati
- Health Protection Agency of Pavia (ATS Pavia), 27100 Pavia, Italy
| | - Paolo Paraluppi
- Health Protection Agency of Pavia (ATS Pavia), 27100 Pavia, Italy
| | - Lorenzo Blandi
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy
| | - Leandro Gentile
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy
| | - Maddalena Gaeta
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy
| | | | - Anna Odone
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy
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19
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Han L, Zhao S, Li S, Gu S, Deng X, Yang L, Ran J. Excess cardiovascular mortality across multiple COVID-19 waves in the United States from March 2020 to March 2022. NATURE CARDIOVASCULAR RESEARCH 2023; 2:322-333. [PMID: 39195997 DOI: 10.1038/s44161-023-00220-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 01/24/2023] [Indexed: 08/29/2024]
Abstract
The COVID-19 pandemic has limited the access of patients with cardiovascular diseases to healthcare services, causing excess deaths. However, a detailed analysis of temporal variations of excess cardiovascular mortality during the COVID-19 pandemic has been lacking. Here we estimate time-varied excess cardiovascular deaths (observed deaths versus expected deaths predicted by the negative binomial log-linear regression model) in the United States. From March 2020 to March 2022 there were 90,160 excess cardiovascular deaths, or 4.9% more cardiovascular deaths than expected. Two large peaks of national excess cardiovascular mortality were observed during the periods of March-June 2020 and June-November 2021, coinciding with two peaks of COVID-19 deaths, but the temporal patterns varied by state, age, sex and race and ethnicity. The excess cardiovascular death percentages were 5.7% and 4.0% in men and women, respectively, and 3.6%, 8.8%, 7.5% and 7.7% in non-Hispanic White, Black, Asian and Hispanic people, respectively. Our data highlight an urgent need for healthcare services optimization for patients with cardiovascular diseases in the COVID-19 era.
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Affiliation(s)
- Lefei Han
- School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- One Health Center, Shanghai Jiao Tong University-The University of Edinburgh, Shanghai, China
| | - Shi Zhao
- JC School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong SAR, China
| | - Siyuan Li
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Siyu Gu
- School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- One Health Center, Shanghai Jiao Tong University-The University of Edinburgh, Shanghai, China
| | - Xiaobei Deng
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lin Yang
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China.
| | - Jinjun Ran
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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Clinical Characteristics and Outcomes of Patients with Acute Respiratory Failure Due to SARS-CoV-2 Interstitial Pneumonia Treated with CPAP in a Medical Intermediate Care Setting: A Retrospective Observational Study on Comparison of Four Waves. J Clin Med 2023; 12:jcm12041562. [PMID: 36836094 PMCID: PMC9959438 DOI: 10.3390/jcm12041562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 02/08/2023] [Accepted: 02/10/2023] [Indexed: 02/18/2023] Open
Abstract
BACKGROUND In COVID-19 patients non-invasive-positive-pressure-ventilation (NIPPV) has held a challenging role to reduce mortality and the need for invasive mechanical ventilation (IMV). The aim of this study was to compare the characteristics of patients admitted to a Medical Intermediate Care Unit for acute respiratory failure due to SARS-CoV-2 pneumonia throughout four pandemic waves. METHODS The clinical data of 300 COVID-19 patients treated with continuous positive airway pressure (CPAP) were retrospectively analysed, from March-2020 to April-2022. RESULTS Non-survivors were older and more comorbid, whereas patients transferred to ICU were younger and had fewer pathologies. Patients were older (from 65 (29-91) years in I wave to 77 (32-94) in IV, p < 0.001) and with more comorbidities (from Charlson's Comorbidity Index = 3 (0-12) in I to 6 (1-12) in IV, p < 0.001). No statistical difference was found for in-hospital mortality (33.0%, 35.8%, 29.6% and 45.9% in I, II, III and IV, p = 0.216), although ICU-transfers rate decreased from 22.0% to 1.4%. CONCLUSIONS COVID-19 patients have become progressively older and with more comorbidities even in critical care area; from risk class analyses by age and comorbidity burden, in-hospital mortality rates remain high and are thus consistent over four waves while ICU-transfers have significantly reduced. Epidemiological changes need to be considered to improve the appropriateness of care.
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Roccetti M. Excess mortality and COVID-19 deaths in Italy: A peak comparison study. MATHEMATICAL BIOSCIENCES AND ENGINEERING : MBE 2023; 20:7042-7055. [PMID: 37161140 DOI: 10.3934/mbe.2023304] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
During a sanitary crisis, excess mortality measures the number of all-cause deaths, beyond what we would have expected if that crisis had not occurred. The high number of COVID-19 deaths started a debate in Italy with two opposite positions: those convinced that COVID-19 deaths were not by default excess deaths, because many COVID-19 deaths were not correctly registered, with most being attributable to other causes and to the overall crisis conditions; and those who presented the opposite hypothesis. We analyzed the curve of the all-cause excess mortality, during the period of January 5, 2020-October 31, 2022, compared to the curve of the daily confirmed COVID-19 deaths, investigating the association between excess mortality and the recurrence of COVID-19 waves in Italy. We compared the two curves looking for the corresponding highest peaks, and we found that 5 out of the 6 highest peaks (83.3%) of the excess mortality curve have occurred, on average, just a week before the concomitant COVID-19 waves hit their highest peaks of daily deaths (Mean 6.4 days; SD 2.4 days). This temporal correspondence between the moments when the excess mortality peaked and the highest peaks of the COVID-19 deaths, provides further evidence in favor of a positive correlation between COVID-19 deaths and all-cause excess mortality.
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Affiliation(s)
- Marco Roccetti
- Department of Computer Science and Engineering, University of Bologna, Bologna, Italy
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22
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Ceccarelli E, Minelli G, Egidi V, Jona Lasinio G. Assessment of Excess Mortality in Italy in 2020-2021 as a Function of Selected Macro-Factors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2812. [PMID: 36833508 PMCID: PMC9956038 DOI: 10.3390/ijerph20042812] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 02/01/2023] [Accepted: 02/02/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Excess mortality (EM) can reliably capture the impact of a pandemic, this study aims at assessing the numerous factors associated with EM during the COVID-19 pandemic in Italy. METHODS Mortality records (ISTAT 2015-2021) aggregated in the 610 Italian Labour Market Areas (LMAs) were used to obtain the EM P-scores to associate EM with socioeconomic variables. A two-step analysis was implemented: (1) Functional representation of EM and clustering. (2) Distinct functional regression by cluster. RESULTS The LMAs are divided into four clusters: 1 low EM; 2 moderate EM; 3 high EM; and 4 high EM-first wave. Low-Income showed a negative association with EM clusters 1 and 4. Population density and percentage of over 70 did not seem to affect EM significantly. Bed availability positively associates with EM during the first wave. The employment rate positively associates with EM during the first two waves, becoming negatively associated when the vaccination campaign began. CONCLUSIONS The clustering shows diverse behaviours by geography and time, the impact of socioeconomic characteristics, and local governments and health services' responses. The LMAs allow to draw a clear picture of local characteristics associated with the spread of the virus. The employment rate trend confirmed that essential workers were at risk, especially during the first wave.
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Affiliation(s)
| | - Giada Minelli
- Statistical Service, Istituto Superiore di Sanità, 00161 Rome, Italy
| | - Viviana Egidi
- Department of Statistical Sciences, La Sapienza University, 00185 Rome, Italy
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23
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Marchi S, Coppola C, Piu P, Benincasa L, Dapporto F, Manenti A, Viviani S, Montomoli E, Trombetta CM. SARS-CoV-2 epidemiological trend before vaccination era: a seroprevalence study in Apulia, Southern Italy, in 2020. ZEITSCHRIFT FUR GESUNDHEITSWISSENSCHAFTEN = JOURNAL OF PUBLIC HEALTH 2023:1-6. [PMID: 36776202 PMCID: PMC9898852 DOI: 10.1007/s10389-023-01834-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 01/23/2023] [Indexed: 02/09/2023]
Abstract
Aim The present study aimed at assessing the prevalence of antibodies against SARS-CoV-2 in the general population in the province of Bari (Apulia region, Southern Italy) during the year 2020. Subject and methods In this study, 1325 serum samples collected from January to December 2020 were tested for the presence of IgM and IgG antibodies against whole-virus SARS-CoV-2 antigen by commercial ELISA. Positive samples were further tested by in-house ELISA for the detection of anti-receptor binding domain (RBD) IgM and IgG antibodies and by micro-neutralization (MN) assay for the detection of neutralizing antibody. Results One hundred (7.55%) samples had the presence of at least one antibody class against SARS-CoV-2 by commercial ELISA, of which 88 (6.6%) showed IgG and 19 (1.4%) showed IgM antibodies. The proportion of samples with IgG antibodies increased from 1.9% in January-February to 9.6% in November-December, while no significant increase was observed for IgM. When tested by in-house ELISA and MN assay, 17.0% and 31.6% were found positive to RBD IgG and RBD IgM, respectively, while 12.0% showed neutralizing antibody. Conclusion The proportion of samples with SARS-CoV-2 IgG antibodies increased during 2020, especially in the second half of the year, consistent with data reported by the routine epidemiological surveillance of SARS-CoV-2 cases. Despite the high number of reported cases, the seroprevalence values are relatively low, and only a small proportion of samples had neutralizing antibodies. Supplementary Information The online version contains supplementary material available at 10.1007/s10389-023-01834-3.
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Affiliation(s)
- Serena Marchi
- Department of Molecular and Developmental Medicine, University of Siena, 53100 Siena, Italy
| | - Chiara Coppola
- Department of Molecular and Developmental Medicine, University of Siena, 53100 Siena, Italy
| | | | | | | | | | - Simonetta Viviani
- Department of Molecular and Developmental Medicine, University of Siena, 53100 Siena, Italy
| | - Emanuele Montomoli
- Department of Molecular and Developmental Medicine, University of Siena, 53100 Siena, Italy
- VisMederi srl, 53100 Siena, Italy
- VisMederi Research srl, 53100 Siena, Italy
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Pilotto A, Custodero C, Palmer K, Sanchez-Garcia EM, Topinkova E, Polidori MC. A multidimensional approach to older patients during COVID-19 pandemic: a position paper of the Special Interest Group on Comprehensive Geriatric Assessment of the European Geriatric Medicine Society (EuGMS). Eur Geriatr Med 2023; 14:33-41. [PMID: 36656486 PMCID: PMC9851592 DOI: 10.1007/s41999-022-00740-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 12/24/2022] [Indexed: 01/20/2023]
Abstract
PURPOSE The COVID-19 pandemic has been a dramatic trigger that has challenged the intrinsic capacity of older adults and of society. Due to the consequences for the older population worldwide, the Special Interest Group on Comprehensive Geriatric Assessment (CGA) of the European Geriatric Medicine Society (EuGMS) took the initiative of collecting evidence on the usefulness of the CGA-based multidimensional approach to older people during the COVID-19 pandemic. METHODS A narrative review of the most relevant articles published between January 2020 and November 2022 that focused on the multidimensional assessment of older adults during the COVID-19 pandemic. RESULTS Current evidence supports the critical role of the multidimensional approach to identify older adults hospitalized with COVID-19 at higher risk of longer hospitalization, functional decline, and short-term mortality. This approach appears to also be pivotal for the adequate stratification and management of the post-COVID condition as well as for the adoption of preventive measures (e.g., vaccinations, healthy lifestyle) among non-infected individuals. CONCLUSION Collecting information on multiple health domains (e.g., functional, cognitive, nutritional, social status, mobility, comorbidities, and polypharmacy) provides a better understanding of the intrinsic capacities and resilience of older adults affected by SARS-CoV-2 infection. The EuGMS SIG on CGA endorses the adoption of the multidimensional approach to guide the clinical management of older adults during the COVID-19 pandemic.
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Affiliation(s)
- Alberto Pilotto
- Geriatrics Unit, Department of Geriatric Care, Orthogeriatrics and Rehabilitation, Galliera Hospital, Genoa, Italy.,Department of Interdisciplinary Medicine, Clinica Medica e Geriatria "Cesare Frugoni", University of Bari Aldo Moro, P.zza Giulio Cesare, 11, 70124, Bari, Italy
| | - Carlo Custodero
- Department of Interdisciplinary Medicine, Clinica Medica e Geriatria "Cesare Frugoni", University of Bari Aldo Moro, P.zza Giulio Cesare, 11, 70124, Bari, Italy.
| | - Katie Palmer
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | | | - Eva Topinkova
- Department of Geriatrics, First Faculty of Medicine, Charles University, Prague, Czech Republic.,Faculty of Health and Social Sciences, University of South Bohemia, Ceske Budejovice, Czech Republic
| | - Maria Cristina Polidori
- Ageing Clinical Research, Department II of Internal Medicine and Center for Molecular Medicine, University of Cologne, Cologne, Germany.,Cologne Excellence Cluster on Cellular Stress-Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany
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25
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Ceccarelli E, Dorrucci M, Minelli G, Jona Lasinio G, Prati S, Battaglini M, Corsetti G, Bella A, Boros S, Petrone D, Riccardo F, Maruotti A, Pezzotti P. Assessing COVID-19-Related Excess Mortality Using Multiple Approaches-Italy, 2020-2021. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192416998. [PMID: 36554878 PMCID: PMC9779266 DOI: 10.3390/ijerph192416998] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 12/12/2022] [Accepted: 12/14/2022] [Indexed: 05/13/2023]
Abstract
INTRODUCTION Excess mortality (EM) is a valid indicator of COVID-19's impact on public health. Several studies regarding the estimation of EM have been conducted in Italy, and some of them have shown conflicting values. We focused on three estimation models and compared their results with respect to the same target population, which allowed us to highlight their strengths and limitations. METHODS We selected three estimation models: model 1 (Maruotti et al.) is a Negative-Binomial GLMM with seasonal patterns; model 2 (Dorrucci et al.) is a Negative Binomial GLM epidemiological approach; and model 3 (Scortichini et al.) is a quasi-Poisson GLM time-series approach with temperature distributions. We extended the time windows of the original models until December 2021, computing various EM estimates to allow for comparisons. RESULTS We compared the results with our benchmark, the ISS-ISTAT official estimates. Model 1 was the most consistent, model 2 was almost identical, and model 3 differed from the two. Model 1 was the most stable towards changes in the baseline years, while model 2 had a lower cross-validation RMSE. DISCUSSION Presently, an unambiguous explanation of EM in Italy is not possible. We provide a range that we consider sound, given the high variability associated with the use of different models. However, all three models accurately represented the spatiotemporal trends of the pandemic waves in Italy.
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Affiliation(s)
- Emiliano Ceccarelli
- Statistical Service, Istituto Superiore di Sanità, 00161 Rome, Italy
- Correspondence:
| | - Maria Dorrucci
- Department of Infectious Diseases, Istituto Superiore di Sanità, 00161 Rome, Italy
| | - Giada Minelli
- Statistical Service, Istituto Superiore di Sanità, 00161 Rome, Italy
| | | | - Sabrina Prati
- Division of Population Register, Demographic and Living Conditions Statistics, Italian National Institute of Statistics, 00184 Rome, Italy
| | - Marco Battaglini
- Division of Population Register, Demographic and Living Conditions Statistics, Italian National Institute of Statistics, 00184 Rome, Italy
| | - Gianni Corsetti
- Division of Population Register, Demographic and Living Conditions Statistics, Italian National Institute of Statistics, 00184 Rome, Italy
| | - Antonino Bella
- Department of Infectious Diseases, Istituto Superiore di Sanità, 00161 Rome, Italy
| | - Stefano Boros
- Department of Infectious Diseases, Istituto Superiore di Sanità, 00161 Rome, Italy
| | - Daniele Petrone
- Department of Infectious Diseases, Istituto Superiore di Sanità, 00161 Rome, Italy
| | - Flavia Riccardo
- Department of Infectious Diseases, Istituto Superiore di Sanità, 00161 Rome, Italy
| | - Antonello Maruotti
- Dipartimento GEPLI, Libera Università Maria Ss Assunta, 00193 Rome, Italy
| | - Patrizio Pezzotti
- Department of Infectious Diseases, Istituto Superiore di Sanità, 00161 Rome, Italy
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26
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Cajachagua-Torres KN, Quezada-Pinedo HG, Huayanay-Espinoza CA, Obeso-Manrique JA, Peña-Rodríguez VA, Vidal E, Huicho L. COVID-19 and drivers of excess death rate in Peru: A longitudinal ecological study. Heliyon 2022; 8:e11948. [PMCID: PMC9710104 DOI: 10.1016/j.heliyon.2022.e11948] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 10/21/2022] [Accepted: 11/22/2022] [Indexed: 12/03/2022] Open
Abstract
Background Peru has experienced unprecedented mortality and economic toll due to the COVID-19 (Coronavirus disease 2019) pandemic in 2020. We aimed to assess the association between socioeconomic factors and excess death rate, and to explore the relative contribution of these factors to the differences in excess death rate during January–December 2020. Methods Different national secondary data sources were used to describe excess death rates and different determinants, from distal to proximal. A confounding-adjusted multilevel mixed-effects linear regression was used to assess the association between these variables and excess death rates. Their relative contributions to the differences in excess death rate between the periods with the highest and lowest excess death rates were analyzed through regression-based Oaxaca-Blinder decomposition methods. Findings The excess death rate showed an increasing trend in all regions, with different slopes. The confounding-adjusted multilevel analysis showed that higher healthcare access was associated with lower excess death rates (difference (95%CI) -0.004 (-0.005, -0.002)), whereas COVID-19 incidence was associated with higher excess death rates (difference (95%CI) 0.052 (0.042, 0.063)). The decomposition analysis showed COVID-19 incidence (41.9%), per capita income (19.4%) and unemployment rate (14.6%) as the main risk factors, while the main protective factors included per capita health expenditure (44.7%), healthcare access (33.2%) and health insurance (12.1%). Interpretation Our study suggests that the excess death rate during the COVID-19 pandemic in Peru may have been influenced by other factors besides COVID-19 incidence, from distal to proximal drivers, including socioeconomic determinants, factors outside and within the health sector, and susceptibility factors. Further studies at individual level are needed to corroborate our findings.
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Affiliation(s)
- Kim N. Cajachagua-Torres
- The Generation R Study Group, Erasmus MC, University Medical Centre Rotterdam, 3000, CA, Rotterdam, the Netherlands
- Centro de Investigación en Salud Materna e Infantil and Centro de Investigación para el Desarrollo Integral y Sostenible, Universidad Peruana Cayetano Heredia, 150135, Lima, Peru
- Corresponding author.
| | - Hugo G. Quezada-Pinedo
- The Generation R Study Group, Erasmus MC, University Medical Centre Rotterdam, 3000, CA, Rotterdam, the Netherlands
- Centro de Investigación en Salud Materna e Infantil and Centro de Investigación para el Desarrollo Integral y Sostenible, Universidad Peruana Cayetano Heredia, 150135, Lima, Peru
| | - Carlos A. Huayanay-Espinoza
- Centro de Investigación en Salud Materna e Infantil and Centro de Investigación para el Desarrollo Integral y Sostenible, Universidad Peruana Cayetano Heredia, 150135, Lima, Peru
| | - Jordan A. Obeso-Manrique
- Centro de Investigación en Salud Materna e Infantil and Centro de Investigación para el Desarrollo Integral y Sostenible, Universidad Peruana Cayetano Heredia, 150135, Lima, Peru
| | - Víctor A. Peña-Rodríguez
- Facultad de Ciencias Físicas, Universidad Nacional Mayor de San Marcos, 15081, Lima, Peru
- Centro de Investigaciones Tecnológicas, Biomédicas y Medioambientales, 15081, Lima, Peru
| | - Elisa Vidal
- Centro de Investigación en Salud Materna e Infantil and Centro de Investigación para el Desarrollo Integral y Sostenible, Universidad Peruana Cayetano Heredia, 150135, Lima, Peru
| | - Luis Huicho
- Centro de Investigación en Salud Materna e Infantil and Centro de Investigación para el Desarrollo Integral y Sostenible, Universidad Peruana Cayetano Heredia, 150135, Lima, Peru
- Facultad de Medicina “Alberto Hurtado”, Universidad Peruana Cayetano Heredia, 150135, Lima, Peru
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27
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Ng RWY, Boon SS, Chen Z, Ho WCS, Fung KSC, Wong BKC, Yeung ACM, Wong MCS, Chan PKS. Cross-Clade Memory Immunity in Adults Following SARS-CoV-1 Infection in 2003. JAMA Netw Open 2022; 5:e2247723. [PMID: 36538327 PMCID: PMC9856533 DOI: 10.1001/jamanetworkopen.2022.47723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
IMPORTANCE Knowledge of the longevity and breath of immune response to coronavirus infection is crucial for the development of next-generation vaccines to control the COVID-19 pandemic. OBJECTIVES To determine the profile of SARS-CoV-2 antibodies among persons infected with the closely related virus, SARS-CoV-1, in 2003 (SARS03 survivors) and to characterize their antibody response soon after the first and second doses of COVID-19 vaccines. DESIGN, SETTING, AND PARTICIPANTS This prospective cohort study examined SARS-CoV-2 antibodies among SARS03 survivors compared with sex- and age-matched infection-naive controls. Participants received the COVID-19 vaccines between March 1 and September 30, 2021. INTERVENTIONS One of the 2 COVID-19 vaccines (inactivated [CoronaVac] or messenger RNA [BNT162b2]) available in Hong Kong. Two doses were given according to the recommended schedule. The vaccine type administered was known to both participants and observers. MAIN OUTCOMES AND MEASURES SARS-CoV-2 antibodies were measured prevaccination, 7 days after the first dose, and 14 days after the second dose. RESULTS Eighteen SARS03 adult survivors (15 women and 3 men; median age, 46.5 [IQR, 40.0-54.3] years) underwent prevaccination serologic examination. The vast majority retained a detectable level of antibodies that cross-reacted with SARS-CoV-2 (16 of 18 [88.9%] with nucleocapsid protein antibodies and 17 of 18 [94.4%] with receptor-binding domain of spike protein antibodies); a substantial proportion (11 of 18 [61.1%]) had detectable cross-neutralizing antibodies. Twelve SARS03 adult survivors (10 women and 2 men) underwent postvaccination serologic examination. At 7 days after the first dose of vaccine, SARS03 survivors mounted significantly higher levels of neutralizing antibodies compared with controls (median inhibition: 89.5% [IQR, 77.1%-93.7%] vs 13.9% [IQR, 11.8%-16.1%] for BNT162b2; 64.9% [IQR, 60.8%-69.5%] vs 13.4% [IQR, 9.5%-16.8%] for CoronaVac; P < .001 for both). At 14 days after the second dose, SARS03 survivors generated a broader antibody response with significantly higher levels of neutralizing antibodies against variants of concern compared with controls (eg, median inhibition against Omicron variant, 52.1% [IQR, 35.8%-66.0%] vs 14.7% [IQR, 2.5%-20.7%]; P < .001). CONCLUSIONS AND RELEVANCE The findings of this prospective cohort study suggest that infection with SARS-CoV-1 was associated with detectable levels of antibodies that cross-react and cross-neutralize SARS-CoV-2, which belongs to a distinct clade under the same subgenus Sarbecovirus. These findings support the development of broadly protective vaccines to cover sarbecoviruses that caused 2 devastating zoonotic outbreaks in humans over the last 2 decades.
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Affiliation(s)
- Rita W. Y. Ng
- Department of Microbiology, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong
| | - Siaw S. Boon
- Department of Microbiology, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong
| | - Zigui Chen
- Department of Microbiology, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong
| | - Wendy C. S. Ho
- Department of Microbiology, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong
| | | | | | - Apple C. M. Yeung
- Department of Microbiology, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong
| | - Martin C. S. Wong
- JC School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong
| | - Paul K. S. Chan
- Department of Microbiology, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong
- Stanley Ho Centre for Emerging Infectious Diseases, Faulty of Medicine, Chinese University of Hong Kong, Hong Kong
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28
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Bertolotti M, Betti M, Giacchero F, Grasso C, Franceschetti G, Carotenuto M, Odone A, Pacileo G, Ferrante D, Maconi A. Long-Term Survival among Patients Hospitalized for COVID-19 during the First Three Epidemic Waves: An Observational Study in a Northern Italy Hospital. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15298. [PMID: 36430015 PMCID: PMC9690296 DOI: 10.3390/ijerph192215298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 11/14/2022] [Accepted: 11/18/2022] [Indexed: 06/16/2023]
Abstract
The mortality rate of hospitalized COVID-19 patients differed strongly between the first three pandemic waves. Nevertheless, their long-term survival has been poorly assessed. The aim of this study was to compare the clinical characteristics and mortality rates of 825 patients with coronavirus disease 2019 (COVID-19) infection who were hospitalized at the Alessandria hub hospital, in Northern Italy, during the first fifty days of the first three pandemic waves. Each subject was followed in terms of vital status for six months from the date of hospital admission or until deceased. Patients admitted during the three waves differed in age (p = 0.03), disease severity (p < 0.0001), Charlson comorbidity index (p = 0.0002), oxygen therapy (p = 0.002), and invasive mechanical ventilation (p < 0.0001). By the end of follow-up, 309 deaths (38.7%) were observed, of which 186 occurred during hub hospitalization (22.5%). Deaths were distributed differently among the waves (p < 0.0001), resulting in being higher amongst those subjects admitted during the first wave. The COVID-19 infection was reported as the main cause of death and patients with a higher mortality risk were those aged ≥65 years [adjusted HR = 3.40 (95% CI 2.20-5.24)], with a higher disease severity [adjusted HR = 1.87 (95%CI 1.43-2.45)], and those requiring oxygen therapy [adjusted HR = 2.30 (95%CI 1.61-3.30)]. In conclusion, COVID-19 patients admitted to our hub hospital during the second and the third waves had a lower risk of long-term mortality than those admitted during the first. Older age, more severe disease, and the need for oxygen therapy were among the strongest risk factors for poor prognosis.
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Affiliation(s)
- Marinella Bertolotti
- Research Training Innovation Infrastructure, Research and Innovation Department (DAIRI), Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy
| | - Marta Betti
- Research Training Innovation Infrastructure, Research and Innovation Department (DAIRI), Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy
| | - Fabio Giacchero
- Research Training Innovation Infrastructure, Research and Innovation Department (DAIRI), Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy
| | - Chiara Grasso
- Research Training Innovation Infrastructure, Research and Innovation Department (DAIRI), Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy
| | - Genny Franceschetti
- Medical Directorate, Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy
| | - Margherita Carotenuto
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy
| | - Anna Odone
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy
| | | | - Daniela Ferrante
- Unit of Medical Statistics, Department of Translational Medicine, Università del Piemonte Orientale and Cancer Epidemiology Unit, CPO-Piemonte, 28100 Novara, Italy
| | - Antonio Maconi
- Research Training Innovation Infrastructure, Research and Innovation Department (DAIRI), Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy
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Scacchi A, Conti A, Politano G, Dalmasso M, Ostellino S, Gianino MM. Impact of COVID-19 on emergency department visits among palliative home care recipients: a retrospective population-based cohort study in the Piedmont region, Italy. Palliat Care Soc Pract 2022; 16:26323524221136880. [PMID: 36405349 PMCID: PMC9666412 DOI: 10.1177/26323524221136880] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 10/14/2022] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Integrated palliative home care (IHPC) is delivered to patients with progressive end-stage diseases. During the COVID-19 pandemic, IHPC needed to provide high-quality home care services for patients who were treated at home, with the goal of avoiding unnecessary care, hospital admissions, and emergency department (ED) visits. This study aimed to compare the ED visits of IHPC recipients in a large Italian region before and during the first two waves of the COVID-19 pandemic and to find sociodemographic or clinical characteristics associated with changes in ED visits during the first two waves of COVID-19 pandemic, compared with the period before. METHODS Administrative databases were used to identify sociodemographic and clinical variables of IHPC recipients admitted before and during the pandemic. The obtained data were balanced by applying a propensity score. The average number of ED visits before and during the pandemic was calculated by using the Welch's t test and stratified by all the variables. RESULTS Before and during the pandemic, 5155 and 3177 recipients were admitted to IHPC, respectively. These individuals were primarily affected by neoplasms. ED visits of IHPC recipients reduced from 1346 to 467 before and during the pandemic, respectively. A reduced mortality among IHCP patients who had at least one ED visit during the pandemic (8% during the pandemic versus 15% before the pandemic) was found. The average number of ED visits decreased during the pandemic [0.143, confidence interval (CI) = (0.128-0.158) versus 0.264, CI = (0.242-0.286) before the pandemic; p < 0.001] for all ages and IHPC duration classes. The presence of a formal caregiver led to a significant decrease in ED use. Medium and high emergency ED admissions showed no difference, whereas a decrease in low-level emergency ED admissions during the pandemic [1.27, CI = (1.194-1.345) versus 1.439, CI = (1.3-1.579) before the pandemic; p = 0.036] was found. CONCLUSION ED visits among IHPC recipients were significantly decreased during the first two waves of the COVID-19 pandemic, especially in those individuals characterized by a low level of emergency. This did not result in an increase in mortality among IHPC recipients. These findings could inform the reorganization of home care services after the pandemic.
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Affiliation(s)
- Alessandro Scacchi
- Department of Public Health and Paediatric
Sciences, University of Turin, Turin, Italy
| | - Alessio Conti
- Department of Public Health and Paediatric
Sciences, University of Turin, Via Santena, 5 bis, Turin 10126, Italy
| | - Gianfranco Politano
- Department of Control and Computer Engineering,
Politecnico di Torino, Torino, Italy
| | - Marco Dalmasso
- Epidemiology Unit, Local Health Unit TO3,
Grugliasco, Italy
| | - Sofia Ostellino
- Department of Control and Computer Engineering,
Politecnico di Torino, Torino, Italy
| | - Maria Michela Gianino
- Department of Public Health and Paediatric
Sciences, University of Turin, Turin, Italy
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30
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Blanca D, Nicolosi S, Bandera A, Blasi F, Mantero M, Hu C, de Amicis MM, Lucchi T, Schinco G, Peyvandi F, Gualtierotti R, Fracanzani AL, Lombardi R, Canetta C, Montano N, Beretta L. Comparison between the first and second COVID-19 waves in Internal Medicine wards in Milan, Italy: a retrospective observational study. Intern Emerg Med 2022; 17:2219-2228. [PMID: 35970982 PMCID: PMC9377666 DOI: 10.1007/s11739-022-03052-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 07/09/2022] [Indexed: 01/08/2023]
Abstract
COVID-19 spread in two pandemic waves in Italy between 2020 and 2021. The aim of this study is to compare the first with the second COVID-19 wave, analyzing modifiable and non-modifiable factors and how these factors affected mortality in patients hospitalized in Internal Medicine wards. Consecutive patients with SARS-CoV-2 infection and dyspnea requiring O2 supplementation were included. The severity of lung involvement was categorized according to the patients' oxygen need. Six hundred and ten SARS-CoV-2 hospitalized patients satisfied the inclusion criteria. The overall estimated 4-week mortality was similar in the two pandemic waves. Several variables were associated with mortality after univariate analysis, but they lacked the significance after multivariable adjustment. Steroids did not exert any protective effect when analyzed in time-dependent models in the whole sample; however, steroids seemed to exert a protective effect in more severe patients. When analyzing the progression to different states of O2 supplementation during hospital stay, mortality was almost exclusively associated with the use of high-flow O2 or CPAP. The analysis of the transition from one state to the other by Cox-Markov models confirmed that age and the severity of lung involvement at admission, along with fever, were relevant factor for mortality or progression.
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Affiliation(s)
- Deborah Blanca
- Division of Internal Medicine, Immunology and Allergology, Center for Systemic Autoimmune Diseases, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, Università Degli Studi di Milano, Milan, Italy
| | - Selene Nicolosi
- Division of Internal Medicine, Immunology and Allergology, Center for Systemic Autoimmune Diseases, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, Università Degli Studi di Milano, Milan, Italy
| | - Alessandra Bandera
- Department of Pathophysiology and Transplantation, Università Degli Studi di Milano, Milan, Italy
- Department of Infectious Diseases, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Francesco Blasi
- Department of Pathophysiology and Transplantation, Università Degli Studi di Milano, Milan, Italy
- Respiratory Unit Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Marco Mantero
- Department of Pathophysiology and Transplantation, Università Degli Studi di Milano, Milan, Italy
- Respiratory Unit Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Cinzia Hu
- Department of Internal Medicine, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Tiziano Lucchi
- Geriatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giuseppina Schinco
- Geriatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Flora Peyvandi
- Department of Pathophysiology and Transplantation, Università Degli Studi di Milano, Milan, Italy
- Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Roberta Gualtierotti
- Department of Pathophysiology and Transplantation, Università Degli Studi di Milano, Milan, Italy
- Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Anna Ludovica Fracanzani
- Department of Pathophysiology and Transplantation, Università Degli Studi di Milano, Milan, Italy
- Unit of Medicine and Metabolic Disease, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Rosa Lombardi
- Department of Pathophysiology and Transplantation, Università Degli Studi di Milano, Milan, Italy
- Unit of Medicine and Metabolic Disease, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Ciro Canetta
- Department of Pathophysiology and Transplantation, Università Degli Studi di Milano, Milan, Italy
- High Care Internal Medicine Unit, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Nicola Montano
- Division of Internal Medicine, Immunology and Allergology, Center for Systemic Autoimmune Diseases, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, Università Degli Studi di Milano, Milan, Italy
| | - Lorenzo Beretta
- Division of Internal Medicine, Immunology and Allergology, Center for Systemic Autoimmune Diseases, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - on behalf of the Covid Network
- Division of Internal Medicine, Immunology and Allergology, Center for Systemic Autoimmune Diseases, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, Università Degli Studi di Milano, Milan, Italy
- Department of Infectious Diseases, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy
- Respiratory Unit Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy
- Department of Internal Medicine, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy
- Geriatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
- Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
- Unit of Medicine and Metabolic Disease, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
- High Care Internal Medicine Unit, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy
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31
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Remondi C, Cirimele F, Pastorelli C, Gerbino M, Gregori F, Plata MG, Zuffianò A. Conspiracy beliefs, regulatory self-efficacy and compliance with COVID-19 health-related behaviors: The mediating role of moral disengagement. CURRENT RESEARCH IN ECOLOGICAL AND SOCIAL PSYCHOLOGY 2022; 3:100069. [PMID: 36341468 PMCID: PMC9617670 DOI: 10.1016/j.cresp.2022.100069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 07/19/2022] [Accepted: 10/28/2022] [Indexed: 06/16/2023]
Abstract
Although recent studies on the 2019 coronavirus disease (COVID-19) have highlighted the negative effects of moral disengagement on intentions to comply with COVID-19 containment measures, little is known about the mediating role of moral disengagement in the relationship between regulatory self-efficacy in complying with the containment measures, beliefs in conspiracy theories and compliance with COVID-19 health-related behaviors. Data were collected from 1164 young adults (women, N = 796; 68.4%; mean age 25.60 ± 4.40 years) who completed an online survey from 15th May to 22nd June 2021. Results of the multi-group path analyses indicated that higher beliefs in conspiracy theories were associated with lower compliance with COVID-19 health-related behaviors, whereas higher self-efficacy beliefs in complying with the containment measures were associated with higher compliance with COVID-19 health-related behaviors. Moral disengagement significantly mediated the associations between beliefs in conspiracy theories, regulatory self-efficacy, and compliance with COVID-19 health-related behaviors. Finally, the tested model was gender-invariant. Findings suggest that public health authorities and social care professionals should promote interventions aimed at improving regulatory self-efficacy, emphasizing the moral significance of respecting or ignoring the recommended COVID-19 measures (e.g., physical distance in public), and enhancing people's concern for the potential harms of their immoral actions.
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Affiliation(s)
- Chiara Remondi
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | - Flavia Cirimele
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | | | - Maria Gerbino
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | - Fulvio Gregori
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | - Maryluz Gomez Plata
- Grupo de investigación Cognición y Educación, Programa de Psicología, Universidad del Magdalena, Santa Marta, Colombia
| | - Antonio Zuffianò
- Department of Psychology, Sapienza University of Rome, Rome, Italy
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Losurdo A, Lisa AVE, Tomatis M, Ponti A, Montemezzi S, Bonzano E, Fortunato L. Highly specialized Breast Centers did not experience delay of care during COVID-19 pandemic in Italy: the Senonetwork experience. Breast Cancer Res Treat 2022; 196:87-95. [PMID: 36018455 PMCID: PMC9412793 DOI: 10.1007/s10549-022-06694-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 07/24/2022] [Indexed: 11/30/2022]
Abstract
Aim of the study The study aims to evaluate the performance of selected, high-volume, highly specialized, Italian Breast Centers at the time of COVID-19 pandemic (year 2020), compared to pre-pandemic time (year 2019), highlighting differences in terms of clinical presentation of breast cancer (BC) and therapeutic strategies. Methods Patients’ data were provided by the Senonetwork data warehouse Senonet. In order to examine changes in the surgical and oncological management of BC patients during different phases of COVID-19 pandemic, we took advantage of a selection quality indicators (QIs). We performed the analyses in two time-frames, from July to September (Jul-Sep) (2019 versus 2020) and from October to December (Oct-Dec) (2019 versus 2020). Results Our analysis did not show any statistically significant difference in terms of diagnosis, surgical, oncological and radiation therapy procedures between the two trimesters 2019 and 2020. Nevertheless, we observed statistically significant differences, favoring 2020, when analyzing time-to surgery and time-to radiotherapy. On the other hand, we observed a significant reduction of neoadjuvant chemotherapy and we did not recollect any data on a major use of neoadjuvant endocrine therapy. Conclusions In Italian Breast Centers, partners of Senonetwork, we could not observe any treatment delay or change in standard clinical practice for BC care during the 2020 pandemic year, compared to 2019 pre-pandemic year. This finding is in contrast with the globally reported decrease in the performance of the Italian Breast Centers due to the COVID-19 pandemic, and has to be linked to the sharp selection of Senonetwork Breast Centers.
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Affiliation(s)
- Agnese Losurdo
- UO of Medical Oncology, Department of Oncology and Hematology, IRCCS Humanitas Research Hospital, via Manzoni 56, 20089, Rozzano, Milan, Italy.,Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090, Pieve Emanuele, Milan, Italy
| | - Andrea Vittorio Emanuele Lisa
- Department of Medical Biotechnology and Translational Medicine BIOMETRA - Plastic Surgery Unit, Reconstructive and Aesthetic Plastic Surgery School, University of Milan, Humanitas Research Hospital, IRCCS, Via Manzoni 56, 20089, Rozzano, Milan, Italy.
| | - Mariano Tomatis
- AOU Città della Salute e Della Scienza'University Hospital, CPO Piemonte, Turin, Italy
| | - Antonio Ponti
- AOU Città della Salute e Della Scienza'University Hospital, CPO Piemonte, Turin, Italy
| | - Stefania Montemezzi
- Department of Radiology, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Elisabetta Bonzano
- Radiation Oncology Department, Fondazione IRCCS Policlinico San Matteo and University of Pavia, Pavia, Italy
| | - Lucio Fortunato
- Breast Surgery Unit, Azienda Ospedaliera San Giovanni Addolorata, Rome, Italy
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Cascini S, Agabiti N, Marino C, Acampora A, Balducci M, Calandrini E, Davoli M, Bargagli AM. Incidence and Outcomes of SARS-CoV-2 Infection in Older Adults Living with Dementia: A Population-Based Cohort Study. J Alzheimers Dis 2022; 89:681-693. [PMID: 35912744 PMCID: PMC9535569 DOI: 10.3233/jad-220369] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Background: The identification of risk factors for SARS-CoV-2 infection and mortality in patients with dementia is a key aspect to support clinical decisions and public health interventions. Objective: To assess the incidence of SARS-CoV-2 infection and COVID-19 related death in a cohort of patients with dementia residing in the Lazio region and to investigate predicting factors for both infection and mortality. Methods: This population-based study used information from administrative databases and the SARS-CoV-2 infection surveillance system. Patients with dementia (age ≥65) were enrolled as of December 31, 2019 and followed-up until February 28, 2021. Cumulative risk of infection and death within 60 days of infection onset, and age-standardized incidence (SIR) and mortality (SMR) ratios were calculated. Logistic regression models were applied to identify factors associated with infection and mortality. Results: Among 37,729 dementia patients, 2,548 had a diagnosis of SARS-CoV-2 infection. The crude risk of infection was 6.7%. An increase in risk of infection was observed both in women (SIR 1.72; 95% CI 1.64–1.80) and men (SIR 1.43; 95% CI 1.33–1.54). Pneumonia, cerebrovascular and blood diseases, femur fracture, anxiety, antipsychotic and antithrombotic use were associated with an increased risk of infection. The crude risk of death was 31.0%, the SMRs 2.32 (95% CI 2.05–2.65) for men, and 2.82 (95% CI 2.55–3.11) for women. Factors associated with mortality included: male gender, age ≥85, symptoms at the diagnosis, antipsychotic and systemic antibiotics treatment. Conclusion: These findings emphasize the need of close and tailored monitoring of dementia patients to reduce the impact of COVID-19 on this fragile population.
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Affiliation(s)
- Silvia Cascini
- Department of Epidemiology of the Regional HealthService-Lazio, Rome, Italy
| | - Nera Agabiti
- Department of Epidemiology of the Regional HealthService-Lazio, Rome, Italy
| | - Claudia Marino
- Department of Epidemiology of the Regional HealthService-Lazio, Rome, Italy
| | - Anna Acampora
- Department of Epidemiology of the Regional HealthService-Lazio, Rome, Italy
| | - Maria Balducci
- Department of Epidemiology of the Regional HealthService-Lazio, Rome, Italy
| | - Enrico Calandrini
- Department of Epidemiology of the Regional HealthService-Lazio, Rome, Italy
| | - Marina Davoli
- Department of Epidemiology of the Regional HealthService-Lazio, Rome, Italy
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Marchi S, Lanave G, Camero M, Dapporto F, Manenti A, Benincasa L, Acciavatti A, Brogi G, Viviani S, Montomoli E, Trombetta CM. SARS-CoV-2 Circulation during the First Year of the Pandemic: A Seroprevalence Study from January to December 2020 in Tuscany, Italy. Viruses 2022; 14:v14071441. [PMID: 35891420 PMCID: PMC9324460 DOI: 10.3390/v14071441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 06/24/2022] [Accepted: 06/28/2022] [Indexed: 11/16/2022] Open
Abstract
Italy was the second country affected by the SARS-CoV-2 pandemic; the virus spread mainly in Northern Italy with a subsequent diffusion to the center and southern part of the country. In this study, we aimed to assess the prevalence of antibodies against SARS-CoV-2 in the general population of the Siena province in the Tuscany region (Central Italy) during 2020. A total of 2480 serum samples collected from January to December 2020 were tested for IgM and IgG antibodies against SARS-CoV-2 by a commercial ELISA. Positive and borderline samples were further tested for the presence of anti-receptor-binding domain (RBD) IgM and IgG antibodies by an in-house ELISA and by a micro-neutralization assay. Out of the 2480 samples tested by the commercial ELISA, 81 (3.3%) were found to be positive or borderline for IgG and 58 (2.3%) for IgM in a total of 133 samples (5.4%) found to be positive or borderline for at least one antibody class. When the commercial ELISA and in-house ELISA/micro-neutralization assay results were combined, 26 samples (1.0%) were positive for RBD IgG, 11 (0.4%) for RBD IgM, and 23 (0.9%) for a neutralizing antibody. An increase in seroprevalence was observed during the year 2020, especially from the end of summer, consistent with the routine epidemiological surveillance of COVID-19 cases.
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Affiliation(s)
- Serena Marchi
- Department of Molecular and Developmental Medicine, University of Siena, 53100 Siena, Italy; (S.V.); (E.M.); (C.M.T.)
- Correspondence:
| | - Gianvito Lanave
- Department of Veterinary Medicine, University of Bari, 70010 Valenzano, Italy; (G.L.); (M.C.)
| | - Michele Camero
- Department of Veterinary Medicine, University of Bari, 70010 Valenzano, Italy; (G.L.); (M.C.)
| | | | | | | | | | - Giulio Brogi
- NeoMedica Srl, 53100 Siena, Italy; (A.A.); (G.B.)
| | - Simonetta Viviani
- Department of Molecular and Developmental Medicine, University of Siena, 53100 Siena, Italy; (S.V.); (E.M.); (C.M.T.)
| | - Emanuele Montomoli
- Department of Molecular and Developmental Medicine, University of Siena, 53100 Siena, Italy; (S.V.); (E.M.); (C.M.T.)
- VisMederi Srl, 53100 Siena, Italy; (F.D.); (A.M.)
- VisMederi Research Srl, 53100 Siena, Italy;
| | - Claudia Maria Trombetta
- Department of Molecular and Developmental Medicine, University of Siena, 53100 Siena, Italy; (S.V.); (E.M.); (C.M.T.)
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Zanon M, Peruch M, Concato M, Moreschi C, Pizzolitto S, Radaelli D, D’Errico S. Spread of COVID-19 Infection in Long-Term Care Facilities of Trieste (Italy) during the Pre-Vaccination Era, Integrating Findings of 41 Forensic Autopsies with Geriatric Comorbidity Index as a Valid Option for the Assessment of Strength of Causation. Vaccines (Basel) 2022; 10:774. [PMID: 35632530 PMCID: PMC9146610 DOI: 10.3390/vaccines10050774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 05/02/2022] [Accepted: 05/11/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND in 2020, a new form of coronavirus spread around the world starting from China. The older people were the population most affected by the virus worldwide, in particular in Italy where more than 90% of deaths were people over 65 years. In these people, the definition of the cause of death is tricky due to the presence of numerous comorbidities. OBJECTIVE to determine whether COVID-19 was the cause of death in a series of older adults residents of nursing care homes. METHODS 41 autopsies were performed from May to June 2020. External examination, swabs, and macroscopic and microscopic examination were performed. RESULTS the case series consisted of nursing home guests; 15 men and 26 women, with a mean age of 87 years. The average number of comorbidities was 4. Based only on the autopsy results, the defined cause of death was acute respiratory failure due to diffuse alveolar damage (8%) or (31%) bronchopneumonia with one or more positive swabs for SARS-CoV-2. Acute cardiac failure with one or more positive swabs for SARS-CoV-2 was indicated as the cause of death in in symptomatic (37%) and asymptomatic (10%) patients. Few patients died for septic shock (three cases), malignant neoplastic diseases (two cases), and massive digestive bleeding (one case). CONCLUSIONS Data from post-mortem investigation were integrated with previously generated Geriatric Index of Comorbidity (GIC), resulting in four different degrees of probabilities: high (12%), intermediate (10%), low (59%), and none (19%), which define the level of strength of causation and the role of COVID-19 disease in determining death.
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Affiliation(s)
- Martina Zanon
- Department of Medical Surgical and Health Sciences, University of Trieste, 34149 Trieste, Italy; (M.Z.); (M.P.); (M.C.); (D.R.)
| | - Michela Peruch
- Department of Medical Surgical and Health Sciences, University of Trieste, 34149 Trieste, Italy; (M.Z.); (M.P.); (M.C.); (D.R.)
| | - Monica Concato
- Department of Medical Surgical and Health Sciences, University of Trieste, 34149 Trieste, Italy; (M.Z.); (M.P.); (M.C.); (D.R.)
| | - Carlo Moreschi
- Department of Medicine, Forensic Medicine University of Udine, 33100 Udine, Italy;
| | - Stefano Pizzolitto
- Department of Pathology, Santa Maria della Misericordia University Hospital, 33100 Udine, Italy;
| | - Davide Radaelli
- Department of Medical Surgical and Health Sciences, University of Trieste, 34149 Trieste, Italy; (M.Z.); (M.P.); (M.C.); (D.R.)
| | - Stefano D’Errico
- Department of Medical Surgical and Health Sciences, University of Trieste, 34149 Trieste, Italy; (M.Z.); (M.P.); (M.C.); (D.R.)
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Mangialavori S, Riva F, Froldi M, Carabelli S, Caimi B, Rossi P, Delle Fave A, Calicchio G. Psychological Distress and Resilience among Italian Healthcare Workers of Geriatric Services during the COVID-19 Pandemic. Geriatr Nurs 2022; 46:132-136. [PMID: 35700680 PMCID: PMC9135690 DOI: 10.1016/j.gerinurse.2022.05.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 05/16/2022] [Accepted: 05/17/2022] [Indexed: 02/07/2023]
Abstract
The COVID-19 pandemic exposed healthcare workers (HW) to heavy workload and psychological distress. This study was aimed to investigate distress levels among Italian physicians, nurses, rehabilitation professionals and healthcare assistants working in geriatric and long-term care services, and to explore the potential role of resilience as a protective resource. The General Health Questionnaire-12, the Connor-Davidson Resilience Scale, and a demographic survey were completed by 708 Italian HWs. Distress and resilience levels were compared between professionals through ANOVA; the contribution of sex, age, professional role, and resilience to distress was explored through regression analyses. Physicians reported significantly higher resilience and distress levels than rehabilitation professionals and healthcare assistants respectively. Women, HWs aged above 45, physicians, and participants reporting low resilience levels were at higher risk for distress. Findings suggest the importance of supporting HW's resilience to counterbalance the pandemic related distress.
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Affiliation(s)
- Sonia Mangialavori
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy.
| | - Fabiana Riva
- Institute of Geriatric Rehabilitation Pio Albergo Trivulzio, Milan, Italy
| | - Marco Froldi
- Institute of Geriatric Rehabilitation Pio Albergo Trivulzio, Milan, Italy; Department of Clinical and Community Sciences, Università degli Studi di Milano, Milan, Italy
| | - Simona Carabelli
- Institute of Geriatric Rehabilitation Pio Albergo Trivulzio, Milan, Italy
| | - Barbara Caimi
- Institute of Geriatric Rehabilitation Pio Albergo Trivulzio, Milan, Italy
| | - Pierluigi Rossi
- Institute of Geriatric Rehabilitation Pio Albergo Trivulzio, Milan, Italy
| | - Antonella Delle Fave
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Giuseppe Calicchio
- Institute of Geriatric Rehabilitation Pio Albergo Trivulzio, Milan, Italy; Department of Clinical and Community Sciences, Università degli Studi di Milano, Milan, Italy
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Pandolfi S, Valdenassi L, Bjørklund G, Chirumbolo S, Lysiuk R, Lenchyk L, Doşa MD, Fazio S. COVID-19 Medical and Pharmacological Management in the European Countries Compared to Italy: An Overview. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:4262. [PMID: 35409942 PMCID: PMC8998583 DOI: 10.3390/ijerph19074262] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 03/16/2022] [Accepted: 03/30/2022] [Indexed: 02/01/2023]
Abstract
(1) Background: Italy accounts for more than 150,000 deaths due to the COVID-19 pandemic, leading the top rank in SARS-CoV-2-caused deceases in Europe. A survey on the different ways by which the COVID-19 pandemic emergency was managed in the foreign European countries compared to Italy is the purpose of this paper. (2) Methods: A literature search and various mathematical algorithms to approach a rank scoring scale were used to describe in detail the different approaches used by European countries to manage the COVID-19 pandemic emergency. (3) Results: The study showed that Italy stands at the bottom ranking for COVID-19 management due to its high mortality rate. Possible causes of the observed huge numbers of hospitalization and deaths were (a) the demographic composition of the European country; (b) its decentralized healthcare system organization; (c) the role of correct pharmacology in the early stages before hospitalization. Post-mortem examinations were of paramount importance to elucidate the etiopathogenesis of COVID-19 and to tailor a suitable and proper therapy in the early symptomatic stages of COVID-19, preventing hospitalization. (4) Conclusions: Factors such as the significant impact on elderly people, the public health organization prevalently state-owned and represented mainly by hospitals, and criticism of the home therapy approach toward SARS-CoV-2-infected people, may have concurred in increasing the number of COVID-19 deaths in Italy.
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Affiliation(s)
- Sergio Pandolfi
- High School Master of Oxygen-Ozone Therapy, University of Pavia, 27100 Pavia, Italy; (S.P.); (L.V.)
| | - Luigi Valdenassi
- High School Master of Oxygen-Ozone Therapy, University of Pavia, 27100 Pavia, Italy; (S.P.); (L.V.)
| | - Geir Bjørklund
- Council for Nutritional and Environmental Medicine (CONEM), 8610 Mo i Rana, Norway;
| | - Salvatore Chirumbolo
- Council for Nutritional and Environmental Medicine (CONEM), 8610 Mo i Rana, Norway;
| | - Roman Lysiuk
- Department of Pharmacognosy and Botany, Danylo Halytsky Lviv National Medical University, 79010 Lviv, Ukraine;
| | - Larysa Lenchyk
- Department of Standardization Kharkiv, National University of Pharmacy, 61002 Kharkiv, Ukraine;
| | - Monica Daniela Doşa
- Department of Pharmacology, Faculty of Medicine, Ovidius University, 900527 Constanța, Romania;
| | - Serafino Fazio
- Department of Internal Medicine, University of Naples Federico II, 80138 Naples, Italy;
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Liu M, Shi L, Chen H, Wang X, Yang M, Jiao J, Yang J, Sun G. Comparison Between China and Brazil in the Two Waves of COVID-19 Prevention and Control. J Epidemiol Glob Health 2022; 12:168-181. [PMID: 35353368 PMCID: PMC8965218 DOI: 10.1007/s44197-022-00036-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 03/14/2022] [Indexed: 12/24/2022] Open
Abstract
Objective This study analyzes the effectiveness of COVID-19 prevention and control in China and Brazil from the perspectives of policy and meteorological conditions, and provides experience for epidemic prevention and control. Methods This study collects data on meteorological conditions, vaccination and mutant strains in the two countries to analyze the reasons for the differences in epidemic status between the two countries and extracts public data on COVID-19 through various official websites, summarizes the prevention and control policies implemented by the two countries, and evaluates their effectiveness. Results As of August 12, 2021, the total number of COVID-19 cases and the daily number of new COVID-19 cases in China have been growing steadily, showing remarkable results in epidemic control. The total number of confirmed cases and the daily number of new confirmed cases in Brazil have continued to increase rapidly. The total death case in Brazil has reached 560,000, far exceeding that in China, and the effect of epidemic prevention and control is not satisfactory. Conclusions Multiple factors, such as meteorological conditions, policies and strategies, and economic conditions, can influence the spread of COVID-19, and therefore, the situation varies greatly from country to country. China and Brazil have chosen different interventions in the fight against COVID-19. The policy measures taken by China are typical containment measures and Brazil has a mitigation strategy. From the perspective of the current situation of the epidemic development in both countries, the cumulative death rate and daily new confirmed cases in Brazil are much higher than those in China, which indicates that the containment strategy is more effective than mitigation strategy in preventing and controlling COVID-19. Fighting the epidemic is a global long-lasting battle, and the two countries should learn from each other with the premise of respecting their national conditions. Countries should deepen cooperation and not let up prematurely.
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Affiliation(s)
- Meiheng Liu
- Department of Health Management, School of Health Management, Southern Medical University, Guangzhou, Guangdong, 510515, People's Republic of China
| | - Leiyu Shi
- Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, 21205, USA
| | - Haiqian Chen
- Department of Health Management, School of Health Management, Southern Medical University, Guangzhou, Guangdong, 510515, People's Republic of China
| | - Xiaohan Wang
- Department of Health Management, School of Health Management, Southern Medical University, Guangzhou, Guangdong, 510515, People's Republic of China
| | - Manfei Yang
- Department of Health Management, School of Health Management, Southern Medical University, Guangzhou, Guangdong, 510515, People's Republic of China
| | - Jun Jiao
- Department of Health Management, School of Health Management, Southern Medical University, Guangzhou, Guangdong, 510515, People's Republic of China
| | - Junyan Yang
- Department of Health Management, School of Health Management, Southern Medical University, Guangzhou, Guangdong, 510515, People's Republic of China
| | - Gang Sun
- Department of Health Management, School of Health Management, Southern Medical University, Guangzhou, Guangdong, 510515, People's Republic of China.
- Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, 21205, USA.
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Minnai F, De Bellis G, Dragani TA, Colombo F. COVID-19 mortality in Italy varies by patient age, sex and pandemic wave. Sci Rep 2022; 12:4604. [PMID: 35301379 PMCID: PMC8929285 DOI: 10.1038/s41598-022-08573-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 03/01/2022] [Indexed: 01/08/2023] Open
Abstract
SARS-CoV-2 has caused a worldwide epidemic of enormous proportions, which resulted in different mortality rates in different countries for unknown reasons. We analyzed factors associated with mortality using data from the Italian national database of more than 4 million SARS-CoV-2-positive cases diagnosed between January 2020 and July 2021, including > 415 thousand hospitalized for coronavirus disease-19 (COVID-19) and > 127 thousand deceased. For patients for whom age, sex and date of infection detection were available, we determined the impact of these variables on mortality 30 days after the date of diagnosis or hospitalization. Multivariable weighted Cox analysis showed that each of the analyzed variables independently affected COVID-19 mortality. Specifically, in the overall series, age was the main risk factor for mortality, with HR > 100 in the age groups older than 65 years compared with a reference group of 15-44 years. Male sex presented a two-fold higher risk of death than female sex. Patients infected after the first pandemic wave (i.e. after 30 June 2020) had an approximately threefold lower risk of death than those infected during the first wave. Thus, in a series of all confirmed SARS-CoV-2-infected cases in an entire European nation, elderly age was by far the most significant risk factor for COVID-19 mortality, confirming that protecting the elderly should be a priority in pandemic management. Male sex and being infected during the first wave were additional risk factors associated with COVID-19 mortality.
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Affiliation(s)
- Francesca Minnai
- Institute of Biomedical Technologies, National Research Council (ITB-CNR), Segrate, MI, Italy
| | - Gianluca De Bellis
- Institute of Biomedical Technologies, National Research Council (ITB-CNR), Segrate, MI, Italy
| | - Tommaso A Dragani
- Department of Research, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy.
| | - Francesca Colombo
- Institute of Biomedical Technologies, National Research Council (ITB-CNR), Segrate, MI, Italy
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Lai A, Caimi B, Franzetti M, Bergna A, Velleca R, Gatti A, Rossi PL, D’Orso M, Pregliasco F, Balotta C, Calicchio G. Durability of Humoral Responses after the Second Dose of mRNA BNT162b2 Vaccine in Residents of a Long Term Care Facility. Vaccines (Basel) 2022; 10:vaccines10030446. [PMID: 35335078 PMCID: PMC8954729 DOI: 10.3390/vaccines10030446] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 03/03/2022] [Accepted: 03/10/2022] [Indexed: 02/04/2023] Open
Abstract
Residents of long-term care facilities (LTCFs) have been dramatically hit by the COVID-19 pandemic on a global scale as older age and comorbidities pose an increased risk of severe disease and death. The aim of the study was to assess the quantity and durability of specific antibody responses to SARS-CoV-2 after the first cycle (two doses) of BNT162b2 vaccine. To achieve this, SARS-CoV-2 Spike-specific IgG (S-IgG) titers was evaluated in 432 residents of the largest Italian LTCF at months 2 and 6 after vaccination. By stratifying levels of humoral responses as high, medium, low and null, we did not find any difference when comparing the two time points; however, the median levels of antibodies halved overtime. As positive nucleocapsid serology was associated with a reduced risk of a suboptimal response at both time points, we conducted separate analyses accordingly. In subjects with positive serology, the median level of anti-S IgG slightly increased at the second time point, while a significant reduction was observed in patients without previous exposure to the virus. At month 6, diabetes alone was associated with an increased risk of impaired response. Our data provide additional insights into the longitudinal dynamics of the immune response to BNT162b2 vaccination in the elderly, highlighting the need for SARS-CoV-2 antibody monitoring following third-dose administration.
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Affiliation(s)
- Alessia Lai
- Department of Biomedical and Clinical Sciences L. Sacco, University of Milan, 20157 Milan, Italy; (A.B.); (C.B.)
- Correspondence: ; Tel.: +39-025-0319-775
| | - Barbara Caimi
- Azienda Servizi alla Persona, Istituti Milanesi Martinitt e Stelline e Pio Albergo Trivulzio, 20146 Milan, Italy; (B.C.); (R.V.); (A.G.); (P.L.R.); (G.C.)
| | - Marco Franzetti
- Infectious Diseases Unit, Legnano General Hospital, ASST Ovest Milanese, 20025 Legnano, Italy;
| | - Annalisa Bergna
- Department of Biomedical and Clinical Sciences L. Sacco, University of Milan, 20157 Milan, Italy; (A.B.); (C.B.)
| | - Rossella Velleca
- Azienda Servizi alla Persona, Istituti Milanesi Martinitt e Stelline e Pio Albergo Trivulzio, 20146 Milan, Italy; (B.C.); (R.V.); (A.G.); (P.L.R.); (G.C.)
| | - Antonella Gatti
- Azienda Servizi alla Persona, Istituti Milanesi Martinitt e Stelline e Pio Albergo Trivulzio, 20146 Milan, Italy; (B.C.); (R.V.); (A.G.); (P.L.R.); (G.C.)
| | - Pier Luigi Rossi
- Azienda Servizi alla Persona, Istituti Milanesi Martinitt e Stelline e Pio Albergo Trivulzio, 20146 Milan, Italy; (B.C.); (R.V.); (A.G.); (P.L.R.); (G.C.)
| | - Marco D’Orso
- Department of Medicine and Surgery, University of Milan-Bicocca, 20900 Monza, Italy;
| | - Fabrizio Pregliasco
- Department of Biomedical Sciences, IRCCS Istituto Ortopedico Galeazzi, University of Milan, 20161 Milan, Italy;
| | - Claudia Balotta
- Department of Biomedical and Clinical Sciences L. Sacco, University of Milan, 20157 Milan, Italy; (A.B.); (C.B.)
| | - Giuseppe Calicchio
- Azienda Servizi alla Persona, Istituti Milanesi Martinitt e Stelline e Pio Albergo Trivulzio, 20146 Milan, Italy; (B.C.); (R.V.); (A.G.); (P.L.R.); (G.C.)
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The Psychological Impact of COVID-19 among Women Accessing Family Care Centers during Pregnancy and the Postnatal Period in Italy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19041983. [PMID: 35206171 PMCID: PMC8872039 DOI: 10.3390/ijerph19041983] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 02/03/2022] [Accepted: 02/07/2022] [Indexed: 02/05/2023]
Abstract
There has been concern about the impact of the COVID-19 outbreak on women's mental health during the perinatal period. We conducted a cross-sectional web-based study aimed at evaluating the psychological impact (BSI-18) of the COVID-19 pandemic on this population and collecting information on the perinatal experiences (COPE-IS) during the second Italian wave. Overall, 1168 pregnant women, and 940 within the first six months after childbirth, were recruited in selected Italian Family Care Centers from October 2020 to May 2021. The prevalence of psychological distress symptoms during pregnancy was 12.1% and 9.3% in the postnatal group. Financial difficulties, a previous mood or anxiety disorder and lack of perceived social support and of support provided by health professionals were associated to psychological distress symptoms in both groups. A third of the women felt unsupported by their social network; 61.7% of the pregnant women experienced changes in antenatal care; 21.2% of those in the postnatal period gave birth alone; more than 80% of the participants identified access to medical and mental health care and self-help as important resources in the present context. Health services should assure enhanced support to the most vulnerable women who face the perinatal period during the pandemic.
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Maruotti A, Jona-Lasinio G, Divino F, Lovison G, Ciccozzi M, Farcomeni A. Estimating COVID-19-induced excess mortality in Lombardy, Italy. Aging Clin Exp Res 2022; 34:475-479. [PMID: 35006542 PMCID: PMC8743436 DOI: 10.1007/s40520-021-02060-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 12/18/2021] [Indexed: 11/03/2022]
Abstract
We compare the expected all-cause mortality with the observed one for different age classes during the pandemic in Lombardy, which was the epicenter of the epidemic in Italy. The first case in Italy was found in Lombardy in early 2020, and the first wave was mainly centered in Lombardy. The other three waves, in Autumn 2020, March 2021 and Summer 2021 are also characterized by a high number of cases in absolute terms. A generalized linear mixed model is introduced to model weekly mortality from 2011 to 2019, taking into account seasonal patterns and year-specific trends. Based on the 2019 year-specific conditional best linear unbiased predictions, a significant excess of mortality is estimated in 2020, leading to approximately 35000 more deaths than expected, mainly arising during the first wave. In 2021, instead, the excess mortality is not significantly different from zero, for the 85+ and 15-64 age classes, and significant reductions with respect to the 2020 estimated excess mortality are estimated for other age classes.
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Affiliation(s)
- Antonello Maruotti
- Dipartimento GEPLI, Libera Università Maria Ss Assunta, Rome, Italy.
- Department of Mathematics, University of Bergen, Bergen, Norway.
| | | | - Fabio Divino
- Dipartimento di Bioscienze e Territorio, Università del Molise, Pesche, Italy
| | - Gianfranco Lovison
- Dipartimento di Scienze Economiche, Aziendali e Statistiche, Università di Palermo, Palermo, Italy
- Department of Epidemiology and Public Health, Swiss TPH, University of Basel, Basel, Switzerland
| | - Massimo Ciccozzi
- Unità di Statistica Medica ed Epidemiologia, Campus Biomedico, Rome, Italy
| | - Alessio Farcomeni
- Dipartimento di Economia e Finanza, Università di Roma "Tor Vergata", Rome, Italy
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Grande E, Fedeli U, Pappagallo M, Crialesi R, Marchetti S, Minelli G, Iavarone I, Frova L, Onder G, Grippo F. Variation in Cause-Specific Mortality Rates in Italy during the First Wave of the COVID-19 Pandemic: A Study Based on Nationwide Data. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:805. [PMID: 35055627 PMCID: PMC8776013 DOI: 10.3390/ijerph19020805] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 12/17/2021] [Accepted: 01/05/2022] [Indexed: 12/23/2022]
Abstract
Italy was a country severely hit by the first coronavirus disease 2019 (COVID-19) pandemic wave in early 2020. Mortality studies have focused on the overall excess mortality observed during the pandemic. This paper investigates the cause-specific mortality in Italy from March 2020 to April 2020 and the variation in mortality rates compared with those in 2015-2019 regarding sex, age, and epidemic area. Causes of death were derived from the national cause-of-death register. COVID-19 was the leading cause of death among males and the second leading cause among females. Chronic diseases, such as diabetes and hypertensive, ischemic heart, and cerebrovascular diseases, with decreasing or stable mortality rates in 2015-2019, showed a reversal in the mortality trend. Moreover, mortality due to pneumonia and influenza increased. No increase in neoplasm mortality was observed. Among external causes of death, mortality increased for accidental falls but reduced for transport accidents and suicide. Mortality from causes other than COVID-19 increased similarly in both genders and more at ages 65 years or above. Compared with other areas in Italy, the Lombardy region showed the largest excess in mortality for all leading causes. Underdiagnosis of COVID-19 at the beginning of the pandemic may, to some extent, explain the mortality increase for some causes of death, especially pneumonia and other respiratory diseases.
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Affiliation(s)
- Enrico Grande
- Integrated System for Health, Social Assistance and Welfare, Italian National Institute of Statistics, 00198 Rome, Italy; (M.P.); (R.C.); (S.M.); (L.F.); (F.G.)
| | - Ugo Fedeli
- Epidemiological Department, Azienda Zero, Veneto Region, 35132 Padova, Italy;
| | - Marilena Pappagallo
- Integrated System for Health, Social Assistance and Welfare, Italian National Institute of Statistics, 00198 Rome, Italy; (M.P.); (R.C.); (S.M.); (L.F.); (F.G.)
| | - Roberta Crialesi
- Integrated System for Health, Social Assistance and Welfare, Italian National Institute of Statistics, 00198 Rome, Italy; (M.P.); (R.C.); (S.M.); (L.F.); (F.G.)
| | - Stefano Marchetti
- Integrated System for Health, Social Assistance and Welfare, Italian National Institute of Statistics, 00198 Rome, Italy; (M.P.); (R.C.); (S.M.); (L.F.); (F.G.)
| | - Giada Minelli
- Statistical Service, Istituto Superiore di Sanità, 00161 Rome, Italy;
| | - Ivano Iavarone
- Department of Environment and Health, Istituto Superiore di Sanità, 00161 Rome, Italy;
| | - Luisa Frova
- Integrated System for Health, Social Assistance and Welfare, Italian National Institute of Statistics, 00198 Rome, Italy; (M.P.); (R.C.); (S.M.); (L.F.); (F.G.)
| | - Graziano Onder
- Department of Cardiovascular, Endocrine-Metabolic Diseases and Ageing, Istituto Superiore di Sanità, 00161 Rome, Italy;
| | - Francesco Grippo
- Integrated System for Health, Social Assistance and Welfare, Italian National Institute of Statistics, 00198 Rome, Italy; (M.P.); (R.C.); (S.M.); (L.F.); (F.G.)
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Bhuiyan AA, Brahmachari S, Ripa IJ, Noor R. Overview of dreadful consequences of SARS-CoV-2 invasion in Italy from March 2020 to March 2022. BULLETIN OF THE NATIONAL RESEARCH CENTRE 2022; 46:176. [PMID: 35756396 PMCID: PMC9207835 DOI: 10.1186/s42269-022-00867-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 06/13/2022] [Indexed: 05/12/2023]
Abstract
BACKGROUND The unpredicted pandemic disease COVID-19 first flared up adversely in Europe by imparting interminable force of infected and fatality cases to Italy. In late February 2020, the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in northern Italy and swiftly proliferated to the entire country, albeit continuous to date (23 March 2022) with a lesser extent of deadliness. Current review focused on the invasions and the associated consequences by SARS-CoV-2 during the period of March 2020-March 2022. MAIN BODY OF THE ABSTRACT Initially, the lethality and transmissibility of the novel virus made Italy stunned within 1 month, the number of death cases reached 12,428 at the end of March 2020. The Italian Government announced an immediate emergency phase in entire country, educational institutions to local businesses, manufacturing works, cultural activities to elective activities were rescinded and all the hospitals to morgues were swamped, ensuing that fear of epidemic was impended. Besides, the Italian National Health System and Service coordinated massive public health interventions and conferred unprecedented efforts to limit the high mortality rate of the first wave of infection. Amidst 2 years of epidemic (as of 23 March 2022), Italy has documented 14,070,450 (23.74% of the population) confirmed infected cases, 12,685,306 (21.41% of the population) healed cases, 158,254 death cases (0.27% of the population) and ranking 9th worldwide in the number of deaths. SHORT CONCLUSION Based on publicly available Italian Ministry of Health COVID-19 data, current review has comprehended region-wise total infected cases, death cases and healed cases for three consecutive years 2020-2022 to foresee different patterns of the regional outbreak and gradual subservience. At a glance, we highlighted the overview of the exhaustion and exertion of COVID-19 crisis throughout the periods in Italy.
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Affiliation(s)
- Asma Akter Bhuiyan
- Molecular Biotechnology and Bioinformatics, Department of Industrial Biotechnologies, Universita Degli Studi di Milano, 20134 Milan, Italy
| | - Sreyashi Brahmachari
- Molecular Biotechnology and Bioinformatics, Department of Industrial Biotechnologies, Universita Degli Studi di Milano, 20134 Milan, Italy
| | - Israt Jahan Ripa
- Medical Biotechnology, Department of Pharmaceutical, Veterinary and Medical Biotechnologies, Università di Bologna, 40126 Bologna, Italy
| | - Rashed Noor
- Department of Life Sciences (DLS), School of Environment and Life Sciences (SELS), Independent University, Bangladesh (IUB), Plot 16, Block B, Bashundhara, Dhaka, 1229 Bangladesh
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Porto ED, Naticchioni P, Scrutinio V. Lockdown, essential sectors, and Covid-19: Lessons from Italy. JOURNAL OF HEALTH ECONOMICS 2022; 81:102572. [PMID: 34958981 PMCID: PMC8648381 DOI: 10.1016/j.jhealeco.2021.102572] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 11/15/2021] [Accepted: 12/01/2021] [Indexed: 05/07/2023]
Abstract
This paper investigates how economic activity impacted Covid-19 infections and all-cause mortality. To this purpose, we exploit the distribution of essential sectors, which were exempted from a national lockdown enacted in Italy during the first wave of the pandemic, across provinces and rich administrative data in a difference-in-differences framework. We find that a standard deviation increase in essential workers per built square kilometre leads to 1.1 additional daily cases and 0.32 additional daily deaths per 100,000 inhabitants. Back of the envelope calculations suggest that about one third (47,000) of the Covid-19 cases and about 13% (13,000) of deaths between March and May of 2020 can be attributed to the less stringent lockdown for these sectors. The effect is heterogeneous across sectors. Finally, we find that the local health system played a relevant role in reducing fatalities with a higher number of general practitioners and hospital beds per capita being associated with a lower mortality.
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Affiliation(s)
| | | | - Vincenzo Scrutinio
- University of Bologna, Centre for Economic Performance - London School of Economics and Political Science, IZA
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Moro MF, Calamandrei G, Poli R, Di Mattei V, Perra A, Kurotschka PK, Restrepo A, Romano F, La Torre G, Preti E, Mascayano F, Picardi A, Chiarotti F, Rapisarda V, Urban A, Alvarado R, Susser E, Carta MG. The Impact of the COVID-19 Pandemic on the Mental Health of Healthcare Workers in Italy: Analyzing the Role of Individual and Workplace-Level Factors in the Reopening Phase After Lockdown. Front Psychiatry 2022; 13:867080. [PMID: 35722544 PMCID: PMC9200968 DOI: 10.3389/fpsyt.2022.867080] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 05/02/2022] [Indexed: 02/04/2023] Open
Abstract
INTRODUCTION Italy is one of the high-income countries hit hardest by Covid-19. During the first months of the pandemic, Italian healthcare workers were praised by media and the public for their efforts to face the emergency, although with limited knowledge and resources. However, healthcare workers soon had to face new challenges at a time when the national health system was working hard to recover. This study focuses on this difficult period to assess the impact of the COVID-19 pandemic on the mental health of Italian healthcare workers. MATERIALS AND METHODS Healthcare workers from all Italian regions [n = 5,502] completed an online questionnaire during the reopening phase after the first wave lockdown. We assessed a set of individual-level factors (e.g., stigma and violence against HCWs) and a set of workplace-level factors (e.g., trust in the workplace capacity to handle COVID-19) that were especially relevant in this context. The primary outcomes assessed were score ≥15 on the Patient Health Questionnaire-9 and score ≥4 on the General Health Questionnaire-12, indicators of clinically significant depressive symptoms and psychological distress, respectively. Logistic regression analyses were performed on depressive symptoms and psychological distress for each individual- and workplace-level factor adjusting for gender, age, and profession. RESULTS Clinically significant depressive symptoms were observed in 7.5% and psychological distress in 37.9% of HCWs. 30.5% of healthcare workers reported having felt stigmatized or discriminated, while 5.7% reported having experienced violence. Feeling stigmatized or discriminated and experiencing violence due to being a healthcare worker were strongly associated with clinically significant depressive symptoms [OR 2.98, 95%CI 2.36-3.77 and OR 4.72 95%CI 3.41-6.54] and psychological distress [OR 2.30, 95%CI 2.01-2.64 and OR 2.85 95%CI 2.16-3.75]. Numerous workplace-level factors, e.g., trust in the workplace capacity to handle COVID-19 [OR 2.43, 95%CI 1.92-3.07] and close contact with a co-worker who died of COVID-19 [OR 2.05, 95%CI 1.56-2.70] were also associated with clinically significant depressive symptoms. Similar results were found for psychological distress. CONCLUSIONS Our study emphasizes the need to address discrimination and violence against healthcare professionals and improve healthcare work environments to strengthen the national health system's capacity to manage future emergencies.
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Affiliation(s)
- Maria Francesca Moro
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States.,University of Cagliari, Cagliari, Italy
| | | | - Ranieri Poli
- Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy
| | | | | | | | - Alexandra Restrepo
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States.,Universidad de Antioquia, Medellín, Colombia
| | - Ferdinando Romano
- Dipartimento di Sanità Pubblica e Malattie Infettive, Università La Sapienza, Rome, Italy
| | - Giuseppe La Torre
- Dipartimento di Sanità Pubblica e Malattie Infettive, Università La Sapienza, Rome, Italy
| | | | - Franco Mascayano
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States.,New York State Psychiatric Institute, NewYork, NY, United States
| | | | | | | | - Antonio Urban
- Azienda Ospedaliero Universitaria di Cagliari, Cagliari, Italy
| | - Ruben Alvarado
- Department of Public Health, School of Medicine, Faculty of Medicine, Universidad de Valparaiso, Valparaíso, Chile
| | - Ezra Susser
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States.,New York State Psychiatric Institute, NewYork, NY, United States
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47
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Alicandro G, Remuzzi G, Centanni S, Gerli A, La Vecchia C. Excess total mortality in 2021 in Italy was about one third of that observed in 2020. LA MEDICINA DEL LAVORO 2021; 112:414-421. [PMID: 34939614 PMCID: PMC8759051 DOI: 10.23749/mdl.v112i6.12601] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Accepted: 11/29/2021] [Indexed: 01/19/2023]
Abstract
Background: Italy was severely hit by the Covid-19 pandemic with an excess of around 90,000 total deaths in 2020. Comparable data in 2021 are needed for monitoring the effects of the interventions adopted to control its spread and reduce the burden. This study estimates the excess mortality in Italy in the first eight months of 2021, with a focus on the working age population. Methods: Excess mortality was estimated as difference between the number of registered deaths and the expected deaths. Expected deaths in March-December 2020 and January-August 2021 were estimated separately by sex, through an over-dispersed Poisson regression model using mortality and population data for the period 2011-2019 (before the Covid-19 outbreak). The models included terms for calendar year, age group, a smooth function of week of the year and the natural logarithm of the population as offset term. Results: In the first eight months of 2021, we estimated 34,599 excess deaths (+7.9% of the expected deaths), of these 3667 were among individuals of working age (25-64 years). In this age group, mortality was 8.2% higher than expected with higher excesses among men (2972 deaths, +10.7%) than women (695 deaths, +4.1%). Conclusions: The excess deaths in the first eight months of 2021 account for about one third of that registered in 2020. Current data indicate that around 5000 excess deaths are expected by the end of the year, leading to a total excess for 2021 of around 40 thousand deaths. Despite the absence of influenza in January-March 2021, a relevant excess was also observed among the working age population.
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Affiliation(s)
- Gianfranco Alicandro
- Department of Pathophysiology and Transplantaersità degli Studi di Milano, Cystic Fibrosis Centre, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy.
| | - Giuseppe Remuzzi
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Bergamo, Italy.
| | - Stefano Centanni
- Respiratory Unit, Department of Health Sciences, ASST Santi Paolo e Carlo, Università degli Studi di Milano, Mi-lan, Italy.
| | - Alberto Gerli
- Respiratory Unit, Department of Health Sciences, ASST Santi Paolo e Carlo, Università degli Studi di Milano, Mi-lan, Italy.
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy.
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48
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Martinez-Lopez J, Hernandez-Ibarburu G, Alonso R, Sanchez-Pina JM, Zamanillo I, Lopez-Muñoz N, Iñiguez R, Cuellar C, Calbacho M, Paciello ML, Ayala R, García-Barrio N, Perez-Rey D, Meloni L, Cruz J, Pedrera-Jiménez M, Serrano-Balazote P, de la Cruz J. Impact of COVID-19 in patients with multiple myeloma based on a global data network. Blood Cancer J 2021; 11:198. [PMID: 34893583 PMCID: PMC8661359 DOI: 10.1038/s41408-021-00588-z] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 11/18/2021] [Accepted: 11/23/2021] [Indexed: 12/13/2022] Open
Abstract
The COVID-19 pandemic has represented a major cause of morbidity/mortality worldwide, overstressing health systems. Multiple myeloma (MM) patients show an increased risk for infections and they are expected to be particularly vulnerable to SARS-CoV-2 infection. Here we have obtained a comprehensive picture of the impact of COVID-19 in MM patients on a local and a global scale using a federated data research network (TriNetX) that provided access to Electronic Medical Records (EMR) from Health Care Organizations (HCO) all over the world. Through propensity score matched analyses we found that the number of new diagnoses of MM was reduced in 2020 compared to 2019 (RR 0.86, 95%CI 0.76-0.96) and the survival of newly diagnosed MM cases decreased similarly (HR 0.61, 0.38-0.81). MM patients showed higher risk of SARS-CoV-2 infection (RR 2.09, 1.58-2.76) and a higher excess mortality in 2020 (difference in excess mortality 9%, 4.4-13.2) than non-MM patients. By interrogating large EMR datasets from HCO in Europe and globally, we confirmed that MM patients have been more severely impacted by COVID-19 pandemic than non-MM patients. This study highlights the necessity of extending preventive measures worlwide to protect vulnerable patients from SARS-CoV-2 infection by promoting social distancing and an intensive vaccination strategies.
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Affiliation(s)
- J Martinez-Lopez
- Hematology Department, Hospital 12 de Octubre, Complutense University, CNIO, Madrid, Spain.
| | | | - R Alonso
- Hematology Department, Hospital 12 de Octubre, Complutense University, CNIO, Madrid, Spain
| | - J M Sanchez-Pina
- Hematology Department, Hospital 12 de Octubre, Complutense University, CNIO, Madrid, Spain
| | - I Zamanillo
- Hematology Department, Hospital 12 de Octubre, Complutense University, CNIO, Madrid, Spain
| | - N Lopez-Muñoz
- Hematology Department, Hospital 12 de Octubre, Complutense University, CNIO, Madrid, Spain
| | - Rodrigo Iñiguez
- Hematology Department, Hospital 12 de Octubre, Complutense University, CNIO, Madrid, Spain
| | - C Cuellar
- Hematology Department, Hospital 12 de Octubre, Complutense University, CNIO, Madrid, Spain
| | - M Calbacho
- Hematology Department, Hospital 12 de Octubre, Complutense University, CNIO, Madrid, Spain
| | - M L Paciello
- Hematology Department, Hospital 12 de Octubre, Complutense University, CNIO, Madrid, Spain
| | - R Ayala
- Hematology Department, Hospital 12 de Octubre, Complutense University, CNIO, Madrid, Spain
| | | | - D Perez-Rey
- Biomedical Informatics Group, Universidad Politécnica de Madrid, Madrid, Spain
| | - L Meloni
- TriNetX, LLC, Cambridge, MA, USA
| | - J Cruz
- Data Science Group, Hospital 12 de Octubre, Madrid, Spain
| | | | | | - J de la Cruz
- Research Institute imas12, Hospital 12 de Octubre, Madrid, Spain
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49
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Kuno T, Sahashi Y, Kawahito S, Takahashi M, Iwagami M, Egorova NN. Prediction of in-hospital mortality with machine learning for COVID-19 patients treated with steroid and remdesivir. J Med Virol 2021; 94:958-964. [PMID: 34647622 PMCID: PMC8662043 DOI: 10.1002/jmv.27393] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 09/20/2021] [Accepted: 10/12/2021] [Indexed: 12/15/2022]
Abstract
We aimed to create the prediction model of in-hospital mortality using machine learning methods for patients with coronavirus disease 2019 (COVID-19) treated with steroid and remdesivir. We reviewed 1571 hospitalized patients with laboratory confirmed COVID-19 from the Mount Sinai Health System treated with both steroids and remdesivir. The important variables associated with in-hospital mortality were identified using LASSO (least absolute shrinkage and selection operator) and SHAP (SHapley Additive exPlanations) through the light gradient boosting model (GBM). The data before February 17th, 2021 (N = 769) was randomly split into training and testing datasets; 80% versus 20%, respectively. Light GBM models were created with train data and area under the curves (AUCs) were calculated. Additionally, we calculated AUC with the data between February 17th, 2021 and March 30th, 2021 (N = 802). Of the 1571 patients admitted due to COVID-19, 331 (21.1%) died during hospitalization. Through LASSO and SHAP, we selected six important variables; age, hypertension, oxygen saturation, blood urea nitrogen, intensive care unit admission, and endotracheal intubation. AUCs using training and testing datasets derived from the data before February 17th, 2021 were 0.871/0.911. Additionally, the light GBM model has high predictability for the latest data (AUC: 0.881) (https://risk-model.herokuapp.com/covid). A high-value prediction model was created to estimate in-hospital mortality for COVID-19 patients treated with steroid and remdesivir.
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Affiliation(s)
- Toshiki Kuno
- Department of Medicine, Icahn School of Medicine at Mount Sinai, Mount Sinai Beth Israel, New York City, New York, USA.,Department of Medicine, Division of Cardiology, Montefiore Medical Center, Albert Einstein Medical College, New York City, New York, USA
| | - Yuki Sahashi
- Department of Cardiology, Gifu University Graduate School of Medicine, Gifu, Japan.,Department of Health Data Science, Graduate School of Data Science, Yokohama City University, Yokohama, Japan.,Department of Cardiovascular Medicine, Gifu Heart Center, Gifu, Japan
| | | | - Mai Takahashi
- Department of Medicine, Icahn School of Medicine at Mount Sinai, Mount Sinai Beth Israel, New York City, New York, USA
| | - Masao Iwagami
- Department of Health Services Research, University of Tsukuba, Tsukuba, Japan
| | - Natalia N Egorova
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
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50
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Nath R, Gupta NK, Jaswal A, Gupta S, Kaur N, Kohli S, Saxena A, Ish P, Kumar R, Tiwari P, Kumar M, Kishore J, Yadav G, Marwein F, Gupta N. Mortality among adult hospitalized patients during the first wave and second wave of COVID-19 pandemic at a tertiary care center in India. Monaldi Arch Chest Dis 2021; 92. [PMID: 34634900 DOI: 10.4081/monaldi.2021.2034] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 09/10/2021] [Indexed: 11/23/2022] Open
Abstract
The similarities and differences between the mortality patterns of the two waves in India remain largely unknown. This was a retrospective study of medical records conducted in the COVID data center of our hospital This study analyzed data of patients who died in the month of August, 2020 to October 2020 (one month before and after the peak of first wave i.e., 16th September, 2020) & April 2021 to June 2021 (one month before and after the peak of second wave i.e., 6th May, 2021), corresponding to an equal part of the pandemic during first (2020) and second (2021) wave. Out of 1893 patients in the study, 764 patients were admitted during the first wave and 1129 patients during the second wave of pandemic. In total, 420 patients died during the entire study period. Of those, 147 (35%) deaths occurred during the first wave and 273 (65%) during the second wave, reflecting a case fatality rate (CFR) of 19.2% during the first wave and a CFR of 24.18%. There were no significant differences in the Age Group, Gender, Presenting Complaints, Duration of Stay and Comorbidities. However, the deceased COVID-19 patients had an increase in Case Fatality Rate, average duration of symptoms from onset to Hospital Admission (DOSHA) and a major shift from MODS to ARDS being the Cause of Death during the second wave of Pandemic. This study demonstrates increased CFR, average DOSHA and a paradigm shift to ARDS as cause of mortality during the second peak of the Pandemic. It is necessary to remain vigilant of newer COVID-19 variants of concern, follow COVID-19 appropriate behaviors and keep emphasizing on care of high-risk groups including patients with comorbidities and elderly population to prevent mortality.
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Affiliation(s)
- Ravindra Nath
- Department of Community Medicine, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi.
| | - Neeraj Kumar Gupta
- Department of Pulmonary and Critical Care Medicine, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi.
| | - Amandeep Jaswal
- Department of Anaesthesiology, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi.
| | - Sparsh Gupta
- Department of Pharmacology, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi.
| | - Navjot Kaur
- Department of Pharmacology, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi.
| | - Santvana Kohli
- Department of Anaesthesiology, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi.
| | - Anirudh Saxena
- Department of Community Medicine, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi.
| | - Pranav Ish
- Department of Pulmonary and Critical Care Medicine, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi.
| | - Rohit Kumar
- Department of Pulmonary and Critical Care Medicine, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi.
| | - Poornima Tiwari
- Department of Community Medicine, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi.
| | - Mukesh Kumar
- Department of Community Medicine, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi.
| | - Jugal Kishore
- Department of Community Medicine, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi.
| | - Geeta Yadav
- Department of Community Medicine, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi.
| | - Fellisha Marwein
- Department of Pulmonary and Critical Care Medicine, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi.
| | - Nitesh Gupta
- Department of Pulmonary and Critical Care Medicine, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi.
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