Declining Mortality Rate of Hospitalised Patients in the Second Wave of the COVID-19 Epidemics in Italy: Risk Factors and the Age-Specific Patterns.

Autor: D'Arminio Monforte A; Institute of Infectious Diseases, Department of Health Science, ASST Santi Paolo e Carlo, University of Milan, 20142 Milan, Italy., Tavelli A; Institute of Infectious Diseases, Department of Health Science, ASST Santi Paolo e Carlo, University of Milan, 20142 Milan, Italy., Bai F; Institute of Infectious Diseases, Department of Health Science, ASST Santi Paolo e Carlo, University of Milan, 20142 Milan, Italy., Tomasoni D; Institute of Infectious Diseases, Department of Health Science, ASST Santi Paolo e Carlo, University of Milan, 20142 Milan, Italy., Falcinella C; Institute of Infectious Diseases, Department of Health Science, ASST Santi Paolo e Carlo, University of Milan, 20142 Milan, Italy., Castoldi R; Institute of Infectious Diseases, Department of Health Science, ASST Santi Paolo e Carlo, University of Milan, 20142 Milan, Italy., Barbanotti D; Institute of Infectious Diseases, Department of Health Science, ASST Santi Paolo e Carlo, University of Milan, 20142 Milan, Italy., Mulè G; Institute of Infectious Diseases, Department of Health Science, ASST Santi Paolo e Carlo, University of Milan, 20142 Milan, Italy., Allegrini M; Institute of Infectious Diseases, Department of Health Science, ASST Santi Paolo e Carlo, University of Milan, 20142 Milan, Italy., Suardi E; Institute of Infectious Diseases, Department of Health Science, ASST Santi Paolo e Carlo, University of Milan, 20142 Milan, Italy., Tesoro D; Institute of Infectious Diseases, Department of Health Science, ASST Santi Paolo e Carlo, University of Milan, 20142 Milan, Italy., Tagliaferri G; Institute of Infectious Diseases, Department of Health Science, ASST Santi Paolo e Carlo, University of Milan, 20142 Milan, Italy., Mondatore D; Institute of Infectious Diseases, Department of Health Science, ASST Santi Paolo e Carlo, University of Milan, 20142 Milan, Italy., Augello M; Institute of Infectious Diseases, Department of Health Science, ASST Santi Paolo e Carlo, University of Milan, 20142 Milan, Italy., Cona A; Institute of Infectious Diseases, Department of Health Science, ASST Santi Paolo e Carlo, University of Milan, 20142 Milan, Italy., Beringheli T; Institute of Infectious Diseases, Department of Health Science, ASST Santi Paolo e Carlo, University of Milan, 20142 Milan, Italy., Gemignani N; Institute of Infectious Diseases, Department of Health Science, ASST Santi Paolo e Carlo, University of Milan, 20142 Milan, Italy., Sala M; Institute of Infectious Diseases, Department of Health Science, ASST Santi Paolo e Carlo, University of Milan, 20142 Milan, Italy., Varisco B; Institute of Infectious Diseases, Department of Health Science, ASST Santi Paolo e Carlo, University of Milan, 20142 Milan, Italy., Molà F; Institute of Infectious Diseases, Department of Health Science, ASST Santi Paolo e Carlo, University of Milan, 20142 Milan, Italy., Pettenuzzo S; Institute of Infectious Diseases, Department of Health Science, ASST Santi Paolo e Carlo, University of Milan, 20142 Milan, Italy., Biasioli L; Institute of Infectious Diseases, Department of Health Science, ASST Santi Paolo e Carlo, University of Milan, 20142 Milan, Italy., Copes A; Institute of Infectious Diseases, Department of Health Science, ASST Santi Paolo e Carlo, University of Milan, 20142 Milan, Italy., Gazzola L; Institute of Infectious Diseases, Department of Health Science, ASST Santi Paolo e Carlo, University of Milan, 20142 Milan, Italy., Viganò O; Institute of Infectious Diseases, Department of Health Science, ASST Santi Paolo e Carlo, University of Milan, 20142 Milan, Italy., Tincati C; Institute of Infectious Diseases, Department of Health Science, ASST Santi Paolo e Carlo, University of Milan, 20142 Milan, Italy., De Bona A; Institute of Infectious Diseases, Department of Health Science, ASST Santi Paolo e Carlo, University of Milan, 20142 Milan, Italy., Bini T; Institute of Infectious Diseases, Department of Health Science, ASST Santi Paolo e Carlo, University of Milan, 20142 Milan, Italy., Marchetti G; Institute of Infectious Diseases, Department of Health Science, ASST Santi Paolo e Carlo, University of Milan, 20142 Milan, Italy.
Jazyk: angličtina
Zdroj: Life (Basel, Switzerland) [Life (Basel)] 2021 Sep 17; Vol. 11 (9). Date of Electronic Publication: 2021 Sep 17.
DOI: 10.3390/life11090979
Abstrakt: Background: Mortality rate from COVID-19 in Italy is among the world's highest. We aimed to ascertain whether there was any reduction of in-hospital mortality in patients hospitalised for COVID-19 in the second-wave period (October 2020-January 2021) compared to the first one (February-May 2020); further, we verified whether there were clusters of hospitalised patients who particularly benefitted from reduced mortality rate.
Methods: Data collected related to in-patients' demographics, clinical, laboratory, therapies and outcome. Primary end-point was time to in-hospital death. Factors associated were evaluated by uni- and multivariable analyses. A flow diagram was created to determine the rate of in-hospital death according to individual and disease characteristics.
Results: A total of 1561 patients were included. The 14-day cumulative incidence of in-hospital death by competing risk regression was of 24.8% (95% CI: 21.3-28.5) and 15.9% (95% CI: 13.7-18.2) in the first and second wave. We observed that the highest relative reduction of death from first to second wave (more than 47%) occurred mainly in the clusters of patients younger than 70 years.
Conclusions: Progress in care and supporting therapies did affect population over 70 years to a lesser extent. Preventive and vaccination campaigns should focus on individuals whose risk of death from COVID-19 remains high.
Databáze: MEDLINE
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