Epidemiological characteristics of COVID-19 cases in non-Italian nationals notified to the Italian surveillance system

Autor: Silvia Declich, Stefania Bellino, Martina Del Manso, Maria C. Rota, Andrea Siddu, Maria Fenicia Vescio, Xanthi Andrianou, Antonino Bella, Fortunato D'Ancona, Flavia Riccardo, Silvio Brusaferro, Ornella Punzo, Alberto Mateo-Urdiales, Massimo Fabiani, Stefano Boros, Giovanni Rezza, Maria Grazia Dente, Patrizio Pezzotti, Antonietta Filia
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Male
Human development index
Delayed Diagnosis
Economics
Comorbidity
030204 cardiovascular system & hematology
Rate ratio
Medical and Health Sciences
Health Services Accessibility
law.invention
Adult
COVID-19
Delivery of Health Care
Female
Healthcare Disparities
Hospitalization
Humans
Intensive Care Units
Italy
Middle Aged
Morbidity
Pandemics
Refugees
Transients and Migrants
SARS-CoV-2
0302 clinical medicine
law
Case fatality rate
Health care
Epidemiology
Diagnosis
Medicine
030212 general & internal medicine
Disease outbreaks
Surveillance
Intensive care unit
Nationality
Covid-19
AcademicSubjects/SOC02610
Traveler
medicine.medical_specialty
Refugee
Sars-cov-2
Infections
03 medical and health sciences
Health Sciences
AcademicSubjects/MED00860
AcademicSubjects/SOC01210
Mortality
Demography
business.industry
Public Health
Environmental and Occupational Health
Outbreak
Health outcomes
medicine.disease
Hospital admission
Confidence interval
Relative risk
Observational study
business
Delayed diagnosis
Zdroj: European Journal of Public Health
The European Journal of Public Health
Popis: Background International literature suggests that disadvantaged groups are at higher risk of morbidity and mortality from SARS-CoV-2 infection due to poorer living/working conditions and barriers to healthcare access. Yet, to date, there is no evidence of this disproportionate impact on non-national individuals, including economic migrants, short-term travellers and refugees. Methods We analyzed data from the Italian surveillance system of all COVID-19 laboratory-confirmed cases tested positive from the beginning of the outbreak (20th of February) to the 19th of July 2020. We used multilevel negative-binomial regression models to compare the case fatality and the rate of admission to hospital and intensive care unit (ICU) between Italian and non-Italian nationals. The analysis was adjusted for differences in demographic characteristics, pre-existing comorbidities, and period of diagnosis. Results We analyzed 213 180 COVID-19 cases, including 15 974 (7.5%) non-Italian nationals. We found that, compared to Italian cases, non-Italian cases were diagnosed at a later date and were more likely to be hospitalized {[adjusted rate ratio (ARR)=1.39, 95% confidence interval (CI): 1.33–1.44]} and admitted to ICU (ARR=1.19, 95% CI: 1.07–1.32), with differences being more pronounced in those coming from countries with lower human development index (HDI). We also observed an increased risk of death in non-Italian cases from low-HDI countries (ARR=1.32, 95% CI: 1.01–1.75). Conclusions A delayed diagnosis in non-Italian cases could explain their worse outcomes compared to Italian cases. Ensuring early access to diagnosis and treatment to non-Italians could facilitate the control of SARS-CoV-2 transmission and improve health outcomes in all people living in Italy, regardless of nationality.
Databáze: OpenAIRE
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