Utility of hospitalization for elderly individuals affected by COVID-19.

<h4>Background</h4>During the COVID-19 pandemic, the number of individuals needing hospital admission has sometimes exceeded the availability of hospital beds. Since hospitalization can have detrimental effects on older individuals, preference has been given to younger patients. The aim...

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Main Authors: Giorgio Costantino, Monica Solbiati, Silvia Elli, Marco Paganuzzi, Didi Massabò, Nicola Montano, Marta Mancarella, Francesca Cortellaro, Emanuela Cataudella, Andrea Bellone, Nicolò Capsoni, Guido Bertolini, Giovanni Nattino, Giovanni Casazza
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2021-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0250730
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author Giorgio Costantino
Monica Solbiati
Silvia Elli
Marco Paganuzzi
Didi Massabò
Nicola Montano
Marta Mancarella
Francesca Cortellaro
Emanuela Cataudella
Andrea Bellone
Nicolò Capsoni
Guido Bertolini
Giovanni Nattino
Giovanni Casazza
author_facet Giorgio Costantino
Monica Solbiati
Silvia Elli
Marco Paganuzzi
Didi Massabò
Nicola Montano
Marta Mancarella
Francesca Cortellaro
Emanuela Cataudella
Andrea Bellone
Nicolò Capsoni
Guido Bertolini
Giovanni Nattino
Giovanni Casazza
author_sort Giorgio Costantino
collection DOAJ
description <h4>Background</h4>During the COVID-19 pandemic, the number of individuals needing hospital admission has sometimes exceeded the availability of hospital beds. Since hospitalization can have detrimental effects on older individuals, preference has been given to younger patients. The aim of this study was to assess the utility of hospitalization for elderly affected by COVID-19. We hypothesized that their mortality decreases when there is greater access to hospitals.<h4>Methods</h4>This study examined 1902 COVID-19 patients consecutively admitted to three large hospitals in Milan, Italy. Overall mortality data for Milan from the same period was retrieved. Based on emergency department (ED) data, both peak and off-peak phases were identified. The percentage of elderly patients admitted to EDs during these two phases were compared by calculating the standardized mortality ratio (SMR) of the individuals younger than, versus older than, 80 years.<h4>Results</h4>The median age of the patients hospitalized during the peak phase was lower than the median age during the off-peak phase (64 vs. 75 years, respectively; p <0.001). However, while the SMR for the younger patients was lower during the off-peak phase (1.98, 95% CI: 1.72-2.29 versus 1.40, 95% CI: 1.25-1.58, respectively), the SMR was similar between both phases for the elderly patients (2.28, 95% CI: 2.07-2.52 versus 2.48, 95% CI: 2.32-2.65, respectively).<h4>Conclusions</h4>Greater access to hospitals during an off-peak phase did not affect the mortality rate of COVID-19-positive elderly patients in Milan. This finding, if confirmed in other settings, should influence future decisions regarding resource management of health care organizations.
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spelling doaj.art-277b8a7a10294b0a9991bee3bc9713502022-12-21T19:58:39ZengPublic Library of Science (PLoS)PLoS ONE1932-62032021-01-01164e025073010.1371/journal.pone.0250730Utility of hospitalization for elderly individuals affected by COVID-19.Giorgio CostantinoMonica SolbiatiSilvia ElliMarco PaganuzziDidi MassabòNicola MontanoMarta MancarellaFrancesca CortellaroEmanuela CataudellaAndrea BelloneNicolò CapsoniGuido BertoliniGiovanni NattinoGiovanni Casazza<h4>Background</h4>During the COVID-19 pandemic, the number of individuals needing hospital admission has sometimes exceeded the availability of hospital beds. Since hospitalization can have detrimental effects on older individuals, preference has been given to younger patients. The aim of this study was to assess the utility of hospitalization for elderly affected by COVID-19. We hypothesized that their mortality decreases when there is greater access to hospitals.<h4>Methods</h4>This study examined 1902 COVID-19 patients consecutively admitted to three large hospitals in Milan, Italy. Overall mortality data for Milan from the same period was retrieved. Based on emergency department (ED) data, both peak and off-peak phases were identified. The percentage of elderly patients admitted to EDs during these two phases were compared by calculating the standardized mortality ratio (SMR) of the individuals younger than, versus older than, 80 years.<h4>Results</h4>The median age of the patients hospitalized during the peak phase was lower than the median age during the off-peak phase (64 vs. 75 years, respectively; p <0.001). However, while the SMR for the younger patients was lower during the off-peak phase (1.98, 95% CI: 1.72-2.29 versus 1.40, 95% CI: 1.25-1.58, respectively), the SMR was similar between both phases for the elderly patients (2.28, 95% CI: 2.07-2.52 versus 2.48, 95% CI: 2.32-2.65, respectively).<h4>Conclusions</h4>Greater access to hospitals during an off-peak phase did not affect the mortality rate of COVID-19-positive elderly patients in Milan. This finding, if confirmed in other settings, should influence future decisions regarding resource management of health care organizations.https://doi.org/10.1371/journal.pone.0250730
spellingShingle Giorgio Costantino
Monica Solbiati
Silvia Elli
Marco Paganuzzi
Didi Massabò
Nicola Montano
Marta Mancarella
Francesca Cortellaro
Emanuela Cataudella
Andrea Bellone
Nicolò Capsoni
Guido Bertolini
Giovanni Nattino
Giovanni Casazza
Utility of hospitalization for elderly individuals affected by COVID-19.
PLoS ONE
title Utility of hospitalization for elderly individuals affected by COVID-19.
title_full Utility of hospitalization for elderly individuals affected by COVID-19.
title_fullStr Utility of hospitalization for elderly individuals affected by COVID-19.
title_full_unstemmed Utility of hospitalization for elderly individuals affected by COVID-19.
title_short Utility of hospitalization for elderly individuals affected by COVID-19.
title_sort utility of hospitalization for elderly individuals affected by covid 19
url https://doi.org/10.1371/journal.pone.0250730
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