The three facets of the SARS-CoV-2 pandemic during the first two waves in the northern, central, and southern Italy
Background: There is a scarcity of information in literature regarding the clinical differences and comorbidities of patients affected by Coronavirus disease 2019 (COVID-19), which could clarify the different prevalence of the outcomes (composite and only death) between several Italian regions. Obje...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-04-01
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| Series: | Journal of Infection and Public Health |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1876034123000321 |
| _version_ | 1797870589741891584 |
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| author | Silvio Buscemi Chiara Davoli Enrico Maria Trecarichi Helen Linda Morrone Bruno Tassone Carola Buscemi Cristiana Randazzo Anna Maria Barile Piero Colombrita Maurizio Soresi Lydia Giannitrapani Antonio Cascio Nicola Scichilone Carlo Cottone Paolo Sbraccia Valeria Guglielmi Frida Leonetti Alexis Elias Malavazos Sara Basilico Michele Carruba Ferruccio Santini Alessandro Antonelli Nicola Viola Marcello Romano Bruno Mario Cesana Carlo Torti |
| author_facet | Silvio Buscemi Chiara Davoli Enrico Maria Trecarichi Helen Linda Morrone Bruno Tassone Carola Buscemi Cristiana Randazzo Anna Maria Barile Piero Colombrita Maurizio Soresi Lydia Giannitrapani Antonio Cascio Nicola Scichilone Carlo Cottone Paolo Sbraccia Valeria Guglielmi Frida Leonetti Alexis Elias Malavazos Sara Basilico Michele Carruba Ferruccio Santini Alessandro Antonelli Nicola Viola Marcello Romano Bruno Mario Cesana Carlo Torti |
| author_sort | Silvio Buscemi |
| collection | DOAJ |
| description | Background: There is a scarcity of information in literature regarding the clinical differences and comorbidities of patients affected by Coronavirus disease 2019 (COVID-19), which could clarify the different prevalence of the outcomes (composite and only death) between several Italian regions. Objective: This study aimed to assess the heterogeneity of clinical features of patients with COVID-19 upon hospital admission and disease outcomes in the northern, central, and southern Italian regions. Methods: An observational cohort multicenter retrospective study including 1210 patients who were admitted for COVID-19 in Infectious diseases, Pulmonology, Endocrinology, Geriatrics and Internal Medicine Units in Italian cities stratified between north (263 patients); center (320 patients); and south (627 patients), during the first and second pandemic waves of SARS-CoV-2 (from February 1, 2020 to January 31, 2021). The data, obtained from clinical charts and collected in a single database, comprehended demographic characteristics, comorbidities, hospital and home pharmacological therapies, oxygen therapy, laboratory values, discharge, death and Intensive care Unit (ICU) transfer. Death or ICU transfer were defined as composite outcomes. Results: Male patients were more frequent in the northern Italian region than in the central and southern regions. Diabetes mellitus, arterial hypertension, chronic pulmonary and chronic kidney diseases were the comorbidities more frequent in the southern region; cancer, heart failure, stroke and atrial fibrillation were more frequent in the central region. The prevalence of the composite outcome was recorded more frequently in the southern region. Multivariable analysis showed a direct association between the combined event and age, ischemic cardiac disease, and chronic kidney disease, in addition to the geographical area. Conclusions: Statistically significant heterogeneity was observed in patients with COVID-19 characteristics at admission and outcomes from northern to southern Italy. The higher frequency of ICU transfer and death in the southern region may depend on the wider hospital admission of frail patients for the availability of more beds since the burden of COVID-19 on the healthcare system was less intense in southern region. In any case, predictive analysis of clinical outcomes should consider that the geographical differences that may reflect clinical differences in patient characteristics, are also related to access to health-care facilities and care modalities. Overall, the present results caution against generalizability of prognostic scores in COVID-19 patients derived from hospital cohorts in different settings. |
| first_indexed | 2024-04-10T00:29:47Z |
| format | Article |
| id | doaj.art-63d052b64e3546a5a0481c81b2c037b0 |
| institution | Directory Open Access Journal |
| issn | 1876-0341 |
| language | English |
| last_indexed | 2024-04-10T00:29:47Z |
| publishDate | 2023-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Infection and Public Health |
| spelling | doaj.art-63d052b64e3546a5a0481c81b2c037b02023-03-15T04:27:33ZengElsevierJournal of Infection and Public Health1876-03412023-04-01164520525The three facets of the SARS-CoV-2 pandemic during the first two waves in the northern, central, and southern ItalySilvio Buscemi0Chiara Davoli1Enrico Maria Trecarichi2Helen Linda Morrone3Bruno Tassone4Carola Buscemi5Cristiana Randazzo6Anna Maria Barile7Piero Colombrita8Maurizio Soresi9Lydia Giannitrapani10Antonio Cascio11Nicola Scichilone12Carlo Cottone13Paolo Sbraccia14Valeria Guglielmi15Frida Leonetti16Alexis Elias Malavazos17Sara Basilico18Michele Carruba19Ferruccio Santini20Alessandro Antonelli21Nicola Viola22Marcello Romano23Bruno Mario Cesana24Carlo Torti25Clinical Nutrition Unit, Department of Health Promotion, Maternal and Childhood, Internal and Specialized Medicine of Excellence (PROMISE), University of Palermo, Palermo, ItalyInfectious and Tropical Diseases Unit, Department of Medical and Surgical Sciences, “Magna Graecia” University – “Mater Domini” Teaching Hospital, Catanzaro, Italy; Correspondence to: Infectious and Tropical Disease Unit, “Magna Graecia” University, Viale Europa, 88100 Catanzaro, Italy.Infectious and Tropical Diseases Unit, Department of Medical and Surgical Sciences, “Magna Graecia” University – “Mater Domini” Teaching Hospital, Catanzaro, ItalyInfectious and Tropical Diseases Unit, Department of Medical and Surgical Sciences, “Magna Graecia” University – “Mater Domini” Teaching Hospital, Catanzaro, ItalyInfectious and Tropical Diseases Unit, Department of Medical and Surgical Sciences, “Magna Graecia” University – “Mater Domini” Teaching Hospital, Catanzaro, ItalyClinical Nutrition Unit, Department of Health Promotion, Maternal and Childhood, Internal and Specialized Medicine of Excellence (PROMISE), University of Palermo, Palermo, ItalyClinical Nutrition Unit, Department of Health Promotion, Maternal and Childhood, Internal and Specialized Medicine of Excellence (PROMISE), University of Palermo, Palermo, ItalyClinical Nutrition Unit, Department of Health Promotion, Maternal and Childhood, Internal and Specialized Medicine of Excellence (PROMISE), University of Palermo, Palermo, ItalyClinical Nutrition Unit, Department of Health Promotion, Maternal and Childhood, Internal and Specialized Medicine of Excellence (PROMISE), University of Palermo, Palermo, ItalyCOVID Internal Medicine Unit, Department of Health Promotion, Maternal and Childhood, Internal and Specialized Medicine of Excellence (PROMISE), University of Palermo, Palermo, ItalyCOVID Internal Medicine Unit, Department of Health Promotion, Maternal and Childhood, Internal and Specialized Medicine of Excellence (PROMISE), University of Palermo, Palermo, ItalyInfectious and Tropical Diseases Unit, Department of Health Promotion, Maternal and Child Care, Internal Medicine, and Medical Specialties “G. D'Alessandro '', University of Palermo, Palermo, ItalyCOVID Pneumology Unit, Department of Health Promotion, Maternal and Childhood, Internal and Specialized Medicine of Excellence (PROMISE), University of Palermo, Palermo, ItalyCOVID Internal Medicine Unit, Petralia Sottana Hospital, ASP 6, Palermo, ItalyDepartment of Systems Medicine, Internal Medicine Unit-Obesity Center, Tor Vergata University of Rome, Tor Vergata Polyclinic, Rome, ItalyDepartment of Systems Medicine, Internal Medicine Unit-Obesity Center, Tor Vergata University of Rome, Tor Vergata Polyclinic, Rome, ItalyDiabetes Unit, Department of Medical-Surgical Sciences and Biotechnology, Santa Maria Goretti Hospital, “La Sapienza” University of Rome, Latina, ItalyEndocrinology, Clinical Nutrition and Cardiovascular Prevention Service Unit, IRCCS Polyclinic San Donato, Milan, Italy; Department of Biomedicine, Surgery and Dental Sciences, University of Milan, Milan, ItalyEndocrinology, Clinical Nutrition and Cardiovascular Prevention Service Unit, IRCCS Polyclinic San Donato, Milan, Italy; Department of Biomedicine, Surgery and Dental Sciences, University of Milan, Milan, ItalyCenter for Studies and Research on Obesity, Department of Biomedical Technologies and Translational Medicine, University of Milan, Milan, ItalyEndocrinology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, ItalyDepartment of Surgical, Medical and Molecular Pathology and Critical Area, University of Pisa, Pisa, ItalyEndocrinology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, ItalyGeriatrics Unit, ARNAS Garibaldi, Catania, ItalyMedical Statistics Unit, Biometrics and Bioinformatics ''Giulio A. Maccacaro'', Department of Clinical Sciences and Community Health, Faculty of Medicine and Surgery, University of Milan, Milan, ItalyInfectious and Tropical Diseases Unit, Department of Medical and Surgical Sciences, “Magna Graecia” University – “Mater Domini” Teaching Hospital, Catanzaro, ItalyBackground: There is a scarcity of information in literature regarding the clinical differences and comorbidities of patients affected by Coronavirus disease 2019 (COVID-19), which could clarify the different prevalence of the outcomes (composite and only death) between several Italian regions. Objective: This study aimed to assess the heterogeneity of clinical features of patients with COVID-19 upon hospital admission and disease outcomes in the northern, central, and southern Italian regions. Methods: An observational cohort multicenter retrospective study including 1210 patients who were admitted for COVID-19 in Infectious diseases, Pulmonology, Endocrinology, Geriatrics and Internal Medicine Units in Italian cities stratified between north (263 patients); center (320 patients); and south (627 patients), during the first and second pandemic waves of SARS-CoV-2 (from February 1, 2020 to January 31, 2021). The data, obtained from clinical charts and collected in a single database, comprehended demographic characteristics, comorbidities, hospital and home pharmacological therapies, oxygen therapy, laboratory values, discharge, death and Intensive care Unit (ICU) transfer. Death or ICU transfer were defined as composite outcomes. Results: Male patients were more frequent in the northern Italian region than in the central and southern regions. Diabetes mellitus, arterial hypertension, chronic pulmonary and chronic kidney diseases were the comorbidities more frequent in the southern region; cancer, heart failure, stroke and atrial fibrillation were more frequent in the central region. The prevalence of the composite outcome was recorded more frequently in the southern region. Multivariable analysis showed a direct association between the combined event and age, ischemic cardiac disease, and chronic kidney disease, in addition to the geographical area. Conclusions: Statistically significant heterogeneity was observed in patients with COVID-19 characteristics at admission and outcomes from northern to southern Italy. The higher frequency of ICU transfer and death in the southern region may depend on the wider hospital admission of frail patients for the availability of more beds since the burden of COVID-19 on the healthcare system was less intense in southern region. In any case, predictive analysis of clinical outcomes should consider that the geographical differences that may reflect clinical differences in patient characteristics, are also related to access to health-care facilities and care modalities. Overall, the present results caution against generalizability of prognostic scores in COVID-19 patients derived from hospital cohorts in different settings.http://www.sciencedirect.com/science/article/pii/S1876034123000321COVID-19SARS-CoV-2EpidemiologyItalyPublic healthMortality |
| spellingShingle | Silvio Buscemi Chiara Davoli Enrico Maria Trecarichi Helen Linda Morrone Bruno Tassone Carola Buscemi Cristiana Randazzo Anna Maria Barile Piero Colombrita Maurizio Soresi Lydia Giannitrapani Antonio Cascio Nicola Scichilone Carlo Cottone Paolo Sbraccia Valeria Guglielmi Frida Leonetti Alexis Elias Malavazos Sara Basilico Michele Carruba Ferruccio Santini Alessandro Antonelli Nicola Viola Marcello Romano Bruno Mario Cesana Carlo Torti The three facets of the SARS-CoV-2 pandemic during the first two waves in the northern, central, and southern Italy Journal of Infection and Public Health COVID-19 SARS-CoV-2 Epidemiology Italy Public health Mortality |
| title | The three facets of the SARS-CoV-2 pandemic during the first two waves in the northern, central, and southern Italy |
| title_full | The three facets of the SARS-CoV-2 pandemic during the first two waves in the northern, central, and southern Italy |
| title_fullStr | The three facets of the SARS-CoV-2 pandemic during the first two waves in the northern, central, and southern Italy |
| title_full_unstemmed | The three facets of the SARS-CoV-2 pandemic during the first two waves in the northern, central, and southern Italy |
| title_short | The three facets of the SARS-CoV-2 pandemic during the first two waves in the northern, central, and southern Italy |
| title_sort | three facets of the sars cov 2 pandemic during the first two waves in the northern central and southern italy |
| topic | COVID-19 SARS-CoV-2 Epidemiology Italy Public health Mortality |
| url | http://www.sciencedirect.com/science/article/pii/S1876034123000321 |
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