Abstract
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.
Highlights
This article is an open access articleIn the last 2-year period SARS CoV-2 pandemics has caused over 4.2 million deaths worldwide [1], causing major socio-economic and health disruptions worldwide
Demographic and clinical characteristics of the remaining 1561 patients are reported in Table 1; differences in patients’ and clinical characteristics were examined according to the two calendar periods
The 14-day cumulative incidence of in-hospital death by competing risk regression was of 24.8% and 15.9% in the first and second wave, respectively
Summary
This article is an open access articleIn the last 2-year period SARS CoV-2 pandemics has caused over 4.2 million deaths worldwide [1], causing major socio-economic and health disruptions worldwide. While the first wave was unexpected and resulted in sudden dramatic changes to health system in different countries, the second one was foreseeable and hospitals were already organised to host a number of COVID-19 in ordinary, subacute and ICU beds. Mortality rates vary widely according to different settings and in different parts of the world [2,3]. This high variability might depend on different factors, first of all the reference population, including either only hospitalised or out-patients, and the health setting including the availability of ICU beds, and individual variables, such as socioeconomical status [3]; all these factors might contribute to disentangle differences on COVID-19 fatality rates in different settings. A flow diagram was created to determine the rate of in-hospital death according to individual and disease characteristics
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
