Abstract

Italy was one of the nations most affected by SARS-CoV-2. During the pandemic period, the national government approved some restrictions to reduce diffusion of the virus. We aimed to evaluate changes in in-hospital mortality and its possible relation with patient comorbidities and different restrictive public health measures adopted during the 2020 pandemic period. We analyzed the hospital discharge records of inpatients from public and private hospitals in Apulia (Southern Italy) from 1 January 2019 to 31 December 2020. The study period was divided into four phases according to administrative restriction. The possible association between in-hospital deaths, hospitalization period, and covariates such as age group, sex, Charlson comorbidity index (CCI) class, and length of hospitalization stay (LoS) class was evaluated using a multivariable logistic regression model. The risk of death was slightly higher in men than in women (OR 1.04, 95% CI: 1.01–1.07) and was lower for every age group below the >75 years age group. The risk of in-hospital death was lower for hospitalizations with a lower CCI score. In summary, our analysis shows a possible association between in-hospital mortality in non-COVID-19-related diseases and restrictive measures of public health. The risk of hospital death increased during the lockdown period.

Highlights

  • IntroductionPublisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations

  • Our analysis shows a possible association between in-hospital mortality in non-COVID-19-related diseases and restrictive measures of public health

  • The risk of in-hospital deaths increased during the lockdown period

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Summary

Introduction

Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. In 2019, more than 7,000,000 patients were discharged from Italian hospitals, of which more than 75% were public hospitals. The most frequent cause of hospitalization was cardiovascular disease, accounting for 14% of all discharges. Breast, and lung cancer were the most frequent cancers, accounting for at least 3% of causes of hospital discharge. In 2019, discharges from Apulia accounted for 5.7% of all Italian discharges

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