Riding the COVID Waves: Clinical Trends, Outcomes, and Remaining Pitfalls of the SARS-CoV-2 Pandemic: An Analysis of Two High-Incidence Periods at a Hospital in Northern Italy.

Marina Sartini,Martino Oliva,Marcello Feasi,Alessandra Battistella,Emanuele Pontali,Silvia Boni,Andrea Parisini,Maria Luisa Cristina,Filippo Del Puente,Alessio Carbone,Elisabetta Blasi Vacca,Nicoletta Bobbio

doi:10.3390/jcm10225239

Marina Sartini, Martino Oliva + Show 10 more

Open Access

https://doi.org/10.3390/jcm10225239

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Abstract

Background. Italy was the first western country to face an uncontrolled outbreak of SARS-CoV-2 infection. The epidemic began in March 2020 within a context characterised by a general lack of knowledge about the disease. The first scientific evidence emerged months later, leading to treatment changes. The aim of our study was to evaluate the effects of these changes. Methods. Data from a hospital in Genoa, Italy, were analysed. Patients deceased from SARS-CoV-2 infection were selected. Data were compared by dividing patients into two cohorts: “phase A” (March–May 2020) and “phase B” (October–December 2020). Results. A total of 5142 patients were admitted. There were 274 SARS-CoV-2-related deaths (162 phase A and 112 phase B). No differences were observed in terms of demographics, presentation, or comorbidities. A significant increase was recorded in corticosteroid use. Mortality was 33.36% during phase A, falling to 21.71% during phase B. When subdividing the trend during the two phases by age, we found a difference in people aged 65–74 years. Conclusions. There is scarce evidence regarding treatment for SARS-CoV-2 (especially for severe infection). However, treatment changes improved the prognosis for people under the age of 75. The prognosis for older people remains poor, despite the improvements achieved.

Highlights

The SARS-CoV-2 infection was first reported in China in 2019 and subsequently spread to the rest of the world
The Italian population is the oldest in Europe. It has been repeatedly cited in the literature that age is possibly the most crucial aspect associated with SARS-CoV-2 infection severity [2]
Phases A and B; (2) to highlight any differences in clinical outcomes and mortality between patients hospitalised during Phases A and B; and (3) to understand which patient categories made most use of therapeutic updates and, which populations did not derive the desired benefit from therapeutic advances, by analysing the conditions of patients who died during the two phases

Summary

Introduction

The SARS-CoV-2 infection was first reported in China in 2019 and subsequently spread to the rest of the world. It had a significant negative impact on Italy, both in terms of morbidity and mortality, causing more than 4 million cases (7% of the population) and more than 132,000 deaths as of October 2021 [1]. Was the first western country to suffer an uncontrolled outbreak This meant that Italian healthcare providers and the government had to develop control and treatment measures rapidly, at a time when scientific evidence on the treatment of SARS-CoV-2 infection was still lacking [3]

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