Abstract
This article examines the main factors affecting COVID-19 lethality across 16 European Countries with a focus on the role of health system characteristics during the first phase of the diffusion of the virus. Specifically, we investigate the leading causes of lethality at 10, 20, 30, 40 days in the first hit of the pandemic. Using a random forest regression (ML), with lethality as outcome variable, we show that the percentage of people older than 65 years (with two or more chronic diseases) is the main predictor variable of lethality by COVID-19, followed by the number of hospital intensive care unit beds, investments in healthcare spending compared to GDP, number of nurses and doctors. Moreover, the variable of general practitioners has little but significant predicting quality. These findings contribute to provide evidence for the prediction of lethality caused by COVID-19 in Europe and open the discussion on health policy and management of health care and ICU beds during a severe epidemic.
Highlights
The new coronavirus (SARS-CoV-2 or COVID-19) outbreak appeared in Wuhan, China in December 2019 and rapidly progressed in Europe becoming an urgent c oncern[1,2,3]
Investigating the factors correlated with the COVID-19 lethality is the key-question of our work to make assumptions whether national health care systems are well-equipped and in general are prepared in dealing with a global health crisis
We find that demographic variables are the most relevant in predicting lethality, with a prevalence of the elders aged over 65 with two or more chronic diseases
Summary
The new coronavirus (SARS-CoV-2 or COVID-19) outbreak appeared in Wuhan, China in December 2019 and rapidly progressed in Europe becoming an urgent c oncern[1,2,3]. One of the most relevant factors that could dampen the devastating power of the epidemic could be the loss of lethality of the v irus[4,8], expressed as the ratio between the deaths and the infected people[9]. For these reasons, the factors influencing the COVID-19 lethality are still undergoing investigation with many studies mainly focused on local factors and health conditions. Recent studies showed that exceeding the health capacity leads to an increase in the mortality/case ratio[22]: one of the main factors implicated in the COVID-19 deaths is the surge of cases that depleted hospital resources[23]
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