Outbreak In Italy Research Articles

Covid-19 in Italy : Impact of Lockdown in Italy on Socio-Economic Situation

The COVID-19 outbreak in Italy ranks third most in the world with very continued growth over time. The purpose of this article is to discuss the case of COVID-19 in Italy and its impact on socioeconomic life as well as international relations between Italy and other countries. This article uses library reviews to perform analysis related to the topic of this article using sources such as academic journals, research reports, news articles and so on.

Covid-19 in Italy : Impact of Lockdown in Italy on Socio-Economic Situation

The COVID-19 outbreak in Italy ranks third most in the world with very continued growth over time. The purpose of this article is to discuss the case of COVID-19 in Italy and its impact on socioeconomic life as well as international relations between Italy and other countries. This article uses library reviews to perform analysis related to the topic of this article using sources such as academic journals, research reports, news articles and so on.

Intensive cardiac care unit admission trends during the COVID-19 outbreak in Italy: a multi-center study.

A significant decline in the admission to intensive cardiac care unit (ICCU) has been noted in Italy during the COVID-19 outbreak. Previous studies have provided data on clinical features and outcome of these patients, but information is still incomplete. In this multicenter study conducted in six ICCUs, we enrolled consecutive adult patients admitted to ICCU in three specific time intervals: from February 8 to March 9, 2020 [before national lockdown (pre-LD)], from March 10 to April 9, 2020 [during the first period of national lockdown (in-LD)] and from May 18 to June 17, 2020 [soon after the end of all containment measures (after-LD)]. Compared to pre-LD, in-LD was associated with a significant drop in the admission to ICCU for all causes (− 35%) and acute coronary syndrome (ACS; − 49%), with a rebound soon after-LD. The in-LD reduction was greater for women (− 49%) and NSTEMI (− 61%) compared to men (− 28%) and STEMI (− 33%). Length-of-stay, and in-hospital mortality did not show any significant change from to pre-LD to in-LD in the whole population as well as in the ACS group. This study confirms a notable reduction in the admissions to ICCUs from pre-LD to in-LD followed by an increment in the admission rates after-LD. These data strongly suggest that people, particularly women and patients with NSTEMI, are reluctant to seek medical care during lockdown, possibly due to the fear of viral infection. Such a phenomenon, however, was not associated with a rise in mortality among patients who get hospitalization.Supplementary InformationThe online version contains supplementary material available at 10.1007/s11739-021-02718-8.

Return towards normality in admissions for myocardial infarction after the lockdown removal for COVID-19 outbreak in Italy

BackgroundInvestigations demonstrated a decrease of admissions for myocardial infarction (MI) during the CoronaVirus Disease-19 (COVID-19) outbreak. No study has evaluated the time required to reverse this downward curve of MI admissions. MethodsThis is a retrospective analysis on patients (N = 2415) admitted to the Emergency Departments for acute MI in nine Italian centers. Primary endpoint was the incidence rates (IRs) of MI admissions in the post-lockdown COVID-19 period (case-period: from May 4 to July 12, 2020) vs. the following control periods: January 1–February 19, 2020 (pre-lockdown period); February 20–May 3, 2020 (intra-lockdown period); May 4–July 12, 2019 (inter-year non-COVID-19 period). ResultsIR of admissions for MI in the post-lockdown period was higher than the intra-lockdown period (IR ratio, IRR: 1.60, 95% CI 1.42–1.81; p = 0.0001), was lower than the pre-lockdown period (IRR: 0.86, 0.77–0.96; p = 0.009) and similar to the inter-year non-COVID-19 period (IRR: 0.96, 0.87–1.07; p = 0.47). Within the case period, the increase in MI admissions was more pronounced in earlier vs later weeks (IRR 1.19, 95% CI 1.02–1.38, p = 0.024) and, compared to the inter-year control period, was significant for non ST-segment elevation MI (IRR: 1.25, 95% CI 1.08–1.46, p = 0.004), but was not observed for ST-segment elevation MI (STEMI), where hospitalizations were reduced (IRR 0.76, 95% CI 0.65–0.88, p = 0.0001). ConclusionsOur study first indicates an increase in the number of admissions for MI after the removal of the national lockdown for COVID-19 in Italy. This increase was prevalent in the first weeks following the lockdown removal, but was under-represented in STEMI patients.

Factors associated with risk of COVID-19 contagion for endoscopy healthcare workers: A survey from the Italian society of digestive endoscopy

Background and aimsThe present study was aimed to assess the risk of SARS-CoV-2 infection and associated factors among HCWs in endoscopy centers in Italy. MethodsAll members of the Italian Society of Digestive Endoscopy (SIED) were invited to participate to a questionnaire-based survey during the first months of the COVID-19 outbreak in Italy. Results314/1306 (24%) SIED members accounting for 201/502 (40%) endoscopic centers completed the survey. Personal Protection Equipment (PPE) were available in most centers, but filtering face-piece masks (FFP2 or FFP3) and negative pressure room were not in 10.9 and 75.1%. Training courses on PPE use were provided in 57.2% of centers only; there was at least one positive HCW in 17.4% of centers globally, 107/3308 (3.2%) HCWs were diagnosed with COVID-19 with similar rates of physicians (2.9%), nurses (3.5%) and other health operators (3.5%). Involvement in a COVID-19 care team (OR: 4.96) and the lack of training courses for PPE, (OR: 2.65) were associated with increased risk. ConclusionsThe risk of COVID-19 among endoscopy HCWs was not negligible and was associated with work in a COVID-19 care team and lack of education on proper PPE use. These data deserve attention during the subsequent waves.

Seroprevalence of Anti-SARS-CoV-2 IgG and IgM among Adults over 65 Years Old in the South of Italy.

SARS-CoV-2 is a zoonotic betacoronavirus associated with worldwide transmission of COVID-19 disease. By the beginning of March, WHO reported about 113,820,000 confirmed cases including more than 2,527,000 deaths all over the world. However, the true extent of virus circulation or its real infection/fatality ratio is not well-estimated due to the huge portion of asymptomatic infections. In this observational study, we have estimated the prevalence of specific immunoglobulin M and G directed towards SARS-CoV-2 antigen in a cohort of 1383 adult volunteers aged over 65 years old, living in the district of Benevento, in the South of Italy. Serological screening was carried out on capillary blood in September 2020, seven months after pandemic outbreak in Italy, to evaluate virus circulation and antibody response among elderly adults, in which severe symptoms due to viral infection are more common. The overall seroprevalence of anti-SARS-CoV-2 antibodies was 4.70% (CI 3.70%–5.95%) with no statistically significant differences between sexes. Among these, 69.69% (CI 55.61%–77.80%) tested positive to IgM, 23.08% (CI 14.51%–34.64%) to IgG and 9.23% (CI 4.30%–18.71%) was positive for both. All patients that were positive to IgM underwent molecular testing through RT-qPCR on oral-rhino pharyngeal swabs and only one specimen was positive for SARS-CoV-2 RNA detection. Instead, the presence of IgG from screened volunteers was confirmed by re-testing serum samples using both an ELISA assay validated for in vitro diagnostic use (IVD) and a recently published synthetic peptide-based ELISA assay. In conclusion, our report suggests that (1) early restrictions were successful in limiting COVID-19 diffusion in the district of Benevento; (2) rapid serological analysis is an ideal testing for both determining real seroprevalence and massive screening, whereas detection of viral RNA remains a gold standard for identification of infected patients; (3) even among people without COVID-19 related symptoms, the antibody response against SARS-CoV-2 antigens has individual features.

Adolescents’ Stress Reactions in Response to COVID-19 Pandemic at the Peak of the Outbreak in Italy

In this study, we evaluated the variation on stress reactions in Italian adolescents during the peak of the COVID-19 pandemic as related to national diffusion of the outbreak, demographic characteristics, and personal experiences related to COVID-19. An online survey was disseminated from April 1 to April 5, 2020. The sample was composed of 5,295 Italian adolescents (75.2% females; mean age = 16.67 years, SD = 1.43), 28.9% of whom presented moderate to high stress reactions during the peak of the pandemic. Older adolescents and females were more likely to be affected by the pandemic. The impact was similar regardless of the varying presence of COVID-19, whether in Lombardy or in regions less affected. Personal experiences with COVID-19 were all associated with stress reactions (direct experience, indirect experience via a friend, or an acquaintance infected). The global nature of the stressor influenced a collective psychological reaction not affected by the specific geographical diffusion of the pandemic.

The Impact of COVID-19 Outbreak in Italy on the Sustainable Food Consumption Intention From a "One Health" Perspective.

Coronavirus disease (COVID-19) is a transmissible illness that was recognized in December 2019 and World Health Organization (WHO) stated a pandemic on 11 March 2020. As no cure has been developed for COVID-19 disease yet, Italy has adopted restrictive measures to avoid the spread of the virus, causing different psychological reactions (e.g., stress, anxiety) that lead people to change lifestyle and in particular the consumer orientation toward food. In addition, the COVID-19 emergency had also affected the Italian economy, causing an 11.3% decrease in GDP (gross domestic product). All these changes gave rise to a sense of instability, but it is known that new possibilities may arise in these situations. In particular, the pandemic could be the turning point to make consumers aware of the close link between human health and the ecosystems, supporting the “One Health” perspective and enhancing the orientation to consumer sustainable food products. However, little is known about how the psychological reactions to COVID-19 emergency have affected the consumers' intention to purchase sustainable food products. In order to answer these questions, a representative sample of 1,004 Italian citizens, extracted by stratified sampling, answered an online survey between May the 12th and 18th 2020. The data were analyzed using ANOVA and contingency tables. The results show that during phase one of COVID-19 disease about 30% of the sample reported that have frequently (often and always) consumed the certified sustainable food products and about 20% of the sample have intention to increase the consumption of them in the next 6 months, percentages that increase among those who feel more vulnerable regarding the risk contagion. Moreover, the psychological impact of the COVID-19 emergency has led to a change in consumers' attitudes, increasing the interest in animal and environmental issues and in human health. These aspects seem to drive the future intention of purchasing sustainable food products. This research highlights how the psychological reactions to the health emergency have changed the consumers' attitudes toward sustainability issues, leading them to follow a more sustainable diet that is recognized as a way to preserve human health, environmental preservation, and animal welfare for present and future generations.

A novel methodology for epidemic risk assessment of COVID-19 outbreak

We propose a novel data-driven framework for assessing the a-priori epidemic risk of a geographical area and for identifying high-risk areas within a country. Our risk index is evaluated as a function of three different components: the hazard of the disease, the exposure of the area and the vulnerability of its inhabitants. As an application, we discuss the case of COVID-19 outbreak in Italy. We characterize each of the twenty Italian regions by using available historical data on air pollution, human mobility, winter temperature, housing concentration, health care density, population size and age. We find that the epidemic risk is higher in some of the Northern regions with respect to Central and Southern Italy. The corresponding risk index shows correlations with the available official data on the number of infected individuals, patients in intensive care and deceased patients, and can help explaining why regions such as Lombardia, Emilia-Romagna, Piemonte and Veneto have suffered much more than the rest of the country. Although the COVID-19 outbreak started in both North (Lombardia) and Central Italy (Lazio) almost at the same time, when the first cases were officially certified at the beginning of 2020, the disease has spread faster and with heavier consequences in regions with higher epidemic risk. Our framework can be extended and tested on other epidemic data, such as those on seasonal flu, and applied to other countries. We also present a policy model connected with our methodology, which might help policy-makers to take informed decisions.

Vascular Surgery During COVID-19 Emergency in Hub Hospitals of Lombardy: Experience on 305 Patients

During the most aggressive phase of the COVID-19 outbreak in Italy, the Regional Authority of Lombardy identified a number of hospitals, named Hubs, chosen to serve the whole region for highly specialised cases, including vascular surgery. This study reports the experience of the four Hubs for Vascular Surgery in Lombardy and provides a comparison of in hospital mortality and major adverse events (MAEs) according to COVID-19 testing.

Digital Pathology During the COVID-19 Outbreak in Italy: Survey Study.

BackgroundTransition to digital pathology usually takes months or years to be completed. We were familiarizing ourselves with digital pathology solutions at the time when the COVID-19 outbreak forced us to embark on an abrupt transition to digital pathology.ObjectiveThe aim of this study was to quantitatively describe how the abrupt transition to digital pathology might affect the quality of diagnoses, model possible causes by probabilistic modeling, and qualitatively gauge the perception of this abrupt transition.MethodsA total of 17 pathologists and residents participated in this study; these participants reviewed 25 additional test cases from the archives and completed a final psychologic survey. For each case, participants performed several different diagnostic tasks, and their results were recorded and compared with the original diagnoses performed using the gold standard method (ie, conventional microscopy). We performed Bayesian data analysis with probabilistic modeling.ResultsThe overall analysis, comprising 1345 different items, resulted in a 9% (117/1345) error rate in using digital slides. The task of differentiating a neoplastic process from a nonneoplastic one accounted for an error rate of 10.7% (42/392), whereas the distinction of a malignant process from a benign one accounted for an error rate of 4.2% (11/258). Apart from residents, senior pathologists generated most discrepancies (7.9%, 13/164). Our model showed that these differences among career levels persisted even after adjusting for other factors.ConclusionsOur findings are in line with previous findings, emphasizing that the duration of transition (ie, lengthy or abrupt) might not influence the diagnostic performance. Moreover, our findings highlight that senior pathologists may be limited by a digital gap, which may negatively affect their performance with digital pathology. These results can guide the process of digital transition in the field of pathology.

Effectively managing diagnostic tests to monitor the COVID-19 outbreak in Italy

Urged by the outbreak of the COVID-19 in Italy, this study aims at helping to tackle the spread of the disease by resorting to operations research techniques. In particular, we propose a mathematical program to model the problem of establishing how many diagnostic tests the Italian regions must perform in order to maximize the overall disease detection capability. An important feature of our approach is its simplicity: data we resort to are easy to obtain and one can employ standard optimization tools to address the problem. The results we obtain when applying our method to the Italian case seem promising.

Comparison of Demand for Drugs Used for COVID-19 Treatment and Other Drugs During the Early Phase of the COVID-19 Pandemic in Italy

This cross-sectional study compares demand for drugs for treatment of coronavirus disease 2019 (COVID-19) between the period directly before the COVID-19 outbreak in Italy and the early period of the outbreak.

Personality and Attitudes Confronting Death Awareness During the COVID-19 Outbreak in Italy and Spain.

Italy and Spain are two representative examples on strict lockdown last March 2020, also suffering a high rate of mortality in Europe. The aim of this study is to examine their attitudes confronting death awareness during the Covid-19 outbreak. Moreover, Personality was also considered. Different sociodemographic, in situ questions related to attitudes and the brief Big Five of Personality were employed in a cross-sectional design. The main results suggested that Personality traits were stable across countries. A relationship was found between Fear to contagious diseases and Neuroticism and other attitudes during the Covid-19 outbreak, and two different clusters were identified with regards to attitudes, however these did not differ on Personality. Finally, a Cluster group, Neuroticism, Age and Sense of belonging to the Country did predict Fear to contagious diseases. Of note, no differences were found across countries during grief.

A study investigating the knowledge and responses of Italian medical students to the COVID-19 pandemic

ABSTRACT Italy was initially one of the worse affected countries by the novel coronavirus (COVID-19). Medical students frequenting hospitals are more susceptible to be infected by the virus but also able to see the effects of the pandemic from the frontline. The aim of this study was to assess the COVID-19 related knowledge, behavioral changes, and perceptions of Italian medical students within the first 90 days after the onset of the outbreak in Italy. A national cross-sectional study was conducted from 23rd April to 31st April 2020. Participants were Italian medical students whose knowledge, behavioral changes, and perceptions of the COVID-19 pandemic were assessed. The survey consisted of: demographics, COVID-19 related general knowledge, behavioral changes, and perceptions of the pandemic. A total of 520 students answered the survey. The majority of the students’ ages ranged from 21 to 25 years old (345, 66.3%). Only 48.6% stated that they had received a formal education about COVID-19 from their medical institutions. However, all the students declared that they tried to inform themselves, mostly through WHO, CDC, UpToDate (56%), but also (21.6%) through national guidelines, social networks (Facebook, Instagram, and YouTube) (11.5%), and other sources (10.9%). Italian medical students demonstrated a high level of COVID-19-related general knowledge as well as self-reported preventative behavioral changes but only had a moderate risk perception regarding the pandemic. They improved their health habits but questioned the reliability of information and handling of the pandemic by health authorities.

The impact of COVID-19 on orthopaedic trauma: A retrospective comparative study from a single university hospital in Italy.

The COVID-19 outbreak strongly affected Italy, putting a strain on the National healthcare system. Hospitals quickly reorganized the activity to cope with the emergency. This retrospective comparative study aimed to analyze the impact of the lockdown imposed in Italy during the COVID-19 outbreak on acute orthopedic trauma, in order to identify critical issues for improvement and future planning. We collected data on all the trauma admissions to a single University hospital DEA (Department of Emergency and Acceptance) in Rome during the COVID- 19 pandemic lockdown in Italy, comparing them with the corresponding period in 2019. We reported demographic data; the characteristics of the injury, including the anatomical location, fracture, sprain, dislocation, contusion, laceration, whether the injury site was exposed or closed, where the injury occurred, and polytrauma. We also recorded the waiting time in the emergency room and mode of transportation. The study sample was composed of 1199 patients, 636 (53.04%) males and 563 (46.96%) females. The overall number of admissions in 2019 (pre-COVID-19 period) was 995; then it was 204 during COVID-19 outbreak in 2020. The average age of the 2020 group was 51.9 ± 24.8 years, significantly higher than that of the 2019 group (41.4 ± 25.7) (p<0.0001). In particular, elderly patients (≥65 years) were the most commonly involved in the COVID-19 group, while in the pre- COVID-19 period they were middle-aged adults (15-44 years) (p<0.0001). The injury occurred at home in 65.7% of cases in the 2020 group, and in 32.3% of patients in the 2019 group. Concerning the injury type, in both groups, the most common injury was a fracture (45.1% in 2019; 62.7% in 2020) (p<0.0001). The most injured anatomical location during COVID-19 lockdown was the hand (14.2%), while in the pre-COVID- 19 group the most frequent injury type was polytrauma (22.8%). Despite the decrease of overall acute trauma referral rates during the COVID-19 outbreak in Italy, the incidence of fractures in elderly individuals remained stable, indicating that not all trauma presentations would necessarily decrease during such times.

Coronavirus Disease Stress Among Italian Healthcare Workers: The Role of Coping Humor.

The study aimed to understand how coping strategies in general and humor-based coping strategies in particular modulate the perception of pandemic-related stress in a sample of Italian healthcare workers during the coronavirus disease (COVID-19) outbreak in Italy. A total of 625 healthcare workers anonymously and voluntarily completed a 10-min questionnaire, which included psychometrically valid measurements preceded by a set of questions aimed at determining workers’ exposure to COVID-19. The Perceived Stress Scale was used to measure healthcare workers’ stress levels, and the Brief COPE Scale and Coping Humor Scale were used to assess participants’ avoidant or approach coping style and verify the degree to which they relied on humor to cope with stress. The results show that (1) levels of perceived stress were higher in healthcare workers who were more exposed to COVID-19 (i.e., who came into contact with COVID-19 patients or worked in wards dedicated to COVID-19) in comparison to less-exposed workers; (2) participants who reported a higher use of avoidant coping strategies perceived the situation as more stressful than those who used them less; and (3) healthcare workers who reported higher use of humor-based coping strategies perceived the situation as less stressful in comparison with those who reported less use of coping humor. Such findings expanded other research studies by including coping humor as a potential factor to mitigate the perceived stress related to COVID-19. The paper concludes with a discussion of implications for future research and limitations of the study.

Effective Containment of a COVID-19 Subregional Outbreak in Italy Through Strict Quarantine and Rearrangement of Local Health Care Services.

BackgroundSince the beginning of the pandemic, the epidemiology of coronavirus disease 2019 (COVID-19) in Italy has been characterized by the occurrence of subnational outbreaks. The World Health Organization recommended building the capacity to rapidly control COVID-19 clusters of cases in order to avoid the spread of the disease. This study describes a subregional outbreak of COVID-19 that occurred in the Emilia Romagna region, Italy, and the intervention undertaken to successfully control it.MethodsCases of COVID-19 were defined by a positive reverse transcriptase polymerase chain reaction (RT-PCR) for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on nasopharyngeal swab. The outbreak involved the residential area of a small town, with ~10 500 inhabitants in an area of 9 km2. After the recognition of the outbreak, local health care authorities implemented strict quarantine and a rearrangement of health care services, consisting of closure of general practitioner outpatient clinics, telephone contact with all residents, activation of health care units to visit at-home patients with symptoms consistent with COVID-19, and a dedicated Infectious Diseases ambulatory unit at the nearest hospital.ResultsThe outbreak lasted from February 24 to April 6, 2020, involving at least 170 people with a cumulative incidence of 160 cases/10 000 inhabitants; overall, 448 inhabitants of the municipality underwent at least 1 nasopharyngeal swab to detect SARS-CoV-2 (positivity rate, 38%). Ninety-three people presented symptoms before March 11 (pre-intervention period), and 77 presented symptoms during the postintervention period (March 11–April 6).ConclusionsIt was possible to control this COVID-19 outbreak by prompt recognition and implementation of a targeted local intervention.

Telemedicine during the Coronavirus Disease (COVID-19) Pandemic: A Multiple Sclerosis (MS) Outpatients Service Perspective.

Background: During the COVID-19 pandemic, the need for a broader implementation of telemedicine for many diseases has become apparent. Televisits are one type of telemedicine in which clinical visits are conducted remotely using an audio-visual connection with the patient at home. The use of televisits is more established in Stroke care but was also recently formally evaluated for Multiple Sclerosis (MS). This retrospective case series describes patient characteristics and reasons for televisits in persons with MS during the COVID-19 pandemic outbreak in Italy, which was declared in February 2020. Methods: Recruitment occurred in a general hospital based MS clinic during Italy’s lockdown months period (9 March–18 May). Each subject completed at least one televisit. The baseline data included were demographics and MS history; reasons for the remote house calls were analyzed focusing on COVID-19 related needs. Results: Forty-six participants completed at least one study visit. The patients enrolled were more often females suffering from Relapsing Remitting Multiple Sclerosis (RRMS). Half of the patients had an intermediate level of education and lived within a 60 min drive from the clinic. These patients predominately had a short disease duration and were mostly involved in oral treatment. The main reasons for the call were drug use and counseling on social distancing. In 5 cases, COVID-19 infection was reported. Conclusions: Televisits during the COVID-19 outbreak demonstrated their utility as a care delivery method for MS. Hence, it is vital to facilitate the implementation of this technology in common practice to both face infectious threats and increase accessibility of the health care system.

Risk Perception and Protective Behaviors During the Rise of the COVID-19 Outbreak in Italy.

Risk perception is important in determining health-protective behavior. During the rise of the COVID-19 epidemic, we tested a comprehensive structural equation model of risk perception to explain adherence to protective behaviors in a crisis context using a survey of 572 Italian citizens. We identified two categories of protective behaviors, labeled promoting hygiene and cleaning, and avoiding social closeness. Social norms and risk perceptions were the more proximal antecedents of both categories. Cultural worldviews, affect, and experience of COVID-19 were the more distal predictors. Promoting hygiene and cleaning was triggered by the negative affective attitude toward coronavirus and mediated by an affective appraisal of risk. The deliberate dimension of risk perception (perceived likelihood) predicted only avoiding social closeness. Social norms predicted both types of behaviors and mediated the relations of cultural worldviews. Individualism (vs. communitarianism), more than hierarchy (vs. egalitarianism), shaped the affective evaluation of coronavirus. The model was an acceptable fit to the data and accounted for 20% and 29% of the variance in promoting hygiene and cleaning, and avoiding social closeness, respectively. The findings were robust to the effect of sociodemographic factors (age, gender, education, socioeconomic status, and zone of the country). Taken together, our findings confirmed the empirical distinction between affective and deliberate processes in risk perception, supported the validity of the affect heuristic, and highlighted the role of social norms as an account for why individualistic people were less likely to follow the prescribed health-protective behaviors. Implications for risk communication are discussed.