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Decreasing hospital burden of COVID-19 during the first wave in Regione Lombardia : an emergency measures context

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Grosso, Francesca Maria, Presanis, Anne Margaret, Kunzmann, Kevin, Jackson, Chris, Corbella, Alice, Grasselli, Giacomo, Andreassi, Aida, Bodina, Annalisa, Gramegna, Maria, Castaldi, Silvana, Cereda, Danilo, Angelis, Daniela De, Ambra, Castrofino, Gabriele, Del Castillo, Lucia, Crottogini, Marcello, Tirani, Alberto, Zanella and Marco, Salmoiraghi (2021) Decreasing hospital burden of COVID-19 during the first wave in Regione Lombardia : an emergency measures context. BMC Public Health, 21 (1). doi:10.1186/s12889-021-11669-w

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Official URL: http://dx.doi.org/10.1186/s12889-021-11669-w

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Abstract

Background:
The aim of this study is to quantify the hospital burden of COVID-19 during the first wave and how it changed over calendar time; to interpret the results in light of the emergency measures introduced to manage the strain on secondary healthcare.

Methods:
This is a cohort study of hospitalised confirmed cases of COVID-19 admitted from February–June 2020 and followed up till 17th July 2020, analysed using a mixture multi-state model. All hospital patients with confirmed COVID-19 disease in Regione Lombardia were involved, admitted from February–June 2020, with non-missing hospital of admission and non-missing admission date.

Results:
The cohort consists of 40,550 patients hospitalised during the first wave. These patients had a median age of 69 (interquartile range 56–80) and were more likely to be men (60%) than women (40%). The hospital-fatality risk, averaged over all pathways through hospital, was 27.5% (95% CI 27.1–28.0%); and steadily decreased from 34.6% (32.5–36.6%) in February to 7.6% (6.3–10.6%) in June. Among surviving patients, median length of stay in hospital was 11.8 (11.6–12.3) days, compared to 8.1 (7.8–8.5) days in non-survivors. Averaged over final outcomes, median length of stay in hospital decreased from 21.4 (20.5–22.8) days in February to 5.2 (4.7–5.8) days in June.

Conclusions:
The hospital burden, in terms of both risks of poor outcomes and lengths of stay in hospital, has been demonstrated to have decreased over the months of the first wave, perhaps reflecting improved treatment and management of COVID-19 cases, as well as reduced burden as the first wave waned. The quantified burden allows for planning of hospital beds needed for current and future waves of SARS-CoV-2 i.

Item Type: Journal Article
Subjects: R Medicine > RA Public aspects of medicine
Divisions: Faculty of Science > Statistics
Library of Congress Subject Headings (LCSH): COVID-19 Pandemic, 2020- , COVID-19 Pandemic, 2020- -- Italy -- Lombardy, COVID-19 (Disease) -- Prevention -- Italy -- Lombardy, COVID-19 (Disease) -- Transmission -- Italy -- Lombardy -- Prevention, Health services administration -- Italy -- Lombardy, Hospitals -- Italy -- Lombardy
Journal or Publication Title: BMC Public Health
Publisher: BioMed Central Ltd.
ISSN: 1471-2458
Official Date: 3 September 2021
Dates:
DateEvent
3 September 2021Published
12 August 2021Accepted
Volume: 21
Number: 1
DOI: 10.1186/s12889-021-11669-w
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Open Access
RIOXX Funder/Project Grant:
Project/Grant IDRIOXX Funder NameFunder ID
MC UU 00002/11[MRC] Medical Research Councilhttp://dx.doi.org/10.13039/501100000265
MC_PC_19074)[MRC] Medical Research Councilhttp://dx.doi.org/10.13039/501100000265
MC_PC_19074)UK Research and Innovationhttp://dx.doi.org/10.13039/100014013

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