ABSTRACT
Background: There is a scarcity of information in literature regarding the clinical differences and co-morbidities of patients affected by Coronavirus disease 2019 (COVID-19), which could clarify the different prevalence of the outcomes (composite and only death) between several Italian regions.Objective: This study aimed to assess the heterogeneity of clinical features of patients with COVID-19 upon hospital admission and disease outcomes in the northern, central, and southern Italian regions.Methods: An observational cohort multicenter retrospective study including 1210 patients who were admitted for COVID-19 in Infectious diseases, Pulmonology, Endocrinology, Geriatrics and Internal Medicine Units in Italian cities stratified between north (263 patients);center (320 patients);and south (627 patients), during the first and second pandemic waves of SARS-CoV-2 (from February 1, 2020 to January 31, 2021). The data, obtained from clinical charts and collected in a single database, comprehended demographic characteristics, co-morbidities, hospital and home pharmacological therapies, oxygen therapy, laboratory values, discharge, death and Intensive care Unit (ICU) transfer. Death or ICU transfer were defined as composite outcomes.Results: Male patients were more frequent in the northern Italian region than in the central and southern regions. Diabetes mellitus, arterial hypertension, chronic pulmonary and chronic kidney diseases were the comorbidities more frequent in the southern region;cancer, heart failure, stroke and atrial fibrillation were more frequent in the central region. The prevalence of the composite outcome was recorded more fre-quently in the southern region. Multivariable analysis showed a direct association between the combined event and age, ischemic cardiac disease, and chronic kidney disease, in addition to the geographical area.Conclusions: Statistically significant heterogeneity was observed in patients with COVID-19 characteristics at admission and outcomes from northern to southern Italy. The higher frequency of ICU transfer and death in the southern region may depend on the wider hospital admission of frail patients for the availability of more beds since the burden of COVID-19 on the healthcare system was less intense in southern region. In any case, predictive analysis of clinical outcomes should consider that the geographical differences that may reflect clinical differences in patient characteristics, are also related to access to health-care facilities and care modalities. Overall, the present results caution against generalizability of prognostic scores in COVID-19 patients derived from hospital cohorts in different settings.(c) 2023 The Author(s). Published by Elsevier Ltd on behalf of King Saud Bin Abdulaziz University for Health Sciences. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/li-censes/by-nc-nd/4.0/).
ABSTRACT
Background and Aim: In February 2020, the pandemic phase of CoViD-19 began in Italy. Healthcare workers were at the forefront of care and were immediately exposed to the risk of infection. Aim of the study was to evaluate the impact of the health surveillance system on the spread of infections in a health population Materials and Methods: The cases of infection in the period February 2020 - February 2021 were examined, compared to the number of molecular swabs performed on the health personnel of the F. Miulli Regional Hospital, in Acquaviva delle Fonti (BA). Results: A total of 14,133 molecular swabs were performed (on average 1,177 per month), finding 169 positive cases (equal to 1.19% of total swabs), on average 14 cases per month. The program included a schedule for performing swabs based on the level of risk of the healthcare staff. The tracking system put in place by the prevention service made it possible to minimize the spread of the infection. In addition, a continuous training program for operators on the use of personal protective equipment has been established, with random checks on correct use. Discussion: The health surveillance system, through the execution of periodic molecular swabs for all staff, together with the constant use of personal protective equipment, has made it possible to minimize the spread of the infection in the population of health workers with considerable benefits also on the safety level of hospitalized patients.