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Introduction: In August 2021, an outbreak of coronavirus disease 2019 (COVID-19) occurred in a summer camp in Piedmont region, Italy, affecting primarily campers aged 16 years. We conducted a retrospective cohort study among campers and personnel (attendees) to determine the attack rate (AR), evaluate possible factors associated with transmission and propose recommended measures for the organization of future summer camps. Materials and methods: A de-identified database including demographic, role of attendees, cohorting, means of transportation to the camp, inter-camper interactions, SARS-CoV-2 testing results and symptomatology was used. All analysis data came from a collection of data carried out by the organizing private company and the information related to the mitigation protocol put in place was provided by the health care personnel. All campers were asked to have an antigen/molecular test within 72 hours before departure. Nine dedicated buses departed from different Italian regions towards the camp. All travellers wore a surgical mask during the trip. Upon arrival, regardless of the bus used, the campers were divided into 11 subgroups with no further contact between them unless they were blood relatives. No SARS-CoV-2 screening tests were scheduled for campers after arrival and during the camp period. On the other hand, personnel had a screening test at each shift change. During the camp period, antigen tests were performed at cases with symptoms suggestive of infection. Only attendees enrolled in the private company and those who received at least one test since arrival at the camp were considered in the study. We calculated overall AR and relative risk (RR) along with specific, transmission-focused risk factors.
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OBJECTIVES: This study was to compare the incidence and clinical outcomes of SARS-CoV-2 infection between Italian and non-Italian nationals. STUDY DESIGN: We retrospectively analysed data from the COVID-19 Italian integrated surveillance system (14 September 2020 to 17 October 2021). METHODS: We used multivariable Cox proportional hazards models to estimate the hazard ratio (HR) of infection and, among cases, the HRs of death, hospitalisation and subsequent admission to intensive care unit in non-Italian nationals relative to Italian nationals. Estimates were adjusted for differences in sociodemographic characteristics and in the week and region of diagnosis. RESULTS: Of 4,111,067 notified cases, 336,265 (8.2%) were non-Italian nationals. Compared with Italian nationals, non-Italians showed a lower incidence of SARS-CoV-2 infection (HR = 0.81, 95% confidence interval [CI]: 0.80-0.81). However, once diagnosed, they were more likely to be hospitalised (HR = 1.90, 95% CI: 1.87-1.92) and then admitted to intensive care unit (HR = 1.08, 95% CI: 1.04-1.13), with differences larger in those coming from countries with a lower human development index. Compared with Italian cases, an increased rate of death was observed in non-Italian cases from low-human development index countries (HR = 1.41, 95% CI: 1.23-1.62). The HRs of SARS-CoV-2 infection and severe outcomes slightly increased after the start of the vaccination campaign. CONCLUSIONS: Underdiagnosis and delayed diagnosis in non-Italian nationals could explain their lower incidence compared with Italians and, among cases, their higher probability to present clinical conditions leading to worse outcomes. Facilitating early access to vaccination, diagnosis and treatment would improve the control of SARS-CoV-2 transmission and health outcomes in this vulnerable group.
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COVID-19 , COVID-19/epidemiology , Hospitalization , Humans , Incidence , Retrospective Studies , SARS-CoV-2ABSTRACT
Introduction: Event-based surveillance (EBS) complements traditional surveillance to identify, track and critically appraise the potential public health (PH) impact of infectious diseases and other health threats. The Ministry of Health, the Istituto Superiore di Sanita, regional health authorities with the support of international partnerships shaped EBS in Italy into a flexible, decentralized, and sustainable system that operates through the existing public health workforce with no additional costs. We report the early activation of EBS in Italy, from mass gatherings to its systematic contribution to risk monitoring during the COVID-19 pandemic. Materials and methods: Italian EBS analysts aim to detect cases/clusters of infectious diseases of PH impact in Italy mainly monitoring MedISys and Google Alerts. A risk assessment matrix was designed to favour coherence in the classification of events. In 2019, the analysts assessed the sustainability of the operations model though an online survey.
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The current study aims to describe the characteristics of the SARS-CoV-2 infection from the beginning of its spread in Italy, in February 2020, up to April 2021 across the tested positive cases in Italy. Global data strongly suggest that a sex/gender-based disparity exists, with men being at higher risk of SARS-CoV-2 infection, hospitalization, poor clinical outcomes and death due to the coronavirus disease 2019 (COVID-19). With this in mind, we focused on a sex/gender analysis, in order to better understand the role of sex/gender-related determinants in the outcome of COVID-19. We used rou-tinely collected data retrieved from the Italian National Surveillance System of confirmed SARS-CoV-2 infections. Data is collected and entered daily on a secure online platform by the 19 Italian Regions and the two Autonomous Prov-inces, and all the system is coordinated by the Italian National Institute of Health. In total, 4.027.075 cases occurred from February 2020 to April 2021, and were included in the analysis. Our results show that in Italy the numbers of SARS-CoV-2 infections are quite similar in women and men, even if some differences in ex-posure and outcomes between sexes are present. In par-ticular, the case fatality rate over 50 years of age is signifi-cantly higher in men than in women, with the difference increasing with age. These data further confirm the importance of the integration of a sex/gender analysis in future studies, thus enabling effective public health measures and gender-specific solutions. © 2022, Il Pensiero Scientifico Editore s.r.l. All rights reserved.