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Decreasing hospital burden of COVID-19 during the first wave in Regione Lombardia: an emergency measures context.
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.
  • Grosso FM; Postgraduate School of Public Health, Department of Biomedical Sciences for Health, Via Pascal 36, University of Milan, Milan, Italy. francesca.grosso@unimi.it.
  • Presanis AM; MRC Biostatistics Unit, University of Cambridge, East Forvie Building, Robinson way, Cambridge, UK.
  • Kunzmann K; MRC Biostatistics Unit, University of Cambridge, East Forvie Building, Robinson way, Cambridge, UK.
  • Jackson C; MRC Biostatistics Unit, University of Cambridge, East Forvie Building, Robinson way, Cambridge, UK.
  • Corbella A; MRC Biostatistics Unit, University of Cambridge, East Forvie Building, Robinson way, Cambridge, UK.
  • Grasselli G; Department of Statistics, University of Warwick, Mathematical Sciences Building, Academic Loop Road, Warwick, UK.
  • Andreassi A; Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Via Francesco Sforza 28, Milan, Italy.
  • Bodina A; Welfare General Directorate, Regione Lombardia, Piazza Città di Lombardia 1, Milan, Italy.
  • Gramegna M; Welfare General Directorate, Regione Lombardia, Piazza Città di Lombardia 1, Milan, Italy.
  • Castaldi S; Welfare General Directorate, Regione Lombardia, Piazza Città di Lombardia 1, Milan, Italy.
  • Cereda D; Postgraduate School of Public Health, Department of Biomedical Sciences for Health, Via Pascal 36, University of Milan, Milan, Italy.
  • Angelis D; Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Via Francesco Sforza 28, Milan, Italy.
BMC Public Health ; 21(1): 1612, 2021 09 03.
Article in English | MEDLINE | ID: covidwho-1496155
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.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Cohort study / Observational study / Prognostic study Limits: Female / Humans / Male Language: English Journal: BMC Public Health Journal subject: Public Health Year: 2021 Document Type: Article Affiliation country: S12889-021-11669-w

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Cohort study / Observational study / Prognostic study Limits: Female / Humans / Male Language: English Journal: BMC Public Health Journal subject: Public Health Year: 2021 Document Type: Article Affiliation country: S12889-021-11669-w