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Factors associated with increased all-cause mortality during the COVID-19 pandemic in Italy.
Mannucci, Edoardo; Nreu, Besmir; Monami, Matteo.
  • Mannucci E; Diabetology, Careggi Hospital, Florence, Italy; University of Florence Medical School, Florence, Italy.
  • Nreu B; University of Florence Medical School, Florence, Italy.
  • Monami M; Diabetology, Careggi Hospital, Florence, Italy. Electronic address: matteo.monami@unifi.it.
Int J Infect Dis ; 98: 121-124, 2020 Sep.
Article in English | MEDLINE | ID: covidwho-620116
ABSTRACT

BACKGROUND:

The number of excess deaths during February-March 2020 in Italy, in comparison with previous years, was considerably higher than the recorded COVID19-related deaths. The present study aimed to explore the association of excess mortality with some indices related to the COVID-19 pandemic and its management.

METHODS:

Data on all-cause mortality from 20 February-31 March in the years 2015-2020, and demographic, socioeconomic and healthcare organisation data of each Italian region were obtained from the Italian Institute of Statistics. Non-COVID-19-Imputed Excess Mortality (NCIEM) was calculated as the difference between the excess 2020 mortality and reported COVID-19 mortality. The association of NCIEM with the rate of COVID-19 cases, COVID-19 mortality and other potential moderators was assessed using linear regression models.

RESULTS:

The nationwide number of excess deaths and COVID-19 deaths was 26,701 and 13,710, respectively, with a difference of 12,991. The NCIEM in different regions showed a direct correlation with COVID-19 mortality (r2 = 0.61, p < 0.001) and total cases (r2 = 0.30, p = 0.012), and an inverse correlation with cases/total tests ratio (r2 = 0.49, p = 0.001). Direct correlations were also found with the proportion of institutionalised elderly, whereas inverse correlations were observed with prevalence of diabetes, cardiovascular mortality and density of general practitioners.

CONCLUSIONS:

The impact of the COVID-19 pandemic on all-cause mortality was considerably greater than that indicated by official counts of victims. Limited testing capacity and causes of death other than COVID-19 could have contributed to the increase in overall mortality rates.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Coronavirus Infections / Betacoronavirus Type of study: Observational study / Prognostic study Limits: Aged / Female / Humans / Male / Middle aged Country/Region as subject: Europa Language: English Journal: Int J Infect Dis Journal subject: Communicable Diseases Year: 2020 Document Type: Article Affiliation country: J.ijid.2020.06.077

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Coronavirus Infections / Betacoronavirus Type of study: Observational study / Prognostic study Limits: Aged / Female / Humans / Male / Middle aged Country/Region as subject: Europa Language: English Journal: Int J Infect Dis Journal subject: Communicable Diseases Year: 2020 Document Type: Article Affiliation country: J.ijid.2020.06.077