COVID-19 in Italy: passing through bitter waters

Guglielmetti, Lorenzo; Chiesi, Sheila

doi:10.1183/13993003.01812-2020

Cited by 4 publications

(4 citation statements)

References 8 publications

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“…In the first stage, the Delphi method [ 13 ] was applied to realize an Ishikawa model [ 29 ] focused on the reasons behind the deaths of the patients in the COVID-19 wards. Such reasons could be described as belonging to four major groups as follows: ( Figure 2 ).…”

Section: Resultsmentioning

confidence: 99%

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Burden of COVID-19 on Italian Internal Medicine Wards: Delphi, SWOT, and Performance Analysis after Two Pandemic Waves in the Local Health Authority “Roma 6” Hospital Structures

Pietrantonio

Rosiello

Alessi

et al. 2021

IJERPH

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Background: COVID-19 causes major changes in day-to-day hospital activity due to its epidemiological characteristics and the clinical challenges it poses, especially in internal medicine wards. Therefore, it is necessary to understand and manage all of the implicated factors in order to maintain a high standard of care, even in sub-par circumstances. Methods: This was a three-phase, mixed-design study. Initially, the Delphi method allowed us to analyze the causes of poor outcomes in a cohort of an aggregate of Italian COVID-19 wards via an Ishikawa diagram. Then, for each retrieved item, a score was assigned according to a pros/cons, opportunities/threats system. Scores were also assigned according to potential value/perceived risk. Finally, the performances of MCs (Medicine-COVID-19 wards) and MCFs (Medicine-COVID-19-free: Internal Medicine wards) units were represented via a Barber’s nomogram. Results: MCFs hospitalized 790 patients (−23.90% compared to 2019 Internal Medicine admissions). The main risk factors for mortality were patients admitted from local facilities (+7%) and the presence of comorbidities (>3: 100%, ≥5: 24.7%). A total of 197 (25%) patients were treated with non-invasive ventilation (NIV). The most deaths (57.14%) occurred in patients admitted from local facilities. Conclusions: Medicine-COVID-19 wards show higher complexity and demand compared to non-COVID-19 ones and they are comparable to sub-intensive therapy wards. It is necessary to promote the use of NIV in such settings.

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Section: Resultsmentioning

confidence: 99%

“…Currently, there are two main alternatives for the hospitalization of symptomatic SARS-CoV-2 patients: Internal Medicine wards and Intensive Care (IT) wards. The choice of destination is made by considering the seriousness of the clinical presentation and the patient’s comorbidities [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Burden of COVID-19 on Italian Internal Medicine Wards: Delphi, SWOT, and Performance Analysis after Two Pandemic Waves in the Local Health Authority “Roma 6” Hospital Structures

Pietrantonio

Rosiello

Alessi

et al. 2021

IJERPH

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“…In Italy again, the crisis abruptly disrupted the previous populist, xenophobic orientation of the public discourse, making space for a new dialogue that has shifted to a recovered sense of human solidarity and cohesion. 19 Other observed effects concern the rebuilding of national pride on the basis of cultural excellence, generosity and the selfless dedication of health professionals, 20 as an example of the deep roots of Italy’s social and cultural values. Furthermore, a regained sense of respect for the authority of experts, not only in the health professions, has been observed.…”

Section: Unintended Consequencesmentioning

confidence: 99%

Public health challenges and opportunities after COVID-19

Sacco¹,

Domenico²

2021

Bull World Health Org

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“…As of October 31st, 2020, 45 667 780 cases of COVID-19 and 1 189 499 deaths have been reported worldwide [2], with 594 472 cases and 37 781 deaths having occurred in Italy [3]. Italy, the first Western country reporting sustained COVID-19 transmission, has been disproportionately affected by the epidemic [4][5][6]. In areas of Northern Italy surrounding the first COVID-19 cluster in the town of Codogno, public healthcare systems have been overwhelmed by the abrupt caseload increase [7].…”

Section: Introductionmentioning

confidence: 99%

Severe COVID-19 pneumonia in Piacenza, Italy — A cohort study of the first pandemic wave

Guglielmetti¹,

Kontsevaya²,

Leoni³

et al. 2021

Journal of Infection and Public Health

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Background Piacenza is the closest city to the first coronavirus disease 2019 (COVID-19) cluster in Italy and has the highest national COVID-19 death rates per population. The objective of this study is to present characteristics and outcomes of patients admitted to medical departments of the Hospital of Piacenza during the first wave of the epidemic. Methods A total of 218 patients with confirmed or suspect COVID-19 and severe pneumonia were included from February 21 st to May 15 th , 2020. Routinely-collected clinical and laboratory data were retrospectively retrieved from electronic medical files. A Cox proportional-hazards model was fit to assess the association of treatment and other variables with death. Results Median age of patients was 68 years; 150 patients (69%) had comorbidities, mainly hypertension (107, 49%). Overall, 185 (85%) patients had acute respiratory distress syndrome (ARDS) on admission, including 103 (47%) with moderate or severe ARDS. Chest computed tomography scan showed bilateral disease in 201 (98%) and extensive lung involvement in 79 (50%) patients. Most patients received antiviral treatment (187, 86%) and corticosteroids (134, 61%). All patients received respiratory support and 64 (29%) were admitted to intensive care unit. As of June 30 th , 100 patients (46%) died, 109 patients (50%) were discharged, and 9 patients (4%) were still hospitalized. In multivariable Cox analysis, age above 65 years, having more than one comorbidity, severe ARDS, low platelet counts, and high LDH levels at admission were associated with mortality, while having diarrhea at admission was associated with survival. The use of antivirals or corticosteroids was not associated with survival. Conclusions Overall case fatality rates were high and associated with comorbidities, extensive lung involvement, ARDS at admission, and advanced age. The use of antivirals was not associated with increased survival.

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COVID-19 in Italy: passing through bitter waters

Cited by 4 publications

References 8 publications

Burden of COVID-19 on Italian Internal Medicine Wards: Delphi, SWOT, and Performance Analysis after Two Pandemic Waves in the Local Health Authority “Roma 6” Hospital Structures

Burden of COVID-19 on Italian Internal Medicine Wards: Delphi, SWOT, and Performance Analysis after Two Pandemic Waves in the Local Health Authority “Roma 6” Hospital Structures

Public health challenges and opportunities after COVID-19

Severe COVID-19 pneumonia in Piacenza, Italy — A cohort study of the first pandemic wave

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