Cross-regional variations of Covid-19 mortality in Italy: an ecological study

Oliva, Cristina; Maddaloni, Francesco Di; Marcellusi, Andrea; Favato, Giampiero

doi:10.1093/pubmed/fdaa248

Cited by 5 publications

(4 citation statements)

References 15 publications

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“…The forecasting metrics were consistent in indicating the Holt–Winters additive exponential model as more accurate, and they were worse for the series of rates in the municipality of Taranto given the smaller population at risk and therefore the lower number of deaths. Regardless of the model used, comparable measures of GoF (such as MAPE) were worse than the predictions made for non-specific causes of death or for larger geographical aggregations (such as the Apulia region or Italy) [ 53 ]. However, an MAPE value between 10 and 20 for the series in the province of Taranto (17.4) indicates a “good forecasting” according to the thresholds proposed by Lewis [ 54 ].…”

Section: Discussionmentioning

confidence: 99%

No Excess of Mortality from Lung Cancer during the COVID-19 Pandemic in an Area at Environmental Risk: Results of an Explorative Analysis

Addabbo

Giotta

Mincuzzi

et al. 2023

IJERPH

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Background: The COVID-19 pandemic and the restrictive measures associated with it placed enormous pressure on health facilities and may have caused delays in the treatment of other diseases, leading to increases in mortality compared to the expected rates. Areas with high levels of air pollution already have a high risk of death from cancer, so we aimed to evaluate the possible indirect effects of the pandemic on mortality from lung cancer compared to the pre-pandemic period in the province of Taranto, a polluted site of national interest for environmental risk in the south of Italy. Methods: We carried out a retrospective observational study on lung cancer data (ICD-10: C34) from the Registry of Mortality (ReMo) for municipalities in Taranto Province over the period of 1 January 2011 to 31 December 2021. Seasonal exponential smoothing, Holt–Winters additive, Holt–Winters multiplicative, and auto-regressive integrated moving average (ARIMA) models were used to forecast the number of deaths during the pandemic period. Data were standardized by sex and age via an indirect method and shown as monthly mortality rates (MRs), standardized mortality ratios (SMRs), and adjusted mortality rates (AMRs). Results: In Taranto Province, 3108 deaths from lung cancer were recorded between 2011 and 2021. In the province of Taranto, almost all of the adjusted monthly mortality rates during the pandemic were within the confidence interval of the predicted rates, with the exception of significant excesses in March (+1.82, 95% CI 0.11–3.08) and August 2020 (+2.09, 95% CI 0.20–3.44). In the municipality of Taranto, the only significant excess rate was in August 2020 (+3.51, 95% CI 0.33–6.69). However, in total, in 2020 and 2021, the excess deaths from lung cancer were not significant both for the province of Taranto (+30 (95% CI −77; +106) for 2020 and +28 (95% CI −130; +133) for 2021) and for the municipality of Taranto alone (+14 (95% CI −47; +74) for 2020 and −2 (95% CI −86; +76) for 2021). Conclusions: This study shows that there was no excess mortality from lung cancer as a result of the COVID-19 pandemic in the province of Taranto. The strategies applied by the local oncological services during the pandemic were probably effective in minimizing the possible interruption of cancer treatment. Strategies for accessing care in future health emergencies should take into account the results of continuous monitoring of disease trends.

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Section: Discussionmentioning

confidence: 99%

No Excess of Mortality from Lung Cancer during the COVID-19 Pandemic in an Area at Environmental Risk: Results of an Explorative Analysis

Addabbo

Giotta

Mincuzzi

et al. 2023

IJERPH

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“…Covid-19 is an unequal killer [16] with a significant impact on disability and life expectancy [17]. Central to the Italian crisis and the medical response were the healthcare workers who were exposed to Covid-19 without having any perception of what they were facing during the first pandemic wave [18,19].…”

Section: Discussionmentioning

confidence: 99%

The impact of Covid-19 vaccination on the Italian healthcare system: a scenario analysis

Marcellusi

Fabiano

Sciattella

et al. 2021

Preprint

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Introduction: The objective of this study is to estimate the effects of the national immunisation strategy for Covid-19 in Italy on the national healthcare system. Methods: An epidemiological scenario analysis was developed in order to simulate the impact of the Covid-19 pandemic on the Italian national healthcare system in 2021. Hospitalisations, ICU admissions and death rates were modelled based on 2020 data. We forecast the impact of the introduction of a primary prevention strategy on the national healthcare system by considering vaccine efficacy, availability of doses and potential population coverage over time. Results: In the absence of immunisation, between 57,000 and 63,000 additional deaths are forecast in 2021. Based on the assumptions underlying the two epidemiological scenarios from the 2020 data, our model predicts that cumulative hospital admissions in 2021 will range from 3.4 to 3.9 million. The deployment of vaccine immunisation has the potential to control the evolution of 2021 infections and avoid from 60 to 67 percent of deaths compared to not vaccinating. Conclusions: In order to inform Italian policymakers on delivering a mass vaccination programme, this study highlights and detects some key factors that must be controlled to ensure that immunisation targets will be met in reasonable time.

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“…In this study, the COVID-19 mortality index was defined as the number of COVID-19 deaths divided by the number of COVID-19 new cases during the study period multiplied by 10,000. The number of physicians per hospital bed (22) , (23) , (24) , number of long-term care facilities (25) , (26) , (27) , and aging rate (28) , (29) were used as regional characteristics in this study. The number of physicians per hospital bed was used as a measure of the distribution of physicians and hospital beds in the healthcare system.…”

Section: Methodsmentioning

confidence: 99%

Regional Variations in Coronavirus Disease 2019 Mortality in Japan: An Ecological Study

2023

JMA J

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Introduction: As the characteristics of coronavirus disease 2019 (COVID-19) vary across regions and countries, the relationship between regional characteristics, such as the distribution of physicians and hospital beds, and COVID-19 mortality was assessed in the 47 prefectures of Japan. Methods: This ecological study was based on the number of patients with COVID-19 by prefecture during the seventh wave of COVID-19 in Japan (June-October 2022). COVID-19 mortality was indexed as the number of COVID-19 deaths divided by the number of new COVID-19 cases. Data on regional factors, such as population size, number of physicians, and hospital beds by prefecture, were obtained from government statistics. Correlations between regional characteristics and COVID-19 mortality index were analyzed by dividing the 47 prefectures into two groups at the median level of population size (more populated group [MPG] ≥ 1.6 million and less populated group [LPG] < 1.6 million). Results: The COVID-19 mortality index (mean 12.7, minimum-maximum: 4.7-25.7) was correlated negatively with the number of physicians per hospital bed (r = −0.386, p = 0.007) and positively with the number of long-term care facilities per 10,000 population (r = 0.397, p = 0.006) and aging rate (the proportion of population aged ≥ 65 years) ( r = 0.471, p = 0.001). The two groups varied with respect to the number of physicians (28.7 physicians in the LPG vs. 26.1 physicians in the MPG, p = 0.038) and hospital beds (156 beds in the LPG vs. 119 beds in the MPG, p < 0.001) per 10,000 population. In the multiple regression analysis, the COVID-19 mortality index was correlated negatively with the number of physicians per hospital bed ( β = −0.543, p = 0.024) and positively with the aging rate ( β = 0.434, p = 0.032) in the LPG, with nonsignificant correlations in the MPG. Conclusions: The data may suggest a need of improvement in the distribution of physicians and hospital beds in the healthcare system in regions with smaller and older populations to reduce the rate of COVID-19.

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Cross-regional variations of Covid-19 mortality in Italy: an ecological study

Cited by 5 publications

References 15 publications

No Excess of Mortality from Lung Cancer during the COVID-19 Pandemic in an Area at Environmental Risk: Results of an Explorative Analysis

No Excess of Mortality from Lung Cancer during the COVID-19 Pandemic in an Area at Environmental Risk: Results of an Explorative Analysis

The impact of Covid-19 vaccination on the Italian healthcare system: a scenario analysis

Regional Variations in Coronavirus Disease 2019 Mortality in Japan: An Ecological Study

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