Declining Mortality Rate of Hospitalised Patients in the Second Wave of the COVID-19 Epidemics in Italy: Risk Factors and the Age-Specific Patterns

Abstract

Background: Mortality rate from COVID-19 in Italy is among the world’s highest. We aimed to ascertain whether there was any reduction of in-hospital mortality in patients hospitalised for COVID-19 in the second-wave period (October 2020–January 2021) compared to the first one (February–May 2020); further, we verified whether there were clusters of hospitalised patients who particularly benefitted from reduced mortality rate. Methods: Data collected related to in-patients’ demographics, clinical, laboratory, therapies and outcome. Primary end-point was time to in-hospital death. Factors associated were evaluated by uni- and multivariable analyses. A flow diagram was created to determine the rate of in-hospital death according to individual and disease characteristics. Results: A total of 1561 patients were included. The 14-day cumulative incidence of in-hospital death by competing risk regression was of 24.8% (95% CI: 21.3–28.5) and 15.9% (95% CI: 13.7–18.2) in the first and second wave. We observed that the highest relative reduction of death from first to second wave (more than 47%) occurred mainly in the clusters of patients younger than 70 years. Conclusions: Progress in care and supporting therapies did affect population over 70 years to a lesser extent. Preventive and vaccination campaigns should focus on individuals whose risk of death from COVID-19 remains high.

Mortality rates among COVID-19 patients hospitalised during the first three waves of the epidemic in Milan, Italy: A prospective observational study

“…In line with the findings of two previous Italian studies [ 31 , 32 ], we also observed a trend towards a reduction in the proportion of critically ill patients upon admission between W1 and W3 (from 25.1% to 22.1% and then 17.6%). This change may have been due to increased access to COVID-19 testing and the detection of cases generally associated with a lower risk of death (testing was initially restricted to the most severely ill patients).…”

Age distribution and disease severity of COVID-19 patients continued to change in a time-dependent manner from May 2021 to April 2022 in the regional core hospital in Japan

“…In addition, the ratio of direct deaths caused by COVID-19 tended to decrease in phase II, where most patients died due to severe comorbidities. This observation is equivalent to that reported in several official releases of epidemiological data and clinical reports (4,15,17,20,(22)(23)(24)(25)(26).…”

Anxiety, Perceived Stress, and Resilience during the COVID-19 Pandemic: Population Estimates of Persons Presenting to a General Practitioner in Romania

“…Mortality owing to COVID-19 has been linked to advanced age and concomitant chronic illnesses, which have been identified as the most significant risk factors [ 39 , 40 ]. In addition, the elderly and those suffering from chronic illnesses are at a higher risk of acquiring the condition [ 41 ]. Individuals with chronic illnesses have higher levels of anxiety (cardiovascular diseases, p < 0.001; metabolic conditions, p < 0.001; pulmonary conditions, p = 0.020; gastrointestinal conditions, p < 0.001), stress (cardiovascular diseases, p < 0.001; gastrointestinal conditions, p = 0.021), and poor resilience (cardiovascular diseases, p < 0.001; metabolic conditions, p = 0.037; gastrointestinal conditions, p = 0.024), which are all results that run parallel to one another.…”