Prevalence and associated factors of COVID-19 across Italian regions: a secondary analysis from a national survey on physiotherapists

Abstract

Background Coronavirus disease 2019 (COVID-19) broke out in China in December 2019 and now is a pandemic all around the world. In Italy, Northern regions were hit the hardest during the first wave. We aim to explore the prevalence and the exposure characteristics of physiotherapists (PTs) working in different Italian regions during the first wave of COVID-19. Methods Between April and May 2020 a structured anonymous online survey was distributed to all PTs registered in the National Professional Registry to collect prevalence data of a confirmed diagnosis of COVID-19 (i.e., nasopharyngeal swab and/or serological test). A bottom-up agglomerative nesting hierarchical clustering method was applied to identify groups of regions based on response rate. Multivariable logistic regression was used to explore personal and work-related factors associated with a confirmed diagnosis of COVID-19. Results A total of 15,566 PTs completed the survey (response rate 43.3%). The majority of respondents (57.7%) were from Northern regions. Considering all respondents, the number of confirmed COVID-19 cases in Northern and Central Italy, was higher compared to those in Southern Italy (6.9% vs. 1.8%, P < 0.001); focusing the analysis on respondents who underwent nasopharyngeal swab and/or serological test led to similar findings (14.1% vs. 6.4%, P < 0.001). Working in Northern and Central regions was associated with a higher risk of confirmed diagnosis of COVID-19 compared to Southern regions (OR 3.4, 95%CI 2.6 to 4.3). PTs working in Northern and Central regions were more likely to be reallocated to a different unit and changing job tasks, compared to their colleagues working in the Southern regions (10.5% vs 3.7%, P < 0.001). Conclusions Work-related risk factors were differently distributed between Italian regions at the time of first pandemic wave, and PTs working in the Northern and Central regions were more at risk of a confirmed diagnosis of COVID-19, especially when working in hospitals. Preventive and organizational measures should be applied to harmonize physiotherapy services in the national context. Registration https://osf.io/x7cha

Risk factors for SARS-CoV-2 virus infection among physiotherapists in Poland. Preparing for the 5th wave of the pandemic

“…An exceptionally hazardous workplace, from the point of view of exposure to the virus, is a hospital as confirmed by the research conducted among Polish physiotherapists, but also, for example, a study carried out on a sample of nearly 30,000 healthcare professionals in Denmark [11]. This conclusion is also supported by a study investigating COVID-19 prevalence factors among Italian phys-iotherapists [12] (a study conducted after the first wave of the pandemic on a sample of more than 15,000 individuals). The study also supported the relatively lower disease risk of physiotherapists working in private physiotherapy clinics.…”

“…A more widely considered factor of potential routes of transmission -as the number of people living together with the respondent in the household -has been confirmed as a significant factor in increasing the risk of infection through studies conducted among British communities [13] as well as healthcare professionals in Turkey [14]. The majority of the research, similarly to the study conducted on Polish physiotherapists, does not support the importance of gender as a feature that differentiates the risk of infection, although it is possible to find studies showing that men were significantly more likely to be infected (see, for example, studies carried out on Italian physiotherapists [12] or Danish [11] and American [15] healthcare professionals). These studies emphasize the gender-specific variation of the work and the associated greater exposure of men to the virus.…”

Association of ventilator-free days with respiratory physiotherapy in critically ill patients with Coronavirus Disease 2019 (COVID-19) during the first pandemic wave. A propensity score-weighted analysis

“…Survival rate is not in line with previous studies ( 39 ) since those patients who did not reach the NMBAs withdrawal and therefore died in ICU were not eligible. The COVID-19 pandemic forced the medical team to allocate treatments in resource-limited circumstances ( 40 ), including respiratory physiotherapy ( 41 ). In our study, each ICU medical team decided autonomously if patients needed or not respiratory physiotherapy and this might have introduced a selection bias.…”

Physiotherapy Screening for Referral of a Patient with Patent Foramen Ovale Presenting with Neck Pain as Primary Complaint: A Case Report

“…There was observable muscle spasm on both the trapezius muscles; neck rotational mobility was limited and painful (NPRS 8/10); neck extension increased head heaviness [ 49 ]. As the history revealed an emerging pattern of cardiovascular risk factors (i.e., thrombocytopenia and leukopenia since he was young, together with hypertension familiarity and symptoms were behavior related to physical exertions), and because of the COVID-19 pandemic, vital sign measurements were performed [ 50 , 51 ]. Temperature was normal, and a regular pulse oxygen saturation level of 99% and 68 bpm resting heart rate (RHR) were assessed by a pulse oximeter [ 52 ].…”