COVID-19 mortality and ICU admission: the Italian experience

Immovilli, Paolo; Morelli, Nicola; Antonucci, Elio; Radaelli, Greta; Barbera, Mario; Guidetti, Donata

doi:10.1186/s13054-020-02957-9

Cited by 78 publications

(80 citation statements)

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“…As reported by others, age is one of the strongest predictors of mortality ( Cagnacci and Xholli, 2020 ; Immovilli et al, 2020 ). Patients who died were on average older (68 years) than those with mild cases (37 years).…”

Section: Discussionmentioning

confidence: 59%

Is Colombia an example of successful containment of the 2020 COVID-19 pandemic? A critical analysis of the epidemiological data, March to July 2020

Hoz-Restrepo¹,

Alvis-Zakzuk²,

Gomez³

et al. 2020

International Journal of Infectious Diseases

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Background: Colombia detected its first coronavirus disease 2019 (COVID-19) case on March 2, 2020. From March 22 to April 25, it implemented a national lockdown that, apparently, allowed the country to keep a low incidence and mortality rate up to mid-May. Forced by the economic losses, the government then opened many commercial activities, which was followed by an increase in cases and deaths. This paper presents a critical analysis of the Colombian surveillance data in order to identify strengths and pitfalls of the control measures. Methods: A descriptive analysis of PCR-confirmed cases between March and July 25 was performed. Data were described according to the level of measurement. Incidence and mortality rates of COVID-19 were estimated by age, sex, and geographical area. Sampling rates for suspected cases were estimated by geographical area, and the potential for case underestimation was assessed using sampling differences. Results: By July 25, Colombia (population 50 372 424) had reported 240 745 cases and 8269 deaths (case fatality rate of 3.4%). A total of 1 370 271 samples had been analyzed (27 405 samples per million people), with a positivity rate of 17%. Sampling rates per million varied by region from 2664 to 158 681 per million, and consequently the incidence and mortality rates also varied. Due to geographical variations in surveillance capacity, Colombia may have overlooked up to 82% of the actual cases. Conclusion: Colombia has a lower case and mortality incidence compared to other South American countries. This may be an effect of the lockdown, but may also be attributed, to some extent, to geographical differences in surveillance capacity. Indigenous populations with little health infrastructure have been hit the hardest.

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Section: Discussionmentioning

confidence: 59%

Is Colombia an example of successful containment of the 2020 COVID-19 pandemic? A critical analysis of the epidemiological data, March to July 2020

Hoz-Restrepo¹,

Alvis-Zakzuk²,

Gomez³

et al. 2020

International Journal of Infectious Diseases

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“…However, the CFR was much higher in Hubei province (5.9%–7.7%) than in other provinces outside Hubei (.86%–.98%) [ 22 , 23 ]. The average CFR in Italy until March 2020 was 7.5%, with CFRs in different regions ranging from 3.1% to 16.7% [ 24 ]. Until early April 2020, the CFR in the United States was 3.2%, ranging from 0.7% to 5.7% among different states [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

“…Another likely reason for the much lower CFR in Hong Kong than that in many other countries was the lower incidence of COVID-19 and the lower burden on surge capacity of our healthcare system. Italy, for example, reported a linear negative correlation between CFR and ICU admission rate among different provinces, indicating higher mortality being associated with absence of ICU care because of the operational capacity of ICUs being exceeded [ 24 ]. Mortality among patients admitted to ICU in other cities ranged from 26% to 62% early in the pandemic [ 28–30 ].…”

Section: Discussionmentioning

confidence: 99%

Significantly Lower Case-fatality Ratio of Coronavirus Disease 2019 (COVID-19) than Severe Acute Respiratory Syndrome (SARS) in Hong Kong—A Territory-Wide Cohort Study

Lui

Yip

Wong

et al. 2020

Clinical Infectious Diseases

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Background The case-fatality ratios (CFR) of coronavirus disease 2019 (COVID-19) and severe acute respiratory syndrome (SARS) appeared to differ substantially. We aimed to compare the CFR and its predictors of COVID-19 and SARS patients using a territory-wide cohort in Hong Kong. Methods This was a territory-wide retrospective cohort study using data captured from all public hospitals in Hong Kong. Laboratory-confirmed COVID-19 and SARS patients were identified. The primary endpoint was a composite endpoint of intensive care unit admission, use of mechanical ventilation, and/or death. Results We identified 1013 COVID-19 patients (mean age, 38.4 years; 53.9% male) diagnosed from 23 January to 14 April 2020 and 1670 SARS patients (mean age, 44.4 years; 44.0% male) from March to June 2003. Fifty-five (5.4%) COVID-19 patients and 432 (25.9%) SARS patients had reached the primary endpoint in 30 days. By 30 June 2003, 286 SARS patients had died (CFR, 17.1%). By 7 June 2020, 4 COVID-19 patients had died (CFR, 0.4%). After adjusting for demographic and clinical parameters, COVID-19 was associated with a 71% lower risk of primary endpoint compared with SARS (adjusted hazard ratio, 0.29; 95% confidence interval, .21–.40; P < .0001). Age, diabetes mellitus, and laboratory parameters (high lactate dehydrogenase, high C-reactive protein, and low platelet count) were independent predictors of the primary endpoint in COVID-19 patients, whereas use of antiviral treatments was not associated with primary endpoint. Conclusions The CFR of COVID-19 was 0.4%. Age and diabetes were associated with worse outcomes, whereas antiviral treatments were not.

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“…Although no information on center allocation in each group is provided, as more than 170 centers participated in the trial for a total of 6425 patients it is likely that center imbalance in group allocation may have occurred, especially in the subgroup of patients receiving mechanical ventilation in which an average of only 6 patients were included per center. As case fatality rates vary across hospitals [ 12 , 13 ], this imbalance may have influenced the results, all other factors being equal. Indeed, in the UK, where the RECOVERY trial was performed, the magnitude of the risk of death varied between centers from 0 to over + 4, similar to the impact of age [ 14 ].…”

Section: Critique Of the Evidencementioning

confidence: 99%

Corticosteroids in severe COVID-19: a critical view of the evidence

Backer

Azoulay²,

Vincent

2020

Crit Care

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COVID-19 mortality and ICU admission: the Italian experience

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Cited by 78 publications

References 1 publication

Is Colombia an example of successful containment of the 2020 COVID-19 pandemic? A critical analysis of the epidemiological data, March to July 2020

Is Colombia an example of successful containment of the 2020 COVID-19 pandemic? A critical analysis of the epidemiological data, March to July 2020

Significantly Lower Case-fatality Ratio of Coronavirus Disease 2019 (COVID-19) than Severe Acute Respiratory Syndrome (SARS) in Hong Kong—A Territory-Wide Cohort Study

Corticosteroids in severe COVID-19: a critical view of the evidence

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