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Decreasing hospital burden of COVID-19 during the first wave in Regione Lombardia: an emergency measures context

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dc.contributor.authorGrosso, Francesca Maria
dc.contributor.authorPresanis, Anne Margaret
dc.contributor.authorKunzmann, Kevin
dc.contributor.authorJackson, Chris
dc.contributor.authorCorbella, Alice
dc.contributor.authorGrasselli, Giacomo
dc.contributor.authorAndreassi, Aida
dc.contributor.authorBodina, Annalisa
dc.contributor.authorGramegna, Maria
dc.contributor.authorCastaldi, Silvana
dc.contributor.authorCereda, Danilo
dc.contributor.authorAngelis, Daniela De
dc.contributor.authorAmbra, Castrofino
dc.contributor.authorGabriele, Del Castillo
dc.contributor.authorLucia, Crottogini
dc.contributor.authorMarcello, Tirani
dc.contributor.authorAlberto, Zanella
dc.contributor.authorMarco, Salmoiraghi
dc.date.accessioned2021-11-22T14:38:44Z
dc.date.available2021-11-22T14:38:44Z
dc.date.issued2021-09-03
dc.date.submitted2021-03-01
dc.date.updated2021-11-22T14:38:43Z
dc.description.abstractAbstract: Background: The aim of this study is to quantify the hospital burden of COVID-19 during the first wave and how it changed over calendar time; to interpret the results in light of the emergency measures introduced to manage the strain on secondary healthcare. Methods: This is a cohort study of hospitalised confirmed cases of COVID-19 admitted from February–June 2020 and followed up till 17th July 2020, analysed using a mixture multi-state model. All hospital patients with confirmed COVID-19 disease in Regione Lombardia were involved, admitted from February–June 2020, with non-missing hospital of admission and non-missing admission date. Results: The cohort consists of 40,550 patients hospitalised during the first wave. These patients had a median age of 69 (interquartile range 56–80) and were more likely to be men (60%) than women (40%). The hospital-fatality risk, averaged over all pathways through hospital, was 27.5% (95% CI 27.1–28.0%); and steadily decreased from 34.6% (32.5–36.6%) in February to 7.6% (6.3–10.6%) in June. Among surviving patients, median length of stay in hospital was 11.8 (11.6–12.3) days, compared to 8.1 (7.8–8.5) days in non-survivors. Averaged over final outcomes, median length of stay in hospital decreased from 21.4 (20.5–22.8) days in February to 5.2 (4.7–5.8) days in June. Conclusions: The hospital burden, in terms of both risks of poor outcomes and lengths of stay in hospital, has been demonstrated to have decreased over the months of the first wave, perhaps reflecting improved treatment and management of COVID-19 cases, as well as reduced burden as the first wave waned. The quantified burden allows for planning of hospital beds needed for current and future waves of SARS-CoV-2 i.
dc.identifier.doi10.17863/CAM.78271
dc.identifier.eissn1471-2458
dc.identifier.others12889-021-11669-w
dc.identifier.other11669
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/330828
dc.languageen
dc.publisherBioMed Central
dc.subjectResearch
dc.titleDecreasing hospital burden of COVID-19 during the first wave in Regione Lombardia: an emergency measures context
dc.typeArticle
dcterms.dateAccepted2021-08-12
prism.issueIdentifier1
prism.publicationNameBMC Public Health
prism.volume21
rioxxterms.licenseref.urihttp://creativecommons.org/licenses/by/4.0/
rioxxterms.versionVoR
rioxxterms.versionofrecord10.1186/s12889-021-11669-w

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