Ontology highlight
ABSTRACT: Background
International literature suggests that disadvantaged groups are at higher risk of morbidity and mortality from SARS-CoV-2 infection due to poorer living/working conditions and barriers to healthcare access. Yet, to date, there is no evidence of this disproportionate impact on non-national individuals, including economic migrants, short-term travellers and refugees.Methods
We analyzed data from the Italian surveillance system of all COVID-19 laboratory-confirmed cases tested positive from the beginning of the outbreak (20th of February) to the 19th of July 2020. We used multilevel negative-binomial regression models to compare the case fatality and the rate of admission to hospital and intensive care unit (ICU) between Italian and non-Italian nationals. The analysis was adjusted for differences in demographic characteristics, pre-existing comorbidities, and period of diagnosis.Results
We analyzed 213 180 COVID-19 cases, including 15 974 (7.5%) non-Italian nationals. We found that, compared to Italian cases, non-Italian cases were diagnosed at a later date and were more likely to be hospitalized {[adjusted rate ratio (ARR)=1.39, 95% confidence interval (CI): 1.33-1.44]} and admitted to ICU (ARR=1.19, 95% CI: 1.07-1.32), with differences being more pronounced in those coming from countries with lower human development index (HDI). We also observed an increased risk of death in non-Italian cases from low-HDI countries (ARR=1.32, 95% CI: 1.01-1.75).Conclusions
A delayed diagnosis in non-Italian cases could explain their worse outcomes compared to Italian cases. Ensuring early access to diagnosis and treatment to non-Italians could facilitate the control of SARS-CoV-2 transmission and improve health outcomes in all people living in Italy, regardless of nationality.
SUBMITTER: Fabiani M
PROVIDER: S-EPMC7851886 | biostudies-literature | 2021 Feb
REPOSITORIES: biostudies-literature
Fabiani Massimo M Mateo-Urdiales Alberto A Andrianou Xanthi X Bella Antonino A Del Manso Martina M Bellino Stefania S Rota Maria C MC Boros Stefano S Vescio Maria F MF D'Ancona Fortunato P FP Siddu Andrea A Punzo Ornella O Filia Antonietta A Brusaferro Silvio S Rezza Giovanni G Dente Maria G MG Declich Silvia S Pezzotti Patrizio P Riccardo Flavia F
European journal of public health 20210201 1
<h4>Background</h4>International literature suggests that disadvantaged groups are at higher risk of morbidity and mortality from SARS-CoV-2 infection due to poorer living/working conditions and barriers to healthcare access. Yet, to date, there is no evidence of this disproportionate impact on non-national individuals, including economic migrants, short-term travellers and refugees.<h4>Methods</h4>We analyzed data from the Italian surveillance system of all COVID-19 laboratory-confirmed cases t ...[more]