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Cross-regional variations of Covid-19 mortality in Italy: an ecological study.


ABSTRACT:

Background

Disparities in cross-regional coronavirus disease 2019 (Covid-19) mortality remain poorly understood. The association between pre-epidemic health and epidemic mortality can inform a policy response to future outbreaks.

Method

We conducted an ecological study of the association between the cumulative deaths attributed to Covid-19 epidemic in the 20 Italian regions and nine determinants of population health derived from a systematic review of the literature. We used a multiple least square regression to predict the cross-regional variation in mortality observed from the onset of the epidemic to 23 September 2020.

Results

Four independent variables best explained the cross-regional differences in the number of deaths attributed to Covid-19: the force of infection, population density, number of elderly living in assisted facilities and the standard rate of diabetes. The semi-partial correlation coefficients suggest that the force of infection and the number of elderly residents in nursing homes were the dominant predictors of the number of deaths attributed to Covid-19. Statistical controls and validation confirmed the generalizability of the predictive model.

Conclusions

Our findings indicate that a significant reduction of social contacts in main metropolitan areas and the timely isolation of elderly and diabetic residents could significantly reduce the death toll of the next wave of Covid-19 infection in Italy.

SUBMITTER: Oliva C 

PROVIDER: S-EPMC7928707 | biostudies-literature | 2021 Jan

REPOSITORIES: biostudies-literature

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Publications

Cross-regional variations of Covid-19 mortality in Italy: an ecological study.

Oliva Cristina C   Di Maddaloni Francesco F   Marcellusi Andrea A   Favato Giampiero G  

Journal of public health (Oxford, England) 20210601 2


<h4>Background</h4>Disparities in cross-regional coronavirus disease 2019 (Covid-19) mortality remain poorly understood. The association between pre-epidemic health and epidemic mortality can inform a policy response to future outbreaks.<h4>Method</h4>We conducted an ecological study of the association between the cumulative deaths attributed to Covid-19 epidemic in the 20 Italian regions and nine determinants of population health derived from a systematic review of the literature. We used a mul  ...[more]

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