Functional data analysis characterizes the shapes of the first COVID-19 epidemic wave in Italy.
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ABSTRACT:
SUBMITTER: Boschi T
PROVIDER: S-EPMC8405612 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Thailand was the first country reporting the first Coronavirus disease 2019 (COVID-19) infected individual outside mainland China. Here we delineated the course of the COVID-19 outbreak together with the timeline of the control measures and public health policies employed by the Thai government during the first wave of the COVID-19 outbreak in Thailand. Based on the comprehensive epidemiological data, we reconstructed the dynamics of COVID-19 transmission in Thailand using a stochastic modeling approach. Our stochastic model incorporated the effects of individual heterogeneity in infectiousness on disease transmission, which allows us to capture relevant features of superspreading events. We found that our model could accurately capture the transmission dynamics of the first COVID-19 epidemic wave in Thailand. The model predicted that at the end of the first wave, the number of cumulative confirmed cases was 3091 (95%CI: 2782-3400). We also estimated the time-varying reproduction number (Rt) during the first epidemic wave. We found that after implementing the nationwide interventions, the Rt in Thailand decreased from the peak value of 5.67 to a value below one in less than one month, indicating that the control measures employed by the Thai government during the first COVID-19 epidemic wave were effective. Finally, the effects of transmission heterogeneity and control measures on the likelihood of outbreak extinction were also investigated.
| S-EPMC8821624 | biostudies-literature
Project description:BackgroundPiacenza is the closest city to the first coronavirus disease 2019 (COVID-19) cluster in Italy and has the highest national COVID-19 death rates per population. The objective of this study is to present characteristics and outcomes of patients admitted to medical departments of the Hospital of Piacenza during the first wave of the epidemic.MethodsA total of 218 patients with confirmed or suspect COVID-19 and severe pneumonia were included from February 21st to May 15th, 2020. Routinely-collected clinical and laboratory data were retrospectively retrieved from electronic medical files. A Cox proportional-hazards model was fit to assess the association of treatment and other variables with death.ResultsMedian age of patients was 68 years; 150 patients (69%) had comorbidities, mainly hypertension (107, 49%). Overall, 185 (85%) patients had acute respiratory distress syndrome (ARDS) on admission, including 103 (47%) with moderate or severe ARDS. Chest computed tomography scan showed bilateral disease in 201 (98%) and extensive lung involvement in 79 (50%) patients. Most patients received antiviral treatment (187, 86%) and corticosteroids (134, 61%). All patients received respiratory support and 64 (29%) were admitted to intensive care unit. As of June 30th, 100 patients (46%) died, 109 patients (50%) were discharged, and 9 patients (4%) were still hospitalized. In multivariable Cox analysis, age above 65 years, having more than one comorbidity, severe ARDS, low platelet counts, and high LDH levels at admission were associated with mortality, while having diarrhea at admission was associated with survival. The use of antivirals or corticosteroids was not associated with survival.ConclusionsOverall case fatality rates were high and associated with comorbidities, extensive lung involvement, ARDS at admission, and advanced age. The use of antivirals was not associated with increased survival.
| S-EPMC7723761 | biostudies-literature
Project description:The aim of this study is to explore qualitatively bereavement experiences of family members who have lost a significant other to coronavirus disease 2019 (COVID-19) in relation to mourners' needs and resources. Twenty individuals bereaved by the first wave of COVID-19 from the most heavily impacted Italian region were interviewed via video call between 1 and 3 months after their loss. Through a thematic analysis, four main themes were identified: reconstructions of the loss experience, responses to grief, resources and looking forward. The suddenness of the death and lack of farewell by means of a funeral prevented participants from realizing the loss and undertaking a meaning-making process. When anger was the main reaction to the loss, mourners focussed all their attention on denouncing medical and government institutions. Acceptance occurred particularly in those who found a way to share their grief and use it as a turning point. Participants relied mainly on informal support offered virtually, but mourners may have sought out in-person comfort in the long term. The results of this study propose new insights for COVID-19 bereavement support and trace the path for health promotion within a community shook by a communal grief experience. Please refer to the Supplementary Material section to find this article's Community and Social Impact Statement.
| S-EPMC9083240 | biostudies-literature
Project description:As the COVID-19 outbreak traveled through various Italian regions, all national and local administrations issued measures to counter the spread of the contagion and organize healthcare. The Italian healthcare system is, indeed, a decentralized system with 21 regional health systems (RHSs), with different models of healthcare service delivery and organization. This study investigates whether a different organization of RHSs would have led to different management of the COVID-19 epidemic, and evaluates the effect of different approaches in epidemic management on the COVID-19 epidemiological trend. A set of indicators is identified by conducting an online synchronous Focus Group, involving an experts panel. A Pearson's correlation test was performed on the values assumed by the historical series of indicators investigate correlations among the trends represented by the indicators or between them and external factors. The comparison between the experiences of the different Italian regions, regarding the management of the epidemic, has helped to confirm and emphasize the importance of a community-based approach in health care-integrated with the hospital's functions for the care of complex conditions and the need for specialized assistance.
| S-EPMC8125969 | biostudies-literature
Project description:The effects of exposure to atmospheric pollution on the incidence and mortality due to COVID-19 have been studied but not for sulfur dioxide (SO2) in most studies. However, most studies failed to consider important cofounding factors in the estimation of health effects of air pollution. The objective of the study was to assess the short- and long-term effects of air pollution on the COVID-19 risk and fatality in Lombardy and Veneto. Air pollutants were studied based on monitoring station information in Lombardy and Veneto from January 2013 to May 2020. The daily number of cases and deaths of COVID-19 were collected from the reports of the Italian Ministry of Health in Italy. A generalized linear model with the generalized estimating equation method was used to evaluate the effects of short- and long-term exposure to air pollution on the COVID-19 outbreak in Lombardy and Veneto. After adjusting for other covariates, we found that short-term exposure to PM2.5 and PM10 had a tendency to increase the incidence and mortality of COVID-19 than long-term exposure, while for other air pollutants, including SO2 and NO2, long-term exposure was more significant than short-term exposure. Both short- and long-term exposure of SO2 resulted in increased health effects on COVID-19 pandemic. Our findings suggest that exposure to atmospheric pollution has a significant impact on COVID-19 pandemic and call for further researches to deeply investigate this topic.
| S-EPMC8123517 | biostudies-literature
Project description:Italy was a country severely hit by the first coronavirus disease 2019 (COVID-19) pandemic wave in early 2020. Mortality studies have focused on the overall excess mortality observed during the pandemic. This paper investigates the cause-specific mortality in Italy from March 2020 to April 2020 and the variation in mortality rates compared with those in 2015-2019 regarding sex, age, and epidemic area. Causes of death were derived from the national cause-of-death register. COVID-19 was the leading cause of death among males and the second leading cause among females. Chronic diseases, such as diabetes and hypertensive, ischemic heart, and cerebrovascular diseases, with decreasing or stable mortality rates in 2015-2019, showed a reversal in the mortality trend. Moreover, mortality due to pneumonia and influenza increased. No increase in neoplasm mortality was observed. Among external causes of death, mortality increased for accidental falls but reduced for transport accidents and suicide. Mortality from causes other than COVID-19 increased similarly in both genders and more at ages 65 years or above. Compared with other areas in Italy, the Lombardy region showed the largest excess in mortality for all leading causes. Underdiagnosis of COVID-19 at the beginning of the pandemic may, to some extent, explain the mortality increase for some causes of death, especially pneumonia and other respiratory diseases.
| S-EPMC8776013 | biostudies-literature
Project description:ObjectivesIn this data collation study, we aimed to provide a comprehensive database describing the epidemic trends and responses during the first wave of coronavirus disease 2019 (COVID-19) throughout the main provinces in China.MethodsFrom mid-January to March 2020, we extracted publicly available data regarding the spread and control of COVID-19 from 31 provincial health authorities and major media outlets in mainland China. Based on these data, we conducted descriptive analyses of the epidemic in the six most-affected provinces.ResultsSchool closures, travel restrictions, community-level lockdown, and contact tracing were introduced concurrently around late January but subsequent epidemic trends differed among provinces. Compared with Hubei, the other five most-affected provinces reported a lower crude case fatality ratio and proportion of critical and severe hospitalised cases. From March 2020, as the local transmission of COVID-19 declined, switching the focus of measures to the testing and quarantine of inbound travellers may have helped to sustain the control of the epidemic.ConclusionsAggregated indicators of case notifications and severity distributions are essential for monitoring an epidemic. A publicly available database containing these indicators and information regarding control measures is a useful resource for further research and policy planning in response to the COVID-19 epidemic.
| S-EPMC7603985 | biostudies-literature
Project description:PurposeTo describe critical care patients with COVID-19 across England, Wales and Northern Ireland and compare them with a historic cohort of patients with other viral pneumonias (non-COVID-19) and with international cohorts of COVID-19.MethodsExtracted data on patient characteristics, acute illness severity, organ support and outcomes from the Case Mix Programme, the national clinical audit for adult critical care, for a prospective cohort of patients with COVID-19 (February to August 2020) are compared with a recent retrospective cohort of patients with other viral pneumonias (non-COVID-19) (2017-2019) and with other international cohorts of critical care patients with COVID-19, the latter identified from published reports.Results10,834 patients with COVID-19 (70.1% male, median age 60 years, 32.6% non-white ethnicity, 39.4% obese, 8.2% at least one serious comorbidity) were admitted across 289 critical care units. Of these, 36.9% had a PaO2/FiO2 ratio of ≤ 13.3 kPa (≤ 100 mmHg) consistent with severe ARDS and 72% received invasive ventilation. Acute hospital mortality was 42%, higher than for 5782 critical care patients with other viral pneumonias (non-COVID-19) (24.7%), and most COVID-19 deaths (88.7%) occurred before 30 days. Meaningful international comparisons were limited due to lack of standardised reporting.ConclusionCritical care patients with COVID-19 were disproportionately non-white, from more deprived areas and more likely to be male and obese. Conventional severity scoring appeared not to adequately reflect their acute severity, with the distribution across PaO2/FiO2 ratio categories indicating acutely severe respiratory disease. Critical care patients with COVID-19 experience high mortality and place a great burden on critical care services.
| S-EPMC7545019 | biostudies-literature
Project description:Maxillofacial departments in 23 surgical units in Italy have been increasingly involved in facing the COVID-19 emergency. Elective surgeries have been progressively postponed to free up beds and offer human and material resources to those infected. We compiled an inventory of 32 questions to evaluate the impact of the SARS-COV2 epidemic on maxillofacial surgery in 23 selected Italian maxillofacial departments. The questionnaire focused on three different aspects: the variation of the workload, showing both a reduction of the number of team members (-16% among specialists, -11% among residents) due to reallocation or contamination and a consistent reduction of elective activities (the number of outpatient visits cancelled during the first month of the COVID-19 epidemic was about 10 000 all over Italy), while only tumour surgery and trauma surgery has been widely guaranteed; the screening procedures on patients and physicians (22% of maxillofacial units found infected surgeons, which is 4% of all maxillofacial surgeons); and the availability of Personal Protective Equipment, is only considered to be partial in 48% of Maxillofacial departments. This emergency has forced those of us in the Italian health system to change the way we work, but only time will prove if these changes have been effective.
| S-EPMC7196423 | biostudies-literature
Project description:The non-medical policies implemented by many countries to "flatten the curve" during the COVID-19 outbreak has people stranded in their homes and some, out of their homes unable to return due to the disruptions in the mobility network. The availability of rich datasets (in our case, Facebook) has made it possible to study the mobility dynamics and spatial distribution of people during lockdown in Italy. Our interpretation is an effort to look deeper, describing the movements occurred during lockdown, including the territorial differences. We observe that, initially, tourists left the country and later Italians abroad managed to return, thereby, stabilising the population. With regards to internal mobility, the earliest affected regions see higher number of stationary users in the initial days of the outbreak while this is less significant for the central/southern regions until the decree for the official lockdown on the 9th of March 2020, due 2 days later. Just before lockdown, there was not a significant exodus of people from the North to the rest of the country, instead, relocation of people between cities and their urban belts, but not towards remote areas. This will be elaborated in conclusions shedding light on possible changes in future cities.
| S-EPMC7680615 | biostudies-literature