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. 2021 Sep 17;11(9):979.
doi: 10.3390/life11090979.

Declining Mortality Rate of Hospitalised Patients in the Second Wave of the COVID-19 Epidemics in Italy: Risk Factors and the Age-Specific Patterns

Antonella D'Arminio Monforte  1 , Alessandro Tavelli  1 , Francesca Bai  1 , Daniele Tomasoni  1 , Camilla Falcinella  1 , Roberto Castoldi  1 , Diletta Barbanotti  1 , Giovanni Mulè  1 , Marina Allegrini  1 , Elisa Suardi  1 , Daniele Tesoro  1 , Gianmarco Tagliaferri  1 , Debora Mondatore  1 , Matteo Augello  1 , Andrea Cona  1 , Tomaso Beringheli  1 , Nicole Gemignani  1 , Matteo Sala  1 , Benedetta Varisco  1 , Francesco Molà  1 , Sofia Pettenuzzo  1 , Lorenzo Biasioli  1 , Alessandro Copes  1 , Lidia Gazzola  1 , Ottavia Viganò  1 , Camilla Tincati  1 , Anna De Bona  1 , Teresa Bini  1 , Giulia Marchetti  1
Affiliations

Declining Mortality Rate of Hospitalised Patients in the Second Wave of the COVID-19 Epidemics in Italy: Risk Factors and the Age-Specific Patterns

Antonella D'Arminio Monforte et al. Life (Basel). .

Abstract

Background: Mortality rate from COVID-19 in Italy is among the world's highest. We aimed to ascertain whether there was any reduction of in-hospital mortality in patients hospitalised for COVID-19 in the second-wave period (October 2020-January 2021) compared to the first one (February-May 2020); further, we verified whether there were clusters of hospitalised patients who particularly benefitted from reduced mortality rate.

Methods: Data collected related to in-patients' demographics, clinical, laboratory, therapies and outcome. Primary end-point was time to in-hospital death. Factors associated were evaluated by uni- and multivariable analyses. A flow diagram was created to determine the rate of in-hospital death according to individual and disease characteristics.

Results: A total of 1561 patients were included. The 14-day cumulative incidence of in-hospital death by competing risk regression was of 24.8% (95% CI: 21.3-28.5) and 15.9% (95% CI: 13.7-18.2) in the first and second wave. We observed that the highest relative reduction of death from first to second wave (more than 47%) occurred mainly in the clusters of patients younger than 70 years.

Conclusions: Progress in care and supporting therapies did affect population over 70 years to a lesser extent. Preventive and vaccination campaigns should focus on individuals whose risk of death from COVID-19 remains high.

Keywords: COVID-19; age; first and second wave of epidemics; hospitalised patients; in-hospital mortality rate.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Marginal predictions of in-hospital death by sub-groups in first and second wave of epidemic (right panel) and relative reduction during the second wave (left panel). yrs = years; F = females; M = males; CCI = age unadjusted Charlson Comorbidity Index.
See this image and copyright information in PMC

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