Fall of viral and bacterial pneumonia hospitalizations following COVID-19 pandemic mitigation strategies: a central Italian Region retrospective study

Abstract

Community-Acquired Pneumonia (CAP) represents one of the first causes of hospitalization and death in the elderly all over the world and weighs heavily on public health system. Since the beginning of the COVID-19 (CoronaVirus Disease-19) pandemic, everybody's behavior was forced to change, as the result of a global lockdown strategy and the obligation of using personal protection equipment (PPE). We aimed to evaluate how the mitigation strategies adopted to fight SARS-CoV-2 (Severe Acute Respiratory Coronavirus Syndrome 2) infection have influenced hospitalizations due to CAP in two different Local Health Boards (LHBs) of central Italy. We considered two main periods of observation: before and after the national start of lockdown, in two Abruzzo's LHBs. We analyzed 19,558 hospital discharge records of bacterial and viral CAP. Excluding SARS-CoV2 infection, a significant decrease in CAP hospitalizations was observed. Through the analysis of Diagnosis Related Group (DRG) values, we highlighted a significant saving of founds for the Regional Health Service. The enactment of social distancing measures to contain COVID-19 spread, brought down admissions for bacterial and viral pneumonia. Our study emphasizes that costs for hospitalizations due to CAP could be drastically reduced by mask wearing and social distancing.

Keywords: Bacterial pneumonia; COVID-19; Community-acquired pneumonia; Containing measures; PPE; SHR; Viral pneumonia.

Fig. 1

Temporal changes in age adjusted SHR for bacterial pneumonia (a), pneumococcal pneumonia (b), viral pneumonia (excluded SARS-CoV-2) (c) and SARS-CoV-2 infection (d) in LHB1 and LHB3 during pre-pandemic period (February 2019–February 2020) and pandemic period (March 2020–March 2021)

Fig. 2

Temporal changes in SHR for bacterial pneumonia in people ≥ 65 y.o. (a) and under 65 y.o. (b) and for viral pneumonia (excluded SARS-CoV-2) in people ≥ 65 y.o. (c) and under 65 y.o. (d) in LHB1 and LHB3 during the pre-pandemic period (February 2019–February 2020) and pandemic period (March 2020–March 2021)