tetano
Editor, Senior Moderator
J Public Health (Oxf)
. 2021 Jan 18;fdaa248.
doi: 10.1093/pubmed/fdaa248. Online ahead of print.
Cross-regional variations of Covid-19 mortality in Italy: an ecological study
Cristina Oliva[SUP] 1 [/SUP], Francesco Di Maddaloni[SUP] 1 [/SUP], Andrea Marcellusi[SUP] 1 2 [/SUP], Giampiero Favato[SUP] 1 [/SUP]
Affiliations
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.
Keywords: infectious disease; mortality; socioeconomic factors.
. 2021 Jan 18;fdaa248.
doi: 10.1093/pubmed/fdaa248. Online ahead of print.
Cross-regional variations of Covid-19 mortality in Italy: an ecological study
Cristina Oliva[SUP] 1 [/SUP], Francesco Di Maddaloni[SUP] 1 [/SUP], Andrea Marcellusi[SUP] 1 2 [/SUP], Giampiero Favato[SUP] 1 [/SUP]
Affiliations
- PMID: 33458758
- DOI: 10.1093/pubmed/fdaa248
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.
Keywords: infectious disease; mortality; socioeconomic factors.