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

• Main Authors: Antonella D’Arminio Monforte, Alessandro Tavelli, Francesca Bai, Daniele Tomasoni, Camilla Falcinella, Roberto Castoldi, Diletta Barbanotti, Giovanni Mulè, Marina Allegrini, Elisa Suardi, Daniele Tesoro, Gianmarco Tagliaferri, Debora Mondatore, Matteo Augello, Andrea Cona, Tomaso Beringheli, Nicole Gemignani, Matteo Sala, Benedetta Varisco, Francesco Molà, Sofia Pettenuzzo, Lorenzo Biasioli, Alessandro Copes, Lidia Gazzola, Ottavia Viganò, Camilla Tincati, Anna De Bona, Teresa Bini, Giulia Marchetti
• Format: Article
• Language: English
• Published: MDPI AG 2021-09-01
• Series: Life
• Subjects: COVID-19; hospitalised patients; age; in-hospital mortality rate; first and second wave of epidemics
• Online Access: https://www.mdpi.com/2075-1729/11/9/979

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.