Caramello Valeria, Catalano Alberto, Macciotta Alessandra, Dansero Lucia, Sacerdote Carlotta, Costa Giuseppe, Aprà Franco, Tua Aldo, Boccuzzi Adriana, Ricceri Fulvio
High Dependency Unit, Emergency Department, San Luigi Gonzaga University Hospital, 10043 Orbassano, TO, Italy.
Department of Clinical and Biological Sciences, University of Turin, 10043 Orbassano, TO, Italy.
J Clin Med. 2022 Jul 25;11(15):4304. doi: 10.3390/jcm11154304.
At the very beginning of the European spread of SARS-CoV-2, Piedmont was one of the most affected regions in Italy, with a strong impact on healthcare organizations. In this study, we evaluated the characteristics and outcomes of the COVID-19 patients in an entire region during the first three pandemic waves, identifying similarities and differences in the SARS-CoV-2 epidemic's timeline. We collected the health-administrative data of all the Piedmont COVID-19 patients infected during the first three pandemic waves (1 March 2020-15 April 2020; 15 October 2020-15 December 2020; 1 March 2021-15 April 2021, respectively). We compared differences among the waves in subjects positive for SARS-CoV-2 and in patients admitted to ICU. Overall, 18.621 subjects tested positive during the first wave (405 patients/day), 144.350 (2366.4 patients/day) in the second, and 81.823 (1778.8 patients/day) in the third. In the second and third waves, we observed a reduction in median age, comorbidity burden, mortality in outpatients, inpatients, and patients admitted to ICU, in intubation, invasive ventilation and tracheostomy, and a parallel increase in the use of CPAP. Our study confirmed a trend towards younger and healthier patients over time but also showed an independent effect of the period on mortality and ICU admission. The appearance of new viral variants, the starting of vaccination, and organizational improvements in tracking, outpatients and inpatients management could have influenced these trends.
在严重急性呼吸综合征冠状病毒2（SARS-CoV-2）于欧洲开始传播之初，皮埃蒙特是意大利受影响最严重的地区之一，对医疗组织产生了巨大冲击。在本研究中，我们评估了整个地区在前三波疫情期间新冠病毒疾病（COVID-19）患者的特征和结局，确定了SARS-CoV-2疫情时间线中的异同。我们收集了在前三波疫情期间（分别为2020年3月1日至2020年4月15日；2020年10月15日至2020年12月15日；2021年3月1日至2021年4月15日）感染的所有皮埃蒙特COVID-19患者的卫生行政数据。我们比较了SARS-CoV-2检测呈阳性的受试者以及入住重症监护病房（ICU）的患者在各波疫情之间的差异。总体而言，第一波疫情期间有18621名受试者检测呈阳性（每天405名患者），第二波为144350名（每天2366.4名患者），第三波为81823名（每天1778.8名患者）。在第二波和第三波疫情中，我们观察到年龄中位数、合并症负担、门诊患者、住院患者和入住ICU患者的死亡率、插管、有创通气和气管切开术有所降低，同时持续气道正压通气（CPAP）的使用有所增加。我们的研究证实，随着时间的推移，患者有年轻化和健康化的趋势，但也显示出不同时期对死亡率和入住ICU有独立影响。新病毒变种的出现、疫苗接种的开始以及追踪、门诊和住院患者管理方面的组织改进可能影响了这些趋势。
