Azienda USL di Reggio EmiliaV.le Amendola n.2 - 42122 REServizio di Prevenzione e Sicurezza negli Ambienti di Lavoro (SPSAL)Dip. di Prevenzione.
Acta Biomed. 2022 Aug 31;93(4):e2022247. doi: 10.23750/abm.v93i4.13190.
Because of their remoteness, Mountain Communities (MC) have been considered at advantage when dealing with infectious diseases. However, earlier reports have identified MC among the hotspots for early spreading of COVID-19 pandemic.
Crude mortality rates (CMR) and Excess mortality rates (EMR) were calculated for 97 municipalities from MC in the Emilia Romagna Region, and resulting estimates were compared to the Parent Provinces. Notification and mortality rates for COVID-19 were also retrieved, and correlated with EMR estimates.
During 2020, a CMR of 150.3/100,000 (95% Confidence Interval [95%CI] 117-185.4) was identified, with substantial heterogeneities between the 8 provinces of Emilia Romagna Region that were included in the analyses. A pooled EMR of +20.3% (95%CI 10.6-30.1) for MC and 19.9% (95%CI 9.5-30.3) was identified. The monthly estimates were quite heterogenous across the various provinces, ranging between -79.7% and +307.4% during the assessed timeframe. Higher estimates were identified in the months of March and April in MC, and during the months of April and May for Parent Provinces. In bivariate analysis, EM in MC was positively correlated with estimates in the parent province (Spearman's r = 0.201, p = 0.049), and also with notification rates for COVID- (i.e. Piacenza, Parma, Reggio Emilia, Modena, Bologna, Ravenna, Rimini, and Forlì Cesena) (r = 0.225, p = 0.045), and particularly with mortality rates for COVID-19 at provincial level (r = 0.372, p < 0.001).
In summary, the study highlights that small geographical and population size, along with remoteness, did not play a substantial advantage for MC against the spread and mortality rate of COVID-19. On the other hand, as the surge of EM in MC anticipated a similar habit in Parent Provinces of several weeks, improved surveillance interventions are also urgently in need. (www.actabiomedica.it).
由于地处偏远，山区社区（MC）在应对传染病方面被认为具有优势。然而，早期的报告已经确定 MC 是 COVID-19 大流行早期传播的热点地区之一。
计算了艾米利亚-罗马涅地区 97 个山区社区的粗死亡率（CMR）和超额死亡率（EMR），并将这些估计值与母省进行了比较。还检索了 COVID-19 的通报和死亡率，并将其与 EMR 估计值相关联。
2020 年，确定了 150.3/100,000（95%置信区间[95%CI]117-185.4）的 CMR，在包括在分析中的艾米利亚-罗马涅地区的 8 个省份之间存在很大的异质性。山区社区的合并 EMR 为+20.3%（95%CI10.6-30.1），母省为+19.9%（95%CI9.5-30.3）。在评估期间，各省份的月度估计值差异很大，范围在-79.7%至+307.4%之间。山区社区的 EMR 估计值在 3 月和 4 月较高，而母省则在 4 月和 5 月较高。在双变量分析中，MC 中的 EM 与母省的估计值呈正相关（Spearman r=0.201，p=0.049），与 COVID-的通报率也呈正相关（即皮亚琴扎、帕尔马、雷焦艾米利亚、摩德纳、博洛尼亚、拉文纳、里米尼和弗利-切塞纳）（r=0.225，p=0.045），特别是与省级 COVID-19 的死亡率呈正相关（r=0.372，p<0.001）。
总之，该研究表明，较小的地理和人口规模以及偏远地区并没有使山区社区在 COVID-19 的传播和死亡率方面具有实质性优势。另一方面，由于 MC 中 EM 的激增预示着母省几周内也会出现类似的情况，因此迫切需要加强监测干预措施。（www.actabiomedica.it）。
