Cargando…
Epidemiological characteristics of COVID-19 cases in non-Italian nationals notified to the Italian surveillance system
BACKGROUND: International literature suggests that disadvantaged groups are at higher risk of morbidity and mortality from SARS-CoV-2 infection due to poorer living/working conditions and barriers to healthcare access. Yet, to date, there is no evidence of this disproportionate impact on non-nationa...
Autores principales: | , , , , , , , , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7851886/ https://www.ncbi.nlm.nih.gov/pubmed/33416859 http://dx.doi.org/10.1093/eurpub/ckaa249 |
_version_ | 1783645710233632768 |
---|---|
author | Fabiani, Massimo Mateo-Urdiales, Alberto Andrianou, Xanthi Bella, Antonino Del Manso, Martina Bellino, Stefania Rota, Maria C Boros, Stefano Vescio, Maria F D'Ancona, Fortunato P Siddu, Andrea Punzo, Ornella Filia, Antonietta Brusaferro, Silvio Rezza, Giovanni Dente, Maria G Declich, Silvia Pezzotti, Patrizio Riccardo, Flavia |
author_facet | Fabiani, Massimo Mateo-Urdiales, Alberto Andrianou, Xanthi Bella, Antonino Del Manso, Martina Bellino, Stefania Rota, Maria C Boros, Stefano Vescio, Maria F D'Ancona, Fortunato P Siddu, Andrea Punzo, Ornella Filia, Antonietta Brusaferro, Silvio Rezza, Giovanni Dente, Maria G Declich, Silvia Pezzotti, Patrizio Riccardo, Flavia |
author_sort | Fabiani, Massimo |
collection | PubMed |
description | BACKGROUND: International literature suggests that disadvantaged groups are at higher risk of morbidity and mortality from SARS-CoV-2 infection due to poorer living/working conditions and barriers to healthcare access. Yet, to date, there is no evidence of this disproportionate impact on non-national individuals, including economic migrants, short-term travellers and refugees. METHODS: We analyzed data from the Italian surveillance system of all COVID-19 laboratory-confirmed cases tested positive from the beginning of the outbreak (20th of February) to the 19th of July 2020. We used multilevel negative-binomial regression models to compare the case fatality and the rate of admission to hospital and intensive care unit (ICU) between Italian and non-Italian nationals. The analysis was adjusted for differences in demographic characteristics, pre-existing comorbidities, and period of diagnosis. RESULTS: We analyzed 213 180 COVID-19 cases, including 15 974 (7.5%) non-Italian nationals. We found that, compared to Italian cases, non-Italian cases were diagnosed at a later date and were more likely to be hospitalized {[adjusted rate ratio (ARR)=1.39, 95% confidence interval (CI): 1.33–1.44]} and admitted to ICU (ARR=1.19, 95% CI: 1.07–1.32), with differences being more pronounced in those coming from countries with lower human development index (HDI). We also observed an increased risk of death in non-Italian cases from low-HDI countries (ARR=1.32, 95% CI: 1.01–1.75). CONCLUSIONS: A delayed diagnosis in non-Italian cases could explain their worse outcomes compared to Italian cases. Ensuring early access to diagnosis and treatment to non-Italians could facilitate the control of SARS-CoV-2 transmission and improve health outcomes in all people living in Italy, regardless of nationality. |
format | Online Article Text |
id | pubmed-7851886 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-78518862021-02-04 Epidemiological characteristics of COVID-19 cases in non-Italian nationals notified to the Italian surveillance system Fabiani, Massimo Mateo-Urdiales, Alberto Andrianou, Xanthi Bella, Antonino Del Manso, Martina Bellino, Stefania Rota, Maria C Boros, Stefano Vescio, Maria F D'Ancona, Fortunato P Siddu, Andrea Punzo, Ornella Filia, Antonietta Brusaferro, Silvio Rezza, Giovanni Dente, Maria G Declich, Silvia Pezzotti, Patrizio Riccardo, Flavia Eur J Public Health Covid-19 BACKGROUND: International literature suggests that disadvantaged groups are at higher risk of morbidity and mortality from SARS-CoV-2 infection due to poorer living/working conditions and barriers to healthcare access. Yet, to date, there is no evidence of this disproportionate impact on non-national individuals, including economic migrants, short-term travellers and refugees. METHODS: We analyzed data from the Italian surveillance system of all COVID-19 laboratory-confirmed cases tested positive from the beginning of the outbreak (20th of February) to the 19th of July 2020. We used multilevel negative-binomial regression models to compare the case fatality and the rate of admission to hospital and intensive care unit (ICU) between Italian and non-Italian nationals. The analysis was adjusted for differences in demographic characteristics, pre-existing comorbidities, and period of diagnosis. RESULTS: We analyzed 213 180 COVID-19 cases, including 15 974 (7.5%) non-Italian nationals. We found that, compared to Italian cases, non-Italian cases were diagnosed at a later date and were more likely to be hospitalized {[adjusted rate ratio (ARR)=1.39, 95% confidence interval (CI): 1.33–1.44]} and admitted to ICU (ARR=1.19, 95% CI: 1.07–1.32), with differences being more pronounced in those coming from countries with lower human development index (HDI). We also observed an increased risk of death in non-Italian cases from low-HDI countries (ARR=1.32, 95% CI: 1.01–1.75). CONCLUSIONS: A delayed diagnosis in non-Italian cases could explain their worse outcomes compared to Italian cases. Ensuring early access to diagnosis and treatment to non-Italians could facilitate the control of SARS-CoV-2 transmission and improve health outcomes in all people living in Italy, regardless of nationality. Oxford University Press 2021-01-08 /pmc/articles/PMC7851886/ /pubmed/33416859 http://dx.doi.org/10.1093/eurpub/ckaa249 Text en © The Author(s) 2021. Published by Oxford University Press on behalf of the European Public Health Association. http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Covid-19 Fabiani, Massimo Mateo-Urdiales, Alberto Andrianou, Xanthi Bella, Antonino Del Manso, Martina Bellino, Stefania Rota, Maria C Boros, Stefano Vescio, Maria F D'Ancona, Fortunato P Siddu, Andrea Punzo, Ornella Filia, Antonietta Brusaferro, Silvio Rezza, Giovanni Dente, Maria G Declich, Silvia Pezzotti, Patrizio Riccardo, Flavia Epidemiological characteristics of COVID-19 cases in non-Italian nationals notified to the Italian surveillance system |
title | Epidemiological characteristics of COVID-19 cases in non-Italian nationals notified to the Italian surveillance system |
title_full | Epidemiological characteristics of COVID-19 cases in non-Italian nationals notified to the Italian surveillance system |
title_fullStr | Epidemiological characteristics of COVID-19 cases in non-Italian nationals notified to the Italian surveillance system |
title_full_unstemmed | Epidemiological characteristics of COVID-19 cases in non-Italian nationals notified to the Italian surveillance system |
title_short | Epidemiological characteristics of COVID-19 cases in non-Italian nationals notified to the Italian surveillance system |
title_sort | epidemiological characteristics of covid-19 cases in non-italian nationals notified to the italian surveillance system |
topic | Covid-19 |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7851886/ https://www.ncbi.nlm.nih.gov/pubmed/33416859 http://dx.doi.org/10.1093/eurpub/ckaa249 |
work_keys_str_mv | AT fabianimassimo epidemiologicalcharacteristicsofcovid19casesinnonitaliannationalsnotifiedtotheitaliansurveillancesystem AT mateourdialesalberto epidemiologicalcharacteristicsofcovid19casesinnonitaliannationalsnotifiedtotheitaliansurveillancesystem AT andrianouxanthi epidemiologicalcharacteristicsofcovid19casesinnonitaliannationalsnotifiedtotheitaliansurveillancesystem AT bellaantonino epidemiologicalcharacteristicsofcovid19casesinnonitaliannationalsnotifiedtotheitaliansurveillancesystem AT delmansomartina epidemiologicalcharacteristicsofcovid19casesinnonitaliannationalsnotifiedtotheitaliansurveillancesystem AT bellinostefania epidemiologicalcharacteristicsofcovid19casesinnonitaliannationalsnotifiedtotheitaliansurveillancesystem AT rotamariac epidemiologicalcharacteristicsofcovid19casesinnonitaliannationalsnotifiedtotheitaliansurveillancesystem AT borosstefano epidemiologicalcharacteristicsofcovid19casesinnonitaliannationalsnotifiedtotheitaliansurveillancesystem AT vesciomariaf epidemiologicalcharacteristicsofcovid19casesinnonitaliannationalsnotifiedtotheitaliansurveillancesystem AT danconafortunatop epidemiologicalcharacteristicsofcovid19casesinnonitaliannationalsnotifiedtotheitaliansurveillancesystem AT sidduandrea epidemiologicalcharacteristicsofcovid19casesinnonitaliannationalsnotifiedtotheitaliansurveillancesystem AT punzoornella epidemiologicalcharacteristicsofcovid19casesinnonitaliannationalsnotifiedtotheitaliansurveillancesystem AT filiaantonietta epidemiologicalcharacteristicsofcovid19casesinnonitaliannationalsnotifiedtotheitaliansurveillancesystem AT brusaferrosilvio epidemiologicalcharacteristicsofcovid19casesinnonitaliannationalsnotifiedtotheitaliansurveillancesystem AT rezzagiovanni epidemiologicalcharacteristicsofcovid19casesinnonitaliannationalsnotifiedtotheitaliansurveillancesystem AT dentemariag epidemiologicalcharacteristicsofcovid19casesinnonitaliannationalsnotifiedtotheitaliansurveillancesystem AT declichsilvia epidemiologicalcharacteristicsofcovid19casesinnonitaliannationalsnotifiedtotheitaliansurveillancesystem AT pezzottipatrizio epidemiologicalcharacteristicsofcovid19casesinnonitaliannationalsnotifiedtotheitaliansurveillancesystem AT riccardoflavia epidemiologicalcharacteristicsofcovid19casesinnonitaliannationalsnotifiedtotheitaliansurveillancesystem AT epidemiologicalcharacteristicsofcovid19casesinnonitaliannationalsnotifiedtotheitaliansurveillancesystem |