PMID- 33412820
OWN - NLM
STAT- MEDLINE
DCOM- 20210118
LR  - 20210118
IS  - 1120-9763 (Print)
IS  - 1120-9763 (Linking)
VI  - 44
IP  - 5-6 Suppl 2
DP  - 2020 Sep-Dec
TI  - [Excess mortality risk in nursing care homes before and during the COVID-19 
      outbreak in Mantua and Cremona provinces (Lombardy Region, Northern Italy)].
PG  - 282-287
LID - 10.19191/EP20.5-6.S2.128 [doi]
AB  - OBJECTIVES: 1. to evaluate mortality risk excess in the population residing in 
      nursing care homes (NCHs) compared to non-NCHs before the COVID-19 outbreak; 2. 
      to verify if the outbreak modified risk excess; 3. to estimate the COVID-19 
      impact; 4. to ascertain incidence-mortality relationship. DESIGN: cohort study. 
      SETTING AND POPULATION: Mantua and Cremona provinces (Lombardy Region, Northern 
      Italy) - included in ATS Val Padana - with COVID-19 incidence rate 7.5 per thousand and 
      16.9 per thousand, respectively. Inhabitants aged >= 75 years as of 1st January 2018, 2019, 
      and 2020 (three cohorts), stratified in NCH or not. The indicators calculated 
      were: 1. rate ratio (RR) for NCH vs non-NCH, adjusted by gender, age, chronic 
      diseases number, at least 1 hospitalisation, at least 1 Emergency room access in 
      the previous year, for 2018, 2019, and 2020; 2. adjusted RR, 2019 and 2020 vs 
      2018, both sub-cohorts (i.e., NCH and non-NCH). MAIN OUTCOME MEASURES: first 
      four-month period mortality of the considered years. RESULTS: aproximately 
      100,000 inhabitants by year, 7% in NCH. In the 2020 first four-month period, 
      4,343 deaths occurred of which 45% in NCH. RR in NCH population vs non-NCH for 
      the year 2018 was 2.13 (95%CI 1.94-2.34); for the year 2019 was 2.70 (95%CI 
      2.43-3.00); for the year 2020 was 6.98 (95%CI 6,49-7,50). Adjusted RR for NCH 
      population in 2020 vs 2018 was 2.22 (95%CI 2.05-2.42) in the whole ATS Val 
      Padana; 1.58 (95%CI 1.40-1.77) in Mantua Province; 2.93 (2.62-3.27) in Cremona 
      Province. Adjusted RR in non-NCH population in the year 2020 vs 2018 was 1.59 
      (95%CI 1.48-1.70) in the whole ATS; 1.34 (95%CI 1.23-1.46) in Mantua Province; 
      1.89 (95%CI 1.73-2.07) in Cremona Province. CONCLUSIONS: the NCH population 
      experienced an excess risk mortality compared to non-NCH before the COVID-19; 
      this excess increased during the outbreak. In 2020, in NCHs the risk was more 
      than double compared to the 2018 risk, while in non-NCHs it rose approximately by 
      60%. The gap between NCHs/non-NCHs COVID-19 impact was higher in Cremona than in 
      Mantua.
FAU - Ballotari, Paola
AU  - Ballotari P
AD  - Osservatorio epidemiologico, ATS Val Padana, Mantova; 
      paola.ballotari@ats-valpadana.it.
FAU - Guarda, Linda
AU  - Guarda L
AD  - Osservatorio epidemiologico, ATS Val Padana, Mantova.
FAU - Giacomazzi, Enrica
AU  - Giacomazzi E
AD  - Osservatorio epidemiologico, ATS Val Padana, Mantova.
FAU - Ceruti, Alessandra
AU  - Ceruti A
AD  - Osservatorio epidemiologico, ATS Val Padana, Mantova.
FAU - Gatti, Luciana
AU  - Gatti L
AD  - Osservatorio epidemiologico, ATS Val Padana, Mantova.
FAU - Ricci, Paolo
AU  - Ricci P
AD  - Osservatorio epidemiologico, ATS Val Padana, Mantova.
LA  - ita
PT  - Comparative Study
PT  - Journal Article
TT  - L'eccesso di rischio di morte nelle residenze sanitarie assistenziali prima e 
      durante l'epidemia di COVID-19 nelle province di Mantova e Cremona.
PL  - Italy
TA  - Epidemiol Prev
JT  - Epidemiologia e prevenzione
JID - 8902507
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - COVID-19/*epidemiology/mortality
MH  - Confidence Intervals
MH  - Female
MH  - Frail Elderly/statistics & numerical data
MH  - Geography, Medical
MH  - Humans
MH  - Incidence
MH  - Institutionalization/statistics & numerical data
MH  - Italy/epidemiology
MH  - Male
MH  - Mortality/*trends
MH  - Nursing Homes/*statistics & numerical data
MH  - *Pandemics
MH  - Risk
MH  - *SARS-CoV-2
OTO - NOTNLM
OT  - long-term care facilities
OT  - mortality
OT  - nursing home
OT  - COVID-19
OT  - elderly people
EDAT- 2021/01/09 06:00
MHDA- 2021/01/20 06:00
CRDT- 2021/01/08 04:07
PHST- 2021/01/08 04:07 [entrez]
PHST- 2021/01/09 06:00 [pubmed]
PHST- 2021/01/20 06:00 [medline]
AID - 5222 [pii]
AID - 10.19191/EP20.5-6.S2.128 [doi]
PST - ppublish
SO  - Epidemiol Prev. 2020 Sep-Dec;44(5-6 Suppl 2):282-287. doi: 
      10.19191/EP20.5-6.S2.128.