1,721,085 research outputs found
Re. Bioelectrical impedance vector analysis, phase-angle assessment and relationship with malnutrition risk in a cohort of frail older hospital patients in the United Kingdom
No full textCOVID-19 pandemic and total mortality in the first six months of 2020 in Italy
Full text linkIn base ai dati di mortalità del 93% dei comuni italiani, si è registrato un eccesso di mortalità totale superiore al 50% a marzo e un eccesso del 38% ad aprile, corrispondenti a oltre 46.000 morti in eccesso in quel periodo di due mesi, rispetto ai 28.000 decessi che in marzo e aprile sono stati attribuiti a COVID-19. Nel periodo successivo, non è stata osservata alcuna mortalità in eccesso e in giugno i decessi totali riportati sono stati del 6,2% inferiori al valore atteso. Complessivamente, nei primi sei mesi del 2020 si è osservato un eccesso di mortalità dell'11,1% in Italia e quasi del 50% in Lombardia, la regione più colpita. Il monitoraggio tempestivo della mortalità totale ha implicazioni rilevanti per il monitoraggio della pandemia COVID-19 e per il controllo delle esposizioni professionali e sociali.Based on mortality data from 93% of Italian municipalities, there was an over 50% excess total mortality in March and a 38% excess in April, corresponding to over 46,000 excess deaths in those two months – as compared to 28,000 deaths attributed to COVID-19 in March and April. No subsequent excess mortality was observed, and in June reported total deaths were 6.2% less than expected. In the first 6 months of 2020, an 11.1% excess mortality was observed in Italy, and an almost 50% excess in Lombardy, the most affected region. Timely monitoring of total mor-tality has relevant implications for monitoring the COVID-19 pandemic and controlling occupational and social exposure
Italy's first wave of the COVID-19 pandemic has ended: no excess mortality in May, 2020
Full text linkIncreased mortality in socioeconomic disadvantaged municipalities during the first phase of the COVID-19 pandemic in Lombardy region
Full text linkBackground: Lombardy was the first European region most severely affected by the coronavirus disease 2019 pandemic in the spring of 2020. During that period, a substantial increase in socioeconomic inequality in total mortality was observed. This study aims to evaluate mortality data in the region up to September 2023 to verify whether the increased disparities between the poorest and the wealthiest municipalities persisted in the subsequent phases of the pandemic. Methods: This study analyzed mortality data from January 2019 to September 2023 in Lombardy's municipalities by month and pandemic phases characterized by the predominance of the different severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants. Municipalities were grouped according to the average income or pension of their residents. Age-standardized mortality rates (ASMRs) and the ASMR ratio between the poorest and the wealthiest municipalities were compared throughout the study period. Results: In the pre-pandemic period (January 2019 - February 2020), the ASMR ratio at all ages between the poorest and the wealthiest municipalities fluctuated between 1.12 [95% confidence interval (CI): 1.07-1.16] and 1.29 (95% CI: 1.25-1.34). In March 2020, the ASMR ratio increased to 1.49 (95% CI: 1.45-1.52 95%) and returned to values registered before the pandemic thereafter. A similar pattern was observed in the analysis of mortality ≥ 65, using the average pension for group municipalities. Conclusions: During the dramatic circumstances that the region faced in March 2020, pre-existing socioeconomic inequalities substantially widened. With the reorganization of the health system and the availability of vaccines, these disparities returned to the levels recorded before the pandemic
Area-level indicators of income and total mortality during the COVID-19 pandemic
No full textBACKGROUND: There is mounting evidence that socioeconomic inequalities in mortality have widened during the COVID-19 pandemic. This study aimed at evaluating the relationship between area-level indicators of income and total mortality during the first phase of COVID-19 pandemic in the most hit Italian region.METHODS: We conducted an ecological study based on the number of deaths registered in the municipalities of the Lombardy region (Italy) between January 2019 and June 2020. Municipalities were grouped according to quintiles of average income and pension of their resident population. Monthly age-standardized mortality ratios (MRs) between the poorest and the richest municipalities and the corresponding 95% confidence intervals (95% CI) were computed to evaluate whether the pre-existing socioeconomic inequities widened during the pandemic.RESULTS: Over the study period, 175.853 deaths were registered. During the pre-pandemic period (January 2019-February 2020) the MR between the poorest and the richest municipalities ranged between 1.12 (95% CI: 1.00-1.25) and 1.33 (95% CI: 1.20-1.47). In March 2020, when the pandemic begun to rapidly spread in the region, it raised up to 1.61 (95% CI: 1.51-1.72) and decreased thereafter, reaching the pre-pandemic values in April 2020. Similar results were observed in the analysis of the mortality at ages 65 and over in municipalities grouped according to average pension, where the MR increased up to 1.82 (95% CI: 1.70-1.94) in March 2020.CONCLUSIONS: The socioeconomic inequities in mortality widened in Lombardy, the Italian region most severely hit during the first phase of the COVID-19 pandemic
Impact of COVID-19 on total excess mortality and geographic disparities in Europe, 2020–2023: a spatio-temporal analysis
Full text linkBackground
COVID-19 dramatically reshaped mortality across Europe. This study aimed to assess its impact on total mortality in European countries taking into consideration the relationship with selected country-level socioeconomic indicators, non-pharmaceutical interventions, and vaccine uptake.
Methods
We obtained weekly mortality data from 2010 to 2023 from the Short-term Mortality Fluctuations data series, the annual population data from the United Nations archives, selected sociodemographic and economic indicators from the World Bank’s database, the stringency index and the percentage of the population fully vaccinated from Our World in Data. A quasi-Poisson regression model trained on pre-pandemic years was used to estimate expected number of deaths in 2020–2023 in 29 European countries. Excess mortality was estimated using three different metrics: excess deaths (number), relative excess mortality (% different from expected deaths) and age-standardized excess death rate per 10,000 population. The relationship between socioeconomic indicators and excess mortality was evaluated using linear regression models, which included both linear and quadratic terms for the predictors to account for possible non-linear relationships.
Findings
We estimated 1,642,586 excess deaths (95% confidence interval, CI: 1,607,161–1,678,010) across all countries over the four years (+8.0% compared to the expected number of deaths). Excess mortality was mainly concentrated in 2020–2022 (0.52 million excess deaths in 2020, 0.57 million in 2021 and 0.44 million in 2022), with no substantial excess (0.11 million) estimated for 2023. Over the period 2020–23, the highest number of excess deaths was estimated for Italy (227,736 deaths, +8.7%), Poland (223,735 deaths, +13.7%), and Germany (218,111 deaths, +5.6%), while the highest excesses in relative terms were in Bulgaria (72,328 deaths, +17.2%), Lithuania (23,813 deaths, +16.1%), and Slovakia (31,984 deaths, +14.9%). The age-standardised death rates ranged from 1.8 per 10,000 population in Sweden to 24.7 in Bulgaria. The percentage of the population living below the poverty line and the Gini index were significantly associated with an increased excess death rate, with p-values for the linear and quadratic terms being 0.003 and 0.003 for the Gini index, and 0.024 and 0.017 for the population living below the poverty line. Conversely, gross domestic product per capita (p-values for the linear and quadratic terms: <0.001, 0.003), health expenditure (0.001, 0.273) and the percentage of people fully vaccinated by the end of 2021 (<0.001, 0.989) or 2022 (0.001, 0.890) were inversely associated with excess death rate. No significant association was observed with population density and stringency index.
Interpretation
The observed geographic disparities in total mortality excess across Europe can be related to differences in socioeconomic contexts, as well as to suboptimal vaccine uptakes in some countries
Cystic fibrosis mortality trend in Italy from 1970 to 2011
No full textBackground: Survival in cystic fibrosis (CF) has progressively improved and the female-gender disadvantage first described many years ago remains controversial. Objectives: To describe the mortality trend due to CF in Italy over the last decades; to verify the female-mortality disadvantage; to compare the comorbidities reported in death certificates of CF patients with those of the general population. Methods: Mortality data were extracted from the database of underlying cause of death (1970-2011) and multiple causes of death (2003-2011) of the Italian National Institute of Statistics. Age-standardized mortality ratio (SMR) was calculated to compare the mortality between genders. The association between CF and other contributing causes of death was verified by calculating the age- and gender-adjusted proportional mortality ratio (PMR). Results: During the study period, 1947 death certificates reported CF as the underlying cause of death. Mortality rate due to CF decreased in newborns and children and by the end of the 1990s also in adolescents and young adults. Adult mortality started to increase in the early 1990s. Over the whole period an excess in mortality was observed in young CF females (1-29 years). The multiple causes of death database included 531 certificates with CF listed as cause of death. Pneumonia, chronic lower respiratory diseases, pulmonary heart disease and diseases of pulmonary circulation, aspergillosis, sepsis, renal failure, diabetes, malnutrition and amyloidosis were more frequently reported in CF death certificates compared to those of the general population (PMR > 1). Conclusions: This mortality trend provides evidence of a consistent improvement in survival, although the excess female-mortality persists despite aggressive treatment of CF lung disease. Several extra-pulmonary conditions associated with CF contributed to the morbidity leading to death
Attitudes towards influenza vaccine and a potential COVID-19 vaccine in Italy and differences across occupational groups, September 2020
Full text linkObjectives: We aimed at describing the attitudes towards influenza vaccination and a potential COVID-19 vac-cine in Italy. Methods: A nationally representative survey based on 1055 Italians aged 15-85 years was conducted in September 16-28, 2020. Results: We found that 40.8% of the population reported the intention to be vaccinated against influenza next winter and 53.7% would accept to receive a potential COVID-19 vaccine. The percentages were higher among individuals aged 55 and over (58.8% for influenza vaccine and 58.2% for a potential COV-ID-19 vaccine) and among professionals, managers and teachers as compared to manual workers and farmers (36.1% vs. 27.6% for influenza vaccine and 51.6% vs. 34.8% for a potential COVID-19 vaccine). Discussion: These data confirm a certain degree of vaccine mistrust in Italy, especially among less qualified workers
The toll of excess mortality in Europe in 2020-2023
No full textThis paper summarizes current evidence on excess mortality in Europe from 2020 to 2023, emphasizing the different drivers of excess death rates during the COVID-19 pandemic. The first two years (2020-2021) accounted for a substantial proportion of additional deaths – estimated at approximately 1,000,000 across 29 European countries – largely due to direct SARS-CoV-2 infection and other factors such as hospital resource constraints and deferred medical care. Excess mortality persisted in 2022 and substantially decreased in 2023. Marked regional disparities emerged, with Eastern Europe, parts of Southern Europe, and specific high-density urban areas reporting some of the highest excess mortality, often linked to structural healthcare limitations and lower vaccination uptake. By contrast, Nordic countries experienced lower surges, partly attributable to robust healthcare infrastructure and proactive public health measures: the smallest excess mortality was in Sweden. Older adults bore most of the burden, underscoring the role of demographic vulnerability. Socioeconomic factors, including gross domestic product and healthcare accessibility, further shaped the uneven toll of the pandemic
Occupational Exposures and Thyroid Cancer
No full textThyroid cancer accounts for the majority of endocrine cancers, and the number of cases is increasing worldwide likely due to increased recognition more than a real increment of the disease. Exposure to ionizing radiation is the main occupational exposure related to thyroid cancer. Several studies were carried out on Chernobyl cleanup workers and healthcare professionals exposed to ionizing radiation. These reported a causal relationship between acute or cumulative exposure to moderate/high radiation dose and thyroid cancer, while there is less clear evidence that chronic exposure to low dose increases the risk. However, the excess risk reported in the majority of studies is likely overestimated because of a higher surveillance among workers whose activity entails exposure to ionizing radiation. Epidemiological studies on other occupational risks are scarce, and it is not possible to draw firm conclusions on other exposure agents, including pesticides, benzene, and formaldehyde as well as on workers employed in semiconductor, wood, paper, and textile industries
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