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Community-Acquired Pneumonia (CAP) represents one of the first causes of hospitalization and death in the elderly all over the world and weighs heavily on public health system. Since the beginning of the COVID-19 (CoronaVirus Disease-19) pandemic, everybody’s behavior was forced to change, as the result of a global lockdown strategy and the obligation of using personal protection equipment (PPE). We aimed to evaluate how the mitigation strategies adopted to fight SARS-CoV-2 (Severe Acute Respiratory Coronavirus Syndrome 2) infection have influenced hospitalizations due to CAP in two different Local Health Boards (LHBs) of central Italy. We considered two main periods of observation: before and after the national start of lockdown, in two Abruzzo’s LHBs. We analyzed 19,558 hospital discharge records of bacterial and viral CAP. Excluding SARS-CoV2 infection, a significant decrease in CAP hospitalizations was observed. Through the analysis of Diagnosis Related Group (DRG) values, we highlighted a significant saving of founds for the Regional Health Service. The enactment of social distancing measures to contain COVID-19 spread, brought down admissions for bacterial and viral pneumonia. Our study emphasizes that costs for hospitalizations due to CAP could be drastically reduced by mask wearing and social distancing.

Background Measures adopted to contain the spread of SARS-CoV-2 could have led to a reduction in the rate of non-COVID-19 infections. We assessed whether a similar reduction was present in patients with stroke. Methods We performed a hospital-based study nested in a prospective population-based registry. We compared prevalence of infections and in-hospital mortality in subjects admitted for acute stroke between the first pandemic year (study period, from March 2020 to February 2021) and the pre-pandemic year (control period, from March 2019 to February 2020). Infections were reported as pneumonia (PNA), urinary tract infections (UTI), and any infection (INF). Results From the control (n = 677) to the study period (n = 520), the prevalence of INF decreased from 11.5 to 4.6% (p p = 0.001). No changes in in-hospital mortality and length of hospital stay were observed between the two periods. Conclusions The observed reduction of in-hospital pneumonias in patients with stroke was likely attributable to the use of protective measures and limitation of hospital visits. Maintaining some of those measures in the long term may contribute to control infections in hospitalized patients with stroke.

Supplemental material, sj-pdf-1-eso-10.1177_2396987320975736 for Clinical usefulness of Edinburgh CT criteria in patients with lobar intracerebral hemorrhage by Raffaele Ornello, Enrico Colangeli, Emanuele Tommasino, Cindy Tiseo, Giulia Perrotta, Ciro Scarpato, Martina Gentile, Leondino Mammarella, Carmine Marini, Francesca Pistoia, Alessandra Splendiani and Simona Sacco in European Stroke Journal

to investigate heart failure (HF) hospitalizations, the following one-year follow-up, and any possible connection between rehospitalizations due to HF and patients' characteristics derived from administrative databases.retrospective longitudinal design.the study was conducted analyzing public hospital records of a district in Abruzzo Region (Central Italy), which counts more than 300,000 inhabitants. Patients hospitalized for HF from 01.01.2016 to 31.12.2017 (index event) were included in the study and followed-up for one year.frequency of repeated hospital admissions, time intervals from the index HF hospitalizations, and causes of readmissions were investigated.a total of 1,587 patients discharged alive after an index hospitalization for HF were included in the study. The mean age of the patients was 79.6 years and the majority of them were females (53.7%). The mean length of stay (LOS) for the index hospitalizations was 8.8 ±6.8 days. During the follow-up period, 336 (21.2%) patients underwent one to four repeated hospitalizations for HF. The first readmission due to HF occurred after a median time of 106.5 days from the index event discharge, and for 20.0% of all cases it occurred within 31 days; 453 patients (28.6%) were readmitted exclusively for other causes, and 67 (4.2%) died out of hospital without any previous HF re-hospitalization. When the outcome was considered as a composite endpoint (out-of-hospital death/HF re-hospitalization), age=75 (HR 1.737; 95%CI 1.330-2.267), LOS at the index hospitalization=8 days (HR 1.302; 95%CI 1.066-1.591), and repeated hospitalizations for other causes (HR 1.789; 95%IC 1.465-2.185) were associated with the risk of repeated hospitalizations for HF.this study shows that about one HF patient out of five experienced at least one re-hospitalization for HF within one year from index hospitalization. In addition to having a longer index hospitalization, these patients were older and frequently suffered from comorbidities which also led to hospitalizations. The results underline the need for a close and careful follow-up after the discharge of old HF patients with multiple pathologies in order to avoid further HF admissions in a short time.

Objective: Preliminary data indicate a reduction in hospitalizations for acute coronary syndromes during the Covid19 outbreak in Northern Italy. We investigated whether the albeit marginal Covid19 burden in the province of L Aquila in Central Italy, had an impact on cardiovascular hospitalizations and outcomes Design and method: We retrospectively analyzed de-identi fied data from all patients admitted to the five hospitals located in the province of L Aquila for allcause and cardiovascular hospitalizations, cardiovascular acute phase treatments (coronary angioplasty, systemic fibrinolysis, endovascular procedures), and inhospital cardiovascular deaths in the time window from January 1 to March 31 in the years 2020 (study period) and 2019 (control period). Unadjusted incidence rate ratios (IRR) comparing study/control period for the number of admissions/ procedures were calculated through Poisson regression. Case fatality rate (%) for cardiovascular diseases in the examined periods was assessed Results: 5908 patients were hospitalized in the first quarter of 2020 (52.9% women mean age 59.2±24.9 years, 64.9 mean daily admissions). In the same period in 2019, 6852 patients were hospitalized (51.8% women, mean age 60.1±24.6 years;76.1 mean daily admissions). Signi ficantly less all-cause and cardiovascular hospitalizations occurred in the study period than in the control period (IRR 0.85 95%CI 0.82-0.88;IRR 0.73, 95%CI 0.67-0.80, respectively). The mean daily number of cardiovascular procedures was also lower (IRR: 0.74, p=0.009). Importantly a disproportionate decrease in the number of procedures was observed in relation to cardiovascular hospitalizations in the study period (13.8% versus 19.3%, p=0.001). More intra-hospital cardiovascular deaths occurred in March 2020 (11.9%) compared with March 2019 (6.1%) (p=0.048) Conclusions: Changes in healthcare seeking behaviors and an increased burden of cardiovascular-related deaths occurred in a Covid19 low prevalence Italian area Besides unmeasured factors, including forced lifestyle changes, late hospital presentations and consequent greater disease severity might have affected eligibility and outcome of cardiovascular procedures. This evidence advances recent concerns regarding the impact of the pandemic on cardiovascular diseases and related deaths.

Background Identifying the cause of intracerebral hemorrhage (ICH) is relevant to optimize its management. We aimed to assess the applicability and utility of the Edinburgh CT criteria for cerebral amyloid angiopathy (CAA) in an unselected cohort of hospitalized patients. Patients and Methods We retrospectively applied the Edinburgh criteria to the first available brain CTs of patients hospitalized for a first-ever lobar ICH in the district of L’Aquila from 2011 to 2017. ICH characteristics and outcomes were compared according to the presence of the Edinburgh CT criteria, including associated subarachnoid hemorrhage (aSAH) and finger-like projections (FLPs). The outcome of ICH in-hospital mortality was assessed with multivariate logistic regression analysis. We adopted the Edinburgh criteria, age, NIHSS and Glasgow Coma Scale scores, systolic blood pressure, antiplatelet treatment, ICH volume, and intraventricular extension on admission as covariates. Results Of 178 patients with lobar ICH, 52 (29.2%) had aSAH+FLPs, 60 (33.7%) aSAH only, 1 (0.6%) FLPs, and 65 (36.5%) none. Patients with aSAH+FLPs were older (79.0 ± 9.2 years) than those with only one criterion or none (74.0 ± 15.3 and 72.2 ± 13.8 years, respectively; P = 0.020). Patients with aSAH+FLPs also had more severe ICH at onset, higher in-hospital case-fatality (log rank test P = 0.003) and higher mRS scores at discharge (P Discussion Our data suggest the applicability of the Edinburgh CT criteria in a hospital setting. The presence of those criteria reflects ICH clinical severity. Conclusions Applying the Edinburgh CT criteria might help refining the diagnosis and improving the management of patients with lobar ICH.

to assess the health inequalities of immigrants in the Local Health Unit (LHU) n.1 of the Abruzzo Region with a real-world approach. In particular, 4 main categories of hospitalisation (MDC) linked to health risk behaviours and social determinants were analysed.retrospective study on hospital discharge data (HDD).resident population in the LHU n.1 of the Abruzzo Region between 2010 and 2018. Hospital discharge forms (HDFs) of the hospitals under the administration of the LHU No. 1 of the Abruzzo Region, which includes three geographical areas (Marsica, Peligno-Sangrina, L'Aquila), in the years 2010-2018 were analysed.crude hospitalisation trends for immigrants and Italians; comparison of standardised hospitalisation rates in the main immigrant communities.overall, 26,570 SDO were analysed. Average age of inpatients was 40 years (±16) and average hospital stay was 4 days (±7). Immigrants showed a lower tendency to hospitalisation than Italians with a decreasing trend from 2010 to 2018, contrary to the Italians. The Romanian population has a hospitalisation risk for alcohol abuse/drugs and induced organic mental disorders about twice as much as the Italian population. Women from Morocco experienced caesarean section with complications about four times more than the Italian women.the analysis of routine data highlighted excesses of hospitalisation by some causes and birthplaces. A real-world approach can be useful and timely to the implementation of preventive strategies for specific diseases in defined local areas.