key: cord-325664-9ool5z9s
authors: Immovilli, Paolo; Morelli, Nicola; Antonucci, Elio; Radaelli, Guido; Barbera, Mario; Guidetti, Donata
title: COVID-19 mortality and ICU admission: the Italian experience
date: 2020-05-15
journal: Crit Care
DOI: 10.1186/s13054-020-02957-9
sha: 
doc_id: 325664
cord_uid: 9ool5z9s

nan

correlation was observed between the CFR and ICU admission rate (Pearson's r − 0.53, p value 0.014) and R 2 was 0.24, suggesting an association between mortality and the absence of treatment in ICU (Fig. 1) .

The analysis of mortality during an outbreak is no easy feat and a precise evaluation can be obtained only once the outbreak is over. Furthermore, the high Italian mortality may well be attributable to a large proportion of elderly persons in the Italian population, to an ascertainment bias and/or diagnosis bias, leading to an underestimation of the milder cases and mortality overestimation.

However, examining the differing outbreak magnitudes in regions with different ICU availability evidenced a discrepancy in the percentage of ICU-admitted patients. Indeed, there was a higher mortality rate in the northern region where fewer patients could be admitted into an ICU. These preliminary data evidence the pivotal preventive role played by early lockdown measures to reduce outbreak magnitude and place less pressure on ICU beds availability; however, these data should be interpreted with caution because of possible bias: patients could be allowed outside the ICU due to various reasons (i.e., age, comorbidities, frailty index), as it occurs in daily clinical practice. 

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The authors thanks Elena Marchesi, Manuela Giovini, Ignazio Semproni, Chiara Terracciano, Domenica Zaino, and Eugenia Rota for their contribution in reading and reviewing the article and Barbara Wade for her linguistic advice. Received: 20 April 2020 Accepted: 8 May 2020

Paolo Immovilli, Nicola Morelli, Elio Antonucci, Guido Radaelli, Mario Barbera, and Donata Guidetti are responsible for study design and all authors wrote and reviewed the manuscript. The authors read and approved the final manuscript.

There was no funding for this article.Availability of data and materials Data published online by Italian Civil Protection Department (http:// opendatadpc.maps.arcgis.com/apps/opsdashboard/index.html#/b0c68bce2 cce478eaac82fe38d4138b1; seen on March 31, 2020).Ethics approval and consent to participate Not applicable.

Not applicable.

The authors have nothing to disclose.