Indirect Effects of the COVID-19 Pandemic on In-Hospital Outcomes among Internal Medicine Departments: A Double-Center Retrospective Study

• Published in: Journal of clinical medicine 2023-08, Vol.12 (16), p.5304
• Main Authors: Di Marco, Maurizio, Miano, Nicoletta, Marchisello, Simona, Coppolino, Giuseppe, L’Episcopo, Giuseppe, Scilletta, Sabrina, Spichetti, Concetta, Torre, Serena, Scicali, Roberto, Zanoli, Luca, Gaudio, Agostino, Castellino, Pietro, Piro, Salvatore, Purrello, Francesco, Di Pino, Antonino
• Format: Article
• Language: English
• Subjects: Blood transfusions; Care and treatment; Cholesterol; Chronic diseases; Chronic illnesses; Chronic obstructive pulmonary disease; Clinical medicine; Control; COVID-19; Departments; Disease transmission; Emergency medical care; Epidemics; Hospital patients; Hospitalization; Hospitals; Infections; Internal medicine; Italy; Kidney diseases; Medicine; Mortality; Older people; Pandemics; Prevention; Risk factors; Safety and security measures; Sepsis; Severe acute respiratory syndrome coronavirus 2; Statistical analysis; Thromboembolism; Variables
• ISSN: 2077-0383; 2077-0383
• DOI: 10.3390/jcm12165304

The coronavirus disease 19 (COVID-19) emergency led to rearrangements of healthcare systems with a significant impact on those internal medicine departments that had not been converted to COVID-19 wards. A reduced number of departments, indeed, had to cope with the same number of patients along with a lack of management of patients’ chronic diseases. We conducted a retrospective study aimed at examiningthe consequences of the COVID-19 pandemic on internal medicine departments that were not directly managing COVID-19 patients. Data from 619 patients were collected: 247 subjects hospitalized in 2019 (pre-COVID-19 era), 178 in 2020 (COVID-19 outbreak era) and 194 in 2021 (COVID-19 ongoing era). We found that in 2020 in-hospital mortality was significantly higher than in 2019 (17.4% vs. 5.3%, p = 0.009) as well as length of in-hospital stay (LOS) (12.7 ± 6.8 vs. 11 ± 6.2, p = 0.04). Finally, we performed a logistic regression analysis of the major determinants of mortality in the entire study population, which highlighted an association between mortality, being bedridden (β = 1.4, p = 0.004), respiratory failure (β = 1.5, p = 0.001), glomerular filtration rate (β = −0.16, p = 0.03) and hospitalization in the COVID-19 outbreak era (β = 1.6, p = 0.005). Our study highlights how the COVID-19 epidemic may have caused an increase in mortality and LOS even in patients not directly suffering from this infection.