PDF(Pubmed)
Abstract：
SARS-CoV-2 virulence is known to increase with lowering of environmental temperature and solar ultraviolet radiation; therefore, we have focused our real-world nationwide study concerning with COVID-19 trend and dynamics on the coldest seasons of the year in Italy, the Western country hardest hit at the onset of the pandemic, comparing the autumn-winter of 2020 (before mass vaccination but when the emergency machinery was fully operative in terms of tracing and swabs) with the autumn-winter of 2021 (after mass vaccination), and analyzing the mortality burden by age groups and life stages in the years 2019 (pre-COVID-19), 2020 (before mass vaccination), and 2021 (after mass vaccination).
METHODS: During the state of national health emergency, the Civil Defense Department released the aggregate data coming from the Higher Institute of Health, the Ministry of Health, the Italian Regions, and the Independent Provinces, to inform the population about the pandemic situation, daily. Among these data, there were the number of contagions, performed swabs, hospitalizations in Intensive Care Units (ICU), non-ICU patients, and deaths. By means of a team effort, we have collected and elaborated all these data, comparing the COVID-19 pandemic in Italy during the autumn-winter of 2020 with the autumn-winter of 2021. Moreover, we have extracted from the database of the National Institute of Statistics the total number of annual deaths in Italy during the years 2019, 2020, and 2021, comparing them to each other in order to evaluate the mortality burden attributable to COVID-19.
RESULTS: From the autumn-winter of 2020 to the autumn-winter of 2021, the contagions increased by ≈285%, against a ≈290% increase in the performed swabs; therefore, the mean positivity rate passed from 8.74% before mass vaccination to 8.59% after mass vaccination. The unprecedent vaccination campaign allowed a ≈251% abatement in COVID-19 deaths, and a reduction of ≈224% and ≈228% in daily ICU and non-ICU hospitalizations due to COVID-19, respectively. Regarding COVID-19 deaths, in 2020, there was a mortality excess of ≈14.3% quantifiable in 105,900 more deaths compared to 2019, the pre-COVID-19 year; 103,183 out of 105,900 deaths occurred in older adults (≥60 years), which is equivalent to ≈97.4%, while in adults over 50, the segment of population just below older adults, in 2020, there were 2807 more deaths than in 2019. Surprisingly, from the analysis of our data, it is emerged that in people under the age of 40 in the years 2019, 2020, and 2021, there were 7103, 6808, and 7165 deaths, respectively. This means that in subjects under 40 during 2020, there were 295 fewer deaths than in 2019, while during 2021, there were 357 more deaths than in 2020, equivalent to ≈5.2% more.
CONCLUSIONS: COVID-19 is a potential life-threatening disease mainly in older adults, as they are the most vulnerable due to inherent immunosenescence and inflammaging. Extensive vaccination in this segment of population with up-to-date vaccines is the means to reduce deaths, hospitalizations, and ICU pressure in the public interest. In the event of future threats, a new mass vaccination campaign should not be implemented without taking into account the individual age; it should primarily be aimed at people over 60 and at patients of any age with immune deficits, and secondly at people over 50. COVID-19 vaccination shows a favorable benefit-risk ratio in older adults, while the balance steps down under the age of 40; this younger segment of the population should be therefore exempt from any mandatory vaccination.
METHODS: During the state of national health emergency, the Civil Defense Department released the aggregate data coming from the Higher Institute of Health, the Ministry of Health, the Italian Regions, and the Independent Provinces, to inform the population about the pandemic situation, daily. Among these data, there were the number of contagions, performed swabs, hospitalizations in Intensive Care Units (ICU), non-ICU patients, and deaths. By means of a team effort, we have collected and elaborated all these data, comparing the COVID-19 pandemic in Italy during the autumn-winter of 2020 with the autumn-winter of 2021. Moreover, we have extracted from the database of the National Institute of Statistics the total number of annual deaths in Italy during the years 2019, 2020, and 2021, comparing them to each other in order to evaluate the mortality burden attributable to COVID-19.
RESULTS: From the autumn-winter of 2020 to the autumn-winter of 2021, the contagions increased by ≈285%, against a ≈290% increase in the performed swabs; therefore, the mean positivity rate passed from 8.74% before mass vaccination to 8.59% after mass vaccination. The unprecedent vaccination campaign allowed a ≈251% abatement in COVID-19 deaths, and a reduction of ≈224% and ≈228% in daily ICU and non-ICU hospitalizations due to COVID-19, respectively. Regarding COVID-19 deaths, in 2020, there was a mortality excess of ≈14.3% quantifiable in 105,900 more deaths compared to 2019, the pre-COVID-19 year; 103,183 out of 105,900 deaths occurred in older adults (≥60 years), which is equivalent to ≈97.4%, while in adults over 50, the segment of population just below older adults, in 2020, there were 2807 more deaths than in 2019. Surprisingly, from the analysis of our data, it is emerged that in people under the age of 40 in the years 2019, 2020, and 2021, there were 7103, 6808, and 7165 deaths, respectively. This means that in subjects under 40 during 2020, there were 295 fewer deaths than in 2019, while during 2021, there were 357 more deaths than in 2020, equivalent to ≈5.2% more.
CONCLUSIONS: COVID-19 is a potential life-threatening disease mainly in older adults, as they are the most vulnerable due to inherent immunosenescence and inflammaging. Extensive vaccination in this segment of population with up-to-date vaccines is the means to reduce deaths, hospitalizations, and ICU pressure in the public interest. In the event of future threats, a new mass vaccination campaign should not be implemented without taking into account the individual age; it should primarily be aimed at people over 60 and at patients of any age with immune deficits, and secondly at people over 50. COVID-19 vaccination shows a favorable benefit-risk ratio in older adults, while the balance steps down under the age of 40; this younger segment of the population should be therefore exempt from any mandatory vaccination.
摘要：
已知SARS-CoV-2毒力随着环境温度和太阳紫外线辐射的降低而增加；因此，我们将真实世界的全国性研究集中在意大利一年中最冷的季节，大流行爆发时受灾最严重的西方国家，将2020年的秋冬季（在大规模疫苗接种之前，但当紧急机械在追踪和拭子方面完全运行时）与2021年的秋冬季（在大规模疫苗接种之后）进行比较，并分析2019年按年龄组和生命阶段划分的死亡负担（新冠肺炎之前），2020年（大规模疫苗接种之前），和2021年（大规模疫苗接种后）。
方法：在国家卫生紧急状态下，民防部门发布了来自高等卫生研究所的汇总数据，卫生部,意大利地区,和独立的省份，为了向人们通报大流行的情况，daily.在这些数据中,有感染的数量，执行拭子，重症监护病房（ICU）住院，非ICU患者,和死亡。通过团队的努力，我们收集和阐述了所有这些数据，将2020年秋冬季意大利的COVID-19大流行与2021年秋冬季进行比较。此外，我们从国家统计局的数据库中提取了2019年，2020年和2021年意大利的年度死亡总数，并将它们相互比较，以评估可归因于COVID-19的死亡负担。
结果：从2020年的秋冬到2021年的秋冬，传染病增加了约285%，而执行的拭子增加约290%；因此，平均阳性率从大规模疫苗接种前的8.74%上升至大规模疫苗接种后的8.59%.前所未有的疫苗接种运动使COVID-19死亡人数减少约251%，由于COVID-19，每日ICU和非ICU住院率分别降低约224%和约228%。关于COVID-19死亡，2020年，与COVID-19之前的2019年相比，105,900人死亡的死亡率超过≈14.3%，可量化；105,900人中有103,183人死亡发生在老年人(≥60岁)，相当于约97.4%，而在50岁以上的成年人中，人口略低于老年人，2020年，死亡人数比2019年多2807人。令人惊讶的是,从我们的数据分析来看，在2019年，2020年和2021年，40岁以下的人群中，有7103、6808和7165人死亡，分别。这意味着，在2020年40岁以下的受试者中，死亡人数比2019年减少了295人，而在2021年，死亡人数比2020年增加了357人，相当于增加了约5.2％。
结论：COVID-19是一种潜在的危及生命的疾病，主要发生在老年人中，因为它们由于固有的免疫衰老和炎症而最脆弱。在这部分人群中广泛接种最新疫苗是减少死亡的手段,住院治疗,和ICU对公共利益的压力。在未来的威胁，不应实施新的大规模疫苗接种运动，而不考虑个人年龄；它应主要针对60岁以上的人和任何年龄的免疫缺陷患者，其次是50岁以上的人。COVID-19疫苗在老年人中显示出良好的获益风险比，而40岁以下的平衡下降；因此，这一年轻的人口群体应该免于任何强制性疫苗接种。
方法：在国家卫生紧急状态下，民防部门发布了来自高等卫生研究所的汇总数据，卫生部,意大利地区,和独立的省份，为了向人们通报大流行的情况，daily.在这些数据中,有感染的数量，执行拭子，重症监护病房（ICU）住院，非ICU患者,和死亡。通过团队的努力，我们收集和阐述了所有这些数据，将2020年秋冬季意大利的COVID-19大流行与2021年秋冬季进行比较。此外，我们从国家统计局的数据库中提取了2019年，2020年和2021年意大利的年度死亡总数，并将它们相互比较，以评估可归因于COVID-19的死亡负担。
结果：从2020年的秋冬到2021年的秋冬，传染病增加了约285%，而执行的拭子增加约290%；因此，平均阳性率从大规模疫苗接种前的8.74%上升至大规模疫苗接种后的8.59%.前所未有的疫苗接种运动使COVID-19死亡人数减少约251%，由于COVID-19，每日ICU和非ICU住院率分别降低约224%和约228%。关于COVID-19死亡，2020年，与COVID-19之前的2019年相比，105,900人死亡的死亡率超过≈14.3%，可量化；105,900人中有103,183人死亡发生在老年人(≥60岁)，相当于约97.4%，而在50岁以上的成年人中，人口略低于老年人，2020年，死亡人数比2019年多2807人。令人惊讶的是,从我们的数据分析来看，在2019年，2020年和2021年，40岁以下的人群中，有7103、6808和7165人死亡，分别。这意味着，在2020年40岁以下的受试者中，死亡人数比2019年减少了295人，而在2021年，死亡人数比2020年增加了357人，相当于增加了约5.2％。
结论：COVID-19是一种潜在的危及生命的疾病，主要发生在老年人中，因为它们由于固有的免疫衰老和炎症而最脆弱。在这部分人群中广泛接种最新疫苗是减少死亡的手段,住院治疗,和ICU对公共利益的压力。在未来的威胁，不应实施新的大规模疫苗接种运动，而不考虑个人年龄；它应主要针对60岁以上的人和任何年龄的免疫缺陷患者，其次是50岁以上的人。COVID-19疫苗在老年人中显示出良好的获益风险比，而40岁以下的平衡下降；因此，这一年轻的人口群体应该免于任何强制性疫苗接种。
