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Association between different screening strategies for SARS-CoV-2 and deaths and severe disease in Italy.
  • Edoardo Mannucci,
  • Antonio Siilverii,
  • Matteo Monami
Edoardo Mannucci
University of Florence
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Antonio Siilverii
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Matteo Monami
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Abstract

Background The WHO recommends testing any suspected person with Severe Acute Respiratory Syndrome CoronaVirus-2 (SARS-CoV-2), in order to limit the spread of the epidemic. In Italy, some Regions opted for extensive testing, whereas others limited tests to selected subjects. To assess the influence of different strategies, we examined the incidence of death and severe cases in Italy. Methods Data on new cases of SARS-CoV-2, number of tests, deaths, and admissions to Intensive Care Units (ICU) were retrieved in each Italian Region, from February 24th to March 18th, 2020. As an index of different screening strategies, the number of tests/positive test results (T/P) ratio as of March 7th, 2020, was considered. The cumulative number of deaths and of new severe cases, between March 23thand 25th was recorded. The association of those two outcomes with the number of T/P ratio was assessed using linear regression models. Results In the interval between March 23th-25th, recorded deaths (*million inhabitants) were 14(3-54), whereas severe cases were 31(10-112). Both the number of deaths and that of severe cases showed a significant correlation (R2 .38 and .37, with p<.01) with the T/P ratio. Deaths and severe cases were associated with higher mean personal income and lower density of General Practioners (GPs). The association of T/P with severe cases and deaths retained statistical significance after adjusting for mean personal income (R2 .20 and .21, respectively; both p=.04) and GPs density (R2.22 and .21, respectively; both p=.03). Conclusions A more aggressive screening strategy for SARS-Cov-2, was associated with lower rates of death and severe disease in Regions of Italy.

Peer review status:UNDER REVIEW

22 Apr 2020Submitted to International Journal of Clinical Practice
23 Apr 2020Submission Checks Completed
23 Apr 2020Assigned to Editor
26 Apr 2020Reviewer(s) Assigned
29 Apr 2020Review(s) Completed, Editorial Evaluation Pending
26 Jun 20201st Revision Received
02 Jul 2020Submission Checks Completed
02 Jul 2020Assigned to Editor
02 Jul 2020Reviewer(s) Assigned