The First 110,593 COVID-19 Patients Hospitalised in Lombardy: A Regionwide Analysis of Case Characteristics, Risk Factors and Clinical Outcomes

Objectives: To describe the monthly distribution of COVID-19 hospitalisations, deaths and case-fatality rates (CFR) in Lombardy (Italy) throughout 2020.Methods: We analysed de-identified hospitalisation data comprising all COVID-19-related admissions from 1 February 2020 to 31 December 2020. The overall survival (OS) from time of first hospitalisation was estimated using the Kaplan-Meier method. We estimated monthly CFRs and performed Cox regression models to measure the effects of potential predictors on OS.Results: Hospitalisation and death peaks occurred in March and November 2020. Patients aged >= 70 years had an up to 180 times higher risk of dying compared to younger patients [70-80: HR 58.10 (39.14-86.22); 80-90: 106.68 (71.01-160.27); >= 90: 180.96 (118.80-275.64)]. Risk of death was higher in patients with one or more comorbidities [1: HR 1.27 (95% CI 1.20-1.35); 2: 1.44 (1.33-1.55); >= 3: 1.73 (1.58-1.90)] and in those with specific conditions (hypertension, diabetes).Conclusion: Our data sheds light on the Italian pandemic scenario, uncovering mechanisms and gaps at regional health system level and, on a larger scale, adding to the body of knowledge needed to inform effective health service planning, delivery, and preparedness in times of crisis.