COVID-19 pandemic and Internal Medicine Units in Italy: a precious effort on the front line
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CE - LETTER TO THE EDITOR
COVID‑19 pandemic and Internal Medicine Units in Italy: a precious effort on the front line Andrea Montagnani1 · Filippo Pieralli2 · Paola Gnerre3 · Chiara Vertulli4 · Dario Manfellotto5 on behalf of FADOI COVID-19 Observatory Group Received: 10 June 2020 / Accepted: 20 July 2020 © Società Italiana di Medicina Interna (SIMI) 2020
Dear Editor, On 30th January 2020, the World Health Organization declared the SARS-CoV-2 infection a pandemic, generating a heavy burden of morbidity, mortality, and stress for healthcare systems [1]. After the initial COVID-19 outbreak in China, Italy was the most affected European country in the earlier phase of the pandemic, and faced an unprecedented healthcare emergency [2]. Internal Medicine Units (IMUs) are widespread in Italy being present in every hospital. As a matter of fact, IMUs constitute the backbone of the infrastructure of wards of the Italian National Healthcare system, and have been widely involved in the organisation of the response to the COVID-19 outbreak [3, 4]. The Federation of Hospital Internists (FADOI) is a scientific society accounting for nearly 3000 internal medicine physicians and representing more than 500 internal medicine wards in Italy. In order to assess the role and contribution of IMUs in tackling the COVID-19 pandemic, the FADOI Research Centre promoted a survey through a short questionnaire delivered to the chiefs of different IMUs in the Italian Regions, which were most involved in the COVID-19 outbreak between 15th April and 4th May 2020. Fifty-two participating centres completed the survey. Of note, 38 (73%) of IMUs were involved in providing direct care to COVID-19 patients (45% in Northern, 37% in Central, and 18% in Southern Italy).
* Chiara Vertulli [email protected] 1
Internal Medicine, Hospital of Pitigliano, Grosseto, Italy
2
Internal Medicine, Hospital “Careggi”, Florence, Italy
3
Internal Medicine, Hospital “San Paolo”, Savona, Italy
4
FADOI Research Centre, Piazzale L. Cadorna, 15, 20123 Milan, Italy
5
Department of Internal Medicine, Hospital “Fatebenefratelli-AFaR”, Rome, Italy
In hospitals where COVID-19 patients were cared for, 58% of total hospital beds were in Internal Medicine Units. A significant reorganization was set in place in most hospitals and many resources were dedicated to COVID-19 patients. Sixty percent and one-third of IMUs dedicated 50% and 80% of beds to COVID-19 care, respectively. In the 38 Internal Medicine units involved in the care of COVID-19 patients, 6650 patients were admitted, accounting for 6% of the total SARS-CoV-2 infections reported by the Health Ministry database on 04 May 2020. During the 3 weeks of the survey, the workload evaluated simply by the number of patients cared for, was the following: 10% of IMUs less than 100 patients, 60% 100–200 patients, 30% more than 200 patients. The surge of COVID-19 patients and the limited number of Intensive Care Unit (ICU) beds, posed a significant stress on the healthcare system and IMUs played a pivot
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