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il virus: covid-19 in italy

There is an Italian report on the characteristics of 3200 patients who died.


I hate relying on auto-translation for this sort of thing but it mostly seems to work quite well.

One of the trickiest elephants in the room is mentioned in the report. The one that people arent sure how to talk about responsibly. See, I dont even want to mention what it is. Perhaps someone else will do the deed if they know what I am getting at and find the sentence in question. Perhaps I will do so myself later if my thoughts on this change, but it really is hard to talk about it without risking unintended consequences.
 
By my quick back of an envelope reckoning the birth rate of Italy is about 1300 a day, so these numbers are now approaching that.
 
elbows If it's the sentence I think it is, it looks like certain well-placed institutions are on the case with rapidly reviewing that, and it's best left for discussion once they issue guidance imho.
 
One of the trickiest elephants in the room is mentioned in the report. The one that people arent sure how to talk about responsibly.
is it to do with transfer to icu? tbf i mostly read the report to see how well my comprehension comes back, not looking to open a can of worms...
 
Hypertension medication.
Common amongst the dead. But it's not clear how many were on it and recovered.

Similarly, it seems to suggest that symptoms -> death = 8 days, and symptoms -> hospital -> death = 4+4 = 8 days. We could draw a few possible conclusions from that, but we don't have enough info to do so.
 
Don't take this the wrong way but can I gently ask that we please avoid the cryptic, and the ensuing guesswork? Either say something or don't.

Yes, I'm sorry, it just represented the dilemma I am having about that aspect. Normally I always shout at elephants in the room, I dont know how to handle that one, especially since it may drag on and we dont know how important it is. It causes me much pain to think about it, especially since I have family members that it potentially affects, and I have no decent way to talk sensibly with them about it at this stage, so I have to keep quiet.
 
Yes, I'm sorry, it just represented the dilemma I am having about that aspect. Normally I always shout at elephants in the room, I dont know how to handle that one, especially since it may drag on and we dont know how important it is. It causes me much pain to think about it, especially since I have family members that it potentially affects, and I have no decent way to talk sensibly with them about it at this stage, so I have to keep quiet.

What are you talking about?
 
There is an Italian report on the characteristics of 3200 patients who died.


I hate relying on auto-translation for this sort of thing but it mostly seems to work quite well.

One of the trickiest elephants in the room is mentioned in the report. The one that people arent sure how to talk about responsibly. See, I dont even want to mention what it is. Perhaps someone else will do the deed if they know what I am getting at and find the sentence in question. Perhaps I will do so myself later if my thoughts on this change, but it really is hard to talk about it without risking unintended consequences.
Is there a translation?
 
there are 3 things which I think it could elbows could be referring, and i've read the whole doc in italian.
1. the vast majority of people who die are over 70. the median age is 80.
2. in the two most affected age groups (70 to 80 and 80 to 90) the vast majority of deaths are men
3. three quarters of the dead had pulmonary arterial hypertension
 
Edited: Sorry if anyone has replied or quoted since. Leave it up, no biggy. I've been stuck in a room for about 6 days and i'm getting a bit intense! Plan to move into a hotel soon, one more night here.
 
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conte has just announced that everything isn't a supermarket, food shop, pharmacy or (let's laugh) tobacconist (which to be fair is sort of the italian equivalent of a post office - you buy stamps and pay bills there) is to be closed from tomorrow. Army already on the streets in major cities. It can't get much more serious than this really.
 
Well what a disaster my plan to just be vague about it was, sorry. I dont know what the forum equivalent of speaking in hushed tones is. This from the report:

Prima del ricovero in ospedale, il 36% dei pazienti deceduti COVID-19 positivi seguiva una terapia con ACEinibitori ed il 16% una terapia con Sartani (bloccanti del recettore per l'angiotensina). Questo dato può però essere sotto-stimato in quanto non sempre dalle cartelle cliniche era possibile evincere la terapia eseguita prima del ricovero.

Auto-translated:

Prior to hospitalization, 36% of COVID-19 positive deceased patients followed ACE inhibitor therapy and 16% treated with Sartani (angiotensin receptor blockers). This data can however be underestimated as it was not always possible to infer the therapy performed from the medical records before admission.

And this sort of article for the prior background story regarding this issue:


And no I dont mean the Italy thing is proof of anything on its own. Its just something to add to the assessment of these matters. There are many complications wtih discovering the full picture, and for a start I would want to see data for patients who had high blood pressure but were treated with drugs that have a different mechanism, to get clues about whether the condition or the medication is increasing the risk of complications and bad outcomes from Covid-19.
 
I am going to assume from context in other discussions that the elephantine sentence in there is the one that says that 36% (minimum) of the deceased were on ACE inhibitors or similar. Disclaimer: I have a dog in this race as I am on ACE inhibitors, so I might not be able to overcome my subconscious instinct to try to minimise the seriousness of this in order to protect my own mental health.

I note that the fatalities have been very much skewed to the elderly in these data - 75% of them over 73 years old. ACE inhibitors are amongst the most common prescribed medicines in the world, especially in the elderly where hypertension is rife (blood pressure tends to increase with age probably due to degradation in the regulatory systems involved - which are targeted directly for control by ACE inhibitors etc). They are also used as continuing treatment for people with coronary artery disease, heart failure, diabetes, chronic kidney disease, and post heart attack conditions.

You can probably see where I am going with this - ACE usage is strongly correlated with factors (age and specific co-morbidities) we already know have heightened mortality rates, not just for this disease, but for other respiratory diseases such as flu, which don’t I believe utilise the ACE2 receptors as part of their pathology.

There is also a sentence in there that in my translation looks encouraging: the number of young fatalities looks very low - 1.1% (36) under 50, of which only 9 under 40, 7 of which had serious underlying conditions (and the other 2 no clinical history).
 
there are 3 things which I think it could elbows could be referring, and i've read the whole doc in italian.
1. the vast majority of people who die are over 70. the median age is 80.
2. in the two most affected age groups (70 to 80 and 80 to 90) the vast majority of deaths are men
3. three quarters of the dead had pulmonary arterial hypertension

I wonder if this isn't because these are the people at the bottom of the priority list for treatment. Younger and healthier people haven't died yet because there is still enough capacity for them, although this will change.
 
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