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 (P/T) ratio as of March 7th , 2020, was considered. The cumulative number of deaths and of new severe cases, between March 23th and 25th was recorded. The association of those two outcomes with the number of P/T 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 .57 and .41, with p<.01) with the P/T ratio. Deaths and severe cases were associated with higher mean personal income and lower density of General Practioners (GPs). The association of P/T with severe cases and deaths retained statistical significance after adjusting for mean personal income (R2 .30 and .41, respectively; both p=.04) and GPs density (R2 .21 and .19, 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.
Association between different screening strategies for SARS-CoV-2 and deaths and severe disease in Italy