Causes of Death during the First COVID-19 Pandemic Wave in Italy: A Comparison with Some European Countries
, Giulia Marcone, Alessia Scuro, Tania Bracci, Simona Cinque, Roberta Crialesi, Luisa Frova, Stefano Marchetti, Simone Navarra, Chiara Orsi, Marilena Pappagallo, Silvia Simeoni and Francesco Grippo *
Round 1
Reviewer 1 Report
Grande et. al. manuscript highlights the cause of death in Italy as compared to Spain, Sweden and England during March-April 2020 i.e the first wave of COVDI-19 pandemic. It shows overall high mortality rate in Italy however on age adjustment England and Spain did worst. Also, study shows that poor diagnosis of COVID-19 infection could have resulted in increase mortality due to respiratory diseases during this time frame in Italy.
Comment:
This study is of great importance to learn about the various direct and indirect effects of COVID-19 pandemic on the public healthcare.
Minor suggest: It will be far more effective if authors can present their results in graph rather than as table.
Author Response
Minor suggest: It will be far more effective if authors can present their results in graph rather than as table.
We thank the reviewer for the encouraging comment. We agree that a graph would be more effective. Nevertheless, the table allows us to include all the information that we used for the comments, such as the absolute number of deaths, that we describe in the results and the discussion. In addition the “brief report” format would not allow for the number of figures needed for exhaustive data representation.
Reviewer 2 Report
The article is quite exciting and can be published as is it.
There is a feeling among health care personnel and the public that the pandemic is blocking health care services. With the hospital system focusing only on COVID-19 patients, the rest were left to fend for themselves. It is known that waiting lists in hospitals, health centers, etc., have increased. But there is little evidence of the collective effects of the pandemic. In this aspect, this article provides some initial evidence that may be interesting for evaluating the impact of the pandemic and the planning of actions and health policies to mitigate the effects of the pandemic. In this situation, the priority is to have quick information.
It is only necessary to include the codes of the international classification of diseases (ICD10) used in each country for each disease as an annex or as supplementary material.
Author Response
It is only necessary to include the codes of the international classification of diseases (ICD10) used in each country for each disease as an annex or as supplementary material.
We thank the reviewer for the suggestion. The causes of death analysed have the same ICD10 codes definition for all the countries. We analysed only those causes with the same code selection for all the countries. For this reason, the causes presented are comparable. We agree that it is important to report ICD10 codes, so we added them to the description of the causes listed in Table 1. We also added a sentence in the last paragraph of the “methods” section:
“In summary, we limited the analysis to a list of causes common to all countries, where each cause is defined by the same set of ICD10 codes reported next to the description of the cause in Table 1”.
