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BACKGROUND: In the present study we aimed to create a model able to predict the short-term need of hospital beds for COVID-19 patients, during SARS-CoV-2 outbreak. METHODS: We retrospectively revised data about all COVID-19 patients hospitalized at a University Hospital in Northern Italy, between March 1 and April 29, 2020. Several polynomial models (from first to fourth order) were fitted to estimate the relationship between the time and the number of occupied hospital beds during the entire period and after the local peak of the outbreak and to provide the prediction of short-term hospital beds demand. Model selection was based on the adjusted R-2 (aR(2)) Index and likelihood ratio test (LRT). RESULTS: We included 836 hospitalizations (800 COVID-19 patients). The median length of hospital in-stay was 12 days. According to the aR(2), the fourth order models best fitted the data considering the entire time period. When only the data after the peak was selected, no statistical improvement was found adding terms of order 3 and 4 and lower order polynomial models were considered for the forecasting of the hospital beds demand. Both approaches had a decreasing trend in the number of occupied beds along with time;however, the quadratic one showed a faster reduction in the predicted number of beds required by patients affected by COVID-19. CONCLUSIONS: We propose a model to predict the hospital bed requirement during the descending phase of COVID-19 outbreak, the validation of which might contribute to decision makers policy in the next weeks of pandemic.

Introduction Psychiatric management of inpatients with suicidal behavior involves psychiatrists and psychiatric nurses. Specific precautions should be adopted: observation on a one to one basis with the cooperation of qualified nurses and accommodating the patient in a room close to the infirmary is usually recommended. An ongoing assessment of suicidal risk is warranted to check the response to treatment over time. Aim To compare the severity of depressive symptoms in depressed inpatients admitted after an attempted suicide and in depressed inpatients admitted for any other reason; to assess the severity of attempted suicide and the management of suicidal risk in the clinical setting. Material and method We divided the sample in two subgroups: patients with a diagnosis of depression admitted for a current suicide attempt and depressed patients without a current suicide attempt. Socio-demographic and clinical features were gathered; assessment included the Montgomery-Asberg Depression Rating Scale (MADRS) and the Nurses’ Global Assessment of Suicide Risk (NGASR). Results 46 patients were recruited in a 1-year period and were eligible for our study: 20 had been admitted to the hospital after attempting suicide, while the other 26 had not attempted suicide and were admitted for other reasons related to their depression. The multivariate analysis yielded a statistically significant correlation between the use of antidepressants and current suicide attempt. The occurrence of suicidal attempt was not significantly related to the severity of depressive symptoms. In the current suicide attempters subgroup, NGASR suicide risk levels at discharge were significantly lower than those measured at admission. Current suicide attempters had a higher number of suicide attempts in their clinical history, compared to the other group. Conclusion We found no significant correlation among psychiatric diagnosis, severity of depressive symptoms and current suicide attempt. Antidepressant therapy was found to play the role of protective factor for suicide attempts. History of suicide attempts was one of the major predictor for reattempted suicide. A more thorough understanding of the complex phenomenon of suicide and of the reasons underlying suicidal behaviors is warranted.