A descriptive analysis of COVID-19 associated mortality in Parma Province: concordance between official national mortality register provided by ISTAT (National Institute of Statistics) and local ADS (Automated Data System) real-time surveillance flow.

Background and aim: The Public Health Department of the Parma Local Health Authority (AUSL) has implemented a computerized system called ADS (Automated Data System) to collect data on COVID-19 cases and related deaths, as required by the Emilia-Romagna Region and the Italian Ministry of Health, to improve the daily flow of real-time information. However, official mortality data for all causes was collected even from the National Institute of Statistics (ISTAT) through death forms that were completed by certifying doctors in each municipality. This analysis aims to verify the agreement between the data collected by ISTAT and the data collected by ADS.

Methods: The study period went from January 1st to December 31st, 2021. The population under observation consisted of residents in the province of Parma who died due to COVID-19, as identified through the ISTAT and/or ADS data flow.

Results: In 2021, a total of 448 deaths due to COVID-19 were reported in the Parma Province, with a median age of 83 years. The ADS system identified 408 of these deaths, whereas ISTAT certified only 347. Three hundred and seven deaths were identified by both flows.

Conclusions: The survey suggests that the ADS surveillance system may have overestimated the COVID-19 mortality data compared to the ISTAT flow. The ADS has been valuable in the immediate response to emergencies, providing a more sensitive system that prioritizes the precautionary principle and enables decisions aimed at minimizing risks for vulnerable populations. However, it is not recommended for routine surveillance, as it is less reliable compared to the ISTAT flow.