{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:46:03Z","timestamp":1787028363377,"version":"build-2736575974"},"reference-count":29,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2023,2,9]],"date-time":"2023-02-09T00:00:00Z","timestamp":1675900800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Background and Objective: The presence of multiple chronic diseases is associated with an increase in mortality when related to COVID-19 infection. The aims of our study were: (i) to evaluate the association between the severity of the COVID-19 disease, defined as symptomatic hospitalized in prison or symptomatic hospitalized out of prison, and the presence of one or more comorbidities in two prisons in central Italy: L\u2019Aquila and Sulmona; (ii) to describe the profiles of inmates using multiple correspondence analysis (MCA). Methods: A database was created including age, gender and clinical variables. The database containing anonymized data was password-protected. The Kruskal\u2013Wallis test was used to evaluate a possible association between diseases and the severity of COVID-19 stratified by age groups. We used MCA to describe a possible characteristic profile of inmates. Results: Our results show that in the 25\u201350-year-old age group (COVID-19-negative) in the L\u2019Aquila prison, 19\/62 (30.65%) were without comorbidity, 17\/62 (27.42%) had 1\u20132 comorbidities and only 3.23% had &gt;2 diseases. It is interesting to note that in the elderly group, the frequency of 1\u20132 or &gt;2 pathologies was higher than in the younger group, and only 3\/51 (5.88%) inmates did not have comorbidities and were COVID-19 negative (p = 0.008). The MCA identified the following profiles: the prison of L\u2019Aquila showed a group of women over 60 with diabetes, cardiovascular and orthopedic problems, and hospitalized for COVID-19; the Sulmona prison presented a group of males over 60 with diabetes, cardiovascular, respiratory, urological, gastrointestinal and orthopedic problems, and hospitalized or symptomatic due to COVID-19. Conclusions: our study has demonstrated and confirmed that advanced age and the presence of concomitant pathologies have played a significant role in the severity of the disease: symptomatic hospitalized in the prison; symptomatic hospitalized out of the prison.<\/jats:p>","DOI":"10.3390\/ijerph20043079","type":"journal-article","created":{"date-parts":[[2023,2,10]],"date-time":"2023-02-10T02:33:27Z","timestamp":1675996407000},"page":"3079","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["SARS-CoV2 Infection and Comorbidity in Inmates: A Study of Central Italy"],"prefix":"10.3390","volume":"20","author":[{"given":"Emma","family":"Altobelli","sequence":"first","affiliation":[{"name":"Department of Life, Public Health and Environmental Sciences, University of L\u2019Aquila, 67100 L\u2019Aquila, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Galassi","sequence":"additional","affiliation":[{"name":"Department of Life, Public Health and Environmental Sciences, University of L\u2019Aquila, 67100 L\u2019Aquila, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianna","family":"Mastrodomenico","sequence":"additional","affiliation":[{"name":"Public Health Unit, Avezzano-Sulmona-L\u2019Aquila, 67100 L\u2019Aquila, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fausto","family":"Frabotta","sequence":"additional","affiliation":[{"name":"Public Health Unit, Avezzano-Sulmona-L\u2019Aquila, 67100 L\u2019Aquila, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Marzi","sequence":"additional","affiliation":[{"name":"Department of Information Engineering, Computer Science and Mathematics University of L\u2019Aquila, 67100 L\u2019Aquila, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna Maria","family":"Angelone","sequence":"additional","affiliation":[{"name":"Department of Life, Public Health and Environmental Sciences, University of L\u2019Aquila, 67100 L\u2019Aquila, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3032-9267","authenticated-orcid":false,"given":"Ciro","family":"Marziliano","sequence":"additional","affiliation":[{"name":"Statistical Observatory and Indicator Monitoring, University of L\u2019Aquila, 67100 L\u2019Aquila, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,2,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Esposito, M., Salerno, M., Di Nunno, N., Ministeri, F., Liberto, A., and Sessa, F. (2022). The Risk of COVID-19 Infection in Prisons and Prevention Strategies: A Systematic Review and a New Strategic Protocol of Prevention. Healthcare, 10.","DOI":"10.3390\/healthcare10020270"},{"key":"ref_2","first-page":"e00083520","article-title":"COVID-19 in prisons: An impossible challenge for public health?","volume":"36","author":"Simas","year":"2020","journal-title":"Cad Saude Publica"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1865","DOI":"10.1001\/jama.2021.17575","article-title":"COVID-19 Incidence and Mortality in Federal and State Prisons Compared with the US Population, April 5, 2020, to April 3, 2021","volume":"326","author":"Marquez","year":"2021","journal-title":"JAMA"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Altobelli, E., Marzi, F., Angelone, A.M., Mazzocca, R., Mastrodomenico, M., Petrocelli, R., and Marziliano, C. (2022). Burden of COVID-19 and Vaccination Coverage in the Italian Population as of October 2021. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph19010496"},{"key":"ref_5","unstructured":"World Health Organization (WHO) (2020). Coronavirus Disease 2019 (COVID-19) Situation Report\u201436, WHO. Available online: https:\/\/www.who.int\/docs\/default-source\/coronaviruse\/situation-reports\/20200225-sitrep-36-covid-19.pdf."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"2000790","DOI":"10.2807\/1560-7917.ES.2020.25.49.2000790","article-title":"Epidemiological characteristics of COVID-19 cases and estimates of the reproductive numbers 1 month into the epidemic, Italy, 28 January to 31 March 2020","volume":"25","author":"Riccardo","year":"2020","journal-title":"Eurosurveillance"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Vella, R., Giuga, G., Piizzi, G., Alunni Fegatelli, D., Petroni, G., Tavone, A.M., Potenza, S., Cammarano, A., Mandarelli, G., and Marella, G.L. (2022). Health Management in Italian Prisons during COVID-19 Outbreak: A Focus on the Second and Third Wave. Healthcare, 10.","DOI":"10.3390\/healthcare10020282"},{"key":"ref_8","unstructured":"World Health Organization Regional Office for Europe (WHO\/Europe) (2013). Good Governance for Prison Health in the 21st Century: A Policy Brief on the Organization of Prison Health, WHO\/Europe. Available online: https:\/\/apps.who.int\/iris\/handle\/10665\/326388."},{"key":"ref_9","unstructured":"Ministero Della Giustizia (2022, November 16). Statistiche Detenuti Italiani e Stranieri Presenti e Capienze per Istituto Aggiornamento al 31 Gennaio 2020. [Italian and Foreignprisoners Present and Capacities by Institution\u2014Update of 31 January 2020. Ministero Della Giustizia: Rome, Italy, 2020. Italian]. Available online: https:\/\/www.giustizia.it\/giustizia\/it\/mg_1_14_1.page?contentId=SST245520&previsiousPage=mg_1_14."},{"key":"ref_10","unstructured":"(2022, November 16). Ministero Della Giustizia. Available online: https:\/\/www.giustizia.it\/giustizia\/it\/mg_2_27.page."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1093\/ageing\/afy186","article-title":"The prevalence of non-communicable disease in older people in prison: A systematic review and meta-analysis","volume":"48","author":"Munday","year":"2018","journal-title":"Age Ageing"},{"key":"ref_12","unstructured":"(2022, November 16). WHO SAGE Roadmap for Prioritizing Uses of COVID-19 Vaccines in the Context of Limited Supply: An Approach to Inform Planning and Subsequent Recommendations Based on Epidemiological Setting and Vaccine Supply Scenarios, First Issued 20 October 2020. Available online: https:\/\/apps.who.int\/iris\/handle\/10665\/342917."},{"key":"ref_13","unstructured":"(2022, November 16). ISS Vaccinazione Contro COVID-19 Nelle Comunit\u00e0 Residenziali in Italia: Priorit\u00e0 e Modalit\u00e0 di Implementazione ad Interim Versione dell\u20198 Luglio 2021. Available online: https:\/\/www.iss.it\/documents\/20126\/0\/Rapporto+ISS+COVID-19+16_2021.pdf\/b39f0142-41d6-7d4d-94e8-0668cfb95bf9?t=1625751318696."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"694795","DOI":"10.3389\/fpubh.2021.694795","article-title":"Efficacy of the Measures Adopted to Prevent COVID-19 Outbreaks in an Italian Correctional Facility for Inmates Affected by Chronic Diseases","volume":"9","author":"Stufano","year":"2021","journal-title":"Front. Public Health"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Voller, F., Silvestri, C., Martino, G., Fanti, E., Bazzerla, G., Ferrari, F., Grignani, M., Libianchi, S., Pagano, A.M., and Scarpa, F. (2016). Health conditions of inmates in Italy. BMC Public Health, 16.","DOI":"10.1186\/s12889-016-3830-2"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1093\/eurpub\/ckaa187","article-title":"Abundance of undiagnosed cardiometabolic risk within the population of a long-stay prison in the UK","volume":"31","author":"Gray","year":"2020","journal-title":"Eur. J. Public Health"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"899930","DOI":"10.3389\/fimmu.2022.899930","article-title":"High Number and Specific Comorbidities Could Impact the Immune Response in COVID-19 Patients","volume":"13","author":"Liu","year":"2022","journal-title":"Front. Immunol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"460","DOI":"10.4103\/jehp.jehp_1589_20","article-title":"Impact of comorbidities on mortality in hospitalized patients with COVID-19: An experience from Iran","volume":"10","author":"Toofan","year":"2021","journal-title":"J. Educ. Health Promot."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"736109","DOI":"10.3389\/fmed.2021.736109","article-title":"Not Only High Number and Specific Comorbidities but Also Age Are Closely Related to Progression and Poor Prognosis in Patients with COVID-19","volume":"8","author":"Liu","year":"2022","journal-title":"Front. Med."},{"key":"ref_20","first-page":"e340","article-title":"The aging process in prison: Pathologies and health conditions in old inmates. An epidemiological research in Italy","volume":"171","author":"Romano","year":"2020","journal-title":"Clin. Ter."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1089","DOI":"10.1016\/S0140-6736(16)30466-4","article-title":"Global burden of HIV, viral hepatitis, and tuberculosis in prisoners and detainees","volume":"388","author":"Dolan","year":"2016","journal-title":"Lancet"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1093\/epirev\/mxx018","article-title":"Understanding and Improving the Health of People Who Experience Incarceration: An Overview and Synthesis","volume":"40","author":"Kinner","year":"2018","journal-title":"Epidemiol. Rev."},{"key":"ref_23","unstructured":"European Centre for Disease Prevention and Control (ECDC) (2022, November 16). Guidance on Infection Prevention and Control of COVID-19 in Migrant and Refugee Reception and Detention Centres in the EU\/EEA and the UK. Available online: https:\/\/www.ecdc.europa.eu\/en\/publications-data\/covid-19-guidance-prevention-control-migrant-refugee-centres."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Wallace, D., Eason, J., Walker, J., Towers, S., Grubesic, T., and Nelson, J. (2021). Is There a Temporal Relationship between COVID-19 Infections among Prison Staff, Incarcerated Persons and the Larger Community in the United States?. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18136873"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1016\/j.fsisyn.2020.05.004","article-title":"Prisoners in a pandemic: We should think about detainees during COVID-19 outbreak","volume":"2","author":"Tozzo","year":"2020","journal-title":"Forensic Sci. Int. Synerg."},{"key":"ref_26","first-page":"1775","article-title":"Case-fatality rate and characteristics of patients dying in relation to COVID-19 in Italy","volume":"323","author":"Onder","year":"2020","journal-title":"JAMA"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1001\/jama.292.4.423","article-title":"Aging Prisoners Stressing Health Care System","volume":"292","author":"Mitka","year":"2004","journal-title":"JAMA"},{"key":"ref_28","unstructured":"Italian Health Ministry (2022, November 16). Relazione sullo Stato Sanitario del Paese 2012\u20132013, Available online: https:\/\/www.salute.gov.it\/imgs\/C_17_pubblicazioni_2258_allegato.pdf."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"e188","DOI":"10.1016\/S2468-2667(20)30058-X","article-title":"Prisons and custodial settings are part of a comprehensive response to COVID-19","volume":"5","author":"Kinner","year":"2020","journal-title":"Lancet Public Health"}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/20\/4\/3079\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:29:18Z","timestamp":1760120958000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/20\/4\/3079"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2,9]]},"references-count":29,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2023,2]]}},"alternative-id":["ijerph20043079"],"URL":"https:\/\/doi.org\/10.3390\/ijerph20043079","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,2,9]]}}}