The role of hospitals in monitoring the emergency: the experience of "Sentinel network" of the Italian Federation of Health Trusts.

The COVID-19 pandemic showed few weak points in health-system resilience and highlighted the need to strengthen surveillance capacities. In Italy, the Federation of Health Trusts (FIASO) established the Sentinel Hospital Network (SHNet) to monitor COVID-19 hospitalizations and support operational decision-making. A multicentre ecological study was conducted across 21 hospitals (November 2021-March 2023), collecting weekly data on admissions, vaccination status, and classification of cases as for or with COVID-19. Trends were compared with national surveillance from the Istituto Superiore di Sanità (ISS). SHNet recorded 48,117 admissions in 2022. Basically vaccination reduced the severe disease, with an 87% decrease in ICU admissions for COVID-19. Hospitalizations with COVID-19 showed limited variation. Strong correlation with ISS trends confirmed SHNet reliability. SHNet provided timely, clinically detailed data complementing national surveillance and improved understanding of hospital burden. Sentinel surveillance represents a preacious tool for preparedness, enabling rapid response, resource optimization, and resilience in future health emergencies.