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Castriotta L, Onder G, Rosolen V, Beorchia Y, Fanizza C, Bellini B, Floridia M, Giuliano M, Silenzi A, Pricci F, Grisetti T, Grassi T, Tiple D, Villa M, Profili F, Francesconi P, Barbone F, Bisceglia L, Brusaferro S. Examining potential Long COVID effects through utilization of healthcare resources: a retrospective, population-based, matched cohort study comparing individuals with and without prior SARS-CoV-2 infection. Eur J Public Health 2024:ckae001. [PMID: 38243748 DOI: 10.1093/eurpub/ckae001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2024] Open
Abstract
BACKGROUND A significant proportion of individuals reports persistent clinical manifestations following SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) acute infection. Nevertheless, knowledge of the burden of this condition-often referred to as 'Long COVID'-on the health care system remains limited. This study aimed to evaluate healthcare utilization potentially related to Long COVID. METHODS Population-based, retrospective, multi-center cohort study that analyzed hospital admissions and utilization of outpatient visits and diagnostic tests between adults aged 40 years and older recovered from SARS-CoV-2 infection occurred between February 2020 and December 2021 and matched unexposed individuals during a 6-month observation period. Healthcare utilization was analyzed by considering the setting of care for acute SARS-CoV-2 infection [non-hospitalized, hospitalized and intensive care unit (ICU)-admitted] as a proxy for the severity of acute infection and epidemic phases characterized by different SARS-CoV-2 variants. Data were retrieved from regional health administrative databases of three Italian Regions. RESULTS The final cohort consisted of 307 994 previously SARS-CoV-2 infected matched with 307 994 uninfected individuals. Among exposed individuals, 92.2% were not hospitalized during the acute infection, 7.3% were hospitalized in a non-ICU ward and 0.5% were admitted to ICU. Individuals previously infected with SARS-CoV-2 (vs. unexposed), especially those hospitalized or admitted to ICU, reported higher utilization of outpatient visits (range of pooled Incidence Rate Ratios across phases; non-hospitalized: 1.11-1.33, hospitalized: 1.93-2.19, ICU-admitted: 3.01-3.40), diagnostic tests (non-hospitalized: 1.35-1.84, hospitalized: 2.86-3.43, ICU-admitted: 4.72-7.03) and hospitalizations (non-hospitalized: 1.00-1.52, hospitalized: 1.87-2.36, ICU-admitted: 4.69-5.38). CONCLUSIONS This study found that SARS-CoV-2 infection was associated with increased use of health care in the 6 months following infection, and association was mainly driven by acute infection severity.
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Affiliation(s)
- Luigi Castriotta
- Institute of Hygiene and Evaluative Epidemiology, Friuli Centrale University Health Authority, Udine, Italy
- Central Directorate for Health, Social Policies and Disability, Friuli Venezia Giulia Region, Trieste, Italy
| | - Graziano Onder
- Istituto Superiore di Sanità-Italian National Institute of Health, Rome, Italy
- Fondazione Policlinico Gemelli IRCCS, Rome, Italy
- Università Cattolica del Sacro Cuore, Rome, Italy
| | - Valentina Rosolen
- Central Directorate for Health, Social Policies and Disability, Friuli Venezia Giulia Region, Trieste, Italy
| | - Yvonne Beorchia
- Institute of Hygiene and Evaluative Epidemiology, Friuli Centrale University Health Authority, Udine, Italy
| | - Caterina Fanizza
- Agenzia Regionale Strategica per la Salute e il Sociale, Regione Puglia, Bari, Italy
| | - Benedetta Bellini
- Agenzia Regionale di Sanità, Regione Toscana, Firenze, Italy
- Agenzia Italiana del Farmaco-Italian Medicines Agency, Rome, Italy
| | - Marco Floridia
- Istituto Superiore di Sanità-Italian National Institute of Health, Rome, Italy
| | - Marina Giuliano
- Istituto Superiore di Sanità-Italian National Institute of Health, Rome, Italy
| | | | - Flavia Pricci
- Istituto Superiore di Sanità-Italian National Institute of Health, Rome, Italy
| | - Tiziana Grisetti
- Istituto Superiore di Sanità-Italian National Institute of Health, Rome, Italy
| | - Tiziana Grassi
- Istituto Superiore di Sanità-Italian National Institute of Health, Rome, Italy
| | - Dorina Tiple
- Istituto Superiore di Sanità-Italian National Institute of Health, Rome, Italy
| | - Marika Villa
- Istituto Superiore di Sanità-Italian National Institute of Health, Rome, Italy
| | | | | | - Fabio Barbone
- Central Directorate for Health, Social Policies and Disability, Friuli Venezia Giulia Region, Trieste, Italy
- Dipartimento Universitario Clinico di Scienze Mediche Chirurgiche e della Salute, Università degli Studi di Trieste, Trieste, Italy
| | - Lucia Bisceglia
- Agenzia Regionale Strategica per la Salute e il Sociale, Regione Puglia, Bari, Italy
| | - Silvio Brusaferro
- Istituto Superiore di Sanità-Italian National Institute of Health, Rome, Italy
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