Valutazione dei potenziali effetti del Long-CoViD attraverso l’utilizzo di risorse sanitarie

La conoscenza dell’impatto del Long-CoViD sul Servizio Sanitario Nazionale rimane limitata, nonostante il numero importante di persone che riferisce manifestazioni cliniche persistenti a seguito di infezione acuta da SARS-CoV-2. Questo studio mira a valutare l’utilizzo dell’assistenza sanitaria correlato al Long-CoViD.

È stato effettuato uno studio di coorte multicentrico retrospettivo in cui sono stati analizzati i ricoveri ospedalieri, l’utilizzo di visite ambulatoriali e test diagnostici in soggetti guariti dall’infezione da SARS-CoV-2 e soggetti non esposti, durante un periodo di osservazione di 6 mesi, tra febbraio 2020 e dicembre 2021. I dati sono stati ottenuti dai database amministrativi sanitari di tre regioni italiane.

I risultati hanno mostrato che i soggetti con precedente infezione da SARS-CoV-2 e, in particolare quelli con ricovo in ospedale o in terapia intensiva, hanno riportato un maggiore utilizzo delle visite ambulatoriali, di accertamenti diagnostici e ricoveri.

Questo studio ha dimostrato che l’infezione da SARS-CoV-2 era associata a un maggiore uso dell’assistenza sanitaria nei 6 mesi successivi all’infezione e l’associazione era principalmente determinata dalla gravità dell’infezione acuta.

Questi dati sono pubblicati in:

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". European Journal of Public Health, 2024;, ckae001

Abstract

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.

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.

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).

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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