MMWR Morb Mortal Wkly Rep. 2021 Apr 30;70(17):644-650. doi: 10.15585/mmwr.mm7017e3.
As of April 19, 2021, 21.6 million COVID-19 cases had been reported among U.S. adults, most of whom had mild or moderate disease that did not require hospitalization (1). Health care needs in the months after COVID-19 diagnosis among nonhospitalized adults have not been well studied. To better understand longer-term health care utilization and clinical characteristics of nonhospitalized adults after COVID-19 diagnosis, CDC and Kaiser Permanente Georgia (KPGA) analyzed electronic health record (EHR) data from health care visits in the 28-180 days after a diagnosis of COVID-19 at an integrated health care system. Among 3,171 nonhospitalized adults who had COVID-19, 69% had one or more outpatient visits during the follow-up period of 28-180-days. Compared with patients without an outpatient visit, a higher percentage of those who did have an outpatient visit were aged ≥50 years, were women, were non-Hispanic Black, and had underlying health conditions. Among adults with outpatient visits, 68% had a visit for a new primary diagnosis, and 38% had a new specialist visit. Active COVID-19 diagnoses* (10%) and symptoms potentially related to COVID-19 (3%-7%) were among the top 20 new visit diagnoses; rates of visits for these diagnoses declined from 2-24 visits per 10,000 person-days 28-59 days after COVID-19 diagnosis to 1-4 visits per 10,000 person-days 120-180 days after diagnosis. The presence of diagnoses of COVID-19 and related symptoms in the 28-180 days following acute illness suggests that some nonhospitalized adults, including those with asymptomatic or mild acute illness, likely have continued health care needs months after diagnosis. Clinicians and health systems should be aware of post-COVID conditions among patients who are not initially hospitalized for acute COVID-19 disease.
截至 2021 年 4 月 19 日,美国成年人中报告了 2160 万例 COVID-19 病例,其中大多数人患有轻度或中度疾病,不需要住院治疗(1)。在 COVID-19 确诊后,非住院成年患者的医疗需求尚未得到充分研究。为了更好地了解 COVID-19 确诊后非住院成年患者的长期医疗保健利用情况和临床特征,CDC 和佐治亚州 Kaiser Permanente(KPGA)分析了一个综合医疗保健系统中 COVID-19 确诊后 28-180 天内门诊就诊的电子健康记录(EHR)数据。在 3171 名非住院的 COVID-19 患者中,69%在 28-180 天的随访期间有一次或多次门诊就诊。与没有门诊就诊的患者相比,有门诊就诊的患者中年龄≥50 岁、女性、非西班牙裔黑人以及有基础疾病的患者比例更高。在有门诊就诊的成年人中,68%是新的主要诊断就诊,38%是新的专科就诊。COVID-19 活跃诊断*(10%)和可能与 COVID-19 相关的症状(3%-7%)是前 20 种新就诊诊断之一;这些诊断的就诊率从 COVID-19 确诊后 2-24 天/每 10000 人-天降至确诊后 120-180 天的 1-4 天/每 10000 人-天。在急性疾病后 28-180 天内出现 COVID-19 和相关症状的诊断表明,一些非住院成年人,包括无症状或轻度急性疾病患者,在确诊后数月内可能仍有持续的医疗保健需求。临床医生和医疗系统应意识到,那些最初未因急性 COVID-19 疾病住院的患者可能患有 COVID-19 后疾病。