Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Via Mario Negri, 2, 20156, Milan, Italy.
Direzione Generale Welfare, Regione Lombardia, Milan, Italy.
Intern Emerg Med. 2023 Apr;18(3):801-809. doi: 10.1007/s11739-023-03228-5. Epub 2023 Mar 21.
With the goal to increase knowledge on the healthcare impact of the post-COVID-19 condition we exploited the administrative claims database of Lombardy, the largest Italian region and the first after China to be heavily hit by the SARS-CoV-2 pandemic in February-May 2020. We chose to employ the dispensation of drugs and diagnostic tests as proxies of the impact of the post-COVID condition in 46,574 cases who recovered from COVID-19 and were negative at PCR testing within June 20, 2020. Data were obtained throughout the 18-month post-negativization period until December 2021 and results on the use of drugs and diagnostic tests were compared with those accrued in the same cases during the pre-COVID period in July-December 2019. After an increase in the first semester after SARS-CoV-2 negativization (July-December 2020), trends in the dispensation of drugs according to the broad ATC classes and of diagnostic tests decreased or remained substantially stable. However, dispensation of drugs for acid related disorders (A02), diabetes (A10), heparins (B01AB), direct oral anticoagulants (B01AP), antipsychotics (N05A), antidepressants (N06A) and for obstructive airways diseases (R03) was still higher than in the pre-COVID period. These findings, based upon drug and diagnostic test dispensation as proxies of the healthcare impact of the post-COVID condition, show that in a substantial proportion of recovered cases the post-COVID condition is active and clinically relevant 18 months after the acute disease. The findings also provide indirect evidence of the body organs and systems more compromised in the post-COVID period.
为了增加对 post-COVID-19 疾病对医疗保健影响的了解，我们利用了伦巴第大区的行政索赔数据库，该数据库是意大利最大的地区，也是 2020 年 2 月至 5 月 SARS-CoV-2 大流行期间继中国之后受影响最严重的地区。我们选择使用药物和诊断测试的配药作为 post-COVID 状况影响的代理指标，在 46574 例从 COVID-19 中康复且在 2020 年 6 月 20 日 PCR 检测呈阴性的病例中进行研究。数据是在 post-negativization 后 18 个月内获得的，直至 2021 年 12 月，并将药物和诊断测试的使用结果与 2019 年 7 月至 12 月 COVID 前期间同一病例累积的数据进行比较。在 SARS-CoV-2 转阴后的第一个学期（2020 年 7 月至 12 月）后，药物配药的趋势根据广泛的 ATC 类别和诊断测试的趋势下降或基本保持稳定。然而，用于酸相关疾病（A02）、糖尿病（A10）、肝素（B01AB）、直接口服抗凝剂（B01AP）、抗精神病药（N05A）、抗抑郁药（N06A）和阻塞性气道疾病（R03）的药物配药仍然高于 COVID 前时期。这些发现基于药物和诊断测试的配药作为 post-COVID 状况对医疗保健影响的代理指标，表明在大量康复病例中，post-COVID 状况在急性疾病后 18 个月仍然活跃且具有临床相关性。这些发现还为 post-COVID 期间身体器官和系统受到更大影响提供了间接证据。
