Harari Sergio, Mannucci Pier Mannuccio, Nobili Alessandro, Galbussera Alessia Antonella, Fortino Ida, Leoni Olivia, Remuzzi Giuseppe, D'Avanzo Barbara, Tettamanti Mauro
Department of Clinical Sciences and Community Health, Università di Milano, Milan, Italy.
Division of Internal Medicine, Multimedica IRCSS, Milan, Italy.
Intern Emerg Med. 2023 Oct;18(7):2011-2018. doi: 10.1007/s11739-023-03396-4. Epub 2023 Aug 31.
The administrative claims database of the Italian region Lombardy, the first in Europe to be hit by the SARS-CoV-2 pandemic, was employed to evaluate the impact on healthcare resource utilization following recovery from the second (mainly alpha-related variant) and third (delta-related) infection waves. 317,164 individuals recovered from the infection and became negative after the second wave, 271,180 after the third. Of them, 1571 (0.5%) and 1575 (0.6%) died in the first 6 post-negativization months. In the remaining cases (315,593 after the second wave and 269,605 after the third), hospitalizations, attendances to emergency rooms and outpatient visits were compared with those recorded in the same pre-pandemic time periods in 2019. Dispensation of drugs as well as of imaging, and functional and biochemical diagnostic tests were also compared as additional proxies of the healthcare impact of the SARS-CoV-2 infection waves. Following both waves, hospitalizations, attendances at emergency rooms, and outpatient visits were similar in number and rates to the pre-pandemic periods. However, there was an increased dispensation a number of drugs and diagnostic tests, particularly those addressing the cardiorespiratory and blood systems. In a large region such as Lombardy taken as a relevant model because early and severely hit by the SARS-CoV-2 pandemic, the post-COVID burden on healthcare facilities was mildly relevant in cases who recovered from the second and third infection waves regarding such pivotal events as deaths, hospitalizations, and need for emergency room and outpatient visits, but was high regarding the dispensation of some drug classes and types of diagnostic tests.
意大利伦巴第大区的行政索赔数据库是欧洲首个受到SARS-CoV-2疫情冲击的数据库，用于评估在第二波（主要与阿尔法相关变体）和第三波（与德尔塔相关）感染浪潮康复后对医疗资源利用的影响。317164人在第二波感染后康复并转阴，271180人在第三波感染后康复并转阴。其中，1571人（0.5%）和1575人（0.6%）在转阴后的前6个月死亡。在其余病例中（第二波后315593例，第三波后269605例），将住院、急诊就诊和门诊就诊情况与2019年疫情前同期记录的情况进行了比较。还比较了药物以及影像、功能和生化诊断测试的配给情况，作为SARS-CoV-2感染浪潮对医疗影响的额外代理指标。在两波疫情之后，住院、急诊就诊和门诊就诊的数量和发生率与疫情前时期相似。然而，一些药物和诊断测试的配给量有所增加，特别是那些针对心肺和血液系统的药物和测试。在伦巴第这样一个大区域，由于早期受到SARS-CoV-2疫情的严重冲击而被视为一个相关模型，对于从第二波和第三波感染浪潮中康复的病例，在死亡、住院以及急诊和门诊就诊需求等关键事件方面，新冠后对医疗设施的负担轻微，但在一些药物类别和诊断测试类型的配给方面负担较重。
