Global Real World Evidence, Pfizer Inc, New York, NY, USA.
Global HEOR, Pfizer Inc, New York, NY, USA.
BMC Med. 2024 Feb 1;22(1):46. doi: 10.1186/s12916-023-03234-6.
Post-COVID conditions encompass a range of long-term symptoms after SARS-CoV-2 infection. The potential clinical and economic burden in the United States is unclear. We evaluated diagnoses, medications, healthcare use, and medical costs before and after acute COVID-19 illness in US patients at high risk of severe COVID-19.
Eligible adults were diagnosed with COVID-19 from April 1 to May 31, 2020, had ≥ 1 condition placing them at risk of severe COVID-19, and were enrolled in Optum's de-identified Clinformatics Data Mart Database for ≥ 12 months before and ≥ 13 months after COVID-19 diagnosis. Percentages of diagnoses, medications, resource use, and costs were calculated during baseline (12 months preceding diagnosis) and the post-acute phase (12 months after the 30-day acute phase of COVID-19). Data were stratified by age and COVID-19 severity.
The cohort included 19,558 patients (aged 18-64 y, n = 9381; aged ≥ 65 y, n = 10,177). Compared with baseline, patients during the post-acute phase had increased percentages of blood disorders (16.3%), nervous system disorders (11.1%), and mental and behavioral disorders (7.7%), along with increases in related prescriptions. Overall, there were substantial increases in inpatient and outpatient healthcare utilization, along with a 23.0% increase in medical costs. Changes were greatest among older patients and those admitted to the intensive care unit for acute COVID-19 but were also observed in younger patients and those who did not require COVID-19 hospitalization.
There is a significant clinical and economic burden of post-COVID conditions among US individuals at high risk for severe COVID-19.
新冠病毒感染后出现的一系列长期症状被称为新冠后症状。在美国，其潜在的临床和经济负担尚不清楚。我们评估了美国新冠高风险患者在急性新冠疾病后的临床诊断、药物使用、医疗保健使用和医疗费用变化。
符合条件的成年人在 2020 年 4 月 1 日至 5 月 31 日期间被诊断患有新冠，有≥1 种导致新冠重症的条件，在新冠诊断前≥12 个月和后≥13 个月期间参加了 Optum 的匿名 Clinformatics Data Mart 数据库。在基线（新冠诊断前 12 个月）和急性后阶段（新冠 30 天急性阶段后 12 个月）计算诊断、药物、资源使用和成本的百分比。根据年龄和新冠严重程度对数据进行分层。
队列包括 19558 名患者（年龄 18-64 岁，n=9381；年龄≥65 岁，n=10177）。与基线相比，急性后阶段的患者血液系统疾病（16.3%）、神经系统疾病（11.1%）和精神和行为障碍（7.7%）的比例增加，相关处方也增加。总体而言，住院和门诊医疗保健利用率大幅增加，医疗费用增加了 23.0%。这些变化在老年患者和因急性新冠入住重症监护病房的患者中最为明显，但在年轻患者和未住院的新冠患者中也观察到了这些变化。
对于新冠高风险的美国个人来说，新冠后症状存在重大的临床和经济负担。
