Paschke Lena Marie, Klimke Kerstin, Below Maike
Department of Prescription Data, Central Research Institute of Ambulatory Health Care, Berlin, Germany.
BMJ Med. 2025 Sep 4;4(1):e000992. doi: 10.1136/bmjmed-2024-000992. eCollection 2025.
To identify and quantify prescriptions after a covid-19 infection compared with other acute respiratory infections in previously healthy patients and those with chronic disease.
Comparative observational study based on German routine data.
Ambulatory care of all residents in Germany with statutory health insurance (88% of the German population).
Adults receiving a diagnosis of covid-19 or an acute respiratory infection between the fourth quarter of 2020 and the second quarter of 2021 who had rarely (70 797 and 173 822 with covid-19 and acute respiratory infection, respectively) or frequently (900 593 and 1 755 691, respectively) accessed outpatient medical care in the past.
Difference in differences in the proportion of prescriptions of relevant drugs before and one year after infection.
In patients who used the healthcare system less frequently before their covid-19 infection than afterwards, increases in prescription rates for antidiabetics (difference in differences 0.23%, P=0.007), antithrombotics (0.71%, P=0.02), and cardiovascular drugs like beta blockers (0.25%, P=0.03) were observed compared with patients with other acute respiratory infections. One year after infection, the difference in antidiabetic prescription rates was highest. Although a peak in antihypertensive prescription rates was observed six months after infection, antithrombotics were predominantly prescribed during the acute phase. Conversely, patients who had already used the healthcare system on a regular basis before their infection showed no significant long term increases in prescription rates across the drug groups analysed.
This study supports findings that diseases such as diabetes and cardiovascular disease are more prevalent after covid-19 than after other acute respiratory infections. Because the effect is apparent in real world data, future societal implications should be considered, including increased disease burden and growing demand for medical care owing to the increasing need for drugs.
在既往健康的患者以及患有慢性病的患者中，识别并量化新冠病毒感染后的处方情况，并与其他急性呼吸道感染后的处方情况进行比较。
基于德国常规数据的比较性观察研究。
德国所有参加法定医疗保险居民的门诊护理（占德国人口的88%）。
在2020年第四季度至2021年第二季度期间被诊断为新冠病毒感染或急性呼吸道感染的成年人，这些人过去很少（分别有70797例和173822例新冠病毒感染和急性呼吸道感染患者）或经常（分别有900593例和1755691例）就诊于门诊医疗服务。
感染前及感染后一年相关药物处方比例的差异。
在新冠病毒感染前比感染后就诊频率较低的患者中，与其他急性呼吸道感染患者相比，观察到抗糖尿病药物的处方率增加（差异为0.23%，P=0.007）、抗血栓药物（0.71%，P=0.02）以及β受体阻滞剂等心血管药物（0.25%，P=0.03）。感染后一年，抗糖尿病药物处方率的差异最大。尽管感染后六个月观察到抗高血压药物处方率出现峰值，但抗血栓药物主要在急性期开具。相反，在感染前就已定期就诊的患者中，在所分析的药物组中，处方率没有显著的长期增加。
本研究支持以下发现，即新冠病毒感染后糖尿病和心血管疾病等疾病比其他急性呼吸道感染后更为普遍。由于这种影响在真实世界数据中很明显，应考虑未来的社会影响，包括疾病负担增加以及由于对药物需求增加而导致的医疗需求增长。
