COVID-19 hospitalization survivors showed delayed but more focused post-discharge specialist and diagnostic care than other respiratory-infection survivors.
Evidence
A population-based administrative cohort study followed Lombardy patients aged 40 or older for 12 months after 2021 hospitalization for COVID-19 or other acute respiratory infections, with regression adjustment for age, sex, and comorbidity.
Caveat
The COVID-19 group was younger, less comorbid, and had much lower post-discharge mortality than the other-ARI group, so residual confounding and survivor bias may affect the comparisons.
Simplified
INTRODUCTION: , often referred to as "long COVID," have raised concerns about increased healthcare utilization following hospitalization. Whether these patterns differ significantly from those observed after other acute respiratory infections (ARIs) remains unclear. This study aimed to compare post-discharge healthcare use between patients hospitalized for COVID-19 and those with other ARIs in Lombardy, Italy.
METHODS: We conducted a population-based cohort study using 2021 administrative healthcare data from the Lombardy Region. Patients aged ≥ 40 years hospitalized for COVID-19 or other ARIs were followed for 12 months post-discharge. We evaluated specialist consultations, rehospitalizations, diagnostic testing, and new chronic drug treatment initiations. Logistic regression models adjusted for age, sex, and comorbidities (Drug-Derived Complexity Index) were used to assess differences.
RESULTS: Among 57,795 patients, 35,458 were hospitalized for COVID-19 and 21,375 for other ARIs. Patients with COVID-19 were younger and had lower comorbidity burden and post-discharge mortality (10.7% vs. 33.5%). A higher proportion received at least one specialist visit (75.8% vs. 70.3%), though with a longer median time to first visit (63 vs. 45 days, p < 0.0001). Patients with COVID-19 had more frequent imaging and spirometry but initiated fewer chronic drug treatments overall. However, a higher prescription rate for antidiabetics (OR 1.42), psychoanaleptic (OR 1.21), and genitourinary/hormonal drugs (OR 1.29) emerged after COVID-19 hospitalizations: this rate remained statistically higher for antidiabetics even after excluding subjects who died in the year following discharge. Hospitalizations for causes other than COVID-19 were more frequent in patients with ARI.
CONCLUSIONS: Compared to other ARIs, COVID-19 survivors exhibited distinct post-discharge healthcare patterns, with delayed but focused specialist care and selective increases in diagnostic and pharmacological interventions.
Key numbers
10.7%
12-month Mortality Rate
Mortality rate for COVID-19 patients vs. 33.5% for other ARIs.
75.8%
Specialist Visit Rate
COVID-19 patients vs. 70.3% for other ARIs.
63 days
Median Time to First Specialist Visit
Compared to 45 days for other ARIs.
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Long Covid