Table_3_The incidence and risk factors of selected drug prescriptions and outpatient care after SARS-CoV-2 infection in low-risk subjects: a multicenter population-based cohort study.docx

BackgroundKnowledge about the dynamics of transmission of SARS-CoV-2 and the clinical aspects of COVID-19 has steadily increased over time, although evidence of the determinants of disease severity and duration is still limited and mainly focused on older adult and fragile populations.
MethodsThe present study was conceived and carried out in the Emilia-Romagna (E-R) and Veneto Regions, Italy, within the context of the EU’s Horizon 2020 research project called ORCHESTRA (Connecting European Cohorts to increase common and effective response to SARS-CoV-2 pandemic) (www.orchestra-cohort.eu). The study has a multicenter retrospective population-based cohort design and aimed to investigate the incidence and risk factors of access to specific healthcare services (outpatient visits and diagnostics, drug prescriptions) during the post-acute phase from day-31 to day-365 after SARS-CoV-2 infection, in a healthy population at low risk of severe acute COVID-19. The study made use of previously recorded large-scale healthcare data available in the administrative databases of the two Italian Regions. The statistical analysis made use of methods for competing risks. Risk factors were assessed separately in the two Regions and results were pooled using random effects meta-analysis.
ResultsThere were 35,128 subjects in E-R and 88,881 in Veneto who were included in the data analysis. The outcome (access to selected health services) occurred in a high percentage of subjects in the post-acute phase (25% in E-R and 21% in Veneto). Outpatient care was observed more frequently than drug prescriptions (18% vs. 12% in E-R and 15% vs. 10% in Veneto). Risk factors associated with the outcome were female sex, age greater than 40 years, baseline risk of hospitalization and death, moderate to severe acute COVID-19, and acute extrapulmonary complications.
ConclusionThe outcome of interest may be considered as a proxy for long-term effects of COVID-19 needing clinical attention. Our data suggest that this outcome occurs in a substantial percentage of cases, even among a previously healthy population with low or mild severity of acute COVID-19. The study results provide useful insights into planning COVID-19-related services.

背景：尽管目前关于新冠病毒（SARS-CoV-2）传播动力学及新冠肺炎（COVID-19）临床特征的相关研究证据随时间推移持续丰富，但有关疾病严重程度与病程决定因素的证据仍较为有限，且主要集中于老年及体弱人群。
方法：本研究于意大利艾米利亚-罗马涅（Emilia-Romagna，下称E-R）及威尼托（Veneto）地区开展，依托欧盟地平线2020（Horizon 2020）研究项目ORCHESTRA（Connecting European Cohorts to increase common and effective response to SARS-CoV-2 pandemic，官网：www.orchestra-cohort.eu）完成。本研究采用多中心基于人群的回顾性队列研究设计，旨在探究新冠病毒感染后31天至365天的急性感染后阶段，低重症新冠肺炎风险的健康人群使用特定医疗服务（门诊就诊与诊断、药物处方）的发生率及相关危险因素。本研究使用了两个意大利地区行政数据库中已存档的大规模医疗健康数据。统计分析采用竞争风险模型方法，分别对两个地区的危险因素进行评估，并通过随机效应meta分析合并研究结果。
结果：本次数据分析共纳入E-R地区35128名受试者、威尼托地区88881名受试者。急性感染后阶段，有较高比例的受试者出现了目标结局（使用选定医疗服务）：E-R地区为25%，威尼托地区为21%。门诊护理的使用率高于药物处方：E-R地区分别为18%与12%，威尼托地区分别为15%与10%。与该结局相关的危险因素包括女性性别、年龄超过40岁、基线住院与死亡风险、中重度急性新冠肺炎以及急性肺外并发症。
结论：本研究关注的结局可作为需要临床干预的新冠肺炎长期后遗症的替代指标。研究数据显示，即便在既往健康、急性新冠肺炎严重程度为轻度或低风险的人群中，该结局的发生比例仍较高。本研究结果可为新冠肺炎相关医疗服务的规划提供有价值的参考依据。