Résilience - COVID-19 - Résilience - Coronavirus disease 2019

Long-term consequences of COVID-19 in hospitalized patients: impact on healthcare consumption and associated risk factors – Long-COCO

Submission summary

A large part of the patients infected by the SARS-CoV-2 present persistent symptoms following the infection, sometimes several months after the initial symptoms onset. This is particularly the case for severe COVID-19 cases requiring hospitalization. Some studies show that around 75% of COVID-19 patients requiring a hospitalization report persistent symptoms up to 6 months following their discharge. The associated clinical picture is variable, including fatigue, dyspnea, chest pain, muscle fatigue, sleep disorders, anxiety or depressive disorders. This persistence of symptoms following the infection, known as “long COVID”, has become an increasingly subject of concern, with the World Health Organization, as well as the Haute Autorité de Santé, calling for research to better understand the causes and consequences of this condition. Indeed, these “long COVIDs" can imply a major economic and public health burden, and we need to study this phenomenon to get the full picture of the public health challenge imposed by the pandemic.

In this proposal, we want to use health insurance databases to describe the healthcare consumption of patients following a COVID-19 requiring hospitalization in France, identify individuals outside the normal healthcare consumption, and characterize them. We will use the Echantillon Généraliste des Bénéficiaires (EGB), which represents 1/97th of the population insured by the public health insurance system in France. This database includes sociodemographic data, the existence of long-lasting conditions, date of hospitalization (if any) and diagnosis associated, and the healthcare consumption among liberal physician, in hospitals and in pharmacies. We will identify hospitalized COVID-19 cases in this database (around 2,300 individuals) and match each of them with 4 controls sharing the same gender, birth year, insurance scheme, geographical area and with the same long-lasting conditions. We will use sequence analysis and unsupervised classification methods to assign each case to a subgroup corresponding to pattern of healthcare consumption in the 6 months following the hospital discharge. By describing the healthcare pathways in each subgroup and among the matched controls, we will be able to identify profiles with deviance from the usual healthcare consumption and quantify the overconsumption among a part of the cases, which we assume it will be due to persistent symptoms. Finally, we will perform the same analysis for each subsequence of the healthcare consumption one-by-one: the number of general practitioner visits, the number of visits to a medical specialist, the number of visits to a paramedical specialist, the number of hospitalization days and the prescription drugs consumption.

This study will constitute a first step in the evaluation of economic long-term consequences of COVID-19 infections in France. The results will allow to better take into account in public health measures se long COVID. More particularly, they could be used in effectiveness and cost-effectiveness modelling of SARS-CoV-2 prevention and treatments currently in clinical trials.

Project coordination

Sylvie Deuffic-Burban (Infection, anti-microbien, modélisation, évolution)

The author of this summary is the project coordinator, who is responsible for the content of this summary. The ANR declines any responsibility as for its contents.

Partner

Université de Lille
IAME Infection, anti-microbien, modélisation, évolution

Help of the ANR 65,100 euros
Beginning and duration of the scientific project: August 2021 - 12 Months

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