Non-Hospitalized COVID-19 Patients Have Low-Risk of Serious Long-Term Effects, But More Visits to General Practitioner

A recent study found that the risk of severe post-acute complications after SARS-CoV-2 infection that did not require hospital admission is low. However, increases in visits to general practitioners and outpatient hospital visits could indicate COVID-19, according to the authors of the study, published in The Lancet Infectious Diseases.

The study authors sought to examine prescription drug and health care use after SARS-CoV-2 infection not requiring hospital admission.

This was a population-based cohort study using the Danish prescription, patient, and health insurance registries. All individuals with a positive or negative RT-PCR test for SARS-CoV-2 in Denmark between February 27, 2020, and May 31, 2020, were eligible for inclusion. Outcomes of interest were delayed acute complications, chronic disease, hospital visits due to persisting symptoms, and prescription drug use.

Data were taken from non-hospitalized SARS-CoV-2-positive and matched SARS-CoV-2-negative individuals from 2 weeks to 6 months after a SARS-CoV-2 test to obtain propensity score-weighted risk differences and risk ratios for initiation of 14 drug groups and 27 hospital diagnoses indicative of potential post-acute effects. Additionally, the study authors calculated prior event rate ratio-adjusted rate ratios of overall health care use.

The findings showed 10,498 eligible individuals tested positive for SARS-CoV-2 in Denmark from February 27, 2020, to May 31, 2020, of whom 8983 were alive and not admitted to the hospital 2 weeks after their positive test. The matched SARS-CoV-2 negative reference population not admitted to the hospital consisted of 80,894 individuals.

Compared with SARS-CoV-2-negative individuals, SARS-CoV-2-positive individuals were not at an increased risk of initiating new drugs, except bronchodilating agents, specifically short-acting β2-agonists and triptans.

There was an increased risk of receiving hospital diagnoses of dyspnoea and venous thromboembolism for SARS-CoV-2-positive individuals compared with negative individuals, but no increased risk of other diagnoses. Prior event rate ratio-adjusted rate ratios of overall general practitioner visits and outpatient hospital visits, but not hospital admission, showed increases among SARS-CoV-2-positive individuals compared with SARS-CoV-2-negative individuals, according to the study authors.

REFERENCE

Lund LC, Hallas J, Nielsen H, et al. Post-acute effects of SARS-CoV-2 infection in individuals not requiring hospital admission: a Danish population-based cohort study. The Lancet Infectious Diseases. 2021. Doi: https://doi.org/10.1016/S1473-3099(21)00211-5