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Post-recovery impact of the second and third SARS-CoV-2 infection waves on healthcare resource utilization in Lombardy, Italy

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Abstract

The administrative claims database of the Italian region Lombardy, the first in Europe to be hit by the SARS-CoV-2 pandemic, was employed to evaluate the impact on healthcare resource utilization following recovery from the second (mainly alpha-related variant) and third (delta-related) infection waves. 317,164 individuals recovered from the infection and became negative after the second wave, 271,180 after the third. Of them, 1571 (0.5%) and 1575 (0.6%) died in the first 6 post-negativization months. In the remaining cases (315,593 after the second wave and 269,605 after the third), hospitalizations, attendances to emergency rooms and outpatient visits were compared with those recorded in the same pre-pandemic time periods in 2019. Dispensation of drugs as well as of imaging, and functional and biochemical diagnostic tests were also compared as additional proxies of the healthcare impact of the SARS-CoV-2 infection waves. Following both waves, hospitalizations, attendances at emergency rooms, and outpatient visits were similar in number and rates to the pre-pandemic periods. However, there was an increased dispensation a number of drugs and diagnostic tests, particularly those addressing the cardiorespiratory and blood systems. In a large region such as Lombardy taken as a relevant model because early and severely hit by the SARS-CoV-2 pandemic, the post-COVID burden on healthcare facilities was mildly relevant in cases who recovered from the second and third infection waves regarding such pivotal events as deaths, hospitalizations, and need for emergency room and outpatient visits, but was high regarding the dispensation of some drug classes and types of diagnostic tests.

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Only upon permission by the Lombardy Region.

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Acknowledgements

The authors would like to thank Giuseppe Preziosi, Monica Arivetti, and Giovanna Rigotti from ARIA S.p.A, Alfredo Bevilacqua from Laife Reply S.p.A., Marco D. Forlani from T Bridge—BV Tech S.p.A, and Igor Monti from Istituto di Ricerche Farmacologiche Mario Negri IRCCS who kindly assisted us with data collection. The authors would also like to thank Regione Lombardia, under Grant/Award No. DGR n. 3375—July 14, 2020, and Health Ministry of the Lombardy, under Grant/Award No. EPIFARM-Pharmaco-epidemiology.

Funding

This work was supported by Regione Lombardia, under Grant/Award No. DGR n. 3375—July 14, 2020, and Health Ministry of the Lombardy, under Grant/Award No. EPIFARM-Pharmaco-epidemiology.

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Authors and Affiliations

  1. Department of Clinical Sciences and Community Health, Università di Milano, Milan, Italy

    Sergio Harari

  2. Division of Internal Medicine, Multimedica IRCSS, Milan, Italy

    Sergio Harari

  3. Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, via Pace 9, 20122, Milan, Italy

    Pier Mannuccio Mannucci

  4. Department of Health Policy, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy

    Alessandro Nobili, Alessia Antonella Galbussera, Giuseppe Remuzzi, Barbara D’Avanzo & Mauro Tettamanti

  5. General Welfare Directorate, Regione Lombardia, Milan, Italy

    Ida Fortino & Olivia Leoni

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  1. Sergio Harari
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Contributions

SH, PMM, AN, MT, GR, BDA, and AAG: study concept and design; IF and OL: acquisition of data; SH, PMM, AN, MT, BDA, and AAG: analysis and interpretation of data; SH, PMM, AN, BDA, and MT: drafting of the manuscript. All authors were involved in the critical revision of the manuscript for important intellectual content. All authors approved the final version of the manuscript.

Corresponding author

Correspondence to Pier Mannuccio Mannucci.

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None of the authors declares to have conflict of interest.

Human and animal rights

This study was conducted according to the principles expressed in the Declaration of Helsinki and its later amendments, and approved by local Institutional Review Board (0051814/19).

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Being a retrospective study performed on an administrative database of anonymized patients, patient informed consent was waived.

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Harari, S., Mannucci, P.M., Nobili, A. et al. Post-recovery impact of the second and third SARS-CoV-2 infection waves on healthcare resource utilization in Lombardy, Italy. Intern Emerg Med 18, 2011–2018 (2023). https://doi.org/10.1007/s11739-023-03396-4

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