ArticleBMJ open respiratory research2025
One-year healthcare trajectories after COVID-19 hospitalisation in patients with chronic respiratory diseases: a nationwide study.
Article in BMJ open respiratory research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
rationaleCOVID-19 pandemic had a significant impact on patients with chronic respiratory diseases (CRD) and was associated with an increased risk of severe outcomes. However, long-term burden of COVID-19 and the dynamics on healthcare utilisation of patients with CRD remain largely unknown.
objectiveThe objective was to evaluate outcomes and healthcare utilisation trajectories 1 year after hospitalisation for COVID-19 in patients with CRD.
methodsData were extracted from the French National Health Database (SNDS). All adults with CRD who had a first hospitalisation for symptomatic COVID-19 and discharged alive between March 2020 and January 2021 were included. Postdischarge care trajectories, including any hospitalisations and ambulatory care recorded in the SNDS, over a 1-year period, were analysed using state sequence analysis. Healthcare utilisation patterns between the year prior to and the year following hospitalisation were then compared, and a multinomial logistic regression analysis was performed to identify baseline CRD category associated with trajectory clusters.
resultsAmong the 40 066 patients with CRD discharged alive, chronic obstructive pulmonary disease was the main CRD followed by asthma, sleep apnoea and interstitial lung disease. Overall, 6913 (17.3%) died at 1 year. Proportion of days alive spent at home without any care decreased from 91.1% to 64.4%. Five distinct clusters of healthcare trajectories were identified: 'home' (52%) with a slight increase in healthcare utilisation, 'home with care' (22%) with a high healthcare utilisation, 'extended hospitalisation' (9.4%) in long-term care or acute care, 'early death' (11%) and 'late death' (5.1%). Asthma was more often associated with the 'home' trajectory, while other CRD categories were more often associated with other clusters.
conclusionPatients with CRD hospitalised for COVID-19 had heterogeneous 1-year trajectories, characterised by increased healthcare utilisation and risk of death. Asthma was the only CRD category not associated with excess mortality or high healthcare consumption.
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