Observational studyBMJ open2026
Unveiling the burden of long covid in hospital and community settings: findings from the Post-Acute Sequelae of SARS-CoV-2 Network (PASCNET) cohort study in Italy's pandemic epicentre.
Observational study in BMJ open, 2026. 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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15 authors.
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Abstract
objectivesPost-COVID-19 condition (PCC) has emerged as a major public health concern. We aimed to estimate the 1-year incidence of PCC in adults with confirmed SARS-CoV-2 infection in Lombardy, Italy, comparing community-managed and hospitalised patients and to assess the prognostic value of the National Institutes of Health (NIH) Researching COVID to Enhance Recovery (RECOVER) score to support estimation of long-term PCC prevalence.
designRetrospective-prospective observational cohort study enrolling patients infected between 1 March 2020 and 31 December 2022. The study visit was conducted between 16 January and 23 December 2024.
settingMulticentre study involving seven public hospitals and general practitioners across Lombardy.
participantsRandomly sampled adults aged 18-70 years with confirmed SARS-CoV-2 infection. Hospitalised patients (HP) were admitted for COVID-19; general practitioner patients (GPP) were managed in the community. The total sample comprised: 1162 (546 HP, 616 GPP).
interventionThis is an observational study with no active intervention. PRIMARY AND SECONDARY OUTCOME MEASURES: Primary outcome: 1-year incidence of PCC retrospectively assessed at the study visit. SECONDARY OUTCOMES: symptom profiles, long-term PCC prevalence at the study visit and predictive value of the NIH RECOVER score.
resultsMedian age was 57.1 years in HP and 42.9 years in GPP; 66.1% of HP and 47.7% of GPP were male. PCC developed in 280 patients (223 HP, 57 GPP). The 1-year cumulative incidence was 39.9% in HP (95% CI 35.9% to 44.1%) and 9.1% in GPP (95% CI 7.1% to 11.7%). The NIH RECOVER score was associated with PCC at 1 year (OR 1.18, 95% CI 1.14 to 1.21). Model-based long-term PCC prevalence was 31.8% in HP and 6.3% in GPP.
conclusionsPCC remained frequent and heterogeneous, particularly among previously HP. In this cohort, the NIH RECOVER score showed prognostic value for estimating longer-term PCC burden. These findings underscore the need for structured long-term follow-up across both hospital and primary care settings.
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