COVID-19对至少有一种严重疾病危险因素的法国门诊患者的公共卫生影响

A. Millier, R. Supiot, K. Benyounes, V. Machuron, K. Le lay, M. Sivignon, C. Leboucher, C. Blein, F. Raffi
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引用次数: 0

摘要

摘要背景量化新冠肺炎负担可能有助于支持未来的资源分配。目的评估新冠肺炎对至少有一种严重疾病危险因素的法国流动患者的公共卫生影响。研究设计马尔可夫模型用于估计2年内的寿命、费用、住院人数、死亡人数和长期/长期新冠肺炎形式。住院概率来自早期访问队列,住院时间特征来自法国国家出院数据库。进行了几次情景分析。结果在急性期(模拟的第一个月),住院人数达到每1000名患者256人,在2年内达到每1000人382人。死亡人数为每1000名患者37人,长期/长期新冠肺炎病例数达到每1000名病人407例。这意味着每个患者在第一个月的生命减少了0.7天,相关费用为1578欧元,在一段时间内减少了27天,相关成本为4280欧元。80岁以上的患者和未接种疫苗的患者的负担最高。情况不那么严重或有新治疗方法的情况显示,负担减轻了不可忽视。结论这项研究使我们能够量化感染者中与新冠肺炎相关的巨大负担,至少有一个严重形式的风险因素。法国迫切需要有能力大幅减少这一负担的策略。
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Public health impact of COVID-19 in French ambulatory patients with at least one risk factor for severe disease
ABSTRACT Background Quantification of COVID-19 burden may be useful to support the future allocation of resources. Objective To evaluate the public health impact of COVID-19 in French ambulatory patients with at least one risk factor for severe disease. Study design A Markov model was used to estimate life years, costs, number of hospitalisations, number of deaths and long/prolonged COVID forms over a time horizon of 2 years. The hospitalisation probabilities were derived from an early access cohort, and the hospitalisation stay characteristics were derived from the French national hospital discharge database. Several scenario analyses were conducted. Results The number of hospitalisations reached 256 per 1,000 patients over the acute phase (first month of simulation), and 382 per 1,000 patients over 2 years. The number of deaths was 37 per 1,000 patients, and the number of long/prolonged COVID forms reached 407 per 1,000 patients. These translated into a reduction of 0.7 days of life per patient in the first month, with an associated cost of €1,578, and a reduction of 27 days of life over the time horizon, with an associated cost of €4,280. The highest burden was observed for patients over 80 years old, and those not vaccinated. The scenarios with a less severe situation or new treatments available showed a non-negligible burden reduction. Conclusion This study allowed us to quantify the considerable burden related to COVID-19 in infected patients, with at least one risk factor for severe form. Strategies with the ability to substantially reduce this burden in France are urgently required.
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