Distinct phenotypes of patients and healthcare resource utilization after hospitalization for COVID-19: an observational study.

Publication date: Jan 27, 2025

Little is known about postdischarge healthcare resource use (HCU) among patients hospitalized for coronavirus disease 2019 (COVID-19). The objective was to identify distinct profiles of patients based on postdischarge cares. This was a retrospective cohort study using the French National Health System claims database. We followed up all patients hospitalized for COVID-19 between 2020/02/01 and 2020/06/30 for 6 months; the discharge date was the index date. We excluded patients who died during the index stay or within 30 days after discharge. We described patients’ HCU over 5 months from day 31 after the index date to the end of follow-up, i. e., the post-COVID-19 period. We described the sociodemographic and clinical characteristics of the participants and 44 selected types of HCU, including medical and emergency room visits, medications, medical and biological tests, oxygen therapy, rehabilitation, rehospitalization, nurse visits, and sick leave. We performed Ward’s ascendant hierarchical clustering (AHC) analysis to identify groups of patients with similar post-COVID-19 HCU and described HCU and clinical characteristics by cluster. The study population included 68,822 patients (median age: 64. 8 years, 47% women). Eight clusters of patients were identified, each comprising between 1,163 and 35,501 patients. Four clusters were characterized by older patients and high proportions of comorbidities, i. e. cancer (cluster 3), mental disorders (cluster 4), cardiac insufficiency (cluster 5) and respiratory failure (cluster 6). Cluster 8 was characterized by younger patients, often obese and with low mortality. Another cluster was characterized by complex index stays (cluster 7) and a last cluster (cluster 2) by specific medical contacts and therapy. The main cluster (cluster 1, n = 35,501) was similar to the overall study population. The duration and complexity of the index stay also varied across clusters. Based on HCU data, AHC identified 8 clinically relevant profiles of patients surviving the acute episode of COVID-19 hospitalization. The clusters illustrate the many impacts of COVID on the health status of infected patients and may help anticipate future needs of care in a similar context.

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Concepts Keywords
Coronavirus Adolescent
French Adult
Hospitalization Aged
Postdischarge Aged, 80 and over
Cluster analysis
COVID-19
Female
France
Health Resources
Healthcare resource use
Hospitalization
Humans
Male
Middle Aged
Patient Discharge
Retrospective Studies
SARS-C
SARS-CoV-2
Young Adult

Semantics

Type Source Name
disease MESH COVID-19
disease MESH emergency
drug DRUGBANK Oxygen
disease MESH cancer
disease MESH mental disorders
disease MESH respiratory failure
disease MESH health status
pathway REACTOME Reproduction
drug DRUGBANK Etodolac
disease MESH severe acute respiratory syndrome
disease MESH overweight
disease MESH hypertension
drug DRUGBANK L-Phenylalanine
disease IDO acute infection
disease MESH death
disease MESH access to care
disease MESH Comorbidity
drug DRUGBANK Pidolic Acid
drug DRUGBANK Huperzine B
disease MESH respiratory diseases
disease MESH obesity
disease MESH chronic diseases
disease MESH infection
disease MESH influenza
disease MESH viral infection
disease MESH abnormalities
disease MESH anxiety
disease MESH sequelae
disease MESH syndrome
disease IDO symptom
disease IDO pathogen
disease IDO replication
drug DRUGBANK Diethylstilbestrol
drug DRUGBANK Elvitegravir
drug DRUGBANK 2′-fluoro-5-ethylarabinosyluracil
disease MESH privacy
drug DRUGBANK L-Aspartic Acid
drug DRUGBANK Guanosine
drug DRUGBANK Cycloserine
disease MESH long COVID
disease MESH pneumonia
drug DRUGBANK Coenzyme M
disease MESH Respiratory Infections
disease MESH Critical Illness

Original Article

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