Health Services Use After Covid-19 Infection in Persons With Non-communicable Diseases (preprint)

ABSTRACT

The COVID-19 pandemic has triggered several changes in health care service at all levels, the primary and specialized care services had to be restructured hampering longitudinal follow-up. Thus, this scenario led to impaired disease management of patients with non-communicable diseases (NCDs), worsening the clinical picture of their pre-existing disease. This study aimed to evaluate the use of health services after COVID-19 infection in persons with non-communicable diseases (NCDs). This is a cross-sectional study in the city of Rio Grande with individuals aged 18 or older, from the urban area of the city, who had a positive diagnosis of COVID-19 by reverse transcription followed by polymerase chain reaction (RT-PCR) from December 2020 to March 2021. Participants were asked if they attend any healthcare services after COVID-19 infection. Regarding exposure, participants were asked if they had a medical diagnosis of the following NCDs systemic arterial hypertension (SAH), diabetes mellitus (DM), respiratory diseases (RD) and heart diseases (HD). Descriptive analyzes were carried out and the Poisson regression was used to verify associations, with robust adjustment of variance. The likelihood of using healthcare services among participants with NCDs was up to four times when compared to individuals without it. Specifically, participants with NCDs were 67% (95% CI 1.33; 2.11) more likely to use urgent and emergency services. When analyzed by specific NCDs, only HD was associated with emergency room and emergency care unit use  (PR 2.14; CI95%1.30-3.54; PR1.70; CI95%1.31-2.20, respectively). An increased use of specialized services (i.e., cardiologist) is highlighted among individuals with at least one NCD (PR3.77; CI95%2.97-4.80), SAH (PR3.47; CI95%2.97-4.31) and DM (PR3.87; CI95%3.11-4.81). People with NCD required more healthcare services after COVID-19 infection, regardless of their disease when compared to those without it.