Long-COVID in Italy: a country perspective

INTRODUCTION: In 2021 the Italian Ministry of Health, recognizing the need to improve knowledge and standardise the approach to Long-COVID nationwide, funded a project, led by the Italian National Institute of Health, with the following objectives: 1) to define the magnitude and impact of Long-COVID; 2) to identify and assess Long-COVID services nationwide; 3) to define Good Clinical Practices for the management of Long-COVID. METHODS: For objective 1, data of 3 Regions (Friuli Venezia Giulia, Tuscany and Apulia), covering a population of about 9 million people, were analysed, comparing service utilization in patients with previous COVID-19 over six months (from end of acute phase) and in controls matched for age, gender and comorbidities. For objective 2, a national survey was performed to map and characterize Long-COVID care services. For objective 3, an expert panel was appointed to produce good practice recommendations. RESULTS: In objective 1, COVID-19 was associated with higher rates of specialist visits (Incidence Rate Ratio, IRR: 1.88, 95% CI 1.65-2.13), hospitalizations (IRR 1.98, 95% CI 1.66-2.36), and instrumental diagnostic procedures (IRR 2.70, 95% CI 2.28-3.19) in the 6 months after acute infection. This association was stronger in individuals with infection causing hospital and/or ICU admission. For objective 2, 124 Long-COVID care centres were identified nationwide, with a high heterogeneity in services provision and organization. For objective 3, the panel issued National Good Practice Recommendations for Long-COVID, with 17 statements that provide key principles on services organization and patient management. CONCLUSIONS: Results of this project can be used nationally to put in place appropriate measures targeting Long-COVID. Additional ongoing activities include the implementation of a surveillance system for Long-COVID and the development of activities aimed at increasing awareness and knowledge of citizens and health professionals about Long-COVID.