Public Health Impact of COVID-19 in French Ambulatory Patients with at Least One Risk Factor for Severe Disease

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 1000 patients over the acute phase (first month of simulation), and 382 per 1000 patients over 2 years. The number of deaths was 37 per 1000 patients, and the number of long/prolonged COVID forms reached 407 per 1000 patients. These translated into a reduction of 0.7 days of life per patient in the first month, with an associated cost of €1578, and a reduction of 27 days of life over the time horizon, with an associated cost of €4280. 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.