Evolution of patients with chronic diseases who did not contract COVID-19 during the first year of the pandemic; new comorbidities, mortality, drug use and use of health and social services: retrospective study and comparison by sex

Abstract Background: The restrictions introduced to stop the spread of the COVID-19 virus have also had a direct impact on people with chronic diseases and especially on diseases to which lifestyles are relevant in their control and management, such as diabetes, hypertension, chronic obstructive pulmonary disease (COPD), etc. The lockdown measures implemented hindered patients’ ability to lead a healthy lifestyle (balanced diet, physical activity, etc.), which plays a crucial role in the proper management and control of chronic diseases. Method: An observational real world data pre-post study of 668,974 people was undertaken. The patients studied were over 16 years of age, had been receiving care from the Aragon Health Service (Northeastern Spain), been diagnosed with one or more chronic diseases and had not contracted COVID-19. Sociodemographic, comorbidity, pharmacological and health resource use variables were collected during the six months prior to the onset of the lockdown and during the six and 12 months following the end of the lockdown. The comparisons by sex were carried out using a Student T-test or chi squared test to analyse differences. Results: Dyslipidaemia (42.1%) followed by hypertension (35.1%) and anxiety and depression (34.6%) were the most prevalent chronic diseases among the study popualtion. 79.2% patients had between zero and four illness comorbidities. There was a decrease in new diagnoses of other chronic comorbidities in this population as well as a decrease in drugs prescribed and the use of health services. Although women received a higher number of diagnoses of chronic diseases, the number of drugs dispensed was lower, but the use of health services was higher. These figures were maintained throughout the pandemic. Conclusion: Our results suggest that there was a decrease in new diagnoses of comorbidities and in the mortality rate from causes unrelated to COVID-19 due to the closure of health centres during the pandemic. This trend was exacerbated in women.