Risk factors, health outcomes, healthcare services utilization, and direct medical costs of patients with long COVID. (March 2023)

• Record Type: Journal Article
• Authors: Tene, Lilac; Bergroth, Tobias; Eisenberg, Anna; David, Shirley Shapiro Ben; Chodick, Gabriel
• Is Part Of: International journal of infectious diseases. Volume 128(2023)
• Page Start: 3
• Page End: 10
• Publication Date: 2023-03
• Subjects: Long COVID -- SARS-CoV-2 -- Healthcare services use -- Direct medical costs; Communicable diseases -- Periodicals; Communicable Diseases -- Periodicals; Communicable diseases; Periodicals; Electronic journals; 616.9
• DOI: 10.1016/j.ijid.2022.12.002
• Languages: English
• ISSNs: 1201-9712

Abstract

Highlights: We identified long COVID complications and related costs among 180, 759 patients. Long COVID incidence (7.8%) is associated with age, smoking, and acute phase symptoms. Long COVID patients had a substantial long-term increase in healthcare costs. Abstract: Objectives: Data on the economic burden of long COVID are scarce. We aimed to examine the prevalence and medical costs of treating long COVID. Methods: We conducted this historical cohort study using data from patients with COVID-19 among members of a large health provider in Israel. Cases were defined according to physician diagnosis (definite long COVID) or suggestive symptoms given ≥ 4 weeks from infection (probable cases). Healthcare resource utilization and direct healthcare costs (HCCs) in the period before infection and afterward were compared across study groups. Results: Between March 2020, and March 2021, a total of 180, 759 COVID-19 patients (mean [SD] age = 32.9 years [19.0 years]; 89, 665 [49.6%] females) were identified. Overall, 14, 088 (7.8%) individuals developed long COVID (mean [SD] age = 40.0 years [19.0 years]; 52.4% females). Among them, 1477(10.5%) were definite long COVID and 12, 611(89.5%) were defined as probable long COVID. Long COVID was associated with age (adjusted odds ratio [AOR] = 1.058 per year, 95% CI: 1.053-1.063), female sex (AOR = 1.138; 95% CI: 1.098-1.180), smoking (AOR = 1.532; 95% CI: 1.358-1.727), and symptomatic acute phase (AOR = 1.178; 95% CI: 1.133-1.224), primarily muscle pain and cough. Hypertension was an important risk factor for long COVID among younger adults. Compared with patients with non-long COVID, definite and probable cases were associated with AORs of 2.47 (2.22-2.75) and 1.76 (1.68-1.84) for post-COVID hospitalization, respectively. Although among patients with non-long COVID HCCs decreased from $1400 during 4 months before the infection to $1021 and among patients with long COVID, HCCs increased from $2435 to $2810. Conclusion: Long COVID is associated with a substantial increase in the utilization of healthcare services and direct medical costs. Our findings underline the need for timely planning and allocating resources for patient-centered care for patients with long COVID as well as for its secondary prevention in high-risk patients.