Substantial health and economic burden of COVID-19 during the year after acute illness among US adults at high risk of severe COVID-19

BMC Med. 2024 Feb 1;22(1):46. doi: 10.1186/s12916-023-03234-6.

Abstract

Background: Post-COVID conditions encompass a range of long-term symptoms after SARS-CoV-2 infection. The potential clinical and economic burden in the United States is unclear. We evaluated diagnoses, medications, healthcare use, and medical costs before and after acute COVID-19 illness in US patients at high risk of severe COVID-19.

Methods: Eligible adults were diagnosed with COVID-19 from April 1 to May 31, 2020, had ≥ 1 condition placing them at risk of severe COVID-19, and were enrolled in Optum's de-identified Clinformatics® Data Mart Database for ≥ 12 months before and ≥ 13 months after COVID-19 diagnosis. Percentages of diagnoses, medications, resource use, and costs were calculated during baseline (12 months preceding diagnosis) and the post-acute phase (12 months after the 30-day acute phase of COVID-19). Data were stratified by age and COVID-19 severity.

Results: The cohort included 19,558 patients (aged 18-64 y, n = 9381; aged ≥ 65 y, n = 10,177). Compared with baseline, patients during the post-acute phase had increased percentages of blood disorders (16.3%), nervous system disorders (11.1%), and mental and behavioral disorders (7.7%), along with increases in related prescriptions. Overall, there were substantial increases in inpatient and outpatient healthcare utilization, along with a 23.0% increase in medical costs. Changes were greatest among older patients and those admitted to the intensive care unit for acute COVID-19 but were also observed in younger patients and those who did not require COVID-19 hospitalization.

Conclusions: There is a significant clinical and economic burden of post-COVID conditions among US individuals at high risk for severe COVID-19.

Keywords: COVID-19; Long COVID; PASC; Post-COVID conditions; SARS-CoV-2.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease
  • Adult
  • COVID-19 Testing
  • COVID-19* / epidemiology
  • Financial Stress
  • Humans
  • Post-Acute COVID-19 Syndrome
  • Retrospective Studies
  • SARS-CoV-2
  • United States / epidemiology