Burdens of post-acute sequelae of COVID-19 by severity of acute infection, demographics and health status

Nat Commun. 2021 Nov 12;12(1):6571. doi: 10.1038/s41467-021-26513-3.


The Post-Acute Sequelae of SARS-CoV-2 infection (PASC) have been characterized; however, the burden of PASC remains unknown. Here we used the healthcare databases of the US Department of Veterans Affairs to build a cohort of 181,384 people with COVID-19 and 4,397,509 non-infected controls and estimated that burden of PASC-defined as the presence of at least one sequela in excess of non-infected controls-was 73.43 (72.10, 74.72) per 1000 persons at 6 months. Burdens of individual sequelae varied by demographic groups (age, race, and sex) but were consistently higher in people with poorer baseline health and in those with more severe acute infection. In sum, the burden of PASC is substantial; PASC is non-monolithic with sequelae that are differentially expressed in various population groups. Collectively, our results may be useful in informing health systems capacity planning and care strategies of people with PASC.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Aged
  • COVID-19 / complications*
  • COVID-19 / etiology
  • COVID-19 / immunology
  • COVID-19 / pathology
  • COVID-19 / virology
  • Cohort Studies
  • Databases, Factual
  • Disease Progression
  • Female
  • Health Status
  • Humans
  • Infections / virology*
  • Male
  • Middle Aged
  • Post-Acute COVID-19 Syndrome
  • SARS-CoV-2 / isolation & purification
  • SARS-CoV-2 / pathogenicity*
  • Severity of Illness Index
  • United States
  • Veterans Health Services