![]() ![]() We conducted a descriptive, retrospective analysis of morbidity, healthcare resource utilization, and costs associated with the post-acute phase of COVID-19 among adult patients aged < 65 years and without any underlying conditions placing them at high risk of progression to severe disease. An understanding of long-term health effects after acute COVID-19 infection, the populations at risk, and the associated strain on healthcare systems is imperative to inform accurate estimations of the evolving clinical and economic burden of COVID-19. In the current landscape where mild COVID-19 illness is becoming more common, owing both to vaccination and the highly transmissible but potentially less virulent Omicron strain, it is necessary to understand the burden on health and healthcare systems after an acute COVID-19 infection among patients who do not have underlying comorbidities and who did not require hospitalization for acute COVID-19. However, numerous reports from several countries have identified high rates of post-COVID conditions, even among patient cohorts with mixed disease severity or mild cases of COVID-19. ![]() Some overlapping but distinct risk factors, such as female sex and older age, have been identified, as well as an association between acute COVID-19 severity and duration of symptoms. Īlthough it is widely accepted that older age, belonging to racial and ethnic minority groups, and certain underlying medical conditions are associated with an increased risk of progression to severe COVID-19 upon initial infection, the characteristics associated with risk of developing post-COVID conditions are largely unknown. ![]() Although a universally accepted definition and timeframe of the condition has not yet been developed, a clinical diagnosis of post-acute sequelae of COVID-19 (PASC) was assigned an International Classification of Diseases 10 (ICD-10) code (U09.9) in October of 2021. For many individuals, post-COVID conditions involve multiple organ systems and significantly impair daily functioning and productivity. These highly variable signs and symptoms, often termed post-COVID conditions, can either begin at the time of initial infection and persist for several months or may be new symptoms or syndromes that develop only after the acute phase of COVID-19. Nearly 20% of adults diagnosed with COVID-19 experience symptoms for ≥ 3 months after first contracting the virus. ConclusionsĪs evidenced by resource use in the post-acute phase, COVID-19 places a significant long-term clinical and economic burden among US individuals, even among patients whose acute infection did not merit hospitalization. However, the burden was apparent across all cohorts. Those who were hospitalized with or without ICU admission during the acute phase had the greatest increases in comorbidities and healthcare resource utilization. Total medical costs increased by 178% during the post-acute phase. Substantial increases in all measures of healthcare utilization were observed among all 3 cohorts. Compared with baseline, patients during the post-acute phase had percentage increases in the diagnosis of the following disorders: blood (166%), endocrine and metabolic (123%), nervous system (115%), digestive system (76%), and mental and behavioral (75%), along with increases in related prescriptions. The study included 3792 patients 56.5% of patients were men, 44% were White, and 94% did not require hospitalization. Data were stratified into 3 cohorts according to disposition during acute COVID-19 illness (i.e., not hospitalized, hospitalized without intensive care unit admission, or admitted to the ICU). Percentages of diagnoses, medications, healthcare utilization, 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). Patients with any condition or risk factor placing them at high risk of progression to severe COVID-19 were excluded. This study included eligible adults who were diagnosed with COVID-19 from April 1 to May 31, 2020, who were 18 − 64 years of age, and enrolled within Optum’s de-identified Clinformatics® Data Mart Database for 12 months before and 13 months after COVID-19 diagnosis. We evaluated diagnoses, medications, healthcare utilization, and medical costs before and after acute COVID-19 illness in US patients who were not at high risk of severe COVID-19. The potential clinical and economic burden of these outcomes in the USA is unclear. Patients recovering from SARS-CoV-2 infection and acute COVID-19 illness can experience a range of long-term post-acute effects.
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