Effects of long COVID on healthcare utilization.

<h4>Background</h4>While most research on Long COVID (LC) has focused on symptoms and quality of life, there remains a critical need to better understand the effect of LC on resource utilization. This study sought to determine the type and amount of healthcare utilization among participa...

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Main Authors: Michael Gottlieb, Erica S Spatz, Huihui Yu, Imtiaz Ebna Mannan, Michelle Santangelo, Caitlin Malicki, Nicole L Gentile, Rachel E Geyer, Alex Charlton, Jonathan W Dyal, Joann G Elmore, Kristyn Gatling, Mandy J Hill, Juan Carlos C Montoy, Kelli N O'Laughlin, Kristin L Rising, Sharon Saydah, Kari A Stephens, Ralph C Wang, Lauren E Wisk, Arjun K Venkatesh, Robert A Weinstein, Innovative Support for Patients with SARS-CoV-2 Infections Registry (INSPIRE) Group
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2025-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0327218
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author Michael Gottlieb
Erica S Spatz
Huihui Yu
Imtiaz Ebna Mannan
Michelle Santangelo
Caitlin Malicki
Nicole L Gentile
Rachel E Geyer
Alex Charlton
Jonathan W Dyal
Joann G Elmore
Kristyn Gatling
Mandy J Hill
Juan Carlos C Montoy
Kelli N O'Laughlin
Kristin L Rising
Sharon Saydah
Kari A Stephens
Ralph C Wang
Lauren E Wisk
Arjun K Venkatesh
Robert A Weinstein
Innovative Support for Patients with SARS-CoV-2 Infections Registry (INSPIRE) Group
author_facet Michael Gottlieb
Erica S Spatz
Huihui Yu
Imtiaz Ebna Mannan
Michelle Santangelo
Caitlin Malicki
Nicole L Gentile
Rachel E Geyer
Alex Charlton
Jonathan W Dyal
Joann G Elmore
Kristyn Gatling
Mandy J Hill
Juan Carlos C Montoy
Kelli N O'Laughlin
Kristin L Rising
Sharon Saydah
Kari A Stephens
Ralph C Wang
Lauren E Wisk
Arjun K Venkatesh
Robert A Weinstein
Innovative Support for Patients with SARS-CoV-2 Infections Registry (INSPIRE) Group
author_sort Michael Gottlieb
collection DOAJ
description <h4>Background</h4>While most research on Long COVID (LC) has focused on symptoms and quality of life, there remains a critical need to better understand the effect of LC on resource utilization. This study sought to determine the type and amount of healthcare utilization among participants with versus without LC.<h4>Methods</h4>This was a secondary analysis of a prospective, longitudinal, multicenter U.S. study of adult participants with symptomatic COVID-19, confirmed with testing, who completed 3-month post-infection surveys and had electronic health record data for at least 180 days pre- and post-index testing. We excluded participants with any COVID-19 infections within the 6 months following enrollment. Consistent with prior work, LC was defined as ≥3 post-infectious symptoms at 3 months, while those with <3 symptoms were categorized as not having LC. Our primary outcome was to compare the change in visit types between pre- and post-index testing (hospitalization, emergency department visit, office visit, procedure, telehealth, and other). As secondary outcomes, we assessed differences in visit complexity using the summative length of each encounter for each category as a measure of total healthcare usage.<h4>Results</h4>A total of 847 participants met inclusion criteria (179 LC, 668 non-LC). When compared with the pre-index period, there was an overall increase in visit numbers of all six visit categories during the post-index period for all groups, most pronounced in office and telehealth visits. When compared with the non-LC group, the LC group was less likely to have ED visits (OR: 0.1; 95% CI 0.0-0.5). However, among those with LC who had at least one hospitalization, they were more likely to have additional hospitalizations (OR: 2.6; 95% CI 1.5-4.6). Visit length for office visits and hospitalization in the LC group was increased when compared with the non-LC group, though this diminished after adjustment for patient baseline characteristics.<h4>Conclusions</h4>All participants who were infected with SARS-CoV-2 had a marked increase in healthcare utilization during the subsequent 180 days. The LC group had significantly higher rates of additional hospitalization compared with those without LC, which may help to inform healthcare resource planning.
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spelling doaj-art-a1015b78bdfc47d5bb83fedee7d7b6a32025-08-20T03:58:03ZengPublic Library of Science (PLoS)PLoS ONE1932-62032025-01-01207e032721810.1371/journal.pone.0327218Effects of long COVID on healthcare utilization.Michael GottliebErica S SpatzHuihui YuImtiaz Ebna MannanMichelle SantangeloCaitlin MalickiNicole L GentileRachel E GeyerAlex CharltonJonathan W DyalJoann G ElmoreKristyn GatlingMandy J HillJuan Carlos C MontoyKelli N O'LaughlinKristin L RisingSharon SaydahKari A StephensRalph C WangLauren E WiskArjun K VenkateshRobert A WeinsteinInnovative Support for Patients with SARS-CoV-2 Infections Registry (INSPIRE) Group<h4>Background</h4>While most research on Long COVID (LC) has focused on symptoms and quality of life, there remains a critical need to better understand the effect of LC on resource utilization. This study sought to determine the type and amount of healthcare utilization among participants with versus without LC.<h4>Methods</h4>This was a secondary analysis of a prospective, longitudinal, multicenter U.S. study of adult participants with symptomatic COVID-19, confirmed with testing, who completed 3-month post-infection surveys and had electronic health record data for at least 180 days pre- and post-index testing. We excluded participants with any COVID-19 infections within the 6 months following enrollment. Consistent with prior work, LC was defined as ≥3 post-infectious symptoms at 3 months, while those with <3 symptoms were categorized as not having LC. Our primary outcome was to compare the change in visit types between pre- and post-index testing (hospitalization, emergency department visit, office visit, procedure, telehealth, and other). As secondary outcomes, we assessed differences in visit complexity using the summative length of each encounter for each category as a measure of total healthcare usage.<h4>Results</h4>A total of 847 participants met inclusion criteria (179 LC, 668 non-LC). When compared with the pre-index period, there was an overall increase in visit numbers of all six visit categories during the post-index period for all groups, most pronounced in office and telehealth visits. When compared with the non-LC group, the LC group was less likely to have ED visits (OR: 0.1; 95% CI 0.0-0.5). However, among those with LC who had at least one hospitalization, they were more likely to have additional hospitalizations (OR: 2.6; 95% CI 1.5-4.6). Visit length for office visits and hospitalization in the LC group was increased when compared with the non-LC group, though this diminished after adjustment for patient baseline characteristics.<h4>Conclusions</h4>All participants who were infected with SARS-CoV-2 had a marked increase in healthcare utilization during the subsequent 180 days. The LC group had significantly higher rates of additional hospitalization compared with those without LC, which may help to inform healthcare resource planning.https://doi.org/10.1371/journal.pone.0327218
spellingShingle Michael Gottlieb
Erica S Spatz
Huihui Yu
Imtiaz Ebna Mannan
Michelle Santangelo
Caitlin Malicki
Nicole L Gentile
Rachel E Geyer
Alex Charlton
Jonathan W Dyal
Joann G Elmore
Kristyn Gatling
Mandy J Hill
Juan Carlos C Montoy
Kelli N O'Laughlin
Kristin L Rising
Sharon Saydah
Kari A Stephens
Ralph C Wang
Lauren E Wisk
Arjun K Venkatesh
Robert A Weinstein
Innovative Support for Patients with SARS-CoV-2 Infections Registry (INSPIRE) Group
Effects of long COVID on healthcare utilization.
PLoS ONE
title Effects of long COVID on healthcare utilization.
title_full Effects of long COVID on healthcare utilization.
title_fullStr Effects of long COVID on healthcare utilization.
title_full_unstemmed Effects of long COVID on healthcare utilization.
title_short Effects of long COVID on healthcare utilization.
title_sort effects of long covid on healthcare utilization
url https://doi.org/10.1371/journal.pone.0327218
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