Late Conditions Diagnosed 1–4 Months Following an Initial Coronavirus Disease 2019 (COVID-19) Encounter: A Matched-Cohort Study Using Inpatient and Outpatient Administrative Data—United States, 1 March–30 June 2020

Abstract

Background Late sequelae of COVID-19 have been reported; however, few studies have investigated the time-course or incidence of late new COVID-19-related health conditions (post-COVID conditions) after COVID-19 diagnosis. Studies distinguishing post-COVID conditions from late conditions caused by other etiologies are lacking. Using data from a large administrative all-payer database, we assessed the type, association, and timing of post-COVID conditions following COVID-19 diagnosis. Methods Using the Premier Healthcare Database Special COVID-19 Release (PHD-SR) (release date, October 20, 2020) data, during March–June 2020, 27,589 inpatients and 46,857 outpatients diagnosed with COVID-19 (case-patients) were 1:1 matched with patients without COVID-19 through the 4-month follow-up period (control-patients) by using propensity score matching. In this matched-cohort study, adjusted odds ratios were calculated to assess for late conditions that were more common in case-patients compared with control-patients. Incidence proportion was calculated for conditions that were more common in case-patients than control-patients during 31–120 days following a COVID-19 encounter. Results During 31–120 days after an initial COVID-19 inpatient hospitalization, 7.0% of adults experienced at least one of five post-COVID conditions. Among adult outpatients with COVID-19, 7.7% experienced at least one of ten post-COVID conditions. During 31–60 days after an initial outpatient encounter, adults with COVID-19 were 2.8 times as likely to experience acute pulmonary embolism as outpatient control-patients and were also more likely to experience a range of conditions affecting multiple body systems (e.g. nonspecific chest pain, fatigue, headache, and respiratory, nervous, circulatory, and gastrointestinal system symptoms) than outpatient control-patients. Children with COVID-19 were not more likely to experience late conditions than children without COVID-19. Conclusions These findings add to the evidence of late health conditions possibly related to COVID-19 in adults following COVID-19 diagnosis and can inform health care practice and resource planning for follow-up COVID-19 care.

Physical and mental health 3 months after SARS-CoV-2 infection (long COVID) among adolescents in England (CLoCk): a national matched cohort study

“… 2 However, little is known about the diagnosis, prevalence, phenotype, or duration of long COVID (also known as post-acute COVID syndrome) in children and young people. 3 The English National Institute for Health and Care Excellence (NICE) defines acute COVID-19 as disease with symptoms that last less than 4 weeks after confirmed infection. Ongoing symptomatic COVID-19 is defined as disease with symptoms lasting 4–12 weeks, and post COVID-19 syndrome as disease with symptoms lasting more than 12 weeks.…”

Long COVID: Distinction between Organ Damage and Deconditioning

“…Various organ manifestations of long COVID syndrome have already been described. They range from endocrinological and gastroenterological diseases to interstitial lung diseases and myocarditis [12][13][14][15][16][17][18]. Neuropsychiatric complaints, such as persistent fatigue and anosmia, which are perceived as extremely wearing, have also been reported.…”

“…Neuropsychiatric complaints, such as persistent fatigue and anosmia, which are perceived as extremely wearing, have also been reported. In a matched cohort analysis of 27,589 inpatients and 46,857 outpatients, long COVID occurred at rates of 7% and 7.7%, respectively [12]. Since these data are based on the collection of new ICD-10 codes after having contracted COVID-19, there is a possibility of underdiagnosis.…”

Implementation of post-intensive care outpatient clinic (I-POINT) for critically ill COVID-19 survivors

“…They revealed that experiencing more than five symptoms during the first week of COVID-19 increased the probability of development of long-COVID by 3.5 times. A propensity matched cohort study [17] matched by age, sex, race, ethnicity, clinical conditions, urbanicity, region and month of hospitalization with non-COVID patients using inpatient and outpatient data showed that late health consequences in 1-4 months following COVID-19 diagnosis could directly be imputed to COVID-19. Of patients, 7.0% and 7.7% experienced post-COVID conditions during 1st-and 4th-month controls, respectively, after the initial COVID-19 inpatient hospitalization.…”