Impacts of COVID-19 on long-term health and health care use

Skyrud, Katrine Damgaard; Telle, Kjetil; Magnusson, Karin

doi:10.1101/2021.02.16.21251807

Cited by 9 publications

(10 citation statements)

References 24 publications

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“…Thus, our findings may imply that the severity grade of post-covid complaints are limited for children (no specialist care needed). These findings of limited impact of mild COVID-19 on long-term morbidities in children, are also consistent with our recent findings of limited long-term comorbidities following mild COVID-19 in adults 1 . However, we here show that the elevation of primary care use may last longer for the youngest children (1-5 years) than what we observed for adults using similar methods 1, 18 .…”

Section: Discussionsupporting

confidence: 92%

“…The content, duration and impact of the post-covid syndrome has been described for adults in several studies. We recently showed that adults with severe COVID-19 may experience complaints for up to 3-6 months after initial infection, mainly due to respiratory and circulatory conditions 1 . These findings line up with a range of other reports showing increased risk of complications after serious disease among adults, implying that severe COVID-19 has a considerable impact on long-term health care utilization [2][3][4][5] .…”

Section: Introductionmentioning

confidence: 99%

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Health care use up to 6 months after COVID-19 in 700.000 children and adolescents: a pre-post study

Magnusson

Skyrud

Surén

et al. 2021

Preprint

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Objectives: To explore whether, and for how long COVID-19 among children gives an increase in use of health care services, when compared to children with no COVID-19. Methods: Studying all Norwegian residents aged 1-5, 6-15 and 16-19 years from August 1st 2020 to February 1st 2021 (N= 768 560), we contrasted rates of monthly all-cause primary and specialist health care use before and after testing for SARS-CoV-2 (% relative change), for children testing positive (non-hospitalized in the acute phase) (N=10 306) vs children with no COVID-19 (N=758 254). Results: We found a substantial elevation in short-term primary care use for children testing positive for SARS-CoV-2 during the first month following positive test when compared to children testing negative (relative elevation 1-5 years: 325%, 95%CI=296-354; 6-15 years: 434%, 95%CI=415-453; 16-19 years: 360%, 95%CI=342-379). There was still elevated primary care use at 2 months (1-5 years: 21%, 95%CI= 4-38; 6-15 years: 13%, 95%CI=2-25) and at 3 months (1-5 years: 26%, 95%CI=7-45, 6-15 years: 15%, 95%CI=3-26) for young children, but not at 2 or 3 months for the older children (16-19 years: 10%, 95%CI=-1-22 and 6%, 95%CI=-5-18, respectively). The 1-5-year-olds also had a long-term (up to 6 months) increase of primary care (14%, 95%CI=1-26) that was not observed for older age groups, when compared to same-aged children testing negative. We observed no elevated use of specialist care. Conclusion: Children in pre-school age used health services for a longer time (3-6 months) after COVID-19 than children in primary and secondary school age (1-3 months).

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Health care use up to 6 months after COVID-19 in 700.000 children and adolescents: a pre-post study

Magnusson

Skyrud

Surén

et al. 2021

Preprint

Self Cite

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“…16,19 Contrary to our findings however, a Norwegian study suggested that mild COVID-19 does not persist to cause a need for healthcare beyond two months following a positive test. 22 It is unclear if symptoms or diseases post-COVID-19 are due to the infection itself, anxiety caused by diagnosis and isolation or due to complications. Whilst this study does not inform us about mechanisms, it further paints the picture, helping us understand the population-level burden of post-COVID-19 sequelae across the spectrum of acute infection severity.…”

Section: Discussionmentioning

confidence: 99%

Post-acute COVID-19 sequelae in cases managed in the community or hospital in the UK: a population based study

Whittaker

Gulea

Koteci

et al. 2021

Preprint

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Objective To compare post-COVID-19 sequelae between hospitalised and non-hospitalised individuals Design Population-based cohort study Setting 1,383 general practices in England contributing to Clinical Practice Research Database Aurum Participants 46,687 COVID-19 cases diagnosed between 1st August to 17th October 2020 (45.4% male; mean age 40), either hospitalised within two weeks of diagnosis or non-hospitalised, and followed-up for a maximum of three months. Main outcome measures Event rates of new symptoms, diseases, prescriptions and healthcare utilisation in hospitalised and non-hospitalised individuals, with between-group comparison using Cox regression. Outcomes compared at 6 and 12 months prior to index date, equating to first UK wave and pre-pandemic. Non-hospitalised group outcomes stratified by age and sex. Results 45,272 of 46,687 people were non-hospitalised; 1,415 hospitalised. Hospitalised patients had higher rates of 13/26 symptoms and 11/19 diseases post-COVID-19 than the community group, received more prescriptions and utilised more healthcare. The largest differences were noted for rates per 100,000 person-weeks [95%CI] of breathlessness: 536 [432 to 663] v. 85 [77 to 93]; joint pain: 295 [221 to 392] v. 168 [158 to 179]; diabetes: 303 [225 to 416] v. 36 [32 to 42], hypertension: 244 [178 to 344] v. 47 [41 to 53]. Although low, rates of chest tightness, tinnitus and lung fibrosis were higher in the community group. 4.2% (1882/45,272) of the community group had a post-acute burden, most frequently reporting anxiety, breathlessness, chest pain and fatigue. In those non-hospitalised, age and sex differences existed in outcome rates. Healthcare utilisation in the community group increased 28.5% post-COVID-19 relative to pre-pandemic. Conclusions Post-COVID-19 sequelae differ between hospitalised and non-hospitalised individuals, with age and sex-specific differences in those non-hospitalised. Most COVID-19 cases managed in the community do not report ongoing issues to healthcare professionals. Post-COVID-19 follow-up and management strategies need to be tailored to specific groups.

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“…Also, we had no comparison group, simply because we did not aim for any causal inference and because comparable data are not available for a similar epidemic or pandemic setting with other infectious diseases. However, in recent studies of post-acute COVID-19, we demonstrate a likely causal effect of being infected with SARS-CoV-2 on the post-acute health care use [14]. Here, we also exclusively included visits that were specific to COVID-19, i.e.…”

Section: Discussionmentioning

confidence: 99%

Pandemic trends in health care use: From the hospital bed to the general practitioner with COVID-19

Methi

Hernæs

Skyrud

et al. 2021

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AimTo explore whether the acute 30-day burden of COVID-19 on health care use has changed from the beginning to the end of the pandemic.MethodsIn all Norwegians (N=122 699) who tested positive for SARS-CoV-2 in three pandemic waves (March 1st-July 31st 2020 (1st wave), August 1st-December 31st 2020 (2nd wave), and January 1st-May 31st 2021 (3rd wave)), we studied the age- and sex-specific share of patients (by age groups 1-19, 20-67, and 68 or more) who had: 1) Relied on self-care, 2) used primary care, and 3) used specialist care.ResultsWe find that a remarkably high and stable share (70-80%) of patients with COVID-19 exclusively had contact with primary care in the acute phase, both in the 1st, 2nd and 3rd wave. The mean number of primary care visits ranged between 2 and 4. We also show that the use of specialist care in the acute 30-day phase of COVID-19 has decreased, from 14% being hospitalized at least once during spring 2020, to 4% during spring 2021. The mean number of hospital bed-days decreased significantly for men from the 1st to the 2nd wave (from 13 days, 95% CI=11.5-14.5 to 10 days (9-11) for men aged ≥68 years, and from 11 days (10-12) to 9 days (8-10) for men aged 20-67 years), but not for women.ConclusionCOVID-19 places a continued high demand on the primary care services, and a decreasing demand on the specialist care services.

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Impacts of COVID-19 on long-term health and health care use

Cited by 9 publications

References 24 publications

Health care use up to 6 months after COVID-19 in 700.000 children and adolescents: a pre-post study

Health care use up to 6 months after COVID-19 in 700.000 children and adolescents: a pre-post study

Post-acute COVID-19 sequelae in cases managed in the community or hospital in the UK: a population based study

Pandemic trends in health care use: From the hospital bed to the general practitioner with COVID-19

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