The burden of long COVID is evident in increased healthcare use, including long-term care facility stays, starting two months after a patient tests positive for SARS-CoV-2, a new study finds.
Investigators analyzed public data from Ontario, Canada, on the rate of healthcare encounters post-COVID-19 infection. Comparisons were made between matched test-positive and test-negative people and results were stratified by sex.
Among more than 530,000 matched people, females and males who had positive COVID-19 tests had more overall healthcare encounters per person-year than those who tested negative. Females also had more days in long-term care facilities and more home care encounters, whereas males had more long-term care days and outpatient visits, but fewer home care encounters in the months after infection.
After accounting for sociodemographic factors, comorbidities and pandemic waves, the average days in the hospital per person-year increased by 6.5 (47%) for females and 8.7 (53%) for males eight weeks or more after a positive COVID-19 test, the researchers reported.
The comparison does not tell the entire story of how SARS-CoV-2 affects post-acute healthcare use, the authors wrote in the Canadian Medical Association Journal. That’s because the greatest increases in use occurred in only 1% or less of people infected, they said.
Small subset, big problems
“Although most of the people with SARS-CoV-2 infection had little-to-no change in healthcare use, a small but important subset of people experienced large increases in their rate of healthcare use,” they wrote.
The results reveal that a small subset of people experience a “substantial burden of morbidity well after a SARS-CoV-2 infection” and will be competing for scarce healthcare resources, they added. To put this in context, the authors noted that a family physician with a typical schedule of 20 outpatient encounters per day before the pandemic would need to accommodate 100 more visits or encounters per year to meet the increase if half of their patients had a recent SARS-CoV-2 infection.
“Stakeholders can use these findings to prepare for healthcare demand associated with post-COVID-19 condition (long COVID),” they concluded.