Healthcare utilisation of 282,080 individuals with long COVID over two years: a multiple matched control, longitudinal cohort analysis

• Published in: Journal of the Royal Society of Medicine 2024-11, Vol.117 (11), p.369-381
• Main Authors: Mu, Yi, Dashtban, Ashkan, Mizani, Mehrdad A, Tomlinson, Chris, Mohamed, Mohamed, Ashworth, Mark, Mamas, Mamas, Priedon, Rouven, Petersen, Steffen, Kontopantelis, Evan, Horstmanshof, Kim, Pagel, Christina, Hocaoğlu, Mevhibe, Khunti, Kamlesh, Williams, Richard, Thygesen, Johan, Lorgelly, Paula, Gomes, Manuel, Heightman, Melissa, Banerjee, Amitava
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Case-Control Studies; Cohort Studies; COVID-19 - epidemiology; COVID-19 - therapy; Female; Health Care Costs - statistics & numerical data; Hospitalization - statistics & numerical data; Humans; Longitudinal Studies; Male; Middle Aged; Pandemics; Patient Acceptance of Health Care - statistics & numerical data; Post-Acute COVID-19 Syndrome; Primary Health Care - statistics & numerical data; SARS-CoV-2; United Kingdom - epidemiology
• ISSN: 0141-0768; 1758-1095; 1758-1095
• DOI: 10.1177/01410768241288345

Objectives To investigate healthcare utilisation and cost in individuals with long COVID (LC) at population level. Design Case–control cohort analysis with multiple age-, sex-, ethnicity-, deprivation-, region- and comorbidity-matched control groups: (1) COVID only, no LC; (2) pre-pandemic; (3) contemporary non-COVID; and (4) pre-LC (self-controlled, pre-COVID pandemic). Setting National, population-based, linked UK electronic health records (British Heart Foundation/NHS England Secure Data Environment). Participants Adults aged ≥18 years with LC between January 2020 and January 2023. Main outcome measures Healthcare utilisation (number of consultations/visits per person: primary care (general practitioner [GP]), secondary care (outpatient [OP], inpatient [IP] and emergency department [ED], investigations and procedures) and inflation-adjusted cost (£) for LC and control populations per month, calendar year and pandemic year for each category. Results A total of 282,080 individuals with LC were included between January 2020 and January 2023. The control groups were COVID only, no LC (n = 1,112,370), pre-pandemic (n = 1,031,285), contemporary non-COVID (n = 1,118,360) and pre-LC (n = 282,080). Healthcare utilisation per person (per month/year) was higher in LC than controls across GP, OP and ED. For IP, LC had higher healthcare utilisation than pre-LC and contemporary non-COVID (all p