Long Term Effects of Coronavirus Disease 2019 on Healthcare Utilization: A Prospective Cohort Study

Background Although most patients recover from coronavirus disease 2019 (Covid-19) in a few weeks, a significant minority can take months to resolve symptoms. The objectives of our study were to evaluate how utilization of the healthcare system differed between patients diagnosed with and without Long Covid; and to identify patient demographics that were associated with increased utilization of healthcare resources. Methods Patients admitted to either the Ascension Providence Hospital Novi or Southfield campuses between March 8, 2020, and May 16, 2020, with confirmed Covid-19 were contacted by phone between September 2021 and March 2022, and asked to complete a survey on their health following recovery from Covid-19. Surveys were completed over the phone with the caller, online via Qualtrics, or via a mailed paper survey. Categorical data were analyzed by Fisher’s exact test, and p<0.05 was considered statistically significant. Results Among the 84 respondents (30% response rate), 63 (75%) had Long Covid and 21 (25%) did not. There was a higher percentage of females in the Long Covid group (75%) compared to the non-Long Covid group (43%, p=0.008) and a trend for a larger proportion of African American patients in the Long Covid group (77%) compared to the non-Long Covid group (55%, p=0.06). Long Covid patients continued to experience an increased frequency of all 10 symptoms surveyed (p<0.0001). Interestingly, there were no significant changes noted in the number of patient visits to their primary care physicians before and after Covid-19. Of significance were the differences in difficulty paying bills (p=0.01) and ability to access healthcare (p=0.01) for the Long Covid group before and after Covid-19 infection. Conclusions By understanding the nuanced experiences of individuals with Long Covid, we will be able to identify needs for implementing targeted interventions based on proper allocation of healthcare resources, thus allowing healthcare professionals to work towards mitigating the impact of this condition on individuals’ health, well-being, and overall quality of life.