Evaluation of long-term healthcare utilization and costs associated with COVID-19 among adults and children in the US

Aims This study assessed long-term healthcare resource utilization (HCRU) and direct medical costs associated with COVID-19 among adults and children in the United States. Using a large national claims database, we quantified the incremental healthcare burden during the year following a first COVID-19 diagnosis compared to matched controls without a COVID-19 diagnosis.Materials and Methods This retrospective cohort study used data from the IQVIA PharMetrics Plus database. Patients with a COVID-19 diagnosis (U07.1) between June 1 and November 30, 2022, were matched 1:1 to non-COVID-19 controls based on age, sex, region, insurance type, Charlson Comorbidity Index, and baseline HCRU. Outcomes were HCRU and all-cause healthcare costs accrued during the post-acute period (≥31 days after first COVID-19 diagnosis), measured cumulatively through 1, 3, 6, 9, and 11 months of follow-up. Generalized linear models estimated cost ratios.Results The study included 944,627 patients with a COVID-19 diagnosis (U07.1) and an equal number of matched controls. Compared with matched controls, mean total costs during 11 months of post-acute follow-up were 27% higher among adults ($11,508 vs $9,040; p < 0.001) and 42% higher among pediatric patients with COVID-19 ($3,997 vs $2,812; p < 0.001). Costs were higher for COVID-19 cases at all follow-up time points. Among adults at the 11-month follow-up time, costs increased with acute infection severity, with mean costs of $10,372 for outpatients, $36,848 for hospitalized patients, and $51,643 for ICU patients, compared with $8,617, $16,926, and $17,620, respectively, among matched controls (all p < 0.001). Among adults, cost ratios peaked at 1 month of follow-up (1.32; 95% CI: 1.31–1.33) and declined to 1.15 (95% CI: 1.14–1.15) at 11 months.Conclusions There were significantly higher post-acute HCRU and costs among both adults and pediatrics with a COVID-19 diagnosis compared to matched controls without one, with elevated cost differences persisting up to 12 months post-infection.