• Candace D McNaughton, Peter C Austin, Atul Sivaswamy, Jiming Fang, Husam Abdel-Qadir, Nick Daneman, Jacob A Udell, Walter P Wodchis, Ivona Mostarac, Douglas S Lee, and Clare L Atzema.
• ICES Central (McNaughton, Austin, Sivaswamy, Fang, Abdel-Qadir, Daneman, Udell, Wodchis, Lee, Atzema); Sunnybrook Research Institute (McNaughton, Austin, Daneman, Mostarac, Atzema); Sunnybrook Health Sciences Centre (McNaughton, Daneman, Atzema); Department of Medicine (McNaughton, Abdel-Qadir, Daneman, Udell, Lee, Atzema), and Institute of Health Policy, Management and Evaluation (Austin, Abdel-Qadir, Udell, Wodchis, Atzema), University of Toronto; Peter Munk Cardiac Centre (Abdel-Qadir, Udell, Lee), Toronto General Hospital; Division of Cardiology (Abdel-Qadir, Udell), Women's College Hospital; Department of Medical Imaging (Lee), and Division of Cardiology (Abdel-Qadir, Udell, Lee), University Health Network, University of Toronto; Ted Rogers Centre for Heart Research (Abdel-Qadir, Lee); Institute for Better Health, Trillium Health Partners, Toronto, Ont. candace.mcnaughton@utoronto.ca.
• CMAJ. 2022 Oct 17; 194 (40): E1368E1376E1368-E1376.

BackgroundThe post-acute burden of health care use after SARS-CoV-2 infection is unknown. We sought to quantify the post-acute burden of health care use after SARS-CoV-2 infection among community-dwelling adults in Ontario by comparing those with positive and negative polymerase chain reaction (PCR) test results for SARS-CoV-2 infection.MethodsWe conducted a retrospective cohort study involving community-dwelling adults in Ontario who had a PCR test between Jan. 1, 2020, and Mar. 31, 2021. Follow-up began 56 days after PCR testing. We matched people 1:1 on a comprehensive propensity score. We compared per-person-year rates for health care encounters at the mean and 99th percentiles, and compared counts using negative binomial models, stratified by sex.ResultsAmong 531 702 matched people, mean age was 44 (standard deviation [SD] 17) years and 51% were female. Females who tested positive for SARS-CoV-2 had a mean of 1.98 (95% CI 1.63 to 2.29) more health care encounters overall per-person-year than those who had a negative test result, with 0.31 (95% CI 0.05 to 0.56) more home care encounters to 0.81 (95% CI 0.69 to 0.93) more long-term care days. At the 99th percentile per-person-year, females who tested positive had 6.48 more days of hospital admission and 28.37 more home care encounters. Males who tested positive for SARS-CoV-2 had 0.66 (95% CI 0.34 to 0.99) more overall health care encounters per-person-year than those who tested negative, with 0.14 (95% CI 0.06 to 0.21) more outpatient encounters and 0.48 (95% CI 0.36 to 0.60) long-term care days, and 0.43 (95% CI -0.67 to -0.21) fewer home care encounters. At the 99th percentile, they had 8.69 more days in hospital per-person-year, with fewer home care (-27.31) and outpatient (-0.87) encounters.InterpretationWe found significantly higher rates of health care use after a positive SARS-CoV-2 PCR test in an analysis that matched test-positive with test-negative people. Stakeholders can use these findings to prepare for health care demand associated with post-COVID-19 condition (long COVID).© 2022 CMA Impact Inc. or its licensors.

12 keywords...

hide…