Impacts of COVID-19 on long-term health and health care use

Skyrud, K. D.; Telle, K. E.; Magnusson, K.

Aim: To explore impacts of mild and severe COVID-19 on acute and long-term utilization of primary care, inpatient- and outpatient specialist health care. Methods: In all persons tested for the SARS-CoV-2 in Norway March 1st to November 1st 2020 (N=1 257 831), we used a difference-in-differences design to contrast the monthly health care use before and after testing, across patients with negative test (no COVID-19) and 1) positive test, not hospitalized (mild COVID-19) and 2) positive test, hospitalized (severe COVID-19). We studied all-cause- and cause-specific health care use for digestive, circulatory, respiratory, endocrine/metabolic/nutritional, genitourinary, eye/ear, musculoskeletal, mental, skin, blood and general/unspecified conditions. Results: Mild COVID-19 impacted on primary care due to respiratory conditions at 0-3 months after having tested positive (786% increase). Severe COVID-19 impacted on visits due to respiratory- (337-3316% increase), circulatory- (166-205% increase), endocrine/metabolic/nutritional- (168-791% increase) as well as visits due to general/unspecified conditions (48-431% increase) in outpatient and inpatient specialist care 0-3 months after being tested. Severe COVID-19 also impacted on outpatient specialist care after 4-6 months, for respiratory and circulatory conditions (199-246% increase) and general/unspecified conditions (40% increase). Conclusion: Our findings imply that mild COVID-19 dos not persist to cause a need for health care beyond two months after having tested positive. Health care contacts increased the most in specialist care for those who had undergone severe COVID-19, both at 0-3 and at 4-6 months. This increase was due to respiratory, circulatory, endocrine/metabolic/nutritional and general/unspecified causes.