Healthcare Resource Utilization (HCRU) and Direct Medical Costs Following Acute SARS-Cov-2 Infection: Findings From a Literature Review

OBJECTIVES: Long-COVID or post-COVID-19 condition (PCC) can occur after SARS-CoV-2 infection. PCC encompasses a broad range of persistent symptoms and complications lasting weeks to months after the acute COVID-19 infection and posing a significant burden on healthcare systems. We aimed to assess the impact of long-term consequences of COVID-19 on HCRU and direct medical costs.

METHODS: A targeted literature review was conducted in PubMed, preprint servers and grey literature in November 2023. Observational studies on HCRU and costs incurred during the post-acute phase of COVID-19 were included.

RESULTS: Fourty-one studies were included; 15 from the US, 2 from Canada, 19 from Europe, and 5 from other countries. The magnitude of burden depended on the control group used. There was notable heterogeneity in the definition of Long-COVID and PCC and methods used measuring economic burden. A majority of studies were retrospective cohort (n=26), with 29 parallel control and 12 single arm, and included 5 cross-sectional studies and 2 with pre- and post-diagnosis comparisons. SARS-CoV-2 infection caused up to a 3-fold increase in total follow-up healthcare costs compared to patients without the infection. HCRU and costs were significantly higher in those diagnosed with PCC. The increased burden was observed over several months to more than 2 years. Severe course of the disease or risk factors for severe COVID-19 were associated with higher costs and HCRU. Up to a 10-fold increase or 17,706$ of burden was observed in patients with COVID-19-related hospitalization compared to non-hospitalized cases, and nearly a 3-fold increase with age (50-64 vs 18-24 years) and in patients with comorbidities (Charlson Comorbidity Index ≥1 vs 0).

CONCLUSIONS: Findings suggest that Long-COVID/PCC poses a lasting burden of considerable magnitude on healthcare systems globally. In the absence of effective treatments, prevention of infection can contribute to containing COVID-19 long-term HCRU and medical spending.