Long COVID: A Costly Condition Imposing Substantial Burden on Society

OBJECTIVES: Long COVID, the broad set of symptoms and conditions which can persist following SARS-CoV-2 infection, may impact work productivity, increase medical spending and generate earning losses. A targeted literature review has assessed the economic impact of long COVID on society.

METHODS: Observational studies and meta-analyses evaluating the impact of long COVID on employment, absenteeism, productivity, healthcare resource utilization (HCRU) and associated costs were identified via Embase, MEDLINE and grey literature sources (published between March 2020 and May 2024).

RESULTS: 16 studies met inclusion criteria (Europe, n=9; North America, n=5; Asia, n=1; global, n=1). Follow-up (FU) ranged from 2 months to >2 years post-acute infection.

Of the 16 studies, 11 assessed impacts on work capacity. With a median FU of 3.4 months, ~20% of individuals in a global study had impaired work ability or were unemployed. In China, 11% of individuals had not returned to work at 2 years of FU. In the US, individuals with long COVID had not returned to pre-COVID productivity levels at 6 months FU, and had greater productivity losses vs. individuals without long COVID (p<0.001). In Germany, estimated national productivity losses due to long COVID, based on a 12-week period of absenteeism, exceeded €5.9 billion.

Five of the 16 studies assessed HCRU. In the UK, individuals managed for acute COVID-19 in a community or hospital setting had higher HCRU (primary care visits, hospital admissions, emergency-department visits) at 3.5 and 2.2 months FU, respectively, vs. the 12 months before infection (p<0.001). In Switzerland, incomplete COVID19 recovery was associated with HCRU (primary care visits, hospital readmissions) at 6–8 months FU.

CONCLUSIONS: Long COVID results in absenteeism, unemployment and widespread economic burden via reduced productivity and increased HCRU. Future research should monitor the impact of long COVID following acute infections, especially those caused by circulating variants.