OBJECTIVES: Long-COVID, the persistence of various symptoms after COVID-19 infection, is still not fully understood. This study evaluated the incidence and chronicity of post-COVID-19 conditions using administrative claims, which provide a large, generalizable sample, to provide insight into the scope of long-COVID in the United States.

METHODS: Patients newly diagnosed with COVID-19 from 4/1/2020-3/31/2021 were identified in the Merative™ MarketScan^® Commercial and Medicare databases. The first COVID-19 diagnosis served as the index date and patients were continuously eligible for 12-months pre- and post-index. Incident conditions were defined as a new diagnosis (no pre-period diagnoses) for one of 17 conditions of interest in the first 60-days of the post-period. Among patients with an incident condition, chronicity of the condition was assessed over the remaining post-period (long-term conditions).

RESULTS: The sample included 503,742 patients; mean±SD age was 39.5±16.5 and 46% were male. The most common incident conditions were respiratory symptoms (24.1%), fatigue (7.3%), muscle pain (6.0%), and headache (5.9%). Among patients with each of these conditions, long-term persistence was observed in 21.9% for respiratory symptoms, 36.8% for muscle pain, 18.3% for fatigue, and 16.0% for headache. Fewer than 5% patients evidenced incident anxiety, mood disorders, myocarditis, sleep disorders, or pulmonary embolism; however, among these patients, over 40% had long-term persistence of the condition. Among patients with long-term conditions, sleep disorders (248±98 days), mood disorders (239±96 days), anxiety (236±95 days), respiratory symptoms (233±92 days), and asthma (230±93 days) had the longest average durations of persistence, evidenced by continued claims over the post-period.

CONCLUSIONS: With the continued presence of COVID-19 an understanding of the risk of long-term symptoms is needed to help manage patients both during and following infection. These findings provide some initial insight into the incidence and tenure of various conditions that are affecting patients diagnosed with COVID-19.