76% of Long COVID Patients Were Not Hospitalized for Their Infection

Most individuals with long COVID did not have an initial infection that would be considered severe, according to a white paper from FAIR Health that relied on private insurance claims.

In the analysis of over 78,000 people diagnosed with post-COVID conditions, 75.8% had initial cases of SARS-CoV-2 that did not require hospitalization, the report found.

Long COVID can involve a wide variety of health issues that develop at least 4 weeks after a SARS-CoV-2 infection, and the sometimes-debilitating condition can include symptoms such as shortness of breath, fatigue, or headache.

Breathing abnormalities (23%), cough (19%), and fatigue/malaise (17%) were the most common post-COVID symptoms observed in FAIR Health’s analysis, but other common symptoms included hypertensive diseases, chest or throat pain, anxiety, asthma, type 2 diabetes, and heartbeat abnormalities (all above 5%), among others.

These conditions were far more prevalent in females (59.8% vs 40.2% in males), despite a less marked difference in the proportion diagnosed with COVID-19 in FAIR Health’s databases (53.8% vs 46.2%, respectively). The bulk of patients diagnosed with post-COVID conditions were those ages 36-50 (34.6%) and 51-64 (32%).

“Post-COVID conditions have become an issue of growing national concern,” said Robin Gelburd, president of FAIR Health, in a statement. “We hope these findings prove helpful for all individuals diagnosed with post-COVID conditions, as well as for providers, payors, policymakers, and researchers.”

The report looked at 78,252 individuals with post-COVID conditions identified from October 2021 — when the ICD-10 code (U09.9) for post-COVID conditions was first introduced — through January 2022, using FAIR Health’s private claims database. Among those who were initially hospitalized for COVID, the average length of stay ranged from 5.3 days for kids 12 and under to 10 days for those 65 and up.

Overall, 30.7% of people with post-COVID conditions had no pre-existing chronic comorbidities before their COVID-19 infection, 13.2% had one, 20.6% had two or three, 14.9% had four or five prior conditions, and 20.7% had six or more.

The report found that certain age groups were more likely to experience specific post-COVID conditions, including multisystem inflammatory syndrome in children age 12 years and under, heartbeat abnormalities in those ages 13-22, anxiety in those ages 23-35, and hypertensive diseases in those 65 and older.

Diagnoses for “other or unspecified myopathies” were 11.1 times more common for people following a post-COVID diagnosis, while pulmonary embolism was 2.6 times more common and post-viral fatigue syndrome, certain types of encephalopathy, and certain brain disorders were twice as common.

“On average, in all age groups, patients with a U09.9 post-COVID condition had higher Department of Health & Human Services-Hierarchical Condition Category (HHS-HCC) risk scores after their diagnosis,” according to the report. These risk scores identify patients who “are likely to consume more healthcare resources and potentially incur more healthcare-related costs in the long run.”