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

Abstract

AimTo explore the temporal impact of mild COVID-19 on need for primary and specialist health care services.MethodsIn all persons tested for SARS-CoV-2 in Norway March 1st 2020 to February 1st 2021 (N=1 401 922), we contrasted the monthly all-cause health care use before and up to 6 months after the test (% relative difference), for patients with a positive test for SARS-CoV-2 (non-hospitalization, i.e. mild COVID-19) and patients with a negative test (no COVID-19).ResultsWe found a substantial short-term elevation in primary care use in all age groups, with men generally having a higher relative increase (men 20-44 years: 522%, 95%CI=509-535, 45-69 years: 439%, 95%CI=426-452, ≥ 70 years: 199%, 95%CI=180-218) than women (20-44 years: 342, 95%CI=334-350, 45-69 years=375, 95%CI=365-385, ≥ 70 years: 156%, 95%CI=141-171) at 1 month following positive test. At 2 months, this sex difference was less pronounced, with a (20-44 years: 21%, 95%CI=13-29, 45-69 years=38%, 95%CI=30-46, ≥ 70 years: 15%, 95%CI=3-28) increase in primary care use for men, and a (20-44 years: 30%, 95%CI=24-36, 45-69 years=57%, 95%CI=50-64, ≥ 70 years: 14%, 95%CI=4-24) increase for women. At 3 months after test, only women aged 45-70 years still had an increased primary care use (14%, 95%CI=7-20). The increase was due to respiratory- and general/unspecified conditions. We observed no long-term (4-6 months) elevation in primary care use, and no elevation in specialist care use.ConclusionMild COVID-19 gives an elevated need for primary care that vanishes 2-3 months after positive test. Middle-aged women had the most prolonged increased primary care use.