Many with long virus not hospitalized for 1st infection

NEW YORK >> More than three-quarters of Americans who developed long COVID-19 were not sick enough to be hospitalized for their initial infection, a new analysis of tens of thousands of private insurance claims reported Wednesday.

The researchers analyzed data from the first few months after doctors began using a special diagnostic code for the condition that was created last year. The results paint a sobering picture of long COVID-19's serious and ongoing impact on people's health and the U.S. health care system.

Long COVID-19, a complex constellation of lingering or new post-infection symptoms that can last for months or longer, has become one of the most daunting legacies of the pandemic. Estimates of how many people may ultimately be affected have ranged from 10%-30% of infected adults; a recent report from the U.S. Government Accountability Office said that between 7.7 million and 23 million people in the United States could have developed long COVID-19. But much remains unclear about the prevalence, causes, treatment and consequences of the condition.

The new study adds to a growing body of evidence that, while patients who have been hospitalized are at greater risk for long COVID-19, people with mild or moderate initial coronavirus infections — who make up the vast majority of coronavirus patients — can still experience debilitating post-COVID-19 symptoms including breathing problems, extreme fatigue, and cognitive and memory issues.

“It's generating a pandemic of people who were not hospitalized but who ended up with this increased disability,” said Dr. Paddy Ssentongo, an assistant professor of infectious disease epidemiology at Penn State, who was not involved in the new study.

The analysis, based on what the report calls the largest database of private health insurance claims in the United States, found 78,252 patients who got a diagnosis with the new code from the International Classification of Diseases — diagnostic code U09.9 for “Post COVID-19 condition, unspecified” — from Oct. 1, 2021, to Jan. 31.

Dr. Claire Steves, a clinical academic and physician at King's College London, who was not involved in the new research, said the overall number of people who received the diagnosis was “huge,” given that the study covered only the first four months after the diagnostic code was introduced and did not include people covered by government health programs like Medicaid or Medicare (though it did include people in private Medicare Advantage plans). “That's probably a drop in the ocean compared to what the real number is,” Steves said.

The study, conducted by FAIR Health, a nonprofit organization that focuses on health care costs and insurance issues, found that 76% of the long COVID-19 patients did not require hospitalization for their initial coronavirus infection.