Lessons Learned From Characterizing Long COVID Among US Medicare Beneficiaries.

IF 2.4 4区医学 Q3 PHARMACOLOGY & PHARMACY

Pharmacoepidemiology and Drug Safety Pub Date : 2025-02-01 DOI:10.1002/pds.70101

Yun Lu, Arnstein Lindaas, Hector S Izurieta, Myrna Cozen, Mikhail Menis, Xiangyu Shi, Whitney R Steele, Michael Wernecke, Yoganand Chillarige, Jeffrey A Kelman, Richard A Forshee

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引用次数: 0

Abstract

Purpose: To characterize long-term effects of COVID-19 among older adults (aged ≥ 65 years).

Methods: This retrospective descriptive study utilized Medicare Fee-for-Service beneficiaries' claims to characterize post-COVID condition diagnosis code usage, long COVID (defined as post-COVID condition diagnoses made ≥ 28 days after an initial COVID-19 diagnosis) incidence, patient demographics, and concurrent diagnoses.

Results: During April 1, 2020 to May 21, 2022, 193 691 (0.6%) of 31 847 927 Medicare beneficiaries were diagnosed with post-COVID conditions using ICD-10-CM diagnosis codes U09.9 and B94.8, regardless of prior COVID-19 diagnosis. Post-COVID condition diagnosis rate was higher among nursing home residents (18.7 per 1000 person-years) than community-dwelling beneficiaries (2.8). Among community-dwelling beneficiaries with a post-COVID condition diagnosis, 17.5% did not have any prior COVID-19 diagnosis code U07.1 recorded. Among beneficiaries with COVID-19 diagnosis, there were no significant sex, age, or race/ethnicity differences between those with post-COVID conditions ≥ 28 days after COVID-19 (i.e., long COVID) and those without post-COVID conditions. Certain myopathies and interstitial pulmonary disease codes were disproportionately present concurrently with long COVID compared to COVID-19.

Conclusions: In this large study of 32 million Medicare beneficiaries, we found approximately 194 000 post-COVID condition diagnoses. Post-COVID condition diagnosis rate was higher among nursing home residents, highlighting the substantial burden of COVID-19 in this vulnerable population. Community-dwelling beneficiaries were less likely to seek medical care for COVID-19 events than nursing home residents, which may suggest differences in COVID-19 severity and respiratory disease detection between these populations. Long COVID risk after COVID-19 infection may be similar across demographic groups.

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从美国医疗保险受益人长期COVID特征中吸取的教训。

目的：研究COVID-19对老年人（≥65岁）的长期影响。方法：本回顾性描述性研究利用医疗保险按服务收费受益人的索赔来描述COVID-19后病症诊断代码的使用、长COVID（定义为首次COVID-19诊断后≥28天进行的COVID-19后病症诊断）发生率、患者人口统计学和并发诊断。结果：在2020年4月1日至2022年5月21日期间，31 847 927名医疗保险受益人中，有193 691人（0.6%）使用ICD-10-CM诊断代码U09.9和B94.8诊断为COVID-19后病症，与先前的COVID-19诊断无关。疗养院居民的新冠肺炎后病症诊断率（每千人年18.7人）高于社区居民（每千人年2.8人）。在诊断为COVID-19后病症的社区居住受益人中，17.5%之前没有记录任何COVID-19诊断代码U07.1。在诊断为COVID-19的受益人中，患有COVID-19后症状≥28天（即长COVID）的患者与没有COVID-19后症状的患者之间没有显着的性别、年龄或种族/民族差异。与COVID-19相比，某些肌病和间质性肺疾病代码与长COVID-19同时出现不成比例。结论：在这项对3200万医疗保险受益人的大型研究中，我们发现了大约19.4万例后covid疾病诊断。疗养院居民的新冠肺炎后病症诊断率较高，凸显了新冠肺炎对这一弱势群体的沉重负担。与养老院居民相比，社区居民因COVID-19事件寻求医疗服务的可能性较小，这可能表明这些人群在COVID-19严重程度和呼吸系统疾病检测方面存在差异。不同人口群体感染COVID-19后的长期COVID-19风险可能相似。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pharmacoepidemiology and Drug Safety 医学-药学

CiteScore

4.80

自引率

7.70%

发文量

173

审稿时长

3 months

期刊介绍： The aim of Pharmacoepidemiology and Drug Safety is to provide an international forum for the communication and evaluation of data, methods and opinion in the discipline of pharmacoepidemiology. The Journal publishes peer-reviewed reports of original research, invited reviews and a variety of guest editorials and commentaries embracing scientific, medical, statistical, legal and economic aspects of pharmacoepidemiology and post-marketing surveillance of drug safety. Appropriate material in these categories may also be considered for publication as a Brief Report. Particular areas of interest include: design, analysis, results, and interpretation of studies looking at the benefit or safety of specific pharmaceuticals, biologics, or medical devices, including studies in pharmacovigilance, postmarketing surveillance, pharmacoeconomics, patient safety, molecular pharmacoepidemiology, or any other study within the broad field of pharmacoepidemiology; comparative effectiveness research relating to pharmaceuticals, biologics, and medical devices. Comparative effectiveness research is the generation and synthesis of evidence that compares the benefits and harms of alternative methods to prevent, diagnose, treat, and monitor a clinical condition, as these methods are truly used in the real world; methodologic contributions of relevance to pharmacoepidemiology, whether original contributions, reviews of existing methods, or tutorials for how to apply the methods of pharmacoepidemiology; assessments of harm versus benefit in drug therapy; patterns of drug utilization; relationships between pharmacoepidemiology and the formulation and interpretation of regulatory guidelines; evaluations of risk management plans and programmes relating to pharmaceuticals, biologics and medical devices.