Investigating the Long-Term Effects of COVID-19 Infection on Health Care Utilization in Individuals With COPD.

Abstract

Individuals with COPD are at elevated risk of severe outcomes following COVID-19 infection. Does COVID-19 have a long-term impact on health care utilization (HCU) for individuals with COPD? This retrospective matched cohort study was conducted by using health administrative data from Ontario, Canada, between April 2020 and June 2022. Individuals with physician-diagnosed COPD who underwent COVID-19 polymerase chain reaction (PCR) testing were included. Patients positive and negative for COVID-19 were matched on age, sex, vaccination status, PCR test date, and a propensity score. Patients were followed up from the end of the acute infection period (12 weeks after PCR) until the study end date. Per-person per-year HCU rates were captured and compared. Analyses were stratified according to COVID-19 variant eras (wild-type/Alpha/Beta, Delta, and Omicron) and vaccination status (0, 1, 2, and ≥ 3). A total of 31,540 matched pairs were identified. Mean age was 66.4 years, and 49.9% were male. Individuals with positive COVID-19 test results had 9% higher HCU rates than those who tested negative (rate ratio [RR], 1.09; 95% CI, 1.067-1.127). Stratifying according to variant, wild-type/Alpha/Beta and Omicron variants had 16% (RR, 1.16; 95% CI, 1.119-1.22) and 5% (RR, 1.051; 95% CI, 1.01-1.092) higher HCU rates, respectively. Individuals with ≥ 3 vaccinations did not have elevated rates of HCU (RR, 1.03; 95% CI, 0.981-1.081) compared with those who tested negative. In this study, patients with COPD who were positive for COVID-19 had significantly greater long-term HCU usage. Although Omicron has been considered milder than previous variants, it was still associated with significantly elevated long-term HCU. Individuals with ≥ 3 vaccinations who tested positive for COVID-19 had HCU rates similar to those who tested negative, suggesting that vaccinations can reduce long-term HCU.