Risk of COVID-Induced New, Persistent Clinical Conditions

Recovering from a COVID-19 infection is only half the battle. Many people of all ages and health statuses have reported experiencing 1 or more new medical conditions after COVID-19 infection.

Older adults are more likely to experience adverse COVID-19 outcomes, but it is unknown whether they face an increased risk of new medical issues after COVID-19. A study published in The BMJ sought to characterize the risk of persistent clinical conditions, or sequelae, among adults 65 years and older.

The observational study used the UnitedHealth Group’s clinical research database to access administrative claims and outpatient laboratory test results from 133366 adults who were diagnosed with COVID-19 before April 1, 2020. Included adults were ≥65 in 2020 and enrolled in a Medicare Advantage plan that covered prescription drugs.

The investigators recorded any persistent or new conditions that began at least 21 days after COVID-19 diagnosis. Over several months, they calculated the increased risk of COVID-19-triggered sequalae by age, race, sex, and whether patients were admitted to the hospital for their COVID-19 infection.

The cohort was matched to 3 comparison groups that did not contract COVID-19, including a 2020 comparison group, an historical 2019 comparison group, and an historical comparison group with preexisting viral lower respiratory tract illness.

The investigators found that 32% of individuals diagnosed with COVID-19 sought medical attention in the post-acute period for 1 or more new persistent conditions, 11% higher than the 2020 comparison group.

The most commonly reported sequalae included complications to the heart, kidneys, lungs, and liver. Compared with the 2020 group, COVID-19 patients were at increased risk of temporary respiratory failure, fatigue, high blood pressure, and mental health diagnoses. In comparison to the viral lower respiratory tract illness group, however, only respiratory failure, dementia, and fatigue were increased among people who contracted COVID-19.

The individuals admitted to the hospital with COVID-19 had a statistically significant elevated risk of most sequalae. The risk of several conditions was increased for men, Black people, and people over 75 years of age.

The results confirm an excess risk of new and persistent sequalae in adults 65 and older after COVID-19 infection.

More research is needed to establish cause of the sequalae, as not all diagnoses may be new conditions triggered by COVID-19 infection. The investigators concluded, “Understanding the magnitude of risk for the most important clinical sequelae might enhance their diagnosis and the management of individuals with sequelae after acute SARS-CoV-2 infection.”