COVID-19 is a respiratory disease caused by infection with the severe acute respiratory syndrome-coronovirus-2. Since the first confirmed case in the United Kingdom in January 2020, around 865,000 people have been hospitalised and more than 195,000 have died with COVID-19 as of May 2022.
A wide range of symptoms are associated with COVID-19; respiratory-related symptoms can include dry cough, breathlessness, and fever. While many people fully recover after COVID-19, up to 10% continue to experience long-term complications such as persistent tiredness, chronic pain or breathing difficulties – often referred to as long COVID.
Several studies in the United States have estimated the cost of care for COVID-19. However, little is known about the UK costs of COVID-19. Furthermore, due to the emerging nature of long COVID within health research, the number of people affected by, and the impact of, this condition remains unclear, in particular in children where research is extremely limited.
This study aims to address these gaps in the literature by describing patient characteristics, the healthcare use and costs observed in the time after a patient tests positive for COVID-19. The study will also help us to understand how these costs differ depending on the severity of COVID-19 illness, and on a patient’s risk of experiencing poorer health during a COVID-19 infection. Lastly this study aims to better-describe which people still experience symptoms more than 12 weeks after the start of COVID-19 illness (i.e. long COVID), and the impact of this condition on patients and the healthcare system.
Aim: Using UK primary care data, with linkage to secondary care data, to describe the characteristics and quantify the economic burden of COVID-19 (per 12-week episode, and by phase: acute COVID-19 [<4 weeks], ongoing symptomatic COVID-19 [4-12 weeks] and post-COVID-19 syndrome [>12 weeks]) among patients diagnosed from August 2020 through January 2022. Patient characteristics and economic burden will also be described among patients who are identified to have long COVID. The study will address evidence gap for healthcare burden during and after acute COVID-19 disease.
Objectives: To: i) quantify healthcare resource use (HCRU) and associated direct healthcare costs per COVID-19 episode, overall, by phase of COVID-19, severity of COVID-19, and COVID-19 risk status; ii) describe the socio-demographic and clinical characteristics of patients with COVID-19 and patients with and patients without long COVID; iii) estimate the incidence of long COVID; iv) quantify the HCRU/costs of long COVID and v) estimate the rate of hospitalisation among patients with and patients without long COVID.
Methods: A retrospective cohort study using UK primary care data (CRPD Aurum), with linkage to secondary care Hospital Episode Statistics (HES) and Office for National Statistics (ONS) datasets, of confirmed COVID-19 patients during the study index period (August 2020 – January 2022).
Exposures: COVID-19 phase; COVID-19 severity; long COVID; immunocompromised status.
Outcomes: Medication use; primary care (GP) consultations; hospitalisations; readmission within COVID-19 episode; sociodemographic and clinical characteristics, total direct healthcare costs; long COVID.
Data Analysis: Analysis will be descriptive in nature. Counts, means, medians, standard deviation (SD), 25th and 75th percentile values will be reported for continuous variables, whilst relative frequencies and proportions/ percentages will be reported for categorical variables. Rates for outcomes assessed and costs per patient per month will be reported.
COVID-19-related healthcare use (medication use, primary care general practice consultations, hospitalisations, total direct healthcare costs); Readmission within COVID-19 episode; Sociodemographic and clinical characteristics; Incidence of long COVID; hospitalisations during long COVID.
Jingyan Yang - Chief Investigator - Pfizer Inc - US Headquarters
Kiran Rai - Corresponding Applicant - Adelphi Real World
Bethany Backhouse - Collaborator - Adelphi Real World
Carmen Tsang - Collaborator - Pfizer Ltd - UK
Jennifer Nguyen - Collaborator - Pfizer Inc - US Headquarters
Kayte Andersen - Collaborator - Pfizer Inc - US Headquarters
Kevin Naicker - Collaborator - Pfizer Ltd - UK
Poppy Payne - Collaborator - Adelphi Real World
Robert Wood - Collaborator - Adelphi Real World
Tamuno Alfred - Collaborator - Pfizer Inc - US Headquarters
Tendai Mugwagwa - Collaborator - Pfizer Ltd - UK
Theo Tritton - Collaborator - Adelphi Real World
HES Admitted Patient Care;ONS Death Registration Data;Patient Level Index of Multiple Deprivation