PT  - JOURNAL ARTICLE
AU  - Candace D. McNaughton
AU  - Peter C. Austin
AU  - Atul Sivaswamy
AU  - Jiming Fang
AU  - Husam Abdel-Qadir
AU  - Nick Daneman
AU  - Jacob A. Udell
AU  - Walter P. Wodchis
AU  - Ivona Mostarac
AU  - Douglas S. Lee
AU  - Clare L. Atzema
TI  - Post-acute health care burden after SARS-CoV-2 infection: a retrospective cohort study
AID  - 10.1503/cmaj.220728
DP  - 2022 Oct 17
TA  - Canadian Medical Association Journal
PG  - E1368--E1376
VI  - 194
IP  - 40
4099  - http://www.cmaj.ca/content/194/40/E1368.short
4100  - http://www.cmaj.ca/content/194/40/E1368.full
SO  - CMAJ2022 Oct 17; 194
AB  - Background: The post-acute burden of health care use after SARS-CoV-2 infection is unknown. We sought to quantify the post-acute burden of health care use after SARS-CoV-2 infection among community-dwelling adults in Ontario by comparing those with positive and negative polymerase chain reaction (PCR) test results for SARS-CoV-2 infection.Methods: We conducted a retrospective cohort study involving community-dwelling adults in Ontario who had a PCR test between Jan. 1, 2020, and Mar. 31, 2021. Follow-up began 56 days after PCR testing. We matched people 1:1 on a comprehensive propensity score. We compared per-person-year rates for health care encounters at the mean and 99th percentiles, and compared counts using negative binomial models, stratified by sex.Results: Among 531 702 matched people, mean age was 44 (standard deviation [SD] 17) years and 51% were female. Females who tested positive for SARS-CoV-2 had a mean of 1.98 (95% CI 1.63 to 2.29) more health care encounters overall per-person-year than those who had a negative test result, with 0.31 (95% CI 0.05 to 0.56) more home care encounters to 0.81 (95% CI 0.69 to 0.93) more long-term care days. At the 99th percentile per-person-year, females who tested positive had 6.48 more days of hospital admission and 28.37 more home care encounters. Males who tested positive for SARS-CoV-2 had 0.66 (95% CI 0.34 to 0.99) more overall health care encounters per-person-year than those who tested negative, with 0.14 (95% CI 0.06 to 0.21) more outpatient encounters and 0.48 (95% CI 0.36 to 0.60) long-term care days, and 0.43 (95% CI −0.67 to −0.21) fewer home care encounters. At the 99th percentile, they had 8.69 more days in hospital per-person-year, with fewer home care (−27.31) and outpatient (−0.87) encounters.Interpretation: We found significantly higher rates of health care use after a positive SARS-CoV-2 PCR test in an analysis that matched test-positive with test-negative people. Stakeholders can use these findings to prepare for health care demand associated with post-COVID-19 condition (long COVID).