Healthcare Database Helps Close Long COVID Surveillance Gap

Long COVID is a chronic condition that occurs after SARS-CoV-2 infection and lasts at least three months. It can follow severe illness, but it can also affect anyone who has been infected. Surveillance systems have closely tracked acute COVID-19 cases, emergency department visits, hospitalizations, and deaths, but comparable monitoring for Long COVID has been limited. To address this gap, researchers used statewide claims data to track Long COVID diagnoses across populations and variant periods.

Researchers at UTHealth Houston (Houston, TX, USA) used the Texas All-Payor Claims Database to assess Long COVID diagnosis patterns from October 2021 to October 2023. The database is maintained by UTHealth Houston and the Center for Health Care Data at UTHealth Houston School of Public Health. It includes medical, pharmacy, and dental claims, as well as eligibility and provider files, and covers approximately 60% of insured Texans.

The analysis examined how documented Long COVID varied by age, sex, insurance type, and geographic region across major COVID-19 variant periods. Long COVID diagnoses generally followed waves of acute infection. Peaks in COVID-19-related emergency department visits typically preceded increases in Long COVID claims by two to three weeks.

The findings showed higher documented Long COVID rates among older adults, especially people age 70 years and older. Medicare fee-for-service beneficiaries also had particularly high rates, and women had higher rates than men. Geographic variation was also observed, with higher rates in parts of the High Plains and northwest Texas and generally higher documented incidence in rural counties than in urban counties.

Among patients who visited an emergency department for COVID-19, the median time from that encounter to a Long COVID diagnosis was 22 days. Among patients whose COVID-19 care did not involve an emergency department visit, the median time was 26 days. The analysis was published in the International Journal of Infectious Diseases.

“Our main conclusion is that large healthcare claims databases such as the Texas All-Payor Claims Database can help researchers understand the documented burden of long COVID at the population level. Claims data can complement surveys, electronic health records, and traditional public health surveillance systems to support future planning for long COVID care,” said Boya Peng, a doctoral candidate in biostatistics at UTHealth Houston School of Public Health.

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