Dataset Information

Predictors of Postacute Sequelae of COVID-19 Development and Rehabilitation: A Retrospective Study.

ABSTRACT:

Objective

To examine the frequency of postacute sequelae of SARS-CoV-2 (PASC) and the factors associated with rehabilitation utilization in a large adult population with PASC.

Design

Retrospective study.

Setting

Midwest hospital health system.

Participants

19,792 patients with COVID-19 from March 10, 2020, to January 17, 2021.

Intervention

Not applicable.

Main outcome measures

Descriptive analyses were conducted across the entire cohort along with an adult subgroup analysis. A logistic regression was performed to assess factors associated with PASC development and rehabilitation utilization.

Results

In an analysis of 19,792 patients, the frequency of PASC was 42.8% in the adult population. Patients with PASC compared with those without had a higher utilization of rehabilitation services (8.6% vs 3.8%, P<.001). Risk factors for rehabilitation utilization in patients with PASC included younger age (odds ratio [OR], 0.99; 95% confidence interval [CI], 0.98-1.00; P=.01). In addition to several comorbidities and demographics factors, risk factors for rehabilitation utilization solely in the inpatient population included male sex (OR, 1.24; 95% CI, 1.02-1.50; P=.03) with patients on angiotensin-converting-enzyme inhibitors or angiotensin-receptor blockers 3 months prior to COVID-19 infections having a decreased risk of needing rehabilitation (OR, 0.80; 95% CI, 0.64-0.99; P=.04).

Conclusions

Patients with PASC had higher rehabilitation utilization. We identified several clinical and demographic factors associated with the development of PASC and rehabilitation utilization.

SUBMITTER: Abdelwahab N

PROVIDER: S-EPMC9098397 | biostudies-literature | 2022 Oct

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Predictors of Postacute Sequelae of COVID-19 Development and Rehabilitation: A Retrospective Study.

Abdelwahab Nermine N Ingraham Nicholas E NE Nguyen Nguyen N Siegel Lianne L Silverman Greg G Sahoo Himanshu Shekhar HS Pakhomov Serguei S Morse Leslie R LR Billings Joanne J Usher Michael G MG Melnik Tanya E TE Tignanelli Christopher J CJ Ikramuddin Farha F

Archives of physical medicine and rehabilitation 20220513 10

<h4>Objective</h4>To examine the frequency of postacute sequelae of SARS-CoV-2 (PASC) and the factors associated with rehabilitation utilization in a large adult population with PASC.<h4>Design</h4>Retrospective study.<h4>Setting</h4>Midwest hospital health system.<h4>Participants</h4>19,792 patients with COVID-19 from March 10, 2020, to January 17, 2021.<h4>Intervention</h4>Not applicable.<h4>Main outcome measures</h4>Descriptive analyses were conducted across the entire cohort along with an ad ...[more]

PMID: 35569640

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Project description:ImportanceA new International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) diagnosis code (U09.9 Post COVID-19 condition, unspecified) was introduced by the Centers for Disease Control and Prevention on October 1, 2021.ObjectiveTo examine the use of the U09.9 code and describe concurrently diagnosed conditions to understand physician use of this code in clinical practice.Design, setting, and participantsThis cohort study of US patients with an ICD-10-CM code for post-COVID-19 condition used deidentified patient-level claims data aggregated by HealthVerity. Children and adolescents (aged 0-17 years) and adults (aged 18-64 and ≥65 years) with a post-COVID-19 condition code were identified between October 1, 2021, and January 31, 2022. To identify a prior COVID-19 diagnosis, 3 months of continuous enrollment (CE) before the post-COVID-19 diagnosis date was required.Main outcomes and measuresPresence of the ICD-10-CM U09.9 code.ResultsThere were 56 143 patients (7723 female patients [61.2%]; mean [SD] age, 47.6 [19.2] years) with a post-COVID-19 diagnosis code, with cases increasing in mid-December 2021 following the trajectory of the Omicron case wave by 3 to 4 weeks. The analysis cohort included 12 622 patients after the 3-month preindex CE criteria was applied. Among this cohort, the median (IQR) age was 49 (35-61) years; however, 1080 (8.6%) were pediatric patients. The U09.9 code was used most often in the outpatient setting, although 305 older adults (14.0%) were inpatients. Only 698 patients (5.5%) had at least 1 of the 5 codes listed as possible concurrent conditions in the coding guidance. Only 8879 patients (70.4%) had a documented acute COVID-19 diagnosis code (569 [52.7%] among children), and the median (IQR) time between acute COVID-19 and post-COVID-19 diagnosis codes was 56 (21-200) days. The most common concurrently coded conditions varied by age; children experienced COVID-19-like symptoms (eg, 207 [19.2%] had cough and 115 [10.6%] had breathing abnormalities), while 459 older adults aged 65 years or older (21.1%) experienced respiratory failure and 189 (8.7%) experienced viral pneumonia.Conclusions and relevanceThis retrospective cohort study found patients with a post-COVID-19 ICD-10-CM diagnosis code following the acute phase of COVID-19 disease among patients of all ages in clinical practice in the US. The use of the U09.9 code encompassed a wide range of conditions. It will be important to monitor how the use of this code changes as the pandemic continues to evolve.

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Dataset Information

Predictors of Postacute Sequelae of COVID-19 Development and Rehabilitation: A Retrospective Study.

Objective

Design

Setting

Participants

Intervention

Main outcome measures

Results

Conclusions

Publications

Predictors of Postacute Sequelae of COVID-19 Development and Rehabilitation: A Retrospective Study.

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