Many patients recover from COVID-19 within a few weeks, but some exhibit persistent or new symptoms more than four weeks after first being diagnosed. Patients with such post-COVID conditions are variously referred to as having long-haul COVID, long COVID or post-acute sequelae of COVID-19 (PASC). Using longitudinal data from a database of over 34 billion private healthcare claim records, FAIR Health studied a total of 1,959,982 COVID-19 patients for the prevalence of post-COVID conditions 30 days or more after their initial diagnosis with COVID-19. To FAIR Health's knowledge, this is the largest population of COVID-19 patients so far studied for post-COVID conditions. The patients' post-COVID conditions were analyzed, with the most common conditions identified. Particular attention was given to age and gender, mental health conditions and death. Among the key findings: (1) Of patients who had COVID-19, 23.2 percent had at least one post-COVID condition. (2) Post-COVID conditions were found to a greater extent in patients who had more severe cases of COVID-19, but also in a substantial share of patients whose cases lacked symptoms. Of patients who were hospitalized with COVID-19, the percentage that had a post-COVID condition was 50 percent; of patients who were symptomatic but not hospitalized, 27.5 percent; and of patients who were asymptomatic, 19 percent. (3) The five most common post-COVID conditions across all ages, in order from most to least common, were pain, breathing difficulties, hyperlipidemia, malaise and fatigue, and hypertension. (4) The ranking of the most common post-COVID conditions varied by age group. For example, in the pediatric population (0-18), pain and breathing difficulties were the top two conditions, as in the all-ages cohort, but intestinal issues, rather than hyperlipidemia, were the third most common. (5) Most of the post-COVID conditions that were evaluated were associated more with females than males. In the case of 12 conditions, however, males more commonly had the condition diagnosed than females. For example, of patients who had post-COVID cardiac inflammation, 52 percent were male and 48 percent female. By age, the largest share (25.4 percent) with this condition was found in a young cohort--individuals aged 19-29. (6) Of the four mental health conditions evaluated as post-COVID conditions, anxiety was associated with the highest percentage of patients after COVID-19 in all age groups. Depression was second, adjustment disorders third and tic disorders fourth. (7) The odds of death 30 days or more after initial diagnosis with COVID-19 were 46 times higher for patients who were hospitalized with COVID-19 and discharged than patients who had not been hospitalized (odds ratio [OR]=46.020, 95 percent confidence interval [CI], 34.778-60.897, P<0.001). Of COVID-19 patients who were hospitalized and discharged, 0.5 percent died 30 days or more after their initial diagnosis. (8) Among COVID-19 patients with preexisting conditions, intellectual disabilities were associated with the highest odds of death 30 days or more after initial COVID-19 diagnosis (OR=3.082, 95 percent CI, 1.183-8.029, P=0.0212).
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