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Observational Study
. 2021 Oct 8;16(10):e0257926.
doi: 10.1371/journal.pone.0257926. eCollection 2021.

Impacts of mild COVID-19 on elevated use of primary and specialist health care services: A nationwide register study from Norway

Katrine Damgaard Skyrud  1 , Kjersti Helene Hernæs  1 , Kjetil Elias Telle  1 , Karin Magnusson  1   2
Affiliations
Observational Study

Impacts of mild COVID-19 on elevated use of primary and specialist health care services: A nationwide register study from Norway

Katrine Damgaard Skyrud et al. PLoS One. .

Abstract

Aim: To explore the temporal impact of mild COVID-19 on need for primary and specialist health care services.

Methods: In all adults (≥20 years) tested for SARS-CoV-2 in Norway March 1st 2020 to February 1st 2021 (N = 1 401 922), we contrasted the monthly all-cause health care use before and up to 6 months after the test (% relative difference), for patients with a positive test for SARS-CoV-2 (non-hospitalization, i.e. mild COVID-19) and patients with a negative test (no COVID-19).

Results: We found a substantial short-term elevation in primary care use in all age groups, with men generally having a higher relative increase (men 20-44 years: 522%, 95%CI = 509-535, 45-69 years: 439%, 95%CI = 426-452, ≥70 years: 199%, 95%CI = 180-218) than women (20-44 years: 342, 95%CI = 334-350, 45-69 years = 375, 95%CI = 365-385, ≥70 years: 156%, 95%CI = 141-171) at 1 month following positive test. At 2 months, this sex difference was less pronounced, with a (20-44 years: 21%, 95%CI = 13-29, 45-69 years = 38%, 95%CI = 30-46, ≥70 years: 15%, 95%CI = 3-28) increase in primary care use for men, and a (20-44 years: 30%, 95%CI = 24-36, 45-69 years = 57%, 95%CI = 50-64, ≥70 years: 14%, 95%CI = 4-24) increase for women. At 3 months after test, only women aged 45-70 years still had an increased primary care use (14%, 95%CI = 7-20). The increase was due to respiratory- and general/unspecified conditions. We observed no long-term (4-6 months) elevation in primary care use, and no elevation in specialist care use.

Conclusion: Mild COVID-19 gives an elevated need for primary care that vanishes 2-3 months after positive test. Middle-aged women had the most prolonged increased primary care use.

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Conflict of interest statement

The study was funded by the Norwegian Institute of Public Health. No external funding was received. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

Figures

Fig 1
Fig 1. Estimated percent (95% CI) of women and men using primary and specialist (inpatient and outpatient) care in a week, from 3 months before to 6 months after week of PCR test for SARS-CoV-2, for persons with mild COVID-19 and no COVID-19, by age groups.
Estimates adjusted for comorbidities, birth country and calendar month. The dip for specialist care around the test week is a mechanical result of the exclusion of persons who were hospitalized with COVID-19 in the test week and the two following weeks.
Fig 2
Fig 2. Estimated percent (95% CI) of women and men using primary care in a week, from 3 months before to 6 months after week of PCR test for SARS-CoV-2, for persons with mild COVID-19 and no COVID-19, by cause-specific diagnosis groups.
Estimates adjusted for age, sex, comorbidities, birth country and calendar month. The cause-specific diagnosis conditions are ordered by decreasing percentage of primary care.
See this image and copyright information in PMC

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