Post-COVID conditions and healthcare utilization among adults with and without disabilities-2021 Porter Novelli FallStyles survey

Abstract

Background: Adults with disabilities are at increased risk for SARS-CoV-2 infection and severe disease; whether adults with disabilities are at an increased risk for ongoing symptoms after acute SARS-CoV-2 infection is unknown.

Objectives: To estimate the frequency and duration of long-term symptoms (>4 weeks) and health care utilization among adults with and without disabilities who self-report positive or negative SARS-CoV-2 test results.

Methods: Data from a nationwide survey of 4510 U.S. adults administered from September 24, 2021-October 7, 2021, were analyzed for 3251 (79%) participants who self-reported disability status, symptom(s), and SARS-CoV-2 test results (a positive test or only negative tests). Multivariable models were used to estimate the odds of having ≥1 COVID-19-like symptom(s) lasting >4 weeks by test result and disability status, weighted and adjusted for socio-demographics.

Results: Respondents who tested positive for SARS-CoV-2 had higher odds of reporting ≥1 long-term symptom (with disability: aOR = 4.50 [95% CI: 2.37, 8.54] and without disability: aOR = 9.88 [95% CI: 7.13, 13.71]) compared to respondents testing negative. Among respondents who tested positive, those with disabilities were not significantly more likely to experience long-term symptoms compared to respondents without disabilities (aOR = 1.65 [95% CI: 0.78, 3.50]). Health care utilization for reported symptoms was higher among respondents with disabilities who tested positive (40%) than among respondents without disabilities who tested positive (18%).

Conclusions: Ongoing symptoms among adults with and without disabilities who also test positive for SARS-CoV-2 are common; however, the frequency of health care utilization for ongoing symptoms is two-fold among adults with disabilities.

Keywords: COVID-19; Disabilities; Long COVID; Post-COVID conditions; Post-acute sequelae of SARS-CoV-2 infection.

Fig. 1

Caption: Frequencies of symptoms lasting longer than 4 weeks among individuals with and without disabilities, stratified by self-reported SARS-CoV-2 test result^∗ (N = 3251). Legend: (black box) With disability tested positive, N = 82, (medium gray box) Without disability tested positive, N = 302, (dark gray box) With disability tested negative, N = 571, (light gray box) Without disability tested negative, N = 2296. Footnote: ^∗Statistical weighting was used to align the sample with U.S. population distributions, adjusting for gender, age, household income, race/ethnicity, household size, education, census region, and metropolitan status. Weights were designed to match the U.S. Census' American Community Survey (ACS) proportions for these variables. Metropolitan status, which is not available from the 1-year ACS, were obtained from the Current Population Survey (CPS) March 2020 Annual Social and Economic Supplement (CPS-ASEC).

Fig. 2

Caption: Health utilization among individuals with and without disabilities who reported at least one symptom lasting for >4 weeks, stratified by self-reported SARS-CoV-2 test result, weighted. Legend: (black box) With disability tested positive, N = 59, (medium gray box) Without disability tested positive, N = 174, (dark gray box) With disability tested negative, N = 212, (light gray box) Without disability tested negative, N = 300.