Abstract
Background: Long COVID can lead to a considerable economic burden because of ongoing care for persistent symptoms such as fatigue, dyspnea, or cognitive dysfunction. However, systematic research quantifying healthcare expenditures associated with long COVID remains limited. Objective: This study estimated the excess total, payer, and out-of-pocket healthcare expenditures associated with long COVID among adults in the United States (US). Methods: This was a cross-sectional analysis on adults ≥18 years using 2022 Medical Expenditure Panel Survey (MEPS) data (N = 17,119; representing approximately 254 million adults). Economic burden was measured with (1) total, (2) payer, and (3) out-of-pocket expenditures by individuals and their families. Generalized linear models (GLMs) with gamma distribution and log link were utilized to estimate excess expenditures associated with long COVID after adjusting for age, sex, race and ethnicity, social determinants of health, health status, and lifestyle factors. Results: Overall, 7.0% of the population reported long COVID. Adults with long COVID exhibited higher total (USD 11,305 vs. USD 7162) and payer (USD 9983 vs. USD 6097) expenditures compared to those with no COVID. In a fully adjusted analysis, long COVID was associated with an excess of USD 4098 in total healthcare expenditures and USD 3705 in payer expenditures. We did not observe significant differences in out-of-pocket expenditures between those with long COVID and no COVID. Conclusions: Adults with long COVID had 1.5 times higher total healthcare costs compared to those without COVID. This study highlights the need for comprehensive strategies and policies to reduce the economic burden associated with long COVID.