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

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

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.

Publication types

  • Comparative Study
  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • COVID-19 / epidemiology*
  • Delivery of Health Care*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Norway
  • Primary Health Care*
  • Registries*
  • SARS-CoV-2*

Grants and funding

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.