Long COVID Correlates With High Mortality: Health Insurer

A giant health insurer says health plan enrollees who suffered from long COVID-19 symptoms were more than twice as likely as other enrollees to die during a 12-month follow-up period.

Andrea DeVries, a researcher at Elevance Health, and three colleagues found that, during the year studied, 2.8% of the 13,435 enrollees classified as having “post-COVID-19 condition” died, according to a study published in the JAMA Health Forum, which is affiliated with the Journal of the American Medical Association.

That compares with a death rate of just 1.2% for similar enrollees without COVID-19 during the same period.

What It Means

Even if the COVID-19 pandemic really is over, the damage already done could continue to affect financial professionals’ efforts to estimate how long clients might live.

That could affect many kinds of annuity purchasing decisions or other income and health care cost planning decisions that rely on life expectancy assumptions.

Examining Claims Data

Elevance Health is the company formerly known as Anthem. The company provides or administers major medical coverage for about 48 million people.

The DeVries looked at claim records for 249,013 Elevance plan enrollees ages and older who were diagnosed with COVID-19 from April 1, 2020, through July 31, 2020 — before regulators had adopted a long COVID diagnosis code.

The team began by identifying enrollees with COVID-19 who had been enrolled in an Elevance plan for at least five months before being diagnosed with COVID-19 and who had survived for at least two months after the diagnosis date.

Because of the lack of a long COVID-19 diagnosis code, the team used claims for other conditions, such as loss of the sense of smell, brain fog, anxiety and heart rate problems, to come up with a list of enrollees with long COVID.

The team then created a control group by finding plan enrollees who were never diagnosed with COVID-19 and who had the same ages, regions, health status scores, socioeconomic status scores and other characteristics as the enrollees classified as having long COVID.

The Findings

The enrollees who developed long COVID had more health problems than typical Elevance enrollees before they came down with COVID-19.

About 27.5% of the long COVID enrollees had been hospitalized with COVID-19 when they first got sick. The hospitalized long COVID enrollees had many more health problems before the pandemic started than other long COVID enrollees.

The research team went through a separate control matching process for the hospitalized long COVID enrollees to make sure they were looking at the effects of COVID-19, not the conditions the patients had before the pandemic began.

All long COVID enrollees in the study were about twice as likely to have heart rhythm problems, heart failure, coronary artery disease and chronic obstructive pulmonary disease as the controls, and they were more than three times as likely to suffer from strokes.

Similarly, the long COVID enrollees who had been hospitalized as a result of COVID were about twice as likely to suffer serious chronic heart and lung problems, and more than three times as likely to suffer from strokes, as the matched controls were.

The researchers did not give separate mortality odds data for the long COVID patients who had been hospitalized.

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