Understanding the use of digital finance among older internet users in urban China: Evidence from an online convenience sample

Inclusive digital financial services should welcome older populations and make them beneficiaries of the digital and financial revolution. To understand older adults' experience of using digital financial tools, we conducted an online survey of 268 older internet users aged 60 or above from urban areas of 14 Chinese provinces after China's nationwide COVID-19 lockdown in 2021. Our results revealed that older internet surfers were active in digital financial activities and engaged most with activities that were highly compatible with their lifestyles. Active users significantly differed from inactive users in sociodemographics, confirming that a digital divide related to social stratification exists among older internet users. Digital finance active users were also distinguished from inactive users' attitudes and perceptions toward digital finance. Logistic regression results indicated that perceived usefulness, access to proper devices for digital finance, risk perceptions, and perceived exclusion if not using technology were associated with their adoption of these advanced tools. Older adults reported the perceived inconvenience of in-person financial services during the lockdown. They also expressed a willingness to participate in relevant training if provided. The findings of this study could help aging-related practitioners to understand older adults' engagement in digital finance and guide policy and project design in the area of financial inclusion of the aging population.

Understanding the Impact Mechanism of User Behavior Pattern toward Real Estate APP Platforms in the Post-COVID Era: A Quantitative Analysis

While technology factors are the main driver of the booming real estate APP platforms with important implications for user behavior pattern during and post-pandemic contexts, there is a lack of adequate research. In response, this study explores the user behavior pattern of real estate APP platforms to promote user mental health by taking the real estate APP platforms users as the participants based on theory of technology readiness and acceptance model. Data collected from offline surveys are analyzed using PLS-SEM. The results reveal the technology readiness index positively affects individuals' perceived usefulness and satisfaction, ultimately positively affects individuals' continuance intention with real estate APP platforms;satisfaction with real estate APP platforms mediated the relationship between technology readiness index, perceived ease of use, perceived usefulness, and individuals' continuance intention with real estate APP platforms. However, the group comparison finds no significant difference in user behavior patterns by gender. The contribution of this study is to reveal the influence mechanisms of digital technology on users' behavioral patterns toward real estate APP platforms, which can help guide the sustainable development of real estate APP platforms and promote user mental health and wellbeing in the post-COVID era.

Task-Technology Fit and ICT Use in Remote Work Practice During the COVID-19 Pandemic

This study examines the use of information and communications technology (ICT) in remote work practice during the COVID-19 pandemic by integrating task-technology fit theory and the post-acceptance model of IS continuance into a research framework. In addition, it operationalizes the technological characteristics of TTF (task-technology fit) with the technology acceptance model (TAM) and the diffusion of innovation (DOI) theory. The methodology to test the research model takes support from the partial least squares structural equation modeling (PLS-SEM) method using a sample of 320 employees. The results show that TAM significantly explains TTF. Furthermore, there is a positive impact of ICT use on individual and organizational performance. User satisfaction has the most significant effect on individual performance, organizational performance, and IS continuance intention. The authors provide some managerial implications for addressing the challenges of remote work related to ICT disruptions for the post-COVID-19 period.

The impact of the COVID-19 pandemic on the healthcare of patients with type 2 diabetes mellitus in the department of veterans affairs

The novel coronavirus (COVID-19) pandemic and strategies meant to mitigate infections caused disruptions to healthcare services across the globe. To evaluate the impact of the COVID-19 pandemic on the healthcare of patients with type 2 diabetes in the VA healthcare system, this work enumerated a cohort of patients with type 2 diabetes who utilized care in the VA across all months between March 2018 and February 2022 and analyzed service utilization, medication adherence, and diabetes-related short-term outcomes.The first objective was to determine the effect of the pandemic's interruption on the utilization of diabetes-related outpatient encounters. Results showed that the share of patients with diabetes with at least one virtual care visit increased from 3.4% in the pre- COVID year (March 2019 to February 2020) to 16.4% in the first year during COVID (March 2020 to February 2021) while the percent of patients with diabetes with an in- person diabetes-related outpatient visit fell from 89.8% to 72.3%.Second, large changes in oral antidiabetic medication use, adherence (i.e., proportion of days (PDC) covered >=80%), and discontinuation (zero days covered) were discovered during the pandemic among patients with treated type 2 diabetes. The mean percent adherent was 23.4%, 11.6%, and 30.1% during the pre-pandemic (i.e., March 2018-February 2020), pre-vaccine pandemic (i.e., March 2020-December 2020), and post-vaccine pandemic (i.e., January 2021-February 2020) periods, respectively.Finally, this study evaluated changes in average A1C measurement, glycemic control, and preventable diabetes outcomes before and during the COVID-19 pandemic. The percent of eligible patients with A1C measurement decreased by 8.6% when the pandemic began, trending back to pre-pandemic levels by January 2021, at which point it fell by about 1% per month to end of study. The rate of uncontrolled diabetes averaged 400 per 100,000 before the pandemic, but rose to almost 550 per 100,000 patients during the pandemic. Likewise, the rate of short-term complications averaged 30 per 100,000, but rose to 49 per 100,000 at its high during the pandemic.The pandemic's interruptions caused vast differences in the healthcare routines of patients with diabetes, which initially led to more negative outcomes than before the pandemic. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Food Processing Waste in Vietnam: Utilization and Prospects in Food Industry for Sustainability Development

Vietnam is a country that produces a variety of agricultural products, including vegetables, tubers, fruits, and processed products. Along with the increase in population, the demand for consumers also increases, and the by-products of farming are increasing and being discharged into the environment. This is one of the critical research issues that need to be solved to ensure sustainability in agriculture. This review summarized recent studies on familiar sources of by-products in Vietnam, such as banana peels, citrus peels, dragon fruit skins, rice bran, and rice husks, and their potential in the food industry. Some solutions are also proposed to solve and turn this low-value raw material into a high-value product and serve a variety of products and consumers in the food industry. Especially after the COVID19 pandemic, the by-products contain valuable and reusable biological resources. These compounds could be future applications to support improving the consumer's immune system and various health benefits. Processed and utilized by-products from food production could not only help increase incomes for farmers, especially in developing countries like Vietnam but also could aid in ensuring food security and sustainability in agricultural production.

An Exploratory Study about the Effect of COVID-19 on the Intention to Adopt Virtual Reality in the Tourism Sector

During the health crisis caused by COVID-19, virtual reality (VR) proved to be useful for the tourism industry, allowing this industry to continue working despite the restrictions imposed. However, it remains to be seen if the impact of this sanitary crisis in the tourism industry influenced managers' intention to adopt this technology in the post-pandemic period. To fill this gap, a qualitative methodological approach was adopted, using the MAXQDA20 software and interviews with managers of tourism enterprises. The results show that the willingness to invest in technology, the perception of VR as a business strategy, and the perception of the impact of the pandemic are factors that regulate the intention of companies to adopt VR. In addition, prior experience with VR and the perception of technical support are also important for its adoption. Thus, it was concluded that VR can be a valuable sustainable strategy for tourism companies to address the challenges imposed by the pandemic. However, adopting the technology depends on factors such as financial availability, business strategy, and previous experience with VR. Furthermore, tourism companies must also receive adequate technical support to ensure its correct implementation.

Blending Academic Writing: The Use of Technology to teach amid Covid-19 Pandemic

Due to the Covid-19 pandemic, teachers have to hesitantly switch to the virtual world of teaching, known as enriched virtual blended learning in which technology, surely plays a significant role in material delivery and discussion. Studies related to blended learning in English language classes, especially in academic writing classes, have been done in many countries, but they are still lacking in the Indonesian setting. This study aimed to investigate the effectiveness of technology utilization in enriched blended learning to teach academic writing and the students' perspectives towards the use of technology in blended learning. This study involving forty-five students in a university in Jakarta applied both quantitative and qualitative methods. A pre-test and a post-test were assigned before and after the blended learning period to study the effectiveness of blended learning. In addition, surveys and interviews were conducted to investigate the students' perspectives. The results indicated that the use of technology in blended learning effectively helped students develop their academic writing skills despite being a new experience. Furthermore, despite some limitations, this strategy of using technology in teaching-learning was accepted with optimism as they started to get accustomed to it. Hence, the use of technology is promising for the future of learning. © 2023 IEEE.

Using Social Media to Build Perceived Mattering of Physical Educators

Social media has become an essential tool in social networking and content sharing. Our professional and personal lives have become inundated with social media platforms such as Facebook, Instagram, and Twitter. Educators are using these platforms increasingly as a way to remain current with developments in their respective fields. Social media can also support teachers in gaining knowledge, and receiving feedback and building relationships with educators around the world. Despite the prevalence of use within physical education, little research exists to understand how social media might enhance the work of physical educators. Given that physical educators experience marginality in their working environments, we propose that social media may provide a tool that can assist PE teachers in overcoming marginality and potentially increase their levels of perceived mattering. The purpose of this article is to discuss how physical educators can use social media to navigate marginality and increase perceptions of mattering.

Post-COVID-19 energy transition strategies: even reaching 100% renewable in Ecuador by 2055 is not enough to face climate change issue

The pandemic scenario caused by Covid-19 generated negative impacts. Covid-19 has made it clear that our daily lives depend to a high degree on access to energy. Therefore, now more than ever, it is necessary to promote new activities such as local food production, but also local energy capture. This article is an attempt to expose and quantify the benefits of a renewable energy transition in Ecuador post Covid-19 and post-oil. The generation, consumption, and reserves of oil in Ecuador were characterized, and the concept of energy transition was applied to evaluate the possibilities of integration of renewables, the progressive exit of thermal power plants, and future energy strategies. The year 2015 was taken as a basis and it was determined that energy use was 154.0 TWh / year, which corresponds to an end-user of approximately 147 TWh / year. The objective was to reduce this end-use demand to 80.0 TWh/year by 2055 through the integration of renewables and energy efficiency, for which 5 transition phases were planned until a 100% renewable system was obtained. It is concluded that the energy transition in Ecuador is technically possible and economically viable, without giving up the energy well-being that we currently enjoy. However, results show that even 100% renewable is not enough to face climate change.

Acceptance of Mobile Learning Technology by Teachers: Influencing Mobile Self-Efficacy and 21st-Century Skills-Based Training

This study aimed to investigate the factors influencing the acceptance of mobile learning technology for 21st-century skills-based training among teachers in Saudi Arabia and Pakistan. This study adopted the Unified Theory of Acceptance and Use of Technology (UTAUT) model, which included constructs such as performance expectancy, effort expectancy, facilitating conditions, social influence, mobile self-efficacy, student self-efficacy, behavioural intention, 21st-century skills-based training, and creative thinking skills. A survey was conducted with 619 teachers from Saudi Arabia and Pakistan who participated in a two-week mobile learning-based training session. The data were analysed using structural equation modeling (SEM). The results show that all hypotheses were supported, indicating a positive relationship between the constructs and the acceptance and use of mobile learning technology for 21st-century skills-based training. This study's findings suggest that by emphasising factors such as performance expectancy, effort expectancy, facilitating conditions, social influence, mobile self-efficacy, and student self-efficacy when designing mobile learning interventions, teachers will be more likely to accept and use mobile learning technology for 21st-century skills-based training and contributed to sustainability by providing increased access to quality education.

The Evolution of the Covid-19 Pandemic in Pediatric Patients with Sickle Cell Disease: From Alpha to Omicron

Background: Approximately two years ago, COVID-19 was declared a global pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and through genomic surveillance, we have seen the emergence of variants of SARS-CoV-2. In the United States, over 78 million cases and >900,000 deaths attributable to COVID-19 have been reported. SCD was identified as a risk factor for severe COVID-19 disease in adults and pediatric patients. The emergence of novel SARs- CoV-2 variants has led to challenges in diagnosis, treatment, and prediction of long-term sequelae in individuals with SCD and COVID-19. Aim(s): We compare the overall seasonal variation of COVID-19 variants and patterns of healthcare utilization and clinical presentation over time in pediatric patients with SCD and COVID-19 at Children's National Hospital (CNH). Method(s): Our single-center, observational cohort study included 193 pediatric patients with SCD (0-21 years) with PCR-confirmed SARSCoV- 2 infection between March 31, 2020, and January 31, 2022. Per the SECURE SCD Registry definitions, clinical severity was classified as asymptomatic, mild, moderate, and severe. Result(s): A total of 193 unique patients with SCD and positive SARS-CoV-2 PCRs between March 2020-January 2022 were included in our registry. Most patients were female (51.8%), and the mean age was 11.2 years (SD 6.5 years). Most of the cohort resides in Maryland (N=135), and HbSS was the dominant genotype (69.4%). During the alpha dominant variant of the COVID-19 pandemic (March 2020- June 2021) there were 70 cases, followed by 40 cases during the Delta variant (July 2021- December 19, 2021), and 83 cases during the Omicron variant dominance (from December 20, 2021-January 31,2022). There were 149 patients (77%) that presented to the emergency department (ED) or were hospitalized. There were a total of 80 hospitalizations (41.5%), and a relative comparison showed that the percentage of hospitalizations was highest during the delta wave (47.5%) and lowest during the omicron wave (36.1%) (p= 0.407). ED-only utilization was highest in the era of omicron (43.4%, N=36), followed by delta (32.5%, N=13), and then alpha (30%, N=21)(p=0.197). The most common SCD-related complication was vaso-occlusive (VOC) pain (33%, N=64) which accounted for half of all hospital admissions (51%, N=41 of 80). Acute chest syndrome (ACS) was reported in 40% (N=32) of admitted patients and was highest in the alpha era (54.8%, N=17). The use of blood transfusion therapy was highest in the alpha (N=17) and delta (N=14) variants, while Remdesivir use was highest in omicron (N=15). A total of 6 patients received monoclonal antibodies (Delta, N=4;omicron, N=2). Throughout all the variants, there was a significant difference in COVID-19 clinical severity (p>0.005). Of the patients classified as asymptomatic (13%, N=25), seventy-two percent (n=18) were diagnosed during the alpha variant. Mild severity was the most prevalent (69%, N=134), with the omicron variant having the highest cases (51.5%, N=69). Severe cases were observed in all variants (6.7%, N=13) but were most prevalent during the alpha variant (46.2%, N=6). Summary - Conclusion(s): Interestingly, while the relative percentage of hospitalizations was lowest during the omicron wave, it saw the highest percentages of ER utilization. Overall, COVID-19 remains mild in pediatric patients with SCD, and notably, there was higher health care utilization in the omicron era.

Healthcare costs vis-à-vis economic growth in pandemic crisis with technology adoption

COVID-19 pandemic brought up issues with healthcare costs, national economic development and welfare of the society in forefront. Nations across the globe followed different approaches to deal with COVID-19, such as zero tolerance, herd immunity, containment to build treatment capability. National healthcare became a contentious sociopolitical issue involving healthcare costs, technologies and societal health. In the United States even during the COVID-19 pandemic, the government approach was pursuing a sustainable improvement in patient care through adoption of medical and information technologies. The national healthcare policies are framed around technological interventions with the assumption that deployment of technologies could keep healthcare costs under control and at the same time improve health outcomes. However, evidences show that the healthcare costs are in the rise even with impressive progress in technological deployment. This article highlights some of the recent trends in healthcare costs, technological preparedness, medical technology developments in managing COVID-19 pandemic. The US government mandated electronic health record (EHR) systems implementation and assess its impact on healthcare costs and health outcomes. This article emphasizes the need for understanding the interconnectedness of costs, technology and societal health.

Assessing the Impact of Disruptive Events on Urban Mobility: A Case Study of Chicago Taxis during COVID-19

The rise of Transportation Network Companies (TNCs) over the last decade has significantly disrupted the taxi industry. Studies have shown that taxi ridership has plummeted, and their capacity utilization rates are lower than 50% in five major U.S. cities. Additionally, the COVID-19 pandemic has dealt a severe blow to the already struggling taxi industry. To monitor the evolution of the taxi industry and its impacts on society, our study evaluates changes in the utilization rates, fuel consumption, and emissions among Chicago taxis, using taxi data with rich information on trip profiles from pre-pandemic and pandemic times. Our findings indicate that the taxi utilization rate decreased during the pandemic. While fuel consumption and emissions per kilometer decreased thanks to the reduced traffic during the pandemic, the overall fuel consumption and emissions increased due to increased deadhead travel. The methods developed in this study can be applied to monitor and evaluate the impact of future disruptive events on urban mobility and transportation systems more effectively. By utilizing mobility data to better understand transportation systems, we can develop more efficient, sustainable, and resilient mobility solutions for smart cities. © 2023 ACM.

Evaluation of a Low-Cost Air Renewal System for Indoor Air Quality Control in a Climate Chamber

There is a growing concern about Indoor Environmental Quality (IEQ) in buildings as humans are spending longer in indoor environments, whether this is associated or not with climate change and vulnerability to extreme weather events. In the wake of the COVID pandemic, the need for indoor air quality control is likely to increase, the result of many adaptations in home environments to switch to remote work. In hot countries in the Global South, one of the alternatives is split A/C units with limited air renewal. While, odorless and colorless CO2, commonly generated by occupants through respiration, is among the relevant indoor air pollutants. The purpose of this study is to evaluate a low-cost, responsive air-renewal system in a climate chamber equipped with a standard split A/C unit. The results show the system's feasibility in curbing IAQ concerns and also highlight the risk of negative impacts on indoor thermal conditions and on energy consumption on using A/C. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.

Forecasting Residential Energy Consumption: A Case Study for Greece

Residential energy consumption forecasting has immense value in energy efficiency and sustainability. In the current work we tried to forecast energy consumption on residences in Athens, Greece. As a proof of concept, smart sensors were installed into two residences that recorded energy consumption, as well as indoors environmental variables (humidity and temperature). It should be noted that the data set was collected during the COVID-19 pandemic. Moreover, we integrated weather data from a public weather site. A dashboard was designed to facilitate monitoring of the sensors' data. We addressed various issues related to data quality and then we tried different models to forecast daily energy consumption. In particular, LSTM neural networks, ARIMA, SARIMA, SARIMAX and Facebook (FB) Prophet were tested. Overall SARIMA and FB Prophet had the best performance. Copyright © 2023 by SCITEPRESS - Science and Technology Publications, Lda. Under CC license (CC BY-NC-ND 4.0)

Development and Current Situation of Forest Use by Camping Sites in Japan

After the Second World War, camping and camping sites in forests have developed and increased significantly from the 1980 s to 1990 s in Japan, relying on the laws and institutions established from the 1950 s to 1970 s across multiple administrative sectors, obtaining social approval as a legitimatized outdoor activity and forest use. Since the 2000s, the management of these camping sites has deteriorated mainly owing to economic recession, which caused the movement of camping site renewal by the private sector. This movement directed the diversification of forest use by camping sites in recent years. Camping facilities have been developed in many ways to meet the needs of campers, including organized group camps that promote education and experience in forests, solo camps, glamping, and workcations under the spread of the COVID-19 that demand relaxing or productive environment, and leisure camps that require enrichment of outdoor activities. As a result of this diversification, possibilities for effective utilization of forests and regional revitalization through the management of camping sites have been observed. Many camping sites have utilized forest lands, standing trees, and forest spaces to develop facilities and services, and there are cases where firewood production for campers has promoted the reorganization and development of local forestry and securing of personnel for forest management. In addition to securing local employment brought by reorganization, local revitalization in rural and mountainous areas has been promoted through the linkage of the needs of campers to positive economic effects, increase of the visitors who deeply connected to local people, and comprehensive and sustainable use of resources in local societies. © 2023 Nihon Ringakkai. All rights reserved.

The Association of Bedside Nurse Staffing on Patient Outcomes and Throughput in a Pediatric Cardiac Intensive Care Unit

Health care throughput is the progression of patients from admission to discharge, limited by bed occupancy and hospital capacity. This study examines heart center throughput, cascading effects of limited beds, transfer delays, and nursing staffing on outcomes utilizing elective surgery cancellation during the initial severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic wave. This study was a retrospective single-center study of staffing, adverse events, and transfers. The study period was January 1, 2018 to December 31, 2020 with the SARS-CoV-2 period March to May 2020. There were 2,589 patients, median age 5 months (6 days-4 years), 1,543 (60%) surgical and 1,046 (40%) medical. Mortality was 3.9% ( n = 101), median stay 5 days (3-11 days), median 1:1 nurse staffing 40% (33-48%), median occupancy 54% (43-65%) for step-down unit, and 81% (74-85%) for cardiac intensive care unit. Every 10% increase in step-down unit occupancy had a 0.5-day increase in cardiac intensive care unit stay ( p = 0.044), 2.1% increase in 2-day readmission ( p = 0.023), and 2.6% mortality increase ( p < 0.001). Every 10% increase in cardiac intensive care unit occupancy had 3.4% increase in surgical delay ( p = 0.016), 6.5% increase in transfer delay ( p = 0.020), and a 15% increase in total reported adverse events ( p < 0.01). Elective surgery cancellation is associated with reduced high occupancy days (23-10%, p < 0.001), increased 1:1 nursing (34-55%, p < 0.001), decreased transfer delays (19-4%, p = 0.008), and decreased mortality (3.7-1.5%, p = 0.044). In conclusion, Elective surgery cancellation was associated with increased 1:1 nursing and decreased mortality. Increased cardiac step-down unit occupancy was associated with longer cardiac intensive care unit stay, increased transfer, and surgical delays.

Impact of COVID-19 (2020-2022) on cotton and garments market of Bangladesh: a small country case. (Special Issue: COVID-19 impacts on selected commodities.)

Bangladesh imports roughly 98% of cotton from abroad to produce fabric or yarn (USDA 2020. Cotton and Products Update. Bangladesh. Also available at https://apps.fas.usda.gov/newgainapi/api/Report/DownloadReportByFileName?fileName=Cotton%20and%20Products%20Update_Dhaka_Bangladesh_11-30-2020). The production of textiles in Bangladesh depends on the price of raw material, the demand for garment products in the importing countries, smooth supply chain management, and the domestic supply of cheap garment laborers. The global pandemic of COVID-19 disrupted the supply chain of almost all physical goods and services, including textiles. It caused the price of textiles to fall due to a drop in worldwide demand, and increased the marginal cost of textile production due to supply chain interruptions. This paper shows how the decline in the demand for garments, coupled with an increase in cost, shrinks the producer welfare of textile manufacturing and garment exports of the small producing country, Bangladesh.

Economics of a Health System's Direct-to-Consumer Telemedicine for Its Employees

Am J Manag Care. 2023;29(6):In Press _____ Takeaway Points The value of direct-to-consumer (DTC) telemedicine services offered by academic health systems is understudied. * DTC telemedicine services for low-acuity or minor illnesses are increasingly offered as an employee benefit, but any per-episode unit cost advantage may be offset by overuse of care. * DTC telemedicine staffed by an academic health system and offered to its employees resulted in lower per-episode unit costs for care within 7 days and only marginally increased the use of services. * DTC telemedicine staffed by an academic health system and offered directly to employees was cost-saving. _____ Employers in the United States have increasingly been offering a direct-to-consumer (DTC) telemedicine benefit for low-acuity or minor illnesses to their employees.1-3 By 2021, more than 95% of employers with 50 or more employees provided some coverage for DTC telemedicine in their largest health plan;more than 75% felt that offering telemedicine was important and nearly 20% either limited or eliminated cost sharing for telemedicine.4 Despite these trends among general employers, few health systems have directly provided DTC telemedicine to their own employees. [...]because these services are easy to access (often available immediately, around the clock, and without travel), they may induce overuse of care, especially for self-limited conditions such as viral upper respiratory infections for which the alternative to in-person care is no care at all, thus increasing the overall cost of care.5-11 Telemedicine will save money relative to in-person care if any unit price advantages are not overwhelmed by the increased use of care overall, induced by its convenience. Employers provide health insurance coverage for 158 million Americans or nearly 50% of the population. Since the COVID-19 pandemic began, telemedicine has represented a significantly larger portion of all medical claims—consistently more than 5% of all medical claims by mid-202112-15—and the estimated value of the global telemedicine industry is projected to reach a quarter of a trillion dollars by 2024.13 Yet, the future of telemedicine remains undetermined with reimbursement rates in debate,16-18 driven in large part because its economic value is understudied and uncertain. Penn Medicine is self-insured and more than 95% of employees use its only employer-sponsored plan—a preferred provider organization (PPO) plan—rather than insurance obtained individually or through a family member. Since 2017, these PPO-insured employees have been offered Penn Medicine OnDemand,19 a 24/7 DTC telemedicine benefit to employees and their adult (≥ 18 years) dependents.

Long COVID-19 Associated with 5-Fold Increase in Total Medical Costs and Greater Use of Inpatient and Outpatient Services Compared to Non-Long COVID-19: An Analysis of Real-World Data

Objectives: Assess real-world evidence data on the prevalence and impact of long COVID (LC) to establish a baseline for the value of potential therapeutic interventions. Method(s): This study was a retrospective, longitudinal analysis of administrative claims from multiple payer channels spanning 4/1/2020-6/30/2022. Inclusion criteria: 1) ICD-10-CM diagnosis code of COVID-19 (U07.1) on or after 4/1/2020 (COVID-19 diagnosis date=index date), 2) 18+ years of age on index, and 3) at least -365/+30 days of continuous plan enrollment surrounding index. Employing a conservative LC definition, patients were classified as LC if they presented at least 1 claim >= 28 days following the index date which included both a COVID-19 diagnosis and >=1 of 8 LC-related symptoms. LC and non-LC patients were compared on demographics, COVID-19 symptoms, healthcare utilization, and medical costs. Descriptive statistics were presented for outcomes, and bivariate tests of significance were used to assess differences between cohorts. Result(s): Of 4,938,801 medically attended COVID-19 patients meeting inclusion criteria, 386,153 (7.8%) qualified as LC. The LC patients were older (Mean(SD) = 67.0(19.0) vs. 51.0(20.7)), were more likely to be female (65.1% vs. 60.4%), were in poorer health (Deyo-Charlson Comorbidity Index=3.51(3.24) vs. 1.47(2.45)), and presented greater baseline total medical expenditures ($39,769($60,401) vs. $15,275($35,640);p < 0.0001). On index, LC patients had a higher rate of LC-related symptoms, and in the 180-day post-index period, LC patients incurred increased total medical costs ($38,874($54,098) vs. $7,319($18,439);p < 0.001) and greater use of inpatient and outpatient medical services. Conclusion(s): Patients with LC presented elevated rates of symptoms and incurred 5-fold greater medical costs post-index compared to non-LC patients. This study is one of the first to longitudinally quantify the cost and symptom burden of LC in a real-world setting and helps to establish a baseline for the value of potential therapeutic interventions.Copyright © 2023