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Volume 29, Number 2—February 2023
Dispatch

Longitudinal Analysis of Electronic Health Information to Identify Possible COVID-19 Sequelae

Eleanor S. Click1Comments to Author , Donald Malec1, Jennifer R. Chevinsky, Guoyu Tao, Michael Melgar, Jennifer E. Giovanni, Adi V. Gundlapalli, S. Deblina Datta, and Karen K. Wong
Author affiliations: Centers for Disease Control and Prevention, Atlanta, Georgia, USA (E.S. Click, J.R. Chevinsky, G. Tao, M. Melgar, J.E. Giovanni, A.V. Gundlapalli, S.D. Datta, K.K. Wong); Centers for Disease Control and Prevention, Hyattsville, Maryland, USA (D. Malec)

Main Article

Table

Diagnostic codes reported during post–COVID-19 interval with increased rate >60 d after acute illness relative to pre–COVID-19 baseline rate, by interval from index date, from large administrative all-payer database, United States, January 2019–December 2020*

Diseases and codes Rate increase relative to pre–COVID-19 rate (SE)†
 Post–COVID-19 rate, encounters/1,000 person-months
60–89 d 90–119 d 120–149 d 60–89 d 90–119 d 120–149 d
Certain infectious and parasitic diseases
B97.21: SARS-associated coronavirus as the cause 
of diseases classified elsewhere 28.7 (12.8) 31.9 (15.6) 82.2 (39.5) 0.22 0.24 0.63
B94.8: Sequelae of other specified infectious and 
parasitic diseases 15.4 (4.5) 17 (5.1) 11.6 (4.2) 0.26 0.29 0.20
A41.53: Sepsis due to Serratia 6 (3.9) NS NS 0.60 NS NS
A41.89: Other specified sepsis 2.8 (0.5) NS NS 0.69 NS NS
B34.2: Coronavirus infection, unspecified 2 (0.6) 2.4 (0.7) NS 0.24 0.29 NS
R65.21: Severe sepsis with septic shock
 1.5 (0.2)
 NS
 NS
1.29
 NS
 NS
Diseases of blood and blood-forming organs and certain disorders involving the immune mechanism
D84.821: Immunodeficiency due to drugs
 7.9 (6.0)
 NS
 NS
0.30
 NS
 NS
Diseases of the circulatory system
B33.24: Viral cardiomyopathy 9.8 (8.8) NS NS 0.30 NS NS
I46.8: Cardiac arrest due to other underlying condition 4.8 (2.3) 3.5 (1.9) NS 0.70 0.50 NS
I46.9: Cardiac arrest, cause unspecified 4.6 (0.9) 3.7 (0.9) 4.5 (1.1) 0.40 0.32 0.38
I40.0: Infective myocarditis
 NS
 12.6 (10.6)
 NS
NS
 0.40
 NS
Diseases of the digestive system
K20.91: Esophagitis, unspecified with bleeding 19.8 (18.4) NS NS 0.30 NS NS
K21.00: Gastro-esophageal reflux disease with 
esophagitis, without bleeding 5.7 (1.3) 6.1 (1.5) 5.7 (1.7) 0.29 0.31 0.29
K20.90: Esophagitis, unspecified without bleeding 3.1 (1.4) 5.8 (2.3) NS 0.70 0.13 NS
K00.7: Teething syndrome
 NS
 4 (2.3)
 NS
NS
 0.50
 NS
Diseases of the genitourinary system
N18.31: Chronic kidney disease, stage 3a 4 (1.4) 5.1 (1.9) 6.4 (2.2) 0.14 0.18 0.22
N18.30: Chronic kidney disease, stage 3 unspecified 3.6 (0.3) 3.8 (0.4) 4.2 (0.5) 1.83 1.91 2.13
N18.32: Chronic kidney disease, stage 3b 2.5 (1.0) 3.2 (1.2) 5.1 (1.9) 0.90 0.12 0.19
Diseases of the musculoskeletal system and connective tissue
M62.59: Muscle wasting and atrophy, not elsewhere 
classified, multiple sites NS 4.1 (2.1) NS NS 0.10 NS
M65.071: Abscess of tendon sheath, right ankle and 
foot
 NS
 NS
 280.3 (550.3)
NS
 NS
 0.10
Diseases of the nervous system
G62.81: Critical illness polyneuropathy 11.8 (6.8) 9.1 (6.8) NS 0.70 0.50 NS
G93.3: Postviral fatigue syndrome 6.8 (2.5) 4.2 (2.1) NS 0.12 0.70 NS
G72.81: Critical illness myopathy 5 (1.5) NS NS 0.30 NS NS
R51.9: Headache, unspecified
 2.6 (0.3)
 3.9 (0.3)
 3.9 (0.4)
1.47
 2.23
 2.23
Diseases of the respiratory system
J12.81: Pneumonia due to SARS-associated 
coronavirus 8.5 (3.6) NS NS 0.90 NS NS
J80: Acute respiratory distress syndrome 7.4 (2.9) 3.9 (1.7) NS 0.32 0.17 NS
J95.851: Ventilator associated pneumonia 5.2 (2.4) 4 (2.1) NS 0.90 0.70 NS
J12.89: Other viral pneumonia
 NS
 16.1 (2.6)
 11 (2.0)
NS
 1.33
 0.91
Diseases of skin and subcutaneous tissue
L65.9: Nonscarring hair loss, unspecified 2.4 (0.5) 3.5 (0.7) 2.3 (0.6) 0.36 0.54 0.35
L89.153: Pressure ulcer of sacral region, stage 3 1.7 (0.4) NS NS 0.42 NS NS
L89.154: Pressure ulcer of sacral region, stage 4
 1.6 (0.3)
 NS
 NS
0.68
 NS
 NS
Endocrine, nutritional, and metabolic diseases
E87.71: Transfusion associated circulatory overload
 4.9 (3.0)
 NS
 NS
0.40
 NS
 NS
Mental, behavioral, and neurodevelopmental disorders
F10.139: Alcohol abuse with withdrawal, unspecified
 8.8 (7.6)
 NS
 NS
0.30
 NS
 NS
Neoplasms
C83.90: Non-follicular (diffuse) lymphoma, unspecified,
unspecified site
 411 (807)
 272.6 (535.2)
 NS
0.14
 0.90
 NS
Symptoms, signs, and abnormal clinical and laboratory findings, not elsewhere classified
R74.01: Elevation of liver transaminase levels 4.8 (1.2) 5 (1.4) 6.5 (1.9) 0.21 0.21 0.28

*Results are significant at p<0.05. Diagnoses are limited to those with RRs significantly increased at >60 d. Clinical Classification Software Refined categories were taken from Agency for Healthcare Research and Quality Clinical Classifications Software Refined (https://www.hcup-us.ahrq.gov/toolssoftware/ccsr/ccs_refined.jsp). NS, not significant; RR, relative rate. †A specific diagnosis is counted for each patient encounter so that 1 patient might contribute >1 diagnosis if they were admitted for that diagnosis more than once during time period of interest.

Main Article

1These authors contributed equally to this article.

Page created: November 18, 2022
Page updated: January 23, 2023
Page reviewed: January 23, 2023
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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