Abul Yasin, Harris Daniel A, Chachlani Preeti, Hayes Kaleen N, Zullo Andrew R, Mor Vincent, Gravenstein Stefan
Center of Innovation in Long Term Services and Supports, Providence VA Medical Center, Providence, Rhode Island, USA.
Division of Geriatric and Palliative Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.
J Gerontol A Biol Sci Med Sci. 2025 Jun 10;80(7). doi: 10.1093/gerona/glaf108.
Long COVID incidence and risk factors in older adults need to be better characterized to identify risk mitigation strategies. Our aim was to quantify the incidence of Long COVID in a population-based sample of older adults and to describe the association between COVID-19 vaccination and Long COVID risk.
This cohort study included Medicare fee-for-service beneficiaries ≥ 66 years diagnosed with COVID-19 between October 1, 2021, and March 31, 2023 (index date). Long COVID diagnoses were identified from Medicare Part A-B claims based on ICD-10-CM code U09.9. We measured the number of COVID-19 vaccine doses administered prior to the index date using Medicare Part B claims and pharmacy records. Kaplan-Meier estimators, Cox proportional hazards, and Fine-Grey regression models were used to estimate the 1-year cumulative incidence and relative rate of Long COVID.
We identified 3 588 671 Medicare beneficiaries diagnosed with COVID-19. Overall, 3.89% of beneficiaries were diagnosed with Long COVID over 1 year. A gradient in the 1-year cumulative incidence of Long COVID was observed according to the number of prior COVID-19 vaccine doses. Beneficiaries with 4 or more COVID-19 vaccine doses had a 39% lower adjusted rate of Long COVID relative to beneficiaries without a prior dose (adjusted hazard ratio = 0.61, 95% CI = 0.60-0.62).
Long COVID diagnoses in Medicare claims were common in a large sample of older adults with COVID-19, and we observed a gradient in Long COVID risk across the number of prior COVID-19 vaccine doses. Promoting continued vaccination may be an effective strategy to mitigate the burden of Long COVID in older adults.
需要更好地明确老年人中长新冠的发病率及风险因素，以确定风险缓解策略。我们的目的是量化基于人群的老年样本中长新冠的发病率，并描述新冠疫苗接种与长新冠风险之间的关联。
这项队列研究纳入了2021年10月1日至2023年3月31日期间（索引日期）诊断为新冠的66岁及以上医疗保险按服务收费受益人。根据国际疾病分类第十次修订本临床修正版（ICD-10-CM）编码U09.9，从医疗保险A-B部分索赔中确定长新冠诊断。我们使用医疗保险B部分索赔和药房记录测量索引日期之前接种的新冠疫苗剂量数。采用Kaplan-Meier估计量、Cox比例风险模型和Fine-Grey回归模型来估计长新冠的1年累积发病率和相对发生率。
我们确定了3588671名诊断为新冠的医疗保险受益人。总体而言，3.89%的受益人在1年内被诊断为长新冠。根据之前接种的新冠疫苗剂量数，观察到长新冠的1年累积发病率存在梯度变化。接种4剂或更多剂新冠疫苗的受益人相对于未接种过疫苗的受益人，长新冠调整后发病率低39%（调整后风险比=0.61，95%置信区间=0.60-0.62）。
在大量感染新冠的老年样本中，医疗保险索赔中的长新冠诊断很常见，并且我们观察到长新冠风险随之前接种的新冠疫苗剂量数存在梯度变化。促进持续接种疫苗可能是减轻老年人长新冠负担的有效策略。
