Background Despite evidence that long-term COVID-19 symptoms may persist for up to a year, their implications for healthcare utilization and costs 6 months post-diagnosis remain unexplored. Methods Our objective is to determine for how many months post-diagnosis healthcare utilization and costs of COVID-19 patients persist above pre-diagnosis levels and explore response heterogeneity across age groups. This population-based retrospective cohort study followed COVID-19 patients' healthcare

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... ation and costs from January 2019 through March 2021 using claims data provided by the COVID-19 Research Database. The patient population includes 328,777 individuals infected with COVID-19 during March-September 2020 and whose last recorded claim was not hospitalization with severe symptoms. We measure the monthly number and costs of total visits and by telemedicine, preventive, urgent care, emergency, immunization, cardiology, inpatient or surgical services and established patient or new patient visits. Results The mean (SD) total number of monthly visits and costs pre-diagnosis were .4805 (4.2035) and 130.67 (1,216.66) dollars compared with 1.1998 (8.5184) visits and 341.7576 (2,439.5581) dollars post-diagnosis. COVID-19 diagnosis associated with .7338 (95% CI, 0.7175 to 0.7500 visits; P < .001) more total healthcare visits and an additional $215.40 (95% CI, 210.76 to 220.00; P<.001) in monthly costs. Excess monthly utilization and costs for individuals under 19 years old subside after 5 months to .021 visits and $3.7, persist at substantial levels for all other groups and most pronounced among individuals 50-59 (.236 visits and $78.60) and 60-69 (.196 visits and $73.10) years old. Conclusions This study found that COVID-19 diagnosis was associated with increased healthcare utilization and costs 6 months post-diagnosis. These findings imply a prolonged burden to the US healthcare system from medical encounters of COVID-19 patients and increased spending.