Predictors of Postacute Sequelae of COVID-19 Development and Rehabilitation: A Retrospective Study

Objective: To examine the frequency of postacute sequelae of SARS-CoV-2 (PASC) and the factors associated with rehabilitation utilization in a large adult population with PASC.Design: Retrospective study.Setting: Midwest hospital health system.Participants: 19,792 patients with COVID-19 from March 10, 2020, to January 17, 2021.Intervention: Not applicable.Main Outcome Measures: Descriptive analyses were conducted across the entire cohort along with an adult subgroup analysis. A logistic regres-sion was performed to assess factors associated with PASC development and rehabilitation utilization. Results: In an analysis of 19,792 patients, the frequency of PASC was 42.8% in the adult population. Patients with PASC compared with those without had a higher utilization of rehabilitation services (8.6% vs 3.8%, P<.001). Risk factors for rehabilitation utilization in patients with PASC included younger age (odds ratio [OR], 0.99; 95% confidence interval [CI], 0.98-1.00; P=.01). In addition to several comorbidities and demo-graphics factors, risk factors for rehabilitation utilization solely in the inpatient population included male sex (OR, 1.24; 95% CI, 1.02-1.50; P=.03) with patients on angiotensin-converting-enzyme inhibitors or angiotensin-receptor blockers 3 months prior to COVID-19 infections having a decreased risk of needing rehabilitation (OR, 0.80; 95% CI, 0.64-0.99; P=.04).Conclusions: Patients with PASC had higher rehabilitation utilization. We identified several clinical and demographic factors associated with the development of PASC and rehabilitation utilization. Archives of Physical Medicine and Rehabilitation 2022;103:2001-8 (c) 2022 by the American Congress of Rehabilitation Medicine. Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)