Health care use up to 6 months after COVID-19 in 700.000 children and adolescents: a pre-post study

ObjectivesTo explore whether, and for how long COVID-19 among children gives an increase in use of health care services, when compared to children with no COVID-19. MethodsStudying all Norwegian residents aged 1-5, 6-15 and 16-19 years from August 1st 2020 to February 1st 2021 (N= 768 560), we contrasted rates of monthly all-cause primary and specialist health care use before and after testing for SARS-CoV-2 (% relative change), for children testing positive (non-hospitalized in the acute phase) (N=10 306) vs children with no COVID-19 (N=758 254). ResultsWe found a substantial elevation in short-term primary care use for children testing positive for SARS-CoV-2 during the first month following positive test when compared to children testing negative (relative elevation 1-5 years: 325%, 95%CI=296-354; 6-15 years: 434%, 95%CI=415-453; 16-19 years: 360%, 95%CI=342-379). There was still elevated primary care use at 2 months (1-5 years: 21%, 95%CI= 4-38; 6-15 years: 13%, 95%CI=2-25) and at 3 months (1-5 years: 26%, 95%CI=7-45, 6-15 years: 15%, 95%CI=3-26) for young children, but not at 2 or 3 months for the older children (16-19 years: 10%, 95%CI=-1-22 and 6%, 95%CI=-5-18, respectively). The 1-5-year-olds also had a long-term (up to 6 months) increase of primary care (14%, 95%CI=1-26) that was not observed for older age groups, when compared to same-aged children testing negative. We observed no elevated use of specialist care. ConclusionChildren in pre-school age used health services for a longer time (3-6 months) after COVID-19 than children in primary and secondary school age (1-3 months).