Persistence of Symptoms among Commercially Insured Patients with Coccidioidomycosis, United States, 2017–2023

Some patients with coccidioidomycosis experience prolonged respiratory and systemic symptoms. However, data on prevalence and persistence of most symptoms are lacking. Using an insurance claims database, we identified patients with coccidioidomycosis diagnoses in the United States during 2017-2023. We assessed prevalence of associated symptoms from 6 months before to 1 year after first diagnosis code (index date) and compared post-index date prevalence to baseline (within 6 to 4 months before index date). Among 2,640 patients, cough (20.8%), dyspnea (13.0%), and fatigue (8.8%) were the most common symptoms at index date. Dyspnea and erythema nodosum were elevated 3-6 months post-index date (p<0.03), and fatigue, headache, joint pain, and weakness were elevated 9-12 months post-index date compared with baseline (p<0.05).These findings demonstrate that symptoms can persist in coccidioidomycosis patients, which could help inform clinical management and refine estimates of the health and economic burden of coccidioidomycosis.