Retrospective Cohort Study Measuring the Disparities in Post-COVID Conditions among Persons with Disabilities: Findings from Primary Care Settings, 2019-2022

Abstract Purpose This study compared the incidence of post-COVID conditions (PCCs) by pre-pandemic disability status within primary care. Methods This retrospective observational study used electronic health record (EHR) data to identify primary care patients with ≥1 visit during January 2018 - December 2019 and ≥ 1 visit during May 2020 - December 2022. Disability status was identified using diagnostic codes from January 2018 to December 2019. COVID-19 diagnosis was captured during April 2020 - December 2022. Accelerated Failure Time models were used to assess time to incident circulatory, endocrine, neurological, and respiratory diagnoses at least 28 days post COVID-19. Results Among patients aged ≥50 years, those with disabilities and COVID-19 had higher incidence and earlier onset of newly diagnosed circulatory (Time Ratio (TR) 0.70, 95% CI 0.64, 0.77), endocrine (TR 0.91, 95% CI 0.84, 0.99), and neurological (TR 0.52, 95% CI 0.44, 0.62), but not respiratory conditions during the post-COVID period as compared to patients with COVID-19 without disability. No associations were found among patients aged <50 years. Conclusion Primary care patients with pre-existing disability experienced a higher incidence and earlier onset of PCCs than patients without disability.