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Introduction: COVID-19 is a pulmonary disease associated with fever and dyspnea, affecting all age groups. Older patients, however, have a higher likelihood of adverse outcomes including death. Severe disease is associated with hyperinflammation and differential expression of inflammatory mediators has been demonstrated for patients aged ≥70 years. Aim: To evaluate the impact of level of care on length of hospital stay (LOS) and costs for COVID-19 patients stratified by age. Methods: We conducted a cohort study of patient data from the Premier Health Database comprising healthcare and billing information for a geographically diverse selection of hospitals in the United States from April 2020 through March 2021. Results: We identified over 162,000 hospitalized COVID-19 patients requiring respiratory support; approximately 68,000 (42%) were aged ≥70 years, 66,000 (41%) were aged 50–69 years, and 28,000 (17%) were aged Conclusion: Higher levels of care for patients with COVID-19 are associated with LOS and costs. Funded by GSK: medical writing support provided by Fishawack Indicia Ltd, funded by GSK.

Background: COVID-19, due to its deadly nature and rapid spread, is causing significant global economic burden. Aim: To summarize emerging data on direct costs associated with disease management of COVID-19. Methods: A targeted review of the literature published before 21 August 2020 reporting direct costs associated with COVID-19 was undertaken using the PubMed/MEDLINE database. Results were compared by country, study type and disease severity. Results: Retrospective studies in China reported an average total hospitalization cost per case of $3,027 (regardless of severity) to $16,652 for critical patients early in the pandemic, with higher costs observed for females and patients with more severe disease and comorbidities. In the US, simulation studies estimated that median medical costs were $57-$96 per patient for mild cases not requiring hospitalization, and from $11,367 (aged 0-17 years) to $88,114 (requiring ventilation for ≥4 days) per case in hospitalized patients. Older age, more severe disease, major complications or comorbidities, and longer requirement for ventilation were predicted to increase medical costs. The total out-of-pocket costs in the US were estimated as $1,300-$10,560 per hospitalized case depending on complications, comorbidities and length of hospital stay. No studies were identified that reported direct costs of COVID-19 in other countries. Conclusions: Direct costs associated with clinical management of COVID-19 were significant for both the health systems and patients, and varied by country, disease severity, age, sex, comorbidities, and ventilation status. Data from observational studies are needed for countries other than China. Funding: GSK [study 214627]