The aftermath of Post COVID-19 Condition in Italy and the United States: an ecological comparison

Post COVID-19 Condition (PCC) is a clinical syndrome following COVID-19 disease. PCC symptoms in adults entail significant productivity loss and reduced quality of life. This study aimed at estimating the epidemiological and economic burden of PCC among the working-age population of Italy and the US. This ecological analysis was conducted on data from January 2020 to April 2023, regarding population aged 18-64. PCC incidence was retrieved for the US, while for Italy it was estimated from COVID-19 cases. Prevalence of factors associated with PCC and parameters to calculate temporary productivity losses (TPL) were retrieved. An estimated Incidence Rate Ratio (eIRR) of PCC incidence in Italy and the US was calculated. TPL for reduced earnings and total Quality-Adjusted Life Years (QALYs) lost were also estimated. The ecological eIRR Italy/US was 0.842 [95%CI: 0.672–1.015], suggesting that, holding COVID-19 cases constant, 15.8% fewer PCC cases have occurred in Italy compared to the US. Overall PCC cases were found to be roughly 12.0 [95%CI: 9.9–14.1] million in the US, with 1.9 [95%CI: 1.6–2.3] million QALYs lost, and around 2.4 [95%CI: 1.8–3.0] million in Italy, with 0.4 [95%CI: 0.3–0.5] million QALYs lost. Up to April 2023, the TPL was estimated to be €4.5 [95%CI: 3.5–6.1] billion in Italy and $41.5 [95%CI: 34.3–48.7] billion in the US. PCC has had a significant epidemiological and economic impact on the working-age population. The findings from this study may be of use for health planning and policy regarding PCC in working-age adults.