COVID-19 is caused by SARS-CoV-2, which spread globally after 2019. Long COVID, recognized by the World Health Organization (WHO), refers to new or persistent symptoms lasting at least 12 weeks. It can affect multiple organ systems and significantly reduce quality of life.
Common symptoms involve cognitive issues, fatigue, and breathlessness, with prevalence varying widely. In response, healthcare systems have developed interdisciplinary clinics that integrate psychosocial care, medical treatment, and rehabilitation by using hybrid delivery approaches.
Specialised outpatient programmes were implemented within a large provincial health system in Alberta (Canada). These programmes support patients with persistent as well as complex symptoms related to COVID-19. These programmes use community referrals, team-based care, and individualised treatment plans. A recent study published in the American Journal of the Medical Sciences aimed to assess their utilisation, patient-reported outcomes, and influence on healthcare use and healthcare costs to inform future long COVID care models.
In this retrospective observational clinical study, data were collected from two urban-based sites serving diverse populations between April 2022 and September 2023. A total of 2,287 (Site A = 43% [n = 977], Site B = 57% [n = 1,310], median age = 49 years, female = 68%) adults with COVID-19 and symptoms persisting for ≥12 weeks were accepted into the programmes. Data sources included administrative databases, electronic medical records, and patient-reported outcome measures like EuroQol 5-dimension 5-level (EQ-5D-5L), Patient Health Questionnaire-9 (PHQ-9), Generalised Anxiety Disorder-7 (GAD-7), and post-COVID functional status (PCFS). Statistical methods included paired t-tests, descriptive statistics, and regression modelling analysis. Cost-effectiveness was evaluated using quality-adjusted life years (QALYs) and incremental cost-effectiveness ratios.
Among accepted patients, 88% were aged 18-65, years and 11.5% were ≥66 years. Most referrals came from family physicians (79%), followed by specialists (18%) and hospital providers (3%). Patients were predominantly from urban regions (86%).
From April 2022 to September 2023, a total of 6,605 visits (Site A = 1,810 and Site B = 4,795) were completed, averaging 184 visits at Site A and 382 visits at Site B monthly. Site B mainly depended on rehabilitation providers (occupational therapists [26%] and physiotherapists [30%]) and virtual care (79%), whereas Site A had more physician-led visits (23%) and telephone use (61%). Wait times averaged 28.5 weeks at Site A compared to 18.2 weeks at Site B.
Common symptoms included dyspnoea (31%), fatigue (38%), and cough (34%). Pulmonary (17.5%) and neurological (17.9%) complications were most commonly observed. Clinical outcomes showed small but statistically significant improvements from baseline to follow-up: PHQ-9 (10.8 to 9.9, p = 0.003) and PCFS (2.0 to 1.9, p < 0.001), as well as EQ-VAS (+4.3, p < 0.05), although the clinical impact was modest. Healthcare costs declined with inpatient costs of $60.27/month, whereas the QALY gain was 0.046, resulting in a cost-effectiveness of $31,140/QALY.
This study’s limitations include its retrospective design without controls, which limits causality, an incomplete and short follow-up period, reliance on self-reported outcomes, missing infection timings, and preliminary economic findings due to limited comparative data.
In conclusion, interdisciplinary long COVID programs demonstrated modest improvements in quality of life, functional status, and depression, with potential cost-effectiveness. However, unchanged healthcare utilization and the absence of control groups limit causal inferences, highlighting the need for long-term comparative studies.
Reference: Zahiriharsini A, Rostami M, Hurd C, et al. Evaluating medical and rehabilitation programs for long COVID: utilization, health outcomes, and healthcare costs. Am J Med Sci. 2026;371(4):362-371. doi:10.1016/j.amjms.2025.12.780
