Improving the recognition and care of patients with long-term health complications of COVID-19

IMPORTANCE: More than one year into the COVID-19 pandemic, clinicians and researchers are learning that many patients who were infected with COVID-19 develop chronic conditions that negatively affect their overall health. This may occur in older adults with multiple prior chronic conditions, or in younger adults who were relatively healthy prior to infection with COVID-19. Presently, there is limited understanding of how long-term post-COVID-19 conditions and a person's prior chronic conditions impact their overall use of the healthcare system, their chances of dying and the types of care they receive, including at the end of their life. This project aims to study and predict the development of clinical conditions, the types and quality of care patients receive in hospital, their long-term patterns of healthcare needs including end of life care, and their risk of death following their discharge from hospital after COVID-19 infection. METHODS: GEMINI has built a data platform that collects and harmonizes patient data from all medical and intensive care admissions at ~30 hospitals across Ontario (representing ~65% of the province's patients). We will use rich clinical data and leverage advanced methods in machine learning to study healthcare delivery and clinical outcomes up to one-year after initial hospitalization for COVID-19. Our partnerships with key knowledge users helped inform our research questions and will allow immediate application of our findings to directly support Canada's ongoing response to the pandemic. IMPACT: Improving our understanding and recognition of patients with post-COVID-19 conditions will allow us to identify gaps in care. We will focus on defining high-quality care that can enhance recovery, improve clinical outcomes and improve the quality of end-of-life care in patients who die by minimizing inequities in access to this care.