Introduction:

Outpatient rehabilitation is recommended in the treatment of post COVID-19 condition. While racial and ethnic disparities in the incidence and severity of COVID-19 have been well documented, little is known about the use of outpatient rehabilitation among patients with post COVID-19 condition.

Objective:

To examine factors associated with outpatient rehabilitation use following COVID-19 and to ascertain whether differential incidence of sequelae explain variation in post-COVID rehabilitation utilization by race and ethnicity.

Design:

Case-control study.

Setting:

Community.

Participants:

U.S. adults with COVID-19 during 2020 in the TriNet X database.

Intervention:

N/A MAIN OUTCOME MEASURES: Receipt of outpatient rehabilitation services within 6 months of COVID-19 diagnosis and incidence of post COVID-19 condition symptoms (weakness, fatigue, pain, cognitive impairment, mobility difficulties, and dyspnea).

Results:

From 406,630 laboratory-confirmed COVID-19 cases, we identified 8,724 individuals who received outpatient rehabilitation and matched 28,719 controls. Of rehabilitation users, 43.3% were 40 years old or younger, 54.8% were female, 58.2% were white, 17.9% were African American/Black, 2.1% were Asian, 13.0% were Hispanic, 39.2% had no comorbidities, and 40.3% had been hospitalized for COVID-19. Dyspnea (20.4%), fatigue (12.4%), and weakness (8.2%) were the most frequently identified symptoms. Although there were no racial differences in the incidence of the 6 post COVID-19 condition symptoms considered, African American/Black individuals were significantly less likely to receive outpatient rehabilitation (OR=0.89; 95% CI: 0.84-0.96; p=0.003) than their white counterparts. Hispanic individuals had higher outpatient rehabilitation utilization (OR=1.22; 95% CI: 1.11-1.33; p<0.001) and a significantly higher incidence of post-COVID fatigue.

Conclusions:

In this large nationally representative study, African American/Black race was associated with lower utilization of outpatient rehabilitation services despite a similar incidence of post COVID-19 condition symptoms. Further research is needed to better understand access barriers to rehabilitation services for post COVID-19 condition recovery care and address racial inequalities in receipt of care. This article is protected by copyright. All rights reserved.