Traveling across the country in a small van

If you see “MD COVID”, (240) 466-4488 or a text from 51454 on your phone, answer the call or complete the web survey. – It’s one of our public health professionals calling with important news about your test result or potential exposure to COVID-19. Please, cooperate and help contact tracers by answering all the questions they ask.

• Contact tracers will provide guidance and help you access resources.
• A contact tracer will never ask you for your social security number, financial or bank account information, or personal details unrelated to COVID-19.
• They will not ask for your passwords.
• They will not ask for money or payment.
• They will ask for verification of your date of birth, address, and any other phone numbers you may have.

If you recently tested positive, instead of a phone call you may receive a text or email with a link to complete the Contact Tracing Web Survey. This survey is much like the one you would complete over the phone with a contact tracer and will provide you with additional guidance and resources upon completion.

What is MD Covid call?

I’ve Been Alerted – CovidLINK | MD Department of Health You received a notification from MD COVID Alert because you have been in close contact with someone with COVID-19. What’s next? To determine your date of exposure on an iPhone, go to Settings and open Exposure Notifications. The exposure date is found under “You might have been exposed to COVID-19” On an Android phone, your date of exposure is conveyed in the alert message under “possible exposure date.” If you receive an exposure alert, you should immediately start to wear a well-fitting mask when around others at home and indoors in public for a full 10 days after your last exposure date. You should get tested 5 full days after your last exposure date and follow testing guidance here. We recommend that you get tested 5 days after exposure. Contact your health care provider or visit to find testing locations near you. Make sure you wear a mask and maintain a distance of 6 feet from others when you go to get tested. You may receive a call, text or email from our contact tracers.

• Please answer if you see MD COVID or 240-466-4488 on your caller ID or follow the link provided by the text from 51454 or email from [email protected].
• You could receive a call, text or email if an individual with COVID-19 shares with a contact tracer that they were in close contact with you while infectious.

The contact tracer will call you and provide guidance on how to monitor for symptoms and when to get tested. This process was developed to help prevent further spread of COVID-19. A contact tracer will never ask you for your social security number, financial or bank account information, or personal details unrelated to COVID-19. : I’ve Been Alerted – CovidLINK | MD Department of Health

What happens if you test positive for Covid in Maryland?

All individuals who test positive for COVID-19, regardless of vaccination status, should complete isolation. –

You must stay home except to get medical care. You may not go to work or school and should tell your employer or school that you tested positive. You should stay in a separate room from other household members and use a separate bathroom, if possible. You should wear a well-fitting mask if you have to be in a room with others. Follow your health care provider’s guidance.

The length of your isolation will depend on how serious your COVID-19 symptoms were.

If you had no symptoms, you may end isolation after day 5 If you had symptoms, you may end isolation after day 5 if:

You are fever-free for 24 hours (without the use of fever-reducing medication) AND Your symptoms are improving

Day 0 is the day your symptoms started OR the day you tested positive if you do not have symptoms. Loss of taste and smell may persist for weeks or months after recovery and need not delay the end of isolation. If COVID caused you   (shortness of breath, difficulty breathing, or hospitalization), or if you have a weakened immune system, you should isolate through day 10. If you have any emergency warning signs for COVID-19, seek medical attention immediately. These include:

trouble breathing persistent pain or pressure in the chest new confusion inability to wake or stay awake pale, gray, or blue-colored skin, lips, or nail beds, depending on skin tone severe abdominal pain

These are not all possible symptoms. Seek medical attention for any other symptoms that are severe or concerning. Call 911 if you have a medical emergency and tell the operator that you have COVID-19.

After 5 days of isolation, if you are feeling better (no fever without the use of fever-reducing medications and symptoms improving), you may end isolation but should continue to wear your mask through day 10.

You can remove your mask sooner than day 10 if you have two negative rapid at-home antigen tests 48 hours apart. You should continue to monitor your symptoms for an additional 5 days.

If you cannot wear a well-fitting mask while around others through Day 10, you should remain in isolation through Day 10.

After you have ended isolation, if you develop COVID-19 symptoms for the first time or your COVID-19 symptoms recur or worsen, restart your isolation at day 0. Talk to a healthcare provider if you have questions about your symptoms or when to end isolation.

Use this CDC to identify who your close contacts are. We encourage you to confidentially and anonymously notify your close contacts of exposure using the site.

Please answer the call from MD COVID or (240) 466-4488, the text from 51454 or email from [email protected] to help Maryland contact tracers slow the spread of COVID-19. are one of many risk-reduction measures, along with,, and physical distancing, that by reducing the chances of spreading COVID.

If you take an at-home test and your results are positive, you should communicate your results to your healthcare provider and let your close contacts know they were exposed to COVID-19. You can report your positive test results either through the mobile app associated with your at-home test, or through the,

Log in on the portal’s home page to submit a report. If you do not have login information, you may register to create an account. Reporting positive results through the At-Home Test Report Portal will initiate the contact tracing process, which is required to receive work or school excuse and release letters. If you test positive for COVID-19, you may be eligible to receive free and potentially life-saving treatments. If you have been recently diagnosed with COVID-19, you should expect a call, text or email from a contact tracer. Through contact tracing, we can better understand disease transmission, prevent new infections, and help slow the spread of COVID-19. : If You Test Positive – CovidLINK | MD Department of Health

Does Maryland have a Covid app?

STEP ONE – For iPhones: Go to Settings and Turn On Exposure Notifications. Opt-in and select your region as Maryland and complete the onboarding as needed. To enable MD COVID Alert, you must have one of the following iOS versions:

iPhone 6s or newer: iOS 13.7 or later iPhone 5s, 6, or 6 Plus: iOS 12.5

All older devices are currently not supported. Apple is working on solutions. We will share updates as more information is available. For Android Devices: The MD COVID Alert app is available on Google Play, You can also search for “MD COVID Alert” directly in the Play Store. Android users can use MD COVID Alert if their phone supports Bluetooth Low Energy, Android Version 6 (API 23) or above, and can access the Google Play Store.

Do I need to quarantine in Maryland?

There is no requirement to self-quarantine when arriving to Maryland.

Do you have to answer the MD Covid call?

If you see “MD COVID”, (240) 466-4488 or a text from 51454 on your phone, answer the call or complete the web survey. – It’s one of our public health professionals calling with important news about your test result or potential exposure to COVID-19. Please, cooperate and help contact tracers by answering all the questions they ask.

Contact tracers will provide guidance and help you access resources. A contact tracer will never ask you for your social security number, financial or bank account information, or personal details unrelated to COVID-19. They will not ask for your passwords. They will not ask for money or payment. They will ask for verification of your date of birth, address, and any other phone numbers you may have.

If you recently tested positive, instead of a phone call you may receive a text or email with a link to complete the Contact Tracing Web Survey. This survey is much like the one you would complete over the phone with a contact tracer and will provide you with additional guidance and resources upon completion.

How does Covid contact tracing work?

Contact tracing starts with a person who tested positive for COVID-19. This person will be advised to stay home except to get medical care until they are no longer contagious. A trained interviewer will reach out to the person who has tested positive and ask for the contact information of close contacts.

How long do you stay contagious after testing positive for COVID-19?

When am I considered recovered? – You are considered recovered when you are no longer infectious for COVID-19. Typically, this is:

7 full days after the start of symptoms or from the date of the positive test (if no symptoms) AND symptoms have been improving for at least 24 hours (or 48 hours if you have gastrointestinal symptoms such as diarrhea or vomiting) and you don’t have a fever

Some people may continue to have a lingering cough, particularly if they are prone to chronic cough. However, if they meet the criteria above, they are no longer considered infectious. Visit https://library.nshealth.ca/CovidRecovery/welcome for more information about your recovery from COVID-19.

Can you get a false positive Covid test?

Risks – There’s a chance that your COVID-19 diagnostic test could return a false-negative result. This means that the test didn’t detect the virus, even though you actually are infected with it. If you have symptoms, you risk unknowingly spreading the virus to others if you don’t take proper precautions, such as wearing a face mask when appropriate.

• There’s also a chance that a COVID-19 rapid antigen test can produce false-positive results if you don’t follow the instructions carefully.
• False-positive results mean the test results show an infection when actually there isn’t one.
• The risk of false-negative or false-positive test results depends on the type and sensitivity of the COVID-19 diagnostic test, thoroughness of the sample collection, and accuracy of the lab analysis.

Be wary of any offers for at-home COVID-19 tests that the FDA has not cleared for use. They often give inaccurate results.

How long will you test positive after having Covid?

COVID-19 and Your Health Important update: Healthcare facilities CDC has updated select ways to operate healthcare systems effectively in response to COVID-19 vaccination. COVID-19 Testing: What You Need to Know Key times to get tested:

If you have, test immediately. If you were exposed to COVID-19 and do not have symptoms, wait at least 5 full days after your exposure before testing. If you test too early, you may be more likely to get an inaccurate result. If you are in certain high-risk settings, you may need to test as part of a screening testing program. Consider testing before contact with someone at high risk for severe COVID-19, especially if you are in an area with a medium or high COVID-19 Community Level.

For guidance on using tests to determine which mitigations are recommended as you recover from COVID-19, go to, Viral tests look for a current infection with SARS-CoV-2, the virus that causes COVID-19, by testing specimens from your nose or mouth. There are two main types of viral tests: nucleic acid amplification tests (NAATs) and antigen tests.

NAATs, such as PCR-based tests, are most often performed in a laboratory. They are typically the most reliable tests for people with or without symptoms. These tests detect viral genetic material, which may stay in your body for up to 90 days after you test positive. Therefore, you should not use a NAAT if you have tested positive in the last 90 days. Antigen tests* are rapid tests which produce results in 15-30 minutes. They are less reliable than NAATs, especially for people who do not have symptoms. A single, negative antigen test result does not rule out infection. To best detect infection, a negative antigen test should be repeated at least 48 hours apart (known as serial testing). Sometimes a follow-up NAAT may be recommended to confirm an antigen test result.

*Self-tests, or at-home tests, are usually antigen tests that can be taken anywhere without having to go to a specific testing site. Follow FDA and manufacturer’s instructions, including for the number of times you may need to test. Multiple negative test results increase the confidence that you are not infected with the virus that causes COVID-19.

You can order free self-test kits at or purchase tests online, in pharmacies, and retail stores. You can also visit to see a list of authorized tests. As noted in the labeling for authorized over-the-counter antigen tests: Negative results should be treated as presumptive (meaning that they are preliminary results). Negative results do not rule out SARS-CoV-2 infection and should not be used as the sole basis for treatment or patient management decisions, including infection control decisions. Please see FDA guidance on the use of at-home COVID-19 antigen tests.

I am in a circumstance where I should get tested and: I have not had COVID-19 or I have not had a positive test within the past 90 days. You may choose NAAT or antigen tests. If you use an antigen test and your result is negative, multiple tests may be necessary.

• I tested positive for COVID-19 in the last 90 days.
• My first positive test result was within: I have symptoms Use antigen tests.
• If negative, multiple tests may be necessary.
• I do not have symptoms Testing is not recommended to detect a new infection.
• My first positive test result was within: I have symptoms Use antigen tests.

If negative, multiple tests may be necessary. I do not have symptoms Use antigen tests. If negative, multiple tests may be necessary After a positive test result, you may continue to test positive for some time after. You may continue to test positive on antigen tests for a few weeks after your initial positive.

Isolate and take precautions including wearing a high-quality mask to protect others from getting infected. Tell people you had recent contact with that they, Monitor your, If you have any, seek emergency care immediately. Consider contacting a healthcare provider,, or pharmacy to learn about that may be available to you. Treatment must be started within several days after you first develop symptoms to be effective.

You are more likely to get very sick if you are an older adult or have an underlying medical condition. may be available for you.

A negative COVID-19 test means the test did not detect the virus, but this doesn’t rule out that you could have an infection, If you used an antigen test, see,

If you have symptoms:

You may have COVID-19, but tested before the virus was detectable, or you may have another illness. Take general public health precautions to prevent spreading an illness to others. Contact a healthcare provider if you have any questions about your test result or if your symptoms worsen.

If you do not have symptoms, but were exposed to the virus that causes COVID-19, you should continue to take recommended steps after exposure. If you do not have symptoms and you have not been exposed to the virus that causes COVID-19, you may return to normal activities.

Need additional help? Use the to get personalized recommendations and resources. Antibody or serology tests look for antibodies in your blood that fight the virus that causes COVID-19. Antibodies are proteins created by your immune system after you have been infected or have been vaccinated against an infection. They can help protect you from infection, or severe illness if you do get infected, for a period of time afterward. How long this protection lasts is different for each disease and each person. Antibody tests should not be used to diagnose a current infection with the virus that causes COVID-19. An antibody test may not show if you have a current infection, because it can take 1 to 3 weeks after the infection for your body to make antibodies. Difference Between Flu and COVID-19 Influenza (Flu) and COVID-19 are both contagious respiratory illnesses, but they are caused by different viruses. COVID-19 is caused by infection with a coronavirus named SARS-CoV-2, and flu is caused by infection with influenza viruses. You cannot tell the difference between flu and COVID-19 by symptoms alone because some of the symptoms are the same. Some PCR tests can differentiate between flu and COVID-19 at the same time. If one of these tests is not available, many provide flu and COVID-19 tests separately. Talk to a healthcare provider about getting tested for both flu and COVID-19 if you have symptoms. : COVID-19 and Your Health

How do I get the Covid certificate from the app?

Access your certificate – To access your certificate, you can download the COVIDCert NI app. Or, you can log in at the link below for a printable PDF version:

Log in to the COVID certificate service

Can you test positive after COVID vaccine?

Myth: I heard that getting vaccinated causes you to test positive for COVID-19. – Truth: COVID-19 vaccines will not cause you to test positive on your COVID-19 test. If your body develops an immune response, which is the goal of vaccination, there is a possibility that you may test positive on some antibody tests.

What a positive Covid test looks like?

A POSITIVE result must show BOTH a BLUE line and a PINK line near the BLUE line. Look closely! Even a very faint, pink Test Line and a blue Control Line is a POSITIVE result. The intensity of the lines may vary.

Why do I keep testing positive for COVID?

Positive COVID-19 Test: A Sign of Viral Shedding – Viral shedding is the release of a virus as it multiplies inside your body. If you are shedding virus, it means you can pass it on and infect other people. Testing positive for COVID-19 is an indication of viral shedding.

What are the abbreviations for Covid?

COVID-19 (Coronavrus Disease 2019) – Official name for the disease caused by the SARS-CoV-2 (2019-nCoV) coronavirus. Informal name: Corona. See Coronavirus Disease 2019 (COVID-19) for details.

What is Covid diagnosis code?

Figure 1. Weekly Number of Post–COVID-19 Diagnosis Codes and COVID-19 Diagnosis Codes, October 1, 2021, to January 28, 2022 (Open and Closed Claims) Light blue indicates COVID-19 diagnosis codes and dark blue indicates post–COVID-19 diagnosis codes. Figure 2. Observed Proportions of Concurrent Diagnosis Codes on the Day of Post–COVID-19 Diagnosis Code by Age COPD indicates chronic obstructive pulmonary disease; GERD, gastroesophageal reflux disease. Figure 3. Observed Proportion of Diagnosis Codes on the Day of the Post–COVID-19 Diagnosis Code vs in the 30 Days Before the Post–COVID-19 Diagnosis Code COPD indicates chronic obstructive pulmonary disease; GERD, gastroesophageal reflux disease. Table. Baseline Characteristics of Patients With a Post–COVID-19 Diagnosis Code, October 1, 2021, to January 31, 2022 Original Investigation Infectious Diseases October 6, 2022 JAMA Netw Open.2022;5(10):e2235089. doi:10.1001/jamanetworkopen.2022.35089

Original Investigation Individuals With Persistent Fatigue, Cognitive, and Respiratory Symptom Clusters After COVID-19 Global Burden of Disease Long COVID Collaborators; Sarah Wulf Hanson, PhD; Cristiana Abbafati, PhD; Joachim G. Aerts, MD; Ziyad Al-Aly, MD; Charlie Ashbaugh, MA; Tala Ballouz, MD; Oleg Blyuss, PhD; Polina Bobkova, MD; Gouke Bonsel, PhD; Svetlana Borzakova, MD; Danilo Buonsenso, MD; Denis Butnaru, PhD; Austin Carter, MPH; Helen Chu, MD; Cristina De Rose, MD; Mohamed Mustafa Diab, MD; Emil Ekbom, MD; Maha El Tantawi, PhD; Victor Fomin, PhD; Robert Frithiof, PhD; Aysylu Gamirova, BSc; Petr V. Glybochko, PhD; Juanita A. Haagsma, PhD; Shaghayegh Haghjooy Javanmard, PhD; Erin B. Hamilton, MPH; Gabrielle Harris, PhD; Majanka H. Heijenbrok-Kal, PhD; Raimund Helbok, MD; Merel E. Hellemons, PhD; David Hillus, MD; Susanne M. Huijts, PhD; Michael Hultström, PhD; Waasila Jassat, MMed; Florian Kurth, MD; Ing-Marie Larsson, PhD; Miklós Lipcsey, PhD; Chelsea Liu, MSc; Callan D. Loflin, BA; Andrei Malinovschi, PhD; Wenhui Mao, PhD; Lyudmila Mazankova, MD; Denise McCulloch, MD; Dominik Menges, MD; Noushin Mohammadifard, PhD; Daniel Munblit, PhD; Nikita A. Nekliudov, MD; Osondu Ogbuoji, ScD; Ismail M. Osmanov, MD; José L. Peñalvo, PhD; Maria Skaalum Petersen, PhD; Milo A. Puhan, PhD; Mujibur Rahman, MD; Verena Rass, PhD; Nickolas Reinig, BS; Gerard M. Ribbers, PhD; Antonia Ricchiuto, MD; Sten Rubertsson, PhD; Elmira Samitova, MD; Nizal Sarrafzadegan, MD; Anastasia Shikhaleva, BSc; Kyle E. Simpson, BS; Dario Sinatti, MD; Joan B. Soriano, MD; Ekaterina Spiridonova, BSc; Fridolin Steinbeis, MD; Andrey A. Svistunov, PhD; Piero Valentini, MD; Brittney J. van de Water, PhD; Rita van den Berg-Emons, PhD; Ewa Wallin, PhD; Martin Witzenrath, MD; Yifan Wu, MPH; Hanzhang Xu, PhD; Thomas Zoller, PhD; Christopher Adolph, PhD; James Albright, BS; Joanne O. Amlag, MPH; Aleksandr Y. Aravkin, PhD; Bree L. Bang-Jensen, MA; Catherine Bisignano, MPH; Rachel Castellano, MA; Emma Castro, MS; Suman Chakrabarti, MA; James K. Collins, BS; Xiaochen Dai, PhD; Farah Daoud, BS; Carolyn Dapper, MA; Amanda Deen, MPH; Bruce B. Duncan, MD; Megan Erickson, MA; Samuel B. Ewald, MS; Alize J. Ferrari, PhD; Abraham D. Flaxman, PhD; Nancy Fullman, MPH; Amiran Gamkrelidze, PhD; John R. Giles, PhD; Gaorui Guo, MPH; Simon I. Hay, DPhil; Jiawei He, MSc; Monika Helak, BA; Erin N. Hulland, MPH; Maia Kereselidze, PhD; Kris J. Krohn, MPH; Alice Lazzar-Atwood, BSc; Akiaja Lindstrom, MEpi; Rafael Lozano, MD; Deborah Carvalho Malta, PhD; Johan Månsson, MS; Ana M. Mantilla Herrera, PhD; Ali H. Mokdad, PhD; Lorenzo Monasta, DSc; Shuhei Nomura, PhD; Maja Pasovic, MEd; David M. Pigott, PhD; Robert C. Reiner Jr, PhD; Grace Reinke, MA; Antonio Luiz P. Ribeiro, MD; Damian Francesco Santomauro, PhD; Aleksei Sholokhov, MSc; Emma Elizabeth Spurlock, MPH; Rebecca Walcott, MPH; Ally Walker, MA; Charles Shey Wiysonge, MD; Peng Zheng, PhD; Janet Prvu Bettger, DSc; Christopher J.L. Murray, DPhil; Theo Vos, PhD

Key Points Question How is the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) code for postacute sequelae of COVID-19 being used in clinical practice? Findings In this cohort study, 56 143 patients had an ICD-10-CM code for post–COVID-19 conditions; among patients with 3 months of preindex continuous enrollment, 1080 (8.6%) were children.

1. Only 698 patients (5.5%) had at least 1 of the 5 codes listed as possible concurrent conditions in the coding guidance.
2. Meaning These findings suggest the diagnosis code is being used to identify patients of all ages with continuing illness following the acute phase of disease; however, the clinical presentation of postacute COVID-19 spans a range of conditions.

Importance A new International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) diagnosis code (U09.9 Post COVID-19 condition, unspecified) was introduced by the Centers for Disease Control and Prevention on October 1, 2021.

Objective To examine the use of the U09.9 code and describe concurrently diagnosed conditions to understand physician use of this code in clinical practice. Design, Setting, and Participants This cohort study of US patients with an ICD-10-CM code for post–COVID-19 condition used deidentified patient-level claims data aggregated by HealthVerity.

Children and adolescents (aged 0-17 years) and adults (aged 18-64 and ≥65 years) with a post–COVID-19 condition code were identified between October 1, 2021, and January 31, 2022. To identify a prior COVID-19 diagnosis, 3 months of continuous enrollment (CE) before the post–COVID-19 diagnosis date was required.

1. Main Outcomes and Measures Presence of the ICD-10-CM U09.9 code.
2. Results There were 56 143 patients (7723 female patients ; mean age, 47.6 years) with a post–COVID-19 diagnosis code, with cases increasing in mid-December 2021 following the trajectory of the Omicron case wave by 3 to 4 weeks.
3. The analysis cohort included 12 622 patients after the 3-month preindex CE criteria was applied.

Among this cohort, the median (IQR) age was 49 (35-61) years; however, 1080 (8.6%) were pediatric patients. The U09.9 code was used most often in the outpatient setting, although 305 older adults (14.0%) were inpatients. Only 698 patients (5.5%) had at least 1 of the 5 codes listed as possible concurrent conditions in the coding guidance.

• Only 8879 patients (70.4%) had a documented acute COVID-19 diagnosis code (569 among children), and the median (IQR) time between acute COVID-19 and post–COVID-19 diagnosis codes was 56 (21-200) days.
• The most common concurrently coded conditions varied by age; children experienced COVID-19–like symptoms (eg, 207 had cough and 115 had breathing abnormalities), while 459 older adults aged 65 years or older (21.1%) experienced respiratory failure and 189 (8.7%) experienced viral pneumonia.

Conclusions and Relevance This retrospective cohort study found patients with a post–COVID-19 ICD-10-CM diagnosis code following the acute phase of COVID-19 disease among patients of all ages in clinical practice in the US. The use of the U09.9 code encompassed a wide range of conditions.

1. It will be important to monitor how the use of this code changes as the pandemic continues to evolve.
2. Postacute sequelae of COVID-19 are increasingly documented in patients recovering from the infection weeks to months after the acute episode.1, 2 These persistent or delayed-onset sequelae can occur across the spectrum of acute infection severity, from asymptomatic patients to those requiring mechanical ventilation.3 Manifestation of post–COVID-19 can range from nonspecific symptoms such as fatigue, muscle weakness, and headache 3 to specific conditions such as myocarditis, 2 decreased glomerular filtration rate, 4 and impaired lung function.1 Given the uncertainties in defining postacute sequelae of COVID-19, diagnosis in clinical practice remains challenging.

To improve the documentation of post–COVID-19, a new International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) diagnosis code (U09.9 Post COVID-19 condition, unspecified) was introduced on October 1, 2021.5 We aimed to examine the use of the new code and describe concurrently diagnosed conditions to understand how physicians are using this code in clinical practice.

This retrospective cohort study followed the Strengthening the Reporting of Observational Studies in Epidemiology ( STROBE ) reporting guideline. This study was considered exempt from review and the need for informed consent by Sterling institutional review board due to the use of deidentified data. We analyzed deidentified patient-level open and closed claims data aggregated by HealthVerity and refreshed in nearly real time.

The HealthVerity database contains all major payer types (commercial, Medicare, and Medicaid) and links the patient journey across inpatient admissions, outpatient visits, and pharmacy services. Children and adolescents (aged 0-17 years) and adult patients (aged 18-64 and ≥65 years) with a post–COVID-19 condition code ( ICD-10-CM code U09.9) were identified in both open and closed claims between October 1, 2021, and January 31, 2022.

• The index date was defined as the first post–COVID-19 diagnosis date.
• Weekly numbers were plotted over time to visually compare the use of the post–COVID-19 condition code to the trajectory of the Omicron case wave.
• To assess patient characteristics and to identify prior COVID-19 diagnosis, we required 3 months of continuous enrollment before the index date, which limited the analysis to closed claims.

The 3-month period was chosen to ensure patients were actively enrolled and all claims were visible to assess prior disease, but also maximized the available sample size. Demographics were measured on the index date. Prior COVID-19 diagnosis ( ICD-10-CM code U07.1) was identified using all available lookback time before the index date (eg, 3-month continuous enrollment and all available history extending back to April 2020).

• The all-available lookback approach attempted to mitigate misclassification of prior COVID-19 status.
• All study variables were summarized with descriptive statistics (ie, counts and percentages for categorical variables, and means, SDs, medians, and IQRs for continuous variables).
• The frequency of concurrent diagnosis codes was evaluated on the index date and was reported descriptively by age category.

We also assessed the most common diagnosis codes within the 30 days before the index post–COVID-19 condition code. Descriptive statistics were performed by Genesis Research, Inc using SAS statistical software version 9.4 (SAS Institute, Inc). As this was a descriptive study using a retrospective database, sample size and power were not calculated.

• There were no sensitivity analyses conducted for this study.
• There were 56 143 patients with a post–COVID-19 condition diagnosis code, of whom 12 622 had 3 months of continuous enrollment (7723 female patients ; median age 49.0 years).
• Among all open and closed claims, the post–COVID-19 code was used immediately after it was released and plateaued until mid-December 2021 when numbers increased.

This followed the trajectory of the Omicron case wave by 3 to 4 weeks ( Figure 1 ). After the 3-month continuous enrollment criteria were applied, there were 12 622 patients remaining in the analytic cohort (eFigure in the Supplement ). The decrease in sample size was due to the use of closed claims (ie, insurance claims sourced from insurance providers that have undergone an adjudication or payment process) for the variables requiring a lookback period.

1. The median (IQR) age at diagnosis was 49 (35-61) years; however, 1080 cases (8.6%) occurred in pediatric patients and 2179 cases (17.3%) occurred in adults aged 65 or more years.
2. The majority (9363 cases ) of post–COVID-19 cases occurred in younger adults.
3. Post–COVID-19 was more common among female patients (7723 cases ), and was often diagnosed in the outpatient setting, although 305 cases (14.0%) occurring in older adults were coded as inpatient.

Only 698 patients (5.5%) had at least 1 of the 5 codes listed as possible concurrent conditions in the coding guidance ( Table ). Additionally, 8879 patients (70.4%) had a documented COVID-19 diagnosis before the post–COVID-19 diagnosis, although fewer children had a prior COVID-19 code (569 cases ).

1. The median (IQR) time between the COVID-19 and post–COVID-19 diagnosis was 56 (21-200) days, ranging from 40 days for children to 59 days for younger adults ( Table ).
2. The most common concurrent conditions varied by age; children aged 0 to 17 years experienced COVID-19–like symptoms (eg, cough, 207 cases ; and breathing abnormalities, 115 cases ), whereas more serious conditions were more common among adults 65 years or older (eg, respiratory failure, 459 cases ; and viral pneumonia,189 cases ) ( Figure 2 and eTable in the Supplement ).

Signs and symptoms (eg, cough and breathing abnormalities) were slightly less common on the day of the post–COVID-19 diagnosis code compared with the 30 days before the post–COVID-19 diagnosis code. Comparatively, more serious conditions (eg, respiratory failure and viral pneumonia) were slightly more common in the 30 days before the post–COVID-19 code compared with the day of the post–COVID-19 code ( Figure 3 ).

After the release of a new ICD-10-CM code for post–COVID-19 condition in October 2021, we observed this code among 56 143 patients through January 31, 2022, in this cohort study. When new codes are added to the ICD-10-CM coding dictionary, it is not always clear how quickly they will be used. Similar to when the code for acute COVID-19 (U07.1) was introduced, there was immediate use in routine clinical practice.6 We also observed increasing use later in January 2022, approximately 1 month after the peak in COVID-19 diagnoses, suggesting a temporal association with acute case epidemiology.

The guidance for the post–COVID-19 condition code recommends concurrently coding 1 of the following conditions: chronic respiratory failure, loss of smell or taste, multisystem inflammatory syndrome, pulmonary embolism, or pulmonary fibrosis.7 However, clinicians’ use of the post–COVID-19 code is not limited to these specific symptoms or diseases.

Indeed, we observed very few patients (5.5%) with these conditions. It appears that physicians are using this code to represent a multitude of symptoms, conditions, and body systems. The seemingly broad use of this new diagnosis code is not unexpected. COVID-19 has previously been linked to developing chronic conditions (eg, cardiovascular and kidney disease), which could be more severe in older age groups.8 This may explain why we observed 14.0% of adults aged 65 years or older coded with post–COVID-19 condition in an inpatient setting.

Although our study was not designed to determine whether these concurrent conditions were incident or exacerbations of preexisting chronic conditions, it is likely that older adults with post–COVID-19 experience more varied and complicated sequelae. Further research using other databases (eg, electronic health records) is needed to examine potential overlap between the post–COVID-19 code and clinical signs and symptoms.

1. Although the majority (74.2%) of post–COVID-19 cases occurred in younger adults, 8.6% occurred in children.
2. The most common concurrent diagnoses in children were signs and symptoms including cough, breathing abnormalities, malaise, and throat and chest pain.
3. These are symptoms similar to those reported in other prospective studies.9 – 11 It is important to note that most post–COVID-19 codes were identified in the outpatient setting vs the inpatient setting.

However, further analyses could stratify by care setting to further describe differences between these patients. Among those with a prior documented COVID-19 diagnosis (8879 cases ), the time to the post–COVID-19 diagnosis code was a median (IQR) of 56 (21-200) days.

• This contributes to the body of literature seeking to understand when post–COVID-19 starts.
• The median time of 56 days is aligned with post–COVID-19 starting at either 3 or 4 weeks, 4 as viral shedding declines over the course of 2 weeks, although prolonged shedding has been documented for severe cases.12 This study has limitations.

HealthVerity includes both open and closed claims, so it is possible that claims for post–COVID-19 were missing, particularly in the later period. Therefore, we did not attempt to estimate the proportion of the population with post–COVID-19. Second, this study captures only medically attended COVID-19 diagnoses and, thus, the 70% with a prior diagnosis is likely an underestimate.

It is possible that individuals tested positive with a home test, with a polymerase chain reaction test that was not submitted, or tested positive before entering the database. Additionally, we did not have laboratory confirmation of COVID-19 diagnosis. Third, this data source includes patients with commercial insurance, Medicaid, and Medicare.

It may not be generalizable to uninsured patients or patients with other types of insurance. Fourth, vaccination status is underestimated in claims data due to the nature of vaccination distribution in the US. Therefore, we were unable to present reliable vaccination information by dose or by brand, or to ensure that the unvaccinated population was truly unvaccinated.

Fifth, given the epidemiology of COVID-19, the lack of racial and ethnic data is also a substantial limitation of this analysis. These findings present an early description of how physicians are using the post–COVID-19 condition ICD-10-CM code in routine care settings. This diagnosis code is being used to identify patients with illness following the acute phase of infection in patients of all ages.

However, manifestations of post–COVID-19 include a wide range of conditions. Although this code could provide a quantifiable method to measure the burden of post–COVID-19 using clinical practice data, further use of this code for research is limited until a standard definition of post–COVID-19 is agreed upon by the medical and public health community.

It will be important to monitor how the use of this code changes as the pandemic continues to evolve. Additional follow-up studies are warranted in other data sources as data becomes available. Accepted for Publication: August 11, 2022. Published: October 6, 2022. doi: 10.1001/jamanetworkopen.2022.35089 Open Access: This is an open access article distributed under the terms of the CC-BY-NC-ND License,

© 2022 McGrath LJ et al. JAMA Network Open, Corresponding Author: Leah J. McGrath, PhD, Real World Evidence Center of Excellence, Pfizer Inc, 235 E 42nd St, New York, NY 10017 ( [email protected] ). Author Contributions: Dr McGrath and Mr Surinach had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

1. Concept and design: McGrath, Scott, Surinach, Malhotra.
2. Acquisition, analysis, or interpretation of data: McGrath, Scott, Surinach, Chambers, Benigno.
3. Drafting of the manuscript: McGrath, Scott, Surinach.
4. Critical revision of the manuscript for important intellectual content: Scott, Surinach, Chambers, Benigno, Malhotra.

Statistical analysis: McGrath, Surinach, Chambers, Benigno. Obtained funding: McGrath. Supervision: Benigno, Malhotra. Conflict of Interest Disclosures: Dr McGrath reported being employed by and holding stock in Pfizer, Inc. Ms Scott reported being employed by and holding stock and stock options in Pfizer, Inc.

• Mr Surinach reported receiving consulting fees from Pfizer, Inc.
• Mr Chambers being employed by Pfizer, Inc.
• Mr Benigno reported being employed by and owning stock in Pfizer, Inc.
• Ms Malhotra reported being employed by and holding stock in Pfizer, Inc.
• No other disclosures were reported.
• Funding/Support: This study was funded by Pfizer, Inc.

Role of the Funder/Sponsor: All authors participated, as employees of Pfizer, Inc, in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

1. Additional Contributions: Amanda Miles, MPH (Pfizer, Inc), provided quality review of this manuscript and figures.
2. Sina Noshad, MD (Genesis Research, Inc), provided writing assistance.
3. Phoenix Riley, PharmD, MSc, and Amy Guisinger, PharmD, MPH (both from AESARA, Inc), provided assistance with revisions and were funded by Pfizer Inc.3.

Tabacof L, Tosto-Mancuso J, Wood J, et al. Post-acute COVID-19 syndrome negatively impacts health and wellbeing despite less severe acute infection.  MedRxiv, Preprint posted online November 6, 2020. doi: 10.1101/2020.11.04.20226126 Google Scholar 7.

Centers for Disease Control and Prevention. ICD-10-CM tabular list of diseases: U09.9.2022. Accessed September 1, 2022. https://icd10cmtool.cdc.gov/ 12. Fontana LM, Villamagna AH, Sikka MK, McGregor JC. Understanding viral shedding of severe acute respiratory coronavirus virus 2 (SARS-CoV-2): review of current literature.

 Infect Control Hosp Epidemiol,2021;42(6):659-668. doi: 10.1017/ice.2020.1273 PubMed Google Scholar Crossref

What does IgM Covid mean?

A positive IgM test indicates that you may have been recently infected or vaccinated and your immune system has started responding to the vaccination or that your immune system has started responding to the virus.

What is Covid MIS?

What is MIS? Multisystem inflammatory syndrome (MIS) can affect children (MIS-C) and adults (MIS-A). MIS is a rare but serious condition associated with COVID-19 in which different body parts become inflamed, including the heart, lungs, kidneys, brain, skin, eyes, or gastrointestinal organs.