To estimate the impact of COVID-19 infection on the requirement for social care services among adults aged ≥50 years in North-West London.

Population-based matched cohort study using linked routinely collected electronic social care, primary care and hospital records (the Discover dataset).

Approximately 4.7 million people with a general practitioner record in North-West London.

150 654 adults aged ≥50 years with a first diagnosis of COVID-19 between January 2020 and February 2023 and 547 704 propensity score matched comparators without a COVID-19 diagnosis during the same period.

Social care use and associated costs overall and by specific type (care home, domiciliary care, respite care, social care assessments) stratified by age group, index year, diagnosis setting, severe COVID-19 risk status, frailty and care home admission prior to index. Overall survival was also assessed.

A total of 9174 (6.09%) individuals with COVID-19 required social care use (of any type) during follow-up, 2.54 times (95% CI 2.48 to 2.61; p

This increase in social care utilisation was observed for all age groups. Adults with COVID-19 had over four times higher social care costs than matched comparators (£1276 per person per year (pppy) vs £276 pppy; mean difference +£1000, 95% CI £947 to £1054, p

COVID-19 infection is associated with meaningfully higher social care requirements in the ≥50 years population. Reducing the need for social care use and the associated costs of care should be one of the goals of interventions to reduce the risk and severity of COVID-19 infection.