Abstract
BackgroundLong COVID describes new or persistent symptoms at least 4 weeks after onset of acute COVID-19. Clinical codes to describe this phenomenon were recently created.AimTo describe the use of long-COVID codes, and variation of use by general practice, demographic variables, and over time.Design and settingPopulation-based cohort study in English primary care.MethodWorking on behalf of NHS England, OpenSAFELY data were used encompassing 96% of the English population between 1 February 2020 and 25 May 2021. The proportion of people with a recorded code for long COVID was measured overall and by demographic factors, electronic health record software system (EMIS or TPP), and week.ResultsLong COVID was recorded for 23 273 people. Coding was unevenly distributed among practices, with 26.7% of practices having never used the codes. Regional variation ranged between 20.3 per 100 000 people for East of England (95% confidence interval [CI] = 19.3 to 21.4) and 55.6 per 100 000 people in London (95% CI = 54.1 to 57.1). Coding was higher among females (52.1, 95% CI = 51.3 to 52.9) than males (28.1, 95% CI = 27.5 to 28.7), and higher among practices using EMIS (53.7, 95% CI = 52.9 to 54.4) than those using TPP (20.9, 95% CI = 20.3 to 21.4).ConclusionCurrent recording of long COVID in primary care is very low, and variable between practices. This may reflect patients not presenting; clinicians and patients holding different diagnostic thresholds; or challenges with the design and communication of diagnostic codes. Increased awareness of diagnostic codes is recommended to facilitate research and planning of services, and also surveys with qualitative work to better evaluate clinicians’ understanding of the diagnosis.
Highlights
Long COVID has been broadly defined as new or persistent symptoms of COVID-19 beyond the acute phase of SARS-CoV-2 infection.[1]
Long COVID was recorded for 23 273 people
Regional variation ranged between 20.3 per 100 000 people for East of England (95% confidence interval [confidence intervals (CIs)] = 19.3 to 21.4) and 55.6 per 100 000 people in London
Summary
Long COVID has been broadly defined as new or persistent symptoms of COVID-19 beyond the acute phase of SARS-CoV-2 infection.[1] The National Institute for Health and Care Excellence (NICE) have produced guidance on managing the long-term effects of COVID-19 as these symptoms can have a significant effect on a person’s quality of life.[1] NICE recognise that as long COVID is such a new condition the exact clinical definition and treatments are evolving. A recent systematic review found a very high prevalence of persisting COVID symptoms after COVID diagnosis.[2] For symptoms lasting 4–12 weeks 83% of people reported at least one persisting symptom, whereas for symptoms lasting beyond 12 weeks, the proportion was 56%. The reported associated symptoms are numerous, but include fatigue, shortness of breath, cough, smell or taste dysfunction, cognitive impairment, and muscle pain. COVID describes new or persistent symptoms at least 4 weeks after onset of acute COVID-19.
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