PT - JOURNAL ARTICLE AU - Alex J Walker AU - Brian MacKenna AU - Peter Inglesby AU - Christopher T Rentsch AU - Helen J Curtis AU - Caroline E Morton AU - Jessica Morley AU - Amir Mehrkar AU - Seb Bacon AU - George Hickman AU - Chris Bates AU - Richard Croker AU - David Evans AU - Tom Ward AU - Jonathan Cockburn AU - Simon Davy AU - Krishnan Bhaskaran AU - Anna Schultze AU - Elizabeth J Williamson AU - William J Hulme AU - Helen McDonald AU - Laurie Tomlinson AU - Rohini Mathur AU - Rosalind M Eggo AU - Kevin Wing AU - Angel YS Wong AU - Harriet Forbes AU - John Tazare AU - John Parry AU - Frank Hester AU - Sam Harper AU - Shaun O'Hanlon AU - Alex Eavis AU - Richard Jarvis AU - Dima Avramov AU - Paul Griffiths AU - Aaron Fowles AU - Nasreen Parkes AU - Ian Douglas AU - Stephen JW Evans AU - Liam Smeeth AU - Ben Goldacre TI - Clinical coding of long COVID in English primary care: a federated analysis of 58 million patient records in situ using OpenSAFELY AID - 10.3399/BJGP.2021.0301 DP - 2021 Jun 28 TA - British Journal of General Practice PG - BJGP.2021.0301 4099 - http://bjgp.org/content/early/2021/06/28/BJGP.2021.0301.short 4100 - http://bjgp.org/content/early/2021/06/28/BJGP.2021.0301.full AB - Background: Long COVID describes new or persistent symptoms at least four weeks after onset of acute COVID-19. Clinical codes to describe this were recently created. Aim: To describe the use of long COVID codes, and variation of use by general practice, demographics and over time. Design and Setting: Population-based cohort study in English primary care records. Method: Working on behalf of NHS England, we used OpenSAFELY data encompassing 96% of the English population between 2020-02-01 and 2021-04-25. We measured the proportion of people with a recorded code for long COVID, overall and by demographic factors, electronic health record software system (EMIS or TPP), and week. Results: Long COVID was recorded for 23,273 people. Coding was unevenly distributed amongst 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 19.3-21.4) and 55.6 in London (95% CI 54.1-57.1). Coding was higher amongst women (52.1, 95% CI 51.3-52.9) than men (28.1, 95% CI 27.5-28.7), and higher amongst EMIS practices (53.7, 95% CI 52.9-54.4) than TPP practices (20.9, 95% CI 20.3-21.4). Conclusion: Long COVID coding in primary care is low compared with early reports of long COVID prevalence. This may reflect under-coding, sub-optimal communication of clinical terms, under-diagnosis, a true low prevalence of long COVID diagnosed by clinicians, or a combination of factors. We recommend increased awareness of diagnostic codes, to facilitate research and planning of services; and surveys of clinicians’ experiences, to complement ongoing patient surveys.