RT Journal Article
SR Electronic
T1 Clinical coding of long COVID in English primary care: a federated analysis of 58 million patient records in situ using OpenSAFELY
JF British Journal of General Practice
JO Br J Gen Pract
FD British Journal of General Practice
SP BJGP.2021.0301
DO 10.3399/BJGP.2021.0301
A1 Alex J Walker
A1 Brian MacKenna
A1 Peter Inglesby
A1 Christopher T Rentsch
A1 Helen J Curtis
A1 Caroline E Morton
A1 Jessica Morley
A1 Amir Mehrkar
A1 Seb Bacon
A1 George Hickman
A1 Chris Bates
A1 Richard Croker
A1 David Evans
A1 Tom Ward
A1 Jonathan Cockburn
A1 Simon Davy
A1 Krishnan Bhaskaran
A1 Anna Schultze
A1 Elizabeth J Williamson
A1 William J Hulme
A1 Helen McDonald
A1 Laurie Tomlinson
A1 Rohini Mathur
A1 Rosalind M Eggo
A1 Kevin Wing
A1 Angel YS Wong
A1 Harriet Forbes
A1 John Tazare
A1 John Parry
A1 Frank Hester
A1 Sam Harper
A1 Shaun O'Hanlon
A1 Alex Eavis
A1 Richard Jarvis
A1 Dima Avramov
A1 Paul Griffiths
A1 Aaron Fowles
A1 Nasreen Parkes
A1 Ian Douglas
A1 Stephen JW Evans
A1 Liam Smeeth
A1 Ben Goldacre
YR 2021
UL http://bjgp.org/content/early/2021/06/28/BJGP.2021.0301.abstract
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.