TY - JOUR T1 - Clinical coding of long COVID in English primary care: a federated analysis of 58 million patient records <em>in situ</em> using OpenSAFELY JF - British Journal of General Practice JO - Br J Gen Pract SP - e806 LP - e814 DO - 10.3399/BJGP.2021.0301 VL - 71 IS - 712 AU - Alex J Walker AU - Brian MacKenna AU - Peter Inglesby AU - Laurie Tomlinson 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 I McDonald 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 J Douglas AU - Stephen JW Evans AU - Liam Smeeth AU - Ben Goldacre AU - (The OpenSAFELY Collaborative) Y1 - 2021/11/01 UR - http://bjgp.org/content/71/712/e806.abstract N2 - Background Long 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.Aim To describe the use of long-COVID codes, and variation of use by general practice, demographic variables, and over time.Design and setting Population-based cohort study in English primary care.Method Working 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.Results Long 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).Conclusion Current 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. ER -