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Jones R, Davis A, Stanley B, et al. Risk Predictors and Symptom Features of Long COVID Within a Broad Primary Care Patient Population Including Both Tested and Untested Patients. Pragmat Obs Res. 2021;12:93-104doi: 10.2147/POR.S316186.
Jones, R., Davis, A., Stanley, B., Julious, S., Ryan, D., Jackson, D. J., Halpin, D. M. G., Hickman, K., Pinnock, H., Quint, J. K., Khunti, K., Heaney, L. G., Oliver, P., Siddiqui, S., Pavord, I., Jones, D. H. M., Hyland, M., Ritchie, L., Young, P., Megaw, T., Davis, S., Walker, S., Holgate, S., Beecroft, S., Kemppinen, A., Appiagyei, F., Roberts, E. J., Preston, M., Hardjojo, A., Carter, V., van Melle, M., & Price, D. (2021). Risk Predictors and Symptom Features of Long COVID Within a Broad Primary Care Patient Population Including Both Tested and Untested Patients. Pragmatic and observational research, 1293-104. https://doi.org/10.2147/POR.S316186
Jones, Rupert, et al. "Risk Predictors and Symptom Features of Long COVID Within a Broad Primary Care Patient Population Including Both Tested and Untested Patients." Pragmatic and observational research vol. 12 (2021): 93-104. doi: https://doi.org/10.2147/POR.S316186
Jones R, Davis A, Stanley B, Julious S, Ryan D, Jackson DJ, Halpin DMG, Hickman K, Pinnock H, Quint JK, Khunti K, Heaney LG, Oliver P, Siddiqui S, Pavord I, Jones DHM, Hyland M, Ritchie L, Young P, Megaw T, Davis S, Walker S, Holgate S, Beecroft S, Kemppinen A, Appiagyei F, Roberts EJ, Preston M, Hardjojo A, Carter V, van Melle M, Price D. Risk Predictors and Symptom Features of Long COVID Within a Broad Primary Care Patient Population Including Both Tested and Untested Patients. Pragmat Obs Res. 2021 Aug 11;12:93-104. doi: 10.2147/POR.S316186. eCollection 2021. PMID: 34408531; PMCID: PMC8366779.
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Pragmat Obs Res. 2021 Aug 11;12:93-104. doi: 10.2147/POR.S316186. eCollection 2021.

Risk Predictors and Symptom Features of Long COVID Within a Broad Primary Care Patient Population Including Both Tested and Untested Patients.

Pragmatic and observational research

Rupert Jones, Andrew Davis, Brooklyn Stanley, Steven Julious, Dermot Ryan, David J Jackson, David M G Halpin, Katherine Hickman, Hilary Pinnock, Jennifer K Quint, Kamlesh Khunti, Liam G Heaney, Phillip Oliver, Salman Siddiqui, Ian Pavord, David H M Jones, Michael Hyland, Lewis Ritchie, Pam Young, Tony Megaw, Steve Davis, Samantha Walker, Stephen Holgate, Sue Beecroft, Anu Kemppinen, Francis Appiagyei, Emma-Jane Roberts, Megan Preston, Antony Hardjojo, Victoria Carter, Marije van Melle, David Price

Affiliations

  1. Optimum Patient Care, Cambridge, UK.
  2. Observational and Pragmatic Research Institute, Singapore, Singapore.
  3. Faculty of Health, University of Plymouth, Plymouth, UK.
  4. University of Sheffield, South Yorkshire, UK.
  5. Usher Institute, University of Edinburgh, Edinburgh, UK.
  6. Guy's & St Thomas' NHS Trust, School of Immunology & Microbial Sciences, King's College London, London, UK.
  7. University of Exeter Medical School, College of Medicine and Health, University of Exeter, Exeter, UK.
  8. Bradford and Leeds Clinical Commissioning Group, Leeds, UK.
  9. Asthma UK Centre for Applied Research, Usher Institute, The University of Edinburgh, Edinburgh, UK.
  10. National Heart & Lung Institute, Imperial College London, London, UK.
  11. Diabetes Research Centre, University of Leicester, Leicester, UK.
  12. Wellcome-Wolfson Centre for Experimental Medicine, Queen's University Belfast, Belfast, Northern Ireland.
  13. Institute for Lung Health, Leicester National Institute for Health Research Biomedical Research Centre, University of Leicester, Leicester, UK.
  14. Respiratory Medicine Unit and Oxford Respiratory NIHR BRC, Nuffield Department of Medicine, University of Oxford, Oxford, UK.
  15. Box Surgery, Wiltshire, UK.
  16. Plymouth Marjon University, Plymouth, UK.
  17. Centre of Academic Primary Care, Division of Applied Health Sciences, University of Aberdeen, Aberdeen, UK.
  18. Wellbeing Software, Mansfield, UK.
  19. Interface Clinical Services, Leeds, UK.
  20. Asthma UK & British Lung Foundation, London, UK.
  21. Clinical and Experimental Sciences, University of Southampton, Southampton, UK.
  22. OPEN Health, Buckinghamshire, UK.

PMID: 34408531 PMCID: PMC8366779 DOI: 10.2147/POR.S316186

Abstract

INTRODUCTION: Symptoms may persist after the initial phases of COVID-19 infection, a phenomenon termed long COVID. Current knowledge on long COVID has been mostly derived from test-confirmed and hospitalized COVID-19 patients. Data are required on the burden and predictors of long COVID in a broader patient group, which includes both tested and untested COVID-19 patients in primary care.

METHODS: This is an observational study using data from Platform C19, a quality improvement program-derived research database linking primary care electronic health record data (EHR) with patient-reported questionnaire information. Participating general practices invited consenting patients aged 18-85 to complete an online questionnaire since 7th August 2020. COVID-19 self-diagnosis, clinician-diagnosis, testing, and the presence and duration of symptoms were assessed via the questionnaire. Patients were considered present with long COVID if they reported symptoms lasting ≥4 weeks. EHR and questionnaire data up till 22nd January 2021 were extracted for analysis. Multivariable regression analyses were conducted comparing demographics, clinical characteristics, and presence of symptoms between patients with long COVID and patients with shorter symptom duration.

RESULTS: Long COVID was present in 310/3151 (9.8%) patients with self-diagnosed, clinician-diagnosed, or test-confirmed COVID-19. Only 106/310 (34.2%) long COVID patients had test-confirmed COVID-19. Risk predictors of long COVID were age ≥40 years (adjusted Odds Ratio [AdjOR]=1.49 [1.05-2.17]), female sex (adjOR=1.37 [1.02-1.85]), frailty (adjOR=2.39 [1.29-4.27]), visit to A&E (adjOR=4.28 [2.31-7.78]), and hospital admission for COVID-19 symptoms (adjOR=3.22 [1.77-5.79]). Aches and pain (adjOR=1.70 [1.21-2.39]), appetite loss (adjOR=3.15 [1.78-5.92]), confusion and disorientation (adjOR=2.17 [1.57-2.99]), diarrhea (adjOR=1.4 [1.03-1.89]), and persistent dry cough (adjOR=2.77 [1.94-3.98]) were symptom features statistically more common in long COVID.

CONCLUSION: This study reports the factors and symptom features predicting long COVID in a broad primary care population, including both test-confirmed and the previously missed group of COVID-19 patients.

© 2021 Jones et al.

Keywords: SARS-CoV-2; chronic diseases; frailty; observational study; questionnaire

Conflict of interest statement

Rupert Jones reports grants, personal fees, and non-financial support from AstraZeneca and OPRI, personal fees and non-financial support from Boehringer Ingelheim, grants, personal fees, and non-finan

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