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Walker AJ, MacKenna B, Inglesby P, et al. Clinical coding of long COVID in English primary care: a federated analysis of 58 million patient records . Br J Gen Pract. 2021;71(712):e806-e814doi: 10.3399/BJGP.2021.0301.
Walker, A. J., MacKenna, B., Inglesby, P., Tomlinson, L., Rentsch, C. T., Curtis, H. J., Morton, C. E., Morley, J., Mehrkar, A., Bacon, S., Hickman, G., Bates, C., Croker, R., Evans, D., Ward, T., Cockburn, J., Davy, S., Bhaskaran, K., Schultze, A., Williamson, E. J., Hulme, W. J., McDonald, H. I., Mathur, R., Eggo, R. M., Wing, K., Wong, A. Y., Forbes, H., Tazare, J., Parry, J., Hester, F., Harper, S., O'Hanlon, S., Eavis, A., Jarvis, R., Avramov, D., Griffiths, P., Fowles, A., Parkes, N., Douglas, I. J., Evans, S. J. (2021). Clinical coding of long COVID in English primary care: a federated analysis of 58 million patient records . The British journal of general practice : the journal of the Royal College of General Practitioners, 71(712), e806-e814. https://doi.org/10.3399/BJGP.2021.0301
Walker, Alex J, et al. "Clinical coding of long COVID in English primary care: a federated analysis of 58 million patient records ." The British journal of general practice : the journal of the Royal College of General Practitioners vol. 71,712 (2021): e806-e814. doi: https://doi.org/10.3399/BJGP.2021.0301
Walker AJ, MacKenna B, Inglesby P, Tomlinson L, Rentsch CT, Curtis HJ, Morton CE, Morley J, Mehrkar A, Bacon S, Hickman G, Bates C, Croker R, Evans D, Ward T, Cockburn J, Davy S, Bhaskaran K, Schultze A, Williamson EJ, Hulme WJ, McDonald HI, Mathur R, Eggo RM, Wing K, Wong AY, Forbes H, Tazare J, Parry J, Hester F, Harper S, O'Hanlon S, Eavis A, Jarvis R, Avramov D, Griffiths P, Fowles A, Parkes N, Douglas IJ, Evans SJ. Clinical coding of long COVID in English primary care: a federated analysis of 58 million patient records . Br J Gen Pract. 2021 Oct 28;71(712):e806-e814. doi: 10.3399/BJGP.2021.0301. Print 2021 Nov. PMID: 34340970; PMCID: PMC8340730.
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Br J Gen Pract. 2021 Oct 28;71(712):e806-e814. doi: 10.3399/BJGP.2021.0301. Print 2021 Nov.

Clinical coding of long COVID in English primary care: a federated analysis of 58 million patient records .

The British journal of general practice : the journal of the Royal College of General Practitioners

Alex J Walker, Brian MacKenna, Peter Inglesby, Laurie Tomlinson, Christopher T Rentsch, Helen J Curtis, Caroline E Morton, Jessica Morley, Amir Mehrkar, Seb Bacon, George Hickman, Chris Bates, Richard Croker, David Evans, Tom Ward, Jonathan Cockburn, Simon Davy, Krishnan Bhaskaran, Anna Schultze, Elizabeth J Williamson, William J Hulme, Helen I McDonald, Rohini Mathur, Rosalind M Eggo, Kevin Wing, Angel Ys Wong, Harriet Forbes, John Tazare, John Parry, Frank Hester, Sam Harper, Shaun O'Hanlon, Alex Eavis, Richard Jarvis, Dima Avramov, Paul Griffiths, Aaron Fowles, Nasreen Parkes, Ian J Douglas, Stephen Jw Evans,

Affiliations

  1. The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford.
  2. Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London.
  3. TPP, Leeds.
  4. EMIS Health, Leeds.

PMID: 34340970 PMCID: PMC8340730 DOI: 10.3399/BJGP.2021.0301

Abstract

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.

© The Authors.

Keywords: COVID-19; electronic health records; general practice; long COVID; primary health care

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