Clinical coding of long COVID in English primary care: a federated analysis of 58 million patient records in situ using OpenSAFELY, 2021, Walker et al

Abstract

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.

The study: Clinical coding of long COVID in English primary care: a federated analysis of 58 million patient records in situ using OpenSAFELY.

 

Definitely not just in England.


GPs in England ‘failing to recognise thousands of long Covid cases’

https://www.theguardian.com/world/2...ng-to-recognise-thousands-of-long-covid-cases

The study: Clinical coding of long COVID in English primary care: a federated analysis of 58 million patient records in situ using OpenSAFELY.


There wasn't even a code for it until recently and many GPs refuse to use it for various reasons that include a general state of hostility towards chronic illness and worse. Frankly that anyone is surprised by this is shocking and of course it's Ben Goldacre who is surprised by the predictable, if only he didn't have this huge blind spot.

Cue physicians saying they haven't seen a single LC case when of course they set their eyes on many, they just didn't see them. As evidence shows.

Turns out denial has consequences. Who knew?