Prevalence, risk factors and characterisation of individuals with long COVID […] in over 1.5 million COVID cases in England, 2024, Wang+

SNT Gatchaman

SNT Gatchaman

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Prevalence, risk factors and characterisation of individuals with long COVID using Electronic Health Records in over 1.5 million COVID cases in England
Han-I Wang; Tim Doran; Michael G Crooks; Kamlesh Khunti; Melissa Heightman; Arturo Gonzalez-Izquierdo; Muhammad Qummer Ul Arfeen; Antony Loveless; Amitava Banerjee; Christina Van Der Feltz-Cornelis

OBJECTIVES
This study examines clinically confirmed long-COVID symptoms and diagnosis among individuals with COVID in England, aiming to understand prevalence and associated risk factors using electronic health records. To further understand long-COVID, the study also explored differences in risks and symptom profiles in three subgroups: hospitalised, non-hospitalised, and untreated COVID cases.

METHODS
A population-based longitudinal cohort study was conducted using data from 1,554,040 individuals with confirmed SARS-CoV-2 infection via Clinical Practice Research Datalink. Descriptive statistics explored the prevalence of long-COVID symptoms 12-weeks post-infection, and Cox regression models analysed the associated risk factors. Sensitivity analysis was conducted to test the impact of right-censoring data.

RESULTS
During an average 400-day follow-up, 7.4% of individuals with COVID had at least one long-COVID symptom after acute phase, yet only 0.5% had long-COVID diagnostic codes. The most common long-COVID symptoms included cough (17.7%), back pain (15.2%), stomach-ache (11.2%), headache (11.1%), and sore throat (10.0%). The same trend was observed in all three subgroups. Risk factors associated with long-COVID symptoms were female sex, non-white ethnicity, obesity, and pre-existing medical conditions like anxiety, depression, type II diabetes, and somatic symptom disorders.

CONCLUSIONS
This study is the first to investigate the prevalence and risk factors of clinically confirmed long-COVID in the general population. The findings could help clinicians identify higher risk individuals for timely intervention and allow decision-makers to more efficiently allocate resources for managing long-COVID.


Link | PDF (Journal of Infection) [Open Access]
 
Didn't note any mention of ME/CFS.

When considering long-COVID prevalence in three subgroups, our results show that the highest proportion of long-COVID cases (22.7%) were observed among the non-hospitalised COVID individuals, followed by hospitalised COVID cases (8.5%) and untreated cases (1.1%).
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Our study reveals the top five most frequently recorded long-COVID symptoms, 12 weeks after the index date, were cough (17.8%), back pain (15.3%), stomach-ache (11.4%), headache (11.2%), and sore throat (10.0%).
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While fatigue (8.1%) and chest pain (8.0%) remained common, other symptoms commonly reported by individuals, such as brain fog and loss of smell, were not commonly recorded in EHRs, suggesting differences in symptoms prioritization between individuals and clinicians, and indicating that not all self-reported long-COVID symptoms may be selected for treatments.
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our findings demonstrate that the risk of having long-COVID is strongly reduced in people on long-term immunosuppressive therapy. Having immunosuppressive therapy was found to reduce HR risk by more than 30% to have long-COVID, indicating that long-COVID may be associated with a pro-inflammatory immune response in COVID-19 cases, leading to hyperactivation of T cells, macrophages and killer cells and overproduction of inflammatory mediators.
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The paper said:
This study is the first to investigate the prevalence and risk factors of clinically confirmed long-COVID in the general population
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It's not, but whatever.

This is a pretty strong deviation from other studies in many aspects, but it looks mainly because of what they choose to look for.

4.5 years and the research is still so damn weak. You can find spicier homeopathic water than this.
 
While fatigue (8.1%) and chest pain (8.0%) remained common, other symptoms commonly reported by individuals, such as brain fog and loss of smell, were not commonly recorded in EHRs, suggesting differences in symptoms prioritization between individuals and clinicians, and indicating that not all self-reported long-COVID symptoms may be selected for treatments.
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There is this overarching problem here where clinicians mainly focus on symptoms that can be treated, which leaves behind symptoms that can't, which makes them under-recorded, which makes it impossible to develop treatments, which makes them less focused on, which makes them less recorded, and so on and on and on...

And then there's what clinical coders choose to focus on. And then there's what researchers choose to look for. It's the classic telephone game, where the final output has almost nothing to do with the initial input.

Sometimes it really feels like a miracle that this profession has ever managed to achieve anything at all. Oh, right, technology, aka knowledge that does work. Without this, barely anything seems to work.
 
FND features though doesn't look like a significant risk factor —

Functional neurological disorder (FND) —

Primary analysis (unadjusted) 1.745 (1.562 to 1.950)***
Primary analysis (adjusted) 0.925 (0.828 to 1.034)
Sensitivity analysis (unadjusted) 1.866 (1.632 to 2.133)***
Sensitivity analysis (adjusted) 0.903 (0.786 to 1.038)
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However Somatic Symptom Disorder —

The top three most significant risk factors were anxiety (adjusted HR: 1.829; 95% CI: 1.806 to 1.853), SSD (adjusted HR: 1.692; 95% CI: 1.659 to 1.726) and T2DM (1.646; 95% CI: 1.624 to 1.668).
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Pre-existing SSD is when a person experiences severe and persistent distress concerning somatic symptoms, whether in the context of a known medical condition or of so-called Medically Not Yet Explained Symptoms. Such pre-existing distress may be aggravated by contracting COVID-19 and be sustained by expectations that recovery may be slow. However, the HRs for pre-existing SSD do not align with other pre-existing mental disorders and should be interpreted cautiously.
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I would expect pre-existing SSD might be misdiagnosed ME/CFS in a number of cases, and quite possibly FND also.
 
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