Understanding the Clinical Characteristics and Timeliness of Diagnosis for Patients Diagnosed With Long Covid: A Retrospective Observational Cohort Study From North West London

IF 3.2 3区医学 Q2 HEALTH CARE SCIENCES & SERVICES

Health Expectations Pub Date : 2025-09-25 DOI:10.1111/hex.70429

Denys Prociuk, Jonathan Clarke, Nikki Smith, Ruairidh Milne, Cassie Lee, Simon de Lusignan, Ghazala Mir, Johannes De Kock, Erik Mayer, Brendan C. Delaney, LOCOMOTION Consortium

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Abstract

Background

Long Covid is a multisystem condition first identified in the Covid-19 pandemic, characterised by a wide range of symptoms including fatigue, breathlessness and cognitive impairment. Considerable disagreement exists in who is most at risk of developing long Covid, driven in part by incomplete coding of a long Covid diagnosis in medical records.

Objective

To describe the incidence and impact of long Covid.

Design

A retrospective observational cohort study.

Setting and Participants

An integrated primary and secondary care dataset from North West London, covering over 2.7 million patients. Patients with long Covid were identified through clinical terms in their primary care records.

Main Variables Studied

Multivariate logistic regression was used to identify factors associated with having a long Covid diagnosis, while multivariate quantile regression was used to identify factors predicting the time a long Covid diagnosis was recorded.

Results

A total of 6078 patients were identified with a long Covid clinical term in their primary care record, 0.33% of the total registered adult population. Women, those aged 41–70 years or of Asian or mixed ethnicity, were more likely to have a recorded long Covid diagnosis, alongside those with pre-existing anxiety, asthma, depressive disorder or eczema and those living outside of the least or most socio-economically deprived areas. Men, those aged 41–70 years, or of black ethnicity, were diagnosed earlier in the pandemic, while those with depressive disorder were diagnosed later.

Discussion

Long Covid is poorly coded in primary care records, and significant differences exist between patient groups in the likelihood of receiving a long Covid diagnosis. A recorded long Covid diagnosis is more likely in women, some ethnic minority patients and those with pre-existing long-term conditions.

Conclusion

The experience of patients with long Covid provides a crucial insight into inequities in access to timely care for complex multisystem conditions and the importance of effective health informatics practices to provide robust, timely analytical support for front line clinical services.

Patient and Public Contribution

This study was co-designed, conducted and written in conjunction with people with long Covid.

Abstract Image

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了解长冠状病毒诊断患者的临床特征和诊断及时性：一项来自伦敦西北部的回顾性观察队列研究

背景：长冠肺炎是在2019冠状病毒病大流行期间首次发现的一种多系统疾病，其特征是多种症状，包括疲劳、呼吸困难和认知障碍。在谁最有可能患上长冠肺炎方面存在相当大的分歧，部分原因是医疗记录中长冠肺炎诊断的编码不完整。目的：了解长冠肺炎的发生率及影响。设计：回顾性观察队列研究。环境和参与者：来自伦敦西北部的综合初级和二级医疗数据集，涵盖270多万患者。通过初级保健记录中的临床术语确定长冠状病毒患者。研究的主要变量：使用多变量逻辑回归来确定与长时间诊断相关的因素，而使用多变量分位数回归来确定预测长时间诊断的因素。结果：共有6078例初级保健记录中发现的新冠肺炎临床期较长的患者，占登记成年人口总数的0.33%。年龄在41-70岁之间、亚洲或混合种族的女性，以及那些先前患有焦虑症、哮喘、抑郁症或湿疹的女性，以及那些生活在社会经济最贫困或最贫困地区以外的女性，更有可能有长期的新冠肺炎诊断记录。年龄在41-70岁之间的男性或黑人在大流行中被诊断出来较早，而患有抑郁症的人被诊断出来较晚。讨论：长冠状病毒在初级保健记录中的编码很差，患者群体之间接受长冠状病毒诊断的可能性存在显著差异。女性、一些少数民族患者和已有长期疾病的患者更有可能被记录为长期诊断。结论：长期Covid患者的经历为了解复杂多系统条件下获得及时护理的不公平现象以及有效的卫生信息学实践为一线临床服务提供强大、及时的分析支持的重要性提供了重要见解。患者和公众贡献：本研究是与长Covid患者共同设计、进行和撰写的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Health Expectations 医学-公共卫生、环境卫生与职业卫生

CiteScore

5.20

自引率

9.40%

发文量

251

审稿时长

>12 weeks

期刊介绍： Health Expectations promotes critical thinking and informed debate about all aspects of patient and public involvement and engagement (PPIE) in health and social care, health policy and health services research including: • Person-centred care and quality improvement • Patients'' participation in decisions about disease prevention and management • Public perceptions of health services • Citizen involvement in health care policy making and priority-setting • Methods for monitoring and evaluating participation • Empowerment and consumerism • Patients'' role in safety and quality • Patient and public role in health services research • Co-production (researchers working with patients and the public) of research, health care and policy Health Expectations is a quarterly, peer-reviewed journal publishing original research, review articles and critical commentaries. It includes papers which clarify concepts, develop theories, and critically analyse and evaluate specific policies and practices. The Journal provides an inter-disciplinary and international forum in which researchers (including PPIE researchers) from a range of backgrounds and expertise can present their work to other researchers, policy-makers, health care professionals, managers, patients and consumer advocates.