Clinical coding of long COVID in primary care 2020-2023 in a cohort of 19 million adults: an OpenSAFELY analysis
Clinical coding of long COVID in primary care 2020-2023 in a cohort of 19 million adults: an OpenSAFELY analysis
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2020-2023 年初级保健中 1900 万成年人队列中长期新冠肺炎的临床编码：OpenSAFELY 分析
DOI：
10.1101/2023.12.04.23299364
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发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Henderson A
中科院分区：
文献类型：
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作者：
Henderson A
背景长期COVID是患者创造的术语，指急性感染后COVID-19疾病持续数周、数月或数年的症状。从自我报告的数据来看，全球长期COVID的负担很大，但对流行病学、病因和治疗方法仍知之甚少。初级保健用于帮助识别和治疗长期COVID患者，因此过去COVID-19患者的电子健康记录（EHR）可用于帮助填补这些知识空白。我们的目的是描述英格兰初级保健记录中记录的长期COVID的人口统计学和临床特征的发病率和差异。MethodsWith the approval of NHS England，我们使用了英格兰超过1900万成年人的常规临床数据，这些数据与SARS-COV-2检测结果相关，住院和疫苗接种数据，以描述2020年11月至2023年1月期间记录的16个与长期COVID相关的临床代码的趋势。使用OpenSAFELY，我们计算了每10万人年的发病率，并绘制了这些发病率随时间的变化。我们比较了原油和调整后的（针对年龄、性别、英格兰9个NHS地区和流行的主要变异）使用负二项模型，在不同关键人口统计学和疫苗接种特征之间的患者记录中记录的长期COVID的比率。440个代码用于进一步评估。新型冠状病毒病长记录的发生率于二零二一年稳步上升，于二零二二年则有所下降。女性的总体发生率为177.5例/100，000人-年（95% CI：175.5-179），男性为100.5例/100，000人-年（99.5-102）。在这项描述性研究中，EHR记录的长期COVID在2020年至2023年期间非常低，而长期COVID的事件记录在2022年有所下降。不幸的是，使用EHR诊断或转诊代码在识别和确定长期COVID的真实病例和时间方面存在重大局限性。基金这项研究得到了国家卫生和护理研究所（NIHR）的支持（OpenPROMPT：COV-LT 2 -0073）。
BackgroundLong COVID is the patient-coined term for the persistent symptoms of COVID-19 illness for weeks, months or years following the acute infection. There is a large burden of long COVID globally from self-reported data, but the epidemiology, causes and treatments remain poorly understood. Primary care is used to help identify and treat patients with long COVID and therefore Electronic Health Records (EHRs) of past COVID-19 patients could be used to help fill these knowledge gaps. We aimed to describe the incidence and differences in demographic and clinical characteristics in recorded long COVID in primary care records in England.MethodsWith the approval of NHS England we used routine clinical data from over 19 million adults in England linked to SARS-COV-2 test result, hospitalisation and vaccination data to describe trends in the recording of 16 clinical codes related to long COVID between November 2020 and January 2023. Using OpenSAFELY, we calculated rates per 100,000 person-years and plotted how these changed over time. We compared crude and adjusted (for age, sex, 9 NHS regions of England, and the dominant variant circulating) rates of recorded long COVID in patient records between different key demographic and vaccination characteristics using negative binomial models.FindingsWe identified a total of 55,465 people recorded to have long COVID over the study period, which included 20,025 diagnoses codes and 35,440 codes for further assessment. The incidence of new long COVID records increased steadily over 2021, and declined over 2022. The overall rate per 100,000 person-years was 177.5 cases in women (95% CI: 175.5–179) and 100.5 in men (99.5–102). The majority of those with a long COVID record did not have a recorded positive SARS-COV-2 test 12 or more weeks before the long COVID record.InterpretationIn this descriptive study, EHR recorded long COVID was very low between 2020 and 2023, and incident records of long COVID declined over 2022. Using EHR diagnostic or referral codes unfortunately has major limitations in identifying and ascertaining true cases and timing of long COVID.FundingThis research was supported by the National Institute for Health and Care Research (NIHR) (OpenPROMPT: COV-LT2-0073).
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DOI：
10.1136/bmjmed-2022-000385
发表时间：
2023
期刊：
BMJ medicine
影响因子：
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作者：
Byambasuren, Oyungerel;Stehlik, Paulina;Clark, Justin;Alcorn, Kylie;Glasziou, Paul
通讯作者：
Glasziou, Paul
影响因子：
56.3
作者：
Iwasaki, Akiko;Putrino, David
通讯作者：
Putrino, David
影响因子：
105.7
作者：
Hulme, William J.;Horne, Elsie M. F.;Parker, Edward P. K.;Keogh, Ruth H.;Williamson, Elizabeth J.;Walker, Venexia;Palmer, Tom M.;Curtis, Helen J.;Walker, Alex J.;Andrews, Colm D.;Mehrkar, Amir;Morley, Jessica;MacKenna, Brian;Bacon, Sebastian C. J.;Goldacre, Ben;Hernan, Miguel A.;Sterne, Jonathan A. C.
通讯作者：
Sterne, Jonathan A. C.
影响因子：
2.9
作者：
Daines L;Mulholland RH;Vasileiou E;Hammersley V;Weatherill D;Katikireddi SV;Kerr S;Moore E;Pesenti E;Quint JK;Shah SA;Shi T;Simpson CR;Robertson C;Sheikh A
通讯作者：
Sheikh A
“长期新冠”如何揭示病毒后综合症
影响因子：
--
作者：
B. Owens
通讯作者：
B. Owens