Risk Predictors and Symptom Features of Long COVID Within a Broad Primary Care Patient Population Including Both Tested and Untested Patients

Rupert Jones; Andrew Davis; Brooklyn Stanley; Steven Julious; Dermot Ryan; David M G Halpin; Katherine Hickman; Hilary Pinnock; Jennifer K Quint; Kamlesh Khunti; Liam G Heaney; Phillip Oliver; Salman Siddiqui; Ian Pavord; Michael Hyland; Lewis Ritchie; Pam Young; Tony Megaw; Steve Davis; Stephen Holgate; Sue Beecroft; Anu Kemppinen; Francis Appiagyei; Emma-Jane Roberts; Megan Preston; Antony Hardjojo; Victoria Carter; Marije van Melle

doi:10.2147/POR.S316186

Risk Predictors and Symptom Features of Long COVID Within a Broad Primary Care Patient Population Including Both Tested and Untested Patients

Rupert Jones, Andrew Davis, Brooklyn Stanley, Steven Julious, Dermot Ryan, David M G Halpin, Katherine Hickman, Hilary Pinnock, Jennifer K Quint, Kamlesh Khunti, Liam G Heaney, Phillip Oliver, Salman Siddiqui, Ian Pavord, Michael Hyland, Lewis Ritchie, Pam Young, Tony Megaw, Steve Davis, Stephen HolgateSue Beecroft, Anu Kemppinen, Francis Appiagyei, Emma-Jane Roberts, Megan Preston, Antony Hardjojo, Victoria Carter, Marije van Melle

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Abstract / Description of output

Introduction: Symptoms may persist after the initial phases of COVID-19 infection, a phenomenon termed long COVID. Current knowledge on long COVID has been mostly derived from test-confirmed and hospitalized COVID-19 patients. Data are required on the burden and predictors of long COVID in a broader patient group, which includes both tested and untested COVID-19 patients in primary care.

Methods: This is an observational study using data from Platform C19, a quality improvement program-derived research database linking primary care electronic health record data (EHR) with patient-reported questionnaire information. Participating general practices invited consenting patients aged 18-85 to complete an online questionnaire since 7th August 2020. COVID-19 self-diagnosis, clinician-diagnosis, testing, and the presence and duration of symptoms were assessed via the questionnaire. Patients were considered present with long COVID if they reported symptoms lasting ≥4 weeks. EHR and questionnaire data up till 22nd January 2021 were extracted for analysis. Multivariable regression analyses were conducted comparing demographics, clinical characteristics, and presence of symptoms between patients with long COVID and patients with shorter symptom duration.

Results: Long COVID was present in 310/3151 (9.8%) patients with self-diagnosed, clinician-diagnosed, or test-confirmed COVID-19. Only 106/310 (34.2%) long COVID patients had test-confirmed COVID-19. Risk predictors of long COVID were age ≥40 years (adjusted Odds Ratio [AdjOR]=1.49 [1.05-2.17]), female sex (adjOR=1.37 [1.02-1.85]), frailty (adjOR=2.39 [1.29-4.27]), visit to A&E (adjOR=4.28 [2.31-7.78]), and hospital admission for COVID-19 symptoms (adjOR=3.22 [1.77-5.79]). Aches and pain (adjOR=1.70 [1.21-2.39]), appetite loss (adjOR=3.15 [1.78-5.92]), confusion and disorientation (adjOR=2.17 [1.57-2.99]), diarrhea (adjOR=1.4 [1.03-1.89]), and persistent dry cough (adjOR=2.77 [1.94-3.98]) were symptom features statistically more common in long COVID.

Conclusion: This study reports the factors and symptom features predicting long COVID in a broad primary care population, including both test-confirmed and the previously missed group of COVID-19 patients.

Original language	English
Pages (from-to)	93-104
Number of pages	12
Journal	Pragmatic and observational research
Volume	2021
Issue number	12
DOIs	https://doi.org/10.2147/POR.S316186
Publication status	Published - 11 Aug 2021

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Risk Predictors and Symptom Features of Long COVID within a Broad Primary Care Patient Population including both Tested and Untested PatientsFinal published version, 1.52 MBLicence: Creative Commons: Attribution Non-Commercial (CC-BY-NC)

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Jones, R., Davis, A., Stanley, B., Julious, S., Ryan, D., Halpin, D. M. G., Hickman, K., Pinnock, H., Quint, J. K., Khunti, K., Heaney, L. G., Oliver, P., Siddiqui, S., Pavord, I., Hyland, M., Ritchie, L., Young, P., Megaw, T., Davis, S., ... van Melle, M. (2021). Risk Predictors and Symptom Features of Long COVID Within a Broad Primary Care Patient Population Including Both Tested and Untested Patients. Pragmatic and observational research, 2021(12), 93-104. https://doi.org/10.2147/POR.S316186

@article{754ab14495bb4b1bb76e768bc3356f88,

title = "Risk Predictors and Symptom Features of Long COVID Within a Broad Primary Care Patient Population Including Both Tested and Untested Patients",

abstract = "Introduction: Symptoms may persist after the initial phases of COVID-19 infection, a phenomenon termed long COVID. Current knowledge on long COVID has been mostly derived from test-confirmed and hospitalized COVID-19 patients. Data are required on the burden and predictors of long COVID in a broader patient group, which includes both tested and untested COVID-19 patients in primary care.Methods: This is an observational study using data from Platform C19, a quality improvement program-derived research database linking primary care electronic health record data (EHR) with patient-reported questionnaire information. Participating general practices invited consenting patients aged 18-85 to complete an online questionnaire since 7th August 2020. COVID-19 self-diagnosis, clinician-diagnosis, testing, and the presence and duration of symptoms were assessed via the questionnaire. Patients were considered present with long COVID if they reported symptoms lasting ≥4 weeks. EHR and questionnaire data up till 22nd January 2021 were extracted for analysis. Multivariable regression analyses were conducted comparing demographics, clinical characteristics, and presence of symptoms between patients with long COVID and patients with shorter symptom duration.Results: Long COVID was present in 310/3151 (9.8%) patients with self-diagnosed, clinician-diagnosed, or test-confirmed COVID-19. Only 106/310 (34.2%) long COVID patients had test-confirmed COVID-19. Risk predictors of long COVID were age ≥40 years (adjusted Odds Ratio [AdjOR]=1.49 [1.05-2.17]), female sex (adjOR=1.37 [1.02-1.85]), frailty (adjOR=2.39 [1.29-4.27]), visit to A&E (adjOR=4.28 [2.31-7.78]), and hospital admission for COVID-19 symptoms (adjOR=3.22 [1.77-5.79]). Aches and pain (adjOR=1.70 [1.21-2.39]), appetite loss (adjOR=3.15 [1.78-5.92]), confusion and disorientation (adjOR=2.17 [1.57-2.99]), diarrhea (adjOR=1.4 [1.03-1.89]), and persistent dry cough (adjOR=2.77 [1.94-3.98]) were symptom features statistically more common in long COVID.Conclusion: This study reports the factors and symptom features predicting long COVID in a broad primary care population, including both test-confirmed and the previously missed group of COVID-19 patients.",

author = "Rupert Jones and Andrew Davis and Brooklyn Stanley and Steven Julious and Dermot Ryan and Halpin, {David M G} and Katherine Hickman and Hilary Pinnock and Quint, {Jennifer K} and Kamlesh Khunti and Heaney, {Liam G} and Phillip Oliver and Salman Siddiqui and Ian Pavord and Michael Hyland and Lewis Ritchie and Pam Young and Tony Megaw and Steve Davis and Stephen Holgate and Sue Beecroft and Anu Kemppinen and Francis Appiagyei and Emma-Jane Roberts and Megan Preston and Antony Hardjojo and Victoria Carter and {van Melle}, Marije",

note = "{\textcopyright} 2021 Jones et al.",

year = "2021",

month = aug,

day = "11",

doi = "10.2147/POR.S316186",

language = "English",

volume = "2021",

pages = "93--104",

journal = "Pragmatic and observational research",

issn = "1179-7266",

number = "12",

}

Jones, R, Davis, A, Stanley, B, Julious, S, Ryan, D, Halpin, DMG, Hickman, K, Pinnock, H, Quint, JK, Khunti, K, Heaney, LG, Oliver, P, Siddiqui, S, Pavord, I, Hyland, M, Ritchie, L, Young, P, Megaw, T, Davis, S, Holgate, S, Beecroft, S, Kemppinen, A, Appiagyei, F, Roberts, E-J, Preston, M, Hardjojo, A, Carter, V & van Melle, M 2021, 'Risk Predictors and Symptom Features of Long COVID Within a Broad Primary Care Patient Population Including Both Tested and Untested Patients', Pragmatic and observational research, vol. 2021, no. 12, pp. 93-104. https://doi.org/10.2147/POR.S316186

TY - JOUR

T1 - Risk Predictors and Symptom Features of Long COVID Within a Broad Primary Care Patient Population Including Both Tested and Untested Patients

AU - Jones, Rupert

AU - Davis, Andrew

AU - Stanley, Brooklyn

AU - Julious, Steven

AU - Ryan, Dermot

AU - Halpin, David M G

AU - Hickman, Katherine

AU - Pinnock, Hilary

AU - Quint, Jennifer K

AU - Khunti, Kamlesh

AU - Heaney, Liam G

AU - Oliver, Phillip

AU - Siddiqui, Salman

AU - Pavord, Ian

AU - Hyland, Michael

AU - Ritchie, Lewis

AU - Young, Pam

AU - Megaw, Tony

AU - Davis, Steve

AU - Holgate, Stephen

AU - Beecroft, Sue

AU - Kemppinen, Anu

AU - Appiagyei, Francis

AU - Roberts, Emma-Jane

AU - Preston, Megan

AU - Hardjojo, Antony

AU - Carter, Victoria

AU - van Melle, Marije

PY - 2021/8/11

Y1 - 2021/8/11

N2 - Introduction: Symptoms may persist after the initial phases of COVID-19 infection, a phenomenon termed long COVID. Current knowledge on long COVID has been mostly derived from test-confirmed and hospitalized COVID-19 patients. Data are required on the burden and predictors of long COVID in a broader patient group, which includes both tested and untested COVID-19 patients in primary care.Methods: This is an observational study using data from Platform C19, a quality improvement program-derived research database linking primary care electronic health record data (EHR) with patient-reported questionnaire information. Participating general practices invited consenting patients aged 18-85 to complete an online questionnaire since 7th August 2020. COVID-19 self-diagnosis, clinician-diagnosis, testing, and the presence and duration of symptoms were assessed via the questionnaire. Patients were considered present with long COVID if they reported symptoms lasting ≥4 weeks. EHR and questionnaire data up till 22nd January 2021 were extracted for analysis. Multivariable regression analyses were conducted comparing demographics, clinical characteristics, and presence of symptoms between patients with long COVID and patients with shorter symptom duration.Results: Long COVID was present in 310/3151 (9.8%) patients with self-diagnosed, clinician-diagnosed, or test-confirmed COVID-19. Only 106/310 (34.2%) long COVID patients had test-confirmed COVID-19. Risk predictors of long COVID were age ≥40 years (adjusted Odds Ratio [AdjOR]=1.49 [1.05-2.17]), female sex (adjOR=1.37 [1.02-1.85]), frailty (adjOR=2.39 [1.29-4.27]), visit to A&E (adjOR=4.28 [2.31-7.78]), and hospital admission for COVID-19 symptoms (adjOR=3.22 [1.77-5.79]). Aches and pain (adjOR=1.70 [1.21-2.39]), appetite loss (adjOR=3.15 [1.78-5.92]), confusion and disorientation (adjOR=2.17 [1.57-2.99]), diarrhea (adjOR=1.4 [1.03-1.89]), and persistent dry cough (adjOR=2.77 [1.94-3.98]) were symptom features statistically more common in long COVID.Conclusion: This study reports the factors and symptom features predicting long COVID in a broad primary care population, including both test-confirmed and the previously missed group of COVID-19 patients.

AB - Introduction: Symptoms may persist after the initial phases of COVID-19 infection, a phenomenon termed long COVID. Current knowledge on long COVID has been mostly derived from test-confirmed and hospitalized COVID-19 patients. Data are required on the burden and predictors of long COVID in a broader patient group, which includes both tested and untested COVID-19 patients in primary care.Methods: This is an observational study using data from Platform C19, a quality improvement program-derived research database linking primary care electronic health record data (EHR) with patient-reported questionnaire information. Participating general practices invited consenting patients aged 18-85 to complete an online questionnaire since 7th August 2020. COVID-19 self-diagnosis, clinician-diagnosis, testing, and the presence and duration of symptoms were assessed via the questionnaire. Patients were considered present with long COVID if they reported symptoms lasting ≥4 weeks. EHR and questionnaire data up till 22nd January 2021 were extracted for analysis. Multivariable regression analyses were conducted comparing demographics, clinical characteristics, and presence of symptoms between patients with long COVID and patients with shorter symptom duration.Results: Long COVID was present in 310/3151 (9.8%) patients with self-diagnosed, clinician-diagnosed, or test-confirmed COVID-19. Only 106/310 (34.2%) long COVID patients had test-confirmed COVID-19. Risk predictors of long COVID were age ≥40 years (adjusted Odds Ratio [AdjOR]=1.49 [1.05-2.17]), female sex (adjOR=1.37 [1.02-1.85]), frailty (adjOR=2.39 [1.29-4.27]), visit to A&E (adjOR=4.28 [2.31-7.78]), and hospital admission for COVID-19 symptoms (adjOR=3.22 [1.77-5.79]). Aches and pain (adjOR=1.70 [1.21-2.39]), appetite loss (adjOR=3.15 [1.78-5.92]), confusion and disorientation (adjOR=2.17 [1.57-2.99]), diarrhea (adjOR=1.4 [1.03-1.89]), and persistent dry cough (adjOR=2.77 [1.94-3.98]) were symptom features statistically more common in long COVID.Conclusion: This study reports the factors and symptom features predicting long COVID in a broad primary care population, including both test-confirmed and the previously missed group of COVID-19 patients.

U2 - 10.2147/POR.S316186

DO - 10.2147/POR.S316186

M3 - Article

C2 - 34408531

SN - 1179-7266

VL - 2021

SP - 93

EP - 104

JO - Pragmatic and observational research

JF - Pragmatic and observational research

IS - 12

ER -

Risk Predictors and Symptom Features of Long COVID Within a Broad Primary Care Patient Population Including Both Tested and Untested Patients

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