Risk Predictors and Symptom Features of Long COVID Within a Broad Primary Care Patient Population Including Both Tested and Untested Patients
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...
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| Veröffentlicht in: | Pragmatic and observational research 2021-01, Vol.12, p.93-104 |
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| creator | Jones, Rupert Davis, Andrew Stanley, Brooklyn Julious, Steven Ryan, Dermot Jackson, David J Halpin, David M G Hickman, Katherine Pinnock, Hilary Quint, Jennifer K Khunti, Kamlesh Heaney, Liam G Oliver, Phillip Siddiqui, Salman Pavord, Ian Jones, David H M Hyland, Michael Ritchie, Lewis Young, Pam Megaw, Tony Davis, Steve Walker, Samantha Holgate, Stephen Beecroft, Sue Kemppinen, Anu Appiagyei, Francis Roberts, Emma-Jane Preston, Megan Hardjojo, Antony Carter, Victoria van Melle, Marije Price, David |
| description | 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.
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.
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.
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. |
| doi_str_mv | 10.2147/POR.S316186 |
| format | Article |
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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.
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.
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.</description><identifier>ISSN: 1179-7266</identifier><identifier>EISSN: 1179-7266</identifier><identifier>DOI: 10.2147/POR.S316186</identifier><identifier>PMID: 34408531</identifier><language>eng</language><publisher>New Zealand: Dove Medical Press Limited</publisher><subject>Age ; Chronic diseases ; Coronaviruses ; COVID-19 ; Disease ; Family medicine ; Health aspects ; Hospital patients ; Hospitals ; Infection ; Infections ; Medical records ; Medical research ; Medicine, Experimental ; Observational studies ; Original Research ; Pandemics ; Patients ; Primary care ; Quality control ; Questionnaires</subject><ispartof>Pragmatic and observational research, 2021-01, Vol.12, p.93-104</ispartof><rights>2021 Jones et al.</rights><rights>COPYRIGHT 2021 Dove Medical Press Limited</rights><rights>2021. This work is licensed under https://creativecommons.org/licenses/by-nc/3.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2021 Jones et al. 2021 Jones et al.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c406t-a51d65c234abde0193b678af1c40696d2037edd25de97099b65f5d7528b4d91d3</citedby><cites>FETCH-LOGICAL-c406t-a51d65c234abde0193b678af1c40696d2037edd25de97099b65f5d7528b4d91d3</cites><orcidid>0000-0002-5463-2981 ; 0000-0003-0149-4869 ; 0000-0002-5976-8386 ; 0000-0002-4288-5973 ; 0000-0001-9601-4690 ; 0000-0002-2823-7996 ; 0000-0003-2009-4406 ; 0000-0003-2343-7099 ; 0000-0002-9728-9992 ; 0000-0002-4115-7376 ; 0000-0002-9665-0635</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8366779/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8366779/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,3849,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34408531$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Jones, Rupert</creatorcontrib><creatorcontrib>Davis, Andrew</creatorcontrib><creatorcontrib>Stanley, Brooklyn</creatorcontrib><creatorcontrib>Julious, Steven</creatorcontrib><creatorcontrib>Ryan, Dermot</creatorcontrib><creatorcontrib>Jackson, David J</creatorcontrib><creatorcontrib>Halpin, David M G</creatorcontrib><creatorcontrib>Hickman, Katherine</creatorcontrib><creatorcontrib>Pinnock, Hilary</creatorcontrib><creatorcontrib>Quint, Jennifer K</creatorcontrib><creatorcontrib>Khunti, Kamlesh</creatorcontrib><creatorcontrib>Heaney, Liam G</creatorcontrib><creatorcontrib>Oliver, Phillip</creatorcontrib><creatorcontrib>Siddiqui, Salman</creatorcontrib><creatorcontrib>Pavord, Ian</creatorcontrib><creatorcontrib>Jones, David H M</creatorcontrib><creatorcontrib>Hyland, Michael</creatorcontrib><creatorcontrib>Ritchie, Lewis</creatorcontrib><creatorcontrib>Young, Pam</creatorcontrib><creatorcontrib>Megaw, Tony</creatorcontrib><creatorcontrib>Davis, Steve</creatorcontrib><creatorcontrib>Walker, Samantha</creatorcontrib><creatorcontrib>Holgate, Stephen</creatorcontrib><creatorcontrib>Beecroft, Sue</creatorcontrib><creatorcontrib>Kemppinen, Anu</creatorcontrib><creatorcontrib>Appiagyei, Francis</creatorcontrib><creatorcontrib>Roberts, Emma-Jane</creatorcontrib><creatorcontrib>Preston, Megan</creatorcontrib><creatorcontrib>Hardjojo, Antony</creatorcontrib><creatorcontrib>Carter, Victoria</creatorcontrib><creatorcontrib>van Melle, Marije</creatorcontrib><creatorcontrib>Price, David</creatorcontrib><title>Risk Predictors and Symptom Features of Long COVID Within a Broad Primary Care Patient Population Including Both Tested and Untested Patients</title><title>Pragmatic and observational research</title><addtitle>Pragmat Obs Res</addtitle><description>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.
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.
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.
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.</description><subject>Age</subject><subject>Chronic diseases</subject><subject>Coronaviruses</subject><subject>COVID-19</subject><subject>Disease</subject><subject>Family medicine</subject><subject>Health aspects</subject><subject>Hospital patients</subject><subject>Hospitals</subject><subject>Infection</subject><subject>Infections</subject><subject>Medical records</subject><subject>Medical research</subject><subject>Medicine, Experimental</subject><subject>Observational studies</subject><subject>Original Research</subject><subject>Pandemics</subject><subject>Patients</subject><subject>Primary care</subject><subject>Quality 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David</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Risk Predictors and Symptom Features of Long COVID Within a Broad Primary Care Patient Population Including Both Tested and Untested Patients</atitle><jtitle>Pragmatic and observational research</jtitle><addtitle>Pragmat Obs Res</addtitle><date>2021-01-01</date><risdate>2021</risdate><volume>12</volume><spage>93</spage><epage>104</epage><pages>93-104</pages><issn>1179-7266</issn><eissn>1179-7266</eissn><abstract>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.
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.
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.
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.</abstract><cop>New Zealand</cop><pub>Dove Medical Press Limited</pub><pmid>34408531</pmid><doi>10.2147/POR.S316186</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0002-5463-2981</orcidid><orcidid>https://orcid.org/0000-0003-0149-4869</orcidid><orcidid>https://orcid.org/0000-0002-5976-8386</orcidid><orcidid>https://orcid.org/0000-0002-4288-5973</orcidid><orcidid>https://orcid.org/0000-0001-9601-4690</orcidid><orcidid>https://orcid.org/0000-0002-2823-7996</orcidid><orcidid>https://orcid.org/0000-0003-2009-4406</orcidid><orcidid>https://orcid.org/0000-0003-2343-7099</orcidid><orcidid>https://orcid.org/0000-0002-9728-9992</orcidid><orcidid>https://orcid.org/0000-0002-4115-7376</orcidid><orcidid>https://orcid.org/0000-0002-9665-0635</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1179-7266 |
| ispartof | Pragmatic and observational research, 2021-01, Vol.12, p.93-104 |
| issn | 1179-7266 1179-7266 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8366779 |
| source | Taylor & Francis Open Access; DOVE Medical Press Journals; DOAJ Directory of Open Access Journals; EZB-FREE-00999 freely available EZB journals; PubMed Central; PubMed Central Open Access |
| subjects | Age Chronic diseases Coronaviruses COVID-19 Disease Family medicine Health aspects Hospital patients Hospitals Infection Infections Medical records Medical research Medicine, Experimental Observational studies Original Research Pandemics Patients Primary care Quality control Questionnaires |
| title | 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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