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 A. Julious; Dermot Ryan; David J Jackson; David MG  Halpin; Katherine  Hickman; Hilary Pinnock; Jennifer K  Quint; Kamlesh Khunti; Liam G Heaney; Phillip Oliver; Salman Siddiqui; Ian D. Pavord; David HM  Jones; Michael E Hyland; Lewis Ritchie; Pam  Young; Tony  Megaw; 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 A. Julious, Dermot Ryan, David J Jackson, David MG Halpin, Katherine Hickman, Hilary Pinnock, Jennifer K Quint, Kamlesh Khunti, Liam G Heaney, Phillip Oliver, Salman Siddiqui, Ian D. Pavord, David HM Jones, Michael E Hyland, Lewis Ritchie, Pam Young, Tony MegawAntony Hardjojo, Victoria Carter, Marije van Melle

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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, cliniciandiagnosed, or test-confirmed COVID-19. Only 106/310 (34.2%) long COVID patients had testconfirmed 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
Early online date	11 Aug 2021
DOIs	https://doi.org/10.2147/POR.S316186
Publication status	Published - 11 Aug 2021

Bibliographical note

Acknowledgments
Other members of the Platform C19 steering committee consist of Sir Prof Lewis Ritchie, OBE from the University of Aberdeen, Steve Davis from Interface Clinical Services, Dr Samantha Walker from Asthma UK & British Lung Foundation, Prof Stephen Holgate from the University of
Southampton and the Medical Research Council, and Sue Beacroft from Open Vie/Harvey Walsh and OPCRD-NEXUS. We wish to acknowledge our GP Partner Practices:
Alnwick Medical Group, Guide Post Medical Group, Priory Medical Group, Highgate Medical Centre, Clifton Medical Centre, Bridge Street Surgery, Park and St Francis Surgery, Brockworth Surgery, Whitemoor Medical Centre, Tong Medical Practice, Eric Moore Partnership, Bridgewater
Surgeries, The Village Surgery, and Queen Square Medical Practice.
Funding
The design, conduct, and writing of this study are funded by Optimum Patient Care UK and the Observational and Pragmatic Research Institute Singapore.

Keywords

SARS-CoV-2
questionnaire
observational study
frailty
chronic disease

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Jones, R., Davis, A., Stanley, B., Julious, S. A., Ryan, D., Jackson, D. J., Halpin, D. MG., Hickman, K., Pinnock, H., Quint, J. K., Khunti, K., Heaney, L. G., Oliver, P., Siddiqui, S., Pavord, I. D., Jones, D. HM., Hyland, M. E., Ritchie, L., Young, P., ... 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

Jones, R, Davis, A, Stanley, B, Julious, SA, Ryan, D, Jackson, DJ, Halpin, DMG, Hickman, K, Pinnock, H, Quint, JK, Khunti, K, Heaney, LG, Oliver, P, Siddiqui, S, Pavord, ID, Jones, DHM, Hyland, ME, Ritchie, L, Young, P, Megaw, T, 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

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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, cliniciandiagnosed, or test-confirmed COVID-19. Only 106/310 (34.2%) long COVID patients had testconfirmed 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",

keywords = "SARS-CoV-2, questionnaire, observational study, frailty, chronic disease",

author = "Rupert Jones and Andrew Davis and Brooklyn Stanley and Julious, {Steven A.} and Dermot Ryan and Jackson, {David J} and Halpin, {David MG} and Katherine Hickman and Hilary Pinnock and Quint, {Jennifer K} and Kamlesh Khunti and Heaney, {Liam G} and Phillip Oliver and Salman Siddiqui and Pavord, {Ian D.} and Jones, {David HM} and Hyland, {Michael E} and Lewis Ritchie and Pam Young and Tony Megaw and Antony Hardjojo and Victoria Carter and {van Melle}, Marije",

note = "Acknowledgments Other members of the Platform C19 steering committee consist of Sir Prof Lewis Ritchie, OBE from the University of Aberdeen, Steve Davis from Interface Clinical Services, Dr Samantha Walker from Asthma UK & British Lung Foundation, Prof Stephen Holgate from the University of Southampton and the Medical Research Council, and Sue Beacroft from Open Vie/Harvey Walsh and OPCRD-NEXUS. We wish to acknowledge our GP Partner Practices: Alnwick Medical Group, Guide Post Medical Group, Priory Medical Group, Highgate Medical Centre, Clifton Medical Centre, Bridge Street Surgery, Park and St Francis Surgery, Brockworth Surgery, Whitemoor Medical Centre, Tong Medical Practice, Eric Moore Partnership, Bridgewater Surgeries, The Village Surgery, and Queen Square Medical Practice. Funding The design, conduct, and writing of this study are funded by Optimum Patient Care UK and the Observational and Pragmatic Research Institute Singapore.",

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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 A.

AU - Ryan, Dermot

AU - Jackson, David J

AU - Halpin, David MG

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 D.

AU - Jones, David HM

AU - Hyland, Michael E

AU - Ritchie, Lewis

AU - Young, Pam

AU - Megaw, Tony

AU - Hardjojo, Antony

AU - Carter, Victoria

AU - van Melle, Marije

N1 - Acknowledgments Other members of the Platform C19 steering committee consist of Sir Prof Lewis Ritchie, OBE from the University of Aberdeen, Steve Davis from Interface Clinical Services, Dr Samantha Walker from Asthma UK & British Lung Foundation, Prof Stephen Holgate from the University of Southampton and the Medical Research Council, and Sue Beacroft from Open Vie/Harvey Walsh and OPCRD-NEXUS. We wish to acknowledge our GP Partner Practices: Alnwick Medical Group, Guide Post Medical Group, Priory Medical Group, Highgate Medical Centre, Clifton Medical Centre, Bridge Street Surgery, Park and St Francis Surgery, Brockworth Surgery, Whitemoor Medical Centre, Tong Medical Practice, Eric Moore Partnership, Bridgewater Surgeries, The Village Surgery, and Queen Square Medical Practice. Funding The design, conduct, and writing of this study are funded by Optimum Patient Care UK and the Observational and Pragmatic Research Institute Singapore.

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, cliniciandiagnosed, or test-confirmed COVID-19. Only 106/310 (34.2%) long COVID patients had testconfirmed 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, cliniciandiagnosed, or test-confirmed COVID-19. Only 106/310 (34.2%) long COVID patients had testconfirmed 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

KW - SARS-CoV-2

KW - questionnaire

KW - observational study

KW - frailty

KW - chronic disease

U2 - 10.2147/POR.S316186

DO - 10.2147/POR.S316186

M3 - Article

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

Abstract

Bibliographical note

Keywords

UN SDGs

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