Understanding the clinical characteristics and timeliness of diagnosis for patients diagnosed with long Covid: a retrospective observational cohort study from North West London
Author(s)
Type
Journal Article
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.
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.
Date Issued
2025-10-01
Date Acceptance
2025-08-25
Citation
Health Expectations, 2025, 28 (5)
ISSN
1369-6513
Publisher
Wiley
Journal / Book Title
Health Expectations
Volume
28
Issue
5
Copyright Statement
© 2025 The Author(s). Health Expectations published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
License URL
Subjects
Health Care Sciences & Services
Health Policy & Services
Life Sciences & Biomedicine
Public, Environmental & Occupational Health
Science & Technology
Publication Status
Published
Article Number
e70429
Date Publish Online
2025-09-25