{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,5]],"date-time":"2026-07-05T23:57:01Z","timestamp":1783295821230,"version":"3.54.6"},"reference-count":26,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T00:00:00Z","timestamp":1758758400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Expectations"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Long Covid is a multisystem condition first identified in the Covid\u201019 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To describe the incidence and impact of long Covid.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A retrospective observational cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting and Participants<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Variables Studied<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>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\u201370\u2009years or of Asian or mixed ethnicity, were more likely to have a recorded long Covid diagnosis, alongside those with pre\u2010existing anxiety, asthma, depressive disorder or eczema and those living outside of the least or most socio\u2010economically deprived areas. Men, those aged 41\u201370\u2009years, or of black ethnicity, were diagnosed earlier in the pandemic, while those with depressive disorder were diagnosed later.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>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\u2010existing long\u2010term conditions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patient and Public Contribution<\/jats:title>\n                    <jats:p>This study was co\u2010designed, conducted and written in conjunction with people with long Covid.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/hex.70429","type":"journal-article","created":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T15:18:57Z","timestamp":1758813537000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Understanding the Clinical Characteristics and Timeliness of Diagnosis for Patients Diagnosed With Long Covid: A Retrospective Observational Cohort Study From North West London"],"prefix":"10.1111","volume":"28","author":[{"given":"Denys","family":"Prociuk","sequence":"first","affiliation":[{"name":"I\u2010X, Imperial College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Clarke","sequence":"additional","affiliation":[{"name":"I\u2010X, Imperial College London London UK"},{"name":"Department of Mathematics Centre for Mathematics of Precision Healthcare, Imperial College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikki","family":"Smith","sequence":"additional","affiliation":[{"name":"Person with Long Covid, Member of the LOCOMOTION Study Patient Advisory Group Windsor UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruairidh","family":"Milne","sequence":"additional","affiliation":[{"name":"Person with Long Covid; and Emeritus Professor of Public Health University of Southampton Southampton UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cassie","family":"Lee","sequence":"additional","affiliation":[{"name":"Imperial College London NHS Trust, Imperial College Respiratory Research Unit (ICRRU) London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"de Lusignan","sequence":"additional","affiliation":[{"name":"Nuffield Department of Primary Care Health Sciences University of Oxford Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5277-6885","authenticated-orcid":false,"given":"Ghazala","family":"Mir","sequence":"additional","affiliation":[{"name":"Leeds Institute of Health Sciences University of Leeds Leeds UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes","family":"De Kock","sequence":"additional","affiliation":[{"name":"NHS Highland, COVID Recovery Service Inverness UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erik","family":"Mayer","sequence":"additional","affiliation":[{"name":"I\u2010X, Imperial College London London UK"},{"name":"iCARE Digital Collaboration Space &amp; Secure Data Environment, NIHR Imperial Biomedical Research Centre, Imperial College Healthcare NHS Trust &amp; Faculty of Medicine, Imperial College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brendan C.","family":"Delaney","sequence":"additional","affiliation":[{"name":"I\u2010X, Imperial College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"LOCOMOTION Consortium","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,9,25]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph21040473"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(23)00053-1"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41579-022-00846-2"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2021.100899"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.2196\/37668"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.2196\/36989"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh-2021-005427"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2024.11370"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-023-43661-w"},{"key":"e_1_2_13_11_1","unstructured":"\u201cSelf\u2010Reported Coronavirus (COVID\u201019) Infections and Associated Symptoms England and Scotland\u2014Office for National Statistics \u201d cited August 29 2024 https:\/\/www.ons.gov.uk\/peoplepopulationandcommunity\/healthandsocialcare\/conditionsanddiseases\/articles\/selfreportedcoronaviruscovid19infectionsandassociatedsymptomsenglandandscotland\/november2023tomarch2024#."},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2024.102590"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(24)00744-X"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2023.0750"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-022-30836-0"},{"key":"e_1_2_13_16_1","doi-asserted-by":"crossref","unstructured":"A. H.Heald R.Williams D. A.Jenkins et al. \u201cThe Prevalence of Long COVID in People With Diabetes Mellitus\u2014Evidence From a UK Cohort \u201d eClinicalMedicine 71 (May2024) https:\/\/www.thelancet.com\/journals\/eclinm\/article\/PIIS2589-5370(24)00186-X\/fulltext.","DOI":"10.1016\/j.eclinm.2024.102607"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0290583"},{"key":"e_1_2_13_18_1","unstructured":"NHS Digital. \u201cCOVID\u201019 and SARS\u2010CoV\u20102 in SNOMED CT: Advice on Competing International and UK Codes \u201d cited December 5 2023 https:\/\/nhsengland.kahootz.com\/COVID19_info_sharing\/view?objectId=101156165."},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.3399\/BJGP.2021.0301"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.2196\/19773"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/hex.70336"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-022-01909-w"},{"key":"e_1_2_13_23_1","unstructured":"\u201cLong Covid in Adults\u2014Referrals to Specialist NHS Services Private Consultations and Investigations That People Would Like for Long Covid \u201d cited August 9 2025 https:\/\/www.hexi.ox.ac.uk\/Long-Covid-In-Adults\/Referrals-to-specialist-NHS-services-private-consultations-and-investigations-that-people-would-li."},{"key":"e_1_2_13_24_1","unstructured":"Public Health England Beyond the Data: Understanding the Impact of COVID\u201019 on BAME Groups https:\/\/assets.publishing.service.gov.uk\/media\/5ee761fce90e070435f5a9dd\/COVID_stakeholder_engagement_synthesis_beyond_the_data.pdf."},{"key":"e_1_2_13_25_1","unstructured":"\u201cCoronavirus and Key Workers in the UK\u2014Office for National Statistics \u201d cited August 29 2024 https:\/\/www.ons.gov.uk\/employmentandlabourmarket\/peopleinwork\/earningsandworkinghours\/articles\/coronavirusandkeyworkersintheuk\/2020-05-15."},{"key":"e_1_2_13_26_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj-2023-076508"},{"key":"e_1_2_13_27_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n1262"}],"container-title":["Health Expectations"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/hex.70429","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T12:12:54Z","timestamp":1766146374000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/hex.70429"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,25]]},"references-count":26,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,10]]}},"alternative-id":["10.1111\/hex.70429"],"URL":"https:\/\/doi.org\/10.1111\/hex.70429","archive":["Portico"],"relation":{},"ISSN":["1369-6513","1369-7625"],"issn-type":[{"value":"1369-6513","type":"print"},{"value":"1369-7625","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,25]]},"assertion":[{"value":"2025-02-05","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-08-25","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-25","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70429"}}