{
  "abstract": "Background We aimed to explore the occurrence and persistence of symptoms, diagnoses and prescribing after COVID-19 among populations from earlier (wave 2) and later (wave 4) in the pandemic.Methods With the approval of NHS England, we analysed data from English primary care using The Phoenix Partnership SystmOne through the OpenSAFELY data analytics platform. Individuals with community-diagnosed COVID-19 September 2020–January 2021 (wave 2) were matched to contemporary (2020–2021) and historical (2017–2018) comparators. Individuals with community COVID-19 December 2021–March 2022 (wave 4) were matched to contemporary comparators (last follow-up 31 March 2023). Occurrence of each of (1) long-COVID symptoms; (2) primary-care diagnoses and (3) new prescriptions was analysed at any time during 1 year after COVID-19 and at: 4–12 weeks, 12 weeks–6 months and 6 months–12 months after COVID-19 to assess persistence.Results 902 885 COVID-19 cases (wave 2) matched to 4 449 265 contemporary (no-COVID-19) comparators. 1 553 160 COVID-19 cases (wave 4) matched to 7 624 770 contemporary comparators. Positive wave 2 associations after COVID-19 were observed for hair loss (OR 1.57, 95% CI 1.48 to 1.66), mobility impairment (1.41, 1.35 to 1.48), fatigue (1.46, 1.42 to 1.49), cognitive impairment (1.39, 1.34 to 1.44) and loss of taste or smell (1.38, 1.31 to 1.46). At 6–12 months reporting persisted for mobility impairment, fatigue and cognitive impairment. There were small increases in new prescriptions for NSAIDs (1.24, 1.23 to 1.26), drugs to treat infections (1.24, 1.23 to 1.25) and musculoskeletal problems (1.23, 1.22 to 1.25). Wave 4 associations were generally weaker than Wave 2.Conclusions Long-COVID symptoms and new prescribing generally reduce over time and are potentially less problematic following less severe illness. Fatigue/cognitive/mobility symptoms persist following COVID-19.",
  "authors": [
    {
      "affiliations": [
        "Glasgow Lab for Health Data Science & AI, Public Health, School of Health & Wellbeing, University of Glasgow, Glasgow, UK",
        "Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK"
      ],
      "name": "Kevin Wing"
    },
    {
      "affiliations": [
        "Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK"
      ],
      "name": "Caroline Morton"
    },
    {
      "affiliations": [
        "Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK"
      ],
      "name": "Viyaasan Mahalingasivam"
    },
    {
      "affiliations": [
        "Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK"
      ],
      "name": "Ruth E Costello"
    },
    {
      "affiliations": [
        "Department of Health Services Research & Policy, London School of Hygiene & Tropical Medicine, London, UK"
      ],
      "name": "Thomas Cowling"
    },
    {
      "affiliations": [
        "Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK",
        "Institute of Environmental and Occupational Health Sciences, Global Health Program, College of Public Health, National Taiwan University, Taipei City, Taiwan"
      ],
      "name": "Liang-Yu Lin"
    },
    {
      "affiliations": [
        "Bennett Institute for Applied Data Science, Primary Care Health Sciences, University of Oxford Nuffield Department of Medicine, Oxford, UK"
      ],
      "name": "Peter Inglesby"
    },
    {
      "affiliations": [
        "Bennett Institute for Applied Data Science, Primary Care Health Sciences, University of Oxford Nuffield Department of Medicine, Oxford, UK"
      ],
      "name": "Alex Walker"
    },
    {
      "affiliations": [
        "Glasgow Lab for Health Data Science & AI, Public Health, School of Health & Wellbeing, University of Glasgow, Glasgow, UK",
        "Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK",
        "Department of Health Services Research & Policy, London School of Hygiene & Tropical Medicine, London, UK",
        "Institute of Environmental and Occupational Health Sciences, Global Health Program, College of Public Health, National Taiwan University, Taipei City, Taiwan",
        "Bennett Institute for Applied Data Science, Primary Care Health Sciences, University of Oxford Nuffield Department of Medicine, Oxford, UK",
        "Department of Medical Statistics, London School of Hygiene & Tropical Medicine, London, UK",
        "Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK",
        "School of Health & Care Sciences, University of Lincoln, Lincoln, UK"
      ],
      "name": "OpenSAFELY Collaborative"
    },
    {
      "affiliations": [
        "Glasgow Lab for Health Data Science & AI, Public Health, School of Health & Wellbeing, University of Glasgow, Glasgow, UK",
        "Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK",
        "Department of Health Services Research & Policy, London School of Hygiene & Tropical Medicine, London, UK",
        "Institute of Environmental and Occupational Health Sciences, Global Health Program, College of Public Health, National Taiwan University, Taipei City, Taiwan",
        "Bennett Institute for Applied Data Science, Primary Care Health Sciences, University of Oxford Nuffield Department of Medicine, Oxford, UK",
        "Department of Medical Statistics, London School of Hygiene & Tropical Medicine, London, UK",
        "Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK",
        "School of Health & Care Sciences, University of Lincoln, Lincoln, UK"
      ],
      "name": "The LH&W NCS (or CONVALESCENCE) Collaborative"
    },
    {
      "affiliations": [
        "Bennett Institute for Applied Data Science, Primary Care Health Sciences, University of Oxford Nuffield Department of Medicine, Oxford, UK"
      ],
      "name": "Sebastian Bacon"
    },
    {
      "affiliations": [
        "Bennett Institute for Applied Data Science, Primary Care Health Sciences, University of Oxford Nuffield Department of Medicine, Oxford, UK"
      ],
      "name": "Amir Mehrkar"
    },
    {
      "affiliations": [
        "Bennett Institute for Applied Data Science, Primary Care Health Sciences, University of Oxford Nuffield Department of Medicine, Oxford, UK"
      ],
      "name": "Ben Goldacre"
    },
    {
      "affiliations": [
        "Department of Medical Statistics, London School of Hygiene & Tropical Medicine, London, UK"
      ],
      "name": "Stephen Evans"
    },
    {
      "affiliations": [
        "Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK"
      ],
      "name": "Ian Douglas"
    },
    {
      "affiliations": [
        "Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK"
      ],
      "name": "Rosalind Eggo"
    },
    {
      "affiliations": [
        "Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK"
      ],
      "name": "Laurie Tomlinson"
    },
    {
      "affiliations": [
        "Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK",
        "School of Health & Care Sciences, University of Lincoln, Lincoln, UK"
      ],
      "name": "Kathryn E Mansfield"
    }
  ],
  "title": "Occurrence and persistence of symptoms, diagnoses and prescriptions after community-diagnosed COVID-19: a matched cohort study using the OpenSAFELY platform",
  "uid": "24aea15b-a116-52d0-8c0c-652386129fd3"
}