| Description: |
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 TPP 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 March 31 st 2023). Occurrence of each of (1) long-COVID symptoms; (2) primary-care diagnoses; and (3) new prescriptions was analysed at anytime during one 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 1.48-1.66), mobility impairment (1.41, 1.35-1.48), fatigue (1.46, 1.42-1.49), cognitive impairment (1.39, 1.34-1.44), and loss of taste or smell (1.38, 1.31-1.46). At 6-12 months reporting persisted for mobility impairment, fatigue and cognitive impairment. There were small increases in new prescriptions for NSAIDs (1.24, 1.23-1.26), drugs to treat infections (1.24, 1.23-1.25) and musculoskeletal problems (1.23, 1.22-1.25). 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. |