Differences in diagnostic coding in long COVID: sociodemographic and symptom interference factors.
We aimed to test associations of participant-reported Long COVID symptom interference with life activities with Long COVID symptoms, presence of U09.9 Long COVID diagnosis code, demographics, and clinical factors. In a subgroup, we documented coding related to Long COVID and post-exertional malaise in the electronic medical record (EMR).
Using a cross-sectional analysis (n = 205) of participant data from a Long COVID survey, we tested associations with Chi-square, Fisher's exact, or Fisher-Freeman-Halton exact statistical tests and Independent Samples T-tests.
Participants were predominately female (67%) with a mean age of 50.9 years. Participants were White (50.0%), African American (47.5%), and Asian (2.5%); 1.5% reported Hispanic ethnicity. 41% of participants reported high Long COVID symptom interference with life activities. Participants who were older (p=.028), were female (p=.002), were obese (p=.049), had worse general health (p<.001), worse physical health (p<.001), had worse mental health (p<.001), and had U09.9 diagnosis (p<.001) were more likely to experience high symptom interference. Among participants with high symptom interference, there were no significant associations with U09.9 diagnosis code. EMR sub-analysis (n = 100) revealed that among participants that reported high symptom interference (n = 39), 64% (n = 25) had a code related to Long COVID.
Although we found discrepancies between self-reported measures and EMR coding, we did not find evidence of demographic biases in diagnosis among participants with high symptom interference.
Not applicable.
Using a cross-sectional analysis (n = 205) of participant data from a Long COVID survey, we tested associations with Chi-square, Fisher's exact, or Fisher-Freeman-Halton exact statistical tests and Independent Samples T-tests.
Participants were predominately female (67%) with a mean age of 50.9 years. Participants were White (50.0%), African American (47.5%), and Asian (2.5%); 1.5% reported Hispanic ethnicity. 41% of participants reported high Long COVID symptom interference with life activities. Participants who were older (p=.028), were female (p=.002), were obese (p=.049), had worse general health (p<.001), worse physical health (p<.001), had worse mental health (p<.001), and had U09.9 diagnosis (p<.001) were more likely to experience high symptom interference. Among participants with high symptom interference, there were no significant associations with U09.9 diagnosis code. EMR sub-analysis (n = 100) revealed that among participants that reported high symptom interference (n = 39), 64% (n = 25) had a code related to Long COVID.
Although we found discrepancies between self-reported measures and EMR coding, we did not find evidence of demographic biases in diagnosis among participants with high symptom interference.
Not applicable.
Authors
Vickers Vickers, Levitan Levitan, Howell Howell, Montgomery Montgomery, Jones Jones, Lund Lund, Erdmann Erdmann
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