Research sheds new light on long COVID conditions NatureComms
. We also cannot rule out the potential for missing data around PCR testing, especially in early 2020. Diagnoses, lab results and death, which was not compared with the National Death Index for the cause of death, also have the potential for missingness; however, we believe our care model and connection to external data sources significantly reduces much of this limitation.
. KPMAS is a closed healthcare system with high ascertainment of COVID-19 in the population, as well as potential PASC conditions and symptoms.Study population and COVID-19 classification SARS-CoV-2 RT-PCR testing, the most widely available test during our study period, has been regarded as the gold standard for COVID patient identification. Given the magnitude of testing performed within our system and external testing linkages, we classified COVID positive patients as those with a confirmed PCR result and refer to those as PCR-positive. We refer to those with only COVID PCR-negative results as PCR-negative.
For each PCR-positive patient , we matched up to three PCR-negative patients, without replacement, by PCR testing month and year , age group at the time of PCR test , race/ethnicity , sex , and service area . When 1:3 matching was not possible, cases were matched to controls 1:2 or 1:1. Demographic covariates of interest abstracted from the EHR included: race/ethnicity age, comorbidities , Body Mass Index , insurance type , pregnancy status, service area, and hospitalizations and known deaths post-index date.The timing and definition of the conditions identified were critical in distinguishing sequelae of significance. Our index date was the PCR test date.
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