Changes in sick notes associated with COVID-19 from 2020 to 2022: a cohort study in 24 million primary care patients in OpenSAFELY-TPP.

Autor:	Schaffer AL; Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, Unviersity of Oxford, Oxford, UK andrea.schaffer@phc.ox.ac.uk., Park RY; Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, Unviersity of Oxford, Oxford, UK., Tazare J; London School of Hygiene and Tropical Medicine, London, UK., Bhaskaran K; London School of Hygiene and Tropical Medicine, London, UK., MacKenna B; Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, Unviersity of Oxford, Oxford, UK., Denaxas S; Institute of Health Informatics, University College London, London, UK.; University College London Hospitals Biomedical Research Centre, London, UK.; BHF Data Science Centre, Health Data Research UK, London, UK., Dillingham I; Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, Unviersity of Oxford, Oxford, UK., Bacon SCJ; Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, Unviersity of Oxford, Oxford, UK., Mehrkar A; Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, Unviersity of Oxford, Oxford, UK., Bates C; TPP, Leeds, UK., Goldacre B; Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, Unviersity of Oxford, Oxford, UK., Greaves F; National Institute for Health and Care Excellence, London, UK.; Department of Primary Care and Public Health, Imperial College London, London, UK., Macleod J; NIHR Applied Research Collaboration West, Bristol, UK., Tomlinson LA; London School of Hygiene and Tropical Medicine, London, UK., Walker A; Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, Unviersity of Oxford, Oxford, UK.
Jazyk:	angličtina
Zdroj:	BMJ open [BMJ Open] 2024 Jul 03; Vol. 14 (7), pp. e080600. Date of Electronic Publication: 2024 Jul 03.
DOI:	10.1136/bmjopen-2023-080600
Abstrakt:	Objectives: Long-term sickness absence from employment has negative consequences for the economy and can lead to widened health inequalities. Sick notes (also called 'fit notes') are issued by general practitioners when a person cannot work for health reasons for more than 7 days. We quantified the sick note rate in people with evidence of COVID-19 in 2020, 2021 and 2022, as an indication of the burden for people recovering from COVID-19. Design: Cohort study. Setting: With National Health Service (NHS) England approval, we used routine clinical data (primary care, hospital and COVID-19 testing records) within the OpenSAFELY-TPP database. Participants: People 18-64 years with a recorded positive test or diagnosis of COVID-19 in 2020 (n=365 421), 2021 (n=1 206 555) or 2022 (n=1 321 313); general population matched in age, sex and region in 2019 (n=3 140 326), 2020 (n=3 439 534), 2021 (n=4 571 469) and 2022 (n=4 818 870); people hospitalised with pneumonia in 2019 (n=29 673). Primary Outcome Measure: Receipt of a sick note in primary care. Results: Among people with a positive SARS-CoV-2 test or COVID-19 diagnosis, the sick note rate was 4.88 per 100 person-months (95% CI 4.83 to 4.93) in 2020, 2.66 (95% CI 2.64 to 2.67) in 2021 and 1.73 (95% CI 1.72 to 1.73) in 2022. Compared with the age, sex and region-matched general population, the adjusted HR for receipt of a sick note over the entire follow-up period (up to 10 months) was 4.07 (95% CI 4.02 to 4.12) in 2020 decreasing to 1.57 (95% CI 1.56 to 1.58) in 2022. The HR was highest in the first 30 days postdiagnosis in all years. Among people hospitalised with COVID-19, after adjustment, the sick note rate was lower than in people hospitalised with pneumonia. Conclusions: Given the under-recording of postacute COVID-19-related symptoms, these findings contribute a valuable perspective on the long-term effects of COVID-19. Despite likely underestimation of the sick note rate, sick notes were issued more frequently to people with COVID-19 compared with those without, even in an era when most people are vaccinated. Most sick notes occurred in the first 30 days postdiagnosis, but the increased risk several months postdiagnosis may provide further evidence of the long-term impact. Competing Interests: Competing interests: Over the past 5 years, BG has received research funding from the Laura and John Arnold Foundation, the NHS National Institute for Health Research (NIHR), the NIHR School of Primary Care Research, the NIHR Oxford Biomedical Research Centre, the Mohn-Westlake Foundation, NIHR Applied Research Collaboration Oxford and Thames Valley, the Wellcome Trust, the Good Thinking Foundation, Health Data Research UK (HDRUK), the Health Foundation and the WHO; he also receives personal income from speaking and writing for lay audiences on the misuse of science. CB is an employee of TPP. BM is also employed by NHS England working on medicines policy and clinical lead for primary care medicines data. (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY. Published by BMJ.)
Databáze:	MEDLINE
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