Duerlund Lærke Storgaard, Shakar Shakil, Nielsen Henrik, Bodilsen Jacob
Department of Infectious Diseases, Aalborg University Hospital, Aalborg, Denmark.
The Department of Medicine, Regionshospitalet Nordjylland Hjørring, Hjørring, Denmark.
Clin Epidemiol. 2022 Feb 9;14:141-148. doi: 10.2147/CLEP.S344515. eCollection 2022.
To examine the positive predictive value (PPV) of International Classification version 10 (ICD-10) diagnosis codes for long coronavirus disease 2019 (long-COVID) in a Danish Health registry.
This was a medical record review of all patients with a diagnosis code of long-COVID (DB948A) at all hospitals in the North Denmark Region from February 27, 2020 through June 30, 2021. Confirmed long-COVID was categorized as fulfillment of all three criteria: (1) a positive polymerase chain reaction (PCR) test for SARS-CoV-2 on a respiratory sample or a positive serum antibody test, (2) symptoms suggestive of long-COVID with no other diagnosis considered more likely, and (3) symptom duration >6 weeks.
A total of 306 patients were assigned a hospital diagnosis code for long-COVID corresponding to 1.4% of all SARS-CoV-2 positive individuals during the study period (n=21,727). Next, 40 patients were excluded due to incomplete diagnostic evaluation at time of record review leaving 266 patients for analysis. The patients had a median age of 51 years (interquartile range 43-60) and 175/266 (66%) were females. Long-COVID was confirmed in 249/266 yielding an overall PPV of 94% (95%CI: 90-96) and did not differ substantially according to most age groups, sex, previous hospitalization for COVID-19, or by using 12 weeks of symptom duration as cut-off. The PPV was low for children and adolescents (n=5), the very elderly (n=9), and those included by secondary long-COVID diagnoses (n=10).
The overall PPV of diagnosis codes for long-COVID in the North Denmark Region was high and was likely suitable for future registry-based studies of long-COVID. Caution is advised at the extremes of age and secondary diagnosis codes.
在丹麦健康登记处检查国际疾病分类第10版（ICD - 10）诊断代码对2019冠状病毒病长期后遗症（长新冠）的阳性预测值（PPV）。
这是一项对2020年2月27日至2021年6月30日期间丹麦北部地区所有医院诊断代码为长新冠（DB948A）的所有患者的病历回顾。确诊的长新冠被归类为满足所有三个标准：（1）呼吸道样本中严重急性呼吸综合征冠状病毒2（SARS-CoV-2）的聚合酶链反应（PCR）检测呈阳性或血清抗体检测呈阳性，（2）有长新冠的症状且没有其他更可能的诊断，（3）症状持续时间>6周。
在研究期间，共有306名患者被分配了长新冠的医院诊断代码，占所有SARS-CoV-2阳性个体的1.4%（n = 21,727）。接下来，40名患者因记录审查时诊断评估不完整而被排除，留下266名患者进行分析。患者的中位年龄为51岁（四分位间距43 - 60），175/266（66%）为女性。249/266的患者被确诊为长新冠，总体PPV为94%（95%CI：90 - 96），并且在大多数年龄组、性别、先前因新冠住院情况或使用12周症状持续时间作为截断值方面没有显著差异。儿童和青少年（n = 5）、高龄老人（n = 9）以及那些通过长新冠二次诊断纳入的患者（n = 10）的PPV较低。
丹麦北部地区长新冠诊断代码的总体PPV较高，可能适用于未来基于登记处的长新冠研究。在年龄极端情况和二次诊断代码方面建议谨慎使用。
