PDF(Pubmed)
Abstract：
OBJECTIVE: 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.
METHODS: Cohort study.
METHODS: 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.
METHODS: 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).
METHODS: 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.
METHODS: Cohort study.
METHODS: 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.
METHODS: 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).
METHODS: 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.
摘要：
目标：长期缺勤对经济有负面影响，并可能导致扩大的健康不平等。如果一个人由于健康原因不能工作超过7天，则由全科医生签发病历单（也称为“健康笔记”）。我们量化了2020年、2021年和2022年有COVID-19证据的人的病态记录率，表明人们从COVID-19中恢复的负担。
方法：队列研究。
方法：经英国国家卫生服务(NHS)批准，我们使用常规临床数据(初级保健，医院和COVID-19测试记录)在OpenSAFELY-TPP数据库内。
方法：在2020年对COVID-19进行阳性检测或诊断的18-64岁人群（n=365421），2021年（n=1206555）或2022年（n=1321313）；一般人口年龄匹配，2019年的性别和地区（n=3140326），2020年（n=3439534），2021年（n=4571469）和2022年（n=4818870）；2019年因肺炎住院的人（n=29673）。
方法：在初级保健中收到病假条。
结果：在SARS-CoV-2检测阳性或COVID-19诊断阳性的人群中，2020年病假记录率为4.88/100人-月(95%CI4.83~4.93),2021年为2.66(95%CI2.64~2.67),2022年为1.73(95%CI1.72~1.73).与年龄相比,性别和地区匹配的一般人群，在整个随访期间（长达10个月），收到病假单的调整后HR在2020年为4.07（95％CI4.02至4.12），在2022年下降至1.57（95％CI1.56至1.58）。在所有年份中，HR在诊断后的前30天最高。在调整后，在住院的COVID-19患者中，病理报率低于肺炎住院患者。
结论：鉴于急性COVID-19相关症状的记录不足，这些发现为COVID-19的长期影响提供了有价值的视角。尽管可能低估了病假纸币的费率，与没有COVID-19的人相比，向患有COVID-19的人发放病假单的频率更高，即使在大多数人接种疫苗的时代。大多数病态记录发生在诊断后的前30天，但诊断后数月风险增加可能为长期影响提供进一步证据.
方法：队列研究。
方法：经英国国家卫生服务(NHS)批准，我们使用常规临床数据(初级保健，医院和COVID-19测试记录)在OpenSAFELY-TPP数据库内。
方法：在2020年对COVID-19进行阳性检测或诊断的18-64岁人群（n=365421），2021年（n=1206555）或2022年（n=1321313）；一般人口年龄匹配，2019年的性别和地区（n=3140326），2020年（n=3439534），2021年（n=4571469）和2022年（n=4818870）；2019年因肺炎住院的人（n=29673）。
方法：在初级保健中收到病假条。
结果：在SARS-CoV-2检测阳性或COVID-19诊断阳性的人群中，2020年病假记录率为4.88/100人-月(95%CI4.83~4.93),2021年为2.66(95%CI2.64~2.67),2022年为1.73(95%CI1.72~1.73).与年龄相比,性别和地区匹配的一般人群，在整个随访期间（长达10个月），收到病假单的调整后HR在2020年为4.07（95％CI4.02至4.12），在2022年下降至1.57（95％CI1.56至1.58）。在所有年份中，HR在诊断后的前30天最高。在调整后，在住院的COVID-19患者中，病理报率低于肺炎住院患者。
结论：鉴于急性COVID-19相关症状的记录不足，这些发现为COVID-19的长期影响提供了有价值的视角。尽管可能低估了病假纸币的费率，与没有COVID-19的人相比，向患有COVID-19的人发放病假单的频率更高，即使在大多数人接种疫苗的时代。大多数病态记录发生在诊断后的前30天，但诊断后数月风险增加可能为长期影响提供进一步证据.
