A model framework for projecting the prevalence and impact of Long-COVID in the UK

  1. Chris Martin
  2. Michiel Luteijn
  3. William Letton
  4. Josephine Robertson
  5. Stuart McDonald

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Abstract

The objective of this paper is to model lost Quality Adjusted Life Years (QALYs) from symptoms arising from COVID-19 disease in the UK population, including symptoms of ‘long-COVID’. The scope includes QALYs lost to symptoms, but not deaths, due to acute COVID-19 and long-COVID. The prevalence of symptomatic COVID-19, encompassing acute symptoms and long-COVID symptoms, was modelled using a decay function. Permanent injury as a result of COVID-19 infection, was modelled as a fixed prevalence. Both parts were combined to calculate QALY loss due to COVID-19 symptoms. Assuming a 60% final attack rate for SARS-CoV-2 infection in the population, we modelled 299,730 QALYs lost within 1 year of infection (90% due to symptomatic COVID-19 and 10% permanent injury) and 557,764 QALYs lost within 10 years of infection (49% due to symptomatic COVID-19 and 51% due to permanent injury). The UK Government willingness-to-pay to avoid these QALY losses would be £17.9 billion and £32.2 billion, respectively. Additionally, 90,143 people were subject to permanent injury from COVID-19 (0.14% of the population). Given the ongoing development in information in this area, we present a model framework for calculating the health economic impacts of symptoms following SARS-CoV-2 infection. This model framework can aid in quantifying the adverse health impact of COVID-19, long-COVID and permanent injury following COVID-19 in society and assist the proactive management of risk posed to health. Further research is needed using standardised measures of patient reported outcomes relevant to long-COVID and applied at a population level.

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  1. Version published to 10.1371/journal.pone.0260843
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    SciScore for 10.1101/2021.05.18.21252341: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    NIH rigor criteria are not applicable to paper type.

    Table 2: Resources

    No key resources detected.

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    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Potential implications: Limitations: The mechanisms of underlying pathogenesis and resulting symptoms of COVID-19 is not yet fully understood. Although NICE have published a working definition, this may be subject to change. This model estimates a disease that is evolving and as such, its ability to predict long-term outcomes will be limited. There is uncertainly around some of the parameters being used in the model and a number of assumptions had to be made. Survival rates of ward and ITU care were based on 2020 data and could since have improved as improvements are being made in care for COVID-19 patients. Improved knowledge on treatment for COVID-19 in wards and ITUs could also reduce the proportion of permanently injured amongst survivors. The quality of the symptom prevalence data used could be improved by standardising measurement and recording of symptoms. Currently data is being gathered using different types of questionnaire in different mediums e.g., Halpin (2020) developed their own COVID-19 rehabilitation telephone screening tool, Arnold (2020) used the SF-36 questionnaire and Sudre (2020) used a self-reporting questionnaire via an app. Standardised and validated questionnaires and tools exist and are used to record patient reported outcomes (PROs). These include the St George’s respiratory questionnaire and the MRC dyspnoea scale (32,33). However, these are often disease-specific and may not be appropriate for use in long-COVID patients. In addition, HRQoL questi...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

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    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
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    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

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  3. Version published to 10.1101/2021.05.18.21252341v1 on medRxiv