Data availability
This study is based in part on data from the Clinical Practice Research Datalink (CPRD) obtained under license from the UK Medicines and Healthcare Products Regulatory Agency. We thank the patients who provided these data and the NHS who collected the data as part of their care and support.
Use of Clinical Practice Research Datalink (CPRD) data for this study was approved via the Research Data Governance (RDG) Process of the UK Medicines and Healthcare Products Regulatory Agency (protocol 23_002603).
Ethical approval for NHR@UiO in this study was obtained from The Regional Committee for Research Ethics (approval number 155294) and the Data Protection Officer at the University of Oslo (approval number 523275).
Ethical approval for CORIVA data was obtained from the Research Ethics Committee of the University of Tartu (No. 351/M-8).
Ethical epproval for HULAFE was obtained from the Comité de ética de la investigación con medicamentos (number 2023-232-1).
Ethical approval for IMASIS was obtained by the Parc de Salut Mar Research Ethics Committee CEIm-Parc de Salut Mar (number 2021/9975).
Ethical approval for IPCI was obtained by the Integrated Primary Care Information review board (registration number 9/2023).
For eDOL, no ethical approval was required according to French law for this study. All patients admitted to the hospital are provided with general information about the collection and secondary use of their data, and an opt-out option is offered.
PharMetrics® Plus for Academics needed no approval for use of pseudoanonymised secondary data.
Funding
This work has been funded by the European Health Data Evidence Network (EHDEN) through an Evidence Generation Fund Grant. EHDEN has received funding from the Innovative Medicines Initiative 2 Joint Undertaking under grant agreement No 806968. This Joint Undertaking receives support from the European Union’s Horizon 2020 research and innovation programme and EFPIA.
The project was supported by the National Institute for Health and Care Research (NIHR) Oxford Biomedical Research Centre (BRC).
D.P.A. is funded through a NIHR Senior Research Fellowship (Grant number SRF-2018-11-ST2-004). The views expressed in this publication are those of the author(s) and not necessarily those of NIHR or the Department of Health and Social Care.
K.L. was supported by the Medical Research Council (grant number MR/W006731/1) and Bayer AG.
R.K. was supported by the European Regional Development Fund (RITA 1/02-120) and the Estonian Research Council grant (PRG1844).
L.P. was supported by a Sara Borrell fellowship awarded by the Spanish Institute of Health Carlos III (CD23/00223).
Author contributions
K.L, M.C, D.P.A, J.X and A.M.J. led the conceptualisation of the study.
K.K., D.P.A. and A.M.J. led the phenotyping of long COVID symptoms.
A.D. mapped and curated CPRD data.
K.L. and M.C. wrote the analytical code.
K.L., M.C., D.Ded., R.K., A.M., M.M., Z.C., D.Del., C.K., J.K., J.M., N.M., J.M.R., N.TH.T. conducted the statistical analyses on the respective databases.
D.Ded., T.D., R.L., G.M., A.A., J.T.A., T.B., E.B., S.K., K.K., C.L., M.A.M., A.N., H.ME.N., J.O.O., R.P., L.P.C., A.U., B.V., D.P.A., J.X., L.M. and A.M.J. clinically interpreted the results.
K.L., D.P.A., L.M. and A.M.J. wrote the first draft of the paper.
All authors read, contributed to, and approved the last version of the paper.
D.P.A and A.M.J. obtained the funding for this project.
Competing interests
D.P.A.’s department has received grant/s from Amgen, Chiesi–Taylor, Lilly, Janssen, Novartis, and UCB Biopharma. His research group has received consultancy fees from Astra Zeneca and UCB Biopharma. Amgen, Astellas, Janssen, Synapse Management Partners and UCB Biopharma have funded or supported training programmes organised by DPA’s department. R.P. reports serving on advisory boards for Gilead Sciences, Inc, Pfizer, Inc, Roche Therapeutics, MSD, GSK, ViiV Healthcare, Eli Lilly and Company, PharmaMar, and Atea Pharmaceuticals, Inc; and receiving research grants paid to his institution from MSD, ViiV Healthcare, Gilead Sciences, and PharmaMar. L.M. reports receiving grants from Grifols; receiving honoraria as a speaker from AstraZeneca, Gilead Sciences, GSK, and Pfizer; and participation in advisory boards for Gilead Sciences and Merck. M.M. works for a research group that in the past 3 years received unconditional research grants from Chiesi, UCB, Amgen, Johnson & Johnson, Innovative Medicines Initiative and the European Medicines Agency. D.Ded., Z.C. and J.O. are employees of the Medicines and Healthcare Products Regulatory Agency, which provides the CPRD research service. K.K. is a consortial author in the US National Institutes of Health National COVID Cohort Collaborative (funding expired in 2022 with no renewal or active impact on any current work).