Abstract

Objectives: Using electronic health records, we derived and internally validated a prediction model to estimate risk factors for long COVID and predict individual risk of developing long COVID. Design: Population-based, retrospective cohort study. Setting: Scotland Participants: Adults (≥18 years) with a positive COVID-19 test, registered with a general medical practice between March 1, 2020 and October 20, 2022. Main outcome measures: Adjusted odds ratios (aORs) with 95% confidence intervals (CIs) for predictors of long COVID, and patients’ predicted probabilities of developing long COVID. Results: 68,486 (5.6%) patients were identified as having long COVID. Predictors of long COVID were increasing age (aOR 3.84; 95%CI 3.66-4.03 and aOR 3.66 95%CI 3.27-4.09 in first and second splines), increasing body mass index (BMI) (aOR 3.17; 95%CI 2.78-3.61 and aOR 3.09 95%CI 2.13-4.49 in first and second splines), severe COVID-19 (aOR 1.78; 95%CI 1.72-1.84); female sex (aOR 1.56; 95%CI 1.53-1.60), deprivation (most versus least deprived quintile, aOR 1.40; 95%CI 1.36-1.44), several existing health conditions. Predictors associated with reduced long COVID risk were testing positive while Delta or Omicron variants were dominant, relative to when the Wild-type variant was dominant (aOR 0.85; 95%CI 0.81-0.88 and aOR 0.64; 95%CI 0.61-0.67, respectively) having received one or two doses of COVID-19 vaccination, relative to unvaccinated (aOR 0.90; 95%CI 0.86-0.95 and aOR 0.96; 95%CI 0.93-1.00). Conclusions: Older age, higher BMI, severe COVID-19 infection, female sex, deprivation, and comorbidities were predictors of long COVID. Vaccination against COVID-19 and testing positive while Delta or Omicron variants were dominant predicted reduced risk

Cite as

Jeffrey, K., Hammersley, V., Maini, R., Crawford, A., Woolford, L., Batchelor, A., Weatherill, D., Millington, T., Kerr, R., Basetti, S., Macdonald, C., Quint, J., Kerr, S., Shah, S., Kurdi, A., Simpson, C., Katikireddi, S., Rudan, I., Robertson, C., Ritchie, L., Sheikh, A. & Daines, L. 2024, 'Deriving and validating a risk prediction model for long COVID: a population-based, retrospective cohort study in Scotland', Journal of the Royal Society of Medicine, 117(12), pp. 402-414. https://doi.org/10.1177/01410768241297833

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Last updated: 09 June 2025
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