Evidence map›Paper›PMID 41670237›Full record

Observational studyHealth expectations : an international journal of public participation in health care and health policy2026

Exploring the Intensity and Continuity of Hospital Care for Patients With Long Covid: Evidence From an English Urban Healthcare System.

Jonathan Clarke, Sneha Jha, Denys Prociuk, Erik Mayer, Simon de Lusignan, Nikki Smith, Ruairidh Milne, Cassie Lee, Johannes De Kock, Manoj Sivan and 2 more

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Health expectations : an international journal of public participation in health care and health policy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Exploring the Intensity and Continuity of Hospital Care for Patients With Long Covid: Evidence From an English Urban Healthcare System.Health expectations : an international journal of public participation in health care and health policy · 2026
    Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Jonathan ClarkeI-X, Imperial College London, London, UK.
Sneha JhaI-X, Imperial College London, London, UK.
Denys ProciukI-X, Imperial College London, London, UK.
Erik MayerI-X, Imperial College London, London, UK.
Simon de LusignanNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Nikki SmithPerson with Long Covid, Member of the LOCOMOTION Study Patient Advisory Group, Windsor, UK.
Ruairidh MilnePerson with Long Covid; and Emeritus Professor of Public Health, University of Southampton, Southampton, UK.
Cassie LeeImperial College London NHS Trust, Imperial College Respiratory Research Unit (ICRRU), London, UK.
Johannes De KockNHS Highland, COVID Recovery Service, Inverness, UK.
Manoj SivanAcademic Department of Rehabilitation Medicine, University of Leeds, Leeds, UK.
Brendan C DelaneyI-X, Imperial College London, London, UK.
LOCOMOTION Study Consortium

Funding

This study was supported by the National Institute for Health and Care Research. This work is supported by grants from the National Institute for Health and Care Research (NIHR - Ref: COV-LT2-0016) and NHS England. JC acknowledges funding from the Wellcome Trust (215938/Z/19/Z). The views expressed in this publication are those of the authors and not necessarily those of NIHR, The Department of Health and Social Care, or NHS England.Wellcome TrustWellcome Trust 215938/Z/19/Z
6 · The paper itself

Abstract

backgroundLong Covid (LC) is a multisystem condition leading to a wide range of symptoms and often requiring treatment by several different clinical specialties. Patients with LC have reported difficulties in accessing care and a lack of coordination of their care, particularly in a hospital setting.

objectiveTo determine the extent to which the intensity and continuity of hospital care changes for patients after they receive an LC diagnosis.

designRetrospective observational cohort study using a linked primary and secondary care dataset. SETTING AND

participantsRoutine healthcare data from North West London Integrated Care System of patients with a recorded diagnosis of LC who had attended a secondary care hospital Trust from 1 January 2019 to 30 September 2023. MAIN VARIABLES STUDIED: The intensity of utilisation of secondary care was calculated, and the continuity of care with respect to hospitals and specialties was computed using the sequential continuity score (SeCon) before the Covid-19 pandemic, before and after an LC diagnosis.

results5611 out of 6270 (90.1%) patients diagnosed with LC had a recorded secondary care interaction in the study period. Intensity of secondary care utilisation increased markedly in outpatient, inpatient and Emergency Department pathways after a diagnosis of LC but peaked in the week of diagnosis. Average hospital SeCon fell significantly after an LC diagnosis from 1.00 to 0.83, while specialty SeCon remained unchanged from after diagnosis (0.40) and before the pandemic (0.44). A notable shift in specialty activity was observed with a focus on respiratory medicine as a major hub in a densely connected patient-sharing network with cardiology and other medical and surgical specialties. DISCUSSION: A recorded LC diagnosis was associated with increases in the intensity of hospital activity and a reduction in hospital-level care continuity, but no change in specialty continuity, which remains low.

conclusionCollectively, this indicates a significant need to support LC patients as they navigate fragmented secondary care pathways. PATIENT AND PUBLIC CONTRIBUTION: This study was co-designed with, conducted with and written in conjunction with people with long Covid.

Indexed as

Continuity of Patient CareCOVID-19Post-Acute COVID-19 SyndromeAgedFemaleHumansLondonMaleMiddle AgedRetrospective StudiesSARS-CoV-2Secondary Health Care

Identifiers

PMID41670237
PMCPMC12892402

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.