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Differences in diagnostic coding in long COVID: sociodemographic and symptom interference factors.
Jasmine K Vickers1, Emily B Levitan2, Carrie R Howell3
1Department of Nursing Research & Scholarship, School of Nursing, University of Alabama at Birmingham, 1720 2nd Ave. South, Magnolia Office Park - Plaza Building Suite #227, Birmingham, AL, 35294-1210, USA. JVickers0502@gmail.com.
BMC Infectious Diseases
|July 7, 2026
Summary
Long COVID symptom interference is linked to various health factors but not demographic biases in diagnosis. Electronic medical record coding for Long COVID showed discrepancies with self-reported symptom severity.
Area of Science:
- Medical research
- Public health
- Epidemiology
Background:
- Long COVID presents a significant public health challenge with varying symptom severity and impact on daily life.
- Understanding the factors associated with Long COVID symptom interference is crucial for effective management and diagnosis.
Purpose of the Study:
- To investigate the relationship between self-reported Long COVID symptom interference and demographic, clinical factors, and diagnostic codes.
- To examine discrepancies between self-reported symptom interference and electronic medical record (EMR) coding for Long COVID.
Main Methods:
- Cross-sectional analysis of 205 participants from a Long COVID survey.
- Statistical tests including Chi-square and Independent Samples T-tests were employed.
- A subgroup analysis of 100 participants documented EMR coding for Long COVID and post-exertional malaise.
Main Results:
- 41% of participants reported high symptom interference. Older age, female sex, obesity, and poorer general, physical, and mental health were associated with higher symptom interference.
- No significant association was found between high symptom interference and the U09.9 Long COVID diagnosis code.
- In the EMR sub-analysis, 64% of participants with high symptom interference had a Long COVID-related code.
Conclusions:
- Discrepancies exist between patient-reported symptom interference and EMR coding for Long COVID.
- No evidence of demographic biases in diagnosis was found among participants experiencing high symptom interference.
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