Studying the Long-term Impact of COVID-19 in Kids (SLICK). Healthcare use and costs in children and young people following community-acquired SARS-CoV-2 infection: protocol for an observational study using linked primary and secondary routinely collected healthcare data from England, Scotland and Wales
Ashley Akbari,
James Farrell,
Aziz Sheikh,
Ben Goldacre,
Alex J Walker,
Ewen M Harrison,
Laurie A Tomlinson,
Ronan Lyons,
Sinead Brophy,
Jennifer Preston,
Colin R Simpson,
Nazir I Lone,
Louisa Pollock,
Annemarie B Docherty,
J Kenneth Baillie,
Malcolm G Semple,
Peter S Hall,
Olivia V Swann,
Sohan Seth,
Thomas C Williams,
Srinivasa V Katikireddi,
Michael J Seaborne,
J. Samantha Ainsworth,
Freya F Semple
Affiliations
Ashley Akbari
Swansea University Medical School, Swansea University, Swansea, UK
James Farrell
Centre for Medical Informatics, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK
Aziz Sheikh
Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK
Ben Goldacre
The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
Alex J Walker
The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
Ewen M Harrison
Centre for Medical Informatics, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK
Laurie A Tomlinson
Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
Ronan Lyons
Swansea University Medical School, Swansea University, Swansea, UK
Sinead Brophy
Health Data Research, Swansea University Medical School, Swansea, UK
Jennifer Preston
Faculty of Humanities and Social Sciences, University of Liverpool, Liverpool, UK
Colin R Simpson
Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK
Nazir I Lone
Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK
Louisa Pollock
Department of Child Health, School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK
Annemarie B Docherty
Centre for Medical Informatics, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK
J Kenneth Baillie
Division of Genetics and Genomics, Roslin Institute, Edinburgh, UK
Malcolm G Semple
NIHR Health Protection Research Unit in Emerging and Zoonotic Infections, Liverpool, UK
Peter S Hall
Institute of Cancer and Genetics, The University of Edinburgh, Edinburgh, UK
Olivia V Swann
Centre for Medical Informatics, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK
Sohan Seth
School of Informatics, The University of Edinburgh, Edinburgh, UK
Thomas C Williams
Department of Child Life and Health, The University of Edinburgh, Edinburgh, UK
Srinivasa V Katikireddi
MRC/CSO Social & Public Health Sciences Unit, University of Glasgow, Glasgow, UK
Michael J Seaborne
Centre for Population Health, Swansea University, Swansea, UK
J. Samantha Ainsworth
Faculty of Humanities and Social Sciences, University of Liverpool, Liverpool, UK
Freya F Semple
School of Medicine Dentistry and Nursing, University of Glasgow, Glasgow, UK
Introduction SARS-CoV-2 infection rarely causes hospitalisation in children and young people (CYP), but mild or asymptomatic infections are common. Persistent symptoms following infection have been reported in CYP but subsequent healthcare use is unclear. We aim to describe healthcare use in CYP following community-acquired SARS-CoV-2 infection and identify those at risk of ongoing healthcare needs.Methods and analysis We will use anonymised individual-level, population-scale national data linking demographics, comorbidities, primary and secondary care use and mortality between 1 January 2019 and 1 May 2022. SARS-CoV-2 test data will be linked from 1 January 2020 to 1 May 2022. Analyses will use Trusted Research Environments: OpenSAFELY in England, Secure Anonymised Information Linkage (SAIL) Databank in Wales and Early Pandemic Evaluation and Enhanced Surveillance of COVID-19 in Scotland (EAVE-II). CYP aged ≥4 and <18 years who underwent SARS-CoV-2 reverse transcription PCR (RT-PCR) testing between 1 January 2020 and 1 May 2021 and those untested CYP will be examined.The primary outcome measure is cumulative healthcare cost over 12 months following SARS-CoV-2 testing, stratified into primary or secondary care, and physical or mental healthcare. We will estimate the burden of healthcare use attributable to SARS-CoV-2 infections in the 12 months after testing using a matched cohort study of RT-PCR positive, negative or untested CYP matched on testing date, with adjustment for confounders. We will identify factors associated with higher healthcare needs in the 12 months following SARS-CoV-2 infection using an unmatched cohort of RT-PCR positive CYP. Multivariable logistic regression and machine learning approaches will identify risk factors for high healthcare use and characterise patterns of healthcare use post infection.Ethics and dissemination This study was approved by the South-Central Oxford C Health Research Authority Ethics Committee (13/SC/0149). Findings will be preprinted and published in peer-reviewed journals. Analysis code and code lists will be available through public GitHub repositories and OpenCodelists with meta-data via HDR-UK Innovation Gateway.
