In the first wave of the pandemic, attention focused on severe presentations, intensive care unit capacity and the timely supply of personal protective equipment. Little is known about the pattern of suspected COVID-19 presentations in primary care.
A cross-sectional study, published in the British Journal of General Practice, used anonymised data from the primary care records of approximately 1.2 million adults registered with 157 practices in four adjacent east London clinical commissioning groups.
Suspected COVID-19 cases were identified clinically and recorded using SNOMED codes. GPs recorded 8985 suspected COVID-19 cases between 10 February 2020 and 30 April 2020.
In a fully adjusted analysis, South Asian patients had nearly twice the odds of suspected infection (OR, 1.93; 95% CI, 1.83-2.04). The OR for black patients was 1.47 (95% CI, 1.38-1.57).
GP coding for suspected COVID-19 followed the same distribution as the national data on test positive cases, but with a three-fold greater volume.
The results from viral antigen tests done either in government-run centres or in hospital settings were not routinely returned to general practice during the study period.
The authors suggest consultations in general practice may be useful as an early warning system for detecting and monitoring new outbreaks that may follow the relaxation of lockdown restrictions.
However, they say ensuring the timely reporting of COVID-19 test results and diagnostic information to practices is a necessary part of this strategy, and will enable practices to provide continuing care to patients with more severe episodes.
They say unpicking the underlying reasons for the higher risk of COVID-19 infection among those from ethnic minority populations will require the study of data from a range of sources, including data on household composition, overcrowding and occupational exposure.
