biostudies-literatureSchaffer ALNIHR-UKRI CONVALESCENCEBritish Heart FoundationBHF Data Science CentreEPSRC Centre for Doctoral Training in Health Data ScienceUniversity College London Hospitals Biomedical Research CentreNational Institute for Health and Care Research Applied Research Collaboration Oxford and Thames ValleyMohn Westlake FoundationNIHR Applied Research Collaborative for North West LondonHealth Data Research UKMedical Research CouncilNIHR Oxford Biomedical Research CentreNational Institute for Health Research (NIHR)National Institute for Health and Care ResearchWellcome Truste080600https://www.ebi.ac.uk/biostudies/studies/S-EPMC11227761biostudies-literatureUnknown14(7)<h4>Objectives</h4>Long-term sickness absence from employment has negative consequences for the economy and can lead to widened health inequalities. Sick notes (also called 'fit notes') are issued by general practitioners when a person cannot work for health reasons for more than 7 days. We quantified the sick note rate in people with evidence of COVID-19 in 2020, 2021 and 2022, as an indication of the burden for people recovering from COVID-19.<h4>Design</h4>Cohort study.<h4>Setting</h4>With National Health Service (NHS) England approval, we used routine clinical data (primary care, hospital and COVID-19 testing records) within the OpenSAFELY-TPP database.<h4>Participants</h4>People 18-64 years with a recorded positive test or diagnosis of COVID-19 in 2020 (n=365 421), 2021 (n=1 206 555) BMJ openChanges in sick notes associated with COVID-19 from 2020 to 2022: a cohort study in 24 million primary care patients in OpenSAFELY-TPP.PMC11227761MR/W016729/1MC_PC_20058AA/18/6/24223MC_PC_20059222097/Z/20/Z220283/Z/20/ZCOV-LT2-0073HDRUK2021.000COV-LT-0009SP/19/3/34678MC_PC_20030NIHR135559MR/V015737/1HDRUK2021.0157EP/S02428X/1Douglas IFinnigan LCowling THowes LHKarthikeyan ASMaddock JGreaves FWilliams DFang CSchaffer ALBadrick EGoldacre BSoares AGTaylor KWielgoszewska BFox LRhead RNigrelli LStewart CWright JLukaschuk EMacKenna BParsons SSmeeth LSteves CPatel KBridger-Staatz CTurner ELCampbell KCNab LMcEachan RHughes AHester FSterne JWalker SFreydin MForbes HWalker VBooth CInglesby PChaturvedi NMcCartney DShah SAStafford JSampri ACarpentieri JTimpson NFisher LGibson AKnueppel ACockburn JCarnemolla AArun KHickman GPerez-Reche FOakley JSheard LHarper SBacon SCParry JGeorge PHerbert ANational Core Studies CollaborativeAndrews CMassey JBolton TSheikh AFlaig RLemanska AHamilton OWei YBridges LMaude SSmith RMHuntley LZaninotto PButler-Cole BFThomas RShaw RWillan KWong AMacleod JMcElroy EKate NGlen FFerreira VWoodward HMorley JCurtis HHorne EAlmaghrabi FGreen ABerman SHerrett EMcLachlan SMitchell RWood AFolarin APiehlmaier DKellas JKnight RGreen MO'Dwyer TWillans REvans KMZhu JBeckford CRoberts ASilverwood ASRCheetham NWhitehorn RRaman BCrane MSanders ZBKromydas TDenaxas SPiechnik SLangan SBrophy SThompson EWang KTunnicliffe EParker MIp SRafeti EBacon SCJSantorelli GKatikireddi VKibble MDenholm RTeece LBaz SHulme WCostello REHopcroft LParker ESaunders LCOpenSAFELY CollaborativeEvans DBoyd AFoster DKwong AKennedy JGarcia PWild JMBates CJones LMoltrecht BBen Goldacre LHYang TSteptoe APark CGriffith GArab MADavy SMcArdle FBhaskaran KTazare JDillingham ITomlinson LACoronado JITomlinson LWard TRapala AMahalingasivam VSharp SToms RNorth TWalker AWiedemann MZheng BMansfield KJezzard PGessa GDKopasker DBen Goldacre AWJacques WBowyer RRanjan YPalmer TDobson RNeubauer SPark RYTilling KMehrkar ASmith SCampbell AHou BPatalay PCezard GfalseChanges in sick notes associated with COVID-19 from 2020 to 2022: a cohort study in 24 million primary care patients in OpenSAFELY-TPP.<h4>Objectives</h4>Long-term sickness absence from employment has negative consequences for the economy and can lead to widened health inequalities. Sick notes (also called 'fit notes') are issued by general practitioners when a person cannot work for health reasons for more than 7 days. We quantified the sick note rate in people with evidence of COVID-19 in 2020, 2021 and 2022, as an indication of the burden for people recovering from COVID-19.<h4>Design</h4>Cohort study.<h4>Setting</h4>With National Health Service (NHS) England approval, we used routine clinical data (primary care, hospital and COVID-19 testing records) within the OpenSAFELY-TPP database.<h4>Participants</h4>People 18-64 years with a recorded positive test or diagnosis of COVID-19 in 2020 (n=365 421), 2021 (n=1 206 555) 2024-01-01T00:00:00Z2024 Jul2025-04-26T05:38:02.892Z2025-04-06T11:38:01.846ZS-EPMC112277613896045810.1136/bmjopen-2023-080600