Long COVID prevalence, follow-up and use of resources in Primary Care: a confirmed case series study

Abstract

Abstract Background SARS-CoV-2 infection may produce symptoms for longer than 4 weeks (long COVID). Its duration, causes and consequences are still not well known. The objective of this study is to estimate the prevalence of long COVID, its signs and symptoms and the use of resources in adult patients in Primary Care (PC). Methods Observational, descriptive, retrospective case series study performed in PC. Patients older than 18 years who had a positive polymerase chain reaction test for SARS-CoV-2 from February 29th until April 15th, 2020 were included. Variables related to clinical symptoms and use of resources were registered from 4 weeks after the confirmed COVID-19 case notification, up to 39 weeks. Results Mean age of the 267 patients analyzed was 57 years old (16.0 SD) and 55.8% were women. In the acute phase, 61.8% of the patients required hospitalization and 43.8% suffered bilateral pneumonia. Long COVID prevalence found was 45.7% (CI 95% 39.6–51.9), and 53.3% of them had symptoms longer than 12 weeks. Most common symptoms were dyspnea (45.1%, CI 95% 36.1–54.3), asthenia (42.6%, CI 95% 33.7–51.9), cough (24.6%, CI 95% 17.2–33.2), and neuropsychiatric disorders (18%, CI 95% 11.7–26). 98.4% of long COVID patients required contact with PC during follow-up, with an average of 6.7 (5.0 SD) contacts. At least 45.1% had a lab test, 34.4% a chest x-ray and 41.8% required work leave. Factors associated with a higher number of contacts with PC included developing ARDS (IRR 1.7, CI 95% 1.2–2.2), long COVID (IRR 2.9, CI 95% 2.5–3.4), requiring a work leave (IRR 2.4, CI 95% 2.1–2.9), and the need of hospitalization (IRR 1.5, CI 95% 1.2–1.9). Conclusion Almost half of the patients of this study developed long COVID, similar to preceding works. Most frequent persistent symptoms were dyspnea, asthenia, and cough. Use of resources such as lab tests, chest x-rays, work leaves, PC appointments and hospital referrals, was two to six times greater among long COVID patients, in contrast with those who did not develop long COVID. Requiring hospitalization and having a severe disease at onset was associated to a higher number of PC contacts.