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.
Subject(s)
Dyspnea , Pneumonia , Mental Disorders , Asthenia , COVID-19ABSTRACT
Background: To estimate the prevalence of symptoms and signs related to a COVID19 case series confirmed by polymerase chain reaction (PCR) for SARS-CoV-2. Risk factors and the associated use of health services will also be analysed. Methods. Observational, descriptive, retrospective case series study. The study was performed at two Primary Care Health Centres located in Madrid, Spain. The subjects studied were all PCR SARS-CoV-2 confirmed cases older than 18 years, diagnosed from the beginning of the community transmission (March 13) until April 15, 2020. We collected sociodemographic, clinical, health service utilization and clinical course variables during the following months. All data was gathered by their own attending physician, and electronic medical records were reviewed individually. Statistical analysis: A descriptive analysis was carried out and a Poisson regression model was adjusted to study associated factors to Health Services use.Results: Out of the 499 patients studied from two health centres, 55.1% were women and mean age was 58.2 (17.3). 25.1% were healthcare professionals. The most frequent symptoms recorded related to COVID19 were cough (77.9%; CI 95% 46.5-93.4), fever (77.7%; CI95% 46.5-93.4) and dyspnoea (54.1%; CI95% 46.6-61.4). 60.7% were admitted to hospital. 64.5% first established contact with their primary care provider before going to the hospital, with a mean number of 11.4 Healthcare Providers Encounters with primary care during all the follow-up period.The number of visit-encounters with primary care was associated with being male [IRR 1.072 (1.013, 1.134)], disease severity {from mild respiratory infection [IRR 1.404 (1.095, 1.801)], up to bilateral pneumonia [IRR 1.852 (1.437,2.386)]}, and the need of a work leave [IRR 1.326 (1.244, 1.413].Conclusion: Symptoms and risk factors in our case series are similar to those in other studies. There was a high number of patients with atypical unilateral or bilateral pneumonia. Care for COVID has required a high use of healthcare resources such as clinical encounters and work leaves.