Prevalence of Post-COVID Syndrome (PCS) Among Adults in Primary Care: Focus on BIPOC Patients

Context Many patients who recovered from the acute phase of SARS-COV-2 infection have persistent symptoms. However, research regarding the prevalence of PCS symptoms in non-hospitalized primary care patients is scarce.

Objective

1. Describe the prevalence of symptoms among patients in a primary care setting

2. Determine if symptoms were different in patients with a positive test compared with a negative test, focused on underrepresented minority groups (URMs).

Study Design and Analysis This observational study was conducted using a survey available in English and Spanish. The survey was developed with clinicians and underwent an iterative review process before it was emailed to patients. Patients with both positive and negative COVID-19 test results were included in this study to compare groups. Adjusted logistic regression was used to determine associations between test results and symptoms.

Setting and Dataset This study took place in Salt Lake City, UT. Patients had their survey responses matched to electronic medical records to provide clinic-demographic information. The information from medical records was used in the adjusted analysis. We excluded surveys that were mostly incomplete.

Population Studied Included patients were aged 18+, visited at least one U of U primary healthcare center since 2019, spoke English or Spanish, and had a documented COVID-19 test result between March 2020 and October 2021. Patients were excluded if they experienced symptoms less than 90 days since the original test date or if they were hospitalized for COVID-19 infection.

Results We included 2,924 responses in the final analysis (13.1% response rate). The average age was 44.6 years, and 63.6% of patients were women. The three most reported symptoms among all patients were fatigue (58.9% of positive tests, 44.5% of negative tests, p<0.001), difficulty sleeping (52.3% of positive tests, 43.5% of negative tests, p<0.001), and anxiety (51.2% of positive tests, 44.6% of negative tests, p<0.026). URM patients had higher rates of fatigue, difficulty sleeping, and anxiety compared to non-URM patients, and the largest symptom difference was difficulty sleeping. Patients experienced a breadth of other symptoms affecting multiple body systems.

Conclusion Persistent symptoms were common in both groups, and several symptoms were statistically more likely in patients with positive COVID tests. More research is needed on URMs to understand their symptom burden.