Post-COVID Conditions in US Primary Care: A PRIME Registry Comparison of Patients With COVID-19, Influenza-Like Illness, and Wellness Visits

PLAIN-LANGUAGE ARTICLE SUMMARY

Original Research

Study Shows Post-COVID Conditions in Primary Care Are Comparable to Flu and Lower Than Subspecialty and Hospital Settings 

Background and Goal: COVID-19 has been considered a condition leading to other post-COVID chronic conditions frequently diagnosed in the primary care setting. This study examines the prevalence of post-COVID conditions among adult patients diagnosed with COVID-19 across the United States from 2020-2021. The study then compares the post-COVID conditions among those patients to patients with influenza-like illness and those who had regular wellness visits but weren’t diagnosed with COVID-19. The goal was to understand the prevalence and types of post-COVID conditions over time, and to see if COVID-19 led to more long-term health problems.

Study Approach:  The study was conducted by researchers from Stanford University, the CDC, the American Board of Family Medicine Foundation, and the Institute for Healthcare Policy and Innovation at the University of Michigan. Researchers used the American Family Cohort, a national primary care registry to examine data from the years 2018 to 2021. They compared data from three groups: people who had COVID-19, people from 2018-2019 with flu-like illnesses, and people from 2020-2021 who had regular health check-ups but not COVID-19. Researchers matched people in each group who were similar in age, gender, health status, and other factors. They then checked how many people in each group had long-lasting health problems, looking at the overall number and type of health issues each group had over time.

Main Results: 

• Patients with COVID-19 had a higher prevalence of certain issues compared to patients with influenza-like illness. Issues included: breathing difficulties, type 2 Diabetes , fatigue and sleep disturbances However, all prevalence differences were less than 3%. This difference suggests that while COVID-19 may lead to specific new health problems, the overall long-term health impact is similar to that of other respiratory illnesses like influenza.

• There were no significant differences in the monthly increase of new health conditions between patients with COVID-19 and those with influenza-like illness. Both groups had a similar rate of increase in health problems each month after their diagnosis.

• Patients with COVID-19 had a higher prevalence of breathing difficulties and type 2 diabetes compared to patients who had regular wellness visits but did not contract COVID-19. While the differences in prevalence were statistically noted, they are described as modest. This indicates that although there is an increase, it is not dramatically higher.

Why It Matters: The findings from this study demonstrate the moderate burden of post-COVID conditions in primary care. The conditions include breathing difficulties, fatigue, sleep disturbances, and type 2 diabetes. Using real-world data from a national primary care registry, the study provides a different picture of the prevalence and impact of post-COVID conditions compared to specialty or hospital settings. Understanding the types and prevalence of post-COVID conditions helps health care professionals diagnose and treat these conditions more effectively. 

Visual Abstract: