Prevalence of long-COVID symptoms among non-hospitalized patients in primary care – Part 1 of 3

Context: Current research on post-COVID-19 conditions, or “long-COVID”, has focused on hospitalized COVID-19 patients, and often lacks a comparison group. Research about PCC among non-hospitalized patients is emerging. In primary care, several symptoms of PCC (e.g., fatigue, weakness, depression) are already common complaints.

Objective: This study assessed the prevalence of long-COVID symptoms in non-hospitalized COVID-19 primary care patients compared to primary care patients not diagnosed with COVID-19.

Study Design and Analysis: This cross-sectional, population-based study (n = 2,539) analyzed and compared the prevalence of long-COVID symptoms in patients with a positive COVID-19 test (n = 1410) and patients with a negative COVID-19 test (n = 1,129) using logistic regression.

Setting or Dataset: The setting was an academic medical institution in the Mountain West. Primary care patients were identified using electronic health records from an academic medical institution in the Mountain West and consented to complete an electronic questionnaire on 54 potential post-COVID-19 symptoms, available in English and Spanish.

Population Studied: Primary care patients never hospitalized for COVID-19 infection.

Intervention/Instrument: n/a

Outcome Measures: Prevalence of long-COVID symptoms.

Results: Long-COVID symptoms are prevalent in both groups and significantly more prevalent in patients with COVID-19. Strong significant differences exist for the twenty most reported conditions, except for anxiety. Common conditions are fatigue (59.5% (COVID-19 positive) vs. 41.3% (COVID-19 negative); OR 2.15, 95% CI [1.79–2.60]), difficulty sleeping (52.1% (positive) vs. 41.9% (negative); OR 1.42, 95% CI [1.18–1.71]) and concentration problems (50.6% (positive) vs 28.5% (negative); OR 2.64, 95% CI [2.17–3.22]). Similar disparities in prevalence are also observed after comparing two groups (positive vs. negative) by age, sex, time since testing, and race/ethnicity.

Conclusions: Long-COVID symptoms are highly prevalent in non-hospitalized COVID-19 patients in primary care. However, it is important to note that long-COVID strongly overlaps with common health symptoms seen in primary care, including fatigue, difficulty sleeping, and headaches, which makes the diagnosis of long-COVID in primary care even more challenging.