The following is a summary of “Frequency, persistence and relation of disease symptoms, psychosomatic comorbidity and daily life impairment after COVID-19: a cohort study in general practice,” published in the August 2024 issue of Primary Care by Hapfelmeier et al.

Persistent symptoms following COVID-19, potentially linked to psychosomatic comorbidity, have been increasingly recognized, yet data on these long-lasting effects within general practice remain limited. This study aimed to investigate the time-dependent prevalence of disease symptoms, their association with psychosomatic comorbidity, and the resulting daily life impairment (DLI) in patients with a history of SARS-CoV-2 infection.

The study employed a comparative cohort design, involving patients who had reported a prior SARS-CoV-2 infection and uninfected controls. Participants were recruited from 14 general practices located in the greater Munich area, with data collection conducted through questionnaires over a 12-month follow-up period. The analysis included descriptive statistics, multivariable regression, and bivariate correlations to examine the relationships between infection status, symptom persistence, psychosomatic comorbidity, and DLI.

The study included a total of 204 patients who had been infected with SARS-CoV-2 up to 42 months prior (141 with Omicron and 63 with earlier variants) and 119 uninfected controls. The results revealed a significantly higher prevalence of disease symptoms in the infected cohort, with 55-79% of cases reporting symptoms within one year of infection compared to 43% among controls. Multivariable analysis, adjusted for socio-demographic factors and psychosomatic comorbidity, demonstrated that individuals with a history of SARS-CoV-2 infection had substantially higher odds of experiencing persistent symptoms. Specifically, the odds ratios (OR) were 4.15 (p < 0.001) for the Omicron cohort and 3.51 (p = 0.054) for those infected with earlier variants, compared to controls. While symptom persistence was consistent over time for those infected with earlier variants (OR 1.00 per month, p = 0.903), a decreasing trend was observed for Omicron infections (OR 0.89 per month, p < 0.001). Among the symptoms, fatigue showed the strongest correlation with DLI (r = 0.628), indicating its significant impact on patients’ ability to manage daily activities.

In conclusion, the findings underscore the need for a holistic treatment approach in general practice, guided by the bio-psycho-social model, to address the complex interplay of persistent symptoms, psychosomatic comorbidity, and DLI in post-COVID-19 patients. Fatigue, in particular, emerges as a critical symptom that may play a key role in restoring patients’ daily life capabilities, highlighting the importance of targeted interventions to alleviate this debilitating condition.

Source: bmcprimcare.biomedcentral.com/articles/10.1186/s12875-024-02551-w