Long-term prognosis of adults with moderate-severe SARS-CoV-2 lower respiratory tract infection managed in primary care: prospective cohort study

ObjectivesTo determine differences in health-related quality of life (HRQoL) and presence and duration of symptoms between adults with and without established SARS-CoV-2 moderately severe lower respiratory tract infection (LRTI) in the 12 months following their primary care visit. DesignProspective cohort study Setting35 general practices in the provinces Noord-Brabant and Utrecht, the Netherlands. ParticipantsIndividuals aged [≥]18 years who presented to their general practitioner (GP) with a moderately severe LRTI during the first COVID-19 waive in The Netherlands (March-June 2021) underwent serology testing (participants, GPs and study personnel remained blinded for serology outcomes during study conduct) and completed baseline and follow-up questionnaires. Of the 315 participants who gave consent, 277 (88%) were suitable for inclusion in the analyses. Complete follow-up date was available in 97% of participants. Main outcome measures1) Scores of SF-36; physical component summary (PCS), mental component summary (MCS) and subscales. 2) Risk of any and individual persisting symptoms (of cough, dyspnea, chest pain, fatigue, brain fog, headache, and anosmia/ageusia) over time. ResultsThe change in SF-36 PSC (p=0.13), MCS (p=0.30), as well as subscale scores, over time did not differ between SARS-CoV-2 serology positive and negative participants after adjusting for sex, age, BMI, diabetes and chronic pulmonary conditions. The risk of any persisting symptom over time did not significantly differ between the groups (aHR 0.61, 95% CI 0.33-1.15), nor did the risk of individual symptoms. ConclusionsIn the 12 months following their moderately severe LRTI, primary care patients with and without confirmed SARS-CoV-2 infection had a comparable HRQoL profile. Albeit a considerable proportion of patients reported persistent symptoms, there was no evidence of a difference in the course of symptoms over time between patients with and without confirmed SARS-CoV-2 infection. Trial registrationDutch Trial Register (NTR) number NL8729