Did aetiology matter in illness duration and complications in patients presenting in primary care with acute respiratory tract infections early in the COVID-19 pandemic: An observational study in nine countries

Despite considerable research into COVID-19 sequelae, little is known about differences in illness duration and complications in patients presenting in primary care with symptoms of acute respiratory tract infections (RTI) that are and are not attributed to SARS-CoV-2 infection. To explore whether a...

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Published in:	The European journal of general practice Vol. 30; no. 1; p. 2376084
Main Authors:	Venekamp, Roderick P., Eijkemans, Marinus J.C., Zuithoff, Nicolaas P.A., Böhmer, Femke, Chlabicz, Slawomir, Colliers, Annelies, García-Sangenís, Ana, Malania, Lile, Pauer, Jozsef, Tomacinschii, Angela, Verheij, Theo J., Goossens, Herman, Vellinga, Akke, Butler, Christopher C., van der Velden, Alike W.
Format:	Journal Article
Language:	English
Published:	England Taylor & Francis Ltd 01.12.2024 Taylor & Francis Taylor & Francis Group
Subjects:	Acute Disease Adult Aged COVID-19 COVID-19 - complications COVID-19 - epidemiology Etiology Europe - epidemiology Female Humans Illnesses Male Middle Aged Observational studies Pandemics prediction Primary care Primary Health Care respiratory tract infection Respiratory Tract Infections - epidemiology SARS-CoV-2 Severe acute respiratory syndrome coronavirus 2 Time Factors Europe prediction covid-19 primary care SARS-CoV-2 respiratory tract infection
ISSN:	1381-4788, 1751-1402, 1751-1402
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Abstract	Despite considerable research into COVID-19 sequelae, little is known about differences in illness duration and complications in patients presenting in primary care with symptoms of acute respiratory tract infections (RTI) that are and are not attributed to SARS-CoV-2 infection. To explore whether aetiology impacted course of illness and prediction of complications in patients presenting in primary care with symptoms of RTI early in the COVID-19 pandemic. Between April 2020-March 2021 general practitioners from nine European countries recruited consecutively contacting patients with RTI symptoms. At baseline, an oropharyngeal-nasal swab was obtained for aetiology determination using PCR after follow-up of 28 days. Time to self-reported recovery was analysed with Kaplan-Meier curves. Predictors (baseline variables of demographics, patient and disease characteristics) of a complicated course (composite of hospital admission and persisting signs/symptoms at 28 days follow-up) were explored with logistic regression modelling. Of 855 patients with RTI symptoms, 237 (27.7%) tested SARS-CoV-2 positive. The proportion not feeling fully recovered (15.6% vs 18.1%, = 0.39), reporting being extremely tired (9.7% vs 12.8%, = 0.21), and not having returned to usual daily activities (18.1% vs 14.4%, = 0.18) at day 28 were comparable between SARS-CoV-2 positive ( = 237) and negative ( = 618) groups. However, among those feeling fully recovered (SARS-CoV-2 positive: 200 patients, SARS-CoV-2 negative: 506 patients), time to full recovery was significantly longer in SARS-CoV-2 patients (10.6 vs 7.7 days, < 0.001). We found no evidence that predictors of a complicated course differed between groups ( = 0.07). Early in the pandemic, the proportion of patients not feeling fully recovered by 28 days was similar between SARS-CoV-2 positive and negative patients presenting in primary care with RTI symptoms, but it took somewhat longer for SARS-CoV-2 patients to feel fully recovered. More research is needed on predictors of a complicated course in RTI.
AbstractList	Despite considerable research into COVID-19 sequelae, little is known about differences in illness duration and complications in patients presenting in primary care with symptoms of acute respiratory tract infections (RTI) that are and are not attributed to SARS-CoV-2 infection.BACKGROUNDDespite considerable research into COVID-19 sequelae, little is known about differences in illness duration and complications in patients presenting in primary care with symptoms of acute respiratory tract infections (RTI) that are and are not attributed to SARS-CoV-2 infection.To explore whether aetiology impacted course of illness and prediction of complications in patients presenting in primary care with symptoms of RTI early in the COVID-19 pandemic.OBJECTIVETo explore whether aetiology impacted course of illness and prediction of complications in patients presenting in primary care with symptoms of RTI early in the COVID-19 pandemic.Between April 2020-March 2021 general practitioners from nine European countries recruited consecutively contacting patients with RTI symptoms. At baseline, an oropharyngeal-nasal swab was obtained for aetiology determination using PCR after follow-up of 28 days. Time to self-reported recovery was analysed with Kaplan-Meier curves. Predictors (baseline variables of demographics, patient and disease characteristics) of a complicated course (composite of hospital admission and persisting signs/symptoms at 28 days follow-up) were explored with logistic regression modelling.METHODSBetween April 2020-March 2021 general practitioners from nine European countries recruited consecutively contacting patients with RTI symptoms. At baseline, an oropharyngeal-nasal swab was obtained for aetiology determination using PCR after follow-up of 28 days. Time to self-reported recovery was analysed with Kaplan-Meier curves. Predictors (baseline variables of demographics, patient and disease characteristics) of a complicated course (composite of hospital admission and persisting signs/symptoms at 28 days follow-up) were explored with logistic regression modelling.Of 855 patients with RTI symptoms, 237 (27.7%) tested SARS-CoV-2 positive. The proportion not feeling fully recovered (15.6% vs 18.1%, p = 0.39), reporting being extremely tired (9.7% vs 12.8%, p = 0.21), and not having returned to usual daily activities (18.1% vs 14.4%, p = 0.18) at day 28 were comparable between SARS-CoV-2 positive (n = 237) and negative (n = 618) groups. However, among those feeling fully recovered (SARS-CoV-2 positive: 200 patients, SARS-CoV-2 negative: 506 patients), time to full recovery was significantly longer in SARS-CoV-2 patients (10.6 vs 7.7 days, p < 0.001). We found no evidence that predictors of a complicated course differed between groups (p = 0.07).RESULTSOf 855 patients with RTI symptoms, 237 (27.7%) tested SARS-CoV-2 positive. The proportion not feeling fully recovered (15.6% vs 18.1%, p = 0.39), reporting being extremely tired (9.7% vs 12.8%, p = 0.21), and not having returned to usual daily activities (18.1% vs 14.4%, p = 0.18) at day 28 were comparable between SARS-CoV-2 positive (n = 237) and negative (n = 618) groups. However, among those feeling fully recovered (SARS-CoV-2 positive: 200 patients, SARS-CoV-2 negative: 506 patients), time to full recovery was significantly longer in SARS-CoV-2 patients (10.6 vs 7.7 days, p < 0.001). We found no evidence that predictors of a complicated course differed between groups (p = 0.07).Early in the pandemic, the proportion of patients not feeling fully recovered by 28 days was similar between SARS-CoV-2 positive and negative patients presenting in primary care with RTI symptoms, but it took somewhat longer for SARS-CoV-2 patients to feel fully recovered. More research is needed on predictors of a complicated course in RTI.CONCLUSIONEarly in the pandemic, the proportion of patients not feeling fully recovered by 28 days was similar between SARS-CoV-2 positive and negative patients presenting in primary care with RTI symptoms, but it took somewhat longer for SARS-CoV-2 patients to feel fully recovered. More research is needed on predictors of a complicated course in RTI. KEY MESSAGES Our primary care-based observational study found that recovery by 28 days was comparable between SARS-CoV-2 positive and negative RTI patients. Future research is needed to unravel which host- and pathogen-related profiles are associated with higher risk of complications and persisting symptoms among patients presenting in primary care with RTI symptoms. Background Despite considerable research into COVID-19 sequelae, little is known about differences in illness duration and complications in patients presenting in primary care with symptoms of acute respiratory tract infections (RTI) that are and are not attributed to SARS-CoV-2 infection.Objective To explore whether aetiology impacted course of illness and prediction of complications in patients presenting in primary care with symptoms of RTI early in the COVID-19 pandemic.Methods Between April 2020-March 2021 general practitioners from nine European countries recruited consecutively contacting patients with RTI symptoms. At baseline, an oropharyngeal-nasal swab was obtained for aetiology determination using PCR after follow-up of 28 days. Time to self-reported recovery was analysed with Kaplan-Meier curves. Predictors (baseline variables of demographics, patient and disease characteristics) of a complicated course (composite of hospital admission and persisting signs/symptoms at 28 days follow-up) were explored with logistic regression modelling.Results Of 855 patients with RTI symptoms, 237 (27.7%) tested SARS-CoV-2 positive. The proportion not feeling fully recovered (15.6% vs 18.1%, p = 0.39), reporting being extremely tired (9.7% vs 12.8%, p = 0.21), and not having returned to usual daily activities (18.1% vs 14.4%, p = 0.18) at day 28 were comparable between SARS-CoV-2 positive (n = 237) and negative (n = 618) groups. However, among those feeling fully recovered (SARS-CoV-2 positive: 200 patients, SARS-CoV-2 negative: 506 patients), time to full recovery was significantly longer in SARS-CoV-2 patients (10.6 vs 7.7 days, p < 0.001). We found no evidence that predictors of a complicated course differed between groups (p = 0.07).Conclusion Early in the pandemic, the proportion of patients not feeling fully recovered by 28 days was similar between SARS-CoV-2 positive and negative patients presenting in primary care with RTI symptoms, but it took somewhat longer for SARS-CoV-2 patients to feel fully recovered. More research is needed on predictors of a complicated course in RTI. Despite considerable research into COVID-19 sequelae, little is known about differences in illness duration and complications in patients presenting in primary care with symptoms of acute respiratory tract infections (RTI) that are and are not attributed to SARS-CoV-2 infection. To explore whether aetiology impacted course of illness and prediction of complications in patients presenting in primary care with symptoms of RTI early in the COVID-19 pandemic. Between April 2020-March 2021 general practitioners from nine European countries recruited consecutively contacting patients with RTI symptoms. At baseline, an oropharyngeal-nasal swab was obtained for aetiology determination using PCR after follow-up of 28 days. Time to self-reported recovery was analysed with Kaplan-Meier curves. Predictors (baseline variables of demographics, patient and disease characteristics) of a complicated course (composite of hospital admission and persisting signs/symptoms at 28 days follow-up) were explored with logistic regression modelling. Of 855 patients with RTI symptoms, 237 (27.7%) tested SARS-CoV-2 positive. The proportion not feeling fully recovered (15.6% vs 18.1%, = 0.39), reporting being extremely tired (9.7% vs 12.8%, = 0.21), and not having returned to usual daily activities (18.1% vs 14.4%, = 0.18) at day 28 were comparable between SARS-CoV-2 positive ( = 237) and negative ( = 618) groups. However, among those feeling fully recovered (SARS-CoV-2 positive: 200 patients, SARS-CoV-2 negative: 506 patients), time to full recovery was significantly longer in SARS-CoV-2 patients (10.6 vs 7.7 days, < 0.001). We found no evidence that predictors of a complicated course differed between groups ( = 0.07). Early in the pandemic, the proportion of patients not feeling fully recovered by 28 days was similar between SARS-CoV-2 positive and negative patients presenting in primary care with RTI symptoms, but it took somewhat longer for SARS-CoV-2 patients to feel fully recovered. More research is needed on predictors of a complicated course in RTI.
Author	Eijkemans, Marinus J.C. García-Sangenís, Ana Colliers, Annelies Malania, Lile Zuithoff, Nicolaas P.A. Tomacinschii, Angela Böhmer, Femke Chlabicz, Slawomir van der Velden, Alike W. Vellinga, Akke Butler, Christopher C. Goossens, Herman Pauer, Jozsef Venekamp, Roderick P. Verheij, Theo J.
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Cites_doi	10.1001/jamainternmed.2021.6454 10.1038/s41598-021-92045-x 10.1136/bmj-2022-071050 10.1016/j.lanepe.2021.100122 10.1093/qjmed/hci149 10.1080/13814788.2023.2270707 10.1002/alr.22832 10.1038/s41591-021-01433-3 10.1093/cid/ciaa1792 10.1136/bmjopen-2021-056284 10.1016/j.eclinm.2022.101762 10.1136/bmj.38933.585764.AE 10.1093/cid/ciab103 10.1038/s41467-023-43661-w
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Snippet	Despite considerable research into COVID-19 sequelae, little is known about differences in illness duration and complications in patients presenting in primary... KEY MESSAGES Our primary care-based observational study found that recovery by 28 days was comparable between SARS-CoV-2 positive and negative RTI patients.... Background Despite considerable research into COVID-19 sequelae, little is known about differences in illness duration and complications in patients presenting...
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StartPage	2376084
SubjectTerms	Acute Disease Adult Aged COVID-19 COVID-19 - complications COVID-19 - epidemiology Etiology Europe - epidemiology Female Humans Illnesses Male Middle Aged Observational studies Pandemics prediction Primary care Primary Health Care respiratory tract infection Respiratory Tract Infections - epidemiology SARS-CoV-2 Severe acute respiratory syndrome coronavirus 2 Time Factors
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Title	Did aetiology matter in illness duration and complications in patients presenting in primary care with acute respiratory tract infections early in the COVID-19 pandemic: An observational study in nine countries
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