Journal of General Practice

Symptoms of the Long COVID and Related Primary Health Care Implications: Systematic Literature Review

Abstract

Kristina Ziuteliene, Erika Fabijonavice*, Gabriele Bartkute and Ida Liseckiene

Since the worldwide COVID-19 pandemic, various sources have indicated the long-term symptoms after recovery that is now known as Long COVID (LC). Knowing the damage acute CoV-2 has caused worldwide, it is predicted that LC will have a massive impact on Primary Health Care (PHC). It remains unknown how PHC should cope with such an upcoming burden. The aim is to review studies exploring the most common symptoms as predictors of LC and potential syndrome management challenges in the PHC context. The study undertook a systematic review using Cochrane methodology and PRISMA guidelines. It is known that LC can have numerous nonspecific manifestations; however the main widespread symptoms were chronic fatigue (up to 68.0%), shortness of breath (up to 59.5%), dry cough, chest, and musculoskeletal pain. Most patients reported neurological symptoms, including headache (up to 68.0%), anosmia, partial olfactory dysfunction, and vertigo. LCS usually manifests in psychiatric disorders, such as depression, anxiety, insomnia, and mood changes. Not many clinical trials determined possible risk factors, however, hospitalization in Intensive Care Unit (ICU), intubation, smoking, obesity, and comorbidities such as diabetes and hypertension are some of few confirmed. There is very limited data on LC management specifics regarding PHC context. Although LC remains to be defined, it is necessary to understand its impact and clinical manifestations promptly, so that Family Physicians (FP) would be able to manage the syndrome. There are no predictors which would let a FP predict LC course, severity and recovery. Hence, new strategies and management guidelines of LC need to be established and elaborated for PHC to function thoroughly.