General practice registrar evaluation of long COVID in patients presenting with fatigue

David Wilkins; Amanda Tapley; Jason Dizon; Elizabeth Holliday; Andrew Davey; Alison Fielding; Dominica Moad; Mieke van Driel; Anna Ralston; Katie Fisher; Parker Magin; Nigel Stocks

Just Accepted

This article has been peer reviewed and accepted for publication. It is in production and has not been edited, so may differ from the final published form.

General practice registrar evaluation of long COVID in patients presenting with fatigue

David Wilkins , Amanda Tapley, Jason Dizon, Elizabeth Holliday, Andrew Davey, Alison Fielding, Dominica Moad, Mieke van Driel, Anna Ralston, Katie Fisher, Parker Magin, Nigel Stocks

Abstract

Background: Long COVID is a new and prevalent condition defined by persistent symptoms following acute COVID-19 infection. While increasing resources are being directed to management, there is little evidence on how general practitioners (GPs) have changed their assessment and differential diagnosis of patients with potential long COVID symptoms including fatigue. This study aimed to examine how often GP registrars consider long COVID in patients presenting with fatigue, how often they think long COVID might be the cause for fatigue, and patient, registrar, practice, and consultation factors associated with these outcomes. Methods: Data were collected through Registrar Clinical Encounters in Training (ReCEnT), an ongoing inception cohort study of GP registrars’ in-consultation experiences, during two collection rounds in 2022–2023. Multivariable logistic regression was used to examine the relationship between predictor variables and outcomes. Results: 969 registrars recorded 3,193 consultations where fatigue was a symptom. Registrars reported considering long COVID as a differential diagnosis in 2,563 encounters (80%, 95% CI 79–82%). Of these, registrars thought long COVID was the likely cause for fatigue in 465 encounters (18%, 95% CI 17–20%). While no patient variables were significantly associated with either outcome, multivariable associations included telehealth consultations having greater odds of both outcomes and Australian-trained registrars having lesser odds of considering long COVID likely. Conclusions: Registrars report usually considering long COVID as a differential for fatigue and frequently considering it a likely diagnosis. Telehealth usage was significantly associated with both outcomes. Future work should explore GPs’ diagnostic approaches to other potential long COVID symptoms.

PY24163 Accepted 08 January 2025