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RESEARCH ARTICLE (Open Access)
Contents Vol 31(1)

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

David Wilkins https://orcid.org/0000-0002-3385-8981 A * , Amanda Tapley B C , Jason Dizon D , Elizabeth Holliday B , Andrew Davey B C , Alison Fielding B C , Dominica Moad B C , Mieke van Driel E , Anna Ralston B C , Katie Fisher B C , Parker Magin B C F Nigel Stocks A
+ Author Affiliations
- Author Affiliations

A Discipline of General Practice, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia.

B School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia.

C Royal Australian College of General Practitioners GP Training Research Department, Newcastle, NSW, Australia.

D Hunter Medical Research Institute, Clinical Research Design, IT and Statistical Support Unit (CReDITSS), Newcastle, NSW, Australia.

E Primary Care Clinical Unit, Faculty of Medicine, The University of Queensland, Brisbane, Qld, Australia.

F School of Population Health, University of New South Wales, Sydney, NSW, Australia.

* Correspondence to: david.wilkins@adelaide.edu.au

Australian Journal of Primary Health 31, PY24163 https://doi.org/10.1071/PY24163
Submitted: 8 October 2024  Accepted: 8 January 2025  Published: 30 January 2025

© 2025 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of La Trobe University. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)

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

A total of 969 registrars recorded 3193 consultations where fatigue was a symptom. Registrars reported considering long COVID as a differential diagnosis in 2563 encounters (80%, 95% confidence interval (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.

Keywords: chronic disease, clinical decision-making, COVID-19, general practice, graduate medical education, long COVID, primary health care, telemedicine.

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