Impact of pre-existing comorbidities and multimorbidities, demography and viral variants on post-acute sequelae of COVID-19 (‘Long COVID’) in Dutch primary care: A retrospective cohort study

Introduction: Post-acute sequelae of COVID-19 (PASC), or Long COVID, involves persistent symptoms following acute infection, posing a global health challenge. While a growing number of studies have investigated potential predictors and risk factors, uncertainties remain regarding their consistency a...

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Main Authors: Matthijs S. Berends, Maarten Homburg, Thijmen Kupers, Eline N. Meijer, Isabelle Bos, Robert Verheij, Jeroen Kuiper, Marjolein Y. Berger, Lilian L. Peters
Format: Article
Language:English
Published: Elsevier 2025-07-01
Series:International Journal of Infectious Diseases
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Online Access:http://www.sciencedirect.com/science/article/pii/S1201971225001353
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author Matthijs S. Berends
Maarten Homburg
Thijmen Kupers
Eline N. Meijer
Isabelle Bos
Robert Verheij
Jeroen Kuiper
Marjolein Y. Berger
Lilian L. Peters
author_facet Matthijs S. Berends
Maarten Homburg
Thijmen Kupers
Eline N. Meijer
Isabelle Bos
Robert Verheij
Jeroen Kuiper
Marjolein Y. Berger
Lilian L. Peters
author_sort Matthijs S. Berends
collection DOAJ
description Introduction: Post-acute sequelae of COVID-19 (PASC), or Long COVID, involves persistent symptoms following acute infection, posing a global health challenge. While a growing number of studies have investigated potential predictors and risk factors, uncertainties remain regarding their consistency and clinical applicability. This study investigates PASC prevalence, comorbidities, demographics and viral variants using Dutch primary care electronic healthcare records (EHR). Methods: A retrospective cohort study used EHR data from 59 general practices in the Northern Netherlands, including 19,638 SARS-CoV-2 PCR-positive patients from January 1, 2020, to December 31, 2021. PASC was identified via World Health Organization and CDC guidelines, a Dutch Word2Vec model, and clinical assessments. Relative risk (RR) calculations analysed comorbidities, demographics and viral variants. Results: PASC prevalence was 5.8% (95% CI: 5.4-6.1%). Comorbidities significantly increasing PASC risk included lung disease (RR: 1.95), cardiovascular disease (RR: 1.73), diabetes (RR: 1.82), kidney disease (RR: 1.98) and mental illness (RR: 1.29). Females and individuals aged ≥45 had increased risk. Multivariate regression revealed higher odds of prolonged PASC for ages 45-59 (adjusted odds ratios [AOR]: 3.02), 60-74 (AOR: 3.25) and 75+ (AOR: 2.44). Combined mental illness and lung disease further increased risk (AOR: 2.55). Conclusion: Chronic conditions, multimorbidity and demographics significantly influence PASC onset and duration. Targeted interventions may mitigate its long-term impact.
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spelling doaj-art-21ca7960eca04e47aac06e7117aa3a392025-08-20T02:35:36ZengElsevierInternational Journal of Infectious Diseases1201-97122025-07-0115610791210.1016/j.ijid.2025.107912Impact of pre-existing comorbidities and multimorbidities, demography and viral variants on post-acute sequelae of COVID-19 (‘Long COVID’) in Dutch primary care: A retrospective cohort studyMatthijs S. Berends0Maarten Homburg1Thijmen Kupers2Eline N. Meijer3Isabelle Bos4Robert Verheij5Jeroen Kuiper6Marjolein Y. Berger7Lilian L. Peters8Department of Primary and Long-term Care, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands; Department of Medical Microbiology and Infection Prevention, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands; Department of Medical Epidemiology, Certe Foundation, Groningen, The NetherlandsDepartment of Primary and Long-term Care, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands; Corresponding author: Maarten Homburg, Department of Primary and Long-term Care, University of Groningen, University Medical Center Groningen, Oostersingel, entrance 47, building 50, Home postal code: FA21Postbus 196 9700 AD, Groningen, The Netherlands.Department of Primary and Long-term Care, University of Groningen, University Medical Center Groningen, Groningen, The NetherlandsDepartment of Primary and Long-term Care, University of Groningen, University Medical Center Groningen, Groningen, The NetherlandsNivel, Netherlands Institute for Health Services Research (Nivel), Utrecht, The NetherlandsNivel, Netherlands Institute for Health Services Research (Nivel), Utrecht, The Netherlands; Department of Social and Behavioral Sciences, Tilburg University, Tranzo, Tilburg, The Netherlands; Dutch National Health Care Institute, Diemen, The NetherlandsMunicipal Health Service Groningen, Groningen, The NetherlandsDepartment of Primary and Long-term Care, University of Groningen, University Medical Center Groningen, Groningen, The NetherlandsDepartment of Primary and Long-term Care, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands; Amsterdam UMC Location Vrije Universiteit Amsterdam, Midwifery Science, Amsterdam, The Netherlands; Midwifery Academy Amsterdam Groningen, Inholland, Amsterdam, The NetherlandsIntroduction: Post-acute sequelae of COVID-19 (PASC), or Long COVID, involves persistent symptoms following acute infection, posing a global health challenge. While a growing number of studies have investigated potential predictors and risk factors, uncertainties remain regarding their consistency and clinical applicability. This study investigates PASC prevalence, comorbidities, demographics and viral variants using Dutch primary care electronic healthcare records (EHR). Methods: A retrospective cohort study used EHR data from 59 general practices in the Northern Netherlands, including 19,638 SARS-CoV-2 PCR-positive patients from January 1, 2020, to December 31, 2021. PASC was identified via World Health Organization and CDC guidelines, a Dutch Word2Vec model, and clinical assessments. Relative risk (RR) calculations analysed comorbidities, demographics and viral variants. Results: PASC prevalence was 5.8% (95% CI: 5.4-6.1%). Comorbidities significantly increasing PASC risk included lung disease (RR: 1.95), cardiovascular disease (RR: 1.73), diabetes (RR: 1.82), kidney disease (RR: 1.98) and mental illness (RR: 1.29). Females and individuals aged ≥45 had increased risk. Multivariate regression revealed higher odds of prolonged PASC for ages 45-59 (adjusted odds ratios [AOR]: 3.02), 60-74 (AOR: 3.25) and 75+ (AOR: 2.44). Combined mental illness and lung disease further increased risk (AOR: 2.55). Conclusion: Chronic conditions, multimorbidity and demographics significantly influence PASC onset and duration. Targeted interventions may mitigate its long-term impact.http://www.sciencedirect.com/science/article/pii/S1201971225001353Long COVIDPost-acute sequelae of COVID-19PASCPost-COVIDGeneral practitionersComorbidities
spellingShingle Matthijs S. Berends
Maarten Homburg
Thijmen Kupers
Eline N. Meijer
Isabelle Bos
Robert Verheij
Jeroen Kuiper
Marjolein Y. Berger
Lilian L. Peters
Impact of pre-existing comorbidities and multimorbidities, demography and viral variants on post-acute sequelae of COVID-19 (‘Long COVID’) in Dutch primary care: A retrospective cohort study
International Journal of Infectious Diseases
Long COVID
Post-acute sequelae of COVID-19
PASC
Post-COVID
General practitioners
Comorbidities
title Impact of pre-existing comorbidities and multimorbidities, demography and viral variants on post-acute sequelae of COVID-19 (‘Long COVID’) in Dutch primary care: A retrospective cohort study
title_full Impact of pre-existing comorbidities and multimorbidities, demography and viral variants on post-acute sequelae of COVID-19 (‘Long COVID’) in Dutch primary care: A retrospective cohort study
title_fullStr Impact of pre-existing comorbidities and multimorbidities, demography and viral variants on post-acute sequelae of COVID-19 (‘Long COVID’) in Dutch primary care: A retrospective cohort study
title_full_unstemmed Impact of pre-existing comorbidities and multimorbidities, demography and viral variants on post-acute sequelae of COVID-19 (‘Long COVID’) in Dutch primary care: A retrospective cohort study
title_short Impact of pre-existing comorbidities and multimorbidities, demography and viral variants on post-acute sequelae of COVID-19 (‘Long COVID’) in Dutch primary care: A retrospective cohort study
title_sort impact of pre existing comorbidities and multimorbidities demography and viral variants on post acute sequelae of covid 19 long covid in dutch primary care a retrospective cohort study
topic Long COVID
Post-acute sequelae of COVID-19
PASC
Post-COVID
General practitioners
Comorbidities
url http://www.sciencedirect.com/science/article/pii/S1201971225001353
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