Determinants of post COVID-19 clinic attendance among SARS-CoV-2-infected individuals in Stockholm, Sweden: a population-based cohort study

Objectives Investigate determinants of post-COVID-19 condition (PCC) clinic attendance among participants not hospitalised versus hospitalised during the SARS-CoV-2 infection.Design Retrospective cohort study.Setting Six population-based registers with high coverage to cover all adults residing in S...

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Main Authors: Anders Ternhag, Pontus Nauclér, Pontus Hedberg, John Karlsson Valik, Peder af Geijerstam, Christer Almgren-Lidman
Format: Article
Language:English
Published: BMJ Publishing Group 2025-06-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/15/6/e098344.full
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author Anders Ternhag
Pontus Nauclér
Pontus Hedberg
John Karlsson Valik
Peder af Geijerstam
Christer Almgren-Lidman
author_facet Anders Ternhag
Pontus Nauclér
Pontus Hedberg
John Karlsson Valik
Peder af Geijerstam
Christer Almgren-Lidman
author_sort Anders Ternhag
collection DOAJ
description Objectives Investigate determinants of post-COVID-19 condition (PCC) clinic attendance among participants not hospitalised versus hospitalised during the SARS-CoV-2 infection.Design Retrospective cohort study.Setting Six population-based registers with high coverage to cover all adults residing in Stockholm County, Sweden.Participants Adults residing in Stockholm County on 31 January 2020, with a SARS-CoV-2 infection through 30 November 2022, who did not die or move out of Stockholm County within 90 days.Primary outcome measures PCC clinic attendance from 90 days after the SARS-CoV-2 test until date of death, date of moving out, or 30 November 30,2023.Results Of non-hospitalised and hospitalised participants, 737 of 464 674 (0.2%) and 433 of 23 374 (1.9%), respectively, attended a PCC clinic. A total of 75 878 (16.3%) of non-hospitalised participants and 6190 (26.5%) of hospitalised participants presented with new-onset symptoms that could indicate PCC in primary care. The strongest determinants of attendance among non-hospitalised participants were mental health disorder (adjusted risk ratio (aRR) 2.57, 95% CI 2.21 to 2.98), asthma (2.39, 1.97–2.92) and >4 PCC symptoms in 2019 (2.27, 1.60–3.24), and among hospitalised participants were >31 sick days in 2019 (1.94, 1.47–2.56), 1–30 sick days in 2019 (1.56, 1.06–2.29) and obesity (1.51, 1.19–1.93). The most common clinical presentation was fatigue (n=526, 71.4%) among non-hospitalised and dyspnoea (n=148, 34.2%) among hospitalised participants.Conclusions PCC clinic attendance characteristics differed between non-hospitalised and hospitalised participants. Distinguishing PCC from conditions with overlapping symptoms and determining the appropriate level of care may be challenging, with risk of resource displacement effects and inappropriate care.
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spelling doaj-art-2ab65ae2d78a403c95d3c4589dc2b27c2025-08-20T03:31:05ZengBMJ Publishing GroupBMJ Open2044-60552025-06-0115610.1136/bmjopen-2024-098344Determinants of post COVID-19 clinic attendance among SARS-CoV-2-infected individuals in Stockholm, Sweden: a population-based cohort studyAnders Ternhag0Pontus Nauclér1Pontus Hedberg2John Karlsson Valik3Peder af Geijerstam4Christer Almgren-Lidman5Department of Medicine Solna, Karolinska Institutet, Stockholm, SwedenDepartment of Medicine Solna, Karolinska Institutet, Stockholm, SwedenDepartment of Medicine Huddinge, Karolinska Institutet, Stockholm, SwedenDepartment of Medicine Solna, Karolinska Institutet, Stockholm, SwedenPrimary Health Care Center Cityhälsan Centrum, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, SwedenDepartment of Medicine Huddinge, Karolinska Institutet, Stockholm, SwedenObjectives Investigate determinants of post-COVID-19 condition (PCC) clinic attendance among participants not hospitalised versus hospitalised during the SARS-CoV-2 infection.Design Retrospective cohort study.Setting Six population-based registers with high coverage to cover all adults residing in Stockholm County, Sweden.Participants Adults residing in Stockholm County on 31 January 2020, with a SARS-CoV-2 infection through 30 November 2022, who did not die or move out of Stockholm County within 90 days.Primary outcome measures PCC clinic attendance from 90 days after the SARS-CoV-2 test until date of death, date of moving out, or 30 November 30,2023.Results Of non-hospitalised and hospitalised participants, 737 of 464 674 (0.2%) and 433 of 23 374 (1.9%), respectively, attended a PCC clinic. A total of 75 878 (16.3%) of non-hospitalised participants and 6190 (26.5%) of hospitalised participants presented with new-onset symptoms that could indicate PCC in primary care. The strongest determinants of attendance among non-hospitalised participants were mental health disorder (adjusted risk ratio (aRR) 2.57, 95% CI 2.21 to 2.98), asthma (2.39, 1.97–2.92) and >4 PCC symptoms in 2019 (2.27, 1.60–3.24), and among hospitalised participants were >31 sick days in 2019 (1.94, 1.47–2.56), 1–30 sick days in 2019 (1.56, 1.06–2.29) and obesity (1.51, 1.19–1.93). The most common clinical presentation was fatigue (n=526, 71.4%) among non-hospitalised and dyspnoea (n=148, 34.2%) among hospitalised participants.Conclusions PCC clinic attendance characteristics differed between non-hospitalised and hospitalised participants. Distinguishing PCC from conditions with overlapping symptoms and determining the appropriate level of care may be challenging, with risk of resource displacement effects and inappropriate care.https://bmjopen.bmj.com/content/15/6/e098344.full
spellingShingle Anders Ternhag
Pontus Nauclér
Pontus Hedberg
John Karlsson Valik
Peder af Geijerstam
Christer Almgren-Lidman
Determinants of post COVID-19 clinic attendance among SARS-CoV-2-infected individuals in Stockholm, Sweden: a population-based cohort study
BMJ Open
title Determinants of post COVID-19 clinic attendance among SARS-CoV-2-infected individuals in Stockholm, Sweden: a population-based cohort study
title_full Determinants of post COVID-19 clinic attendance among SARS-CoV-2-infected individuals in Stockholm, Sweden: a population-based cohort study
title_fullStr Determinants of post COVID-19 clinic attendance among SARS-CoV-2-infected individuals in Stockholm, Sweden: a population-based cohort study
title_full_unstemmed Determinants of post COVID-19 clinic attendance among SARS-CoV-2-infected individuals in Stockholm, Sweden: a population-based cohort study
title_short Determinants of post COVID-19 clinic attendance among SARS-CoV-2-infected individuals in Stockholm, Sweden: a population-based cohort study
title_sort determinants of post covid 19 clinic attendance among sars cov 2 infected individuals in stockholm sweden a population based cohort study
url https://bmjopen.bmj.com/content/15/6/e098344.full
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