Lingering symptoms in non-hospitalized patients with COVID-19 – a prospective survey study of symptom expression and effects on mental health in Germany

Abstract Background The infection rates with SARS-CoV 2 virus, known since 2019, are currently significantly weakened in their dynamics. Nevertheless, COVID 19 is still a common disease, which in most cases is overcome quite well and can be treated by the general practitioner. Despite an initially u...

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Main Authors: Jörn Rohde, René Bundschuh, Yvonne Kaußner, Anne Simmenroth
Format: Article
Language:English
Published: BMC 2025-04-01
Series:BMC Primary Care
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Online Access:https://doi.org/10.1186/s12875-025-02784-3
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author Jörn Rohde
René Bundschuh
Yvonne Kaußner
Anne Simmenroth
author_facet Jörn Rohde
René Bundschuh
Yvonne Kaußner
Anne Simmenroth
author_sort Jörn Rohde
collection DOAJ
description Abstract Background The infection rates with SARS-CoV 2 virus, known since 2019, are currently significantly weakened in their dynamics. Nevertheless, COVID 19 is still a common disease, which in most cases is overcome quite well and can be treated by the general practitioner. Despite an initially uncomplicated disease progression, the long-term consequences can be considerable. Symptoms persisting over a period of more than 12 weeks after infection are summarized as Post-COVID (PC) syndrome. The aim of this study is to document the symptom expression in PC patients in the outpatient setting, with a major focus on limitations in daily life and consequences for mental health. Methods This survey is part of a prospective European collaborative study with the German cohort having been slightly extended and evaluated separately. Data collection was performed by telephone interviews of adult SARS CoV 2 positive patients using standardized questionnaires (38 open and 6 closed questions). After an inclusion interview, follow-up interviews were conducted every 4 weeks over a period of 6 months. Participants were recruited in collaboration with the local health department (Wuerzburg, Germany). Results Sixty participants were recruited in April and May 2021. After 12 weeks (PC cutoff), 48.3% still reported symptoms related to SARS-CoV-2 infection. The most commonly reported symptoms were fatigue/tiredness (33.3%), reduced concentration (26.7%), and shortness of breath (23.3%). One-quarter of respondents reported impaired functioning, with the most common daily limitations being sports (28.3%), work (25.0%), and social life (15.0%). At 6 months, 21.6% of respondents experienced anxiety and 11.6% reported depressive symptoms. Overall, 40.0% of respondents were concerned that their health would deteriorate again or not fully normalize because of COVID-19. Over two-thirds (70.0%) visited a physician during the course of the study because of COVID-19, 73.8% of whom visited their general practitioner. Conclusion PC in outpatient care appears to be a complex and multifaceted condition that not only presents with physical symptoms, but also has a significant impact on mental health and daily life. Although the complexity of the condition is not yet fully understood, our findings suggest that it presents long-term challenges, particularly in outpatient care. Further research, particularly in larger and more diverse cohorts, is needed to confirm these observations. Routine screening for psychosocial comorbidities could be a valuable approach to identify supportive interventions that may help to reduce the risk of chronification and/or somatization.
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spelling doaj-art-2d99eb44258b48d1ade0e85d70967e932025-08-20T03:07:43ZengBMCBMC Primary Care2731-45532025-04-0126111210.1186/s12875-025-02784-3Lingering symptoms in non-hospitalized patients with COVID-19 – a prospective survey study of symptom expression and effects on mental health in GermanyJörn Rohde0René Bundschuh1Yvonne Kaußner2Anne Simmenroth3Department of General Practice, University Hospital WuerzburgDepartment of General Practice, University Hospital WuerzburgCounseling Center for Employees, University Hospital WuerzburgDepartment of General Practice, University Hospital WuerzburgAbstract Background The infection rates with SARS-CoV 2 virus, known since 2019, are currently significantly weakened in their dynamics. Nevertheless, COVID 19 is still a common disease, which in most cases is overcome quite well and can be treated by the general practitioner. Despite an initially uncomplicated disease progression, the long-term consequences can be considerable. Symptoms persisting over a period of more than 12 weeks after infection are summarized as Post-COVID (PC) syndrome. The aim of this study is to document the symptom expression in PC patients in the outpatient setting, with a major focus on limitations in daily life and consequences for mental health. Methods This survey is part of a prospective European collaborative study with the German cohort having been slightly extended and evaluated separately. Data collection was performed by telephone interviews of adult SARS CoV 2 positive patients using standardized questionnaires (38 open and 6 closed questions). After an inclusion interview, follow-up interviews were conducted every 4 weeks over a period of 6 months. Participants were recruited in collaboration with the local health department (Wuerzburg, Germany). Results Sixty participants were recruited in April and May 2021. After 12 weeks (PC cutoff), 48.3% still reported symptoms related to SARS-CoV-2 infection. The most commonly reported symptoms were fatigue/tiredness (33.3%), reduced concentration (26.7%), and shortness of breath (23.3%). One-quarter of respondents reported impaired functioning, with the most common daily limitations being sports (28.3%), work (25.0%), and social life (15.0%). At 6 months, 21.6% of respondents experienced anxiety and 11.6% reported depressive symptoms. Overall, 40.0% of respondents were concerned that their health would deteriorate again or not fully normalize because of COVID-19. Over two-thirds (70.0%) visited a physician during the course of the study because of COVID-19, 73.8% of whom visited their general practitioner. Conclusion PC in outpatient care appears to be a complex and multifaceted condition that not only presents with physical symptoms, but also has a significant impact on mental health and daily life. Although the complexity of the condition is not yet fully understood, our findings suggest that it presents long-term challenges, particularly in outpatient care. Further research, particularly in larger and more diverse cohorts, is needed to confirm these observations. Routine screening for psychosocial comorbidities could be a valuable approach to identify supportive interventions that may help to reduce the risk of chronification and/or somatization.https://doi.org/10.1186/s12875-025-02784-3Post-COVIDLong-COVIDPrimary careMental health
spellingShingle Jörn Rohde
René Bundschuh
Yvonne Kaußner
Anne Simmenroth
Lingering symptoms in non-hospitalized patients with COVID-19 – a prospective survey study of symptom expression and effects on mental health in Germany
BMC Primary Care
Post-COVID
Long-COVID
Primary care
Mental health
title Lingering symptoms in non-hospitalized patients with COVID-19 – a prospective survey study of symptom expression and effects on mental health in Germany
title_full Lingering symptoms in non-hospitalized patients with COVID-19 – a prospective survey study of symptom expression and effects on mental health in Germany
title_fullStr Lingering symptoms in non-hospitalized patients with COVID-19 – a prospective survey study of symptom expression and effects on mental health in Germany
title_full_unstemmed Lingering symptoms in non-hospitalized patients with COVID-19 – a prospective survey study of symptom expression and effects on mental health in Germany
title_short Lingering symptoms in non-hospitalized patients with COVID-19 – a prospective survey study of symptom expression and effects on mental health in Germany
title_sort lingering symptoms in non hospitalized patients with covid 19 a prospective survey study of symptom expression and effects on mental health in germany
topic Post-COVID
Long-COVID
Primary care
Mental health
url https://doi.org/10.1186/s12875-025-02784-3
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