Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2023 May 24;13(5):e068424.
doi: 10.1136/bmjopen-2022-068424.

Initial characteristics and course of disease in patients with suspected COVID-19 managed in general practice: a prospective, multicentre cohort study

Tan-Trung Phan  1   2 , William Mirat  1   3 , Sophie Brossier  1   2 , Emmauelle Boutin  4   5 , Julie Fabre  1   6 , Jean-Denis Hoonakker  1   7 , Sylvie Bastuji-Garin  4   8 , Vincent Renard  1   4 , Emilie Ferrat  9   4   10
Affiliations
Multicenter Study

Initial characteristics and course of disease in patients with suspected COVID-19 managed in general practice: a prospective, multicentre cohort study

Tan-Trung Phan et al. BMJ Open. .

Abstract

Objectives: To describe and compare the initial clinical characteristics of a cohort of patients with suspected COVID-19 managed by general practitioners (GPs); to assess whether 3-month persistent symptoms were more frequent among confirmed cases than among no-COVID cases; and to identify factors predictive of persistent symptoms and adverse outcomes among confirmed cases.

Design and setting: A comparative, prospective, multicentre cohort study in primary care in the Paris region of France.

Participants: 521 patients aged ≥18 with suspected COVID-19 were enrolled between March and May 2020.

Outcome measures: Initial symptoms, COVID-19 status, persistent symptoms 3 months after inclusion and a composite criterion for potentially COVID-19-related events (hospitalisation, death, emergency department visits). The final COVID-19 status ('confirmed', 'no-COVID' and 'uncertain' cases) was determined by the GP after the receipt of the laboratory test results.

Results: 516 patients were analysed; 166 (32.2%) were classified into the 'confirmed COVID' group, 180 (34.9%) into the 'no-COVID' group and 170 (32.9%) in the 'uncertain COVID' group. Confirmed cases were more likely to have persistent symptoms than no-COVID cases (p=0.09); initial fever/feeling feverish and anosmia were independently associated with persistent symptoms. At 3 months, we observed 16 (9.8%) COVID-19-related hospital admissions, 3 (1.8%) intensive care unit admissions, 13 (37.1%) referrals to an emergency department and no death. Age >70 and/or at least one comorbidity (OR 6.53; 95% CI 1.13-37.84; p=0.036), abnormalities in a lung examination (15.39; 95% CI 1.61-146.77; p=0.057) and two or more systemic symptoms (38.61; 95% CI 2.30-647.40; p=0.011) were associated with the composite criterion.

Conclusions: Although most patients with COVID-19 in primary care had mild disease with a benign course, almost one in six had persistent symptoms at 3 months. These symptoms were more frequent in the 'confirmed COVID' group. Our findings need to be confirmed in a prospective study with longer follow-up.

Keywords: COVID-19; PRIMARY CARE; Public health.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Study flow diagram. GP, general practitioner.
See this image and copyright information in PMC

References

    1. Saint-Lary O, Gautier S, Le Breton J, et al. . How GPs adapted their practices and organisations at the beginning of COVID-19 outbreak: a French national observational survey. BMJ Open 2020;10:e042119. 10.1136/bmjopen-2020-042119 - DOI - PMC - PubMed
    1. Greenhalgh T, Koh GCH, Car J. Covid-19: a remote assessment in primary care. BMJ 2020:m1182. 10.1136/bmj.m1182 - DOI - PubMed
    1. Argenziano MG, Bruce SL, Slater CL, et al. . Characterization and clinical course of 1000 patients with Coronavirus disease 2019 in New York: retrospective case series. BMJ 2020;369:m1996. 10.1136/bmj.m1996 - DOI - PMC - PubMed
    1. Docherty AB, Harrison EM, Green CA, et al. . Features of 20 133 UK patients in hospital with COVID-19 using the ISARIC WHO clinical characterisation protocol: prospective observational cohort study. BMJ 2020;369:m1985. 10.1136/bmj.m1985 - DOI - PMC - PubMed
    1. Tostmann A, Bradley J, Bousema T, et al. . Strong associations and moderate predictive value of early symptoms for SARS-CoV-2 test positivity among Healthcare workers. Euro Surveill 2020;25:2000508. 10.2807/1560-7917.ES.2020.25.16.2000508 - DOI - PMC - PubMed

Publication types