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. 2025 Dec;31(1):2501306.
doi: 10.1080/13814788.2025.2501306. Epub 2025 Jun 2.

Long-term prognosis of adults with moderately severe SARS-CoV-2 lower respiratory tract infection managed in primary care: Prospective cohort study

Tamara N Platteel  1 , Johannes C Koelmans  1 , Daniela Cianci  1 , Natasha J H Broers  2 , Eefje G P M de Bont  2 , Jochen W L Cals  2 , Roderick P Venekamp  1 , Theo J M Verheij  1
Affiliations

Long-term prognosis of adults with moderately severe SARS-CoV-2 lower respiratory tract infection managed in primary care: Prospective cohort study

Tamara N Platteel et al. Eur J Gen Pract. 2025 Dec.

Abstract

Background: Information about the incidence of persisting symptoms after COVID-19 and its impact on patients treated in primary care are scarce.

Objectives: To determine differences in health-related quality of life (HRQoL) and symptomatology between adults with and without SARS-CoV-2 moderately severe lower respiratory tract infection (LRTI) in the 12 months following their primary care visit.

Methods: Prospective cohort study in 35 Dutch practices. Individuals aged ≥18 years who presented to their general practitioner (GP) with a moderately severe LRTI during the first COVID-19 waive in The Netherlands (March-June 2020, n = 277; 268 (97%) with complete follow-up) were included between September and December 2020, then underwent serology testing (participants, GPs and study personnel remained blinded for serology outcomes during study conduct) and completed baseline and follow-up questionnaires. Main outcome measures: (1) SF-36 scores, and (2) risk of persisting symptoms during 12 months follow-up.

Results: The change in SF-36 PSC (p = 0.13), MCS (p = 0.30) during 12 months follow-up did not differ between SARS-CoV-2 serology positive and negative participants after adjusting for sex, age, BMI, diabetes, and chronic pulmonary conditions. The risk of any persisting symptom during 12 months follow-up did not significantly differ between the groups (aHR 0.61, 95% CI 0.33-1.15), nor did the risk of individual symptoms.

Conclusions: In the 12 months following their moderately severe LRTI, primary care patients with and without confirmed SARS-CoV-2 infection had a comparable HRQoL profile. A substantial proportion of participants reported persisting symptoms, indicating that persisting symptoms can occur following LRTIs irrespective of causative pathogen.

Keywords: COVID-19; long-term prognosis; primary care.

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Conflict of interest statement

No potential conflict of interest was reported by the author(s).

Figures

Figure 1.
Figure 1.
Timeline index consultation, baseline and follow-up measurements.
Figure 2.
Figure 2.
Patient selection flowchart.
Figure 3.
Figure 3.
Estimated mean physical component summary (PCS) score (SF-36) over time, based on mixed model. Estimated differences: negative versus positive SARS-CoV-2 serology test result 0–90 days: 0.55 (95%CI −0.16 to 1.25); 0–180 days: 1.10 (95% CI −0.31 to 2.50); 0–270 days: 1.64 (95%CI −0.47 to 3.75) and 0–360 days: 2.22 (95%CI −0.63 to 5.07).
Figure 4.
Figure 4.
Kaplan–Meier curve of the proportion of patients with any persisting symptom over the 12 month follow up.
See this image and copyright information in PMC

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