German general practitioners' experiences of managing post-COVID-19 syndrome: A qualitative interview study

Eur J Gen Pract. 2024 Dec;30(1):2413095. doi: 10.1080/13814788.2024.2413095. Epub 2024 Oct 21.

Abstract

Background: The management of the long-term sequelae of coronavirus disease 2019 (COVID-19) infection, known as post-COVID-19 syndrome (PCS), continues to challenge the medical community, largely owing to a significant gap in the understanding of its aetiology, diagnosis and effective treatment.

Aim: To examine general practitioners' (GPs) experiences of caring for patients with PCS and to identify unmet care needs and opportunities for improvement.

Design and setting: This study follows a qualitative design, using in-depth semi-structured telephone interviews with GPs (N = 31) from across Germany.

Method: Interviews were audio-recorded, transcribed verbatim and analysed using qualitative content analysis.

Results: GPs reported that they were often the first point of contact for patients with persistent symptoms following SARS-CoV-2 infection, with symptoms typically resolving within weeks. While ongoing symptomatic COVID-19 is perceived to be more common, the relevance of PCS to GP practices is considerable given its severe impact on patients' functioning, social participation and the substantial time required for patient care. GPs coordinate diagnosis and treatment but face challenges because of the unclear definition of PCS and difficulties in attributing symptoms, resulting in a cautious approach to ICD-10 coding. Interviewees highlight lengthy diagnostic pathways and barriers to accessing specialist care.

Conclusion: The findings confirm the high functional limitations and psychosocial burden of PCS on patients, and the central role of GPs in their care. The study suggests a need for further research and health policy measures to support GPs in navigating diagnostic uncertainty, interprofessional communication and the limited evidence on effective treatments.

Keywords: COVID-19; Primary health care; pandemics; post-acute COVID-19 syndrome; qualitative research.

Plain language summary

Limited evidence on causes and treatment of PCS challenges GPs.The findings illustrate symptom-driven approaches adopted by GPs to diagnose and manage PCS and highlight the role of psychosocial support.Efforts should focus on supporting GPs in their central role in the management of PCS to handle diagnostic uncertainty, improving interprofessional communication and addressing barriers to accessing specialist care.

MeSH terms

  • Adult
  • Attitude of Health Personnel
  • COVID-19*
  • Female
  • General Practitioners*
  • Germany
  • Humans
  • Interviews as Topic*
  • Male
  • Middle Aged
  • Post-Acute COVID-19 Syndrome*
  • Qualitative Research*

Grants and funding

This study was conducted as part of the LoCoVICF study (‘Long-term sequelae, limitations of activities, and rehabilitation needs after a SARS-CoV-2 infection of work forces in health and welfare services’) funded by the German Federal Ministry of Education and Research (grant no. 01EP2110A). We acknowledge financial support from the Open Access Publication Fund of the University Medical Center Hamburg-Eppendorf.