Evaluating post-COVID care: a retrospective cohort study into long-term symptoms

<bold>Background:</bold> Post-COVID refers to persistent symptoms lasting at least 3 months after a COVID-19 infection. Currently, 1 in 8 people experience long-term symptoms. In the Northern Netherlands, a multidisciplinary care pathway has been developed for this patient group to ensure optimal treatment and rehabilitation. <bold>Aim:</bold> To evaluate the post-COVID care pathway in the Northern Netherlands by measuring changes in persistent symptoms. <bold>Method:</bold> Data were collected from patients who visited the post-COVID outpatient clinic between August 2020 and August 2023. Patient characteristics and symptoms were assessed at baseline and the first follow-up visit. Changes over time were assessed using the Wilcoxon rank test and McNemar test. <bold>Results:</bold> 655 patients visited the outpatient clinic at a mean±SD of 32.6±28.8 weeks after their first COVID-19 infection. Of these, 484 patients (31% male, age 47.2±13.7 years, FEV₁ 96.0±15.2 %pred) had a follow-up visit after a mean of 13.2±9.3 weeks. At baseline, these 484 patients reported a median [IQR] number of 4 [3-5] symptoms, which decreased to 2 [1-3] symptoms at follow-up (p<0.01). The most commonly reported symptoms were fatigue (76% at baseline vs. 55% at follow-up), dyspnoea (73% vs. 45%), exercise intolerance (33% vs. 22%), difficulty concentrating (27% vs. 16%) and cough (26% vs. 12%), all of which improved over time (p<0.01). Interestingly, 25 patients (5.4%) reported being symptom-free at follow-up. <bold>Conclusion:</bold> These results show that the established care approach seems effective in improving persistent symptoms. Further research is needed to assess the durability of these outcomes and to explore characteristics of individuals who may not experience immediate improvement.