A Qualitative Interview Study of General Practitioners' Experiences of Managing Post-COVID-19 Syndrome

Abstract

Background The management of the long-term sequelae of COVID-19 infection, known as post-COVID-19 syndrome (PCS), continues to challenge the medical community, largely due 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 Patients with persistent symptoms after SARS-CoV-2 infection often consult their GPs as the first point of contact, 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 difficulties 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.

How this fits in Post-COVID-19 syndrome has garnered attention in research and healthcare, but limited evidence on its causes and effective treatment challenges clinicians. This study illustrates the symptom-driven approaches to diagnosis and treatment adopted by general practitioners and their concerns about referring patients to specialist clinics. Greater collaboration and communication across sectors and disciplines is needed to meet the identified need for interprofessional care. Research should also focus on developing comprehensive differential diagnostic protocols, and health policy should address barriers to accessing specific outpatient services.

Competing Interest Statement

The authors have declared no competing interest.

Funding Statement

This study was carried out as part of the LoCoV-ICF-Study, a multicentre mixed-methods research project aimed at exploring long-term consequences, activity limitations, and rehabilitation needs in health and social services workers following SARS-CoV-2 infection from different perspectives. The study received financial support from the German Federal Ministry of Education and Research (grant no. 01EP2110A).

Author Declarations

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

Ethical approval for this study was obtained from the local ethics committee at the Center for Psychosocial Medicine of the University Medical Center Hamburg-Eppendorf (approval no. LPEK-0483).

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Yes

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

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I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

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Data Availability

Participants in this study did not give written consent for their data to be made public, so no supporting data is available due to the sensitive nature of the research. Coding examples can be found in the coding frame.

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