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- Page navigation anchor for Necessity of accurate diagnosis of COVID-19 in primary careNecessity of accurate diagnosis of COVID-19 in primary care
We would like to take this opportunity to respond to three statements in the eLetter by Ryuichi Ohta1 related to our paper.2
1. “…This research clarified that patients not diagnosed but suspected of COVID-19 tend to have persistent fatigue….”
We now realise that referring to ‘suspected COVID-19’ in our paper might be incorrectly chosen. We selected the term ‘suspected COVID-19’ to be transparent that at the very beginning of the pandemic there was no test capacity in the Netherlands and therefore all patients were included in the study based on a clinical diagnosis of COVID-19.3 In primary care, a clinical diagnosis based on specific symptoms is standard practice for many diseases. All participating GPs are part of a large registration network (FaMe-net) and are therefore experienced in registering morbidity reliably. Although misclassification cannot be completely ruled out, we want to emphasize that all included patients were diagnosed with COVID-19 by GPs using standard best practice clinical criteria.2. “…Considering this study's results, family physicians should diagnose COVID-19 precisely among physically and mentally vulnerable patients not to induce fatigue among them….”
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We believe GPs should always diagnose COVID-19 precisely, not only in vulnerable patients. As highlighted above, all patients included in the study were diag...Competing Interests: None declared. - Page navigation anchor for Necessity of accurate diagnosis of COVID-19 in primary careNecessity of accurate diagnosis of COVID-19 in primary care
I have read, with great surprise, the research titled “Prognostic factors for persistent fatigue after COVID-19: a prospective matched cohort study in primary care.”1 This research clarified that patients not diagnosed but suspected of COVID-19 tend to have persistent fatigue, one of the typical symptoms of long COVID in clinical courses, four times more frequently than those not suspected of COVID-19. The clarified associated factors to fatigue were frequent GP contact, polypharmacy, and frequent life events, showing that physically and mentally vulnerable patients tend to have fatigue when suspected of COVID-19.
Considering this study's results, family physicians should diagnose COVID-19 precisely among physically and mentally vulnerable patients not to induce fatigue among them. Long COVID is not understood clearly based on the pathophysiology and prognosis.2 Mentally vulnerable patients tend to be affected more by medically vague conditions such as Long COVID, causing further mental stress.3 Although the fear of COVID-19 is dispelled, vulnerable patients are informed about possible critical conditions when infected. So, when diagnosed with COVID-19, they may have colossal stress, causing mental imbalance and manifesting the symptoms of fatigue.3 COVID-19 is not a superficial viral infection and has social aspects affecting patients’ mentality. To prevent needless fatigue from suspecting COV...
Competing Interests: None declared.