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With long COVID estimated to impact 5–10% of Australians infected by the SARS-CoV-2 virus, it is vital to monitor the incidence and effects of long COVID, leading to better support for patients and general practice.
General practice services are likely to be the primary contact point for individuals experiencing the post-infectious sequelae known as long COVID. These services are also likely to play a critical role in Australia’s response to long COVID, helping to identify and monitor health trends while providing an early warning system of increasing incidence. General practitioners (GPs) are also suppliers of key health care advice to their patients to protect the health of the community.
Long COVID refers to a condition where a person experiences symptoms or develops new health problems after the acute phase of SARS-CoV-2 infection. Long COVID has multisystemic symptoms, including respiratory (shortness of breath, cough), cardiovascular (chest pain, myocarditis, tachycardia), neurological (fatigue, brain fog, dizziness), gastrointestinal (abdominal pain, nausea), and more.
As pointed out by a recent National Academies of Sciences, Engineering and Medicine report from the US (2024), long COVID can affect children and adults, irrespective of the person’s health, ability/disability, socio-economic status, age, sex, ethnicity, or geographic residence.
To date, understanding of long COVID has been hindered by the absence of a widely accepted definition that can be used to deliver consistent tracking, documentation, diagnosis and enhance the accessibility and provision of appropriate services.
People living with long COVID (particularly those with comorbid conditions, socio-economically disadvantaged groups, or based in rural/remote areas) may not recognise or report their symptoms or may not have adequate access to health care. This can result in under-reporting and an inaccurate estimate of the prevalence of long COVID and subsequent population, health system and economic impacts.
There is also concern about the potential overestimation of the prevalence of long COVID due to the broadness and inconsistency of definitions and insufficient methodological rigour, including lack of, or inadequate, control groups.
To date, most evidence about long COVID has come from research undertaken outside of Australia, particularly in the US and UK. In 2022, an Australian Institute of Health and Welfare investigation of the scale and impact of long COVID estimated that around 5 to 10% of COVID-19 cases in Australia reported symptoms for more than three months. But even this estimate may be conservative because of the lack of available data sources to monitor the incidence and effects of long COVID in Australia.
We undertook a retrospective observational case–control study using electronic de-identified general practice data from March 2018 to March 2023 (published in the Medical Journal of Australia). Our study contained over 7 million patient records covering approximately 60% and 43% of the Victorian and New South Wales populations, respectively, across 869 general practice clinics from four primary health networks — two in NSW and two in Victoria. Our study identified a cohort of GP-led long COVID diagnoses using electronic records. We contrasted this with a comparison cohort made up of all records between January 2020 and March 2023 without a documented history of COVID-19 infection or GP-led long COVID diagnosis.
We found that female patients were more likely to be diagnosed with long COVID than male patients. Patients diagnosed with long COVID were likely to be older, between 40 and 59 years, and residing in high socio-economic areas. Pre-existing conditions such as mental health, respiratory conditions (such as asthma or emphysema), cancer or musculoskeletal conditions (such as arthritis) were also likely to be present. Of the individuals diagnosed with long COVID in the study, 29% had a previously diagnosed mental health condition, 20% had a respiratory condition, and 17.8% had a musculoskeletal condition.
General practice clinical data (in secure de-identified form) can help to inform and monitor conditions and changes associated with long COVID over time. General practice thus has an important role to play in helping to coordinate and integrate care across multiple disciplines and clinical care settings.
Read the research in the Medical Journal of Australia
Professor Andrew Georgiou is a health informatics researcher with a strong international research profile in the areas of outcome measurement, aged care informatics, quality and safety, diagnostic informatics and organisational communications research.
Dr Mirela Prgomet is a Senior Research Fellow and health services researcher focusing on the evaluation of the impact of digital health technologies on the efficiency, effectiveness and safety of clinical work practices and patient care.
Dr Judith Thomas is a Research Fellow and health services researcher in diagnostics informatics focusing on test results management, quality, safety and workflows.
The statements or opinions expressed in this article reflect the views of the authors and do not necessarily represent the official policy of the AMA, the MJA or InSight+ unless so stated.
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