ZusammenfassungDie vorliegende Leitlinie S1 fasst den Stand der Kenntnis zu Long COVID zum Zeitpunkt des Redaktionsschlusses zusammen. Aufgund der starken Dynamik der Wissensentwicklung versteht sie sich als „living guideline“. Der Schwerpunkt liegt auf der praktischen Anwendbarkeit auf der Ebene der hausärztlichen Primärversorgung, die als geeignete Stelle für den Erstzutritt und für die primäre Betreuung und Behandlung verstanden wird. Die Leitlinie gibt Empfehlungen zur Differenzialdiagnostik der häufigsten Symptome, die in der Folge einer Infektion mit SARS-CoV‑2 auftreten können, zu therapeutischen Optionen, zu Patient:innenführung und -betreuung, sowie zu Wiedereingliederung in den Alltag, und die Rehabilitation. Entsprechend des Krankheitsbildes ist die Leitlinie in einem interdisziplinären Prozess entstanden und gibt Empfehlungen zu Schnittstellen und Kooperationsmöglichkeiten.

Summary Objective To increase knowledge of discrete symptoms shall help to avoid misinterpretation of test results and to gain better understanding of associations between early symptoms and severe disease to provide additional criteria for targeted early interventions. Design Retrospective observational study. Setting Austrian GP practices in the year 2020, patients above 18 years were included. Participants We recruited 25 practices which included 295 participants with a positive SARS-CoV‑2 test. Main outcome measures Data collection comprised basic demographic data, risk factors and the recording of symptoms at several points in time in the course of the illness. Descriptive analyses for possible associations between demographics and symptoms were conducted by means of cross tabulation. Group differences (hospitalized yes/no) were assessed using Fisher’s exact test. The significance level was set to 0.05; due to the observational character of the study, no adjustment for multiplicity was performed. Results Only one third of patients report symptoms generally understood to be typical for COVID‑19. Most patients presented with unspecific complaints. We found symptoms indicating complicated disease, depending on when they appear. The number of symptoms may be a predictor for the need of hospital care. More than 50% of patients still experience symptoms 14 days after onset. Conclusion Unspecific symptoms are valuable indicators in the detection of early COVID‑19 disease that practitioners and the general public should be aware of also in the interpretation of low sensitivity tests. Monitoring patients using the indicators we identified may help to identify patients who are likely to profit from early intervention.

Background Early detection is essential to control COVID-19. Symptoms are often unspecific. Data collected merely from patients tested according to testing criteria might lead to missing a bulk of spreaders. Knowledge of symptom development during the disease helps to detect complications early. Few data have been collected in primary care so far. Aim To extend knowledge of early symptoms as a precondition of timely diagnosis, isolation and contact tracing. To gain understanding of associations between symptoms and complicated disease to help avoid hospitalization. Design and Settings This study was designed as a retrospective observational study in Austrian GP practices in the year 2020. Methods Patients above 18 years with a positive SARS-CoV-2 test were included. Data collection comprised basic demographic data, risk factors and the recording of symptoms at several points in time during the course of the infection. Further descriptive data analysis was carried out by using the statistical software program R. Results Symptoms clearly typical for COVID-19 are rare. Most symptoms are nonspecific, like malaise, fatigue or joint ache. We found symptoms indicating complicated disease, depending on the time of their occurrence. Anosmia we found to develop only after several days in many cases. At the end of the isolation period many patients still experience symptoms. Conclusion Low threshold contact in GP practices including testing can prevent overlooking early symptoms. Patients may benefit from early monitoring. We recommend a medical check-up at the end of the isolation period.

Of 27 patients undergoing major surgical procedures--mainly orthopaedic ones--we took the temperature, blood sedimentation rate, total white blood cell count, fraction of immature to total neutrophils (I:T proportion) and C-reactive protein. With the exception of the I:T proportion all unspecific indicators of inflammation showed an increase after the operation. Therefore, the I:T proportion is the most reliable parameter for the postoperative control of infections, since it is not subject to surgical trauma.