Pre-pandemic health patterns influence risk of developing post-COVID

Women who frequently sought healthcare for recurring symptoms before the pandemic were more likely to later be diagnosed with post-COVID, according to a thesis at the University of Gothenburg.

One of the sub-studies in the thesis includes just over 200,000 Swedish women. The researchers analyzed the women's visits to primary care in the years before the pandemic and compared them with those who later received diagnoses such as post-COVID, long-term fatigue after viral infection or fatigue syndrome.

The analyzed healthcare visits before the pandemic concerned symptoms such as fatigue, pain, dizziness or other physical complaints where a clear diagnosis could not always be established at the visit.

Five times as likely

The results show that the more such care visits the women had before the pandemic, the greater the likelihood of later receiving one of the diagnoses. Women with more than eight such care visits before the pandemic were more than five times as likely to later receive a diagnosis of post-covid or fatigue syndrome compared to women without such visits.

Post-COVID is often described as a direct consequence of the infection. Our results show that there may also be a longer background of illness and care seeking that plays a role in who later receives the diagnosis."

Agnes af Geijerstam, physician and PhD in community medicine and public health, University of Gothenburg

At the same time, the study shows that approximately one fifth of the women who were diagnosed with post-COVID had not had any such care visits before the pandemic. This suggests that several different factors may contribute to the development and diagnosis of the disease.

Broad picture of COVID

The study is based on Swedish national health registers and follows women's healthcare contacts over time. Agnes af Geijerstam's thesis, which includes the study, provides a broader picture of different factors during different stages of life that can affect the risk of infection, severe illness and diagnosis during the Covid-19 pandemic. 

– The pandemic did not affect everyone equally. Our studies show that both biological, psychological and social factors during life are linked to how people were affected by COVID-19, says Agnes af Geijerstam.