Frontiers in medicine · 2026
Long-term health effects of COVID-19 among patients in Croatian primary care settings.
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Popović Branislava, Lesac Brizić Ana, Ljubotina Aleksandar, Zavidić Tina, Tudor Špalj Vedrana, Marković Štimac Roberta, Fišić Jurković Martina, Bašić Marković Nina, Diminić Lisica Ines, Vučak Jasna, Radošević Quadranti Nives
Аннотация
INTRODUCTION: The COVID-19 pandemic has left lasting effects that extend beyond the acute phase of infection, with increasing evidence of long-term health consequences. This study aimed to assess the prevalence of post-COVID symptoms and conditions and to identify associated risk factors, including pre-existing chronic diseases, COVID-19 vaccination status, and severity of acute infection.
METHODS: This retrospective cross-sectional study was conducted in 10 family medicine practices in Croatia. The data collected from medical records included demographics, COVID-19 vaccination status, SARS-CoV-2 infection history and severity, and documented health conditions before and after infection. Descriptive statistics were used to summarize the data. Group differences were analyzed using the independent samples t-test or χ2 test. Variables significant in univariate analyses (p < 0.05) were included into multivariate regression models. Multiple linear regression was used to identify predictors of COVID-19 severity, and binary logistic regression was applied to determine factors associated with post-COVID conditions. Results are presented as regression coefficients (β) or odds ratios (OR) with 95% confidence intervals (CI). A p-value < 0.05 was considered statistically significant.
RESULTS: The study included 1,423 participants (58.0% female; mean age 52.6 ± 17.2 years), of whom 82.4% had confirmed SARS-CoV-2 infection and 32.3% were unvaccinated. At least one chronic disease was present in 28.1% of participants. The most frequently reported post-COVID conditions were brain fog (4.9%), neurological disorders (4.7%), cardiovascular diseases (2.9%), shortness of breath (2.8%), obesity (2.7%) and mental health disorders (2.6%). Greater COVID-19 severity was independently associated with pulmonary disease (β = 0.22; p = 0.031) and older age, particularly 51-65 years (β = 0.31; p < 0.001) and ≥66 years (β = 0.50; p < 0.001). COVID-19 vaccination was associated with milder disease (β = -0.21; p < 0.001). Previous cardiovascular and musculoskeletal diseases significantly increased the risk of thromboembolism. Diabetes, obesity, and number of vaccine doses were predictors of brain fog, while neurological comorbidities predicted post-COVID mental health disorders.
CONCLUSION: Post-COVID symptoms and conditions represent an important long-term public health challenge. Family medicine physicians play a key role in early recognition, monitoring, and management of post-COVID sequelae, contributing to improved long-term patient outcomes.
METHODS: This retrospective cross-sectional study was conducted in 10 family medicine practices in Croatia. The data collected from medical records included demographics, COVID-19 vaccination status, SARS-CoV-2 infection history and severity, and documented health conditions before and after infection. Descriptive statistics were used to summarize the data. Group differences were analyzed using the independent samples t-test or χ2 test. Variables significant in univariate analyses (p < 0.05) were included into multivariate regression models. Multiple linear regression was used to identify predictors of COVID-19 severity, and binary logistic regression was applied to determine factors associated with post-COVID conditions. Results are presented as regression coefficients (β) or odds ratios (OR) with 95% confidence intervals (CI). A p-value < 0.05 was considered statistically significant.
RESULTS: The study included 1,423 participants (58.0% female; mean age 52.6 ± 17.2 years), of whom 82.4% had confirmed SARS-CoV-2 infection and 32.3% were unvaccinated. At least one chronic disease was present in 28.1% of participants. The most frequently reported post-COVID conditions were brain fog (4.9%), neurological disorders (4.7%), cardiovascular diseases (2.9%), shortness of breath (2.8%), obesity (2.7%) and mental health disorders (2.6%). Greater COVID-19 severity was independently associated with pulmonary disease (β = 0.22; p = 0.031) and older age, particularly 51-65 years (β = 0.31; p < 0.001) and ≥66 years (β = 0.50; p < 0.001). COVID-19 vaccination was associated with milder disease (β = -0.21; p < 0.001). Previous cardiovascular and musculoskeletal diseases significantly increased the risk of thromboembolism. Diabetes, obesity, and number of vaccine doses were predictors of brain fog, while neurological comorbidities predicted post-COVID mental health disorders.
CONCLUSION: Post-COVID symptoms and conditions represent an important long-term public health challenge. Family medicine physicians play a key role in early recognition, monitoring, and management of post-COVID sequelae, contributing to improved long-term patient outcomes.