HMN 2026: How Pre-pandemic symptom visits are linked to higher odds of post-COVID,

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Credit: Ron Lach from Pexels

Women who frequently sought health care for recurring symptoms before the pandemic were more likely to later be diagnosed with post-COVID, according to a thesis from the University of Gothenburg. One of the sub-studies in the thesis by Agnes af Geijerstam 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 health care 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. A concurrently published article, “Pre-pandemic care-seeking patterns and subsequent diagnoses of post-COVID condition, post-viral fatigue syndrome, and exhaustion disorder: a registry-based cohort study of 208,050 Swedish women” appeared in the Scandinavian Journal of Primary Health Care.

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,” says Geijerstam, physician and Ph.D. 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 health care contacts over time. 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 Geijerstam.

More information

Agnes af Geijerstam et al, Pre-pandemic care-seeking patterns and subsequent diagnoses of post-COVID condition, post viral fatigue syndrome, and exhaustion disorder: a registry-based cohort study of 208,050 Swedish women, Scandinavian Journal of Primary Health Care (2026). DOI: 10.1080/02813432.2025.2611886

Key medical concepts

Myalgic Encephalomyelitis/Chronic Fatigue Syndrome


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