JMIR Publications

Background:

Real time access to guidance for physicians has been offered through Rapid Access to Consultative Expertise (RACE) in British Columbia (BC) for the past 12 years. In the context of the novel coronavirus (COVID-19), the service for RACE was expanded to include a Long-COVID RACE line. This is answered by a dedicated group of General Internal Medicine (GIM) Specialists with an interest and experience with acute and chronic COVID. The guidance provided by the Internal Medicine physicians includes diagnostic investigations, management, and navigation of these complex patients.

Objective:

We report here the types and frequencies of questions asked to GIM experts in Long-COVID, by general practitioners in BC. This analysis enables the identification of trends in patient presentations, primary care practitioner concerns, and related questions. This data informs on the development of education, tools, and care plans which improves the quality of care and long-term support for COVID-19 patients and their health care providers.

Methods:

149 RACE line call medical notes, from its launch in August 2020 to June 2021, were reviewed to extract data regarding the variables of interest: patient demographics (age, sex, region) and types of queries related to COVID-19 (acute symptoms, subacute symptoms, chronic symptoms, vaccination inquiries, miscellaneous questions). This data was tabulated for analysis.

Results:

The data indicates the most common age group of RACE line patients as being between the ages 40-49 years old. Females made up 63.6% of patients, while males made up 36.4%. The most frequent geographic locations for the RACE line patient’s healthcare providers were in the Greater Vancouver and Fraser Valley region. The data demonstrates that subacute (2-12 weeks following diagnosis) symptoms (52) and vaccination queries (29) were the most common RACE line call matters. A larger frequency of RACE line calls to the COVID-GIM-Post-Infection division occurred between the January 2021 - March 2021 (60) and April 2021 – June 2021 (62) time periods, in comparison to the earlier August 2020 – December 2020 period (27) studied. Questions about specific symptoms varied by time post-infection, but the most frequent symptoms across time periods included shortness of breath, cough, and fatigue.

Conclusions:

This study investigated the COVID-GIM-Post-Infection Care RACE line calls between August 2020 and June 2021, revealing many trends in data. These calls mainly involved consults regarding the post-infection COVID-19 symptoms being experienced by PCPs’ patients. Respiratory symptoms were the leading type of symptoms reported, with shortness of breath, cough, fatigue, and fevers being the most common, respectively. This data will be used to inform future resource utilization and provide insights on the usage of the Long-COVID RACE line. Moving forward, RACE calls can be monitored in situations of emerging diseases to better inform and educate community physicians to common complaints that patients are presenting with.