ArticleScandinavian journal of primary health care2026
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.
Article in Scandinavian journal of primary health care, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundWomen are disproportionately diagnosed with symptom-based conditions, notably post-COVID condition (PCC). In Sweden, as of February 2022, 2.3% of PCR-verified female COVID-19 cases versus 1.6% of male cases had a PCC diagnosis. Post-viral fatigue syndrome (PVFS) and exhaustion disorder (ED), a common and relevant diagnosis in Sweden, share substantial symptom overlap with PCC.
aimsTo quantify the association between pre-pandemic, symptom-based primary-care visits and subsequent PCC, PVFS, and ED among adult women, adjusting for risk factors for severe COVID-19.
methodsWe conducted a registry-based prospective cohort study of 208,050 women from the Swedish Medical Birth Register, linked to primary-care data and national sociodemographic registers. The exposure was the frequency of visits for predefined symptom-based conditions during 2015-2019. Adjusted odds ratios (ORs) for diagnoses in 2020-2024 were estimated using logistic regression controlling for BMI, education, age, and region of birth.
resultsAcross 2,431,182 primary-care physician visits, 19% were symptom-based. Women with >8 such visits had higher odds of all three outcomes: PCC (OR 5.45, 95% CI 4.43-6.71), PVFS (OR 7.71, 95% CI 5.97-9.96), and ED (OR 5.32, 95% CI 4.84-5.85). Pre-pandemic BMI and education were not associated with PCC or PVFS but showed some association with ED. Still, 17% of women with PCC had no recorded symptom-based visits before the pandemic.
conclusionsPre-pandemic symptom-based primary-care visits were strongly associated with higher risk of PCC, PVFS, and ED in a dose-dependent way, but modest discrimination underscores heterogeneous individual risk. Patterns suggest other influences alongside biological susceptibility.
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