Most patients with COVID19 have milder disease and are treated outside hospitals. In the CovidNor project, we have investigated the symptoms, complaints and concerns of patients treated in primary health care, and we have explored how GPs and municipal doctors handle the pandemic.
The CovidNor project was divided into three work packages:
1. Through an online survey, we have collected information on symptoms, follow-up and concerns of people in isolation or quarantine. The study period was from March/April 2020 through June 2021. Results will be presented in scientific papers and scientific oral forums in the near future. Subsequent record linkage of this information with data from various health registries may disclose predictors for developing a more serious disease as well as to detect possible complications and long-term effects of COVID19.
2. Through the research network PraksisNett, we have collected information through GPs on how patients with respiratory tract infection are seen, examined, treated and followed up during the pandemic. A scientific paper is currently being prepared.
3. We have performed in-depth interviews with GPs, head physicians for municipal out-of-hours units (OoH-leaders) and municipal chief medical officers in Norway and infection control personnel in Sweden about how the pandemic was handled. We have paid particular interested in the collaboration between GPs and the municipality, management, communication and distribution of tasks, and adaptation to a situation characterized by rapid change. This has been, and is still, extensive work, and the first scientific paper is expected published in a short while, and futher data material is being analyzed.
The survey data from Covid-19 patients and people in quarantine outside hospitals, will give better knowledge of the presentation and natural history of mild to moderate COVID-19 cases as well as provide insight to the concerns and feeling of safety during the pandemic in Norway. Linking patient trajectories with national health registries might reveal possible risk factors for developing a more severe disease as well as it may disclose possible later complications to the disease. Experiences from health care professionals in primary care on how they adapted to the situation, might aid responses to possible future outbreaks, as well as provide insights when evaluating collaboration between health authorities and municipalities during the pandemic.
The results of this project will aid future patients with Covid-19 to better understand their symptoms and risks, as well as aiding primary care health workers diagnosing and treating these patients. The understanding of the response by health officers in municipalities will help preparing and organizing responses to future epidemics.
Current research on the clinical manifestations of COVID-19 have been mainly based on hospitalized patients. However, most infections are not severe and a majority of COVID-19 patients are diagnosed and handled in primary care.
The overall project objective is to understand the clinical picture of early, mild to moderate forms of the disease and fears and experience of safeguarding among people personally affected by COVID-19 outside hospitals, as well as the response of the local medical teams in primary health care and the supporting health care system response including infection prevention and control.
Through a web-based survey, we will invite people in isolation/quarantine at home to report symptoms and personal experiences and emotions throughout the course of the illness and/or period in isolation/quarantine. The survey results will be linked to registry follow-up to detect complications and long-term effects of COVID-19. We will invite general practitioners (GPs) to record case information of patients with respiratory tract infections during six weeks of the epidemic to provide clinical information of patients presenting to primary care. In-depth interview studies from a primary care perspective of GPs, leaders of municipal out-of-hours units and municipality chief medical officers will provide insight into how health care workers in Norwegian and Swedish primary care handle the epidemic. We want to focus in particular on their experiences of the local health care system responses including infection control.
The clinical observational data of cases outside hospitals, both self-reported data and reported by GPs, will provide knowledge of the natural history of mild to moderate COVID-19 cases. This may help clinicians and health authorities in better identifying patients with COVID-19. The interview studies will provide valuable information regarding the infection control response during the epidemic as experienced from primary care and municipalities.