Post Covid-19 Condition as a Diagnosis: A Qualitative Study on Epistemological Tensions Among Experts in Sweden

Background

At the onset of the Covid-19 pandemic, it became clear that some individuals experienced lingering symptoms after the infection. This condition, known as post Covid-19 condition (or long Covid), is defined by WHO as persistent or new symptoms 3 months after the initial infection, lasting for at least 2 months, and not attributable to another diagnosis. Hence, the definition is very broad.

Aim

This study aims to examine how post Covid-19 condition as a diagnosis is viewed and interpreted by Swedish stakeholders, showing how these understandings carry a range of epistemological tensions. The study also seeks to understand the implications of these epistemological tensions for treatment and care organisation.

Methods

Qualitative interviews with 36 experts and key individuals in Sweden have been conducted.

Result

Experts agree that post Covid-19 condition is a complex syndrome and that persons who suffer are in need of care. However, several tensions in post Covid-19 condition as a diagnosis can be discerned. Most experts agreed on the gender and racial disparity where white women with Swedish background were a majority of post Covid-19 sufferers, while migrant patients and the elderly are largely absent. In relation to social categories, the question if children can have post Covid-19 condition is here a highly contested question. There is also disagreement on the aetiology of post Covid-19 condition, with some experts viewing it as a new, unique condition requiring specialised treatment, while others see it as similar to other post-viral conditions, treatable in primary care.

Conclusion

The article concludes that experts are divided in their understanding and that this affects Swedish policy on post Covid-19 care and treatment, showing that post Covid-19 condition is not only a medical issue but also a political battleground where science, expert opinion and patient experience shape policy.

Patient and Public Contribution

The article focuses on studying stakeholders' perspectives as these are key for informing public opinion and policy. In this article, all main organisations and authorities involved in post Covid-19 care are represented. We also see patients as crucial stakeholders and representatives of patient organisations, as well as representatives of some migrant communities, who have been interviewed. The latter were included to gain insights from groups that were largely absent in post Covid-19 care.