Long COVID has emerged as a significant public health concern. General practitioners (GPs) are the first point of contact for managing these patients, but data on the related workload remains limited.This study aimed to assess the impact of long COVID on GPs' workload in France over one year and to identify factors associated with higher consultation volumes.We conducted a longitudinal prospective study from June 2023 to May 2024 involving 141 GPs recruited through the French Sentinel network and the National College of General Practitioners. Monthly, GPs reported the number of distinct long COVID patients seen (WHO criteria); the same patient could be reported across multiple months. Multivariate logistic regression analyses identified factors associated with cumulative monthly patients reports at or above the sample mean.GPs reported a mean of 0.72 distinct long COVID patients per month (SD = 1.39), corresponding to a cumulative total of nine over 12 months (used as threshold). Most GPs (77.3%) reported below the threshold; 22.7% at or above. GPs’ self-reported overall workload (three levels) was significantly associated with reporting at or above threshold. Compared with GPs reporting moderate workload, those with strong and very strong self-reported workloads had ORs of 1.18 (95% CI [0.29–5.34]) and 5.65 (95% CI [1.31–30.2], p = 0.017), respectively. GPs comfortable managing anxiety/depressive were less likely to report at or above threshold (OR = 0.18, 95% CI [0.03-0.88], p = 0.033). Higher patient volumes trended toward access to dedicated resources (OR = 3.03, 95% CI [1.00-10.2], p = 0.051).The low observed workload contrasts with international (30–51%) and French (4–8%), prevalence estimates, potentially reflecting definition or methodological differences between studies. The negative association between managing anxiety/depression comfortably and the number of long COVID cases is likely explained by GPs attributing overlapping symptoms to anxiety or depression rather than retaining a long COVID diagnosis.Long COVID represents a low workload for French GPs. The negative association between confidence in managing anxiety/depression and long COVID patient volumes warrants further investigation to understand how GPs conceptualize and diagnose this complex condition.

Fixed drug eruption (FDE) is a type IV hypersensitivity reaction characterised by well-demarcated erythematous macules or plaques that recur at the same site after re-exposure to the causative drug. It accounts for 2.5–22% of cutaneous adverse drug reactions, with rising incidence due to increased drug use and awareness. FDE affects all ages and both sexes, most commonly adults aged 20–40 years. Typical triggers include antibiotics, non-steroidal anti-inflammatory drugs, and paracetamol. Lesions usually appear within 48–72 hours after exposure and often resolve with residual hyperpigmentation. Diagnosis is mainly clinical and may be supported by skin biopsy. Management includes discontinuation of the offending drug and topical corticosteroids.A 55-year-old overweight man with type 2 diabetes developed malaise, myalgia, respiratory symptoms, and fever. He tested positive for COVID-19 and was treated with nirmatrelvir 300 mg plus ritonavir 100 mg twice daily for five days, with rapid improvement. Twelve days after starting treatment, he noticed a ring-shaped erythema in the right groin. .Suspected Lyme disease was treated with azithromycin without effect, and the lesion enlarged and darkened. Antifungal therapy was also ineffective. Laboratory tests were normal and there was no systemic involvement. Dermatological assessment suggested FDE. Skin biopsy showed interface dermatitis with apoptotic keratinocytes, sparse eosinophils, and post-inflammatory hyperpigmentation, confirming the diagnosis. Treatment with topical betamethasone led to gradual fading over several months, with persistent hyperpigmentation.Nirmatrelvir/ritonavir is widely used in patients at risk of severe COVID-19. Reported adverse effects are mostly mild, while cutaneous reactions are uncommon. Re-exposure to the causative drug should be avoided, as recurrence may be more severe and progress to generalised bullous FDE.As use of this therapy continues, awareness of possible cutaneous adverse reactions is essential for early recognition and prevention of serious complications.

The COVID-19 pandemic significantly disrupted primary care organization, prompting innovative responses such as the establishment of numerous ambulatory COVID-19 consultation centers in the Yvelines department, France. These centers enabled real-time epidemiological work by centralizing clinical data, addressing the increasing need for primary care data to inform healthcare improvements. Among the scientific debates sparked by the pandemic, the role of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs)—common first-line antihypertensive treatments—in COVID-19 progression has been particularly contentious. Since the ACE2 receptor serves as the entry point for SARS-CoV-2, and its expression is altered by these medications, their potential impact on disease severity has been closely examined.This study aimed to assess whether exposure to ACEIs or ARBs in outpatient COVID-19 care in Trappes (Yvelines, France) influenced the risk of developing severe disease requiring hospitalization.The research included 296 adult patients with positive PCR tests who consulted at the Trappes COVID-19 center. Data were collected via physician-completed questionnaires and medical record reviews. Univariate and multivariate logistic analyses were performed to evaluate the risk of hospital referral47 patients were treated with renin-angiotensin-aldosterone system (RAAS) inhibitors. These patients were older and had more comorbidities. Statistical analysis revealed a significant association between RAAS inhibitor use and increased risk of hospitalization (OR = 1.17 [1.03–1.34]).While this study highlights long-term ACEI/ARB treatment as a risk marker for hospitalization among COVID-19 patients, the finding may reflect underlying comorbidities or local socio-economic factors rather than a direct drug effect. Previous meta-analyses have not confirmed a harmful impact of these treatments on COVID-19 outcomes. Limitations include potential biases from questionnaire-based data collection and lack of systematic follow-up. Conducted during the first two pandemic waves, the results may not apply to current, less virulent SARS-CoV-2 variantsThis research underscores the value of regional primary care databases for identifying population-specific risk factors. Routine data collection could enable general practitioners to better identify at-risk patients and tailor their care, potentially adjusting treatments at the local or regional level as needed.

The overprescribing of antibiotics in acute lung disease is considered a global health problem because it is a major driver of antimicrobial resistance (AMR), which leads to increased morbidity, mortality, and healthcare costs worldwide. Lung ultrasound(LUS) demonstrates high diagnostic accuracy in the assessment of patients with acute respiratory disease.  For pneumonia, pooled meta-analyses report sensitivity ranging from 88% to 95% and specificity from 94% to 98% when compared to chest radiography or CT. In the emergency setting, lung ultrasound outperforms chest radiography in sensitivity while maintaining similar specificity. A doctor can become competent at performing LUS assessment for the diagnosis of pneumonia after a focused training program consisting of 2 to 5 hours of didactic and hands-on instruction, followed by 20–25 supervised examinations.Review of current published literatureSeveral key lessons emerge  First, lung ultrasound is a highly accurate, rapid, and noninvasive diagnostic tool  Second, overprescribing antibiotics for acute lung disease is driven by diagnostic uncertainty and patient expectations, especially in primary careLung ultrasound reduces diagnostic uncertainty. The diagnostic accuracy is achievable by family physicians after focused, practical training, with competence improving further with ongoing practice and feedback. There is a need to train family doctors in the use of LUS. This is likely to have a significant positive impact in reducing inappropriate use of antibiotic prescribing which in turn will slow down antibiotic resistance. Healthcare systems would benefit from potential cost savings and improved equity. However this would require investment in education, equipment, and quality assurance infrastructure.The successful implementation of LUS in primary care requires tailored, longitudinal training programs, ongoing mentorship, and system-level support to overcome barriers such as equipment access, supervision, and workflow integration. When these are addressed, family doctors report increased confidence, skill, and frequency of LUS use, with positive impact on clinical decision-making and resource utilization.

The global cumulative incidence of Post-COVID-19 condition, or long COVID, is estimated at 409 million individuals, with a persistent prevalence ranging between 6% and 7% of adults.  Its symptoms, numerous and unspecific, undoubtedly impact the quality of life of those affected. Many factors have been associated with poorer recovery (e.g. smoking, obesity). Factors associated with a better quality of life have been little studied.To identify healthcare utilization profiles associated with a better quality of life among members of the "Tous Partenaires COVID" a large audience national association of patients with long COVID.A self-administered online questionnaire was sent to the members of the association. The questionnaire included the criteria of the WHO definition of long COVID. It focused on the current health status felt by the participants using the standardized EQ-5D-5L scale, and listed a panel of interventions (e.g. rehabilitation program), social support (e.g. support from relatives) and life changes (e.g. workstation adjustment) that were perceived (or not) as helpful by the subjects interviewed. Comorbidities before COVID-19, the period of onset of the acute infection and the notion of vaccination against SARS-CoV-2 were also recorded.Four profiles of healthcare utilization were identified among patients with long COVID: complex care involving several specialists and rehabilitation, specialized medical care without rehabilitation, follow-up by general practitioner alone, and minimal use of the conventional medical system. Patients without conventional medical follow-up and those followed only by a general practitioner reported a higher perceived quality of life. Conversely, patients receiving more complex care displayed lower quality of life scores, suggesting that sophisticated medical care does not always correlate with perceived health improvement.These paradoxical results could be due to a causal bias, with the most disabled and distressed subjects receiving complex care and the least symptomatic subjects receiving lighter care. But they also raise questions about the potentially iatrogenic impact of healthcare system utilization in the context of “medically unexplained” somatic symptoms, which may contribute to their reinforcement and persistence.Access to ultra-specialized healthcare services may not be correlated with a better quality of life.

The SARS-CoV-2 pandemic has drawn attention to its potential neurocognitive sequelae, with evidence suggesting post-infectious impairments in memory, attention, and executive functions. However, community-based data in Primary Care remain limited. This study explores whether a history of COVID-19 is associated with cognitive decline and which sociodemographic factors influence cognitive performance.To identify cognitive differences between patients with and without prior COVID-19 infection, evaluate the influence of age, sex, and educational level, and determine which cognitive domains are most affected in the post-pandemic period.A cross-sectional observational study was conducted during 2024–2025 at XXXXXXXXXXXXX. The self-administered SAGE questionnaire was applied to 380 patients aged ≥14 years. Sociodemographic variables, history of COVID-19, hospitalization, and ICU stay were analyzed. A SAGE score <17 points was considered indicative of cognitive impairment.The mean SAGE score was 18.4 ± 3.9. The overall prevalence of cognitive impairment (SAGE < 17) was 22.9%. There was no significant association between prior COVID-19 infection and global cognitive impairment (p = 0.409). Lower scores were strongly associated with older age (≥60 years; p<0.001) and low educational level (p<0.001), while sex showed no significant effect. The “money” subtest, which assesses simple calculations and functional reasoning, showed a modest but significant difference (p = 0.021).These findings suggest that age and education remain the strongest determinants of cognitive performance, while the impact of COVID-19 infection itself appears minimal in community-dwelling individuals. The slight difference in financial-calculation performance may reflect specific-domain cognitive reserve rather than a direct viral effect. These results are consistent with large community cohorts reporting limited long-term cognitive effects after mild COVID-19.In this Primary Care sample, no direct cognitive impact of prior SARS-CoV-2 infection was found. Older age and lower education were confirmed as key predictors of cognitive decline. The SAGE test proved useful and sensitive for detecting subtle cognitive changes and is recommended for routine screening in vulnerable populations.