BACKGROUND: The COVID-19 pandemic has underlined the essential role of primary healthcare (PHC) in epidemiological surveillance and public health decision-making. Across Europe, the integration of electronic health records (EHRs) and the sentinel networks have been pivotal in monitoring COVID-19. However, the lack of standardized PHC indicators for COVID-19 hinders the comparability of data among countries. OBJECTIVE: To establish a consensus on a set of standardized PHC activity indicators related to the COVID-19 pandemic for 31 countries, enhancing the capability of health authorities to make informed decisions and prepare for future health crises. METHODS: A two-round eDelphi study was conducted using a structured web-based survey, following the CREDES guidelines, to achieve consensus among a panel of 164 experts from the Eurodata study. 86 Indicators were selected based on their availability during the current pandemic, with participants rating the relevance and utility of proposed indicators. RESULTS: Of the 22 initial indicators, seven received consensuses for inclusion, while two remained contentious after the second round. The study found significant discrepancies in the awareness of sentinel networks and accessibility to PHC data. The consensus emphasized the necessity for indicators to be standardized, reproducible, and easily extractable from databases, with recommendations for disaggregation by age, sex, and vaccination status. CONCLUSION: Key COVID-19 indicators for PHC were identified, reflecting a consensus among healthcare professionals. Further cooperation between PHC providers and national public health authorities is warranted both on the national and the international level to harmonized healthcare indicators in response to future health emergencies.

Aragones Health Service Patient Safety Working Party of semFYC Board Member of WONCA World Barcelona Spain

Center for Family Medicine Medical Faculty Skopje Skopje North Macedonia

Chair of General Practice 2 and Patient Centredness in Primary Care Institute of General Practice and Primary Care Faculty of Health Witten Herdecke University Witten Germany

CHNP Rehaklinik Ettelbruck Luxembourg

Comprehensive Health Research Center NOVA Medical School Universidade Nova de Lisboa Lisbon Portugal

Department of Behavioural and Cognitive Sciences Faculty of Humanities Education and Social Sciences Luxembourg University Esch sur Alzette Luxembourg

Department of Biomedical Metabolic and Neural Sciences University of Modena and Reggio Emilia Modena Italy

Department of Clinical Sciences in Malmö Centre for Primary Health Care Research Lund University Malmö Sweden

Department of Epidemiology and Public Health Health Services Research Sciensano Brussels Belgium

Department of Family Medicine and Outpatient Care Medical Faculty 2 Uzhhorod National University Uzhhorod Ukraine

Department of Family Medicine Andrija Stampar School of Public Health School of Medicine University of Zagreb Health Centre Zagreb West Zagreb Croatia

Department of Family Medicine Andrzej Frycz Modrzewski Krakow University Krakow Poland

Department of Family Medicine Care and Public Health Research Institute Maastricht University Maastricht The Netherlands

Department of Family Medicine Faculty of Medical and Health Sciences Tel Aviv University Tel Aviv Israel

Department of Family Medicine Faculty of Medicine University of Ljubljana Ljubljana Slovenia

Department of Family Medicine Semmelweis University Budapest Hungary

Department of Family Medicine Uniwersytet Jagielloński Collegium Medicum Kraków Poland

Department of General Practice University of Lille UFR3S Lille France

Department of Medical Psychology OE 5430 Hannover Medical School Hanover Germany

Department of Medical Sciences Academy of Applied Studies Polytechnic Belgrade Serbia

Department of Postgraduate Medical Education and Czech Society of General Practice Prague Czech Republic

Department of Primary Care and Public Health Imperial College London London UK

Department of Primary Care Medicine Medical University of Vienna Vienna Austria

Department of Public Health and Primary Care KU Leuven Leuven Belgium

Department of Public Health Institute of General Medical Practice Aarhus University Aarhus Denmark

Department of Public Health Institute of Health Sciences Faculty of Medicine Vilnius University Vilnius Lithuania

Department of Urology and General Practice Faculty of Medicine Medical University of Plovdiv Plovdiv Bulgaria

Faculty of Medicine of the University of Porto Porto Portugal

Faculty of Medicine Ss Cyril and Methodius University Skopje North Macedonia

Federica Montseny Health Centre Gerencia Asistencial de Atención Primaria Servicio Madrileño de Salud Madrid Spain

Fundación de Investigación e Innovación Biosanitaria de Atención Primaria Spain

Health Center Dr Đorđe Kovačević Lazarevac Belgrade Serbia

Health Center Krupa na Uni Bosnia and Herzegovina Republic of Srpska

Health Centre Zagreb Centar Zagreb Croatia

Health Service of Aragon GIIS011 Instituto de Investigación Sanitaria de Aragón Zaragoza Spain

Home Health Services Unit Egil District State Hospital Diyarbakir Turkey

Homecare Unit Van Gürpınar District Hospital Gürpınar Van Turkey

Institute of General Practice and Family Medicine Martin Luther University Halle Wittenberg Halle Saale Germany

Instituto de Investigación Sanitaria Gregorio Marañón Madrid Spain

Investigation Support Multidisciplinary Unit for Primary Care and Community North Area of Madrid Gerencia Asistencial Atención Primaria Servicio Madrileño de Salud Madrid Spain

Member of Irish College of General Practice Dublin Ireland

Member of Royal College of Physician Dublin Ireland

Portfolio GP Handsworth Medical Practice Birmingham UK

Primary Health Care Centre in Ekholmen and Department of Health Medicine and Caring Sciences Linköping University Linköping Sweden

QiSP Tar Research Group Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut IDIAP Jordi Gol Barcelona Spain

Research Group Self Regulation and Health Institute for Health and Behaviour Luxembourg Luxembourg

Research Network on Chronicity Primary Care and Health Promotion RICAPPS Spain

Research Unit for General Medicine and Primary Health Care Faculty of Medicine School of Health Science University of Ioannina Ioannina Greece

School of Social Sciences Hellenic Open University Patra Greece

Spiru Haret University Bucharest Romania

Universidad Miguel Hernández Elche Spain

Universitas Health Centre Zaragoza Spain

USF das Conchas Regional Health Administration Lisbon and Tagus Valley Lisbon Portugal

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