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Severity, predictors and clinical correlates of Post-COVID syndrome (PCS) in Germany: A prospective, multi-centre, population-based cohort study.
Bahmer, Thomas; Borzikowsky, Christoph; Lieb, Wolfgang; Horn, Anna; Krist, Lilian; Fricke, Julia; Scheibenbogen, Carmen; Rabe, Klaus F; Maetzler, Walter; Maetzler, Corina; Laudien, Martin; Frank, Derk; Ballhausen, Sabrina; Hermes, Anne; Miljukov, Olga; Haeusler, Karl Georg; Mokhtari, Nour Eddine El; Witzenrath, Martin; Vehreschild, Jörg Janne; Krefting, Dagmar; Pape, Daniel; Montellano, Felipe A; Kohls, Mirjam; Morbach, Caroline; Störk, Stefan; Reese, Jens-Peter; Keil, Thomas; Heuschmann, Peter; Krawczak, Michael; Schreiber, Stefan.
Affiliation
  • Bahmer T; Internal Medicine Department I, University Medical Center Schleswig-Holstein Campus Kiel, Arnold-Heller-Straße 3, 24105 Kiel, Germany.
  • Borzikowsky C; Airway Research Center North (ARCN), German Center for Lung Research (DZL), Wöhrendamm 80, 22927 Großhansdorf, Germany.
  • Lieb W; Institute of Medical Informatics and Statistics, Kiel University, University Medical Center Schleswig-Holstein, Brunswiker Straße 10, 24105 Kiel, Germany.
  • Horn A; Institute of Epidemiology, Kiel University, University Medical Center Schleswig-Holstein, Niemannsweg 11, 24105 Kiel, Germany.
  • Krist L; Institute of Clinical Epidemiology and Biometry, University of Würzburg, Josef-Schneider-Straße 2, 97080 Würzburg, Germany.
  • Fricke J; Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Luisenstr. 57, 10117 Berlin, Germany.
  • Scheibenbogen C; Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Luisenstr. 57, 10117 Berlin, Germany.
  • Rabe KF; Institute of Medical Immunology, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany.
  • Maetzler W; Airway Research Center North (ARCN), German Center for Lung Research (DZL), Wöhrendamm 80, 22927 Großhansdorf, Germany.
  • Maetzler C; LungenClinic Grosshansdorf, Pneumology, Wöhrendamm 80, 22927 Großhansdorf, Germany.
  • Laudien M; Neurology Department, University Medical Center Schleswig-Holstein Campus Kiel, Arnold-Heller-Straße 3, 24105 Kiel, Germany.
  • Frank D; Neurology Department, University Medical Center Schleswig-Holstein Campus Kiel, Arnold-Heller-Straße 3, 24105 Kiel, Germany.
  • Ballhausen S; ENT Department, University Medical Center Schleswig-Holstein Campus Kiel, Arnold-Heller-Straße 3, 24105 Kiel, Germany.
  • Hermes A; Internal Medicine Department III, University Medical Center Schleswig-Holstein Campus Kiel, Arnold-Heller-Straße 3, 24105 Kiel, Germany.
  • Miljukov O; Internal Medicine Department I, University Medical Center Schleswig-Holstein Campus Kiel, Arnold-Heller-Straße 3, 24105 Kiel, Germany.
  • Haeusler KG; Institute of Epidemiology, Kiel University, University Medical Center Schleswig-Holstein, Niemannsweg 11, 24105 Kiel, Germany.
  • Mokhtari NEE; Institute of Clinical Epidemiology and Biometry, University of Würzburg, Josef-Schneider-Straße 2, 97080 Würzburg, Germany.
  • Witzenrath M; Department of Neurology, University Hospital Würzburg, Josef-Schneider-Straße 11, 97080 Würzburg, Germany.
  • Vehreschild JJ; Imland Klinik Rendsburg, Lilienstraße 20-48, 24768 Rendsburg, Germany.
  • Krefting D; Department of Infectious Diseases and Respiratory Medicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany.
  • Pape D; Medical Department 2, Hematology/ Oncology and Infectious Diseases, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany.
  • Montellano FA; University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I for Internal Medicine, Kerpener Straße 62, 50937 Cologne, Germany.
  • Kohls M; German Center for Infection Research (DZIF), Partner Site Bonn-Cologne, Kerpener Straße 62, 50937 Cologne, Germany.
  • Morbach C; Institute for Medical Informatics, University Medical Center Göttingen, Von-Siebold-Straße 3, 37075 Göttingen, Germany.
  • Störk S; Internal Medicine Department I, University Medical Center Schleswig-Holstein Campus Kiel, Arnold-Heller-Straße 3, 24105 Kiel, Germany.
  • Reese JP; Institute of Clinical Epidemiology and Biometry, University of Würzburg, Josef-Schneider-Straße 2, 97080 Würzburg, Germany.
  • Keil T; Department of Neurology, University Hospital Würzburg, Josef-Schneider-Straße 11, 97080 Würzburg, Germany.
  • Heuschmann P; Comprehensive Heart Failure Center, University and University Hospital Würzburg, Am Schwarzenberg 15, 97080 Würzburg, Germany.
  • Krawczak M; Institute of Clinical Epidemiology and Biometry, University of Würzburg, Josef-Schneider-Straße 2, 97080 Würzburg, Germany.
  • Schreiber S; Comprehensive Heart Failure Center, University and University Hospital Würzburg, Am Schwarzenberg 15, 97080 Würzburg, Germany.
EClinicalMedicine ; 51: 101549, 2022 Sep.
Article in En | MEDLINE | ID: mdl-35875815
Background: Post-COVID syndrome (PCS) is an important sequela of COVID-19, characterised by symptom persistence for >3 months, post-acute symptom development, and worsening of pre-existing comorbidities. The causes and public health impact of PCS are still unclear, not least for the lack of efficient means to assess the presence and severity of PCS. Methods: COVIDOM is a population-based cohort study of polymerase chain reaction (PCR) confirmed cases of SARS-CoV-2 infection, recruited through public health authorities in three German regions (Kiel, Berlin, Würzburg) between November 15, 2020 and September 29, 2021. Main inclusion criteria were (i) a PCR confirmed SARS-CoV-2 infection and (ii) a period of at least 6 months between the infection and the visit to the COVIDOM study site. Other inclusion criteria were written informed consent and age ≥18 years. Key exclusion criterion was an acute reinfection with SARS-CoV-2. Study site visits included standardised interviews, in-depth examination, and biomaterial procurement. In sub-cohort Kiel-I, a PCS (severity) score was developed based upon 12 long-term symptom complexes. Two validation sub-cohorts (Würzburg/Berlin, Kiel-II) were used for PCS score replication and identification of clinically meaningful predictors. This study is registered at clinicaltrials.gov (NCT04679584) and at the German Registry for Clinical Studies (DRKS, DRKS00023742). Findings: In Kiel-I (n = 667, 57% women), 90% of participants had received outpatient treatment for acute COVID-19. Neurological ailments (61·5%), fatigue (57·1%), and sleep disturbance (57·0%) were the most frequent persisting symptoms at 6-12 months after infection. Across sub-cohorts (Würzburg/Berlin, n = 316, 52% women; Kiel-II, n = 459, 56% women), higher PCS scores were associated with lower health-related quality of life (EQ-5D-5L-VAS/-index: r = -0·54/ -0·56, all p < 0·0001). Severe, moderate, and mild/no PCS according to the individual participant's PCS score occurred in 18·8%, 48·2%, and 32·9%, respectively, of the Kiel-I sub-cohort. In both validation sub-cohorts, statistically significant predictors of the PCS score included the intensity of acute phase symptoms and the level of personal resilience. Interpretation: PCS severity can be quantified by an easy-to-use symptom-based score reflecting acute phase disease burden and general psychological predisposition. The PCS score thus holds promise to facilitate the clinical diagnosis of PCS, scientific studies of its natural course, and the development of therapeutic interventions. Funding: The COVIDOM study is funded by the Network University Medicine (NUM) as part of the National Pandemic Cohort Network (NAPKON).
Key words

Full text: 1 Collection: 01-internacional Database: MEDLINE Type of study: Etiology_studies / Observational_studies / Prognostic_studies / Qualitative_research / Risk_factors_studies Aspects: Patient_preference Language: En Journal: EClinicalMedicine Year: 2022 Document type: Article Affiliation country: Country of publication:

Full text: 1 Collection: 01-internacional Database: MEDLINE Type of study: Etiology_studies / Observational_studies / Prognostic_studies / Qualitative_research / Risk_factors_studies Aspects: Patient_preference Language: En Journal: EClinicalMedicine Year: 2022 Document type: Article Affiliation country: Country of publication: