Bahmer, Thomas, Borzikowsky, Christoph ORCID: 0000-0002-5489-0032, Lieb, Wolfgang, Horn, Anna, Krist, Lilian ORCID: 0000-0002-6089-5163, Fricke, Julia ORCID: 0000-0002-7625-474X, Scheibenbogen, Carmen, Rabe, Klaus F. ORCID: 0000-0002-7020-1401, Maetzler, Walter, Maetzler, Corina, Laudien, Martin, Frank, Derk, Ballhausen, Sabrina, Hermes, Anne ORCID: 0000-0003-1111-0005, Miljukov, Olga, Haeusler, Karl Georg, El Mokhtari, Nour Eddine, Witzenrath, Martin, Vehreschild, Joerg Janne, Krefting, Dagmar ORCID: 0000-0002-7238-5339, Pape, Daniel, Montellano, Felipe A. ORCID: 0000-0002-9438-0854, Kohls, Mirjam ORCID: 0000-0003-4943-7791, Morbach, Caroline, Stork, Stefan, Reese, Jens-Peter, Keil, Thomas, Heuschmann, Peter, Krawczak, Michael ORCID: 0000-0003-2603-1502 and Schreiber, Stefanie ORCID: 0000-0003-4439-4374 (2022). Severity, predictors and clinical correlates of Post-COVID syndrome (PCS) in Germany: A prospective, multi-centre, population-based cohort study. EClinicalMedicine, 51. AMSTERDAM: ELSEVIER. ISSN 2589-5370

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Abstract

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, Wurzburg) 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 (Wurzburg/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 (Wurzburg/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. Copyright (C) 2022 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Bahmer, ThomasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Borzikowsky, ChristophUNSPECIFIEDorcid.org/0000-0002-5489-0032UNSPECIFIED
Lieb, WolfgangUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Horn, AnnaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Krist, LilianUNSPECIFIEDorcid.org/0000-0002-6089-5163UNSPECIFIED
Fricke, JuliaUNSPECIFIEDorcid.org/0000-0002-7625-474XUNSPECIFIED
Scheibenbogen, CarmenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Rabe, Klaus F.UNSPECIFIEDorcid.org/0000-0002-7020-1401UNSPECIFIED
Maetzler, WalterUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Maetzler, CorinaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Laudien, MartinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Frank, DerkUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ballhausen, SabrinaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hermes, AnneUNSPECIFIEDorcid.org/0000-0003-1111-0005UNSPECIFIED
Miljukov, OlgaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Haeusler, Karl GeorgUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
El Mokhtari, Nour EddineUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Witzenrath, MartinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Vehreschild, Joerg JanneUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Krefting, DagmarUNSPECIFIEDorcid.org/0000-0002-7238-5339UNSPECIFIED
Pape, DanielUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Montellano, Felipe A.UNSPECIFIEDorcid.org/0000-0002-9438-0854UNSPECIFIED
Kohls, MirjamUNSPECIFIEDorcid.org/0000-0003-4943-7791UNSPECIFIED
Morbach, CarolineUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Stork, StefanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Reese, Jens-PeterUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Keil, ThomasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Heuschmann, PeterUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Krawczak, MichaelUNSPECIFIEDorcid.org/0000-0003-2603-1502UNSPECIFIED
Schreiber, StefanieUNSPECIFIEDorcid.org/0000-0003-4439-4374UNSPECIFIED
URN: urn:nbn:de:hbz:38-694756
DOI: 10.1016/j.eclinm.2022.101549
Journal or Publication Title: EClinicalMedicine
Volume: 51
Date: 2022
Publisher: ELSEVIER
Place of Publication: AMSTERDAM
ISSN: 2589-5370
Language: English
Faculty: Faculty of Arts and Humanities
Divisions: Faculty of Arts and Humanities > Fächergruppe 1: Kunstgeschichte, Musikwissenschaft, Medienkultur und Theater, Linguistik, IDH > Institut für Linguistik > Phonetik
Subjects: Language, Linguistics
Uncontrolled Keywords:
KeywordsLanguage
INTERNATIONAL CONSENSUS; SARS-COV-2 INFECTION; SEQUELAEMultiple languages
Medicine, General & InternalMultiple languages
Refereed: Yes
URI: http://kups.ub.uni-koeln.de/id/eprint/69475

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