Treated post-acute sequelae after COVID-19 in a German matched cohort study using routine data from 230,256 adults

Area of Science:

• Epidemiology
• Infectious Diseases
• Public Health

Background:

• Post-acute sequelae of COVID-19 (long COVID) present ongoing challenges due to knowledge gaps in prevalence, pathogenesis, and outcomes.
• Understanding the long-term health impact of SARS-CoV-2 infection is crucial for effective medical management.

Purpose of the Study:

• To evaluate if SARS-CoV-2 infection during Germany's first COVID-19 wave increases disease rates in the subsequent 12 months.
• To compare disease incidence in individuals with prior documented SARS-CoV-2 infection against matched control groups.

Main Methods:

• Utilized health insurance data to define 50 outcome variables (diagnoses, symptoms, treatments).
• Employed logistic regression comparing two groups: outpatient (COV-OUT) and inpatient (COV-IN) COVID-19 cases against matched controls (CG).
• Risk adjustment included age, administrative region, and propensity-score matching (1:5).

Main Results:

• Increased mortality observed in both COV-OUT (OR 1.5) and COV-IN (OR 1.7) groups compared to controls.
• Higher likelihood of experiencing at least one outcome in COV-OUT (OR 1.4) and COV-IN (OR 2.5) groups.
• Significant increases in specific outcomes: loss of taste/smell (COV-OUT, OR 5.8), interstitial respiratory diseases (COV-IN, OR 12.2), and pulmonary embolism/anticoagulation (COV-IN, OR 5.9).

Conclusions:

• COVID-19 infection, especially severe cases, leads to a substantial increase in new diagnoses, symptoms, and treatments within 12 months.
• The wide range of post-COVID conditions necessitates interdisciplinary and interprofessional collaboration for patient management.
• Long-term monitoring and management strategies are essential for COVID-19 survivors.