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Updated: May 22, 2025

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Three-Year Follow-Up of COVID-19 Cases in District of Constance, Germany. A Prospective, Controlled Cohort Study

Ann-Kathrin Kohler¹, Stephan Richter¹, Michael Schmid¹

¹Hegau Bodensee Klinikum Singen, Gesundheitsverbund Landkreis Konstanz, Virchow Str. 10, 78224 Singen, Germany.

Journal of Clinical Medicine

|March 17, 2025

Summary

This summary is machine-generated.

Mild COVID-19 cases did not increase hospitalizations over three years. However, infected individuals reported lower quality of life and functional status, particularly concerning energy and fatigue.

Keywords:

COVID-19 post-COVID conditions sequalae virus variants

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Area of Science:

Infectious Diseases
Public Health
Epidemiology

Background:

Long-term sequelae of viral infections, including SARS-CoV-2 (COVID-19), can cause multi-organ involvement.
Persistent symptoms affect millions globally, with early variants posing a higher risk for post-COVID-19 conditions.
A three-year observational study investigated long-term effects of COVID-19 on hospitalization and quality of life.

Purpose of the Study:

To assess long-term hospitalization rates and clinical events in COVID-19 survivors.
To evaluate health-related quality of life and functional status post-COVID-19 infection.
To compare outcomes between SARS-CoV-2 positive individuals and a control group over three years.

Main Methods:

Prospective, controlled cohort study (FSC19-KN) in Konstanz, Germany.
Inclusion of SARS-CoV-2 positive subjects (March-December 2020) and a negative antibody test control group.
Primary endpoint: hospitalization rates and diagnoses (Jan 2021-July 2024). Secondary endpoints: SF-36 questionnaire and PCFS for quality of life and function.

Main Results:

No significant difference in hospitalization rates between COVID-19 positive and control groups (OR 1.24, p=0.30).
COVID-19 survivors reported significantly lower SF-36 scores across most dimensions.
Reduced quality of life and functional outcomes were observed in SARS-CoV-2 positive subjects, notably in 'energy and fatigue'.

Conclusions:

Mild COVID-19 does not significantly impact long-term hospitalization rates.
SARS-CoV-2 infection is associated with reduced health-related quality of life and functional status.
Significant differences in 'energy and fatigue' persisted between groups after three years.