Severity, predictors and clinical correlates of Post-COVID syndrome (PCS) in Germany: A prospective, multi-centre, population-based cohort study

被引:89
作者
Bahmer, Thomas [1 ,2 ]
Borzikowsky, Christoph [3 ]
Lieb, Wolfgang [4 ]
Horn, Anna [5 ]
Krist, Lilian [6 ]
Fricke, Julia [6 ]
Scheibenbogen, Carmen [7 ]
Rabe, Klaus F. [2 ,8 ]
Maetzler, Walter [9 ]
Maetzler, Corina [9 ]
Laudien, Martin [10 ]
Frank, Derk [11 ]
Ballhausen, Sabrina [1 ]
Hermes, Anne [4 ]
Miljukov, Olga [5 ]
Haeusler, Karl Georg [12 ]
El Mokhtari, Nour Eddine [13 ]
Witzenrath, Martin [14 ,15 ,16 ]
Vehreschild, Joerg Janne [17 ,18 ,19 ,20 ]
Krefting, Dagmar [21 ]
Pape, Daniel [1 ]
Montellano, Felipe A. [5 ,12 ,22 ,23 ]
Kohls, Mirjam [5 ]
Morbach, Caroline [22 ,23 ,24 ]
Stork, Stefan [22 ,23 ,24 ]
Reese, Jens-Peter [5 ]
Keil, Thomas [5 ,6 ,25 ]
Heuschmann, Peter [5 ,22 ,23 ,26 ]
Krawczak, Michael [3 ]
Schreiber, Stefan [1 ]
机构
[1] Univ Med Ctr Schleswig Holstein, Internal Med Dept 1, Campus Kiel, D-24105 Kiel, Germany
[2] German Ctr Lung Res DZL, Airway Res Ctr North ARCN, Wohrendamm 80, D-22927 Grosshansdorf, Germany
[3] Univ Kiel, Univ Med Ctr Schleswig Holstein, Inst Med Informat & Stat, Brunswiker Str 10, D-24105 Kiel, Germany
[4] Univ Kiel, Univ Med Ctr Schleswig Holstein, Inst Epidemiol, Niemannsweg 11, D-24105 Kiel, Germany
[5] Univ Wurzburg, Inst Clin Epidemiol & Biometry, Josef Schneider Str 2, D-97080 Wurzburg, Germany
[6] Charite Univ Med Berlin, Inst Social Med Epidemiol & Hlth Econ, Luisenstr 57, D-10117 Berlin, Germany
[7] Charite Univ Med Berlin, Inst Med Immunol, Augustenburger Pl 1, D-13353 Berlin, Germany
[8] LungenClin Grosshansdorf, Pneumol, Wohrendamm 80, D-22927 Grosshansdorf, Germany
[9] Med Ctr Schleswig Holstein, Neurol Dept, Campus Kiel,Arnold Heller Str 3, D-24105 Kiel, Germany
[10] Univ Med Ctr Schleswig Holstein, ENT Dept, Campus Kiel,Arnold Heller Str 3, D-24105 Kiel, Germany
[11] Univ Med Ctr Schleswig Holstein, Internal Med Dept 3, Campus Kiel,Arnold Heller Str 3, D-24105 Kiel, Germany
[12] Univ Hosp Wurzburg, Dept Neurol, Josef Schneider Str 11, D-97080 Wurzburg, Germany
[13] Imland Klin Rendsburg, Lilienstr 20-48, D-24768 Rendsburg, Germany
[14] Charite Univ Med Berlin, Dept Infect Dis & Resp Med, Charitepl 1, D-10117 Berlin, Germany
[15] Free Univ Berlin, Charitepl 1, D-10117 Berlin, Germany
[16] Humboldt Univ, Charitepl 1, D-10117 Berlin, Germany
[17] Univ Hosp Frankfurt, Hematol Oncol & Infect Dis, Med Dept 2, Theodor Stern Kai 7, D-60590 Frankfurt, Germany
[18] Univ Cologne, Fac Med, Kerpener Str 62, D-50937 Cologne, Germany
[19] Univ Hosp Cologne, Dept & Internal Med, Kerpener Str 62, D-50937 Cologne, Germany
[20] German Ctr Infect Res DZIF, Partner Site Bonn Cologne, Kerpener Str 62, D-50937 Cologne, Germany
[21] Univ Med Ctr Gottingen, Inst Med Informat, Von Siebold Str 3, D-37075 Gottingen, Germany
[22] Univ Wurzburg, Comprehens Heart Failure Ctr, Schwarzenberg 15, D-97080 Wurzburg, Germany
[23] Univ Hosp Wurzburg, Schwarzenberg 15, D-97080 Wurzburg, Germany
[24] Univ Hosp Wurzburg, Dept Internal Med 1, Oberdurrbacher Str 6, D-97080 Wurzburg, Germany
[25] Bavarian Hlth & Food Safety Author, State Inst Hlth, Eggenreuther Weg 43, D-91058 Erlangen, Germany
[26] Univ Hosp Wurzburg, Clin Trial Ctr Wurzburg CTC ZKS, Josef Schneider Str 2, D-97080 Wurzburg, Germany
关键词
COVID-19; Post-COVID-Syndrome (PCS); LongCOVID; Post-acute sequelae of SARS-CoV-2 infection (PASC); SARS-CoV-2; infection; Fatigue; Resilience; INTERNATIONAL CONSENSUS; SARS-COV-2; INFECTION; SEQUELAE;
D O I
10.1016/j.eclinm.2022.101549
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
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/)
引用
收藏
页数:16
相关论文
共 50 条
[41]   Incidence and mortality due to thromboembolic events during the COVID-19 pandemic: Multi-sourced population-based health records cohort study [J].
Aktaa, Suleman ;
Wu, Jianhua ;
Nadarajah, Ramesh ;
Rashid, Muhammad ;
de Belder, Mark ;
Deanfield, John ;
Mamas, Mamas A. ;
Gale, Chris P. .
THROMBOSIS RESEARCH, 2021, 202 :17-23
[42]   Clinical severity of Omicron subvariants BA.1, BA.2, and BA.5 in a population-based cohort study in British Columbia, Canada [J].
Russell, Shannon L. ;
Klaver, Braeden R. A. ;
Harrigan, Sean P. ;
Kamelian, Kimia ;
Tyson, John ;
Hoang, Linda ;
Taylor, Marsha ;
Sander, Beate ;
Mishra, Sharmistha ;
Prystajecky, Natalie ;
Janjua, Naveed Z. ;
Zlosnik, James E. A. ;
Sbihi, Hind .
JOURNAL OF MEDICAL VIROLOGY, 2023, 95 (01)
[43]   Mycoplasma pneumoniae incidence, phenotype, and severity in children and adolescents in Denmark before, during, and after the COVID-19 pandemic: a nationwide multicentre population-based cohort study [J].
Dungu, Kia H. S. ;
Holm, Mette ;
Harding, Ulla ;
Jensen, Lise H. ;
Nielsen, Allan Bybeck ;
Schmidt, Lisbeth S. ;
Toustrup, Lise B. ;
Hansen, Lotte H. ;
Dahl, Kathrin W. ;
Matthesen, Kirstine T. ;
Nordholm, Anne C. ;
Uldum, Soren ;
Emborg, Hanne-Dorthe ;
Rytter, Maren J. H. ;
Nygaard, Ulrikka .
LANCET REGIONAL HEALTH-EUROPE, 2024, 47
[44]   Primary care clinical management following self-harm during the first wave of COVID-19 in the UK: population-based cohort study [J].
Steeg, Sarah ;
Carr, Matthew ;
Trefan, Laszlo ;
Ashcroft, Darren ;
Kapur, Navneet ;
Nielsen, Emma ;
McMillan, Brian ;
Webb, Roger .
BMJ OPEN, 2022, 12 (02)
[45]   Artificial Intelligence Predicts Severity of COVID-19 Based on Correlation of Exaggerated Monocyte Activation, Excessive Organ Damage and Hyperinflammatory Syndrome: A Prospective Clinical Study [J].
Krysko, Olga ;
Kondakova, Elena ;
Vershinina, Olga ;
Galova, Elena ;
Blagonravova, Anna ;
Gorshkova, Ekaterina ;
Bachert, Claus ;
Ivanchenko, Mikhail ;
Krysko, Dmitri V. ;
Vedunova, Maria .
FRONTIERS IN IMMUNOLOGY, 2021, 12
[46]   Uptake, effectiveness and safety of COVID-19 vaccines in individuals at clinical risk due to immunosuppressive drug therapy or transplantation procedures: a population-based cohort study in England [J].
Chen, Daniel Tzu-Hsuan ;
Copland, Emma ;
Hirst, Jennifer A. ;
Mi, Emma ;
Dixon, Sharon ;
Coupland, Carol ;
Hippisley-Cox, Julia .
BMC MEDICINE, 2024, 22 (01)
[47]   Seizures in hospitalised paediatric patients with SARS-CoV-2 and comparison of severity with seizures in hospitalised paediatric patients with other respiratory viruses during the COVID-19 pandemic: a population-based cohort study [J].
Anastasopoulou, Stavroula ;
Svensson, Eva ;
Wickstroem, Ronny ;
Hertting, Olof ;
Rinder, Malin Ryd ;
Bennet, Rutger ;
Eriksson, Margareta .
ARCHIVES OF DISEASE IN CHILDHOOD, 2024, 109 (02) :152-157
[48]   Sixty-Day Mortality Among 520 Italian Hospitalized COVID-19 Patients According to the Adopted Ventilatory Strategy in the Context of an Integrated Multidisciplinary Clinical Organization: A Population-Based Cohort Study [J].
Potalivo, Antonella ;
Montomoli, Jonathan ;
Facondini, Francesca ;
Sanson, Gianfranco ;
Agli, Luigi Arcangelo Lazzari ;
Perin, Tiziana ;
Cristini, Francesco ;
Cavagna, Enrico ;
De Giovanni, Raffaella ;
Biagetti, Carlo ;
Panzini, Ilaria ;
Ravaioli, Cinzia ;
Bitondo, Maria Maddalena ;
Guerra, Daniela ;
Giuliani, Giovanni ;
Mosconi, Elena ;
Guarino, Sonia ;
Marchionni, Elisa ;
Gangitano, Gianfilippo ;
Valentini, Ilaria ;
Giampaolo, Luca ;
Muratore, Francesco ;
Nardi, Giuseppe .
CLINICAL EPIDEMIOLOGY, 2020, 12 :1421-1431
[49]   Short-term acute outcomes by clinical and socioeconomic characteristics in adults with SARS-CoV-2: a population-based cohort study focused on the first two years of the COVID-19 pandemic [J].
Corsaro, Alice ;
Banchelli, Federico ;
Buttazzi, Rossella ;
Ricchizzi, Enrico ;
Gagliotti, Carlo ;
Fabbri, Elisa ;
Gentilotti, Elisa ;
Rolli, Maurizia ;
Tacconelli, Evelina ;
Moro, Maria Luisa ;
Caranci, Nicola ;
Berti, Elena .
ARCHIVES OF PUBLIC HEALTH, 2025, 83 (01)
[50]   Swab and Sputum SARS-CoV-2 RNA-Negative, CT-Positive, Symptomatic Contacts of COVID-19 Cases: A Hypothesis-Generating Prospective Population-Based Cohort Study of Eight Clusters [J].
Huang, Lei ;
Zhang, Xiuwen ;
Zhang, Lingli ;
Xu, Jingjing ;
Wei, Zhijian ;
Xu, Yuanhong ;
Zhang, Chengyuan ;
Xu, Aman .
FRONTIERS IN MEDICINE, 2021, 8