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2022-11-10Zeitschriftenartikel
Post-COVID-19-associated morbidity in children, adolescents, and adults: A matched cohort study including more than 157,000 individuals with COVID-19 in Germany
dc.contributor.authorRoessler, Martin
dc.contributor.authorTesch, Falko
dc.contributor.authorBatram, Manuel
dc.contributor.authorJacob, Josephine
dc.contributor.authorLoser, Friedrich
dc.contributor.authorWeidinger, Oliver
dc.contributor.authorWende, Danny
dc.contributor.authorVivirito, Annika
dc.contributor.authorToepfner, Nicole
dc.contributor.authorEhm, Franz
dc.contributor.authorSeifert, Martin
dc.contributor.authorNagel, Oliver
dc.contributor.authorKönig, Christina
dc.contributor.authorJucknewitz, Roland
dc.contributor.authorArmann, Jakob Peter
dc.contributor.authorBerner, Reinhard
dc.contributor.authorTreskova-Schwarzbach, Marina
dc.contributor.authorHertle, Dagmar
dc.contributor.authorScholz, Stefan
dc.contributor.authorStern, Stefan
dc.contributor.authorBallesteros, Pedro
dc.contributor.authorBaßler, Stefan
dc.contributor.authorBertele, Barbara
dc.contributor.authorRepschläger, Uwe
dc.contributor.authorRichter, Nico
dc.contributor.authorRiederer, Cordula
dc.contributor.authorSobik, Franziska
dc.contributor.authorSchramm, Anja
dc.contributor.authorSchulte, Claudia
dc.contributor.authorWieler, Lothar H.
dc.contributor.authorWalker, Jochen
dc.contributor.authorScheidt-Nave, Christa
dc.contributor.authorSchmitt, Jochen
dc.date.accessioned2024-09-03T16:23:08Z
dc.date.available2024-09-03T16:23:08Z
dc.date.issued2022-11-10none
dc.identifier.other10.1371/journal.pmed.1004122
dc.identifier.urihttp://edoc.rki.de/176904/12083
dc.description.abstractBackground Long-term health sequelae of the Coronavirus Disease 2019 (COVID-19) are a major public health concern. However, evidence on post-acute COVID-19 syndrome (post-COVID-19) is still limited, particularly for children and adolescents. Utilizing comprehensive healthcare data on approximately 46% of the German population, we investigated post-COVID-19-associated morbidity in children/adolescents and adults. Methods and findings We used routine data from German statutory health insurance organizations covering the period between January 1, 2019 and December 31, 2020. The base population included all individuals insured for at least 1 day in 2020. Based on documented diagnoses, we identified individuals with polymerase chain reaction (PCR)-confirmed COVID-19 through June 30, 2020. A control cohort was assigned using 1:5 exact matching on age and sex, and propensity score matching on preexisting medical conditions. The date of COVID-19 diagnosis was used as index date for both cohorts, which were followed for incident morbidity outcomes documented in the second quarter after index date or later.Overall, 96 prespecified outcomes were aggregated into 13 diagnosis/symptom complexes and 3 domains (physical health, mental health, and physical/mental overlap domain). We used Poisson regression to estimate incidence rate ratios (IRRs) with 95% confidence intervals (95% CIs). The study population included 11,950 children/adolescents (48.1% female, 67.2% aged between 0 and 11 years) and 145,184 adults (60.2% female, 51.1% aged between 18 and 49 years). The mean follow-up time was 236 days (standard deviation (SD) = 44 days, range = 121 to 339 days) in children/adolescents and 254 days (SD = 36 days, range = 93 to 340 days) in adults. COVID-19 and control cohort were well balanced regarding covariates. The specific outcomes with the highest IRR and an incidence rate (IR) of at least 1/100 person-years in the COVID-19 cohort in children and adolescents were malaise/fatigue/exhaustion (IRR: 2.28, 95% CI: 1.71 to 3.06, p < 0.01, IR COVID-19: 12.58, IR Control: 5.51), cough (IRR: 1.74, 95% CI: 1.48 to 2.04, p < 0.01, IR COVID-19: 36.56, IR Control: 21.06), and throat/chest pain (IRR: 1.72, 95% CI: 1.39 to 2.12, p < 0.01, IR COVID-19: 20.01, IR Control: 11.66). In adults, these included disturbances of smell and taste (IRR: 6.69, 95% CI: 5.88 to 7.60, p < 0.01, IR COVID-19: 12.42, IR Control: 1.86), fever (IRR: 3.33, 95% CI: 3.01 to 3.68, p < 0.01, IR COVID-19: 11.53, IR Control: 3.46), and dyspnea (IRR: 2.88, 95% CI: 2.74 to 3.02, p < 0.01, IR COVID-19: 43.91, IR Control: 15.27). For all health outcomes combined, IRs per 1,000 person-years in the COVID-19 cohort were significantly higher than those in the control cohort in both children/adolescents (IRR: 1.30, 95% CI: 1.25 to 1.35, p < 0.01, IR COVID-19: 436.91, IR Control: 335.98) and adults (IRR: 1.33, 95% CI: 1.31 to 1.34, p < 0.01, IR COVID-19: 615.82, IR Control: 464.15). The relative magnitude of increased documented morbidity was similar for the physical, mental, and physical/mental overlap domain. In the COVID-19 cohort, IRs were significantly higher in all 13 diagnosis/symptom complexes in adults and in 10 diagnosis/symptom complexes in children/adolescents. IRR estimates were similar for age groups 0 to 11 and 12 to 17. IRs in children/adolescents were consistently lower than those in adults. Limitations of our study include potentially unmeasured confounding and detection bias. Conclusions In this retrospective matched cohort study, we observed significant new onset morbidity in children, adolescents, and adults across 13 prespecified diagnosis/symptom complexes, following COVID-19 infection. These findings expand the existing available evidence on post-COVID-19 conditions in younger age groups and confirm previous findings in adults.eng
dc.language.isoengnone
dc.publisherRobert Koch-Institut
dc.rights(CC BY 3.0 DE) Namensnennung 3.0 Deutschlandger
dc.rights.urihttp://creativecommons.org/licenses/by/3.0/de/
dc.subject.ddc610 Medizin und Gesundheitnone
dc.titlePost-COVID-19-associated morbidity in children, adolescents, and adults: A matched cohort study including more than 157,000 individuals with COVID-19 in Germanynone
dc.typearticle
dc.identifier.urnurn:nbn:de:0257-176904/12083-5
dc.type.versionpublishedVersionnone
local.edoc.container-titlePLOS Medicinenone
local.edoc.container-issn1549-1676none
local.edoc.pages22none
local.edoc.type-nameZeitschriftenartikel
local.edoc.container-typeperiodical
local.edoc.container-type-nameZeitschrift
local.edoc.container-urlhttps://journals.plos.org/plosmedicine/none
local.edoc.container-publisher-namePLOSnone
local.edoc.container-volume19none
local.edoc.container-issue11none
local.edoc.container-reportyear2022none
dc.description.versionPeer Reviewednone

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